{"title":"Changing epidemiology in patients with heart failure","authors":"J. Gierula","doi":"10.31887/hm.2019.80/mkearney","DOIUrl":"https://doi.org/10.31887/hm.2019.80/mkearney","url":null,"abstract":"Heart failure (HF) and type 2 diabetes mellitus (DM) are current global epidemics with increasing prevalence that show no signs of slowing down. Of particular concern is the burden that both of these disorders place on individuals and society as a whole. Individually, both are expensive in resources, have high mortality rates, and cause significant reductions in quality of life. However, 30% to 45% of patients with HF have DM, and DM is an independent risk factor for the development of progressive HF and cardiovascular death, complicating management for physicians and further raising \u0000pressures on health and social care systems. Breakthroughs in the medical management of DM and HF have reduced mortality rates, meaning that the current epidemic is largely fueled by increased prevalence of the two disorders. Of particular concern is the rise of DM in developing countries, as these areas of the world become more prosperous, with the trappings of Western civilization rapidly infiltrating their cultures. Subsequent declines in physical activity and increased consumption of refined foods, drastically removed from indigenous eating habits, are resulting in DM sweeping the globe.","PeriodicalId":35477,"journal":{"name":"Heart and Metabolism","volume":"66 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80893805","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":"Energy metabolism in patients with diabetes and heart failure","authors":"","doi":"10.31887/hm.2019.80/gdlopaschuk","DOIUrl":"https://doi.org/10.31887/hm.2019.80/gdlopaschuk","url":null,"abstract":"The heart has a very high energy demand, which is mostly met by mitochondrial oxidative phosphorylation and, to a lesser extent, by glycolysis. In heart failure, there are substantial alterations in myocardial energy metabolism that lead to an “energy-deficient” state. This includes a marked reduction in overall mitochondrial oxidative phosphorylation and an uncoupling between high glycolysis rates and low glucose oxidation, which together contributes to the energy deficit and deteriorates contractile dysfunction. Cardiac ketone oxidation is also increased in heart failure, although it has yet to be determined whether this is an adaptive or maladaptive alteration. Diabetes is a major risk factor for heart failure development. It induces alterations in myocardial energy metabolism and is often associated with ventricular dysfunction. Similar to heart failure, a major change in myocardial energy metabolism in diabetic patients is a reduction in glucose oxidation, which negatively influences cardiac function. In both heart failure and diabetes, a growing body of evidence suggests that targeting myocardial energy metabolism by optimizing cardiac energy substrate preference could be a potential therapeutic approach to improve patient outcomes.","PeriodicalId":35477,"journal":{"name":"Heart and Metabolism","volume":"49 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86835094","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":"Heart Failure in patients with Diabetes","authors":"","doi":"10.31887/hm.2019.80","DOIUrl":"https://doi.org/10.31887/hm.2019.80","url":null,"abstract":"","PeriodicalId":35477,"journal":{"name":"Heart and Metabolism","volume":"116 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79565996","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":"Personalized approach for patients with heart failure and diabetes: responding to current unmet needs","authors":"J. A. Magaña","doi":"10.31887/hm.2019.80/jmserrano","DOIUrl":"https://doi.org/10.31887/hm.2019.80/jmserrano","url":null,"abstract":"67-year-old female hispanic patient presented with effort angina, dyspnea, and fatigue despite pharmacologic therapy.","PeriodicalId":35477,"journal":{"name":"Heart and Metabolism","volume":"60 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74402133","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":"CLINICAL APPLICATIONS OF ELECTROCHEMOTHERAPY","authors":"G. Serša","doi":"10.5644/pi2019.181.01","DOIUrl":"https://doi.org/10.5644/pi2019.181.01","url":null,"abstract":"Electroporation has several biomedical and industrial applications. The biomedical applications are in the field of drug or gene delivery. Electrochemotherapy utilizes electroporation for the increased delivery of cytotoxic drugs like bleomycin or cisplatin into tumors. The use of electrochemotherapy