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Wahl Z, Courbon C, Macindo JRB, Torres GCS, Lecoultre C. Surgical Patient Preoperative Readiness: Translation into French, Cultural Adaptation for Switzerland and Cross-Sectional Exploratory Study in a Tertiary Hospital. J Perianesth Nurs 2024:S1089-9472(24)00051-0. [PMID: 38819361 DOI: 10.1016/j.jopan.2024.02.005] [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: 10/18/2023] [Revised: 02/08/2024] [Accepted: 02/12/2024] [Indexed: 06/01/2024]
Abstract
PURPOSE Preoperative evaluation of elective surgery patients traditionally focuses on somatic and organizational aspects of the situation. Patient feelings of readiness, called preoperative readiness (PR), impacts postoperative outcomes, and yet is rarely evaluated. The Preoperative Assessment Tool (PART) is a validated and reliable 15-item questionnaire available in Filipino and English. A reliable tool is essential for evaluating PR within the Swiss health context to offer optimized and comprehensive perioperative care. The aim of this study was to both translate into French and adapt culturally the Preoperative Assessment Tool for Switzerland's francophone population, and to explore patient PR in the preoperative consultation within a Swiss tertiary hospital. DESIGN A mixed design with methodologic phases and descriptive study. METHODS A mixed design in two phases with a methodologic phase with (1) translation and (2) cultural adaptation for Romandie of the PART, following Wild's 10 steps methodology (n = 11) and (3) a cross-sectional exploratory descriptive study with pilot testing of the translated version in a general elective preoperative consultation in a tertiary hospital in Romandie (N = 88). FINDINGS Translation and cultural adaptations are well accepted and understood by the participants (n = 9/11), modifications are accepted by the authors and deemed adequate by the participants (n = 11/11). Time of completion is short (m = 69.06 seconds) and adapted to clinical context. The translated version has a Cronbach (α = 0.85) comparable to the original validated scale (α = 0.86). CONCLUSIONS The translation and cultural adaptation for Switzerland of the PART was achieved, and PR was explored. Further psychometric testing of the PART-FrenCH must be conducted to assess fully the tool before its use in a clinical setting. Including PR in preoperative evaluations could enhance patient-centered approaches and lead to improvement in the quality of care.
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Affiliation(s)
- Zoé Wahl
- Department of Nursing, Haute Ecole de Santé Vaud (HESAV), University of Applied Sciences and Arts Western Switzerland (HES-SO), Lausanne, Vaud, Switzerland; College of Nursing, Institute of Higher Education and Research in Healthcare, Lausanne University Hospital and University of Lausanne, Vaud, Switzerland.
| | - Cécile Courbon
- Department of Anesthesiology, University Hospital of Lausanne (CHUV), Lausanne, Vaud, Switzerland
| | | | - Gian Carlo S Torres
- College of Nursing, University of Santo Tomas, Manila, Philippines; College of Nursing, University of the Philippines, Manila, Philippines
| | - Claudia Lecoultre
- Department of Surgery and Cardio-Vascular, University Hospital of Lausanne (CHUV), Lausanne, Vaud, Switzerland
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Rabanal-Ruiz Y, Llanos-González E, Alcain FJ. The Use of Coenzyme Q10 in Cardiovascular Diseases. Antioxidants (Basel) 2021; 10:antiox10050755. [PMID: 34068578 PMCID: PMC8151454 DOI: 10.3390/antiox10050755] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 05/03/2021] [Accepted: 05/04/2021] [Indexed: 02/06/2023] Open
Abstract
CoQ10 is an endogenous antioxidant produced in all cells that plays an essential role in energy metabolism and antioxidant protection. CoQ10 distribution is not uniform among different organs, and the highest concentration is observed in the heart, though its levels decrease with age. Advanced age is the major risk factor for cardiovascular disease and endothelial dysfunction triggered by oxidative stress that impairs mitochondrial bioenergetic and reduces NO bioavailability, thus affecting vasodilatation. The rationale of the use of CoQ10 in cardiovascular diseases is that the loss of contractile function due to an energy depletion status in the mitochondria and reduced levels of NO for vasodilatation has been associated with low endogenous CoQ10 levels. Clinical evidence shows that CoQ10 supplementation for prolonged periods is safe, well-tolerated and significantly increases the concentration of CoQ10 in plasma up to 3–5 µg/mL. CoQ10 supplementation reduces oxidative stress and mortality from cardiovascular causes and improves clinical outcome in patients undergoing coronary artery bypass graft surgery, prevents the accumulation of oxLDL in arteries, decreases vascular stiffness and hypertension, improves endothelial dysfunction by reducing the source of ROS in the vascular system and increases the NO levels for vasodilation.
