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Dalzell J.R.,Scottish Advanced Heart Failure Unit | Jackson C.E.,University of Glasgow
Future Cardiology | Year: 2010

Despite considerable therapeutic advances over recent years, chronic heart failure remains associated with significant morbidity and mortality. Further improvements in the treatment of this syndrome are therefore needed and this will require advances in the understanding of its underlying pathophysiology. This article reviews the literature regarding recently identified neurohormonal pathways that are declaring themselves as potential therapeutic targets in chronic heart failure. © 2010 Future Medicine Ltd. Source


Dalzell J.R.,Scottish Advanced Heart Failure Unit | Jackson C.E.,Scottish Advanced Heart Failure Unit | Chong K.S.,Crosshouse Hospital | McDonagh T.A.,Kings College | Gardner R.S.,Scottish Advanced Heart Failure Unit
Biomarkers in Medicine | Year: 2014

Aim: Apelin is an endogenous vasodilator and inotrope, plasma concentrations of which are reduced in advanced heart failure (HF). We determined the prognostic significance of plasma concentrations of apelin in advanced HF. Patients & methods: Plasma concentrations of apelin were measured in 182 patients with advanced HF secondary to left ventricular systolic dysfunction. The predictive value of apelin for the primary end point of all-cause mortality was assessed over a median follow-up period of 544 (IQR: 196-923) days. Results: In total, 30 patients (17%) reached the primary end point. Of those patients with a plasma apelin concentration above the median, 14 (16%) reached the primary end point compared with 16 (17%) of those with plasma apelin levels below the median (p = NS). NT-proBNP was the most powerful prognostic marker in this population (log rank statistic: 10.37; p = 0.001). Conclusion: Plasma apelin concentrations do not predict medium to long-term prognosis in patients with advanced HF secondary to left ventricular systolic dysfunction. © 2014 Future Medicine Ltd. Source


Dalzell J.R.,University of Glasgow | Dalzell J.R.,Scottish Advanced Heart Failure Unit | Rocchiccioli J.P.,University of Glasgow | Weir R.A.P.,Hairmyres Hospital | And 6 more authors.
Journal of Cardiac Failure | Year: 2015

The apelin-APJ system is a novel neurohormonal pathway, with studies to date suggesting that it may be of pathophysiologic relevance in heart failure and may indeed be a viable therapeutic target in this syndrome. This interest is driven primarily by the demonstration of its vasodilator, inotropic, and aquaretic actions as well as its apparent antagonistic relationship with the renin-angiotensin system. However, its promise is heightened further by the observation that, unlike other and more established cardioprotective pathways, it appears to be down-regulated in heart failure, suggesting that augmentation of this axis may have a powerful effect on the heart failure syndrome. We review the literature regarding the apelin-APJ system in heart failure and suggest areas requiring further research. © 2015 Elsevier Inc. All rights reserved. Source


Dalzell J.R.,Scottish Advanced Heart Failure Unit | Cannon J.A.,University of Glasgow | Jackson C.E.,Scottish Advanced Heart Failure Unit | Lang N.N.,Scottish Advanced Heart Failure Unit | Gardner R.S.,Scottish Advanced Heart Failure Unit
Biomarkers in Medicine | Year: 2014

A growing array of biological pathways underpins the syndrome we recognize as heart failure. These include both deleterious pathways promoting its development and progression, as well as compensatory cardioprotective pathways. Components of these pathways can be utilized as biomarkers of this condition to aid diagnosis, prognostication and potentially guide management. As our understanding of the pathophysiology of heart failure deepens further candidate biomarkers are being identified. We provide an overview of the more recently emerging biomarkers displaying potential promise for future clinical use. © 2014 Future Medicine Ltd. Source


Dalzell J.R.,Scottish Advanced Heart Failure Unit | Cannon J.A.,University of Glasgow | Simpson J.,University of Glasgow | Gardner R.S.,Scottish Advanced Heart Failure Unit | Petrie M.C.,Scottish Advanced Heart Failure Unit
Expert Review of Cardiovascular Therapy | Year: 2015

Peripartum cardiomyopathy (PPCM) is a rare condition with a diverse spectrum of potential outcomes, ranging from frequent complete recovery to fulminant heart failure and death. The pathogenesis of PPCM is not well understood, and relatively little is known about its incidence and prevalence. PPCM is often under-recognised in the clinical setting. Early investigation and diagnosis with subsequent expert management may improve outcomes. The development of registries will allow this condition to be better characterised and may help answer crucial questions regarding its optimal medical and surgical management. This paper reviews the potential approaches to improve outcomes in patients with PPCM.. © 2015 Informa UK Ltd. Source

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