Biomarkers in HFpEF for Diagnosis, Prognosis, and Biological Phenotyping
AbstractPurpose of ReviewThe heterogeneity of heart failure with preserved ejection fraction (HFpEF) is responsible for the limited success of broad management strategies. The role of biomarkers has been evolving helping to provide insight into the diversity of pathophysiology, prognosis, and potential targets for treatments. We will review the role of traditional and novel biomarkers in diagnosing, prognosticating, and evolving the management of patients with HFpEF. As circulating biomarker discovery rapidly evolves, we will explore technology for new biomarker discovery with examples of successful implementation.Recent F...
Source: Current Heart Failure Reports - October 5, 2022 Category: Cardiology Source Type: research
Heart Failure After Right Ventricular Myocardial Infarction
AbstractPurpose of ReviewHeart failure (HF) after right ventricular myocardial infarction (RVMI) is common and complicates its clinical course. This review aims to provide a current overview on the characteristic features of RV failure with focus on acute management.Recent FindingsWhile HF after RVMI is classically seen after acute proximal right coronary artery occlusion, RV dysfunction may also occur after larger infarctions in the left coronary artery. Because of its different anatomy and physiology, the RV appears to be more resistant to permanent infarction compared to the LV with greater potential for recovery of isc...
Source: Current Heart Failure Reports - October 5, 2022 Category: Cardiology Source Type: research
Optimization of Drug Therapy for Heart Failure With Reduced Ejection Fraction Based on Gender
AbstractPurpose of ReviewOver the last decades, several classes of drugs have been introduced for the treatment of patients with heart failure with reduced ejection fraction (HFrEF). Their use has been supported by randomized controlled trials that have demonstrated improved patient outcomes. However, these trials enrolled a small number of female patients and sometimes have reported gender-related differences regarding the efficacy of the treatments. The aim of this review is to revise the available data about the influence of gender on the optimal treatment and drug dose in patients with HFrEF.Recent FindingsSeveral gend...
Source: Current Heart Failure Reports - October 5, 2022 Category: Cardiology Source Type: research
Biomarkers in HFpEF for Diagnosis, Prognosis, and Biological Phenotyping
AbstractPurpose of ReviewThe heterogeneity of heart failure with preserved ejection fraction (HFpEF) is responsible for the limited success of broad management strategies. The role of biomarkers has been evolving helping to provide insight into the diversity of pathophysiology, prognosis, and potential targets for treatments. We will review the role of traditional and novel biomarkers in diagnosing, prognosticating, and evolving the management of patients with HFpEF. As circulating biomarker discovery rapidly evolves, we will explore technology for new biomarker discovery with examples of successful implementation.Recent F...
Source: Current Heart Failure Reports - October 5, 2022 Category: Cardiology Source Type: research
Heart Failure After Right Ventricular Myocardial Infarction
AbstractPurpose of ReviewHeart failure (HF) after right ventricular myocardial infarction (RVMI) is common and complicates its clinical course. This review aims to provide a current overview on the characteristic features of RV failure with focus on acute management.Recent FindingsWhile HF after RVMI is classically seen after acute proximal right coronary artery occlusion, RV dysfunction may also occur after larger infarctions in the left coronary artery. Because of its different anatomy and physiology, the RV appears to be more resistant to permanent infarction compared to the LV with greater potential for recovery of isc...
Source: Current Heart Failure Reports - October 5, 2022 Category: Cardiology Source Type: research
Optimization of Drug Therapy for Heart Failure With Reduced Ejection Fraction Based on Gender
AbstractPurpose of ReviewOver the last decades, several classes of drugs have been introduced for the treatment of patients with heart failure with reduced ejection fraction (HFrEF). Their use has been supported by randomized controlled trials that have demonstrated improved patient outcomes. However, these trials enrolled a small number of female patients and sometimes have reported gender-related differences regarding the efficacy of the treatments. The aim of this review is to revise the available data about the influence of gender on the optimal treatment and drug dose in patients with HFrEF.Recent FindingsSeveral gend...
Source: Current Heart Failure Reports - October 5, 2022 Category: Cardiology Source Type: research
Comprehensive and Safe Decongestion in Acutely Decompensated Heart Failure
AbstractPurpose of the ReviewProgressive intravascular, interstitial, and alveolar fluid overload underlies the transition from compensated to acutely decompensated heart failure and loop diuretics are the mainstay of treatment. Adverse effects and resistance to loop diuretics received much attention while the contribution of a depressed cardiac output to diuretic resistance was downplayed.Recent FindingsAnalysis of experience with positive inotropic agents, especially dobutamine, indicates that enhancement of cardiac output is not consistently associated with increased renal blood flow. However, urinary output and renal s...
