Beneficial Effects of Vaccination on Cardiovascular Events: Myocardial Infarction, Stroke, Heart Failure

Cardiology ◽  
2018 ◽  
Vol 141 (2) ◽  
pp. 98-106 ◽  
Author(s):  
Katerina Fountoulaki ◽  
Sotirios Tsiodras ◽  
Eftychia Polyzogopoulou ◽  
Christophoros Olympios ◽  
John Parissis
Keyword(s):  
Heart Failure ◽  
Cardiovascular Events ◽  
Respiratory Infections ◽  
Pneumococcal Vaccination ◽  
Cost Effective ◽  
Optimal Dose ◽  
Current Evidence ◽  
Pneumococcal Infections ◽  
Potential Cost ◽  
Beneficial Effects

Influenza and pneumococcal infections have been suggested to be potential risk factors for causing adverse cardiovascular events, especially in high-risk patients. Vaccination against respiratory infections in patients with established cardiovascular disease (CVD) could serve as a potential cost-effective intervention to improve their clinical outcomes and cardiac societies have encouraged it. Previous studies have shown that influenza vaccination reduce mortality, acute coronary syndromes and hospitalization in patients with coronary heart disease (CHD) and/or heart failure (HF). However, there is a paucity of randomized prospective clinical trials in the field of the pneumococcal vaccination, and additional higher-quality evidence is needed. Furthermore, questions around the role of vaccination in the primary prevention of CVD, the optimal dose and timing are largely unanswered. The pathophysiologic mechanism in which vaccination provides cardiovascular protection may be related to the modification of the immune-inflammatory model of atherogenesis. The present review summarizes the current evidence and understanding for vaccination against influenza and streptococcus pneumoniae in CHD, HF and stroke and highlights its beneficial effect in the reduction of adverse cardiovascular events.

scholarly journals Implications of Altered Ketone Metabolism and Therapeutic Ketosis in Heart Failure

Circulation ◽  
2020 ◽  
Vol 141 (22) ◽  
pp. 1800-1812 ◽  
Author(s):  
Senthil Selvaraj ◽  
Daniel P. Kelly ◽  
Kenneth B. Margulies
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Current Evidence ◽  
Pharmacological Intervention ◽  
Reduced Ejection Fraction ◽  
Beneficial Effects ◽  
Failing Heart ◽  
Sodium Glucose Cotransporter ◽  
Treatment Paradigm ◽  
Promising Treatment

Despite existing therapy, patients with heart failure (HF) experience substantial morbidity and mortality, highlighting the urgent need to identify novel pathophysiological mechanisms and therapies, as well. Traditional models for pharmacological intervention have targeted neurohormonal axes and hemodynamic disturbances in HF. However, several studies have now highlighted the potential for ketone metabolic modulation as a promising treatment paradigm. During the pathophysiological progression of HF, the failing heart reduces fatty acid and glucose oxidation, with associated increases in ketone metabolism. Recent studies indicate that enhanced myocardial ketone use is adaptive in HF, and limited data demonstrate beneficial effects of exogenous ketone therapy in studies of animal models and humans with HF. This review will summarize current evidence supporting a salutary role for ketones in HF including (1) normal myocardial ketone use, (2) alterations in ketone metabolism in the failing heart, (3) effects of therapeutic ketosis in animals and humans with HF, and (4) the potential significance of ketosis associated with sodium-glucose cotransporter 2 inhibitors. Although a number of important questions remain regarding the use of therapeutic ketosis and mechanism of action in HF, current evidence suggests potential benefit, in particular, in HF with reduced ejection fraction, with theoretical rationale for its use in HF with preserved ejection fraction. Although it is early in its study and development, therapeutic ketosis across the spectrum of HF holds significant promise.

scholarly journals Vaccination for Respiratory Infections in Patients with Heart Failure

2021 ◽  
Vol 10 (19) ◽  
pp. 4311
Author(s):  
Nicolas Girerd ◽  
Nicolas Chapet ◽  
Camille Roubille ◽  
Jérôme Roncalli ◽  
Muriel Salvat ◽  
...  
Keyword(s):  
Heart Failure ◽  
Protective Effect ◽  
Vaccination Coverage ◽  
Randomized Clinical Trials ◽  
Respiratory Infections ◽  
Pneumococcal Infection ◽  
Pneumococcal Vaccination ◽  
Health Providers ◽  
Vaccination Recommendations ◽  
Patients With Heart Failure

