Unveiling the Systemic Impact of Congestion in Heart Failure: A Narrative Review of Multisystem Pathophysiology and Clinical Implications

Journal of Cardiovascular Development and Disease, Journal Year: 2025, Volume and Issue: 12(4), P. 124 - 124

Published: March 31, 2025

Congestion is a key clinical feature of heart failure (HF), contributing to hospitalizations, disease progression, and poor outcomes. While traditionally considered hemodynamic issue, congestion now recognized as systemic process affecting multiple organs. Renal dysfunction arises from impaired perfusion sodium retention, leading maladaptive left ventricular remodeling. Hepatic contributes cholestatic liver injury, while metabolic disturbances drive anemia, muscle wasting, inflammation. Additionally, disrupts the intestinal barrier immune function, exacerbating HF progression. Given its widespread impact, effective management requires shift cardiovascular-centered approach comprehensive, multidisciplinary strategy. Targeted decongestive therapy, nutritional optimization, modulation are crucial in mitigating congestion-related organ dysfunction. Early recognition intervention essential slow preserve functional capacity, improve survival. Addressing through personalized, evidence-based strategies vital for optimizing long-term care advancing treatment paradigms.

Language: Английский

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Effects of levothyroxine in subclinical hypothyroidism and heart failure with reduced ejection fraction: An open-label randomized trial

Cell Reports Medicine, Journal Year: 2024, Volume and Issue: 5(4), P. 101473 - 101473

Published: March 26, 2024

We report a randomized, multicenter, open-label trial (ClinicalTrials.gov: NCT03096613) to investigate the clinical benefits of levothyroxine (L-T4) administration in subclinical hypothyroidism (SCH) patients with heart failure reduced ejection fraction (HFrEF). Overall, 117 were enrolled and received L-T4 plus standard HFrEF treatment (experimental group, N = 57) or therapy alone (control 60). The change 6-min walk test distance experimental group was significantly higher than that control at 24 weeks (70.08 ± 85.76 m vs. 27.73 82.00 m, mean difference [95% confidence interval (CI)] 46.90 [12.90, 80.90], p < 0.001). Improvements New York Heart Association (NYHA) classification (p 0.033) thyroid function significant. Adverse event incidence similar between groups (risk ratio CI]: 0.942 1.053 (0.424, 2.616); 0.628). addition improved activity tolerance, NYHA class, within 6 months, suggesting its potential for combined SCH. Future double-blind, placebo-controlled trials should be performed confirm these results.

Language: Английский

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Progenitor Cell Function and Cardiovascular Remodelling Induced by SGLT2 Inhibitors

Frontiers in Bioscience-Landmark, Journal Year: 2024, Volume and Issue: 29(4), P. 145 - 145

Published: April 9, 2024

Sodium-glucose cotransporters 2 (SGLT2) are high-capacity, low-affinity transporters, expressed mainly in the early portion of proximal renal tube, mediating up to 90% glucose uptake, while SGLT1 receptors found small intestine, facilitating absorption. SGLT2 inhibitors (SGLT2i) originally emerged as agents for treatment type diabetes mellitus; however, they soon demonstrated remarkable cardio- and renoprotective actions that led their licensed use heart failure chronic kidney disease, regardless diabetic status. Cardiovascular remodelling represents an umbrella term encompasses changes occur cardiovascular system, from molecular cellular level, tissue organs after local injury, stress, or pressure. SGLT modulation has been shown positively affect many these observed during pathological remodelling. Among different pathophysiological mechanisms contribute adverse remodelling, various stem progenitor cells have be involved, through alterations number function. Recent studies examined effects SGLT2i on cell populations more specifically endothelial (EPCs). Although some no significant effect, others showed can modulate morphology function EPCs. These preliminary observations effect EPCs may responsible beneficial gliflozins and, by extension, disease. The purpose this narrative review is critically discuss recent evidence cardioprotective SGLT2is, context cardiac

Language: Английский

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Individualized Nutritional Support Improves Cardiac Function and Nutritional Status of Elderly Heart Failure Patients

