Cardiac Resynchronization Therapy Optimization: A Comprehensive Approach

Katbeh, Asim; Camp, Guy Van; Barbato, Emanuele; Galderisi, Maurizio; Trimarco, Bruno; Bartúnek, Jozef; Vanderheyden, Marc; Pěnička, Martin

doi:10.1159/000499192

Cited by 20 publications

(15 citation statements)

References 90 publications

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“…With the rapid development of medical technology, the continuous popularization and promotion of PCI, coronary artery bypass grafting (CABG), and coronary thrombolysis technologies and drugs have brought great help to patients with ischemic cardiomyopathy [28]. But in clinical, MIRI is an unavoidable problem, which is also a problem that needs to be solved urgently in clinical practice.…”

Section: Discussionmentioning

confidence: 99%

Systematic Pharmacology Reveals the Antioxidative Stress and Anti-Inflammatory Mechanisms of Resveratrol Intervention in Myocardial Ischemia-Reperfusion Injury

Xing

Xiong³

et al. 2021

Evidence-Based Complementary and Alternative Medicine

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Objective. To explore the oxidative stress and inflammatory mechanisms of resveratrol intervention in myocardial ischemia-reperfusion injury (MIRI). Methods. The potential targets of resveratrol were predicted by PharmMapper. The MIRI genes were collected by Online Mendelian Inheritance in Man (OMIM), GeneCards is used to collect related disease genes, and String is used for enrichment analysis. Animal experiments were then performed to verify the systematic pharmacological results. Hematoxylin-eosin (HE) staining was used to observe myocardial damage. The levels of serum interleukin-1β (IL-1β), IL-6, and tumor necrosis factor-α (TNF-α) in each experimental group were detected. The protein and mRNA expressions of Toll-like receptor 4 (TLR4), nuclear factor-kappa (NF-κB) p65, IL-1β, IL-6, and TNF-α in rat myocardial tissue were measured. Results. The results of systematic pharmacology showed that insulin resistance, FoxO signaling pathway, adipocytokine signaling pathway, insulin signaling pathway, PI3K-Akt signaling pathway, ErbB signaling pathway, T-cell receptor signaling pathway, peroxisome proliferator-activated receptors (PPAR) signaling pathway, Ras signaling pathway, TNF signaling pathway, and so on were regulated to improve MIRI. The results of animal experiments showed that the myocardial cells of the sham operation group were arranged in fibrous form, and the myocardial ischemia-reperfusion injury group had obvious cell morphology disorder. Compared with the MIRI group, the resveratrol group had a certain degree of relief. Compared with the MIRI group, serum IL-1β, TNF-α, and IL-6 in the resveratrol group was significantly reduced ( P < 0.05), and myocardial tissue TLR4, NF-κB p65, IL-1β, IL-6, and TNF-α mRNA and protein expressions were significantly reduced ( P < 0.05). Conclusion. Resveratrol can effectively improve MIRI, and its mechanism may be related to antioxidative stress and anti-inflammatory.

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Section: Discussionmentioning

confidence: 99%

Systematic Pharmacology Reveals the Antioxidative Stress and Anti-Inflammatory Mechanisms of Resveratrol Intervention in Myocardial Ischemia-Reperfusion Injury

Xing

Xiong³

et al. 2021

Evidence-Based Complementary and Alternative Medicine

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“…By various clinical experiments have shown that CRT improves cardiac function, as well as monolithic quality of livelihood, and decreases HF hospitalizations, health care expenses, and mortality. In spite of the stepped-up progress of CRT device technique and its enhancive application to HF patients' treatment, nearly one-third of these patients have non-respond to the remedy or gain some clinical advantages from device implantation.CRT remaining a primary challenge that faces electrophysiologists and research workers [33,34].…”

Section: Non-drug Treatment 41 Crtmentioning

confidence: 99%

The Heart failure treatment, All at once!

Shen

2020

E3S Web Conf.

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Heart failure (HF) shows great public health concerns and it is important to cure the disease. For now nearly 20 million people are influenced and the number of the effected people is still arising. HF is a complicated disease which can be induced from lots of reasons, including disruption of myocardial function, obesity and diabetes. According to the clinical guidance, the types of HF are different due to different standards, which means the treatments are also different as well. Here we focused on the mainly treatment of HF like drug treatment and non-drug treatment, listing the key performance of each therapy. At last, we summarized the whole picture of the treatment of HF and gave several directions of the future development of treatments on HF.

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“…Patients with CRT benefit from the effects of electric and mechanical synchronization of their ventricular muscle and LV function is ultimately improved. However, CRT is not effective in approximately 1/3 of the patients and this CRT non-responder issue has not been resolved to date [2,3]. Therefore, for achieving a more ubiquitous performance of CRT in patients with HF, patient-specific simulation methods for screening CRT non-responders need to be established.…”

Section: Introductionmentioning

confidence: 99%

In silico screening method for non-responders to cardiac resynchronization therapy in patients with heart failure: a pilot study

Hwang¹,

Uhm

Park

et al. 2022

Int J Arrhythm

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Background Cardiac resynchronization therapy (CRT) is an effective treatment option for patients with heart failure (HF) and left ventricular (LV) dyssynchrony. However, the problem of some patients not responding to CRT remains unresolved. This study aimed to propose a novel in silico method for CRT simulation. Methods Three-dimensional heart geometry was constructed from computed tomography images. The finite element method was used to elucidate the electric wave propagation in the heart. The electric excitation and mechanical contraction were coupled with vascular hemodynamics by the lumped parameter model. The model parameters for three-dimensional (3D) heart and vascular mechanics were estimated by matching computed variables with measured physiological parameters. CRT effects were simulated in a patient with HF and left bundle branch block (LBBB). LV end-diastolic (LVEDV) and end-systolic volumes (LVESV), LV ejection fraction (LVEF), and CRT responsiveness measured from the in silico simulation model were compared with those from clinical observation. A CRT responder was defined as absolute increase in LVEF ≥ 5% or relative increase in LVEF ≥ 15%. Results A 68-year-old female with nonischemic HF and LBBB was retrospectively included. The in silico CRT simulation modeling revealed that changes in LVEDV, LVESV, and LVEF by CRT were from 174 to 173 mL, 116 to 104 mL, and 33 to 40%, respectively. Absolute and relative ΔLVEF were 7% and 18%, respectively, signifying a CRT responder. In clinical observation, echocardiography showed that changes in LVEDV, LVESV, and LVEF by CRT were from 162 to 119 mL, 114 to 69 mL, and 29 to 42%, respectively. Absolute and relative ΔLVESV were 13% and 31%, respectively, also signifying a CRT responder. CRT responsiveness from the in silico CRT simulation model was concordant with that in the clinical observation. Conclusion This in silico CRT simulation method is a feasible technique to screen for CRT non-responders in patients with HF and LBBB.

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Cardiac Resynchronization Therapy Optimization: A Comprehensive Approach

Cited by 20 publications

References 90 publications

Systematic Pharmacology Reveals the Antioxidative Stress and Anti-Inflammatory Mechanisms of Resveratrol Intervention in Myocardial Ischemia-Reperfusion Injury

Systematic Pharmacology Reveals the Antioxidative Stress and Anti-Inflammatory Mechanisms of Resveratrol Intervention in Myocardial Ischemia-Reperfusion Injury

The Heart failure treatment, All at once!

In silico screening method for non-responders to cardiac resynchronization therapy in patients with heart failure: a pilot study

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