Economic Considerations of Cardiovascular Implantable Electronic Devices for The Treatment of Heart Failure
AbstractPurpose of ReviewHeart failure (HF) is a major public health problem worldwide, affecting more than 64 million people [1]. The complex and severe nature of HF presents challenges in providing cost-effective care as patients often require multiple hospitalizations and treatments. This review of relevant studies with focus on the last 10 years summarizes the health and economic implications of various HF treatment options in Europe and beyond. Although the main cost drivers in HF treatment are clinical (re)admission and decompensation of HF, an assessment of the economic impacts of various other device therapy opti...
Source: Current Heart Failure Reports - April 25, 2024 Category: Cardiology Source Type: research
(Non)-Exertional Variables of Cardiopulmonary Exercise Testing in Heart Failure with and Without Cardiac Amyloidosis
AbstractPurpose of ReviewCardiac amyloidosis (CA) constitutes an important etiology of heart failure with preserved ejection fraction (HFpEF) or heart failure with mildly reduced ejection fraction (HFmrEF). Since patients with CA show early exhaustion, we aimed to investigate whether non-exertional variables of cardiopulmonary exercise testing (CPET) provide additional information in comparison to traditional peak oxygen consumption (VO2peak).Recent FindingsWe retrospectively investigated CPET variables of patients with HFpEF and HFmrEF with (n = 21) and without (n = 21, HF) CA at comparable age and ejection fracti...
Source: Current Heart Failure Reports - April 18, 2024 Category: Cardiology Source Type: research
Putting More Weight on Obesity Trials in Heart Failure
AbstractPurpose of ReviewTo review ongoing and planned clinical trials of weight loss among individuals with or at high risk of heart failure.Recent FindingsIntentional weight loss via semaglutide among persons with heart failure and preserved ejection fraction and obesity significantly improves weight loss and health status as assessed by the KCCQ-CSS score and is associated with improvements in 6-min walk test.SummaryOngoing and planned trials will explore the role of intentional weight loss with treatments such as semaglutide or tirzepatide for individuals with heart failure across the entire ejection fraction spectrum....
Source: Current Heart Failure Reports - April 15, 2024 Category: Cardiology Source Type: research
Combinational Diuretics in Heart Failure
AbstractPurpose of ReviewDiuretics are the cornerstone therapy for acute heart failure (HF) and congestion. Patients chronically exposed to loop diuretics may develop diuretic resistance as a consequence of nephron remodelling, and the combination of diuretics will be necessary to improve diuretic response and achieve decongestion. This review integrates data from recent research and offers a practical approach to current pharmacologic therapies to manage congestion in HF with a focus on combinational therapy.Recent FindingsUntil recently, combined diuretic treatment was based on observational studies and expert opinion. R...
Source: Current Heart Failure Reports - April 9, 2024 Category: Cardiology Source Type: research
Chronic Obstructive Pulmonary Disease in Heart Failure: Challenges in Diagnosis and Treatment for HFpEF and HFrEF
AbstractPurpose of ReviewChronic obstructive pulmonary disease (COPD) is common in heart failure (HF), and it has a significant impact on the prognosis and quality of life of patients. Additionally, COPD is independently associated with lower adherence to first-line HF therapies. In this review, we outline the challenges of identifying and managing HF with preserved (HFpEF) and reduced (HFrEF) ejection fraction with coexisting COPD.Recent FindingsSpirometry is necessary for COPD diagnosis and prognosis but is underused in HF. Therefore, misdiagnosis is a concern. Also, disease-modifying drugs for HF and COPD are usually sa...
Source: Current Heart Failure Reports - March 28, 2024 Category: Cardiology Source Type: research
Catheter Ablation of Ventricular Tachycardia in Ischemic Heart Disease: What Is Known and New Perspectives
AbstractPurpose of the ReviewThis review aims to evaluate current evidence regarding ventricular tachycardia ablation in patients with ischemic heart disease and explore novel approaches currently developing to improve procedural and long-term outcomes.Recent FindingsRecently published trials (PARTITA, PAUSE-SCD, and SURVIVE-VT) have demonstrated the prognostic benefit of prophylactic ventricular tachycardia ablation compared to current clinical practice. Advanced cardiac imaging provides a valuable pre-procedural evaluation of the arrhythmogenic substrate, identifying ablation targets non-invasively. Advanced cardiac mapp...
Source: Current Heart Failure Reports - March 27, 2024 Category: Cardiology Source Type: research
Is There a Mitochondrial Protection via Remote Ischemic Conditioning in Settings of Anticancer Therapy Cardiotoxicity?
