Most Heart Failure Patients Die from Pump Failure: Implications for Therapy

Pereira-Barretto, Antônio Carlos; Bacal, Fernando; Albuquerque, Denílson Campos de

doi:10.1007/s40256-015-0135-2

Cited by 5 publications

(4 citation statements)

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“…The use of anti-arrhythmic drugs such as amiodarone combined with beta-blockers (atenolol and propanolol) and/or pacemakers has been extensively described for the treatment of heart dysfunction. (29) By focusing on myocarditis reduction, immunomodulatory approaches aimed at reversing heart disease in experimental Chagas model shave been proposed, which may lead to new methods for the management of cardiac patients; immunomodulatory drugs could represent an interesting strategy for this. (30) Alternative N1 formulations and their combination with trypanocidal and/or anti-arrhythmic drugs could be tested, which may reduce the naphthoimidazole dose and consequently its toxicity.…”

Section: Discussionmentioning

confidence: 99%

Antiparasitic and anti-inflammatory activities of ß-lapachone-derived naphthoimidazoles in experimental acute Trypanosoma cruzi infection

Cascabulho

Meuser-Batista

Moura

et al. 2020

Mem. Inst. Oswaldo Cruz

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BACKGROUND Chagas disease, which is caused by the protozoan Trypanosoma cruzi, is endemic to Latin America and mainly affects low-income populations. Chemotherapy is based on two nitrocompounds, but their reduced efficacy encourages the continuous search for alternative drugs. Our group has characterised the trypanocidal effect of naphthoquinones and their derivatives, with naphthoimidazoles derived from β-lapachone (N1, N2 and N3) being the most active in vitro. OBJECTIVES In the present work, the effects of N1, N2 and N3 on acutely infected mice were investigated. METHODS in vivo activity of the compounds was assessed by parasitological, biochemical, histopathological, immunophenotypical, electrocardiographic (ECG) and behavioral analyses. FINDINGS Naphthoimidazoles led to a decrease in parasitaemia (8 dpi) by reducing the number of bloodstream trypomastigotes by 25-50% but not by reducing mortality. N1 protected mice from heart injury (15 dpi) by decreasing inflammation. Bradycardia was also partially reversed after treatment with N1 and N2. Furthermore, the three compounds did not reverse hepatic and renal lesions or promote the improvement of other evaluated parameters. MAIN CONCLUSION N1 showed moderate trypanocidal and promising immunomodulatory activities, and its use in combination with benznidazole and/or anti-arrhythmic drugs as well as the efficacy of its alternative formulations must be investigated in the near future.

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Section: Discussionmentioning

confidence: 99%

Antiparasitic and anti-inflammatory activities of ß-lapachone-derived naphthoimidazoles in experimental acute Trypanosoma cruzi infection

Cascabulho

Meuser-Batista

Moura

et al. 2020

Mem. Inst. Oswaldo Cruz

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“…Previamente, se reportó que en nuestro país estos tiempos fueron subóptimos en relación con lo recomendado internacionalmente, siendo mayor en relación con la angioplastia primaria, especialmente cuando se requiere el traslado hospitalario; además, reflejan una baja calidad de atención de nuestro sistema (4) . A diferencia de nuestros hallazgos, otros estudios (12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22) han reportado factores asociados adicionales que pueden impactar en una mortalidad anual incrementada, como la frecuencia cardiaca en reposo elevada, la falla cardiaca a la admisión, la disfunción ventricular izquierda, complicaciones de sangrado, el sexo, historia de enfermedad arterial coronaria obstructiva, tabaquismo, diabetes, falla renal, hipertensión, enfermedad arterial periférica, enfermedad hepática crónica y el cáncer.…”