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Affiliation(s)
- Yoana Rabanal-Ruiz
- Department of Medical Sciences, Faculty of Medicine, University of Castilla-La Mancha, 13071 Ciudad Real, Spain; (Y.R.-R.); (E.L.-G.)
- Oxidative Stress and Neurodegeneration Group, Regional Centre for Biomedical Research CRIB, University of Castilla-La Mancha, 13071 Ciudad Real, Spain
| | - Emilio Llanos-González
- Department of Medical Sciences, Faculty of Medicine, University of Castilla-La Mancha, 13071 Ciudad Real, Spain; (Y.R.-R.); (E.L.-G.)
- Oxidative Stress and Neurodegeneration Group, Regional Centre for Biomedical Research CRIB, University of Castilla-La Mancha, 13071 Ciudad Real, Spain
| | - Francisco Javier Alcain
- Department of Medical Sciences, Faculty of Medicine, University of Castilla-La Mancha, 13071 Ciudad Real, Spain; (Y.R.-R.); (E.L.-G.)
- Oxidative Stress and Neurodegeneration Group, Regional Centre for Biomedical Research CRIB, University of Castilla-La Mancha, 13071 Ciudad Real, Spain
- Correspondence:
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Relationship Between Preoperative Gait Speed and Discharge Disposition After Open Heart Surgery: An Observational Study. Cardiopulm Phys Ther J 2020. [DOI: 10.1097/cpt.0000000000000123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Critical appraisal on the impact of preoperative rehabilitation and outcomes after major abdominal and cardiothoracic surgery: A systematic review and meta-analysis. Surgery 2020; 167:540-549. [DOI: 10.1016/j.surg.2019.07.032] [Citation(s) in RCA: 47] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Revised: 07/15/2019] [Accepted: 07/29/2019] [Indexed: 12/26/2022]
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Drudi LM, Tat J, Ades M, Mata J, Landry T, MacKenzie KS, Steinmetz OK, Gill HL. Preoperative Exercise Rehabilitation in Cardiac and Vascular Interventions. J Surg Res 2019; 237:3-11. [DOI: 10.1016/j.jss.2018.11.042] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Revised: 10/29/2018] [Accepted: 11/21/2018] [Indexed: 10/27/2022]
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Packiasabapathy S, Susheela AT, Mueller A, Patxot M, Gasangwa DV, O’Gara B, Shaefi S, Marcantonio ER, Yeh GY, Subramaniam B. Guided meditation as an adjunct to enhance postoperative recovery after cardiac surgery: study protocol for a prospective randomized controlled feasibility trial. Trials 2019; 20:39. [PMID: 30635064 PMCID: PMC6329114 DOI: 10.1186/s13063-018-3103-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Accepted: 12/04/2018] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Cardiac surgical procedures are associated with postoperative neurological complications such as cognitive decline and delirium, which can complicate recovery and impair quality of life. Perioperative depression and anxiety may be associated with increased mortality after cardiac surgeries. Surgical prehabilitation is an emerging concept that includes preoperative interventions to potentially reduce postoperative complications. While most current prehabilitation interventions focus on optimizing physical health, mind-body interventions are an area of growing interest. Preoperative mind-body interventions such as Isha Kriya meditation, may hold significant potential to improve postsurgical outcomes. METHODS This is a prospective, randomized controlled feasibility trial. A total of 40 adult patients undergoing cardiac surgery will be randomized to one of three study groups. Participants randomized to either of the two intervention groups will receive meditative intervention: (1) commencing two weeks before surgery; or (2) commencing only from the day after surgery. Meditative intervention will last for four weeks after the surgery in these groups. Participants in the third control group will receive the current standard of care with no meditative intervention. All participants will undergo assessments using neurocognitive, sleep, depression, anxiety, and pain questionnaires at various time points in the perioperative period. Blood samples will be collected at baseline, preoperatively, and postoperatively to assess for inflammatory biomarkers. The primary aim of this trial is to assess the feasibility of implementing a perioperative meditative intervention program. Other objectives include studying the effect of meditation on postoperative pain, sleep, psychological wellbeing, cognitive function, and delirium. These will be used to calculate effect size to design future studies. DISCUSSION This study serves as the first step towards understanding the feasibility of implementing a mind-body intervention as a prehabilitative intervention to improve postoperative surgical outcomes after cardiac surgery. TRIAL REGISTRATION Clinicaltrials.gov, NCT03198039 . Registered on 23 June 2017.
