17 results on '"Harjola, Veli-Pekka"'
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2. 2014 ESC Guidelines on the diagnosis and management of acute pulmonary embolism: The Task Force for the Diagnosis and Management of Acute Pulmonary Embolism of the European Society of Cardiology (ESC)Endorsed by the European Respiratory Society (ERS)
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Konstantinides, Stavros V., Torbicki, Adam, Agnelli, Giancarlo, Danchin, Nicolas, Fitzmaurice, David, Galiè, Nazzareno, Gibbs, J. Simon R., Huisman, Menno V., Humbert, Marc, Kucher, Nils, Lang, Irene, Lankeit, Mareike, Lekakis, John, Maack, Christoph, Mayer, Eckhard, Meneveau, Nicolas, Perrier, Arnaud, Pruszczyk, Piotr, Rasmussen, Lars H., Schindler, Thomas H., Svitil, Pavel, Vonk Noordegraaf, Anton, Zamorano, Jose Luis, Zompatori, Maurizio, Zamorano, Jose Luis, Achenbach, Stephan, Baumgartner, Helmut, Bax, Jeroen J., Bueno, Hector, Dean, Veronica, Deaton, Christi, Erol, Çetin, Fagard, Robert, Ferrari, Roberto, Hasdai, David, Hoes, Arno, Kirchhof, Paulus, Knuuti, Juhani, Kolh, Philippe, Lancellotti, Patrizio, Linhart, Ales, Nihoyannopoulos, Petros, Piepoli, Massimo F., Ponikowski, Piotr, Sirnes, Per Anton, Tamargo, Juan Luis, Tendera, Michal, Torbicki, Adam, Wijns, William, Windecker, Stephan, Erol, Çetin, Jimenez, David, Ageno, Walter, Agewall, Stefan, Asteggiano, Riccardo, Bauersachs, Rupert, Becattini, Cecilia, Bounameaux, Henri, Büller, Harry R., Davos, Constantinos H., Deaton, Christi, Geersing, Geert-Jan, Sanchez, Miguel Angel Gómez, Hendriks, Jeroen, Hoes, Arno, Kilickap, Mustafa, Mareev, Viacheslav, Monreal, Manuel, Morais, Joao, Nihoyannopoulos, Petros, Popescu, Bogdan A., Sanchez, Olivier, Spyropoulos, Alex C., Skoro-Sajer, Nika, Najafov, Ruslan, Sudzhaeva, Svetlana, De Pauw, Michel, Baraković, Fahir, Tokmakova, Mariya, Skoric, Bosko, Rokyta, Richard, Hansen, Morten Lock, Elmet, Märt, Harjola, Veli-Pekka, Meyer, Guy, Chukhrukidze, Archil, Rosenkranz, Stephan, Androulakis, Aristides, Forster, Tamás, Fedele, Francesco, Sooronbaev, Talant, Maca, Aija, Ereminiene, Egle, Micallef, Josef, Andreasen, Arne, Kurzyna, Marcin, Ferreira, Daniel, Petris, Antoniu Octavian, Dzemeshkevich, Sergey, Asanin, Milika, Šimkova, Iveta, Anguita, Manuel, Christersson, Christina, Kostova, Nela, Baccar, Hedi, Sade, Leyla Elif, Parkhomenko, Alexander, and Pepke-Zaba, Joanna
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- 2014
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3. 2017 ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation
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Ibanez, Borja, James, Stefan, Agewall, Stefan, Antunes, Manuel J., Bucciarelli-Ducci, Chiara, Bueno, Hector, Caforio, Alida L. P., Crea, Filippo, Goudevenos, John A., Halvorsen, Sigrun, Hindricks, Gerhard, Kastrati, Adnan, Lenzen, Mattie J., Prescott, Eva, Roffi, Marco, Valgimigli, Marco, Varenhorst, Christoph, Vranckx, Pascal, Widimský, Petr, Baumbach, Andreas, Bugiardini, Raffaele, Coman, Ioan Mircea, Delgado, Victoria, Fitzsimons, Donna, Gaemperli, Oliver, Gershlick, Anthony H., Gielen, Stephan, Harjola, Veli-Pekka, Katus, Hugo A., Knuuti, Juhani, Kolh, Philippe, Leclercq, Christophe, Lip, Gregory Y. H., Morais, Joao, Neskovic, Aleksandar N., Neumann, Franz-Josef, Niessner, Alexander, Piepoli, Massimo Francesco, Richter, Dimitrios J., Shlyakhto, Evgeny, Simpson, Iain A, Steg, Ph Gabriel, Terkelsen, Christian Juhl, Thygesen, Kristian, Windecker, Stephan, Zamorano, Jose