Cardiovascular-Kidney-Metabolic Health: A Presidential Advisory From the American Heart Association

Circulation, Journal Year: 2023, Volume and Issue: 148(20), P. 1606 - 1635

Published: Oct. 9, 2023

Cardiovascular-kidney-metabolic health reflects the interplay among metabolic risk factors, chronic kidney disease, and cardiovascular system has profound impacts on morbidity mortality. There are multisystem consequences of poor cardiovascular-kidney-metabolic health, with most significant clinical impact being high associated incidence disease events is a prevalence in population, disproportionate burden seen those adverse social determinants health. However, there also growing number therapeutic options that favorably affect function, or both have cardioprotective effects. To improve related outcomes critical need for (1) more clarity definition syndrome; (2) an approach to staging promotes prevention across life course; (3) prediction algorithms include exposures relevant health; (4) strategies management relation reflect harmonization major subspecialty guidelines emerging scientific evidence. It incorporate considerations into care models syndrome reduce fragmentation by facilitating approaches patient-centered interdisciplinary care. This presidential advisory provides guidance definition, staging, paradigms, holistic patients details multicomponent vision effectively equitably enhancing population.

Language: Английский

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Worsening of chronic heart failure: definition, epidemiology, management and prevention. A clinical consensus statement by the Heart Failure Association of the European Society of Cardiology

European Journal of Heart Failure, Journal Year: 2023, Volume and Issue: 25(6), P. 776 - 791

Published: April 27, 2023

Language: Английский

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Efficacy and Safety of Dapagliflozin in Patients With Acute Heart Failure

Journal of the American College of Cardiology, Journal Year: 2024, Volume and Issue: 83(14), P. 1295 - 1306

Published: April 1, 2024

Language: Английский

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Pre‐discharge and early post‐discharge management of patients hospitalized for acute heart failure: A scientific statement by the Heart Failure Association of the ESC

European Journal of Heart Failure, Journal Year: 2023, Volume and Issue: 25(7), P. 1115 - 1131

Published: May 18, 2023

Language: Английский

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2024 update in heart failure

ESC Heart Failure, Journal Year: 2024, Volume and Issue: unknown

Published: May 28, 2024

Abstract In the last years, major progress has occurred in heart failure (HF) management. The 2023 ESC focused update of 2021 HF guidelines introduced new key recommendations based on results years science. First, two drugs, sodium–glucose co‐transporter‐2 (SGLT2) inhibitors and finerenone, a novel nonsteroidal, selective mineralocorticoid receptor antagonist (MRA), are recommended for prevention patients with diabetic chronic kidney disease (CKD). Second, SGLT2 now treatment across entire left ventricular ejection fraction spectrum. benefits quadruple therapy reduced (HFrEF) well established. Its rapid early up‐titration along close follow‐up frequent clinical laboratory re‐assessment after an episode acute (the so‐called ‘high‐intensity care’ strategy) was associated better outcomes STRONG‐HF trial. Patients experiencing worsening might require fifth drug, vericiguat. STEP‐HFpEF‐DM STEP‐HFpEF trials, semaglutide 2.4 mg once weekly administered 1 year decreased body weight significantly improved quality life 6 min walk distance obese preserved (HFpEF) or without history diabetes. Further data safety efficacy, including also hard endpoints, needed to support addition acetazolamide hydrochlorothiazide standard diuretic regimen hospitalized due HF. meantime, PUSH‐AHF supported use natriuresis‐guided therapy. options most recent evidence HF, specific drugs cardiomyopathies (i.e., mavacamten hypertrophic cardiomyopathy tafamidis transthyretin cardiac amyloidosis), device therapies, contractility modulation percutaneous valvulopathies, finding from TRILUMINATE Pivotal trial, reviewed this article.

