更新于：2024-11-01

Edema, Cardiac

心源性水肿

更新于：2024-11-01

基本信息

别名

Cardiac Edema、Cardiac Edemas、Cardiac edema

+ [33]

简介

Abnormal fluid retention by the body due to impaired cardiac function or heart failure. It is usually characterized by increase in venous and capillary pressure, and swollen legs when standing. It is different from the generalized edema caused by renal dysfunction (NEPHROTIC SYNDROME).

关联

项与心源性水肿相关的药物

Tolvaptan Sodium Phosphate

托伐普坦磷酸钠

靶点

AVPR2

作用机制

AVPR2拮抗剂

在研机构

Otsuka Pharmaceutical Co., Ltd. [+1]

原研机构

Otsuka Pharmaceutical Co., Ltd.

在研适应症

体液潴留 [+2]

非在研适应症-

最高研发阶段批准上市

首次获批国家/地区

日本

首次获批日期2022-03-28

Etelcalcetide

盐酸依特卡肽

靶点

CaSR

作用机制

CaSR激动剂

在研机构

原研机构

在研适应症

非在研适应症

最高研发阶段批准上市

首次获批国家/地区

欧盟 [+3]

首次获批日期2016-11-11

Tolvaptan

托伐普坦

靶点

AVPR2

作用机制

AVPR2拮抗剂

在研机构

Otsuka Pharmaceutical Co., Ltd. [+5]

原研机构

Otsuka Holdings Co., Ltd.

在研适应症

腹水 [+7]

非在研适应症

急性失代偿性心力衰竭 [+14]

最高研发阶段批准上市

首次获批国家/地区

美国

首次获批日期2009-05-19

项与心源性水肿相关的临床试验

NCT06021860 / Not yet recruiting临床4期

A Phase IV, Two-part, Open-label Study Assessing the Pharmacokinetics, Safety and Pharmacodynamics of Single and Multiple Doses of Spironolactone Oral Suspension in Pediatric Patients With Edema Due to Heart Failure or Cirrhosis

This is a 2-part, 2 periods per part, open-label study with spironolactone oral suspension in pediatric patients with edema due to HF or hepatic cirrhosis. Both study parts will evaluate the safety, PK and PD of multiple doses of spironolactone in patients aged from birth to ≤17 years of age.

开始日期2024-06-01

申办/合作机构

CMP Development LLC

JPRN-jRCT2071220069 / Recruiting临床2期IIT

A Multicenter, Randomized, Double-blind, Placebo-controlled, Parallel-group, Doseranging Trial of OPC-131461 in Cardiac Edema (Congestive Heart Failure [CHF])

开始日期2023-01-10

申办/合作机构-

NCT05615363 / Recruiting临床2期

A Multicenter, Randomized, Double-blind, Placebo-controlled, Parallel-group, Doseranging Trial of OPC-131461 in Cardiac Edema (Congestive Heart Failure [CHF])

To investigate the dose response in respect of weight decrease following repeated oral administration of OPC-131461 at 1, 2, 5, and 10 mg or placebo in patients with CHF with volume overload despite having received diuretics other than vasopressin antagonists

开始日期2023-01-10

申办/合作机构

Otsuka Pharmaceutical Co., Ltd.

100 项与心源性水肿相关的临床结果

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100 项与心源性水肿相关的转化医学

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0 项与心源性水肿相关的专利（医药）

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595

项与心源性水肿相关的文献（医药）

2024-12-01·Molecular Biology Reports

Inhibition of cytochrome P450 epoxygenase promotes endothelium-to-mesenchymal transition and exacerbates doxorubicin-induced cardiovascular toxicity

Article

作者: Maayah, Zaid H ; Therachiyil, Lubna ; Younis, Shahd M ; Yalcin, Huseyin C ; Dhulkifle, Hevna ; Sayed, Tahseen S ; Hasan, Maram H ; Korashy, Hesham M