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Affiliation(s)
- Senthil Packiasabapathy
- Department of Anesthesia, Critical Care and Pain Medicine, Indiana University School of Medicine, 340 W 10th St #6200, Indianapolis, IN 46202 USA
| | - Ammu T. Susheela
- Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, 330 Brookline Ave, Boston, MA 02215 USA
- Harvard Medical School, 25 Shattuck St, Boston, MA 02115 USA
| | - Ariel Mueller
- Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, 330 Brookline Ave, Boston, MA 02215 USA
- Harvard Medical School, 25 Shattuck St, Boston, MA 02115 USA
| | - Melissa Patxot
- Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, 330 Brookline Ave, Boston, MA 02215 USA
| | - Doris-Vanessa Gasangwa
- Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, 330 Brookline Ave, Boston, MA 02215 USA
| | - Brian O’Gara
- Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, 330 Brookline Ave, Boston, MA 02215 USA
- Harvard Medical School, 25 Shattuck St, Boston, MA 02115 USA
| | - Shahzad Shaefi
- Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, 330 Brookline Ave, Boston, MA 02215 USA
- Harvard Medical School, 25 Shattuck St, Boston, MA 02115 USA
| | - Edward R. Marcantonio
- Harvard Medical School, 25 Shattuck St, Boston, MA 02115 USA
- Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center, 330 Brookline Ave, Boston, MA 02215 USA
| | - Gloria Y. Yeh
- Harvard Medical School, 25 Shattuck St, Boston, MA 02115 USA
- Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center, 330 Brookline Ave, Boston, MA 02215 USA
| | - Balachundhar Subramaniam
- Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, 330 Brookline Ave, Boston, MA 02215 USA
- Harvard Medical School, 25 Shattuck St, Boston, MA 02115 USA
- Beth Israel Deaconess Medical Center, 375 Longwood Avenue, W/MASCO-414, Boston, MA 02215 USA
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Torres GCS, Macindo JRB. Scale Development and Psychometric Evaluation of the Preoperative Assessment of Readiness Tool. J Perianesth Nurs 2018; 33:895-907. [DOI: 10.1016/j.jopan.2016.07.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2016] [Revised: 07/10/2016] [Accepted: 07/25/2016] [Indexed: 10/18/2022]
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Zozina VI, Covantev S, Goroshko OA, Krasnykh LM, Kukes VG. Coenzyme Q10 in Cardiovascular and Metabolic Diseases: Current State of the Problem. Curr Cardiol Rev 2018; 14:164-174. [PMID: 29663894 PMCID: PMC6131403 DOI: 10.2174/1573403x14666180416115428] [Citation(s) in RCA: 82] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Revised: 04/04/2018] [Accepted: 04/11/2018] [Indexed: 12/12/2022] Open
Abstract
The burden of cardiovascular and metabolic diseases is increasing with every year. Although the management of these conditions has improved greatly over the years, it is still far from perfect. With all of this in mind, there is a need for new methods of prophylaxis and treatment. Coenzyme Q10 (CoQ10) is an essential compound of the human body. There is growing evidence that CoQ10 is tightly linked to cardiometabolic disorders. Its supplementation can be useful in a variety of chronic and acute disorders. This review analyses the role of CoQ10 in hypertension, ischemic heart disease, myocardial infarction, heart failure, viral myocarditis, cardiomyopathies, cardiac toxicity, dyslipidemia, obesity, type 2 diabetes mellitus, metabolic syndrome, cardiac procedures and resuscitation.
