Novel Strategies for Diagnosis and Treatment of Heart Failure

A special issue of Medicina (ISSN 1648-9144). This special issue belongs to the section "Cardiology".

Deadline for manuscript submissions: closed (15 May 2024) | Viewed by 2249

Special Issue Editors


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Guest Editor
Heart Failure Unit, Department of Cardiology, AORN dei Colli-Monaldi Hospital, Naples, Italy
Interests: heart failure; hypertension; cardiomyopathies; advanced cardiac multimodality imaging; cardioncology
Special Issues, Collections and Topics in MDPI journals

E-Mail
Guest Editor
Heart Failure Unit, Department of Cardiology, AORN dei Colli-Monaldi Hospital, Naples, Italy
Interests: heart failure; cardiomyopathies; pediatric cardiology; cardioncology
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Heart failure (HF) is a complex clinical syndrome that may be caused by a number of structural and/or functional cardiac abnormalities. Developing the condition will result in a reduced cardiac output and/or elevated intracardiac pressures at rest or during stress.

As a growing public health problem with a prevalence of 1–2% in the adult population, HF impacts heavily on patient survival, quality of life and health care costs. Despite the advancement in medical and device therapy, the management of HF remains a challenge.

The early and accurate diagnosis of HF, paired with proper identification of the underlying etiology, is of great importance for treatment and ultimately for enhancing prognosis and quality of life.

In particular, HF is one of the most severe clinical manifestations of classical and novel cancer therapies and can occur either acutely or after years of treatment. As suggested by recent cardio-oncology guidelines, prevention and early detection have become a priority.

Current clinical strategies for the management of patients with HF are heavily based on information provided by multimodality cardiovascular imaging that allows non-invasive morphological and functional assessment, tissue characterization, blood flow and perfusion evaluation.

Therefore, further research on cardiovascular imaging may substantially contribute to the early etiological diagnosis, prognostic stratification and treatment management of HF patients.

In this Special Issue, we invite experts in the field of HF and Cardioncology to submit their original research and/or systematic reviews covering one or more of the following topics:

  1. Recent advances in heart failure treatment;
  2. Expert reviews on the latest and ongoing RCTs on HF medications;
  3. Multimodality imaging as an approach to individualize treatment, guide long-term management, and stratify prognosis in HF;
  4. Multimodality imaging for assessment of specific HF etiologies;
  5. Multimodality imaging in risk stratification, early detection of cardiovascular sequelae of cancer and related therapies.

Dr. Carla Contaldi
Dr. Giuseppe Pacileo
Guest Editors

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Keywords

  • heart failure treatment
  • HFrEF
  • HFpEF
  • cardiovascular pharmacotherapy
  • multimodality cardiovascular imaging
  • echocardiography
  • cardiac magnetic resonance
  • cardioncology
  • cardiotoxicity

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Published Papers (1 paper)

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Review

16 pages, 3040 KiB  
Review
Clinical Implications of Ivabradine in the Contemporary Era
by Teruhiko Imamura
Medicina 2024, 60(2), 303; https://doi.org/10.3390/medicina60020303 - 10 Feb 2024
Viewed by 1887
Abstract
Ivabradine is a recently introduced inhibitor of the If ion channel, which exhibits the capacity to reduce heart rate while preserving hemodynamic stability. At present, ivabradine finds its clinical indication in patients suffering from heart failure with reduced ejection fraction and maintaining [...] Read more.
Ivabradine is a recently introduced inhibitor of the If ion channel, which exhibits the capacity to reduce heart rate while preserving hemodynamic stability. At present, ivabradine finds its clinical indication in patients suffering from heart failure with reduced ejection fraction and maintaining a relative sinus rhythm refractory to beta-blockers. To optimize heart rate control, it is recommended to pursue an aggressive up-titration of ivabradine. This approach may ameliorate tachycardia-induced hypotension by incrementally enhancing cardiac output and allow further up-titration of agents aimed at ameliorating heart failure, such as beta-blockers. Both the modulation of heart rate itself and the up-titration of agents targeting heart failure lead to cardiac reverse remodeling, consequently culminating in a subsequent reduction in mortality and morbidity. A novel overlap theory that our team proposed recently has emerged in recent times. Under trans-mitral Doppler echocardiography, the E-wave and A-wave closely juxtapose one another without any overlapping at the optimal heart rate. Employing echocardiography-guided ivabradine for heart-rate modulation to minimize the overlap between the E-wave and A-wave appears to confer substantial benefits to patients with heart failure. This approach facilitates superior cardiac reverse remodeling and yields more favorable clinical outcomes when compared to those patients who do not receive echocardiography-guided care. The next pertinent issue revolves around the potential expansion of ivabradine’s clinical indications to encompass a broader spectrum of diseases. It is imperative to acknowledge that ivabradine may not yield clinically significant benefits in patients afflicted by heart failure with preserved ejection fraction, acute heart failure, sepsis, or stable angina. An important fact yet to be explored is the clinical applicability of ivabradine in patients with atrial fibrillation, a concern that beckons future investigation. In this review, the concept of overlap theory it introduced, along with its application to expand the indication of ivabradine and the overlap theory-guided optimal ivabradine therapy. Full article
(This article belongs to the Special Issue Novel Strategies for Diagnosis and Treatment of Heart Failure)
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