Heart Failure Connect
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Heart failure with preserved ejection fraction: diagnosis, risk assessment, and treatment - PubMed

Heart failure with preserved ejection fraction: diagnosis, risk assessment, and treatment - PubMed

Source : https://pubmed.ncbi.nlm.nih.gov/38602566/

The aetiology of heart failure with preserved ejection fraction (HFpEF) is heterogenous and overlaps with that of several comorbidities like atrial fibrillation, diabetes mellitus, chronic kidney disease, valvular heart disease,...

HFpEF involves heterogenous etiologies and comorbidities. Diagnosis relies on imaging, natriuretic peptides, and guideline-recommended algorithms. Sodium-glucose cotransporter-2 inhibitors show strong evidence, while beta-blockers are discouraged unless comorbidities warrant use.

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Diuretic Treatment in Patients with Heart Failure: Current Evidence and Future Directions - Part I: Loop Diuretics - PubMed

Diuretic Treatment in Patients with Heart Failure: Current Evidence and Future Directions - Part I: Loop Diuretics - PubMed

Source : https://pubmed.ncbi.nlm.nih.gov/38240883/

We will assess recent trials including DOSE, TRANSFORM, ADVOR, CLOROTIC, OSPREY-AHF, and PUSH-AHF amongst others, and assess how these may influence current practice and future research. There are few data...

Fluid retention in heart failure remains challenging; recent trials highlight high-dose loop diuretics' benefits over low-dose, yet guidelines lag. Improved research is crucial for advancing diuretic strategies and outcomes.

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Did you know? Radiation-induced vasculopathy can occur after cancer treatment, where radiation accelerates the development of age-related conditions like atherosclerosis. This condition can lead to the thickening and narrowing of blood vessels, increasing the risk of cardiovascular issues long after the cancer treatment is complete.

How can health care providers monitor and manage the long-term cardiovascular risks associated with radiation therapy in cancer survivors?

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How can health care providers monitor and manage the long-term cardiovascular risks associated with radiation therapy in cancer survivors?

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Vitamin C deficiency can lead to pulmonary hypertension: a systematic review of case reports - PubMed

Vitamin C deficiency can lead to pulmonary hypertension: a systematic review of case reports - PubMed

Source : https://pubmed.ncbi.nlm.nih.gov/38504249/

The cases analyzed in our study indicate that pulmonary hypertension can be one explanation for the reported heart failure of scurvy patients in the early literature. It would seem sensible...

This study suggests that vitamin C deficiency may contribute to pulmonary hypertension (PH) and right ventricular enlargement, with improvement in mean pulmonary artery pressure (mPAP) following vitamin C supplementation.

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Acute Heart Failure in the Course of Macrophage Activation Syndrome Due to Newly Diagnosed Systemic Lupus Erythematosus: Case Presentation and Literature Review - PubMed

Acute Heart Failure in the Course of Macrophage Activation Syndrome Due to Newly Diagnosed Systemic Lupus Erythematosus: Case Presentation and Literature Review - PubMed

Source : https://pubmed.ncbi.nlm.nih.gov/38541118/

Macrophage activation syndrome is an uncommon yet dangerous and potentially fatal complication of many rheumatic diseases, inducing multiple organ failure, including, although rarely, acute heart failure. In the following paper,...

A 37-year-old woman developed acute heart failure from macrophage activation syndrome following lupus onset post-gynecological procedure. The paper reviews macrophage roles across organs, diagnostic criteria, and cardiac involvement.

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Acute Heart Failure Is a Malignant Process: But We Can Induce Remission - PubMed

Acute Heart Failure Is a Malignant Process: But We Can Induce Remission - PubMed

Source : https://pubmed.ncbi.nlm.nih.gov/37889197/

Acute heart failure is a common and increasingly prevalent condition, affecting >10 million people annually. For those patients who survive to discharge, early readmissions and death rates are >30% everywhere...

Acute heart failure affects millions globally, with high readmission and death rates. Rapid, full-dose treatment can induce remissions, highlighting the urgent need for collaborative efforts to improve implementation and outcomes.

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Multiprofessional heart failure self-development framework - PubMed

Multiprofessional heart failure self-development framework - PubMed

Source : https://pubmed.ncbi.nlm.nih.gov/38242561/

People with heart failure can be complex and have needs that require input from a broad range of specialties. This publication focuses on the vital impact of wider multidisciplinary groups...

This framework outlines essential heart failure competencies for diverse healthcare professionals, emphasizing multidisciplinary collaboration to address complex patient needs, supporting future professionals in delivering comprehensive heart failure care.

