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Heart Failure Reviews

Athanasios Chalkias, Eleni Arnaoutoglou, Theodoros Xanthos
Resuscitation guidelines remain uniform across all cardiac arrest patients, focusing on the delivery of chest compressions to a standardized rate and depth and algorithmic vasopressor dosing. However, individualizing resuscitation to the appropriate hemodynamic and ventilatory goals rather than a standard "one-size-fits-all" treatment seems a promising new therapeutic strategy. In this article, we present a new physiology-guided treatment strategy to titrate the resuscitation efforts to patient's physiologic response after cardiac arrest...
February 11, 2019: Heart Failure Reviews
Mieczysław Dutka, Rafał Bobiński, Jan Korbecki
Myocardial infarction and post-infarction left ventricular remodelling involve a high risk of morbidity and mortality. For this reason, ongoing research is being conducted in order to learn the mechanisms of unfavourable left ventricular remodelling following a myocardial infarction. New biomarkers are also being sought that would allow for early identification of patients with a high risk of post-infarction remodelling and dysfunction of the left ventricle. In recent years, there has been ever more experimental data that confirms the significance of microRNA in cardiovascular diseases...
February 2, 2019: Heart Failure Reviews
Amir Abbas Momtazi-Borojeni, Elham Abdollahi, Banafsheh Nikfar, Shahla Chaichian, Mahnaz Ekhlasi-Hundrieser
Accumulation of macrophages within the artery wall is an eminent feature of atherosclerotic plaques. Macrophages are influenced by various plaque microenvironmental stimuli, such as oxidized lipids, cytokines, and senescent erythrocytes, and thereby polarize into two main phenotypes called proinflammatory M1 and anti-inflammatory M2 macrophages. In the hemorrhagic zones of atheroma, upon exposure to iron, sequestration of iron by M1 macrophages results in an uncontrolled proinflammatory phenotype impairing wound healing, while M2 macrophages phagocytose both apoptotic cells and senescent erythrocytes...
January 23, 2019: Heart Failure Reviews
Jae Gyun Oh, Changwon Kho, Roger J Hajjar, Kiyotake Ishikawa
Experimental models of cardiac disease play a key role in understanding the pathophysiology of the disease and developing new therapies. The features of the experimental models should reflect the clinical phenotype, which can have a wide spectrum of underlying mechanisms. We review characteristics of commonly used experimental models of cardiac physiology and pathophysiology in all translational steps including in vitro, small animal, and large animal models. Understanding their characteristics and relevance to clinical disease is the key for successful translation to effective therapies...
January 22, 2019: Heart Failure Reviews
Rabia Johnson, Phiwayinkosi Dludla, Sihle Mabhida, Mongi Benjeddou, Johan Louw, Faghri February
Blood pressure (BP) is a complex trait that is regulated by multiple physiological pathways and include but is not limited to extracellular fluid volume homeostasis, cardiac contractility, and vascular tone through renal, neural, or endocrine systems. Uncontrolled hypertension (HTN) has been associated with an increased mortality risk. Therefore, understanding the genetics that underpins and influence BP regulation will have a major impact on public health. Moreover, uncontrolled HTN has been linked to inter-individual variation in the drugs' response and this has been associated with an individual's genetics architecture...
January 15, 2019: Heart Failure Reviews
Angelos G Rigopoulos, Muhammad Ali, Elena Abate, Marios Matiakis, Hannes Melnyk, Sophie Mavrogeni, Dionyssios Leftheriotis, Boris Bigalke, Michel Noutsias
Treatment of left ventricular outflow tract (LVOT) obstruction in hypertrophic obstructive cardiomyopathy (HOCM) with septal reduction, either with myectomy or alcohol septal ablation, is aiming to reduce the LVOT gradient and improve symptoms in patients who are refractory to or do not tolerate medical treatment. Apart from contributing to the evolution to heart failure, LVOT obstruction is considered a risk factor for sudden cardiac death (SCD). Both septal reduction treatments have been proven effective in reducing symptoms and seem to improve survival, which has been shown equal to the expected in the normal population...
January 8, 2019: Heart Failure Reviews
Maxwell Eyram Afari, Joe Aoun, Sarthak Khare, Lana Tsao
The prevalence of heart failure (HF) is on the rise. By 2030, over eight million Americans (46% increase from current prevalence) will have heart failure. In the USA, approximately 30 billion dollars is spent annually on heart failure and this number will likely double in 2030. Thus, HF represents a significant economic burden. Acute decompensated heart failure (ADHF) is a clinical spectrum, which refers to increasing symptoms and signs of heart failure prompting an emergency room visit or hospitalization. In ADHF, inpatient administration of intravenous diuretic is the standard of care due to the variability in the absorption of oral diuretics...
