RESUMEN
The loop of Henle plays a key role in kidney function, especially in retaining solutes and concentrating urine. Diuretic agents, crucial for managing fluid overload and related conditions like hypertension and heart failure (HF), enhance water and electrolyte excretion. The history of diuretics dates back to 1775 with the discovery of Digitalis, evolving significantly with the introduction of chlorothiazide in 1957, which revolutionized diuretic therapy. Loop diuretics, developed in the 1950s and including drugs like torsemide, furosemide, and ethacrynic acid, are potent agents acting on the loop of Henle. They are vital for treating severe fluid overload conditions and require careful monitoring to manage potential side effects.
Asunto(s)
Inhibidores del Simportador de Cloruro Sódico y Cloruro Potásico , Humanos , Furosemida/historia , Furosemida/uso terapéutico , Insuficiencia Cardíaca/tratamiento farmacológico , Insuficiencia Cardíaca/historia , Historia del Siglo XVIII , Historia del Siglo XIX , Historia del Siglo XX , Historia del Siglo XXI , Inhibidores del Simportador de Cloruro Sódico y Cloruro Potásico/historia , Inhibidores del Simportador de Cloruro Sódico y Cloruro Potásico/uso terapéuticoRESUMEN
The new Imperial era, Reiwa, started in May, 2019. After World War II, Reiwa is the third Imperial era following Showa and Heisei. In each era, we had specific healthcare problems in cardiovascular medicine and implemented preventive strategies against them. Furthermore, nationwide healthcare policies such as a universal healthcare insurance system (kaihoken) and health check-up system largely contribute to overcoming these problems. Here, we summarize the specific issues in cardiovascular medicine and nationwide strategies policies against them in each era. We also describe what we should do in the new Imperial era from the cardiovascular viewpoint.
Asunto(s)
Cardiología/tendencias , Política de Salud/tendencias , Insuficiencia Cardíaca/terapia , Atención de Salud Universal , Cobertura Universal del Seguro de Salud/tendencias , Cardiología/historia , Predicción , Política de Salud/historia , Insuficiencia Cardíaca/diagnóstico , Insuficiencia Cardíaca/epidemiología , Insuficiencia Cardíaca/historia , Historia del Siglo XX , Historia del Siglo XXI , Humanos , Japón/epidemiología , Formulación de Políticas , Factores de Tiempo , Cobertura Universal del Seguro de Salud/historiaRESUMEN
Heart transplantation has become a standard therapy option for advanced heart failure. The translation of heart transplantation from innovative experiments to long-term clinical success has married prescient insights with discipline and organization in the domains of surgical techniques, organ preservation, immunosuppression, organ donation and transplantation logistics, infection control, and long-term graft surveillance. This review explores the key milestones of the past 50 years of heart transplantation and discusses current challenges and promising innovations on the clinical horizon.
Asunto(s)
Insuficiencia Cardíaca/historia , Trasplante de Corazón/historia , Animales , Difusión de Innovaciones , Rechazo de Injerto/historia , Rechazo de Injerto/prevención & control , Supervivencia de Injerto , Insuficiencia Cardíaca/mortalidad , Insuficiencia Cardíaca/fisiopatología , Insuficiencia Cardíaca/cirugía , Trasplante de Corazón/efectos adversos , Trasplante de Corazón/mortalidad , Historia del Siglo XX , Historia del Siglo XXI , Humanos , Inmunosupresores/historia , Inmunosupresores/uso terapéutico , Preservación de Órganos/historia , Calidad de Vida , Recuperación de la Función , Factores de Riesgo , Recolección de Tejidos y Órganos/historia , Resultado del TratamientoRESUMEN
On October 17, 1849, Poland's greatest composer, Frédéric Chopin (1810-1849) died aged 39. His cause of death remains unknown. An investigation of the documental sources was performed to reconstruct the medical history of the artist. Since his earliest years, his life had been dominated by poor health. Recurrent episodes of cough, fever, headaches, lymphadenopathy- a series of symptoms that may be attributed to viral respiratory infections- manifested in his teens. Later in life, he had chest pain, hemoptysis, hematemesis, neuralgia, and arthralgia. Exhaustion and breathlessness characterized all his adult life. Coughing, choking, and edema of the legs and ankles manifested four months before his death. Several hypotheses ranging from cystic fibrosis to alpha-1 anti-trypsin deficiency and pulmonary tuberculosis have been proposed to explain Chopin's lifelong illness. We suggest that Chopin had dilated cardiomyopathy with consequent heart failure and cirrhosis that caused his death.
