Cardioprotection and thyroid hormones
The objective of this review was to highlight the cardioprotective role of triiodothyronine in the complexity of post-ischemic disease evolution. (Source: Heart Failure Reviews)
Source: Heart Failure Reviews - March 23, 2016 Category: Cardiology Source Type: research

The role of pharmacotherapy in the prevention of sudden cardiac death in patients with heart failure
Abstract Sudden cardiac death remains a significant threat to the survival of patients with heart failure. Long-term cardiac remodeling predisposes these patients to develop malignant ventricular arrhythmias. Permanent implantable and temporary external defibrillators remain a mainstay for the prevention of sudden cardiac death in this population. For decades, researchers have attempted to identify reliable drug therapies to avoid such arrhythmias; however, to date, success has been inconsistent. This review aims to explore the evidence defining the role of drug therapies for direct and indirect suppression of arr...
Source: Heart Failure Reviews - March 21, 2016 Category: Cardiology Source Type: research

Diaphragm abnormalities in heart failure and aging: mechanisms and integration of cardiovascular and respiratory pathophysiology
Abstract Inspiratory function is essential for alveolar ventilation and expulsive behaviors that promote airway clearance (e.g., coughing and sneezing). Current evidence demonstrates that inspiratory dysfunction occurs during healthy aging and is accentuated by chronic heart failure (CHF). This inspiratory dysfunction contributes to key aspects of CHF and aging cardiovascular and pulmonary pathophysiology including: (1) impaired airway clearance and predisposition to pneumonia; (2) inability to sustain ventilation during physical activity; (3) shallow breathing pattern that limits alveolar ventilation and gas exch...
Source: Heart Failure Reviews - March 21, 2016 Category: Cardiology Source Type: research

Effect of continuous positive airway pressure treatment on pulmonary artery pressure in patients with isolated obstructive sleep apnea: a meta-analysis
Abstract Pulmonary hypertension (PH) can occur in patients with obstructive sleep apnea (OSA) in the absence of cardiac or lung disease. Data on the development and severity of PH, and the effect of continuous positive airway pressure (CPAP) therapy on pulmonary artery (PA) pressures in these patients have been inconsistent in the literature. We sought to determine whether CPAP therapy affects PA pressures in patients with isolated OSA in this meta-analysis. We searched PubMed, Medline, EMBASE and other databases from January 1980 to August 2015. Studies of patients with OSA, defined as an apnea–hypopnea ind...
Source: Heart Failure Reviews - March 21, 2016 Category: Cardiology Source Type: research

A review on B-type natriuretic peptide monitoring: assays and biosensors
Abstract Since its discovery in 1988, B-type natriuretic peptide (BNP) has been recognized as a powerful cardiovascular biomarker for a number of disease states, specifically heart failure. Concurrent with such a discovery, much effort has been allocated to the precise monitoring of physiological BNP levels. Thus, it can be used to guide the therapy of heart failure and determine the patient’s stage of disease. Thus, we discuss in this article BNP as a potent biomarker. Subsequently, we will review the progress of biosensing devices as they could be applied to monitor BNP levels as assays, benchtop biosensor...
Source: Heart Failure Reviews - March 15, 2016 Category: Cardiology Source Type: research

Mitochondrial DNA repair: a novel therapeutic target for heart failure
Abstract Mitochondria play a crucial role in a variety of cellular processes ranging from energy metabolism, generation of reactive oxygen species (ROS) and Ca2+ handling to stress responses, cell survival and death. Malfunction of the organelle may contribute to the pathogenesis of neuromuscular, cancer, premature aging and cardiovascular diseases (CVD), including myocardial ischemia, cardiomyopathy and heart failure (HF). Mitochondria contain their own genome organized into DNA–protein complexes, called “mitochondrial nucleoids,” along with multiprotein machineries, which promote mitochondrial ...
Source: Heart Failure Reviews - March 3, 2016 Category: Cardiology Source Type: research