Bronchopulmonary infections are a major trigger of cardiac decompensation and are frequently associated with hospitalizations in patients with heart failure (HF). Adverse cardiac effects associated with respiratory infections, more specifically Streptococcus pneumoniae and influenza infections, are the consequence of inflammatory processes and thrombotic events. For both influenza and pneumococcal vaccinations, large multicenter randomized clinical trials are needed to evaluate their efficacy in preventing cardiovascular events, especially in HF patients. No study to date has evaluated the protective effect of the COVID-19 vaccine in patients with HF. Different guidelines recommend annual influenza vaccination for patients with established cardiovascular disease and also recommend pneumococcal vaccination in patients with HF. The Heart Failure group of the French Society of Cardiology recently strongly recommended vaccination against COVID-19 in HF patients. Nevertheless, the implementation of vaccination recommendations against respiratory infections in HF patients remains suboptimal. This suggests that a national health policy is needed to improve vaccination coverage, involving not only the general practitioner, but also other health providers, such as cardiologists, nurses, and pharmacists. This review first summarizes the pathophysiology of the interrelationships between inflammation, infection, and HF. Then, we describe the current clinical knowledge concerning the protective effect of vaccines against respiratory diseases (influenza, pneumococcal infection, and COVID-19) in patients with HF and finally we propose how vaccination coverage could be improved in these patients.

scholarly journals Effects of Yoga on Mental and Physical Health: A Short Summary of Reviews

2012 ◽  
Vol 2012 ◽  
pp. 1-7 ◽  
Author(s):  
Arndt Büssing ◽  
Andreas Michalsen ◽  
Sat Bir S. Khalsa ◽  
Shirley Telles ◽  
Karen J. Sherman
Keyword(s):  
Physical Health ◽  
Behavioral Treatment ◽  
Randomized Clinical Trials ◽  
Meta Analysis ◽  
Cost Effective ◽  
Current Evidence ◽  
Adjunct Treatment ◽  
Beneficial Effects ◽  
Positive Side ◽  
Mental And Physical Health

This report summarizes the current evidence on the effects of yoga interventions on various components of mental and physical health, by focussing on the evidence described in review articles. Collectively, these reviews suggest a number of areas where yoga may well be beneficial, but more research is required for virtually all of them to firmly establish such benefits. The heterogeneity among interventions and conditions studied has hampered the use of meta-analysis as an appropriate tool for summarizing the current literature. Nevertheless, there are some meta-analyses which indicate beneficial effects of yoga interventions, and there are several randomized clinical trials (RCT’s) of relatively high quality indicating beneficial effects of yoga for pain-associated disability and mental health. Yoga may well be effective as a supportive adjunct to mitigate some medical conditions, but not yet a proven stand-alone, curative treatment. Larger-scale and more rigorous research with higher methodological quality and adequate control interventions is highly encouraged because yoga may have potential to be implemented as a beneficial supportive/adjunct treatment that is relatively cost-effective, may be practiced at least in part as a self-care behavioral treatment, provides a life-long behavioural skill, enhances self-efficacy and self-confidence and is often associated with additional positive side effects.

Reasons for adult immunization – Prevention of most frequent respiratory infections

2014 ◽  
Vol 155 (44) ◽  
pp. 1743-1747 ◽  
Author(s):  
Endre Ludwig
Keyword(s):  
Older Adults ◽  
Respiratory Infections ◽  
Pneumococcal Vaccination ◽  
The Elderly ◽  
Community Acquired Pneumonia ◽  
Pneumococcal Infections ◽  
Incidence And Mortality ◽  
Severe Infections ◽  
The Individual ◽  
Adult Immunization

The adult vaccination is utilized insufficiently as a preventional method currently, even the incidence and mortality of vaccine-preventable infections is very high in the elderly and patients with immuncompromised conditions. They should be protected due to many reasons: the rate of these individuals are getting higher in the population, the effectiveness of antibiotic therapy is limited and becoming more significant due to antibiotic resistance, the quality of life in survivors of severe infections is deteriorated, resulting huge burden to the individual and society as well. The impaired functions of immune system with the advancing age cause higher morbidity and mortality especially in respiratory infections, it is representing in the incidence and high letality of community acquired pneumonia in older adults. Beyond the old polysaccharide vaccine (PPV23) the inclusion of new conjugate vaccine (PCV13) means a significant improvement in the prevention of pneumococcal infections, providing a possibility to prevent not just pneumococcal infections with bacteraemia caused by serotypes presented in the vaccine, but non-bacteraemic pneumonias as well. The necessity of flu vaccines cannot be stressed enough even the vaccines is not so effective in elderly than in younger adults: annual immunization against influenza administering together with pneumococcal vaccination decrease significantly the number, severity and complications in older adults as well. Further improvement in protection of immuncompromised patients is the establishment of cocoon immunity with the vaccination of close contacts. Orv. Hetil., 2014, 155(44), 1743–1747.

