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Acute heart failure with dyspnoea: initial treatment. Furosemide and trinitrine, despite the lack of a proven survival benefit.

For patients with acute heart failure and dyspnoea due to pulmonary congestion, the risk of death in the short term is high. To determine ho … such trials of nitrate derivatives. In patients with cardiogenic shock, inotropes (mainly dopamine, dobutamine and milrinone) improve symptoms and haemodynamic parameters but may increase mortality.These drugs carry a risk of ventricular and supraventricular arrhythmias and tachycardia. Their use requires continuous monitoring in an intensive care unit. Card …

Hypertonic-hyperoncotic solutions improve cardiac function in children after open-heart surgery.

OBJECTIVES: Hypertonic-hyperoncotic solutions are used for the improvement of micro- and macrocirculation in various types of shock. In pedi … end of volume loading. Hemodynamic parameters were registered at the same time. The total amount of dobutamine required was documented, as well as the 24- and 48-hour fluid balances. RESULTS: In the hypertonic-hyperoncotic solution group, cardiac index was 3.6 +/- 0.26 L/min per m2 before volume administration and increased to 5.96 +/- 0.27 after the admini …

Stress echocardiography to assess stenosis severity and predict outcome in patients with paradoxical low-flow, low-gradient aortic stenosis and preserved LVEF.

The objective of this study was to examine the value of stress-echocardiography in patients with paradoxical low-flow, low-gradient (PLFLG) aortic stenosis (AS). The projected aortic valve area (AVAProj) at a normal flow rate was calculated in 55 patients with PLFLG AS. In the subset of patients (n = 13) who underwent an aortic valve replacement within 3 months after stress echocardiography, AVA(Proj) correlated better with the valve weight compared to traditional resting and stress echocardiographic parameters of AS severity (AVA(Proj): r = -0.78 vs. other parameters: r = 0.46 to 0.56). In th

Gene deletion of P2Y4 receptor lowers exercise capacity and reduces myocardial hypertrophy with swimming exercise.

Nucleotides released within the heart under pathological conditions can be involved in cardioprotection or cardiac fibrosis through the activation purinergic P2Y(2) and P2Y(6) receptors, respectively. We previously demonstrated that adult P2Y(4)-null mice display a microcardia phenotype related to a cardiac angiogenic defect. To evaluate the functional consequences of this defect, we performed here a combination of cardiac monitoring and exercise tests. We investigated the exercise capacity of P2Y(4) wild-type and P2Y(4)-null mice in forced swimming and running tests. Analysis of their stress,

Cost analysis of iron-related complications in a single institute.

Background/aimsThe financial burden of caring for iron-related complications (IRCs) is an emerging medical problem in Korea, as in Western countries. We produced a preliminary estimate of the costs of treating patients for IRCs.MethodsThe medical records of patients who had received multiple transfusions were reviewed. Newly developed cardiomyopathy, heart failure, diabetes mellitus, liver cirrhosis, and liver cancer were defined as IRCs. The costs of laboratory studies, medication, oxygenation, intervention, and education were calculated using working criteria we defined. Costs that had a def

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… Charges for inotropics (epinephrine, dopamine, dobutamine, digoxin, etc.), diuretics (furosemide, spironolactone, etc.), angiotensin converting enzyme inhibitors (ramipril, enalapril, etc.) and inhaled oxygen were included as charges for medication and intervention. …

Assessment and Management of Cardiotoxicity in Hematologic Malignancies.

With the increasing overall survival of cancer patients due to recent discoveries in oncology, the incidence of side effects is also rising, and along with secondary malignancies, cardiotoxicity is one of the most concerning side effects, affecting the quality of life of cancer survivors. There are two types of cardiotoxicity associated with chemotherapy; the first one is acute, life-threatening but, fortunately, in most of the cases, reversible; and the second one is with late onset and mostly irreversible. The most studied drugs associated with cardiotoxicity are anthracyclines, but many new

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… Also, a study made on 49 patients with breast cancer revealed a subtle alteration of myocardial contractile function in 17% of them during low-dose dobutamine [ 20 ]. … Early reduction in left ventricular contractile reserve detected by dobutamine stress echo predicts high-dose chemotherapy-induced cardiac toxicity. International Journal of Cardiology. 2006;111(1):120–126. doi: 10.1016/j.ijcard.2005.07.029. 21. Hare J. L., Brown J. …

Trimetazidine and the contractile response of dysfunctional myocardium in ischaemic cardiomyopathy.

