Renal effects of ularitide in patients with decompensated heart failure

Lüss, Hartmut; Mitrović, Veselin; Seferović, Petar; Simeunović, Dejan; Ristić, Arsen D.; Moiseyev, V.S.; Forssmann, Wolf‐Georg; Hamdy, Ahmed; Meyer, Markus

doi:10.1016/j.ahj.2008.02.011

Cited by 50 publications

(30 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…2 and 3), and these changes may be, at least in part, results of ischemic injury (17). Theoretically, decreases in mean blood pressure and cardiac output in HF patients (6,28) can induce ischemic injury, leading to loss of PTCs in the kidney. However, that was not the case in the present study (Fig.…”

Section: Histological Features and Mechanisms Of Hf-rd: Differences Fmentioning

confidence: 99%

See 1 more Smart Citation

Deterioration of Renal Function by Chronic Heart Failure is Associated with Congestion and Oxidative Stress in the Tubulointerstitium

et al. 2011

View full text Add to dashboard Cite

Objective We examined the hypothesis that renal congestion is responsible for the decline in renal function in patients with heart failure (HF) via tubulointerstitial inflammation. Methods First, in a longitudinal study, we retrospectively examined the relationship between cardiac functions and the decline of renal function during a period of 6.4±3.2 years in 20 patients who had a left ventricular ejection fraction of <40% and an estimated glomerular filtration ratio (eGFR) of <60 mL/min/1.73 m 2 . Second, we compared the renal histology in autopsy cases of HF-induced renal dysfunction (HF-RD), cases of nephrosclerosis (NSC) and cases of neither RD nor HF (controls) in a cross-sectional study. Third, we retrospectively examined renal function in HF patients with predominantly right, but not left, ventricular dysfunction.Results eGFR decreased at 9.4±4.6%/year in the cohort of the longitudinal study. The rate of eGFR decline was correlated with blood pressure and with diameter of the inferior vena cava (IVCd) (r=0.5) measured at the initial work-up. Multivariate analysis indicated that the IVCd is an independent determinant of decline of eGFR in HF. In the cross-sectional study, fibrosis, Rac1 expression, protein nitrosylation, and number of CD68-positive cells were increased in the tubulointerstitium in both cases of HF-RD and NSC. Peritubular capillaries in HF-RD were dilated by 35% without any change in density compared with those in the controls. In right sided HF, the reduction of IVCd after treatment was associated with improvement of eGFR. Conclusion Venous congestion may contribute to HF-induced deterioration of renal function by augmenting oxidative stress-mediated inflammation in the tubulointerstitium.

show abstract

Section: Histological Features and Mechanisms Of Hf-rd: Differences Fmentioning

confidence: 99%

“…The rationale for this hypothesis is three fold. First, venous congestion has been shown to induce hypoxia in hepatic tissues (13,(28)(29)(30)(31)(32). Second, tissue hypoxia increases the production of reactive oxygen species, which provokes inflammatory reactions (33,34).…”

Section: Possible Roles Of Oxidative Stress In Egfr Decline By Progrementioning

confidence: 99%

Deterioration of Renal Function by Chronic Heart Failure is Associated with Congestion and Oxidative Stress in the Tubulointerstitium

et al. 2011

View full text Add to dashboard Cite

show abstract

“…Ularitide currently is being evaluated and is showing promising effects on preserving renal function in patients with decompensated heart failure. These results also need to be further investigated in lager trials [21,22].…”

Section: Guanylate Cyclase Pathwaymentioning

confidence: 99%

Soluble Guanylate Cyclase Modulators in Heart Failure

Mitrović

Jovanović

Lehinant

2011

Curr Heart Fail Rep

Self Cite

View full text Add to dashboard Cite

“…Early studies in patients with HF reported favorable hemodynamic effects and possibly enhanced diuresis and natriuresis with ularitide. SIRIUS I [57] and SIRIUS II [58,59] studied three doses of ularitide compared to placebo in 24 and 221 patients hospitalized with AHF, respectively. Ularitide was found to have beneficial symptomatic, hemodynamic (PCWP and cardiac index) and neuro-hormonal effects.…”

Section: Vasodilatorsmentioning

confidence: 99%

The pathophysiology of AHF<br>—New insights from recent studies of novel diuretics and vascular modulating therapies</br>

Cotter¹,

Milo²,

Davison³

2013

WJCD

View full text Add to dashboard Cite

Treatment of chronic congestive heart failure (HF) has improved substantially during the past decades, with the introduction of modulators of the renin angiotensin aldosterone system (RAAS) such as angiotensin converting enzyme (ACE) inhibitors, angiotensin II receptor blockers (ARBs) and aldosterone antagonists and the introduction of the lifesaving beta-blockers as well as device therapy. Despite the dramatic improvement in the treatment of chronic HF, no such progress was achieved in the treatment of acute heart failure (AHF). Diuretics that were never rigorously examined in well controlled large prospective randomized studies remain the cornerstone and almost exclusively the only intravenous therapeutic option for AHF and no further effective therapy as introduced in more than 30 years. As a result, the short term morbidity and most importantly mortality of AHF remains extremely high with up to 20% of patients dying in the first months after admission for AHF and an additional 20% being readmitted to the hospital. In the current manuscript we will address the practical concerns regarding established and novel diuretic and vascular modulating therapies in patients with AHF, examine their recommended use and seek to determine a path to developing better and more effective therapies for AHF.

show abstract

Renal effects of ularitide in patients with decompensated heart failure

Cited by 50 publications

References 28 publications

Deterioration of Renal Function by Chronic Heart Failure is Associated with Congestion and Oxidative Stress in the Tubulointerstitium

Deterioration of Renal Function by Chronic Heart Failure is Associated with Congestion and Oxidative Stress in the Tubulointerstitium

Soluble Guanylate Cyclase Modulators in Heart Failure

The pathophysiology of AHF<br>—New insights from recent studies of novel diuretics and vascular modulating therapies</br>

Contact Info

Product

Resources

About

Renal effects of ularitide in patients with decompensated heart failure

Cited by 50 publications

References 28 publications

Deterioration of Renal Function by Chronic Heart Failure is Associated with Congestion and Oxidative Stress in the Tubulointerstitium

Deterioration of Renal Function by Chronic Heart Failure is Associated with Congestion and Oxidative Stress in the Tubulointerstitium

Soluble Guanylate Cyclase Modulators in Heart Failure

The pathophysiology of AHF&lt;br&gt;—New insights from recent studies of novel diuretics and vascular modulating therapies&lt;/br&gt;

Contact Info

Product

Resources

About

The pathophysiology of AHF<br>—New insights from recent studies of novel diuretics and vascular modulating therapies</br>