Current Heart Failure Reports最新文献

{"title":"Sex-Related Differences in Heart Failure Diagnosis.","authors":"Daniela Maidana,&nbsp;Clara Bonanad,&nbsp;Carolina Ortiz-Cortés,&nbsp;Andrea Arroyo-Álvarez,&nbsp;Guillermo Barreres-Martín,&nbsp;Carles Muñoz-Alfonso,&nbsp;Eva Maicas-Alcaine,&nbsp;Cristina García-Pérez,&nbsp;Andrea Aparici-Redal,&nbsp;Victòria Freitas-Durks,&nbsp;Alberto Esteban-Fernández","doi":"10.1007/s11897-023-00609-x","DOIUrl":"https://doi.org/10.1007/s11897-023-00609-x","url":null,"abstract":"<p><strong>Purpose of review: </strong>The literature on the importance of sex in heart failure diagnosis is scarce. This review aims to summarize current knowledge on sex differences regarding the diagnosis of heart failure.</p><p><strong>Recent findings: </strong>Comorbidities are frequent in patients with heart failure, and their prevalence differs between sexes; some differences in symptomatology and diagnostic imaging techniques were also found. Biomarkers also usually show differences between sexes but are not significant enough to establish sex-specific ranges. This article outlines current information related to sex differences in HF diagnosis. Research in this field remains to be done. Maintaining a high diagnostic suspicion, actively searching for the disease, and considering the sex is relevant for early diagnosis and better prognosis. In addition, more studies with equal representation are needed.</p>","PeriodicalId":10830,"journal":{"name":"Current Heart Failure Reports","volume":"20 4","pages":"254-262"},"PeriodicalIF":0.0,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10602237","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Growth Differentiation Factor 15 (GDF-15), a New Biomarker in Heart Failure Management.","authors":"Khalid Sawalha,&nbsp;Nicholas B Norgard,&nbsp;Betty M Drees,&nbsp;Angel López-Candales","doi":"10.1007/s11897-023-00610-4","DOIUrl":"https://doi.org/10.1007/s11897-023-00610-4","url":null,"abstract":"<p><p>The emergence of biomarkers across medicine's subspecialties continues to evolve. In essence, a biomarker is a biological observation that clearly substitutes a clinical endpoint or intermediate outcome not only are more difficult to observe but also, biomarkers are easier, less expensive and could be measured over shorter periods. In general, biomarkers are versatile and not only used for disease screening and diagnosis but, most importantly, for disease characterization, monitoring, and determination of prognosis as well as individualized therapeutic responses. Obviously, heart failure (HF) is no exception to the use of biomarkers. Currently, natriuretic peptides are the most used biomarkers for both diagnosis and prognostication, while their role in the monitoring of treatment is still debatable. Although several other new biomarkers are currently under investigation regarding diagnosis and determination of prognosis, none of them are specific for HF, and none are recommended for routine clinical use at present. However, among these emerging biomarkers, we would like to highlight the potential for growth differentiation factor (GDF)-15 as a plausible new biomarker that could be helpful in providing prognostic information regarding HF morbidity and mortality.</p>","PeriodicalId":10830,"journal":{"name":"Current Heart Failure Reports","volume":"20 4","pages":"287-299"},"PeriodicalIF":0.0,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10236410","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of Ventricular Arrhythmias in Heart Failure.","authors":"Sara Vázquez-Calvo,&nbsp;Ivo Roca-Luque,&nbsp;Till F Althoff","doi":"10.1007/s11897-023-00608-y","DOIUrl":"https://doi.org/10.1007/s11897-023-00608-y","url":null,"abstract":"<p><strong>Purpose of review: </strong>Despite substantial progress in medical and device-based heart failure (HF) therapy, ventricular arrhythmias (VA) and sudden cardiac death (SCD) remain a major challenge. Here we review contemporary management of VA in the context of HF with one particular focus on recent advances in imaging and catheter ablation.