2007, Number 3
<< Back Next >>
Acta Med 2007; 5 (3)
Pharmacological strategies for the treatment of acute cardiac failure syndromes
Herrera CÁ, Martínez BM, García VM, Pech OLG, Díaz GE, Rodríguez WF
Language: Spanish
References: 30
Page: 134-140
PDF size: 92.40 Kb.
ABSTRACT
The Cardiac Insufficiency continues being a problem of public health. In the United States of North America a million hospitalizations to the year by fault take place approximately cardiac. Thanks to the advances in therapeutic the medical one, the life expectancy has been increased. In spite of these so discouraging numbers few clinical tests have appeared on new therapeutic agents to treat the cardiac failure. Diverse drugs exist that are in charge to maintain a balance between the demands of oxygenate and the miocardic function. The short term treatment of the cardiac failure acute syndrome must go focused to preserve the organic operation and to improve the hemodynamic profile. The ideal agent for the treatment of the SFCA is that reduces the ventricular filling pressure, improves and preserves the renal function, improves the simptomatology, preserves the viable myocardium, reduces the neurohumoral answer, that is not arrhythmogenic nor that produces symptomatic hypotension. The tests are focused to the search of the medicines that improve the hemodynamic profile without causing miocardic damage, so is the case of Levosimendan, a drug with properties anti ischemics and that improve the hemodynamic profile.
REFERENCES
Signal Transduction in Smooth Muscle, Invited Review: Arteriolar smooth muscle mechanotransduction: Ca2+ signaling pathways underlying myogenic reactivity. J Appl Physiol 2001; 91: 973-983.
Gheorghiade M. Mebazaa A. Introduction to acute heart failure syndromes. The American Journal of Cardiology Sept 19 2005.
Perna ER, Macin SM, Parras JI et al. Cardiac troponin T levels are associated with poor short-and-long term prognosis in patients with acute pulmonary edema. Am Heart J 2002; 149: 209-216.
Shulz R, Guth BD, Pieper K et al. Recruitment of an inotropic reserve in moderately ischemic myocardium at the expenses of metabolic recovery: a model of short-term hibernation. Cir Res 1992; 70: 1282-1295.
Schrier RW, Abraham WT. Hormones and hemodynamics in heart failure. N Engl J Med 1999; 341: 577-585.
Bayram M, De Luca L, Massie B et al. Dobutamina, dopamina, and milrinona in the management of acute heart failure syndromes: a reassessment. Am J Cardiol 2005; 96(Suppl 6A).
Graves EJ, Kozak LJ. National Hospital Discharge Survey: Annual Summary, 1996. Vital Health Stat 1999: 1-46[series 13].
Mendeep RM. Optimizing outcomes in patient with acute decompensated heart failure. Am Heart J 2006; 151: 571-579.
Lee DS, Austin PC, Rouleau JL et al. Predicting mortality among patients hospitalized for heart failure: derivation and validation of a clinical model. JAMA 2003; 290: 2581-2587.
Caldicott LD, Hawley K, Heppel R et al. Intravenous enoximone or dobutamine for severe heart failure after acute myocardial infarction: a randomized double-blind trail. Eur Heart J 1993; 14: 696-700.
Peacock F, Emerman CL, Costanzo MR et al. Early initiation of intravenous vasoactive therapy improves heart failure outcomes: an analysis from the ADHERE register database [abstract 92]. Ann Emerg Med 2003; 42(4 Suppl): S26.
Burger AJ, Horton DP, LeJemtel T et al. Effect of nesiritide (B-type natriuretic peptide) and dobutamine on ventricular arrhythmias in the treatment of patients with acutely decompensated congestive heart failure: The PRECEDENT Study. Am Heart J 2002; 144: 1102-1108.
Yasue H, Yoshimura M, Sumida H, Kikuta K, Kugiyama K, Jougasaki M et al. Localization and mechanism of secretion of B-type natriuretic peptide in comparison with those of A-type natriuretic peptide in normal subjects and patients with heart failure. Circulation 1994; 90: 195-203.
Colucci WS, Elkayam U, Horton DP et al. Intravenous nesiritide, a natriuretic peptide, in the treatment of decompensated congestive heart failure. N Engl J Med 2000; 343: 246-253.
Butler J, Emerman C, Peacock WF et al. The efficacy and safety of B-type natriuretic peptide (nesiritide) in patients with renal insufficiency and acutely decompensated congestive heart failure. Nephrol Dial Transplant 2004; 19: 391-399.
Goldsmith SR. Vasopressin, a therapeutic target in congestive heart failure? J Cardiol Fail 1999; 5: 347-356.
Yamane Y. Plasma ADH level in patients with chronic congestive heart failure. Jpn Circ J 1968; 32: 745-759.
Nielsen S, Know TH, Christensen BM et al. Physiology and pathophysiology of renal aquaporins. J Am Soc Nephrol 1999; 10: 647-663.
Gheorghiade M, Gattis Wa, O´Connor CM et al. Effects of tolvaptan, a vasopressin antagonist, in patients hospitalized with worsening heart failure: a randomized controlled trail. JAMA 2004; 291: 1963-1971.
Edes I, Kiss E, Kitada Y et al. Effects of levosimendan, a cardiotonic agent targeted to troponin C, on cardiac function and on phosphorylation and Ca 2+ sensitivity of cardiac myofibrils and sarcoplasmic reticulum in guinea pig heart. Circ Res 1995; 77: 107-113.
Gheorghiade M, Teerlink JR, Mebazza A. Pharmacology of new agents for acute heart failure syndromes. The American Journal of Cardiology 2005; 96(6A): 68-73.
Kersten JR, Montgomery MW, Pagel PS. Levosimendan a new positive inotropic drug, decreases myocardial infarct size via activation of K ATP channels. Anesth Analog 2000; 90: 5-11.
Lillberg J, Nieminen MS, Akkila J et al. Effects of a new calcium sensitizer, levosimendan, on haemodynamics, coronary blood floor and myocardial substrate utilization early after coronary artery bypass grafting. Eur Heart J 1998; 19: 660-668.
Kivikko M, Antila S, Eha J et al. Pharmacokinetics of levosimendan and its metabolites during and after 24-hour continuous infusion in patients with severe heart failure. Int J Clin Pharmacol Ther 2002; 40: 465-471.
Edes I, Kiss E, Kitada Y et al. Effects of levosimendan, a cardiotonic agent targeted to troponin C, on cardiac function and on phosphorylation and Ca 2+ sensitivity of cardiac myofibrils and sarcoplasmic reticulum in guinea pig heart. Circ Res 1995; 77: 107-113.
Yanagisawa M, Kurihara H, Kimura S et al. A novel potent vasoconstrictor peptide produced by vascular endothelial cells. Nature 1988; 332: 411-415.
Aronson D, Burger AJ. Neurohumoral activation and ventricular arrhythmias in patients with decompensated congestive heart failure: role of endothelin. PACE PACINE Clin Electrophysiol 2003; 26: 703-710.
Clozel M, Breu V, Gray GA et al. Pharmacological characterization of bosentan, a new potent orally active nonpeptide endothelin receptor antagonist. J Pharmacol Exp Ther 1994; 270: 228-235.
Rosas PM. Mecanismos de progresión en insuficiencia cardiaca. Arch Inst Cardiol Mex 2001; 71(Supl 1): 153-159.
Yamane Y. Plasma ADH level in patients with chronic congestive heart failure. Jpn Circ J 1968; 32: 745-759.