Use of Oral Anticoagulant Drugs in Patients with Pulmonary Hypertension
Pulmonary hypertension (PH), in particular pulmonary arterial hypertension and chronic thromboembolic PH, burdens patients with relevant morbidity and mortality. The use of oral anticoagulants (OACs) seems able to mitigate the risk of adverse outcomes and death in these patients. Despite scarce evidence, the use of OAC is recommended to treat PH patients, mainly based on observational data. So far, data are still unclear about the impact of direct oral anticoagulant (DOACs), whereas vitamin K antagonists are the main drugs recommended. More data are needed to fully clarify the role of OAC and DOACs in PH patients. (Source:...
Source: Heart Failure Clinics - November 24, 2022 Category: Cardiology Authors: Pablo Demelo-Rodriguez, Francisco Galeano-Valle, Marco Proietti Source Type: research
Pregnancy and Pulmonary Hypertension
Pulmonary hypertension is one of the highest risk medical conditions in pregnancy and carries significant maternal morbidity and mortality as well as neonatal morbidity. Diagnosis is commonly delayed due to the nonspecific nature of early symptoms. Disease progression can lead to right ventricular failure, which carries mortality rates as high as 25% to 56%. Pregnancy-related complications arise from cardiac inability to accommodate increased plasma volume and cardiac output, decreased systemic vascular resistance, and hypercoagulability. Patients in this high-risk cohort necessitate preconception risk stratification and m...
Source: Heart Failure Clinics - November 24, 2022 Category: Cardiology Authors: Jenny Y. Mei, Richard N. Channick, Yalda Afshar Source Type: research
Noncoding RNAs in Pulmonary Arterial Hypertension
Several microRNAs and long noncoding RNAs contribute to pulmonary arterial hypertension (PAH) pathogenesis by impairing nitric oxide production, enhancing proliferation and migration and decreasing apoptosis of smooth muscle cells, and promoting endothelial-to-mesenchymal transition in pulmonary arteries. These noncoding RNAs (ncRNAs) could serve as both biomarkers and therapeutic targets for PAH. Nonetheless, the knowledge about their role in PAH is still incomplete. Furthermore, ncRNAs may vary across species and often act differently in different tissues and organs, and technical issues currently limit the implementatio...
Source: Heart Failure Clinics - November 24, 2022 Category: Cardiology Authors: Nadia Bernardi, Eva Bianconi, Andrea Vecchi, Pietro Ameri Source Type: research
Unusual Forms of Pulmonary Hypertension
There are several forms of pulmonary hypertension that can be considered unusual not solely due to their prevalence but also due to their geographic distribution. The aim of this review is to highlight some of these forms, most of them classified within group 5 of the current pulmonary hypertension classification. This review also discusses on schistosomiasis-associated pulmonary hypertension, a prevalent form of pulmonary hypertension mostly limited to developing countries. (Source: Heart Failure Clinics)
Source: Heart Failure Clinics - November 24, 2022 Category: Cardiology Authors: Yuri de Deus Montalverne Parente, Natalia Fernandes da Silva, Rogerio Souza Source Type: research
How to Treat Right Heart Failure. Tips for Clinicians in Everyday Practice
In recent years, several observations reported that intolerance of physical exertion and other cardinal symptoms in heart failure (HF) are closely related to the functionality of the right ventricular (RV), regardless of left heart. It has been demonstrated that the RV dysfunction complicates the course, aggravates the quality of life, and increases the mortality of HF patients. The present review is aimed to report tips physicians about the current therapeutic management of right HF during acute stage and chronic phase, shedding light on the RV and its failure and providing physicians with essential information for everyd...
Source: Heart Failure Clinics - November 24, 2022 Category: Cardiology Authors: Giulia Crisci, Roberta D ’Assante, Valeria Valente, Federica Giardino, Anna D’Agostino, Brigida Ranieri, Michele Arcopinto, Alberto M. Marra, Carmen Rainone, Michele Modestino, Salvatore Rega, Ludovica Fulgione, Chiara Sepe, Giuseppe Caruso, Eduardo B Source Type: research
Impact of Hormonal-Anabolic Deficiencies in Idiopathic Pulmonary Arterial Hypertension
Anabolic deficiencies play a pivotal role in left-sided heart failure. Little is known about their impact on idiopathic pulmonary arterial hypertension (iPAH). Therefore, the aim of this study was to assess the impact of multiple hormone-metabolic deficiencies on clinical features and outcomes in idiopathic pulmonary arterial hypertension. We have demonstrated that the assessment of anabolic hormone levels in patients with iPAH allows the identification of a subpopulation with worse exercise capacity, pulmonary hemodynamics, right ventricular size, and function generating the hypothesis about the potential role of hormonal...
