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Heart Failure: Clinical Diagnostics and Treatment

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A special issue of Journal of Cardiovascular Development and Disease (ISSN 2308-3425). This special issue belongs to the section "Cardiovascular Clinical Research".

Deadline for manuscript submissions: closed (30 June 2024) | Viewed by 26209

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Special Issue Editors

Dr. Evgeny Belyavskiy

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Deutsches Herzzentrum der Charité, Medizinisches Versorgungszentrum, Augustenburger Platz 1, 13353 Berlin, Germany
Interests: HFpEF (heart failure with preserved ejection fraction); diastolic dysfunction; echocardiography; stress-echocardiography; diastolic stress test; speckle-tracking echocardiography; strain; hypertension; sleep apnea
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Dr. Nicolas Merke

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Deutsches Herzzentrum der Charité, Medizinisches Versorgungszentrum, Augustenburger Platz 1, 13353 Berlin, Germany
Interests: 3D echocardiography; advanced heart failure; peri operative echocardiography
Special Issues, Collections and Topics in MDPI journals

Dr. Daniel A. Morris

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Department of Internal Medicine and Cardiology, Charité-Universitätsmedizin Berlin, Campus Virchow Klinikum, Augustenburger Platz 1, 13353 Berlin, Germany
Interests: HFpEF (heart failure with preserved ejection fraction); diastolic dysfunction; echocardiography; speckle-tracking echocardiography; strain; LV strain; LA strain; RV strain; aortic stenosis
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Heart failure (HF) is a major global health problem, and its prevalence is increasing. HF is currently divided into three different phenotypes based on the measurement of left ventricular ejection fraction (LVEF). Each phenotype has its own characteristics and criteria for diagnosis, treatment, and prevention. The development of multimodality imaging in recent years has opened up the possibility of a thorough investigation of all aspects of all types of HF, including diagnosis, individualized treatment, monitoring of the success of therapy, and prevention.

Although echocardiography remains the primary method of non-invasive diagnosis of heart failure, other non-invasive diagnostic techniques such as scintigraphy, CT, MRI, and PET-CT have demonstrated important clinical utility in patients with HF in recent years, mainly for the characterization or diagnosis of specific HF etiologies such as ATTR amyloidosis, sarcoidosis, and myocarditis. However, many unresolved etiological questions remain, especially in patients with HFpEF and HFmrEF.

Modern cardiovascular medicine involves the simultaneous use of several imaging modalities that provide additional information about complex diseases and enable timely and more effective treatment (whether medication, transcatheter interventions, or cardiovascular surgery), leading to better outcomes for our patients.

Therefore, the aim of this Special Issue is to provide scientific evidence on the potential usefulness and clinical relevance of multimodality imaging in patients with HF.

You are invited to submit a scientific paper or review article on any aspect related to the topic of this Special Issue.

Dr. Evgeny Belyavskiy
Dr. Nicolas Merke
Dr. Daniel A. Morris
Guest Editors

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
echocardiography
strain imaging
cardiovascular magnetic resonance
heart valve disease
new frontiers in valve therapy intervention and surgery
3D imaging
lung ultrasound
stress echocardiography
exercise echocardiography in heart valve disease
contrast echocardiography (ultrasound-enhancing agents)
echocardiography in mechanical circulatory support (ECMO, Impella, LVAD)

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Related Special Issue

Heart Failure: Clinical Diagnostics and Treatment, 2nd Edition in Journal of Cardiovascular Development and Disease

Published Papers (11 papers)

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Research

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11 pages, 513 KiB

Open AccessArticle

Comparison of Left Ventricular Global Longitudinal Strain and Left Ventricular Ejection Fraction in Acute Respiratory Failure Patients Requiring Invasive Mechanical Ventilation

by Zubair Bashir, Feven Ataklte, Shuyuan Wang, Edward W. Chen, Vishnu Kadiyala, Charles F. Sherrod, Phinnara Has, Christopher Song, Corey E. Ventetuolo, James Simmons and Philip Haines

