2024 Guidelines of the Taiwan Society of Cardiology for the Diagnosis and Treatment of Heart Failure with Preserved Ejection Fraction. DOI
Yi‐Heng Li, Chun‐Chieh Wang, Chung‐Lieh Hung

et al.

PubMed, Journal Year: 2024, Volume and Issue: 40(2), P. 148 - 171

Published: March 1, 2024

Heart failure with preserved ejection fraction (HFpEF) is a multi-organ systemic syndrome that involves cardiac and extra-cardiac pathophysiological abnormalities. Its growing prevalence causes major public concern worldwide. HFpEF usually associated multiple comorbidities, non-cardiovascular death common in patients HFpEF. In Asia, has younger age, higher of diabetes chronic kidney disease than Western countries. A 2-step diagnostic algorithm recommended this guideline. the first step, diagnosis can be made if have symptoms and/or signs heart failure, left ventricular ≥ 50%, increased natriuretic peptide, objective evidence atrial or abnormalities raised filling pressure. If still uncertain, invasive noninvasive stress test performed second step. Comorbidities need to controlled Weight reduction for obesity supervised exercise training are For pharmacological therapy, diuretic used relieve congestion sodium-glucose cotransporter 2 inhibitor, empagliflozin dapagliflozin, improve prognosis The research on advancing at rapid pace. It expected newer modalities management could appear near future.

Language: Английский

2024 update in heart failure DOI Creative Commons

Alberto Beghini,

Antonio Maria Sammartino, Z. Papp

et al.

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

Citations

31
Heart failure with preserved ejection fraction: diagnosis, risk assessment, and treatment DOI Creative Commons
Stephan von Haehling, Birgit Aßmus, Tarek Bekfani

et al.

Clinical Research in Cardiology, Journal Year: 2024, Volume and Issue: 113(9), P. 1287 - 1305

Published: April 11, 2024

Abstract The aetiology of heart failure with preserved ejection fraction (HFpEF) is heterogenous and overlaps that several comorbidities like atrial fibrillation, diabetes mellitus, chronic kidney disease, valvular iron deficiency, or sarcopenia. diagnosis HFpEF involves evaluating cardiac dysfunction through imaging techniques assessing increased left ventricular filling pressure, which can be measured directly estimated various proxies including natriuretic peptides. To better narrow down the differential HFpEF, European American guidelines advocate use different algorithms require rigorous treatment during evaluation process. Therapeutic recommendations differ between guidelines. Whilst sodium glucose transporter 2 inhibitors have a solid evidence base, regard to renin–angiotensin–aldosterone axis. Unless indicated for specific comorbidities, beta-blockers should discouraged in HFpEF. aim this article provide an overview current state art diagnosis, clinical evaluation, treatment. Graphical

Language: Английский

Citations

9
Acute heart failure – transitioning from symptom-based care to remission DOI Creative Commons
Gad Cotter, Beth A. Davison, Douglas L. Mann

et al.

Journal of Cardiac Failure, Journal Year: 2025, Volume and Issue: unknown

Published: Feb. 1, 2025

During the last century characteristics of patients with heart failure (HF) and acute HF (AHF) have shifted from severe pump due to rheumatic, hypertensive ischemic disease older more obese multiple comorbidities. The pathophysiology AHF has in parallel that advanced, end-stage, caused by left ventricular dysfunction age, obesity comorbidity-related cardiovascular combined neurohormonal inflammatory dysregulation or "inflammaging". With advent blockers leading improved outcomes chronic HF, focus therapy also changed care directed at early symptom improvement therapies towards longer-term improvements quality life outcomes. Studies conducted 5 years suggest beneficial effects seen 4 pillars guideline-directed medical for mostly comprising blockade, can be extended when these are initiated rapidly uptitrated during admission after discharge. A recent pilot study (CORTAHF) suggested benefits treating markers activation anti-inflammatory therapies. Future studies should further examine whether blockade lead reversal disrupted underlying remission AHF.

Language: Английский

Citations

1
Non‐cardiac comorbidities and intensive up‐titration of oral treatment in patients recently hospitalized for heart failure: Insights from the STRONG‐HF trial DOI Open Access

Ovidiu Chioncel,

Beth A. Davison, Marianna Adamo

et al.

European Journal of Heart Failure, Journal Year: 2023, Volume and Issue: 25(11), P. 1994 - 2006

Published: Sept. 20, 2023

Language: Английский

Citations

22
Blood pressure and intensive treatment up‐titration after acute heart failure hospitalization: Insights from the STRONG‐HF trial DOI
Matteo Pagnesi,

Oscar A. Gomez Vilamajo,

Alejandro Meiriño

et al.

