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  • Hurdles to Cardioprotection in the Critically Ill

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    Wells246643.pdf (794.6Kb)
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    Version of Record (VoR)
    Author(s)
    See Hoe, Louise E
    Bartnikowski, Nicole
    Wells, Matthew A
    Suen, Jacky Y
    Fraser, John F
    Griffith University Author(s)
    See Hoe, Louise
    Wells, Matt A.
    Year published
    2019
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    Abstract
    Cardiovascular disease is the largest contributor to worldwide mortality, and the deleterious impact of heart failure (HF) is projected to grow exponentially in the future. As heart transplantation (HTx) is the only effective treatment for end-stage HF, development of mechanical circulatory support (MCS) technology has unveiled additional therapeutic options for refractory cardiac disease. Unfortunately, despite both MCS and HTx being quintessential treatments for significant cardiac impairment, associated morbidity and mortality remain high. MCS technology continues to evolve, but is associated with numerous disturbances ...
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    Cardiovascular disease is the largest contributor to worldwide mortality, and the deleterious impact of heart failure (HF) is projected to grow exponentially in the future. As heart transplantation (HTx) is the only effective treatment for end-stage HF, development of mechanical circulatory support (MCS) technology has unveiled additional therapeutic options for refractory cardiac disease. Unfortunately, despite both MCS and HTx being quintessential treatments for significant cardiac impairment, associated morbidity and mortality remain high. MCS technology continues to evolve, but is associated with numerous disturbances to cardiac function (e.g., oxidative damage, arrhythmias). Following MCS intervention, HTx is frequently the destination option for survival of critically ill cardiac patients. While effective, donor hearts are scarce, thus limiting HTx to few qualifying patients, and HTx remains correlated with substantial post-HTx complications. While MCS and HTx are vital to survival of critically ill cardiac patients, cardioprotective strategies to improve outcomes from these treatments are highly desirable. Accordingly, this review summarizes the current status of MCS and HTx in the clinic, and the associated cardiac complications inherent to these treatments. Furthermore, we detail current research being undertaken to improve cardiac outcomes following MCS/HTx, and important considerations for reducing the significant morbidity and mortality associated with these necessary treatment strategies.
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    Journal Title
    International Journal of Molecular Sciences
    Volume
    20
    Issue
    15
    DOI
    https://doi.org/10.3390/ijms20153823
    Copyright Statement
    © 2019 by the authors. Licensee MDPI, Basel, Switzerland. This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited (CC BY 4.0).
    Subject
    Other chemical sciences
    Genetics
    Other biological sciences
    Cardiovascular medicine and haematology
    Clinical sciences
    cardioprotection
    heart failure
    heart transplantation
    mechanical circulatory support
    cardioprotection
    Publication URI
    http://hdl.handle.net/10072/386621
    Collection
    • Journal articles

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