Current Cardiology Reviews, Год журнала: 2024, Номер 20(3)
Опубликована: Фев. 15, 2024
Chronic heart failure (HF) is frequently associated with various comorbidities. These comorbid conditions, such as anemia, diabetes mellitus, renal insufficiency, and sleep apnea, can significantly impact the prognosis of patients HF.
Язык: Английский
Journal of the American College of Cardiology, Год журнала: 2023, Номер 81(18), С. 1810 - 1834
Опубликована: Апрель 19, 2023
Язык: Английский
Процитировано
253
New England Journal of Medicine, Год журнала: 2024, Номер 390(15), С. 1394 - 1407
Опубликована: Март 28, 2024
Obesity and type 2 diabetes are prevalent in patients with heart failure preserved ejection fraction characterized by a high symptom burden. No approved therapies specifically target obesity-related persons diabetes.
Язык: Английский
Процитировано
234
Cardiovascular Research, Год журнала: 2022, Номер 118(18), С. 3434 - 3450
Опубликована: Июль 26, 2022
Abstract Obesity and heart failure with preserved ejection fraction (HFpEF) represent two intermingling epidemics driving perhaps the greatest unmet health problem in cardiovascular medicine 21st century. Many patients HFpEF are either overweight or obese, recent data have shown that increased body fat its attendant metabolic sequelae widespread, protean effects systemically on system leading to symptomatic HFpEF. The paucity of effective therapies underscores importance understanding distinct pathophysiological mechanisms obese develop novel therapies. In this review, we summarize current non-cardiovascular features phenotype HFpEF, how adiposity might pathophysiologically contribute phenotype, these processes be targeted therapeutically.
Язык: Английский
Процитировано
207
Circulation, Год журнала: 2022, Номер 146(9), С. 676 - 686
Опубликована: Авг. 29, 2022
Background: Empagliflozin improves outcomes in patients with heart failure a preserved ejection fraction, but whether the effects are consistent and without diabetes remains to be elucidated. Methods: Patients class II through IV left ventricular fraction >40% were randomized receive empagliflozin 10 mg or placebo addition usual therapy. We undertook prespecified analysis comparing of versus diabetes. Results: Of 5988 enrolled, 2938 (49%) had The risk primary outcome (first hospitalization for cardiovascular death), total hospitalizations failure, estimated glomerular filtration rate decline was higher reduced irrespective status (hazard ratio, 0.79 [95% CI, 0.67, 0.94] hazard 0.78 0.64, 0.95] diabetes; P interaction =0.92). effect reduce also attenuate during double-blind treatment present diabetes, although more pronounced (1.77 0.98 mL/min/1.73m 2 =0.01). Across these 3 end points, did not differ prediabetes normoglycemia (33% 18% patient population, respectively). When investigated as continuous variable, baseline hemoglobin A1c modify on ( =0.26). There no increased hypoglycemic events either subgroup compared placebo. Conclusions: In enrolled EMPEROR-Preserved (Empagliflozin Outcome Trial With Chronic Heart Failure Preserved Ejection Fraction), significantly at baseline. Registration: URL: https://www.clinicaltrials.gov ; Unique identifier: NCT03057951.
Язык: Английский
Процитировано
92
Cardiovascular Diabetology, Год журнала: 2023, Номер 22(1)
Опубликована: Авг. 31, 2023
Abstract Background Insulin resistance (IR) can be effectively assessed using the dependable surrogate biomarker triglyceride-glucose (TyG) index. In various critical care contexts, like contrast-induced acute kidney injury (AKI), an elevated TyG index has demonstrated a robust correlation with incidence of AKI. Nonetheless, potential to predict AKI in critically ill patients heart failure (HF) remains uncertain. Methods A cohort participants was non-consecutively selected from Medical Information Mart for Intensive Care IV (MIMIC-IV) database and divided into quartiles based on their values. The primary outcome. secondary endpoint in-hospital mortality within both whole study population subset patients. use renal replacement therapy (RRT) which represented progression severity also included as representing restricted cubic splines model Cox proportional hazards models were utilized evaluate association risk HF condition. Kaplan-Meier survival analysis employed estimate disparities across groups differentiated by Results This total 1,393 patients, 59% being male. 82.8%. analyses revealed significant between HF. illustrated linear relationship higher increased this specific patient population. Furthermore, unveiled statistically differences RRT Conclusions results highlight independent predictor poor outcome However, further confirmation causality necessitates larger prospective studies.
