首页 > 最新文献

Heart Failure Reviews最新文献

英文 中文
Advanced Markers for Hemodynamic Monitoring in Cardiogenic Shock and End-Stage Heart Failure: A Mini Review. 心源性休克和终末期心力衰竭血液动力学监测的先进标志物:一个小型综述。
IF 4.5 2区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2025-01-14 DOI: 10.1007/s10741-025-10483-5
Konstantinos Sideris, Christos P Kyriakopoulos, Lina Brinker, Iosif Taleb, Sotiria Liori, Aliya Hutman-Zahler, Nicholas Hendren, Eric Hall, Stavros G Drakos, Josef Stehlik, James C Fang, Mark H Drazner, Spencer Carter

Right heart catheterization (RHC) provides critical hemodynamic insights by measuring atrial, ventricular, and pulmonary artery pressures, as well as cardiac output (CO). Although the use of RHC has decreased, its application has been linked to improved outcomes. Advanced hemodynamic markers such as cardiac power output (CPO), aortic pulsatility index (API), pulmonary artery pulsatility index (PAPi), right atrial pressure to pulmonary capillary wedge pressure ratio (RAP/PCWP) and right ventricular stroke work index (RVSWI) have been introduced to enhance risk stratification in cardiogenic shock (CS) and end-stage heart failure (HF) patients. CPO has emerged as a potent prognostic tool, with values below 0.6 Watts significantly associated with mortality. Similarly, API and PAPi have demonstrated strong predictive power for adverse outcomes, including death and the need for advanced HF therapies. RAP/PCWP ratio is shown to be a valuable a prognostic tool for RV dysfunction, mortality, and adverse outcomes. Despite mixed evidence on the prognostic utility of RVSWI, its physiologic relevance in assessing right ventricular function remains important. A novel clinical observation, involving patients with an RAP numerically greater than pulmonary artery saturation, was associated with a 71% 30-day mortality rate, underscoring the potential prognostic value of this finding. This review aims to summarize key advanced hemodynamic markers and their role in improving risk stratification and guiding treatment in CS and end-stage HF. The integration of these markers into clinical practice holds the potential to enhance personalized care and improve outcomes for patients with CS and advanced HF.

右心导管(RHC)通过测量心房、心室和肺动脉压力以及心输出量(CO)提供关键的血流动力学信息。虽然RHC的使用减少了,但其应用与改善的预后有关。先进的血流动力学指标,如心功率输出量(CPO)、主动脉脉搏指数(API)、肺动脉脉搏指数(PAPi)、右心房压与肺毛细血管楔压比(RAP/PCWP)和右心室卒中工作指数(RVSWI)已被引入,以加强心源性休克(CS)和终末期心力衰竭(HF)患者的风险分层。CPO已成为一种有效的预后工具,其值低于0.6瓦特与死亡率显著相关。同样,API和PAPi对不良结局(包括死亡和对高级心衰治疗的需求)具有很强的预测能力。RAP/PCWP比值被证明是判断右心室功能障碍、死亡率和不良后果的一个有价值的预后工具。尽管RVSWI的预后应用证据不一,但其在评估右心室功能方面的生理学相关性仍然很重要。一项新的临床观察,涉及RAP数值大于肺动脉饱和度的患者,与71%的30天死亡率相关,强调了这一发现的潜在预后价值。本文旨在总结关键的先进血流动力学指标及其在改善CS和终末期HF的风险分层和指导治疗中的作用。将这些标志物整合到临床实践中,有可能增强CS和晚期心衰患者的个性化护理和改善预后。
{"title":"Advanced Markers for Hemodynamic Monitoring in Cardiogenic Shock and End-Stage Heart Failure: A Mini Review.","authors":"Konstantinos Sideris, Christos P Kyriakopoulos, Lina Brinker, Iosif Taleb, Sotiria Liori, Aliya Hutman-Zahler, Nicholas Hendren, Eric Hall, Stavros G Drakos, Josef Stehlik, James C Fang, Mark H Drazner, Spencer Carter","doi":"10.1007/s10741-025-10483-5","DOIUrl":"https://doi.org/10.1007/s10741-025-10483-5","url":null,"abstract":"<p><p>Right heart catheterization (RHC) provides critical hemodynamic insights by measuring atrial, ventricular, and pulmonary artery pressures, as well as cardiac output (CO). Although the use of RHC has decreased, its application has been linked to improved outcomes. Advanced hemodynamic markers such as cardiac power output (CPO), aortic pulsatility index (API), pulmonary artery pulsatility index (PAPi), right atrial pressure to pulmonary capillary wedge pressure ratio (RAP/PCWP) and right ventricular stroke work index (RVSWI) have been introduced to enhance risk stratification in cardiogenic shock (CS) and end-stage heart failure (HF) patients. CPO has emerged as a potent prognostic tool, with values below 0.6 Watts significantly associated with mortality. Similarly, API and PAPi have demonstrated strong predictive power for adverse outcomes, including death and the need for advanced HF therapies. RAP/PCWP ratio is shown to be a valuable a prognostic tool for RV dysfunction, mortality, and adverse outcomes. Despite mixed evidence on the prognostic utility of RVSWI, its physiologic relevance in assessing right ventricular function remains important. A novel clinical observation, involving patients with an RAP numerically greater than pulmonary artery saturation, was associated with a 71% 30-day mortality rate, underscoring the potential prognostic value of this finding. This review aims to summarize key advanced hemodynamic markers and their role in improving risk stratification and guiding treatment in CS and end-stage HF. The integration of these markers into clinical practice holds the potential to enhance personalized care and improve outcomes for patients with CS and advanced HF.</p>","PeriodicalId":12950,"journal":{"name":"Heart Failure Reviews","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142978059","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Focusing on microvascular function in heart failure with preserved ejection fraction. 聚焦于保留射血分数的心力衰竭的微血管功能。
IF 4.5 2区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2025-01-13 DOI: 10.1007/s10741-024-10479-7
Ornela Velollari, Karl-Philipp Rommel, Karl-Patrik Kresoja, Philipp Lurz, Tommaso Gori

