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Heart failure new treatments review

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https://www.readbyqxmd.com/read/28318519/major-developments-in-the-2016-european-guidelines-for-heart-failure
#1
J C Trullàs, Á González-Franco
The European Society of Cardiology has recently published new guidelines on the diagnosis and treatment of acute and chronic heart failure (HF). This article aims to review these recommendations and their level of scientific evidence and to present the most innovative aspects. The most significant deviations from the 2012 edition are: 1) the introduction of the concept of HF with midrange LVEF (40-49%); 2) a new diagnostic algorithm for chronic HF, initially considering the clinical probability; 3) recommendations on preventing or delaying the apparition of HF; 4) indications for the use of the new sacubitril-valsartan compound, the first angiotensin receptor blocker and neprilysin inhibitor; 5) modification of indications for cardiac resynchronisation therapy; and 6) a new algorithm for a combined diagnostic and treatment strategy for acute HF based on the presence or absence of congestion and hypoperfusion...
March 15, 2017: Revista Clínica Española
https://www.readbyqxmd.com/read/28314659/diagnostic-and-prognostic-value-of-cmr-t1-mapping-in-patients-with-heart-failure-and-preserved-ejection-fraction
#2
Karl-Philipp Rommel, Christian Lücke, Philipp Lurz
Heart failure with preserved ejection fraction (HFpEF) presents a major challenge in modern cardiology. Although this syndrome is of increasing prevalence and is associated with unfavorable outcomes, treatment trials have failed to establish effective therapies. Currently, solutions to this dilemma are being investigated, including categorizing and characterizing patients more diversely to individualize treatment. In this regard, new imaging techniques might provide important information. Diastolic dysfunction is a diagnostic and pathophysiological cornerstone in HFpEF and is believed to be caused by systemic inflammation with the development of interstitial myocardial fibrosis and myocardial stiffening...
March 14, 2017: Revista Española de Cardiología
https://www.readbyqxmd.com/read/28302741/cardiac-regeneration-lessons-from-development
#3
Francisco X Galdos, Yuxuan Guo, Sharon L Paige, Nathan J VanDusen, Sean M Wu, William T Pu
Palliative surgery for congenital heart disease has allowed patients with previously lethal heart malformations to survive and, in most cases, to thrive. However, these procedures often place pressure and volume loads on the heart, and over time, these chronic loads can cause heart failure. Current therapeutic options for initial surgery and chronic heart failure that results from failed palliation are limited, in part, by the mammalian heart's low inherent capacity to form new cardiomyocytes. Surmounting the heart regeneration barrier would transform the treatment of congenital, as well as acquired, heart disease and likewise would enable development of personalized, in vitro cardiac disease models...
March 17, 2017: Circulation Research
https://www.readbyqxmd.com/read/28292573/-use-of-micrornas-in-heart-failure-management
#4
Luis Alejandro Arias Sosa
Heart failure (HF) is a high impact disease that affects all human populations, demanding the development of new strategies and methods to manage this pathology. That's why microRNAs, small noncoding RNAs that regulate gene expression, appear as an important option in the diagnosis, prognosis and treatment of this disease. MiRNAs seems to have a future on HF handling, because can be isolated from body fluids such as blood, and changes in its levels can be associated with the presence, stage and specific disease features, which makes them an interesting option as biomarkers...
March 11, 2017: Archivos de Cardiología de México
https://www.readbyqxmd.com/read/28290795/-a-breakthrough-in-the-treatment-of-patients-with-heart-failure-with-reduced-ejection-fraction-the-clinical-significance-of-the-paradigm-hf-trial
#5
Zh D Kobalava, S V Villevalde, O I Lukina
The implementation into clinical practice of new therapeutic strategies that could improve the prognosis of patients with heart failure (HF) with reduced ejection fraction (HFrEF) remains relevant. Innovative approach is to restore imbalances of neurohumoral systems by inhibiting angiotensin II receptor and neprilysin. The review presents the role of the natriuretic peptides system in the HFrEF pathophysiology, historical approaches to neurohormonal modulation, clinical pharmacology of the first in the class of angiotensin receptor and neprilysin inhibitor sakubitril/valsartan...
