Digital Solutions to Optimize Guideline-Directed Medical Therapy Prescriptions in Heart Failure Patients: Current Applications and Future Directions
We report on the efficacy, characteristics of the study, and population of published digital solutions for GDMT optimization. The following digital solutions are discussed: teleconsultation, telemonitoring, cardiac implantable electronic devices, clinical decision support embedded within electronic health records, and multifaceted interventions. Effect of digital solutions is reported in dedicated studies, retrospective studies, or larger studies with another focus that also commented on GDMT use. Overall, we see more studies on digital solutions that report a significant increase in GDMT use. However, there is a large het...
Source: Current Heart Failure Reports - February 16, 2024 Category: Cardiology Source Type: research
Impact of Frailty on Heart Failure Prognosis: Is Sex Relevant?
AbstractPurpose of ReviewHeart failure (HF) is one of the most frequent causes of hospital admission in elderly patients, especially in women, who present a high prevalence of geriatric syndromes like frailty. Studies have suggested that frailty and its impact may also differ between males and females. Understanding how frailty may differently affect HF patients depending on sex is therefore imperative for providing personalized care. The aim of this review is to summarize the role of sex in the prognostic impact of frailty in HF patients.Recent FindingsNumerous studies have identified frailty as a significant predictor of...
Source: Current Heart Failure Reports - February 16, 2024 Category: Cardiology Source Type: research
Contrast Echocardiography in Heart Failure: Update 2023
AbstractPurpose of ReviewThe application of ultrasound-enhancing agents (contrast agents) has improved the accuracy and reproducibility of echocardiography. The review focuses on the currently approved and evolving indications for contrast echocardiography in patients with heart failure, specifically examining clinical studies conducted after the publication of the guidelines in 2017 and 2018.Recent FindingsThe current ASE/EACVI recommendations for contrast echocardiography are based on its accuracy and reproducibility in comparison to non-enhanced echocardiography or other imaging modalities like cardiac MRI. However, tis...
Source: Current Heart Failure Reports - February 2, 2024 Category: Cardiology Source Type: research
Antiarrhythmic Treatment in Heart Failure
Abstract Purpose of ReviewArrhythmias are common in patients with heart failure (HF) and are associated with a significant risk of mortality and morbidity. Optimal antiarrhythmic treatment is therefore essential. Here, we review current approaches to antiarrhythmic treatment in patients with HF.Recent FindingsIn atrial fibrillation, rhythm control and ventricular rate control are accepted therapeutic strategies. In recent years, clinical trials have demonstrated a prognostic benefit of early rhythm control strategies and AF catheter ablation, especially in patients with HF with reduced ejection fraction. Prevention of...
Source: Current Heart Failure Reports - February 1, 2024 Category: Cardiology Source Type: research
The Role of the Wearable Defibrillator in Heart Failure
AbstractPurpose of ReviewWearable cardioverter defibrillators (WCDs) have been developed as a temporary measure for protecting patients at risk for sudden cardiac death that do not meet the indication for implantable cardioverter defibrillator (ICD), most notably in the early stages of heart failure with reduced ejection fraction before reassessment of their left ventricular ejection fraction. In this review, we report available evidence in the literature and guidelines regarding WCD use in order to try to define the role WCDs may have in heart failure.Recent FindingsIn the last decade, most observational studies found WCD...
Source: Current Heart Failure Reports - February 1, 2024 Category: Cardiology Source Type: research
Sex Differences in Circulating Biomarkers of Heart Failure
AbstractPurpose of RevSiewEvidence is scaling up for sex differences in heart failure; however, clinical relevance of sex-specific differential thresholds for biomarkers is not clearly known. Current ambiguity warrants a further look into the sex-specific studies on cardiac biomarkers and may facilitate understanding of phenotypic presentations, clinical manifestations, and pathophysiologic pathway differences in men and women.Recent FindingsRecent studies have confirmed the fact that females have differential threshold for biomarkers, with lower troponin and higher NT proBNP levels. Ambiguity continues to exist in the cli...
Source: Current Heart Failure Reports - February 1, 2024 Category: Cardiology Source Type: research
Diuretic Treatment in Patients with Heart Failure: Current Evidence and Future Directions —Part II: Combination Therapy
AbstractPurpose of ReviewFluid retention or congestion is a major cause of symptoms, poor quality of life, and adverse outcome in patients with heart failure (HF). Despite advances in disease-modifying therapy, the mainstay of treatment for congestion —loop diuretics—has remained largely unchanged for 50 years. In these two articles (part I: loop diuretics and part II: combination therapy), we will review the history of diuretic treatment and current trial evidence for different diuretic strategies and explore potential future directions of r esearch.Recent FindingsWe will assess recent trials, including DOSE, TRANSFOR...
