1,721,115 research outputs found
Alterazioni muscolari e intolleranza allo sforzo nello scompenso cardiaco congestizio: ruolo centrale della periferia
Ambient air pollution as a new risk factor for cardiovascular diseases: Time to take action
Air pollution is a recently recognized risk factor for cardiovascular disease
Chronic heart failure and cardiac cachexia and links between the endocrine and immune system
Emerging strategies for chronic heart failure: the role of gene therapy
Heart failure (HF) is a complex clinical syndrome and a major growing public health problem in Western countries. HF is a leading cause of death and morbidity in modern society, and its incidence continues to increase with the aging population. The complexity of this syndrome and its multifactorial origin constitute problems in the management of patients. Pharmacological treatments aim to interfere with the activation of the neurohormonal and adrenergic systems, which are key pathophysiological mechanisms underlying disease progression. Despite the improvements achieved by current therapies, patients in end stages of the disease still have a poor prognosis. Gene therapy represents a new approach to the treatment of HF, with the ambitious aim of repairing the molecular abnormalities that lead to the disease. Current medical management of clinical HF and novel gene therapies for treatment of HF are presented here
Growth hormone resistance in chronic heart failure and its therapeutic implications.
In recent years the administration of recombinant human growth hormone (GH) has received great attention. This review compares the potential of this therapeutic intervention in heart failure with that in other diseases where wasting is commonly seen. The pathophysiologic importance of GH and insulin-like growth factor (IGF)-I in these conditions will be discussed.
METHODS AND RESULTS:
Abnormalities of the GH-IGF-I axis play an important role in the development of cachexia in chronic illnesses. GH resistance is a major determinant of the wasting process, acting through several different mechanisms: increased catabolism, impaired anabolism, and enhanced apoptosis in peripheral tissues. GH therapy has been evaluated in chronic heart failure (CHF); acquired GH resistance may explain the general lack of therapeutic success in the majority of studies. The assessment of plasma levels of GH, IGF-I, and, in particular, GH binding protein may help to guide dosing of GH for CHF patients.
CONCLUSIONS:
GH resistance might be overcome by use of intermittent or higher doses of GH, or alternatively by combining GH with IGF-I. Randomized studies of GH therapy in catabolic states, with targeted dosing and longer duration of treatment are required to fully assess the safety and efficacy of this treatment approach
Oxidative stress and hyperuricaemia: pathophysiology, clinical relevance, and therapeutic implications in chronic heart failure.
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