Journal of Cardiovascular Pharmacology最新文献

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Investigating the Transfer of Lisinopril into Human Milk: A Quantitative Analysis. 利辛普利向母乳转移的研究:定量分析
IF 2.6 4区 医学
Journal of Cardiovascular Pharmacology Pub Date : 2024-10-15 DOI: 10.1097/FJC.0000000000001642
Julie Chugh, Jean Dai, Palika Datta, Kaytlin Krutsch
{"title":"Investigating the Transfer of Lisinopril into Human Milk: A Quantitative Analysis.","authors":"Julie Chugh, Jean Dai, Palika Datta, Kaytlin Krutsch","doi":"10.1097/FJC.0000000000001642","DOIUrl":"https://doi.org/10.1097/FJC.0000000000001642","url":null,"abstract":"<p><p>Lisinopril is commonly prescribed to manage conditions such as hypertension and heart failure. While concerns about fetal toxicity have traditionally limited the use of lisinopril in women of reproductive age, recent ACOG guidelines promote aggressive treatment of hypertension, which may require the use of pharmacologic agents not previously considered in the postpartum period. We aimed to estimate infant exposure to maternal lisinopril via breastmilk and report the tolerance of the breastfed infant. Five volunteers taking lisinopril provided samples of their human milk and their associated health information for research through the InfantRisk Center Human Milk Biorepository. The milk pharmacokinetics of lisinopril were measured using liquid chromatography-mass spectrometry. The mean milk concentration of lisinopril was 0.49 ng/mL per 10 mg daily dose. The Relative Infant Dose (RID) was 0.06% for lisinopril, more than 100 times lower than the standard 10% safety threshold. The minimal transfer of lisinopril into human milk in this study suggests the drug is unlikely to pose a clinically significant risk to healthy breastfed infants.</p>","PeriodicalId":15212,"journal":{"name":"Journal of Cardiovascular Pharmacology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142466353","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Canonical Transient Receptor Potential (TRPC) Channels in Cardiovascular Pathology and their Modulators. 心血管病理中的典型瞬时受体电位(TRPC)通道及其调节剂。
IF 2.6 4区 医学
Journal of Cardiovascular Pharmacology Pub Date : 2024-10-15 DOI: 10.1097/FJC.0000000000001643
Hussein N Rubaiy
{"title":"Canonical Transient Receptor Potential (TRPC) Channels in Cardiovascular Pathology and their Modulators.","authors":"Hussein N Rubaiy","doi":"10.1097/FJC.0000000000001643","DOIUrl":"10.1097/FJC.0000000000001643","url":null,"abstract":"<p><p>Ion channels play a crucial role in various aspects of cardiac function, such as regulating rhythm and contractility. As a result, they serve as key targets for therapeutic interventions in cardiovascular diseases. Cell function is substantially influenced by the concentration of free cytosolic calcium (Ca 2+ ) and the voltage across the plasma membrane. These characteristics are known to be regulated by Ca 2+ -permeable non-selective cationic channels, although our knowledge of these channels is still inadequate. The transient receptor potential (TRP) superfamily comprises of many non-selective cation channels with diverse Ca 2+ permeability. Canonical or classical TRP (TRPC) channels are a subgroup of the TRP superfamily that are expressed ubiquitously in mammalian cells. TRPC channels are multidimensional signalling protein complexes that play essential roles in a variety of physiological and pathological processes in humans, including cancer, neurological disorders, cardiovascular diseases, and others. The objective of this article is to focus on the role that TRPC channels play in the cardiovascular system. The role of TRPC channels will be deeply discussed in cardiovascular pathology. Together, a critical element in developing novel treatments that target TRPC channels is comprehending the molecular mechanisms and regulatory pathways of TRPC channels in related cardiovascular diseases and conditions.