</p><p><strong>Recent findings: </strong>Besides limited efficacy of antiarrhythmic drugs (AADs), their potentially life-threatening side effects are increasingly acknowledged. On the other hand, with tremendous advances in catheter technology, electroanatomical mapping, imaging, and understanding of arrhythmia mechanisms, catheter ablation has evolved into a safe, efficacious therapy. In fact, recent randomized trials support early catheter ablation, demonstrating superiority over AAD. Importantly, CMR imaging with gadolinium contrast has emerged as a central tool for the management of VA complicating HF: CMR is not only essential for an accurate diagnosis of the underlying entity and subsequent treatment decisions, but also improves risk stratification for SCD prevention and patient selection for ICD therapy. Finally, 3-dimensional characterization of arrhythmogenic substrate by CMR and imaging-guided ablation approaches substantially enhance procedural safety and efficacy. VA management in HF patients is highly complex and should be addressed in a multidisciplinary approach, preferably at specialized centers. While recent evidence supports early catheter ablation of VA, an impact on mortality remains to be demonstrated. Moreover, risk stratification for ICD therapy may have to be reconsidered, taking into account imaging, genetic testing, and other parameters beyond left ventricular function.</p>","PeriodicalId":10830,"journal":{"name":"Current Heart Failure Reports","volume":"20 4","pages":"237-253"},"PeriodicalIF":0.0,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10236374","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Heart and Artificial Intelligence-How Can We Improve Medicine Without Causing Harm.","authors":"Christoph Reich,&nbsp;Benjamin Meder","doi":"10.1007/s11897-023-00606-0","DOIUrl":"https://doi.org/10.1007/s11897-023-00606-0","url":null,"abstract":"<p><strong>Purpose of review: </strong>The introduction of Artificial Intelligence into the healthcare system offers enormous opportunities for biomedical research, the improvement of patient care, and cost reduction in high-end medicine. Digital concepts and workflows are already playing an increasingly important role in cardiology. The fusion of computer science and medicine offers great transformative potential and enables enormous acceleration processes in cardiovascular medicine.</p><p><strong>Recent findings: </strong>As medical data becomes smart, it is also becoming more valuable and vulnerable to malicious actors. In addition, the gap between what is technically possible and what is allowed by privacy legislation is growing. Principles of the General Data Protection Regulation that have been in force since May 2018, such as transparency, purpose limitation, and data minimization, seem to hinder the development and use of Artificial Intelligence. Concepts to secure data integrity and incorporate legal and ethical principles can help to avoid the potential risks of digitization and may result in an European leadership in regard to privacy protection and AI. The following review provides an overview of relevant aspects of Artificial Intelligence and Machine Learning, highlights selected applications in cardiology, and discusses central ethical and legal considerations.</p>","PeriodicalId":10830,"journal":{"name":"Current Heart Failure Reports","volume":"20 4","pages":"271-279"},"PeriodicalIF":0.0,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10250175/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10602232","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Non-Alcoholic Fatty Liver Disease as an Emerging Risk Factor for Heart Failure.","authors":"Riccardo M Inciardi,&nbsp;Alessandro Mantovani,&nbsp;Giovanni Targher","doi":"10.1007/s11897-023-00613-1","DOIUrl":"10.1007/s11897-023-00613-1","url":null,"abstract":"<p><strong>Purpose of the review: </strong>Non-alcoholic fatty liver disease (NAFLD) and heart failure (HF) are two chronic diseases that have become important global public health problems. This narrative review provides a comprehensive overview of the association between NAFLD and increased risk of new-onset HF, briefly discusses the putative biological mechanisms linking these two conditions, and summarizes targeted pharmacotherapies for NAFLD that might also beneficially affect cardiac complications leading to new-onset HF.