European Journal of Heart Failure, Journal Year: 2024, Volume and Issue: 26(3), P. 638 - 651

Published: March 1, 2024

Language: Английский

Citations

6
Advances in management of heart failure DOI Open Access
Paul A. Heidenreich, Alexander T. Sandhu

BMJ, Journal Year: 2024, Volume and Issue: unknown, P. e077025 - e077025

Published: April 10, 2024

ABSTRACT Heart failure is increasing in prevalence many countries with aging populations. Fortunately, remarkable scientific advances have been made the past few years that led to new treatments and improved prognosis for patients heart failure. This review examines these changes a focus on diagnosis medical management of The include increase four foundational drug classes (pillars therapy) now recommended reduced left ventricular ejection fraction, use sodium-glucose cotransporter-2 inhibitors those higher importance rapid initiation life prolonging therapies once has made. Device other non-drug also evolved publication clinical trials. emphasizes evidence published since recent guidelines European Society Cardiology American College Cardiology/American Association/Heart Failure America 2021 2022. Additional studies are needed determine how best implement interventions practice.

Language: Английский

Citations

6
“Durable left ventricular assist devices as a bridge to transplantation in The Old and The New World” DOI
A. Fernandez Valledor, Gal Rubinstein, C. Moeller

et al.

The Journal of Heart and Lung Transplantation, Journal Year: 2024, Volume and Issue: 43(6), P. 1010 - 1020

Published: Feb. 14, 2024

Language: Английский

Citations

4
Clinical efficacy and hemodynamic effects of levosimendan in cardiac surgery patients after surgery DOI Creative Commons
Meiling Zhao, Yunfeng Hou, Yuan Meng

et al.

Journal of Cardiothoracic Surgery, Journal Year: 2025, Volume and Issue: 20(1)

Published: Jan. 7, 2025

Abstract Objective To investigate the therapeutic effect of levosimendan on hemodynamics in patients undergoing major cardiac surgery and presenting with acute postoperative heart failure. Methods The subjects study were 160 severe conditions who underwent had Eighty cases each assigned to research control groups using a random number table. Document general patient data for two groups; compare clinical outcomes groups. hemodynamic states compared both before after therapy. 48 h surgery, echocardiography was performed determine function. N -terminal pro-brain B -type natriuretic peptide (NT-Pro-BNP) levels between Results overall effective rate significantly higher group (92.5%) (76.25%, P < 0.05). Post-treatment, demonstrated significant reduction CVP (9.25 ± 2.11 cmH2O vs. 11.36 3.08 cmH2O, 0.001), (100.30 8.69 bpm 105.74 7.69 bpm, lactic acid (1.68 0.59 mmol/L 2.69 0.55 mmol/L, 0.001). also showed improvements SBP (117.23 8.74 mmHg 113.25 7.55 mmHg, = 0.002) urine output (4.21 1.76 mL/kg/h 3.65 1.23 mL/kg/h, 0.021). Cardiac function indicators indicated LVEF (55.21 8.04% 47.18 6.60%, 0.001) lower LVEDVi LVESVi ( 0.001 both). NT-Pro-BNP (6010.19 1208.52 pg/mL 9663.21 2391.34 pg/mL, incidence complications (5% 22.5%, Conclusion are prone failure surgery. Treatment can improve efficacy reduce complications. It effectively patients' promote stability.

Language: Английский

Citations

0
Increasing evidence supports the benefits of rapid uptitration of the neurohormonal blockade in HFmrEF/HFpEF patients with AHF DOI Creative Commons
Gad Cotter,

Beth Davison,

Jan Biegus

et al.

Journal of Cardiac Failure, Journal Year: 2025, Volume and Issue: unknown

Published: Feb. 1, 2025

Language: Английский

Citations

0
Up‐titration of medication in patients with new‐onset heart failure with and without atrial fibrillation DOI Creative Commons
Arietje J.L. Zandijk, Bernadet T. Santema,

Friso D.J. Inkelaar

et al.

ESC Heart Failure, Journal Year: 2025, Volume and Issue: unknown

Published: Feb. 19, 2025

Abstract Aims Differences in guideline‐directed medical therapy (GDMT) and clinical outcomes have been observed between heart failure (HF) patients with atrial fibrillation (AF) versus those sinus rhythm. This study evaluated the effects of up‐titration HF therapies, consisting beta‐blockers, angiotensin‐converting‐enzyme inhibitors (ACEis)/angiotensin‐receptor blockers (ARBs) mineralocorticoid receptor antagonists (MRAs), new‐onset without AF. Methods Among 607 (<3 months) from a specialized nurse‐led clinic Netherlands, 187 (31%) had AF, 420 (69%) were rhythm at baseline electrocardiogram. After an period 9 months, achieved doses reasons for not reaching target documented. Results Patients AF older, less likely to ischaemic disease higher N‐terminal B‐type natriuretic peptide levels (all P < 0.05). Left ventricular ejection fraction (LVEF) was similar (37% vs. 36%, = 0.453). Prescription GDMT comparable rhythm, except lower ACEi/ARB prescription use diuretics (79% 86%; 0.038; 86% 59%, 0.001, respectively, compared rhythm). Up‐titration guideline‐recommended beta‐blocker, MRA (31% 24%, 0.096; 32% 40%, 0.098; 23.7% 30.5%, 0.125, respectively). Reasons further up‐titrating recommended consistent across LVEF improvement ≥5% ≥10% after more common than (67% 53%, 0.017; 48% 0.043). Achieving therapies associated mortality rehospitalization rates 3 years both Conclusions In HF, but greater

Language: Английский

Citations

0