AbstractBackgroundDoxorubicin (DOX) is a potent chemotherapy widely used in treating various neoplastic diseases. However, the clinical use of DOX is limited due to its potential toxic effect on the cardiovascular system. Thus, identifying the pathway involved in this toxicity may help minimize chemotherapy risk and improve cancer patients’ quality of life. Recent studies suggest that Endothelial-to-Mesenchymal transition (EndMT) and endothelial toxicity contribute to the pathogenesis of DOX-induced cardiovascular toxicity. However, the molecular mechanism is yet unknown. Given that arachidonic acid and associated cytochrome P450 (CYP) epoxygenase have been involved in endothelial and cardiovascular function, we aimed to examine the effect of suppressing CYP epoxygenases on DOX-induced EndMT and cardiovascular toxicity in vitro and in vivo.Methods and ResultsTo test this, human endothelial cells were treated with DOX, with or without CYP epoxygenase inhibitor, MSPPOH. We also investigated the effect of MSPPOH on the cardiovascular system in our zebrafish model of DOX-induced cardiotoxicity. Our results showed that MSPPOH exacerbated DOX-induced EndMT, inflammation, oxidative stress, and apoptosis in our endothelial cells. Furthermore, we also show that MSPPOH increased cardiac edema, lowered vascular blood flow velocity, and worsened the expression of EndMT and cardiac injury markers in our zebrafish model of DOX-induced cardiotoxicity.ConclusionOur data indicate that a selective CYP epoxygenase inhibitor, MSPPOH, induces EndMT and endothelial toxicity to contribute to DOX-induced cardiovascular toxicity.

2024-11-01·Aquatic Toxicology

Aryl phosphate ester-induced pericardial edema in zebrafish embryos is influenced by the ionic composition of exposure media

Article

作者: Mersman, Zoe ; Volz, David C ; Wiegand, Jenna ; Volz, David C. ; Jimenez, Nicholas ; Michalicek, Kevin ; Hoang, John

Pericardial edema - fluid accumulation within the pericardium - is a frequently observed malformation in zebrafish embryo-based chemical toxicity screens. We recently discovered that the severity of triphenyl phosphate (TPHP)-induced pericardial edema was dependent on the ionic strength of exposure media. TPHP is an aryl phosphate ester (APE) widely used as a plasticizer and flame retardant. APEs are characterized by having one or more aryl groups bound to a phosphate center, with TPHP containing only unsubstituted aryl groups. Therefore, the objective of this study was to begin investigating whether, similar to TPHP, pericardial edema induced by other structurally related APEs is dependent on the ionic composition of exposure media. We first mined the peer-reviewed literature to identify other APEs that 1) induced pericardial edema in zebrafish embryos within a minimum of three peer-reviewed publications, and 2) demonstrated a statistically significant induction of pericardial edema in at least 70 % of the studies evaluated. Based on this meta-analysis, we identified four other APEs that caused pericardial edema in zebrafish embryos: isopropylated triphenyl phosphate (IPTPP), cresyl diphenyl phosphate (CDP), tricresyl phosphate (TMPP), and 2-ethylhexyl diphenyl phosphate (EDHPHP). Using TPHP as a positive control and pericardial edema as a readout, we developed concentration-response curves for all four APEs based on static exposure from 24 to 72 h post-fertilization (hpf). We then conducted co-exposures with D-Mannitol (an osmotic diuretic) and exposures within reverse osmosis (RO) water determine whether the ionic composition of exposure media mitigated APE-induced pericardial edema at 72 hpf. Using pericardial edema as an endpoint, the approximate EC₅₀s for TPHP (positive control), IPTPP, CDP, TMPP, and EDHPHP were 6.25, 3.125, 3.125, 25, and 100 µM, respectively, based on exposure from 24 to 72 hpf. Interestingly, similar to our findings with TPHP, co-exposure with D-Mannitol and exposure within ion-deficient water significantly mitigated IPTPP- CDP-, TMPP-, and EDHPHP-induced pericardial edema in zebrafish embryos, suggesting that chemically-induced pericardial edema may be 1) dependent on the ionic composition of exposure media and 2) driven by a disruption in osmoregulation across the embryonic epidermis. Therefore, similar to other assay parameters, our findings underscore the need to standardize the osmolarity of exposure media in order to minimize the potential for false positive/negative hits in zebrafish embryo-based chemical toxicity screens conducted around the world.

