Trends and complications associated with acute new-onset heart failure: a National Readmissions Database –based cohort study
The objective of this study is to study the outcomes of AHFpEF and AHFrEF in the USA. Data from the National Readmissions Database (NRD) sample that constitutes 49.1% of the stratified sample of all hospitals in the USA, representing more than 95% of the national population, were analyzed for hospitalization visits for acute heart failure. ICD-9 and ICD-10 codes were used to identify AHF. A total of 2,559,102 adult index AHF patients (mean age 70.79  ± 14.58 years, 49.4% females), 1,028,970 (40.2%) AHFpEF and 1,330,999 (52%) AHFrEF, were recorded in the National Readmissions Database for the years...
Source: Heart Failure Reviews - July 28, 2021 Category: Cardiology Source Type: research

Osteoprotegerin and RANKL-RANK-OPG-TRAIL signalling axis in heart failure and other cardiovascular diseases
This article presents the current state of knowledge on the mechanisms of action of OPG and TRAIL in the circulatory system and their role in cardiovascular diseases. Understanding these mechanisms may allow their use as a therapeutic target in cardiovascular diseases i n the future. (Source: Heart Failure Reviews)
Source: Heart Failure Reviews - July 27, 2021 Category: Cardiology Source Type: research

Dependence and reduced motor function in heart failure: future directions for well-being
This article summarizes reports of reduced independence and highlights its significant adverse outcomes in the patients with heart failure. Finally, this article discusses potential causes of reduced independence based on existing reports of impaired central and peripheral nervous systems in the patients with heart failure. Overall, the article provides a solid foundation for future studies investigating motor impairments in patients with heart failure. Such studies may lead to advances in treatment and prevention of reduced independence associated with heart failure, which ultimately contribute to the well-being of patien...
Source: Heart Failure Reviews - July 24, 2021 Category: Cardiology Source Type: research

Transcatheter therapies for secondary mitral regurgitation in advanced heart failure: what are we aiming for?
AbstractA severe secondary mitral regurgitation (SMR) can be found in a significant portion of patients affected by advanced heart failure (AHF). Conventional therapies (optimal medical therapy, devices, surgery) present restricted clinical efficacy in this stage of the left ventricle disease which is burdened by high mortality and morbidity rates. Although the treatment of choice is represented by heart transplantation (HTx), there is an unmet need related to the limited supply of donor hearts (as opposed to the growing prevalence of AHF) and the low eligibility of highly symptomatic patients. In case of concomitant sever...
Source: Heart Failure Reviews - July 22, 2021 Category: Cardiology Source Type: research

Deciphering hypertrophic cardiomyopathy with electrocardiography
AbstractThe comprehensive assessment of patients with hypertrophic cardiomyopathy is a complex process, with each step concurrently focusing on confirmation of the diagnosis, differentiation between sarcomeric and non-sarcomeric disease (phenocopy), and prognostication. Novel modalities such as genetic testing and advanced imaging have allowed for substantial advancements in the understanding of this condition and facilitate patient management. However, their availability is at present not universal, and interpretation requires a high level of expertise. In this setting, electrocardiography, a fast and widely available met...
Source: Heart Failure Reviews - July 21, 2021 Category: Cardiology Source Type: research

The place of vericiguat in the landscape of treatment for heart failure with reduced ejection fraction
AbstractThe significant morbidity and mortality associated with heart failure with reduced (HFrEF) or preserved ejection fraction (HFpEF) justify the search for novel therapeutic agents. The nitric oxide (NO) –soluble guanylate cyclase (sGC)-cyclic guanosine monophosphate (cGMP) pathway plays an important role in the regulation of cardiovascular function. This pathway is disrupted in HF resulting in decreased protection against myocardial injury. The sGC activator cinaciguat increases cGMP levels by di rect, NO-independent activation of sGC, and may be particularly effective in conditions of increased oxidative stres...
Source: Heart Failure Reviews - July 21, 2021 Category: Cardiology Source Type: research

