Abstract 1951: Circulating Dendritic Cells May Play an Important Role in Pathophysiology in Heart Failure in Humans

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Yusuke Sugi ◽  
Hideo Yasukawa ◽  
Hisashi Kai ◽  
Daisuke Fukui ◽  
Nobuyoshi Futamata ◽  
...  
Keyword(s):  
Heart Failure ◽  
Dendritic Cells ◽  
Decompensated Heart Failure ◽  
Left Ventricular ◽  
Primary Immune Response ◽  
Left Ventricular Ejection ◽  
Heart Failure Treatment ◽  
Heart Failure Patients ◽  
Control Subjects ◽  
Failure Treatment

Dendritic cells (DCs) are the most potent antigen-presenting cells and play a central role in initiating the primary immune response. Although increasing evidence supports immune-mediated inflammation plays an important role in the pathophysiology of heart failure, little is known regarding the source and mechanism that trigger immune responses. The present study examined whether circulating DCs have any role in the pathophysiology in heart failure in humans. Methods and Results: With multi-color flow-cytometry we determined the numbers of circulating myeloid DCs (mDCs) and plasmacytoid DCs (pDCs) in decompensated heart failure patients with NYHA class III or IV on admission (n=27) and the age-matched control subjects (n=21). DC activation markers such as CD40 and CCR7 were also measured. On admission, circulating mDC and pDC counts were significantly lower in decompensated heart failure patients compared to control subjects (12417 ± 2849 versus 5394 ± 3547 and 3321 ± 1491 versus 1800 ± 1474/ml, respectively, p<0.01). Circulating DCs were activated in the decompensated heart failure patients compared to control subjects (CD40; 1.6 ± 1.8 versus 8.5 ± 9.2, CCR7; 3.5 ± 4.1 versus 13.5 ± 10.0, respectively, p<0.05). Heart failure treatment significantly restored the reduction and the activation of circulating DCs (p<0.05). The increases of circulating DCs numbers after treatment were correlated with the decreases in B-type natriuretic peptide (BNP) and troponin-T (r=0.64, p<0.01 and r=0.46, respectively, p<0.05) and with the increase in left ventricular ejection fraction (LVEF) (r=0.73, p<0.01). Furthermore, we found that patients with smaller circulating DCs numbers (less than 10000/ml) after heart failure treatment had poor prognosis compaired with those who had greater DCs numbers (more than 10000/ml) during the 6-month follow-up (p<0.01). Thus, we found that changes of circulating DCs numbers were well correlated with cardiac injury and function, and that poor recovery of the circulating DCs number after treatment predicted recurrence of decompensated heart failure. Conclusion : These findings suggest that circulating DCs may play an important role in pathophysiology in heart failure in humans.

scholarly journals Effects of a multidisciplinary heart failure program in short term readmissions of heart failure patients, preliminary results

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
J Gorriz Magana ◽  
M.J Espinosa Pascual ◽  
R Abad Romero ◽  
R Olsen Rodriguez ◽  
D Nieto Ibanez ◽  
...  
Keyword(s):  
Heart Failure ◽  
Acute Decompensated Heart Failure ◽  
Decompensated Heart Failure ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Short Term ◽  
Ventricular Ejection Fraction ◽  
Heart Failure Patients ◽  
Basic Characteristics ◽  
The Impact

Abstract Background Unexpected readmissions are frequent among heart failure patients, due to their natural history that implies multiple readmissions, with high costs and clinical relevance. Purpose We aimed to assess the impact of a Multidisciplinary Heart Failure Program (MHFP) on the readmission-free period after an episode of acute decompensated heart failure (ADHF). Methods We carried out an analytical and observational study including all patients admitted to our Universitary Hospital, which covers 220,000 individuals, with an episode of heart failure when there was not a Multidisciplinary Heart Failure Program (January 2013 to December 2013). Once the MHFP was established, we compared non-MHFP patients with every patient admitted during February 2019 and February 2020 in terms of clinical data, imaging technique findings and short-term readmissions. Results The rate of readmission during this period was a 24.8% in non-MHFP and 17.2% in MHFP (p=0.15). However, we could find differences in median time to readmission due to ADHF, that was 1.74 months (CI 95%, 0.12–3.35) in non-MHFP, compared to 5.125 months (CI 95%, 4.15–6.09) in MHFP (p=0.002) (see Graph 1). There were also no significant differences in terms of basic characteristics between the MHFP and the non-MHFP patients (age, gender, left ventricular ejection fraction, left bundle branch block, hypertension). It is remarkable that establishing a MHFP has lengthened the readmission-free period. The rate of decompensation in the first and sixth month was respectively in the non–MHFP 9% and 21%; and in the MHFP 2% and 10%. Conclusion According to our results, the implantation of this Multidisciplinary Heart Failure Program has shown a reduction in the time to ADHF readmission compared with a cohort of similar pts some years before, which is clinically relevant. Graph 1 Funding Acknowledgement Type of funding source: None

New guidelines for the heart failure treatment (2021)

2021 ◽  
Vol 14 (4) ◽  
pp. 338-342
Author(s):  
Radosław Grabysa
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Mineralocorticoid Receptor ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Heart Failure Treatment ◽  
Ventricular Ejection Fraction ◽  
Failure Treatment ◽  
New Guidelines

At this year’s ESC congress in London, it was announced an update of the guidelines for the treatment of chronic heart failure with reduced left ventricular ejection fraction. Key change compared to last guidelines is withdrawal the long-term titration strategy and introducing a simpler and faster regimen based on four groups of drugs: blocking the renin–angiotensin–aldosterone system (ACE-I, ARNI), sodium-glucose co-transporter inhibitors (dapagliflozin, empagliflozin), β-adrenolytic drugs, mineralocorticoid receptor inhibitors.

Strong risk factors for depression and anxiety in heart failure patients

2021 ◽  
Author(s):  
Naila Niaz ◽  
Syed Muhammad Faraz Ali ◽  
Attaullah Younas ◽  
Tallat Anwar Faridi ◽  
Asif Hanif
Keyword(s):  
Risk Factors ◽  
Heart Failure ◽  
Ejection Fraction ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Anxiety And Depression ◽  
Team Approach ◽  
Depression And Anxiety ◽  
Ventricular Ejection Fraction ◽  
Heart Failure Patients

Despite advancing medical technology, Heart Failure (HF) is still a prevalent disease with high mortality and high health expenditure. To improve patient outcome and prognosis, it is important to identify the association of risk factors which leads to the co-morbid depression and anxiety in heart failure patients. Objectives: To determine the association of depression and/or anxiety with age, gender and ejection fraction in heart failure patients. Methods: It is an analytical cross sectional study including 323 CHF patients who visited the to the Faisalabad Institute of Cardiology hospital Out-Patient Department, 250 were males and 73 were females, mean age was 54.1 ± 9.2 years having 70 years as maximum and 25 years as minimum.  Data collection was done using Hospital Anxiety and Depression Scale (HADS) questionnaire to assess depression and anxiety. Data was analyzed using SPSS version 24. For quantitative data, mean and standard deviation was calculated and for qualitative data frequency and percentages was calculated. To measure the association of anxiety and depression with age categories, ejection fraction and gender, chi square test was used. P values less than and equal to 0.05 were taken as significant. Results: No association of depression and anxiety with gender and Left Ventricular Ejection Fraction (LVEF) was observed. However, depression and anxiety were found to be significantly associated with age Conclusions: The study concluded that age is a strong risk factor of depression and anxiety in congestive heart failure patients. Multidisciplinary health care team approach and interventions are required to cater chronic heart failure (CHF) patients to address the psychological burden.

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