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

Barth syndrome cardiomyopathy: targeting the mitochondria with elamipretide
AbstractBarth syndrome (BTHS) is a rare, X-linked recessive, infantile-onset debilitating disorder characterized by early-onset cardiomyopathy, skeletal muscle myopathy, growth delay, and neutropenia, with a worldwide incidence of 1/300,000 –400,000 live births. The high mortality rate throughout infancy in BTHS patients is related primarily to progressive cardiomyopathy and a weakened immune system. BTHS is caused by defects in the TAZ gene that encodes tafazzin, a transacylase responsible for the remodeling and maturation of the mi tochondrial phospholipid cardiolipin (CL), which is critical to normal mitochondrial...
Source: Heart Failure Reviews - September 30, 2020 Category: Cardiology Source Type: research

Hemodynamic effects of ivabradine use in combination with intravenous inotropic therapy in advanced heart failure
AbstractIntravenous inotropic therapy can be used in patients with advanced heart failure, as palliative therapy or as a bridge to cardiac transplantation or mechanical circulatory support, as well as in cardiogenic shock. Their use is limited to increasing cardiac output in low cardiac output states and reducing ventricular filling pressures to alleviate patient symptoms and improve functional class. Many advanced heart failure patients have sinus tachycardia as a compensatory mechanism to maintain cardiac output. However, excessive sinus tachycardia caused by intravenous inotropes can increase myocardial oxygen consumpti...
Source: Heart Failure Reviews - September 29, 2020 Category: Cardiology Source Type: research

Vaccines against components of the renin –angiotensin system
This article reviews the different vaccination attempts with proteins and peptides against the different molecules of the renin–angiotensin system in the last two decades, safety issues, and other novel prospects biomarkers in hypertension, and summarizes the potential of th is immunomodulatory approach in clinical practice. (Source: Heart Failure Reviews)
Source: Heart Failure Reviews - September 28, 2020 Category: Cardiology Source Type: research

Cardiac contractility modulation for patient with refractory heart failure: an updated evidence-based review
AbstractHeart failure is the cardiovascular epidemic of the twenty-first century, with poor prognosis and quality of life despite optimized medical treatment. Despite over the last decade significant improvements, with a major impact on morbidity and mortality, have been made in therapy for heart failure with reduced ejection fraction, little progress was made in the development of devices, with the implantable defibrillator indicated for patients with left ventricle ejection fraction ≤ 35% and cardiac resynchronization therapy for those with QRS ≥ 130 ms and evidence of left bundle branch block...
Source: Heart Failure Reviews - September 23, 2020 Category: Cardiology Source Type: research

Drug development in oncology and devices —lessons for heart failure drug development and approval? a review
AbstractHeart failure (HF) and cancer are of the most common diseases globally, both associated with significant adverse outcomes and greatly impaired quality of life. Despite those similarities, over the last 15 years, the United States (USA) and European authorities have approved only 5 and 3 new drugs for HF respectively, none using an accelerated process and none for patients with either acute HF (AHF) or with HF and preserved ejection fraction (HFpEF). During the same period, more than 100 new drugs were approved for treatment of various cancers, several receiving accelerated approval. HF drugs in the last 15 years we...
Source: Heart Failure Reviews - September 15, 2020 Category: Cardiology Source Type: research

Diabetes-related cardiovascular and economic burden in patients hospitalized for heart failure in the US: a recent temporal trend analysis from the National Inpatient Sample
AbstractWe aimed to study the cardiovascular and economic burden of diabetes mellitus (DM) in patients hospitalized for heart failure (HF) in the US and to assess the recent temporal trend. Data from the National Inpatient Sample were analyzed between 2005 and 2014. The prevalence of DM increased from 40.4 to 46.5% in patients hospitalized for HF. In patients with HF and DM, mean (SD) age slightly decreased from 71 (13) to 70 (13)  years, in which 47.5% were males in 2005 as compared with 52% in 2014 (p trend  
Source: Heart Failure Reviews - September 14, 2020 Category: Cardiology Source Type: research

Hospitalizations in adult patients with congenital heart disease: an emerging challenge
This article reviews the available literature on hospitalization patterns in ACHD patients, with a focus on HF-related hospital admissions and specific diagnostic subgroups. (Source: Heart Failure Reviews)
Source: Heart Failure Reviews - September 9, 2020 Category: Cardiology Source Type: research

