Cardiovascular therapeutic targets of sodium-glucose co-transporter 2 (SGLT2) inhibitors beyond heart failure DOI Creative Commons
Matteo Armillotta,

Francesco Angeli,

Pasquale Paolisso

et al.

Pharmacology & Therapeutics, Journal Year: 2025, Volume and Issue: 270, P. 108861 - 108861

Published: April 15, 2025

Sodium-glucose co-transporter 2 (SGLT2) inhibitors are oral antidiabetic agents that have shown significant improvements in cardiovascular and renal outcomes among patients with heart failure (HF), regardless of diabetic status, establishing them as a cornerstone therapy. In addition to glycemic control the osmotic diuretic effect, inhibition SGLT2 improves endothelial function vasodilation, optimizing myocardial energy metabolism preserving cardiac contractility. Moreover, may exhibit anti-inflammatory properties attenuate acute ischemia/reperfusion injury, thereby reducing infarct size, enhancing left ventricular function, mitigating arrhythmias. These pleiotropic effects demonstrated efficacy across various conditions, ranging from chronic coronary syndromes extending arrhythmias, valvular disease, cardiomyopathies, cardio-oncology, cerebrovascular disease. This review provides an overview current literature on potential mechanisms underlying effectiveness wide range diseases beyond HF.

Language: Английский

Hereditary Transthyretin Amyloidosis (ATTRv) DOI
Filippos Triposkiadis, Αlexandros Briasoulis, Randall C. Starling

et al.

Current Problems in Cardiology, Journal Year: 2025, Volume and Issue: unknown, P. 103019 - 103019

Published: Feb. 1, 2025

Language: Английский

Citations

0
Portuguese recommendations for the management of transthyretin amyloid cardiomyopathy (Part 1 of 2): Screening, diagnosis and treatment. Developed by the Task Force on the management of transthyretin amyloid cardiomyopathy of the Working Group on Myocardial and Pericardial Diseases of the Portuguese Society of Cardiology DOI Creative Commons
Nuno Marques, Sílvia Aguiar Rosa, Filipa Cordeiro

et al.

Revista Portuguesa de Cardiologia, Journal Year: 2025, Volume and Issue: 44, P. 7 - 48

Published: Feb. 1, 2025

Language: Английский

Citations

0
Guideline-Directed Medical Therapy for Heart Failure in Transthyretin Amyloid Cardiomyopathy DOI
Stéphanie K. Schwarting, Thomas Bieber, Daniel R. Davies

et al.

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

Published: Feb. 18, 2025

Cardiac amyloidosis is an underdiagnosed cause of infiltrative cardiomyopathy, leading to heart failure across the spectrum ejection fractions. Although there are approved disease-modulating therapies for transthyretin subtype (transthyretin amyloid cardiomyopathy [ATTR-CM]), role medications remains uncertain and challenging in clinical practice. Their effects on outcomes, such as mortality hospitalization, unknown ATTR-CM. This review aims explore use these ATTR-CM, considering disease’s stage patient-specific issues, fluid homeostasis, autonomic dysfunction, conduction disorders, low fixed stroke volumes, decreased functional capacity. As our understanding this condition deepens, it important reassess impact contemporary medication Finally, relevance guideline recommendations drugs based left ventricular fraction should be reconsidered context

Language: Английский

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Cardiac amyloidosis: Innovations in diagnosis and treatment DOI Creative Commons

Vincenzo Castiglione,

Sabrina Montuoro,

Giulia Orlando

et al.

