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Impact of Sex in the Incidence of Heart Failure in Patients with Chronic Coronary Syndrome. 性别对慢性冠状动脉综合征患者心衰发生率的影响
IF 3.8 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-08-01 Epub Date: 2024-05-04 DOI: 10.1007/s11897-024-00663-z
Ramón López-Palop, Pilar Carrillo, Íñigo Lozano

Purpose of review: This review examines the available evidence concerning the incidence of heart failure in patients with chronic coronary syndrome, with a focus on gender differences.

Recent findings: The incidence of heart failure in the context of chronic coronary syndrome presents conflicting data. Most of the available information stems from studies involving stable patients' post-acute coronary syndrome, revealing a wide range of incidence rates, from less than 3% to over 20%, observed over 5 years of follow-up. Regarding the gender differences in heart failure incidence, there is no consensus about whether women exhibit a higher incidence, particularly in the presence of evidence of obstructive coronary artery disease. However, in cases where obstructive coronary artery disease is absent, women may face a more unfavourable prognosis due to a higher prevalence of microvascular disease and heart failure with preserved ventricular function. The different profile of ischaemic heart disease in women difficult to establish differences in prognosis independently associated with female sex. Targeted investigations are essential to discern the incidence of heart failure in chronic coronary syndrome and explore potential gender-specific associations.

综述目的:本综述研究了有关慢性冠状动脉综合征患者心力衰竭发生率的现有证据,重点关注性别差异:慢性冠状动脉综合征心力衰竭的发病率数据相互矛盾。现有资料大多来自对急性冠状动脉综合征后病情稳定的患者进行的研究,结果显示,随访 5 年的发病率范围很广,从不到 3% 到超过 20%。关于心力衰竭发病率的性别差异,目前还没有就女性是否发病率更高达成共识,尤其是在有证据表明存在阻塞性冠状动脉疾病的情况下。然而,在没有阻塞性冠状动脉疾病的情况下,由于微血管疾病和心室功能保留的心力衰竭的发病率较高,女性可能会面临更不利的预后。女性缺血性心脏病的不同特征难以确定与女性性别独立相关的预后差异。有针对性的调查对于确定慢性冠状动脉综合征心力衰竭的发病率和探索潜在的性别特异性关联至关重要。
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引用次数: 0
The Role of Coagulation in Heart Failure: A Literature Review. 凝血在心力衰竭中的作用:文献综述。
IF 3.8 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-08-01 Epub Date: 2024-06-13 DOI: 10.1007/s11897-024-00671-z
Farhan Anjum, Mahrukh Gilani, Maryam Latif, Aqsa Sattar, Habiba Ashraf, Saira Rafaqat

Purpose of review: This article summarizes the role of coagulation factors in the pathophysiology of heart failure including D-dimer, fibrinogen and fibrin, prothrombin, p-selectin, tissue factor, tissue plasminogen activator, von Willebrand factor, β-thromboglobulin, Factor XI, tissue thromboplastin, plasminogen activator inhibitor-1 (PAI-1), thrombomodulin, soluble urokinase-type plasminogen activator receptor (suPAR) and stuart-prower factor.

Recent findings: The D-dimer, P-selectin, prothrombin, von Willebrand factor, tissue plasminogen activator, fibrinogen, suPAR, tissue factor, thrombomodulin and Factor XI play significant roles the pathophysiology of heart failure. However, no associations were found between β-thromboglobulin, tissue thromboplastin, PAI-1 and stuart-prower factor in the context of heart failure. Coagulation factors play significant role in the pathophysiology of heart failure. Consequently, the underlying pathophysiological mechanisms that explain changes in the cascade are closely related to the diagnostic, prognostic and therapeutic roles of coagulation cascade factors, which help physicians identify and treat heart failure.

综述目的:本文总结了凝血因子在心力衰竭病理生理学中的作用,包括D-二聚体、纤维蛋白原和纤维蛋白、凝血酶原、P-选择素、组织因子、组织凝血酶原激活物、von Willebrand因子、β-凝血酶原球蛋白、因子XI、组织凝血活酶、凝血酶原激活物抑制剂-1(PAI-1)、血栓调节蛋白、可溶性尿激酶型凝血酶原激活物受体(suPAR)和stuart-prower因子:最新研究结果:D-二聚体、P-选择素、凝血酶原、冯-威廉因子、组织纤溶酶原激活物、纤维蛋白原、suPAR、组织因子、血栓调节蛋白和因子 XI 在心力衰竭的病理生理学中发挥着重要作用。然而,β-凝血酶原球蛋白、组织凝血活酶、PAI-1 和 stuart-prower 因子与心力衰竭之间没有关联。凝血因子在心力衰竭的病理生理学中起着重要作用。因此,解释级联变化的潜在病理生理学机制与凝血级联因子的诊断、预后和治疗作用密切相关,有助于医生识别和治疗心衰。
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引用次数: 0
Is There a Mitochondrial Protection via Remote Ischemic Conditioning in Settings of Anticancer Therapy Cardiotoxicity? 在抗癌治疗心脏毒性的情况下,远程缺血调节对线粒体有保护作用吗?
IF 3.8 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-08-01 Epub Date: 2024-03-21 DOI: 10.1007/s11897-024-00658-w
Petra Kleinbongard, Ioanna Andreadou