has spread throughout Europe for the treatment of cutaneous tumors or metastases. It is in the NICE guidelines and is becoming standard ablative technique in treatment of cancer. The technological advancements have also enabled the use of electrochemotherapy for the treatment of deep seated tumors, such as soft tissue or liver tumors. Clinical studies demonstrate good effectiveness on fibrosarcomas, colorectal liver metastases and hepatocellular carcinoma. However, electrochemotherapy is a local treatment that also induces moderate local immune response. This so called “in situ vaccination” induced by electrochemotherapy can be exploited in combined treatment with immune checkpoint inhibitors or electrogene therapy with immunostimulating effect. Therefore, gene electrotransfer of plasmid coding for interleukin 12 (IL-12), in combination with electrochemotherapy could result in transformation of electrochemotherapy from local into systemic treatment. This is also of our current interest, and we are undertaking steps to bring this idea from preclinical into clinical testing.","PeriodicalId":35477,"journal":{"name":"Heart and Metabolism","volume":"2 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80297044","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":"Diagnosing diabetic cardiomyopathy","authors":"S. Wheatcroft","doi":"10.31887/hm.2019.80/swheatcroft","DOIUrl":"https://doi.org/10.31887/hm.2019.80/swheatcroft","url":null,"abstract":"Diabetic cardiomyopathy reflects the presence of structural or functional abnormalities of the myocardium in an individual with diabetes which are not fully explained by other factors known to cause myocardial dysfunction. Diabetes promotes a range of molecular and cellular changes leading to left ventricular concentric hypertrophy, fibrosis, abnormal perfusion, lipid deposition, altered metabolism, diastolic dysfunction, and later progression to systolic dysfunction. Diagnosis of diabetic cardiomyopathy requires identification of such pathological features whilst at the same time excluding other causes of left ventricular dysfunction. In this article, avail- able modalities which can contribute to a diagnosis of diabetic cardiomyopathy are discussed. In most cases a diagnosis of diabetic cardiomyopathy can be reached by echocardiography or cardiac magnetic resonance imaging to detect structural and functional myocardial changes, with computed tomography coronary angiography being employed to exclude obstructive coronary artery disease which could account for left ventricular dysfunction.","PeriodicalId":35477,"journal":{"name":"Heart and Metabolism","volume":"35 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79965432","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":"Complications of diabetes: beyond the heart, kidneys, and eyes","authors":"J. Kovalik","doi":"10.31887/hm.12019.80/jpkovalik","DOIUrl":"https://doi.org/10.31887/hm.12019.80/jpkovalik","url":null,"abstract":"Diabetes is a leading global health problem. Clinicians and most patients are aware that diabetes can lead to complications in the heart, kidneys, and eyes. Given the high morbidity and mortality, much effort is made to screen for and treat these complications. Other organ systems can also be affected by diabetes. The pathogenesis and risk factors for developing these other complications does not always match those for heart, kidneys, and eyes. Additionally, treatment for these other complications is often limited or absent. Here we will review some of the major musculoskeletal, neuropathic, and skin complications linked to diabetes.","PeriodicalId":35477,"journal":{"name":"Heart and Metabolism","volume":"37 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77588510","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":"WHAT IS NEW IN CARDIOVASCULAR MEDICINE?","authors":"S. Mesihović-Dinarević","doi":"10.5644/pi2019.181.03","DOIUrl":"https://doi.org/10.5644/pi2019.181.03","url":null,"abstract":"The rapid pace of change continues to be a hallmark in cardiovascular medicine and many see that pace accelerating in adult cardiovascular medicine as well as in paediatric cardiology medicine. Cardiovascular medicine is an area of clinical practice with a continually rapid expansion of knowledge, guidelines, best practices and new technology. Cardiovascular diseases are the leading cause of mortality in the world and cause major costs for the health sector and economy. Primary care clinicians are challenged to optimally manage a multitude of diseases including congestive heart failure, coronary artery disease, valvular diseases, arrhythmias, lipid disorders, and hypertension. Multimodality imaging techniques are being used more frequently as their utility is better appreciated. Echocardiography has been the mainstay approach, cardiac computerized tomography and magnetic resonance imaging provide a good imaging alternative for patients with multiple complex surgeries. 