Luis, Zeymer, Uwe, Ibanez, Borja, James, Stefan, Agewall, Stefan, Antunes, Manuel J., Bucciarelli-Ducci, Chiara, Bueno, Hector, Caforio, Alida L. P., Crea, Filippo, Goudevenos, John A., Halvorsen, Sigrun, Hindricks, Gerhard, Kastrati, Adnan, Lenzen, Mattie J., Prescott, Eva, Roffi, Marco, Valgimigli, Marco, Varenhorst, Christoph, Vranckx, Pascal, Widimskã½, Petr, Baumbach, Andrea, Bugiardini, Raffaele, Coman, Ioan Mircea, Delgado, Victoria, Fitzsimons, Donna, Gaemperli, Oliver, Gershlick, Anthony H., Gielen, Stephan, Harjola, Veli-Pekka, Katus, Hugo A., Knuuti, Juhani, Kolh, Philippe, Leclercq, Christophe, Lip, Gregory Y. H., Morais, Joao, Neskovic, Aleksandar N., Neumann, Franz-Josef, Niessner, Alexander, Piepoli, Massimo Francesco, Richter, Dimitrios J., Shlyakhto, Evgeny, Simpson, Iain A, Steg, Ph Gabriel, Terkelsen, Christian Juhl, Thygesen, Kristian, Windecker, Stephan, Zamorano, Jose Lui, and Zeymer, Uwe
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Quality indicator ,medicine.medical_treatment ,Quality indicators ,Guideline ,ST-segment elevation ,030204 cardiovascular system & hematology ,0302 clinical medicine ,ST segment ,030212 general & internal medicine ,Myocardial infarction ,reproductive and urinary physiology ,Emergency medical system ,Evidence ,Risk assessment ,MINOCA ,Ischaemic heart disease ,Fibrinolysis ,Secondary prevention ,Primary percutaneous coronary intervention ,Reperfusion therapy ,Antithrombotics ,embryonic structures ,Cardiology ,Acute coronary syndrome ,biological phenomena, cell phenomena, and immunity ,Cardiology and Cardiovascular Medicine ,medicine.medical_specialty ,Acute myocardial infarction ,Acute coronary syndromes ,Guidelines ,Antithrombotic therapy ,03 medical and health sciences ,Antithrombotic ,Internal medicine ,medicine ,Fibrinolysi ,In patient ,cardiovascular diseases ,urogenital system ,Task force ,business.industry ,medicine.disease ,Settore MED/11 - MALATTIE DELL'APPARATO CARDIOVASCOLARE ,business - Abstract
The ESC Guidelines represent the views of the ESC and were produced after careful consideration of the scientific and medical knowledge and the evidence available at the time of their publication. The ESC is not responsible in the event of any contradiction, discrepancy and/or ambiguity between the ESC Guidelines and any other official recommendations or guidelines issued by the relevant public health authorities, in particular in relation to good use of healthcare or therapeutic strategies. Health professionals are encouraged to take the ESC Guidelines fully into account when exercising their clinical judgment, as well as in the determination and the implementation of preventive, diagnostic or therapeutic medical strategies; however, the ESC Guidelines do not override, in any way whatsoever, the individual responsibility of health professionals to make appropriate and accurate decisions in consideration of each patient's health condition and in consultation with that patient and, where appropriate and/or necessary, the patient's caregiver. Nor do the ESC Guidelines exempt health professionals from taking into full and careful consideration the relevant official updated recommendations or guidelines issued by the competent public health authorities, in order to manage each patient's case in light of the scientifically accepted data pursuant to their respective ethical and professional obligations. It is also the health professional's responsibility to verify the applicable rules and regulations relating to drugs and medical devices at the time of prescription.
