Circulating galectin-3 on admission and prognosis in acute heart failure patients: a meta-analysis
AbstractChanges of serum galectin-3 have been associated with the pathogenesis of many cardiovascular diseases. The aim of the study was to evaluate the prognostic role of serum galectin-3 in patients with acute heart failure (AHF) in a meta-analysis. Follow-up studies evaluating the association between serum galectin-3 on admission and clinical outcomes in AHF patients were identified via search of PubMed and Embase databases. A random effects or a fixed effects model was applied to pool the results depending on the heterogeneity. Subgroup analysis was used to evaluate the influences of study characteristics on the outcom...
Source: Heart Failure Reviews - October 22, 2019 Category: Cardiology Source Type: research

Ultrasound guidance for volume management in patients with heart failure
AbstractCongestion is one of the most prominent characteristics of patients presented with decompensated heart failure and it implies unfavorable prognosis for the heart failure patient. Neurohumoral and immuno-inflammatory activation secondary to cardiac dysfunction constitute the pivotal mechanisms driving the heart failure syndrome that results in progressive fluid accumulation. In addition, fluid redistribution between different vascular compartments in human body guided from sympathetic activity constitutes another mechanism for heart failure decompensation. Ultrasound applied in the form of echocardiography provides ...
Source: Heart Failure Reviews - October 22, 2019 Category: Cardiology Source Type: research

Neurohormones, inflammatory mediators, and cardiovascular injury in the setting of heart failure
AbstractNeurohormones and inflammatory mediators have effects in both the heart and the peripheral vasculature. In patients with heart failure (HF), neurohormonal activation and increased levels of inflammatory mediators promote ventricular remodeling and development of HF, as well as vascular dysfunction and arterial stiffness. These processes may lead to a vicious cycle, whereby arterial stiffness perpetuates further ventricular remodeling leading to exacerbation of symptoms. Although significant advances have been made in the treatment of HF, currently available treatment strategies slow, but do not halt, this cycle. Th...
Source: Heart Failure Reviews - October 21, 2019 Category: Cardiology Source Type: research

Congestion occurrence and evaluation in acute heart failure scenario: time to reconsider different pathways of volume overload
AbstractAlthough congestion is considered to be the main reason for hospital admission in patients with acute heart failure, a simplistic view considering idro saline retention and total body volume accumulation did not provide convincing data. Clinical congestion occurrence is often the tip of the iceberg of several different mechanisms ranging from increased filling pressure to extravascular fluid accumulation and blood flow redistribution. Therefore, the clinical evaluation is often restricted to a simple physical examination including few and inaccurate signs and symptoms. This superficial approach has led to contradic...
Source: Heart Failure Reviews - October 18, 2019 Category: Cardiology Source Type: research

Basic and advanced echocardiography in advanced heart failure: an overview
AbstractAdvanced chronic heart failure (ACHF) is the last phase in the evolution of heart failure and is characterized by high hospitalization and mortality rates and is refractory to medical therapy, therefore requiring more aggressive therapies, such as mechanical circulatory support or heart transplantation. Over the last years, the incidence of ACHF was continuously growing, together with the increase in population survival rates. Therefore, the early recognition of the transition to ACHF is of crucial importance in HF patients, which also helps in prognostication of such patients, since advanced therapeutic options ar...
Source: Heart Failure Reviews - October 15, 2019 Category: Cardiology Source Type: research

Ketone body metabolism in diabetic and non-diabetic heart failure
AbstractHeart failure (HF) is one of the most common cardiovascular diseases, causing large disease and economic burden worldwide. Impaired metabolic balance has been confirmed as a significant aspect of HF, and alteration of substrate utilization plays a vital role in the development of HF. Diabetes mellitus is strictly related with HF, and patients with diabetes show a higher mortality and morbidity of HF. Furthermore, HF patients and animals with diabetes behave different characteristics of metabolic pattern and substrate utilization comparing to those without diabetes. Recently, ketone body has been demonstrated as an ...
Source: Heart Failure Reviews - October 15, 2019 Category: Cardiology Source Type: research

Muscle, vessels, or nerves: which one of these plays a key role in the heart of patients with takotsubo syndrome?
(Source: Heart Failure Reviews)
Source: Heart Failure Reviews - October 8, 2019 Category: Cardiology Source Type: research

