Cor pulmonale: the role of traditional and advanced echocardiography in the acute and chronic settings
AbstractCor pulmonale is the condition in which the right ventricle undergoes morphological and/or functional changes due to diseases that affect the lungs, the pulmonary circulation, or the breathing process. Depending on the speed of onset of the pathological condition and subsequent effects on the right ventricle, it is possible to distinguish the acute cor pulmonale from the chronic type of disease. Echocardiography plays a central role in the diagnostic and therapeutic work-up of these patients, because of its non-invasive nature and wide accessibility, providing its greatest usefulness in the acute setting. It also r...
Source: Heart Failure Reviews - February 20, 2021 Category: Cardiology Source Type: research

Angiotensin-converting enzyme 2: a double-edged sword in COVID-19 patients with an increased risk of heart failure
AbstractThe coronavirus disease (COVID-19) pandemic is a global health priority. Given that cardiovascular diseases (CVD) are the leading cause of morbidity around the world and that several trials have reported severe cardiovascular damage in patients infected with SARS-CoV-2, a substantial number of COVID-19 patients with underlying cardiovascular diseases need to continue their medications in order to improve myocardial contractility and to prevent the onset of major adverse cardiovascular events (MACEs), including heart failure. Some of the current life-saving medications may actually simultaneously expose patients to ...
Source: Heart Failure Reviews - February 20, 2021 Category: Cardiology Source Type: research

Cardiorespiratory fitness in patients with type 2 diabetes: A missing piece of the puzzle
AbstractFunctional capacity represents an important predictor for cardiovascular and all-cause mortality in patients with diabetes mellitus (DM). Impaired cardiopulmonary fitness is frequently seen in DM patients, and it might partly explain morbidity and mortality in these patients. There are several potential reasons that could explain impaired functional capacity in DM patients: hyperglycemia, insulin resistance, endothelial dysfunction, inflammation, microvascular impairment, myocardial dysfunction, and skeletal muscle changes. These changes are partly reversible, and improvement of any of these components might increa...
Source: Heart Failure Reviews - February 20, 2021 Category: Cardiology Source Type: research

Management of RAASi-associated hyperkalemia in patients with cardiovascular disease
AbstractRenin –angiotensin–aldosterone system inhibitors (RAASi) reduce morbidity and mortality in heart failure (HF) with reduced ejection fraction in a dose-dependent manner. They also have a positive impact in other cardiovascular diseases (CVDs). However, RAASi may induce hyperkalemia, a potentially life- threatening disorder. This risk is further increased in those with concomitant chronic kidney disease, diabetes mellitus, and/or in patients with hypertension. Current treatment guidelines recommend maximal RAASi dosing to improve clinical outcomes; however, this is often limited by the development of hype...
Source: Heart Failure Reviews - February 18, 2021 Category: Cardiology Source Type: research

The efficacy of bone marrow mononuclear stem cell transplantation in patients with non-ischemic dilated cardiomyopathy —a meta analysis
We present an analysis of the following outcomes: left ventricular ejection fraction (LVEF), left ventricular end-diastolic diameter (LVEDD), and six minutes walking test. Data were pooled as mean differences (MD) and relative confidence intervals (CI). The analysis of 667 pa tients from 11 studies receiving autologous bone marrow cell therapy for non-ischemic dilated cardiomyopathy is presented. A total of 338 patients were allocated to the treatment group, and 329 participants entered the control group. The mean age of the patients in the treatment group is 52.4 ± 4 .3 years, while that of the contr...
Source: Heart Failure Reviews - February 15, 2021 Category: Cardiology Source Type: research

Balloon pulmonary angioplasty vs. pulmonary endarterectomy in patients with chronic thromboembolic pulmonary hypertension: a  systematic review and meta-analysis
AbstractAlthough balloon pulmonary angioplasty (BPA) and pulmonary endarterectomy (PEA) are effective in chronic thromboembolic pulmonary hypertension (CTEPH), the comparison of their efficacy and safety is still unclear. We identified studies through a systematic review of PubMed, Cochrane Library, and Embase and used a random effects meta-analysis model to synthesize estimates of weighted mean differences or combined effect size. In total, 54 studies were included in this meta-analysis. The survival rates at perioperative/in-hospital period, 2 years, and 3 years were 100%, 99%, and 97%, respectively, in BPA group and 93%...
Source: Heart Failure Reviews - February 5, 2021 Category: Cardiology Source Type: research