J. Cardiovasc. Dev. Dis. 2024, 11(11), 339; https://doi.org/10.3390/jcdd11110339 - 24 Oct 2024

Viewed by 1180

Abstract

Left ventricular (LV) dysfunction is associated with poor clinical outcomes in acute respiratory failure (ARF). This study evaluates the efficacy of LV strain in detecting LV dysfunction in ARF patients requiring invasive mechanical ventilation (IMV) compared to conventionally measured left ventricular ejection fraction (LVEF). ARF patients requiring IMV who had echocardiography performed during MICU admission were included. LV global longitudinal strain (LVGLS) and LVEF were measured retrospectively using speckle tracking (STE) and traditional transthoracic echocardiography (TTE), respectively, by investigators blinded to the status of IMV and clinical data. The cohort was divided into three groups: TTE during IMV (TTE-IMV), before IMV (TTE-bIMV), and after IMV (TTE-aIMV). Multivariable regression models, adjusted for illness severity score, chronic cardiac disease, acute respiratory failure etiology, body mass index, chronic obstructive pulmonary disease, and obstructive sleep apnea, evaluated associations between LV function parameters and the presence of IMV. Among 376 patients, TTE-IMV, TTE-bIMV, and TTE-aIMV groups constituted 223, 68, and 85 patients, respectively. The median age was 65 years (IQR: 56–74), with 53.2% male participants. Adjusted models showed significantly higher LVGLS in groups not on IMV at the time of TTE (TTE-bIMV: β = 4.19, 95% CI 2.31 to 6.08, p < 0.001; TTE-aIMV: β = 3.79, 95% CI 2.03 to 5.55, p < 0.001), while no significant differences in LVEF were observed across groups. In a subgroup analysis of patients with LVEF ≥55%, the significant difference in LVGLS among the groups remained (TTE-bIMV: β = 4.18, 95% CI 2.22 to 6.15, p < 0.001; TTE-aIMV: β = 3.45, 95% CI 1.50 to 5.40, p < 0.001), but was no longer present in those with LVEF < 55%. This suggests an association between IMV and lower LVGLS in ARF patients requiring IMV, indicating that LVGLS may be a more sensitive marker for detecting subclinical LV dysfunction compared to LVEF in this population. Future studies should track and assess serial echocardiography data in the same cohort of patients pre-, during, and post-IMV in order to validate these findings and prognosticate STE-detected LV dysfunction in ARF patients requiring IMV. Full article

(This article belongs to the Special Issue Heart Failure: Clinical Diagnostics and Treatment)

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14 pages, 1752 KiB

Open AccessArticle

Improved Interpretation of Pulmonary Artery Wedge Pressures through Left Atrial Volumetry—A Cardiac Magnetic Resonance Imaging Study

by Gülmisal Güder, Theresa Reiter, Maria Drayss, Wolfgang Bauer, Björn Lengenfelder, Peter Nordbeck, Georg Fette, Stefan Frantz, Caroline Morbach and Stefan Störk

