1
|
Ghio S, Traversi E, Maestri R, Camporotondo R, Caporotondi A, Caprino A, Fasolino A, Guazzotti G, Scelsi L, Turco A, La Rovere MT. Sodium nitroprusside infusion in patients with advanced heart failure. Vascul Pharmacol 2024; 156:107395. [PMID: 38964495 DOI: 10.1016/j.vph.2024.107395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2024] [Revised: 06/01/2024] [Accepted: 06/16/2024] [Indexed: 07/06/2024]
Abstract
AIMS Advanced heart failure (AdvHF) poses significant treatment challenges, particularly when mechanical circulatory support or transplant options are unavailable, highlighting a gap in evidence-based medical management. The aim of this study was to evaluate the safety and effectiveness of sodium nitroprusside infusion (SNP) for enhancing systemic and renal perfusion in patients with AdvHF, with or without concomitant inotropic support. METHODS AND RESULTS We retrospectively analyzed the medical records of 406 patients with AdvHF admitted between October 2014 and September 2018 who received nocturnal SNP infusions for at least one week. In 55 patients with symptomatic hypotension or signs of peripheral hypoperfusion (differential systemic BP < 15 mmHg), continuous dobutamine infusion was added. In a subset of 155 patients who required multiple hospitalizations (median 3), data from the last hospitalization were used. No symptomatic hypotension leading to discontinuation of SNP (mean dose: 0.5 ± 0.1 μg/kg/min) was reported. Patients showed a significant increase in differential systemic blood pressure after infusion (29.2 ± 8.1 to 36.8 ± 11.6 mmHg, p < 0.001) independent of dobutamine use. Administration of SNP and dobutamine resulted in greater weight loss compared to SNP alone (-5.33 ± 7.02 vs -3.32 ± 4.0 kg, p < 0.003), but it was also associated with a significant increase in creatinine levels compared to SNP alone (+0.24 ± 0.87 vs +0.02 ± 0.43, p = 0.005). CONCLUSIONS The results show that SNP is a safe therapeutic choice in AdvHF patients with or without concomitant inotropic support and highlight the potential efficacy of nitroprusside in improving systemic and renal perfusion in these advanced patients.
Collapse
Affiliation(s)
- Stefano Ghio
- Division of Cardiology, Fondazione IRCCS Policlinico S.Matteo, Pavia, Italy.
| | - Egidio Traversi
- Department of Cardiac Rehabilitation, Istituti Clinici Scientifici Maugeri IRCCS, Montescano, Pavia, Italy
| | - Roberto Maestri
- Department of Cardiac Rehabilitation, Istituti Clinici Scientifici Maugeri IRCCS, Montescano, Pavia, Italy
| | - Rita Camporotondo
- Division of Cardiology, Fondazione IRCCS Policlinico S.Matteo, Pavia, Italy
| | - Angelo Caporotondi
- Department of Cardiac Rehabilitation, Istituti Clinici Scientifici Maugeri IRCCS, Montescano, Pavia, Italy
| | - Alessandra Caprino
- Department of Cardiac Rehabilitation, Istituti Clinici Scientifici Maugeri IRCCS, Montescano, Pavia, Italy
| | | | - Giampaolo Guazzotti
- Department of Cardiac Rehabilitation, Istituti Clinici Scientifici Maugeri IRCCS, Montescano, Pavia, Italy
| | - Laura Scelsi
- Division of Cardiology, Fondazione IRCCS Policlinico S.Matteo, Pavia, Italy
| | - Annalisa Turco
- Division of Cardiology, Fondazione IRCCS Policlinico S.Matteo, Pavia, Italy
| | - Maria Teresa La Rovere
- Department of Cardiac Rehabilitation, Istituti Clinici Scientifici Maugeri IRCCS, Montescano, Pavia, Italy
| |
Collapse
|
2
|
Ghio S, Mandurino-Mirizzi A, La Rovere MT, Traversi E, Lombardi C, Scelsi L, Senni M, Iacovoni A. Sodium nitroprusside for advanced heart failure. A metanalysis of literature data. Vascul Pharmacol 2023; 148:107140. [PMID: 36563732 DOI: 10.1016/j.vph.2022.107140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 12/03/2022] [Accepted: 12/17/2022] [Indexed: 12/24/2022]
Abstract
Advanced heart failure (HF) is associated with a very poor prognosis and places a big burden on health-care services. The gold standard treatment, i.e. long-term mechanical circulatory support or heart transplantation, is precluded in many patients but observational studies suggest that the use of SNP might be associated with favourable long-term clinical outcomes. We performed a metanalysis of published studies that compared sodium nitroprusside (SNP) with optimal medical therapy to examine the safety and efficacy of SNP as part of the treatment regimen of patients hospitalized for advanced heart failure (HF). We searched PUBMED, EMBASE and WEB OF SCIENCE for studies that compared SNP with optimal medical therapy in advanced HF on July 2022. After screening 700 full-text articles, data from two original articles were included in a combined analysis. The analysis demonstrated a 66% reduction in the odds of death in advanced HF patients treated with SNP. The results show the potential importance of the inclusion of SNP in the treatment regimen of patients hospitalized because of advanced HF and underlines that controlled, randomized studies are still required in this condition.