SGLT2 inhibitors: a focus on cardiac benefits and potential mechanisms
AbstractThis paper highlights the cardioprotective potential of sodium-glucose cotransporter 2 inhibitors (SLGT2i), as well as several most discussed mechanisms responsible for their cardioprotection. Cardiovascular diseases are considered a primary cause of death in nearly 80% of type 2 diabetes mellitus (T2DM) patients, with a 2 –4-fold greater incidence of heart failure (HF) among diabetics. As novel hypoglycemics, SGLT2i showed exceptional cardiovascular benefits, reflected through robust reductions of cardiovascular mortality and hospitalization for HF in T2DM patients. Recently, those effects have been reported...
Source: Heart Failure Reviews - February 3, 2021 Category: Cardiology Source Type: research

Weighing in on heart failure: the potential impact of bariatric surgery
AbstractObesity is a growing worldwide epidemic with significant economic burden that carries with it impacts on every physiologic system including the cardiovascular system. Specifically, the risk of heart failure has been shown to increase dramatically in obese individuals. The purpose of this review is to provide background on the individual burdens of heart failure and obesity, followed by exploring proposed physiologic mechanisms that interconnect these conditions, and furthermore introduce treatment strategies for weight loss focusing on bariatric surgery. Review of the existing literature on patients with obesity an...
Source: Heart Failure Reviews - January 25, 2021 Category: Cardiology Source Type: research

Factors associated with non-use and sub-target dosing of medical therapy for heart failure with reduced ejection fraction
In conclusion, several common patient characteristics are associated with non-use and sub-target dosing of medical therapy for HFrEF. These high-risk groups are in particular need of further studies to improve implementation of available medications and to define the role of novel therapies. (Source: Heart Failure Reviews)
Source: Heart Failure Reviews - January 20, 2021 Category: Cardiology Source Type: research

Practical recommendations for the diagnosis and management of transthyretin cardiac amyloidosis
AbstractCardiac amyloidosis (CA) is an infiltrative restrictive cardiomyopathy caused by accumulation in the heart interstitium of amyloid fibrils formed by misfolded proteins. Most common CA types are light chain amyloidosis (AL) caused by monoclonal immunoglobulin light chains and transthyretin amyloidosis (ATTR) caused by either mutated or wild-type transthyretin aggregates. Previously considered a rare disease, CA is increasingly recognized among patients who may be misdiagnosed as undifferentiated heart failure with preserved ejection fraction (HFPEF), paradoxical low-flow/low-gradient aortic stenosis, or otherwise un...
Source: Heart Failure Reviews - January 15, 2021 Category: Cardiology Source Type: research

A meta-analysis of microRNA expression profiling studies in heart failure
AbstractHeart failure (HF) is a major consequence of many cardiovascular diseases with high rate of morbidity and mortality. Early diagnosis and prevention are hampered by the lack of informative biomarkers. The aim of this study was to perform a meta-analysis of the miRNA expression profiling studies in HF to identify novel candidate biomarkers or/and therapeutic targets. A comprehensive literature search of the PubMed for miRNA expression studies related to HF was carried out. The vote counting and robust rank aggregation meta-analysis methods were used to identify significant meta-signatures of HF-miRs. The targets of H...
Source: Heart Failure Reviews - January 14, 2021 Category: Cardiology Source Type: research

Efficacy of adaptive servo-ventilation and continuous positive airway pressure treatment in chronic heart failure with sleep-disordered breathing: a systematic review and meta-analysis
This study aims to explore the effects of NPPV on cardiac function and survival in patients with sleep-disordered breathing and chronic congestive heart failure. This meta-analysis was based on literature searches of publications published before August 31, 2019, in the PubMed, EMBASE, Cochrane Library, and Web of Science databases. A total of 88 independent studies were summarized and compared, comprising a sampling of 19,259 subjects. Compared with the nontreatment group, treatment with ASV had no effect on all-cause mortality in patients with HFrEF + CSA (hazard ratio (HR)  = 1.13 [0.84, 1.51]). Short-term...
Source: Heart Failure Reviews - January 14, 2021 Category: Cardiology Source Type: research

