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Heart Failure Pathogenesis and Management
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Heart Failure Pathogenesis and Management

A special issue of Journal of Cardiovascular Development and Disease (ISSN 2308-3425).

Deadline for manuscript submissions: closed (1 June 2017) | Viewed by 69191

Special Issue Editor

Dr. Joel D. Schilling

E-Mail Website
Guest Editor
Diabetic Cardiovascular Disease Center, Section of Advanced Heart Failure and Cardiac Transplantation, Division of Cardiology, Washington University School of Medicine, St. Louis, MO 63110, USA
Interests: inflammation; macrophage; diabetes; cardiomyopathy; diabetic complications; lipid metabolism

Special Issue Information

Dear Colleagues,

The Journal of Cardiovascular Development and Disease is launching a Special Issue on “Heart Failure Pathogenesis and Management”. Heart failure remains a leading cause of morbidity and mortality worldwide. With the aging population, increasing prevalence of diabetes, and better therapies for acute coronary syndromes the number of patients with heart failure will continue to increase at a staggering rate. At the same time, there have been several major advancements in our understanding of heart failure pathogenesis, which have led to novel therapeutic approaches. With this Special Issue, we aim to present the most up-to-date information about heart failure development, diagnosis, and management. Insights into both heart failure with preserved ejection fraction (HFpEF) and reduced ejection fraction (HFrEF) will be included. In addition, exciting new developments in the molecular pathogenesis of adverse cardiac remodeling will be emphasized.

Dr. Joel D. Schilling
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Cardiovascular Development and Disease is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2700 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • Heart failure with preserved ejection fraction (HFpEF)
  • cardiac macrophage
  • pulmonary hypertension
  • adverse cardiac remodelling
  • post-MI heart failure
  • cardiac metabolism
  • Cardiac imaging
  • Arrhythmias
  • Diabetes
  • exercise

Published Papers (7 papers)

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Research

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926 KiB  
Article
A Multiparametric Approach Based on NT-proBNP, ST2, and Galectin3 for Stratifying One Year Prognosis of Chronic Heart Failure Outpatients
by Dario Grande, Marta Leone, Caterina Rizzo, Paola Terlizzese, Giuseppe Parisi, Margherita Ilaria Gioia, Tiziana Leopizzi, Antonio Segreto, Piero Guida, Roberta Romito, Marco Matteo Ciccone, Francesca Di Serio and Massimo Iacoviello
J. Cardiovasc. Dev. Dis. 2017, 4(3), 9; https://doi.org/10.3390/jcdd4030009 - 15 Jul 2017
Cited by 22 | Viewed by 3623
Abstract
Galectin-3 and ST2 are emerging biomarkers involved in myocardial fibrosis. We evaluate the relevance of a multiparametric biomarker approach based on increased serum levels of NT-proBNP, galectin-3, and ST2 in stratifying the prognosis of chronic heart failure (CHF) outpatients. In 315 CHF outpatients [...] Read more.
Galectin-3 and ST2 are emerging biomarkers involved in myocardial fibrosis. We evaluate the relevance of a multiparametric biomarker approach based on increased serum levels of NT-proBNP, galectin-3, and ST2 in stratifying the prognosis of chronic heart failure (CHF) outpatients. In 315 CHF outpatients in stable clinical condition clinical and echocardiographic evaluations were performed. Routine chemistry and serum levels of NT-proBNP, galectin-3, and ST2 were also assessed. During a 12 month follow-up, cardiovascular death, and/or heart failure (HF) occurred in 64 patients. The presence of NT-proBNP, galectin-3, and ST2 were higher than the recommended cutoffs and were all associated with events at univariate Cox regression analysis, as well as in a multivariate analysis including the three biomarkers. When a score based on the number of biomarkers above the recommended cut-offs was used (in a range of 0–3), it was associated with events both with respect to the univariate (HR 2.96, 95% CI 2.21–3.95, p < 0.001, C-index 0.78) and the multivariate (HR 1.52, 95% CI 1.06–2.17, p: 0.023, C-index 0.87) analyses, after correction for the variables of a reference model. Our results suggest that an easy prognostic approach based on the combination of three biomarkers, although with partially-overlapping pathophysiological mechanisms, is able to identify patients with the highest risk of heart failure progression. Full article
(This article belongs to the Special Issue Heart Failure Pathogenesis and Management)
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Review

