Archives des Maladies du Coeur et des Vaisseaux - Pratique, Journal Year: 2024, Volume and Issue: 2024(327), P. 13 - 19
Published: March 28, 2024
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
European Journal of Heart Failure, Journal Year: 2024, Volume and Issue: 26(7), P. 1585 - 1593
Published: May 29, 2024
Language: Английский
Citations
12
Journal of Cardiovascular Medicine, Journal Year: 2024, Volume and Issue: unknown
Published: Jan. 10, 2024
Aims To evaluate the role of tricuspid regurgitation in advanced heart failure. Methods The multicenter observational HELP-HF registry enrolled consecutive patients with failure and at least one ‘I NEED HELP’ criterion evaluated four Italian centers between January 2020 November 2021. Patients no data on and/or receiving valve intervention during follow-up were excluded. population was stratified by no/mild vs. moderate severe regurgitation. Variables independently associated regurgitation, as well association clinical outcomes investigated. primary outcome all-cause mortality. Results Among 1085 included this study, 508 (46.8%) had 373 (34.4%) 204 (18.8%) History atrial fibrillation, any prior surgery, high dose furosemide, preserved left ventricular ejection fraction, moderate/severe mitral pulmonary hypertension found to be an increased likelihood Estimated rates 1-year death 21.4, 24.5 37.1% respectively (log-rank P < 0.001). As compared nonsevere a higher risk mortality (adjusted hazard ratio 1.38, 95% confidence interval 1.01–1.88, = 0.042), whereas did not. Conclusion In contemporary, real-world cohort failure, several echocardiographic characteristics are have
Language: Английский
Citations
7
European Journal of Heart Failure, Journal Year: 2024, Volume and Issue: 26(6), P. 1399 - 1407
Published: May 14, 2024
Abstract Aims Frailty is highly prevalent in patients with heart failure (HF), but a concordant definition of this condition lacking. The Heart Failure Association the European Society Cardiology (HFA‐ESC) proposed 2019 new multi‐domain frailty, it has never been validated. Methods and results Patients from HELP‐HF registry were stratified according to number HFA‐ESC frailty domains fulfilled cumulative deficits index (FI) quintiles. Prevalence each domain was reported, as well rate composite all‐cause death HF hospitalization, its single components, cardiovascular group quintile. Among 854 included patients, 37 (4.3%), 206 (24.1%), 365 (42.8%), 217 (25.4%), 29 (3.4%) zero, one, two, three, or four domains, respectively, while 179 had FI < 0.21 considered not frail. 1‐year risk adverse events increased proportionally (for criterion increase, hospitalization: hazard ratio [HR] 1.43, 95% confidence interval [CI] 1.27–1.62; death: HR 1.72, CI 1.46–2.02, hospitalizations: subHR 1.21, 1.04–1.31; 1.77, 1.45–2.15). Consistent found stratifying cohort for continuous variable demonstrated higher discriminative ability than (area under curve = 0.68 vs. 0.64, p 0.004). Conclusion at advanced HF, assessed via approach FI, identifies those events. be slightly more effective identifying mortality.
Language: Английский
Citations
6
Kardiologiia, Journal Year: 2025, Volume and Issue: 65(2), P. 64 - 68
Published: Feb. 28, 2025
Aim To evaluate the efficacy of I NEED HELP scale in determining six-month prognosis for patients on heart transplant waiting list (HTWL) Almazov National Medical Research Center Russian Ministry Health. Material and methods This retrospective study included 42 from HTWL. The patients’ survival more than 6 months was assessed. composite end point (CEP) adverse outcome all-cause death, transplantation (HT) due to increased urgency surgical intervention according UNOS within after inclusion Patients were evaluated using scale. Statistical analysis performed by nonparametric methods. Results median score 4 [from 1 7]. increase positively correlated with incidence outcomes (r=0.5; p=0.0007). group an unfavorable had a higher one survivors (score 5 vs. 4, respectively; p=0.001). greatest effect exerted low systolic blood pressure (SBP) (p=0.003); failure or necessity decrease doses disease-modifying drugs (p=0.039); target organ dysfunction (p=0.039). sensitivity specificity at 100% 84%, respectively. Conclusion pilot demonstrated patient population specialized center HTWL high determined threshold outcome. It is appropriate continue expanded sample validation cohorts hospitals various healthcare system levels.
