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Adipokine profile in acute heart failure: associations with natriuretic response and prognosis.

INTRODUCTION: Adipose tissue signalling is linked to heart failure (HF), but its role in acute HF (AHF), especially concerning early diuretic response, is unclear. Early natriuretic response to loop diuretics is vital for effective decongestion.The objective was to characterize and evaluate the associations between circulating adipokine profiles, early natriuretic response, and clinical outcomes in AHF. METHODS: We conducted a prospective observational study including 262 consecutive AHF patients. Early diuretic response was assessed by measuring post-diuretic spot urine sodium (uNa+) 2 h aft…

The 'Chloride Theory' for Heart Failure Pathophysiology: An Updated Narrative Review 2025.

Most studies of heart failure (HF) syndromes have focused on fluid regulation, particularly the balance of sodium and water. Approximately 10 years ago, in 2017, the "chloride theory" was proposed as a unifying hypothesis, suggesting that changes in serum chloride concentration are associated with shifts in plasma volume, hemodynamics, and neurohormonal activity during HF progression and treatment. This narrative review updates the chloride theory based on emerging clinical evidence. It further examines diuretic classification from a chloride-centered perspective, recent advances in guideline-…

The Impact of Emergency Department Initiated Palliative Care for Heart Failure Patients.

BACKGROUND: The Emergency Department (ED) frequently cares for patients with heart failure (HF). There is a paucity of literature evaluating the effect of Palliative Care (PC) on ED utilization amongst patients with HF. OBJECTIVES: Evaluate the effects of early PC consults on subsequent ED utilization after discharge for patients with HF. METHODS: We evaluated Veterans admitted to Veterans Administration (VA) hospitals for HF exacerbation between 2010 and 2024. We compared early versus standard versus no PC. Early PC is defined as completion of consultation within 24 h of ED presentation. St…

SLC31A1 knockdown mitigates post-MI heart failure via regulation of copper metabolism.

INTRODUCTION: Cuproptosis due to copper overload is a contributor to the progression of cardiovascular diseases, especially heart failure (HF) after acute myocardial infarction (AMI). Solute carrier family 31 member 1 (SLC31A1) is a major Cu2+ transporter responsible for intracellular Cu2+ uptake. In this study, we investigated the role and detailed mechanism of SLC31A1 in post-AMI HF. METHODS: Mouse left anterior descending coronary artery was ligated to produce an in vivo post-AMI HF model. These mice were subjected to treatments with short hairpin RNA targeting SLC31A1, the copper chelator…

Hematopoietic expression of cIAP2 drives inflammation and heart failure after myocardial infarction.

Ischemic heart disease, driven largely by myocardial infarction (MI), remains the leading cause of mortality and morbidity. Although early suppression of post-MI inflammation improves outcomes, current therapies have limited efficacy. Here we show that the cellular inhibitor of apoptosis 2 (cIAP2), a regulator of cell death, is upregulated after MI and promotes acute inflammation and cardiac injury. Global deletion of cIAP2, or its loss through bone marrow transfer, reduced inflammatory injury and cardiac dysfunction after MI, indicating that the cardioprotective effect of cIAP2 deficiency is

MR-ProADM Predicts Mortality and Heart Failure Events in ATTR Cardiac Amyloidosis.

BACKGROUND: With the increasing diagnosis of transthyretin amyloid cardiomyopathy (ATTR-CM) at earlier stages and new therapies, there is a … months (IQR, 6.5-42.3), 67 patients (19.9%) died/underwent heart transplantation, and 81 (24%) had heart failure events. MR-proADM was the biomarker with the strongest prognostic performance, with a C-index of 0.788 (95% CI, 0.723-0.851) for all-cause mortality and 0.721 (95% CI, 0.669-0.772) for the composite endpoint of death and heart failure events. MR-pro …

Ocular microvascular alterations in patients with heart failure with preserved ejection fraction.

