A look back: the quest for thrombosis in heart failure continues after COMMANDER HF

Heart failure (HF) has been associated with an increased incidence of thromboembolic events, while many HF deaths have been thought to be of thrombotic aetiology.1 In terms of pathophysiology, HF bears several prothrombotic features. The deceleration of peripheral and intracardiac blood flow due to peripheral congestion and impaired cardiac contractility, respectively, the prolonged bed rest in severely ill cases, the associated endothelial dysfunction, the increased risk for atrial fibrillation (AF) due to structural and electrical atrial remodelling in the presence of elevated atrial pressures due to left ventricular dysfunction, and the presence of coagulation defects as, for example, in the case of ventricular assist devices are only some of the potential thrombophilic mechanisms in HF.2,3 At the molecular level, endothelial dysfunction with impaired vascular but also platelet response to nitric oxide (NO) has been observed in HF patients with either reduced or preserved ejection fraction, leading to impaired vascular tone and increased platelet aggregation, respectively.4 Impaired NO response seems to result in turn from NO scavenging and reduced activity of soluble guanylate cyclase (sGC), the principal NO sensor.5 In this complex association, HF may be the cause of the prothrombotic state but also the result of common pathogenetic pathways leading to both conditions.
Source: Cardiovascular Research - Category: Cardiology Source Type: research

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CONCLUSION: We found that even moderate serum levels of NT-proBNP were associated with the risk of total and ischemic strokes among Japanese whose NT-proBNP levels were relatively low compared with Westerners. PMID: 31932552 [PubMed - as supplied by publisher]
Source: Journal of Atherosclerosis and Thrombosis - Category: Cardiology Tags: J Atheroscler Thromb Source Type: research
Conclusion A great deal of progress is being made in the matter of treating aging: in advocacy, in funding, in the research and development. It can never be enough, and it can never be fast enough, given the enormous cost in suffering and lost lives. The longevity industry is really only just getting started in the grand scheme of things: it looks vast to those of us who followed the slow, halting progress in aging research that was the state of things a decade or two ago. But it is still tiny compared to the rest of the medical industry, and it remains the case that there is a great deal of work yet to be done at all...
Source: Fight Aging! - Category: Research Authors: Tags: Newsletters Source Type: blogs
Conclusion A great deal of progress is being made in the matter of treating aging: in advocacy, in funding, in the research and development. It can never be enough, and it can never be fast enough, given the enormous cost in suffering and lost lives. The longevity industry is really only just getting started in the grand scheme of things: it looks vast to those of us who followed the slow, halting progress in aging research that was the state of things a decade or two ago. But it is still tiny compared to the rest of the medical industry, and it remains the case that there is a great deal of work yet to be done at all...
Source: Fight Aging! - Category: Research Authors: Tags: Of Interest Source Type: blogs
Publication date: January 2020Source: JACC: Heart Failure, Volume 8, Issue 1Author(s): Milton PackerAbstractBoth obesity and type 2 diabetes are important risk factors for the development of heart failure with a preserved ejection fraction (HFpEF), and both disorders increase the risk of systemic thromboembolic events. Traditionally, the risk of stroke has been explained by the strong association of these disorders with atrial fibrillation (AF). However, adiposity and diabetes are risk factors for systemic thromboembolism, even in the absence of AF, because both can lead to the development of an inflammatory and fibrotic a...
Source: JACC: Heart Failure - Category: Cardiology Source Type: research
To examine the role of the CHA2DS2-VASc (Congestive heart failure; Hypertension; Age ≥75 years [doubled]; Diabetes; previous Stroke, transient ischemic attack, or thromboembolism [doubled]; Vascular disease; Age 65-75 years; and Sex category) score as a prognostic marker of in-hospital mortality in critically ill patients who develop new-onset atrial fibrillation (NOAF).
Source: Journal of Cardiothoracic and Vascular Anesthesia - Category: Anesthesiology Authors: Tags: Original Article Source Type: research
Abstract The incorporation of biomarkers in the actually used risk scores seem to be helpful for early identifying atrial fibrillation (AF) patients at higher risk. The aim of this critical review of the scientific literature is to investigate the potential clinical significance of red blood cell distribution width (RDW) in AF. A systematic electronic search was carried out to identify all articles describing an epidemiological association between RDW and AF in adult human populations. Data abstraction was conducted on a final number of 35 articles (13 cross-sectional, 12 prospective and 10 retrospective studies)....
Source: World Journal of Cardiology - Category: Cardiology Authors: Tags: World J Cardiol Source Type: research
AbstractObesity and diabetes can lead to heart failure with preserved ejection fraction (HFpEF), potentially because they both cause expansion and inflammation of epicardial adipose tissue and thus lead to microvascular dysfunction and fibrosis of the underlying left ventricle. The same process also causes an atrial myopathy, which is clinically evident as atrial fibrillation (AF); thus, AF may be the first manifestation of HFpEF. Many patients with apparently isolated AF have latent HFpEF or subsequently develop HFpEF. Most patients with obesity or diabetes who have AF and exercise intolerance have increased left atrial p...
Source: European Journal of Heart Failure - Category: Cardiology Authors: Tags: Review Source Type: research
Publication date: Available online 12 December 2019Source: Canadian Journal of CardiologyAuthor(s): Christopher C. Cheung, Thomas M. Roston, Jason G. Andrade, Matthew T. Bennett, Margot K. DavisAbstractCardiac amyloidosis occurs secondary to the deposition of insoluble protein fibrils in cardiac tissue leading to progressive myocardial dysfunction, clinical heart failure, and arrhythmia. In recent years, increasing awareness and improved screening have resulted in an increased prevalence of cardiac amyloidosis, with contemporary estimates reporting a prevalence of 18 to 55 cases per 100,000 person-years, and accounting for...
Source: Canadian Journal of Cardiology - Category: Cardiology Source Type: research
European Journal of Heart Failure, EarlyView.
Source: European Journal of Heart Failure - Category: Cardiology Authors: Tags: Editorial Comment Source Type: research
AbstractPurpose of ReviewAtrial fibrillation (AF) is the most common arrhythmia in adults. The number of patients with AF is anticipated to increase annually, mainly due to the aging population alongside improved arrhythmia detection. AF is associated with a significantly elevated risk of hospitalization, stroke, thromboembolism, heart failure, and all-cause mortality. Echocardiography is one of the key components of routine assessment and management of AF. Therefore, the aim of this review is to briefly summarize current knowledge on “novel” echocardiographic parameters that may be of value in the management o...
Source: Current Cardiovascular Imaging Reports - Category: Radiology Source Type: research
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