Effect of antidepressants on death in patients with heart failure: a systematic review and meta-analysis
AbstractDepression is associated with an increased risk of death in patients with heart failure (HF); however, the association between the use of antidepressants and HF prognoses remains controversial. Therefore, this meta-analysis aimed to evaluate the effect of antidepressants on the risk of death in HF patients. We retrieved data from the PubMed and EMBASE databases until August 2019 for studies reporting the use of antidepressants in HF patients. Data were extracted from the eligible articles, and a random effects model was used to pool the effect estimates (risk ratios (RRs) and 95% confidence intervals (CIs)). A tota...
Source: Heart Failure Reviews - September 16, 2019 Category: Cardiology Source Type: research

Loop diuretic resistance complicating acute heart failure
AbstractAcute heart failure hospitalizations complicated by diuretic resistance are associated with worse outcomes. Yet, quantification of the frequency and accompanying risk from loop diuretic resistance is limited by the absence of a comprehensive definition with universal clinical application. Herein, we outline limitations of the current metrics used to identify and define diuretic resistance. We discuss the best available methods to identify and prognosticate outcomes in diuretic resistance. We propose a mechanism-based classification system of diuretic resistance by anatomical location as follows: pre-nephron resista...
Source: Heart Failure Reviews - September 13, 2019 Category: Cardiology Source Type: research

The renin-angiotensin-aldosterone system: a crossroad from arterial hypertension to heart failure
AbstractThe renin-angiotensin-aldosterone system (RAAS) plays a pivotal role in the regulation of blood pressure and volume homeostasis, promoting critical structural changes in every component of the cardiovascular system, including the heart and blood vessels. Consequently, the RAAS is a crucial therapeutic target for several chronic diseases of the cardiovascular system, spanning from arterial hypertension (AH) to heart failure (HF). AH represents a leading risk factor for the development of symptomatic HF, particularly with left ventricle (LV) preserved ejection fraction (HFpEF). LV diastolic dysfunction and cardiac re...
Source: Heart Failure Reviews - September 11, 2019 Category: Cardiology Source Type: research

Anti-fibrotic effects of curcumin and some of its analogues in the heart
We presented a review of Cur effects on cardiac fibrosis and the discovered underlying mechanisms by them Cur interact to establish its cardio-protective effects. (Source: Heart Failure Reviews)
Source: Heart Failure Reviews - September 11, 2019 Category: Cardiology Source Type: research

CardioMEMS, the real progress in heart failure home monitoring
AbstractThe burden of hospitalizations driven by exacerbation of acute heart failure remains unacceptably high. The associated use of hospital resources drives increasing patient, caregiver, and economic costs. Noninvasive telemedical systems investigated in randomized controlled trials have failed to demonstrate to reduce hospitalization rates probably because of the indirect (non-linear) relationship of the measured biological signals with the patient congestion status. Instead, there is increasing evidence that direct measure of intracardiac and pulmonary artery pressure can effectively guide heart failure management an...
Source: Heart Failure Reviews - September 11, 2019 Category: Cardiology Source Type: research

Usefulness and clinical relevance of left ventricular global longitudinal systolic strain in patients with heart failure with preserved ejection fraction
AbstractIn recent years, several studies have shown the usefulness and clinical relevance of left ventricular global longitudinal systolic strain (GLS) in different cardiovascular diseases. In line with this, the role of GLS in patients with heart failure with preserved ejection fraction (HFpEF) has achieved great importance in this predominant form of heart failure in the last years. In this regard, GLS has shown to be not only a sensitive parameter to detect subtle myocardial abnormalities but also a parameter of clinical and prognostic relevance in patients with HFpEF. In this review, we analyze the current evidence con...
Source: Heart Failure Reviews - September 5, 2019 Category: Cardiology Source Type: research