Advanced cardiovascular multimodal imaging and aortic stenosis
AbstractAortic valve stenosis has become the most common valvular heart disease on account of  aging population and increasing life expectancy. Echocardiography is the primary diagnosis tool for this, but it still has many flaws. Therefore, advanced cardiovascular multimodal imaging techniques are continuously being developed in order to overcome these limitations. Cardiac magnetic resonan ce imaging (CMR) allows a comprehensive morphological and functional evaluation of the aortic valve and provides important data for the diagnosis and risk stratification in patients with aortic stenosis. CMR can functional...
Source: Heart Failure Reviews - July 19, 2021 Category: Cardiology Source Type: research

Current and emerging drug targets in heart failure treatment
AbstractAfter initial strategies targeting inotropism and congestion, the neurohormonal interpretative model of heart failure (HF) pathophysiology has set the basis for current pharmacological management of HF, as most of guideline recommended drug classes, including beta-blockers, angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, and mineralocorticoid receptor antagonists, blunt the activation of detrimental neurohormonal axes, namely sympathetic and renin –angiotensin–aldosterone (RAAS) systems. More recently, sacubitril/valsartan, a first-in-class angiotensin receptor neprilysin inhibi...
Source: Heart Failure Reviews - July 17, 2021 Category: Cardiology Source Type: research

The use of diflunisal for transthyretin cardiac amyloidosis: a review
AbstractTransthyretin cardiac amyloidosis (ATTR-CM) is caused by the accumulation of misfolded transthyretin (TTR) protein in the myocardium. Diflunisal, an agent that stabilizes TTR, has been used as an off-label therapeutic for ATTR-CM. Given limited data surrounding the use of diflunisal, a systematic review of the literature is warranted. We searched the PubMed, MEDLINE, and Embase databases for studies that reported on the use of diflunisal therapy for patients with ATTR-CM. We included English language studies which assessed the effect of diflunisal in adult patients with ATTR-CM who received diflunisal as primary tr...
Source: Heart Failure Reviews - July 16, 2021 Category: Cardiology Source Type: research

Functional tricuspid regurgitation, related right heart remodeling, and available treatment options: good news for patients with heart failure?
AbstractSignificant functional tricuspid regurgitation (FTR) represents a poor prognostic factor independent of right ventricular (RV) function. It is usually the consequence of left-sided cardiac diseases that induce RV dilatation and dysfunction, but it can also resulted from right atrial (RA) enlargement and consequent tricuspid annular dilatation. FTR is very frequent among patients with heart failure, particularly in those with reduced LVEF and concomitant functional mitral regurgitation. The development of three-dimensional echocardiography enabled detailed assessment of tricuspid valve anatomy, subvavlular apparatus...
Source: Heart Failure Reviews - July 15, 2021 Category: Cardiology Source Type: research

Risk stratification in cardiogenic shock: a focus on the available evidence
AbstractCardiogenic shock is a clinical syndrome which is defined as the presence of primary cardiac disorder that results in hypotension together with signs of organ hypoperfusion in the state of normovolaemia or hypervolaemia. It represents a complex life-threatening condition, characterized by a high mortality rate, that requires urgent diagnostic assessment as well as treatment; therefore, it is of paramount important to advocate for a thorough risk stratification. In fact, the early identification of patients that could benefit the most from more aggressive and invasive approaches could facilitate a more efficient res...
Source: Heart Failure Reviews - July 14, 2021 Category: Cardiology Source Type: research

Dilated cardiomyopathy in the era of precision medicine: latest concepts and developments
AbstractDilated cardiomyopathy (DCM) is an umbrella term entailing a wide variety of genetic and non-genetic etiologies, leading to left ventricular systolic dysfunction and dilatation, not explained by abnormal loading conditions or coronary artery disease. The clinical presentation can vary from asymptomatic to heart failure symptoms or sudden cardiac death (SCD) even in previously asymptomatic individuals. In the last 2 decades, there has been striking progress in the understanding of the complex genetic basis of DCM, with the discovery of additional genes and genotype –phenotype correlation studies. Rigorous clin...
Source: Heart Failure Reviews - July 14, 2021 Category: Cardiology Source Type: research