J. Cardiovasc. Dev. Dis. 2024, 11(6), 178; https://doi.org/10.3390/jcdd11060178 - 11 Jun 2024

Viewed by 1542

Abstract

Background: The pulmonary artery wedge pressure (PAWP) is regarded as a reliable indicator of left ventricular end-diastolic pressure (LVEDP), but this association is weaker in patients with left-sided heart disease (LHD). We compared morphological differences in cardiac magnetic resonance imaging (CMR) in patients with heart failure (HF) and a reduced left ventricular ejection fraction (LVEF), with or without elevation of PAWP or LVEDP. Methods: We retrospectively identified 121 patients with LVEF < 50% who had undergone right heart catheterization (RHC) and CMR. LVEDP data were available for 75 patients. Results: The mean age of the study sample was 63 ± 14 years, the mean LVEF was 32 ± 10%, and 72% were men. About 53% of the patients had an elevated PAWP (>15 mmHg). In multivariable logistic regression analysis, NT-proBNP, left atrial ejection fraction (LAEF), and LV end-systolic volume index independently predicted an elevated PAWP. Of the 75 patients with available LVEDP data, 79% had an elevated LVEDP, and 70% had concomitant PAWP elevation. By contrast, all but one patient with elevated PAWP and half of the patients with normal PAWP had concomitant LVEDP elevation. The Bland–Altman plot revealed a systematic bias of +5.0 mmHg between LVEDP and PAWP. Notably, LAEF was the only CMR variable that differed significantly between patients with elevated LVEDP and a PAWP ≤ or >15 mmHg. Conclusions: In patients with LVEF < 50%, a normal PAWP did not reliably exclude LHD, and an elevated LVEDP was more frequent than an elevated PAWP. LAEF was the most relevant determinant of an increased PAWP, suggesting that a preserved LAEF in LHD may protect against backward failure into the lungs and the subsequent increase in pulmonary pressure. Full article

(This article belongs to the Special Issue Heart Failure: Clinical Diagnostics and Treatment)

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13 pages, 3451 KiB

Open AccessArticle

Intravenous Cavutilide for Pharmacological Conversion of Paroxysmal and Persistent Atrial Fibrillation in Patients with Heart Failure

by Maria M. Beliaeva, Khava M. Dzaurova, Yulia A. Yuricheva, Peter S. Novikov, Nikolay Yu. Mironov, Gennady S. Tarasovskiy, Maksim A. Zelberg, Sergey F. Sokolov and Sergey P. Golitsyn

J. Cardiovasc. Dev. Dis. 2023, 10(12), 487; https://doi.org/10.3390/jcdd10120487 - 6 Dec 2023

Viewed by 1916

Abstract

This work aimed to study the efficacy and safety of the class III antiarrhythmic agent cavutilide (Niferidil, Refralon) for pharmacological cardioversion in patients with paroxysmal and persistent atrial fibrillation (AF) and heart failure (HF). Methods and Results: In this retrospective cohort study, 58 patients with stable HF (aged 69 [61;73] years, 30 males, 78% with persistent AF) and 274 patients without HF (aged 63 [57;70] years, 196 males, 56% with persistent AF) were included. The median AF duration in the group with HF was 35.5 [10.6;124] days, and that in the group without HF was 14.5 [3.6;90] days. All patients received 5–30 µg/kg cavutilide intravenously in one to four (if needed) boluses of 5–5–10–10 µg/kg at 15 min intervals. Subsequent boluses were not administered if the patient’s sinus rhythm (SR) was restored or if bradycardia, QT prolongation > 500 ms or evidence of proarrhythmia was observed. Holter electrocardiogram monitoring was started before infusion and was continued for 24 h. The main criterion for an antiarrhythmic effect was sinus rhythm restoration within 24 h of the initial bolus. Results: Cavutilide converted AF to SR in 37.9% of patients with HF after bolus 1 (5 µg/kg), in 58.6% after bolus 2 (cumulative dose = 10 µg/kg), in 74% of cases after bolus 3 (cumulative dose = 20 µg/kg) and in 92.8% of cases after bolus 4 (cumulative dose = 30 µg/kg). Cavutilide was effective in 89% of cases with persistent AF with a median duration of 70.5 [30;159] days and in 92% of cases with paroxysmal AF with a median duration of 36 [24;102] h. In the group of patients without HF, the effectiveness of bolus 1 was 36.9%, that of the bolus 2 was 58%, that of the bolus 3 was 77% and that of the bolus 4 was 90.1%. Cavutilide restored SR in 90% of patients with persistent AF with a median duration of 82.5 [28;180] days and in 90% of cases with paroxysmal AF with a median duration of 50 [24;120] h. No statistically significant difference in the probability of SR restoration or the effectiveness of each bolus of cavutilide was found between patients with and without HF. The median time to restoration of SR in patients with HF was 23 [11;55] min, and that in patients without HF was 22 [10;45] min (p = 0.424). No cases of symptomatic/severe bradycardia were observed in either group. QT prolongation over 500 ms after cavutilide injection was registered in 19% of patients without HF and in 15.5% of those with HF (p = 0.58). Short runs of Torsade de pointes tachycardia occurred in one patient (0.4%) without HF after 10 µg cavutilide administration and were successfully treated with MgSO₄. Conclusions: Cavutilide demonstrated a high likelihood of AF conversion to SR in paroxysmal (92%) and persistent (89%) arrhythmia and HF. Concomitant HF and its severity do not affect the efficacy and safety of cavutilide. Full article

