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Medicina
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New Insights into Heart Failure
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New Insights into Heart Failure

A special issue of Medicina (ISSN 1648-9144). This special issue belongs to the section "Cardiology".

Deadline for manuscript submissions: 31 December 2024 | Viewed by 4789

Special Issue Editors

Dr. Nilima Rajpal Kundnani

E-Mail Website
Guest Editor
1. Discipline of Internal Medicine and Ambulatory Care, Prevention and Cardiovascular Recovery, Department of Cardiology, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania
2. Research Centre of Timisoara Institute of Cardiovascular Diseases, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania
Interests: cardiovascular disease; atrial fibrillation; heart failure; stroke; coronary artery disease; cardiomyopathy; physical exercise or training; quality of life; anticoagulation; cardiac rehabilitation; primary and secondary prevention; valvular heart diseases; congenital heart disease; cardio genetics; clinical cardiology
Prof. Dr. Simona Dragan

E-Mail Website
Guest Editor
1. Discipline of Internal Medicine and Ambulatory Care, Prevention and Cardiovascular Recovery, Department of Cardiology, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania
2. Research Centre of Timisoara Institute of Cardiovascular Diseases, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania
Interests: cardiovascular disease; atrial fibrillation; heart failure; stroke; coronary artery disease; cardiomyopathy; physical exercise or training; quality of life; anticoagulation; cardiac rehabilitation; primary and secondary prevention; valvular heart diseases; congenital heart disease; cardio genetics; clinical cardiology

Special Issue Information

Dear Colleagues,

The Special Issue on “New Insights into Heart Failure” seeks to address the advancements in the diagnosis, treatment, and prevention of heart failure (HF).

HF is a clinical syndrome associated with increased morbidity, mortality, and healthcare costs. Heart failure affects about 26 million people worldwide, with more than 960,000 new cases each year. Left ventricular (LV) failure causes shortness of breath and fatigue, and right ventricular (RV) failure causes peripheral and abdominal fluid accumulation, but the ventricles can be involved together or separately. A wide variety of coexisting pathologies, diseases, or conditions can be found in HF patients, both cardiovascular and non-cardiovascular in nature, exhibiting diverse clinical relevance. The complex inter-relationship of comorbidities and their impact on the cardiovascular system contribute to the features of HF, both with reduced (HFrEF) and preserved ejection fraction (HFpEF). Hence, it can be stated that the coexisting morbidities help us determine the different phenotypes and consequences of HF. Understanding the pathogenesis and its complex associations with comorbidities can play a pivotal role in the prevention and treatment of HF.

This Special Issue invites contributions from researchers, clinicians, and experts in the field to explore the diverse challenges associated with heart failure, encompassing aspects such as etiology, diagnosis, treatment modalities, and patient care.

This Special Issue is now open for submissions (including original research articles, review papers, and case presentations) from clinicians and researchers in cardiovascular medicine and as well as researchers and clinicians specializing in different areas (i.e. metabolic diseases, pneumology, hematology, intensive care medicine, rheumatology, endocrinology, nephrology, internal medicine, family doctors, etc.).

Dr. Nilima Rajpal Kundnani
Prof. Dr. Simona Dragan
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. Medicina 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 2200 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
  • risk factors
  • treatment
  • device therapy
  • biomarkers
  • aging
  • cardiovascular disease
  • coronary artery disease
  • valvular heart disease
  • arrythmias
  • stroke
  • COPD
  • cancers
  • liver cirrhosis

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Published Papers (5 papers)