Purpose of review: To provide an overview of (a) protective effects on mitochondria induced by remote ischemic conditioning (RIC) and (b) mitochondrial damage caused by anticancer therapy. We then discuss the available results of studies on mitochondrial protection via RIC in anticancer therapy-induced cardiotoxicity.

Recent findings: In three experimental studies in healthy mice and pigs, there was a RIC-mediated protection against anthracycline-induced cardiotoxicity and there was some evidence of improved mitochondrial function with RIC. The RIC-mediated protection was not confirmed in the two available studies in cancer patients. In adult cancer patients, RIC was associated with an adverse outcome. There are no data on mitochondrial function in cancer patients. Studies in tumor-bearing animals are needed to determine whether RIC does not interfere with the anticancer properties of the drugs and whether RIC actually improves mitochondrial function, ultimately resulting in improved cardiac function.

综述的目的:综述(a)远程缺血调节(RIC)对线粒体的保护作用和(b)抗癌治疗对线粒体的损伤。然后,我们讨论了在抗癌治疗引起的心脏毒性中通过 RIC 保护线粒体的现有研究结果:在对健康小鼠和猪进行的三项实验研究中,RIC 对蒽环类药物诱导的心脏毒性有保护作用,而且有证据表明 RIC 改善了线粒体功能。在对癌症患者进行的两项研究中,RIC 介导的保护作用未得到证实。在成年癌症患者中,RIC 与不良预后有关。目前还没有关于癌症患者线粒体功能的数据。需要在肿瘤动物中进行研究,以确定 RIC 是否不会干扰药物的抗癌特性,以及 RIC 是否真的会改善线粒体功能,最终导致心脏功能的改善。
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引用次数: 0
Sex-based Differences in Heart Failure Biomarkers. 心力衰竭生物标志物的性别差异
IF 3.8 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-08-01 Epub Date: 2024-05-20 DOI: 10.1007/s11897-024-00665-x
Ainhoa Robles-Mezcua, Nelsa González Aguado, Antonia Pilar Martin de la Rosa, Concepción Cruzado-Álvarez, Clara Jiménez Rubio, Alejandro IPérez Cabeza, Juan José Gómez-Doblas, Manuel F Jiménez-Navarro, Mora Murri Pierri, José M García-Pinilla

Purpose of review: Differences in HF biomarker levels by sex may be due to hormonal, genetic, and fat distribution differences. Knowledge of these differences is scarce, and it is not well established whether they may affect their usefulness in the management of HF.

Recent findings: The different biomarker profiles in women and men have been confirmed in recent studies: in women, markers of cardiac stretch and fibrosis (NP and galectin-3) are higher, whereas in men, higher levels of markers of cardiac injury and inflammation (cTn and sST2) are found. The use of new biomarkers, together with growing evidence that a multimarker approach can provide better risk stratification, raises the question of building models that incorporate sex-specific diagnostic criteria. More and more research are being devoted to understanding sex-related differences in HF. The aim of this review is to review the dynamics of HF biomarkers according to sex and in different situations, to learn whether these sex differences may affect their use in the diagnosis and follow-up of HF patients.