Renal protection: a leading mechanism for cardiovascular benefit in patients treated with SGLT2 inhibitors
AbstractInitially developed as glucose-lowering drugs, sodium-glucose co-transporter type 2 inhibitors (SGLT2i) have demonstrated to be effective agents for the risk reduction of cardiovascular (CV) events in patients with type 2 diabetes mellitus (T2DM). Subsequently, data has emerged showing a significant CV benefit in patients treated with SGLT2i regardless of diabetes status. Renal protection has been initially evaluated in CV randomized trials only as secondary endpoints; nonetheless, the positive results gained have rapidly led to the evaluation of nephroprotection as primary outcome in the CREDENCE trial. Different ...
Source: Heart Failure Reviews - September 7, 2020 Category: Cardiology Source Type: research

Takotsubo cardiomyopathy with low ventricular ejection fraction and apical ballooning predicts mortality: a systematic review and meta-analysis
AbstractTakotsubo cardiomyopathy (TCM) is characterized by temporary wall motion abnormality of the left ventricle. There is much debate upon the prognostic parameters. We conducted a systematic review and meta-analysis to investigate whether LVEF and the presence of apical ballooning predict long-term mortality in TCM. PubMed and Embase were searched through to October 30, 2017 without language restrictions, followed by an additional search through to February 2, 2020. Our search identified 18 studies that met the inclusion criteria, with a total of 5168 patients. Reduced LVEF as a categorical variable was associated with...
Source: Heart Failure Reviews - September 6, 2020 Category: Cardiology Source Type: research

Non-invasive cardiac allograft rejection surveillance: reliability and clinical value for prevention of heart failure
This article gives an overview of the current knowledge about the reliability and clinical value of non-invasive cardiac allograft AR surveillance. Particular attention is focused on the potential usefulness of non-invasive tools and techniques for detection and functional grading of early and late ARs in asymptomatic patients. Overall, the review aimed to provide a theoretical and practical basis for those engaged in this particularly demanding up-to-date topic. (Source: Heart Failure Reviews)
Source: Heart Failure Reviews - September 4, 2020 Category: Cardiology Source Type: research

Beyond genomics —technological advances improving the molecular characterization and precision treatment of heart failure
AbstractDilated cardiomyopathy (DCM) is a major cause of heart failure and cardiovascular mortality. In the past 20  years, there has been an overwhelming focus on developing therapeutics that target common downstream disease pathways thought to be involved in all forms of heart failure independent of the initial etiology. While this strategy is effective at the population level, individual responses vary tremen dously and only approximately one third of patients receive benefit from modern heart failure treatments. In this perspective, we propose that DCM should be considered as a collection of diseases with a common...
Source: Heart Failure Reviews - September 2, 2020 Category: Cardiology Source Type: research

Renin-angiotensin-system inhibition in the context of corona virus disease-19: experimental evidence, observational studies, and clinical implications
AbstractCoronavirus disease 2019 (COVID-19) is due to severe acute respiratory syndrome coronavirus (SARS-CoV)-2 which binds and enters the host cells through the angiotensin-converting enzyme (ACE)2. While the potential for benefit with the use of renin-angiotensin-aldosterone system inhibitors (RAASi) and the risks from stopping them is more evident, potential harm by RA ΑSi may also be caused by the increase in the activity of the ACE2 receptor, the inefficient counter regulatory axis in the lungs in which the proinflammatory prolyloligopeptidase (POP) is the main enzyme responsible for the conversion of deleterio...
Source: Heart Failure Reviews - August 31, 2020 Category: Cardiology Source Type: research

A reappraisal of the pharmacologic management of gastrointestinal bleeding in patients with continuous flow left ventricular assist devices
AbstractAdvancements in the design and functionality of continuous flow left ventricular assist devices (CF-LVADs), as well as a limited number of donor hearts, have resulted in an increased utilization of this therapy among advanced heart failure (HF) patients. Despite these advancements, gastrointestinal bleeding (GIB) remains a common complication after CF-LVAD implantation. The mechanism of GIB in these patients is complex and includes a combination of angiodysplasia, platelet dysfunction, acquired von Willebrand disease, and a variety of patient-specific factors including advanced age and history of GIB. Several pharm...
Source: Heart Failure Reviews - August 31, 2020 Category: Cardiology Source Type: research

