Assessing the Role of Rare Genetic Variation in Patients With Heart Failure

Abstract Background The non-invasive assessment of myocardial work (MW) by pressure-strain loops analysis (PSL) is a relative new tool for the evaluation of myocardial performance. Sacubitril/Valsartan is a treatment for heart failure with reduced ejection fraction (HFrEF) which has a spectacular effect on the reduction of cardiovascular events (MACEs). Purposes of this study were to evaluate 1) the short and medium term effect of Sacubitril/Valsartan treatment on MW parameters; 2) the prognostic value of MW in this specific group of patients. Methods 79 patients with HFrEF (mean age: 66±12 years; LV ejection fraction: 28±9%) were prospectively included in the study and treated with Sacubitril/Valsartan. Echocardiographic examination was performed at baseline, and after 6- and 12-month of therapy with Sacubitril/Valsartan. Results Sacubitril/Valsartan significantly increased global myocardial constructive work (CW) (1023±449 vs 1424±484 mmHg%, p<0.0001) and myocardial work efficiency (WE) [87 (78–90) vs 90 (86–95), p<0.0001]. During FU (2.6±0.9 years), MACEs occurred in 13 (16%) patients. After correction for LV size, LVEF and WE, CW was the only predictor of MACEs (Table 1). A CW<910 mmHg (AUC=0.81, p<0.0001, Figure 1A) identified patients at particularly increase risk of MACEs [HR 11.09 (1.45–98.94), p=0.002, log-rank test p<0.0001] (Figure 1 B). Conclusions In patients with HFrEF who receive a comprehensive background beta-blocker and mineral-corticoid receptor antagonist therapy, Sacubitril/Valsartan induces a significant improvement of myocardial CW and WE. In this population, the estimation of CW before the initiation of Sacubitril/Valsartan therapy allows the prediction of MACEs. Funding Acknowledgement Type of funding source: None

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Interleukin-6 Could Be a Potential Prognostic Factor in Ambulatory Elderly Patients with Stable Heart Failure: Results from a Pilot Study

Journal of Clinical Medicine ◽

10.3390/jcm10030504 ◽

2021 ◽

Vol 10 (3) ◽

pp. 504

Author(s):

Marina Povar-Echeverría ◽

Pablo Esteban Auquilla-Clavijo ◽

Emmanuel Andrès ◽

Francisco Javier Martin-Sánchez ◽

María Victoria Laguna-Calle ◽

...

Keyword(s):

Heart Failure ◽

Atrial Fibrillation ◽

Renal Failure ◽

Interleukin 6 ◽

Kaplan Meier ◽

Patients With Heart Failure ◽

Potential Prognostic Factor ◽

Fundamental Phenomenon ◽

Group 2

Introduction: Inflammation is a fundamental phenomenon in heart failure, but the prognostic or therapeutic role of markers such as interleukin-6 (IL-6) has not yet been clarified. The objective of this study is to describe the clinical profile of patients with elevated IL-6 and determine if they have worse clinical outcomes. Methods: A retrospective c.ohort observational study including 78 patients with heart failure followed up at the Heart Failure Outpatient Clinic of the Internal Medicine Department. IL-6 was determined in all patients, who were then assigned into two groups according to IL-6 level (normal or high). Clinical and prognostic data were collected to determine the differences in both groups. Results: The average age was 79 years, 60% female. A total of 53.8% of the patients had elevated IL-6 (group 2). Patients with elevated IL-6 presented more frequently with anemia mellitus (64.3% vs. 41.7%; p = 0.046), atrial fibrillation (83.3% vs. 61.9% p = 0.036), dyslipidemia (76.2% vs. 58.2%; p = 0.03), higher creatinine levels (1.35 mg/dL vs. 1.08 mg/dL; p = 0.024), lower glomerular filtration rate (43.6 mL/min/m2 vs. 59.9 mL/min/m2; p = 0.007), and anemia 25% vs. 52.4% p = 0.014. The factors independently associated with the increase in IL-6 were anemia 3.513 (1.163–10.607) and renal failure 0.963 (0.936–0.991), p < 0.05. Mortality was higher in the group with elevated IL-6 levels (16% vs. 2%; p = 0.044) with a log-rank p = 0.027 in the Kaplan–Meier curve. Conclusion: Patients with heart failure and elevated IL-6 most often have atrial fibrillation, diabetes mellitus, dyslipidemia, anemia, and renal failure. In addition, mortality was higher and a tendency of higher hospital admission was observed in stable HF patients with elevated IL-6.

