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Left Main Coronary Artery Fistula Presenting as Heart Failure: A Case Report.

BACKGROUND Coronary artery fistulas are rare and typically congenital but can result from various acquired conditions. They involve abnormal connections between a coronary artery and a cardiac chamber or vessel, often creating a left-to-right shunt. Most coronary artery fistulas are asymptomatic and found incidentally, though larger fistulas can cause symptoms like ischemia or heart failure, requiring intervention. Management depends on the fistula size and clinical findings. Many small fistulas close spontaneously. CASE REPORT A 44-year-old woman with massive left atrial dilation and longstan…

Finerenone in heart failure with left ventricular ejection fraction ≥40%: a correspondence.

Finerenone, the first nonsteroidal mineralocorticoid receptor antagonist approved by the U.S. Food and Drug Administration for treating heart failure (HF) with mildly reduced ejection fraction and HF with preserved ejection fraction reduces morbidity and mortality by mitigating inflammation and fibrosis. The FINEARTS-HF (Finerenone in Heart Failure with Mildly Reduced or Preserved Ejection Fraction) trial demonstrated significant benefits, particularly after recent HF events, with ongoing studies evaluating broader applications across the cardio-kidney-metabolic spectrum.

Systolic blood pressure increase in chronic heart failure associates with survival advantage.

BACKGROUND: The impact of systolic blood pressure (SBP) variation on chronic heart failure (HF) is largely unknown. We assessed the impact of SBP variation in patients with chronic HF. METHODS: This is a retrospective analysis of adult ambulatory patients with HF with left ventricular systolic dysfunction (LVSD). SBP variation = SBP at the index visit - SBP at the 1-year visit. Patients dying in the first year or with missing data concerning SBP were excluded. Patients with SBP increase ≥10 mmHg during the first year were compared with the remaining. Determinants of SBP increase were assessed…

Natriuretic response prediction equation for use with oral diuretics in heart failure.

BACKGROUND AND AIMS: Limited data are available to assess oral diuretic response in outpatients with heart failure (HF). The natriuretic response prediction equation (NRPE) predicts natriuresis following a loop diuretic dose using a urine sample 2 h after the dose and was validated to accurately predict intravenous diuretic response. The primary aim was to validate the NRPE's assessment of oral diuretic response in patients with HF. METHODS: The NRPE was evaluated in two HF patient cohorts receiving oral loop diuretics: Mechanisms of Diuretic Resistance (MDR) and TRANSFORM-Mechanism. Particip…

Hypochloremia in chronic and acute heart failure scenarios: Prevalence and risk factors.

AIMS: Chloride plays a key role in maintaining volume homeostasis. Low plasmatic chloride levels are associated with diuretic resistance and worse outcomes in patients with heart failure (HF). This study focused on determining the prevalence and factors related to hypochloremia in patients with heart failure (HF) in chronic and acute settings. METHODS: We conducted a retrospective analysis of three cohorts: chronic HF patients from the Spanish Cardiorenal Registry, ambulatory patients with worsening heart failure (WHF) from the SALT-HF trial, and inpatient WHF admitted in a teaching-level cen…

Periodic breathing during exercise in heart failure: beyond the classic risk factors.

Periodic breathing is a peculiar ventilatory pattern in patients with heart failure (HF), characterized by cyclic oscillations in minute ventilation. This phenomenon has been observed in awake patients, during sleep, and during exercise. Periodic breathing during exercise, also known as exercise oscillatory ventilation (EOV), is an important marker of clinical and functional status, morbidity, and mortality in HF patients. However, a clear understanding of the meaning, causes, and possible occurrence of different forms of EOV is still currently lacking. This review focuses on what is known, li…

Differences Between Ischemic and Nonischemic Cardiomyopathy in Heart Failure Related Cardiogenic Shock.

BACKGROUND: Heart failure-related cardiogenic shock (HF-CS) accounts for a growing proportion of cardiogenic shock (CS)-related admissions to contemporary cardiac intensive care units. Limited data exist comparing nonischemic (NICM) and ischemic cardiomyopathy (ICM) in this setting. METHODS AND RESULTS: We sought to examine the differences in patients' characteristics, in-hospital treatments and outcomes in individuals admitted with ICM and NICM HF-CS. The study population included CS admissions within the Critical Care Cardiology Trials Network registry from 2017-2022. CS due to acute myocar…

Prevalence and Prognostic Differences Between Sarcopenia and Sarcopenic Obesity in Heart Failure.