Palliative care needs-assessment and measurement tools used in patients with heart failure: a systematic mixed-studies review with narrative synthesis
AbstractPatients with heart failure have comparable illness burden and palliative care needs to those with cancer. However, few of them are offered timely palliative care. One main barrier is the difficulty in identifying those who require palliative care. Several palliative care needs-assessment/measurement tools were used to help identify these patients and assess/measure their needs, but it is not known which one is the most appropriate for this population. This review aimed to identify the most appropriate palliative care needs-assessment/measurement tools for patients with heart failure. Cochrane Library, MEDLINE Comp...
Source: Heart Failure Reviews - August 2, 2020 Category: Cardiology Source Type: research

Effect of beta-blockers on heart failure severity in patients with heart failure with preserved ejection fraction: a meta-analysis of randomized controlled trials
AbstractPatients with heart failure with preserved ejection fraction (HFpEF) are often elderly and likely to have cardiac comorbidities such as coronary artery disease (CAD) and atrial fibrillation (AF). The primary chronic symptom of HFpEF patients is severe exercise intolerance. The inability to adequately increase heart rate during exercise is commonly present in HFpEF patients and contributes to their exercise intolerance. Although beta-blockers are frequently used for the treatment of myocardial ischemia and tachycardia in HFpEF patients, there is a concern that slowing heart rate by beta-blockers may worsen chronotro...
Source: Heart Failure Reviews - August 2, 2020 Category: Cardiology Source Type: research

Cardiac complications in inherited mitochondrial diseases
In this study, we looked at molecular genetics of MIDs and cardiac manifestations in patients with mitochondrial dysfunction. (Source: Heart Failure Reviews)
Source: Heart Failure Reviews - July 28, 2020 Category: Cardiology Source Type: research

Machine learning versus conventional clinical methods in guiding management of heart failure patients —a systematic review
AbstractMachine learning (ML) algorithms “learn” information directly from data, and their performance improves proportionally with the number of high-quality samples. The aim of our systematic review is to present the state of the art regarding the implementation of ML techniques in the management of heart failure (HF) patients. We ma nually searched MEDLINE and Cochrane databases as well the reference lists of the relevant review studies and included studies. Our search retrieved 122 relevant studies. These studies mainly refer to (a) the role of ML in the classification of HF patients into distinct categorie...
Source: Heart Failure Reviews - July 26, 2020 Category: Cardiology Source Type: research

Heart failure and COVID-19
AbstractHeart failure is a common disease state that can be encountered at different stages in the course of a COVID-19 patient presentation. New or existing heart failure in the setting of COVID-19 can present a set of unique challenges that can complicate presentation, management, and prognosis. A careful understanding of the hemodynamic and diagnostic implications is essential for appropriate triage and management of these patients. Abnormal cardiac biomarkers are common in COVID-19 and can stem from a variety of mechanisms that involve the viral entry itself through the ACE2 receptors, direct cardiac injury, increased ...
Source: Heart Failure Reviews - July 26, 2020 Category: Cardiology Source Type: research

Noninvasive measurement of arterial blood pressure in patients with continuous-flow left ventricular assist devices: a systematic review
AbstractAccurate mean blood pressure determination is essential to prevent adverse events in patients with continuous-flow left ventricular assist devices (CFLVAD). We sought to evaluate the accuracy of noninvasive methods of blood pressure measurement compared with invasive intra-arterial recordings in patients with CFLVAD. Systematic electronic search was performed on four online databases (PubMed, Scopus, Embase, and Web of Knowledge) for the terms “Blood Pressure” AND (“Heart-Assist Devices” OR “Left ventricular Assist Devices”). Only studies that compared an intra-arterial and nonin...
Source: Heart Failure Reviews - July 20, 2020 Category: Cardiology Source Type: research

Dipeptidyl peptidase-4 inhibitors as new tools for cardioprotection
AbstractPrevious studies have demonstrated that individuals with type 2 diabetes mellitus (T2DM) have a two- to fourfold propensity to develop cardiovascular disease (CVD) than nondiabetic population, making CVD a major cause of death and disability among people with T2DM. The present treatment options for management of diabetes propose the earlier and more frequent use of new antidiabetic drugs that could control hyperglycaemia and reduce the risk of cardiovascular events. Findings from basic and clinical studies pointed out DPP-4 inhibitors as potentially novel pharmacological tools for cardioprotection. There is a growi...
Source: Heart Failure Reviews - July 20, 2020 Category: Cardiology Source Type: research