(This article belongs to the Special Issue Heart Failure: Clinical Diagnostics and Treatment)

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21 pages, 3121 KiB

Open AccessArticle

Relationship of Acylcarnitines to Myocardial Ischemic Remodeling and Clinical Manifestations in Chronic Heart Failure

by Yuri N. Belenkov, Anton A. Ageev, Maria V. Kozhevnikova, Natalia V. Khabarova, Anastasia V. Krivova, Ekaterina O. Korobkova, Ludmila V. Popova, Alexey V. Emelyanov, Svetlana A. Appolonova, Natalia E. Moskaleva, Ksenia M. Shestakova and Elena V. Privalova

J. Cardiovasc. Dev. Dis. 2023, 10(10), 438; https://doi.org/10.3390/jcdd10100438 - 21 Oct 2023

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Abstract

Background: Progressive myocardial remodeling (MR) in chronic heart failure (CHF) leads to aggravation of systolic dysfunction (SD) and clinical manifestations. Identification of metabolomic markers of these processes may help in the search for new therapeutic approaches aimed at achieving reversibility of MR and improving prognosis in patients with CHF. Methods: To determine the relationship between plasma acylcarnitine (ACs) levels, MR parameters and clinical characteristics, in patients with CHF of ischemic etiology (n = 79) and patients with coronary heart disease CHD (n = 19) targeted analysis of 30 ACs was performed by flow injection analysis mass spectrometry. Results: Significant differences between cohorts were found for the levels of 11 ACs. Significant positive correlations (r > 0.3) between the medium- and long-chain ACs (MCACs and LCACs) and symptoms (CHF NYHA functional class (FC); r = 0.31−0.39; p < 0.05); negative correlation (r = −0.31−0.34; p < 0.05) between C5-OH and FC was revealed. Positive correlations of MCACs and LCACs (r = 0.31−0.48; p < 0.05) with the left atrium size and volume, the right atrium volume, right ventricle, and the inferior vena cava sizes, as well as the pulmonary artery systolic pressure level were shown. A negative correlation between C18:1 and left ventricular ejection fraction (r = −0.31; p < 0.05) was found. However, a decrease in levels compared to referent values of ACs with medium and long chain lengths was 50% of the CHF-CHD cohort. Carnitine deficiency was found in 6% and acylcarnitine deficiency in 3% of all patients with chronic heart disease. Conclusions: ACs may be used in assessing the severity of the clinical manifestations and MR. ACs are an important locus to study in terms of altered metabolic pathways in patients with CHF of ischemic etiology and SD. Further larger prospective trials are warranted and needed to determine the potential benefits to treat patients with CV diseases with aberrate AC levels. Full article

(This article belongs to the Special Issue Heart Failure: Clinical Diagnostics and Treatment)

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13 pages, 1504 KiB

Open AccessArticle

Benefit of Catheter Ablation for Atrial Fibrillation in Heart Failure Patients with Different Etiologies

by Songbing Long, Yuanjun Sun, Xianjie Xiao, Zhongzhen Wang, Wei Sun, Lianjun Gao, Yunlong Xia and Xiaomeng Yin

