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Wan SH, Torres-Courchoud I, McKie PM, Slusser JP, Redfield MM, Burnett JC, Hodge DO, Chen HH. Cardiac Versus Renal Response to Volume Expansion in Preclinical Systolic Dysfunction With PDEV Inhibition and BNP. ACTA ACUST UNITED AC 2020; 4:962-972. [PMID: 31909303 PMCID: PMC6939015 DOI: 10.1016/j.jacbts.2019.08.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Revised: 08/28/2019] [Accepted: 08/29/2019] [Indexed: 12/11/2022]
Abstract
In preclinical systolic dysfunction, defined as left ventricular systolic dysfunction with no heart failure signs or symptoms, impairment in cardiorenal response to volume expansion may lead to symptomatic heart failure. Rescue of this impaired process in preclinical disease may prevent development of symptomatic heart failure. In preclinical systolic dysfunction, inhibition of phosphodiesterase-V in combination with exogenous B-type natriuretic peptide administration results in improved cardiac function but worsened renal function in response to acute volume expansion. Future studies are needed to further define the physiological effects and long-term outcomes of phosphodiesterase-V inhibition and exogenous BNP administration. Understanding the cardiorenal effects and outcomes of combination phosphodiesterase-V with exogenous B-type natriuretic peptide may affect the clinical management of patients with preclinical systolic dysfunction and renal dysfunction.
Impaired cardiorenal response to acute saline volume expansion in preclinical systolic dysfunction (PSD) may lead to symptomatic heart failure. The objective was to determine if combination phosphodiesterase-V inhibition and exogenous B-type natriuretic peptide (BNP) administration may enhance cardiorenal response. A randomized double-blinded, placebo-controlled study was conducted in 21 subjects with PSD and renal dysfunction. Pre-treatment with tadalafil and subcutaneous BNP resulted in improved cardiac function, as evidenced by improvement in ejection fraction, left atrial volume index, and left ventricular end-diastolic volume. However, there was reduced renal response with reduction in renal plasma flow, glomerular filtration rate, and urine flow. (Tadalafil and Nesiritide as Therapy in Pre-clinical Heart Failure; NCT01544998)
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Key Words
- ACC, American College of Cardiology
- AHA, American Heart Association
- ANP, atrial natriuretic peptide
- B-type natriuretic peptide
- BNP, B-type natriuretic peptide
- GFR, glomerular filtration rate
- HF, heart failure
- LAVI, left atrial volume index
- LVEDV, left ventricular end-diastolic volume
- LVEF, left ventricular ejection fraction
- LVESV, left ventricular end-systolic volume
- NP, natriuretic peptide
- PDEV, type V phosphodiesterase
- PSD, preclinical systolic dysfunction
- RPF, renal plasma flow
- SC, subcutaneous
- VE, acute saline volume expansion
- cGMP, cyclic guanosine monophosphate
- cardiorenal
- heart failure
- nesiritide
- phosphodiesterase inhibition
- systolic dysfunction
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Affiliation(s)
- Siu-Hin Wan
- Department of Cardiovascular Diseases, Mayo Clinic and Foundation, Rochester, Minnesota.,Cardiorenal Research Laboratory, Division of Cardiovascular Diseases, Mayo Clinic and Foundation, Rochester, Minnesota
| | | | - Paul M McKie
- Department of Cardiovascular Diseases, Mayo Clinic and Foundation, Rochester, Minnesota.,Cardiorenal Research Laboratory, Division of Cardiovascular Diseases, Mayo Clinic and Foundation, Rochester, Minnesota
| | - Joshua P Slusser
- Department of Health Sciences Research, Mayo Clinic and Foundation, Rochester, Minnesota
| | - Margaret M Redfield
- Department of Cardiovascular Diseases, Mayo Clinic and Foundation, Rochester, Minnesota.,Cardiorenal Research Laboratory, Division of Cardiovascular Diseases, Mayo Clinic and Foundation, Rochester, Minnesota
| | - John C Burnett
- Department of Cardiovascular Diseases, Mayo Clinic and Foundation, Rochester, Minnesota.,Cardiorenal Research Laboratory, Division of Cardiovascular Diseases, Mayo Clinic and Foundation, Rochester, Minnesota
| | - David O Hodge
- Department of Health Sciences Research, Mayo Clinic and Foundation, Rochester, Minnesota
| | - Horng H Chen
- Department of Cardiovascular Diseases, Mayo Clinic and Foundation, Rochester, Minnesota.,Cardiorenal Research Laboratory, Division of Cardiovascular Diseases, Mayo Clinic and Foundation, Rochester, Minnesota
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Navarro-Aguilar ME, Navarro-Calzada J, Torres-Courchoud I, Iguzquiza-Pellejero MJ, Cantín-Golet A. [Pneumomediastinum: When asthma exacerbation does not improve]. Semergen 2017. [PMID: 28645695 DOI: 10.1016/j.semerg.2017.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- M E Navarro-Aguilar
- Especialidad en Medicina Interna, Servicio de Urgencias, Hospital Universitario Lozano Blesa, Zaragoza, España.
| | - J Navarro-Calzada
- Especialidad en Medicina Interna, Servicio de Urgencias, Hospital Universitario Lozano Blesa, Zaragoza, España
| | - I Torres-Courchoud
- Especialidad en Medicina Interna, Servicio de Urgencias, Hospital Universitario Lozano Blesa, Zaragoza, España
| | - M J Iguzquiza-Pellejero
- Especialidad en Medicina Interna, Servicio de Urgencias, Hospital Universitario Lozano Blesa, Zaragoza, España
| | - A Cantín-Golet
- Especialidad en Medicina Familiar y Comunitaria, Servicio de Urgencias, Hospital Universitario Lozano Blesa, Zaragoza, España
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Torres-Courchoud I, Martínez-Gil R, Aibar-Arregui MA, Andrés-Gracia A, Torralba-Cabeza MA. Amiloidosis cardiaca secundaria a la mutación familiar Glu54Gln del gen de la transtiretina. Rev Esp Cardiol 2017. [DOI: 10.1016/j.recesp.2016.06.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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