The therapeutic effect of anti-ischemic compounds is related to their ability to improve the oxygen supply-demand balance of the ischemic my … showed that trimetazidine improved the contractile response of dysfunctional myocardial to low-dose dobutamine in patients with ischemic heart disease and left ventricular function. Twenty-two patients with prior anterior myocardial infarction and injection fraction < 35% (33 +/- 7%) were randomized into 2 groups. A group (= 11) received trimetazidine (20 mg …

CSI position statement on management of heart failure in India.

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… Contrast echocardiography can be combined with stress echocardiography for identification of wall motion abnormalities with treadmill stress and dobutamine stress echocardiography. … Table 14 CO PCWP SVR MAP HR Dobutamine ↑↑↑ ↓/⟵→ ↓ ↓/⟵→ ↑/⟵→ Dopamine- moderate ↑↑ ↑ / ⟵→ ↑ / ⟵→ ↑↑ ↑ Dopamine- high ↑ ↑ ↑↑↑ ↑↑ ↑↑ Milrinone ↑↑ ↓ ↓↓ ↓ / ⟵→ ↑ / ⟵→ Levosimendan ↑↑↑ ↓↓ ↓↓ ↓ ↑ Table 14 Hemodynamic effects of ionotropic agents. …

[Postoperative intensive care of biliary atresia patients treated with living donor liver transplantation].

OBJECTIVE: To summarize experience of pediatric intensive care and explore the incidence of complications, the involved pathogens among live … 16) days (range, 11 - 48 days). Mean requirement for artificial ventilation was 37.6 h. Mean use of dobutamine, prostaglandin E1 and dopamine was 3.3, 7.5 and 8.8 days, respectively. Preoperatively, 3 children had gastrointestinal bleeding, 18 had ascites, 2 had encephalopathy, 22 had jaundice, and 16 had coagulopathy. There were multiple early operative com …

Mortality prediction and influencing factors for intensive care unit patients with acute tubular necrosis: random survival forest and cox regression analysis.

Background: Patients with acute tubular necrosis (ATN) not only have severe renal failure, but also have many comorbidities, which can be life-threatening and require timely treatment. Identifying the influencing factors of ATN and taking appropriate interventions can effectively shorten the duration of the disease to reduce mortality and improve patient prognosis. Methods: Mortality prediction models were constructed by using the random survival forest (RSF) algorithm and the Cox regression. Next, the performance of both models was assessed by the out-of-bag (OOB) error rate, the integrated b

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… | Death | Survival | p -value The treatment Antibiotic (%) | < 0.0001 No | 15(2.0) | 158(6.4) | Yes | 748(98.0) | 2,299(93.6) | Dobutamine (%) | 0.0008 No | 707(92.7) | 2,351(95.7) | Yes | 56(7.3) | 106(4.3) | Dopamine (%) | 0.0367 No | 700(91.7) | 2,307(93.9) | Yes | 63(8.3) | 150(6.1) | Nerve … 0.7-0.97) | 0.02 | 0.89(0.75-1.1) | 0.2 Ethnicity | 1.1(0.99-1.1) | 0.095 | | Weight | 0.99(0.99-1) | < 0.0001 | 1(0.99-1) | 0.095 First care unit | 1(0.95-1.1) | 0.76 | | Length of stay in the ICU | 0.96(0.95-0.97) | < 0.0001 | 0.95(0.94-0.95) | < 0.0001 Antibiotic | 1.1(0.58-1.9) | 0.85 | | Dobutamine …

Cancer-Therapy-Related Cardiac Dysfunction: Latest Advances in Prevention and Treatment.