Collapse
Affiliation(s)
- S Ghio
- Division of Cardiology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
| | | | - M T La Rovere
- Department of Cardiac Rehabilitation, IRCCS Istituti Clinici Scientifici Maugeri, Montescano, Pavia, Italy
| | - E Traversi
- Department of Cardiac Rehabilitation, IRCCS Istituti Clinici Scientifici Maugeri, Montescano, Pavia, Italy
| | - C Lombardi
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Italy
| | - L Scelsi
- Division of Cardiology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - M Senni
- Division of Cardiology, ASST Papa Giovanni XXIII, Bergamo, Italy
| | - A Iacovoni
- Division of Cardiology, ASST Papa Giovanni XXIII, Bergamo, Italy
| |
Collapse
|
3
|
Read JM, Azih NI, Peters CJ, Gurtu V, Vishram-Nielsen JK, Wright SP, Alba AC, Gregoski MJ, Pilch NA, Hsu S, Genuardi MV, Inampudi C, Jackson GR, Pope N, Witer LP, Kilic A, Houston BA, Mak S, Birati EY, Tedford RJ. Hemodynamic reserve predicts early right heart failure after LVAD implantation. J Heart Lung Transplant 2022; 41:1716-1726. [PMID: 35934606 PMCID: PMC10729844 DOI: 10.1016/j.healun.2022.07.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 06/09/2022] [Accepted: 07/05/2022] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Early right heart failure (RHF) remains a major source of morbidity and mortality after left ventricular assist device (LVAD) implantation, yet efforts to predict early RHF have proven only modestly successful. Pharmacologic unloading of the left ventricle may be a risk stratification approach allowing for assessment of right ventricular and hemodynamic reserve. METHODS We performed a multicenter, retrospective analysis of patients who had undergone continuous-flow LVAD implantation from October 2011 to April 2020. Only those who underwent vasodilator testing with nitroprusside during their preimplant right heart catheterization were included (n = 70). Multivariable logistic regression was used to determine independent predictors of early RHF as defined by Mechanical Circulatory Support-Academic Research Consortium. RESULTS Twenty-seven patients experienced post-LVAD early RHF (39%). Baseline clinical characteristics were similar between patients with and without RHF. Patients without RHF, however, achieved higher peak stroke volume index (SVI) (30.1 ± 8.8 vs 21.7 ± 7.4 mL/m2; p < 0.001; AUC: 0.78; optimal cut-point: 22.1 mL/m2) during nitroprusside administration. Multivariable analysis revealed that peak SVI was significantly associated with early RHF, demonstrating a 16% increase in risk of early RHF per 1 ml/m2 decrease in SVI. A follow up cohort of 10 consecutive patients from July 2020 to October 2021 resulted in all patients being categorized appropriately in regards to early RHF versus no RHF according to peak SVI. CONCLUSION Peak SVI with nitroprusside administration was independently associated with post-LVAD early RHF while resting hemodynamics were not. Vasodilator testing may prove to be a strong risk stratification tool when assessing LVAD candidacy though additional prospective validation is needed.
