1,721,102 research outputs found
Chronic heart failure and cachexia: Role of endocrine system
No full textChronic heart failure (CHF) is a major health problem that carries a devastating prognosis. The prognosis worsens considerably once cardiac cachexia has been diagnosed. Neurohormonal, metabolic, hemodynamic and immunological alterations are involved in the initiation and progression of cardiac cachexia. Cachexia is characterized by a hypothalamic inappropriate response to the mechanisms controlling energy homeostasis. Levels of the anorexigenic hormone leptin are decreased whereas the orexigenic gherlin hormone levels are normal or elevated. Nevertheless, energy intake is not increased as expected due to a persistent activation of the proopiomelanocortin (POMC) system (anorexigenic) paralleled by a decreased activity of the neuropeptide Y (NPY, orexigenic) neurons. Cachexia is also characterized by an imbalance in anabolic (impairment in the growth hormone/insulin-like growth factor-I axis, insulin resistance) and catabolic (increased levels of catecholamines, increased cortisol/ dehydroepiandrosterone ratio and activation of proinflammatory cytokines such as tumor necrosis factor-alpha, interleuchin-6, interleuchin-1,) at the basis of the wasting process. This review discusses the complex role of the endocrine system in modulating energy balance, appetite and metabolism in patients with chronic heart failure. A joint multidisciplinary effort of the cardiologists, immunologists and endocrinologists might be useful to identify the precise mechanisms involved in the neuroendocrine alteration and to develop therapeutic strategies able to improve the prognosis of CHF patients
Metabolic syndrome: What are the acknowledged markers, and how reliable are they?
No full textInsulin resistance and its cluster of associated abnormalities, defined as the metabolic syndrome, are important coronary heart disease (CHD) risk factors. The report of the Adult Treatment Panel-III (ATP III) serves as a formal recognition of this, and the fact that approximately 25% of Western populations may be suffering from the untoward consequences of insulin resistance emphasizes the magnitude of the clinical problem. The aim of the definition of the metabolic syndrome based on ATP III criteria is to provide a tool able to identify insulin-resistant individuals, and it offers a pragmatic approach to the early identification of individuals at risk for CHD, with the potential benefit of a more aggressive lifestyle intervention and a more focused follow-up
Diabetes and chronic heart failure: from diabetic cardiomyopathy to therapeutic approach
No full textDiabetes and chronic heart failure are interrelated conditions with major medical and economic impact that have to be treated as a distinct entity. Several pathological mechanisms have been investigated and proposed to explain the structural and functional changes associated with diabetic cardiomyopathy. These mechanisms are likely to act synergically and may potentiate one the other. This review outlines recent advances in the pathophysiological mechanisms implicated in the development and progression of diabetic cardiomyopathy and in current therapeutic strategies
Efficacy and tolerability of the long-term administration of carvedilol in patients with chronic heart failure with and without concomitant diabetes mellitus
No full textCONSIDERAZIONI CLINICO DIAGNOSTICHE E TERAPEUTICHE SU UN CASO SPORADICO AUTOCTONO DI DISTOMATOSI EPATICA
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Efficacy and tolerability of long-term beta-blocker therapy in the patients with heart failure and concomitant diabetes mellitus
No full textDiabetes mellitus does not influence the efficacy and tolerability of beta blocker terapy in the patients with chronic heart failure.
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