February 2017: Kardiologiia
https://www.readbyqxmd.com/read/28286751/new-delivery-systems-of-stem-cells-for-vascular-regeneration-in-ischemia
#6
REVIEW
Adegbenro Omotuyi John Fakoya
The finances of patients and countries are increasingly overwhelmed with the plague of cardiovascular diseases as a result of having to chronically manage the associated complications of ischemia such as heart failures, neurological deficits, chronic limb ulcers, gangrenes, and amputations. Hence, scientific research has sought for alternate therapies since pharmacological and surgical treatments have fallen below expectations in providing the desired quality of life. The advent of stem cells research has raised expectations with respect to vascular regeneration and tissue remodeling, hence assuring the patients of the possibility of an improved quality of life...
2017: Frontiers in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28281174/potential-expanded-indications-for-neprilysin-inhibitors
#7
REVIEW
Elizabeth Riddell, Justin M Vader
PURPOSE OF REVIEW: The goal of this article is to review potential expanded indications for neprilysin inhibitors. This article reviews the rationale and design for ongoing and future trials of sacubitril/valsartan in cardiovascular and non-cardiovascular disease. RECENT FINDINGS: Randomized trial data are lacking for use of sacubitril/valsartan in acute heart failure and advanced heart failure. Mechanistic data from animal studies suggest a role for neprilysin inhibition in the treatment of post-myocardial infarction systolic dysfunction and heart failure with preserved ejection fraction...
April 2017: Current Heart Failure Reports
https://www.readbyqxmd.com/read/28279415/proteasome-inhibitors-as-a-potential-cause-of-heart-failure
#8
REVIEW
Georgios Koulaouzidis, Alexander R Lyon
Proteasome inhibitors have become an important drug class in the treatment of multiple myeloma. In addition to its role in myeloma cells, the proteasome plays a critical role in the myocardium, particularly in the context of cardiac stress. The growing awareness of the cardiovascular toxicity of proteasome inhibitors is emerging following the phase 3 trials and the transition into real-world practice. This article reviews the background to this problem and the incidence of the problem in phase 3 trials and subsequent phase 2 trials in new patient cohorts and discusses the strategy to detect and manage this emerging problem...
April 2017: Heart Failure Clinics
https://www.readbyqxmd.com/read/28259753/long-noncoding-rnas-lncrnas-the-dawning-of-a-new-treatment-for-cardiac-hypertrophy-and-heart-failure
#9
Dong Han, Quansheng Gao, Feng Cao
Long noncoding RNAs (lncRNAs) represent a category of noncoding RNAs with the potential for genetic and epigenetic regulations. As important regulators of gene expression, increasing evidence has proven that lncRNAs play a significant regulatory role in various cardiovascular pathologies. In particular, lncRNAs have been proved to be participating in gene regulatory mechanisms involved in heart growth and development that can be exploited to repair the injured adult heart. Furthermore, lncRNAs have been revealed as possible therapeutic targets for heart failure with different causes and in different stages...
March 1, 2017: Biochimica et Biophysica Acta
https://www.readbyqxmd.com/read/28245343/eplerenone-for-hypertension
#10
REVIEW
Tina Sc Tam, May Hy Wu, Sarah C Masson, Matthew P Tsang, Sarah N Stabler, Angus Kinkade, Anthony Tung, Aaron M Tejani
BACKGROUND: Eplerenone is an aldosterone receptor blocker that is chemically derived from spironolactone. In Canada, it is indicated for use as adjunctive therapy to reduce mortality for heart failure patients with New York Heart Association (NYHA) class II systolic chronic heart failure and left ventricular systolic dysfunction. It is also used as adjunctive therapy for patients with heart failure following myocardial infarction. Additionally, it is indicated for the treatment of mild and moderate essential hypertension for patients who cannot be treated adequately with other agents...