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Affiliation(s)
- Vladlena I Zozina
- Department of Clinical Pharmacology and Propaedeutics of Internal Diseases, Federal State Autonomous Educational Institution of Higher Education I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation, Moscow, Russian Federation
| | - Serghei Covantev
- Laboratory of Allergology and Clinical Immunology, State University of Medicine and Pharmacy «Nicolae Testemitanu», Chisinau, Moldova, Republic of
| | - Olga A Goroshko
- Federal State Budgetary Institution "Scientific Centre for Expert Evaluation of Medical Products" of the Ministry of Health of the Russian Federation, Moscow, Russian Federation
| | - Liudmila M Krasnykh
- Federal State Budgetary Institution "Scientific Centre for Expert Evaluation of Medical Products" of the Ministry of Health of the Russian Federation, Moscow, Russian Federation
| | - Vladimir G Kukes
- Department of Clinical Pharmacology and Propaedeutics of Internal Diseases, Federal State Autonomous Educational Institution of Higher Education I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation, Moscow, Russian Federation
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Braun L, Stanguts C, Spitzer O, Hose L, Gunawan M, Kure CE, Kwa L, Esmore D, Bailey M, Rosenfeldt F. A wellness program for cardiac surgery improves clinical outcomes. ADVANCES IN INTEGRATIVE MEDICINE 2014. [DOI: 10.1016/j.aimed.2013.08.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Rosenfeldt F, Braun L, Spitzer O, Bradley S, Shepherd J, Bailey M, van der Merwe J, Leong JY, Esmore D. Physical conditioning and mental stress reduction--a randomised trial in patients undergoing cardiac surgery. Altern Ther Health Med 2011; 11:20. [PMID: 21385466 PMCID: PMC3063826 DOI: 10.1186/1472-6882-11-20] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2010] [Accepted: 03/09/2011] [Indexed: 01/14/2023]
Abstract
BACKGROUND Preoperative anxiety and physical unfitness have been shown to have adverse effects on recovery from cardiac surgery. This study involving cardiac surgery patients was primarily aimed at assessing the feasibility of delivering physical conditioning and stress reduction programs within the public hospital setting. Secondary aims were to evaluate the effect of these programs on quality of life (QOL), rates of postoperative atrial fibrillation (AF) and length of stay (LOS) in hospital. METHODS Elective patients scheduled for coronary artery bypass graft and/or valve surgery at a public hospital in Melbourne, Australia were enrolled. Patients were randomized to receive either holistic therapy (HT) or usual care (UC). HT consisted of a series of light physical exercise sessions together with a mental stress reduction program administered in an outpatient setting for the first two weeks after placement on the waiting list for surgery. A self-administered SF-36 questionnaire was used to measure QOL and hospital records to collect data on LOS and rate of postoperative AF. RESULTS The study population comprised 117 patients of whom 60 received HT and 57 received UC. Both programs were able to be delivered within the hospital setting but ongoing therapy beyond the two week duration of the program was not carried out due to long waiting periods and insufficient resources. HT, as delivered in this study, compared to UC did not result in significant changes in QOL, LOS or AF incidence. CONCLUSIONS Preoperative holistic therapy can be delivered in the hospital setting, although two weeks is insufficient to provide benefits beyond usual care on QOL, LOS or postoperative AF. Further research is now required to determine whether a similar program of longer duration, or targeted to high risk patients can provide measurable benefits. TRIAL REGISTRATION This trial was conducted as part of a larger study and according to the principles contained in the CONSORT statement 2001.
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Villalba JM, Parrado C, Santos-Gonzalez M, Alcain FJ. Therapeutic use of coenzyme Q10 and coenzyme Q10-related compounds and formulations. Expert Opin Investig Drugs 2010; 19:535-54. [PMID: 20367194 DOI: 10.1517/13543781003727495] [Citation(s) in RCA: 90] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
IMPORTANCE OF THE FIELD Coenzyme Q(10) (CoQ(10)) is found in blood and in all organs. CoQ(10) deficiencies are due to autosomal recessive mutations, ageing-related oxidative stress and carcinogenesis processes, and also statin treatment. Many neurodegenerative disorders, diabetes, cancer and muscular and cardiovascular diseases have been associated with low CoQ(10) levels, as well as different ataxias and encephalomyopathies. AREAS COVERED IN THIS REVIEW We review the efficacy of a variety of commercial formulations which have been developed to solubilise CoQ(10) and promote its better absorption in vivo, and its use in the therapy of pathologies associated with low CoQ(10) levels, with emphasis in the results of the clinical trials. Also, we review the use of its analogues idebenone and MitoQ. WHAT THE READER WILL GAIN This review covers the most relevant aspects related with the therapeutic use of CoQ(10), including existing formulations and their effects on its bioavailability. TAKE HOME MESSAGE CoQ(10) does not cause serious adverse effects in humans and new formulations have been developed that increase CoQ(10) absorption. Oral CoQ(10) is a viable antioxidant strategy in many diseases, providing a significant to mild symptomatic benefit. Idebenone and MitoQ are promising substitutive CoQ(10)-related drugs which are well tolerated and safe.