综述的目的:高血压生物标志物水平的性别差异可能是由于荷尔蒙、遗传和脂肪分布差异造成的。对这些差异的了解还很少,也没有很好地确定这些差异是否会影响它们在高血压管理中的作用:最近的研究证实了女性和男性不同的生物标志物特征:女性的心脏舒张和纤维化标志物(NP 和 galectin-3)更高,而男性的心脏损伤和炎症标志物(cTn 和 sST2)水平更高。新生物标志物的使用,以及越来越多的证据表明多标志物方法可以提供更好的风险分层,提出了建立包含性别特异性诊断标准的模型的问题。越来越多的研究致力于了解心房颤动与性别有关的差异。本综述旨在回顾不同性别和不同情况下心房颤动生物标志物的动态变化,以了解这些性别差异是否会影响它们在心房颤动患者诊断和随访中的应用。
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引用次数: 0
Exergaming to Increase Physical Activity in Older Adults: Feasibility and Practical Implications. Exergaming to Increase Physical Activity in Older Adults:可行性和实际意义。
IF 3.8 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-08-01 Epub Date: 2024-07-18 DOI: 10.1007/s11897-024-00675-9
Patrik Rytterström, Anna Strömberg, Tiny Jaarsma, Leonie Klompstra

Purpose of review: To evaluate the feasibility of exergaming among older adults, focusing on acceptability, demand, implementation, and practicality. Additionally, to offer practical implications based on the review's findings.

Recent findings: Exergaming is a safe for older adults, potentially increasing physical activity, balance, cognition, and mood. Despite these possible benefits, barriers such as unfamiliarity with equipment, complex controls, and unclear instructions may challenge older adults in exergaming. Based on the experience of older adults, they found exergaming enjoyable, particularly the social interactions. Exergaming was perceived as physically and cognitively demanding, with technical and safety challenges. Introducing exergaming requires thorough familiarization, including written and video instructions, follow-up support, and home accessibility. To be able to follow improvements during exergaming as well as age-appropriate challenges are important for successful integration into daily life. Based on these findings, an ExerGameFlow model for older adults was developed which provides practical implications for future design of exergames and interventions.

审查目的:从可接受性、需求、实施和实用性等方面,评估老年人参与电子游戏的可行性。此外,根据综述结果提出实际意义:外部游戏对老年人来说是安全的,有可能增加身体活动、平衡、认知和情绪。尽管有这些可能的益处,但诸如不熟悉设备、复杂的控制和不明确的说明等障碍可能会对老年人玩电子游戏造成挑战。根据老年人的经验,他们认为外部游戏很有趣,尤其是社交互动。他们认为电子游戏对体力和认知能力要求较高,在技术和安全方面存在挑战。引入电子游戏需要全面的熟悉,包括书面和视频指导、后续支持和家庭无障碍环境。要想成功融入日常生活,就必须能够跟踪外部游戏过程中的改进情况,以及与年龄相适应的挑战。基于这些发现,我们为老年人开发了一个ExerGameFlow模型,该模型为未来设计外部游戏和干预措施提供了实际意义。
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引用次数: 0
Estimated Glomerular Filtration Rate Slope as an Endpoint in Cardiovascular Trials. 将估计肾小球滤过率斜率作为心血管试验的终点。
IF 3.8 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-08-01 Epub Date: 2024-05-25 DOI: 10.1007/s11897-024-00668-8
Arsalan Hamid, Stephen J Greene, Ankit Mehta, Javed Butler, Muhammad Shahzeb Khan

Purpose of review: End stage kidney disease can be a slow process and it may be challenging to achieve required follow-up for sufficient events. Therefore, a surrogate kidney endpoint, such as estimated glomerular filtration rate (eGFR) slope maybe attractive to assess the kidney in cardiovascular trials, especially heart failure (HF).

Recent findings: eGFR slope can generate informative results in a shorter follow-up period, has decreased risk of type-2 error, and is less sensitive to eGFR shifts compared with other surrogate kidney endpoints (eGFR decline≥40% or doubling creatinine). However, eGFR slope has its limitations with acute effects, heterogeneity in slope calculation/reporting, and deviations from linearity. eGFR slope is a kidney endpoint which may be well-suited for HF trials. Cross-collaborated guideline recommendations are needed to optimize the use of eGFR slope as a kidney endpoint in patients with HF.

审查目的:终末期肾病可能是一个缓慢的过程,要实现所需的充分事件随访可能具有挑战性。最近的研究结果:与其他替代肾脏终点(eGFR 下降≥40% 或肌酐翻倍)相比,eGFR 斜率能在较短的随访期内产生有参考价值的结果,减少 2 型错误的风险,对 eGFR 变化的敏感性较低。然而,eGFR 斜率也有其局限性,如急性效应、斜率计算/报告的异质性以及线性偏差等。为优化 eGFR 斜率作为肾脏终点在心房颤动患者中的应用,需要制定交叉合作的指南建议。
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引用次数: 0
Cellular Alterations in Immune Checkpoint Inhibitor Therapy-Related Cardiac Dysfunction. 免疫检查点抑制剂疗法导致的心功能障碍中的细胞变化
Q1 Medicine Pub Date : 2024-06-01 Epub Date: 2024-03-02 DOI: 10.1007/s11897-024-00652-2
Lars Michel, Peter Ferdinandy, Tienush Rassaf

Purpose of review: Immune checkpoint inhibitor (ICI) therapy has emerged as a pivotal advancement in cancer treatment, but the widespread adoption has given rise to a growing number of reports detailing significant cardiovascular toxicity. This review concentrates on elucidating the mechanisms behind ICI-related cardiovascular complications, emphasizing preclinical and mechanistic data.

