scholarly journals Melatonin in Heart Failure: A Promising Therapeutic Strategy?

Molecules ◽  
2018 ◽  
Vol 23 (7) ◽  
pp. 1819 ◽  
Author(s):  
Frederic Nduhirabandi ◽  
Gerald Maarman
Keyword(s):  
Heart Failure ◽  
Cardiovascular Health ◽  
Experimental Studies ◽  
Clinical Syndrome ◽  
The Body ◽  
Curative Therapy ◽  
Cardiometabolic Disorders ◽  
Patients With Heart Failure ◽  
Poor Outcomes

Heart failure is a multifactorial clinical syndrome characterized by the inability of the heart to pump sufficient blood to the body. Despite recent advances in medical management, poor outcomes in patients with heart failure remain very high. This highlights a need for novel paradigms for effective, preventive and curative strategies. Substantial evidence supports the importance of endogenous melatonin in cardiovascular health and the benefits of melatonin supplementation in various cardiac pathologies and cardiometabolic disorders. Melatonin plays a crucial role in major pathological processes associated with heart failure including ischemic injury, oxidative stress, apoptosis, and cardiac remodeling. In this review, available evidence for the role of melatonin in heart failure is discussed. Current challenges and possible limitations of using melatonin in heart failure are also addressed. While few clinical studies have investigated the role of melatonin in the context of heart failure, current findings from experimental studies support the potential use of melatonin as preventive and adjunctive curative therapy in heart failure.

Abstract MP03: Plasma Sphingolipids and Risks of Heart Failure and Atrial Fibrillation in Older Adults: The Cardiovascular Health Study

Circulation ◽  
2018 ◽  
Vol 137 (suppl_1) ◽  
Author(s):  
Rozenn N Lemaitre ◽  
Paul N Jensen ◽  
Barbara McKnight ◽  
Andrew Hoofnagle ◽  
Irena B King ◽  
...  
Keyword(s):  
Heart Failure ◽  
Atrial Fibrillation ◽  
Fatty Acid ◽  
Lower Risk ◽  
Cardiovascular Health ◽  
Biological Activities ◽  
Experimental Studies ◽  
Health Study ◽  
Cardiovascular Health Study

Introduction: Ceramides and sphingomyelins (sphingolipids) are circulating lipids involved in multiple physiological pathways relevant to heart failure (HF) and atrial fibrillation (AF), including apoptosis, oxidative stress, and inflammation. Experimental studies suggest that sphingolipids with different saturated fatty acids exhibit different biological activities, but their relationships with HF and AF are unknown. Hypothesis: Higher levels of plasma ceramide and sphingomyelin that contain the fatty acid 16:0 are associated with higher risks of HF and AF; and higher levels of ceramides and sphingomyelins that contain the fatty acid 20:0, 22:0 or 24:0 are associated with lower risks. Methods: We measured sphingolipids in the Cardiovascular Health Study (CHS) in plasma samples from 1994-95 (N=4026) or from 1992-93 (N=586). We assessed the separate associations of the levels of 8 sphingolipids with risks of incident HF and incident AF using Cox regression. A p-value threshold of 0.006 was used to account for multiple testing. Results: Among 4,612 participants, 1179 incident HF and 1198 incident AF occurred during >40,000 person-years of follow-up. In adjusted analyses, higher levels of Cer-16 (ceramide with 16:0) and SM-16 (sphingomyelin with 16:0) were associated with higher risk of incident HF, but not with risk of incident AF (Table). In contrast, higher levels of Cer-20, Cer-22 and Cer-24 were each associated with lower risk of AF, but not with risk of HF. Higher levels of SM-20, SM-22, and SM-24 tended to be associated with lower risks of AF and HF, with only the association of SM-20 with AF significant. Conclusions: Plasma levels of ceramide and sphingomyelin with 16:0 show different associations with HF and AF than species with 20:0, 22:0 or 24:0. Associations of Cer-16 and SM-16 specifically with higher risk of HF may be due to a role of apoptosis in HF. The novel findings that Cer-20, Cer-22, and Cer-24 are associated with lower risk of AF warrant further examination of the role of these sphingolipids in protecting from AF.

scholarly journals PATOMEKANISME PENYAKIT GAGAL JANTUNG KONGESTIF

el–Hayah ◽  
2014 ◽  
Vol 4 (2) ◽  
pp. 81 ◽  
Author(s):  
Lailia Nur Rachma
Keyword(s):  
Heart Failure ◽  
Clinical Manifestations ◽  
The United States ◽  
Clinical Syndrome ◽  
The Body ◽  
Reduced Ejection Fraction ◽  
Patients With Heart Failure ◽  
Male Patients ◽  
Failure Prognosis ◽  
The Cost