Review of nutritional screening and assessment tools and clinical outcomes in heart failure
Abstract Recent studies have suggested that undernutrition as defined using multidimensional nutritional evaluation tools may affect clinical outcomes in heart failure (HF). The evidence supporting this correlation is unclear. Therefore, we conducted this systematic review to critically appraise the use of multidimensional evaluation tools in the prediction of clinical outcomes in HF. We performed descriptive analyses of all identified articles involving qualitative analyses. We used STATA to conduct meta-analyses when at least three studies that tested the same type of nutritional assessment or screening tools an...
Source: Heart Failure Reviews - February 26, 2016 Category: Cardiology Source Type: research

Roles and indications for use of implantable defibrillator and resynchronization therapy in the prevention of sudden cardiac death in heart failure
Abstract Implantable devices are indicated in the primary and secondary prevention of potentially life-threatening ventricular tachyarrhythmias in patients with heart failure. Early studies, including the landmark MADIT trials, showed that implantable cardioverter–defibrillator (ICD) and cardiac resynchronization therapy (CRT) devices can play a significant role in aborting and preventing ventricular arrhythmias, respectively, that can cause sudden cardiac death. To this day, there have been a number of randomized controlled trials, with respective substudy analyses, that have attempted to better underst...
Source: Heart Failure Reviews - February 24, 2016 Category: Cardiology Source Type: research

Mitochondrial involvement in myocyte death and heart failure
This article reviews the background and recent evidence of mitochondrial involvement in several types of cell death (apoptosis, necrosis and autophagy) occurring in HF. In addition, potential strategies for targeting mitochondria are examined, and their utility in HF therapy considered. (Source: Heart Failure Reviews)
Source: Heart Failure Reviews - February 17, 2016 Category: Cardiology Source Type: research

Cell death in the pathogenesis and progression of heart failure
(Source: Heart Failure Reviews)
Source: Heart Failure Reviews - February 17, 2016 Category: Cardiology Source Type: research

The fibrosis-cell death axis in heart failure
Abstract Cardiac stress can induce morphological, structural and functional changes of the heart, referred to as cardiac remodeling. Myocardial infarction or sustained overload as a result of pathological causes such as hypertension or valve insufficiency may result in progressive remodeling and finally lead to heart failure (HF). Whereas pathological and physiological (exercise, pregnancy) overload both stimulate cardiomyocyte growth (hypertrophy), only pathological remodeling is characterized by increased deposition of extracellular matrix proteins, termed fibrosis, and loss of cardiomyocytes by necrosis, apopto...
Source: Heart Failure Reviews - February 16, 2016 Category: Cardiology Source Type: research

Heart failure and orthostatic hypotension
Abstract Orthostatic hypotension (OH) is traditionally defined as a fall of ≥20 mmHg in systolic and/or ≥10 mmHg in diastolic blood pressure within 3 min of active standing. OH is a common comorbidity among patients with heart failure (HF). A comprehensive review regarding the relationship between OH and HF has not been published in the English literature. Here we provide current information about concomitant HF and OH, including: pathophysiology, methods of evaluation, prevalence, risk factors, prognosis and management of OH in HF patients, as well as the incidence of HF among patients wi...
Source: Heart Failure Reviews - February 15, 2016 Category: Cardiology Source Type: research

Necroptotic cell death in failing heart: relevance and proposed mechanisms
Abstract As cardiomyocytes have a limited capability for proliferation, renewal, and repair, the loss of heart cells followed by replacement with fibrous tissue is considered to result in the development of ventricular dysfunction and progression to heart failure (HF). The loss of cardiac myocytes in HF has been traditionally believed to occur mainly due to programmed apoptosis or unregulated necrosis. While extensive research work is being carried out to define the exact significance and contribution of both these cell death modalities in the development of HF, recent knowledge has indicated the existence and imp...
Source: Heart Failure Reviews - February 12, 2016 Category: Cardiology Source Type: research