Comparison of clinical profiles between takotsubo syndrome and acute coronary syndrome: a systematic review and meta-analysis
AbstractA systematic review and meta-analysis were performed to analyse the differences in clinical profiles between takotsubo syndrome (TTS) and acute coronary syndrome (ACS) patients and to consolidate the evidence regarding the mortality predictors in TTS patients. Literature search of PubMed, EMBASE and the Cochrane Central Register was made, and 55 studies with a total of 66,653 TTS patients were included. Compared with ACS subjects, TTS subjects had significantly lower left ventricle ejection fraction (LVEF) values on admission; however, cardiovascular risks were fewer and the recovery LVEF was notably higher at both...
Source: Heart Failure Reviews - August 24, 2019 Category: Cardiology Source Type: research

Correction to: Structural and myocardial dysfunction in heart failure beyond ejection fraction
The original version of this article unfortunately contained a mistake. (Source: Heart Failure Reviews)
Source: Heart Failure Reviews - August 24, 2019 Category: Cardiology Source Type: research

Endomyocardial fibrosis: past, present, and future
AbstractEndomyocardial fibrosis (EMF) is a neglected idiopathic disorder, predominant in tropical and subtropical regions of the developing world. It is characterized by fibrotic thickening of the endocardium and myocardium of one or both ventricles. EMF was an important cause of heart failure which accounted for up to 20% of the cases in endemic areas of Africa (rural community in Mozambique), but during the last few years, incidents of the disease have decreased considerably. Although its pathogenesis and etiology are not fully understood, its pathology resembles conditions such as eosinophilic cardiomyopathy and hypereo...
Source: Heart Failure Reviews - August 14, 2019 Category: Cardiology Source Type: research

The metabolic syndrome in heart failure: insights to specific mechanisms
AbstractThe presence of comorbidities significantly influences long-term morbidity and mortality of symptomatic and asymptomatic heart failure (HF) patients. Metabolic syndrome and diabetic cardiomyopathy are two clinical conditions that share multiple pathophysiological mechanisms and that might be both responsible for cardiac dysfunction. However, it is argued whether metabolic syndrome (MS) independently increases HF risk or the association between MS and HF merely reflects the impact of individual risk factors included in its definition on HF development. Similarly, in the context of diabetic cardiomyopathy, many aspec...
Source: Heart Failure Reviews - August 14, 2019 Category: Cardiology Source Type: research

Minireview: are SGLT2 inhibitors heart savers in diabetes?
AbstractSodium-glucose cotransporter 2 (SGLT2) inhibitors, a class of drugs that promote urinary glucose excretion in the treatment of diabetes, have provoked large interest of scientific and professional community due to their positive and, somehow, unexpected results in the three major cardiovascular outcome trials (EMPA-REG OUTCOME trial with empagliflozin, CANVAS Program with canagliflozin, and DECLARE-TIMI 58 with dapagliflozin). In fact, along with the reduction of major adverse cardiovascular events, SGLT2 inhibitors reduced significantly hospitalization for heart failure regardless of existing atherosclerotic cardi...
Source: Heart Failure Reviews - August 13, 2019 Category: Cardiology Source Type: research

Efficacy and safety of oral anticoagulants in atrial fibrillation patients with cancer —a network meta-analysis
AbstractThere are no guideline recommendations for the use of anticoagulant therapy in atrial fibrillation (AF) patients with cancer, which creates uncertainty about the optimal antithrombotic treatment in these patients. We conducted a network meta-analysis for the first time to assess the efficacy and safety of anticoagulant drugs in patients with AF and concurrent cancer. The PubMed, EMBASE, and Cochrane databases were searched up to March 2019. A search was made for the main anticoagulant drugs (warfarin, dabigatran, apixaban, rivaroxaban, and edoxaban). Outputs were presented as odds ratios (ORs), their corresponding ...
Source: Heart Failure Reviews - August 13, 2019 Category: Cardiology Source Type: research

Risk of heart failure progression in patients with reduced ejection fraction: mechanisms and therapeutic options
AbstractTransition from stage C to stage D of heart failure (HF) represents an irreversible process toward end-stage disease. Crucial interventions to be adopted in the attempt to interfere with this process are represented by the identification of patients at high risk to develop HF progression and by an effective and prompt management. Markers of worse prognosis and disease progression are well established and include recurrence of HF decompensation, intolerance to the neurohormonal standard pharmacological treatment, and resistance to loop diuretics. In addition, both NT-proBNP and sympathetic nervous system (SNS) overd...
Source: Heart Failure Reviews - August 13, 2019 Category: Cardiology Source Type: research