AbstractPurpose of ReviewTo provide an overview of (a) protective effects on mitochondria induced by remote ischemic conditioning (RIC) and (b) mitochondrial damage caused by anticancer therapy. We then discuss the available results of studies on mitochondrial protection via RIC in anticancer therapy-induced cardiotoxicity.Recent FindingsIn three experimental studies in healthy mice and pigs, there was a RIC-mediated protection against anthracycline-induced cardiotoxicity and there was some evidence of improved mitochondrial function with RIC. The RIC-mediated protection was not confirmed in the two available studies in ca...
Source: Current Heart Failure Reports - March 21, 2024 Category: Cardiology Source Type: research
Pregnancy, Reproductive Factors, and Female Heart Failure Risk and Outcomes
AbstractPurpose of ReviewThe purpose of this review is to provide an overview of recent evidence on female-specific risk factors related to reproductive status or pregnancy.Recent FindingsPregnancy-related factors, including hypertensive disorders and gestational diabetes, increase the risk of heart failure in women, while breastfeeding and hormone therapy may offer protection.SummaryHypertensive disorders of pregnancy, gestational diabetes, polycystic ovarian syndrome, placental abruption, younger maternal age at first live birth, younger maternal age at last live birth, number of stillbirths, number of pregnancies, onset...
Source: Current Heart Failure Reports - March 20, 2024 Category: Cardiology Source Type: research
Hypertrophic Cardiomyopathy
AbstractPurpose of ReviewHypertrophic cardiomyopathy (HCM) is a common inherited cardiac condition with potential for severe complications including sudden cardiac death. Early diagnosis allows appropriate risk stratification and prompt intervention to minimise the potential for adverse outcomes. The implications of poorly coordinated screening are significant, either missing relatives at high-risk or burdening low-risk individuals with a diagnosis associated with reduced life expectancy. We aim to guide clinicians through the diagnostic pathway through to novel treatment options. Several conditions mimic the condition, an...
Source: Current Heart Failure Reports - March 15, 2024 Category: Cardiology Source Type: research
Non-Coding Ribonucleic Acids as Diagnostic and Therapeutic Targets in Cardiac Fibrosis
AbstractPurpose of ReviewCardiac fibrosis is a crucial juncture following cardiac injury and a precursor for many clinical heart disease manifestations. Epigenetic modulators, particularly non-coding RNAs (ncRNAs), are gaining prominence as diagnostic and therapeutic tools.Recent FindingsmiRNAs are short linear RNA molecules involved in post-transcriptional regulation; lncRNAs and circRNAs are RNA sequences greater than 200 nucleotides that also play roles in regulating gene expression through a variety of mechanisms including miRNA sponging, direct interaction with mRNA, providing protein scaffolding, and encoding their o...
Source: Current Heart Failure Reports - March 15, 2024 Category: Cardiology Source Type: research
Cellular Alterations in Immune Checkpoint Inhibitor Therapy-Related Cardiac Dysfunction
AbstractPurpose of ReviewImmune checkpoint inhibitor (ICI) therapy has emerged as a pivotal advancement in cancer treatment, but the widespread adoption has given rise to a growing number of reports detailing significant cardiovascular toxicity. This review concentrates on elucidating the mechanisms behind ICI-related cardiovascular complications, emphasizing preclinical and mechanistic data.Recent FindingsAccumulating evidence indicates a more significant role of immune checkpoints in maintaining cardiac integrity than previously understood, and new key scientific data are available to improve our understanding of ICI-rel...
Source: Current Heart Failure Reports - March 2, 2024 Category: Cardiology Source Type: research
Evaluation and Management of Hyponatremia in Heart Failure
AbstractPurpose of ReviewTo provide a contemporary overview of the pathophysiology, evaluation, and treatment of hyponatremia in heart failure (HF).Recent FindingsPotassium and magnesium losses due to poor nutritional intake and treatment with diuretics cause an intracellular sodium shift in HF that may contribute to hyponatremia. Impaired renal blood flow leading to a lower glomerular filtration rate and increased proximal tubular reabsorption lead to an impaired tubular flux through diluting distal segments of the nephron, compromising electrolyte-free water excretion.SummaryHyponatremia in HF is typically a condition of...
Source: Current Heart Failure Reports - February 27, 2024 Category: Cardiology Source Type: research
Digital Solutions to Optimize Guideline-Directed Medical Therapy Prescriptions in Heart Failure Patients: Current Applications and Future Directions
We report on the efficacy, characteristics of the study, and population of published digital solutions for GDMT optimization. The following digital solutions are discussed: teleconsultation, telemonitoring, cardiac implantable electronic devices, clinical decision support embedded within electronic health records, and multifaceted interventions. Effect of digital solutions is reported in dedicated studies, retrospective studies, or larger studies with another focus that also commented on GDMT use. Overall, we see more studies on digital solutions that report a significant increase in GDMT use. However, there is a large het...
Source: Current Heart Failure Reports - February 16, 2024 Category: Cardiology Source Type: research