Collapse
Affiliation(s)
| | | | - Carli J Peters
- Cardiovascular Division, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Vikram Gurtu
- Division of Cardiology, Department of Medicine, University Health Network, Toronto, Ontario, Canada
| | - Julie K Vishram-Nielsen
- Division of Cardiology, Department of Medicine, University Health Network, Toronto, Ontario, Canada
| | - Stephen P Wright
- Division of Cardiology, Department of Medicine, University Health Network, Toronto, Ontario, Canada
| | - Ana Carolina Alba
- Division of Cardiology, Department of Medicine, University Health Network, Toronto, Ontario, Canada
| | - Mathew J Gregoski
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC
| | - Nicole A Pilch
- Deparment of Pharmacy, Medical University of South Carolina, Charleston, SC
| | - Steven Hsu
- Division of Cardiology, Department of Medicine, John Hopkins School of Medicine, Baltimore, MD
| | - Michael V Genuardi
- Cardiovascular Division, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | | | - Gregory R Jackson
- Division of Cardiology, Medical University of South Carolina, Charleston, SC
| | - Nicholas Pope
- Division of Cardiothoracic Surgery, Department of Surgery, Medical University of South Carolina, Charleston, SC
| | - Lucas P Witer
- Division of Cardiothoracic Surgery, Department of Surgery, Medical University of South Carolina, Charleston, SC
| | - Arman Kilic
- Division of Cardiothoracic Surgery, Department of Surgery, Medical University of South Carolina, Charleston, SC
| | - Brian A Houston
- Division of Cardiology, Medical University of South Carolina, Charleston, SC
| | - Susanna Mak
- Division of Cardiology, Department of Medicine, University Health Network, Toronto, Ontario, Canada
| | - Edo Y Birati
- Cardiovascular Division, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA; Cardiovascular Division, Poriya Medical Center, Bar Ilan University, Isreal
| | - Ryan J Tedford
- Division of Cardiology, Medical University of South Carolina, Charleston, SC.
| |
Collapse
|
4
|
Chung CW, Liao BW, Huang SW, Chiou SJ, Chang CH, Lin SJ, Chen BH, Liu WL, Hu SH, Chuang YC, Lin CH, Hsu IJ, Cheng CM, Huang CC, Lu TT. Magnetic Responsive Release of Nitric Oxide from an MOF-Derived Fe 3O 4@PLGA Microsphere for the Treatment of Bacteria-Infected Cutaneous Wound. ACS APPLIED MATERIALS & INTERFACES 2022; 14:6343-6357. [PMID: 35080366 DOI: 10.1021/acsami.1c20802] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Nitric oxide (NO) is an essential endogenous signaling molecule regulating multifaceted physiological functions in the (cardio)vascular, neuronal, and immune systems. Due to the short half-life and location-/concentration-dependent physiological function of NO, translational application of NO as a novel therapeutic approach, however, awaits a strategy for spatiotemporal control on the delivery of NO. Inspired by the magnetic hyperthermia and magneto-triggered drug release featured by Fe3O4 conjugates, in this study, we aim to develop a magnetic responsive NO-release material (MagNORM) featuring dual NO-release phases, namely, burst and steady release, for the selective activation of NO-related physiology and treatment of bacteria-infected cutaneous wound. After conjugation of NO-delivery [Fe(μ-S-thioglycerol)(NO)2]2 with a metal-organic framework (MOF)-derived porous Fe3O4@C, encapsulation of obtained conjugates within the thermo-responsive poly(lactic-co-glycolic acid) (PLGA) microsphere completes the assembly of MagNORM. Through continuous/pulsatile/no application of the alternating magnetic field (AMF) to MagNORM, moreover, burst/intermittent/slow release of NO from MagNORM demonstrates the AMF as an ON/OFF switch for temporal control on the delivery of NO. Under continuous application of the AMF, in particular, burst release of NO from MagNORM triggers an effective anti-bacterial activity against both Gram-positive Staphylococcus aureus (S. aureus) and Gram-negative Escherichia coli (E. coli). In addition to the magneto-triggered bactericidal effect of MagNORM against E. coli-infected cutaneous wound in mice, of importance, steady release of NO from MagNORM without the AMF promotes the subsequent collagen formation and wound healing in mice.
