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Recent Advances and Emerging Therapeutic Approaches for the Treatment of Heart Failure

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

Deadline for manuscript submissions: closed (25 October 2024) | Viewed by 7358

Special Issue Editors

Prof. Dr. Nikolaos K. Fragakis

E-Mail Website
Guest Editor
Second Department of Cardiology, Hippokration General Hospital, Aristotle University of Thessaloniki, 54642 Thessaloniki, Greece
Interests: arrhythmias; supraventricular tachycardia; syncope; bradycardia; ventricular arrhythmias; sudden cardiac death (SCD); atrial fibrillation; heart failure
Special Issues, Collections and Topics in MDPI journals
Dr. Efstratios Karagiannidis

E-Mail Website
Guest Editor
1. Second Department of Cardiology, Hippokration General Hospital, Aristotle University of Thessaloniki, 54642 Thessaloniki, Greece
2. Department of Emergency Medicine, AHEPA University Hospital, 54636 Thessaloniki, Greece
Interests: myocardial infarction; heart failure; coronary artery disease; atrial fibrillation; arrhythmias
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Heart failure (HF) has been described as a growing epidemic, due to the ageing population as well as the improvement in survival after its diagnosis. Despite striking advances in recent years, considerable uncertainties still surround its pathophysiologic mechanisms and optimal management. This Special Issue of the Journal of Clinical Medicine aims to highlight the recent advances and the emerging therapeutic approaches in the field of HF management. Researchers will have the opportunity to publish both original research and review articles related to contemporary findings about both invasive and non-invasive treatment of HF across the spectrum of ejection fraction. This Special Issue aims to contribute to the implementation of novel therapeutic approaches regarding holistic, personalized, and patient-centered management of HF in everyday clinical practice.

Prof. Dr. Nikolaos K. Fragakis
Dr. Efstratios Karagiannidis
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 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

  • heart failure
  • heart failure with reduced ejection fraction
  • heart failure with preserved ejection fraction
  • cardiomyopathies
  • therapeutic approaches

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Published Papers (5 papers)