J. Cardiovasc. Dev. Dis. 2023, 10(10), 437; https://doi.org/10.3390/jcdd10100437 - 20 Oct 2023

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Abstract

(1) Background: A plethora of studies have elucidated the safety and efficacy of catheter ablation (CA) for patients afflicted with atrial fibrillation (AF) and concomitant reduction in left ventricular ejection fraction (LVEF). Nevertheless, the literature on the benefits of CA in the specific etiological context of heart failure (HF) remains limited. This study delineates a comparative assessment of outcomes for patients with AF and reduced LVEF across the primary etiologies. (2) Methods: Our inquiry encompassed 216 patients diagnosed with congestive heart failure and an LVEF of less than 50 percent who were referred to our institution for circumferential pulmonary vein isolation (CPVI) between the years 2016 and 2020. The selection criteria included a detailed medical history while excluding those suffering from valvular disease, congenital heart disease, and hypertrophic cardiomyopathy. In an effort to scrutinize varying etiologies, patients were stratified into three categories: dilated cardiomyopathy (DCM, n = 56, 30.6%), ischemic cardiomyopathy (ICM, n = 68, 37.2%), and tachycardia-induced cardiomyopathy (TIC, n = 59, 32.2%). (3) Results: Following an average (±SD) duration of 36 ± 3 months, the prevalence of sinus rhythm was 52.1% in the DCM group, 50.0% in the ICM group, and 68.14% in the TIC group (p = 0.014). This study revealed a significant disparity between the DCM and TIC groups (p = 0.021) and the ICM and TIC groups (p = 0.007), yet no significant distinction was discerned between the TIC and ICM groups (p = 0.769). Importantly, there were no significant variations in the application of antiarrhythmic drugs or recurrence of procedures among the three groups. The mortality rates were 14.29% for the DCM group and 14.71% for the ICM group, which were higher than the 3.39% observed in the TIC group (DCM vs. TIC p = 0.035 (HR = 4.50 (95%CI 1.38–14.67)), ICM vs. TIC p = 0.021 (HR = 5.00 (95%CI 1.61–15.50))). A noteworthy enhancement in heart function was evidenced in the TIC group in comparison to the DCM and ICM groups, including a higher LVEF (p < 0.001), diminution of LV end-diastolic diameter (p < 0.001), and an enhanced New York Heart Association classification (p = 0.005). Hospitalization rates for heart failure were discernibly lower in TIC patients (0.98 (0,2) times) relative to those with DCM (1.74 (0,3) times, p < 0.01) and TIC (1.78 (0,4) times, p < 0.001). Patients with paroxysmal atrial fibrillation and brief episodes were found to achieve superior clinical outcomes through a catheter ablation strategy. (4) Conclusion: Patients diagnosed with TIC demonstrated a more pronounced benefit from catheter ablation compared to those with DCM and ICM. This encompassed an augmented improvement in cardiac function, an enhanced maintenance of sinus rhythm, and a reduced mortality rate. Full article

(This article belongs to the Special Issue Heart Failure: Clinical Diagnostics and Treatment)

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10 pages, 859 KiB

Open AccessArticle

Differences in Demographics, in-Hospital Management and Short-Term Prognosis in Admissions for Acutely Decompensated Heart Failure to Cardiology vs. Internal Medicine Departments: A Prospective Study

by Maria-Anna Bazmpani, Christos A. Papanastasiou, Vasilios Giampatzis, Vasileios Kamperidis, Thomas Zegkos, Pantelis Zebekakis, Christos Savopoulos, Haralambos Karvounis, Georgios K. Efthimiadis, Antonios Ziakas and Theodoros D. Karamitsos