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474 KiB  
Review
The Dark Side of the Moon: The Right Ventricle
by Massimiliano Foschi, Michele Di Mauro, Fabrizio Tancredi, Carlo Capparuccia, Renata Petroni, Luigi Leonzio, Silvio Romano, Sabina Gallina, Maria Penco, Mario Cibelli and Antonio Calafiore
J. Cardiovasc. Dev. Dis. 2017, 4(4), 18; https://doi.org/10.3390/jcdd4040018 - 20 Oct 2017
Cited by 35 | Viewed by 9230
Abstract
The aim of this review article is to summarize current knowledge of the pathophysiology underlying right ventricular failure (RVF), focusing, in particular, on right ventricular assessment and prognosis. The right ventricle (RV) can tolerate volume overload well, but is not able to sustain [...] Read more.
The aim of this review article is to summarize current knowledge of the pathophysiology underlying right ventricular failure (RVF), focusing, in particular, on right ventricular assessment and prognosis. The right ventricle (RV) can tolerate volume overload well, but is not able to sustain pressure overload. Right ventricular hypertrophy (RVH), as a response to increased afterload, can be adaptive or maladaptive. The easiest and most common way to assess the RV is by two-dimensional (2D) trans-thoracic echocardiography measuring surrogate indexes, such as tricuspid annular plane systolic excursion (TAPSE), fractional area change (FAC), and tissue Doppler velocity of the lateral aspect of the tricuspid valvular plane. However, both volumes and function are better estimated by 3D echocardiography and cardiac magnetic resonance (CMR). The prognostic role of the RV in heart failure (HF), pulmonary hypertension (PH), acute myocardial infarction (AMI), and cardiac surgery has been overlooked for many years. However, several recent studies have placed much greater importance on the RV in prognostic assessments. In conclusion, RV dimensions and function should be routinely assessed in cardiovascular disease, as RVF has a significant impact on disease prognosis. In the presence of RVF, different therapeutic approaches, either pharmacological or surgical, may be beneficial. Full article
(This article belongs to the Special Issue Heart Failure Pathogenesis and Management)
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591 KiB  
Review
Management of Arrhythmias in Heart Failure
by Daniele Masarone, Giuseppe Limongelli, Marta Rubino, Fabio Valente, Rossella Vastarella, Ernesto Ammendola, Rita Gravino, Marina Verrengia, Gemma Salerno and Giuseppe Pacileo
J. Cardiovasc. Dev. Dis. 2017, 4(1), 3; https://doi.org/10.3390/jcdd4010003 - 28 Feb 2017
Cited by 43 | Viewed by 10680
Abstract
Heart failure patients are predisposed to develop arrhythmias. Supraventricular arrhythmias can exacerbate the heart failure symptoms by decreasing the effective cardiac output and their control require pharmacological, electrical, or catheter-based intervention. In the setting of atrial flutter or atrial fibrillation, anticoagulation becomes paramount [...] Read more.
Heart failure patients are predisposed to develop arrhythmias. Supraventricular arrhythmias can exacerbate the heart failure symptoms by decreasing the effective cardiac output and their control require pharmacological, electrical, or catheter-based intervention. In the setting of atrial flutter or atrial fibrillation, anticoagulation becomes paramount to prevent systemic or cerebral embolism. Patients with heart failure are also prone to develop ventricular arrhythmias that can present a challenge to the managing clinician. The management strategy depends on the type of arrhythmia, the underlying structural heart disease, the severity of heart failure, and the range from optimization of heart failure therapy to catheter ablation. Patients with heart failure, irrespective of ejection fraction are at high risk for developing sudden cardiac death, however risk stratification is a clinical challenge and requires a multiparametric evaluation for identification of patients who should undergo implantation of a cardioverter defibrillator. Finally, patients with heart failure can also develop symptomatic bradycardia, caused by sinus node dysfunction or atrio-ventricular block. The treatment of bradycardia in these patients with pacing is usually straightforward but needs some specific issue. Full article
(This article belongs to the Special Issue Heart Failure Pathogenesis and Management)
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1612 KiB  
Review
Mechanical Circulatory Support for Advanced Heart Failure: Are We about to Witness a New “Gold Standard”?
by Massimo Capoccia
J. Cardiovasc. Dev. Dis. 2016, 3(4), 35; https://doi.org/10.3390/jcdd3040035 - 12 Dec 2016
Cited by 21 | Viewed by 6837
Abstract
The impact of left ventricular assist devices (LVADs) for the treatment of advanced heart failure has played a significant role as a bridge to transplant and more recently as a long-term solution for non-eligible candidates. Continuous flow left ventricular assist devices (CF-LVADs), based [...] Read more.
The impact of left ventricular assist devices (LVADs) for the treatment of advanced heart failure has played a significant role as a bridge to transplant and more recently as a long-term solution for non-eligible candidates. Continuous flow left ventricular assist devices (CF-LVADs), based on axial and centrifugal design, are currently the most popular devices in view of their smaller size, increased reliability and higher durability compared to pulsatile flow left ventricular assist devices (PF-LVADs). The trend towards their use is increasing. Therefore, it has become mandatory to understand the physics and the mathematics behind their mode of operation for appropriate device selection and simulation set up. For this purpose, this review covers some of these aspects. Although very successful and technologically advanced, they have been associated with complications such as pump thrombosis, haemolysis, aortic regurgitation, gastro-intestinal bleeding and arterio-venous malformations. There is perception that the reduced arterial pulsatility may be responsible for these complications. A flow modulation control approach is currently being investigated in order to generate pulsatility in rotary blood pumps. Thrombus formation remains the most feared complication that can affect clinical outcome. The development of a preoperative strategy aimed at the reduction of complications and patient-device suitability may be appropriate. Patient-specific modelling based on 3D reconstruction from CT-scan combined with computational fluid dynamic studies is an attractive solution in order to identify potential areas of stagnation or challenging anatomy that could be addressed to achieve the desired outcome. The HeartMate II (axial) and the HeartWare HVAD (centrifugal) rotary blood pumps have been now used worldwide with proven outcome. The HeartMate III (centrifugal) is now emerging as the new promising device with encouraging preliminary results. There are now enough pumps on the market: it is time to focus on the complications in order to achieve the full potential and selling-point of this type of technology for the treatment of the increasing heart failure patient population. Full article