Kardiologiia, Journal Year: 2025, Volume and Issue: 65(2), P. 48 - 56

Published: Feb. 28, 2025

Background The quality of life the patient is diminished by chronic heart failure (CHF), which also costs healthcare system. This study examined benefits individualized nutritional support provided a specialized nursing team on status and cardiac function elderly patients with CHF. Material methods included 102 elderly, hospitalized CHF patients. were randomly assigned to two groups 51 each. During protocol, control group received regular care, while experimental team. Nutritional-related indicators, inflammatory factors, scores measured before after protocol compared. Results There was significant increase in total albumin, hemoglobin, protein both during but final concentrations significantly higher (p<0.05). In groups, left ventricular ejection fraction increased end-systolic dimension end-diastolic decreased. improvements these variables greater exhibited reduced tumor necrosis factor-α, interleukin-6, high sensitivity C-reactive (p<0.05), reported (p<0.05) satisfaction Conclusion Nutritional administered improved nutrition, function, status, compared standard nutrition care.

Language: Английский

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Revisiting Secondary Dilative Cardiomyopathy

International Journal of Molecular Sciences, Journal Year: 2025, Volume and Issue: 26(9), P. 4181 - 4181

Published: April 28, 2025

Secondary dilated cardiomyopathy (DCM) refers to left ventricular dilation and impaired systolic function arising from identifiable extrinsic causes, such as ischemia, hypertension, toxins, infections, systemic diseases, or metabolic disorders. Unlike primary DCM, which is predominantly genetic, secondary DCM represents a diverse spectrum of pathophysiological mechanisms linked external insults on myocardial structure function. The increasing prevalence conditions alcohol use disorder, chemotherapy-induced cardiotoxicity, viral myocarditis underscores the need for heightened awareness early recognition DCM. A comprehensive analysis clinical trial data observational studies involving dilative was conducted, with focus mortality, symptom relief, major adverse events. systematic literature review performed using databases, including PubMed, Embase, ClinicalTrials.gov, following PRISMA guidelines study selection. Data were extracted patient demographics, etiology dilation, design, outcomes, follow-up duration. Advances in diagnostic modalities have refined ability identify underlying causes For example, high-sensitivity troponin cardiac magnetic resonance imaging are pivotal diagnosing differentiating it ischemic cardiomyopathy. Novel insights into toxin-induced cardiomyopathies, those related anthracyclines immune checkpoint inhibitors, highlighted pathways mitochondrial dysfunction oxidative stress. Treatment strategies emphasize management causing condition alongside standard heart failure therapies, RAAS inhibitors beta-blockers. Emerging recovery protocols peripartum immune-modulating treatments myocarditis, promising reversing dysfunction. encompasses heterogeneous group disorders that require precise etiological diagnosis effective management. Timely identification treatment cause, combined optimized can significantly improve outcomes. Future research focuses developing targeted therapies exploring role biomarkers precision medicine tailoring

Language: Английский

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Top Ten Tips Palliative Care Clinicians Should Know About the Psychiatric Manifestations of Nonpsychiatric Serious Illness and Treatments

Journal of Palliative Medicine, Journal Year: 2024, Volume and Issue: 27(12), P. 1657 - 1665

Published: May 10, 2024

Mental health issues are widespread and significant among individuals with serious illness. Among patients receiving palliative care (PC), psychiatric comorbidities common impact patient quality of life. Despite their prevalence, PC clinicians face challenges in effectively addressing the intricate relationship between medical disorders due to complex, intertwined bidirectionally influential nature. This article, created collaboratively a team psychiatric-palliative experts, is second two-part series examining bidirectional illness PC. article explores 10 prevalent manifestations associated severe its treatment. Building upon first which focused on physical PC, these two articles advocate for an integrated approach that prioritizes mental emotional wellbeing across continuum

Language: Английский

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Growth Hormone Secretory Capacity Is Associated with Cardiac Morphology and Function in Overweight and Obese Patients: A Controlled, Cross-Sectional Study

Cells, Journal Year: 2022, Volume and Issue: 11(15), P. 2420 - 2420

Published: Aug. 4, 2022

Obesity is associated with increased cardiovascular morbidity. Adult patients growth hormone deficiency (GHD) show morpho-functional cardiological alterations. A total of 353 overweight/obese are enrolled in the period between 2009 and 2019 to assess relationships GH secretory capacity metabolic phenotype, risk factors, body composition cardiac echocardiographic parameters. All underwent GHRH + arginine test evaluate capacity, DEXA for assessment transthoracic echocardiography. Blood samples also collected evaluation In total, 144 had 209 normal secretion. comparing two groups, we found significant differences fat distribution predominantly visceral adipose tissue accumulation GHD patients. Metabolic syndrome more prevalent group. particular, fasting glycemia, triglycerides systolic diastolic blood pressure be linearly correlated capacity. Epicardial thickness, E/A ratio indexed ventricular mass worse population studied, composition, factors morphology related secretion obese patient seems an important determinant health.