Section: Variables De Estudiounclassified

One-year survival among patients with ST-elevation myocardial infarction in Peru

Chacón-Díaz

Hernández-Vasquéz

Custodio-Sánchez

2022

Arch Peru Cardiol Cir Cardiovasc

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Objetivos. Determinar la sobrevida al año y los factores asociados con la mortalidad en pacientes con infarto de miocardio con elevación del segmento ST en el Perú. Métodos. Se realizó un análisis de la cohorte de pacientes incluidos en el registro PERSTEMI-II durante el año 2020, en quienes se evaluó la sobrevida al año del evento y sus factores de riesgo mediante el análisis de sobrevida de Kaplan-Meier y regresión de Cox. Resultados. De 374 pacientes del estudioPERSTEMI-II, 366 (97.9%) completaron el seguimiento hasta el año del evento con una sobrevida de 85%. La reperfusión exitosa del infarto se relacionó con mejor sobrevida al año (Hazard ratio [HR]=0,30, IC 95%: 0,14-0,62, p=0,001). La edad (HR=1,04, IC 95%: 1,01-1,07, p=0,003); la enfermedad renal crónica (HR=2,15, IC 95%: 1,04-4,39, p=0,037) y el choque cardiogénico (HR=6,67, IC 95%: 3,72-11,97, p<0,001) fueron factores de mayor mortalidad al año de seguimiento. Conclusión. El registro PERSTEMI-II es el primer registro peruano que brinda datos de sobrevida tras un infarto de miocardio con elevación del segmento ST, siendo esta del 85% al año. La reperfusión exitosa mejora la sobrevida al año posinfarto.

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“…Moreover, the deaths avoided are especially pump failure deaths, which were reduced by 26 % ( p = 0.014), with no effect on sudden cardiac death [ 28 ]. This is a particularly important result, since pump failure death is currently the first cause of death in HF [ 41 ], independently of whether they are newly diagnosed or not [ 42 , 43 ].…”

Section: Effect Of Ivabradine On Pump Failure Hospitalizations and Dementioning

confidence: 99%

Addressing Major Unmet Needs in Patients with Systolic Heart Failure: The Role of Ivabradine

Pereira-Barretto

2016

Am J Cardiovasc Drugs

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We reviewed clinical evidence for the use of ivabradine in systolic heart failure (HF), in which it appears to improve symptoms, improve quality of life, prevent hospitalization, and prolong survival, thereby addressing unmet needs in the management of HF. Ivabradine provides symptomatic benefits in HF on top of standard therapies, in terms of functional parameters and exercise capacity, and there is some evidence that this leads to improvements in quality of life in symptomatic HF patients, who may have dyspnea, altered exercise capacity, and fatigue. The SHIFT trial demonstrated that ivabradine has significant beneficial effects on major outcomes in HF. Ivabradine had a significant effect on pump failure death, which was reduced by 26 % (p = 0.014), with no effect on sudden cardiac death. This is an important result since pump failure death is currently the main cause of death in HF, and also because the reductions in mortality obtained with beta-blockers and spironolactone in the last 20 years appear to be mainly due to reduction in sudden death rather than reduction in pump failure death. Ivabradine also has a beneficial effect on hospital admissions (−26 %, p < 0.0001), which is clinically relevant since a quarter of HF patients can expect to be readmitted to hospital for HF within 1 month of discharge. Ivabradine-treated patients are also at significantly lower risk of experiencing a second or third hospitalization for worsening HF. Ivabradine clearly has a key role to play in the management of HF by covering the main therapeutic objectives of symptoms, quality of life, and outcomes.

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Most Heart Failure Patients Die from Pump Failure: Implications for Therapy

Cited by 5 publications

References 56 publications

Antiparasitic and anti-inflammatory activities of ß-lapachone-derived naphthoimidazoles in experimental acute Trypanosoma cruzi infection

Antiparasitic and anti-inflammatory activities of ß-lapachone-derived naphthoimidazoles in experimental acute Trypanosoma cruzi infection

One-year survival among patients with ST-elevation myocardial infarction in Peru

Addressing Major Unmet Needs in Patients with Systolic Heart Failure: The Role of Ivabradine

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