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Evaluation of a multimarker panel in chronic heart failure: a 10-year follow-up

Biomarkers in Medicine ◽

10.2217/bmm-2020-0722 ◽

2021 ◽

Author(s):

Susanne Bauer ◽

Christina Strack ◽

Ekrem Ücer ◽

Stefan Wallner ◽

Ute Hubauer ◽

...

Keyword(s):

Heart Failure ◽

Prognostic Role ◽

Blood Samples ◽

Kaplan Meier ◽

Risk Of Mortality ◽

Patients With Heart Failure ◽

All Cause Mortality ◽

Long Time

Aim: We assessed the 10-year prognostic role of 11 biomarkers with different pathophysiological backgrounds. Materials & methods/results: Blood samples from 144 patients with heart failure were analyzed. After 10 years of follow-up (median follow-up was 104 months), data regarding all-cause mortality were acquired. Regarding Kaplan–Meier analysis, all markers, except TIMP-1 and GDF-15, were significant predictors for all-cause mortality. We created a multimarker model with nt-proBNP, hsTnT and IGF-BP7 and found that patients in whom all three markers were elevated had a significantly worse long-time-prognosis than patients without elevated markers. Conclusion: In a 10-year follow-up, a combination of three biomarkers (NT-proBNP, hs-TnT, IGF-BP7) identified patients with a high risk of mortality.

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The Correlation between Social Support and Self-care in Patients with Heart Failure: The Mediating Role of Illness Perception

Journal of Health Promotion Managment ◽

10.21859/jhpm-07036 ◽

2017 ◽

Vol 7 (3) ◽

pp. 43-50 ◽

Cited By ~ 1

Author(s):

Nastaran Mansoreye ◽

Hamid Poursharifi ◽

Mohammad Reza Taban Sadegi ◽

Mohammad Reza Seirafi ◽

◽

...

Keyword(s):

Heart Failure ◽

Social Support ◽

Illness Perception ◽

Self Care ◽

Mediating Role ◽

Patients With Heart Failure

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Metabolic Therapy in Heart Failure

Cardiac Failure Review ◽

10.15420/cfr.2015.1.2.112 ◽

2015 ◽

Vol 1 (2) ◽

pp. 112 ◽

Cited By ~ 6

Author(s):

Yury Lopatin ◽

Keyword(s):

Heart Failure ◽

Fatty Acid ◽

Glucose Oxidation ◽

Acid Oxidation ◽

Patients With Heart Failure ◽

Cardiac Energy Metabolism ◽

Conventional Medical Therapy ◽

Cardiac Energy ◽

Metabolic Impairments

Metabolic impairments play an important role in the development and progression of heart failure. The use of metabolic modulators, the number of which is steadily increasing, may be particularly effective in the treatment of heart failure. Recent evidence suggests that modulating cardiac energy metabolism by reducing fatty acid oxidation and/or increasing glucose oxidation represents a promising approach to the treatment of patients with heart failure. This review focuses on the role of metabolic modulators, in particular trimetazidine, as a potential additional medication to conventional medical therapy in heart failure.