Language: Английский
Citations
0
Journal of Clinical Medicine, Journal Year: 2025, Volume and Issue: 14(8), P. 2539 - 2539
Published: April 8, 2025
Background/Objectives: Heart transplantation (HTX) is the definitive treatment for advanced heart failure (AdHF). The angiotensin receptor neprilysin inhibitor (ARNI) sacubitril/valsartan (S/V) has been shown to reduce (HF) hospitalizations and mortality when compared conventionally administered HF medications (i.e. angiotensin-converting enzyme inhibitors (ACEIs) II blockers (ARBs)). Nevertheless, limited data are available on hemodynamic (HD) effects of ARNI in patients with AdHF. Therefore, aim present study was compare echocardiographic, laboratory, HD parameters relevant before after switching AdHF awaiting HTX. Methods: A retrospective analysis conducted utilizing parameters, N-terminal pro-brain natriuretic peptide (NT-proBNP) levels, kidney function, therapy, comorbidities. cohort comprised 13 (3 women, 10 men; mean age 56.4 ± 9 years) whom 53.8% presented non-ischemic 46.2% ischemic etiology. All were transitioned therapy between 2018 2021. Results: After ARNI, we observed significant improvements: left ventricular ejection fraction (LVEF: 27.27 1.04% vs. 23.65 1.02%, p = 0.03; given as SEM respectively), cardiac output (CO: 4.90 0.35 L/min 3.83 0.24 L/min, 0.013), stroke volume (SV: 70.9 5.9 mL 55.5 4.12 mL, 0.013). Significant reductions systemic vascular resistance (SVR: 1188 79.8 1600 100 DS/cm5, 0.004) pulmonary (PVR: 232.5 34.8 278.9 31.7 0.04) also noted. Central venous pressure (CVP), arterial systolic diastolic pressures (PAPs PAPd), capillary wedge (PCWP), NT-proBNP levels did not exhibit changes upon administration. Conclusions: Early transition offers benefits invasively measured AdHF, potentially aiding stabilization improvement this vulnerable patient population.
Language: Английский
Citations
0
Archives des Maladies du Coeur et des Vaisseaux - Pratique, Journal Year: 2024, Volume and Issue: 2024(327), P. 7 - 12
Published: Feb. 28, 2024
Citations
1
Current Pharmaceutical Design, Journal Year: 2024, Volume and Issue: 30(33), P. 2597 - 2605
Published: July 15, 2024
: Loop diuretics are the cornerstone of decongestive therapy in patients presenting with acute heart failure and have been extensively studied randomized clinical trials. Therefore, current guidelines, they only drug a class I recommendation to treat signs symptoms congestion when present. However, percentage achieving successful decongestion is suboptimal, diuretic resistance frequently develops. Patients poor response loop those discharged residual characterized by worse prognosis over time. Recently, renovated interest different classes sprouted among researchers order improve strategies ameliorate short- long-term outcomes. Randomized trials investigating associations performed but yielded variable results. despite initial evidence possible benefit from some these compounds, definite way approach via combination still missing. The aim this review summarize on use suggest avoid or counteract resistance.
Language: Английский
Citations
1
European Journal of Heart Failure, Journal Year: 2024, Volume and Issue: unknown
Published: Nov. 19, 2024
Aims Management of advanced heart failure (HF) remains challenging despite specific sections in the 2021 European Society Cardiology/Heart Failure Association (ESC/HFA) guidelines, with delays referrals exacerbating issue. This study aimed to evaluate awareness and implementation these guidelines among cardiologists identify barriers effective referral. Methods results From June October 2023, an online survey was disseminated through ESC mailing list, targeting across Europe. The investigated four areas: guideline awareness, healthcare network organization, clinical case management, perceptions mechanical circulatory support (MCS) outcomes. Respondents were categorized into (HFCs), general (GCs), other participants (OPs). Among 497 respondents, 25% HFCs, 40% GCs, 35% OPs. A total 84% HFCs reported a high level knowledge, compared 57% GCs 62% OPs ( p < 0.001). Additionally, 76% ‘regularly or always’ used ESC/HFA criteria HF, 44% 48% Correct responses regarding recommendation class for transplantation 84%, 55%, 60% 0.0001), MCS as bridge transplantation, 69%, 65%, 55% = 0.018) OPs, respectively. Referring patients severe HF tertiary centre team found be ‘very difficult’ ‘difficult’ by 8.4% 19.6% 18.2% 0.0005). Conclusion highlights significant disparities knowledge application cardiologists, revealing opportunity educational initiatives. difficulty referring centres underscores need improve referral pathway patients.
Language: Английский
Citations
1
Published: Feb. 6, 2024
In this thesis, we first focused on the prognostic impact of mitral regurgitation (MR) across different heart failure (HF) scenarios: chronic worsening HF, acute HF and advanced HF. BIOSTAT-CHF study HELP-HF registry, significant MR was independently associated with worse outcomes among patients respectively. However, in RELAX-AHF-2 trial, moderate-severe had a primary composite endpoint (180-day cardiovascular death or rehospitalization for renal failure) at univariable analyses after adjustment age sex, but not extensive multivariable adjustment. Subsequently, explored pathophysiological mechanisms underlying presence BIOSTAT-CHF, differentially expressed circulating biomarkers without were investigated. A distinct expression profile identified MR, differently versus related to congestion, mineral metabolism, lipid metabolism cachexia, oxidative stress. Finally, determinants changes optimization medical therapy severity dynamically changed up-titration, strong independent impact. Of note, higher ACEi/ARB up-titration left ventricular ejection fraction ≥50% likelihood improvement optimization.
Language: Английский
Citations
0