Collapse
Affiliation(s)
- Chieh-Wei Chung
- Institute of Biomedical Engineering, National Tsing Hua University, Hsinchu 30013, Taiwan
| | - Bo-Wen Liao
- Institute of Biomedical Engineering, National Tsing Hua University, Hsinchu 30013, Taiwan
| | - Shu-Wei Huang
- Department of Emergency Medicine, Taipei Veterans General Hospital, Taipei 11217, Taiwan
| | - Show-Jen Chiou
- Department of Applied Chemistry, National Chiayi University, Chiayi 60004, Taiwan
| | - Cheng-Han Chang
- Department of Biomedical Engineering and Environmental Sciences, National Tsing Hua University, Hsinchu 30013, Taiwan
| | - Sheng-Ju Lin
- Institute of Biomedical Engineering, National Tsing Hua University, Hsinchu 30013, Taiwan
| | - Bo-Hao Chen
- National Synchrotron Radiation Research Center, Hsinchu 30076, Taiwan
| | - Wei-Ling Liu
- Department of Chemistry, National Taiwan Normal University, Taipei 11677, Taiwan
| | - Shang-Hsiu Hu
- Department of Biomedical Engineering and Environmental Sciences, National Tsing Hua University, Hsinchu 30013, Taiwan
| | - Yu-Chun Chuang
- National Synchrotron Radiation Research Center, Hsinchu 30076, Taiwan
| | - Chia-Her Lin
- Department of Chemistry, National Taiwan Normal University, Taipei 11677, Taiwan
| | - I-Jui Hsu
- Department of Molecular Science and Engineering, Research and Development Center of Smart Textile Technology, National Taipei University of Technology, Taipei 10608, Taiwan
| | - Chao-Min Cheng
- Institute of Biomedical Engineering, National Tsing Hua University, Hsinchu 30013, Taiwan
| | - Chieh-Cheng Huang
- Institute of Biomedical Engineering, National Tsing Hua University, Hsinchu 30013, Taiwan
| | - Tsai-Te Lu
- Institute of Biomedical Engineering, National Tsing Hua University, Hsinchu 30013, Taiwan
| |
Collapse
|
5
|
Paulo M, Costa DEFR, Bonaventura D, Lunardi CN, Bendhack LM. Nitric Oxide Donors as Potential Drugs for the Treatment of Vascular Diseases Due to Endothelium Dysfunction. Curr Pharm Des 2021; 26:3748-3759. [PMID: 32427079 DOI: 10.2174/1381612826666200519114442] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Accepted: 04/07/2020] [Indexed: 11/22/2022]
Abstract
Endothelial dysfunction and consequent vasoconstriction are a common condition in patients with hypertension and other cardiovascular diseases. Endothelial cells produce and release vasodilator substances that play a pivotal role in normal vascular tone. The mechanisms underlying endothelial dysfunction are multifactorial. However, enhanced reactive oxygen species (ROS) production and consequent vasoconstriction instead of endothelium-derived relaxant generation and consequent vasodilatation contribute to this dysfunction considerably. The main targets of the drugs that are currently used to treat vascular diseases concerning enzyme activities and protein functions that are impaired by endothelial nitric oxide synthase (eNOS) uncoupling and ROS production. Nitric oxide (NO) bioavailability can decrease due to deficient NO production by eNOS and/or NO release to vascular smooth muscle cells, which impairs endothelial function. Considering the NO cellular mechanisms, tackling the issue of eNOS uncoupling could avoid endothelial dysfunction: provision of the enzyme cofactor tetrahydrobiopterin (BH4) should elicit NO release from NO donors, to activate soluble guanylyl cyclase. This should increase cyclic guanosine-monophosphate (cGMP) generation and inhibit phosphodiesterases (especially PDE5) that selectively degrade cGMP. Consequently, protein kinase-G should be activated, and K+ channels should be phosphorylated and activated, which is crucial for cell membrane hyperpolarization and vasodilation and/or inhibition of ROS production. The present review summarizes the current concepts about the vascular cellular mechanisms that underlie endothelial dysfunction and which could be the target of drugs for the treatment of patients with cardiovascular disease.
Collapse
Affiliation(s)
- Michele Paulo
- Department Physics and Chemistry, Faculty of Pharmaceutical Sciences of Ribeirao Preto- University of Sao Paulo Av. Do Cafe SN, Brazil
| | - Daniela E F R Costa
- Department of Pharmacology, Biological Sciences Institute, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Daniella Bonaventura
- Department of Pharmacology, Biological Sciences Institute, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Claure N Lunardi
- Laboratory of Photochemistry and Nanobiotechnology, University of Brasilia, Brasilia, Brazil
| | - Lusiane M Bendhack
- Department Physics and Chemistry, Faculty of Pharmaceutical Sciences of Ribeirao Preto- University of Sao Paulo Av. Do Cafe SN, Brazil
| |
Collapse
|
6
|
Pieretti JC, Rubilar O, Weller RB, Tortella GR, Seabra AB. Nitric oxide (NO) and nanoparticles - Potential small tools for the war against COVID-19 and other human coronavirus infections. Virus Res 2021; 291:198202. [PMID: 33086123 PMCID: PMC7568847 DOI: 10.1016/j.virusres.2020.198202] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2020] [Revised: 10/11/2020] [Accepted: 10/14/2020] [Indexed: 12/12/2022]
Abstract
The endogenous free radical nitric oxide (NO) plays a pivotal role in the immunological system. NO has already been reported as a potential candidate for use in the treatment of human coronavirus infections, including COVID-19. In fact, inhaled NO has been used in clinical settings for its antiviral respiratory action, and in the regulation of blood pressure to avoid clot formation. In this mini-review, we discuss recent progress concerning the antivirus activity of NO in clinical, pre-clinical and research settings, and its beneficial effects in the treatment of clinical complications in patients infected with coronaviruses and other respiratory viral diseases, including COVID-19. We also highlight promising therapeutic effects of NO donors allied to nanomaterials to combat COVID-19 and other human coronavirus infections. Nanomaterials can be designed to deliver sustained, localized NO release directly at the desired application site, enhancing the beneficial effects of NO and minimizing the side effects. Challenges and perspectives are presented to open new fields of research.
