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Biomedicines
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Cardiomyopathies and Heart Failure: Charting the Future
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Cardiomyopathies and Heart Failure: Charting the Future

A special issue of Biomedicines (ISSN 2227-9059). This special issue belongs to the section "Molecular and Translational Medicine".

Deadline for manuscript submissions: 31 January 2025 | Viewed by 9337

Special Issue Editor

Dr. Ali Amr

E-Mail Website
Guest Editor
Institute for Cardiomyopathies Heidelberg (ICH), University Hospital Heidelberg, 69120 Heidelberg, Germany
Interests: cardiomyopathies; heart failure; SCD risk stratification; genetics of heart disease; AI in cardiomyopathies

Special Issue Information

Dear Colleagues,

As our knowledge in medical sciences continues to evolve, the significance of specialized research in complex heart diseases has never been more critical. Cardiomyopathies, a heterogeneous group of heart muscle diseases, stand as a leading cause of heart failure, posing an immense challenge to healthcare systems worldwide. The heterogeneity and pathophysiological complexity of cardiomyopathies, both primary and secondary, present significant challenges, particularly in relation to heart failure. One of the most daunting aspects lies in elucidating the molecular mechanisms underlying the diverse subtypes of cardiomyopathies, such as hypertrophic, dilated, and arrhythmogenic cardiomyopathy. This heterogeneity demands multifaceted investigative approaches to discern distinct genetic, epigenetic, and environmental factors contributing to myocardial remodeling and subsequent heart failure. This is indispensable for the development of new diagnostic tools, risk stratification methods, patient management, and therapies in enhancing the quality of care.

This Special Issue of Biomedicines, titled “Cardiomyopathies and Heart Failure: Charting the Future”, aims to amass a compilation of articles focusing on cardiomyopathies and their implications on heart failure. We encourage the submission of both original research articles and review papers. Furthermore, given the transformative role of artificial intelligence in medicine, we are particularly interested in studies that explore its application in the realm of cardiomyopathies. Investigations into how artificial intelligence can aid in early detection, treatment optimization, and patient monitoring, and novel therapeutic developments are highly encouraged.

Topics of interest for this Special Issue include, but are not limited to, the following:

  • Various forms of cardiomyopathies and their role in heart failure;
  • Early diagnosis and screening methods for cardiomyopathies;
  • Risk stratification and patient management in cardiomyopathies;
  • Novel therapeutic strategies for treating cardiomyopathies;
  • Machine learning algorithms for analyzing cardiac imaging in cardiomyopathies;
  • Global health perspectives on cardiomyopathies and heart failure.

We look forward to your contributions.

Dr. Ali Amr
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. Biomedicines 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 2600 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

  • cardiomyopathies
  • heart failure
  • risk stratification
  • management of cardiomyopathies
  • cardiac imaging
  • telemedicine

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Published Papers (5 papers)

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Research

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10 pages, 2931 KiB  
Article
Differentiation of Myocardial Properties in Physiological Athletic Cardiac Remodeling and Mild Hypertrophic Cardiomyopathy
by Lars G. Klaeboe, Øyvind H. Lie, Pål H. Brekke, Gerhard Bosse, Einar Hopp, Kristina H. Haugaa and Thor Edvardsen
Biomedicines 2024, 12(2), 420; https://doi.org/10.3390/biomedicines12020420 - 12 Feb 2024
Viewed by 1283
Abstract
Clinical differentiation between athletes’ hearts and those with hypertrophic cardiomyopathy (HCM) can be challenging. We aimed to explore the role of speckle tracking echocardiography (STE) and cardiac magnetic resonance imaging (CMR) in the differentiation between athletes’ hearts and those with mild HCM. We [...] Read more.
Clinical differentiation between athletes’ hearts and those with hypertrophic cardiomyopathy (HCM) can be challenging. We aimed to explore the role of speckle tracking echocardiography (STE) and cardiac magnetic resonance imaging (CMR) in the differentiation between athletes’ hearts and those with mild HCM. We compared 30 competitive endurance elite athletes (7% female, age 41 ± 9 years) and 20 mild phenotypic mutation-positive HCM carriers (15% female, age 51 ± 12 years) with left ventricular wall thickness 13 ± 1 mm. Mechanical dispersion (MD) was assessed by means of STE. Native T1-time and extracellular volume (ECV) were assessed by means of CMR. MD was higher in HCM mutation carriers than in athletes (54 ± 16 ms vs. 40 ± 11 ms, p = 0.001). Athletes had a lower native T1-time (1204 (IQR 1191, 1234) ms vs. 1265 (IQR 1255, 1312) ms, p < 0.001) and lower ECV (22.7 ± 3.2% vs. 25.6 ± 4.1%, p = 0.01). MD > 44 ms optimally discriminated between athletes and HCM mutation carriers (AUC 0.78, 95% CI 0.65–0.91). Among the CMR parameters, the native T1-time had the best discriminatory ability, identifying all HCM mutation carriers (100% sensitivity) with a specificity of 75% (AUC 0.83, 95% CI 0.71–0.96) using a native T1-time > 1230 ms as the cutoff. STE and CMR tissue characterization may be tools that can differentiate athletes’ hearts from those with mild HCM. Full article
(This article belongs to the Special Issue Cardiomyopathies and Heart Failure: Charting the Future)
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Review

