Arrhythmia in Cardiomyopathy: Sex and Gender Differences
AbstractPurpose of ReviewThere is emerging evidence for important sex differences in cardiac arrhythmias. In this up-to-date review, we summarise the differences in incidence, aetiology, treatment and prevention of ventricular arrhythmias (VAs) and sudden cardiac death (SCD) in women versus men, in the context of ischaemic and nonischaemic cardiomyopathies.Recent FindingsThe incidence of ventricular tachyarrhythmia and SCD is significantly lower in women than in men with ischaemic cardiomyopathy, whereas sex differences in nonischaemic cardiomyopathy are less clear. Women who receive a primary prevention implantable cardio...
Source: Current Heart Failure Reports - September 22, 2021 Category: Cardiology Source Type: research
SGLT2 Inhibitors and Their Mode of Action in Heart Failure —Has the Mystery Been Unravelled?
This article discusses the current clinical evidence for using SGLT2i in different types of heart failure and provides an overview about the possible underlying mechanisms.Recent findingsClinical and basic data strongly support and extend the use of SGLT2i in HF. Improvement of conventional secondary risk factors is unlikely to explain the prognostic benefits of these drugs in HF. However, different multidirectional mechanisms of SGLT2i could improve HF status including volume regulation, cardiorenal mechanisms, metabolic effects, improved cardiac remodelling, direct effects on cardiac contractility and ion-homeostasis, re...
Source: Current Heart Failure Reports - September 15, 2021 Category: Cardiology Source Type: research
Optimal CRT Implantation —Where and How To Place the Left-Ventricular Lead?
This article reviews current strategies for a successful planning, implementation, and validation of the optimal CRT implantation. Pre-implant imaging modalities offer promising assistance for complex cases; empirical lead positioning and intraoperative testing remain the cornerstone in most cases and ensure a successful CRT effect. (Source: Current Heart Failure Reports)
Source: Current Heart Failure Reports - September 8, 2021 Category: Cardiology Source Type: research
Insights Into Genetics and Pathophysiology of Arrhythmogenic Cardiomyopathy
AbstractPurpose of ReviewArrhythmogenic cardiomyopathy (ACM) is a genetic disease characterized by life-threatening ventricular arrhythmias and sudden cardiac death (SCD) in apparently healthy young adults. Mutations in genes encoding for cellular junctions can be found in about half of the patients. However, disease onset and severity, risk of arrhythmias, and outcome are highly variable and drug-targeted treatment is currently unavailable.Recent FindingsThis review focuses on advances in clinical risk stratification, genetic etiology, and pathophysiological concepts. The desmosome is the central part of the disease, but ...
Source: Current Heart Failure Reports - September 3, 2021 Category: Cardiology Source Type: research
Sex Differences in Hypertrophic Cardiomyopathy: Interaction With Genetics and Environment
AbstractPurpose of ReviewWe explore the sex-specific interaction of genetics and the environment on the clinical course and outcomes of hypertrophic cardiomyopathy (HCM).Recent FindingsWomen account for approximately one-third of patients in specialist HCM centres and reported in observational studies. As a result, evidence informing clinical guideline recommendations is based predominantly on risk factors and outcomes seen in men. However, disease progression appears to be different between the sexes. Women present at a more advanced stage of disease, are older at diagnosis, have higher symptom burden, carry greater risk ...
Source: Current Heart Failure Reports - September 3, 2021 Category: Cardiology Source Type: research
Clinical Phenotypes in Patients With Type 2 Diabetes Mellitus: Characteristics, Cardiovascular Outcomes and Treatment Strategies
AbstractPurpose of ReviewWith recent advances in the pharmacological management of type 2 diabetes mellitus (T2DM), there is a growing need to understand which patients optimally benefit from these novel therapies. Various clinical clustering methodologies have emerged that utilise data-agnostic strategies to categorise patients that have similar clinical characteristics and outcomes; broadly, this characterisation is termed phenotyping. In patients with T2DM, we aimed to describe patient characteristics from phenotype studies, their cardiovascular risk profiles and the impact of antihyperglycemic treatment.Recent Findings...
Source: Current Heart Failure Reports - August 24, 2021 Category: Cardiology Source Type: research
Echocardiographic Longitudinal Strain Analysis in Heart Failure: Real Usefulness for Clinical Management Beyond Diagnostic Value and Prognostic Correlations? A Comprehensive Review
We describe, by critical analysis of thepros andcons, various clinical settings in HF, and how the appropriate use and interpretation of GLS can provide important clues. (Source: Current Heart Failure Reports)
Source: Current Heart Failure Reports - August 16, 2021 Category: Cardiology Source Type: research
The Potential of Oxygenation-Sensitive CMR in Heart Failure
AbstractPurpose of ReviewCardiac magnetic resonance imaging (CMR) use in the context of heart failure (HF) has increased over the last decade as it is able to provide detailed, quantitative information on function, morphology, and myocardial tissue composition. Furthermore, oxygenation-sensitive CMR (OS-CMR) has emerged as a CMR imaging method capable of monitoring changes of myocardial oxygenation without the use of exogenous contrast agents.Recent FindingsThe contributions of OS-CMR to the investigation of patients with HF includes not only a fully quantitative assessment of cardiac morphology, function, and tissue chara...
