Sympathetic Activation in Hypertensive Chronic Kidney Disease – A Stimulus for Cardiac Arrhythmias and Sudden Cardiac Death?

Studies have revealed a robust and independent correlation between chronic kidney disease (CKD) and cardiovascular (CV) events, including death, heart failure, and myocardial infarction. Recent clinical trials extend this range of adverse CV events, including malignant ventricular arrhythmias and sudden cardiac death (SCD). Moreover, other studies point out that cardiac structural and electrophysiological changes are a common occurrence in this population. These processes are likely contributors to the heightened hazard of arrhythmias in CKD population and may be useful indicators to detect patients who are at a higher SCD risk. Sympathetic overactivity is associated with increased CV risk, specifically in the population with CKD, and it is a central feature of the hypertensive state, occurring early in its clinical course. Sympathetic hyperactivity is already evident at the earliest clinical stage of CKD and is directly related to the progression of renal failure, being most pronounced in those with end-stage renal disease. Sympathetic efferent and afferent neural activity in kidney failure is a crucial facilitator for the perpetuation and evolvement of the disease. Here, we will revisit the role of the feedback loop of the sympathetic neural cycle in the context of CKD and how it may aggravate several of the risk factors responsible for causing SCD. Targeting the overactive sympathetic nervous system therapeutically, either pharmacologically or with newly available device-b...
Source: Frontiers in Physiology - Category: Physiology Source Type: research

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Heart failure (HF) is a leading cause of mortality and hospital readmissions in the United States. A large proportion of these patients are readmitted from skilled nursing facilities (SNF). The implementation of quality initiatives, such as staff education, to recognize early measures of clinical instability could improve HF management at these facilities.
Source: Journal of the American Medical Directors Association - Category: Health Management Authors: Source Type: research
The geriatric population is at high risk of severe low blood glucose (LBG) events due to diminished homeostatic mechanisms, especially on hypoglycemic medications. Moderate to severe LBG events in these patients can contribute to behavior changes such as agitation, change in level of consciousness, disruption of sleep, instability and increased risk of myocardial infarction, stroke and falls. Rapid recognition and appropriate treatment and prevention of LBG and recurrences can reduce risk for hospitalization in the geriatric population.
Source: Journal of the American Medical Directors Association - Category: Health Management Authors: Source Type: research
CONCLUSIONS.: Our results confirm the multidimensional nature of mania. Hyperactivity, increased speech, and thought disorder appear as core features of the clinical construct. The mood experience could be heterogeneous, depending on the co-occurrence of euphoric (elevated mood) and dysphoric (irritability and depressive mood) emotions of varying intensity. Results are also discussed regarding their relationship with other constitutive elements of bipolar disorder, such as mixed and depressive states. PMID: 32093802 [PubMed - in process]
Source: Journal of the Association of European Psychiatrists - Category: Psychiatry Tags: Eur Psychiatry Source Type: research
Authors: Biederman J, DiSalvo M, Woodworth KY, Fried R, Uchida M, Biederman I, Spencer TJ, Surman C, Faraone SV Abstract BACKGROUND.: A growing body of research suggests that deficient emotional self-regulation (DESR) is common and morbid among attention-deficit/hyperactivity disorder (ADHD) patients. The main aim of the present study was to assess whether high and low levels of DESR in adult ADHD patients can be operationalized and whether they are clinically useful. METHODS.: A total of 441 newly referred 18- to 55-year-old adults of both sexes with Diagnostic and Statistical Manual of Mental Disorders: Fifth...
Source: Journal of the Association of European Psychiatrists - Category: Psychiatry Tags: Eur Psychiatry Source Type: research
Source: Journal of Renal Nutrition - Category: Urology & Nephrology Source Type: research
Authors: Medeiros MC, Rocha N, Bandeira E, Dantas I, Chaves C, Oliveira M, Bandeira F Abstract Sclerostin (Scl) is an osteoblast-inhibiting glycoprotein that is secreted mainly by osteocytes and is regulated by hormonal changes and skeletal loading. Decreased physical function and high serum Scl concentrations have been reported in chronic renal failure patients but little is known to date about the differences between diabetic and non-diabetic patients on hemodialysis who are susceptible to both sarcopenia and bone fragility. Objective.To determine the prevalence of sarcopenia and its association with serum Scl co...
Source: International Journal of Nephrology - Category: Urology & Nephrology Tags: Int J Nephrol Source Type: research
We thank Dr Reiffel for his interest in our case description1 and his comments. Indeed, the presence of precordial T-wave inversions in the setting of pulmonary embolism has been described periodically in the literature. The cases described by Dr Reiffel supplement the cases we referenced in our report to reinforce this point. Two theories are often cited as an explanation for this finding. The first is heightened sympathetic tone caused by an autonomic nervous system –mediated response triggered by acute pulmonary embolism.
Source: The American Journal of Medicine - Category: General Medicine Authors: Tags: Letter Source Type: research
Publication date: Available online 26 February 2020Source: Current Therapeutic ResearchAuthor(s): Hailemaryam Alemu, Workagegnehu Hailu, Aynshet Adane
Source: Current Therapeutic Research - Category: Drugs & Pharmacology Source Type: research
Authors: Fernandez-Gomez F, Tran H, Dhaenens CM, Caillet-Boudin ML, Schraen-Maschke S, Blum D, Sablonnière B, Buée-Scherrer V, Buee L, Sergeant N Abstract Myotonic dystrophies (DM) are rare inherited neuromuscular disorders linked to microsatellite unstable expansions in non-coding regions of ubiquitously expressed genes. The DMPK and ZNF9/CNBP genes which mutations are responsible for DM1 and DM2 respectively. DM are multisystemic disorders with brain affection and cognitive deficits. Brain lesions consisting of neurofibrillary tangles are often observed in DM1 and DM2 brain. Neurofibrillary tangles ...
Source: Advances in Experimental Medicine and Biology - Category: Research Tags: Adv Exp Med Biol Source Type: research
Publication date: April 2020Source: IJC Heart &Vasculature, Volume 27Author(s): Michele Correale, Adriana Mallardi, Pietro Mazzeo, Lucia Tricarico, Claudia Diella, Valentina Romano, Armando Ferraretti, Alessandra Leopizzi, Giuseppina Merolla, Matteo Di Biase, Natale Daniele Brunetti
Source: IJC Heart and Vasculature - Category: Cardiology Source Type: research
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