Heart failure is a prevalent global health issue. Heart failure with preserved ejection fraction (HFpEF), which already represents half of all heart cases worldwide, is projected to further increase, driven by aging populations and rising cardiovascular risk factors. Effective therapies for HFpEF remain limited, particularly due to its pathophysiological heterogeneity and incomplete understanding of underlying pathomechanisms and implications. Coronary microvascular dysfunction (CMD), characterized by structural and functional changes in the coronary microcirculation, is increasingly recognized as a significant factor in HFpEF even though the exact nature of their causal relationship is still unclear. This review explores prevalence, prognostic implications, and potential therapeutic targets for CMD in HFpEF. CMD's role in HFpEF might involve impaired coronary blood flow regulation, leading to myocardial ischemia, impaired relaxation, and/or adverse remodeling. Vice versa, increased wall stress in patients with HFpEF might elevate coronary resistances, further worsening microvascular perfusion. Finally, abnormalities in substrate metabolism might cause both CMD and HFpEF. Current treatments, including pharmacotherapy and device-based therapies, show limited success, highlighting the need for more targeted approaches. New possible therapies, such as the coronary sinus reducer device, may show promise in improving myocardial perfusion and function. However, further large-scale studies are required to elucidate the mechanistic links between CMD and HFpEF and to develop specialized treatments for distinct heart failure phenotypes.