Collapse
Affiliation(s)
- Joana C Pieretti
- Center for Natural and Human Sciences (CCNH), Federal University of ABC (UFABC), Santo André, SP, Brazil
| | - Olga Rubilar
- Department of Chemical Engineering, Universidad de La Frontera, Temuco, Chile; Centro de Excelencia en Investigación Biotecnologica Aplicada al Medio Ambiente (CIBAMA-BIOREN), Universidad de La Frontera, Temuco, Chile
| | - Richard B Weller
- Centre for Inflammation Research, University of Edinburgh, 47 Little France Crescent, Edinburgh, EH16 4TJ, UK
| | - Gonzalo R Tortella
- Department of Chemical Engineering, Universidad de La Frontera, Temuco, Chile; Centro de Excelencia en Investigación Biotecnologica Aplicada al Medio Ambiente (CIBAMA-BIOREN), Universidad de La Frontera, Temuco, Chile
| | - Amedea B Seabra
- Center for Natural and Human Sciences (CCNH), Federal University of ABC (UFABC), Santo André, SP, Brazil.
| |
Collapse
|
7
|
Hsiao HY, Chung CW, Santos JH, Villaflores OB, Lu TT. Fe in biosynthesis, translocation, and signal transduction of NO: toward bioinorganic engineering of dinitrosyl iron complexes into NO-delivery scaffolds for tissue engineering. Dalton Trans 2019; 48:9431-9453. [DOI: 10.1039/c9dt00777f] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
The ubiquitous physiology of nitric oxide enables the bioinorganic engineering of [Fe(NO)2]-containing and NO-delivery scaffolds for tissue engineering.
Collapse
Affiliation(s)
- Hui-Yi Hsiao
- Center for Tissue Engineering
- Chang Gung Memorial Hospital
- Taoyuan
- Taiwan
| | - Chieh-Wei Chung
- Institute of Biomedical Engineering
- National Tsing Hua University
- Hsinchu
- Taiwan
| | | | - Oliver B. Villaflores
- Department of Biochemistry
- Faculty of Pharmacy
- University of Santo Tomas
- Manila
- Philippines
| | - Tsai-Te Lu
- Institute of Biomedical Engineering
- National Tsing Hua University
- Hsinchu
- Taiwan
| |
Collapse
|
8
|
Yang T, Zelikin AN, Chandrawati R. Progress and Promise of Nitric Oxide-Releasing Platforms. ADVANCED SCIENCE (WEINHEIM, BADEN-WURTTEMBERG, GERMANY) 2018; 5:1701043. [PMID: 29938181 PMCID: PMC6010811 DOI: 10.1002/advs.201701043] [Citation(s) in RCA: 150] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/18/2017] [Revised: 01/24/2018] [Indexed: 05/05/2023]
Abstract
Nitric oxide (NO) is a highly potent radical with a wide spectrum of physiological activities. Depending on the concentration, it can enhance endothelial cell proliferation in a growth factor-free medium, mediate angiogenesis, accelerate wound healing, but may also lead to tumor progression or induce inflammation. Due to its multifaceted role, NO must be administered at a right dose and at the specific site. Many efforts have focused on developing NO-releasing biomaterials; however, NO short half-life in human tissues only allows this molecule to diffuse over short distances, and significant challenges remain before the full potential of NO can be realized. Here, an overview of platforms that are engineered to release NO via catalytic or noncatalytic approaches is presented, with a specific emphasis on progress reported in the past five years. A number of NO donors, natural enzymes, and enzyme mimics are highlighted, and recent promising developments of NO-releasing scaffolds, particles, and films are presented. In particular, key parameters of NO delivery are discussed: 1) NO payload, 2) maximum NO flux, 3) NO release half-life, 4) time required to reach maximum flux, and 5) duration of NO release. Advantages and drawbacks are reviewed, and possible further developments are suggested.