Peripartum cardiomyopathy
AbstractPeripartum cardiomyopathy is now increasingly recognized as a cause of heart failure in the later months of pregnancy and early postpartum period. Clinical diagnosis may be challenging as it closely resembles several common medical and obstetric complications. Complex pathogenesis, unpredictable onset, staggered recovery, and unanticipated fetomaternal risks pose unique challenge to clinicians. Prevalence seems to vary with race, geographic location, and diagnostic criteria. The presence of multiple risk factors substantially elevates the risk of PPCM. Transthoracic echocardiographic examination can exclude the maj...
Source: Heart Failure Reviews - January 13, 2021 Category: Cardiology Source Type: research

Assessing the future risks of subsequent pregnancies in peripartum cardiomyopathy
AbstractPeripartum cardiomyopathy is a myocardial disease process which occurs in young women either in late pregnancy or the early postpartum period. Due to the young age of women effected by this disease, many of these patients elect to pursue a subsequent pregnancy after their initial diagnosis. Currently, echocardiography is used to better elucidate the cardiovascular risks these young patients face when undergoing a subsequent pregnancy; however, the most accurate modality to determine these risks is debatable. In this review, we explore the current literature regarding the use and accuracy of resting transthoracic ec...
Source: Heart Failure Reviews - January 12, 2021 Category: Cardiology Source Type: research

Device-based treatment options for heart failure with preserved ejection fraction
AbstractHeart failure with preserved ejection fraction (HFpEF) is a syndrome with an unfavorable prognosis, and the number of the patients continues to grow. Because there is no effective therapy established as a standard, including pharmacological treatments, a movement to develop and evaluate device-based therapies is an important emerging area in the treatment of HFpEF patients. Many devices have set their target to reduce the left atrial pressure or pulmonary capillary wedge pressure because they are strongly related to the symptoms and prognosis of HFpEF, but the methodology to achieve it varies based on the devices. ...
Source: Heart Failure Reviews - January 12, 2021 Category: Cardiology Source Type: research

Challenges and the innovations in the care of advanced heart failure patients during COVID-19
AbstractThe COVID-19 pandemic underscored our healthcare system ’s unpreparedness to manage an unprecedented pandemic. Heart failure (HF) physicians from 14 different academic and private practice centers share their systems’ challenges and innovations to care for patients with HF, heart transplantation, and patients on LVAD support during the COVID-19 pande mic. We discuss measures implemented to alleviate the fear in seeking care, ensure continued optimization of guideline directed medical therapy (GDMT), manage the heart transplant waiting list, continue essential outpatient monitoring of anticoagulation in ...
Source: Heart Failure Reviews - January 12, 2021 Category: Cardiology Source Type: research

Challenge of post-COVID era: management of cardiovascular complications in asymptomatic carriers of SARS-CoV-2
AbstractSevere Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2), a highly pathogenic member of family coronaviridae, has caused an exponentially growing global pandemic termed as the coronavirus disease 2019 (COVID-19) with more than 12 million cases worldwide till date. This deadly disease has average fatality rate of 6.5% and even higher among elderly patients and patients with comorbidities. SARS-CoV-2 uses angiotensin-converting enzyme 2 (ACE-2) as the entry receptor into host cell. ACE-2, a type-I transmembrane metallocarboxypeptidase, is a critical regulator of the renin-angiotensin system. The entry of SARS-CoV...
Source: Heart Failure Reviews - January 11, 2021 Category: Cardiology Source Type: research

Echocardiography for left ventricular assist device implantation and evaluation: an indispensable tool
AbstractEchocardiography is an indispensable tool in the evaluation, placement, management and follow-up of patients with left ventricular assist devices (LVAD). While transoesophageal echocardiography is the ideal tool in guiding the implantation procedure, transthoracic echocardiography is essential during the initial evaluation, patient selection and in the post-operative follow-up. This review attempts to summarize which parameters the echocardiographic assessment should focused on during each step. In particular, during the pre-operative assessment, it is of paramount importance to assess the presence of aortic regurg...
Source: Heart Failure Reviews - January 11, 2021 Category: Cardiology Source Type: research