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Mitochondrial Structure and Function in Human Heart Failure - PubMed

Mitochondrial Structure and Function in Human Heart Failure - PubMed

Source : https://pubmed.ncbi.nlm.nih.gov/38963864/

Despite clinical and scientific advancements, heart failure is the major cause of morbidity and mortality worldwide. Both mitochondrial dysfunction and inflammation contribute to the development and progression of heart failure....

This review explores mitochondrial dysfunction and inflammation in heart failure, focusing on mitochondrial dynamics, ultrastructure changes, and therapeutic targets to improve cardiac function and energy metabolism.

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Impact of empagliflozin on insulin needs in patients with heart failure and diabetes: An EMPEROR-Pooled analysis - PubMed

Impact of empagliflozin on insulin needs in patients with heart failure and diabetes: An EMPEROR-Pooled analysis - PubMed

Source : https://pubmed.ncbi.nlm.nih.gov/38558314/

Empagliflozin exerts a consistent benefit on cardiovascular outcomes and renal function decline, irrespective of baseline insulin use, and reduces the need for sustained insulin initiation in patients with HF and...

Empagliflozin benefits cardiovascular outcomes and renal function in heart failure patients with diabetes, regardless of baseline insulin use, and reduces the need for sustained insulin initiation in non-insulin users.

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Novel Prediction Equations for Absolute Risk Assessment of Total Cardiovascular Disease Incorporating Cardiovascular-Kidney-Metabolic Health: A Scientific Statement From the American Heart Association - PubMed

Novel Prediction Equations for Absolute Risk Assessment of Total Cardiovascular Disease Incorporating Cardiovascular-Kidney-Metabolic Health: A Scientific Statement From the American Heart Association - PubMed

Source : https://pubmed.ncbi.nlm.nih.gov/37947094/

Cardiovascular-kidney-metabolic (CKM) syndrome is a novel construct recently defined by the American Heart Association in response to the high prevalence of metabolic and kidney disease. Epidemiological data demonstrate higher absolute...

The PREVENT equations assess 10- and 30-year cardiovascular disease risk, incorporating CKM syndrome predictors, kidney function, and social determinants of health to enhance primary prevention strategies for diverse populations.

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Summary and Comparison of the 2022 ACC/AHA/HFSA and 2021 ESC Heart Failure Guidelines - PubMed

Summary and Comparison of the 2022 ACC/AHA/HFSA and 2021 ESC Heart Failure Guidelines - PubMed

Source : https://pubmed.ncbi.nlm.nih.gov/37653361/

The guidelines released by the American College of Cardiology/American Heart Association/Heart Failure Society of America (ACC/AHA/HFSA) in 2022 and those released in 2021 by the European Society of Cardiology (ESC)...

The 2022 ACC/AHA/HFSA and 2021 ESC guidelines for heart failure align on key recommendations but differ due to timing; this review highlights differences to support evidence-based clinical decision-making.

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Distinct Comorbidity Clusters in Patients With Acute Heart Failure: Data From RELAX-AHF-2 - PubMed

Distinct Comorbidity Clusters in Patients With Acute Heart Failure: Data From RELAX-AHF-2 - PubMed

Source : https://pubmed.ncbi.nlm.nih.gov/38970586/

Comorbidities naturally clustered into 5 mutually exclusive groups in RELAX-AHF-2, showing variations in clinical outcomes. These data emphasize that the specific combination of comorbidities can influence adverse outcomes and treatment...

The study identified five multimorbidity groups in acute heart failure patients, highlighting distinct clinical outcomes and treatment responses, emphasizing the importance of comorbidity patterns in managing these patients.

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Cardiorenal interactions in heart failure: insights from recent therapeutic advances - PubMed

Cardiorenal interactions in heart failure: insights from recent therapeutic advances - PubMed

Source : https://pubmed.ncbi.nlm.nih.gov/37364186/

Heart failure is a syndrome that may develop when cardiovascular disease progresses or is insufficiently treated and associated with a poor quality of life, high mortality rates, and increased healthcare...

New therapies, including SGLT2 inhibitors, GLP-1 receptor agonists, and non-steroidal MRAs, enhance cardiovascular and renal outcomes in high-risk patients with diabetes and heart failure, significantly improving patient management.

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The Convoy-Pal intervention demonstrated feasibility and potential benefits for heart failure patients and their caregivers, highlighting the need for digital tools that effectively integrate both parties in palliative care.