Effect of ivabradine on exercise capacity in individuals with heart failure with preserved ejection fraction
This study was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement and supplemented by guidance from the Coc hrane Collaboration Handbook for Systematic Reviews of Interventions. For the meta-analysis, a forest plot was used to graphically present the effect sizes and the 95% CIs. Four randomized controlled trials were included. Ivabradine did not change exercise capacity expressed by peak VO2 and 6MWT (MD  = 0.8; 95% CI − 2.5 to 4.3;P = 0.62) (Fig.4a). In our secondary analysis, the ivabradine group showed a significant resting HR re...
Source: Heart Failure Reviews - July 10, 2020 Category: Cardiology Source Type: research

Mechanistic implications of altered protein expression in rheumatic heart disease
AbstractRheumatic heart disease (RHD) is a major cause of cardiovascular morbidity and mortality in low- and middle-income countries, where living conditions promote spread of group A β-haemolytic streptococcus. Autoimmune reactions due to molecular mimicry of bacterial epitopes by host proteins cause acute rheumatic fever (ARF) and subsequent disease progression to RHD. Despite knowledge of the factors that predispose to ARF and RHD, determinants of the progression to valvular damage and the molecular events involved remain incompletely characterised. This review focuses on altered protein expression in heart valves,...
Source: Heart Failure Reviews - July 10, 2020 Category: Cardiology Source Type: research

Correction to: Angiotensin II and angiotensin 1 –7: which is their role in atrial fibrillation?
There was a mistake in Prof. Giuseppe Massimo Claudio Rosano ’s affiliation. (Source: Heart Failure Reviews)
Source: Heart Failure Reviews - July 8, 2020 Category: Cardiology Source Type: research

Targeting the forkhead box protein P1 pathway as a novel therapeutic approach for cardiovascular diseases
AbstractCardiovascular disease (CVD) is the leading cause of death worldwide and encompasses diverse diseases of the vasculature, myocardium, cardiac electrical circuit, and cardiac development. Forkhead box protein P1 (Foxp1) is a large multi-domain transcriptional regulator belonging to the Fox family with winged helix DNA-binding protein, which plays critical roles in cardiovascular homeostasis and disorders. The broad distribution of Foxp1 and alternative splicing isoforms implicate its distinct functions in diverse cardiac and vascular cells and tissue types. Foxp1 is essential for diverse biological processes and has...
Source: Heart Failure Reviews - July 8, 2020 Category: Cardiology Source Type: research

Therapeutic angiogenesis with exosomal microRNAs: an effectual approach for the treatment of myocardial ischemia
AbstractTherapeutic angiogenesis presents a potential approach for treating ischemic heart diseases especially in patients who are not appropriate candidates for traditional approaches of revascularization. This approach acts through inducing the neovascularization or maturation of pre-existing collateral vessels into functional arteries to bypass the blocked arteries and restore perfusion to ischemic myocardium. Successful stimulation of local angiogenesis can be established by the cross talk between stem cells, endothelial cells, and cardiomyocytes, which is mainly mediated by paracrine communication accompanied by secre...
Source: Heart Failure Reviews - July 5, 2020 Category: Cardiology Source Type: research

The roles of epicardial adipose tissue in heart failure
AbstractHeart failure is a growing health problem resulting in the decreased life expectancy of patients and severely increased the healthcare burden. Penetrating research on the pathogenesis and regulation mechanism of heart failure is important for treatment of heart failure. Epicardial adipose tissue (EAT) has been demonstrated as not only a dynamic organ with biological functions but also an inert lipid store with regulating systemic metabolism. EAT mediates physiological and pathophysiological processes of heart failure by regulating adipogenesis, cardiac remodeling, insulin resistance, cardiac output, and renin angio...
Source: Heart Failure Reviews - June 28, 2020 Category: Cardiology Source Type: research

Letter regarding the article “Immunomodulatory treatment for lymphocytic myocarditis—a systematic review and meta-analysis”
(Source: Heart Failure Reviews)
Source: Heart Failure Reviews - June 24, 2020 Category: Cardiology Source Type: research