Exosomes in atrial fibrillation: therapeutic potential and role as clinical biomarkers
AbstractAtrial fibrillation (AF), the most common cardiac arrhythmia, is a global epidemic. AF can cause heart failure and myocardial infarction and increase the risk of stroke, disability, and thromboembolic events. AF is becoming increasingly ubiquitous and is associated with increased morbidity and mortality at higher ages, resulting in an increasing threat to human health as well as substantial medical and social costs. Currently, treatment strategies for AF focus on controlling heart rate and rhythm with medications to restore and maintain sinus rhythm, but this approach has limitations. Catheter ablation is not entir...
Source: Heart Failure Reviews - July 12, 2021 Category: Cardiology Source Type: research

Dilated cardiomyopathy: a new insight into the rare but common cause of heart failure
AbstractHeart failure is a global health burden responsible for high morbidity and mortality with a prevalence of greater than 60 million individuals worldwide. One of the major causes of heart failure is dilated cardiomyopathy (DCM), characterized by associated systolic dysfunction. During the last few decades, there have been remarkable advances in our understanding about the genetics of dilated cardiomyopathy. The genetic causes were initially thought to be associated with mutations in genes encoding proteins that are localized to cytoskeleton and sarcomere only; however, with the advancement in mechanistic understandin...
Source: Heart Failure Reviews - July 10, 2021 Category: Cardiology Source Type: research

Unveiling the role of exercise training in targeting the inflammatory paradigm of heart failure with preserved ejection fraction: a narrative review
In conclusion, despite the scarcity of clinical studies in this population, there is compelling evidence suggesting that EXT modulates crucial aspects of the inflammatory pathway described for HFpEF and future investigation on cellular and molecular mechanisms are encouraged. (Source: Heart Failure Reviews)
Source: Heart Failure Reviews - July 10, 2021 Category: Cardiology Source Type: research

Ventricular non-compaction review
AbstractLeft ventricular non-compaction cardiomyopathy (LVNC) is a rare and unclassified cardiomyopathy that carries the potential to cause heart failure, arrhythmias, and embolic events within adults. The diagnosis of this cardiomyopathy can be based off a variety of echocardiographic, cardiac magnetic resonance (CMR), and computed tomography (CT) imaging criteria; none of which have been standardized to establish a firm diagnosis. This is further complicated by the observation from prior studies that LVNC may present as different forms of cardiomyopathy, each with its own subset of nuances that may change treatment strat...
Source: Heart Failure Reviews - July 7, 2021 Category: Cardiology Source Type: research

Prognostic value of natriuretic peptides in heart failure: systematic review and meta-analysis
AbstractRisk models, informing optimal long-term medical management, seldom use natriuretic peptides (NP) in ascertaining the absolute risk of outcomes for HF patients. Individual studies evaluating the prognostic value of NPs in HF patients have reported varying effects, arriving at best estimates requires a systematic review. We systematically summarized the best evidence regarding the prognostic value of brain natriuretic peptide (BNP) and NT-proBNP in predicting mortality and hospitalizations in ambulatory heart failure (HF) patients. We searched bibliographic databases from 2005 to 2018 and included studies evaluating...
Source: Heart Failure Reviews - July 5, 2021 Category: Cardiology Source Type: research

Heart failure and atrial fibrillation: new concepts in pathophysiology, management, and future directions
AbstractA bidirectional pathophysiological link connects heart failure and atrial fibrillation, creating a frequent and challenging comorbidity, which includes neurohormonal hyperactivation, fibrosis development, and electrophysiologic remodeling, while they share mutual risk factors. Management for these devastating comorbidities includes most of the established treatment measures for heart failure as well as rhythm or rate control and anticoagulation mostly for atrial fibrillation, which can be achieved with either pharmaceutical or non-pharmaceutical approaches. The current manuscript aims to review the existing literat...
Source: Heart Failure Reviews - July 4, 2021 Category: Cardiology Source Type: research

