Biomarcadores cardio-renales en falla cardiaca aguda
Cardiorenal biomarkers in acute heart failure.
Choudhary R, Gopal D, Kipper BA, De La Parra Landa A, Lee HA, Shah S, Maisel AS.
VA Medical Center, 3350 La Jolla Village Drive, San Diego, CA 92103, USA.
J Geriatr Cardiol. 2012 Sep;9(3):292-304. doi: 10.3724/SP.J.1263.2012.02291.
Abstract
Managing patients with heart failure (HF) is a challenging task within itself, but the presence of associated worsening renal function can greatly increase mortality and morbidity. Early diagnosis and treatment is the key to prevent re-hospitalizations and reduce healthcare costs. Biomarkers have long been established as highly sensitive and specific tools in diagnosing and prognosticating patients with HF. Reflecting distinct pathophysiological events and ongoing cellular insult, biomarkers have been proven superior to conventional laboratory tests. Availability of better assays and rapid analysis has allowed the use of biomarkers as point-of-care tests in the emergency department and at the patient's bed-side. Acute HF patients often go on to develop worsening renal function, termed as acute cardiorenal syndrome. The growing breadth of studies has shown the implications of combining multiple biomarkers to better chart outcomes and produce desirable results in such patients.
KEYWORDS: Acute kidney injury, Cardiorenal biomarkers, Heart failure
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3470029/pdf/jgc-09-03-292.pdf
Manejo de la falla cardiaca en 2013: Paradigmas cambiantes
Managing heart failure in 2013: Changing paradigms.
Pradhan AK.
Heart India [serial online] 2013 [cited 2013 Dec 10];1:67-72.
Abstract
Heart failure (HF) imposes huge morbidity and mortality on society. In recent times, HF with preserved ejection fraction (EF) has emerged as the predominant form of HF syndromes. Natriuretic peptides (B-type natriuretic peptide [BNP] and N-terminal [NT] pro BNP) have now emerged as preferred biomarkers for diagnosis and guiding further therapy in HF. Ivabradine and Eplerenone are now approved for HF patients who are symptomatic despite optimal therapy. Tolvaptan has been shown to improve hyopnatremia as well as dyspnea in patients of HF. Coronary bypass grafting has demonstrated a decrease in cardiovascular death and HF hospitalization in patients with of HF with angina. Cardiac resynchronization therapy has now consistently shown to decrease mortality in Mild HF.
Keywords: Cardiac resynchronization therapy, coronary artery bypass grafting, eplerenone, heart failure, ivabradine, natriuretic peptides, preserved ejection fraction, tovlaptan
http://www.heartindia.net/text.asp?2013/1/3/67/122779
http://www.heartindia.net/downloadpdf.asp?issn=2321-449x;year=2013;volume=1;issue=3;spage=67;epage=72;aulast=Pradhan;type=2
Tratamiento farmacológico del síndrome cardio-renal
Pharmacologic Management of the Cardio-renal Syndrome.
Kim CS.
Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea.
Electrolyte Blood Press. 2013 Jun;11(1):17-23. doi: 10.5049/EBP.2013.11.1.17. Epub 2013 Jun 30.
Abstract
Cardio-renal syndromes are disorders of the heart and kidney wherein acute or long-term dysfunction in one organ may induce acute or long-term dysfunction of the other. Because of this complex organ interaction, management of cardiorenal syndrome must be tailored to the underlying pathophysiology. Clinical guidelines exist for the treatment of heart failure or renal failure as separate conditions. Thus far, however, there has been no consensus about managing patients with cardio-renal and reno-cardiac syndromes. Pharmacologic treatment remains a controversial subject. Standard cardiac drugs such as diuretics and inotropes may have limited effect because resistance often develops after long-term use. Recent studies of patients with acute cardio-renal syndromes have focused on newer therapies, including phosphodiesterase inhibitors, vasopressin antagonists, adenosine A1 receptor antagonists, and renal protective dopamine. Initial clinical trials of these agents have shown encouraging results in some patients with heart failure, but have failed to demonstrate a clear superiority over more conventional treatments. Similarly, the benefits of diuretics, aspirin, erythropoietin agents, and iron supplements for management of chronic cardiorenal syndromes are unknown.
KEYWORDS:
Cardio-renal syndrome, Drug, Management
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3741438/pdf/ebp-11-17.pdf
Atentamente
Anestesiología y Medicina del Dolor
www.anestesia-dolor.org
Cardiorenal biomarkers in acute heart failure.
