Heart Failure ReviewsPub Date : 2024-07-01Epub Date: 2024-03-26DOI: 10.1007/s10741-024-10396-9
Xu Huang, Yi Shen, Yiwei Liu, Hao Zhang
{"title":"Current status and future directions in pediatric ventricular assist device.","authors":"Xu Huang, Yi Shen, Yiwei Liu, Hao Zhang","doi":"10.1007/s10741-024-10396-9","DOIUrl":"10.1007/s10741-024-10396-9","url":null,"abstract":"<p><p>A ventricular assist device (VAD) is a form of mechanical circulatory support that uses a mechanical pump to partially or fully take over the function of a failed heart. In recent decades, the VAD has become a crucial option in the treatment of end-stage heart failure in adult patients. However, due to the lack of suitable devices and more complicated patient profiles, this therapeutic approach is still not widely used for pediatric populations. This article reviews the clinically available devices, adverse events, and future directions of design and implementation in pediatric VADs.</p>","PeriodicalId":12950,"journal":{"name":"Heart Failure Reviews","volume":null,"pages":null},"PeriodicalIF":4.5,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140293331","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}
{"title":"Pooled prevalences of obstructive sleep apnea and heart failure: a systematic review and meta-analysis.","authors":"Wisarud Prechaporn, Phasu Hantrakul, Chetta Ngamjarus, Wattana Sukeepaisarnjaroen, Kittisak Sawanyawisuth, Sittichai Khamsai","doi":"10.1007/s10741-024-10399-6","DOIUrl":"10.1007/s10741-024-10399-6","url":null,"abstract":"<p><p>Obstructive sleep apnea (OSA) is a disease with intermittent hypoxemia during sleep. It has been shown that OSA is related to several cardiovascular diseases including heart failure. Both OSA and heart failure have a close association bidirectionally. This study aimed to estimate the pooled prevalence of OSA in patients with heart failure as well as pooled prevalence of heart failure in patients with OSA. This was a systematic review with a meta-analysis. The inclusion criteria were observational or epidemiological studies conducted in adult patients with heart failure to evaluate the prevalence of OSA and patients with OSA to evaluate the prevalence of heart failure. The outcomes of this study were prevalence of OSA in patients with heart failure and prevalence of heart failure in patients with OSA. Four databases were used for systematic searching including PubMed, Science Direct, Scopus, and CINAHL Plus. Manual searches for related studies were also conducted. Proportion meta-analyses using a random-effects model were conducted to identify pooled proportion (prevalence) of heart failure in patients with OSA and vice versa. Among 3,941 articles from the four databases met the study criteria. Thirty-three studies showed the prevalence of OSA in patients with heart failure, while thirteen studies presented the prevalence of heart failure in patients with OSA. The prevalence of OSA in patients with heart failure was 38.4% (95% CI 31.9 to 45.2; I<sup>2</sup> of 96.1%). Using a diagnostic criterion of OSA of more than 10 events/hr had the highest prevalence of OSA in patients with heart failure at 53.4% (95% CI 42.0 to 64.5). The highest prevalence of OSA in patients with heart failure was 60.1% (95% CI 51.4 to 68.3) in a report from India. The pooled prevalence of heart failure in patients with OSA was 12.8% (95% CI 8.1 to 19.5; I<sup>2</sup> of 94.6%). The prevalence in Romania was highest at 22.6% (95% CI 20.4 to 24.9). The pooled prevalence of OSA in patients with heart failure was higher than the pooled prevalence of heart failure in patients with OSA. The pooled prevalence rates of these associations varied among the diagnostic criteria of OSA and countries.</p>","PeriodicalId":12950,"journal":{"name":"Heart Failure Reviews","volume":null,"pages":null},"PeriodicalIF":4.6,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140897897","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}
Heart Failure ReviewsPub Date : 2024-07-01Epub Date: 2024-03-20DOI: 10.1007/s10741-024-10398-7
Matteo Lisi, Giovanni Andrea Luisi, Maria Concetta Pastore, Giulia Elena Mandoli, Giovanni Benfari, Federica Ilardi, Alessandro Malagoli, Simona Sperlongano, Michael Y Henein, Matteo Cameli, Antonello D'Andrea
