Correction to: Is it time to revisit ICD indications?
(Source: Heart Failure Reviews)
Source: Heart Failure Reviews - February 15, 2022 Category: Cardiology Source Type: research
Rate adaptive pacing in people with chronic heart failure increases peak heart rate but not peak exercise capacity: a systematic review
AbstractRate adaptive cardiac pacing (RAP) allows increased heart rate (HR) in response to metabolic demand in people with implantable electronic cardiac devices (IECD). The aim of this work was to conduct a systematic review to determine if RAP increases peak exercise capacity (peak VO2) in line with peak HR in people with chronic heart failure. We conducted a systematic literature search from 1980, when IECD and RAP were first introduced, until 31 July 2021. Databases searched include PubMed, Medline, EMBASE, EBSCO, and the Clinical Trials Register. A comprehensive search of the literature produced a total of 246 possibl...
Source: Heart Failure Reviews - February 9, 2022 Category: Cardiology Source Type: research
Cardiorenal syndrome: long road between kidney and heart
AbstractAlmost 200 years ago, the first evidence described by Robert Bright (1836) showed the strong interaction between the kidneys and heart and, since then, the scientific community has dedicated itself to better understanding the mechanisms involved in the kidney–heart relationship, known in recent decades as cardiorenal syndrome (CRS). This syndrome includes a wide clinical variety that affects the kidneys and heart, in an acute or chronic manner. Moreover, it is well established in the literature that the immune system, the sympathetic nervous system, the renin–angiotensin–aldosterone, and the oxid ative stre...
Source: Heart Failure Reviews - February 8, 2022 Category: Cardiology Source Type: research
Redefining diabetes mellitus treatments according to different mechanisms beyond hypoglycaemic effect
AbstractEarly epidemiologic studies in type 2 diabetes suggested that the long-term risk of microvascular and macrovascular complications increase progressively as glucose concentrations rise, inspiring the pursuit of near euglycaemia as a means of preventing these complications in type 1 and type 2 diabetes. Evidence emerging over the past decade, however, showed that the aggressive efforts often needed to achieve low HbA1c levels can ultimately lead to worse clinical outcomes, greater risk of severe hypoglycaemia, and higher burden of treatment. The acknowledgment of the disappointing results obtained with therapies aime...
Source: Heart Failure Reviews - February 8, 2022 Category: Cardiology Source Type: research
An updated systematic review on heart failure treatments for patients with renal impairment: the tide is not turning
AbstractAdvanced chronic kidney disease (CKD) frequently aggravates heart failure (HF). However, these patients have inherently been excluded from most HF trials. We aim to provide updated estimates of the representation of patients with advanced CKD and the provision of baseline renal function indices in HF trials with a focused interest on the landmark trials. Updated systematic review was performed from the inception of MEDLINE to 31 December 2019 to identify all chronic HF randomized trials published in the three major cardiology and medical journals, respectively, which included mortality endpoint. The included stud...
Source: Heart Failure Reviews - February 7, 2022 Category: Cardiology Source Type: research
Evaluation of donor heart for transplantation
AbstractCardiac transplantation is considered the gold-standard treatment option for patients suffering from end-stage heart failure refractory to maximum medical therapy. A major determinant of graft function and recipient survival is a comprehensive evaluation of the donor allograft. Challenges arise when designing and implementing an evidence-based donor evaluation protocol due to the number of influential donor-specific characteristics and the complex interactions that occur between them. Here, we present our systematic approach to donor evaluation by examining the impact that relevant donor variables have on graft fun...
Source: Heart Failure Reviews - February 4, 2022 Category: Cardiology Source Type: research
State-of-the-art review on management of end-stage heart failure in amyloidosis: transplant and beyond
AbstractCardiac involvement occurs in light-chain (AL), transthyretin wild-type (wtATTR), and hereditary (hATTR) amyloidosis; other types of amyloidosis account for < 5% of all cardiac amyloidosis (CA). CA can present subclinically on screening, insidiously with symptoms such as exertional dyspnea, or abruptly as cardiogenic shock. Initially, CA patients were thought to be poor candidates for transplant due to short long-term survival; however, there is a mark ed improvement in heart and multi-organ transplant outcomes over the past 10 years with newer treatments and improvements in support with temporary and dur...
Source: Heart Failure Reviews - February 3, 2022 Category: Cardiology Source Type: research
Future perspective in diabetic patients with pre- and post-capillary pulmonary hypertension
AbstractPulmonary hypertension is a clinical syndrome that may include multiple clinical conditions and can complicate the majority of cardiovascular and respiratory diseases. Pulmonary hypertension secondary to left heart disease is the prevalent clinical condition and accounts for two-thirds of all cases. Type 2 diabetes mellitus, which affects about 422 million adults worldwide, has emerged as an independent risk factor for the development of pulmonary hypertension in patients with left heart failure. While a correct diagnosis of pulmonary hypertension secondary to left heart disease requires invasive hemodynamic eval...