Mitochondrial dynamics and cell death in heart failure
Abstract The highly regulated processes of mitochondrial fusion (joining), fission (division) and trafficking, collectively called mitochondrial dynamics, determine cell-type specific morphology, intracellular distribution and activity of these critical organelles. Mitochondria are critical for cardiac function, while their structural and functional abnormalities contribute to several common cardiovascular diseases, including heart failure (HF). The tightly balanced mitochondrial fusion and fission determine number, morphology and activity of these multifunctional organelles. Although the intracellular architectur...
Source: Heart Failure Reviews - February 12, 2016 Category: Cardiology Source Type: research

Role of cell death in the progression of heart failure
Abstract All multicellular organisms develop during evolution the highly regulated and interconnected pathways of cell death. This complex network contributes to the pathogenesis of various cardiovascular disorders including ischemia/reperfusion injury, myocardial infarction, heart failure, dysrhythmias and atherosclerosis. Chronic cardiac remodeling response and transition to overt HF have been associated with modestly increased apoptosis, although the actual burden of chronic cell loss attributable to apoptosis is not clear. Central mediators of cardiomyocyte survival and death are the mitochondrial organelles. ...
Source: Heart Failure Reviews - February 12, 2016 Category: Cardiology Source Type: research

The role of inflammation and cell death in the pathogenesis, progression and treatment of heart failure
Abstract Chronic inflammation underlies a variety of seemingly unrelated conditions including coronary artery disease. The interest in exploring the role of inflammation in heart failure (CHF) arises from earlier observations that circulating pro-inflammatory biomarker levels are elevated in patients with both ischaemic and non-ischaemic cardiomyopathies and correlate with severity of disease and prognosis (McMurray et al. in Eur Heart J 33:1787–1847, 2012; Mosterd and Hoes in Heart 93:1137–1146, 2007; Owan et al. in New Engl J Med 355:251–259, 2006). In acute decompensated HF, pro-inflammatory b...
Source: Heart Failure Reviews - February 12, 2016 Category: Cardiology Source Type: research

Atrophied cardiomyocytes and their potential for rescue and recovery of ventricular function
Abstract Cardiomyocytes must be responsive to demands placed on the heart’s contractile work as a muscular pump. In turn, myocyte size is largely dependent on the workload they perform. Both hypertrophied and atrophic myocytes are found in the normal and diseased ventricle. Individual myocytes become atrophic when encumbered by fibrillar collagen, such as occurs at sites of fibrosis. The mechanisms include: (a) being immobilized and subject to disuse with ensuing protein degradation mediated by redox-sensitive, proteolytic ligases of the ubiquitin–proteasome system and (b) dedifferentiated re-expressin...
Source: Heart Failure Reviews - February 12, 2016 Category: Cardiology Source Type: research

Cellular apoptosis in the cardiorenal axis
Abstract Cardiomyocyte apoptosis plays a pivotal role in the pathogenesis of heart failure. It may be induced by different stimuli, and it seems to be perpetuated by oxidative stress and inflammation. In this scenario, heart failure may trigger various cell-mediated and humoral pathways affecting distant organs, such as kidneys, contributing to higher therapeutic costs, morbidity and mortality. The term Cardiorenal Syndromes describes this condition and represents an important model for exploring the pathophysiology of cardiac and renal dysfunction. In this review, we have analyzed the mechanisms of organ inte...
Source: Heart Failure Reviews - February 6, 2016 Category: Cardiology Source Type: research

Personalised computational cardiology: Patient-specific modelling in cardiac mechanics and biomaterial injection therapies for myocardial infarction
Abstract Predictive computational modelling in biomedical research offers the potential to integrate diverse data, uncover biological mechanisms that are not easily accessible through experimental methods and expose gaps in knowledge requiring further research. Recent developments in computing and diagnostic technologies have initiated the advancement of computational models in terms of complexity and specificity. Consequently, computational modelling can increasingly be utilised as enabling and complementing modality in the clinic—with medical decisions and interventions being personalised. Myocardial infar...
Source: Heart Failure Reviews - February 1, 2016 Category: Cardiology Source Type: research

