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Hurdles to Cardioprotection in the Critically Ill

Critical Care Research Group, The Prince Charles Hospital, Chermside 4032, Australia
Faculty of Medicine, University of Queensland, Chermside 4032, Australia
Science and Engineering Faculty, Queensland University of Technology, Chermside 4032, Australia
School of Medical Science, Griffith University, Southport 4222, Australia
Author to whom correspondence should be addressed.
These authors contributed equally to this work.
Int. J. Mol. Sci. 2019, 20(15), 3823;
Received: 5 July 2019 / Revised: 26 July 2019 / Accepted: 3 August 2019 / Published: 5 August 2019
Cardiovascular disease is the largest contributor to worldwide mortality, and the deleterious impact of heart failure (HF) is projected to grow exponentially in the future. As heart transplantation (HTx) is the only effective treatment for end-stage HF, development of mechanical circulatory support (MCS) technology has unveiled additional therapeutic options for refractory cardiac disease. Unfortunately, despite both MCS and HTx being quintessential treatments for significant cardiac impairment, associated morbidity and mortality remain high. MCS technology continues to evolve, but is associated with numerous disturbances to cardiac function (e.g., oxidative damage, arrhythmias). Following MCS intervention, HTx is frequently the destination option for survival of critically ill cardiac patients. While effective, donor hearts are scarce, thus limiting HTx to few qualifying patients, and HTx remains correlated with substantial post-HTx complications. While MCS and HTx are vital to survival of critically ill cardiac patients, cardioprotective strategies to improve outcomes from these treatments are highly desirable. Accordingly, this review summarizes the current status of MCS and HTx in the clinic, and the associated cardiac complications inherent to these treatments. Furthermore, we detail current research being undertaken to improve cardiac outcomes following MCS/HTx, and important considerations for reducing the significant morbidity and mortality associated with these necessary treatment strategies. View Full-Text
Keywords: heart failure; heart transplantation; mechanical circulatory support; cardioprotection heart failure; heart transplantation; mechanical circulatory support; cardioprotection
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MDPI and ACS Style

See Hoe, L.E.; Bartnikowski, N.; Wells, M.A.; Suen, J.Y.; Fraser, J.F. Hurdles to Cardioprotection in the Critically Ill. Int. J. Mol. Sci. 2019, 20, 3823.

AMA Style

See Hoe LE, Bartnikowski N, Wells MA, Suen JY, Fraser JF. Hurdles to Cardioprotection in the Critically Ill. International Journal of Molecular Sciences. 2019; 20(15):3823.

Chicago/Turabian Style

See Hoe, Louise E., Nicole Bartnikowski, Matthew A. Wells, Jacky Y. Suen, and John F. Fraser. 2019. "Hurdles to Cardioprotection in the Critically Ill" International Journal of Molecular Sciences 20, no. 15: 3823.

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