Heart Failure- Pubmed Results

Background Cardiac sarcoidosis (CS) may present with conduction abnormalities, ventricular arrhythmias, and heart failure. The delay in recognizing cardiac involvement in systemic sarcoidosis leads to disease progression, resulting in major morbidity and mortality. We studied the clinical, electrocardiographic, and imaging features of cardiac sarcoidosis and its mortality predictors. Methods The clinical data of patients with CS who presented to the Sree Chitra Tirunal Institute for Medical...

CONCLUSIONS: This study identified proteomic biomarkers for HF, highlighted potential pathways that inform biological mechanisms, and demonstrated that proteomic data enhanced HF risk prediction in individuals with T2D.

Obesity is a major and potentially modifiable risk factor for heart failure (HF); however, the biological mediators linking excess adiposity to adverse cardiac remodeling and HF progression remain incompletely defined. Among adipose-derived factors, leptin has emerged as a candidate mediator because of its associations with neurohormonal activation, vascular dysfunction, inflammation, oxidative stress, and myocardial remodeling. This review synthesizes contemporary evidence regarding the role of...

Heart failure is a chronic disease that leads to disabling symptoms and recurrent hospitalizations, mainly for acute heart failure episodes, having a major impact on patients' quality of life. An effective treatment is available but not always accessible, for miscellaneous reasons including difficulties in understanding the prescription and in reaching guideline-directed medical therapies to the optimal tolerated dose.Patient education is a key component of heart failure management, enabling...

CONCLUSIONS: Smartphone ownership accounted for just over 50% of the patients in this population. It was less common among older adults, patients with comorbidities, and those with markers of lower socioeconomic status. This needs to be considered when delivering mHealth interventions.

CONCLUSIONS: Psychological well-being is associated with determinants of SR acceptability in patients with HF, while psychological distress and personality traits are not associated with these determinants. These patient-level factors ought to be examined more closely before SR implementation.

CONCLUSION: This audit provides the first concrete evidence of widespread potential inequity in access to AHF therapies across the UK and Ireland. These findings have important implications for national healthcare planning, including workforce development and allocation of public health resources. Further work is required to investigate barriers to referral, enhance clinician awareness and optimise care pathways for patients in need of both life-prolonging and supportive therapies.

Symptomatic heart failure (HF) with reduced ejection fraction is traditionally drawn as 2 stages. Most stage C patients report manageable symptoms on guideline-directed medical therapy (GDMT), whereas stage D therapies are transplant or durable circulatory support, if eligible, and otherwise palliation with inotropic infusions or hospice considered for most. However, advanced HF includes not only end-stage D patients but also a large ambulatory population progressing beyond sustained response to...

CONCLUSION: The HALP and PNI scores, which reflect nutritional status, were associated with mortality and may provide supportive prognostic information in ICU patients with decompensated HF; however, they were not independent predictors in multivariate analysis.

ObjectiveSodium-glucose cotransporter 2 inhibitors are widely used in the management of diabetes mellitus and have demonstrated substantial cardiovascular and renal protective effects, particularly in patients with heart failure. However, their impact on cardiovascular outcomes in patients with chronic obstructive pulmonary disease remains insufficiently characterized.MethodsWe conducted a systematic review and meta-analysis of randomized controlled trials to evaluate the efficacy and safety of...

A growing number of studies have shown that plasma lipids and immune cells are related to the occurrence and development of heart failure (HF), but the causal relationship between them is unclear. Therefore, it is critical to obtain a thorough understanding of the impact of plasma lipids and immune cells on the risk of developing HF. In addition, it is important to further explore whether immune cells play a mediating role in this relationship. First, a two-way, two-sample Mendelian...

Apixaban plays a crucial role in preventing cardioembolic events in patients with nonvalvular atrial fibrillation (NVAF). However, in clinical practice, physicians often adjust apixaban dosing based on kidney function, deviating from guideline-recommended dosing. This study investigated the effects of real-world, off-label apixaban dosing on long-term outcomes in patients with heart failure (HF), NVAF, and end-stage kidney disease (ESKD). We analyzed data from a HF registry of patients with NVAF...

CONCLUSION: Glycemic variability in hospitalized patients with T2DM and HF is influenced by multiple clinical and metabolic factors. C-peptide level, age, diabetes duration, HF severity (reflected by NT-proBNP), and overall glycemic control are primary factors associated with GV. These findings suggest that clinical management should adopt individualized strategies that account for the heterogeneity and distinct characteristics of different GV indices.

CONCLUSIONS: In an asymptomatic CVD-free community sample, subclinical CVD was increasingly associated with higher 10-year HF and ASCVD risks calculated by the Predicting Risk of CVD Events equations.