<em>Heart failure is a clinical syndrome characterized by abnormalities in the structure or function of the heart, resulting in inability of heart to pump blood to meet the metabolic needs of the body tissue. Heart failure is characterized by clinical manifestations such as circulation congestion, tightness, fatigue, and weakness. Heart failure is a major problem in industrial and developing Country. Currently, the incidence and prevalence of heart failure tends to increase, it is also accompanied by an increase in mortality of heart failure cases. In the United States, 1 million patients hospitalized due to heart failure cases, which contribute to 50,000 deaths each year. While the number of visits to the hospital due to heart failure estimated at 6.5 million. Heart failure prognosis is generally poor despite the patients accepted adequate therapy. From the data obtained, only about 35% of male patients and 50% female patients who survived after the onset of acute heart failure. Generaly, the data obtained high mortality are occurs in patients with grade IV (presence of symptoms at rest) is about 30-70%, grade III (presence of symptoms with mild activity) 10-20%, class II (presence of symptoms when the activity being 5-10 %). Higher mortality was found in older patients, men, patients with reduced ejection fraction, and in patients with coronary disease. Once someone is suffering from heart failure, then he shall bear the very high cost. In America, the cost of issued for heart failure therapy between 15-40 trillion US$. In this review, we will discuss about pathomechanism of heart failure. So it is expected to be a reference to the diagnosis of patients with heart failure, which is expected to be recognized early on that could ultimately improve the quality of heart failure patient life, and reduce the number of mortality due to heart failure</em>

Heart Failure

2014 ◽  
pp. 830-842
Author(s):  
Garrick C. Stewart
Keyword(s):  
Heart Failure ◽  
Poor Quality ◽  
Clinical Syndrome ◽  
The Body ◽  
Structural Abnormality ◽  
Cardiac Diseases ◽  
Cardiac Structure ◽  
Patients With Heart Failure ◽  
End Stage

Heart failure is a complex clinical syndrome occurring in patients with an abnormality of cardiac structure or function that impairs the ability of the heart to fill with or eject blood. Patients with heart failure develop a constellation of symptoms (dyspnea and fatigue) and signs (edema and rales) that lead to frequent hospitalizations, poor quality of life, and a shortened life expectancy. Heart failure has also been defined as the failure of the heart to pump enough blood to meet the metabolic demands of the body, or the ability to do so only at elevated filling pressures. Congestive heart failure is the end stage for many cardiac diseases. Cardiomyopathy refers to any condition in which there is a structural abnormality of the myocardium itself.

Prognostic role of myocardial work in patients with heart failure and reduced ejection fraction treated by sacubitril/valsartan

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
E Galli ◽  
Y Bouali ◽  
C Laurin ◽  
A Gallard ◽  
A Hubert ◽  
...  
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Rank Test ◽  
Reduced Ejection Fraction ◽  
Non Invasive ◽  
Patients With Heart Failure ◽  
Increase Risk ◽  
Echocardiographic Examination ◽  
Constructive Work

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&lt;0.0001) and myocardial work efficiency (WE) [87 (78–90) vs 90 (86–95), p&lt;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&lt;910 mmHg (AUC=0.81, p&lt;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&lt;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

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

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.

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

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.

scholarly journals Nutritional and Non-Nutritional Predictors of Low Spot Urinary Creatinine Concentration in Patients with Heart Failure

Nutrients ◽  
2021 ◽  
Vol 13 (11) ◽  
pp. 3994
Author(s):  
Jolanta Malinowska-Borowska ◽  
Aleksandra Kulik ◽  
Marta Buczkowska ◽  
Weronika Ostręga ◽  
Apolonia Stefaniak ◽  
...  
Keyword(s):  
Risk Factors ◽  
Heart Failure ◽  
Weight Loss ◽  
Creatinine Concentration ◽  
Urinary Creatinine ◽  
Under Nutrition ◽  
Patients With Heart Failure ◽  
Poor Outcomes ◽  
Biochemical Indices ◽  
Appendicular Muscle Mass

Low spot urinary creatinine concentration (SUCR) is a marker of muscle wasting and clinical outcome. The risk factors for low SUCR in heart failure (HF) remain poorly understood. We explored the risk factors for low SUCR related to poor outcomes. In 721 HF patients (age: 52.3 ± 11 years, female: 14%, NYHA: 2.7 ± 0.7) SUCR and Dexa body composition scans were performed. BMI prior HF-onset, weight loss, and appendicular muscle mass were obtained. Each patient was classified as malnutrition or normal by GLIM criteria and three other biochemical indices (CONUT, PNI, and GRNI). Sarcopenia index (SI) as creatinine to cystatin C ratio was also calculated. Within 1 year, 80 (11.1%) patients died. In ROC curve we identified a SUCR value of 0.628 g/L as optimally discriminating surviving from dead. In low SUCR group more advanced HF, higher weight loss and catabolic components of weight trajectory (CCWT), more frequent under-nutrition by GLIM, and lower SI were observed. In multivariate analysis the independent predictors of low SUCR were SI, CCWT, and GNRI score. In conclusion: the risk of low SUCR was associated with a worse outcome. Low SUCR was associated with greater catabolism and sarcopenia but not with biochemical indices of malnutrition.

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

2017 ◽  
Vol 7 (3) ◽  
pp. 43-50 ◽  
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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