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- 2017
4. Markers of renal function and acute kidney injury in acute heart failure: definitions and impact on outcomes of the cardiorenal syndrome
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Lassus, Johan P.E., Nieminen, Markku S., Peuhkurinen, Keijo, Pulkki, Kari, Siirilä-Waris, Krista, Sund, Reijo, and Harjola, Veli-Pekka
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- 2010
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5. Contemporary management of octogenarians hospitalized for heart failure in Europe: Euro Heart Failure Survey II
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Komajda, Michel, Hanon, Olivier, Hochadel, Matthias, Lopez-Sendon, Jose Luis, Follath, Ferenc, Ponikowski, Piotr, Harjola, Veli-Pekka, Drexler, Helmut, Dickstein, Kenneth, Tavazzi, Luigi, and Nieminen, Markku
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- 2009
6. Prognostic value of cystatin C in acute heart failure in relation to other markers of renal function and NT-proBNP
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Lassus, Johan, Harjola, Veli-Pekka, Sund, Reijo, Siirilä-Waris, Krista, Melin, John, Peuhkurinen, Keijo, Pulkki, Kari, and Nieminen, Markku S.
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- 2007
7. New risk factors of heart failure?
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Siirilä-Waris, Krista, Lassus, Johan, and Harjola, Veli-Pekka
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- 2007
8. Characteristics, outcomes, and predictors of 1-year mortality in patients hospitalized for acute heart failure
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Siirilä-Waris, Krista, Lassus, Johan, Melin, John, Peuhkurinen, Keijo, Nieminen, Markku S., and Harjola, Veli-Pekka
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- 2006
9. EuroHeart Failure Survey II (EHFS II): a survey on hospitalized acute heart failure patients: description of population
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Nieminen, Markku S., Brutsaert, Dirk, Dickstein, Kenneth, Drexler, Helmut, Follath, Ferenc, Harjola, Veli-Pekka, Hochadel, Matthias, Komajda, Michel, Lassus, Johan, Lopez-Sendon, Jose Luis, Ponikowski, Piotr, and Tavazzi, Luigi
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- 2006
10. Protein-based cardiogenic shock patient classifier
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Rueda, Ferran, primary, Borràs, Eva, additional, García-García, Cosme, additional, Iborra-Egea, Oriol, additional, Revuelta-López, Elena, additional, Harjola, Veli-Pekka, additional, Cediel, Germán, additional, Lassus, Johan, additional, Tarvasmäki, Tuukka, additional, Mebazaa, Alexandre, additional, Sabidó, Eduard, additional, and Bayés-Genís, Antoni, additional
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- 2019
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11. 2019 ESC Guidelines for the diagnosis and management of acute pulmonary embolism developed in collaboration with the European Respiratory Society (ERS): The Task Force for the diagnosis and management of acute pulmonary embolism of the European Society of Cardiology (ESC)
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Konstantinides, Stavros V, Meyer, Guy, Becattini, Cecilia, Bueno, Héctor, Geersing, Geert-Jan, Harjola, Veli-Pekka, Huisman, Menno V, Humbert, Marc, Jennings, Catriona Sian, Jiménez, David, Kucher, Nils, Lang, Irene Marthe, Lankeit, Mareike, Lorusso, Roberto, Mazzolai, Lucia, Meneveau, Nicolas, Áinle, Fionnuala Ní, Prandoni, Paolo, Pruszczyk, Piotr, and Righini, Marc
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- 2020
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12. Early discharge and home treatment of patients with low-risk pulmonary embolism with the oral factor Xa inhibitor rivaroxaban: an international multicentre single-arm clinical trial.