Pathophysiological mechanism and therapeutic role of S100 proteins in cardiac failure: a systematic review
Abstract S100 proteins are a family of highly acidic calcium-binding proteins involved in calcium handling in many tissues and organs. Some of these proteins are highly expressed in cardiac tissue, and an impairment of some specific S100 proteins has been related to heart failure. To check this hypothesis, we decided to review the literature since 2008 until May 2015. According to the studies collected, recovering S100A1 levels may enhance contractile/relaxing performance in heart failure, reverse negative force–frequency relationship, improve contractile reserve, reverse diastolic dysfunction and protect ag...
Source: Heart Failure Reviews - January 30, 2016 Category: Cardiology Source Type: research

The right ventricle and pulmonary hypertension
Abstract In patients with pulmonary hypertension (PH), the primary cause of death is right ventricular (RV) failure. Improvement in RV function is therefore one of the most important treatment goals. In order to be able to reverse RV dysfunction and also prevent RV failure, a detailed understanding of the pathobiology of RV failure and the underlying mechanisms concerning the transition from a pressure-overloaded adapted right ventricle to a dilated and failing right ventricle is required. Here, we propose that insufficient RV contractility, myocardial fibrosis, capillary rarefaction, and a disturbed metabolis...
Source: Heart Failure Reviews - January 29, 2016 Category: Cardiology Source Type: research

Medical therapies for pulmonary arterial hypertension
Abstract Pulmonary Arterial hypertension (PAH) is a chronic and progressive disease characterized by an increase in pulmonary vascular resistance due to severe remodeling of the small pulmonary arteries. In PAH, the endothelial cells fail to maintain their homeostatic balance, with the consequent impaired production of vasodilators and over-expression of vasoconstrictors and proliferators. Current treatment of PAH is based on the discovery of three main pathways of endothelial dysfunction (prostacyclin, nitric oxide and endothelin-1), and includes drugs such as prostacyclin analogs, phosphodiesterase-5 inhibitors ...
Source: Heart Failure Reviews - January 20, 2016 Category: Cardiology Source Type: research

Sudden cardiac death in heart failure with preserved ejection fraction: a target for therapy?
Abstract The incidence and mechanisms of sudden cardiac death (SCD) among patients with heart failure with reduced ejection fraction have been well characterized. Conversely, limited data are available exploring the landscape of SCD in patients with heart failure with preserved ejection fraction (HFpEF). HFpEF is a heterogeneous clinical syndrome of increasing prevalence and is associated with substantial morbidity and mortality. This review will aim to contextualize recent data regarding rates and predictors of SCD in this growing population and to discuss the potential role of pharmacologic and device therapy fo...
Source: Heart Failure Reviews - January 13, 2016 Category: Cardiology Source Type: research

Chronic thromboembolic pulmonary hypertension: detection, medical and surgical treatment approach, and current outcomes
Abstract Pulmonary hypertension due to chronic thromboembolic disease is potentially curable with pulmonary thromboendarterectomy surgery. As a result, it is important for clinicians to recognize and appropriately diagnose this form of pulmonary hypertension. Advances in this field with changes in surgical technique, the availability of PH-targeted medical therapy for select patient subgroups, and the development of balloon pulmonary angioplasty have broadened therapeutic options for patients. This review will examine what is known about the epidemiology and medical conditions placing patients at risk of devel...
Source: Heart Failure Reviews - January 6, 2016 Category: Cardiology Source Type: research

Combined post- and pre-capillary pulmonary hypertension in heart failure with preserved ejection fraction
Abstract Over 2.5 million patients in the USA suffer from heart failure with preserved ejection fraction (HFpEF), and pulmonary hypertension (PH) is present in the majority of these patients. PH represents an adverse prognostic factor in HFpEF and has been identified as a potential therapeutic target to improve symptoms and outcomes. The recognition and investigation of a subset of patients with superimposed pulmonary vascular disease (on top of pulmonary venous hypertension) has led to further subclassification of PH due to left heart disease (PH-LHD) into two categories: isolated post-capillary PH and combined p...
Source: Heart Failure Reviews - December 29, 2015 Category: Cardiology Source Type: research