Clinical variants of myocardial involvement in COVID-19-positive patients: a cumulative experience of 2020
AbstractMyocardial injury, diagnosed by troponin elevation, is common in COVID-19 patients, but cardiac involvement with clinical manifestations occurs less frequently. We analyzed the literature on COVID-19 (2020) and systematically reviewed the cases where individual patient data were presented. We searched PubMed and Google Scholar for “COVID,” “COVID-19,” and “coronavirus” in combination with “myocarditis,” “heart failure,” “takotsubo,” “cardiomyopathy,” and “cardiogenic shock.” We identified 90 cases of COVID-19 with myocar...
Source: Heart Failure Reviews - July 2, 2021 Category: Cardiology Source Type: research

Polypharmacy definition and prevalence in heart failure: a systematic review
AbstractPolypharmacy and heart failure are becoming increasingly common due to an ageing population and the rise of multimorbidity. Treating heart failure necessitates prescribing of multiple medications, in-line with national and international guidelines predisposing patients to polypharmacy. This review aims to identify how polypharmacy has been defined among heart failure patients in the literature, whether a standard definition in relation to heart failure could be identified and to describe the prevalence. The Healthcare Database Advanced Search (HDAS) was used to search EMBASE, MEDLINE, PubMed, Cinahl and PsychInfo f...
Source: Heart Failure Reviews - July 2, 2021 Category: Cardiology Source Type: research

Cardiac 1H 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 - May 25, 2021 Category: Cardiology Source Type: research

Right ventricular diastolic dysfunction and failure: a review
AbstractRight ventricular diastolic dysfunction and failure (RVDDF) has been increasingly identified in patients with cardiovascular diseases, including heart failure and other diseases with cardiac involvement. It is unknown whether RVDDF exists as a distinct clinical entity; however, its presence and degree have been shown to be a sensitive marker of end-organ dysfunction related to multiple disease processes including systemic hypertension, pulmonary hypertension, heart failure, and endocrine disease. In this manuscript, we review issues pertaining to RVDDF including anatomic features of the right ventricle, physiologic...
Source: Heart Failure Reviews - May 19, 2021 Category: Cardiology Source Type: research

Fibrosis in hypertrophic cardiomyopathy: role of novel echo techniques and multi-modality imaging assessment
AbstractHypertrophic cardiomyopathy (HCM) represents one of the primary cardiomyopathies and may lead to heart failure and sudden cardiac death. Among various histologic features of the disease examined, assessment of myocardial fibrosis may offer valuable information, since it may be considered the common nominator for all HCM connected complications. Late gadolinium-enhanced cardiac magnetic resonance (LGE-CMR) has emerged as the reference noninvasive method for visualizing and quantifying myocardial fibrosis in patients with HCM. T1 mapping, a promising new CMR technique, may provide an advantage over conventional LGE-C...
Source: Heart Failure Reviews - May 15, 2021 Category: Cardiology Source Type: research

Theoretical considerations for a left atrial pump in heart failure with preserved ejection fraction
AbstractHeart failure with preserved ejection fraction (HFpEF) is a heterogenous group of disorders, unified by findings of elevated left atrial and left ventricular filling pressures in the setting of normal systolic function. Medical therapies for HFpEF patients are markedly limited, and these patients are often unable to tolerate conventional left ventricular assist device therapies because of small chamber size. The Synergy System (CircuLite, Inc., Saddle Brook, NJ) was a micropump-based form of mechanical circulatory support in which flow derived from the left atrium was  delivered to the subclavian artery. In th...
Source: Heart Failure Reviews - May 12, 2021 Category: Cardiology Source Type: research

Mitochondrial abnormalities: a hub in metabolic syndrome-related cardiac dysfunction caused by oxidative stress
AbstractMetabolic syndrome (MetS) refers to a group of cardiovascular risk elements comprising insulin resistance, obesity, dyslipidemia, increased glucose intolerance, and increased blood pressure. Individually, all the MetS components can lead to cardiac dysfunction, while their combination generates additional risks of morbidity and mortality. Growing evidence suggests that oxidative stress, a dominant event in cellular damage and impairment, plays an indispensable role in cardiac dysfunction in MetS. Oxidative stress can not only disrupt mitochondrial activity through inducing oxidative damage to mitochondrial DNA, RNA...
Source: Heart Failure Reviews - May 5, 2021 Category: Cardiology Source Type: research