Recent findings: Accumulating evidence indicates a more significant role of immune checkpoints in maintaining cardiac integrity than previously understood, and new key scientific data are available to improve our understanding of ICI-related cardiovascular toxicity, including hidden cardiotoxicity. New avenues for innovative concepts are hypothesized, and opportunities to leverage the knowledge from ICI-therapy for pioneering approaches in related scientific domains can be derived from the latest scientific projects. Cardiotoxicity from ICI therapy is a paramount challenge for cardio-oncology. Understanding the underlying effects builds the foundation for tailored cardioprotective approaches in the growing collective at risk for severe cardiovascular complications.

综述目的:免疫检查点抑制剂(ICI)疗法已成为癌症治疗领域的一项重要进展,但其广泛应用也引发了越来越多关于心血管毒性的报道。这篇综述集中阐明了 ICI 相关心血管并发症背后的机制,强调了临床前和机理数据:不断积累的证据表明,免疫检查点在维持心脏完整性方面的作用比以前所理解的更为重要,而且新的关键科学数据的出现提高了我们对 ICI 相关心血管毒性(包括隐性心脏毒性)的认识。最新的科学项目提出了创新概念的新途径,并提供了在相关科学领域利用 ICI 治疗知识开创性方法的机会。ICI 疗法引起的心脏毒性是心脏肿瘤学面临的最大挑战。了解其潜在影响可为针对越来越多的严重心血管并发症高危人群量身定制心脏保护方法奠定基础。
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引用次数: 0
Pregnancy, Reproductive Factors, and Female Heart Failure Risk and Outcomes. 妊娠、生殖因素与女性心力衰竭的风险和结果。
Q1 Medicine Pub Date : 2024-06-01 Epub Date: 2024-03-20 DOI: 10.1007/s11897-024-00657-x
Guillermo Moreno, Manuel Martínez-Sellés, María Jesús Vicente-Galán, Lourdes Vicent

Purpose of review: The purpose of this review is to provide an overview of recent evidence on female-specific risk factors related to reproductive status or pregnancy.

Recent findings: Pregnancy-related factors, including hypertensive disorders and gestational diabetes, increase the risk of heart failure in women, while breastfeeding and hormone therapy may offer protection. Hypertensive disorders of pregnancy, gestational diabetes, polycystic ovarian syndrome, placental abruption, younger maternal age at first live birth, younger maternal age at last live birth, number of stillbirths, number of pregnancies, onset of menstruation before 12 years of age, shorter reproductive age, ovariectomy, and prolonged absence of ovarian hormones may increase the risk of heart failure in women. Conversely, breastfeeding status and hormone therapy (for menopause or contraception) may serve as protective factors, while fertility treatments have no discernible effect on the risk of heart failure.

综述目的:本综述旨在概述与生殖状况或妊娠有关的女性特异性风险因素的最新证据:与妊娠有关的因素,包括高血压疾病和妊娠糖尿病,会增加女性心力衰竭的风险,而母乳喂养和激素治疗可能会提供保护。妊娠期高血压疾病、妊娠期糖尿病、多囊卵巢综合征、胎盘早剥、首次活产时产妇年龄较小、最后一次活产时产妇年龄较小、死胎数量、妊娠次数、12 岁前月经初潮、生育年龄较短、卵巢切除术和长期缺乏卵巢激素可能会增加女性心衰的风险。相反,母乳喂养状况和激素治疗(绝经或避孕)可能是保护因素,而生育治疗对心衰风险没有明显影响。
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引用次数: 0
Evaluation and Management of Hyponatremia in Heart Failure. 心力衰竭患者低钠血症的评估与管理。
Q1 Medicine Pub Date : 2024-06-01 Epub Date: 2024-02-27 DOI: 10.1007/s11897-024-00651-3
Giulio M Mondellini, Frederik H Verbrugge

Purpose of review: To provide a contemporary overview of the pathophysiology, evaluation, and treatment of hyponatremia in heart failure (HF).