Asunto(s)
Cardiomiopatía Dilatada/historia , Personajes , Insuficiencia Cardíaca/historia , Música/historia , Cardiomiopatía Dilatada/complicaciones , Causas de Muerte , Insuficiencia Cardíaca/etiología , Historia del Siglo XIX , Humanos , Masculino , PoloniaAsunto(s)
Investigación Biomédica/historia , Cardiología/historia , Insuficiencia Cardíaca/historia , Agonistas de Receptores Adrenérgicos alfa 1/historia , Agonistas de Receptores Adrenérgicos alfa 1/uso terapéutico , Selección de Profesión , Insuficiencia Cardíaca/metabolismo , Insuficiencia Cardíaca/fisiopatología , Historia del Siglo XX , Historia del Siglo XXI , Humanos , Receptores Adrenérgicos alfa 1/historia , Reproducibilidad de los Resultados , Carga de TrabajoRESUMEN
Although detrimental effects of tumor necrosis factor-α (TNF-α) have been reported in failing myocardium, clinical trials using TNF-α antagonists did not show the benefit of TNF-α inhibition in patients with chronic heart failure (CHF). The double-edged effects of TNF-α/Toll-like receptors (TLRs)-related proinflammatory cytokines and downstream signal transduction, nuclear factor (NF)-κB activation on failing myocardium are discussed.
Asunto(s)
Insuficiencia Cardíaca/historia , Factor de Necrosis Tumoral alfa/metabolismo , Animales , Anticuerpos Monoclonales/historia , Anticuerpos Monoclonales/uso terapéutico , Insuficiencia Cardíaca/tratamiento farmacológico , Insuficiencia Cardíaca/metabolismo , Historia del Siglo XX , Ratones , Ratones Transgénicos , Factor de Necrosis Tumoral alfa/antagonistas & inhibidoresRESUMEN
Digoxin has been a key therapeutic for heart failure and atrial tachyarrhythmias for over 200â years following Withering's groundbreaking work depicting the therapeutic benefit of the common botanical foxglove in his 1785 monograph. The use of digoxin preceded any randomised evidence or even basic understanding of its mechanism of action. Over the past two decades, there has been mounting evidence further challenging the safety and efficacy of digoxin, while multiple other therapies for both heart failure and atrial tachyarrhythmias have proven to be more effective and safe. Altogether, digoxin still has an important role in contemporary pharmacotherapeutics, though its role remains controversial and should be reserved for selective patients and clinical situations, with careful attention to serum concentrations.