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Barco, Stefano, Schmidtmann, Irene, Ageno, Walter, Bauersachs, Rupert M, Becattini, Cecilia, Bernardi, Enrico, Beyer-Westendorf, Jan, Bonacchini, Luca, Brachmann, Johannes, Christ, Michael, Czihal, Michael, Duerschmied, Daniel, Empen, Klaus, Espinola-Klein, Christine, Ficker, Joachim H, Fonseca, Cândida, Genth-Zotz, Sabine, Jiménez, David, Harjola, Veli-Pekka, and Held, Matthias
- Abstract
Aims To investigate the efficacy and safety of early transition from hospital to ambulatory treatment in low-risk acute PE, using the oral factor Xa inhibitor rivaroxaban. Methods and results We conducted a prospective multicentre single-arm investigator initiated and academically sponsored management trial in patients with acute low-risk PE (EudraCT Identifier 2013-001657-28). Eligibility criteria included absence of (i) haemodynamic instability, (ii) right ventricular dysfunction or intracardiac thrombi, and (iii) serious comorbidities. Up to two nights of hospital stay were permitted. Rivaroxaban was given at the approved dose for PE for ≥3 months. The primary outcome was symptomatic recurrent venous thromboembolism (VTE) or PE-related death within 3 months of enrolment. An interim analysis was planned after the first 525 patients, with prespecified early termination of the study if the null hypothesis could be rejected at the level of α = 0.004 (<6 primary outcome events). From May 2014 through June 2018, consecutive patients were enrolled in seven countries. Of the 525 patients included in the interim analysis, three (0.6%; one-sided upper 99.6% confidence interval 2.1%) suffered symptomatic non-fatal VTE recurrence, a number sufficiently low to fulfil the condition for early termination of the trial. Major bleeding occurred in 6 (1.2%) of the 519 patients comprising the safety population. There were two cancer-related deaths (0.4%). Conclusion Early discharge and home treatment with rivaroxaban is effective and safe in carefully selected patients with acute low-risk PE. The results of the present trial support the selection of appropriate patients for ambulatory treatment of PE. [ABSTRACT FROM AUTHOR]
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- 2020
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13. Treatments targeting inotropy
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Maack, Christoph, primary, Eschenhagen, Thomas, additional, Hamdani, Nazha, additional, Heinzel, Frank R, additional, Lyon, Alexander R, additional, Manstein, Dietmar J, additional, Metzger, Joseph, additional, Papp, Zoltán, additional, Tocchetti, Carlo G, additional, Yilmaz, M Birhan, additional, Anker, Stefan D, additional, Balligand, Jean-Luc, additional, Bauersachs, Johann, additional, Brutsaert, Dirk, additional, Carrier, Lucie, additional, Chlopicki, Stefan, additional, Cleland, John G, additional, de Boer, Rudolf A, additional, Dietl, Alexander, additional, Fischmeister, Rodolphe, additional, Harjola, Veli-Pekka, additional, Heymans, Stephane, additional, Hilfiker-Kleiner, Denise, additional, Holzmeister, Johannes, additional, de Keulenaer, Gilles, additional, Limongelli, Giuseppe, additional, Linke, Wolfgang A, additional, Lund, Lars H, additional, Masip, Josep, additional, Metra, Marco, additional, Mueller, Christian, additional, Pieske, Burkert, additional, Ponikowski, Piotr, additional, Ristić, Arsen, additional, Ruschitzka, Frank, additional, Seferović, Petar M, additional, Skouri, Hadi, additional, Zimmermann, Wolfram H, additional, and Mebazaa, Alexandre, additional
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- 2018
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14. 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure