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Efficacy of catheter ablation for atrial fibrillation in heart failure: a meta-analysis of randomized controlled trials

Efficacy of catheter ablation for atrial fibrillation in heart failure: a meta-analysis of randomized controlled trials

Source : https://pubmed.ncbi.nlm.nih.gov/38661235/

The study aims to evaluate whether rhythm control by catheter ablation is superior to medical therapy for the patients with atrial fibrillation (AF) and heart failure (HF). The literatures were...

Catheter ablation significantly improves survival, reduces heart failure re-hospitalization, enhances left ventricular function, and quality of life in atrial fibrillation patients with heart failure compared to medical therapy.

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Systematic review and meta-analysis of stroke and thromboembolism risk in atrial fibrillation with preserved vs. reduced ejection fraction heart failure - PubMed

Systematic review and meta-analysis of stroke and thromboembolism risk in atrial fibrillation with preserved vs. reduced ejection fraction heart failure - PubMed

Source : https://pubmed.ncbi.nlm.nih.gov/39289613/

The findings suggest that there is no significantly different risk of stroke and systemic thromboembolism in cases of AF with associated HFpEF or HFrEF. The finding does not support integration...

This study found no significant difference in stroke and thromboembolism risk between atrial fibrillation patients with preserved or reduced ejection fraction, suggesting ejection fraction shouldn't factor into stroke risk assessments.

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A comparison of heart failure patients with reduced ejection fraction in the Moravian Midlands Registry with the LCZ696 patients in the Paradigm-HF trial - PubMed

A comparison of heart failure patients with reduced ejection fraction in the Moravian Midlands Registry with the LCZ696 patients in the Paradigm-HF trial - PubMed

Source : https://pubmed.ncbi.nlm.nih.gov/36748670/

The differences between the groups for the majority of clinical parameters compared were minimal, except for younger age, higher body mass index and serum creatinine level and lower left ventricular...

A study compared heart failure patients in the Moravian Midlands Registry with Paradigm-HF trial participants, revealing younger age, higher BMI, lower ejection fraction, and more device therapies in the MMR cohort.

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A patient with dyspnea on exertion, orthopnea, and cough

A 68-year-old woman, Mrs. M presents with a history of hypertension and paroxysmal atrial fibrillation. She complains of fatigue, dry cough, and shortness of breath while walking her dog or lying down flat. She is not experiencing chest pain or lightheadedness. She drinks alcohol rarely, has never smoked tobacco, and does not engage in recreational drug use.

She is taking the following medications:

  • Diuretic
  • Beta-blocker
  • Angiotensin-converting enzyme inhibitor
  • Anticoagulant

Her physical exam reveals:

  • Body mass index 29 kg/m2
  • Blood pressure 128/74 mm Hg
  • Heart rate 88 beats/minute; regular rhythm; no murmur
  • Bilateral rales
  • Bilateral pedal edema

Her N-terminal pro B-type natriuretic peptide score is 990 pg/mL. All other laboratory tests are within normal limits. Electrocardiography shows normal sinus rhythm. On echocardiography, she has a left ventricular (LV) ejection fraction of 55%, LV wall thickness of 14 mm, and an average E/e’ ratio of 16.

Based on these results, you decide to initiate guideline-directed medical therapy for heart failure with preserved ejection fraction (HFpEF) and assess Mrs. M for symptomatic improvement.

Based on HFpEF guidelines, which class(es) of medication would help reduce Mrs. M’s risk of hospitalization for heart failure and cardiovascular death, and why?

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  • 1yr
    She is in mild CHF so initial approach is to decongest. For the long term, treatment of her HFpEF with SGLT2i, MRA, and ARNI will help decrease risk of hospitalization Show More
  • 2yr
    For this patient with HFPEF would add SGLT2I - Jardiance or Farxiga. As well her diuretic therapy should include MRA like spironolactone.

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Role of dietary sodium restriction in chronic heart failure: systematic review and meta-analysis - PubMed

Role of dietary sodium restriction in chronic heart failure: systematic review and meta-analysis - PubMed

Source : https://pubmed.ncbi.nlm.nih.gov/37389661/

In a meta-analysis, sodium restriction in CHF patients worsened the prognosis in terms of a composite of mortality and hospitalizations and did not influence all-cause mortality and HF hospitalisation rate.

Dietary sodium restriction in chronic heart failure patients may worsen prognosis, increasing composite mortality and hospitalization risk without significantly affecting overall mortality or heart failure admissions.

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