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Research

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13 pages, 335 KiB  
Article
Correlation of the FIB-4 Liver Biomarker Score with the Severity of Heart Failure
by Roxana Buzas, Paul Ciubotaru, Alexandra Corina Faur, Marius Preda, Melania Ardelean, Doina Georgescu, Patrick Dumitrescu, Daniel Florin Lighezan and Mihaela-Diana Popa
Medicina 2024, 60(12), 1943; https://doi.org/10.3390/medicina60121943 - 26 Nov 2024
Viewed by 90
Abstract
Background and Objectives: Heart failure is associated with high morbidity and mortality and linked with several pre-existing health conditions and risk factors. Early detection and prompt management in heart failure improves patient outcomes. Liver involvement is associated with heart failure disease progression, [...] Read more.
Background and Objectives: Heart failure is associated with high morbidity and mortality and linked with several pre-existing health conditions and risk factors. Early detection and prompt management in heart failure improves patient outcomes. Liver involvement is associated with heart failure disease progression, and hence liver biomarkers and liver fibrosis may have a prognostic impact. Several blood test based markers and scoring systems estimate liver fibrosis and hence can be useful prognostic tools. Materials and Methods: We retrospectively analyzed a series of 303 patients with decompensated heart failure in a city in western Romania over a period of 6 months. Several biochemical parameters were measured, the FIB-4 score was estimated and echocardiography was performed. Results for targeted variables are presented using descriptive statistics. Patients were analyzed based on their LVEF categories. Statistical analysis was based on ANOVA one-way tests for continuous variables and Chi-square tests for categorical variables. Pairwise comparisons were performed based on Bonferroni adjusted significance tests. The correlations between FIB-4 score, LVEF and NT-pro BNP in patients with and without diabetes and hypertension were explored using Spearman’s correlation coefficient. Result: Age, gender, NYHA class, death, history of (h/o) type 2 diabetes mellitus (T2DM), h/o coronary artery disease (CAD), h/o arrhythmias, sodium, potassium, creatinine, eGFR, uric acid, NT-pro BNP, left atrial volume, LDL, HDL, and TG were analyzed by LVEF categories using ANOVA one-way tests, Chi-square tests, and Bonferroni correction comparisons. We found a strong statistically significant correlation between each of NT-pro BNP, left atrial volume, LDL, and HDL with the LVEF categories. Discussion: Early detection of cardiac dysfunction leads to better management in patients with cardiovascular risk factors including diabetes and hypertension. High LDL and low HDL levels contribute to a reduction in left ventricular (LV) function. Available literature suggests the FIB-4 score as superior to other non-invasive markers of fibrosis. It utilizes the patient’s age, platelet count, AST, and ALT, which can be available retrospectively, making it an easy and inexpensive tool. FIB-4 score has a few limitations. Conclusions: Our study has shown a statistically significant positive correlation between severity categories of LVEF and FIB-4 score for heart failure patients with and without diabetes, and for heart failure patients with or without hypertension. We propose the implementation of FIB-4 score as a prognostic tool for heart failure. Full article
(This article belongs to the Special Issue New Insights into Heart Failure)
21 pages, 1397 KiB  
Article
Factors Influencing the Development and Severity of Cognitive Decline in Patients with Chronic Heart Failure
by Marius Militaru, Daniel Florin Lighezan, Cristina Tudoran, Mariana Tudoran and Anda Gabriela Militaru
Medicina 2024, 60(11), 1859; https://doi.org/10.3390/medicina60111859 - 13 Nov 2024
Viewed by 401
Abstract
Background and Objectives: Considering the increasing prevalence of chronic heart failure (CHF) and cognitive decline (CD) observed in recent decades and the complex interrelation between these two pathologies often encountered in the same patient, in this study, we aimed to highlight the [...] Read more.
Background and Objectives: Considering the increasing prevalence of chronic heart failure (CHF) and cognitive decline (CD) observed in recent decades and the complex interrelation between these two pathologies often encountered in the same patient, in this study, we aimed to highlight the connection between CHF, defined as recommended by the European Society of Cardiology guidelines, and CD, evaluated by employing five neuropsychological scales. Materials and Methods: Our study was conducted on 190 patients with very high cardiovascular risk profiles admitted between 5 September 2021 and 15 November 2023 in the Municipal Emergency Hospital Timisoara. Of these, 103 had CHF (group A) and 87 did not (group B). Results: Although similar concerning age, sex distribution, and risk factors (excepting lipid profile), patients from group A had lower Mini Mental State Evaluation (MMSE) and Montreal Cognitive Assessment (MoCA levels (p = 0.003, respectively, p = 0.017) scores, more reduced daily activity (p = 0.021), and more severe depression (p = 0.015) compared to group B. We documented statistically significant correlations between left-ventricular ejection fraction (LVEF) and the levels of N-terminal pro–B-type natriuretic peptide (NT-pro-BNP), as well as with the results of MMSE (r = 0.226, p = 0.002 and r = −0.275, p = 0.005, respectively), daily activity, and depression (p ˂ 0.001). Multi-logistic regression models indicated age, blood pressure values, decreased daily activity, and depression as risk factors for CD in patients with CHF. Conclusions: In patients with CHF, there is an increased propensity of CD, with a direct relationship between MMSE and LVEF levels and an indirect one between MMSE and NT-pro-BNP levels. The concomitance of depression and reduced activity levels are aggravating CD in these patients. Full article
(This article belongs to the Special Issue New Insights into Heart Failure)
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14 pages, 646 KiB  
Article
The Impact of Heart Failure Chronic Treatment Prior to Cardiac Transplantation on Early Outcomes
by Dragos-Florin Baba, Horatiu Suciu, Calin Avram, Marius Mihai Harpa, Mircea Stoian, Diana-Andreea Moldovan, Laurentiu Huma, Gabriel Rusu, Tunde Pal, Alina Danilesco, Adina Stoian and Anca-Ileana Sin
Medicina 2024, 60(11), 1801; https://doi.org/10.3390/medicina60111801 - 3 Nov 2024
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Abstract
Background and Objectives: Cardiac transplantation represents the option for patients with end-stage heart failure (HF), providing the best survival rate. However, the postoperative complications of transplant patients remain a challenge for clinicians. The objective of our study was to evaluate the effect [...] Read more.
Background and Objectives: Cardiac transplantation represents the option for patients with end-stage heart failure (HF), providing the best survival rate. However, the postoperative complications of transplant patients remain a challenge for clinicians. The objective of our study was to evaluate the effect of preoperative chronic HF treatment on the occurrence of in-hospital complications. Materials and Methods: We retrospectively included a total of 50 patients who underwent cardiac transplantation between January 2011 and December 2023 from the Emergency Institute for Cardiovascular Diseases and Transplantation of Targu Mures. We correlated the preoperative chronic HF treatment with the postoperative complications by Spearmen’s correlation coefficient, respectively. With logistic regression, the associations between the treatment and specific complications were determined. Results: Significant negative correlations were found between Carvedilol treatment with 2-month mortality (r = −0.30; 95% CI: −0.53–−0.02; p = 0.03), Ramipril with hospital stay (r = −0.38; 95% CI: −0.60–-0.12; p < 0.01) and intensive care unit (ICU) stay (r = −0.37; 95% CI: −0.59–−0.11; p = 0.01), and Spironolactone usage with hospitalization duration (r = −0.28; 95% CI: −0.52–−0.01; p = 0.04). Furthermore, Carvedilol treatment represented a protective factor against early acute kidney injury (AKI) (OR: 0.22; 95% CI: 0.05–0.91; p = 0.03). Spironolactone treatment was a protective factor against AGR (OR: 0.12; 95% CI: 0.02–0.66; p = 0.01) treatment, in contrast to angiotensin-converting enzyme inhibitor (ACEI) therapy (OR: 5.30; 95% CI: 1.03–27.17; p = 0.04). Conclusions: Pre-transplant Carvedilol treatment was negatively correlated with the 2-month mortality rate. Ramipril and Spironolactone therapy were negatively correlated with hospitalization duration, and Ramipril was additionally correlated with ICU stay. Moreover, Carvedilol therapy represented a protective factor against early AKI. Pre-transplant Spironolactone was associated with lower event rates of AGR, in contrast to ACEI treatment. Prospective studies with larger cohorts are needed in order to draw drastic conclusions. Full article
(This article belongs to the Special Issue New Insights into Heart Failure)
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Review