β-Adrenergic receptor, an essential target in cardiovascular diseases
Abstractβ-Adrenergic receptors (βARs) belong to a large family of cell surface receptors known as G protein–coupled receptors (GPCRs). They are coupled to Gs protein (Gαs) for the activation of adenylyl cyclase (AC) yielding cyclic AMP (CAMP), and this provides valuable responses, which can affect the cardiac function such as injury. The binding of an agonist to βAR enhances conformation changes that lead to the Gαs subtype of heterotrimeric G protein which is the AC stimulatory G protein for activation ofCAMP in the cells. However, cardiovascular diseases (CVD) have been reported as having...
Source: Heart Failure Reviews - August 13, 2019 Category: Cardiology Source Type: research

Adult congenital heart disease with pulmonary arterial hypertension: mechanisms and management
AbstractAdult congenital heart disease (ACHD) encompasses a range of structural cardiac abnormalities present before birth attributable to abnormal foetal cardiac development. The pulmonary circulation of patients with ACHD and intracardiac or extracardiac defects is often exposed to increased blood flow and occasionally to systemic pressures. Depending on the location and magnitude of the defect as well as the time of surgical correction, the patient with ACHD is at risk of developing pulmonary arterial hypertension (PAH), which dramatically increases morbidity and mortality. It is encouraging that therapies applied in id...
Source: Heart Failure Reviews - August 12, 2019 Category: Cardiology Source Type: research

Effects of exercise training in heart failure with preserved ejection fraction: an updated systematic literature review
AbstractPhysical activity is associated with a lower risk of adverse cardiovascular outcomes, including heart failure (HF). Exercise training is a class IA level recommendation in patients with stable HF, but its impact is less clear in heart failure with preserved ejection fraction (HFpEF). The aim of this study was to analyze the effects of the exercise training on cardiovascular outcomes in patients with HFpEF. A systematic literature search was conducted on the main electronic databases, proceedings of major meetings, and reference lists of the identified studies, using specific terms for only English language studies ...
Source: Heart Failure Reviews - August 9, 2019 Category: Cardiology Source Type: research

Meta-analysis on the immunohistological detection of inflammatory cardiomyopathy in endomyocardial biopsies
AbstractMeta-analysis on immunohistological (IHC) concepts for the detection of inflammatory cardiomyopathy (InfCM) in endomyocardial biopsies (EMB). We included 61 publications, with 10,491 patients (mean age 47.1  years; men 66%) who underwent EMB and IHC evaluation. The 460 control patients were devoid of IHC proof of InfCM. The mean IHC detection rate of InfCM was 50.8% (95% CI 47.7–53.8%; range 18.4–91.7%). A publication bias was excluded (Funnel Plotp = 0.4264). This IHC detection rate was significantly (p 
Source: Heart Failure Reviews - August 8, 2019 Category: Cardiology Source Type: research

Association of QRS narrowing with response to cardiac resynchronization therapy —a systematic review and meta-analysis of observational studies
AbstractProlonged QRS duration, which reflects a higher degree of mechanical dysynchrony, is a predictor of response to CRT. However, the association of QRS narrowing after biventricular pacing with CRT response rates is not clear. Our aim was to conduct a systematic review and meta-analysis on the association between QRS narrowing after cardiac resynchronization therapy (CRT) and clinical and echocardiographic response to CRT in patients with heart failure. Two independent investigators searched MedLine and EMBASE databases through July 2018 without any limitations. Studies providing estimates (continuous data) on the ass...
Source: Heart Failure Reviews - August 7, 2019 Category: Cardiology Source Type: research

Delirium in heart failure
AbstractDespite relative frequency of delirium in elderly hospitalized heart failure patients, skills and expertise in managing such complication are usually poor for physicians and nurses facing this clinical condition. International guidelines on heart failure do not provide detailed indication for such clinical condition, and evidence on this topic is limited. A multi-disciplinary approach (cardiologists, internists, geriatricians, psychologists, and psychiatrists) is often required; this review will therefore focus on diagnosis and clinical management of delirium in heart failure patients from a multidisciplinary point...
Source: Heart Failure Reviews - August 4, 2019 Category: Cardiology Source Type: research