</p>","PeriodicalId":15212,"journal":{"name":"Journal of Cardiovascular Pharmacology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142466351","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Interleukin-1 blockade with RPH-104 (goflikicept) in patients with ST-segment elevation myocardial infarction (STEMI): secondary endpoints from an international, double blind, randomized, placebo-controlled, phase IIa study. RPH-104(gofikicept)对 ST 段抬高型心肌梗死(STEMI)患者的白细胞介素-1 阻断作用:一项国际双盲、随机、安慰剂对照 IIa 期研究的次要终点。
IF 2.6 4区 医学
Journal of Cardiovascular Pharmacology Pub Date : 2024-10-02 DOI: 10.1097/FJC.0000000000001635
Antonio Abbate, Benjamin Van Tassell, Vlad Bogin, Roshanak Markley, Dmitry V Pevzner, Paul C Cremer, Imad A Meray, Dmitry V Privalov, Angela Taylor, Sergey A Grishin, Alina N Egorova, Ekaterina G Ponomar, Yan Lavrovsky, Mikhail Yu Samsonov
{"title":"Interleukin-1 blockade with RPH-104 (goflikicept) in patients with ST-segment elevation myocardial infarction (STEMI): secondary endpoints from an international, double blind, randomized, placebo-controlled, phase IIa study.","authors":"Antonio Abbate, Benjamin Van Tassell, Vlad Bogin, Roshanak Markley, Dmitry V Pevzner, Paul C Cremer, Imad A Meray, Dmitry V Privalov, Angela Taylor, Sergey A Grishin, Alina N Egorova, Ekaterina G Ponomar, Yan Lavrovsky, Mikhail Yu Samsonov","doi":"10.1097/FJC.0000000000001635","DOIUrl":"10.1097/FJC.0000000000001635","url":null,"abstract":"<p><p>In a randomized double-blinded clinical trial of patients with ST segment elevation myocardial infarction (STEMI), goflikicept, an Interleukin-1 (IL-1) blocker, significantly reduced systemic inflammation, measured as the area-under-the-curve (AUC) for high-sensitivity C reactive protein (hsCRP) at 14 days. We report secondary analyses of biomarkers at 28 days, and cardiac function and clinical endpoints at 1 year. Patients received a single administration of goflikicept 80 mg (n=34), goflikicept 160 mg (n=34), or placebo (n=34). Both doses of goflikicept significantly reduced the AUC for hsCRP at 28 days compared with placebo, without statistically significant differences between the doses. There we no statistically significant differences between groups in the AUC for natriuretic peptides at 28 days. There were no significant differences between placebo, goflikicept 80 mg and 160 mg groups in deaths (2.9%, 2.9% and 0%), hospitalization for cardiovascular reasons (9.1%, 5.9%, and 0%), new-onset or progression of heart failure (9.1%, 5.9%, and 5.9%), and new or increased use of loop diuretics (24.2%, 14.7%, and 17.6%), nor in the number of patients with treatment emergent adverse events, with no treatment-related serious adverse events in any group. In conclusion, in patients with STEMI, IL-1 blockade with goflikicept 80 mg or 160 mg was well tolerated and associated with significant reduction of systemic inflammation. Further adequately powered studies are warranted to determine whether the reduction in systemic inflammation with goflikicept translates into a clinical benefit in patients with STEMI.</p>","PeriodicalId":15212,"journal":{"name":"Journal of Cardiovascular Pharmacology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142365364","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Antithrombotic Treatment Regimens in Patients Undergoing Percutaneous Coronary Revascularization Requiring Oral Anticoagulation: What Real-World Evidence Shows Us. 需要口服抗凝药的经皮冠状动脉血运重建术患者的抗血栓治疗方案:真实世界的证据告诉我们什么。
IF 2.6 4区 医学
Journal of Cardiovascular Pharmacology Pub Date : 2024-10-01 DOI: 10.1097/FJC.0000000000001619