J. Cardiovasc. Dev. Dis. 2023, 10(8), 315; https://doi.org/10.3390/jcdd10080315 - 26 Jul 2023

Viewed by 1318

Abstract

Heart failure (HF) is among the leading causes of unplanned hospital admissions worldwide. Patients with HF carry a high burden of comorbidities; hence, they are frequently admitted for non-cardiac conditions and managed in Internal Medicine Departments (IMD). The aim of our study was to investigate differences in demographics, in-hospital management, and short-term outcomes of HF patients admitted to IMD vs. cardiology departments (CD). A prospective cohort study enrolling consecutive patients with acutely decompensated HF either as primary or as secondary diagnosis during the index hospitalization was conducted. Our primary endpoint was a combined endpoint of in-hospital mortality and 30-day rehospitalization for HF. A total of 302 patients participated in the study, with 45% of them admitted to IMD. Patients managed by internists were older with less pronounced HF symptoms on admission. In-hospital mortality was higher for patients admitted to IMD vs. CD (21% vs. 6%, p < 0.001). The composite endpoint of in-hospital death and heart failure hospitalizations at 30 days post-discharge was higher for patients admitted to IMD both in univariate [OR: 3.2, 95% CI (1.8–5.7); p < 0.001] and in multivariate analysis [OR 3.74, 95% CI (1.72–8.12); p = 0.001]. In addition, the HF rehospitalization rate at 6 months after discharge was higher in IMD patients [HR 1.65, 95% CI (1.1, 2.4), p = 0.01]. Overall, HF patients admitted to IMD have worse short-term outcomes compared to patients admitted to CD. Full article

(This article belongs to the Special Issue Heart Failure: Clinical Diagnostics and Treatment)

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10 pages, 620 KiB

Open AccessArticle

Glucose-Induced Hemodynamic and Metabolic Response of Skeletal Muscle in Heart Failure Patients with Reduced vs. Preserved Ejection Fraction—A Pilot Study

by Michael Boschmann, Lars Klug, Frank Edelmann, Anja Sandek, Stephan von Haehling, Hans-Dirk Düngen, Jochen Springer, Stefan D. Anker, Wolfram Doehner and Nadja Jauert

J. Cardiovasc. Dev. Dis. 2022, 9(12), 456; https://doi.org/10.3390/jcdd9120456 - 13 Dec 2022

Cited by 1 | Viewed by 2006

Abstract

(1) Background: Insulin resistance (IR) is a characteristic pathophysiologic feature in heart failure (HF). We tested the hypothesis that skeletal muscle metabolism is differently impaired in patients with reduced (HFrEF) vs. preserved (HFpEF) ejection fraction. (2) Methods: carbohydrate and lipid metabolism was studied in situ by intramuscular microdialysis in patients with HFrEF (59 ± 14y, NYHA I-III) and HFpEF (65 ± 10y, NYHA I-II) vs. healthy subjects of similar age during the oral glucose load (oGL); (3) Results: There were no difference in fasting serum and interstitial parameters between the groups. Blood and dialysate glucose increased significantly in HFpEF vs. HFrEF and controls upon oGT (both p < 0.0001), while insulin increased significantly in HFrEF vs. HFpEF and controls (p < 0.0005). Muscle tissue perfusion tended to be lower in HFrEF vs. HFpEF and controls after the oGL (p = 0.057). There were no differences in postprandial increases in dialysate lactate and pyruvate. Postprandial dialysate glycerol was higher in HFpEF vs. HFrEF and controls upon oGL (p = 0.0016); (4) Conclusion: A pattern of muscle glucose metabolism is distinctly different in patients with HFrEF vs. HFpEF. While postprandial IR was characterized by impaired tissue perfusion and higher compensatory insulin secretion in HFrEF, reduced muscle glucose uptake and a blunted antilipolytic effect of insulin were found in HFpEF. Full article

(This article belongs to the Special Issue Heart Failure: Clinical Diagnostics and Treatment)

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8 pages, 655 KiB

Open AccessEditor’s ChoiceArticle

Right Ventricular Septal Versus Apical Pacing: Long-Term Incidence of Heart Failure and Survival

by André Dias-Frias, Ricardo Costa, Andreia Campinas, André Alexandre, David Sá-Couto, Maria João Sousa, Carla Roque, Pinheiro Vieira, Vitor Lagarto, Hipólito Reis and Severo Torres