Source: Current Heart Failure Reports - August 11, 2021 Category: Cardiology Source Type: research
The Interplay Between Autophagy and Senescence in Anthracycline Cardiotoxicity
AbstractPurpose of ReviewDoxorubicin (DOXO) is a highly effective chemotherapeutic drug employed for the treatment of a wide spectrum of cancers, spanning from solid tumours to haematopoietic malignancies. However, its clinical use is hampered by severe and dose-dependent cardiac side effects that ultimately lead to heart failure (HF).Recent FindingsMitochondrial dysfunction and oxidative stress are well-established mechanisms of DOXO-induced cardiotoxicity, although recent evidence suggests that deregulation of other biological processes, like autophagy, could be involved. It is increasingly recognized that autophagy dere...
Source: Current Heart Failure Reports - August 1, 2021 Category: Cardiology Source Type: research
The Surgeon ’s Role in Cardiogenic Shock
AbstractPurpose of ReviewCardiogenic shock represents a very challenging patient population due to the undifferentiated pathologies presenting as cardiogenic shock, difficult decision-making, prognostication, and ever-expanding support options. The role of cardiac surgeons on this team is evolving.Recent FindingsThe implementation of a shock team is associated with improved outcomes in patients with cardiogenic shock. Early deployment of mechanical circulatory support devices may allow an opportunity to rescue these patients.SummaryCardiothoracic surgeons are a critical component of the shock team who can deploy timely mec...
Source: Current Heart Failure Reports - August 1, 2021 Category: Cardiology Source Type: research
Role of CMR Imaging in Diagnostics and Evaluation of Cardiac Involvement in Muscle Dystrophies
AbstractPurpose of ReviewThis review aims to outline the utility of cardiac magnetic resonance (CMR) in patients with different types of muscular dystrophies for the assessment of myocardial involvement, risk stratification and in guiding therapeutic decisions.Recent FindingsIn patients suffering from muscular dystrophies (MD), even mild initial dysfunction may lead to severe heart failure over a time course of years. CMR plays an increasing role in the diagnosis and clinical care of these patients, mostly due to its unique capability to precisely characterize subclinical and progressive changes in cardiac geometry, functi...
Source: Current Heart Failure Reports - July 28, 2021 Category: Cardiology Source Type: research
Guideline-Directed Medical Therapy in Females with Heart Failure with Reduced Ejection Fraction
AbstractPurpose of ReviewThis narrative review synthesizes sex differences in guideline-directed medical therapy (GDMT) use and response among female patients with heart failure with reduced ejection fraction (HFrEF), discusses female representation in HFrEF clinical trials, and outlines future areas of investigation to reduce sex disparities in HFrEF care globally.Recent FindingsObservational registries suggest sex-specific disparities persist in GDMT rates, and there may be key sex-specific differences in optimal dosing of GDMT in HFrEF patients. Underrepresentation of female patients in HF clinical trials is a key barri...
Source: Current Heart Failure Reports - July 2, 2021 Category: Cardiology Source Type: research
New-Onset Cancer in the HF Population: Epidemiology, Pathophysiology, and Clinical Management
AbstractPurpose of ReviewOncological treatments are known to induce cardiac toxicity, but the impact of new-onset cancer in patients with pre-existing HF remains unknown. This review focuses on the epidemiology, pathophysiological mechanisms, and clinical implications of HF patients who develop malignancies.Recent FindingsNovel findings suggest that HF and cancer, beside common risk factors, are deeply linked by shared pathophysiological mechanisms. In particular, HF itself may enhance carcinogenesis by producing pro-inflammatory cytokines, and it has been suggested that neurohormonal activation, commonly associated with t...
Source: Current Heart Failure Reports - June 28, 2021 Category: Cardiology Source Type: research
Pathophysiology and Treatment of Hypertrophic Cardiomyopathy: New Perspectives
AbstractPurpose of ReviewWe provide a state of the art of therapeutic options in hypertrophic cardiomyopathy (HCM), focusing on recent advances in our understanding of the pathophysiology of sarcomeric disease.Recent FindingsA wealth of novel information regarding the molecular mechanisms associated with the clinical phenotype and natural history of HCM have been developed over the last two decades. Such advances have only recently led to a number of controlled randomized studies, often limited in size and fortune. Recently, however, the allosteric inhibitors of cardiac myosin adenosine triphosphatase, countering the main ...
Source: Current Heart Failure Reports - June 20, 2021 Category: Cardiology Source Type: research
Takotsubo Syndrome —Is There a Need for CMR?
AbstractPurpose of ReviewTakotsubo syndrome (TTS) is a transient but severe myocardial dysfunction that has been known for decades and is still to be fully understood regarding its clinical presentations and pathophysiological mechanisms. Cardiac magnetic resonance (CMR) imaging plays a key role in the comprehensive analysis of patients with TTS in acute and follow-up examinations. In this review, we focus on the major advantages and latest evolutions of CMR in diagnosis and prognostication of TTS and discuss future perspectives and needs in the field of research and cardiovascular imaging in TTS.Recent FindingsSpecific CM...
Source: Current Heart Failure Reports - June 20, 2021 Category: Cardiology Source Type: research