January 8, 2019: Heart Failure Reviews
Chris J Kapelios, Jonathan R Murrow, Thomas G Nührenberg, Maria N Montoro Lopez
Heart failure with preserved ejection fraction (HFpEF) is a disease with limited evidence-based treatment options. Mineralocorticoid receptor antagonists (MRA) offer benefit in heart failure with reduced ejection fraction (HFrEF), but their impact in HFpEF remains unclear. We therefore evaluated the effect of MRA on echocardiographic, functional, and systemic parameters in patients with HFpEF by a systematic review and meta-analysis. We searched MEDLINE, EMBASE, , and Cochrane Clinical Trial Collection to identify randomized controlled trials that (a) compared MRA versus placebo/control in patients with HFpEF and (b) reported echocardiographic, functional, and/or systemic parameters relevant to HFpEF...
January 7, 2019: Heart Failure Reviews
Francesco Negri, Antonio De Luca, Enrico Fabris, Renata Korcova, Carlo Cernetti, Chrysanthos Grigoratos, Giovanni Donato Aquaro, Gaetano Nucifora, Paolo G Camici, Gianfranco Sinagra
The presence of myocardial noncompaction (NC), regardless of the criterion used, does not identify cardiomyopathy per se. The distinction between a morphological variant and the presence of an NC cardiomyopathy is challenging. However, thanks to larger cohorts of patients and longer periods of follow-up, better clinical characterization and prognostic evaluation are becoming available. Indeed, the physician is required to integrate the evidence of NC with the clinical history of the patient, which is supplemented by necessary advanced instrumental investigations before a definite diagnosis of NC cardiomyopathy can be made...
January 5, 2019: Heart Failure Reviews
Jirka Cops, Sibren Haesen, Bart De Moor, Wilfried Mullens, Dominique Hansen
Congestion (i.e., backward failure) is an important culprit mechanism driving disease progression in heart failure. Nevertheless, congestion remains often underappreciated and clinicians underestimate the importance of congestion on the pathophysiology of decompensation in heart failure. In patients, it is however difficult to study how isolated congestion contributes to organ dysfunction, since heart failure and chronic kidney disease very often coexist in the so-called cardiorenal syndrome. Here, we review the existing relevant and suitable backward heart failure animal models to induce congestion, induced in the left- (i...
January 5, 2019: Heart Failure Reviews
Marijana Tadic, Cesare Cuspidi
Obesity represents one of the most common comorbidities in patients with heart failure and preserved ejection fraction (HFpEF). Studies have shown that obesity is not only a comorbidity, but it could also be an important risk factor for HFpEF development. The mechanisms that connect obesity and HFpEF vary from obesity-induced hemodynamic changes to important biohumoral systems such as adipocitokines, renin-angiotensin-aldosterone and sympathetic nervous systems, natriuretic peptide, and oxidative stress. Studies agree about the negative influence of morbid obesity on cardiac remodeling and HFpEF development...
January 5, 2019: Heart Failure Reviews
Yangjing Xue, Jinsheng Wang, Jiaoni Wang, Saroj Thapa, Kaiyu Huang, Yangpei Peng, Lu Qian, Jiwu Li, Kangting Ji
Cardiac resynchronization therapy (CRT) has been established to improve prognosis for patients with heart failure and SR. Whether the benefit observed with CRT on survival was similar in AF patients receiving atrio-ventricular junction ablation (AVJA) or not and patients in SR remains uncertain. The primary purpose of this study was to comprehensively evaluate the impact of CRT on the outcome of survival in atrial fibrillation (AF) patients with or without AVJA and patients in sinus rhythm (SR). Medline, Embase, and the Cochrane Library were searched for inception through June 31, 2018...
January 4, 2019: Heart Failure Reviews
Andrew J Sauer, Robert Cole, Brian C Jensen, Jay Pal, Nakul Sharma, Amin Yehya, Justin Vader
Sacubitril/valsartan is a first-in-class angiotensin receptor-neprilysin inhibitor (ARNI) that has been recommended in clinical practice guidelines to reduce morbidity and mortality in patients with chronic, symptomatic heart failure (HF) with reduced ejection fraction (HFrEF). This review provides an overview of ARNI therapy, proposes strategies to improve the implementation of sacubitril/valsartan in clinical practice, and provides clinicians with evidence-based, practical guidance on the use of sacubitril/valsartan in patients with HFrEF...