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Ponikowski, Piotr, primary, Voors, Adriaan A., additional, Anker, Stefan D., additional, Bueno, Héctor, additional, Cleland, John G. F., additional, Coats, Andrew J. S., additional, Falk, Volkmar, additional, González-Juanatey, José Ramón, additional, Harjola, Veli-Pekka, additional, Jankowska, Ewa A., additional, Jessup, Mariell, additional, Linde, Cecilia, additional, Nihoyannopoulos, Petros, additional, Parissis, John T., additional, Pieske, Burkert, additional, Riley, Jillian P., additional, Rosano, Giuseppe M. C., additional, Ruilope, Luis M., additional, Ruschitzka, Frank, additional, Rutten, Frans H., additional, and van der Meer, Peter, additional
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- 2016
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15. Treatments targeting inotropy
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Dietmar J. Manstein, Jean-Luc Balligand, Joseph M. Metzger, Veli-Pekka Harjola, Christoph Maack, Frank Ruschitzka, Marco Metra, Stefan Chlopicki, Nazha Hamdani, Alexander Dietl, Denise Hilfiker-Kleiner, M. Birhan Yilmaz, Johannes Holzmeister, Alexander R. Lyon, Christian Mueller, Petar M. Seferovic, Stefan D. Anker, Johann Bauersachs, Gilles W. De Keulenaer, Giuseppe Limongelli, Alexandre Mebazaa, Dirk L. Brutsaert, Rodolphe Fischmeister, Lucie Carrier, Rudolf A. de Boer, Josep Masip, Burkert Pieske, John G.F. Cleland, Wolfram H. Zimmermann, Zoltán Papp, Frank R. Heinzel, Carlo G. Tocchetti, Piotr Ponikowski, Lars H. Lund, Stephane Heymans, Thomas Eschenhagen, Wolfgang A. Linke, Arsen D. Ristić, Hadi Skouri, Maack, Christoph, Eschenhagen, Thoma, Hamdani, Nazha, Heinzel, Frank R, Lyon, Alexander R, Manstein, Dietmar J, Metzger, Joseph, Papp, Zoltán, Tocchetti, Carlo G, Yilmaz, M Birhan, Anker, Stefan D, Balligand, Jean-Luc, Bauersachs, Johann, Brutsaert, Dirk, Carrier, Lucie, Chlopicki, Stefan, Cleland, John G, de Boer, Rudolf A, Dietl, Alexander, Fischmeister, Rodolphe, Harjola, Veli-Pekka, Heymans, Stephane, Hilfiker-Kleiner, Denise, Holzmeister, Johanne, de Keulenaer, Gille, Limongelli, Giuseppe, Linke, Wolfgang A, Lund, Lars H, Masip, Josep, Metra, Marco, Mueller, Christian, Pieske, Burkert, Ponikowski, Piotr, Ristic, Arsen, Ruschitzka, Frank, Seferovic, Petar M, Skouri, Hadi, Zimmermann, Wolfram H, Mebazaa, Alexandre, HUS Emergency Medicine and Services, University of Helsinki, Department of Diagnostics and Therapeutics, Cardiologie, MUMC+: MA Med Staf Spec Cardiologie (9), RS: Carim - H02 Cardiomyopathy, RS: CARIM - R2.02 - Cardiomyopathy, Maack, C, Eschenhagen, T, Hamdani, N, Heinzel, Fr, Lyon, Ar, Manstein, Dj, Metzger, J, Papp, Z, Tocchetti, Cg, Yilmaz, Mb, Anker, Sd, Balligand, Jl, Bauersachs, J, Brutsaert, D, Carrier, L, Chlopicki, S, Cleland, Jg, de Boer, Ra, Dietl, A, Fischmeister, R, Harjola, Vp, Heymans, S, Hilfiker-Kleiner, D, Holzmeister, J, de Keulenaer, G, Limongelli, G, Linke, Wa, Lund, Lh, Masip, J, Metra, M, Mueller, C, Pieske, B, Ponikowski, P, Ristic, A, Ruschitzka, F, Seferovic, Pm, Skouri, H, Zimmermann, Wh, Mebazaa, A, UCL - SSS/IREC/FATH - Pôle de Pharmacologie et thérapeutique, and UCL - (SLuc) Service de médecine interne générale
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Inotrope ,Acute decompensated heart failure ,Phosphodiesterase Inhibitors ,Swine ,Levosimendan ,030204 cardiovascular system & hematology ,Omecamtiv mecarbil ,Contractility ,Antioxidants ,Placebos ,0302 clinical medicine ,Catecholamines ,Diastole ,Dobutamine ,Inotropes ,Urea ,Adrenergic receptors ,1102 Cardiorespiratory Medicine and Haematology ,Excitation Contraction Coupling ,Clinical Trials as Topic ,Cardiogenic shock ,3. Good health ,Receptors, Adrenergic ,Mitochondria ,Acute Disease ,Models, Animal ,Cardiology ,Nitrogen Oxides ,Cardiology and Cardiovascular Medicine ,Oxidation-Reduction ,medicine.drug ,Cardiac function curve ,Sarcomeres ,medicine.medical_specialty ,Cardiotonic Agents ,Systole ,Shock, Cardiogenic ,Heart failure ,03 medical and health sciences ,Special Article ,Dogs ,Internal medicine ,Energetics ,medicine ,Animals ,Humans ,Simendan ,business.industry ,030229 sport sciences ,medicine.disease ,Myocardial Contraction ,Excitation-contraction coupling ,Cardiovascular System & Hematology ,3121 General medicine, internal medicine and other clinical medicine ,Case-Control Studies ,Nitroxyl ,Calcium ,Human medicine ,business ,Energy Metabolism - Abstract