Social and environmental risks as contributors to the clinical course of heart failure
AbstractHeart failure is a major contributor to healthcare expenditures. Many clinical risk factors for the development and exacerbation of heart failure had been reported, including diabetes, renal dysfunction, and respiratory disease. In addition to these clinical parameters, the effects of social factors, such as occupation or lifestyle, and environmental factors may have a great impact on disease development and progression of heart failure. However, the current understanding of social and environmental factors as contributors to the clinical course of heart failure is insufficient. To present the knowledge of these fa...
Source: Heart Failure Reviews - May 4, 2021 Category: Cardiology Source Type: research

Letter to the Editor regarding the article “SGLT2 inhibitors and cardiovascular and renal outcomes: a meta‑analysis and trial sequential analysis”
(Source: Heart Failure Reviews)
Source: Heart Failure Reviews - May 4, 2021 Category: Cardiology Source Type: research

Response to letter to the editor regarding the article “SGLT2 inhibitors and cardiovascular and renal outcomes: a meta-analysis and trial sequential analysis” Cardiac, renal protection with SGLT2 inhibitors is evident but not in every diabetic patient
(Source: Heart Failure Reviews)
Source: Heart Failure Reviews - May 4, 2021 Category: Cardiology Source Type: research

Cognitive impairment in heart failure: clinical implications, tools of assessment, and therapeutic considerations
AbstractCognitive impairment (CI) is an important comorbidity in patients with heart failure (HF). Its prevalence parallels the severity of heart failure, while it is an independent prognostic marker of adverse events. Various factors contribute to cognitive decline in HF, influencing self-care. There are no standardized screening methods for the diagnosis and management of these patients. The aim of the present manuscript is to provide an overview of the impact of cognitive impairment in HF, describe the utility of assessment tools and imaging methods for the evaluation of CI, and propose a comprehensive diagnostic and ma...
Source: Heart Failure Reviews - May 3, 2021 Category: Cardiology Source Type: research

Angiotensin receptor-neprilysin inhibition in patients with acute decompensated heart failure: an expert consensus position paper
AbstractThe short-term mortality and rehospitalization rates after admission for acute heart failure (AHF) remain high, despite the high level of adherence to contemporary practice guidelines. Observational data from non-randomized studies in AHF strongly support the in-hospital administration of oral evidence-based modifying chronic heart failure (HF) medications (i.e., b-blockers, ACE inhibitors, mineralocorticoid receptor antagonists) to reduce morbidity and mortality. Interestingly, a well-designed prospective randomized multicenter study (PIONEER-HF) showed an improved clinical outcome and stress/injury biomarker prof...
Source: Heart Failure Reviews - May 1, 2021 Category: Cardiology Source Type: research

Left atrial assist device for heart failure with preserved ejection fraction: initial results with torque control mode in diastolic heart failure model
In this study, we tested four different TC settings (TC modes 0.9, 1.0, 1.25, and 1.5) using an in vitro mock circulatory loop. Mild, moderate, and severe diastolic heart failure (DHF) conditions, as well as normal heart condition, were simulated with the four TC modes. Also, we evaluated the LAAD in vivo with three calves. The LAAD was implanted at the mitral position with four TC settings (TC modes 0.9, 1.0, 1.1, 1.2). With LAAD support, the in vitro cardiac output and aortic pressure recovered to normal heart levels at TC 1.25 and 1.5 even under severe DHF conditions with little pump regurgitation. The TC mode tested in...
Source: Heart Failure Reviews - May 1, 2021 Category: Cardiology Source Type: research

Serum potassium and heart failure: association, causation, and clinical implications
AbstractDyskalemia (hypo- and hyperkalemia) is a common clinical encounter in patients with heart failure (HF), linked to underlying pathophysiologic alterations, pharmacological treatments, and concomitant comorbidities. Both hypo- and hyperkalemia have been associated with a poor outcome in HF. However, it is not known if this association is causal. In order to investigate this relation, we implemented the Bradford Hill criteria for causation examining the available literature. Of note, hypokalemia and low-normal potassium levels (serum potassium  5.0 mmol/L) and adverse clinical outcomes in HF appears unlikely...
Source: Heart Failure Reviews - April 6, 2021 Category: Cardiology Source Type: research