Language: Английский

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Effect of levothyroxine replacement therapy in patients with subclinical hypothyroidism and chronic heart failure: A systematic review

Frontiers in Endocrinology, Journal Year: 2022, Volume and Issue: 13

Published: Nov. 15, 2022

Chronic heart failure (CHF) affects the health care system with high social and economic costs due to recurrent hospital admissions or frequent ambulatory reassessments. Subclinical hypothyroidism (SCH) is commonly observed in patients CHF negatively myocardial function remodeling and, ultimately, increases risk of hospitalizations all-cause cardiovascular (CV) mortality. The role levothyroxine replacement on relevant CV outcomes SCH unclear.To assess effect (compared placebo no treatment) incidence mortality, major adverse events, CHF.PubMed/MEDLINE, Cochrane Library, ClinicalTrial.gov were searched for randomized clinical trials, non-randomized observational, multicentric, comparative studies. No language restrictions included. After duplicate removal, articles screened extracted synthesis according a hierarchical strategy that included title, abstract, full-text appraisal. bias was assessed by RoB2 ROBIN-I tools. Grading Recommendations Assessment, Development Evaluation (GRADE) methodology applied rate quality evidence grade strength recommendations.Two trials systematic review considerable indirectness inaccuracy down-graded level evidence.No supports use treating lack reliable well-designed trials.CV outcome dose-response are needed understand better treatment safer prescription this setting.

Language: Английский

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A Cross-Sectional Study of Acute Coronary Syndrome and Thyroid Profile: Dissecting the Relationship to Improve Patient Care

Cureus, Journal Year: 2024, Volume and Issue: unknown

Published: March 8, 2024

Introduction: Thyroid-releasing hormones are pivotal in regulating cardiovascular (CVS) function and maintaining its hemodynamics homeostasis. Even a minor alteration thyroid has an enormous implication on CVS morbidity mortality. Moreover, hypothyroidism was found to be potential menace for coronary artery disease (CAD). The objective of this study determine the role thyroid-releasing patients suffering from acute syndrome (ACS). Methodology: Among cohort 100 with ACS, complete history clinical information followed by physical examination electrocardiography were recorded. Blood samples also collected record blood sugar levels i.e., fasting (FBS), postprandial (PPBS), profile, including free stimulating hormone (TSH), thyroxine (fT4), triiodothyronine (fT3), reverse (rT3). data analyzed using SPSS version 26 software (IBM Corp., Armonk, NY, USA). Result: identified alterations 27% ACS. prevalence euthyroid sick 59.3%, while subclinical hyperthyroidism reported among 18.5% 14.8% respectively. There no significant difference between males females. illustrated greater occurrence aberrant profiles those aged 40-60 years. ST-elevated myocardial infarction (STEMI) group had statistically higher profile compared non-ST-elevated (NSTEMI) unstable angina (UA) groups (p=0.02). A total nine died ACS all low fT3 TSH values rT3 (p<0.05). Conclusion: An atypical status been elevate likelihood developing CAD experiencing This condition can impact ventricular serum cholesterol as well heart rate rhythm. Therefore, understanding relationship could potentially lead improved treatment strategies individuals which will further prevent major complications.

Language: Английский

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Prognostic value of serum IGF-1, Gal-3, and PTX-3 levels in elderly patients with chronic heart failure

American Journal of Translational Research, Journal Year: 2024, Volume and Issue: 16(4), P. 1393 - 1400

Published: Jan. 1, 2024

To evaluate the diagnostic and prognostic value of insulin-like growth factor-1 (IGF-1), galactoagglutinin-3 (GAL-3), pentamerin-3 (PTX-3) levels in elderly patients with chronic heart failure (CHF).

Language: Английский

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