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
Fabry Disease: Cardiac Implications and Molecular Mechanisms
AbstractPurpose of ReviewThis review explores the interplay among metabolic dysfunction, oxidative stress, inflammation, and fibrosis in Fabry disease, focusing on their potential implications for cardiac involvement. We aim to discuss the biochemical processes that operate in parallel to sphingolipid accumulation and contribute to disease pathogenesis, emphasizing the importance of a comprehensive understanding of these processes.Recent FindingsBeyond sphingolipid accumulation, emerging studies have revealed that mitochondrial dysfunction, oxidative stress, and chronic inflammation could be significant contributors to Fab...
Source: Current Heart Failure Reports - January 30, 2024 Category: Cardiology Source Type: research
Diuretic Treatment in Patients with Heart Failure: Current Evidence and Future Directions – Part I: Loop Diuretics
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 the current trial evidence for different diuretic strategies and explore potential future directions of research.Recent FindingsWe will assess recent trials including DOSE, TRANSF...
Source: Current Heart Failure Reports - January 19, 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 - January 18, 2024 Category: Cardiology Source Type: research
Evolutions in Combined Heart-Kidney Transplant
AbstractPurpose of ReviewThis review describes management practices, outcomes, and allocation policies in candidates for simultaneous heart-kidney transplantation (SHKT).Recent FindingsIn patients with heart failure and concomitant kidney disease, SHKT confers a survival advantage over heart transplantation (HT) alone in patients with dialysis dependence or an estimated glomerular filtration rate (eGFR) < 40 mL/min/1.73 m2. However, when compared to kidney transplantation (KT) alone, SHKT is associated with worse patient and kidney allograft survival. In September 2023, the United Network of Organ Sharing adopted ...
Source: Current Heart Failure Reports - January 17, 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 - January 15, 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 - December 28, 2023 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 - December 22, 2023 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 - December 7, 2023 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 - December 7, 2023 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 - December 4, 2023 Category: Cardiology Source Type: research
Cardiac CT Beyond Coronaries: Focus on Structural Heart Disease
AbstractPurpose of ReviewCardiac computed tomography (CT) is an established non-invasive imaging tool for the assessment of coronary artery disease. Furthermore, it plays a key role in the preinterventional work-up of patients presenting with structural heart disease.Recent FindingsCT is the gold standard for preprocedural annular assessment, device sizing, risk determination of annular injury, coronary occlusion or left ventricular outflow tract obstruction, calcification visualization and quantification of the target structure, and prediction of a co-planar fluoroscopic angulation for transcatheter interventions in patie...
Source: Current Heart Failure Reports - December 1, 2023 Category: Cardiology Source Type: research