Evidence directly comparing sarcopenia and sarcopenic obesity in hospitalized heart failure (HF) patients, especially in young and middle-aged individuals, remains limited. This study aimed to (1) investigate the prevalence and clinical characteristics of sarcopenia and sarcopenic obesity, and (2) compare their prognostic impacts on adverse outcomes to identify protective body composition phenotypes. The findings are hypothesized to provide new perspectives on the HF obesity paradox. This prospective cohort study was conducted from June 2022 to October 2023. The primary endpoint was 1-year HF-…

Noninvasive Multiparameter Monitoring for the Detection of Decompensated Heart Failure: Exploratory Study.

BACKGROUND: Remote patient monitoring strategies in patients with heart failure (HF) are often based on manual readings and interpretation of various parameters by health care professionals. Automated multiparameter predictive models (MPMs) have the potential to improve early recognition of decompensated HF and to reduce the workload for both health care professionals and patients. To reduce costs and facilitate large-scale implementation, these models should preferably be based on noninvasive measurements, with user-friendly devices. OBJECTIVE: This exploratory study aimed to evaluate whethe…

Fluid Restriction in Patients with Pulmonary Arterial Hypertension and Right Heart Failure.

INTRODUCTION: In pulmonary arterial hypertension (PAH), right heart (RH) failure is associated with high mortality and poor prognosis. The objective of this cohort study was to assess, whether reduction of fluid intake is associated with RH size and clinical outcome in PAH patients. METHODS: A retrospective, exploratory analysis of patients with invasively diagnosed PAH and signs of fluid retention who were routinely clinically monitored for 8.4 ± 5.3 months including fluid uptake and signs of RH failure was performed. Patients were advised to reduce fluid uptake to a maximum of 2 L per day (

Autonomic Imbalance in Cardiomyopathy and Heart Failure: From Neurobiology to Precision Neuromodulation.

PURPOSE OF THE REVIEW: This review provides a framework for understanding autonomic neural regulation of cardiac function and dysfunction, highlighting the anatomical and functional organization of the autonomic nervous system, from intrinsic cardiac neurons to central cortical control centers. We review pathways leading to autonomic dysregulation in heart failure (HF) and cardiomyopathy (CMY), and we discuss the potential for precision neuromodulation informed by biomarkers and neuroimaging. RECENT FINDINGS: We synthesize emerging insights into the molecular, inflammatory, and psychological …

Heart failure decreases adipocyte progenitors with impaired differentiation capacity toward mature adipocytes.

Cardiac cachexia, characterized by adipose tissue atrophy, has the most unfavorable outcome in heart failure (HF). Adipose dysfunction might worsen HF as adipose tissue has been found to have cardioprotective effects mediated through its metabolic and endocrine functions, and therefore, could serve as a novel therapy target. In the context of adipose tissue homeostasis, adipocyte progenitor cells (APCs) play critical roles in maintaining the number and function of mature adipocytes, including lipid metabolism and hormone secretion. However, the mechanism by which HF affects APCs has not been e…

Cardiovascular, kidney, and metabolic health: an actionable vision for heart failure prevention.

The substantial and growing prevalence of heart failure, which remains the leading cause of preventable hospitalisation worldwide, has brought heart failure prevention into sharp focus. Although this condition has historically been characterised by impaired cardiac function, mounting evidence has underscored its complex and multisystem pathobiology. Epidemiological studies have indicated that other forms of cardiovascular disease, along with kidney and metabolic dysfunction, frequently and increasingly contribute to heart failure onset. Clinical trials have additionally demonstrated the power …

Decongestion in patients with advanced chronic kidney disease coexisting with heart failure.

Heart failure (HF) and chronic kidney disease (CKD) are closely interconnected conditions. Congestion, a central element in HF and CKD pathophysiology, progresses from haemodynamic changes to pulmonary oedema, with asymptomatic pulmonary congestion and an isolated increase in brain natriuretic peptide (BNP) as an intermediate step. Management strategies include sodium restriction, diuretics and emerging technologies for fluid monitoring. Diuretics, while essential, present challenges such as resistance and side effects, necessitating combination therapies and alternatives, like SGLT-2 inhibito…

First in-human microelectrode recordings of vagus nerve activity in heart failure.

