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Advances in Acute and Chronic Heart Failure
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Advances in Acute and Chronic 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 (30 June 2023) | Viewed by 12535

Special Issue Editor

Dr. Akito Nakagawa

E-Mail Website
Guest Editor
1. Nakagawa Clinic, Shoushoukai Healthcare Corporation, Suita, Osaka 564-0082, Japan
2. Department of Cardiovascular Medicine, Graduate School of Medicine, Osaka University, Suita, Osaka 565-0871, Japan
3. Department of Medical Informatics, Graduate School of Medicine, Osaka University, Suita, Osaka 565-0871, Japan
Interests: heart failure; imaging; echocardiography; observational studies; medical informatics
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Several promising therapeutic candidates have emerged for not only heart failure (HF) with reduced ejection fraction, but also for HF with preserved ejection fraction. However, the pathophysiology, clinical background, and social environment of HF patients vary widely, making it difficult to apply the optimal solution to each individual patient. It is also necessary to distinguish between patients with acute decompensated HF and those with chronic persistent HF. Because of their different physical conditions and urgency, they should have different priorities and even different goals for treatment strategies. When considering the management of patients with acute HF, optimization and the continuation of guideline-directed medical therapy is necessary, but is often difficult to apply due to a variety of patient factors. Given the management of patients with advanced HF, the applications of palliative care, including palliative inotropic agents as well as aggressive intensive care, should be evaluated by a specialized HF team. As mentioned above, there is a wide variety of topics related to the management and treatment of HF that need to be considered and discussed in depth.

In this Special Issue, we encourage authors to submit papers on strategies for developing solutions to challenges in acute and chronic HF.

Dr. Akito Nakagawa
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

  • acute heart failure
  • chronic heart failure
  • pathophysiology
  • diagnosis
  • hemodynamic assessment
  • therapeutic strategy
  • outcomes

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Published Papers (5 papers)

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Research

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10 pages, 1737 KiB  
Article
Presence of Pleural Effusion in the Assessment of Remote Dielectric Sensing
by Teruhiko Imamura, Toshihide Izumida, Riona Yamamoto, Yu Nomoto, Kousuke Aakao and Koichiro Kinugawa
J. Clin. Med. 2023, 12(13), 4415; https://doi.org/10.3390/jcm12134415 - 30 Jun 2023
Viewed by 1018
Abstract
Background: The remote dielectric sensing (ReDS) system is a recently introduced non-invasive technology used to easily estimate the degree of lung fluid volume without any expert techniques. In the previous literature, ReDS values had a moderate correlation with invasively measured pulmonary artery wedge [...] Read more.
Background: The remote dielectric sensing (ReDS) system is a recently introduced non-invasive technology used to easily estimate the degree of lung fluid volume without any expert techniques. In the previous literature, ReDS values had a moderate correlation with invasively measured pulmonary artery wedge pressure (PAWP), the gold standard for representing left heart preload. Considering the mechanism of ReDS technology, ReDS values may be inappropriately elevated in the presence of pleural effusion (PE), and the ability of the ReDS system to estimate PAWP may decrease in such a situation. Methods: In-hospital patients with cardiovascular diseases underwent computed tomography, and the presence of pleural effusion (PE) was evaluated. The measurement of ReDS values using the ReDS system and the measurement of PAWP using invasive right heart catheterization were also performed simultaneously. The impact of the presence of PE on the relationship between the ReDS values and PAWP was evaluated. Results: A total of 59 patients (79 years, 30 male) were included. The median ReDS value was 25% (IQR: 22%, 30%) and the median PAWP level was 13 (IQR: 10, 18) mmHg. Of these patients, 11 had PE. PAWP was not significantly different between the two groups, whereas the ReDS values in the PE group were significantly higher than in the no-PE group. The impact of the presence of PE on the ReDS values was significant, with a beta value of 6.61 (95% confidence interval: 4.80–8.42, p < 0.001) upon adjusting for the levels of PAWP. Conclusions: We should pay attention to interpreting ReDS values when assessing the degree of pulmonary congestion in patients with PE, because ReDS values may be inappropriately elevated in this cohort. Full article
(This article belongs to the Special Issue Advances in Acute and Chronic Heart Failure)
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11 pages, 930 KiB  
Article
Risk Predictors of 3-Month and 1-Year Outcomes in Heart Failure Patients with Prior Ischemic Stroke
by Ding Li, Yu Wang, Feng Ze, Xu Zhou and Xue-Bin Li
J. Clin. Med. 2022, 11(19), 5922; https://doi.org/10.3390/jcm11195922 - 7 Oct 2022
Cited by 1 | Viewed by 1769
Abstract
Background: Despite available therapy, mortality, and readmission rates within 60–90 days of discharge for patients hospitalized with heart failure (HF) are higher compared to the 1-year rates. This study sought to identify the risk factors of the combined endpoint of all-cause readmission or [...] Read more.
Background: Despite available therapy, mortality, and readmission rates within 60–90 days of discharge for patients hospitalized with heart failure (HF) are higher compared to the 1-year rates. This study sought to identify the risk factors of the combined endpoint of all-cause readmission or death among HF patients. Methods: Patients with a diagnosis of HF aged 65 or older were included in this prospective observational cohort study. The outcomes were estimated within 3-months and 1 year of discharge. Risk modeling was performed using a multivariable Cox regression analysis of HF patients older than 65 who had experienced ischemic stroke. Results: A total of 951 HF patients enrolled, of whom 340 (35.8%) had suffered a prior ischemic stroke. Significant predictors of increased 3-month all-cause readmission or death included DBP (p = 0.045); serum albumin (p = 0.025), TSH (p = 0.017); and discharge without ACE-inhibitor/ARB/ARNI (p = 0.025), β-blockers (p = 0.029), and antiplatelet drugs (p = 0.005). Heart rate (p = 0.040), laboratory parameters—including serum albumin (p = 0.003), CRP p = 0.028), and FT4 (p = 0.018)—and discharge without β-blockers (p = 0.003), were significant predictors of increased 1-year all-cause readmission and death. Conclusions: Without β-blockers, lower serum albumin and abnormal thyroid function increase the risks of readmission and death in elderly HF patients who have had an ischemic stroke by 3 months and 1 year after discharge. The other factors, such as being without ACEI/ARB and a high heart rate, only increase risks before 3 months or 1 year, not both. Full article
(This article belongs to the Special Issue Advances in Acute and Chronic Heart Failure)
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Review