Angiotensin II and angiotensin 1 –7: which is their role in atrial fibrillation?
AbstractAtrial fibrillation (AF) is a significant cause of morbidity and mortality as well as a public health burden considering the high costs of AF-related hospitalizations. Pre-clinical and clinical evidence showed a potential role of the renin angiotensin system (RAS) in the etiopathogenesis of AF. Among RAS mediators, angiotensin II (AII) and angiotensin 1 –7 (A1–7) have been mostly investigated in AF. Specifically, the stimulation of the pathway mediated by AII or the inhibition of the pathway mediated by A1–7 may participate in inducing and sustaining AF. In this review, we summarize the evidence s...
Source: Heart Failure Reviews - August 2, 2019 Category: Cardiology Source Type: research

Advancements in the diagnostic workup, prognostic evaluation, and treatment of takotsubo syndrome
AbstractTakotsubo syndrome (TTS) is an acute and mostly reversible cardiomyopathy that mimics an acute coronary syndrome with left ventricular (LV) systolic dysfunction without relevant obstructive coronary artery disease. Its prevalence is probably underestimated and reaches 1.2 –2% in patients with acute coronary syndrome undergoing coronary catheterization. Although supraphysiological epinephrine levels have been associated with TTS, the detailed pathophysiology is incompletely understood. Chest pain is the most common clinical presentation; however, cardiac decompensat ion, cardiogenic shock, and sudden cardiac d...
Source: Heart Failure Reviews - August 1, 2019 Category: Cardiology Source Type: research

Heart failure with preserved ejection fraction: the missing pieces in diagnostic imaging
AbstractHeart failure with preserved ejection fraction (HFpEF) is an increasingly prevalent phenotype affecting over half of today ’s heart failure patients. With no proven therapy and no universally accepted diagnostic guideline, many HFpEF patients continue to be misdiagnosed or underdiagnosed at the early stages until the disease has progressed much further along. It is extremely difficult to diagnose the HFpEF patient, be cause they have a normal ejection fraction and present with non-specific symptoms such as dyspnea or exercise intolerance. To provide greater specificity, the current diagnostic criteria mandate...
Source: Heart Failure Reviews - July 31, 2019 Category: Cardiology Source Type: research

Relative Efficacy of Spironolactone, Eplerenone, and cAnRenone in patients with Chronic Heart failure (RESEARCH): a systematic review and network meta-analysis of randomized controlled trials
This study aims to assess the comparative benefit and risk profile of treatment with mineralocorticoid receptor antagonists (MRAs) with regard to all-cause mortality (primary endpoint), cardiovascular mortality, or heart failure (HF) –related hospitalization (secondary endpoints) and the safety endpoints hyperkalemia, acute renal failure, and gynecomastia in patients with chronic HF. We conducted a systematic review and network meta-analysis following PRISMA-P and PRISMA-NMA guidelines. From 16 different sources, 14 randomized controlled trials totaling 12,213 patients testing an active treatment of either spironolac...
Source: Heart Failure Reviews - July 30, 2019 Category: Cardiology Source Type: research

Prevention of non-response to cardiac resynchronization therapy: points to remember
AbstractCardiac resynchronization therapy (CRT) is an important and effective therapy for end-stage heart failure. Non-response to CRT is one of the main obstacles to its application in clinical practice. There is no uniform consensus or definition of CRT “response.” Clinical symptoms, ventricular remodeling indices, and cardiovascular events have been reported to be associated with non-responders. To prevent non-response to CRT, three aspects should be thoroughly considered: preoperative patient selection, electrode implantation, and postoperati ve management. Preoperative selection of appropriate patients for...
Source: Heart Failure Reviews - July 27, 2019 Category: Cardiology Source Type: research

Current challenges in sudden cardiac death prevention
AbstractIschemic heart disease and non-ischemic dilated cardiomyopathy are the most common causes of arrhythmic sudden cardiac death (SCD). Implantable cardioverter defibrillator (ICD) therapy is the only strategy that proved to be effective in preventing SCD in high-risk individuals while the role of antiarrhythmic drugs is limited to symptoms relief. Current guidelines recommend selecting candidates to ICD implantation based on etiology, symptoms of heart failure (NYHA class), and severely depressed left ventricular ejection fraction, but these parameters are neither sensitive nor specific. The review addresses the mecha...
Source: Heart Failure Reviews - July 26, 2019 Category: Cardiology Source Type: research