February 28, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28243251/ppar%C3%AE-and-its-role-in-cardiovascular-diseases
#11
REVIEW
Mini Chandra, Sumitra Miriyala, Manikandan Panchatcharam
Peroxisome proliferator-activated receptor Gamma (PPARγ), a ligand-activated transcription factor, has a role in various cellular functions as well as glucose homeostasis, lipid metabolism, and prevention of oxidative stress. The activators of PPARγ are already widely used in the treatment of diabetes mellitus. The cardioprotective effect of PPARγ activation has been studied extensively over the years making them potential therapeutic targets in diseases associated with cardiovascular disorders. However, they are also associated with adverse cardiovascular events such as congestive heart failure and myocardial infarction...
2017: PPAR Research
https://www.readbyqxmd.com/read/28238768/regulation-of-autophagy-by-some-natural-products-as-a-potential-therapeutic-strategy-for-cardiovascular-disorders
#12
REVIEW
Mahmoud Hashemzaei, Reza Entezari Heravi, Ramin Rezaee, Ali Roohbakhsh, Gholamreza Karimi
Autophagy is a lysosomal degradation process through which long-lived and misfolded proteins and organelles are sequestered, degraded by lysosomes, and recycled. Autophagy is an essential part of cardiomyocyte homeostasis and increases the survival of cells following cellular stress and starvation. Recent studies made clear that dysregulation of autophagy in the cardiovascular system leads to heart hypertrophy and failure. In this manner, autophagy seems to be an attractive target in the new treatment of cardiovascular diseases...
February 23, 2017: European Journal of Pharmacology
https://www.readbyqxmd.com/read/28223818/an-evidence-based-review-on-urate-lowering-treatments-implications-for-optimal-treatment-of-chronic-hyperuricemia
#13
REVIEW
Marilisa Bove, Arrigo Francesco Giuseppe Cicero, Maddalena Veronesi, Claudio Borghi
Several studies suggest that chronic hyperuricemia, the main precursor of gout, is involved in the pathogenesis of different systemic disorders that affect cardiovascular and renal systems, such as hypertension, obesity, hypercholesterolemia, atherosclerosis, metabolic syndrome, chronic heart failure, and chronic kidney disease. Recent epidemiological evidence has shown an increasing trend in the prevalence of hyperuricemia and gout in the Western world: a number of population-based studies estimate a prevalence of up to 21% for hyperuricemia and 1%-4% for gout...
2017: Vascular Health and Risk Management
https://www.readbyqxmd.com/read/28196811/the-heart-failure-epidemic-a-uk-perspective
#14
REVIEW
Martin R Cowie
Heart failure is appropriately described as an epidemic, with 1-2% of health care expenditure being directed at its management. In England, the National Institute for Health and Care Excellence (NICE) has issued guidance on the best practice for the diagnosis and treatment of acute and chronic heart failure. Echocardiography is key to the diagnosis of the underlying cardiac abnormalities, and access to this (with our without biochemical testing using natriuretic peptides) is key to high-quality and speedy diagnosis...
March 2017: Echo Research and Practice
https://www.readbyqxmd.com/read/28185170/mechanisms-of-cardiomyocyte-proliferation-and-differentiation-in-development-and-regeneration
#15
REVIEW
Jessie Wettig Yester, Bernhard Kühn
PURPOSE OF REVIEW: Congenital heart disease is the most common birth defect and acquired heart disease is the leading cause of death in adults. Understanding the mechanisms that drive cardiomyocyte proliferation and differentiation has the potential to advance the understanding and potentially the treatment of different cardiac pathologies, ranging from myopathies and heart failure to myocardial infarction. This review focuses on studies aimed at elucidating signal transduction pathways and molecular mechanisms that promote proliferation, differentiation, and regeneration of differentiated heart muscle cells, cardiomyocytes...