Marco Giuseppe Del Buono, Giulia La Vecchia, Dominck J Angiolillo
{"title":"Antithrombotic Treatment Regimens in Patients Undergoing Percutaneous Coronary Revascularization Requiring Oral Anticoagulation: What Real-World Evidence Shows Us.","authors":"Marco Giuseppe Del Buono, Giulia La Vecchia, Dominck J Angiolillo","doi":"10.1097/FJC.0000000000001619","DOIUrl":"10.1097/FJC.0000000000001619","url":null,"abstract":"","PeriodicalId":15212,"journal":{"name":"Journal of Cardiovascular Pharmacology","volume":" ","pages":"391-393"},"PeriodicalIF":2.6,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141901863","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Management of Patients Treated With Oral Anticoagulant Therapy Undergoing Percutaneous Coronary Intervention With Stent Implantation: The PERSEO Registry. 接受经皮冠状动脉介入治疗和支架植入术的口服抗凝疗法患者的管理:PERSEO 登记。
IF 2.6 4区 医学
Journal of Cardiovascular Pharmacology Pub Date : 2024-10-01 DOI: 10.1097/FJC.0000000000001607
Alessandro Sciahbasi, Salvatore De Rosa, Giuseppe Gargiulo, Daniele Giacoppo, Paolo Calabrò, Giovanni Paolo Talarico, Filippo Zilio, Giuseppe Talanas, Matteo Tebaldi, Giuseppe Andò, Stefano Rigattieri, Leonardo Misuraca, Bernardo Cortese, Gerardo Musuraca, Valerio Lucci, Vincenzo Guiducci, Giulia Renda, Luigi Zezza, Francesco Versaci, Maria Benedetta Giannico, Marco Caruso, Dionigi Fischetti, Mauro Colletta, Andrea Santarelli, Claudio Larosa, Alessandro Iannone, Giovanni Esposito, Giuseppe Tarantini, Giuseppe Musumeci, Andrea Rubboli
{"title":"Management of Patients Treated With Oral Anticoagulant Therapy Undergoing Percutaneous Coronary Intervention With Stent Implantation: The PERSEO Registry.","authors":"Alessandro Sciahbasi, Salvatore De Rosa, Giuseppe Gargiulo, Daniele Giacoppo, Paolo Calabrò, Giovanni Paolo Talarico, Filippo Zilio, Giuseppe Talanas, Matteo Tebaldi, Giuseppe Andò, Stefano Rigattieri, Leonardo Misuraca, Bernardo Cortese, Gerardo Musuraca, Valerio Lucci, Vincenzo Guiducci, Giulia Renda, Luigi Zezza, Francesco Versaci, Maria Benedetta Giannico, Marco Caruso, Dionigi Fischetti, Mauro Colletta, Andrea Santarelli, Claudio Larosa, Alessandro Iannone, Giovanni Esposito, Giuseppe Tarantini, Giuseppe Musumeci, Andrea Rubboli","doi":"10.1097/FJC.0000000000001607","DOIUrl":"10.1097/FJC.0000000000001607","url":null,"abstract":"<p><strong>Abstract: </strong>In patients on oral anticoagulant (OAC) therapy undergoing percutaneous coronary intervention (PCI) with stent, international guidelines endorse the use of direct oral anticoagulants (DOAC) rather than vitamin K antagonists (VKA) and dual antithrombotic therapy (DAT) rather than triple antithrombotic therapy (TAT). The aim of this study was to evaluate contemporary real-world data on antithrombotic regimens and outcome in patients on OAC undergoing PCI with stent. Consecutive patients on OAC undergoing PCI were enrolled in the multicenter, prospective, observational PERSEO registry (NCT03392948). Primary end point was net adverse clinical events (NACE) with VKA versus DOAC, whereas a secondary prespecified end point was NACE with DAT versus TAT both at 1-year follow-up. From February 2018 to February 2022; in total, 1234 consecutive patients were included. The main indication for OAC was atrial fibrillation (86%), and the mean CHA 2 DS 2 VASc and HAS-BLED scores were 4 ± 2 and 3.6 ± 1, respectively. Of the 1228 patients discharged alive, 222 (18%) were on VKA and 1006 (82%) on DOAC ( P < 0.01). DAT was employed in 197 patients whereas TAT in 1028. At follow-up, NACE rate was significantly higher than VKA compared with DOAC (23% vs. 16%, P = 0.013) and confirmed after propensity score adjustment. TAT and DAT did not differ as regards NACE rate (17% vs. 19%, P = 0.864) although, compared with TAT, DAT was associated with less major bleedings (2% vs. 5%, P = 0.014), confirmed after propensity score adjustment. In conclusion, in patients on OAC undergoing PCI, DOAC, compared with VKA, was associated with a significantly lower occurrence of NACE and DAT reduced bleedings compared with TAT.