Heart Failure Reviews最新文献

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Assessment and management of heart failure in patients with chronic kidney disease. 慢性肾脏病患者心力衰竭的评估和管理。
IF 4.6 2区 医学
Heart Failure Reviews Pub Date : 2024-03-01 Epub Date: 2023-09-20 DOI: 10.1007/s10741-023-10346-x
Andrea Igoren Guaricci, Francesca Sturdà, Roberto Russo, Paolo Basile, Andrea Baggiano, Saima Mushtaq, Laura Fusini, Fabio Fazzari, Fulvio Bertandino, Francesco Monitillo, Maria Cristina Carella, Marco Simonini, Gianluca Pontone, Marco Matteo Ciccone, Giuseppe Grandaliano, Giuseppe Vezzoli, Francesco Pesce
{"title":"Assessment and management of heart failure in patients with chronic kidney disease.","authors":"Andrea Igoren Guaricci, Francesca Sturdà, Roberto Russo, Paolo Basile, Andrea Baggiano, Saima Mushtaq, Laura Fusini, Fabio Fazzari, Fulvio Bertandino, Francesco Monitillo, Maria Cristina Carella, Marco Simonini, Gianluca Pontone, Marco Matteo Ciccone, Giuseppe Grandaliano, Giuseppe Vezzoli, Francesco Pesce","doi":"10.1007/s10741-023-10346-x","DOIUrl":"10.1007/s10741-023-10346-x","url":null,"abstract":"<p><p>Heart failure (HF) and chronic kidney disease (CKD) are two pathological conditions with a high prevalence in the general population. When they coexist in the same patient, a strict interplay between them is observed, such that patients affected require a clinical multidisciplinary and personalized management. The diagnosis of HF and CKD relies on signs and symptoms of the patient but several additional tools, such as blood-based biomarkers and imaging techniques, are needed to clarify and discriminate the main characteristics of these diseases. Improved survival due to new recommended drugs in HF has increasingly challenged physicians to manage patients with multiple diseases, especially in case of CKD. However, the safe administration of these drugs in patients with HF and CKD is often challenging. Knowing up to which values ​​of creatinine or renal clearance each drug can be administered is fundamental. With this review we sought to give an insight on this sizable and complex topic, in order to get clearer ideas and a more precise reference about the diagnostic assessment and therapeutic management of HF and CKD.</p>","PeriodicalId":12950,"journal":{"name":"Heart Failure Reviews","volume":" ","pages":"379-394"},"PeriodicalIF":4.6,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10942934/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41134251","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Sex differences in transthyretin cardiac amyloidosis. 转甲状腺素心脏淀粉样变性的性别差异。
IF 4.6 2区 医学
Heart Failure Reviews Pub Date : 2024-03-01 Epub Date: 2023-08-11 DOI: 10.1007/s10741-023-10339-w
Alberto Aimo, Giorgia Panichella, Manuel Garofalo, Simone Gasparini, Chiara Arzilli, Vincenzo Castiglione, Giuseppe Vergaro, Michele Emdin, Silvia Maffei
{"title":"Sex differences in transthyretin cardiac amyloidosis.","authors":"Alberto Aimo, Giorgia Panichella, Manuel Garofalo, Simone Gasparini, Chiara Arzilli, Vincenzo Castiglione, Giuseppe Vergaro, Michele Emdin, Silvia Maffei","doi":"10.1007/s10741-023-10339-w","DOIUrl":"10.1007/s10741-023-10339-w","url":null,"abstract":"<p><p>Transthyretin cardiac amyloidosis (ATTR-CA) is a progressive disease characterized by the deposition of abnormal transthyretin protein fibrils in the heart, leading to cardiac dysfunction. Recent evidence suggests that sex differences may play a significant role in various steps of ATTR-CA, including clinical presentation, diagnostic challenges, disease progression, and treatment outcomes. ATTR-CA predominantly affects men, whereas women are older at presentation. Women generally present with a history of heart failure with preserved ejection fraction and/or carpal tunnel syndrome. When indexed, left ventricular (LV) wall thickness is equal, or even increased, than men. Women also have smaller LV cavities, more preserved ejection fractions, and apparently a slightly worse right ventricular and diastolic function. Given the under-representation on women in clinical trials, no data regarding sex influence on the treatment response are currently available. Finally, it seems there are no differences in overall prognosis, even if premenopausal women may have a certain level of myocardial protection. Genetic variations, environmental factors, and hormonal changes are considered as potential contributors to observed disparities. Understanding sex differences in ATTR-CA is vital for accurate diagnosis and management. By considering these differences, clinicians can improve diagnostic accuracy, tailor treatments, and optimize outcomes for both sexes with ATTR-CA.</p>","PeriodicalId":12950,"journal":{"name":"Heart Failure Reviews","volume":" ","pages":"321-330"},"PeriodicalIF":4.6,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10942898/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9977800","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Can the hemodynamic model in heart failure be restored based on analysis of ventricular-arterial coupling? 心室-动脉耦合分析能否恢复心力衰竭的血流动力学模型?