CONCLUSIONS: Adding oral traditional Chinese medicine containing Astragalus to WM treatment can further improve the clinical efficacy of heart failure. However, due to the limited number and quality of the included studies in this research, the above conclusions still require further validation through well-designed randomized double-blind controlled trials.

CONCLUSIONS: SGLT2 inhibitors significantly reduce the mortality and heart failure hospitalizations while improving the biomarker and cardiac function parameters, independent of diabetes status or heart failure phenotype. The consistency and magnitude of benefit confirm a class effect and support SGLT2 inhibitors as foundational therapy for heart failure across all ejection fraction categories.

CONCLUSIONS: Late-systolic RV pressure dynamics captured by RVEEP are strongly associated with mortality in PH-HFpEF, outperforming traditional hemodynamic indices for risk discrimination.

Cardiovascular‑kidney‑metabolic (CKM) syndrome is an emerging clinical construct that emphasizes the intertwined pathophysiology of cardiovascular disease, chronic kidney disease, and metabolic disorders. Accumulating evidence reveals profound sex‑based differences in the incidence, progression, and outcomes across the spectrum of CKM syndrome. These disparities are rooted in complex interactions between sex hormones and pathophysiological processes such as inflammation, endothelial dysfunction,...

Sodium-glucose cotransporter 2 inhibitors (SGLT2i) have demonstrated clinical benefits in heart failure with preserved ejection fraction (HFpEF), yet the underlying mechanisms remain poorly defined. Given that mitochondrial dysfunction represents a central feature of HFpEF pathophysiology, we investigate whether modulation of mitochondrial homeostasis contributes to the cardioprotective effects of dapagliflozin. Using a Dahl salt-sensitive rat model of HFpEF, we find that dapagliflozin markedly...

Heart failure (HF) is a heterogeneous clinical syndrome characterized by phenotype-specific metabolic remodeling (e.g., ischemic vs. nonischemic, HF with HFrEF vs. HFpEF), with impaired metabolic flexibility serving as a central pathophysiological link. The physiological basis of normal cardiac metabolic flexibility is outlined, and the temporal trajectories and molecular mechanisms of metabolic remodeling across compensated, early decompensated, and end-stage HF are delineated. Key mechanisms,...

An estimated 3.7 million adults in the United States have hyperkalemia. It commonly occurs in patients with chronic kidney disease (CKD) and/or heart failure (HF) and as a result of treatment with renin-angiotensin-aldosterone system inhibitors (RAASi), a class of medications recommended by professional guidelines for patients with CKD and those with HF. While lifestyle alterations have been previously recommended to control potassium levels for some patients with hyperkalemia, emerging evidence...

The current guidelines of the European Society of Cardiology recommend the use of cardiac glycosides/digitalis in patients with heart failure and sinus rhythm only if the LVEF is ≤40% and if heart failure symptoms persist despite therapy with Betablockers, ACE inhibitors (or angiotensin receptor-neprilysin inhibitors), and mineralocorticoid receptor antagonists, in order to reduce the risk of further hospitalizations. Therapy with cardiac glycosides is not recommended in heart failure with an...

Hyperkalemia is associated with poor prognosis in heart failure (HF), but its reporting in administrative data is likely suboptimal. The aim was to evaluate the frequency and impact of hyperkalemia ICD coding during HF hospitalizations in Brazil. We analyzed 3,551,738 HF hospitalizations from the DATASUS database (2008-2024). ICD codes were used to identify hyperkalemia. Logistic and Cox regression analyses assessed associations between comorbidities, outcomes, and resource utilization. Only 491...

CONCLUSIONS: TyG index is a simple, accessible marker for early myocardial dysfunction and future HF risk, particularly when combined with SLVD or early-stage HF.

Pulmonary embolism (PE) remains a leading cause of cardiovascular mortality, particularly in its high-risk and intermediate-high risk presentations where acute right ventricular (RV) failure is the primary driver of hemodynamic collapse. This review comprehensively examines the pathophysiology of RV failure in PE, their indications based on current evidence and guidelines, practical considerations for implementation, management strategies, complications, and integration with other therapeutic...

Mitochondrial dysfunction has long been recognized as a central driver of heart failure (HF) pathogenesis, and emerging evidence highlights that impaired mitochondrial communication, rather than merely energy metabolism dysfunction, plays a pivotal role in the initiation and progression of HF. These communication networks are critical for maintaining cardiac metabolic homeostasis, and their disruption in HF leads to dysregulated energy metabolism, oxidative stress, lipotoxicity, and impaired...

