Efficacy of remote physiological monitoring-guided care for chronic heart failure: an updated meta-analysis
AbstractPrevious studies have reported contradictory findings on the utility of remote physiological monitoring (RPM)-guided management of patients with chronic heart failure (HF). Multiple databases were searched for studies that evaluated the clinical efficacy of RPM-guided management versus standard of care (SOC) for HF patients. The primary outcome was HF-related hospitalization (HFH). The secondary outcomes were all-cause mortality, cardiovascular-related (CV) mortality, and emergency department (ED) visits. Pooled relative risk (RR) and corresponding 95% confidence intervals (CIs) were calculated and combined using a...
Source: Heart Failure Reviews - October 5, 2021 Category: Cardiology Source Type: research
Remote monitoring for heart failure using implantable devices: a systematic review, meta-analysis, and meta-regression of randomized controlled trials
AbstractIn heart failure (HF) patients, remote monitoring using implantable devices may be used to predict and reduce HF exacerbations and mortality. Data from randomized controlled trials (RCTs) was assessed to determine the effectiveness of implantable remote monitoring on the improvement of outcomes in HF patients. A systematic review and meta-analysis of RCTs testing remote monitoring versus standard of care for management of HF patients was performed. Primary endpoints were all-cause mortality and a composite of cardiovascular (CV) and HF hospitalizations. Rate ratios (RRs) and 95% confidence intervals (CI) were calcu...
Source: Heart Failure Reviews - September 24, 2021 Category: Cardiology Source Type: research
Resistance training in heart failure patients: a systematic review and meta-analysis
AbstractAerobic training (AT) has been the primary mode of exercise training in cardiac rehabilitation. Historically, the reason for the prescription of AT was that it was speculated that although RT may be beneficial for some clinical outcomes, it may have an adverse effect on ventricular structure and function. However, RT has now made its way into current cardiac rehabilitation guidelines, including those directed towards patients with HF, albeit differences exist across institutions and guidelines. A systematic search of PubMed, EMBASE and Cochrane Trials Register on April 30, 2021, was conducted for exercise-based reh...
Source: Heart Failure Reviews - September 20, 2021 Category: Cardiology Source Type: research
The protective effects of 17- β estradiol and SIRT1 against cardiac hypertrophy: a review
AbstractOne of the major causes of morbidity and mortality worldwide is cardiac hypertrophy (CH), which leads to heart failure. Sex differences in CH can be caused by sex hormones or their receptors. The incidence of CH increases in postmenopausal women due to the decrease in female sex hormone 17- β estradiol (E2) during menopause. E2 and its receptors inhibit CH in humans and animal models. Silent information regulator 1 (SIRT1) is a NAD+-dependent HDAC (histone deacetylase) and plays a major role in biological processes, such as inflammation, apoptosis, and oxidative stress responses. Probably SIRT1 because of these ef...
Source: Heart Failure Reviews - September 18, 2021 Category: Cardiology Source Type: research
Filamin C in cardiomyopathy: from physiological roles to DNA variants
AbstractCardiomyopathy affects approximately 1 in 500 adults and is the leading cause of death. Familial cases are common, and mutations in many genes are involved in cardiomyopathy, especially those in genes encoding cytoskeletal, sarcomere, and nuclear envelope proteins. Filamin C is an actin-binding protein encoded byfilamin C (FLNC) gene and participates in sarcomere stability maintenance.FLNC was first demonstrated to be a causal gene of myofibrillar myopathy; recently, it has been found thatFLNC mutation plays a critical role in the pathogenesis of cardiomyopathy. In this review, we summarized the physiological roles...
Source: Heart Failure Reviews - September 17, 2021 Category: Cardiology Source Type: research
The genetics of cardiac amyloidosis
AbstractHeritable cardiac amyloidosis (CA) is an underrecognized cause of morbidity and mortality in the USA. It results from the accumulation of the misfolded protein transthyretin within the myocardium, resulting in amyloid transthyretin-associated cardiomyopathy (ATTR-CM). Over 150 different pathologic point mutations within the transthyretin gene have been identified, each carrying variable clinical phenotypes and penetrance. In the USA, the most common cause of hereditary ATTR is the Val122Ile point mutation, with a prevalence of 3.4 –4.0% in North Americans of African and Caribbean descent. Among Caucasians with he...
Source: Heart Failure Reviews - September 13, 2021 Category: Cardiology Source Type: research
Mechanisms, time course and predictability of premature ventricular contractions cardiomyopathy —an update on its development and resolution
AbstractFrequent premature ventricular contractions (PVCs) associated left ventricular systolic dysfunction (LVSD) is a well-known clinical scenario and numerous predictors for cardiomyopathy (CMP) development have been already thoroughly described. It may present as a"pure" form of dissynchrony-induced cardiomyopathy or it may be an aggravating component of a multifactorial structural heart disease. However, the precise risk to develop PVC-induced CMP (which would allow for tailored-patient monitoring and/or early treatment) and the degree of CMP reversibility after PVC suppression/elimination (which may permit ...