IF 4.6 2区 医学
Heart Failure Reviews Pub Date : 2024-03-01 Epub Date: 2023-12-02 DOI: 10.1007/s10741-023-10374-7
Johannes Soma
{"title":"Can the hemodynamic model in heart failure be restored based on analysis of ventricular-arterial coupling?","authors":"Johannes Soma","doi":"10.1007/s10741-023-10374-7","DOIUrl":"10.1007/s10741-023-10374-7","url":null,"abstract":"<p><p>The hemodynamic model was inappropriate to explain the disappointing effect of vasodilation and the beneficial effect of beta-blockade in chronic heart failure. A more nuanced hemodynamic analysis, taking both steady and pulsatile hemodynamics into consideration, improves insight into these apparently enigmatic effects. Of particular interest is the velocity of early systolic flow as a determinant of left ventricular afterload. Several drugs, in particular beta-blockers, directly or indirectly, influence the velocity of early systolic flow. Thus, the hemodynamic model in heart failure may deserve reconsideration.</p>","PeriodicalId":12950,"journal":{"name":"Heart Failure Reviews","volume":" ","pages":"463-464"},"PeriodicalIF":4.6,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138470213","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Current perspectives of sudden cardiac death management in hypertrophic cardiomyopathy. 肥厚型心肌病心源性猝死管理的最新进展。
IF 4.6 2区 医学
Heart Failure Reviews Pub Date : 2024-03-01 Epub Date: 2023-10-22 DOI: 10.1007/s10741-023-10355-w
Lutong Pu, Jialin Li, Weitang Qi, Jinquan Zhang, Hongyu Chen, Zihuan Tang, Yuchi Han, Jie Wang, Yucheng Chen
{"title":"Current perspectives of sudden cardiac death management in hypertrophic cardiomyopathy.","authors":"Lutong Pu, Jialin Li, Weitang Qi, Jinquan Zhang, Hongyu Chen, Zihuan Tang, Yuchi Han, Jie Wang, Yucheng Chen","doi":"10.1007/s10741-023-10355-w","DOIUrl":"10.1007/s10741-023-10355-w","url":null,"abstract":"<p><p>Hypertrophic cardiomyopathy (HCM) is an autosomal dominant disorder characterized by left ventricular hypertrophy. Sudden cardiac death (SCD) is a rare but the most catastrophic complication in patients with HCM. Implantable cardioverter-defibrillators (ICDs) are widely recognized as effective preventive measures for SCD. Individualized risk stratification and early intervention in HCM can significantly improve patient prognosis. In this study, we review the latest findings regarding pathogenesis, risk stratification, and prevention of SCD in HCM patients, highlighting the clinic practice of cardiovascular magnetic resonance imaging for SCD management.</p>","PeriodicalId":12950,"journal":{"name":"Heart Failure Reviews","volume":" ","pages":"395-404"},"PeriodicalIF":4.6,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49690194","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Molecular mechanisms and emerging therapies in wild-type transthyretin amyloid cardiomyopathy. 野生型转甲状腺素淀粉样变性心肌病的分子机制和新兴疗法。
IF 4.6 2区 医学
Heart Failure Reviews Pub Date : 2024-03-01 Epub Date: 2024-01-18 DOI: 10.1007/s10741-023-10380-9
Danni Wu, Wei Chen
{"title":"Molecular mechanisms and emerging therapies in wild-type transthyretin amyloid cardiomyopathy.","authors":"Danni Wu, Wei Chen","doi":"10.1007/s10741-023-10380-9","DOIUrl":"10.1007/s10741-023-10380-9","url":null,"abstract":"<p><p>Wild-type transthyretin amyloid cardiomyopathy (ATTRwt-CM) is an underrecognized cause of heart failure due to misfolded wild-type transthyretin (TTRwt) myocardial deposition. The development of wild-type TTR amyloid fibrils is a complex pathological process linked to the deterioration of homeostatic mechanisms owing to aging, plausibly implicating multiple molecular mechanisms. The components of amyloid transthyretin often include serum amyloid P, proteoglycans, and clusterin, which may play essential roles in the localization and elimination of amyloid fibrils. Oxidative stress, impaired mitochondrial function, and perturbation of intracellular calcium dynamics induced by TTR contribute to cardiac impairment. Recently, tafamidis has been the only drug approved by the U.S. Food and Drug Administration (FDA) for the treatment of ATTRwt-CM. In addition, small interfering RNAs and antisense oligonucleotides for ATTR-CM are promising therapeutic approaches and are currently in phase III clinical trials. Newly emerging therapies, such as antibodies targeting amyloid, inhibitors of seed formation, and CRISPR‒Cas9 technology, are currently in the early stages of research. The development of novel therapies is based on progress in comprehending the molecular events behind amyloid cardiomyopathy. There is still a need to further advance innovative treatments, providing patients with access to alternative and effective therapies, especially for patients diagnosed at a late stage.