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16 pages, 861 KiB  
Review
Multifaceted Impact of SGLT2 Inhibitors in Heart Failure Patients: Exploring Diverse Mechanisms of Action
by Christos Piperis, Anastasios Marathonitis, Artemis Anastasiou, Panagiotis Theofilis, Konstantinos Mourouzis, Alexios Giannakodimos, Elsi Tryfou, Evangelos Oikonomou, Gerasimos Siasos and Dimitris Tousoulis
Biomedicines 2024, 12(10), 2314; https://doi.org/10.3390/biomedicines12102314 - 11 Oct 2024
Viewed by 661
Abstract
Heart failure (HF) is a growing concern due to the aging population and increasing prevalence of comorbidities. Despite advances in treatment, HF remains a significant burden, necessitating novel therapeutic approaches. Sodium–glucose cotransporter 2 inhibitors (SGLT2is) have emerged as a promising treatment option, demonstrating [...] Read more.
Heart failure (HF) is a growing concern due to the aging population and increasing prevalence of comorbidities. Despite advances in treatment, HF remains a significant burden, necessitating novel therapeutic approaches. Sodium–glucose cotransporter 2 inhibitors (SGLT2is) have emerged as a promising treatment option, demonstrating benefits across the entire spectrum of HF, regardless of left ventricular ejection fraction (LVEF). This review explores the multifaceted mechanisms through which SGLT2is exert cardioprotective effects, including modulation of energy metabolism, reduction of oxidative stress, attenuation of inflammation, and promotion of autophagy. SGLT2is shift myocardial energy substrate utilization from carbohydrates to more efficient fatty acids and ketone bodies, enhancing mitochondrial function and reducing insulin resistance. These inhibitors also mitigate oxidative stress by improving mitochondrial biogenesis, reducing reactive oxygen species (ROS) production, and regulating calcium-signaling pathways. Inflammation, a key driver of HF progression, is alleviated through the suppression of proinflammatory cytokines and modulation of immune cell activity. Additionally, SGLT2is promote autophagy, facilitating the clearance of damaged cellular components and preserving myocardial structure and function. Beyond their glucose-lowering effects, SGLT2is provide significant benefits in patients with chronic kidney disease (CKD) and HF, reducing the progression of CKD and improving overall survival. The pleiotropic actions of SGLT2is highlight their potential as a cornerstone in HF management. Further research is needed to fully elucidate their mechanisms and optimize their use in clinical practice. Full article
(This article belongs to the Special Issue Cardiomyopathies and Heart Failure: Charting the Future)
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26 pages, 2275 KiB  
Review
Transient Left Ventricular Dysfunction from Cardiomyopathies to Myocardial Viability: When and Why Cardiac Function Recovers
by Giancarlo Trimarchi, Lucio Teresi, Roberto Licordari, Alessandro Pingitore, Fausto Pizzino, Patrizia Grimaldi, Danila Calabrò, Paolo Liotta, Antonio Micari, Cesare de Gregorio and Gianluca Di Bella
Biomedicines 2024, 12(5), 1051; https://doi.org/10.3390/biomedicines12051051 - 9 May 2024
Cited by 5 | Viewed by 2688
Abstract
Transient left ventricular dysfunction (TLVD), a temporary condition marked by reversible impairment of ventricular function, remains an underdiagnosed yet significant contributor to morbidity and mortality in clinical practice. Unlike the well-explored atherosclerotic disease of the epicardial coronary arteries, the diverse etiologies of TLVD [...] Read more.
Transient left ventricular dysfunction (TLVD), a temporary condition marked by reversible impairment of ventricular function, remains an underdiagnosed yet significant contributor to morbidity and mortality in clinical practice. Unlike the well-explored atherosclerotic disease of the epicardial coronary arteries, the diverse etiologies of TLVD require greater attention for proper diagnosis and management. The spectrum of disorders associated with TLVD includes stress-induced cardiomyopathy, central nervous system injuries, histaminergic syndromes, various inflammatory diseases, pregnancy-related conditions, and genetically determined syndromes. Furthermore, myocardial infarction with non-obstructive coronary arteries (MINOCA) origins such as coronary artery spasm, coronary thromboembolism, and spontaneous coronary artery dissection (SCAD) may also manifest as TLVD, eventually showing recovery. This review highlights the range of ischemic and non-ischemic clinical situations that lead to TLVD, gathering conditions like Tako-Tsubo Syndrome (TTS), Kounis syndrome (KS), Myocarditis, Peripartum Cardiomyopathy (PPCM), and Tachycardia-induced cardiomyopathy (TIC). Differentiation amongst these causes is crucial, as they involve distinct clinical, instrumental, and genetic predictors that bode different outcomes and recovery potential for left ventricular function. The purpose of this review is to improve everyday clinical approaches to treating these diseases by providing an extensive survey of conditions linked with TLVD and the elements impacting prognosis and outcomes. Full article
(This article belongs to the Special Issue Cardiomyopathies and Heart Failure: Charting the Future)
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11 pages, 805 KiB  
Review
Insulin Resistance/Hyperinsulinemia, Neglected Risk Factor for the Development and Worsening of Heart Failure with Preserved Ejection Fraction
by Serafino Fazio, Valentina Mercurio, Valeria Fazio, Antonio Ruvolo and Flora Affuso
Biomedicines 2024, 12(4), 806; https://doi.org/10.3390/biomedicines12040806 - 4 Apr 2024
Cited by 2 | Viewed by 3435
Abstract
Heart failure (HF) has become a subject of continuous interest since it was declared a new pandemic in 1997 because of the exponential increase in hospitalizations for HF in the latest years. HF is the final state to which all heart diseases of [...] Read more.
Heart failure (HF) has become a subject of continuous interest since it was declared a new pandemic in 1997 because of the exponential increase in hospitalizations for HF in the latest years. HF is the final state to which all heart diseases of different etiologies lead if not adequately treated. It is highly prevalent worldwide, with a progressive increase with age, reaching a prevalence of 10% in subjects over the age of 65 years. During the last two decades, it was possible to see that the prevalence of heart failure with preserved ejection fraction (HFpEF) was increasing while that of heart failure with reduced ejection fraction (HFrEF) was decreasing. HFpEF is typically characterized by concentric remodeling of the left ventricle (LV) with impaired diastolic function and increased filling pressures. Over the years, also the prevalence of insulin resistance (IR)/hyperinsulinemia (Hyperins) in the general adult population has progressively increased, primarily due to lifestyle changes, particularly in developed and developing countries, with a range that globally ranges between 15.5% and 46.5%. Notably, over 50% of patients with HF also have IR/Hyperins, and the percentage is even higher in those with HFpEF. In the scientific literature, it has been well highlighted that the increased circulating levels of insulin, associated with conditions of insulin resistance, are responsible for progressive cardiovascular alterations over the years that could stimulate the development and/or the worsening of HFpEF. The aim of this manuscript was to review the scientific literature that supports a pathophysiologic connection between IR/Hyperins and HFpEF to stimulate the scientific community toward the identification of hyperinsulinemia associated with insulin resistance as an independent cardiovascular risk factor in the development and worsening of HF, believing that its adequate screening in the general population and an appropriate treatment could reduce the prevalence of HFpEF and improve its progression. Full article
(This article belongs to the Special Issue Cardiomyopathies and Heart Failure: Charting the Future)
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Other