Language: Английский

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Cardiac and kidney benefits of empagliflozin in heart failure across the spectrum of kidney function: Insights from the EMPEROR‐Preserved trial

European Journal of Heart Failure, Journal Year: 2023, Volume and Issue: 25(8), P. 1337 - 1348

Published: April 17, 2023

In the EMPEROR-Preserved trial, empagliflozin improved clinical outcomes of patients with heart failure (HF) preserved ejection fraction. this pre-specified analysis, we aim to study effect on cardiovascular and kidney across spectrum function.Patients were categorized by presence or absence chronic disease (CKD) at baseline (CKD defined an estimated glomerular filtration rate [eGFR] <60 ml/min/1.73 m2 urine albumin creatinine ratio >300 mg/g). The primary key secondary (i) a composite death first HF hospitalization (primary outcome); (ii) total number hospitalization, (iii) eGFR slope; exploratory outcome including sustained ≥40% decline in eGFR, dialysis renal transplant. median follow-up was 26.2 months. A 5988 randomized placebo, whom 3198 (53.5%) had CKD. Irrespective CKD status, reduced (with CKD: hazard [HR] 0.80, 95% confidence interval [CI] 0.69-0.94; without HR 0.75, CI 0.60-0.95; interaction p = 0.67) (first recurrent) hospitalizations for 0.68, 0.54-0.86; 0.89, 0.66-1.21; 0.17). Empagliflozin slowed slope 1.43 (1.01-1.85) /year 1.31 (0.88-1.74) (interaction 0.70). did not reduce 0.97, 0.71-1.34; 0.92, 0.58-1.48; 0.86) but progression macroalbuminuria risk acute injury. consistent five categories (all >0.05). well tolerated independent status.In EMPEROR-Preserved, beneficial efficacy Overall, benefit safety wide range function spectrum, down 20 .

Language: Английский

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Optimisation of treatments for heart failure with reduced ejection fraction in routine practice: a position statement from a panel of experts

Revista Española de Cardiología (English Edition), Journal Year: 2023, Volume and Issue: 76(10), P. 813 - 820

Published: March 11, 2023

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Pre-treatment bicarbonate levels and decongestion by acetazolamide: the ADVOR trial

European Heart Journal, Journal Year: 2023, Volume and Issue: 44(22), P. 1995 - 2005

Published: May 4, 2023

Acetazolamide inhibits proximal tubular sodium and bicarbonate re-absorption improved decongestive response in acute heart failure the ADVOR trial. It is unknown whether levels alter to acetazolamide.This a sub-analysis of randomized, double-blind, placebo-controlled trial that randomized 519 patients with volume overload 1:1 ratio intravenous acetazolamide (500 mg/day) or matching placebo on top standardized loop diuretics (dose equivalent twice oral maintenance dose). The primary endpoint was complete decongestion after 3 days treatment (morning day 4). Impact baseline HCO3 effect assessed. : Of enrolled patients, 516 (99.4%) had measurement. Continuous modelling illustrated higher proportional for if ≥ 27 mmol/l. A total 234 (45%) Randomization towards over entire range HCO3- (P = 0.004); however, elevated exhibited significant [primary endpoint: no vs. HCO3; OR 1.37 (0.79-2.37) 2.39 (1.35-4.22), P-interaction 0.065), diuretic natriuretic (both < 0.001), greater reduction congestion score consecutive (treatment × time by HCO3-interaction <0.001) length stay (P-interaction 0.019). larger mainly explained development diminished arm (loop only), both regard reaching as well score. Development further worsened 0.041). only strategy associated an increase during phase which prevented (day 3: 74.8% 41.3%, P 0.001).Acetazolamide improves levels; magnified diuretic-induced (marker nephron NaHCO3 retention) specifically counteracting this component resistance.

Language: Английский

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Dual-Organ Transplantation: Indications, Evaluation, and Outcomes for Heart-Kidney and Heart-Liver Transplantation: A Scientific Statement From the American Heart Association

Circulation, Journal Year: 2023, Volume and Issue: 148(7), P. 622 - 636

Published: July 13, 2023

Although heart transplantation is the preferred therapy for appropriate patients with advanced failure, presence of concomitant renal or hepatic dysfunction can pose a barrier to isolated transplantation. Because donor organ supply limits availability transplantation, allocation this scarce resource essential; thus, clear guidance simultaneous heart-kidney and heart-liver urgently required. The purposes scientific statement are (1) describe impact pretransplantation on posttransplantation outcomes; (2) discuss assessment dysfunction; (3) provide an approach patient selection management; (4) explore ethics multiorgan

Language: Английский

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Comorbidity of patients with noncommunicable diseases in general practice. Eurasian guidelines

CARDIOVASCULAR THERAPY AND PREVENTION, Journal Year: 2024, Volume and Issue: 23(3), P. 3696 - 3696

Published: April 1, 2024

Создание руководства поддержано Советом по терапевтическим наукам отделения клинической медицины Российской академии наук.

Language: Русский

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