2024-11-01·Cardiovascular Toxicology

Therapeutic Efficacy of Selenium Pre-treatment in Mitigating Cadmium-Induced Cardiotoxicity in Zebrafish (Danio rerio)

Article

作者: Noor, Md Imran ; Covington, Myles A ; Guevara, Gabriella A ; Heuer, Rachael M ; Heuer, Rachael M. ; Covington, Myles A. ; Shelton, Delia S ; Falagan-Lotsch, Priscila ; Umeh, Olaedo G. ; Guevara, Gabriella A. ; Deperalto, Madison ; Shelton, Delia S. ; Koop, Rebekka R. ; Koop, Rebekka R ; Okutsu, Jessica ; Umeh, Olaedo G

AbstractCardiovascular diseases are a rampant public health threat. Environmental contaminants, such as Cadmium (Cd), a toxic metal, are risk factors for cardiovascular diseases. Given that human exposure to Cd is increasing, there is a need for therapies to ameliorate Cd toxicity. Selenium (Se), an essential trace element, has been proposed to rescue the effects of Cd toxicity, with mixed effects. Se's narrow therapeutic window necessitates precise dosing to avoid toxicity. Here, we assessed the effects of various waterborne Cd and Se concentrations and sequences on cardiac function using zebrafish (Danio rerio). We showed that Cd induced pericardial edemas and modified heart rates in zebrafish larvae in a concentration-dependent manner. To identify the therapeutic range of Se for Cd-induced cardiotoxicity, zebrafish embryos were treated with 0, 10, 50, 100, 150, or 200 μg/L Se for 1–4 days prior to exposure to 2.5 and 5 μg/L Cd. We found that a 50 µg/L Se pre-treatment before 2.5 μg/L Cd, but not 5 μg/L Cd, reduced the prevalence of pericardial edemas and ameliorated Cd-induced bradycardia in zebrafish. Zebrafish exposed to 10 and 50 μg/L of Se for up to 4 days showed typical heart morphology, whereas other Se-exposed and control fish presented pericardial edemas. Longer Se pre-treatment durations led to fewer incidences of pericardial edemas. Overall, this study highlights the importance of optimizing Se concentrations and pre-treatment periods to harness its protective effects against Cd-induced cardiotoxicity. These findings provide insights into potential therapeutic strategies for reducing Cd-related cardiovascular damage in humans.Graphical Abstract

