Ursodeoxycholic Acid in Patients With Chronic Heart Failure

Haehling, Stephan von; Schefold, Joerg C.; Jankowska, Ewa A.; Springer, Jochen; Vazir, Ali; Kalra, Paul R.; Sandek, Anja; Fauler, Günter; Stojaković, Tatjana; Trauner, Michael; Ponikowski, Piotr; Volk, Hans‐Dieter; Doehner, Wolfram; Coats, Andrew J.S.; Poole‐Wilson, Philip A.; Anker, Stefan D.

doi:10.1016/j.jacc.2011.10.880

Cited by 75 publications

(21 citation statements)

References 35 publications

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“…Furthermore, alterations of BA metabolism have been found in cardiac disease and heart failure [30, 31, 53]. Recently, G-protein-coupled BA receptor-1 has been identified as central pathway in BA-mediated hemodynamic alterations [28, 29].…”

Section: Discussionmentioning

confidence: 99%

Circulating bile acids predict outcome in critically ill patients

Horvatits

Drolz

Rutter

et al. 2017

Ann. Intensive Care

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BackgroundJaundice and cholestatic hepatic dysfunction are frequent findings in critically ill patients associated with increased mortality. Cholestasis in critically ill patients is closely associated with stimulation of pro-inflammatory cytokines resulting in impaired bile secretion and subsequent accumulation of bile acids.Aim of this study was to evaluate the clinical role of circulating bile acids in critically ill patients.MethodsTotal and individual serum bile acids were assessed via high-performance liquid chromatography in 320 critically ill patients and 19 controls.ResultsTotal serum bile acids were threefold higher in septic than cardiogenic shock patients and sixfold higher than in post-surgical patients or controls (p < 0.001). Elevated bile acid levels correlated with severity of illness, renal dysfunction and inflammation (p < 0.05). Total bile acids predicted 28-day mortality independently of sex, age, serum bilirubin and severity of illness (HR 1.041, 95% CI 1.013–1.071, p < 0.005). Best prediction of mortality of total bile acids was seen in patients suffering from septic shock.ConclusionsIndividual and total BAs are elevated by various degrees in different shock conditions. BAs represent an early predictor of short-term survival in a mixed cohort of ICU patients and may serve as marker for early risk stratification in critically ill patients. Future studies should elucidate whether modulation of BA metabolism and signalling influences the clinical course and outcome in critically ill patients.Electronic supplementary materialThe online version of this article (doi:10.1186/s13613-017-0272-7) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Circulating bile acids predict outcome in critically ill patients

Horvatits

Drolz

Rutter

et al. 2017

Ann. Intensive Care

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“…Interestingly, 6 weeks’ UDCA therapy was found to improve endothelium-dependent vasodilatation and arterial blood flow in patients with CHF under conditions of impaired nitric oxide production (91). In addition, a randomized, placebo-controlled clinical trial demonstrated that UDCA significantly improved peak post-ischemic blood flow in the arm (105). It will be important to find out if increased endothelial DDAH1 expression and/or reduction of ADMA levels played a role in the beneficial effects of UDCA observed in these clinical studies.…”

Section: Regulation Of Ddah1 Expression By Farnesoid X Receptors (Fxrmentioning

confidence: 99%

Effect of asymmetric dimethylarginine (ADMA) on heart failure development

Liu

Hou

et al. 2016

Nitric Oxide

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Asymmetric dimethylarginine (ADMA) is an endogenous inhibitor of nitric oxide synthases that limits nitric oxide bioavailability and can increase production of NOS derived reactive oxidative species. Increased plasma ADMA is a one of the strongest predictors of mortality in patients who have had a myocardial infarction or suffer from chronic left heart failure, and is also an independent risk factor for several other conditions that contribute to heart failure development, including hypertension, coronary artery disease/atherosclerosis, diabetes, and renal dysfunction. The enzyme responsible for ADMA degradation is dimethylarginine dimethylaminohydrolase-1 (DDAH1). DDAH1 plays an important role in maintaining nitric oxide bioavailability and preserving cardiovascular function in the failing heart. Here, we examine mechanisms of abnormal NO production in heart failure, with particular focus on the role of ADMA and DDAH1.

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“…It should be noted, however, that treatment with UDCA can only alleviate some of the symptoms in the early stages of the disease, not cure it. Interestingly, current studies are under way to test the effects of UDCA in cardiovascular disease [55], which lends further credibility to Turi’s suggested use of the compound.…”

Section: Discussionmentioning

confidence: 86%

Johan Turi’s animal, mineral, vegetable cures and healing practices: an in-depth analysis of Sami (Saami) folk healing one hundred years ago

DuBois

Lang

2013

J Ethnobiology Ethnomedicine

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BackgroundThe healing knowledge of a Sami (Saami) hunter and reindeer herder was surveyed as a window into the concepts of health, healing, and disease in early twentieth-century Sapmi (Northern Sweden). The two books of Johan Turi (1854–1936)—An Account of the Sami (1910) and Lappish Texts (1918–19) were examined to determine the varieties of recorded zootherapeutic, mineral, chemical, and ethnobotanical lore, as well as the therapeutic acts, identified conditions, and veterinary knowledge included.MethodsTabulation of the materials and species mentioned in Turi’s descriptions (n = 137) permitted analysis of the relative frequency of differing types of healing in Turi’s overall therapeutic repertoire, his relative attention to chronic vs. acute ailments, and the frequency of magic as a component of healing. A qualitative appraisal was made of the degree to which outside influences affected Sami healing of the period. A further assessment of the possible clinical efficacy of the recorded remedies was undertaken.ResultsTuri’s remedies consist most often of zootherapeutics (31%), followed by physical acts such as massage, moxibustion, or manipulation (22%). Ethnobotanical cures make up a significantly smaller portion of his repertoire (17%), followed by mineral and chemical cures (12%). Magic rituals (including incantations and ritual acts) make up a significant portion of Turi’s repertoire, and could be used alone (17%) or in conjunction with other types of healing (38%). Turi’s healing aimed primarily at acute ailments (65%), with chronic conditions addressed less often (35%). A literature review revealed that Turi’s remedies held a marked frequency of likely efficacy, at least in cases in which it was possible to ascertain the precise species, conditions, or substances described. Although it is possible at times to recognize foreign sources in Turi’s repertoire, it is clear that Turi understood all his healing methods as distinctively Sami.ConclusionThe research illustrates the variety and depth of a single informant’s healing knowledge, and demonstrates the value of both historical sources and in-depth data collection with single experts as useful means of assessing and characterizing an indigenous population’s healing traditions.

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Ursodeoxycholic Acid in Patients With Chronic Heart Failure

Abstract: UDCA is well tolerated in patients with CHF. UDCA improves peripheral blood flow and is associated with improved markers of liver function.

Cited by 75 publications

References 35 publications

Circulating bile acids predict outcome in critically ill patients

Circulating bile acids predict outcome in critically ill patients

Effect of asymmetric dimethylarginine (ADMA) on heart failure development

Johan Turi’s animal, mineral, vegetable cures and healing practices: an in-depth analysis of Sami (Saami) folk healing one hundred years ago

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