Source: Current Heart Failure Reports - February 1, 2024 Category: Cardiology Source Type: research
Novel Trial Designs in Heart Failure: Using Digital Health Tools to Increase Pragmatism
AbstractPurpose of ReviewHeart failure is an important clinical and public health issue. There is an urgent need to improve the efficiency of clinical trials in heart failure to rapidly identify new therapies and evidence-based implementation strategies for currently existing therapies. Electronic health (eHealth) platforms and digital health tools are being integrated into heart failure care. In this manuscript, we review opportunities to use these tools to potentially improve the design of and reduce the complexity of clinical trials in heart failure.Recent FindingsThe PRECIS-2 tool outlines clinical trial design domains...
Source: Current Heart Failure Reports - February 1, 2024 Category: Cardiology Source Type: research
Implications of Sex Differences on the Treatment Effectiveness in Heart Failure with Reduced Ejection Fraction Related to Clinical Endpoints and Quality of Life
AbstractPurpose of the ReviewThis narrative review will emphasize the necessity for more female enrollment in heart failure (HF) trials and proposes future investigations regarding optimal dosages. Ultimately, a deeper understanding of the unique pathophysiology and medication responses in both men and women is crucial for effective HF management and may improve the quality of life in women.Recent FindingsAn analysis of 740 cardiovascular studies reveals that women make up only 38.2% of participants on average. Regarding to trials testing the effectiveness of HF medications, women ’s involvement are as low as 23.1%. Whil...
Source: Current Heart Failure Reports - February 1, 2024 Category: Cardiology Source Type: research
Heart Failure: a Punch from the Gut
This article seeks to elucidate the mechanisms underlying the bidirectional relationship between the gut and the heart, focusing on the pathophysiology of heart failure. We have previously demonstrated that Heart failure (HF) has significant effects on splanchnic vasculature and leads to key alterations in the gut microbiome, portending greater comorbidity with HF.Recent FindingsA growing field of research is focused on the effects of a “leaky gut” in the development of disease across organ systems. The leaky gut hypothesis centers on intestinal epithelial barrier dysfunction causing increased permeability of the gut a...
Source: Current Heart Failure Reports - February 1, 2024 Category: Cardiology Source Type: research
Rethinking the Impact and Management of Diabetes in Heart Failure Patients
AbstractPurpose of ReviewThe following overview article summarizes the most important aspects of diagnosis and screening and provides an overview on the current evidence of glucose-lowering and heart failure treatment in patients with diabetes.Recent FindingsPatients with diabetes exhibit an increased risk to develop heart failure and the presence of both comorbidities has a major impact on the prognosis of these patients. Thus, it is of utmost importance to detect heart failure in patients with diabetes and to screen all patients with heart failure for the presence of diabetes. Moreover, the diagnosis of heart failure in ...
Source: Current Heart Failure Reports - February 1, 2024 Category: Cardiology Source Type: research
Appetite and its Regulation: Are there Palatable Interventions for Heart Failure?
AbstractPurpose of ReviewObesity is a major driver of heart failure (HF) incidence, and aggravates its pathophysiology. We summarized key reported and ongoing randomized clinical trials of appetite regulation and/or dietary energy restriction in individuals with HF.Recent FindingsWeight loss can be achieved by structured supervised diet programs with behavioural change, medications, or surgery. The new glucagon-like peptide-1 receptor agonists alone or in combination with other agents (e.g., glucose-dependent insulinotropic polypeptide and glucagon receptor agonists or amylin analogues) potently and sustainably reduce appe...
Source: Current Heart Failure Reports - February 1, 2024 Category: Cardiology Source Type: research
Correction to: Differentiating Cardiac Troponin Levels During Cardiac Myosin Inhibition or Cardiac Myosin Activation Treatments: Drug Effect or the Canary in the Coal Mine?
(Source: Current Heart Failure Reports)
Source: Current Heart Failure Reports - February 1, 2024 Category: Cardiology Source Type: research
Diuretic Treatment in Patients with Heart Failure: Current Evidence and Future Directions —Part II: Combination Therapy
AbstractPurpose of ReviewFluid retention or congestion is a major cause of symptoms, poor quality of life, and adverse outcome in patients with heart failure (HF). Despite advances in disease-modifying therapy, the mainstay of treatment for congestion —loop diuretics—has remained largely unchanged for 50 years. In these two articles (part I: loop diuretics and part II: combination therapy), we will review the history of diuretic treatment and current trial evidence for different diuretic strategies and explore potential future directions of r esearch.Recent FindingsWe will assess recent trials, including DOSE, TRANSFOR...
Source: Current Heart Failure Reports - February 1, 2024 Category: Cardiology Source Type: research