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Affiliation(s)
- Jose M Villalba
- Universidad de Córdoba, Facultad de Ciencias, Departamento de Biología Celular, Fisiología e Inmunología, Campus Universitario de Rabanales, Edificio Severo Ochoa, 3a planta 14014 Córdoba, Spain.
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Leong JY, van der Merwe J, Pepe S, Bailey M, Perkins A, Lymbury R, Esmore D, Marasco S, Rosenfeldt F. Perioperative metabolic therapy improves redox status and outcomes in cardiac surgery patients: A randomised trial. Heart Lung Circ 2010; 19:584-91. [DOI: 10.1016/j.hlc.2010.06.659] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2010] [Accepted: 06/07/2010] [Indexed: 10/19/2022]
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Shelley M, Pakenham KI, Frazer I. Cortisol changes interact with the effects of a cognitive behavioural psychological preparation for surgery on 12-month outcomes for surgical heart patients. Psychol Health 2009; 24:1139-52. [DOI: 10.1080/08870440802126704] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Tang HYJ, Harms V, Vezeau T. An Audio Relaxation Tool for Blood Pressure Reduction in Older Adults. Geriatr Nurs 2008; 29:392-401. [PMID: 19064137 DOI: 10.1016/j.gerinurse.2008.02.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2007] [Revised: 02/07/2008] [Accepted: 02/09/2008] [Indexed: 11/30/2022]
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Socioeconomic status and comorbidity as predictors of preoperative quality of life in cardiac surgery. J Thorac Cardiovasc Surg 2008; 136:665-72, 672.e1. [DOI: 10.1016/j.jtcvs.2008.04.016] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2007] [Revised: 02/27/2008] [Accepted: 04/06/2008] [Indexed: 11/23/2022]
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Pepe S, Leong JY, Merwe JVD, Marasco SF, Hadj A, Lymbury R, Perkins A, Rosenfeldt FL. Targeting oxidative stress in surgery: Effects of ageing and therapy. Exp Gerontol 2008; 43:653-657. [DOI: 10.1016/j.exger.2008.03.011] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2007] [Revised: 03/14/2008] [Accepted: 03/17/2008] [Indexed: 01/10/2023]
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van der Merwe J, Leong JY, Kaye D, Opat S, Bergin PJ, Taylor AJ, Rosenfeldt F. Antioxidant Therapy for Severe Cardiac Failure Induced by Iron Overload Secondary to Dyserythropoietic Anaemia. Heart Lung Circ 2007; 16:394-7. [PMID: 17314073 DOI: 10.1016/j.hlc.2006.12.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2006] [Revised: 11/24/2006] [Accepted: 12/19/2006] [Indexed: 01/29/2023]
Abstract
We present a case of a patient with longstanding transfusion-dependent congenital dyserythropoietic anaemia (CDA) who developed cardiomyopathy despite iron chelation therapy. She presented with severe heart failure that responded poorly to conventional therapy, recovering only when therapy was augmented with metabolic agents including antioxidants and with increased iron chelation. The present case gives support to the concept of treating oxidatively induced heart failure with metabolic and antioxidant therapy. This therapy may have wider application in refractory heart failure and in the prevention of cardiomyopathy in patients receiving regular red cell transfusions who are at risk of transfusional haemosiderosis.
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Hadj A, Pepe S, Rosenfeldt F. The Clinical Application of Metabolic Therapy for Cardiovascular Disease. Heart Lung Circ 2007; 16 Suppl 3:S56-64. [PMID: 17618830 DOI: 10.1016/j.hlc.2007.04.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Metabolic therapy involves the administration of a substance normally found in the body to enhance a metabolic reaction within the cell. This may be achieved in two ways. Firstly, for some systems a substance can be given to achieve greater than normal levels in the body so as to drive an enzymic reaction in a preferred direction. Secondly, metabolic therapy may be used to correct an absolute or relative deficiency of a cellular component. Thus, metabolic therapy differs greatly from most standard cardiovascular pharmacologic therapies such as the use of ACE Inhibitors, beta-blockers, statins and calcium channel antagonists that are given to block rather than enhance cellular processes.
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Affiliation(s)
- Anthony Hadj
- Cardiac Surgical Research Unit, Department of Cardiothoracic Surgery, Alfred Hospital and Baker Heart Research Institute, Victoria, Australia
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