Source: Heart Failure Reviews - January 31, 2022 Category: Cardiology Source Type: research
Renal effects of SGLT2 inhibitors in cardiovascular patients with and without chronic kidney disease: focus on heart failure and renal outcomes
AbstractThe kidney has a prominent role in maintaining glucose homeostasis by using glucose as a metabolic substrate. This occurs by generating glucose through gluconeogenesis, and by reuptaking filtered glucose through the sodium –glucose cotransporters SGLT1 and SGLT2 located in the proximal tubule. In recent studies, the administration of sodium–glucose cotransporters inhibitors demonstrated that inhibition of renal glucose reabsorption significantly reduces adverse renal events and heart failure exacerbations, in typ e 2 diabetic patients with and without cardiovascular damage as well as in advanced chronic kidney...
Source: Heart Failure Reviews - January 31, 2022 Category: Cardiology Source Type: research
Sudden cardiac death in cardiomyopathies: acting upon “acceptable” risk in the personalized medicine era
AbstractPatients with cardiomyopathies are confronted with the risk of sudden cardiac death (SCD) throughout their lifetime. Despite the fact that SCD is relatively rare, prognostic stratification is an integral part of physician –patient discussion, with the goal of risk modification and prevention. The current approach is based on a concept of “acceptable risk.” However, there are intrinsic problems with an algorithm-based approach to risk management, magnified by the absence of robust evidence underlying clinical de cision support tools, which can make high- versus low-risk classifications arbitrary. Strategies ai...
Source: Heart Failure Reviews - January 27, 2022 Category: Cardiology Source Type: research
Left atrial structure and function in heart failure with reduced (HFrEF) versus preserved ejection fraction (HFpEF): systematic review and meta-analysis
AbstractLeft atrial (LA) structure and function in heart failure with reduced (HFrEF) versus preserved ejection fraction (HFpEF) is only established in small studies. Therefore, we conducted a systematic review of LA structure and function in order to find differences between patients with HFrEF and HFpEF. English literature on LA structure and function using echocardiography was reviewed to calculate pooled prevalence and weighted mean differences (WMD). A total of 61 studies, comprising 8806 patients with HFrEF and 9928 patients with HFpEF, were included. The pooled prevalence of atrial fibrillation (AF) was 34.4% versus...
Source: Heart Failure Reviews - January 26, 2022 Category: Cardiology Source Type: research
Is it time to revisit ICD indications?
(Source: Heart Failure Reviews)
Source: Heart Failure Reviews - January 26, 2022 Category: Cardiology Source Type: research
Meta-analysis addressing the impact of cardiovascular-acting medication on peak oxygen uptake of patients with HFpEF
AbstractAs our therapeutic armamentarium for HFpEF is insufficient, research has been focusing on the potential beneficial effect of existing pharmaceutical regimens on this specific patient population. A series of RCTs have recently examined the impact of various pharmaceutical treatments with proven benefit in HFrEF, on the improvement of symptoms of HFpEF patients. This systematic review and meta-analysis comprised studies of adult patients with HFpEF and evaluated the impact of different cardiovascular acting medication on cardiorespiratory fitness, reflected by peak VO2 values measured during CPET. The primary outcome...
Source: Heart Failure Reviews - January 24, 2022 Category: Cardiology Source Type: research
An update on diabetes spectrum in heart failure: current evidence and potential therapeutic applications
AbstractThis is an introduction to this special issue on diabetes and heart failure (HF). The issue deals with the primary features and key questions regarding the coexistence of diabetes and heart failure. Evidence for most treatments of this disease state comes from post hoc analysis of clinical trials and registries. Recent evidence shows a significant decrease in HF-related events with the newer antidiabetic agents. Therefore, in this issue, we briefly summarize the most relevant cardiovascular outcome trials supporting the use of newer antidiabetic drugs beyond traditional glucose-lowering agents. Notably, this issue ...
Source: Heart Failure Reviews - January 24, 2022 Category: Cardiology Source Type: research
Prognostic value of non-contrast myocardial T1 mapping in cardiovascular diseases: a systematic review and meta-analysis
AbstractMyocardial fibrosis predisposes the development of main adverse cardiovascular events (MACEs) in various cardiac disorders. Native T1 derived from cardiac magnetic resonance allows the quantitative assessment of myocardial fibrosis without the use of contrast media. However, the prognostic value of native T1 in risk stratification remains uncertain. We searched MEDLINE®, Embase, and the Cochrane Library for cohort studies up to July 31, 2021, that reported prognostic data for native T1 in various cardiac disorders; the studies enrolling patients with myocardial iron or amyloid deposition, edema, and inflammation w...
Source: Heart Failure Reviews - January 22, 2022 Category: Cardiology Source Type: research
