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Heart Failure: From Subtype to Personalized Medicine
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Heart Failure: From Subtype to Personalized Medicine

A special issue of Journal of Personalized Medicine (ISSN 2075-4426). This special issue belongs to the section "Mechanisms of Diseases".

Deadline for manuscript submissions: 10 October 2024 | Viewed by 3945

Special Issue Editor

Dr. Yuji Nagatomo

E-Mail Website
Guest Editor
Department of Cardiology, National Defense Medical College, Tokorozawa, Saitama 359, Japan
Interests: heart failure; cardiomyopathy; autoimmunity; microbitoa; biomarkers; genetic testing
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Heart failure (HF) is a major social problem that has been increasing in its prevalence worldwide due to a rapidly aging society. Even though recent progress in the understanding of the pathology of HF and certain forms of cardiomyopathies (e.g. amyloidosis, Fabry disease) has enabled the development of novel diagnostic and management strategies, their prognosis has not yet been satisfactory. The currently unsolved problems of this field include poor prognosis, quality of life, repeated HF hospitalization, a high burden due to cardiovascular and non-cardiovascular comorbidities and the risk of sudden cardiac death.

Besides, newly recognized cardiovascular diease entities have emerged as new problems. There have been limited therapeutics for heart failure with preserved ejection fraction (HFpEF). Recent advances in cancer therapy have improved life expectancy for cancer patients, but instead survivors often are left suffering from cardiovascular complications such as cancer therapeutics-related caridac dysfunction (CTRCD). The current devastating COVID-19 outbreak might cause various cardiovascular complications, such as myocarditis and thrombosis, for some affected patients. However, cardioprotective strategies for these emerging diseases have not yet been established.

On the other hand, novel agents such as angiotensin receptor neprilysin inhibitor (ARNi), sodium-glucose cotransporter 2 inhibitor (SGLT-2i), ivabradine and vericiguat have been shown to improve the long-term outcome for patients with HF. However, the responders/non-responders for these agents, both in terms of subsequent reverse remodeling and outcome, have been ill-defined.

In this context, we have been seeking for novel approaches which enable more precise risk prediction and the discovery of optimal treatment strategies for individual patients. This Special Issue of the Journal of Personalized Medicine aims to highlight the current knowledge and future perspectives potentially leading to novel personalized approaches to HF.

Dr. Yuji Nagatomo
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 Personalized Medicine 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

  • heart failure
  • personalized medicine
  • cardiomyopathy
  • heart failure with reduced ejection fraction
  • heart failure with preserved ejection fraction
  • amyloidosis
  • Fabry disease
  • cancer therapeutics related cardiac dysfunction
  • COVID-19
  • frailty

Published Papers (3 papers)

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Research

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15 pages, 2062 KiB  
Article
Phenotype-Specific Outcome and Treatment Response in Heart Failure with Preserved Ejection Fraction with Comorbid Hypertension and Diabetes: A 12-Month Multicentered Prospective Cohort Study
by Ngoc-Thanh-Van Nguyen, Hoai-An Nguyen, Hai Hoang Nguyen, Binh Quang Truong and Hoa Ngoc Chau
J. Pers. Med. 2023, 13(8), 1218; https://doi.org/10.3390/jpm13081218 - 31 Jul 2023
Cited by 1 | Viewed by 1829
Abstract
Despite evidence of SGLT2 inhibitors in improving cardiovascular outcomes of heart failure with preserved ejection fraction (HFpEF), the heterogenous mechanism and characteristic multimorbidity of HFpEF require a phenotypic approach. Metabolic phenotype, one common HFpEF phenotype, has various presentations and prognoses worldwide. We aimed [...] Read more.
Despite evidence of SGLT2 inhibitors in improving cardiovascular outcomes of heart failure with preserved ejection fraction (HFpEF), the heterogenous mechanism and characteristic multimorbidity of HFpEF require a phenotypic approach. Metabolic phenotype, one common HFpEF phenotype, has various presentations and prognoses worldwide. We aimed to identify different phenotypes of hypertensive-diabetic HFpEF, their phenotype-related outcomes, and treatment responses. The primary endpoint was time to the first event of all-cause mortality or hospitalization for heart failure (HHF). Among 233 recruited patients, 24.9% experienced primary outcomes within 12 months. A total of 3.9% was lost to follow-up. Three phenotypes were identified. Phenotype 1 (n = 126) consisted of lean, elderly females with chronic kidney disease, anemia, and concentric hypertrophy. Phenotype 2 (n = 62) included younger males with coronary artery disease. Phenotype 3 (n = 45) comprised of obese elderly with atrial fibrillation. Phenotype 1 and 2 reported higher primary outcomes than phenotype 3 (p = 0.002). Regarding treatment responses, SGLT2 inhibitor was associated with fewer primary endpoints in phenotype 1 (p = 0.003) and 2 (p = 0.001). RAAS inhibitor was associated with fewer all-cause mortality in phenotype 1 (p = 0.003). Beta blocker was associated with fewer all-cause mortality in phenotype 1 (p = 0.024) and fewer HHF in phenotype 2 (p = 0.011). Our pioneering study supports the personalized approach to optimize HFpEF management in hypertensive-diabetic patients. Full article
(This article belongs to the Special Issue Heart Failure: From Subtype to Personalized Medicine)
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Review