Beyond the myocardium? SGLT2 inhibitors target peripheral components of reduced oxygen flux in the diabetic patient with heart failure with preserved ejection fraction
AbstractRecent cardiovascular outcome trials have highlighted the propensity of the antidiabetic agents, SGLT2 inhibitors (SGLT2is or -flozin drugs), to exert positive clinical outcomes in patients with cardiovascular disease at risk for major adverse cardiovascular events (MACEs). Of interest in cardiac diabetology is the physiological status of the patient with T2DM and heart failure with preserved ejection fraction (HFpEF), a well-examined association. Underlying this pathologic tandem are the effects that long-standing hyperglycemia has on the ability of the HFpEF heart to adequately deliver oxygen. It is believed that...
Source: Heart Failure Reviews - June 23, 2020 Category: Cardiology Source Type: research

Direct oral anticoagulants across the heart failure spectrum: the precision medicine era
AbstractHeart failure (HF) is characterized by a pro-thrombotic state, which might aggravate its morbidity and, consequently, mortality. Several and commonly observed comorbidities, such as coronary artery disease, atrial fibrillation (AF), renal dysfunction, and diabetes often complicate HF, increasing the thromboembolic risk. In the past decade, direct oral anticoagulants (DOACs) have been approved for the treatment and prevention of stroke and embolic events in patients with nonvalvular AF. Due to their lower bleeding risk, these drugs are frequently used instead of warfarin; however, some controversies exist on their u...
Source: Heart Failure Reviews - June 23, 2020 Category: Cardiology Source Type: research

Cardiac xenotransplantation: a promising way to treat advanced heart failure
AbstractCardiac xenotransplantation (CXTx) might be a promising approach to bridge the gap between the supply and demand of a donor heart. The survival of cardiac xenograft has been significantly extended in pig-to-nonhuman primate (NHP) CXTx, with records of 195  days and 945 days for orthotropic and heterotopic CXTx, respectively. To present the history of CXTx, we list the reported clinical CXTx, compare pigs and NHPs as sources of hearts, and compare three different kinds of preclinical CXTx models. The application of genetically modified pigs and nove l immunosuppressive drugs accelerates the development of ...
Source: Heart Failure Reviews - June 22, 2020 Category: Cardiology Source Type: research

Cardiovascular magnetic resonance for the diagnosis and management of heart failure with preserved ejection fraction
AbstractHeart failure with preserved ejection fraction (HFpEF) is characterized by an impaired ventricular filling resulting in the development of dyspnea and other HF symptoms. Even though echocardiography is the cornerstone to demonstrate structural and/or functional alterations of the heart as the underlying cause for the clinical presentation, cardiovascular magnetic resonance (CMR) represents the noninvasive gold standard to assess cardiac morphology, function, and tissue changes. Indeed, CMR allows quantification of biventricular volumes, mass, wall thickness, systolic function, and intra- and extracardiac flows; dia...
Source: Heart Failure Reviews - June 21, 2020 Category: Cardiology Source Type: research

Association of loop diuretics use and dose with outcomes in outpatients with heart failure: a systematic review and meta-analysis of observational studies involving 96,959 patients
AbstractThere is ongoing controversy regarding the association between loop diuretics (LD), especially in high doses, and adverse clinical outcomes in outpatients with heart failure (HF). We performed a systematic review of the evidence for LD in outpatients with HF. We searched MEDLINE, EMBASE, and Cochrane Clinical Trial Collection to identify controlled studies, evaluating the association between LD and morbidity and mortality in patients with HF. The primary endpoint was all-cause mortality and secondary endpoint  HF hospitalizations. Quantitative analysis was performed by generating forest plots and pooling adjus...
Source: Heart Failure Reviews - June 20, 2020 Category: Cardiology Source Type: research

Arrhythmic risk stratification by cardiac magnetic resonance tissue characterization: disclosing the arrhythmic substrate within the heart muscle
AbstractSudden cardiac death (SCD) is a pivotal health problem worldwide. The identification of subjects at increased risk of SCD is crucial for the accurate selection of candidates for implantable cardioverter defibrillator (ICD) therapy. Current strategies for arrhythmic stratification largely rely on left ventricular (LV) ejection fraction (EF), mostly measured by echocardiography, and New York Heart Association functional status for heart failure with reduced EF. For specific diseases, such as hypertrophic and arrhythmogenic cardiomyopathy, some risk scores have been proposed; however, these scores take into account so...
Source: Heart Failure Reviews - June 19, 2020 Category: Cardiology Source Type: research