{"title":"New perspectives in the echocardiographic hemodynamics multiparametric assessment of patients with heart failure.","authors":"Matteo Lisi, Giovanni Andrea Luisi, Maria Concetta Pastore, Giulia Elena Mandoli, Giovanni Benfari, Federica Ilardi, Alessandro Malagoli, Simona Sperlongano, Michael Y Henein, Matteo Cameli, Antonello D'Andrea","doi":"10.1007/s10741-024-10398-7","DOIUrl":"10.1007/s10741-024-10398-7","url":null,"abstract":"<p><p>International Guidelines consider left ventricular ejection fraction (LVEF) as an important parameter to categorize patients with heart failure (HF) and to define recommended treatments in clinical practice. However, LVEF has some technical and clinical limitations, being derived from geometric assumptions and is unable to evaluate intrinsic myocardial function and LV filling pressure (LVFP). Moreover, it has been shown to fail to predict clinical outcome in patients with end-stage HF. The analysis of LV antegrade flow derived from pulsed-wave Doppler (stroke volume index, stroke distance, cardiac output, and cardiac index) and non-invasive evaluation of LVFP have demonstrated some advantages and prognostic implications in HF patients. Speckle tracking echocardiography (STE) is able to unmask intrinsic myocardial systolic dysfunction in HF patients, particularly in those with LV preserved EF, hence allowing analysis of LV, right ventricular and left atrial (LA) intrinsic myocardial function (global peak atrial LS, (PALS)). Global PALS has been proven a reliable index of LVFP which could fill the gaps \"gray zone\" in the previous Guidelines algorithm for the assessment of LV diastolic dysfunction and LVFP, being added to the latest European Association of Cardiovascular Imaging Consensus document for the use of multimodality imaging in evaluating HFpEF. The aim of this review is to highlight the importance of the hemodynamics multiparametric approach of assessing myocardial function (from LVFP to stroke volume) in patients with HF, thus overcoming the limitations of LVEF.</p>","PeriodicalId":12950,"journal":{"name":"Heart Failure Reviews","volume":null,"pages":null},"PeriodicalIF":4.5,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11189326/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140174435","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}
Heart Failure ReviewsPub Date : 2024-05-01Epub Date: 2024-02-21DOI: 10.1007/s10741-024-10393-y
Keivan Mohammadi, Davood Shafie, Newsha Ghomashi, Ali Abdolizadeh, Majid Sadeghpour
{"title":"Kinin-kallikrein system: New perspectives in heart failure.","authors":"Keivan Mohammadi, Davood Shafie, Newsha Ghomashi, Ali Abdolizadeh, Majid Sadeghpour","doi":"10.1007/s10741-024-10393-y","DOIUrl":"10.1007/s10741-024-10393-y","url":null,"abstract":"<p><p>Heart failure (HF) is a pervasive clinical challenge characterized by compromised cardiac function and reduced quality of life. The kinin-kallikrein system (KSS), a multifaceted peptide cascade, has garnered substantial attention due to its potential role in HF. Through activation of B1 and/or B2 receptors and downstream signaling, kinins modulate various physiological processes, including inflammation, coagulation, pain, blood pressure control, and vascular permeability. Notably, aberrations in KKS components have been linked to HF risk. The elevation of vasodilatory bradykinin (BK) due to kallikrein activity reduces preload and afterload, while concurrently fostering sodium reabsorption inhibition. However, kallikrein's conversion of prorenin to renin leads to angiotensinsII upregulation, resulting in vasoconstriction and fluid retention, alongside increased immune cell activity that fuels inflammation and cardiac remodeling. Importantly, prolonged KKS activation resulting from volume overload and tissue stretch contributes to cardiac collagen loss. The conventional renin-angiotensin-aldosterone system (RAAS) inhibitors used in HF management may inadvertently intensify KKS activity, exacerbating collagen depletion and cardiac remodeling. It is crucial to balance the KKS's role in acute cardiac damage, which may temporarily enhance function and metabolic parameters against its detrimental long-term effects. Thus, KKS blockade emerges as a promising strategy to impede HF progression. By attenuating the link between immune system function and tissue damage, KKS inhibition can potentially reduce cardiac remodeling and alleviate HF symptoms. However, the nuanced roles of BK in various acute conditions necessitate further investigation into the sustained benefits of kallikrein inhibitors in patients with chronic HF.</p>","PeriodicalId":12950,"journal":{"name":"Heart Failure Reviews","volume":null,"pages":null},"PeriodicalIF":4.6,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139912495","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}
Heart Failure ReviewsPub Date : 2024-05-01Epub Date: 2024-02-11DOI: 10.1007/s10741-024-10391-0
Kengo Z Soghoyan, Maya Guglin