European Heart Journal Supplements, Journal Year: 2025, Volume and Issue: 27(Supplement_1), P. i88 - i97

Published: Feb. 1, 2025

Cardiac amyloidosis (CA) is a progressive, underdiagnosed condition caused by the deposition of misfolded proteins in myocardium, forming amyloid fibrils that impair cardiac structure and function. This review highlights recent advances diagnosis treatment light-chain (AL) transthyretin (ATTR) CA, which globally account for most cases CA. Novel diagnostic tools, including artificial intelligence-enhanced analysis advanced imaging modalities like positron emission tomography with amyloid-specific tracers, might improve detection rates accuracy to enable non-invasive subtype differentiation. Furthermore, many innovative treatments are being investigated. For AL-CA, anti-fibril therapies showing promising results, complementing traditional chemotherapy autologous stem cell transplantation. In ATTR-CA, gene silencing tested clinical trials hold promise halting disease progression reducing deposits, respectively.

Language: Английский

Citations

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Knowledge Landscape and Hotspots of Research in Transthyretin Amyloid Cardiomyopathy: A Bibliometric Analysis DOI Creative Commons

Yanzhi Liu,

Xinqing Li,

Anran Xin

et al.

International Journal of Medical Sciences, Journal Year: 2025, Volume and Issue: 22(7), P. 1585 - 1601

Published: Feb. 28, 2025

Background: Transthyretin amyloid cardiomyopathy (ATTR-CM) is a progressive and frequently underdiagnosed cause of heart failure characterized by the pathological deposition misfolded transthyretin (TTR) proteins in cardiac tissue, leading to poor prognosis significant reduction quality life. Despite its severity, therapeutic options remain limited, knowledge gaps persist. This study aims construct map identify research hotspots within field ATTR-CM. Methods: Data were extracted from Web Science Core Collection (WoSCC), covering period January 1, 2000 June 2024. Bibliometric analyses supplemented qualitative assessments. VOSviewer, CiteSpace, Bibliometrix used visualize academic community clusters, collaboration citation networks trends ATTR-CM research. Results: A total 1855 publications analyzed. Contributions multiple disciplines fueled consistent upward trend citations. Europe United States dominated research, with Mathew S. Maurer as most prolific author, University London institution. The journals publishing these documents references demonstrated credibility broad disciplinary coverage. Reference analysis identified 10 main fields. Keyword unveiled five promising themes for research: early diagnosis algorithm, specific medication development, management comorbidities complications, epidemiology genotype-phenotype correlation, molecular biology mechanisms. Conclusion: first comprehensive bibliometric field, It systematically examines development trends, networks, themes, while identifying proposing future directions approaches. These findings provide valuable insights deepen understanding may foster advancements scientific clinical applications.

Language: Английский

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Supranormal Ejection Fraction in Heart Failure: Exploring the Heterogeneity of a Distinct Clinical Phenotype DOI Creative Commons
Luca Fazzini, G Togni, Emilia D’Elia

et al.

Journal of the American Heart Association, Journal Year: 2025, Volume and Issue: unknown

Published: March 13, 2025

Language: Английский

Citations

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Dapagliflozin effects on exercise, cardiac remodeling, biomarkers, and renal and pulmonary function in heart failure patients: not as good as expected? DOI Creative Commons
Massimo Mapelli, Irene Mattavelli, Elisabetta Salvioni

et al.

