scholarly journals Novel potential biomarkers with predictive power on response to therapy in cardiac resynchronization therapy – cardiac oxidative stress assesment

2020 ◽  
Vol 30 (2) ◽  
pp. 241-249
Author(s):  
Sergiu Sipos ◽  
Radu Ciudin ◽  
Corina Grigore ◽  
Carmen Ginghina
Keyword(s):  
Oxidative Stress ◽  
Heart Failure ◽  
Predictive Power ◽  
Heart Rhythm ◽  
Response To Therapy ◽  
Response To Treatment ◽  
Cardiac Resynchronization ◽  
Resynchronization Therapy ◽  
Patients With Heart Failure ◽  
Before And After

CRT represents the transition from the heart rhythm therapy, started more than 60 years ago with the first pacemakers, to the optimization therapy of myocardial contractility in heart failure. It is estimated that about a quarter of the population of patients with heart failure have electrical and mechanical criteria for cardiac asynchrony. They are the target of resynchronization therapy. The current indications for resynchronization therapy use basic selection criteria, without having high predictive power in terms of response to treatment. About one-third of patients undergoing resynchronization are found to be non-responsive to therapy. In this study we tested a new direction in our effort to increase the number of post-resynchronization beneficiaries, using markers of oxidative stress in patients with heart failure, assessed before and after intervention, with promising results.

Chronic heart failure diagnosis: symptoms, signs, and the ECG

ESC CardioMed ◽  
2018 ◽  
pp. 1758-1762
Author(s):  
Pardeep S. Jhund
Keyword(s):  
Heart Failure ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Clinical History ◽  
Response To Treatment ◽  
Cardiac Resynchronization ◽  
Patients With Heart Failure ◽  
Third Heart Sound ◽  
Therapeutic Decision Making ◽  
Heart Failure Diagnosis

The clinical history aims to elicit the symptoms that are commonly experienced by patients with heart failure such as dyspnoea, paroxysmal nocturnal dyspnoea, orthopnoea, and fatigue. The history may also provide clues as to the aetiology of heart failure and symptoms that suggest alternative diagnoses. Similarly, signs that are elicited on clinical examination are used to support the diagnosis of heart failure. In addition, they can be used to determine prognosis and assess response to treatment or the need for more intensive treatment. Common signs such as peripheral oedema, jugular venous distension, and pulmonary crackles are less specific for the diagnosis of heart failure than others such as a third heart sound. The presence of some clinical signs may help determine the aetiology of heart failure and indicate other potential diagnoses that may present like heart failure but require very different treatment. While signs and symptoms are used in conjunction with imaging evidence and raised natriuretic peptides to make the diagnosis of heart failure, the electrocardiogram (ECG) still plays a central role. The ECG can be used to determine underlying aetiology (such as evidence of prior myocardial infarction) and guide therapeutic decision-making such as the need for cardiac resynchronization therapy in those with bundle branch block. Information on symptoms, signs, and investigations such as the ECG need to be integrated to ensure the accurate diagnosis and optimal treatment of patients with heart failure.

Sign in / Sign up

Export Citation Format

Share Document