{"title":"Durable ventricular assist device in adult patients with single ventricle: a systematic literature review.","authors":"Kengo Z Soghoyan, Maya Guglin","doi":"10.1007/s10741-024-10391-0","DOIUrl":"10.1007/s10741-024-10391-0","url":null,"abstract":"<p><p>The worldwide experience with mechanical circulatory support in adult patients with single ventricle and Fontan palliation is limited. We aimed to see the outcomes in such patients on durable left ventricular assist device. We systematically reviewed the English language literature found on PubMed and Google Scholar, searching the terms \"Fontan,\" \"single ventricle,\" \"ventricular assist device,\" \"LVAD,\" and \"mechanical circulatory support,\" and selected all individual cases with reported outcomes. We identified 4 patients on pulsatile left ventricular assist device, all of whom were successfully bridged to transplant, and 15 patients on continuous flow LVAD, age 25.9 ± 5.8, predominantly males. Mean time on LVAD support was 718.6 ± 616.5 days, and only 2 patients (13.3%) died. Durable left ventricular assist device support in adult patients with Fontan provides excellent results and should be used more frequently.</p>","PeriodicalId":12950,"journal":{"name":"Heart Failure Reviews","volume":null,"pages":null},"PeriodicalIF":4.6,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139717519","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}
{"title":"Heart failure with mildly reduced and preserved ejection fraction: A review of disease burden and remaining unmet medical needs within a new treatment landscape.","authors":"Nihar Desai, Elzbieta Olewinska, Agata Famulska, Cécile Remuzat, Clément Francois, Kerstin Folkerts","doi":"10.1007/s10741-024-10385-y","DOIUrl":"10.1007/s10741-024-10385-y","url":null,"abstract":"<p><p>This review provides a comprehensive overview of heart failure with mildly reduced and preserved ejection fraction (HFmrEF/HFpEF), including its definition, diagnosis, and epidemiology; clinical, humanistic, and economic burdens; current pharmacologic landscape in key pharmaceutical markets; and unmet needs to identify key knowledge gaps. We conducted a targeted literature review in electronic databases and prioritized articles with valuable insights into HFmrEF/HFpEF. Overall, 27 randomized controlled trials (RCTs), 66 real-world evidence studies, 18 clinical practice guidelines, and 25 additional publications were included. Although recent heart failure (HF) guidelines set left ventricular ejection fraction thresholds to differentiate categories, characterization and diagnosis criteria vary because of the incomplete disease understanding. Recent epidemiological data are limited and diverse. Approximately 50% of symptomatic HF patients have HFpEF, more common than HFmrEF. Prevalence varies with country because of differing definitions and study characteristics, making prevalence interpretation challenging. HFmrEF/HFpEF has considerable mortality risk, and the mortality rate varies with study and patient characteristics and treatments. HFmrEF/HFpEF is associated with considerable morbidity, poor patient outcomes, and common comorbidities. Patients require frequent hospitalizations; therefore, early intervention is crucial to prevent disease burden. Recent RCTs show promising results like risk reduction of composite cardiovascular death or HF hospitalization. Costs data are scarce, but the economic burden is increasing. Despite new drugs, unmet medical needs requiring new treatments remain. Thus, HFmrEF/HFpEF is a growing global healthcare concern. With improving yet incomplete understanding of this disease and its promising treatments, further research is required for better patient outcomes.</p>","PeriodicalId":12950,"journal":{"name":"Heart Failure Reviews","volume":null,"pages":null},"PeriodicalIF":4.6,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11035416/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139971663","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}
Heart Failure ReviewsPub Date : 2024-05-01Epub Date: 2024-02-23DOI: 10.1007/s10741-024-10390-1
George Bazoukis, Athanasios Saplaouras, Polyxeni Efthymiou, Andronicos Yiannikourides, Tong Liu, Konstantinos P Letsas, Michael Efremidis, Konstantinos Lampropoulos, Sotirios Xydonas, Gary Tse, Antonis A Armoundas
{"title":"Cardiac contractility modulation in patients with heart failure - A review of the literature.","authors":"George Bazoukis, Athanasios Saplaouras, Polyxeni Efthymiou, Andronicos Yiannikourides, Tong Liu, Konstantinos P Letsas, Michael Efremidis, Konstantinos Lampropoulos, Sotirios Xydonas, Gary Tse, Antonis A Armoundas","doi":"10.1007/s10741-024-10390-1","DOIUrl":"10.1007/s10741-024-10390-1","url":null,"abstract":"<p><p>Experimental in vivo and in vitro studies showed that electric currents applied during the absolute refractory period can modulate cardiac contractility. In preclinical studies, cardiac contractility modulation (CCM) was found to improve calcium handling, reverse the foetal myocyte gene programming associated with heart failure (HF), and facilitate reverse remodeling. Randomized control trials and observational studies have provided evidence about the safety and efficacy of CCM in patients with HF. Clinically, CCM therapy is indicated to improve the 6-min hall walk, quality of life, and functional status of HF patients who remain symptomatic despite guideline-directed medical treatment without an indication for cardiac resynchronization therapy (CRT) and have a left ventricular ejection fraction (LVEF) ranging from 25 to 45%. Although there are promising results about the role of CCM in HF patients with preserved LVEF (HFpEF), further studies are needed to elucidate the role of CCM therapy in this population. Late gadolinium enhancement (LGE) assessment before CCM implantation has been proposed for guiding the lead placement. Furthermore, the optimal duration of CCM application needs further investigation. This review aims to present the existing evidence regarding the role of CCM therapy in HF patients and identify gaps and challenges that require further studies.