J. Cardiovasc. Dev. Dis. 2022, 9(12), 444; https://doi.org/10.3390/jcdd9120444 - 9 Dec 2022

Cited by 2 | Viewed by 2366

Abstract

The clinical benefits of right ventricular septal (RVS) pacing compared to those of right ventricular apical (RVA) pacing are still in debate. We aimed to compare the incidence of heart failure (HF) and all-cause mortality in patients submitted to RVS and RVA pacing during a longer follow-up. This a single-center, retrospective study analysis of consecutive patients submitted to pacemaker implantation. The primary outcome was defined as the occurrence of HF during follow-up. The secondary outcome was all-cause death. A total of 251 patients were included, 47 (18.7%) with RVS pacing. RVS pacing was associated to younger age, male gender, lower body mass index, ischemic heart disease, and atrial fibrillation. During a follow-up period of 5.2 years, the primary outcome occurred in 89 (37.1%) patients. RVS pacing was independently associated with a 3-fold lower risk of HF, after adjustment. The secondary outcome occurred in 83 (34.2%) patients, and pacemaker lead position was not a predictor. Fluoroscopy time and rate of complications (rarely life-threatening) were similar in both groups. Our study points to a potential clinical benefit of RVS positioning, with a 3.3-fold lower risk of HF, without accompanying increase in procedure complexity nor complication rate. Full article

(This article belongs to the Special Issue Heart Failure: Clinical Diagnostics and Treatment)

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10 pages, 870 KiB

Open AccessArticle

An Inverse Correlation between the Atherogenic Index of Plasma and Heart Failure: An Analysis of the National Health and Nutrition Examination Survey 2017–March 2020 Pre-Pandemic Data

by Jianying Xue, Lu He, Hang Xie, Xuegang Xie and Haiyan Wang

J. Cardiovasc. Dev. Dis. 2022, 9(12), 412; https://doi.org/10.3390/jcdd9120412 - 23 Nov 2022

Cited by 5 | Viewed by 2184

Abstract

Aims: The atherogenic index of plasma (AIP) is associated with cardiovascular diseases. Nevertheless, limited studies have investigated the association between AIP and the risk of heart failure (HF) in the general population. This study aimed to explore the association between AIP and HF risk using a large-scale population dataset from the National Health and Nutrition Examination Survey (NHANES) 2017–March 2020 Pre-pandemic data. Methods: A total of 5598 individuals were included in the analysis of the association between AIP and HF from the NHANES database. The relationship between AIP and HF was examined using multivariate logistic regression and smooth curve fitting. An association between the two was detected based on the odds ratios (ORs) and 95% confidence intervals (CIs). Results: The overall prevalence of HF among the 5598 participants analyzed was 3.21%. Compared with individuals in the lowest quartile of AIP, participants in the higher quartiles showed a significantly reduced probability of HF. Smooth curve fitting analysis revealed a linear association between AIP and HF. Compared with individuals in Q1 of the AIP, participants in Q2 (OR = 0.38, 95% CI = 0.2–0.72, p = 0.0033), Q3 (OR = 0.24, 95% CI = 0.12–0.48, p < 0.0001), and Q4 (OR = 0.32, 95% CI = 0.14–0.74, p = 0.0075) had a significantly decreased risk of HF after adjusting for other risk factors. Analysis of subgroup strata revealed that AIP may interact with age and statin use (p for interaction = 0.012 and 0.0022, respectively). Conclusion: Our results suggest that a high AIP value is negatively correlated with HF prevalence. The AIP may be an effective method for identifying individuals at a high risk of HF. Full article

(This article belongs to the Special Issue Heart Failure: Clinical Diagnostics and Treatment)