Exercise intervention in hospitalized heart failure patients, with emphasis on congestion-related complications: a review
AbstractThe importance of physical activity has become evident since a sedentary lifestyle drives cardiovascular disease progression and is associated with increased morbidity and mortality. The favorable effects of exercise training in chronic heart failure (HF) and chronic kidney disease (CKD) are widely recognized and exercise training is recommended by European and American guidelines. However, the application of exercise intervention in HF patients hospitalized for acute decompensation or acute worsening in cardiac function has not been explored extensively and, as a result, knowledge about the effects of exercise tra...
Source: Heart Failure Reviews - July 25, 2019 Category: Cardiology Source Type: research

Myocardial ischemia and coronary disease in heart failure
AbstractHeart failure is a complex clinical syndrome and represents the final path of numerous heart diseases. Coronary artery disease is recognized as the primary risk factor for heart failure development, being the main etiological factor in more than 50% of heart failure patients in North America and Europe. Regardless of overt coronary artery disease, myocardial ischemia is a common finding in failing hearts, likely due to structural or functional coronary circulation alterations. Ischemia is a self-propagating process which irreversibly impairs the cardiac function and negatively impacts prognosis. Thus, a better and ...
Source: Heart Failure Reviews - July 22, 2019 Category: Cardiology Source Type: research

New perspectives and future directions in the treatment of heart failure
AbstractThe management of heart failure has changed significantly over the last 30  years, leading to improvements in the quality of life and outcomes, at least for patients with a substantially reduced left ventricular ejection fraction (HFrEF). This has been made possible by the identification of various pathways leading to the development and progression of heart failure, whic h have been successfully targeted with effective therapies. Meanwhile, many other potential targets of treatment have been identified, and the list is constantly expanding. In this review, we summarise planned and ongoing trials exploring the...
Source: Heart Failure Reviews - July 20, 2019 Category: Cardiology Source Type: research

From left ventricular ejection fraction to cardiac hemodynamics: role of echocardiography in evaluating patients with heart failure
AbstractIn clinical practice heart failure (HF) patients are generally classified on the basis of left ventricular (LV) ejection fraction. This approach, however, has important limitations. According to the definition of HF as a clinical syndrome that results from any impairment of LV filling or ejection of blood, a more articulated hemodynamic categorization of HF patients taking into account both LV forward flow and filling pressure would be desirable. However, the reliability of hemodynamic measures using echocardiographic techniques, which are the most used in current clinical practice for evaluation of HF patients, ne...
Source: Heart Failure Reviews - July 20, 2019 Category: Cardiology Source Type: research

Structural and myocardial dysfunction in heart failure beyond ejection fraction
AbstractHeart failure is a multifaceted syndrome addressing for a high rate of death among the general population. The common approach to this disease has been always based on the evaluation of the left ventricular ejection fraction by two-dimensional echocardiography with Simpson ’s method. Mounting evidences have demonstrated the pitfalls of this method and have suggested that the management of heart failure requires a deep knowledge of the pathophysiological insights of the disease and cannot rely only on the evaluation of the left ventricular ejection fraction. Several advanced imaging technologies overwhelm the ...
Source: Heart Failure Reviews - July 17, 2019 Category: Cardiology Source Type: research

Pharmacological preconditioning with phosphodiestrase inhibitor: an answer to stem cell survival against ischemic injury through JAK/STAT signaling
AbstractStem cell transplantation in regenerative medicine has been widely used in various disorders including cardiovascular diseases (CVD) and emerging next-generation therapy. However, transplanted stem cell encountered ischemia/reperfusion (IR) injury which is a major challenge for stem cell survival. During the acute phase after myocardial infarction (MI) cytokine –rich hostile microenvironment, extensive immune cell infiltration and lack of oxygen have been a bottleneck in cell-based therapy. During prolonged ischemia, intracellular pH and ATP level decrease results in anaerobic metabolism and lactate accumulat...
Source: Heart Failure Reviews - July 15, 2019 Category: Cardiology Source Type: research