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38 pages, 2373 KiB  
Systematic Review
His Bundle Pacing and Left Bundle Branch Pacing in Patients with Heart Failure
by Patrycja Paluszkiewicz, Adrian Martuszewski, Jadwiga Radziejewska, Jacek Zawadzki, Jacek Smereka and Jacek Gajek
Biomedicines 2024, 12(10), 2356; https://doi.org/10.3390/biomedicines12102356 - 16 Oct 2024
Viewed by 422
Abstract
Background: His bundle pacing (HBP) and left bundle branch pacing (LBBP) are emerging therapies for patients with heart failure and conduction disorders, offering potential advantages over traditional pacing methods. These approaches aim to restore physiological conduction and improve cardiac function more effectively. Objective: [...] Read more.
Background: His bundle pacing (HBP) and left bundle branch pacing (LBBP) are emerging therapies for patients with heart failure and conduction disorders, offering potential advantages over traditional pacing methods. These approaches aim to restore physiological conduction and improve cardiac function more effectively. Objective: This study aims to evaluate the efficacy and safety of HBP and LBBP in patients with heart failure and conduction disturbances, comparing these techniques to conventional pacing. Methods: A comprehensive review of recent studies and clinical trials was conducted, focusing on the performance of HBP and LBBP in improving cardiac function, reducing QRS duration, and enhancing overall patient outcomes. The analysis includes data on clinical efficacy, procedural safety, and long-term benefits associated with these pacing modalities. Results: Both HBP and LBBP have demonstrated significant improvements in cardiac function and clinical outcomes compared to conventional pacing. HBP effectively restores physiological conduction with improved synchronization and a reduction in QRS duration. LBBP has shown enhanced left ventricular activation, leading to better overall cardiac performance. Both techniques have been associated with a lower incidence of complications and a higher success rate in achieving optimal pacing thresholds. Conclusions: HBP and LBBP offer promising alternatives to traditional pacing for patients with heart failure and conduction disorders. These advanced pacing strategies provide superior clinical outcomes and improved cardiac function with reduced risk of complications. Further research and clinical trials are needed to fully establish the long-term benefits and safety profiles of these techniques in diverse patient populations. Full article
(This article belongs to the Special Issue Cardiomyopathies and Heart Failure: Charting the Future)
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