Uncovering the Role of Epicardial Adipose Tissue in Heart Failure With Preserved Ejection Fraction DOI Creative Commons

Sarah A Goldman,

Juan Antonio Requena-Ibáñez, Ana Devesa

et al.

JACC Advances, Journal Year: 2023, Volume and Issue: 2(9), P. 100657 - 100657

Published: Oct. 30, 2023

Heart failure with preserved ejection fraction (HFpEF) is the most common form of heart failure. Obesity a modifiable risk factor HFpEF; however, body mass index provides limited information on visceral adiposity and patients similar anthropometrics can present variable cardiovascular risk. Epicardial adipose tissue (EAT) closest fat deposit to has been proposed as biomarker adiposity. EAT may be particularly important for cardiac function, because its location (under pericardium) it acts metabolically active endocrine organ (which produce both beneficial detrimental cytokines). In this paper, authors review role in normal pathologic conditions discuss noninvasive imaging modalities that allow identification. This highlights implications HFpEF new therapies act might also exert effects system.

Language: Английский

Inflammation in Obesity-Related HFpEF DOI Creative Commons

Subodh Verma,

Mark C. Petrie, Barry A. Borlaug

et al.

Journal of the American College of Cardiology, Journal Year: 2024, Volume and Issue: 84(17), P. 1646 - 1662

Published: Aug. 30, 2024

Inflammation is thought to be an important mechanism for the development and progression of obesity-related heart failure with preserved ejection fraction (HFpEF). In STEP-HFpEF Program, once-weekly 2.4 mg semaglutide improved failure-related symptoms, physical limitations, exercise function, reduced levels C-reactive protein (CRP), a biomarker inflammation, body weight in participants HFpEF. However, neither prevalence nor clinical characteristics patients who have various magnitudes inflammation context HFpEF been well described. Furthermore, whether beneficial effects on HF efficacy endpoints Program are modified by baseline has not fully established. Finally, relationship between reduction changes CRP across defined.

Language: Английский

Citations

23
Tirzepatide Reduces LV Mass and Paracardiac Adipose Tissue in Obesity-Related Heart Failure DOI Creative Commons
Christopher M. Kramer, Barry A. Borlaug,

Michael R Zile M

et al.

Journal of the American College of Cardiology, Journal Year: 2024, Volume and Issue: unknown

Published: Nov. 1, 2024

Language: Английский

Citations

20
Heart failure: an update from the last years and a look at the near future DOI Creative Commons
Mauro Riccardi, Antonio Maria Sammartino, Massimo Piepoli

et al.

ESC Heart Failure, Journal Year: 2022, Volume and Issue: 9(6), P. 3667 - 3693

Published: Dec. 1, 2022

Abstract In the last years, major progress occurred in heart failure (HF) management. Quadruple therapy is now mandatory for all patients with HF reduced ejection fraction. Whilst verciguat becoming available across several countries, omecamtiv mecarbil waiting to be released clinical use. Concurrent use of potassium‐lowering agents may counteract hyperkalaemia and facilitate renin–angiotensin–aldosterone system inhibitor implementations. The results EMPagliflozin outcomE tRial Patients With chrOnic heaRt Failure Preserved Ejection Fraction (EMPEROR‐Preserved) trial were confirmed by Dapagliflozin Heart Mildly Reduced or (DELIVER) trial, we have, first time, evidence treatment also preserved a pre‐specified meta‐analysis randomized controlled trials, sodium–glucose co‐transporter‐2 inhibitors all‐cause mortality, cardiovascular (CV) hospitalization regardless left ventricular Other steps forward have decompensated HF. Acetazolamide Acute Decompensated Volume Overload (ADVOR) showed that addition intravenous acetazolamide loop diuretics leads greater decongestion vs. placebo. hydrochlorothiazide was evaluated CLOROTIC trial. Torasemide did not change outcomes, compared furosemide, TRANSFORM‐HF. Ferric derisomaltose had an effect on primary outcome CV mortality rehospitalizations IRONMAN (rate ratio 0.82; 95% confidence interval 0.66–1.02; P = 0.070). Further options HF, including device therapies, cardiac contractility modulation, percutaneous valvulopathies, are summarized this article.

Language: Английский

Citations

49
Obesity: the perfect storm for heart failure DOI Creative Commons
Maria Lembo, Teresa Strisciuglio, Celeste Fonderico

et al.

ESC Heart Failure, Journal Year: 2024, Volume and Issue: 11(4), P. 1841 - 1860

Published: March 15, 2024

Abstract Obesity condition causes morphological and functional alterations involving the cardiovascular system. These can represent substrates for different diseases, such as atrial fibrillation, coronary artery disease, sudden cardiac death, heart failure (HF) with both preserved ejection fraction (EF) reduced EF. Different pathogenetic mechanisms may help to explain association between obesity HF including left ventricular remodelling epicardial fat accumulation, endothelial dysfunction, microvascular dysfunction. Multi‐imaging modalities are required appropriate recognition of subclinical systolic dysfunction typically associated obesity, echocardiography being most cost‐effective technique. Therapeutic approach in patients is challenging, particularly regarding EF which few strategies high level evidence available. Weight loss extreme importance HF, a primary therapeutic intervention. Sodium–glucose co‐transporter‐2 inhibitors have been recently introduced novel tool management patients. The present review aims at analysing recent studies supporting pathogenesis, diagnosis, HF.

Language: Английский

Citations

15
Mast cells: a novel therapeutic avenue for cardiovascular diseases? DOI Creative Commons
Remo Poto, Gianni Marone, Stephen J. Galli

et al.