Cardiac 1 H MR spectroscopy: development of the past five decades and future perspectives
AbstractContinued advances in laboratory medicine are required to realize the potential of individualized medicine to impact common cardiovascular diseases. Magnetic resonance imaging (MRI) and spectroscopy (MRS) techniques have advanced over recent years and offer unique, powerful insights into cardiac anatomic and metabolic changes, respectively, occurring in both nascent and advanced heart disease. Although numerous MRI-based in vivo diagnostics are already used in routine clinical practice and more are anticipated, MRS has been less incorporated into routine clinical practice. Given the ability of1H MRS to identify and...
Source: Heart Failure Reviews - January 7, 2021 Category: Cardiology Source Type: research

Mechanisms underlying the pathophysiology of heart failure with preserved ejection fraction: the tip of the iceberg
AbstractHeart failure with preserved ejection fraction (HFpEF) is a multifaceted syndrome with a complex aetiology often associated with several comorbidities, such as left ventricle pressure overload, diabetes mellitus, obesity, and kidney disease. Its pathophysiology remains obscure mainly due to the complex phenotype induced by all these associated comorbidities and to the scarcity of animal models that adequately mimic HFpEF. Increased oxidative stress, inflammation, and endothelial dysfunction are currently accepted as key players in HFpEF pathophysiology. However, we have just started to unveil HFpEF complexity and t...
Source: Heart Failure Reviews - January 7, 2021 Category: Cardiology Source Type: research

The soluble catalytic ectodomain of ACE2 a biomarker of cardiac remodelling: new insights for heart failure and COVID19
AbstractThe angiotensin-converting enzyme 2 (ACE2) is a type I integral membrane that was discovered two decades ago. The ACE2 exists as a transmembrane protein and as a soluble catalytic ectodomain of ACE2, also known as the soluble ACE2 that can be found in plasma and other body fluids. ACE2 regulates the local actions of the renin-angiotensin system in cardiovascular tissues, and the ACE2/Angiotensin 1 –7 axis exerts protective actions in cardiovascular disease. Increasing soluble ACE2 has been associated with heart failure, cardiovascular disease, and cardiac remodelling. This is a review of the molecular structu...
Source: Heart Failure Reviews - January 6, 2021 Category: Cardiology Source Type: research

Screening, detection, and management of heart failure in the SARS-CoV2 (COVID-19) pandemic
AbstractObservational studies suggest that a heart failure (HF) diagnosis carries a poor prognosis in subjects with severe SARS-CoV2 (COVID-19) infection, but it is unknown whether this association reflects direct myocardial damage due to COVID-19 or the consequence of preexisting cardiac defects and related cardiovascular disease (CVD) risk burden. Although the close relation between CVD and COVID-19 outcomes is well established, contrasting data exists about the occurrence of HF complications during COVID-19 infection. Therefore, a specific algorithm focused on diagnostic differentiation in acute patients distinguishing ...
Source: Heart Failure Reviews - January 6, 2021 Category: Cardiology Source Type: research

Cardiotoxicity in HER2-positive breast cancer patients
AbstractDue to the recent advances in diagnosis and management of patients with HER2-positive breast cancer, especially through novel HER2-targeted agents, cardiotoxicity becomes an emerging problem. Although chemotherapy significantly increases survival, the risk of cardiovascular disease development is high and still underestimated and could imply treatment discontinuation. Frequently, due to lack of rigorous diagnosis strategies, cardiotoxicity assessment is delayed, and, moreover, the efficacy of current therapy options in restoring heart function is questionable. For a comprehensive risk assessment, it is vital to cha...
Source: Heart Failure Reviews - January 6, 2021 Category: Cardiology Source Type: research