Etiology and pathophysiology of heart failure in people with HIV
AbstractHIV-associated cardiomyopathy is a well-established sequela in people infected with HIV (PHIV). Despite significant advances in HIV management through the use of highly active anti-retroviral therapy (HAART), PHIV on HAART continue to have elevated risk of cardiomyopathy and heart failure, even when accounting for known cardiovascular risk factors. This review article will explore the proposed mechanisms by which chronic HIV infection induces cardiomyopathy and heart failure in the setting of HAART. Evaluation, work-up, and management of cardiomyopathy in PHIV will also be briefly discussed. The advent of HAART has...
Source: Heart Failure Reviews - April 6, 2021 Category: Cardiology Source Type: research

Cardiac disease in mitochondrial disorders
(Source: Heart Failure Reviews)
Source: Heart Failure Reviews - April 6, 2021 Category: Cardiology Source Type: research

Minimally invasive versus conventional continuous-flow left ventricular assist device implantation for heart failure: a meta-analysis
In conclusion, minimally invasive techniques can reduce the risks of major bleeding, severe r ight heart failure, and blood-product utilization, as well as have positive impacts on reducing mechanical ventilation time and the risk of respiratory failure. Minimally invasive centrifugal pump implantation can reduce the length of ICU and hospital stay. (Source: Heart Failure Reviews)
Source: Heart Failure Reviews - April 3, 2021 Category: Cardiology Source Type: research

Global longitudinal strain predicts responders after cardiac resynchronization therapy —a systematic review and meta-analysis
AbstractTo evaluate the association between baseline global longitudinal strain (GLS) and ΔGLS (difference of baseline GLS and follow-up) and cardiac resynchronization therapy (CRT) response defined either with clinical or with echocardiographic characteristics. This meta-analysis was performed in accordance to both the Meta-Analysis of Observational Studies in Epidemiology and Strengt hening the Reporting of Observational Studies in Epidemiology guidelines. Two independent investigators performed a comprehensive systematic search in MedLine, EMBASE and Cochrane databases through September 2019 without limitatio...
Source: Heart Failure Reviews - March 30, 2021 Category: Cardiology Source Type: research

Prognostic impact of antiplatelet therapy in Takotsubo syndrome: a systematic review and meta-analysis of the literature
The objective of this study was to determine whether patients with TTS benefit from anti-aggregation, in terms of either short-term or long-term outcomes. A systematic review and meta-analysis was conducted. A comprehensive search of the literature included MEDLINE, Cochrane Library, Clinicaltrials.gov, EU Clinical Trial Register, References, and contact with the authors. Methodological quality assessment and data extraction were systematically performed. The review adhered to the PRISMA framework guidelines. A total of 86 citations were identified, six being eligible for inclusion, for a total of 1997 patients. One of the...
Source: Heart Failure Reviews - March 29, 2021 Category: Cardiology Source Type: research

Clinical comparison of V122I genotypic variant of transthyretin amyloid cardiomyopathy with wild-type and other hereditary variants: a systematic review
AbstractV122I genotype variant (pV142I) is the most common hereditary transthyretin amyloidosis (hATTR) in the USA, with 3 –3.5% of African-Americans being the carriers of this mutation. We aimed to compare baseline clinical features, cardiac parameters, and mortality in V122I-ATTR with the wild-type ATTR and other hATTR subtypes. We systematically searched PubMed/Medline and Google Scholar databases to identify relev ant studies from inception to 10th September, 2020 reporting phenotypic, echocardiographic, and/or laboratory parameters in patients with hereditary and wild types of cardiac amyloidoses. A total of 284...
Source: Heart Failure Reviews - March 25, 2021 Category: Cardiology Source Type: research