项与心源性水肿相关的新闻（医药）

2022-07-22

·丁香园

左氧+呋塞米静推差点出大事？左氧氟沙星的配伍禁忌不可不知

病例再现：患者，男性，69 岁，因「咽部堵塞感、胸闷伴间歇性胸痛 4 天」，住院给予祛痰止咳、预防感染、活血化瘀、稳定心律及其他对症支持治疗。在静脉输注左氧氟沙星时，给予呋塞米注射液 20 mg 静脉注射，输液管中出现白色浑浊状现象，予立即重新更换输液管；将药物更换成生理盐水，再给予呋塞米注射液 20 mg 静脉注射，液体呈透明状，静滴完毕后患者无不适。左氧氟沙星为氧氟沙星的左旋异构体，其抗菌活性是氧氟沙星的 2 倍，可通过抑制细菌 DNA 复制、转录、修复和重组所需的拓扑异构酶 IV 和 DNA 促旋酶发挥抗菌作用，具有抗菌谱广、抗菌作用强特点，对革兰氏阳性菌和革兰氏阴性菌有高度的抗菌活性。呋塞米为强效髓袢利尿剂，临床主要用于水肿型疾病包括心源性水肿、肾性水肿、肝硬化水肿、功能障碍或血管障碍所引起的周围性水肿尤其适用于急需消除水肿的紧急情况如急性肺水肿、脑水肿和高血压危象等。一般用法为入壶静滴。呋塞米抑制肾小管髓袢厚壁段对 NaCl 的主动重吸收起到利尿作用，可避免左氧氟沙星引起结晶尿现象。多篇报道曾指出当两种药物溶液混合时会有乳白色絮状物出现。有研究者将注射用左氧氟沙星 0.3 g 溶于生理盐水 100 mL 中静脉滴注时给予呋塞米 40mg 入壶，滴管内液体立即呈现浑浊，并出现白色絮状物，将上述两种药物分别取 1 mL 混合，注射器中同样出现白色絮状物，放置 24 h 无变化，从而证明两种药物的确存在配伍禁忌。下表总结了左氧氟沙星常见配伍禁忌总结左氧氟沙星临床应用广泛 , 联合用药的现象较为常见，临床医务人员需要充分掌握左氧氟沙星注射液常见的配伍禁忌，保障药物应用安全性。当左氧氟沙星注射液需要与其他药物联合使用时，输液后及时冲管，对于无法序贯输入的药物应该采用适当的溶媒对输液管进行及时冲洗，特别是与中药注射液联合使用时，不管输液的顺序，都需要采用前一种溶媒进行冲管。策划：美超投稿：wangmeichao@dxy.cn题图：站酷海洛参考文献：[1] 许雷. 左氧氟沙星注射液配伍的研究进展 [J]. 中国医药指南,2019,17(15):40-42.[2] 胡蝶. 左氧氟沙星注射剂与其他药物的配伍禁忌分析 [J]. 中国实用医药,2016,11(10):274-275.DOI:10.14163/j.cnki.11-5547/r.2016.10.202.[3] 王晓彬, 郭瑛. 左氧氟沙星注射液与常用药物配伍的稳定性 [J]. 医学信息,2014,(11):475-476.DOI:10.3969/j.issn.1006-1959.2014.11.589.[4] 黎清. 浅论盐酸左氧氟沙星注射液和多种药物的配伍禁忌 [J]. 当代医药论丛,2017,15(6):56-57.DOI:10.3969/j.issn.2095-7629.2017.06.041.[5] 谭红阳, 万建伟. 左氧氟沙星注射液配伍禁忌的分析 [J]. 医学信息,2017,30(15):42-44.DOI:10.3969/j.issn.1006-1959.2017.15.021.[6] 张义春, 彭军, 李霞霞, 吴寅萍. 乳酸左氧氟沙星氯化钠注射液与注射用帕瑞昔布存在配伍禁忌 [J]. 海峡药学,2021,33(10):140-141.DOI:10.3969/j.issn.1006-3765.2021.10.052.[7] 邢力丹, 刘丽丽. 乳酸左氧氟沙星注射液与注射用血凝酶存在配伍禁忌 [J]. 中华现代护理杂志,2019,25(13):1624.DOI:10.3760/j.issn.1674-2907.2019.13.011.[8] 王丹. 左氧氟沙星氯化钠注射液与注射用米卡芬净钠存在配伍禁忌 [J]. 当代护士（下旬刊）,2018,25(12):180.[9] 雷大榜. 盐酸左氧氟沙星注射液与地塞米松磷酸钠注射液的配伍禁忌 [J]. 饮食保健,2017,4(22):72.DOI:10.3969/j.issn.2095-8439.2017.22.083.[10] 张永刚. 头孢哌酮钠舒巴坦钠与左氧氟沙星静注配伍禁忌探究 [J]. 中国继续医学教育,2017,9(32):91-93.DOI:10.3969/j.issn.1674-9308.2017.32.050.[11] 汪宝, 马红. 刍议左氧氟沙星和莫西沙星注射剂常见的配伍禁忌 [J]. 临床医药文献电子杂志,2017,4(59):11649,11651.DOI:10.3877/j.issn.2095-8242.2017.59.094.[12] 龚艳, 杨莉琴. 注射用硫辛酸与左氧氟沙星氯化钠注射液存在配伍禁忌 [J]. 中华现代护理杂志,2016,22(15):2143-2143.DOI:10.3760/cma.j.issn.1674-2907.2016.15.021.