174 Early beneficial effects of vasopeptidase inhibtion n an experimental model of heart failure

2003 ◽  
Vol 2 (1) ◽  
pp. 33-34
Author(s):  
B SHIVALKAR ◽  
B MEURIS ◽  
R VANBENEDEN ◽  
J KETESLEGERS ◽  
F BECKERS ◽  
...  
Keyword(s):  
Heart Failure ◽  
Experimental Model ◽  
Beneficial Effects

Emerging Cardiac Resynchronisation Therapy Indications

2011 ◽  
Vol 7 (1) ◽  
pp. 29
Author(s):  
Charlotte Eitel ◽  
Gerhard Hindricks ◽  
Christopher Piorkowski ◽  
◽  
◽  
...  
Keyword(s):  
Heart Failure ◽  
Systolic Heart Failure ◽  
Cardiac Resynchronisation Therapy ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Current Evidence ◽  
Class Iii ◽  
Ventricular Ejection Fraction ◽  
Cardiac Resynchronisation ◽  
Resynchronisation Therapy

Cardiac resynchronisation therapy (CRT) is an efficacious and cost-effective therapy in patients with highly symptomatic systolic heart failure and delayed ventricular conduction. Current guidelines recommend CRT as a class I indication for patients with sinus rhythm, New York Heart Association (NYHA) functional class III or ambulatory class IV, a QRS duration ≥120ms, and left ventricular ejection fraction (LVEF) ≤35%, despite optimal pharmacological therapy. Recent trials resulted in an extension of current recommendations to patients with mild heart failure, patients with atrial fibrillation, and patients with an indication for permanent right ventricular pacing with the aim of morbidity reduction. The effectiveness of CRT in patients with narrow QRS, patients with end-stage heart failure and cardiogenic shock, and patients with an LVEF >35% still needs to be proved. This article reviews current evidence and clinical applications of CRT in heart failure and provides an outlook on future developments.

Diabetes and Heart Failure: Is it Hyperglycemia or Hyperinsulinemia?

2020 ◽  
Vol 18 (2) ◽  
pp. 148-157 ◽  
Author(s):  
Triantafyllos Didangelos ◽  
Konstantinos Kantartzis
Keyword(s):  
Heart Failure ◽  
Insulin Treatment ◽  
Close Association ◽  
Adverse Outcomes ◽  
Negative Effects ◽  
Beneficial Effects ◽  
Appropriate Treatment ◽  
Increased Risk ◽  
Treatment Of Diabetes

The cardiac effects of exogenously administered insulin for the treatment of diabetes (DM) have recently attracted much attention. In particular, it has been questioned whether insulin is the appropriate treatment for patients with type 2 diabetes mellitus and heart failure. While several old and some new studies suggested that insulin treatment has beneficial effects on the heart, recent observational studies indicate associations of insulin treatment with an increased risk of developing or worsening of pre-existing heart failure and higher mortality rates. However, there is actually little evidence that the associations of insulin administration with any adverse outcomes are causal. On the other hand, insulin clearly causes weight gain and may also cause serious episodes of hypoglycemia. Moreover, excess of insulin (hyperinsulinemia), as often seen with the use of injected insulin, seems to predispose to inflammation, hypertension, dyslipidemia, atherosclerosis, heart failure, and arrhythmias. Nevertheless, it should be stressed that most of the data concerning the effects of insulin on cardiac function derive from in vitro studies with isolated animal hearts. Therefore, the relevance of the findings of such studies for humans should be considered with caution. In the present review, we summarize the existing data about the potential positive and negative effects of insulin on the heart and attempt to answer the question whether any adverse effects of insulin or the consequences of hyperglycemia are more important and may provide a better explanation of the close association of DM with heart failure.

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