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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...
November 13, 2018: Heart Failure Reviews
Gursharan K Singh, Patricia M Davidson, Peter S Macdonald, Phillip J Newton
Individuals with chronic heart failure have high utilisation of hospital-related services towards the end of life and receive treatments that provide symptom relief without improving life expectancy. The aim of this discussion paper is to determine chronic heart failure patients' use of acute hospital-based services in their last year of life and to discuss the potential for palliative care to reduce service utilisation. A systematic search of the literature was conducted. Medline, Cumulative Index for Nursing and Allied Health (CINAHL) and SCOPUS databases were used to systematically search for literature from database commencement to September 2016...
November 3, 2018: Heart Failure Reviews
Hidekatsu Fukuta, Toshihiko Goto, Kazuaki Wakami, Takeshi Kamiya, Nobuyuki Ohte
Influenza infection is associated with increased risk for mortality and hospitalization in heart failure patients. Although there are no published randomized controlled trials examining the effect of influenza vaccination on clinical outcomes in heart failure patients, the effect has been examined in observational cohort studies. Nevertheless, results are inconsistent due partly to limited power with small sample sizes and use of different definitions of outcomes. We therefore aimed to conduct a systematic review and meta-analysis of the effect of influenza vaccination on mortality and hospitalization in heart failure patients...
October 26, 2018: Heart Failure Reviews
Brahmanaidu Parim, V V Sathibabu Uddandrao, Ganapathy Saravanan
Diabetic complications are among the largely exigent health problems currently. Cardiovascular complications, including diabetic cardiomyopathy (DCM), account for more than 80% of diabetic deaths. Investigators are exploring new therapeutic targets to slow or abate diabetes because of the growing occurrence and augmented risk of deaths due to its complications. Research on rodent models of type 1 and type 2 diabetes mellitus, and the use of genetic engineering techniques in mice and rats have significantly sophisticated for our understanding of the molecular mechanisms in human DCM...
October 22, 2018: Heart Failure Reviews
Vincenzo Marafioti, Giovanni Benfari
No abstract text is available yet for this article.
October 20, 2018: Heart Failure Reviews
Ram B Singh, Krasimira Hristova, Jan Fedacko, Galal El-Kilany, Germaine Cornelissen
The underlying mechanism for clinical and biochemical manifestations of chronic heart failure (HF) may be due in part to neurohumoral adaptations, such as activation of the renin-angiotensin-aldosterone and sympathetic nervous systems in the periphery and the brain. Internet search and discussion with colleagues are the methods for this study. Since chronic HF is associated with autonomic imbalance with increased sympathetic nerve activity and a withdrawal of parasympathetic activity, it may be considered a brain disease...
October 20, 2018: Heart Failure Reviews
Ahmed Bendary, Mohamed Bendary, Mohamed Salem
Heart failure with reduced ejection fraction (HFrEF) represents a significant public health burden associated with incremental health care costs. Given the limitations associated with pharmacological autonomic regulation therapy (ART), device-based autonomic neuromodulation is on the horizon now for ART in those patients. This systematic review aimed primarily to determine the effect of ART by devices on functional status and quality of life (QOL) in patients with HFrEF. We performed a meta-analysis of five randomized controlled trials (1074 patients) comparing ART by devices versus optimal medical therapy (OMT) in HFrEF...
October 13, 2018: Heart Failure Reviews
Binh N Pham, Sandra V Chaparro
Heart failure is a widespread condition in the United States that is predicted to significantly increase in prevalence in the next decade. Many heart failure patients are given a left ventricular assist device (LVAD) while they wait for a heart transplant, while those that are not able to undergo a heart transplant may be given an LVAD permanently. However, past studies have observed a small subset of heart failure patients that recovered cardiac function of their native heart after being placed on an LVAD...