Collapse
Affiliation(s)
- Tao Yang
- School of Chemical EngineeringThe University of New South Wales (UNSW Sydney)SydneyNSW2052Australia
- School of Chemical and Biomolecular EngineeringThe University of SydneySydneyNSW2006Australia
| | - Alexander N. Zelikin
- Department of Chemistry and iNANO Interdisciplinary Nanoscience CenterAarhus UniversityAarhusC 8000Denmark
| | - Rona Chandrawati
- School of Chemical EngineeringThe University of New South Wales (UNSW Sydney)SydneyNSW2052Australia
- School of Chemical and Biomolecular EngineeringThe University of SydneySydneyNSW2006Australia
| |
Collapse
|
9
|
Hammond DA, Smith MN, Lee KC, Honein D, Quidley AM. Acute Decompensated Heart Failure. J Intensive Care Med 2016; 33:456-466. [PMID: 27638544 DOI: 10.1177/0885066616669494] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Heart failure (HF) is a societal burden due to its high prevalence, frequent admissions for acute decompensated heart failure (ADHF), and the economic impact of direct and indirect costs associated with HF and ADHF. Common etiologies of ADHF include medication and diet noncompliance, arrhythmias, deterioration in renal function, poorly controlled hypertension, myocardial infarction, and infections. Appropriate medical management of ADHF in patients is guided by the identification of signs and symptoms of fluid overload or low cardiac output and utilization of evidence-based practices. In patients with fluid overload, various strategies for diuresis or ultrafiltration may be considered. Depending on hemodynamics and patient characteristics, vasodilator, inotropic, or vasopressor therapies may be of benefit. Upon ADHF resolution, patients should be medically optimized, have lifestyle modifications discussed and implemented, and medication concierge service considered. After discharge, a multidisciplinary HF team should follow up with the patient to ensure a safe transition of care. This review article evaluates the management options and considerations when treating a patient with ADHF.
Collapse
Affiliation(s)
- Drayton A Hammond
- 1 Department of Pharmacy Practice, University of Arkansas for Medical Sciences College of Pharmacy, Little Rock, AR, USA
| | - Melanie N Smith
- 2 Department of Pharmacy, Medical University of South Carolina, Charleston, SC, USA
| | - Kristen C Lee
- 3 Department of Pharmacy, Orlando Regional Medical Center, Orlando, FL, USA
| | - Danielle Honein
- 4 Department of Pharmacy, Sarasota Memorial Hospital, Sarasota, FL, USA
| | | |
Collapse
|
10
|
Sani M, Sebai H, Refinetti R, Mondal M, Ghanem-Boughanmi N, Boughattas NA, Ben-Attia M. Effects of sodium nitroprusside on mouse erythrocyte catalase activity and malondialdehyde status. Drug Chem Toxicol 2016; 39:350-6. [PMID: 26738972 DOI: 10.3109/01480545.2015.1122032] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
There is controversy about the anti- or pro-oxidative effects of the nitric oxide (NO)-donor sodium nitroprusside (SNP). Hence, the activity of the antioxidant enzyme catalase (CAT) and the status of malondialdehyde (MDA) were investigated after a 2.5 mg/kg dose of SNP had been i.p. administered to different and comparable groups of mice (n = 48). The drug was administered at two different circadian times (1 and 13 h after light onset [HALO]). There were, irrespectively of sampling time, no significant differences in the means of CAT activity and MDA status between control and SNP-treated groups, no matter the treatment time. However, CAT activity was significantly (Student's t-test, p < 0.001) increased 1 h following SNP administration at 1 HALO, whereas the significant (p < 0.001) increase in the enzyme activity was found only 3 h after injection at 13 HALO. The drug dosing either at 1 or 13 HALO resulted in no significant differences of MDA status between control and treated groups regardless to the sampling time. Two-way analysis of variance (ANOVA) detected a significant (F0.05(7,88)= 5.3; p < 0.0006) interaction between sampling time and treatment in mice injected at 1 HALO, suggesting the influence of treatment on sampling-time-related changes in CAT activity. However, ANOVA validated no interaction between the two factors in mice treated at 13 HALO, illustrating that the sampling-time differences in enzyme activity were greater. Furthermore, two-way ANOVA revealed no interaction in the variation of MDA status in animals treated either at 1 or 13 HALO. This study indicates that SNP significantly affected the anti-oxidant system.