The common characteristics and mutual effects of heart failure and atrial fibrillation: initiation, progression, and outcome of the two aging-related heart diseases
AbstractAtrial fibrillation (AF) and heart failure (HF) are common chronic diseases noted in humans. AF and HF share several risk factors, such as age, hypertension, obesity, diabetes, and dyslipidemia. They can interact with each other, while both their morbidity and mortality have been considerably increased. And AF and HF often occur together, suggesting a strong association between the two. However, the underlying mechanism behind this association is not well understood. Among them, aging is the most significant common risk factor, which represents an aging heart and is characterized by fibrosis and decreased number of...
Source: Heart Failure Reviews - March 25, 2021 Category: Cardiology Source Type: research

Hospitalisation costs associated with heart failure with preserved ejection fraction (HFpEF): a systematic review
AbstractHeart failure with preserved ejection fraction (HFpEF) is problematic to treat, with guidelines for HFpEF management concentrated on treating prevalent comorbidities. The aim of this study is to conduct a systematic review of the economic burden of hospitalisation for HFpEF.  We conducted a systematic literature search from 2001, when HFpEF was first identified as an isolated diagnosis, up to July 1, 2020. Databases searched include PubMed, Medline, EMBASE, EBSCO, National Health Service Economic Evaluation and the National Bureau of Economic Research. The primary outc ome measure was hospitalisation costs rel...
Source: Heart Failure Reviews - March 25, 2021 Category: Cardiology Source Type: research

COVID-19 and myocarditis: a systematic review and overview of current challenges
AbstractMyocardial inflammation in COVID-19 has been documented. Its pathogenesis is not fully elucidated, but the two main theories foresee a direct role of ACE2 receptor and a hyperimmune response, which may also lead to isolated presentation of COVID-19-mediated myocarditis. The frequency and prognostic impact of COVID-19-mediated myocarditis is unknown. This review aims to summarise current evidence on this topic. We performed a systematic review of MEDLINE and Cochrane Library (1/12/19 –30/09/20). We also searched clinicaltrials.gov for unpublished studies testing therapies with potential implication for COVID-1...
Source: Heart Failure Reviews - March 24, 2021 Category: Cardiology Source Type: research

State-of-the art review: Noncompaction cardiomyopathy in pediatric patients
AbstractNoncompaction cardiomyopathy (NCCM) is a disease characterized by hypertrabeculation, commonly hypothesized due to an arrest in compaction during fetal development. In 2006, NCCM was classified as a distinct form of cardiomyopathy (CMP) by the American Heart Association. NCCM in childhood is more frequently familial than when diagnosed in adulthood and is associated with other congenital heart diseases (CHDs), other genetic CMPs, and neuromuscular diseases (NMDs). It is yet a rare cardiac diseased with an estimated incidence of 0.12 per 100.000 in children up to 10 years of age. Diagnosing NCCM can be challenging d...
Source: Heart Failure Reviews - March 14, 2021 Category: Cardiology Source Type: research

SGLT2 inhibitors break the vicious circle between heart failure and insulin resistance: targeting energy metabolism
AbstractHeart failure (HF) often coexists with insulin resistance (IR), and the incidence of HF in type 2 diabetes mellitus (T2DM) patients is significantly higher. The reciprocal relationship between HF and IR has long been recognized, and the integration complicates the therapy of both. A number of mechanisms ascribe to the progression of cardiac IR, in which the main factors are the shift of myocardial substrate metabolism. Studies have found that SGLT2 inhibitors, an anti-diabetic drug, can improve the cardiac prognosis of patients with T2DM, which may be at least partially due to the relief of cardiac IR. Basic and cl...
Source: Heart Failure Reviews - March 12, 2021 Category: Cardiology Source Type: research

How to deal with low-flow low-gradient aortic stenosis and reduced left ventricle ejection fraction: from literature review to tips for clinical practice
AbstractLow-flow low-gradient aortic stenosis (LFLG AS) with reduced left ventricle ejection fraction (LVEF) is still a diagnostic and therapeutic challenge. The aim of this paper is to review the latest evidences about the assessment of the valvular disease, usually difficult because of the low-flow status, and the therapeutic options. Special emphasis is given to the available diagnostic tools for the characterization of LFLG AS without functional reserve at stress echocardiography and to the factors that clinicians should evaluate to choose between surgical aortic valve repair, transcatheter aortic valve implantation, o...
Source: Heart Failure Reviews - March 8, 2021 Category: Cardiology Source Type: research