October 9, 2018: Heart Failure Reviews
Guangze Zhao, Ye Qiu, Huifang M Zhang, Decheng Yang
Intercalated discs (ICDs) are highly orchestrated structures that connect neighboring cardiomyocytes in the heart. Three major complexes are distinguished in ICD: desmosome, adherens junction (AJ), and gap junction (GJ). Desmosomes are major cell adhesion junctions that anchor cell membrane to the intermediate filament network; AJs connect the actin cytoskeleton of adjacent cells; and gap junctions metabolically and electrically connect the cytoplasm of adjacent cardiomyocytes. All these complexes work as a single unit, the so-called area composita, interdependently rather than individually...
October 5, 2018: Heart Failure Reviews
Kamil A Kobak, Malwina Radwańska, Magdalena Dzięgała, Monika Kasztura, Krystian Josiak, Waldemar Banasiak, Piotr Ponikowski, Ewa A Jankowska
Iron deficiency (ID) is a common and ominous comorbidity in heart failure (HF) and predicts worse outcomes, independently of the presence of anaemia. Accumulated data from animal models of systemic ID suggest that ID is associated with several functional and structural abnormalities of the heart. However, the exact role of myocardial iron deficiency irrespective of systemic ID and/or anaemia has been elusive. Recently, several transgenic models of cardiac-specific ID have been developed to investigate the influence of ID on cardiac tissue...
October 3, 2018: Heart Failure Reviews
Dinesh Chandra Voruganti, Alexandros Briasoulis, Mohsan Chaudhry, Paulino Alvarez, Vlad Cotarlan, Jay K Bhama, Michael Giudici
The impact of cardiac resynchronization therapy (CRT) on clinical outcome in patients with a continuous-flow left ventricular assist device (LVAD) is currently not well understood. We conducted a systematic literature review and meta-analysis with an intention to summarize all published clinical evidence. We searched MEDLINE and EMBASE databases through March 2018 for studies that compared the outcomes in patients with LVAD and CRT. Pooled odds ratios (OR) and 95% confidence intervals (CI) were calculated using a random-effects model, inverse variance method...
September 27, 2018: Heart Failure Reviews
Vasiliki Katsi, Maria Marketou, Alexios S Antonopoulos, Dimitrios Vrachatis, Fragkiskos Parthenakis, Dimitris Tousoulis
Obesity is a major risk factor for the development of chronic heart failure (CHF) and does not only pose diagnostic challenges, but also has prognostic implications for these patients. Paradoxically, obese patients with CHF have a better prognosis than thinner individuals. In recent years, it has been demonstrated that the adipose tissue, even in patients with HF, is not always detrimental, and that obesity may coexist with a phenotype of benign adiposity without systemic metabolic abnormalities. Experimental data have shown that natriuretic peptides (NPs), and in particular brain natriuretic peptide (BNP), play a major role in the communication of the heart with the adipose tissue...
September 25, 2018: Heart Failure Reviews
Feng Hu, Lihui Zheng, Ligang Ding, Zhongpeng Du, Erpeng Liang, Lingmin Wu, Gang Chen, Xiaohan Fan, Yan Yao, Yu Jiang
Cardiac resynchronization therapy (CRT) is an effective treatment for selected patients with systolic heart failure. Unlike conventional biventricular pacing (BIP), the left ventricular multipoint pacing (MPP) can increase the number of left ventricular pacing sites via a quadripolar lead positioned in the coronary sinus. This synthetic study was conducted to integratively and quantitatively evaluate the clinical outcome of MPP in comparison with BIP. We systematically searched the databases of EMBASE, Ovid medline, and Cochrane Library through May 2018 for studies comparing the clinical outcome of MPP with BIP in the patients who accepted CRT...