</p><p><strong>Recent findings: </strong>Recent observational cohort studies supported a significant association between NAFLD and the long-term risk of new-onset HF. Notably, this risk remained statistically significant even after adjustment for age, sex, ethnicity, adiposity measures, pre-existing type 2 diabetes and other common cardiometabolic risk factors. In addition, the risk of incident HF was further increased with more advanced liver disease, especially with higher severity of liver fibrosis. There are multiple potential pathophysiological mechanisms by which NAFLD (especially in its more advanced forms) may increase the risk of new-onset HF. Because of the strong link existing between NAFLD and HF, more careful surveillance of these patients will be needed. However, further prospective and mechanistic studies are required to better decipher the existing but complex link between NAFLD and risk of new-onset HF.</p>","PeriodicalId":10830,"journal":{"name":"Current Heart Failure Reports","volume":"20 4","pages":"308-319"},"PeriodicalIF":0.0,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10421789/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10299050","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Role of the Vasculature in Heart Failure.","authors":"Mithilesh Joshi, Patrick Tran, Thomas M Barber, Waqar Ayub, Michael Kuehl, Prithwish Banerjee","doi":"10.1007/s11897-023-00602-4","DOIUrl":"10.1007/s11897-023-00602-4","url":null,"abstract":"<p><p>The contribution of the vasculature in the development and progression of heart failure (HF) syndromes is poorly understood and often neglected. Incorporating both arterial and venous systems, the vasculature plays a significant role in the regulation of blood flow throughout the body in meeting its metabolic requirements. A deterioration or imbalance between the cardiac and vascular interaction can precipitate acute decompensated HF in both preserved and reduced ejection fraction phenotypes. This is characterised by the increasingly recognised concept of ventricular-arterial coupling: a well-balanced relationship between ventricular and vascular stiffness, which has major implications in HF. Often, the cause of decompensation is unknown, with international guidelines mainly centred on arrhythmia, infection, acute coronary syndrome and its mechanical complications as common causes of decompensation; the vascular component is often underrecognised. A better understanding of the vascular contribution in cardiovascular failure can improve risk stratification, earlier diagnosis and facilitate earlier optimal treatment. This review focuses on the role of the vasculature by integrating the concepts of ventricular-arterial coupling, arterial stiffness and venous return in a failing heart.</p>","PeriodicalId":10830,"journal":{"name":"Current Heart Failure Reports","volume":"20 3","pages":"179-190"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9597780","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of Sodium and Sodium Restriction in Heart Failure.","authors":"Pieter Martens, W H Wilson Tang","doi":"10.1007/s11897-023-00607-z","DOIUrl":"10.1007/s11897-023-00607-z","url":null,"abstract":"<p><strong>Purpose of review: </strong>Sodium plays an essential role in the regulation of extracellular volume. The current review discusses the physiologic handling of sodium in the body, underscores pathophysiologic alterations in sodium handling in heart failure and assesses the evidence and rational for sodium restriction in heart failure.</p><p><strong>Recent findings: </strong>Recent trials such as the SODIUM-HF trial have failed to demonstrate a benefit of sodium restriction in heart failure. The current review re-evaluates physiologic elements in sodium handling and discusses how the intrinsic renal sodium avidity, which drives the renal propensity towards retaining sodium, differs amongst patients. The sodium intake in heart failure patients is often above the threshold set by guidelines. This review gives an overview of the pathophysiology of sodium retention in heart failure and the rational for sodium restriction and potential of individualizing sodium restriction recommendations based on renal sodium avidity profiles.</p>","PeriodicalId":10830,"journal":{"name":"Current Heart Failure Reports","volume":"20 3","pages":"230-236"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9607859","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Myocardial Fatigue at a Glance.","authors":"Patrick Tran, Prithwish Banerjee","doi":"10.1007/s11897-023-00603-3","DOIUrl":"10.1007/s11897-023-00603-3","url":null,"abstract":"<p><p>Expanding on the modern lexicon of heart failure (HF), the novel mechano-energetic concept of myocardial fatigue describes a transiently energy-depleted myocardium with impaired contractility and relaxation in the face of adverse haemodynamic load. It encompasses established concepts of ventricular-arterial decoupling, deranged cardiac energetics and impaired myocardial efficiency, offering an alternative explanation for functional causes of HF.