Acute heart failure (HF) and in particular, cardiogenic shock are associated with high morbidity and mortality. A therapeutic dilemma is that the use of positive inotropic agents, such as catecholamines or phosphodiesterase-inhibitors, is associated with increased mortality. Newer drugs, such as levosimendan or omecamtiv mecarbil, target sarcomeres to improve systolic function putatively without elevating intracellular Ca2+. Although meta-analyses of smaller trials suggested that levosimendan is associated with a better outcome than dobutamine, larger comparative trials failed to confirm this observation. For omecamtiv mecarbil, Phase II clinical trials suggest a favourable haemodynamic profile in patients with acute and chronic HF, and a Phase III morbidity/mortality trial in patients with chronic HF has recently begun. Here, we review the pathophysiological basis of systolic dysfunction in patients with HF and the mechanisms through which different inotropic agents improve cardiac function. Since adenosine triphosphate and reactive oxygen species production in mitochondria are intimately linked to the processes of excitation–contraction coupling, we also discuss the impact of inotropic agents on mitochondrial bioenergetics and redox regulation. Therefore, this position paper should help identify novel targets for treatments that could not only safely improve systolic and diastolic function acutely, but potentially also myocardial structure and function over a longer-term.
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- 2019
16. Treatments targeting inotropy.
- Author
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Maack C, Eschenhagen T, Hamdani N, Heinzel FR, Lyon AR, Manstein DJ, Metzger J, Papp Z, Tocchetti CG, Yilmaz MB, Anker SD, Balligand JL, Bauersachs J, Brutsaert D, Carrier L, Chlopicki S, Cleland JG, de Boer RA, Dietl A, Fischmeister R, Harjola VP, Heymans S, Hilfiker-Kleiner D, Holzmeister J, de Keulenaer G, Limongelli G, Linke WA, Lund LH, Masip J, Metra M, Mueller C, Pieske B, Ponikowski P, Ristić A, Ruschitzka F, Seferović PM, Skouri H, Zimmermann WH, and Mebazaa A
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- Acute Disease, Animals, Antioxidants adverse effects, Antioxidants therapeutic use, Calcium metabolism, Cardiotonic Agents adverse effects, Case-Control Studies, Catecholamines adverse effects, Catecholamines therapeutic use, Clinical Trials as Topic, Diastole drug effects, Dobutamine adverse effects, Dobutamine therapeutic use, Dogs, Energy Metabolism drug effects, Heart Failure mortality, Humans, Mitochondria metabolism, Models, Animal, Myocardial Contraction drug effects, Nitrogen Oxides adverse effects, Nitrogen Oxides therapeutic use, Oxidation-Reduction drug effects, Phosphodiesterase Inhibitors adverse effects, Phosphodiesterase Inhibitors therapeutic use, Placebos administration & dosage, Receptors, Adrenergic drug effects, Sarcomeres drug effects, Sarcomeres metabolism, Shock, Cardiogenic mortality, Simendan adverse effects, Simendan therapeutic use, Swine, Systole drug effects, Urea adverse effects, Urea analogs & derivatives, Urea therapeutic use, Cardiotonic Agents therapeutic use, Excitation Contraction Coupling drug effects, Heart Failure drug therapy, Shock, Cardiogenic drug therapy
- Abstract