</p>","PeriodicalId":15212,"journal":{"name":"Journal of Cardiovascular Pharmacology","volume":" ","pages":"457-467"},"PeriodicalIF":2.6,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141727294","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The Efficacy of I Na Block to Cardiovert Atrial Fibrillation Is Enhanced by Inhibition of I K1. 抑制 IK1 可增强 INa 阻滞对心房颤动的心脏复律疗效。
IF 2.6 4区 医学
Journal of Cardiovascular Pharmacology Pub Date : 2024-10-01 DOI: 10.1097/FJC.0000000000001617
Alexander Burashnikov, Charles Antzelevitch
{"title":"The Efficacy of I Na Block to Cardiovert Atrial Fibrillation Is Enhanced by Inhibition of I K1.","authors":"Alexander Burashnikov, Charles Antzelevitch","doi":"10.1097/FJC.0000000000001617","DOIUrl":"10.1097/FJC.0000000000001617","url":null,"abstract":"<p><strong>Abstract: </strong>There is a need for more efficient pharmacological cardioversion of atrial fibrillation (AF). We tested the hypothesis that inhibition of I K1 significantly enhances the efficacy of I Na block to depress atrial excitability and to cardiovert AF. The study was conducted in canine isolated arterially perfused right atrial preparations with rim of ventricular tissue. AF was induced in the presence of acetylcholine (ACh; 0.5 µM). BaCl 2 (10 µM) was used to inhibit I K1 and flecainide (1.5 µM) to block I Na . Sustained AF (>45 minutes) was recorded in 100% atria (5/5) in the presence of ACh alone. Flecainide cardioverted AF in 50% of atria (4/8), BaCl 2 in 0% (0/5), and their combination in 100% (5/5). AF cardioversion occurred in 15 ± 9 minutes with flecainide alone (n = 4) and in 8 ± 9 minutes with the combination (n = 5). Following drug-induced AF cardioversion, AF was inducible in 4/4 atria with flecainide alone (≤5 minutes duration) and in 2/5 atria with the combination (≤30 seconds duration). Atrial excitability was significantly more depressed by combined versus monotherapies. There was little to no effect on ventricular excitability under any condition tested. Thus, inhibition of I K1 significantly enhances the efficacy of flecainide to depress atrial excitability and to cardiovert AF in our experimental setting. A combination of I Na and I K1 inhibition may be an effective approach for cardioversion of AF.</p>","PeriodicalId":15212,"journal":{"name":"Journal of Cardiovascular Pharmacology","volume":" ","pages":"434-439"},"PeriodicalIF":2.6,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141901868","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Nrf2 Ameliorates Atrial Fibrosis During Antithrombotic Therapy for Atrial Fibrillation by Modulating CYP2C9 Activity. Nrf2通过调节CYP2C9的活性改善心房颤动抗栓治疗期间的心房纤维化。
IF 2.6 4区 医学
Journal of Cardiovascular Pharmacology Pub Date : 2024-10-01 DOI: 10.1097/FJC.0000000000001618
Liting Wu, Zhumeng Li, Lijuan Xu, Yingchao Fan, Delong Mao, Hanxiao Sun, Wenfang Zhuang