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Role of Lung Ultrasound and Inferior Vena Cava Diameter in Assessment of Patients with Heart Failure

The Egyptian Journal of Hospital Medicine ◽

10.21608/ejhm.2021.207097 ◽

2021 ◽

Vol 85 (2) ◽

pp. 4102-4107

Author(s):

Hussein Abd El-Fattah Mohammed ◽

Mohamed Salah El-Feshawy ◽

Fareed Shawky Basiony ◽

Mustafa Abu shady

Keyword(s):

Heart Failure ◽

Inferior Vena Cava ◽

Inferior Vena ◽

Lung Ultrasound ◽

Vena Cava ◽

Patients With Heart Failure ◽

Inferior Vena Cava Diameter

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The Evolving Role of Catheter Ablation in Patients With Heart Failure and AF

Arrhythmia & Electrophysiology Review ◽

10.15420/aer.2019.9.2 ◽

2019 ◽

Vol 8 (1) ◽

pp. 47-53

Author(s):

Sandeep Prabhu ◽

Wei H Lim ◽

Richard J Schilling

Keyword(s):

Heart Failure ◽

Clinical Practice ◽

Catheter Ablation ◽

Patient Group ◽

Clinical Practice Guidelines ◽

Practice Guidelines ◽

Evidence Base ◽

Patients With Heart Failure ◽

Recent Developments

AF and heart failure are emerging epidemics worldwide. Several recent trials have provided a growing evidence base for the benefits of catheter ablation in this patient group, which are yet to be universally adopted in clinical practice guidelines. This paper provides a summary of recent developments in this field and provides pragmatic advice to the treating physician regarding the appropriate role of catheter ablation in the overall management of patients with comorbid AF and heart failure.

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High-Sensitive Troponin I and Re-Hospitalization in Patients With Decompensated Congestive Heart Failure

ACTA MEDICA IRANICA ◽

10.18502/acta.v57i2.1766 ◽

2019 ◽

Author(s):

Shokoufeh Hajsadeghi ◽

Yaghoub Bagheri ◽

Mohammad Hossein Ghafouri ◽

Scott Reza Jafarian Kerman ◽

Morteza Hassanzadeh

Keyword(s):

Heart Failure ◽

Troponin I ◽

Decompensated Heart Failure ◽

Left Ventricular ◽

Hospitalized Patients ◽

Post Discharge ◽

Shock Delivery ◽

Coronary Syndrome ◽

Patients With Heart Failure

Abstract- Patients with heart failure (HF) are frequently admitted for episodes of decompensation. Cardiac troponins are easily accessible biomarkers role of which for risk stratification of re-hospitalization among HF patients is less certain. We aimed to evaluate high-sensitive cardiac troponin I (hs-cTnI) levels among re-hospitalized patients with decompensated heart failure (D-HF). Consecutive subjects admitted with D-HF to 2 hospitals in Tehran, during the year 2014 were recruited. Excluded ones were patients with a suspected acute coronary syndrome or myocarditis/pericarditis, those with cardiopulmonary resuscitation/DC shock delivery, or major complications during or after hospitalization. Along with echocardiography parameters, level of hs-cTnI was checked at the first hour of hospitalization and 3 months after discharge. The patients were then categorized according to having or not having re-hospitalization during 3 months post discharge. A total of 97 patients were finally recruited. Among re-hospitalized patients, Left ventricular (LV) ejection fraction was significantly lower (38±14 % vs. 50 ± 12%; P=0.001), and LV end-systolic dimension was significantly higher (44±9 mm vs. 38±11 mm; P=0.012) compared to the other group. Moreover, levels of hs-cTnI were significantly higher among the re-hospitalized patients, both at initial visit (0.66±0.43 ng/ml vs 0.51±0.14 ng/ml, respectively; P=0.017) and at 3 months (0.59±0.48 ng/ml vs 0.48±0.23 ng/ml, respectively; P=0.030). This prospective study demonstrated that levels of hs-cTnI (both at the base and at follow up) are higher among patients who readmitted during 3 months of hospitalization for D-HF.

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