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12 pages, 614 KiB  
Review
Digital Health Technologies for Post-Discharge Care after Heart Failure Hospitalisation to Relieve Symptoms and Improve Clinical Outcomes
by Paweł Krzesiński
J. Clin. Med. 2023, 12(6), 2373; https://doi.org/10.3390/jcm12062373 - 19 Mar 2023
Cited by 5 | Viewed by 4688
Abstract
The prevention of recurrent heart failure (HF) hospitalisations is of particular importance, as each such successive event may increase the risk of death. Effective care planning during the vulnerable phase after discharge is crucial for symptom control and improving patient prognosis. Many clinical [...] Read more.
The prevention of recurrent heart failure (HF) hospitalisations is of particular importance, as each such successive event may increase the risk of death. Effective care planning during the vulnerable phase after discharge is crucial for symptom control and improving patient prognosis. Many clinical trials have focused on telemedicine interventions in HF, with varying effects on the primary endpoints. However, the evidence of the effectiveness of telemedicine solutions in cardiology is growing. The scope of this review is to present complementary telemedicine modalities that can support outpatient care of patients recently hospitalised due to worsening HF. Remote disease management models, such as video (tele) consultations, structured telephone support, and remote monitoring of vital signs, were presented as core components of telecare. Invasive and non-invasive monitoring of volume status was described as an important step forward to prevent congestion—the main cause of clinical decompensation. The idea of virtual wards, combining these facilities with in-person visits, strengthens the opportunity for education and enhancement to promote more intensive self-care. Electronic platforms provide coordination of tasks within multidisciplinary teams and structured data that can be effectively used to develop predictive algorithms based on advanced digital science, such as artificial intelligence. The rapid progress in informatics, telematics, and device technologies provides a wide range of possibilities for further development in this area. However, there are still existing gaps regarding the use of telemedicine solutions in HF patients, and future randomised telemedicine trials and real-life registries are still definitely needed. Full article
(This article belongs to the Special Issue Advances in Acute and Chronic Heart Failure)
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8 pages, 1772 KiB  
Review
Secretoneurin as a Novel Biomarker of Cardiovascular Episodes: Are We There Yet? A Narrative Review
by Jiří Plášek, Marie Lazárová, Jozef Dodulík, Patrik Šulc, David Stejskal, Zdeněk Švagera, František Všianský and Jan Václavík
J. Clin. Med. 2022, 11(23), 7191; https://doi.org/10.3390/jcm11237191 - 3 Dec 2022
Cited by 5 | Viewed by 2116
Abstract
Secretoneurin (SN) is a 33 amino-acid evolutionary conserved neuropeptide from the chromogranin peptide family. SN’s main effects may be cardioprotective and are believed to be mediated through its inhibition of calmodulin-dependent kinase II (CaMKII), which influences intracellular calcium handling. SN inhibition of CaMKII [...] Read more.
Secretoneurin (SN) is a 33 amino-acid evolutionary conserved neuropeptide from the chromogranin peptide family. SN’s main effects may be cardioprotective and are believed to be mediated through its inhibition of calmodulin-dependent kinase II (CaMKII), which influences intracellular calcium handling. SN inhibition of CaMKII suppresses calcium leakage from the sarcoplasmic reticulum through the ryanodine receptor. This action may reduce the risk of ventricular arrhythmias and calcium-dependent remodelling in heart failure. SN is also involved in reducing the intracellular reactive oxygen species concentration, modulating the immune response, and regulating the cell cycle, including apoptosis. SN can predict mortality in different disease states, beyond the classical risk factors and markers of myocardial injury. Plasma SN levels are elevated soon after an arrhythmogenic episode. In summary, SN is a novel biomarker with potential in cardiovascular medicine, and probably beyond. Full article
(This article belongs to the Special Issue Advances in Acute and Chronic Heart Failure)
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Other