Beneficial effects on kidney during treatment with sodium-glucose cotransporter 2 inhibitors: proposed role of ketone utilization
AbstractModestly elevated circulating levels of the ketone β-hydroxybutyrate (βOHB) during treatment with sodium-glucose cotransporter 2 (SGLT2) inhibitors cause different beneficial effects on organs and cells, depending on the succinyl-CoA:3-ketoacid CoA transferase (SCOT) level. In the failing heart, SCOT is highly expressed/up-regulated, and thus, βO HB may be an energy source, in addition to fat and glucose oxidation. However, SCOT is not highly expressed/down-regulated in the kidney, and thus, βOHB may cause different beneficial effects, rather than acting as an alternative energy source in patien...
Source: Heart Failure Reviews - January 6, 2021 Category: Cardiology Source Type: research

Wearable cardioverter defibrillator: bridging for implantable defibrillators in left ventricular assist device patients
AbstractThere is currently conflicting data available regarding the use of implantable cardioverter-defibrillators  (ICD) in left ventricular assist device (LVAD) patients. While the benefit of an ICD in heart failure patients is well demonstrated, such benefit has failed to reach the LVAD population. In lack of randomized control trial data on the topic of ICD use in LVAD recipients, major societal guidelines are in disagreement when comes to the topic of routine implantation of a permanent defibrillator in prospective ventricular assist device patients. Alternative permanent defibrillator strategies have been sugges...
Source: Heart Failure Reviews - January 6, 2021 Category: Cardiology Source Type: research

Response to letter to Editor by: Josef Finsterer
(Source: Heart Failure Reviews)
Source: Heart Failure Reviews - January 5, 2021 Category: Cardiology Source Type: research

Bias in natriuretic peptide-guided heart failure trials: time to improve guideline adherence using alternative approaches
AbstractTreatment of patients with heart failure with reduced ejection fraction (HFrEF) with currently available therapies reduces morbidity and mortality. However, implementation of these therapies is a problem with only few patients achieving guideline-recommended maximal doses of therapy. In an effort to improve guideline adherence and uptitration, several trials have investigated a biomarker-guided strategy (using natriuretic peptide targets in specific), but although conceptually promising, these trials failed to show a consistent beneficial effect on outcomes. In this review, we discuss different methodological issue...
Source: Heart Failure Reviews - December 29, 2020 Category: Cardiology Source Type: research

Transthyretin amyloid cardiomyopathy in women: frequency, characteristics, and diagnostic challenges
This study was registered within the International Prospective Register of Systematic Reviews (PROSPERO) database of the University of York (CRD42019146995). (Source: Heart Failure Reviews)
Source: Heart Failure Reviews - December 29, 2020 Category: Cardiology Source Type: research

Comparative effects of furosemide and other diuretics in the treatment of heart failure: a systematic review and combined meta-analysis of randomized controlled trials
AbstractDiuretics have an essential role in the management of heart failure (HF). However, each drug has its own benefit and side effect. Side effects include fluid, electrolyte abnormalities, and acid-base disturbance. These adverse effects of diuretics predispose patients to serious cardiac arrhythmias and may increase the risk of arrhythmic mortality. Herein, we aim to summarize the relative efficacy and safety of all available diuretics used in the treatment of patients with HF. In June 2017, a systematic electronic database search was conducted in nine databases. All randomized controlled trials (RCTs) comparing the d...
Source: Heart Failure Reviews - December 29, 2020 Category: Cardiology Source Type: research

Oxidative stress and inflammation: determinants of anthracycline cardiotoxicity and possible therapeutic targets
AbstractChemotherapy with anthracycline-based regimens remains a cornerstone of treatment of many solid and blood tumors but is associated with a significant risk of cardiotoxicity, which can manifest as asymptomatic left ventricular dysfunction or overt heart failure. These effects are typically dose-dependent and cumulative and may require appropriate screening strategies and cardioprotective therapies in order to minimize changes to anticancer regimens or even their discontinuation. Our current understanding of cardiac damage by anthracyclines includes a central role of oxidative stress and inflammation. The identificat...
Source: Heart Failure Reviews - December 15, 2020 Category: Cardiology Source Type: research

Correction to: Cardiac resynchronization therapy in heart failure patients: tough road but clear future
Junmeng Zhang was added as corresponding author and his affiliation was changed. (Source: Heart Failure Reviews)
Source: Heart Failure Reviews - December 4, 2020 Category: Cardiology Source Type: research