February 2017: Current Cardiology Reports
https://www.readbyqxmd.com/read/28169951/cardiac-gene-therapy-with-adeno-associated-virus-based-vectors
#16
Kyle Chamberlain, Jalish M Riyad, Thomas Weber
PURPOSE OF REVIEW: Cardiac gene therapy with adeno-associated virus (AAV)-based vectors is emerging as an entirely new platform to treat, or even cure, so far intractable cardiac disorders. This review describes our current knowledge of cardiac AAV gene therapy with a particular focus on the biggest obstacle for the successful translation of cardiac AAV gene therapy into the clinic, namely the efficient delivery of the therapeutic gene to the myocardium. RECENT FINDINGS: We summarize the significant recent progress that has been made in treating heart failure in preclinically relevant animal models with AAV gene therapy and the recent results of clinical trials with cardiac AAV gene therapy for the treatment of heart failure...
February 4, 2017: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/28164755/regulation-of-na-k-atpase-by-estradiol-and-igf-1-in-cardio-metabolic-diseases
#17
Milan Obradovic, Julijana Stanimirovic, Anastasija Panic, Nikola Bogdanovic, Emina Sudar-Milovanovic, Desanka Cenic-Milosevic, Esma R Isenovic
BACKGROUND: The sodium/potassium- adenosine- triphosphatase (Na+/K+-ATPase) is an important mediator in vasculature tone and contractility, and its abnormal regulation has been implicated in many diseases such as obesity, insulin resistance, diabetes, and hypertension. Decreased Na+/K+-ATPase abundance and its altered isoform expression induce cardiomyocytes death and cardiac dysfunction, possibly leading to the development of myocardial dilation and heart failure. Therefore, the regulation of Na+/K+-ATPase activity/expression could be important in treatment and possible prevention of cardio-metabolic diseases...
February 3, 2017: Current Pharmaceutical Design
https://www.readbyqxmd.com/read/28162002/pharmacokinetic-drug-evaluation-of-bucindolol-for-the-treatment-of-atrial-fibrillation-in-heart-failure-patients
#18
Gian Marco Rosa, Giovanni Meliota, Claudio Brunelli, Simone Ferrero
Atrial fibrillation (AF) and heart failure (HF) often coexist. When AF and HF are both present, they are associated with negative outcomes, increased hospitalizations and mortality. As β-blockade is effective inF and may be useful in presence of AF, bucindolol, a non-selective β-blocker with α-1 vasodilatory effect, may be used. Area covered: This review evaluates the efficacy and safety of bucindolol in HF patients with AF. The largest amount of data comes from BEST trial which evaluated the efficacy of bucindolol in HF patients...
February 6, 2017: Expert Opinion on Drug Metabolism & Toxicology
https://www.readbyqxmd.com/read/28161770/posterior-ventricular-restoration-treatment-for-heart-failure-a-review-past-present-and-future-aspects
#19
REVIEW
Tadashi Isomura, Yasuhisa Fukada, Takuya Miyazaki, Minoru Yoshida, Akimasa Morisaki, Masahiro Endo
Congestive heart failure (CHF) is one of the major causes of death and occurs in more than 15,000,000 patients worldwide. The incidence is expected to increase in parallel with the aging population. Most current therapies for CHF are medications, and biventricular pacing implantation as appropriated by cardiologists, or surgical interventions. The heart transplantation for indicated patients is still gold standard surgery although the 10-year survival rate is approximately 60% based on the worldwide data. However, the cardiac transplantation remains epidemiologically insignificant because of donor pool limitations...
March 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28161130/pharmacological-reasons-that-may-explain-why-randomized-clinical-trials-have-failed-in-acute-heart-failure-syndromes
#20
REVIEW
Juan Tamargo, Giuseppe M C Rosano, Eva Delpón, Luis Ruilope, Jose López-Sendón
Acute heart failure (AHF) represents a clinical challenge as it encloses a heterogeneous group of syndromes (AHFS) with different pathophysiology, clinical presentations, prognosis and response to therapy. In the last 25years multiple therapeutic targets have been identified and numerous new drugs were evaluated but, up to now, all failed to demonstrate a consistent benefit on clinical outcomes. Moreover, a repeated finding has been the poor correlation between the encouraging results of preclinical and early clinical trials and the lack of effect on outcomes observed in phase III trials...
April 15, 2017: International Journal of Cardiology
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