CONCLUSIONS: Pre-transplant VAD support was associated with non-inferior survival despite greater baseline severity among patients who survived to transplantation, enabling access to transplantation, but at the cost of higher VAD-related complications, particularly stroke, with no differences in hospital LOS or rejection.

Heart failure (HF) cardiogenic shock (CS) remains a highly morbid condition with scarce data for utilization of temporary mechanical circulatory support. Consensus statements from major societies aid in improving recognition of patients at risk for the disease and standardizing approach to patient management. Given differences in pathophysiology of HF-CS compared with acute myocardial infarction-CS, dedicated research into the field is needed.

Glucagon-like Peptide 1 (GLP-1)-based medications have been extensively studied for the management of type 2 diabetes, obesity, chronic kidney disease, and atherosclerotic cardiovascular disease. More recently, their potential role in preventing and treating heart failure has gained increasing attention. Given the strong pathophysiological links among diabetes, obesity, and heart failure, GLP-1-based medications represent a promising therapeutic option to improve morbidity and mortality across...

Background and Objectives: There is limited evidence supporting the incorporation of dietary patterns into heart failure (HF) management. The Dietary Approaches to Stop Hypertension (DASH) diet is linked to cardiovascular disease prevention, but evidence correlating DASH adherence to HF risk is sparse. This study is the first prospective investigation into the relationship between the DASH diet, incident HF and its associated risk factors-hypertension and diabetes mellitus (DM)-in Australian...

Background and Objectives: Breast cancer surgery is increasingly performed in older patients with multimorbidity, in whom cardiovascular disease and frailty may substantially modify perioperative risk, including vulnerability to heart failure decompensation and other major medical complications. However, most available studies report global perioperative complication rates and composite medical endpoints, with heart failure events only rarely captured as dedicated outcomes, and operative...

This review highlights current approaches in managing hypertensive acute heart failure (H-AHF) relevant to nurse practitioners. It emphasizes the shift from volume overload to vascular redistribution as the primary cause of congestion, prioritizing vasodilators over diuretics unless overt fluid overload exists. Sequential nephron blockade and high-dose IV nitroglycerin demonstrate promise in overcoming diuretic resistance and rapidly reducing cardiac pressures. Noninvasive ventilation supports...

Background and Objectives: SGLT2 inhibitors increase hemoglobin and hematocrit in multiple clinical settings, an effect increasingly attributed to stimulation of erythropoiesis rather than hemoconcentration. However, most mechanistic evidence derives from diabetic populations, leaving uncertainty as to whether this response depends on diabetes-related metabolic changes. To evaluate whether dapagliflozin stimulates erythropoiesis in non-diabetic patients with heart failure and to determine...

Heart failure with reduced ejection fraction (HFrEF) is increasingly recognized as a systemic metabolic disorder. The aim of this study was to characterize amino acid-related metabolic differences between heart failure with moderately reduced ejection fraction (HFmrEF) (LVEF 40-49%) and HFrEF (LVEF < 40%) and to derive a biologically interpretable composite metabolomic index capable of discriminating between these two stages of systolic dysfunction. We conducted a cross-sectional metabolomic...

Heart failure is a leading cause of global morbidity and mortality, often developing as a consequence of acute myocardial infarction. Current management focuses on timely reperfusion via percutaneous coronary intervention. Yet, this approach fails to prevent the molecular cascades that drive the death of viable yet stressed cardiomyocytes within the infarct and peri-infarct zone. Effective antifibrotic therapies remain limited, highlighting a critical gap in current management strategies. This...

CONCLUSION: The FFM-adjusted cutoff can complement the traditional TBW-adjusted cutoff by correcting the confounding bias of excessive adiposity or low muscle mass, providing incremental prognostic value for risk stratification in Asian patients with HF.

Left ventricular assist device (LVAD) implantation is a life-saving therapy for end-stage heart failure but may compromise immune integrity. Mechanical shear stress and surface-induced innate immune activation can trigger bleeding and thromboembolic complications. While thrombotic mechanisms are well characterized, the associated inflammatory response remains poorly studied. We investigated thromboinflammation in patients with terminal heart failure (n = 8) implanted with the HeartWare...

CONCLUSIONS: Depression and suicidality represent significant and complex challenges in patients undergoing advanced cardiac therapies, particularly LVAD support. Systematic mental health screening and integrated, multidisciplinary care models are essential to improve patient outcomes. Future research should focus on longitudinal assessment, standardized suicide risk monitoring, and the development of targeted, evidence-based interventions for this vulnerable population.