Collapse
Affiliation(s)
- Mamane Sani
- a Département De Biologie, Faculté Des Sciences Et Techniques De Maradi , UMR Biosurveillance Et Toxicologie Environnementale , Maradi , Niger .,c Circadian Rhythm Laboratory , Boise State University , Boise , ID , USA
| | - Hichem Sebai
- b Département Des Sciences De La Vie , UR Ethnobotanie Et Stress Oxydant , Zarzouna , Tunisia
| | - Roberto Refinetti
- c Circadian Rhythm Laboratory , Boise State University , Boise , ID , USA
| | - Mohan Mondal
- d National Dairy Research Institute , Kalyani , West Bengal , India
| | - Néziha Ghanem-Boughanmi
- b Département Des Sciences De La Vie , UR Ethnobotanie Et Stress Oxydant , Zarzouna , Tunisia
| | - Naceur A Boughattas
- e Laboratoire De Pharmacologie, Faculté De Médecine , Monastir , Tunisia , and
| | - Mossadok Ben-Attia
- f Laboratoire De Biosurveillance De L'environnement, Faculté Des Sciences De Bizerte , Zarzouna , Tunisia
| |
Collapse
|
11
|
Hottinger DG, Beebe DS, Kozhimannil T, Prielipp RC, Belani KG. Sodium nitroprusside in 2014: A clinical concepts review. J Anaesthesiol Clin Pharmacol 2014; 30:462-71. [PMID: 25425768 PMCID: PMC4234779 DOI: 10.4103/0970-9185.142799] [Citation(s) in RCA: 110] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Sodium nitroprusside has been used in clinical practice as an arterial and venous vasodilator for 40 years. This prodrug reacts with physiologic sulfhydryl groups to release nitric oxide, causing rapid vasodilation, and acutely lowering blood pressure. It is used clinically in cardiac surgery, hypertensive crises, heart failure, vascular surgery, pediatric surgery, and other acute hemodynamic applications. In some practices, newer agents have replaced nitroprusside, either because they are more effective or because they have a more favorable side-effect profile. However, valid and adequately-powered efficacy studies are sparse and do not identify a superior agent for all indications. The cyanide anion release concurrent with nitroprusside administration is associated with potential cyanide accumulation and severe toxicity. Agents to ameliorate the untoward effects of cyanide are limited by various problems in their practicality and effectiveness. A new orally bioavailable antidote is sodium sulfanegen, which shows promise in reversing this toxicity. The unique effectiveness of nitroprusside as a titratable agent capable of rapid blood pressure control will likely maintain its utilization in clinical practice for the foreseeable future. Additional research will refine and perhaps expand indications for nitroprusside, while parallel investigation continues to develop effective antidotes for cyanide poisoning.
Collapse
Affiliation(s)
- Daniel G Hottinger
- Department of Anesthesiology, University of Minnesota, Minneapolis, MN 55455, USA
| | - David S Beebe
- Department of Anesthesiology, University of Minnesota, Minneapolis, MN 55455, USA
| | - Thomas Kozhimannil
- Department of Anesthesiology, University of Minnesota, Minneapolis, MN 55455, USA
| | - Richard C Prielipp
- Department of Anesthesiology, University of Minnesota, Minneapolis, MN 55455, USA
| | - Kumar G Belani
- Department of Anesthesiology, University of Minnesota, Minneapolis, MN 55455, USA
| |
Collapse
|
12
|
Sani M, Sebai H, Ghanem-Boughanmi N, Boughattas NA, Ben-Attia M. Dosing-time dependent oxidative effects of sodium nitroprusside in brain, kidney, and liver of mice. ENVIRONMENTAL TOXICOLOGY AND PHARMACOLOGY 2014; 38:625-633. [PMID: 25199989 DOI: 10.1016/j.etap.2014.08.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/07/2014] [Revised: 08/17/2014] [Accepted: 08/18/2014] [Indexed: 06/03/2023]
Abstract
UNLABELLED The purpose of this study was to investigate if the oxidative effects of sodium nitroprusside (SNP) are dosing-time dependent. Therefore, the variation of malondialdehyde (MDA) status was assessed after a single i.p. administration of SNP (2.5mgkg(-1) b.w.) or vehicle (9‰ NaCl) to different and comparable groups of mice (n=48) at two different circadian times (1 and 13h after light onset [HALO]). Brain, kidney, and liver tissues were excised over 36h, and their MDA contents were estimated at 0, 1, 3, 6, 9, 12, 24, and 36h after SNP administration. RESULTS indicated mean MDA level was not significantly changed in each investigated tissue compared with the control. In contrast, the mean MDA value varied among organs and was comparable in brain and liver but lower than in kidney. The data show SNP significantly (P<0.05) increases MDA status in both tissues and exerts time-dependent oxidative effects with the greatest toxicity coinciding with the beginning of the diurnal rest span (local time: 08:00h, i.e., at 1 HALO). The obtained results reveal SNP-induced oxidative damage (evidenced by MDA accumulation) varies according to both the dosing-time and the target organ.
