Pathogenesis of edema in constrictive pericarditis. Studies of body water and sodium, renal function, hemodynamics, and plasma hormones before and after pericardiectomy.

Anand, Inder; Ferrari, Roberto; Kalra, Gagan; Wahi, P. L.; Poole‐Wilson, Philip A.; Harris, Peter C.

doi:10.1161/01.cir.83.6.1880

Cited by 73 publications

(51 citation statements)

References 15 publications

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“…Therefore, most of these data need to be set aside. In the late 1980s and early 1990s, a series of studies was done on patients with severe chronic low-or high-output HF who had never received any form of pharmacological treatment (26)(27)(28)(29)(30)(31). Because these patients were untreated, it can be assumed that the insights into the mechanisms being tested were not being confounded by the effects of drugs.…”

Section: Role Of Hemodynamic Abnormalities In the Pathogenesis Of Crsmentioning

confidence: 99%

Cardiorenal Syndrome

Anand

2013

Clinical Journal of the American Society of Nephrology

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Summary The cardiorenal syndrome has recently been defined as “disorders of the heart and kidney whereby acute or chronic dysfunction in one organ may induce acute or chronic dysfunction of the other.” The syndrome is extremely common and independently associated with poor clinical outcomes. However, no pharmacological therapy has been shown to improve its outcomes. Unfortunately, the mechanisms that initiate the development of renal dysfunction in heart failure are still debated. This review tries to clarify some of the misunderstanding regarding the principle hemodynamic factors that drive the kidneys to retain salt and water.

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Section: Role Of Hemodynamic Abnormalities In the Pathogenesis Of Crsmentioning

confidence: 99%

Cardiorenal Syndrome

Anand

2013

Clinical Journal of the American Society of Nephrology

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“…Chronic obstructive pulmonary disease Braunstein et al [6] In the Medicare study 26% of the patients had COPD Gustafsson et al [9] In the Danish Diamond study 22% had COPD Ni et al [53] In this study only 10% had COPD McCullough et al [54] In this Emergency department study 21% of the patients had COPD Anemia Tanner et al [59] The prevalence of anemia was 15% Ezekowitz et al [60] The prevalence of anemia was 17% Silverberg et al [61] The prevalence of anemia was 50% and in patients with severe HF 80% Komajda [62] In this review the prevalence of anemia and its clinical characteristics are discussed Efficacy of heart failure treatment similar in diabetic and nondiabetic patients Rydén et al [28] Similar effect in the ATLAS study as in the SOLVD study (Shindler et al [25]) CIBIS II trial [49] Similar results in the CIBIS II-study evaluating the effect of a beta-blocker The Task force of the ESC [50] Loop-diuretics are recommended instead of thiazide diuretics in patients with diabetes, because of the hypothesis that thiazide diuretics may impair the metabolic state in diabetic patients Herings RBM et al [51] Since it has been reported hypoglycemia in connection with treatment with ACE-inhibitors careful monitoring is recommended Malmberg et al [52] Aggressive insulin treatment has not been performed in patients with heart failure but in patients with acute myocardial infarction and with a favourable outcome Chronic obstructive pulmonary disease Gosker et al [56] If use of beta-blockers beta-1 selective beta-blockers as bisoprolol is recommended Salpeter et al [57] Similar results shown in this meta-analysis, beta-1-selective beta-blockers are recommended Anemia Anand et al [72] Blood transfusions have shown beneficial effects in terms of clinical improvement Low-Friedrich et al [74] Administration of erythropoietin has beneficial effects in terms of unloading the heart Silverberg et al [66] Administration of erythropoietin together with intravenous iron improve cardiac and renal function, NYHA functional class and morbidity (reduce heavily the number of hospitalisations due to heart failure)…”

Section: Study Resultsmentioning

confidence: 63%

“…Studies using blood-transfusions to correct the developed anemia in patients with HF have shown beneficial effects in terms of clinical improvement [72]. Moreover, it is important to correct the anemia in order to improve the prognosis of the patients.…”