MELAS syndrome and cardiomyopathy: linking mitochondrial function to heart failure pathogenesis
Abstract Heart failure remains an important clinical burden, and mitochondrial dysfunction plays a key role in its pathogenesis. The heart has a high metabolic demand, and mitochondrial function is a key determinant of myocardial performance. In mitochondrial disorders, hypertrophic remodeling is the early pattern of cardiomyopathy with progression to dilated cardiomyopathy, conduction defects and ventricular pre-excitation occurring in a significant proportion of patients. Cardiac dysfunction occurs in approximately a third of patients with mitochondrial myopathy, encephalopathy, lactic acidosis and stroke-like e...
Source: Heart Failure Reviews - December 28, 2015 Category: Cardiology Source Type: research

Echocardiographic assessment of left ventricular systolic function: from ejection fraction to torsion
Abstract Assessment of left ventricular (LV) systolic function is the cornerstone of the echocardiographic examination. There are many echocardiographic parameters that can be used for clinical and research purposes, each one with its pros and cons. The LV ejection fraction is the most used one due to its feasibility and predictability, but it also has many limits, related to both the imaging technique used for calculation and to the definition itself. LV longitudinal function is expression of subendocardial fibers contraction. Because the subendocardium is often involved early in many pathological processes, its ...
Source: Heart Failure Reviews - December 28, 2015 Category: Cardiology Source Type: research

Partial adenosine A1 receptor agonism: a potential new therapeutic strategy for heart failure
Abstract Heart failure (HF) represents a global public health and economic problem associated with unacceptable rates of death, hospitalization, and healthcare expenditure. Despite available therapy, HF carries a prognosis comparable to many forms of cancer with a 5-year survival rate of ~50 %. The current treatment paradigm for HF with reduced ejection fraction (EF) centers on blocking maladaptive neurohormonal activation and decreasing cardiac workload with therapies that concurrently lower blood pressure and heart rate. Continued development of hemodynamically active medications for stepwise addition t...
Source: Heart Failure Reviews - December 23, 2015 Category: Cardiology Source Type: research

Molecular pathogenesis and current pathology of pulmonary hypertension
Abstract Following its initial description over a century ago, pulmonary arterial hypertension (PAH) continues to challenge researchers committed to understanding its pathobiology and finding a cure. The last two decades have seen major developments in our understanding of the genetics and molecular basis of PAH that drive cells within the pulmonary vascular wall to produce obstructive vascular lesions; presently, the field of PAH research has taken numerous approaches to dissect the complex amalgam of genetic, molecular and inflammatory pathways that interact to initiate and drive disease progression. In this rev...
Source: Heart Failure Reviews - December 22, 2015 Category: Cardiology Source Type: research

Left atrial strain: a new parameter for assessment of left ventricular filling pressure
Abstract In order to obtain accurate diagnosis, treatment and prognostication in many cardiac conditions, there is a need for assessment of left ventricular (LV) filling pressure. While systole depends on ejection function of LV, diastole and its disturbances influence filling function and pressures. The commonest condition that represents the latter is heart failure with preserved ejection fraction in which LV ejection is maintained, but diastole is disturbed and hence filling pressures are raised. Significant diastolic dysfunction results in raised LV end-diastolic pressure, mean left atrial (LA) pressure and pu...
Source: Heart Failure Reviews - December 19, 2015 Category: Cardiology Source Type: research

Depression and anxiety as predictors of mortality among heart failure patients: systematic review and meta-analysis
Abstract Several studies suggest that psychological factors are associated with negative outcomes and in particular higher mortality rates among heart failure (HF) patients. We aimed to evaluate the effect sizes of depression and anxiety on all-cause mortality in HF patients. We conducted a systematic review according to the PRISMA methodology. We searched for studies on depression or anxiety effects on all-cause mortality among HF patients published up to June 2015. A number of 26 and 6 articles met inclusion criteria for depression (total 80,627 patients) and anxiety (total 17,214 patients), respectively. The ef...
Source: Heart Failure Reviews - November 16, 2015 Category: Cardiology Source Type: research