Collapse
Affiliation(s)
- Mamane Sani
- UMR Biosurveillance et Toxicologie Environnementale, Département de Biologie, Faculté des Sciences et Techniques de Maradi, 465 Maradi, Niger.
| | - Hichem Sebai
- UR Ethnobotanie et Stress Oxydant, Département des Sciences de la Vie, Faculté des Sciences de Bizerte, 7021 Zarzouna, Tunisia
| | - Néziha Ghanem-Boughanmi
- UR Ethnobotanie et Stress Oxydant, Département des Sciences de la Vie, Faculté des Sciences de Bizerte, 7021 Zarzouna, Tunisia
| | | | - Mossadok Ben-Attia
- Laboratoire de Biosurveillance de l'Environnement, Faculté des Sciences de Bizerte, 7021 Zarzouna, Tunisia
| |
Collapse
|
13
|
Cicci JD, Reed BN, McNeely EB, Oni-Orisan A, Patterson JH, Rodgers JE. Acute decompensated heart failure: evolving literature and implications for future practice. Pharmacotherapy 2013; 34:373-88. [PMID: 24214219 DOI: 10.1002/phar.1369] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Acute decompensated heart failure (ADHF) is associated with substantial morbidity and mortality, and represents a considerable financial burden to society. Historically, few prospective, randomized, double-blinded trials have investigated the optimal management of ADHF, and most guideline recommendations are based primarily on expert opinion. However, in the last decade, a considerable amount of research has added to the understanding of the management of ADHF in both patients with fluid overload and low cardiac output. In addition, as mechanical circulatory support devices and heart transplantation continue to evolve, significant advances have also been made with regard to the proper selection of patients for advanced surgical options. Finally, several novel pharmacologic agents have shown promise in early trials and may represent the next steps in ADHF management. Although advances have been made over the past decade, many questions remain.
Collapse
Affiliation(s)
- Jonathan D Cicci
- Department of Pharmacy, University of North Carolina Hospitals and Clinics, Chapel Hill, North Carolina
| | | | | | | | | | | |
Collapse
|
14
|
Shih YYI, Li G, Muir ER, De La Garza BH, Kiel JW, Duong TQ. Pharmacological MRI of the choroid and retina: blood flow and BOLD responses during nitroprusside infusion. Magn Reson Med 2011; 68:1273-8. [PMID: 22183830 DOI: 10.1002/mrm.24112] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2011] [Revised: 10/06/2011] [Accepted: 11/18/2011] [Indexed: 11/10/2022]
Abstract
Nitroprusside, a vasodilatory nitric oxide donor, is clinically used during vascular surgery and to lower blood pressure in acute hypertension. This article reports a novel application of blood flow (BF) and blood oxygenation level dependent (BOLD) MRI on an 11.7T scanner to image the rat chorioretinal BF and BOLD changes associated with graded nitroprusside infusion. At low doses (1 or 2 μg/kg/min), nitroprusside increased BF as expected but decreased BOLD signals, showing an intriguing BF-BOLD uncoupling. At high doses (3-5 μg/kg/min), nitroprusside decreased BF and markedly decreased BOLD signals. To our knowledge, this is the first pharmacological MRI application of the retina. This approach has potential to open up new avenues to study the drug-related hemodynamic functions and to evaluate the effects of novel therapeutic interventions on BOLD and BF in the normal and diseased retinas.
Collapse
Affiliation(s)
- Yen-Yu I Shih
- Research Imaging Institute, University of Texas Health Science Center, San Antonio, Texas 78229, USA.
| | | | | | | | | | | |
Collapse
|