Therapeutic options in advanced heart failure

The pyruvate-lactate axis modulates cardiac hypertrophy and heart failure

“…Chronic HF has numerous etiologies (Jessup and Brozena, 2003;Metra and Teerlink, 2017) and frequently results from cardiomyopathy of unknown cause (Kasper et al, 1994;McNally and Mestroni, 2017). Therapeutic options for patients with advanced HF are limited, but include invasive procedures such as heart transplantation and left ventricular assist device (LVAD) implantation, which restores adequate blood flow and hemodynamics via mechanical support (i.e., unloading) (Bekfani et al, 2018). Originally, LVADs were seen as either a temporary intervention while patients awaited a donor heart or as a lifetime therapy (i.e., destination therapy).…”

Neues zur Diagnostik und Therapie der Herzinsuffizienz

“…Klassische, positiv-inotrope Substanzen können bei akuter Herzinsuffizienz über das Einwirken in die Kalziumhomöostase der Myozyten zwar zu einer kurzfristigen Stabilisierung der Patienten beitragen, sind aber langfristig mit einer erhöhten Mortalitätsrate assoziiert [ 65 ]. Neben diesen Kalzitropika (Dobutamin, Dopamin, Katecholamine, PDE[Phosphodiesterase]-5-Inhibitoren) stehen aber noch weitere inotrope Substanzen zur Verfügung, die entsprechend ihren Angriffspunkten zur Gruppe der Mitotropika (Mitochondrien als Angriffspunkt) oder zur Gruppe der Myotropika (Myosin-Aktin-Interaktion als Angriffspunkt) gezählt werden [ 66 ].…”

Nanomaterials for Cardiac Tissue Engineering

“…Myocardial tissue has very limited innate regenerative capacity, and no options are currently available for myocardial tissue regeneration. Current options for end organ intervention include either durable left ventricular assist device (LVAD) or heart transplant [16,17]. Both of these options require massive financial costs and major investment of time and effort by the patient and by medical care teams.…”