PURPOSE: To investigate ocular circulation characteristics and their association with cardiac function in patients with heart failure with preserved ejection fraction (HFpEF). STUDY DESIGN: Prospective observational study. METHODS: This prospective study included 15 patients with and 15 individuals without HFpEF. Best-corrected visual acuity (BCVA), central retinal thickness (CRT), central choroidal thickness (CCT), laser speckle flowgraphy (LSFG), and optical coherence tomography angiography (OCTA) were assessed. LSFG was performed to evaluate blood flow in the optic nerve head (ONH) and ma…

Тестирование на недостаточностью железа у лиц с случайной сердечной недостаточностью в системе первичной медико-санитарной помощи

Предыстория 50% У людей с сердечной недостаточность железа, в руководящих указаниях рекомендуется скрининг. Неясно, в какой степени это делается в области первичной медико-санитарной помощи и является ли тестирование справедливым. Цель сообщения о доле людей, страдающих от сердечной недостаточности, которые проходят тест на ферритин внутри 12 месяцев. Проектирование и установка ретроспективного когортного исследования первичной медико-санитарной помощи с использованием данных исследований клинической практики 2016 и 2021. Мы составляем данные о доле взрослых с диагнозом сердечной недостаточнос

Совпадение в аннотации оригинала
Background Given around 50% of people with heart failure have a degree of iron deficiency, guidelines recommend screening. It is uncertain to what extent this is done in primary care and whether testing is equitable. Aim To report the proportion of people with incident heart failure who undergo a ferritin test within 12 months. Design and setting Retrospecti…

Factors associated with short-term adverse events in hypertensive acute heart failure.

OBJECTIVE: To analyse the factors associated with adverse events in patients presenting with hypertensive acute heart failure (AHF), and to assess whether differences exist according to patient sex. METHODS: We included patients diagnosed with AHF Spanish emergency departments (EDs), with a decompensation episode and elevated systolic blood pressure (SBP) on arrival. We analysed the association between 22 independent variables and in-hospital mortality. One-year mortality and 30-day post-discharge composite adverse events (defined as ED revisit, hospitalisation, or death) were analysed. RESU…

Immunometabolic regulation of cardiac macrophages in heart failure with preserved ejection fraction.

Heart failure with preserved ejection fraction (HFpEF) is a complex syndrome driven by comorbidities, chronic low-grade inflammation, and cardiac remodeling. Cardiac resident macrophages (CRMs) and monocyte-derived macrophages (MDMs) play central roles in linking immunometabolism to HFpEF pathogenesis. Resident CCR2- macrophages maintain homeostasis and tissue repair, whereas monocyte-derived CCR2+ macrophages drive inflammation, fibrosis, and diastolic dysfunction. In HFpEF, comorbidity-induced metabolic shifts promote pro-inflammatory macrophage polarization, while metabolites like fatty aci…

Aberrant myocardial calcium cycling: pathogenic mechanisms and targeted therapeutics for heart failure.

Cardiovascular diseases rank as the global primary cause of mortality. Heart failure (HF) represents a progressive cardiac syndrome triggered by structural or functional myocardial damage that compromises ventricular systolic output. Intracellular calcium homeostasis underpins cardiomyocyte excitation-contraction coupling. Calcium overload and dysregulated calcium handling act as central pathogenic forces driving HF progression. Sympathetic β1-adrenergic receptor (β1-AR) and parasympathetic M2 muscarinic acetylcholine receptor (M2-AChR) coordinate dual regulatory signaling to control cardiac c…

Syntabulin promotes heart failure by enhancing SR-mitochondria tethering and impairing mitofission.

AIMS: Mitochondrial dysfunction is a critical driver of heart failure (HF). Syntabulin (SYBU), known for its role as a motor linker at the outer mitochondrial membrane in neuronal system, has recently been suggested as a HF-associated gene. However, the role of SYBU in regulating cardiac function remains unclear. METHODS AND RESULTS: Pressure overload-induced cardiac hypertrophy and HF was produced by transverse aortic constriction in mice and phenylephrine (PE) stimulation in neonatal rat ventricular myocytes. SYBU expression was significantly increased in hypertrophic mouse hearts and patie…

Macrophage-Dependent Intercellular Crosstalk in Multiphenotypic Heart Failure With Preserved Ejection Fraction.

