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Delivery of Herbal Cardiovascular Drugs in the Scenario of Nanotechnology: An Insight
Published in Mahfoozur Rahman, Sarwar Beg, Mazin A. Zamzami, Hani Choudhry, Aftab Ahmad, Khalid S. Alharbi, Biomarkers as Targeted Herbal Drug Discovery, 2022
Kumar Anand, Subhabrata Ray, Md. Adil Shaharyar, Mahfoozur Rahman, Rudranil Bhowmik, Sanmoy Karmakar, Monalisha Sen Gupta
Depending on various reports and studies fetal cardiac arrhythmias is found to occur in 1% of pregnancies and can result in fatal heart failure (Thakur et al., 2013; Huhta, 2005). This kind of arrhythmias can also represent a leading cause of fetal hydrops, i.e., effusions in more than one fetal compartment, which has an incidence of 1 in 2500 pregnancies (Thakur et al., 2013; Parker, 2006). Digoxin is the drug of choice for the treatment of fetal tachyarrhythmias as well as fetal CHF (Mongiovì et al., 2010). As digoxin is a substrate for the efflux transporter P-gp, transplacental transfer of digoxin to the fetus is limited because P-gp is highly expressed in human placenta (Petropoulos, Gibb, and Matthews, 2010), and is also well expressed in BeWo cells (Utoguchi et al., 2000). So as a result, higher, and more frequent doses of digoxin are required during pregnancy to maintain therapeutic concentrations (Kleinman and Nehgme, 2004). Use of digoxin for prenatal therapy can lead to undesirable side effects for the mother, because the majority of the dose remains in the maternal circulation (Ward, 1996). These side effects can be seen as palpitations, second-degree atrioventricular block, and hypotension like serious effect (Ward, 1996). Now observing these situations, it’s a great need to improve the delivery of digoxin to the fetus and simultaneously minimize maternal drug exposure. It is only possible by novel drug delivery systems which has the potential for better efficiency of DL with reduced dose and hence reduction in overall toxicity. As a result of these studies, it has been demonstrated that polymeric (PEGylated PLGA) nanoparticles is possible to be loaded successfully with digoxin with significant high encapsulation efficiency with the help of modified solvent displacement method. These developed nanoparticles will show sustained drug release kinetics, and further these nanoencapsulation is made to protect the loaded digoxin from P-gp-mediated efflux in the placental trophoblast layer, resulting in increased maternal-to fetal transfer of the drug, which is desired to optimize fetal drug therapy. Here delivery of digoxin is increased to the fetus which results in lower levels of the drug in the maternal circulation, which should result in reduced risks for the aforementioned maternal side effects (Norah et al., 2015). Here as a conclusion, use of polymeric nanoparticles encapsulated digoxin is to treat fetal cardiac arrhythmia and it has significantly improved outcomes for both the mother and her fetus.
Can we reduce conduction disturbances following transcatheter aortic valve replacement?
Published in Expert Review of Medical Devices, 2020
Alberto Alperi Garcia, Guillem Muntané-Carol, Lucia Junquera, David del Val, Laurent Faroux, François Philippon, Josep Rodés-Cabau
Although the need for PPI is recognized as the most impactful complication among conduction disturbances following TAVR, new-onset LBBB is even more frequent and should also be taken into consideration. New-onset persistent LBBB has a negative impact on left ventricular function [38] and associates with a less favorable cardiac reverse remodeling after TAVR demonstrated by cardiac magnetic resonance evaluation [39]. It also confers a greater risk of complete heart block (CHB) or high degree atrioventricular block (HAVB) leading to PPI, and has also been associated with higher rates of heart failure hospitalization, cardiovascular mortality, and all-cause mortality in a recent metanalysis evaluating more than 7000 patients with new-onset post-TAVR LBBB [36]. The rate of new-onset LBBB with earlier and newer generation valves has been of 32% (ranging from 4% to 65%) [40] and 16.4% (ranging from 5.8% to 23%), respectively [41,42].
Towards assisted electrocardiogram interpretation using an AI-enabled Augmented Reality headset
Published in Computer Methods in Biomechanics and Biomedical Engineering: Imaging & Visualization, 2021
P. Lampreave, G. Jimenez-Perez, I. Sanz, A. Gomez, O. Camara
ECG data from the PhysioNet/CinC 2020 Challenge (Perez Alday et al. 2020) was used, specifically the first released data batch corresponding to the China Physiological Signal Challenge 2018 (Liu et al. 2018). The database consists of 12-lead ECG recordings of 6877 patients (46.21% female) collected from 11 hospitals. The recordings were sampled at 500 Hz, lasting between six and sixty seconds, and were classified into 9 possible cardiomyopathies, including Atrial fibrillation (AF), First-degree atrioventricular block (I-AVB), Left bundle branch block (LBBB), Right bundle branch block (RBBB), Premature atrial contraction (PAC), Premature ventricular contraction (PVC), ST-segment depression (STD) and ST-segment elevation (STE).
The 12-lead electrocardiogram of the elite female footballer as defined by different interpretation criteria across the competitive season
Published in European Journal of Sport Science, 2022
Barbara Morrison, Aleah Mohammad, David Oxborough, John Somauroo, Sarah Lindsay, Aimee L. Drane, Rob Shave, Keith George
All ECG parameters were within normal ranges except resting heart rate (lower than normative values). There were no significant differences in ECG patterns across testing sessions (P > 0.05; Table 2). Early repolarisation pattern (85% across all time points) and sinus bradycardia (69%, 77% and 54%, at PRE, MID and END, respectively) were the most common training-related ECG patterns. First degree atrioventricular block was observed in one athlete at both PRE and END assessments. One athlete demonstrated a single borderline ECG finding (right axis deviation) observed only at the END testing session. All remaining ECG recordings were considered normal across all seasonal time points.