Review: Precision Medicine Approaches for Genetic Cardiomyopathy: Targeting Phospholamban R14del
AbstractPurpose of ReviewHeart failure is a syndrome with poor prognosis and no curative options for the majority of patients. The standard one-size-fits-all-treatment approach, targeting neurohormonal dysregulations, helps to modulate symptoms of heart failure, but fails to address the cause of the problem. Precision medicine aims to go beyond symptom modulation and targets pathophysiological mechanisms that underlie disease. In this review, an overview of how precision medicine can be approached as a treatment strategy for genetic heart disease will be discussed. PLN R14del, a genetic mutation known to cause cardiomyopat...
Source: Current Heart Failure Reports - June 14, 2022 Category: Cardiology Source Type: research
Missed Opportunities in the Diagnosis of Heart Failure: Evaluation of Pathways to Determine Sources of Delay to Specialist Evaluation
AbstractMissed opportunities are incidents where different actions by those involved could have resulted in more desirable events. Heart failure is a complex clinical syndrome presenting as symptoms and signs common to other diagnoses, in patients frequently with multiple co-morbidities. Heart failure itself is not a diagnosis, but is the common clinical presentation of a variety of cardiac conditions. Correct diagnosis involves amalgamation of the clinical presentation, the results of general and specific investigations, and the clinician ’s ability to synthesize the overall picture. It is not surprising therefore that ...
Source: Current Heart Failure Reports - June 6, 2022 Category: Cardiology Source Type: research
Targeting the Metabolic-Inflammatory Circuit in Heart Failure With Preserved Ejection Fraction
AbstractPurpose of ReviewHeart failure with preserved ejection fraction (HFpEF) is a leading cause of morbidity and mortality. The current mechanistic paradigm supports a comorbidity-driven systemic proinflammatory state that evokes microvascular and myocardial dysfunction. Crucially, diabetes and obesity are frequently prevalent in HFpEF patients; as such, we review the involvement of a metabolic-inflammatory circuit in disease pathogenesis.Recent FindingsExperimental models of diastolic dysfunction and genuine models of HFpEF have facilitated discovery of underlying drivers of HFpEF, where metabolic derangement and syste...
Source: Current Heart Failure Reports - June 1, 2022 Category: Cardiology Source Type: research
Digital Technologies to Support Better Outcome and Experience of Care in Patients with Heart Failure
AbstractPurpose of ReviewIn this article, we review a range of digital technologies for possible application in heart failure patients, with a focus on lessons learned. We also discuss a future model of heart failure management, as digital technologies continue to become part of standard care.Recent FindingsDigital technologies are increasingly used by healthcare professionals and those living with heart failure to support more personalised and timely shared decision-making, earlier identification of problems, and an improved experience of care. The COVID-19 pandemic has accelerated the acceptability and implementation of ...
Source: Current Heart Failure Reports - June 1, 2022 Category: Cardiology Source Type: research
Management of Atrial Tachyarrhythmias in Heart Failure —an Interventionalist’s Point of View
AbstractPurpose of ReviewAtrial fibrillation (AF) and heart failure (HF) are commonly encountered clinical disorders that often co-exist, accelerating disease progression and adverse outcomes. It is known that restoration of sinus rhythm positively impacts this population; however, the complex comorbidity profile associated with HF introduces intricacies not encountered in other patient populations. The current review focuses on the safety and efficacy of an interventional-based management for atrial tachyarrhythmias in HF.Recent FindingsWhile pharmacotherapy has been the standard treatment of cardiac dysrhythmias in the H...
Source: Current Heart Failure Reports - June 1, 2022 Category: Cardiology Source Type: research
Evaluation of the Interaction of Sex Hormones and Cardiovascular Function and Health
AbstractPurpose of ReviewSex hormones drive development and function of reproductive organs or the development of secondary sex characteristics but their effects on the cardiovascular system are poorly understood. In this review, we identify the gaps in our understanding of the interaction between sex hormones and the cardiovascular system.Recent FindingsStudies are progressively elucidating molecular functions of sex hormones in specific cell types in parallel with the initiation of crucial large randomized controlled trials aimed at improving therapies for cardiovascular diseases (CVDs) associated with aberrant levels of...
Source: Current Heart Failure Reports - May 28, 2022 Category: Cardiology Source Type: research
Novel Biomarkers of Kidney Disease in Advanced Heart Failure: Beyond GFR and Proteinuria
AbstractPurposeKidney disease is a common finding in patients with heart failure and can significantly impact treatment decisions and outcomes. Abnormal kidney function is currently determined in clinical practice using filtration markers in the blood to estimate glomerular filtration rate, but the manifestations of kidney disease in the setting of heart failure are much more complex than this. In this manuscript, we review novel biomarkers that may provide a more well-rounded assessment of kidney disease in patients with heart failure.Recent FindingsGalectin-3, ST2, FGF-23, suPAR, miRNA, GDF-15, and NAG may be prognostic ...