Source: Heart Failure Reviews - September 12, 2021 Category: Cardiology Source Type: research
Advanced airway management and respiratory care in decompensated pulmonary hypertension
AbstractMeticulous risk stratification is essential when considering intubation of a patient with decompensated pulmonary hypertension (dPH). It is paramount to understand both the pathophysiology of dPH (and associated right ventricular failure) and the complications related to a high-risk intubation before attempting the procedure. There are few recommendations in this area and the literature, guiding these recommendations, is limited to expert opinion and very few case reports/case series. This review will discuss the complex pathophysiology of dPH, the complications associated with intubation, the debates surrounding i...
Source: Heart Failure Reviews - September 2, 2021 Category: Cardiology Source Type: research
Echocardiographic assessment of cardiac amyloidosis
AbstractCardiac amyloidosis, a form of infiltrative cardiomyopathy, is associated with poor prognosis in untreated patients. Early diagnosis is important for timely initiation of effective therapies. Despite advances in diagnostic modalities, it remains a challenging diagnosis, requiring high index of clinical suspicion. Echocardiography represents the first-line cardiac imaging modality for evaluation of heart failure and suspected cardiac amyloidosis. In this review, we discuss echocardiographic findings in cardiac amyloidosis. (Source: Heart Failure Reviews)
Source: Heart Failure Reviews - August 30, 2021 Category: Cardiology Source Type: research
New insights into the roles of glucocorticoid signaling dysregulation in pathological cardiac hypertrophy
AbstractPathological cardiac hypertrophy is a process of abnormal remodeling of the myocardium in response to stress overload or ischemia that results in myocardial injury, which is an independent risk factor for the increased morbidity and mortality of heart failure. Elevated circulating glucocorticoids (GCs) levels are associated with an increased risk of pathological cardiac hypertrophy, but the exact role remains unclear. In the heart, GCs exerts physiological and pharmacological effects by binding the glucocorticoid receptor (GR, NR3C1). However, under the state of tissue damage or oxidative stress, GCs can also bind ...
Source: Heart Failure Reviews - August 28, 2021 Category: Cardiology Source Type: research
Multiple roles of cardiac macrophages in heart homeostasis and failure
AbstractMacrophages are essential components of the immune system and play a role in the normal functioning of the cardiovascular system. Depending on their origin and phenotype, cardiac macrophages perform various functions. In a steady-state, these cells play a beneficial role in maintaining cardiac homeostasis by defending the body from pathogens and eliminating apoptotic cells, participating in electrical conduction, vessel patrolling, and arterial tone regulation. However, macrophages also take part in adverse cardiac remodeling that could lead to the development and progression of heart failure (HF) in such HF comorb...
Source: Heart Failure Reviews - August 13, 2021 Category: Cardiology Source Type: research
The role of non-invasive imaging modalities in cardiac allograft vasculopathy: an updated focus on current evidences
AbstractCardiac allograft vasculopathy (CAV) is an obliterative and diffuse form of vasculopathy affecting almost 50% of patients after 10 years from heart transplant and represents the most common cause of long-term cardiovascular mortality among heart transplant recipients. The gold standard diagnostic technique is still invasive coronary angiography, which however holds potential for complications, especially contrast-related kidn ey injury and procedure-related vascular lesions. Non-invasive and contrast-sparing imaging techniques have been advocated and investigated over the past decades, in order to identify those ...
Source: Heart Failure Reviews - August 12, 2021 Category: Cardiology Source Type: research
Vascular and metabolic effects of SGLT2i and GLP-1 in heart failure patients
AbstractAlterations of endothelial function, inflammatory activation, and nitric oxide-cyclic guanosine monophosphate (NO-cGMP) pathway are involved in the pathophysiology of heart failure. Metabolic alterations have been studied in the myocardium of heart failure (HF) patients; alterations in ketone body and amino acid/protein metabolism have been described in patients affected by HF, as well as mitochondrial dysfunction and other modified metabolic signaling. However, their possible contributions toward cardiac function impairment in HF patients are not completely known. Recently, sodium-glucose co-transporter 2 inhibito...
Source: Heart Failure Reviews - August 11, 2021 Category: Cardiology Source Type: research
Can mechanical circulatory support be an effective treatment for HFpEF patients?
AbstractHeart failure with preserved ejection fraction (HFpEF) is increasing in prevalence and represents approximately 50% of all heart failure (HF) patients. Patients with this complex clinical scenario, characterized by high filling pressures, and reduced cardiac output (CO) associated with progressive multi-organ involvement, have so far not experienced any significant improvement in quality of life or survival with traditional HF treatment. Left ventricular assist devices (LVAD) have offered a new treatment alternative in terminal heart failure patients with reduced ejection fraction (HFrEF), providing a unique combin...
Source: Heart Failure Reviews - August 9, 2021 Category: Cardiology Source Type: research
A deep dive into the darning effects of biomaterials in infarct myocardium: current advances and future perspectives
AbstractMyocardial infarction (MI) occurs due to the obstruction of coronary arteries, a major crux that restricts blood flow and thereby oxygen to the distal part of the myocardium, leading to loss of cardiomyocytes and eventually, if left untreated, leads to heart failure. MI, a potent cardiovascular disorder, requires intense therapeutic interventions and thereby presents towering challenges. Despite the concerted efforts, the treatment strategies for MI are still demanding, which has paved the way for the genesis of biomaterial applications. Biomaterials exhibit immense potentials for cardiac repair and regeneration, w...
Source: Heart Failure Reviews - August 3, 2021 Category: Cardiology Source Type: research