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14 pages, 485 KiB  
Review
The Safety and Efficacy of Sodium-Glucose Cotransporter-2 Inhibitors for Patients with Sarcopenia or Frailty: Double Edged Sword?
by Ayami Naito, Yuji Nagatomo, Akane Kawai, Midori Yukino-Iwashita, Ryota Nakazawa, Akira Taruoka, Asako Takefuji, Risako Yasuda, Takumi Toya, Yukinori Ikegami, Nobuyuki Masaki, Yasuo Ido and Takeshi Adachi
J. Pers. Med. 2024, 14(2), 141; https://doi.org/10.3390/jpm14020141 - 26 Jan 2024
Cited by 1 | Viewed by 1426
Abstract
Sodium-glucose cotransporter-2 inhibitors (SGLT-2is) show cardiovascular protective effects, regardless of the patient’s history of diabetes mellitus (DM). SGLT2is suppressed cardiovascular adverse events in patients with type 2 DM, and furthermore, SGLT-2is reduced the risk of worsening heart failure (HF) events or cardiovascular death [...] Read more.
Sodium-glucose cotransporter-2 inhibitors (SGLT-2is) show cardiovascular protective effects, regardless of the patient’s history of diabetes mellitus (DM). SGLT2is suppressed cardiovascular adverse events in patients with type 2 DM, and furthermore, SGLT-2is reduced the risk of worsening heart failure (HF) events or cardiovascular death in patients with HF. Along with these research findings, SGLT-2is are recommended for patients with HF in the latest guidelines. Despite these benefits, the concern surrounding the increasing risk of body weight loss and other adverse events has not yet been resolved, especially for patients with sarcopenia or frailty. The DAPA-HF and DELIVER trials consistently showed the efficacy and safety of SGLT-2i for HF patients with frailty. However, the Rockwood frailty index that derived from a cumulative deficit model was employed for frailty assessment in these trials, which might not be suitable for the evaluation of physical frailty or sarcopenia alone. There is no fixed consensus on which evaluation tool to use or its cutoff value for the diagnosis and assessment of frailty in HF patients, or which patients can receive SGLT-2i safely. In this review, we summarize the methodology of frailty assessment and discuss the efficacy and safety of SGLT-2i for HF patients with sarcopenia or frailty. Full article
(This article belongs to the Special Issue Heart Failure: From Subtype to Personalized Medicine)
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Other

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10 pages, 1123 KiB  
Study Protocol
Propelling Nurse-Led Structured Intervention to Enhance Self-Care among Patients with Chronic Heart Failure (PROACT-HF): A Cluster Randomized Controlled Trial Study Protocol
by Momoko Okazaki, Takahiro Suzuki, Atsushi Mizuno, Toshimi Ikegame, Noriki Ito, Mai Onoda, Ikuko Miyawaki, Yuka Moriyama, Taku Yabuki, Satomi Yamada, Daisuke Yoneoka, Yuko Iwasawa, Kyoko Tagami and Kumiko Yoshikawa
J. Pers. Med. 2024, 14(8), 832; https://doi.org/10.3390/jpm14080832 - 6 Aug 2024
Viewed by 225
Abstract
Background: Heart Failure (HF) is a common chronic disease that has a high readmission rate and is associated with worsening symptoms and major financial impacts. Disease management implemented during or after an HF hospitalization has been shown to reduce hospitalization and mortality rates. [...] Read more.
Background: Heart Failure (HF) is a common chronic disease that has a high readmission rate and is associated with worsening symptoms and major financial impacts. Disease management implemented during or after an HF hospitalization has been shown to reduce hospitalization and mortality rates. Particularly for outpatients, it is necessary to provide self-care interventions. Structured nurse-led support such as timely follow-ups, including phone calls, is beneficial for improving self-care assessments. Evidence for nurse-led support has been investigated but is less than conclusive. The aim of this study is to compare the effectiveness of a nurse-led structured intervention for outpatients with chronic HF against the usual medical care in terms of self-care behaviors and occurrence of symptom exacerbation or rehospitalization. Methods and analysis: This is a cluster-randomized controlled trial. A total of 40 facilities with certified HF nurses will be allocated to two-arm clusters at a 1:1 ratio, randomly to the intervention or usual care arms. A total of 210 participants will be assigned from the hospital. Participants will be adults aged 18 years or older diagnosed with chronic HF who are classified as Stage C according to the ACCF/AHA Heart Failure staging system. In the intervention group, patients will receive structured nursing support. This begins with weekly support, including phone calls, for the first month, then transitions to monthly support thereafter. The aim is to ensure the stability of their living conditions, promote medication adherence, and encourage self-management. In the control group, patients will receive the usual care. Primary outcomes will assess the improvement or continuation of self-care behavior as measured by changes in EHFScBS (European Heart Failure Self-Care Behavior Scale) scores. Secondary outcomes include occurrence of readmission within 30 days, 3 months, 6 months, and 1 year after discharge, duration of home care until readmission, and blood levels of BNP and NT-proBNP. Full article
(This article belongs to the Special Issue Heart Failure: From Subtype to Personalized Medicine)
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