The increasing efficacy of cancer therapies has significantly improved survival rates, but it has also highlighted the prevalence of cancer-therapy-related cardiac dysfunction (CTRCD). This review provides a comprehensive overview of the identification, monitoring, and management of CTRCD, a condition resulting from several treatments, such as anthracyclines, HER2-targeted therapies, target therapies, and radiotherapy. The paper includes a discussion of the mechanisms of CTRCD associated with various cancer treatments. Early detection through serum biomarkers and advanced imaging techniques is

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… A reduced contractile reserve (at least a 5% reduction) on dobutamine stress echocardiography in patients treated with anthracyclines identifies patients at high risk developing late LV systolic dysfunction early [ 39 , 40 ]. … Evaluation of cardiac reserved function by high-dose dobutamine stress echocardiography in asymptomatic anthracycline-treated survivors of childhood cancer. Pediatr. Int. 2006;48:313–320. doi: 10.1111/j.1442-200X.2006.02210.x. 41. …

Position Statement on the Use of Myocardial Strain in Cardiology Routines by the Brazilian Society of Cardiology's Department Of Cardiovascular Imaging - 2023.

Central Illustration : Position Statement on the Use of Myocardial Strain in Cardiology Routines by the Brazilian Society of Cardiology's Department Of Cardiovascular Imaging - 2023 Proposal for including strain in the integrated diastolic function assessment algorithm, adapted from Nagueh et al.67 Am: mitral A-wave duration; Ap: reverse pulmonary A-wave duration; DD: diastolic dysfunction; LA: left atrium; LASr: LA strain reserve; LVGLS: left ventricular global longitudinal strain; TI: tricuspid insufficiency. Confirm concentric remodeling with LVGLS. In LVEF, mitral E wave deceleration time

Therapeutic plasma exchange as rescue therapy in severe sepsis and septic shock: retrospective observational single-centre study of 23 patients.

BackgroundSeveral case series and small randomized controlled trials suggest that therapeutic plasma exchange (TPE) improves coagulation, hemodynamics and possibly survival in severe sepsis. However, the exact role of TPE in modern sepsis therapy remains unclear.MethodsWe performed a retrospective observational single-centre study on the use of TPE as rescue therapy in 23 consecutive patients with severe sepsis or septic shock from 2005 to 2012. Main surrogate markers of multiple organ failure (MOF) before, during and after TPE as well as survival rates are reported.ResultsAt baseline, mean SO

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… Norepinephrine was required by 21 (91%) during the ICU stay, vasopressin/terlipressin by 7 (30%), dobutamine by 7 (30%), and levosimendan by 1 patient (4%). … Norepinephrine plus dobutamine versus epinephrine alone for management of septic shock: a randomised trial. Lancet. 2007;370:676–84. doi: 10.1016/S0140-6736(07)61344-0. Jones AE, Trzeciak S, Kline JA. …

Krukenberg's Spindle-Like Corneal Changes in a Patient With Prolonged ICU Admission: A Case Report.

Krukenberg's spindles are vertical, spindle-shaped pigment deposits on the posterior cornea and are primarily associated with pigment dispersion syndrome (PDS). We present a case of Krukenberg's spindle-like corneal changes in a 39-year-old male patient following prolonged ICU management for thyroid storm complicated by infective endocarditis. The patient's complex ICU course included mechanical ventilation, veno-arterial extracorporeal membrane oxygenation (VA-ECMO), and multiple medications. Ophthalmological examination revealed bilateral, brownish, linear changes in the central corneal stro

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… Intravenous injection July 31 | August 1 | Rocuronium bromide | Intravenous injection July 31 | August 3 | Vancomycin hydrochloride | Intravenous injection July 31 | August 5 | Vasopressin | Intravenous injection July 31 | August 6 | Calcium gluconate hydrate | Intravenous injection July 31 | August 6 | Dobutamine …

Intractable right coronary artery spasm in the early postoperative period after heart transplantation: a case report.

Coronary artery spasm after heart transplantation is a very rare complication. In one observational study and many anecdotal reports, most cases of coronary artery spasm occurred more than 1 year after surgery and had good outcomes. However, cases of intractable coronary artery spasm during the early postoperative period resulting in fatality are limited. This report presents a case of two cardiac arrests caused by coronary artery spasms within a short period of time after heart transplantation.