Язык: Английский
Процитировано
58
ESC Heart Failure, Год журнала: 2024, Номер unknown
Опубликована: Май 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.
Язык: Английский
Процитировано
38
The Lancet Diabetes & Endocrinology, Год журнала: 2025, Номер unknown
Опубликована: Янв. 1, 2025
Data on the effect of mineralocorticoid receptor antagonist therapy HbA1c levels and new-onset diabetes are conflicting. We aimed to examine oral finerenone, compared with placebo, incident in Finerenone Trial Investigate Efficacy Safety Superior Placebo Patients Heart Failure (FINEARTS-HF) trial. In this randomised, double-blind, placebo-controlled trial, 6001 participants heart failure New York Association functional class II-IV, left ventricular ejection fraction 40% or higher, evidence structural disease, elevated N-terminal pro-B-type natriuretic peptide were randomly assigned finerenone administered orally. Randomisation was performed concealed allocation. The primary outcome trial composite cardiovascular death total (first recurrent) events (ie, hospitalisation urgent visit). present analysis, at baseline (investigator-reported history ≥6·5%) excluded. New-onset defined as a measurement 6·5% higher two consecutive follow-up visits new initiation glucose-lowering therapy. full-analysis set comprised all study treatment, analysed according their treatment assignment irrespective received intention treat). safety analysis who took least one dose investigational product, actually received. This is registered ClinicalTrials.gov, NCT04435626, closed participants. Between Sept 14, 2020, Jan 10, 2023, recruited placebo. 3222 (53·7%) did not have population. During median duration 31·3 months (IQR 21·5-36·3), 115 (7·2%) group 147 (9·1%) placebo developed diabetes, corresponding rate 3·0 per 100 person-years (95% CI 2·5-3·6) 3·9 (3·3-4·6) group. Compared significantly reduced hazard by 24% (hazard ratio [HR] 0·76 [95% 0·59-0·97], p=0·026). Fine-Gray competing risk accounting for death, yielded similar finding (subdistribution HR 0·75 [0·59-0·96], p=0·024). Results sensitivity analyses, which definition expanded include SGLT2 inhibitor indication, restricted measurements only, drugs only (excluding treatment). Findings when treated excluded (n=15). consistent across key participant subgroups. Seven had an adverse event captured any definitions above. mildly preserved without representing meaningful additional clinical benefit these individuals. Bayer.
Язык: Английский
Процитировано
4
JACC Heart Failure, Год журнала: 2023, Номер 11(6), С. 619 - 636
Опубликована: Май 3, 2023
Язык: Английский
Процитировано
39
Biomedicines, Год журнала: 2024, Номер 12(9), С. 2112 - 2112
Опубликована: Сен. 16, 2024
Obesity is a significant predisposing factor for heart failure with preserved ejection fraction (HFpEF). Although substantial proportion of individuals HFpEF also have obesity, those obesity are under-represented in clinical trials failure. In turn, current guidelines provided limited recommendations the medical management this patient population. Both and diabetes induce pro-inflammatory state that can contribute to endothelial dysfunction coronary microvascular impairment, finally resulting HFpEF. Additionally, leads increased epicardial chest wall adiposity, which enhances ventricular interdependence. This condition further aggravated by plasma blood volume expansion excessive vasoconstriction, ultimately worsening Despite well-documented benefits GLP-1 receptor agonists subjects diabetes, or both, their role obesity-related remains unclear. light recently published literature, review aims investigate potential mechanisms synthesize available evidence regarding patients
Язык: Английский
Процитировано
15
The Lancet Diabetes & Endocrinology, Год журнала: 2025, Номер unknown
Опубликована: Янв. 1, 2025
Язык: Английский
Процитировано
2