Source: Current Heart Failure Reports - October 1, 2022 Category: Cardiology Source Type: research
The Right Ventricle: From Embryologic Development to RV Failure
AbstractPurpose of ReviewThe right ventricle (RV) and left ventricle (LV) have different developmental origins, which likely plays a role in their chamber-specific response to physiological and pathological stress. RV dysfunction is encountered frequently in patients with congenital heart disease (CHD) and right heart abnormalities emerge from different causes than increased afterload alone as is observed in RV dysfunction due to pulmonary hypertension (PH). In this review, we describe the developmental, structural, and functional differences between ventricles while highlighting emerging therapies for RV dysfunction.Recen...
Source: Current Heart Failure Reports - October 1, 2022 Category: Cardiology Source Type: research
Right-Sided Mechanical Circulatory Support – A Hemodynamic Perspective
AbstractPurpose of ReviewRight ventricular (RV) failure is increasingly recognized as a major cause of morbidity and mortality. When RV failure is refractory to medical therapy, escalation to right-sided mechanical circulatory support (MCS) should be considered. In this review, we begin by recapitulating the hemodynamics of RV failure, then we delve into current and future right-sided MCS devices and describe their hemodynamic profiles.Recent FindingsThe field of temporary right-sided MCS continues to expand, with evolving strategies and new devices actively under development. All right-sided MCS devices bypass the RV, wit...
Source: Current Heart Failure Reports - October 1, 2022 Category: Cardiology Source Type: research
Defining the Phenotypes for Heart Failure With Preserved Ejection Fraction
AbstractPurpose of ReviewHeart failure with preserved ejection fraction (HFpEF) imposes a significant burden on society and healthcare. The lack in efficacious therapies is likely due to the significant heterogeneity of HFpEF. In this review, we define various phenotypes based on underlying comorbidities or etiologies, discuss phenotypes arrived at by novel methods, and explore therapeutic targets.Recent FindingsA few studies have used machine learning methods to uncover sub-phenotypes within HFpEF in an unbiased manner based on clinical features, echocardiographic findings, and biomarker levels.SummaryWe synthesized the l...
Source: Current Heart Failure Reports - September 30, 2022 Category: Cardiology Source Type: research
Right Heart Function in Cardiorenal Syndrome
AbstractPurpose of ReviewSince CRS is critically dependent on right heart function and involved in interorgan crosstalk, assessment and monitoring of both right heart and kidney function are of utmost importance for clinical outcomes. This systematic review aims to comprehensively report on novel diagnostic and therapeutic paradigms that are gaining importance for the clinical management of the growing heart failure population suffering from CRS.Recent FindingsCardiorenal syndrome (CRS) in patients with heart failure is associated with poor outcome. Although systemic venous congestion and elevated central venous pressure h...
Source: Current Heart Failure Reports - September 27, 2022 Category: Cardiology Source Type: research
‘Acute Heart Failure’: Should We Abandon the Term Altogether?
AbstractPurpose of ReviewThe distinction between ‘acute’ and ‘chronic’ heart failure persists. Our review aims to explore whether reclassifying heart failure decompensation more accurately as an event within the natural history of chronic heart failure has the potential to improve outcomes.Recent FindingsAlthough hospitalisation for worsening heart failure confers a poor prognosis, much of this reflects chronic disease severity. Most patients survive hospitalisation with most deaths occurring in the post-discharge ‘vulnerable phase’. Current evidence supports four classes of medications proven to reduce cardiov...
Source: Current Heart Failure Reports - September 27, 2022 Category: Cardiology Source Type: research
Review of Hydroxychloroquine Cardiotoxicity: Lessons From the COVID-19 Pandemic
AbstractPurpose of ReviewThe coronavirus disease 2019 (COVID-19) pandemic has popularized the usage of hydroxychloroquine and chloroquine (HCQ/CQ) as treatments for COVID-19. Previously used as anti-malarial and now commonly used in rheumatologic conditions, preliminary in vitro studies have demonstrated these medications also have anti-viral properties. Retinopathy and neuromyopathy are well recognized complications of using these treatments; however, cardiotoxicity is under-recognized. This review will discuss the implications and cardiotoxicity of HCQ/CQ, their mechanisms of action, and their utility in COVID-19.Recent ...
Source: Current Heart Failure Reports - September 27, 2022 Category: Cardiology Source Type: research
Right Heart Function in Cardiorenal Syndrome
AbstractPurpose of ReviewSince CRS is critically dependent on right heart function and involved in interorgan crosstalk, assessment and monitoring of both right heart and kidney function are of utmost importance for clinical outcomes. This systematic review aims to comprehensively report on novel diagnostic and therapeutic paradigms that are gaining importance for the clinical management of the growing heart failure population suffering from CRS.Recent FindingsCardiorenal syndrome (CRS) in patients with heart failure is associated with poor outcome. Although systemic venous congestion and elevated central venous pressure h...
Source: Current Heart Failure Reports - September 27, 2022 Category: Cardiology Source Type: research