A perspective on sympathetic renal denervation in chronic congestive heart failure
Abstract Medical therapy has indisputably been the mainstay of management for chronic congestive heart failure. However, a significant percentage of patients continue to experience worsening heart failure (HF) symptoms despite treatment with multiple therapeutic agents. Recently, catheter-based interventional strategies that interrupt the renal sympathetic nervous system have shown promising results in providing better symptom control in patients with HF. In this article, we will review the pathophysiology of HF for better understanding of the interplay between the cardiovascular system and the kidney. Subsequentl...
Source: Heart Failure Reviews - November 12, 2015 Category: Cardiology Source Type: research

Insulin resistance: an additional risk factor in the pathogenesis of cardiovascular disease in type 2 diabetes
Abstract Sedentary life style and high calorie dietary habits are prominent leading cause of metabolic syndrome in modern world. Obesity plays a central role in occurrence of various diseases like hyperinsulinemia, hyperglycemia and hyperlipidemia, which lead to insulin resistance and metabolic derangements like cardiovascular diseases (CVDs) mediated by oxidative stress. The mortality rate due to CVDs is on the rise in developing countries. Insulin resistance (IR) leads to micro or macro angiopathy, peripheral arterial dysfunction, hampered blood flow, hypertension, as well as the cardiomyocyte and the endothelia...
Source: Heart Failure Reviews - November 5, 2015 Category: Cardiology Source Type: research

Classification and diagnosis of pulmonary hypertension
Abstract Pulmonary hypertension has been classified into five major subgroups in order to better understand and apply knowledge from the areas of molecular biology, pathophysiology and clinical science. Accurate classification of the patient not only optimizes diagnostic approach but also confers the best benefit, as therapeutic approaches are applied accurately. Current diagnostic strategies begin with a detailed history and physical, which are directed to elucidate symptoms that may increase the degree of suspicion. Subsequent application of a logical approach to progress through the diagnostic algorithm , wi...
Source: Heart Failure Reviews - October 24, 2015 Category: Cardiology Source Type: research

Temporal cardiac remodeling post-myocardial infarction: dynamics and prognostic implications in personalized medicine
Abstract Despite dramatic improvements in short-term mortality rates following myocardial infarction (MI), long-term survival for MI patients who progress to heart failure remains poor. MI occurs when the left ventricle (LV) is deprived of oxygen for a sufficient period of time to induce irreversible necrosis of the myocardium. The LV response to MI involves significant tissue, cellular, and molecular level modifications, as well as substantial hemodynamic changes that feedback negatively to amplify the response. Inflammation to remove necrotic myocytes and fibroblast activation to form a scar are key wound healin...
Source: Heart Failure Reviews - October 23, 2015 Category: Cardiology Source Type: research

Hospital and intensive care unit management of decompensated pulmonary hypertension and right ventricular failure
Abstract Pulmonary hypertension and concomitant right ventricular failure present a diagnostic and therapeutic challenge in the intensive care unit and have been associated with a high mortality. Significant co-morbidities and hemodynamic instability are often present, and routine critical care unit resuscitation may worsen hemodynamics and limit the chances of survival in patients with an already underlying poor prognosis. Right ventricular failure results from structural or functional processes that limit the right ventricle’s ability to maintain adequate cardiac output. It is commonly seen as the result o...
Source: Heart Failure Reviews - October 20, 2015 Category: Cardiology Source Type: research

Care-seeking decisions for worsening symptoms in heart failure: a qualitative metasynthesis
Abstract Over 50 % of heart failure (HF) patients delay seeking help for worsening symptoms until these reach acute levels and require emergency hospitalisation. This metasynthesis aimed to identify and explore factors influencing timely care-seeking in patients with HF. Electronic databases searched were MEDLINE, Embase, and CINAHL. Studies were included if they were peer-reviewed journal articles, written in English, and reported perspectives of HF patients following qualitative data collection and analysis. Forty articles underwent analysis following the approach of Thomas and Harden. Leventhal’s sel...
Source: Heart Failure Reviews - October 11, 2015 Category: Cardiology Source Type: research