</p>","PeriodicalId":12950,"journal":{"name":"Heart Failure Reviews","volume":null,"pages":null},"PeriodicalIF":4.6,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139930924","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}
Heart Failure ReviewsPub Date : 2024-05-01Epub Date: 2024-02-13DOI: 10.1007/s10741-024-10389-8
Dimitrios Bismpos, Jan Wintrich, Julian Hövelmann, Michael Böhm
{"title":"Latest pharmaceutical approaches across the spectrum of heart failure.","authors":"Dimitrios Bismpos, Jan Wintrich, Julian Hövelmann, Michael Böhm","doi":"10.1007/s10741-024-10389-8","DOIUrl":"10.1007/s10741-024-10389-8","url":null,"abstract":"<p><p>Despite major advances in prevention and medical therapy, heart failure (HF) remains associated with high morbidity and mortality, especially in older and frailer patients. Therefore, a complete, guideline-based treatment is essential, even in HF patients with conditions traditionally associated with a problematic initiation and escalation of the medical HF therapy, such as chronic kidney disease and arterial hypotension, as the potential adverse effects are overcome by the overall decrease of the absolute risk. Furthermore, since the latest data suggest that the benefit of a combined medical therapy (MRA, ARNI, SGLT2i, beta-blocker) may extend up to a LVEF of 65%, further trials on these subgroups of patients (HFmrEF, HFpEF) are needed to re-evaluate the guideline-directed medical therapy across the HF spectrum. In particular, the use of SGLT2i was recently extended to HFpEF patients, as evidenced by the DELIVER and EMPEROR-preserved trials. Moreover, the indication for other conservative treatments in HF patients, such as the intravenous iron supplementation, was accordingly strengthened in the latest guidelines. Finally, the possible implementation of newer substances, such as finerenone, in guideline-directed medical practice for HF is anticipated with great interest.</p>","PeriodicalId":12950,"journal":{"name":"Heart Failure Reviews","volume":null,"pages":null},"PeriodicalIF":4.6,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11035443/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139722329","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}
{"title":"Stem cell-based therapies for heart failure management: a narrative review of current evidence and future perspectives.","authors":"Gbolahan Olatunji, Emmanuel Kokori, Ismaila Yusuf, Emmanuel Ayanleke, Olakanmi Damilare, Samson Afolabi, Busayo Adetunji, Saad Mohammed, Olumide Akinmoju, Gbolahan Aboderin, Nicholas Aderinto","doi":"10.1007/s10741-023-10351-0","DOIUrl":"10.1007/s10741-023-10351-0","url":null,"abstract":"<p><p>Heart failure (HF) is a prevalent and debilitating global cardiovascular condition affecting around 64 million individuals, placing significant strain on healthcare systems and diminishing patients' quality of life. The escalating prevalence of HF underscores the urgent need for innovative therapeutic approaches that target the root causes and aim to restore normal cardiac function. Stem cell-based therapies have emerged as promising candidates, representing a fundamental departure from conventional treatments focused primarily on symptom management. This review explores the evolving landscape of stem cell-based therapies for HF management. It delves into the mechanisms of action, clinical evidence from both positive and negative outcomes, ethical considerations, and regulatory challenges. Key findings include the potential for improved cardiac function, enhanced quality of life, and long-term benefits associated with stem cell therapies. However, adverse events and patient vulnerabilities necessitate stringent safety assessments. Future directions in stem cell-based HF therapies include enhancing efficacy and safety through optimized stem cell types, delivery techniques, dosing strategies, and long-term safety assessments. Personalized medicine, combining therapies, addressing ethical and regulatory challenges, and expanding access while reducing costs are crucial aspects of the evolving landscape.</p>","PeriodicalId":12950,"journal":{"name":"Heart Failure Reviews","volume":null,"pages":null},"PeriodicalIF":4.6,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41127475","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}