Heart failure with preserved ejection fraction (HFpEF) is now recognized as a complex, multiphenotypic metabolic syndrome fueled by inflammation and metabolic dysregulation, rather than a single disease entity. Cardiac macrophages, as the most abundant immune cells in the heart, are emerging as central players in HFpEF pathogenesis by orchestrating intercellular crosstalk and driving maladaptive remodeling. This review delineates the intricate macrophage-dependent vicious cycle in HFpEF. We first elaborate on the heterogeneity of cardiac macrophages and the diverse clinical and preclinical phe…

Increased Risk of Heart Failure Among Stroke Survivors: A Nationwide Cohort Study.

Background/Objectives: Stroke-induced cardiac damage may lead to lifelong cardiac problems, such as heart failure (HF). We aimed to compare the incidence of HF between stroke survivors and the general non-stroke population. Methods: We performed a population-based study of individuals in the Korean National Health Insurance Service database. We included 220,231 stroke survivors between 2010 and 2018 and 1:1 age- and sex-matched non-stroke controls. The study outcome was HF and the cohort was followed up until 2019. Cox hazards models were used to estimate adjusted hazard ratios (aHRs) and 95% …

Chronic Right Heart Failure: Pathogenesis, Haemodynamic Foundations, and a Pragmatic Diagnostic Algorithm.

Chronic right heart failure (RHF) is a complex, progressive syndrome that remains underrecognized and inadequately defined in current clinical guidelines, where it is often relegated to a secondary complication of left-sided heart disease. Because the thin-walled right ventricle (RV) is well adapted to maintain pressures within the highly distensible venous system well below plasma oncotic pressure but poorly equipped to sustain pressure overload, when myocardial failure supervenes, conventional RV systolic indices frequently fail to capture the very essence of the syndrome. This review clarif…

TRIM40 Drives Pathological Cardiac Hypertrophy and Heart Failure via Ubiquitination of PKN2.

Pathological cardiac hypertrophy is a major predisposing factor for heart failure (HF). This study investigates the role of the E3 ubiquitin ligase Tripartite Motif-Containing 40 (TRIM40) in cardiac hypertrophy. Using TRIM40 knockout (TRIM40-/-), cardiac-specific knockdown and overexpressing mice, pathological hypertrophy was induced by angiotensin II (Ang II) infusion or transverse aortic constriction (TAC). Results showed that TRIM40 expression was upregulated in hypertrophic hearts. TRIM40 deficiency attenuated cardiac hypertrophy and dysfunction, whereas its overexpression exacerbated path…

Inhibition of RBM25 preserves cardiac mitochondrial homeostasis and attenuates ischemic heart failure.

Heart failure (HF) after myocardial infarction (MI) is a serious complication that endangers the health of the patient. Mitochondrial dysfunction is an important mechanism in the development of ischemic HF. RNA-binding motif protein 25 (RBM25) is an RNA-binding protein that regulates a variety of biological processes and has been associated with HF. However, its role and underlying mechanism in mitochondrial dysfunction in ischemic HF remain unclear. Left anterior descending artery was ligated to establish an MI model in male C57BL/6 N mice, and cardiac function was evaluated by echocardiograp…

Prognostic value of plasma cortisol concentration in dogs with congestive heart failure.

BACKGROUND: The association of plasma cortisol concentration with prognosis for dogs with congestive heart failure (CHF) is unknown. HYPOTHESIS/OBJECTIVES: To determine whether higher plasma cortisol concentration was independently associated with greater risk of cardiac mortality in dogs with CHF. Additional study aims were to evaluate the associations between other clinical, neurohormonal, and echocardiographic indices and cardiac mortality. ANIMALS: Thirty-one client-owned dogs with CHF secondary to myxomatous mitral valve disease (MMVD). METHODS: Prospective cohort observational study. …

Telemetry-based insights: clinical indicators linked to unfavorable outcomes in heart failure.

OBJECTIVE: Evaluate the clinical profile of heart failure patients under telemetry and identify associations with unfavorable outcomes. METHODS: Cross-sectional study from 2019 to 2024 at a public university hospital. Coronary Care Unit nurses collected data from electronic medical records, which were analyzed using SPSS®. The project was approved by the Ethics Committee (Nº. 2019-0046). RESULTS: Out of 425 medical records, 43% showed events, primarily non-sustained ventricular tachycardia (14.8%). After arrhythmic events, 29.6% underwent urgent electrocardiogram, 30.1% had pharmacological a…