Source: Current Heart Failure Reports - May 28, 2022 Category: Cardiology Source Type: research
Biomarker-Based Assessment for Infectious Risk Before and After Heart Transplantation
AbstractPurpose of ReviewSurvival outcomes for heart transplant recipients have improved in recent decades, but infection remains a significant cause of morbidity and mortality. In this review, we discuss several biological markers, or biomarkers, that may be used to monitor immunologic status in this patient population.Recent FindingsWhile modest, data on the utility of immune biomarkers in heart transplant recipients suggest correlation between low level of immune response and increased infection risk. More novel assays, such as the detection of circulating levels of pathogen cell-free DNA in plasma and the use of Torque...
Source: Current Heart Failure Reports - May 21, 2022 Category: Cardiology Source Type: research
The Role of Cardiac Computed Tomography in Heart Failure
AbstractPurpose of ReviewCardiac computed tomography (CT) is becoming a more widely applied tool in the diagnosis and management of a variety of cardiovascular conditions, including heart failure. The aim of this narrative review is to examine the role of cardiac CT in patients with heart failure.Recent FindingsCoronary computed tomographic angiography has robust diagnostic accuracy for ruling out coronary artery disease. These data are reflected in updated guidelines from major cardiology organizations. New roles for cardiac CT in myocardial imaging, perfusion scanning, and periprocedural planning, execution, and monitori...
Source: Current Heart Failure Reports - May 19, 2022 Category: Cardiology Source Type: research
Targeting Myocardial Substrate Metabolism in the Failing Heart: Ready for Prime Time?
AbstractPurpose of ReviewWe review the clinical benefits of altering myocardial substrate metabolism in heart failure.Recent FindingsModulation of cardiac substrates (fatty acid, glucose, or ketone metabolism) offers a wide range of therapeutic possibilities which may be applicable to heart failure. Augmenting ketone oxidation seems to offer great promise as a new therapeutic modality in heart failure.SummaryThe heart has long been recognized as metabolic omnivore, meaning it can utilize a variety of energy substrates to maintain adequate ATP production. The adult heart uses fatty acid as a major fuel source, but it can al...
Source: Current Heart Failure Reports - May 14, 2022 Category: Cardiology Source Type: research
Harnessing NAD+ Metabolism as Therapy for Cardiometabolic Diseases
AbstractPurpose of the ReviewThis review summarizes current understanding on the roles of nicotinamide adenine dinucleotide (NAD+) metabolism in the pathogeneses and treatment development of metabolic and cardiac diseases.Recent FindingsNAD+ was identified as a redox cofactor in metabolism and a co-substrate for a wide range of NAD+-dependent enzymes. NAD+ redox imbalance and depletion are associated with many pathologies where metabolism plays a key role, for example cardiometabolic diseases. This review is to delineate the current knowledge about harnessing NAD+ metabolism as potential therapy for cardiometabolic disease...
Source: Current Heart Failure Reports - May 13, 2022 Category: Cardiology Source Type: research
Non-invasive Imaging in Women With Heart Failure — Diagnosis and Insights Into Disease Mechanisms
AbstractPurpose of ReviewTo summarise the role of different imaging techniques for diagnosis and investigation of heart failure in women.Recent FindingsAlthough sex differences in heart failure are well recognised, and the scope of imaging techniques is expanding, there are currently no specific guidelines for imaging of heart failure in women.SummaryDiagnosis and stratification of heart failure is generally performed first line using transthoracic echocardiography. Understanding the aetiology of heart failure is central to ongoing management, and with non-ischaemic causes more common in women, a multimodality approach is ...
Source: Current Heart Failure Reports - May 4, 2022 Category: Cardiology Source Type: research
Digital Technologies to Support Better Outcome and Experience of Care in Patients with Heart Failure
AbstractPurpose of ReviewIn this article, we review a range of digital technologies for possible application in heart failure patients, with a focus on lessons learned. We also discuss a future model of heart failure management, as digital technologies continue to become part of standard care.Recent FindingsDigital technologies are increasingly used by healthcare professionals and those living with heart failure to support more personalised and timely shared decision-making, earlier identification of problems, and an improved experience of care. The COVID-19 pandemic has accelerated the acceptability and implementation of ...
Source: Current Heart Failure Reports - April 29, 2022 Category: Cardiology Source Type: research
The Digital Future of Heart Failure Care
(Source: Current Heart Failure Reports)
Source: Current Heart Failure Reports - April 19, 2022 Category: Cardiology Source Type: research
Targeting the Metabolic-Inflammatory Circuit in Heart Failure With Preserved Ejection Fraction
AbstractPurpose of ReviewHeart failure with preserved ejection fraction (HFpEF) is a leading cause of morbidity and mortality. The current mechanistic paradigm supports a comorbidity-driven systemic proinflammatory state that evokes microvascular and myocardial dysfunction. Crucially, diabetes and obesity are frequently prevalent in HFpEF patients; as such, we review the involvement of a metabolic-inflammatory circuit in disease pathogenesis.Recent FindingsExperimental models of diastolic dysfunction and genuine models of HFpEF have facilitated discovery of underlying drivers of HFpEF, where metabolic derangement and syste...
Source: Current Heart Failure Reports - April 11, 2022 Category: Cardiology Source Type: research