SGLT2-inhibitors; more than just glycosuria and diuresis
AbstractHeart failure (HF) continues to be a serious public health challenge despite significant advancements in therapeutics and is often complicated by multiple other comorbidities. Of particular concern is type 2 diabetes mellitus (T2DM) which not only amplifies the risk, but also limits the treatment options available to patients. The sodium-glucose linked cotransporter subtype 2 (SGLT2)-inhibitor class, which was initially developed as a treatment for T2DM, has shown great promise in reducing cardiovascular risk, particularly around HF outcomes – regardless of diabetes status.There are ongoing efforts to elucida...
Source: Heart Failure Reviews - December 4, 2020 Category: Cardiology Source Type: research

Ultrafiltration is better than diuretic therapy for volume-overloaded acute heart failure patients: a meta-analysis
AbstractStudies on the effectiveness of ultrafiltration (UF) in patients hospitalized with acute decompensated heart failure (ADHF) have led to heterogeneous study outcomes. This meta-analysis aimed to assess the impact of UF therapy in ADHF patients. We searched the medical literature to identify well-designed studies comparing UF with the usual diuretic therapy in this setting. Systematic evaluation of 8 randomized controlled trials enrolling 801 participants showed greater fluid removal (difference in means 1372.5  mL, 95% CI 849.6 to 1895.4 mL;p 
Source: Heart Failure Reviews - November 26, 2020 Category: Cardiology Source Type: research

Cost-effectiveness analysis of mitral valve repair with the MitraClip delivery system for patients with mitral regurgitation: a systematic review
AbstractTo assess the cost-effectiveness of mitral valve repair with the MitraClip delivery system for patients with mitral regurgitation and heart failure, a systematic literature search was conducted in various electronic databases to January 3, 2020. Eligibility criteria are the population (patients with mitral regurgitation (MR)), intervention (transcatheter mitral valve repair using the MitraClip), comparator (conventional medical treatment), outcomes, and designs (Model-based or trial-based full economic evaluations).The quality of included studies was assessed using the CHEERS checklist. Mortality and survival rate,...
Source: Heart Failure Reviews - November 24, 2020 Category: Cardiology Source Type: research

Psychological stress in heart failure: a potentially actionable disease modifier
AbstractPsychological stress is common in patients with heart failure, due in part to the complexities of effective disease self-management and progressively worsening functional limitations, including frequent symptom exacerbations and hospitalizations. Emerging evidence suggests that heart failure patients who experience higher levels of stress may have a more burdensome disease course, with diminished quality of life and increased risk for adverse events, and that multiple behavioral and pathophysiological pathways are involved. Furthermore, the reduced quality of life associated with heart failure can serve as a life s...
Source: Heart Failure Reviews - November 20, 2020 Category: Cardiology Source Type: research

The spectrum of lupus myocarditis: from asymptomatic forms to cardiogenic shock
AbstractLupus myocarditis is a serious, potentially deadly disease. When it presents as an acute or fulminant myocarditis in a patient without an established diagnosis of lupus, lupus as an etiology of the condition is not commonly suspected. Meanwhile, it has a distinct treatment which may be lifesaving. Review of the literature can shed more light as current management is mostly based on clinical experience and case reports rather than randomized control trials. In this review we are discussing this diagnostic entity, focusing on cardiogenic shock as a manifestation of lupus myocarditis, and discussing management includi...
Source: Heart Failure Reviews - November 19, 2020 Category: Cardiology Source Type: research

Exercise rehabilitation in cardiac resynchronization: systematic review and a meta-analysis
Conclusion: Peak VO2 and AT-VO2 are increased with aerobic exercise in CRT recipients, demonstrating a significant improvement in functional capacity. (Source: Heart Failure Reviews)
Source: Heart Failure Reviews - November 17, 2020 Category: Cardiology Source Type: research