</p>","PeriodicalId":12950,"journal":{"name":"Heart Failure Reviews","volume":" ","pages":"511-521"},"PeriodicalIF":4.6,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10942909/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139485505","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Investigating the place of sodium-glucose cotransporter-2 inhibitors and dual sodium-glucose cotransporter-1 and dual sodium-glucose cotransporter-2 inhibitors in heart failure therapy: a systematic review of the literature. 研究钠-葡萄糖共转运体-2抑制剂以及钠-葡萄糖共转运体-1和钠-葡萄糖共转运体-2双重抑制剂在心力衰竭治疗中的地位:文献系统回顾。
IF 4.6 2区 医学
Heart Failure Reviews Pub Date : 2024-03-01 Epub Date: 2024-02-01 DOI: 10.1007/s10741-024-10388-9
Taylor McKenzie, Genevieve M Hale, Amelia Miner, Jean Colón Colón, Garrett Evins, Jasmine Wade
{"title":"Investigating the place of sodium-glucose cotransporter-2 inhibitors and dual sodium-glucose cotransporter-1 and dual sodium-glucose cotransporter-2 inhibitors in heart failure therapy: a systematic review of the literature.","authors":"Taylor McKenzie, Genevieve M Hale, Amelia Miner, Jean Colón Colón, Garrett Evins, Jasmine Wade","doi":"10.1007/s10741-024-10388-9","DOIUrl":"10.1007/s10741-024-10388-9","url":null,"abstract":"<p><p>Sodium-glucose cotransporter-2 inhibitors have been shown to have significant metabolic, renal, and atherosclerotic cardiovascular disease benefits. Recent randomized controlled trials have extended these benefits to patients with heart failure. In fact, the robust findings from these studies in patients with any type of heart failure have led to the incorporation of this drug class in currently updated evidence-based guidelines for this condition. However, given the novelty in utilizing these agents in heart failure, there is uncertainty regarding place in therapy and sequencing in treatment. As such, this review aims to summarize existing literature to guide practitioners regarding the use of these agents in the management of heart failure.</p>","PeriodicalId":12950,"journal":{"name":"Heart Failure Reviews","volume":" ","pages":"549-558"},"PeriodicalIF":4.6,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139650669","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Advance in the pharmacological and comorbidities management of heart failure with preserved ejection fraction: evidence from clinical trials. 射血分数保留型心力衰竭的药物和合并症治疗进展:临床试验证据。
IF 4.6 2区 医学
Heart Failure Reviews Pub Date : 2024-03-01 Epub Date: 2023-08-10 DOI: 10.1007/s10741-023-10338-x
Wu Meifang, Wu Ying, Chen Wen, Xu Kaizu, Song Meiyan, Lin Liming
{"title":"Advance in the pharmacological and comorbidities management of heart failure with preserved ejection fraction: evidence from clinical trials.","authors":"Wu Meifang, Wu Ying, Chen Wen, Xu Kaizu, Song Meiyan, Lin Liming","doi":"10.1007/s10741-023-10338-x","DOIUrl":"10.1007/s10741-023-10338-x","url":null,"abstract":"<p><p>The prevalence of heart failure with preserved ejection fraction (HFpEF) accounts for approximately 50% of the total heart failure population, and with the aging of the population and the increasing prevalence of hypertension, obesity, and type 2 diabetes (T2DM), the incidence of HFpEF continues to rise and has become the most common subtype of heart failure. Compared with heart failure with reduced ejection fraction, HFpEF has a more complex pathophysiology and is more often associated with hypertension, T2DM, obesity, atrial fibrillation, renal insufficiency, pulmonary hypertension, obstructive sleep apnea, and other comorbidities. HFpEF has generally been considered a syndrome with high phenotypic heterogeneity, and no effective treatments have been shown to reduce mortality to date. Diuretics and comorbidity management are traditional treatments for HFpEF; however, they are mostly empirical due to a lack of clinical evidence in the setting of HFpEF. With the EMPEROR-Preserved and DELIVER results, sodium-glucose cotransporter 2 inhibitors become the first evidence-based therapies to reduce rehospitalization for heart failure. Subgroup analyses of the PARAGON-HF, TOPCAT, and CHARM-Preserved trials suggest that angiotensin receptor-neprilysin inhibitors, spironolactone, and angiotensin II receptor blockers may be beneficial in patients at the lower end of the ejection fraction spectrum. Other potential pharmacotherapies represented by non-steroidal mineralocorticoid receptor antagonists finerenone and antifibrotic agent pirfenidone also hold promise for the treatment of HFpEF. This article intends to review the clinical evidence on current pharmacotherapies of HFpEF, as well as the comorbidities management of atrial fibrillation, hypertension, T2DM, obesity, pulmonary hypertension, renal insufficiency, obstructive sleep apnea, and iron deficiency, to optimize the clinical management of HFpEF.