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相关概念视频

Heart Failure Drugs: Inhibitors of Renin-Angiotensin System01:26

Heart Failure Drugs: Inhibitors of Renin-Angiotensin System

419
The activation of the sympathetic nervous system and the renin-angiotensin-aldosterone system (RAAS) contributes to cardiac remodeling, and inhibiting the RAAS is a pharmacological target in heart failure management. As a result, neurohumoral modulation is a crucial treatment principle for managing heart failure. This approach involves using medications like ACE inhibitors (ACEIs), angiotensin receptor blockers (ARBs), β-blockers, mineralocorticoid receptor antagonists (MRAs), and neutral...
419
Heart Failure Drugs: Diuretics01:22

Heart Failure Drugs: Diuretics

362
Heart failure and kidney perfusion are interconnected in a complex way. Reduced renal perfusion and venous congestion are two significant factors that contribute to renal dysfunction in heart failure. The kidneys, primarily responsible for fluid balance in the body, are adversely affected due to compromised cardiac output and increased venous pressure. In response to reduced renal perfusion, the kidneys activate neurohumoral mechanisms to restore balance. However, these mechanisms can be...
362
Heart Failure Drugs: Inotropic Agents01:26

Heart Failure Drugs: Inotropic Agents

564
Positive inotropic agents are commonly used as the first line of treatment for heart failure. One such agent is digoxin, derived from the genus Digitalis, which has been known for centuries but effectively utilized since 1785. However, these cardiac glycosides can have potentially toxic effects due to their mechanism of action, which involves inhibiting Na+/K+-ATPase and increasing contractility. Digoxin is absorbed orally and distributed in various tissues, including the CNS. It has a long...
564
Factors Affecting Renal Clearance: Renal Impairment01:17

Factors Affecting Renal Clearance: Renal Impairment

81
Renal dysfunction significantly impairs the renal clearance of drugs, leading to potential complications in drug therapy. Renal failure, which can be caused by various factors, poses a significant challenge in the elimination of drugs from the body.
One condition associated with renal failure is uremia. Uremia is characterized by impaired glomerular filtration and fluid accumulation in the body. This condition hinders the renal clearance of drugs, resulting in drug accumulation and potential...
81
Renal Failure: Dose Adjustments01:11

Renal Failure: Dose Adjustments

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In patients with renal impairment, drugs undergo significant changes in their pharmacokinetics, which require dosage adjustments to ensure safe and effective therapy.
Reduced renal clearance and elimination rate are common outcomes of renal impairment. These alterations lead to a prolonged elimination half-life and an altered apparent volume of distribution for drugs. As a result, dosage adjustments are typically necessary to maintain optimal drug levels in the body.
However, dosage adjustments...
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相关实验视频

Updated: Jun 22, 2025

Evaluation of Cardiac Contractility Modulation Therapy in 2D Human Stem Cell-Derived Cardiomyocytes
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长期功能与心脏收缩性调制疗法治疗

Goekhan Yuecel1,2, Babak Yazdani3, Kristin Schreiner1

  • 1Department of Cardiology, Angiology, Haemostaseology and Medical Intensive Care, University Medical Centre Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.

Cardiorenal medicine
|June 27, 2024
PubMed
概括

心脏收缩性调制 (CCM) 疗法可以长期稳定心力衰竭患者的功能. 患者心脏功能有所改善,但功能受损表明心力衰竭并发症的风险更高.

关键词:
调节心脏收缩能力的调节.心脏病综合征是什么心脏病综合征慢性心力衰竭 慢性心力衰竭慢性脏疾病 慢性脏疾病

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科学领域:

  • 心脏病学 心脏病学
  • 腎臟病學 (nephrology) 是一種醫學專業.
  • 医疗器械 医疗器械

背景情况:

  • 心脏植入式电气设备可以通过血液动力学变化影响功能.
  • 心脏收缩性调制 (CCM) 是一种治疗慢性心力衰竭 (HF) 患者的疗法,患者对医疗治疗没有反应.
  • 需要进一步调查CCM治疗的长期心脏和脏效应.

研究的目的:

  • 评估CCM治疗对心力衰竭患者功能的长期 (长达60个月) 影响.
  • 为了比较晚期慢性病 (aCKD) 和保存或轻度CKD (pCKD) 的患者之间的功能变化.
  • 评估基线功能和CCM后的HF并发症之间的关系.

主要方法:

  • 该研究分析了60个月的MAINTAINED研究中的187名CCM接受者.
  • 使用血清肌素和估计的淋巴细胞过率 (eGFR) 监测功能.
  • 为了进行比较,患者被分为aCKD (eGFR ≤59 mL/min/1.73 m2) 和pCKD (eGFR ≥60 mL/min/1.73 m2) 的两组.

主要成果:

  • 在60个月的随访期间,CKD阶段分布保持稳定.
  • 在60个月后的总队列中观察到eGFR的轻微但显著下降,主要是在pCKD组中.
  • 在两组中,CCM治疗导致NYHA分类和LVEF显著改善.
  • 患有CKD的患者经历了更多的HF住院和腹腔心动力障碍.

结论:

  • 在心力衰竭患者中,CCM疗法可以长期保持稳定的功能和CKD阶段.
  • 无论基线功能如何,都观察到LVEF和功能状态的改善.
  • 在CCM患者中,先前存在的功能受损可能与心血管并发症的增加和HF并发症风险的增加有关.