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Assessing Strategies and Challenges in Heart Failure: An Update
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Assessing Strategies and Challenges in Heart Failure: An Update

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Cardiology".

Deadline for manuscript submissions: 25 May 2025 | Viewed by 267

Special Issue Editor

Dr. Shiro Hoshida

E-Mail Website
Guest Editor
Department of Cardiovascular Medicine, Yao Municipal Hospital, Osaka, Japan
Interests: heart failure; atrial fibrillation; pulmonary vein isolation; cardiology; clinical pharmacology; epidemiology

Special Issue Information

Dear Colleagues,

In an era with an increasing number of patients having heart failure, we unavoidably change clinical comprehensive understandings for pathophysiological situations. In the focus of treatment, certain progress has been made in terms of pharmacological agents and auxiliary circulation devices in addition to cardiac transplantation. In the facet of pathophysiology, the determination of its phenotype is progressing, but the evaluation of coronary microvascular dysfunction and/or myocardial metabolic injury and their means for improvement remain to be defined. In fact, pharmacological agents for diuresis and vasodilation could not improve the hard clinical endpoint, although signs and symptoms may be improved. In other words, the strategy for the evaluation of myocardial pathophysiology in heart failure should be established and challenging for their connection to treatment. This Special Issue aims to reveal an attractive strategy for the rescue of myocardial damage, resulting in the improved prognosis of patients with heart failure even in older age. I am pleased to invite you to submit any types of manuscripts, such as original research articles, reviews, perspectives, and state-of-the-art papers, regarding the clarification of the structural and functional mechanisms of CMD, cardiac functional/metabolic changes, or related issues in the pathophysiology and prognosis of heart failure.

I look forward to receiving your contributions.

Dr. Shiro Hoshida
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 Clinical Medicine is an international peer-reviewed open access semimonthly 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

  • cardiac MR
  • coronary microvascular dysfunction
  • diagnosis
  • endothelial function
  • heart failure
  • myocardial metabolism
  • prognosis

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Published Papers (1 paper)

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Research

12 pages, 806 KiB  
Article
Alternative Factors in Possible Involvement of Coronary Microvascular Dysfunction in Older Patients with HFpEF
by Shiro Hoshida, Tetsuya Watanabe, Nobutaka Masunaga, Yukinori Shinoda, Masahiro Seo, Takaharu Hayashi, Masamichi Yano, Takahisa Yamada, Yoshio Yasumura, Shungo Hikoso, Katsuki Okada, Daisaku Nakatani, Yohei Sotomi and Yasushi Sakata
J. Clin. Med. 2024, 13(19), 5911; https://doi.org/10.3390/jcm13195911 - 3 Oct 2024
Abstract
Objectives: Coronary microvascular dysfunction (CMD) is associated with many heart diseases, including heart failure (HF) with preserved ejection fraction (HFpEF). Invasive examinations for CMD detection are difficult in older patients with HFpEF, and the decision criteria for noninvasive CMD measurements are unclear. [...] Read more.
Objectives: Coronary microvascular dysfunction (CMD) is associated with many heart diseases, including heart failure (HF) with preserved ejection fraction (HFpEF). Invasive examinations for CMD detection are difficult in older patients with HFpEF, and the decision criteria for noninvasive CMD measurements are unclear. We aimed to identify alternative factors in the possible involvement of CMD in the progression and prognosis of HFpEF. Methods: We analyzed 607 patients with HFpEF who were hospitalized for acute decompensated HF without a history of coronary artery disease (CAD). Blood tests and transthoracic echocardiography were performed. We focused on left ventricular hypertrophy (LVH) and coronary perfusion pressure (diastolic blood pressure, dBP). Results: The patients with LVH showed reduced diastolic function (E/e’) and a lower incidence of atrial fibrillation (AF) compared with those without LVH, with no differences in age or dBP. No differences were observed in all-cause mortality between patients with low and high dBP without LVH. In the patients with LVH, the incidence of all-cause mortality was significantly higher, with a lower incidence of AF, reduced renal function, and higher C-reactive protein levels in those with low dBP than in those with high dBP. The comprehensive diastolic functional index, diastolic elastance/arterial elastance, was markedly higher in the patients with LVH, especially in those with all-cause mortality. This index, but not E/e’, was a significant prognostic index in the multivariate Cox hazard analysis when adjusting for age, sex and N-terminal pro-brain natriuretic peptide levels. Conclusions: LVH and dBP were clinically important factors in elderly HFpEF patients without a history of CAD. Full article
(This article belongs to the Special Issue Assessing Strategies and Challenges in Heart Failure: An Update)
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