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Review

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14 pages, 1030 KiB

Open AccessReview

A Critical Evaluation of Patient Pathways and Missed Opportunities in Treatment for Heart Failure

by Chun Shing Kwok, Duwarakan Satchithananda, Fozia Z. Ahmed, Colin D. Chue, Diane Barker, Ashish Patwala, Simon Duckett and Christian D. Mallen

J. Cardiovasc. Dev. Dis. 2022, 9(12), 455; https://doi.org/10.3390/jcdd9120455 - 12 Dec 2022

Cited by 6 | Viewed by 2126

Abstract

Background: Heart failure (HF) is a global problem responsible for significant morbidity and mortality. Methods: This review describes the patient pathways and missed opportunities related to treatment for patients with HF. Results: The contemporary management strategies in HF, including medical therapies, device therapy, transplant, and palliative care. Despite the strong evidence base for therapies that improve prognosis and symptoms, there remains a large number of patients that are not optimally managed. The treatment of patients with HF is highly influenced by those who are caring for them and varies widely across geographical regions. HF patients can be broadly classified into two key groups: those who have known HF, and those who are incidentally found to have reduced left ventricular systolic dysfunction or other cardiac abnormality when an echocardiogram is performed. While all patients are under the care of a general practitioner or family doctor, in other instances, non-cardiologist physicians, cardiologists, and specialist HF nurses—each will have varying levels of expertise in managing HF—are part of the broader team involved in the specialist management of patients with HF. Conclusions: There are many potential missed opportunities in HF treatment, which include general opportunities, medications, etiology-specific therapy, device therapy, therapies when initial treatments fail, and palliative care. Full article

(This article belongs to the Special Issue Heart Failure: Clinical Diagnostics and Treatment)

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Other

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15 pages, 1800 KiB

Open AccessSystematic Review

Educational Nursing Intervention in Reducing Hospital Readmission and the Mortality of Patients with Heart Failure: A Systematic Review and Meta-Analysis

by Cleidinaldo Ribeiro de Goes Marques, Andreia Freire de Menezes, Yasmim Anayr Costa Ferrari, Alan Santos Oliveira, Arthur César Melo Tavares, André Sales Barreto, Rita de Cássia Almeida Vieira, Cassiane Dezoti da Fonseca and Eduesley Santana-Santos

J. Cardiovasc. Dev. Dis. 2022, 9(12), 420; https://doi.org/10.3390/jcdd9120420 - 28 Nov 2022

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Abstract

(1) Background: Heart failure (HF) represents a public health problem due to its high morbidity and mortality, increased consumption of health resources, prolonged hospitalization, and frequent readmissions. This study was conducted to evaluate the effectiveness of a nursing educational intervention using home visits (HV) combined with telephone contact in reducing hospital readmission and the mortality of patients with HF. (2) Methods: This is systematic review and meta-analysis of randomized controlled trials (RCTs). The databases used were CINAHL, Cochrane, PubMed and SciELO. A gray literature search included Google Scholar, OpenThesis, Clinical trials and reference lists of eligible studies. RCTs of patients diagnosed with HF were included, distributed between the control group (CG) and intervention (IG), in which the IG was submitted to the nursing intervention with HV and telephone contact in association and analyzed the result of readmission and mortality. (3) Results: The search resulted in 2528 articles and, after following steps, 11 remained for final analysis. A total of 1417 patients were analyzed and distributed: 683 in the IG and 734 in the CG. As a primary outcome, the meta-analysis identified a 36% reduction in the risk of readmission [RR 0.64, 95% CI, 0.54–0.75, p < 0.01] and a 35% reduction in mortality in the IG [RR 0.65, 95% CI, 0.50–0.85, p < 0.01]. Heterogeneity was moderate for readmission and homogeneous for mortality. (4) Conclusions: HV and telephone contact are an effective intervention strategy for nurses’ educational practice. Full article

(This article belongs to the Special Issue Heart Failure: Clinical Diagnostics and Treatment)

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