Choudhary R, Gopal D, Kipper BA, De La Parra Landa A, Lee HA, Shah S, Maisel AS.
VA Medical Center, 3350 La Jolla Village Drive, San Diego, CA 92103, USA.
J Geriatr Cardiol. 2012 Sep;9(3):292-304. doi: 10.3724/SP.J.1263.2012.02291.
Abstract
Managing patients with heart failure (HF) is a challenging task within itself, but the presence of associated worsening renal function can greatly increase mortality and morbidity. Early diagnosis and treatment is the key to prevent re-hospitalizations and reduce healthcare costs. Biomarkers have long been established as highly sensitive and specific tools in diagnosing and prognosticating patients with HF. Reflecting distinct pathophysiological events and ongoing cellular insult, biomarkers have been proven superior to conventional laboratory tests. Availability of better assays and rapid analysis has allowed the use of biomarkers as point-of-care tests in the emergency department and at the patient's bed-side. Acute HF patients often go on to develop worsening renal function, termed as acute cardiorenal syndrome. The growing breadth of studies has shown the implications of combining multiple biomarkers to better chart outcomes and produce desirable results in such patients.
KEYWORDS: Acute kidney injury, Cardiorenal biomarkers, Heart failure
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3470029/pdf/jgc-09-03-292.pdf
Manejo de la falla cardiaca en 2013: Paradigmas cambiantes
Managing heart failure in 2013: Changing paradigms.
Pradhan AK.
Heart India [serial online] 2013 [cited 2013 Dec 10];1:67-72.
Abstract
Heart failure (HF) imposes huge morbidity and mortality on society. In recent times, HF with preserved ejection fraction (EF) has emerged as the predominant form of HF syndromes. Natriuretic peptides (B-type natriuretic peptide [BNP] and N-terminal [NT] pro BNP) have now emerged as preferred biomarkers for diagnosis and guiding further therapy in HF. Ivabradine and Eplerenone are now approved for HF patients who are symptomatic despite optimal therapy. Tolvaptan has been shown to improve hyopnatremia as well as dyspnea in patients of HF. Coronary bypass grafting has demonstrated a decrease in cardiovascular death and HF hospitalization in patients with of HF with angina. Cardiac resynchronization therapy has now consistently shown to decrease mortality in Mild HF.
Keywords: Cardiac resynchronization therapy, coronary artery bypass grafting, eplerenone, heart failure, ivabradine, natriuretic peptides, preserved ejection fraction, tovlaptan
http://www.heartindia.net/text.asp?2013/1/3/67/122779
http://www.heartindia.net/downloadpdf.asp?issn=2321-449x;year=2013;volume=1;issue=3;spage=67;epage=72;aulast=Pradhan;type=2
Tratamiento farmacológico del síndrome cardio-renal
Pharmacologic Management of the Cardio-renal Syndrome.
Kim CS.
Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea.
Electrolyte Blood Press. 2013 Jun;11(1):17-23. doi: 10.5049/EBP.2013.11.1.17. Epub 2013 Jun 30.
Abstract
Cardio-renal syndromes are disorders of the heart and kidney wherein acute or long-term dysfunction in one organ may induce acute or long-term dysfunction of the other. Because of this complex organ interaction, management of cardiorenal syndrome must be tailored to the underlying pathophysiology. Clinical guidelines exist for the treatment of heart failure or renal failure as separate conditions. Thus far, however, there has been no consensus about managing patients with cardio-renal and reno-cardiac syndromes. Pharmacologic treatment remains a controversial subject. Standard cardiac drugs such as diuretics and inotropes may have limited effect because resistance often develops after long-term use. Recent studies of patients with acute cardio-renal syndromes have focused on newer therapies, including phosphodiesterase inhibitors, vasopressin antagonists, adenosine A1 receptor antagonists, and renal protective dopamine. Initial clinical trials of these agents have shown encouraging results in some patients with heart failure, but have failed to demonstrate a clear superiority over more conventional treatments. Similarly, the benefits of diuretics, aspirin, erythropoietin agents, and iron supplements for management of chronic cardiorenal syndromes are unknown.
KEYWORDS:
Cardio-renal syndrome, Drug, Management
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3741438/pdf/ebp-11-17.pdf
Atentamente
Anestesiología y Medicina del Dolor
www.anestesia-dolor.org
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