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Research

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12 pages, 1975 KiB  
Article
The Prognostic Role of RDW in Hospitalized Heart Failure Patients with and Without Chronic Kidney Disease
by Grigorios Giamouzis, Christos Kourek, Dimitrios E. Magouliotis, Alexandros Briasoulis, George E. Zakynthinos, Assaf Sawafta, Nikolaos Iakovis, Georgios Afxonidis, Kyriakos Spiliopoulos, Filippos Triposkiadis, Thanos Athanasiou, John Skoularigis and Andrew Xanthopoulos
J. Clin. Med. 2024, 13(23), 7395; https://doi.org/10.3390/jcm13237395 - 4 Dec 2024
Viewed by 696
Abstract
Background: Chronic kidney disease (CKD) and heart failure (HF) are interrelated conditions that exacerbate each other through mechanisms like fluid retention, neurohormonal activation, and inflammation. Red blood cell distribution width (RDW), a measure of red blood cell size variability, has emerged as a [...] Read more.
Background: Chronic kidney disease (CKD) and heart failure (HF) are interrelated conditions that exacerbate each other through mechanisms like fluid retention, neurohormonal activation, and inflammation. Red blood cell distribution width (RDW), a measure of red blood cell size variability, has emerged as a potential prognostic marker in HF. This study aimed to assess the prognostic value of RDW in HF patients, both with and without CKD, focusing on all-cause mortality and HF rehospitalizations. Methods: This observational retrospective study included 171 patients hospitalized for acute decompensated HF in a tertiary university hospital in Greece. Patients were divided into two groups based on their estimated glomerular filtration rate (eGFR), as Group 1 (eGFR < 60 mL/min/1.73 m2) and Group 2 (eGFR ≥ 60 mL/min/1.73 m2). RDW was measured upon admission, and outcomes of interest were all-cause mortality and HF rehospitalizations over a median follow-up period of 6.1 months. Statistical analyses included Kaplan–Meier survival curves, whereas the discrimination traits of RDW were evaluated by constructing receiver operating characteristic (ROC) curves and by calculating the area under the ROC curve (AUC). A p-value <0.05 was indicative of a statistically important result. Results: Patients in Group 1 (eGFR < 60 mL/min/1.73 m2) were older (80 (73–86) vs. 75 (62–83)) and manifested higher median RDW values (16.6 (15.0–18.8) vs. 15.6 (14.1–17.8)) and received less frequent (57.9% vs. 75%) mineralocorticoid receptor antagonists (MRAs) as compared to those in Group 2 (eGFR ≥ 60 mL/min/1.73 m2). RDW demonstrated better prognostic value in predicting combined mortality and rehospitalization outcomes in Group 2 patients (area under the curve: 0.70; 95% CI (0.62–0.80)) compared to those in Group 1 (area under the curve: 0.53; 95% CI (0.35–0.72)). No statistically significant differences (p = 0.579) were observed in survival between patients with high (≥15%) and low (<15%) RDW values in the overall population, though trends favored worse outcomes with elevated RDW. Similarly, no significant differences (p = 0.374) were observed in survival between patients with high (Group 2) and low (Group 1) eGFR values. Conclusions: RDW appears to be a meaningful prognostic biomarker for HF patients, particularly in those without CKD. Further multicenter studies are needed to validate its clinical utility and potential for guiding treatment in this high-risk population. Full article
(This article belongs to the Special Issue Recent Advances and Emerging Therapeutic Approaches for the Treatment of Heart Failure)
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11 pages, 1750 KiB  
Article
Prognostic Impact of Body Mass Index in Atrial Fibrillation
by Maria Nteli, Despoina Nteli, Dimitrios V. Moysidis, Anastasia Foka, Panagiotis Zymaris, Triantafyllia Grantza, Olga Kazarli, Alexis Vagianos, Andreas S. Papazoglou, Anastasios Kartas, Athanasios Samaras, Alexandra Bekiaridou, Efstathios Spyridonidis, Antonios Ziakas, Apostolos Tzikas and George Giannakoulas
J. Clin. Med. 2024, 13(11), 3294; https://doi.org/10.3390/jcm13113294 - 3 Jun 2024
Cited by 1 | Viewed by 815
Abstract
Background/Objectives: Contradictory results have been reported regarding the influence of obesity on the prognosis of atrial fibrillation (AF). The present study aimed to explore the potential association of body mass index (BMI) with the clinical outcomes of hospitalized patients with AF. Methods [...] Read more.
Background/Objectives: Contradictory results have been reported regarding the influence of obesity on the prognosis of atrial fibrillation (AF). The present study aimed to explore the potential association of body mass index (BMI) with the clinical outcomes of hospitalized patients with AF. Methods: In this retrospective, post hoc analysis of the MISOAC-AF randomized trial, 1113 AF patients were included and stratified as the following: underweight (BMI < 18 kg/m2), normal weight (BMI 18–24.9 kg/m2), overweight (BMI 25–29.9 kg/m2), and obese (BMI ≥ 30 kg/m2). The primary outcome was all-cause mortality; the secondary composite outcome was any hospitalization related to AF, heart failure (HF), or stroke. Cox regression analysis, survival analysis, and spline curve models were utilized. Results: Of the patients (median age: 76 years (IQR: 13), male: 54.6%), the majority were overweight (41.4%), followed by obese (33%), normal weight (24%), and underweight (1.6%). During a median 31-month follow-up, 436 (39.2%) patients died and 657 (59%) were hospitalized due to AF, HF, or stroke. Underweight, overweight, and obesity groups were significantly associated with an increased risk of all-cause mortality (p-values 0.02, 0.001, and <0.001, respectively), while overweight and obesity were significantly associated with the composite endpoint (p-values 0.01, <0.001, respectively) compared to normal weight. The spline curve analyses yielded that BMIs > 26.3 and > 25 were incrementally associated with all-cause mortality and the composite endpoint, respectively. A J-shaped relationship between BMI and AF prognosis was deduced. Conclusions: In conclusion, in recently hospitalized AF patients, BMI values outside the normal range were independently associated with poorer prognosis; therefore, it is essential that AF patients maintain a normal weight. Full article
(This article belongs to the Special Issue Recent Advances and Emerging Therapeutic Approaches for the Treatment of Heart Failure)
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11 pages, 952 KiB  
Article
Systemic Congestion as a Determinant of Efficacy in Adaptive Servo-Ventilation Therapy: A Retrospective Observational Study
by Yu Nomoto, Teruhiko Imamura and Koichiro Kinugawa
J. Clin. Med. 2024, 13(3), 674; https://doi.org/10.3390/jcm13030674 - 24 Jan 2024
Viewed by 919
Abstract
Background: The optimal criteria for patient selection in the context of adaptive servo-ventilation (ASV) therapy remain a subject of ongoing investigation. We postulate that baseline plasma volume, assessable through several straightforward clinical parameters, might be correlated with a more pronounced reduction in plasma [...] Read more.
Background: The optimal criteria for patient selection in the context of adaptive servo-ventilation (ASV) therapy remain a subject of ongoing investigation. We postulate that baseline plasma volume, assessable through several straightforward clinical parameters, might be correlated with a more pronounced reduction in plasma B-type natriuretic peptide (BNP) levels following mid-term ASV therapy. Methods: We included patients diagnosed with congestive heart failure who had received continuous ASV therapy for a minimum of three months. The primary outcome of interest was the extent of decline in logarithmically transformed plasma BNP levels, defined as a decrease of more than 0.10 during the 3-month ASV treatment period. Results: A total of 66 patients were included in the study. The median age of the cohort was 66 years, with 53 patients (80%) being male. The median plasma volume status at baseline was −16.9%, and patients were categorized into two groups based on this median value. Patients with elevated baseline plasma volume status experienced a statistically significant reduction in plasma BNP levels (p = 0.016), whereas those with lower plasma volume exhibited no significant change in BNP levels (p = 0.23). A higher baseline plasma volume status was independently associated with a significant reduction in plasma BNP levels, with an adjusted odds ratio of 1.036 (95% confidence interval: 1.01–1.07, p = 0.032). Conclusions: The presence of systemic congestion at baseline, quantified by the estimated plasma volume status, may serve as a crucial determinant of the efficacy of ASV therapy, leading to improvements in plasma BNP levels among patients suffering from congestive heart failure. Full article
(This article belongs to the Special Issue Recent Advances and Emerging Therapeutic Approaches for the Treatment of Heart Failure)
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Review