We know that ischaemic cardiomyopathy leads to compensatory changes in the cardiovascular system to offset the reduction in cardiac output; … al activity to be reduced, given the evidence for an overall reduction in heart rate variability in heart failure and the interpretation that this largely reflects an increase in cardiac sympathetic drive and a decrease in parasympathetic drive. However compared to data obtained in healthy participants the magnitude of cardiac modulation of vagal activity was s …

Percutaneous mechanical circulatory support for acute right heart failure: A practical approach.

Acute right heart failure (RHF) represents a critical entity with significant morbidity and mortality. This review examines the role of percutaneous right ventricular assist devices (pRVADs) as a cornerstone of therapy in cases refractory to conventional management. Devices such as the Impella RP and dual-lumen cannulas provide targeted haemodynamic support, with indications in various clinical scenarios, including acute myocardial infarction, post-cardiac surgery, myocarditis, and after left ventricular assist device (LVAD) implantation. Successful implementation requires meticulous haemodyna…

Tricuspid Regurgitation Across the Spectrum of Heart Failure With Preserved Ejection Fraction.

BACKGROUND: Secondary tricuspid regurgitation (STR) in heart failure with preserved ejection fraction (HFpEF) is linked to more advanced stages with pulmonary vascular disease (PVD), but it may also develop at earlier stages of HFpEF, such as those with isolated exercise-induced congestion. OBJECTIVES: This study sought to evaluate the prevalence, distribution, and prognostic significance of STR mechanisms across the spectrum of HFpEF. METHODS: Cardiac structure, function, hemodynamics, and clinical outcomes were compared among patients with HFpEF phenotypes categorized according to the pres…

Оптимизация осуществимости и воспроизводимости модели сердечной недостаточности в свиньях.

Сердечная недостаточность (ВЧ) является одной из основных проблем в области здравоохранения во всем мире, где генная терапия может обеспечить перспективные новые подходы к эффективному лечению. Тахикардиомиопатия, вызванная пакуляцией, у крупных животных является хорошо зарекомендовавшей себя моделью ВЧ, но она страдает от низкой терпимости и переменных результатов. В этом исследовании мы разработали воспроизводимый, осуществимый и приемлемый протокол изучения генотерапии ВФ. Однокамерные кардиостимуляторы были имплантированы в свиней. Контроль за развитием ВЧ осуществлялся с помощью трансхиру

Совпадение в аннотации оригинала
Heart failure (HF) is a major health problem worldwide, where gene therapy could provide promising new approaches for effective treatments. Pacing-induced tachycardiomyopathy in large animals is a well-established HF model but it suffers from poor tolerability and variable outcomes. In this study, we developed a reproducible, feasible, and tolerable pacing p…

Synergistic Lyme Carditis and Coxsackievirus A Myocarditis Presenting With Fulminant Heart Failure.

BACKGROUND: Myocarditis typically results from single viral pathogens, most commonly Coxsackievirus B. Concomitant bacterial-viral myocarditis remains exceptionally rare. CASE SUMMARY: A healthy 28-year-old man developed progressive heart failure over 2 months, culminating in cardiogenic shock. Echocardiography revealed severe biventricular dysfunction (ejection fraction: 15%-20%) with complete heart block. Serologic testing confirmed dual infection with Lyme disease and Coxsackievirus A. Despite targeted antibiotic therapy, conduction did not recover, requiring cardiac resynchronization ther…

Hallmarks of cancer in patients with heart failure: data from BIOSTAT-CHF.

BACKGROUND: Within cardio-oncology, emerging epidemiologic studies have demonstrated a bi-directional relationship between heart failure (HF) and cancer. In the current study, we aimed to further explore this relationship and investigate the underlying pathophysiological pathways that connect these two disease entities. METHODS: We conducted a post-hoc analysis in which we identified 24 Gene Ontology (GO) processes associated with the hallmarks of cancer based on 92 biomarkers in 1960 patients with HF. We performed Spearman's correlations and Cox-regression analyses to evaluate associations w…