The Liver in Cardiovascular Disease

Tiukinhoy-Laing, Susan D.; Blei, Andrés T.; Gheorghiade, Mihai

doi:10.1002/9780470691861.ch20a

Textbook of Hepatology 2007

DOI: 10.1002/9780470691861.ch20a

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The Liver in Cardiovascular Disease

Susan D. Tiukinhoy-Laing¹,

Andrés T. Blei²,

Mihai Gheorghiade³

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Cited by 3 publications

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“…and the direct effects on the binding of t-PA to the fibrin clot are the mechanisms of 4 ultrasound on the enhanced thrombolysis(Tiukinhoy-Laing et al, 2007). In the future, we plan 5 further studies of evaluation of the thrombolytic effect of t-PA complexes with or without the 6 local ultrasound irradiation around the infarction site of blood vessels in rabbit and swine ultrasound-responsive nano gelatin complexes of t-PA stabilized by 11 zinc ions were designed.…”

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confidence: 99%

Ultrasound-responsive thrombus treatment with zinc-stabilized gelatin nano-complexes of tissue-type plasminogen activator

Uesugi

Kawata

Saito

et al. 2011

Journal of Drug Targeting

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This study is undertaken to design zinc-stabilized gelatin nano-complexes of tissue-type plasminogen activator (t-PA) for thrombolytic therapy where the t-PA activity can be recovered in the blood circulation upon ultrasound irradiation. Various molecular weights of gelatin were complexed with t-PA by their simply mixing in aqueous solution. Then, zinc acetate, calcium acetate or magnesium acetate was added to form nano-sized gelatin-t-PA complexes. The complexes had the apparent molecular size of about 100 nm. When zinc ions were added to the gelatin-t-PA complexes, the t-PA activity was suppressed most strongly to 57% of the original, free t-PA activity. Upon ultrasound exposure in vitro, the t-PA activity was fully recovered. A cell culture experiment with L929 fibroblasts demonstrated no cytotoxicity of complexes at the concentration used for the in vivo experiment. The half-life of t-PA in the blood circulation prolonged by the complexation with gelatin and zinc ions. The zinc-stabilized t-PA-gelatin complex is a promising t-PA delivery system which can manipulate the thrombolytic activity by the local ultrasound irradiation.

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mentioning

confidence: 99%

Ultrasound-responsive thrombus treatment with zinc-stabilized gelatin nano-complexes of tissue-type plasminogen activator

Uesugi

Kawata

Saito

et al. 2011

Journal of Drug Targeting

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The heart and the liver

Möller

Dümcke

Krag

2009

Expert Review of Gastroenterology & Hepatology

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Cardiac failure affects the liver and liver dysfunction affects the heart. Chronic and acute heart failure can lead to cardiac cirrhosis and cardiogenic ischemic hepatitis. These conditions may impair liver function and treatment should be directed towards the primary heart disease and seek to secure perfusion of vital organs. In patients with advanced cirrhosis, physical and/or pharmacological stress may reveal a reduced cardiac performance with systolic and diastolic dysfunction and electrophysical abnormalities, termed cirrhotic cardiomyopathy. Pathophysiological mechanisms include reduced beta-adrenergic receptor signal transduction and defective cardiac electromechanical coupling. However, the QT interval is prolonged in approximately half of patients with cirrhosis and it may be improved by beta-blockers. No specific therapy can be recommended but it should be supportive and directed against the heart failure. Transjugular intrahepatic portosystemic shunt insertion and liver transplantation affect cardiac function in portal hypertensive patients and cause stress to the cirrhotic heart, with a risk of perioperative heart failure. The risk and prevalence of coronary artery disease are increasing in cirrhotic patients and since perioperative mortality is high, careful evaluation of such patients with dobutamine stress echocardiography, coronary angiography and myocardial perfusion imaging is required prior to liver transplantation. Future research should focus on beneficial effects of treatment on cardiac function and mortality.

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Liver in systemic disease

Shimizu¹

2008

WJG

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Potential causes of abnormal liver function tests include viral hepatitis, alcohol intake, nonalcoholic fatty liver disease, autoimmune liver diseases, hereditary diseases, hepatobiliary malignancies or infection, gallstones and drug-induced liver injury. Moreover, the liver may be involved in systemic diseases that mainly affect other organs. Therefore, in patients without etiology of liver injury by screening serology and diagnostic imaging, but who have systemic diseases, the abnormal liver function test results might be caused by the systemic disease. In most of these patients, the systemic disease should be treated primarily. However, some patients with systemic disease and severe liver injury or fulminant hepatic failure require intensive treatments of the liver.

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The Liver in Cardiovascular Disease

Cited by 3 publications

References 57 publications

Ultrasound-responsive thrombus treatment with zinc-stabilized gelatin nano-complexes of tissue-type plasminogen activator

Ultrasound-responsive thrombus treatment with zinc-stabilized gelatin nano-complexes of tissue-type plasminogen activator

The heart and the liver

Liver in systemic disease

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