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13 pages, 494 KiB  
Review
Percutaneous Mechanical Circulatory Support in Acute Heart Failure Complicated with Cardiogenic Shock
by Maria Parthena Xenitopoulou, Kyriaki Ziampa, Alexandros P. Evangeliou, Stergios Tzikas and Vasileios Vassilikos
J. Clin. Med. 2024, 13(9), 2642; https://doi.org/10.3390/jcm13092642 - 30 Apr 2024
Viewed by 2072
Abstract
Despite advancements in algorithms concerning the management of cardiogenic shock, current guidelines still lack the adequate integration of mechanical circulatory support devices. In recent years, more and more devices have been developed to provide circulatory with or without respiratory support, when conservative treatment [...] Read more.
Despite advancements in algorithms concerning the management of cardiogenic shock, current guidelines still lack the adequate integration of mechanical circulatory support devices. In recent years, more and more devices have been developed to provide circulatory with or without respiratory support, when conservative treatment with inotropic agents and vasopressors has failed. Mechanical circulatory support can be contemplated for patients with severe, refractory, or acute-coronary-syndrome-related cardiogenic shock. Through this narrative review, we delve into the differences among the types of currently used devices by presenting their notable advantages and inconveniences. We address the technical issues emerging while choosing the best possible device, temporarily as a bridge to another treatment plan or as a destination therapy, in the optimal timing for each type of patient. We also highlight the diverse implantation and removal techniques to avoid major complications such as bleeding and limb ischemia. Ultimately, we hope to shed some light in the gaps of evidence and the importance of conducting further organized studies around the topic of mechanical circulatory support when dealing with such a high mortality rate. Full article
(This article belongs to the Special Issue Recent Advances and Emerging Therapeutic Approaches for the Treatment of Heart Failure)
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Other

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16 pages, 2601 KiB  
Systematic Review
Intravenous Landiolol for Rate Control in Supraventricular Tachyarrhythmias in Patients with Left Ventricular Dysfunction: A Systematic Review and Meta-Analysis
by Athina Nasoufidou, Andreas S. Papazoglou, Panagiotis Stachteas, Efstratios Karagiannidis, Athanasios Samaras, Sophia Alexiou, Michail-Angelos Mourtzos, George Kassimis and Nikolaos Fragakis
J. Clin. Med. 2024, 13(6), 1683; https://doi.org/10.3390/jcm13061683 - 14 Mar 2024
Cited by 1 | Viewed by 1441
Abstract
Background: This systematic review explores the effects of landiolol administration in individuals presenting with supraventricular tachyarrhythmia (SVT) and concurrent left ventricular dysfunction, without being septic or in a peri-operative period. Methods: We systematically searched PubMed, Cochrane, Web of Science, and Scopus databases, retrieving [...] Read more.
Background: This systematic review explores the effects of landiolol administration in individuals presenting with supraventricular tachyarrhythmia (SVT) and concurrent left ventricular dysfunction, without being septic or in a peri-operative period. Methods: We systematically searched PubMed, Cochrane, Web of Science, and Scopus databases, retrieving a total of 15 eligible studies according to prespecified eligibility criteria. Results: Patients treated with landiolol experienced a substantial reduction in heart rate (HR) (mean HR reduction: 42 bpm, 95% confidence intervals (CIs): 37–47, I2 = 82%) and were more likely to achieve the target HR compared to those receiving alternative antiarrhythmic therapy (pooled odds ratio (OR): 5.37, 95% CIs: 2.87–10.05, I2 = 0%). Adverse events, primarily hypotension, occurred in 14.7% of patients receiving landiolol, but no significant difference was observed between the landiolol and alternative antiarrhythmic receiving groups (pooled OR: 1.02, 95% CI: 0.57–1.83, I2 = 0%). No significant difference was observed between the two groups concerning sinus rhythm restoration (pooled OR: 0.97, 95% CI: 0.25–3.78, I2 = 0%) and drug discontinuation due to adverse events (pooled OR: 5.09, 95% CI: 0.6–43.38, I2 = 0%). Conclusion: While further research is warranted, this systematic review highlights the potential benefits of landiolol administration in the management of SVTs in the context of left ventricular dysfunction. Full article
(This article belongs to the Special Issue Recent Advances and Emerging Therapeutic Approaches for the Treatment of Heart Failure)
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