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… After the procedure, intravascular nicorandil was continuously infused (1 mg/hr), while other vasodilators were not prescribed because of the pre-existing hypotension (94/54 mmHg with the support of vasoactive drugs: norepinephrine (16 μg/min), dopamine (10 μg/kg/min), and dobutamine (2.5 μg/kg/min). …

Teclistamab Treatment Followed by Heart Transplantation for Advanced Immunoglobulin Light Chain Amyloid Cardiomyopathy.

BackgroundImmunoglobulin light chain (AL) cardiac amyloidosis carries high mortality, particularly when refractory to standard plasma cell-directed therapy. Deep hematologic remission is essential for heart transplant eligibility.Case summaryA 37-year-old woman with advanced AL cardiomyopathy and refractory plasma cell dyscrasia did not respond to daratumumab-based therapy and could not tolerate venetoclax. She developed rapidly progressive, inotrope-dependent heart failure. Salvage therapy with a B-cell maturation antigen-directed bispecific antibody, teclistamab, induced a rapid, minimal res

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… The hemodynamic evaluation revealed low-output heart failure (Stevenson profile C), and she was started on a continuous dobutamine drip. During this time, her plasma cell dyscrasia progressed. …

Cardiovascular toxicities associated with chimeric antigen receptor T-cell therapy.

Chimeric antigen receptor (CAR) T-cell therapy has emerged as a groundbreaking immunotherapeutic approach, particularly for oncohematological patients who are refractory to conventional treatments. As clinical trials expand the applications of CAR T-cell therapy beyond hematologic malignancies, a critical understanding of its associated toxicities, particularly cardiovascular complications, becomes imperative. This review synthesizes current literature on the interplay between cytokine release syndrome (CRS) and cardiotoxicity related to CAR T-cell therapy, emphasizing the potential severity o

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… Supportive care and antipyretics are commonly used to manage mild CRS, including inotropic support with dobutamine or milrinone when necessary ( Faqihi et al., 2020 ; Ashkar et al., 2025 ). … Dobutamine , in StatPearls ( Treasure Island (FL) : StatPearls Publishing ). 29262042 Asnani A. ( 2018 ). Cardiotoxicity of immunotherapy: incidence, diagnosis, and management . Curr. Oncol. Rep. 20 ( 6 ), 44 . 10.1007/s11912-018-0690-1 29644505 Avelar E. Strickland C. R. Rosito G. ( 2017 ). …

Carfilzomib-induced sinus bradycardia: A case report and literature review.

Carfilzomib is a second-generation irreversible proteasome inhibitors commonly used in the treatment of relapsed or refractory multiple myeloma. However, cardiac toxicity (heart failure, hypertension, coronary heart disease, etc.) has become the main factor leading to its reduction or withdrawal. We report a case of a 55-year-old female patient with multiple myeloma who developed sinus bradycardia following the administration of carfilzomib, along with a review of the relevant literature. The correlation between carfilzomib and cardiotoxicity was assessed by reviewing the medical history, appl

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… None | \ | Symptomatic improvement | Reused Takakuwa et al. 24 | Female/74 | Carfilzomib | 2 days | Acute heart failure | None | Peripheral oxygen saturation reduced to 88%, ejection fraction reduced from 59% to 28%, radiography revealed pulmonary congestion with pleural effusions | Norepinephrine, dobutamine …

European Association of Cardiovascular Imaging/Cardiovascular Imaging Department of the Brazilian Society of Cardiology recommendations for the use of cardiac imaging to assess and follow patients after heart transplantation.

The cohort of long-term survivors of heart transplant is expanding, and the assessment of these patients requires specific knowledge of the … be considered taking into account the overall echocardiographic assessment and patient evaluation. Dobutamine stress echocardiography might be a suitable alternative to routine coronary angiography to assess cardiac allograft vasculopathy (CAV) at centres with adequate experience with the methodology. Coronary flow reserve and/or contrast infusion to assess …

Ethical pitfalls in neonatal comparative effectiveness trials.

Evidence-based medicine has been embraced wholeheartedly, and rightly so, as the best approach for reducing clinical uncertainty and ensurin … eas some of us do not, some of us reach for dopamine when blood pressure falls while some of us use dobutamine. For our patients, these uncertainties represent a lottery, the throw of the dice that determines whether they receive the treatment advocated by Dr. A or Dr. B. They deserve better than this. Randomization is considered the gold standard approach t …