Cardiogenic shock in autoimmune rheumatologic diseases: an insight on etiologies, management, and treatment outcomes
AbstractAutoimmune rheumatological disorders are known to have an increased risk for cardiovascular diseases including coronary artery disease (CAD), myocarditis, pericarditis, valvulopathy, and in consequence cardiogenic shock. Data on cardiogenic shock in rheumatological diseases are scarce; however, several reports have highlighted this specific entity. We sought to review the available literature and highlight major outcomes and the management approaches in each disease. Systematic literature search, including PubMed, Ovid/Medline, Cochrane Library, and Web of Science, was conducted between January 2000 and December 20...
Source: Heart Failure Reviews - June 19, 2020 Category: Cardiology Source Type: research

Effect of renin-angiotensin system inhibition on cardiac structure and function and exercise capacity in heart failure with preserved ejection fraction: a meta-analysis of randomized controlled trials
AbstractTargeting the renin-angiotensin system (RAS) pathways has been considered a logical intervention for patients with heart failure with preserved ejection fraction (HFpEF), due to its hypothesized link to left ventricular (LV) remodeling. Although the effects of RAS inhibitors including angiotensin-converting enzyme inhibitors (ACE-Is), angiotensin receptor blockers (ARBs), and direct renin inhibitors (DRIs) on LV structure and function and exercise capacity in HFpEF patients have been examined in multiple randomized controlled trials (RCTs), results are inconsistent due partly to limited power. We conducted a meta-a...
Source: Heart Failure Reviews - June 18, 2020 Category: Cardiology Source Type: research

Right ventricular phenotype, function, and failure: a journey from evolution to clinics
AbstractThe right ventricle has long been perceived as the “low pressure bystander” of the left ventricle. Although the structure consists of, at first glance, the same cardiomyocytes as the left ventricle, it is in fact derived from a different set of precursor cells and has a complex three-dimensional anatomy and a very distinct contraction pattern. M echanisms of right ventricular failure, its detection and follow-up, and more specific different responses to pressure versus volume overload are still incompletely understood. In order to fully comprehend right ventricular form and function, evolutionary biolog...
Source: Heart Failure Reviews - June 16, 2020 Category: Cardiology Source Type: research

Ventricular arrhythmias and ARNI: is it time to reappraise their management in the light of new evidence?
AbstractThe remarkable scientific progress in the treatment of patients with heart failure (HF) and reduced ejection fraction (HFrEF) has more than halved the risk of sudden cardiac death (SCD) in this setting. However, SCD remains one of the major causes of death in this patient population. Beyond the acknowledged role of beta blockers and inhibitors of the renin-angiotensin-aldosterone system (RAAS), a new class of drugs, the angiotensin receptor neprilysin inhibitors (ARNI), proved to reduce the overall cardiovascular mortality and, more specifically, the risk of SCD in HFrEF patients. The mechanism by which ARNI may re...
Source: Heart Failure Reviews - June 16, 2020 Category: Cardiology Source Type: research

A systematic review on focal takotsubo syndrome: a not-so-small matter
AbstractA focal contraction pattern in takotsubo syndrome (TTS) is considered rare. Due to its peculiar presentation, which includes segmental left ventricular (LV) regional wall motion abnormalities (RWMA), the focal TTS pattern may be hardly differentiable from other entities, such as myocarditis or myocardial infarction. We performed a comprehensive systematic literature review researching for works in English published in Journals indexed in Embase, available online for consultation, using the following keywords (in Title and/or Abstract): ( “takotsubo” OR “broken heart” OR “apical balloon...
Source: Heart Failure Reviews - June 12, 2020 Category: Cardiology Source Type: research

Pathogenesis of chronic heart failure: cardiovascular aging, risk factors, comorbidities, and disease modifiers
AbstractChronic heart failure (HF) is rare in the young and common in the elderly in the Western world. HF in the young is usually due to specific causes, predominantly or exclusively affecting the heart (adult congenital heart disease, different types of cardiomyopathies, myocarditis, or cardiotoxicity). In contrast, the mechanisms underlying HF development in the elderly have not been completely delineated. We propose that in most elderly patients, HF, regardless of the left ventricular ejection fraction (LVEF), is the consequence of the acceleration of cardiovascular aging by specific risk factors (usually hypertension,...
Source: Heart Failure Reviews - June 9, 2020 Category: Cardiology Source Type: research