Acute heart failure (HF) and in particular, cardiogenic shock are associated with high morbidity and mortality. A therapeutic dilemma is that the use of positive inotropic agents, such as catecholamines or phosphodiesterase-inhibitors, is associated with increased mortality. Newer drugs, such as levosimendan or omecamtiv mecarbil, target sarcomeres to improve systolic function putatively without elevating intracellular Ca2+. Although meta-analyses of smaller trials suggested that levosimendan is associated with a better outcome than dobutamine, larger comparative trials failed to confirm this observation. For omecamtiv mecarbil, Phase II clinical trials suggest a favourable haemodynamic profile in patients with acute and chronic HF, and a Phase III morbidity/mortality trial in patients with chronic HF has recently begun. Here, we review the pathophysiological basis of systolic dysfunction in patients with HF and the mechanisms through which different inotropic agents improve cardiac function. Since adenosine triphosphate and reactive oxygen species production in mitochondria are intimately linked to the processes of excitation-contraction coupling, we also discuss the impact of inotropic agents on mitochondrial bioenergetics and redox regulation. Therefore, this position paper should help identify novel targets for treatments that could not only safely improve systolic and diastolic function acutely, but potentially also myocardial structure and function over a longer-term., (Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2018. For permissions, please email: journals.permissions@oup.com.)
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- 2019
- Full Text
- View/download PDF
17. Indications and practical approach to non-invasive ventilation in acute heart failure.
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Masip J, Peacock WF, Price S, Cullen L, Martin-Sanchez FJ, Seferovic P, Maisel AS, Miro O, Filippatos G, Vrints C, Christ M, Cowie M, Platz E, McMurray J, DiSomma S, Zeymer U, Bueno H, Gale CP, Lettino M, Tavares M, Ruschitzka F, Mebazaa A, Harjola VP, and Mueller C
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- Acute Disease, Heart Failure physiopathology, Humans, Heart Failure therapy, Noninvasive Ventilation
- Abstract
In acute heart failure (AHF) syndromes significant respiratory failure (RF) is essentially seen in patients with acute cardiogenic pulmonary oedema (ACPE) or cardiogenic shock (CS). Non-invasive ventilation (NIV), the application of positive intrathoracic pressure through an interface, has shown to be useful in the treatment of moderate to severe RF in several scenarios. There are two main modalities of NIV: continuous positive airway pressure (CPAP) and pressure support ventilation (NIPSV) with positive end expiratory pressure. Appropriate equipment and experience is needed for NIPSV, whereas CPAP may be administered without a ventilator, not requiring special training. Both modalities have shown to be effective in ACPE, by a reduction of respiratory distress and the endotracheal intubation rate compared to conventional oxygen therapy, but the impact on mortality is less conclusive. Non-invasive ventilation is also indicated in patients with AHF associated to pulmonary disease and may be considered, after haemodynamic stabilization, in some patients with CS. There are no differences in the outcomes in the studies comparing both techniques, but CPAP is a simpler technique that may be preferred in low-equipped areas like the pre-hospital setting, while NIPSV may be preferable in patients with significant hypercapnia. The new modality 'high-flow nasal cannula' seems promising in cases of AHF with less severe RF. The correct selection of patients and interfaces, early application of the technique, the achievement of a good synchrony between patients and the ventilator avoiding excessive leakage, close monitoring, proactive management, and in some cases mild sedation, may warrant the success of the technique., (Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2017. For permissions, please email: journals.permissions@oup.com.)
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- 2018
- Full Text
- View/download PDF
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