Mechanisms of COVID-19-induced heart failure: a short review
AbstractThe severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that causes coronavirus disease 2019 (COVID-19) has infected more than 42.5 million people globally resulting in the death of over  1.15 million subjects. It has inflicted severe public health and economic hardships across the world. In addition to acute respiratory distress syndrome, respiratory failure, sepsis, and acute kidney injury, COVID-19 also causes heart failure (HF). COVID-19-induced HF is manifested via different m echanisms, including, but not limited to, (1) virus-induced infiltration of inflammatory cells, which could impair the fu...
Source: Heart Failure Reviews - November 16, 2020 Category: Cardiology Source Type: research

Correction to: Vitamin c: historical perspectives and heart failure
There was an error in Figure 2. The error is in the middle frame of Figure 2. The correct figure is shown below: (Source: Heart Failure Reviews)
Source: Heart Failure Reviews - November 16, 2020 Category: Cardiology Source Type: research

Impact of atrial fibrillation on the outcomes of transcatheter mitral valve repair using MitraClip: a systematic review and meta-analysis
AbstractAtrial fibrillation (AF) is a common arrhythmia in patients with mitral regurgitation (MR) undergoing transcatheter mitral valve repair (TMVR). In this systematic review, we aimed to investigate the outcomes of TMVR using MitraClip in AF patients. We performed a systematic search using PubMed, SCOPUS, EMBASE, and Google Scholar, from inception to May 10, 2020, for studies that reported outcomes following MitraClip, in patients with AF versus without AF. Seven studies with a total of 7678 patients met the inclusion criteria. The risk of 1-year all-cause mortality following TMVR was higher in AF patients (RR 1.40, 95...
Source: Heart Failure Reviews - November 10, 2020 Category: Cardiology Source Type: research

Machine learning and statistical methods for predicting mortality in heart failure
AbstractHeart failure is a debilitating clinical syndrome associated with increased morbidity, mortality, and frequent hospitalization, leading to increased healthcare budget utilization. Despite the exponential growth in the introduction of pharmacological agents and medical devices that improve survival, many heart failure patients, particularly those with a left ventricular ejection fraction less than 40%, still experience persistent clinical symptoms that lead to an overall decreased quality of life. Clinical risk prediction is one of the strategies that has been implemented for the selection of high-risk patients and ...
Source: Heart Failure Reviews - November 9, 2020 Category: Cardiology Source Type: research

Neural tone and cardio-renal outcomes in patients with type 2 diabetes mellitus: a review of the literature with a focus on SGLT2 inhibitors
AbstractRecent clinical trials involving the systemic effects of sodium-glucose cotransporter 2 inhibitors (SGLT2i) have revealed beneficial outcomes pertaining to the microvascular sequelae of type 2 diabetes mellitus (T2DM) such as nephropathy, as well as macrovascular effects such as major adverse cardiovascular effects (MACE). Such findings have spurred the elevation of these agents to level A-tiers of recommendation within clinical guidelines addressing the management of complicated T2DM. While the mechanisms of SGLTi (-flozin drugs) are still being elucidated, a paucity of data exists within the literature appraising...
Source: Heart Failure Reviews - November 9, 2020 Category: Cardiology Source Type: research

The utility of cardiovascular imaging in heart failure with preserved ejection fraction: diagnosis, biological classification and risk stratification
AbstractHeart failure with preserved ejection fraction (HFpEF) does not exist as a singular clinical or pathological entity but as a syndrome encompassing a wide range of clinical and biological phenotypes. There is an urgent need to progress from the unsuccessful ‘one-size-fits-all’ approach to more precise disease classification, in order to develop targeted therapies, personalise risk stratification and guide future research. In this regard, this review discusses the current and emerging roles of cardiovascular imaging for the diagnosis of HFpEF, for d istilling HFpEF into distinct disease entities according...
Source: Heart Failure Reviews - November 5, 2020 Category: Cardiology Source Type: research

Sodium glucose cotransporter 2 inhibitors: mechanisms of action in heart failure
This article presents the current state of knowledge a bout the mechanisms of action of SGLT2is developed for the treatment of diabetes and which, thanks to their cardioprotective effects, may, in the future, become a treatment for patients with HF. (Source: Heart Failure Reviews)
Source: Heart Failure Reviews - November 4, 2020 Category: Cardiology Source Type: research