</p>","PeriodicalId":12950,"journal":{"name":"Heart Failure Reviews","volume":" ","pages":"305-320"},"PeriodicalIF":4.6,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9969827","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Device therapy for patients with atrial fibrillation and heart failure with preserved ejection fraction. 保留射血分数的心房颤动和心力衰竭患者的装置治疗。
IF 4.6 2区 医学
Heart Failure Reviews Pub Date : 2024-03-01 Epub Date: 2023-11-08 DOI: 10.1007/s10741-023-10366-7
Zixi Zhang, Yichao Xiao, Yongguo Dai, Qiuzhen Lin, Qiming Liu
{"title":"Device therapy for patients with atrial fibrillation and heart failure with preserved ejection fraction.","authors":"Zixi Zhang, Yichao Xiao, Yongguo Dai, Qiuzhen Lin, Qiming Liu","doi":"10.1007/s10741-023-10366-7","DOIUrl":"10.1007/s10741-023-10366-7","url":null,"abstract":"<p><p>Device therapy is a nonpharmacological approach that presents a crucial advancement for managing patients with atrial fibrillation (AF) and heart failure with preserved ejection fraction (HFpEF). This review investigated the impact of device-based interventions and emphasized their potential for optimizing treatment for this complex patient demographic. Cardiac resynchronization therapy, augmented by atrioventricular node ablation with His-bundle pacing or left bundle-branch pacing, is effective for enhancing cardiac function and establishing atrioventricular synchrony. Cardiac contractility modulation and vagus nerve stimulation represent novel strategies for increasing myocardial contractility and adjusting the autonomic balance. Left ventricular expanders have demonstrated short-term benefits in HFpEF patients but require more investigation for long-term effectiveness and safety, especially in patients with AF. Research gaps regarding complications arising from left ventricular expander implantation need to be addressed. Device-based therapies for heart valve diseases, such as transcatheter aortic valve replacement and transcatheter edge-to-edge repair, show promise for patients with AF and HFpEF, particularly those with mitral or tricuspid regurgitation. Clinical evaluations show that these device therapies lessen AF occurrence, improve exercise tolerance, and boost left ventricular diastolic function. However, additional studies are required to perfect patient selection criteria and ascertain the long-term effectiveness and safety of these interventions. Our review underscores the significant potential of device therapy for improving the outcomes and quality of life for patients with AF and HFpEF.</p>","PeriodicalId":12950,"journal":{"name":"Heart Failure Reviews","volume":" ","pages":"417-430"},"PeriodicalIF":4.6,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10943171/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71521275","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Anti-bradycardia pacing-impact on patients with HFpEF: a systematic review. 抗心动过缓起搏--对高房颤患者的影响:系统性综述。
IF 4.5 2区 医学
Heart Failure Reviews Pub Date : 2024-03-01 Epub Date: 2024-01-28 DOI: 10.1007/s10741-024-10382-1
Alexandru Ababei, Luciana Andreea Hrib, Adalia Cristiana Iancu, Andra-Valeria Hadarag, Ahmad Khebbaiz, Radu Vătășescu, Ștefan Bogdan
{"title":"Anti-bradycardia pacing-impact on patients with HFpEF: a systematic review.","authors":"Alexandru Ababei, Luciana Andreea Hrib, Adalia Cristiana Iancu, Andra-Valeria Hadarag, Ahmad Khebbaiz, Radu Vătășescu, Ștefan Bogdan","doi":"10.1007/s10741-024-10382-1","DOIUrl":"10.1007/s10741-024-10382-1","url":null,"abstract":"<p><p>Heart failure with preserved ejection fraction (HFpEF) has become an emerging concern. The protective effect of bradycardia in patients with reduced ejection fraction using beta-blockers or ivabradine does not improve symptoms in HFpEF. This review aims to assess current data regarding the impact of anti-bradycardia pacing in patients with HFpEF. A search was conducted on PubMed, ScienceDirect, Springer, and Wiley Online Library, selecting studies from 2013 to 2023. Relevant and eligible prospective studies and randomized controlled trials were included. Functional