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20 pages, 4310 KiB  
Review
Genotype-Phenotype Insights of Inherited Cardiomyopathies—A Review
by Oana Raluca Voinescu, Adina Ionac, Raluca Sosdean, Ioana Ionac, Luca Silvia Ana, Nilima Rajpal Kundnani, Stelian Morariu, Maria Puiu and Adela Chirita-Emandi
Medicina 2024, 60(4), 543; https://doi.org/10.3390/medicina60040543 - 27 Mar 2024
Cited by 1 | Viewed by 1727
Abstract
Background: Cardiomyopathies (CMs) represent a heterogeneous group of primary myocardial diseases characterized by structural and functional abnormalities. They represent one of the leading causes of cardiac transplantations and cardiac death in young individuals. Clinically they vary from asymptomatic to symptomatic heart failure, [...] Read more.
Background: Cardiomyopathies (CMs) represent a heterogeneous group of primary myocardial diseases characterized by structural and functional abnormalities. They represent one of the leading causes of cardiac transplantations and cardiac death in young individuals. Clinically they vary from asymptomatic to symptomatic heart failure, with a high risk of sudden cardiac death due to malignant arrhythmias. With the increasing availability of genetic testing, a significant number of affected people are found to have an underlying genetic etiology. However, the awareness of the benefits of incorporating genetic test results into the care of these patients is relatively low. Aim: The focus of this review is to summarize the current basis of genetic CMs, including the most encountered genes associated with the main types of cardiomyopathies: hypertrophic, dilated, restrictive arrhythmogenic, and non-compaction. Materials and Methods: For this narrative review, we performed a search of multiple electronic databases, to select and evaluate relevant manuscripts. Results: Advances in genetic diagnosis led to better diagnosis precision and prognosis prediction, especially with regard to the risk of developing arrhythmias in certain subtypes of cardiomyopathies. Conclusions: Implementing the genomic information to benefit future patient care, better risk stratification and management, promises a better future for genotype-based treatment. Full article
(This article belongs to the Special Issue New Insights into Heart Failure)
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Other