Cardiovascular Research, Journal Year: 2024, Volume and Issue: 120(7), P. 681 - 698

Published: April 16, 2024

Abstract Mast cells are tissue-resident immune strategically located in different compartments of the normal human heart (the myocardium, pericardium, aortic valve, and close to nerves) as well atherosclerotic plaques. Cardiac mast produce a broad spectrum vasoactive proinflammatory mediators, which have potential roles inflammation, angiogenesis, lymphangiogenesis, tissue remodelling, fibrosis. release preformed mediators (e.g. histamine, tryptase, chymase) de novo synthesized cysteinyl leukotriene C4 prostaglandin D2), cytokines chemokines, can activate resident macrophages) structural fibroblasts endothelial cells) aorta. The transcriptional profiles various cell populations highlight their heterogeneity distinct gene proteome expression. plasticity enable these for performing different, even opposite, functions response changing contexts. Human cardiac display significant differences compared with isolated from other organs. These characteristics make intriguing, given dichotomous inducing or protecting against cardiovascular diseases. Identification subpopulations represents prerequisite understanding multifaceted health disease. Several new drugs specifically targeting activation under development clinical trials. and/or potentially represent novel therapeutic targets disorders.

Language: Английский

Citations

12
Heart Failure With Preserved Ejection Fraction in the Elderly Population: Basic Mechanisms and Clinical Considerations DOI

Kimia Gharagozloo,

Mozhdeh Mehdizadeh,

George Heckman

et al.

Canadian Journal of Cardiology, Journal Year: 2024, Volume and Issue: 40(8), P. 1424 - 1444

Published: April 10, 2024

Citations

11
State of precision medicine for heart failure with preserved ejection fraction in a new therapeutic age DOI Creative Commons
Roy Rasalam, Andrew Sindone, Gary Deed

et al.

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

Published: Jan. 23, 2025

Abstract Heart failure with preserved ejection fraction (HFpEF) is defined by heart (HF) a left ventricular (LVEF) of at least 50%. HFpEF has complex and heterogeneous pathophysiology multiple co‐morbidities contributing to its presentation. Establishing the diagnosis can be challenging. Two algorithms, ‘Heavy, 2 or more Hypertensive drugs, atrial Fibrillation, Pulmonary hypertension, Elderly age >60, elevated Filling pressures’ (H FPEF) ‘Heart Failure Association Pre‐test assessment, Echocardiography natriuretic peptide, Functional testing, Final aetiology’ (HFA‐PEFF), help determine likelihood in individuals symptoms HF. Phenotype clusters largely total number types may delineate groups patients different management needs. It important recognize alternative diagnoses mimics such as infiltrative cardiomyopathies, coronary artery disease, lung anxiety, depression, anaemia, severe obesity, physical deconditioning, among others. Treatment sodium‐glucose co‐transporter inhibitors (dapagliflozin empagliflozin) recommended for all unless contraindicated. Future research should consider approaches guide initial treatment HFpEF, including phenotype clustering models artificial intelligence, whether LVEF most useful distinguishing feature categorizing Ongoing clinical trials are evaluating novel pharmacological device‐based address pathophysiological consequences HFpEF.

Language: Английский

Citations

2
Unlocking Therapeutic Potential for Cardiac Remodeling in Obesity-Related HFpEF DOI

Khurram Nasir,

Carlos Eduardo Rochitte

Journal of the American College of Cardiology, Journal Year: 2025, Volume and Issue: unknown

Published: Feb. 1, 2025

Language: Английский

Citations

2
The Aging Heart: A Molecular and Clinical Challenge DOI Open Access
Davide Lazzeroni, Andrea Villatore,

Gaia Souryal

et al.

International Journal of Molecular Sciences, Journal Year: 2022, Volume and Issue: 23(24), P. 16033 - 16033

Published: Dec. 16, 2022

Aging is associated with an increasing burden of morbidity, especially for cardiovascular diseases (CVDs). General risk factors, ischemic heart diseases, failure, arrhythmias, and cardiomyopathies present a significant prevalence in older people, are characterized by peculiar clinical manifestations that have distinct features compared the same conditions younger population. Remarkably, aging phenotype both healthy individuals patients CVD reflects modifications at cellular level. An improvement knowledge physiological pathological molecular mechanisms underlying cardiac could improve management offer new therapeutic targets.

Language: Английский

Citations

32
Inflammation in acute heart failure DOI Creative Commons
Manuel Garofalo,

Rossana Corso,

Daniela Tomasoni

et al.

Frontiers in Cardiovascular Medicine, Journal Year: 2023, Volume and Issue: 10

Published: Nov. 17, 2023

Acute heart failure (AHF) represents a common clinical scenario that requires prompt evaluation and therapy is characterized by high risk of mortality or subsequent rehospitalizations. The pathophysiology leading to AHF decompensation still not fully understood. Significant activation inflammatory pathways has been identified in patients with AHF, particularly its most severe forms, it hypothesized systemic inflammation role pathogenesis. Several mediators cytokines, such as sensitivity C-reactive protein, tumor necrosis factor-α, interleukin-6, interleukin-1, soluble suppression tumorigenicity 2 galectin-3, have shown play the pathogenesis, development worsening this condition an independent prediction adverse outcomes. This manuscript reviews prevalence prognostic value well potential anti-inflammatory therapies, focusing on available evidence from trials ongoing studies.

Language: Английский

Citations

21