{"title":"Nrf2 Ameliorates Atrial Fibrosis During Antithrombotic Therapy for Atrial Fibrillation by Modulating CYP2C9 Activity.","authors":"Liting Wu, Zhumeng Li, Lijuan Xu, Yingchao Fan, Delong Mao, Hanxiao Sun, Wenfang Zhuang","doi":"10.1097/FJC.0000000000001618","DOIUrl":"10.1097/FJC.0000000000001618","url":null,"abstract":"<p><strong>Abstract: </strong>Anticoagulant therapy can significantly reduce the incidence of stroke and peripheral embolism events in patients with atrial fibrillation (AF). Although warfarin is widely used as an anticoagulant drug, a wrong dose can lead to increased risks of bleeding or blood clots. The aim of this study was to assess whether nuclear factor-erythroid-2-related factor 2 (Nrf2) can improve the efficacy of warfarin through the regulation of cytochrome P450 family 2 subfamily C member 9 (CYP2C9) using a rat model of AF. Results showed that AF significantly reduced Nrf2 in myocardial tissue of sham-operated rats. Furthermore, Nrf2 overexpression effectively reduced AF-induced atrial fibrosis by reducing collagen in the left atrium, inhibiting the expression of the fibrosis-related genes collagen I and transforming growth factor-β1 in rats with AF. Nrf2 overexpression can activate CYP2C9, decrease the serum concentration of warfarin, and decrease prothrombin time and international normalized ratio in AF rats. In this article, Nrf2 overexpression protects against fibrosis, increased survival in AF rats, and activated CYP2C9 expression, thus broadening the therapeutic range of warfarin in AF rats.</p>","PeriodicalId":15212,"journal":{"name":"Journal of Cardiovascular Pharmacology","volume":" ","pages":"440-450"},"PeriodicalIF":2.6,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11446533/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141988075","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The Combination of Valsartan and Spironolactone Mitigated Mitral Regurgitation-Induced Cardiac Dysfunction in a Novel Rat Model. 在一种新型大鼠模型中,缬沙坦和螺内酯联用可减轻二尖瓣反流引起的心功能不全。
IF 2.6 4区 医学
Journal of Cardiovascular Pharmacology Pub Date : 2024-10-01 DOI: 10.1097/FJC.0000000000001614
Wei-Ting Chang, Yu-Wen Lin, Chin-Yu Chen, Chon-Seng Hong, Zhih-Cherng Chen, You-Cheng Lin, Jhih-Yuan Shih
{"title":"The Combination of Valsartan and Spironolactone Mitigated Mitral Regurgitation-Induced Cardiac Dysfunction in a Novel Rat Model.","authors":"Wei-Ting Chang, Yu-Wen Lin, Chin-Yu Chen, Chon-Seng Hong, Zhih-Cherng Chen, You-Cheng Lin, Jhih-Yuan Shih","doi":"10.1097/FJC.0000000000001614","DOIUrl":"10.1097/FJC.0000000000001614","url":null,"abstract":"<p><strong>Abstract: </strong>Despite its high prevalence, effective treatment for degenerative mitral regurgitation (MR) remains elusive. Although the mineralocorticoid-receptor antagonist spironolactone, in conjunction with renin-angiotensin-aldosterone system inhibitors, has been shown to reduce mortality in patients with heart failure with reduced ejection fraction, its efficacy in managing degenerative MR is uncertain. In this study, we aimed to compare the effectiveness of valsartan (a renin-angiotensin system inhibitor), spironolactone, and combination therapy in mitigating MR-induced myocardial dysfunction. Using a mini-invasive model of degenerative MR, we administered valsartan (31 mg/kg/d), spironolactone (80 mg/kg/d), or a combination of both to rats over a 4-week period. Serial echocardiography and pressure-volume loops were utilized to assess cardiac function and hemodynamics. Rats with degenerative MR treated with valsartan or spironolactone alone did not show significant improvement in myocardial dysfunction. In contrast, combination therapy resulted in significant improvement. Similarly, the pressure-volume relationship was significantly improved in rats treated with the combination therapy compared with that in rats treated with a single therapy. Mechanistically, combination therapy effectively suppressed circulating and cardiac expression of aldosterone- and apoptosis-associated proteins. Overall, combination treatment with valsartan and spironolactone significantly attenuated the degenerative MR-induced myocardial stress and dysfunction, suggesting a potential therapeutic avenue for managing degenerative MR-induced heart failure.</p>","PeriodicalId":15212,"journal":{"name":"Journal of Cardiovascular Pharmacology","volume":" ","pages":"410-417"},"PeriodicalIF":2.6,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141901867","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Metolazone Versus Chlorothiazide in Acute Heart Failure Patients With Diuretic Resistance and Renal Dysfunction: A Retrospective Cohort Study. 美托拉宗与氯噻嗪对利尿剂耐药性和肾功能不全的急性心力衰竭患者的对比:一项回顾性队列研究。