Cardiogenic shock in cancer
AbstractCardiogenic shock (CS) is increasingly recognized in patients with malignancies, while cancer is independently associated with worse prognosis in CS. A number of conditions may lead to CS in cancer, including acute coronary syndromes, cardiomyopathy, takotsubo syndrome, myocarditis, pulmonary embolism, tamponade, and cardiac herniation. In these conditions, CS may be related to cancer itself or to cancer therapy, including surgery, chemotherapy, or radiotherapy. Given the significantly improved overall survival of patients with malignancies, the early recognition and proper management of CS in cancer become increas...
Source: Heart Failure Reviews - July 4, 2019 Category: Cardiology Source Type: research

Gender-related differences in heart failure: beyond the “one-size-fits-all” paradigm
AbstractCardiovascular diseases show many sex-related differences in prevalence, etiology, phenotype expression, and outcomes. Complex molecular mechanisms underlie this diverse pathological manifestation, from sex-determined differential gene expression to sex hormones interaction with their specific receptors in different tissues. More recently, differential non-coding RNAs regulation also turned out to be an involved mechanism. This review focuses on sex impact on the various heart failure syndromes, including coronary artery disease, heart failure with preserved ejection fraction and with reduced ejection fraction, wit...
Source: Heart Failure Reviews - July 2, 2019 Category: Cardiology Source Type: research

Sex differences in anthracycline-induced cardiotoxicity: the benefits of estrogens
AbstractAnthracyclines are the cornerstone for many oncologic treatments, but their cardiotoxicity has been recognized for several decades. Female subjects, especially before puberty and adolescence, or after menopause, seem to be more at increased risk, with the prognostic impact of this sex issue being less consistent compared to other cardiovascular risk factors. Several studies imply that sex differences could depend on the lack of the protective effect of sex hormones against the anthracycline-initiated damage in cardiac cells, or on differential mitochondria-related oxidative gene expression. This is also reflected b...
Source: Heart Failure Reviews - June 29, 2019 Category: Cardiology Source Type: research

A comparison of anticoagulation, antiplatelet, and placebo treatment for patients with heart failure reduced ejection fraction in sinus rhythm: a systematic review and meta-analysis
AbstractPrevious meta-analyses have not recommended routine warfarin use in heart failure (HF) patients but included limited data on contemporary anticoagulants and practices. We conducted an updated meta-analysis in light of newer literature evaluating rivaroxaban in this patient population. The aim of this meta-analysis was to assess if anticoagulation is associated with a decrease in all-cause mortality, myocardial infarction (MI), stroke, and hospitalization for HF exacerbation without an increased risk of major bleeding. A systematic search was conducted for randomized controlled trials to evaluate the use of antithro...
Source: Heart Failure Reviews - June 29, 2019 Category: Cardiology Source Type: research

miRNAs emerge as circulating biomarkers of post-myocardial infarction heart failure
AbstractHeart failure (HF) is a clinical syndrome that involves structural changes in the heart, leading to a decrease in cardiac output, mainly caused by myocardial infarction (MI), which is the most common form of cardiovascular disease worldwide. Clinical evaluation remains the most accurate diagnostic method for ischemic HF, since the known biomarkers have high cost, are difficult to use for early diagnosis, and have low specificity. This often leads to late diagnosis since only ~  25% symptoms of HF appear after MI. Studies suggest that small non-coding RNAs (miRNAs) play an important role in the regulation of ...
Source: Heart Failure Reviews - June 28, 2019 Category: Cardiology Source Type: research

Iron deficiency as therapeutic target in heart failure: a translational approach
AbstractHeart failure (HF) is a potentially debilitating condition, with a prognosis comparable to many forms of cancer. It is often complicated by anemia and iron deficiency (ID), which have been shown to even further harm patients ’ functional status and hospitalization risk. Iron is a cellular micronutrient that is essential for oxygen uptake and transportation, as well as mitochondrial energy production. Iron is crucially involved in electrochemical stability, maintenance of structure, and contractility of cardiomyocytes. There is mounting evidence that ID indeed hampers the homeostasis of these properties. Anima...
Source: Heart Failure Reviews - June 22, 2019 Category: Cardiology Source Type: research