Prognostic value of blood pressure in ambulatory heart failure: a meta-analysis and systematic review. Ambulatory blood pressure predicts heart failure prognosis
AbstractPrevious primary studies have explored the association between blood pressure (BP) and mortality in ambulatory heart failure (HF) patients reporting varying and contrasting associations. The aim is to determine the pooled BP prognostic value and explore potential reasons for between-study inconsistency. We searched Medline, Cochrane, EMBASE and CINAHL from January 2005 to October 2018 for studies with  ≥ 50 events (mortality and/or hospitalization) and included BP in a multivariable model in ambulatory HF patients. We pooled hazard ratios (random effects model) for systolic BP (SBP) or diastolic BP (...
Source: Heart Failure Reviews - March 8, 2021 Category: Cardiology Source Type: research

Mechanical circulatory support in patients with cardiogenic shock not secondary to cardiotomy: a network meta-analysis
AbstractTo compare the efficacy and safety of different mechanical circulatory support (MCS) devices in CS. A total of 24 studies (7 randomized controlled trials —RCTs—and 17 non-RCTs) involving 11,117 patients were entered in a Bayesian network meta-analysis. The primary endpoint was 30-day mortality. Secondary endpoints were stroke and bleeding (requiring transfusion and/or intracranial and/or fatal). Compared with no MCS, extra-corporeal membrane oxyg enation (ECMO) reduced 30-day mortality when used both alone (OR 0.37, 95% CrI 0.15–0.90) and together with the micro-axial pump Impella (OR 0.13, 95% Cr...
Source: Heart Failure Reviews - March 6, 2021 Category: Cardiology Source Type: research

Complications in children with ventricular assist devices: systematic review and meta-analyses
AbstractHeart failure is a significant cause of mortality in children with cardiovascular diseases. Treatment of heart failure depends on patients ’ symptoms, age, and severity of their condition, with heart transplantation required when other treatments are unsuccessful. However, due to lack of fitting donor organs, many patients are left untreated, or their transplant is delayed. In these patients, ventricular assist devices (VADs) are use d to bridge to heart transplant. However, VAD support presents various complications in patients. The aim of this study was to compile, review, and analyse the studies reporting ...
Source: Heart Failure Reviews - March 4, 2021 Category: Cardiology Source Type: research

Contemporary device management of cardiogenic shock following acute myocardial infarction
AbstractDespite advances in the overall management of acute myocardial infarction (AMI), cardiogenic shock in the setting of AMI (CS-AMI) continues to be associated with poor patient outcomes. There are multiple devices that can be used in CS-AMI to support the failing circulation, although their utility in improving outcomes as compared with conventional pharmacotherapy of vasopressors and inotropes remains to be established. This contemporary review provides an update on the evidence base for each of these techniques. In CS-AMI, acute thrombotic occlusion of a major epicardial artery leads to hypoxia and myocardial ischa...
Source: Heart Failure Reviews - March 3, 2021 Category: Cardiology Source Type: research

A critical approach for successful use of circulating microRNAs as biomarkers in cardiovascular diseases: the case of hypertrophic cardiomyopathy
AbstractMicroRNAs (miRNAs) are small noncoding RNA molecules that act as major regulators of gene expression at the post-transcriptional level. As the potential applications of miRNAs in the diagnosis and treatment of human diseases have become more evident, many studies of hypertrophic cardiomyopathy (HCM) have focused on the systemic identification and quantification of miRNAs in biofluids and myocardial tissues. HCM is a hereditary cardiomyopathy caused by mutations in genes encoding proteins of the sarcomere. Despite overall improvements in survival, progression to heart failure, stroke, and sudden cardiac death remain...
Source: Heart Failure Reviews - March 3, 2021 Category: Cardiology Source Type: research

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