Publications by authors named "Peter Natov"
Background: The ATHENA-HF (Aldosterone Targeted Neurohormonal Combined with Natriuresis Therapy in Heart Failure) clinical trial found no improvements in natriuretic peptide levels or clinical congestion when spironolactone 100 mg/day for 96 hours was used in addition to usual treatment for acute heart failure.
Methods: We performed a post hoc analysis of ATHENA-HF to determine whether spironolactone treatment induced any detectable pharmacodynamic effects and whether patients with potentially greater aldosterone activity experienced additional decongestion. Trial subjects previously treated with spironolactone were excluded.
Article Synopsis
- A study analyzed data from 7,070 patients with cardiogenic shock (CS), finding that 5.6% developed acute limb ischemia (ALI), particularly among women and those with peripheral arterial disease.* -
- ALI incidence increased with the severity of CS, with highest rates among patients using advanced support devices like VA-ECMO and balloon pumps, yet less than half used distal perfusion catheters.* -
- Mortality rates were significantly higher for patients with ALI (57.4%) compared to those without (38.0%), highlighting ALI's severe impact on survival in CS patients.*
Article Synopsis
- Cardiolipin is crucial for mitochondrial function and is impacted by VA-ECMO, which is used in treating acute myocardial infarction, but its effects on heart damage are not well understood.
- The study found that both human patients requiring VA-ECMO and healthy swine subjected to this treatment showed significantly lower levels of cardiolipin and the enzyme tafazzin, indicating potential detrimental effects on the heart.
- Importantly, VA-ECMO increased heart damage during ischemia/reperfusion, evidenced by a larger infarct size in swine, suggesting that depleting cardiolipin during treatment may worsen myocardial injury.
Background: Improvement in renal function (IRF) in acute decompensated heart failure is associated with adverse outcomes. The mechanisms driving this paradox remain undefined.
Methods: Using the ROSE-AHF study (Renal Optimization Strategies Evaluation-Acute Heart Failure), 277 patients were grouped according to renal function, with IRF defined by a ≥20% increase (N=75), worsening renal function by a ≥20% decline (N=53), and stable renal function (SRF) by a <20% change (N=149) in estimated glomerular filtration rate between baseline and 72 hours.
Background Because of discrepancies between donor supply and recipient demand, the cardiac transplantation process aims to prioritize the most medically urgent patients. It remains unknown how recipients with the lowest medical urgency compare to others in the allocation process. We aimed to examine differences in clinical characteristics, organ allocation patterns, and outcomes between cardiac transplantation candidates with the lowest and highest medical urgency.
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- Researchers found that a special process called O-GlcNAc helps protect cells from damage during stress by changing certain proteins.
- There are only two important proteins, OGT and O-GlcNAcase, that add and remove O-GlcNAc from many other proteins.
- The study showed that over 130 proteins interact with OGT, and some of these interactions change when the cell is under stress, helping scientists understand how OGT works better.
Revascularization in Cardiogenic Shock and Advanced Heart Failure.
Curr Treat Options Cardiovasc Med
February 2019
Purpose Of Review: Ischemic heart disease is the most common cause of heart failure with systolic dysfunction. The progressive course of heart failure characterized by increasing levels of care and worsening quality of life often indicates an advanced stage. Similarly, cardiogenic shock remains a major clinical problem with prohibitively high mortality rates despite major advances in clinical care.
View Article and Find Full Text PDFBackground: Acute heart failure refractory to medical therapy is a major cause of morbidity and mortality. The Aortix device (Procyrion Inc) is a percutaneously delivered entrainment pump positioned in the descending aorta.
Methods And Results: Using the newest generation Aortix device in 8 adult male Yorkshire swine, we tested the hypothesis that positioning in the abdominal aorta may provide superior hemodynamic effects than thoracic positioning in a swine model of postinfarct left ventricular injury.
Article Synopsis
- Heart failure following acute myocardial infarction (AMI) significantly impacts patient health, and research indicates that reducing left ventricular (LV) work before restoring blood flow (primary unloading) could minimize heart damage.
- This study in male swine showed that 30 minutes of LV unloading before reperfusion effectively reduced infarct size and improved heart function long-term, compared to immediate reperfusion.
- Mechanistic findings revealed that unloading enhances cellular respiration and protects against heart tissue damage by increasing levels of a cardioprotective protein (SDF-1α), ultimately leading to less scar tissue and better cardiac performance after 28 days.
Article Synopsis
- Heart failure is a critical health concern that involves the development of cardiac fibrosis, which can worsen heart function; TGF-β1 is a key player in promoting fibrosis but also has regulatory pathways, while BMP9, a TGF-β family member, may help mitigate this effect.
- Research indicates that BMP9 levels are elevated in heart failure patients and that it reduces collagen production in human cardiac fibroblasts, suggesting a protective role against fibrosis.
- In animal models, BMP9 treatment showed potential benefits in reducing cardiac fibrosis and improving heart function, while disruption of endoglin, which interacts with BMP9, further enhances BMP9's positive effect on the heart.
Stress-induced O-GlcNAcylation: an adaptive process of injured cells.
Biochem Soc Trans
February 2017
In the 30 years, since the discovery of nucleocytoplasmic glycosylation, -GlcNAc has been implicated in regulating cellular processes as diverse as protein folding, localization, degradation, activity, post-translational modifications, and interactions. The cell co-ordinates these molecular events, on thousands of cellular proteins, in concert with environmental and physiological cues to fine-tune epigenetics, transcription, translation, signal transduction, cell cycle, and metabolism. The cellular stress response is no exception: diverse forms of injury result in dynamic changes to the -GlcNAc subproteome that promote survival.
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