The gap between policy and practice: a systematic review of patient-centred care interventions in chronic heart failure
Abstract Patient-centred care (PCC) is recommended in policy documents for chronic heart failure (CHF) service provision, yet it lacks an agreed definition. A systematic review was conducted to identify PCC interventions in CHF and to describe the PCC domains and outcomes. Medline, Embase, CINAHL, PsycINFO, ASSIA, the Cochrane database, clinicaltrials.gov, key journals and citations were searched for original studies on patients with CHF staged II–IV using the New York Heart Association (NYHA) classification. Included interventions actively supported patients to play informed, active roles in decision-making...
Source: Heart Failure Reviews - October 5, 2015 Category: Cardiology Source Type: research

Definition, epidemiology and registries of pulmonary hypertension
Abstract Pulmonary arterial hypertension (PAH) is a subcategory of pulmonary hypertension (PH) that comprises a group of disorders with similar pulmonary vascular pathology. Though PH is common, the estimated incidence of IPAH is 1–3 cases per million, making it a rare disease. The hemodynamic definition of PAH is a mean pulmonary artery pressure at rest>OR = 25 mm Hg in the presence of a pulmonary capillary wedge pressure
Source: Heart Failure Reviews - October 5, 2015 Category: Cardiology Source Type: research

Myocardial interstitial remodelling in non-ischaemic dilated cardiomyopathy: insights from cardiovascular magnetic resonance
Abstract Myocardial remodelling involves not only the myocytes, but also non-myocyte cells and the extracellular matrix, which constitutes around 6 % of the normal heart and includes fluid, collagen and glycoproteins. In non-ischaemic dilated cardiomyopathy (DCM), the cardiac interstitium increases as a result of diffuse interstitial (microscopic) fibrosis, post-necrotic replacement (macroscopic) fibrosis or myocardial oedema. The activation of the renin–angiotensin–aldosterone system is a major determinant of fibroblasts activation and collagen deposition, with the transforming growth factor &bet...
Source: Heart Failure Reviews - September 30, 2015 Category: Cardiology Source Type: research

Heart failure preserved ejection fraction (HFpEF): an integrated and strategic review
Abstract In the USA, 5.7 million Americans ≥20 years have heart failure (HF) and heart failure preserved ejection fraction (HFpEF) accounts for at least 50 % of all hospital admissions for HF. HFpEF has no single guideline for diagnosis or treatment, the patient population is heterogeneously and inconsistently described, and longitudinal studies are lacking. The primary aims of this manuscript were to present an integrated review of the current state of the science on HFpEF, demonstrate gaps in the literature and provide the rationale for the design and implementation of future research to yield i...
Source: Heart Failure Reviews - September 24, 2015 Category: Cardiology Source Type: research

Absence of structural lesions in human renal arcuate arteries after LVAD implantation: response to a letter regarding “left ventricular assist devices: a kidney’s perspective”
(Source: Heart Failure Reviews)
Source: Heart Failure Reviews - September 22, 2015 Category: Cardiology Source Type: research

Letter to the Editor regarding the article “Left ventricular assist devices: a kidney’s perspective”
(Source: Heart Failure Reviews)
Source: Heart Failure Reviews - September 19, 2015 Category: Cardiology Source Type: research

Chemotherapy-induced cardiomyopathy
Abstract Cardiomyopathy is an adverse outcome of antineoplastic drug therapy that has become increasingly relevant in the management of cancer survivors. As the efficacy of anticancer treatments has improved, long-term outcomes are altered by the development of cardiotoxicity, which may be associated with an even worse prognosis than that of the underlying malignancy. From the research into mechanisms, prevention, and treatment, the specialized field of cardio-oncology has evolved, but the recognition and appropriate management of these patients is important for the general internist and general cardiologist a...
Source: Heart Failure Reviews - September 3, 2015 Category: Cardiology Source Type: research

