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001-es BibID:BIBFORM076736
035-os BibID:(WoS)000501730100012 (Scopus)85075326564
Első szerző:Maack, Christoph
Cím:Treatments targeting inotropy : a position paper of the Committees on Translational Research and Acute Heart Failure of the Heart Failure Association of the European Society of Cardiology / Christoph Maack, Thomas Eschenhagen, Nazha Hamdani, Frank R. Heinzel, Alexander R. Lyon, Dietmar J. Manstein, Joseph Metzger, Zoltán Papp, Carlo G. Tocchetti, M. Birhan Yilmaz, Stefan D. Anker, Jean-Luc Balligand, Johann Bauersachs, Dirk Brutsaert, Lucie Carrier, Stefan Chlopicki, John G. Cleland, Rudolf A. de Boer, Alexander Dietl, Rodolphe Fischmeister, Veli-Pekka Harjola, Stephane Heymans, Denise Hilfiker-Kleiner, Johannes Holzmeister, Gilles de Keulenaer, Giuseppe Limongelli, Wolfgang A. Linke, Lars H. Lund, Josep Masip, Marco Metra, Christian Mueller, Burkert Pieske, Piotr Ponikowski, Arsen Ristic, Frank Ruschitzka, Petar M. Seferovic, Hadi Skouri, Wolfram H. Zimmermann, Alexandre Mebazaa
Dátum:2019
ISSN:0195-668X
Megjegyzések: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.
Tárgyszavak:idegen nyelvű folyóiratközlemény külföldi lapban
folyóiratcikk
Heart failure
Acute decompensated heart failure
Inotropes
Cardiogenic shock
Excitation-contraction coupling
Calcium
Sarcomeres
Mitochondria
Energetics
Adrenergic receptors
Contractility
Levosimendan
Omecamtiv mecarbil
Nitroxyl
Megjelenés:European Heart Journal. - 40 : 44 (2019), p. 3626-3640. -
További szerzők:Eschenhagen, Thomas Hamdani, Nazha Heinzel, Frank R. Lyon, Alexander Manstein, Dietmar J. Metzger József Papp Zoltán (1965-) (kardiológus, élettanász) Tocchetti, Carlo G. Yilmaz, Mehmet Birhan Anker, Stefan D. Balligand, Jean-Luc Bauersachs, Johann Brutsaert, Dirk L. Carrier, Lucie Chlopicki, Stefan Cleland, John G. Boer, Rudolf A. de Dietl, Alexander Fischmeister, Rodolphe Harjola, Veli-Pekka Heymans, Stephane Hilfiker-Kleiner, Denise Holzmeister, Johannes De Keulenaer, Gilles Limongelli, Giuseppe Linke, Wolfgang A. Lund, Lars H. Masip, Josep Metra, Marco Mueller, Christian Pieske, Burkert Ponikowski, Piotr Ristić, Arsen D. Ruschitzka, Frank Seferović, Petar M. Skouri, Hadi Zimmermann, Wolfram H. Mebazaa, Alexandre
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