status, quality of life, and echocardiographic parameters were assessed. Six studies conformed to the selection criteria. Four were prospective studies with a total of 90 patients analyzed. Two were randomized controlled trials with a total of 129 patients assessed. The 6-min walk test (6MWT) and the Minnesota Living with Heart Failure Questionnaire (MLHFQ) score improved in all prospective studies. My-PACE trial showed improvements in MLHFQ score (p < 0.001), significant relative lowering in NT-proBNP levels (p = 0.02), and an increased mean daily activity in the personalized accelerated pacing group compared to usual care. RAPID-HF trial proved that pacemaker implantation to enhance exercise heart rate (HR) did not improve exercise capacity and was associated with increased adverse events. HFpEF requires a more individualized approach and quality of life management. This review demonstrates that higher resting HR by atrial pacing may improve symptoms and even outcomes in HFpEF, while a higher adaptive rate during exertion has not been proven beneficial.</p>","PeriodicalId":12950,"journal":{"name":"Heart Failure Reviews","volume":" ","pages":"523-534"},"PeriodicalIF":4.5,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10942895/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139569959","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The role and application of current pharmacological management in patients with advanced heart failure. 当前药物治疗在晚期心力衰竭患者中的作用和应用。
IF 4.6 2区 医学
Heart Failure Reviews Pub Date : 2024-03-01 Epub Date: 2024-01-29 DOI: 10.1007/s10741-024-10383-0
Alberto Palazzuoli, Gaetano Ruocco, Marco Giuseppe Del Buono, Simona Pavoncelli, Elvira Delcuratolo, Antonio Abbate, Carl J Lavie
{"title":"The role and application of current pharmacological management in patients with advanced heart failure.","authors":"Alberto Palazzuoli, Gaetano Ruocco, Marco Giuseppe Del Buono, Simona Pavoncelli, Elvira Delcuratolo, Antonio Abbate, Carl J Lavie","doi":"10.1007/s10741-024-10383-0","DOIUrl":"10.1007/s10741-024-10383-0","url":null,"abstract":"<p><p>In the last decades, several classifications and definitions have been proposed for advanced heart failure (ADVHF) patients, including clinical, functional, hemodynamic, imaging, and electrocardiographic features. Despite different inclusion criteria, ADVHF is characterized by some common items, such as drug intolerance, low arterial pressure, multiple organ dysfunction, chronic kidney disease, and diuretic use dependency. Additional features include fatigue, hypotension, hyponatremia, and unintentional weight loss associated with a specific laboratory profile reflecting systemic multiorgan dysfunction. Notably, studies evaluating guideline-directed medical therapy recently endorsed by guidelines in stable HF, including the 4 drug classes all together (i.e., betablocker, mineral corticoid antagonist, renin angiotensin inhibitors/neprilysin inhibitors, and sodium glucose transporter inhibitors), remain scarcely analyzed in ADVHF and New York Heart Association (NYHA) Class IV. Additionally, due to the common conditions associated with advanced stages, the balance between drug tolerance and potential benefits of the contemporary use of all agents is questioned. Therefore, less hard endpoints, such as exercise tolerance, quality of life (QoL) and self-competency, are not clearly demonstrated. Specific analyses evaluating outcome and rehospitalization of each drug provided conflicting results and are often limited to subjects with stable conditions and less advanced NYHA class. Current European Society of Cardiology/American Heart Association (ESC/AHA) Guidelines do not indicate the type of treatment, dosage, and administration modalities, and they do not suggest specific indications for ADVHF patients. Due to these concerns, there is an impelling need to understand what drugs may be used as the first line, what management leads to the better outcome, and what is the best treatment algorithm in this setting. In this paper, we summarize the most common pitfalls and limitations for the use of the traditional agents, and we propose a personalized approach aiming at preserve drug tolerance and maintaining adverse event protection and satisfactory QoL.</p>","PeriodicalId":12950,"journal":{"name":"Heart Failure Reviews","volume":" ","pages":"535-548"},"PeriodicalIF":4.6,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139569960","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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