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23 pages, 2687 KiB  
Systematic Review
Multidimensional Interventions on Supporting Disease Management for Hospitalized Patients with Heart Failure: The Role of Clinical and Community Pharmacists
by Magdalena Jasińska-Stroschein and Magdalena Waszyk-Nowaczyk
J. Clin. Med. 2023, 12(8), 3037; https://doi.org/10.3390/jcm12083037 - 21 Apr 2023
Cited by 5 | Viewed by 2187
Abstract
Background: existing trials on the role of clinical pharmacists in managing chronic disease patients have focused on variety of interventions, including preparing patients for the transition from hospital to home. However, little quantitative evidence is available regarding the effect of multidimensional interventions on [...] Read more.
Background: existing trials on the role of clinical pharmacists in managing chronic disease patients have focused on variety of interventions, including preparing patients for the transition from hospital to home. However, little quantitative evidence is available regarding the effect of multidimensional interventions on supporting disease management for hospitalized patients with heart failure (HF). The present paper reviews the effects of inpatient, discharge and/or after-discharge interventions performed on hospitalized HF patients by multidisciplinary teams, including pharmacists. Methods: articles were identified through search engines in three electronic databases following the PRISMA Protocol. Randomized controlled trials (RCTs) or non-randomized intervention studies conducted in the period 1992–2022 were included. In all studies, baseline characteristics of patients as well as study end-points were described in relation to a control group i.e., usual care and a group of subjects that received care from a clinical and/or community pharmacist, as well as other health professionals (Intervention). Study outcomes included all-cause hospital 30-day re-admission or emergency room (ER) visits, all-cause hospitalization within >30 days after discharge, specific-cause hospitalization rates, medication adherence and mortality. The secondary outcomes included adverse events and quality of life. Quality assessment was carried out using RoB 2 Risk of Bias Tool. Publication bias across studies was determined using the funnel plot and Egger’s regression test. Results: a total of 34 protocols were included in the review, while the data from 33 trials were included in further quantitative analyses. The heterogeneity between studies was high. Pharmacist-led interventions, usually performed within interprofessional care teams, reduced the rates of 30-day all-cause hospital re-admission (odds ratio, OR = 0.78; 95% CI 0.62–0.98; p = 0.03) and all-cause hospitalization >30 days after discharge (OR = 0.73; 95% CI 0.63–0.86; p = 0.0001). Subjects hospitalized primarily due to heart failure demonstrated reduced risk of hospital admission within longer periods, i.e., from 60 to 365 days after discharge (OR = 0.64; 95% CI 0.51–0.81; p = 0.0002). The rate of all-cause hospitalization was reduced by multidimensional interventions taken by pharmacists: reviews of medicine lists and/or their reconciliation at discharge (OR = 0.63; 95% CI 0.43–0.91; p = 0.014), as well as interventions that were based mainly on patient education and counseling (OR = 0.65; 95% CI 0.49–0.88; p = 0.0047). In conclusion, given that HF patients often have complex treatment regimens and multiple comorbid conditions, our findings highlight the need for greater involvement from skilled clinical and community pharmacists in disease management. Full article
(This article belongs to the Special Issue Advances in Acute and Chronic Heart Failure)
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