Hormonal prostate cancer therapies and cardiovascular disease: a systematic review
AbstractTherapeutic intervention for prostate cancer mostly relies on eliminating circulating androgen or antagonizing its effect at the cellular level. As the use of endocrine therapies grows, an under-reported incidence of cardiovascular toxicities occurs in prostate cancer patients. In this review, we summarize data of clinical studies, investigating the cardiovascular and metabolic alterations associated with the use of old and new endocrine drugs (gonadotropin-releasing hormone [GnRH] agonists and antagonists, androgen receptor inhibitors, 17 α-hydroxylase/c-17,20-lyase [CYP17] inhibitor) in prostate cancer. To ...
Source: Heart Failure Reviews - June 3, 2020 Category: Cardiology Source Type: research

The effect of nutraceuticals on multiple signaling pathways in cardiac fibrosis injury and repair
AbstractCardiac fibrosis is one of the most common pathological conditions caused by different heart diseases, including myocardial infarction and diabetic cardiomyopathy. Cardiovascular disease is one of the major causes of mortality worldwide. Cardiac fibrosis is caused by different processes, including inflammatory reactions and oxidative stress. The process of fibrosis begins by changing the balance between production and destruction of extracellular matrix components and stimulating the proliferation and differentiation of cardiac fibroblasts. Many studies have focused on finding drugs with less adverse effects for th...
Source: Heart Failure Reviews - June 2, 2020 Category: Cardiology Source Type: research

Cardiac magnetic resonance in cocaine-induced myocardial damage: cocaine, heart, and magnetic resonance
AbstractThe use of cocaine constitutes a major health problem. Cocaine use is associated with acute and chronic complications that might involve any system, the most common being the cardiovascular system. The precise incidence of cocaine-induced cardiomyopathy remains mysterious and probably underreported. Cocaine use should be considered in young patients presenting with chest pain or heart failure without other underlying risk factors. Cocaine-related cardiovascular complications can be acute or chronic and include ischemic and non-ischemic events. Frequent cocaine users have a seven-fold higher risk of myocardial infar...
Source: Heart Failure Reviews - June 1, 2020 Category: Cardiology Source Type: research

Diagnostic value of echocardiographic markers for diastolic dysfunction and heart failure with preserved ejection fraction
This study aimed to evaluate the diagnostic performance of echocardiographic markers of heart failure with preserved ejection fraction (HFpEF) and left ventricular diastolic dysfunction (LVDD) in comparison with the gold standard of cardiac catheterization. Diagnosing HFpEF is challenging, as symptoms are non-specific and often absent at rest. A clear need exists for sensitive echocardiographic markers to diagnose HFpEF. We systematically searched for studies testing the diagnostic value of novel echocardiographic markers for HFpEF and LVDD. Two investigators independently reviewed the studies and assessed the risk of bias...
Source: Heart Failure Reviews - June 1, 2020 Category: Cardiology Source Type: research

Clinical inertia in the treatment of heart failure: a major issue to tackle
AbstractDespite an enormous improvement in heart failure management during the last decades, the hospitalization and mortality rate of heart failure patients still remain very high. Clinical inertia, defined as the lack of treatment intensification in a patient not at evidence-based goals for care, is an important underlying cause. Clinical inertia is extensively described in hypertension and type 2 diabetes mellitus, but increasingly recognized in heart failure as well. Given the well-established guidelines for the management of heart failure, these are still not being reflected in clinical practice. While the absolute ma...
Source: Heart Failure Reviews - May 29, 2020 Category: Cardiology Source Type: research

Anthracycline-induced cardiotoxicity and renin-angiotensin-aldosterone system —from molecular mechanisms to therapeutic applications
AbstractFew millions of new cancer cases are diagnosed worldwide every year. Due to significant progress in understanding cancer biology and developing new therapies, the mortality rates are decreasing with many of patients that can be completely cured. However, vast majority of them require chemotherapy which comes with high medical costs in terms of adverse events, of which cardiotoxicity is one of the most serious and challenging. Anthracyclines (doxorubicin, epirubicin) are a class of cytotoxic agents used in treatment of breast cancer, sarcomas, or hematological malignancies that are associated with high risk of cardi...
Source: Heart Failure Reviews - May 29, 2020 Category: Cardiology Source Type: research