Recent findings: Potassium and magnesium losses due to poor nutritional intake and treatment with diuretics cause an intracellular sodium shift in HF that may contribute to hyponatremia. Impaired renal blood flow leading to a lower glomerular filtration rate and increased proximal tubular reabsorption lead to an impaired tubular flux through diluting distal segments of the nephron, compromising electrolyte-free water excretion. Hyponatremia in HF is typically a condition of impaired water excretion by the kidneys on a background of potassium and magnesium depletion. While those cations can and should be easily repleted, further treatment should mainly focus on improving the underlying HF and hemodynamics, while addressing congestion. For decongestive treatment, proximally acting diuretics such as sodium-glucose co-transporter-2 inhibitors, acetazolamide, and loop diuretics are the preferred options.

综述的目的:概述心力衰竭(HF)患者低钠血症的病理生理学、评估和治疗:营养摄入不足和利尿剂治疗导致的钾和镁损失会引起心力衰竭患者细胞内钠转移,从而导致低钠血症。肾血流量受损导致肾小球滤过率降低,近端肾小管重吸收增加,从而使肾小管通过稀释远端肾小管的通量受损,影响无电解质水的排泄。高血钾症中的低钠血症通常是在钾和镁耗竭的背景下肾脏排泄水功能受损所致。虽然这些阳离子可以而且应该很容易得到补充,但进一步的治疗应主要侧重于改善潜在的高血压和血液动力学,同时解决充血问题。在消除充血的治疗中,首选近端作用的利尿剂,如钠-葡萄糖共转运体-2 抑制剂、乙酰唑胺和襻利尿剂。
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引用次数: 0
Chronic Obstructive Pulmonary Disease in Heart Failure: Challenges in Diagnosis and Treatment for HFpEF and HFrEF. 心衰患者的慢性阻塞性肺病:心衰患者的慢性阻塞性肺病:HFpEF 和 HFrEF 诊断和治疗的挑战》。
Q1 Medicine Pub Date : 2024-06-01 Epub Date: 2024-03-28 DOI: 10.1007/s11897-024-00660-2
Sergio Henrique Rodolpho Ramalho, André Luiz Pereira de Albuquerque

Purpose of review: Chronic obstructive pulmonary disease (COPD) is common in heart failure (HF), and it has a significant impact on the prognosis and quality of life of patients. Additionally, COPD is independently associated with lower adherence to first-line HF therapies. In this review, we outline the challenges of identifying and managing HF with preserved (HFpEF) and reduced (HFrEF) ejection fraction with coexisting COPD.

Recent findings: Spirometry is necessary for COPD diagnosis and prognosis but is underused in HF. Therefore, misdiagnosis is a concern. Also, disease-modifying drugs for HF and COPD are usually safe but underprescribed when HF and COPD coexist. Patients with HF-COPD are poorly enrolled in clinical trials. Guidelines recommend that HF treatment should be offered regardless of COPD presence, but modern registries show that undertreatment persists. Treatment gaps could be attenuated by ensuring an accurate and earlier COPD diagnosis in patients with HF, clarifying the concerns related to pharmacotherapy safety, and increasing the use of non-pharmacologic treatments. Acknowledging the uncertainties, this review aims to provide key clinical resources to support better physician-patient co-decision-making and improve collaboration between health professionals.

综述目的:慢性阻塞性肺疾病(COPD)是心力衰竭(HF)的常见病,对患者的预后和生活质量有重大影响。此外,慢性阻塞性肺病还与较低的一线心力衰竭治疗依从性有关。在这篇综述中,我们概述了识别和管理射血分数保留(HFpEF)和射血分数降低(HFrEF)的合并慢性阻塞性肺疾病的挑战:肺活量测定对慢性阻塞性肺病的诊断和预后非常必要,但在高血压中却使用不足。因此,误诊是一个令人担忧的问题。此外,治疗高血脂和慢性阻塞性肺病的改变病情药物通常是安全的,但在高血脂和慢性阻塞性肺病并存时却用药不足。高血压合并慢性阻塞性肺病患者很少参与临床试验。指南建议,无论是否存在慢性阻塞性肺病,都应提供高血压治疗,但现代登记显示,治疗不足的情况依然存在。通过确保对高血压患者进行更早和更准确的慢性阻塞性肺病诊断、澄清与药物治疗安全性相关的问题以及增加非药物治疗的使用,可以缩小治疗差距。由于存在不确定性,本综述旨在提供关键的临床资源,以支持医生与患者更好地共同决策,并改善医疗专业人员之间的合作。
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引用次数: 0
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Current Heart Failure Reports
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