Asunto(s)
Cardiotónicos/administración & dosificación , Digoxina/administración & dosificación , Insuficiencia Cardíaca/tratamiento farmacológico , Taquicardia/tratamiento farmacológico , Cardiotónicos/farmacología , Digoxina/farmacología , Interacciones Farmacológicas , Medicina Basada en la Evidencia , Insuficiencia Cardíaca/historia , Insuficiencia Cardíaca/fisiopatología , Historia del Siglo XVIII , Historia del Siglo XIX , Historia del Siglo XX , Historia del Siglo XXI , Historia Antigua , Humanos , Estudios Retrospectivos , Taquicardia/historia , Taquicardia/fisiopatología , Resultado del TratamientoAsunto(s)
Insuficiencia Cardíaca , Infarto del Miocardio , Medicina de Precisión/historia , Ensayos Clínicos como Asunto , Insuficiencia Cardíaca/historia , Insuficiencia Cardíaca/prevención & control , Insuficiencia Cardíaca/terapia , Historia del Siglo XVIII , Historia del Siglo XIX , Historia del Siglo XX , Historia del Siglo XXI , Humanos , Infarto del Miocardio/historia , Infarto del Miocardio/prevención & control , Infarto del Miocardio/terapiaRESUMEN
This is an essay dealing with the 1785 cohort study by William Withering (the "account"), in which he reported the results of the treatment with foxglove (Digitalis purpurea) in 163 patients suffering from various forms of hydropsy (water retention). Withering reported the results of all patients, and classified them into responders and non-responders. He identified the responders as suffering from heart failure. In the 18th century, medical treatments were judged as successful if they complied with the criteria a priori of the theory of the four humors, and not on the patient's response to the treatment. Withering was the first not only to compare the patient's conditions before and after treatment, but also to identify the individual clinical characteristics of the patients who responded. In modern medicine, drugs are released on the market and approved for use after what is known as "population-derived clinical research", principally randomized controlled trials, and guidelines. More than 200 years ago, Withering anticipated the current and growing trend towards individual responses to treatment, and personalized medicine.
Asunto(s)
Digitalis/química , Insuficiencia Cardíaca/historia , Medicina de Precisión/historia , Edema/tratamiento farmacológico , Edema/historia , Insuficiencia Cardíaca/tratamiento farmacológico , Historia del Siglo XVIII , Humanos , Medicina de Precisión/métodos , Resultado del TratamientoAsunto(s)
Cardiología/historia , Cardiología/tendencias , Fármacos Cardiovasculares/uso terapéutico , Terapia Combinada , Insuficiencia Cardíaca/historia , Insuficiencia Cardíaca/terapia , Trasplante de Corazón/historia , Historia del Siglo XX , Historia del Siglo XXI , Humanos , Neprilisina/uso terapéutico , Estados UnidosRESUMEN
The topic of this article, stated a more familiar way, is whether left ventricular assist devices (LVADs) are ready for 'Primetime' as a therapeutic option in and of themselves. In order to provide an update and insight on this question, we briefly review from where the field has come, and in more detail describe its current state and where we are heading. We believe the short answer to this question is 'Yes', but like many things, a short answer is not adequate. Here we attempt to deliver a more comprehensive answer, providing some historical context, outlining the great achievements that have been made, as well as the many challenges that still remain before LVADs become a truly mainstream therapy.
Asunto(s)
Insuficiencia Cardíaca/terapia , Corazón Auxiliar , Análisis Costo-Beneficio , Insuficiencia Cardíaca/economía , Insuficiencia Cardíaca/historia , Corazón Auxiliar/economía , Corazón Auxiliar/historia , Historia del Siglo XX , Historia del Siglo XXI , Humanos , Calidad de Vida , Análisis de Supervivencia , Resultado del TratamientoRESUMEN
Heart failure (HF) is a progressive disease characterized by variable durations of symptomatic stability often punctuated by episodes of worsening despite continued therapy. These periods of clinical worsening are increasingly recognized as a distinct phase in the history of HF, termed worsening HF (WHF). The definition of WHF continues to evolve from a historical focus solely on hospitalization to now include nonhospitalization events (eg, need for intravenous diuretic therapy in the emergency or outpatient setting). Most HF clinical trials to date have had HF hospitalization and death as primary endpoints, and only recently, some studies have included other WHF events regardless of location of care. This article reviews the evolution of the WHF definition, highlights the importance of considering the onset of WHF as an event that marks a new phase of HF, summarizes the latest clinical trials investigating novel therapies, and outlines unmet needs regarding identification and treatment of WHF.