Heart failure and sepsis: practical recommendations for the optimal management
AbstractAcute heart failure (AHF) is a common clinical challenge that a wide spectrum of physicians encounters in every practice. In many cases, AHF is due to decompensation of chronic heart failure. This decompensation may be triggered by various reasons, with sepsis being a notable one. Sepsis is defined as a life-threatening organ dysfunction caused by the dysregulated host response to infection and is associated with a very high mortality, which may reach 25%. Alarmingly, the increase in the mortality rate of patients with combined cardiac dysfunction and sepsis is extremely high (may reach 90%). Thus, these patients n...
Source: Heart Failure Reviews - June 21, 2019 Category: Cardiology Source Type: research

Oxygen use in chronic heart failure to relieve breathlessness: A systematic review
AbstractTo appraise published studies on the use of supplemental oxygen in chronic heart failure. Chronic breathlessness is a characterizing symptom of symptomatic heart failure resulting in substantial disability and healthcare utilization and is the primary reason for emergency room visits and hospitalizations. In spite of the variable evidence, oxygen therapy is commonly administered both acutely and chronically. Moreover, the role of oxygen therapy to relieve chronic breathlessness in heart failure is not well described, particularly in normoxemic or mild or intermittent hypoxemic states. In fact, several studies have ...
Source: Heart Failure Reviews - June 19, 2019 Category: Cardiology Source Type: research

Pathogenesis and pathophysiology of heart failure with reduced ejection fraction: translation to human studies
AbstractHeart failure represents the end result of different pathophysiologic processes, which culminate in functional impairment. Regardless of its aetiology, the presentation of heart failure usually involves symptoms of pump failure and congestion, which forms the basis for clinical diagnosis. Pathophysiologic descriptions of heart failure with reduced ejection fraction (HFrEF) are being established. Most commonly, HFrEF is centred on a reactive model where a significant initial insult leads to reduced cardiac output, further triggering a cascade of maladaptive processes. Predisposing factors include myocardial injury o...
Source: Heart Failure Reviews - June 17, 2019 Category: Cardiology Source Type: research

Patients with high-dose diuretics should get ultrafiltration in the management of decompensated heart failure: a meta-analysis
AbstractThe identification of specific patients with decompensated heart failure (DHF) who may benefit from ultrafiltration (UF) is important in clinical practice. We undertook a meta-analysis to compare the effects of ultrafiltration and diuretics on major clinical outcomes. The outcomes included weight change, length of hospital stay, rehospitalization for HF, mortality, change in serum creatinine, dialysis dependence, and adverse outcomes. We identified 14 trials including 975 patients with HF, met the eligibility criteria. There was a reduction in heart failure-related rehospitalization in ultrafiltration group when co...
Source: Heart Failure Reviews - June 17, 2019 Category: Cardiology Source Type: research

Re-evaluating the causes and consequences of non-resolving inflammation in chronic cardiovascular disease
AbstractCardiac injuries, like heart attacks, drive the secondary pathology with advanced heart failure. In this process, non-resolving inflammation is a prime component of accelerated cardiovascular disease and subsequent fatal events associated with imbalanced diet, physical inactivity, disrupted circadian rhythms, neuro-hormonal stress, and poly- or co-medication. Laboratory rodents have established that splenic leukocyte –directed resolution mechanisms are essential for cardiac repair after injury. Here, we discuss the impact of three lifestyle-related factors that are prime causes of derailed cardiac healing, pu...
Source: Heart Failure Reviews - June 14, 2019 Category: Cardiology Source Type: research

Takotsubo syndrome: an overview of pathophysiology, diagnosis and treatment with emphasis on cancer patients
AbstractTakotsubo syndrome is a disease of great clinical importance that remains underdiagnosed. It is a form of acute heart failure characterized by a transient wall motion abnormality of the left ventricular apex typically triggered by emotional or physical stress. Takotsubo syndrome is commonly associated with cancer and results in poor outcomes. Therefore, early recognition and prompt therapy are essential to improve prognosis. The aim of this manuscript is to review the consequences of the association between cancer and Takotsubo to summarize the available evidence to guide physicians to improve the management of the...
Source: Heart Failure Reviews - June 13, 2019 Category: Cardiology Source Type: research