Section: Correction Of Anemiamentioning

confidence: 99%

Frequent non-cardiac comorbidities in patients with chronic heart failure

Dahlström

2005

European Journal of Heart Failure

104

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Heart failure (HF) in elderly patients is associated with more diffuse symptoms and signs due to the presence of other noncardiac comorbidities. This can cause difficulties in assessing the correct diagnosis and initiating appropriate therapy. The four most frequently occurring noncardiac comorbidities and therapies used to treat them are discussed in the present paper.Hypertension is an important precursor of HF, and is still the most common risk factor for HF in the general population. About 50% of patients with untreated hypertension will develop HF. Pressure overload leads to the development of left ventricular hypertrophy (LVH) and diastolic dysfunction.Diabetes, which occurs in about 20-30% of patients with HF, is an important comorbidity resulting in morphological and metabolic disturbances affecting myocardial blood flow and hormonal regulation leading to a poor outcome and necessitating aggressive conventional treatment.Chronic obstructive pulmonary disease (COPD), occurs in approximately 20-30% of heart failure patients, and may complicate HF treatment, it is therefore important to recognize and treat it effectively.Finally, the early detection of anemia, which occurs in 20-30% of HF patients, is important since it is associated with functional impairment and increased mortality and morbidity. Combined treatment with erythropoietin and intravenous iron has shown beneficial effects on clinical symptoms and morbidity.In conclusion early detection of concomitant diseases in patients with HF is important and should be considered carefully when initiating therapy.

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“…Improvement in symptoms and normalization of cardiac pressures may occur within a few months after pericardiectomy (14). As for patients in functional class I with no clinical signs of heart failure, pericardiectomy is not to be recommended (9).…”

Section: Discussionmentioning

confidence: 99%

N-terminal prohormone brain natriuretic peptide (NT-proBNP) as a noninvasive marker for restrictive syndromes

Mady

Fernandes

Ramires

et al. 2008

Braz J Med Biol Res

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Constrictive pericarditis (CP) and restrictive cardiomyopathy share many similarities in both their clinical and hemodynamic characteristics and N-terminal prohormone brain natriuretic peptide (NT-proBNP) is a sensitive marker of cardiac diastolic dysfunction. The objectives of the present study were to determine whether serum NT-proBNP was high in patients with endomyocardial fibrosis (EMF) and CP, and to investigate how this relates to diastolic dysfunction. Thirty-three patients were divided into two groups: CP (16 patients) and EMF (17 patients). The control group consisted of 30 healthy individuals. Patients were evaluated by bidimensional echocardiography, with restriction syndrome evaluated by pulsed Doppler of the mitral flow and serum NT-proBNP measured by immunoassay and detected by electrochemiluminescence. Spearman correlation coefficient was used to analyze the association between log NT-proBNP and echocardiographic parameters. Log NT-proBNP was significantly higher (P < 0.05) in CP patients (log mean: 2.67 pg/mL; 95%CI: 2.43-2.92 log pg/mL) and in EMF patients (log mean: 2.91 pg/mL; 95%CI: 2.70-3.12 log pg/mL) compared with the control group (log mean: 1.45; 95%CI: 1.32-1.60 log pg/mL). There were no statistical differences between EMF and CP patients (P = 0.689) in terms of NT-proBNP. The NT-proBNP log tended to correlate with peak velocity of the E wave (r = 0.439; P = 0.060, but not with A wave (r = -0.399; P = 0.112). Serum NT-proBNP concentration can be used as a marker to detect the presence of diastolic dysfunction in patients with restrictive syndrome; however, serum NT-proBNP levels cannot be used to differentiate restrictive cardiomyopathy from CP.

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Pathogenesis of edema in constrictive pericarditis. Studies of body water and sodium, renal function, hemodynamics, and plasma hormones before and after pericardiectomy.

Cited by 73 publications

References 15 publications

Cardiorenal Syndrome

Cardiorenal Syndrome

Frequent non-cardiac comorbidities in patients with chronic heart failure

N-terminal prohormone brain natriuretic peptide (NT-proBNP) as a noninvasive marker for restrictive syndromes

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