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10 pages, 2267 KiB  
Case Report
Fournier’s Gangrene as an Adverse Event Following Treatment with Sodium Glucose Cotransporter 2 Inhibitors
by Ioana-Maria Suciu, Alin Greluș, Alina-Ramona Cozlac, Bogdan-Simion Suciu, Svetlana Stoica, Silvia Luca, Constantin-Tudor Luca and Dan-Ion Gaiță
Medicina 2024, 60(5), 837; https://doi.org/10.3390/medicina60050837 - 20 May 2024
Viewed by 1506
Abstract
We present the case of a 51-year-old male with known congestive heart failure and acute myocarditis who presented to the emergency department (ED) with swollen testicles and urinary symptoms two weeks after the initiation of sodium glucose cotransporter 2 (SGLT2) inhibitor treatment. Abdominal [...] Read more.
We present the case of a 51-year-old male with known congestive heart failure and acute myocarditis who presented to the emergency department (ED) with swollen testicles and urinary symptoms two weeks after the initiation of sodium glucose cotransporter 2 (SGLT2) inhibitor treatment. Abdominal and pelvic computed tomography (CT) scan was consistent with the diagnosis of Fournier’s gangrene (FG). Intravenous antibiotics were administered and surgical exploratory intervention and excision of necrotic tissue were performed, stopping the evolution of necrotizing fasciitis. FG, a reported adverse event, may rarely occur when SGLT2 inhibitors are administered in patients with diabetes. To our knowledge, there have been no reported cases of FG in Romania since SLGT2 inhibitors were approved. The distinguishing feature of this case is that the patient was not diabetic, which emphasizes that patients without diabetes who are treated for heart failure with SGLT2 inhibitors may also be at risk of developing genitourinary infections. The association of predisposing factors may have contributed to the development of FG in this case and even though the benefits of SGLT2 inhibitors outweigh the risks, serious adverse events need to be voluntarily reported in order to intervene promptly, verify the relationship, and minimize the risk of bias. Full article
(This article belongs to the Special Issue New Insights into Heart Failure)
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