Source: Heart Failure Clinics - November 24, 2022 Category: Cardiology Authors: Alberto M. Marra, Anna D ’Agostino, Andrea Salzano, Stefania Basili, Michele D’Alto, Eduardo Bossone, Antonio Cittadini, Carmine Dario Vizza, Roberto Badagliacca Source Type: research
Sex- and Gender-Related Aspects in Pulmonary Hypertension
Biological sex and sociocultural gender are emerging as pivotal modifiers of health and diseases. Sex-based differences exist in the development, pathogenesis, and management of individuals with pulmonary arterial hypertension (PAH). The interplay between gender domains (ie, identity, roles, relations, and institutionalized gender) and PAH has been barely investigated. The aim of this narrative review is to describe up-to-date evidence on the integration of sex and gender in PAH research, highlighting areas for future investigation. (Source: Heart Failure Clinics)
Source: Heart Failure Clinics - November 24, 2022 Category: Cardiology Authors: Anna D ’Agostino, Paola Guindani, Gerarda Scaglione, Alessandra Di Vincenzo, Sara Tamascelli, Riccardo Spaggiari, Andrea Salzano, Andrea D’Amuri, Alberto Maria Marra, Louise Pilote, Valeria Raparelli Source Type: research
Challenges in Pulmonary Hypertension
Pulmonary hypertension (PH) is a clinical condition that has gained mounting attention in the last two decades. The development of several effective drugs has led to a remarkable improvement in quality of life and prognosis of patients with pulmonary arterial hypertension (PAH), which in fact is no longer considered an orphan disease as it was in the 1990s. However, there are several outstanding diagnostic and therapeutic issues that need to be addressed by clinical research in PAH and other forms of PH. (Source: Heart Failure Clinics)
Source: Heart Failure Clinics - November 24, 2022 Category: Cardiology Authors: Alberto M. Marra, Alexander E. Sherman, Pietro Ameri, Eduardo Bossone Tags: Preface Source Type: research
Challenges in Pulmonary Hypertension
HEART FAILURE CLINICS (Source: Heart Failure Clinics)
Source: Heart Failure Clinics - November 24, 2022 Category: Cardiology Authors: Alberto M. Marra, Alexander E. Sherman, Pietro Ameri Source Type: research
Copyright
ELSEVIER (Source: Heart Failure Clinics)
Source: Heart Failure Clinics - November 24, 2022 Category: Cardiology Source Type: research
Contributors
EDUARDO BOSSONE, MD, PhD, FCCP, FESC, FACC (Source: Heart Failure Clinics)
Source: Heart Failure Clinics - November 24, 2022 Category: Cardiology Source Type: research
Contents
Alberto M. Marra, Alexander E. Sherman, Pietro Ameri, and Eduardo Bossone (Source: Heart Failure Clinics)
Source: Heart Failure Clinics - November 24, 2022 Category: Cardiology Source Type: research
Forthcoming Issues
Covid-19 (Source: Heart Failure Clinics)
Source: Heart Failure Clinics - November 24, 2022 Category: Cardiology Source Type: research
SGLT2 Inhibitors and Safety in Older Patients
SGLT2 inhibitors (SGLT2i) are effective in the management of diabetes and in reducing adverse cardiovascular and renal outcomes. Randomized clinical trials demonstrated safety and tolerability in older adults. Adverse effects associated with SGLT2i are impacted by patient frailty, comorbidities, and concomitant medication use and, therefore, must be thoroughly evaluated before initiating treatment. The risk of volume depletion, hypoglycemia, genital infections, and diabetic ketoacidosis can be minimized by appropriate patient selection, patient education, and early symptom recognition. Limited data exists regarding the ris...
Source: Heart Failure Clinics - October 1, 2022 Category: Cardiology Authors: Rena Pollack, Avivit Cahn Source Type: research
SGLT2 Inhibitors in Heart Failure
Sodium-glucose cotransporter-2 inhibitors (SGLT2i) are a recent addition to the pillars of medical therapy for heart failure (HF) with reduced ejection fraction, all of which improve quality of life, morbidity, and mortality. These benefits are evident within the first 30 days of initiation. This review discusses the rationale for SGLT2i initiation in simultaneous or in rapid sequence with other guideline-directed medical therapy (GDMT). We also discuss SGLT2i use and early benefits in HF patients with an ejection fraction greater than 40%. (Source: Heart Failure Clinics)
Source: Heart Failure Clinics - October 1, 2022 Category: Cardiology Authors: Neal M. Dixit, Boback Ziaeian, Gregg C. Fonarow Source Type: research