</p>","PeriodicalId":10830,"journal":{"name":"Current Heart Failure Reports","volume":"20 3","pages":"191-193"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9606787","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of Right Ventricular Function-a State of the Art.","authors":"Abdul Hameed, Robin Condliffe, Andrew J Swift, Samer Alabed, David G Kiely, Athanasios Charalampopoulos","doi":"10.1007/s11897-023-00600-6","DOIUrl":"10.1007/s11897-023-00600-6","url":null,"abstract":"<p><strong>Purpose of review: </strong>The right ventricle (RV) has a complex geometry and physiology which is distinct from the left. RV dysfunction and failure can be the aftermath of volume- and/or pressure-loading conditions, as well as myocardial and pericardial diseases.</p><p><strong>Recent findings: </strong>Echocardiography, magnetic resonance imaging and right heart catheterisation can assess RV function by using several qualitative and quantitative parameters. In pulmonary hypertension (PH) in particular, RV function can be impaired and is related to survival. An accurate assessment of RV function is crucial for the early diagnosis and management of these patients. This review focuses on the different modalities and indices used for the evaluation of RV function with an emphasis on PH.</p>","PeriodicalId":10830,"journal":{"name":"Current Heart Failure Reports","volume":"20 3","pages":"194-207"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10256637/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9607574","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Do Women Physicians Accept and Follow Heart Failure Guidelines More Than Men?","authors":"Jesús Álvarez-García, María José Cristo Ropero, Ángel Manuel Iniesta Manjavacas, Pablo Díez-Villanueva, Alberto Esteban-Fernández, Javier de Juan Bagudá, Mercedes Rivas-Lasarte, Mikel Taibo Urquía, Juan Górriz-Magaña, Marta Cobo Marcos, Josebe Goirigolzarri-Artaza, Diego Iglesias Del Valle, Ramón Bover Freire, Cristina Beltrán Herrera, Adolfo Villa, Raquel Campuzano Ruiz, Manuel Martínez-Sellés","doi":"10.1007/s11897-023-00597-y","DOIUrl":"10.1007/s11897-023-00597-y","url":null,"abstract":"<p><strong>Purpose of review: </strong>Our aim was to assess the degree of acceptance of the European Clinical Practice Guidelines (CPG) on heart failure (HF) among Spanish physicians according to sex. This was a cross-sectional study, employing Google Forms, conducted by a group of HF experts from the Region of Madrid (Spain), between November 2021 and February 2022, among specialists and residents of Cardiology, Internal Medicine, and Primary Care from Spain.</p><p><strong>Recent findings: </strong>A total of 387 physicians-173 women (44.7%)-from 128 different centers completed the survey. Compared to men, women were significantly younger (38.2 ± 9.1 years vs. 40.6 ± 11.2 years; p = 0.024) and had fewer years of clinical practice (12.1 ± 8.1 years vs. 14.5 ± 10.7 years; p = 0.014). Briefly, women and men had a positive opinion of the guidelines and thought that implementing quadruple therapy is feasible in less than 8 weeks. Women followed more frequently than men the new paradigm of \"4 pillars at lowest doses\" and considered more frequently the establishment of quadruple therapy before implanting a cardiac device. Although they agreed about \"low blood pressure\" as the major limitation for achieving quadruple therapy in heart failure with reduced ejection fraction, there were discrepancies on the second most frequent barrier, and women were more proactive when initiating SGLT2 inhibitors. In a large survey including nearly 400 doctors from all over Spain to provide real-world opinion on 2021 ESC HF Guidelines and experience with SGLT2 inhibitors, women follow more frequently the new paradigm of \"4 pillars at lowest doses\", consider more frequently the establishment of quadruple therapy before implanting a cardiac device, and were more proactive when initiating SGLT2 inhibitors. Further studies confirming an association of sex with a better compliance of HF guidelines are needed.</p>","PeriodicalId":10830,"journal":{"name":"Current Heart Failure Reports","volume":"20 3","pages":"151-156"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9659078","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}