Vitamin C: historical perspectives and heart failure
AbstractVitamin C (Vit C) is an ideal antioxidant as it is easily available, water soluble, very potent, least toxic, regenerates other antioxidants particularly Vit E, and acts as a cofactor for different enzymes. It has received much attention due to its ability in limiting reactive oxygen species, oxidative stress, and nitrosative stress, as well as it helps to maintain some of the normal metabolic functions of the cell. However, over 140 clinical trials using Vit C in different pathological conditions such as myocardial infarction, gastritis, diabetes, hypertension, stroke, and cancer have yielded inconsistent results....
Source: Heart Failure Reviews - October 8, 2020 Category: Cardiology Source Type: research

The role of cardiac magnetic resonance imaging in the detection and monitoring of cardiotoxicity in patients with breast cancer after treatment: a comprehensive review
AbstractThe use of chemotherapy medicines for breast cancer (BC) has been associated with an increased risk of cardiotoxicity. In recent years, there have been growing interests regarding the application of cardiovascular magnetic resonance (CMR) imaging, a safe and noninvasive modality, with the potential to identify subtle morphological and functional changes in the myocardium. In this investigation, we aimed to review the performance of various CMR methods in diagnosing cardiotoxicity in BC, induced by chemotherapy or radiotherapy. For this purpose, we reviewed the literature available in PubMed, MEDLINE, Cochrane, Goog...
Source: Heart Failure Reviews - October 6, 2020 Category: Cardiology Source Type: research

The role of cardiac magnetic resonance in diagnosis of cardiac sarcoidosis
AbstractSarcoidosis is a systemic granulomatous disease with a high prevalence of cardiac involvement in autopsic studies. Cardiac sarcoidosis is associated with increased cardiovascular morbidity and mortality. Endomyocardial biopsy is a specific technique, but unfortunately not sensitive enough. Non-invasive cardiac imaging has an important role in the evaluation of patients with suspected or confirmed cardiac sarcoidosis. Echocardiography remains the first choice imaging technique because of its availability and low cost. However, this method could not provide tissue characterization or evaluation of disease activity le...
Source: Heart Failure Reviews - October 5, 2020 Category: Cardiology Source Type: research

Heal the heart through gut (hormone) ghrelin: a potential player to combat heart failure
AbstractGhrelin, a small peptide hormone (28 aa), secreted mainly by X/A-like cells of gastric mucosa, is also locally produced in cardiomyocytes. Being an orexigenic factor (appetite stimulant), it promotes release of growth hormone (GH) and exerts diverse physiological functions, viz. regulation of energy balance, glucose, and/or fat metabolism for body weight maintenance. Interestingly, administration of exogenous ghrelin significantly improves cardiac functions in CVD patients as well as experimental animal models of heart failure. Ghrelin ameliorates pathophysiological condition of the heart in myocardial infarction, ...
Source: Heart Failure Reviews - October 5, 2020 Category: Cardiology Source Type: research

A manifesto of collaborative longitudinal cardiovascular care in heart failure
AbstractIn this document, we outline the challenges faced by patients and clinicians in heart failure, specifically centered around the needed coordination of care among the various subspecialties within cardiovascular medicine. We call for a more organized and collaborative effort among clinicians in primary care, general cardiology, electrophysiology, interventional cardiology, cardiothoracic surgery, cardiac imaging, and heart failure —all caring for mutual patients. Care is contextualized within the framework of two phases: a cardiomyopathy phase and an advanced heart failure phase, each of which lends to differe...
Source: Heart Failure Reviews - October 5, 2020 Category: Cardiology Source Type: research

Cardiogenic shock and acute kidney injury: the rule rather than the exception
AbstractCardiogenic shock (CS) is a life-threatening condition of poor end-organ perfusion, caused by any cardiovascular disease resulting in a severe depression of cardiac output. Despite recent advances in replacement therapies, the outcome of CS is still poor, and its management depends more on empirical decisions rather than on evidence-based strategies. By its side, acute kidney injury (AKI) is a frequent complication of CS, resulting in the onset of a cardiorenal syndrome. The combination of CS with AKI depicts a worse clinical scenario and holds a worse prognosis. Many factors can lead to acute renal impairment in t...
Source: Heart Failure Reviews - October 1, 2020 Category: Cardiology Source Type: research