3D printing has seen a rapid growth in use for planning treatments for patients with congenital heart disease. Simulation using 3D models is emerging as a fundamental resource for teaching procedural techniques and a new standard of care. Artificial intelligence holds the greatest potential for revolutionizing medicine. Innovative technologies in the world of cardiovascular health are expanding every day: wearable computing technologies, bioresorbable stents, leadless pacemaker, valve-in-valve procedure, protein patch for heart muscle growth and others. As a part of lifelong learning process for all professionals in cardiovascular medicine, the imperative is to have continuity of reviewing novelties, with results data from numerous researches in order to treat patient according to best practices and evidence-based medicine.","PeriodicalId":35477,"journal":{"name":"Heart and Metabolism","volume":"64 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79304726","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":"Antihyperglycemic drugs that improve cardiovascular outcomes and a model of diabetic cardiomyopathy","authors":"R. Bell","doi":"10.31887/hm.2019.80/rbell","DOIUrl":"https://doi.org/10.31887/hm.2019.80/rbell","url":null,"abstract":"Recent cardiovascular outcome trials (CVOTs) have transformed the landscape for the management of type 2 diabetes mellitus. In a remarkably short period of time, national and international guidelines have been overhauled to reflect the remarkable cardiovascular benefits of sodium/glucose linked transporter-2 inhibitors (SGLT2is) and glucagon-like peptide-1 receptor analogues (GLP-1RA) in mitigating cardiovascular risk. Both SGLT2is and GLP-1RAs remain second-line to metformin, reflecting the historical importance of this biguanide antihyperglycemic. In this review, these three very different antihyperglycemics are discussed in the light of CVOT data and of the preclinical data revealing remarkable pleiotropic signaling effects of these drugs. A model of diabetic cardiomyopathy is discussed, and the points of contact that these therapeutic interventions have upon this model may of help in understanding how each can be best targeted in this complex pathophysiological disease process.","PeriodicalId":35477,"journal":{"name":"Heart and Metabolism","volume":"19 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84137366","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":"“Glocalization” of concomitant heart failure and diabetes in Asia","authors":"C. Chandramouli","doi":"10.31887/hm.2019.80/cchandramouli","DOIUrl":"https://doi.org/10.31887/hm.2019.80/cchandramouli","url":null,"abstract":"Asia has witnessed significant economic growth and urbanization in the past few decades. In parallel, this has increased the burden of diabetes, obesity, and heart failure (HF). Emerging data has shown that between 40% and 57% of Asian patients with HF have concomitant diabetes. Compared with their Caucasian counterparts, Asian patients with HF have a threefold higher burden of diabetes, are a decade younger, have a lower body mass index, and have greater comorbidity burden. In Asia, there are important differences in clinical correlates and left ventricular remodeling patterns associated with diabetes between HF with reduced ejection fraction (HFrEF) and HF with preserved ejection (HFpEF). Irrespective of the HF subtype, diabetes portends worse quality of life and clinical outcomes. Simultaneously, evidence for a lean diabetic phenotype in HF is accumulating in this region. Given the rich ethnic and regional diversity in Asia, one size certainly does not fit all here. Tailoring therapies and public health policies which cater to these distinct Asian phenotypes is essential for strategic management of concomitant diabetes and HF. This review will explore the epidemiology, clinical correlates, and the unique characteristics of concomitant diabetes in both HFrEF and HFpEF in Asia, with emphasis on the lean diabetic phenotype of HF.","PeriodicalId":35477,"journal":{"name":"Heart and Metabolism","volume":"198 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80004163","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}
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