Frontiers in Cardiovascular Medicine, Journal Year: 2025, Volume and Issue: 12

Published: March 17, 2025

Sodium-glucose cotransporter-2 inhibitors (SGLT2-i) are standard therapy for heart failure (HF). We performed a holistic evaluation of dapagliflozin, including its effects on exercise performance, left ventricle (LV) reverse remodeling, cardiac biomarkers, fluid retention, and renal pulmonary function. enrolled HF reduced ejection fraction (LVEF) outpatients (EF <40%) eligible SGLT2-i cardiopulmonary tests (CPET), function tests, bioelectrical impedance vector analysis, laboratory echocardiographic assessments at baseline (T = 0), after 2-4 weeks (T1), 6 months treatment (T2). None the patients interrupted adverse events albeit follow-up was completed by 67 75 patients. At T2, mean LVEF increased (from 34.6 ± 7.8 to 37.5 9.2%; p < 0.001) while end-diastolic (EDV) end-systolic (ESV) volumes decreased [EDV: 186 (145-232) vs. 177 (129-225) mL, ESV: 113 (87-163) 110 (76-145) mL; 0.001]. Peak oxygen intake unchanged [peakVO2: 16.2 (13.4-18.7) 16.0 (13.3-18.9) mL/kg/min; 0.297], ventilatory efficiency (VE/VCO2 slope) improved [from 34.2 (31.1-39.2) 33.7 (30.2-37.6); 0.006]. Mean hemoglobin 13.8 1.5 14.6 1.7 g/dL; 0.001), did not change transient worsening T1. NT-proBNP, ST-2, hs-TNI as overall body fluids quality life assessed KCCQ. NYHA class (p=0.002), paralleled decrease MECKI (Metabolic Exercise test data combined with Cardiac Kidney Indexes) score, from 3.3% (1.9-8.0) 2.8% (1.2-5.7), suggestive positive impact 2 years prognosis (p 0.001). Dapagliflozin induced LV improvement efficiency, but without peakVO2 status biomarkers changes.

Language: Английский

Citations

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Amyloidosis of the heart: pathophysiology, diagnosis and treatment DOI
Andy Wang,

Uzair Mahmoud,

Jared M. Feldman

et al.

Expert Opinion on Pharmacotherapy, Journal Year: 2025, Volume and Issue: unknown

Published: March 20, 2025

Cardiacamyloidosis is characterized by amyloid fibril aggregation due tomisfolded circulating proteins and their deposition in the heart,leading to cardiac damage dysfunction. Given amyloidosisis associated with a poor prognosis without treatment, earlydiagnosis management are critical increase survival from thedisease. Thisarticle provides an overview of disease process, diagnosticmodalities, therapies for amyloidosis. Recenttechnological advances have led development reliable andaccurate diagnostic modalities identifying amyloidosis.Recent introduction novel disease-modifying cardiacamyloidosis resulted improvements andprognosis disease.

Language: Английский

Citations

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Kidney outcomes in patients with hereditary transthyretin amyloid nephropathy treated with TTR stabilizers and gene-silencer therapies DOI Creative Commons
Julien Dang, Justine Solignac, Sophie Ferlicot

et al.

Kidney International Reports, Journal Year: 2025, Volume and Issue: unknown

Published: March 1, 2025

Language: Английский

Citations

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Cardiac disease monitoring measures in patients with transthyretin amyloid cardiomyopathy treated with tafamidis DOI
Dimitrios Bampatsias, Abdirahman Wardhere, Lawrence Zeldin

et al.

Heart, Journal Year: 2025, Volume and Issue: unknown, P. heartjnl - 324826

Published: March 23, 2025

Background Patients with transthyretin amyloid cardiomyopathy (ATTR-CM) often experience worsening cardiac disease (WCD) despite disease-modifying treatment. However, a strict definition is lacking. Recent studies have shown that N-terminal pro-B-natriuretic peptide (NT-proBNP increase), or intensification of oral diuretics, associated increased mortality risk. Aim To describe the pattern WCD at 1 year in patients ATTR-CM on tafamidis and explore association cardiovascular (CV) hospitalisation. Methods diagnosed Columbia University after 2018 who were treated enrolled study. was defined as: increase NT-proBNP >700 pg/mL >30% from baseline diuretic (ODI) both. Survival CV hospitalisation risk analysis performed using Kaplan-Meier curves, Cox regression competing adjusted for age, genotype severity by National Amyloidosis Centre (NAC) stage. Results A total 238 enrolled, 100 (42%) whom showed year. (log rank, p<0.0001, HR=1.91 (1.10–3.32), p=0.023, adjustment NAC stage). In analysis, CV-related (HR=1.8 (1.17–2.99, p=0.009)) Conclusions ODI can serve as markers predict hospitalisations cohort taking tafamidis.

Language: Английский

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0