September 12, 2018: Heart Failure Reviews
Justas Simonavičius, Christian Knackstedt, Hans-Peter Brunner-La Rocca
Loop diuretics remain the cornerstone of congestion management in contemporary chronic heart failure care. However, their use is not supported by high quality data, and there is doubt about the safety in the outpatient heart failure setting. Still, congestion is related to a worse outcome, and there is general consensus among experts that congestion should not be tolerated in heart failure patients. Recommendations in international guidelines, regarding decongestion strategies in chronic heart failure, are limited...
September 7, 2018: Heart Failure Reviews
Nonhlakanipho F Sangweni, Phiwayinkosi V Dludla, Rebamang A Mosa, Abidemi P Kappo, Andy Opoku, Christo J F Muller, Rabia Johnson
The epidemic of cardiovascular diseases is a global phenomenon that is exaggerated by the growing prevalence of diabetes mellitus. Coronary artery disease and diabetic cardiomyopathy are the major cardiovascular complications responsible for exacerbated myocardial infarction in diabetic individuals. Increasing research has identified hyperglycemia and hyperlipidemia as key factors driving the augmentation of oxidative stress and a pro-inflammatory response that usually results in increased fibrosis and reduced cardiac efficiency...
August 31, 2018: 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...
August 24, 2018: Heart Failure Reviews
Nikolaos Karamichalakis, John Parissis, George Bakosis, Vasiliki Bistola, Ignatios Ikonomidis, Antonios Sideris, Gerasimos Filippatos
Reducing heart failure hospitalizations represents a major challenge for modern clinicians. Early detection of congestion plays a key role in disease management strategy. Apart from traditional methods (patient reporting symptoms, body weight monitoring), novel home-care strategies allow guided adjustments in medical therapy through telemonitoring embedded in cardiac electronic implantable devices or through stand-alone diagnostic devices for hemodynamic monitoring. Wireless pulmonary artery pressure monitoring seems to reduce re-admission risk and is currently approved for this purpose in patients with heart failure...
November 2018: Heart Failure Reviews
R De Rosa, D Schranz
Elevated left atrial (LA) filling pressures are associated with poor prognosis in patients with heart failure (HF). Recent evidences have shown that, in this setting, the presence of restrictive small atrial defect may protect from an extreme increase in LA pressure and prevent consecutive pulmonary congestion and acute decompensation, without the expense of an unfavourable significant left-to-right shunt. Therefore, decompression of LA by creating a unidirectional but restrictive left-to-right interatrial shunt has been emerging as a new therapeutic strategy in patients suffering from both HF with preserved and reduced ejection fraction...
November 2018: Heart Failure Reviews
Valerio Zacà, Theodore Murphy, Mauro Biffi
Chronic heart failure with reduced (≤ 40%) ejection fraction (HFrEF) poses a significant residual mortality risk despite modern optimal medical therapy. In the last decades, we have witnessed the introduction of breakthrough cardiac implantable electronic devices (CIED) aimed at addressing sudden cardiac death and HF progression in patients with HFrEF, leading to improved survival and functional capacity. Following their introduction, implantable cardioverter defibrillators (ICD) and cardiac resynchronization therapy (CRT) have undergone substantial technological improvements and have been investigated in different settings of HFrEF, some of which yielded controversial results...
November 2018: Heart Failure Reviews
Chirag Bavishi, Dhaval Kolte, Paul C Gordon, J Dawn Abbott
Severe aortic stenosis (AS) and heart failure (HF) represent an important and high-risk group of patients who are often referred for transcatheter aortic valve replacement (TAVR) due to high risk for surgical intervention. Thus far, randomized controlled trials have shown comparable outcomes between TAVR and surgical aortic valve replacement in patients with severe AS and heart failure with reduced ejection fraction. In the current review, we will discuss (1) the pathophysiology of HF in patients with severe AS, (2) role of imaging modalities in management, (3) role of biomarkers of HF on prognosis, (4) impact of other valvular heart diseases, (5) evidence from the contemporary trials on the role of TAVR in patients with severe AS and HF, and (6) future directions and research...
November 2018: Heart Failure Reviews
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