The short-term and long-term effects of tolvaptan in patients with heart failure: a meta-analysis of randomized controlled trials
The objective of this meta-analysis was to assess the short-term and long-term effects of tolvaptan in patients with HF. Articles were searched from PubMed, MEDLINE and Cochrane Library before March 31, 2015. Randomized controlled trials enrolling adult HF patients and reporting the all-cause mortality, cardiac events, body weight change or changes of serum electrolytes including sodium, potassium and creatinine were included in our meta-analysis. Ten studies covering 5574 patients met the inclusion criteria. Based on the data of meta-analysis, tolvaptan had no impact on the all-cause mortality [relative risk (RR) 0.96; 95...
Source: Heart Failure Reviews - September 3, 2015 Category: Cardiology Source Type: research

Resuscitation of a dead cardiomyocyte
Abstract Although cardiac resuscitation can revive the whole body, the mechanisms are unclear. To this end, we propose that reviving a dead/dysfunctional cardiomyocyte will shed light on resuscitation mechanisms and pave the way to treat cardiac myopathies. The degradation of the myocyte cytoskeleton by the proteasome system which involves calpains, ubiquitin, caspases and matrix metalloproteases is the main focus of this review. The activation of calpains beyond the calpastatin-mediated inhibition due to extensive calcium harbor can lead to titin degradation, damage to the sarcomere and contractile dysfunction. T...
Source: Heart Failure Reviews - August 27, 2015 Category: Cardiology Source Type: research

Fabry’s disease: an example of cardiorenal syndrome type 5
Abstract Cardiorenal syndrome type 5 (CRS-5) includes conditions where there is a simultaneous involvement of the heart and kidney from a systemic disorder. This is a bilateral organ cross talk. Fabry’s disease (FD) is a devastating progressive inborn error of metabolism with lysosomal glycosphingolipid deposition in variety of cell types, capillary endothelial cells, renal, cardiac and nerve cells. Basic effect is absent or deficient activity of lysosomal exoglycohydrolase a-galactosidase A. Renal involvement consists of proteinuria, isosthenuria, altered tubular function, presenting in second or third deca...
Source: Heart Failure Reviews - July 31, 2015 Category: Cardiology Source Type: research

Long-term outcome with cardiac resynchronization therapy in mild heart failure patients with left bundle branch block from US and Europe MADIT-CRT
Abstract Early intervention with cardiac resynchronization therapy with defibrillator (CRT-D) in mild heart failure (HF) patients with a left bundle branch block (LBBB) ECG pattern was associated with a significant reduction in mortality in the long-term MADIT-CRT trial. Whether patients in MADIT-CRT enrolled from centers in the USA and in Europe have different long-term clinical response to CRT-D remains unknown. We compared the baseline clinical characteristics and clinical and echocardiographic long-term clinical response to CRT-D between MADIT-CRT patients with LBBB who were enrolled in USA (n = ...
Source: Heart Failure Reviews - July 27, 2015 Category: Cardiology Source Type: research

The role of CaMKII in diabetic heart dysfunction
Abstract Diabetes mellitus (DM) is an increasing epidemic that places a significant burden on health services worldwide. The incidence of heart failure (HF) is significantly higher in diabetic patients compared to non-diabetic patients. One underlying mechanism proposed for the link between DM and HF is activation of calmodulin-dependent protein kinase (CaMKIIδ). CaMKIIδ mediates ion channel function and Ca2+ handling during excitation–contraction and excitation-transcription coupling in the myocardium. CaMKIIδ activity is up-regulated in the myocardium of diabetic patients and mouse models...
Source: Heart Failure Reviews - July 22, 2015 Category: Cardiology Source Type: research

Improving the preclinical models for the study of chemotherapy-induced cardiotoxicity: a Position Paper of the Italian Working Group on Drug Cardiotoxicity and Cardioprotection
Abstract Although treatment for heart failure induced by cancer therapy has improved in recent years, the prevalence of cardiomyopathy due to antineoplastic therapy remains significant worldwide. In addition to traditional mediators of myocardial damage, such as reactive oxygen species, new pathways and target cells should be considered responsible for the impairment of cardiac function during anticancer treatment. Accordingly, there is a need to develop novel therapeutic strategies to protect the heart from pharmacologic injury, and improve clinical outcomes in cancer patients. The development of novel protective...
Source: Heart Failure Reviews - July 14, 2015 Category: Cardiology Source Type: research