IF 2.6 4区 医学
Journal of Cardiovascular Pharmacology Pub Date : 2024-10-01 DOI: 10.1097/FJC.0000000000001623
Caitlin M Gibson, Meghan M Beard, Alisa K Escano, Brittany L Good, Teresa G Potter, Albert M Truong, Benjamin Van Tassell
{"title":"Metolazone Versus Chlorothiazide in Acute Heart Failure Patients With Diuretic Resistance and Renal Dysfunction: A Retrospective Cohort Study.","authors":"Caitlin M Gibson, Meghan M Beard, Alisa K Escano, Brittany L Good, Teresa G Potter, Albert M Truong, Benjamin Van Tassell","doi":"10.1097/FJC.0000000000001623","DOIUrl":"10.1097/FJC.0000000000001623","url":null,"abstract":"<p><strong>Abstract: </strong>Guidelines recommend intravenous loop diuretics as first-line therapy for patients hospitalized with acute heart failure (AHF) and volume overload. Additional agents can be used for augmentation, but there is limited guidance on agent selection. The study objective was to determine if chlorothiazide or metolazone is associated with differences in diuretic efficacy or safety in loop diuretic-resistant patients with AHF and renal dysfunction (eGFR <45 mL/min/1.73 m²). We conducted a multicenter, retrospective cohort study of patients hospitalized with AHF and renal dysfunction who received metolazone or chlorothiazide in addition to intravenous loop diuretics. The primary end point was a comparison of 24-hour urine output (UOP) between the 24 hours before and after thiazide administration. Secondary and safety end points included weight change, requirement for vasopressors or inotropes, electrolyte abnormalities, and changes in renal function. A total of 221 patients were included. The mean daily diuretic doses were chlorothiazide 632 mg and metolazone 7 mg. The mean 24-hour UOP increased more among chlorothiazide-treated (from 1668 mL to 3826 mL) versus metolazone-treated patients (from 1672 mL to 2834 mL) ( P < 0.001) after the addition of the second diuretic. Statistically significant reductions in serum creatinine were observed in the chlorothiazide group following 72 hours of treatment ( P = 0.016). More hypomagnesemia was observed in the chlorothiazide group; no differences in other electrolytes or changes in weight were observed. Overall, chlorothiazide was associated with a greater increase in 24-hour UOP than metolazone without an excess of potassium or serum creatinine derangements. However, weight changes did not differ significantly between groups. Future prospective studies are needed to confirm potential differences in diuretic response and safety.</p>","PeriodicalId":15212,"journal":{"name":"Journal of Cardiovascular Pharmacology","volume":" ","pages":"451-456"},"PeriodicalIF":2.6,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141901865","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Valtrate Suppresses TNFSF14-Mediated Arrhythmia After Myocardial Ischemia-Reperfusion by Inducing N-linked Glycosylation of LTβR to Regulate MGA/MAX/c-Myc/Cx43. 戊酸盐通过诱导LTβR的N-连接糖基化来调节MGA/MAX/c-Myc/Cx43,从而抑制心肌缺血再灌注后TNFSF14介导的心律失常。
IF 2.6 4区 医学
Journal of Cardiovascular Pharmacology Pub Date : 2024-10-01 DOI: 10.1097/FJC.0000000000001613
Jing Zhang, Xiaoqi Xiong, Jun Li, Changjun Luo, Qiang Su, Xin Hao, Qiang Wu, Wanzhong Huang
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