(This article belongs to the Special Issue Heart Failure Pathogenesis and Management)
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477 KiB  
Review
Management of Mechanical Ventilation in Decompensated Heart Failure
by Brooks T. Kuhn, Laura A. Bradley, Timothy M. Dempsey, Alana C. Puro and Jason Y. Adams
J. Cardiovasc. Dev. Dis. 2016, 3(4), 33; https://doi.org/10.3390/jcdd3040033 - 02 Dec 2016
Cited by 19 | Viewed by 15488
Abstract
Mechanical ventilation (MV) is a life-saving intervention for respiratory failure, including decompensated congestive heart failure. MV can reduce ventricular preload and afterload, decrease extra-vascular lung water, and decrease the work of breathing in heart failure. The advantages of positive pressure ventilation must be [...] Read more.
Mechanical ventilation (MV) is a life-saving intervention for respiratory failure, including decompensated congestive heart failure. MV can reduce ventricular preload and afterload, decrease extra-vascular lung water, and decrease the work of breathing in heart failure. The advantages of positive pressure ventilation must be balanced with potential harm from MV: volutrauma, hyperoxia-induced injury, and difficulty assessing readiness for liberation. In this review, we will focus on cardiac, pulmonary, and broader effects of MV on patients with decompensated HF, focusing on practical considerations for management and supporting evidence. Full article
(This article belongs to the Special Issue Heart Failure Pathogenesis and Management)
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3271 KiB  
Review
Myocarditis in Paediatric Patients: Unveiling the Progression to Dilated Cardiomyopathy and Heart Failure
by Inês Teixeira Farinha and Joana Oliveira Miranda
J. Cardiovasc. Dev. Dis. 2016, 3(4), 31; https://doi.org/10.3390/jcdd3040031 - 08 Nov 2016
Cited by 13 | Viewed by 17376
Abstract
Myocarditis is a challenging and potentially life-threatening disease associated with high morbidity in some paediatric patients, due to its ability to present as an acute and fulminant disease and to ultimately progress to dilated cardiomyopathy. It has been described as an inflammatory disease [...] Read more.
Myocarditis is a challenging and potentially life-threatening disease associated with high morbidity in some paediatric patients, due to its ability to present as an acute and fulminant disease and to ultimately progress to dilated cardiomyopathy. It has been described as an inflammatory disease of the myocardium caused by diverse aetiologies. Viral infection is the most frequent cause of myocarditis in developed countries, but bacterial and protozoal infections or drug hypersensitivity may also be causative agents. The prompt diagnosis in paediatric patients is difficult, as the spectrum of clinical manifestation can range from no myocardial dysfunction to sudden cardiac death. Recent studies on myocarditis pathogenesis have revealed a triphasic nature of this disease, which influences the diagnostic and therapeutic strategies to adopt in each patient. Endomyocardial biopsy remains the gold standard for diagnosing myocarditis, and several non-invasive diagnostic tools can be used to support the diagnosis. Intravenous immunoglobulin has become part of routine practice in the treatment of myocarditis in paediatric patients at many centres, but its true effect on the cardiac function has been the target of many studies. The aim of this review is to approach the recently discovered facets of paediatric myocarditis regarding its progression to dilated cardiomyopathy. Full article
(This article belongs to the Special Issue Heart Failure Pathogenesis and Management)
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614 KiB  
Review
Heart Failure in Patients with Preserved Ejection Fraction: Questions Concerning Clinical Progression
by George E. Louridas and Katerina G. Lourida
J. Cardiovasc. Dev. Dis. 2016, 3(3), 27; https://doi.org/10.3390/jcdd3030027 - 08 Sep 2016
Cited by 6 | Viewed by 5028
Abstract
Over the last two decades, important advances have been made in explaining some pathophysiological aspects of heart failure with preserved ejection fraction (HFpEF) with repercussions for the successful clinical management of the syndrome. Despite these gains, our knowledge for the natural history of [...] Read more.
Over the last two decades, important advances have been made in explaining some pathophysiological aspects of heart failure with preserved ejection fraction (HFpEF) with repercussions for the successful clinical management of the syndrome. Despite these gains, our knowledge for the natural history of clinical progression from the pre-clinical diastolic dysfunction (PDD) until the final clinical stages is significantly limited. The subclinical progression of PDD to the clinical phenotype of HFpEF and the further clinical progression to some more complex clinical models with multi-organ involvement, similar to heart failure with reduced ejection fraction (HFrEF), continue to be poorly understood. Prospective studies are needed to elucidate the natural history of clinical progression in patients with HFpEF and to identify the exact left ventricular remodeling mechanism that underlies this progression. Full article
(This article belongs to the Special Issue Heart Failure Pathogenesis and Management)
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