Sustainable development goals series, Год журнала: 2024, Номер unknown, С. 127 - 144
Опубликована: Янв. 1, 2024
Язык: Английский
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
31
European Journal of Heart Failure, Год журнала: 2025, Номер unknown
Опубликована: Фев. 26, 2025
Язык: Английский
Процитировано
2
Journal of Cardiac Failure, Год журнала: 2025, Номер unknown
Опубликована: Фев. 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.
Язык: Английский
Процитировано
1
European Journal of Heart Failure, Год журнала: 2024, Номер 26(6), С. 1273 - 1277
Опубликована: Июнь 1, 2024
Язык: Английский
Процитировано
0
ESC Heart Failure, Год журнала: 2024, Номер unknown
Опубликована: Сен. 26, 2024
Abstract Aims Despite significant morbidity and mortality, recent advances in cardiogenic shock (CS) management have been associated with increased survival. However, little is known regarding the of patients who survive CS heart failure (HF) reduced left ventricular ejection fraction (LVEF, HFrEF), utilization guideline‐directed medical therapy (GDMT) these has not well described. To fill this gap, we investigated use GDMT during an admission for short‐term outcomes using Inova single‐centre registry. Methods We implementation survived HFrEF data from our registry January 2017 to December 2019. Baseline characteristics, discharge clinical status, on 30 day, 6 month 12 patient were collected by retrospective chart review. Results Among 520 hospitalized study period, 185 (35.6%) had upon survival discharge. The median age was 64 years [interquartile range (IQR) 56, 70], 72% ( n = 133) male, 22% 40) Black 7% 12) Hispanic. Forty‐one per cent 76) presented related acute myocardial infarction (AMI), while 59% 109) HF‐related (HF‐CS). length hospital stay days (IQR 7, 18). At discharge, proportions beta‐blockers, angiotensin‐converting enzyme inhibitors (ACEis)/angiotensin receptor blockers (ARBs)/angiotensin receptor/neprilysin (ARNIs) mineralocorticoid antagonists (MRAs) 78% 144), 58% 107) 55% 101), respectively. Utilization three‐drug 33.0% 61). Ten survivors 19) prescribed any component at Multivariable logistic regression adjusted baseline revealed that lower LVEF those transferred centre outside more likely experience addition P < 0.05). Patients least one additional class higher odds 1 year 0.01): On average, 7.1 times greater [confidence interval (CI) 1.9, 28.5] 6.0 than did added (CI 20.5). Conclusions Most all classes or goal doses These findings highlight urgent need augment multidisciplinary efforts enhance post‐discharge HFrEF.
Язык: Английский
Процитировано
0
Sustainable development goals series, Год журнала: 2024, Номер unknown, С. 127 - 144
Опубликована: Янв. 1, 2024
Язык: Английский
Процитировано
0