December 18, 2018: Heart Failure Reviews
Habib Haybar, Elahe Khodadi, Saeid Shahrabi
Cardiovascular disease (CVD) is still a factor of mortality in the whole world. Through canonical and noncanonical pathways and with different receptors, the Wnt/β-catenin signaling pathway plays an essential role in response to heart injuries. Wnt regulates the mobilization and proliferation of cells in endothelium and epicardium in an infarcted heart. Therefore, with its profibrotic effects as well as its antagonism with other proteins, Wnt/β-catenin signaling pathway leads to beneficial effects on fibrosis and cardiac remodeling in myocardium...
December 12, 2018: Heart Failure Reviews
Jinhui Wang, Weijian Zhou, Xiaoning Yin
Hyponatremia at admission is predictive of poor prognosis in patients with acute decompensated heart failure (ADHF). We performed a meta-analysis of cohort studies to evaluate whether improvement of hyponatremia is associated with improved survival in patients with ADHF and hyponatremia. Relevant studies were identified through systematic search of PubMed and Embase. A random-effect model was used to pool the results. Predefined subgroup analyses were performed to explore the source of heterogeneity. Five thousand seven hundred fourteen patients with ADHF and hyponatremia from eight cohort studies were included...
December 10, 2018: Heart Failure Reviews
Vikas Kumar, T R Santhosh Kumar, C C Kartha
Mitochondrial dysfunction is widely recognized as a major factor for the progression of cardiac failure. Mitochondrial uptake of metabolic substrates and their utilization for ATP synthesis, electron transport chain activity, reactive oxygen species levels, ion homeostasis, mitochondrial biogenesis, and dynamics as well as levels of reactive oxygen species in the mitochondria are key factors which regulate mitochondrial function in the normal heart. Alterations in these functions contribute to adverse outcomes in heart failure...
December 10, 2018: Heart Failure Reviews
Shan Huang, Qin Zhao, Zhi-Gang Yang, Kai-Yue Diao, Yong He, Ke Shi, Meng-Ting Shen, Hang Fu, Ying-Kun Guo
Some randomized controlled trials (RCTs) have tested the efficacy of beta-blockers as prophylactic agents on cancer therapy-induced cardiotoxicity; however, the quality of this evidence remains undetermined. This systematic review and meta-analysis study aims to evaluate the prophylactic effects of beta-blockers, especially carvedilol, on chemotherapy-induced cardiotoxicity. RCTs were identified by searching the MEDLINE (PubMed), Embase (OvidSP), Cochrane CENTRAL (OvidSP), etc., until December 2017. Inclusion criteria were randomized clinical trial and adult cancer patients started beta-blockers before chemotherapy...
December 6, 2018: Heart Failure Reviews
David Goldgrab, Kathir Balakumaran, Min Jung Kim, Sara R Tabtabai
Heart failure (HF) and HF 30-day readmission rates have been a major focus of efforts to reduce health care cost in the recent era. Since the implementation of the Affordable Care Act (ACA) in 2012 and the Hospital Readmission Reduction Program (HRRP), concerted efforts have focused on reduction of 30-day HF readmissions and other admission diagnoses targeted by the HRRP. Hospitals and organizations have instituted wide-ranging programs to reduce short-term readmissions, but the data supporting these programs is often mixed...
November 28, 2018: Heart Failure Reviews
Paul Palmquist-Gomes, José María Pérez-Pomares, Juan Antonio Guadix
Ischemic cardiomyopathy is the cardiovascular condition with the highest impact on the Western population. In mammals (humans included), prolonged ischemia in the ventricular walls causes the death of cardiomyocytes (myocardial infarction, MI). The loss of myocardial mass is soon compensated by the formation of a reparative, non-contractile fibrotic scar that ultimately affects heart performance. Despite the enormous clinical relevance of MI, no effective therapy is available for the long-term treatment of this condition...
January 2019: Heart Failure Reviews
Benjamin J Sieniewicz, Justin Gould, Bradley Porter, Baldeep S Sidhu, Thomas Teall, Jessica Webb, Gerarld Carr-White, Christopher A Rinaldi
Heart failure is a complex clinical syndrome associated with a significant morbidity and mortality burden. Reductions in left ventricular (LV) function trigger adaptive mechanisms, leading to structural changes within the LV and the potential development of dyssynchronous ventricular activation. This is the substrate targeted during cardiac resynchronisation therapy (CRT); however, around 30-50% of patients do not experience benefit from this treatment. Non-response occurs as a result of pre-implant, peri-implant and post implant factors but the technical constraints of traditional, transvenous epicardial CRT mean they can be challenging to overcome...
January 2019: Heart Failure Reviews
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