Calcium channel blockers (CCBs) are frequently used in the emergency department and intensive care unit for a wide range of critical conditions, including atrial fibrillation, hypertensive emergencies, acute pulmonary edema with sympathetic crashing, pulmonary hypertension, and vasospastic syndromes. However, their toxicity can lead to significant hemodynamic compromise, underscoring the importance of understanding their pharmacologic effects and safety profile. This review summarizes the...

Background: Heart failure (HF) has traditionally been interpreted through hemodynamic, neurohormonal, and cardiorenal frameworks. Although these models explain many aspects of clinical decompensation, they do not fully account for persistent tissue congestion, unresolved myocardial edema, chronic sterile inflammation, and progressive fibrosis despite optimized therapy. Objectives: To review the anatomy, physiology, and pathobiological relevance of the cardiac lymphatic system in HF and to...

CONCLUSIONS: In primary PCI-treated STEMI survivors, MetS independently predicts ten-year MACE and heart failure but not mortality. The number of MetS criteria at baseline, rather than the binary classification, was more strongly associated with heart failure risk; whether prospective modification of individual components reduces this risk requires dedicated interventional studies. The lean MetS-positive phenotype may represent a candidate subgroup warranting further investigation.

Heart failure is a growing public health burden with high morbidity and mortality, often requiring mechanical circulatory support such as femoral intra-aortic balloon pump (f-IABP) for patients in cardiogenic shock awaiting heart transplantation. Traditionally, bedrest is a standard practice for f-IABP patients due to concerns over catheter displacement, leading to muscle deconditioning and functional decline. This quality improvement project implemented and evaluated a nurse-led, modified...

Heart failure (HF) is one of the largest contributors to disease burden and healthcare expenditure worldwide. Countless studies have shown that microRNAs (miRNAs) are pivotal regulators of heart homeostasis and promising biomarkers for the diagnosis and management of HF. Among the reported miRNAs, miR-106b-5p and miR-185-5p have been implicated in various cardiovascular diseases through involvement in cardiac injury, fibrosis, and cell survival pathways. Although cellular functions of...

Type-1 ryanodine receptor (RyR1) is essential for skeletal muscle contraction. This Ca^(2+) release channel is expressed in cardiac myocytes; however, its function remains elusive. Cardiac-specific RyR1 overexpression (OE) mice were generated under the cardiac-specific Myh6 promoter. Cardiac hypertrophy (CH), cardiac functions, and mechanistic changes in RyR1 OE and control (wildtype, WT) mice were assessed using hematoxylin and eosin staining, echocardiography, electrocardiogram, quantitative...

CONCLUSIONS: In this interim analysis, cardiac remuscularization with BioVAT was associated with an increase in the target heart-wall thickness, left ventricular ejection fraction, and KCCQ-OSS at 3 months; all the patients had at least one adverse event. Longer-term follow-up and further clinical investigation are warranted. (Funded by the German Center for Cardiovascular Research and Repairon; BioVAT-HF ClinicalTrials.gov number, NCT04396899.).

Advanced heart failure (AHF) poses a significant challenge in modern cardiology, often necessitating surgical interventions to alleviate symptoms and improve patient outcomes. This article provides an overview of surgical interventions available for treating AHF, with a primary focus on established procedures such as heart transplantation, ventricular assist device implantation, and emerging techniques including minimally invasive approaches and novel device therapies. The efficacy, indications,...

CONCLUSION: VHD severity was associated with maternal heart failure hospitalization, but functional status and prior decompensation were equally important. These findings highlight the importance of pre-pregnancy evaluation and structured perinatal care. Multidisciplinary management may reduce complications, even in high-risk patients.

Cardiac imaging is pivotal in evaluating ventricular function, residual lesions, and long-term complications in patients with adult congenital heart disease (ACHD). Longitudinal imaging in ACHD is key for the timely identification of patients requiring evaluation for advanced therapies. The guidelines recommend routine imaging surveillance. In all patients undergoing evaluation with cardiac imaging, it is critical that studies are performed at centers with expertise and that the imaging...

Atrial fibrillation (AF) and heart failure (HF) synergistically interact to exacerbate each other. However, treatment of one entity can greatly improve management of the other. Although historically, permissive medical therapy was the mainstay of AF management in the HF population, recent data strongly favor early, often invasive, intervention for AF to reduce hard HF outcomes. It seems that intervening earlier in the time course of AF, though still not excluding persistent AF from treatment,...

Durable left ventricular assist devices (LVADs) are a virtually limitless advanced therapy option for an increasingly growing population of patients with end-stage advanced heart failure. As of 2019, 30% to 40% of all patients diagnosed with heart failure were categorized as New York Heart Association class III or IV. In 2018 more than 3.2 million office visits and 1.4 million emergency department visits carried a primary diagnosis of heart failure. Given the rapid growth of the LVAD population,...