心力衰竭是全球普遍存在的健康问题。射血分数保留型心力衰竭(HFpEF)已占全球心脏病病例总数的一半,预计在人口老龄化和心血管风险因素增加的推动下,这种病例还会进一步增加。针对射血分数过低(HFpEF)的有效疗法仍然有限,特别是由于其病理生理学的异质性以及对其潜在病理机制和影响的不完全了解。冠状动脉微血管功能障碍(CMD)以冠状动脉微循环的结构和功能变化为特征,越来越被认为是导致 HFpEF 的一个重要因素,尽管其因果关系的确切性质仍不清楚。本综述探讨了 CMD 在 HFpEF 中的发病率、预后影响和潜在治疗靶点。CMD 在 HFpEF 中的作用可能涉及冠状动脉血流调节受损,从而导致心肌缺血、松弛受损和/或不良重塑。反之亦然,HFpEF 患者冠状动脉壁应力增加可能会提高冠状动脉阻力,进一步恶化微血管灌注。最后,底物代谢异常可能同时导致 CMD 和 HFpEF。目前的治疗方法,包括药物疗法和基于设备的疗法,效果都很有限,因此需要更有针对性的方法。新的可行疗法,如冠状动脉窦减容装置,可能有望改善心肌灌注和功能。然而,还需要进一步开展大规模研究,以阐明 CMD 与高频心力衰竭之间的机理联系,并针对不同的心力衰竭表型开发专门的治疗方法。
{"title":"Focusing on microvascular function in heart failure with preserved ejection fraction.","authors":"Ornela Velollari, Karl-Philipp Rommel, Karl-Patrik Kresoja, Philipp Lurz, Tommaso Gori","doi":"10.1007/s10741-024-10479-7","DOIUrl":"https://doi.org/10.1007/s10741-024-10479-7","url":null,"abstract":"<p><p>Heart failure is a prevalent global health issue. Heart failure with preserved ejection fraction (HFpEF), which already represents half of all heart cases worldwide, is projected to further increase, driven by aging populations and rising cardiovascular risk factors. Effective therapies for HFpEF remain limited, particularly due to its pathophysiological heterogeneity and incomplete understanding of underlying pathomechanisms and implications. Coronary microvascular dysfunction (CMD), characterized by structural and functional changes in the coronary microcirculation, is increasingly recognized as a significant factor in HFpEF even though the exact nature of their causal relationship is still unclear. This review explores prevalence, prognostic implications, and potential therapeutic targets for CMD in HFpEF. CMD's role in HFpEF might involve impaired coronary blood flow regulation, leading to myocardial ischemia, impaired relaxation, and/or adverse remodeling. Vice versa, increased wall stress in patients with HFpEF might elevate coronary resistances, further worsening microvascular perfusion. Finally, abnormalities in substrate metabolism might cause both CMD and HFpEF. Current treatments, including pharmacotherapy and device-based therapies, show limited success, highlighting the need for more targeted approaches. New possible therapies, such as the coronary sinus reducer device, may show promise in improving myocardial perfusion and function. However, further large-scale studies are required to elucidate the mechanistic links between CMD and HFpEF and to develop specialized treatments for distinct heart failure phenotypes.</p>","PeriodicalId":12950,"journal":{"name":"Heart Failure Reviews","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142970567","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Lessons learned and future perspectives from the PRO-HF trial. PRO-HF试验的经验教训和未来展望。
IF 4.5 2区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2025-01-10 DOI: 10.1007/s10741-025-10482-6
Mario Enrico Canonico, Andrew P Ambrosy, Marc D Samsky
{"title":"Lessons learned and future perspectives from the PRO-HF trial.","authors":"Mario Enrico Canonico, Andrew P Ambrosy, Marc D Samsky","doi":"10.1007/s10741-025-10482-6","DOIUrl":"https://doi.org/10.1007/s10741-025-10482-6","url":null,"abstract":"","PeriodicalId":12950,"journal":{"name":"Heart Failure Reviews","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142964562","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Heart failure outpatient clinics resources in Italy: a viewpoint of Italian Society of Cardiology organization. 意大利心力衰竭门诊资源:意大利心脏病学会组织的观点。
IF 4.5 2区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2025-01-08 DOI: 10.1007/s10741-024-10480-0
Alberto Palazzuoli, Piergiuseppe Agostoni, Savina Nodari, Stefania Paolillo, Pasquale Perrone Filardi

The current paper reports the model organization, level of health care, and type of medical and research activities related to the existing heart failure centers of the Italian Society of Cardiology. Of note, we conduced an internal survey among the members of heart failure working group and related hospital and territorial sites about the quality of care and assistance levels according to the local hospital resources and type of diagnostic therapeutic and management resources. Thirty-two hospital ambulatorial structures have been identified, the centers were equally distributed within the national ground, with similar concentration between north and south regions of the Italian country. We distinguished three different levels of organization: (1) basal territorial clinics in which patients with suspected or already diagnosed heart failure (HF) are initially identified and screened; (2) intermediate clinics in which HF patients can be routinary followed by HF specialists supported by a dedicated staff including imaging and arrythmologist experts, and interventional cardiologist; (3) advanced clinics composed by all the technical and staff resources capable of guarantying repetitive invasive assessment, continuous invasive monitoring, dedicated telemedicine structures focused on more advanced HF management integrated by heart transplantation or mechanical assistance programs. Different type of assistance is supported by a relevant number of research activity primarily conducted by the Italian Society of Cardiology or spontaneous studies arranged by HF specialist members. The number of HF centers has increased over the past few decades in proportion to the progressive rise in HF diagnoses and associated hospitalization. The expansion of ambulatory structures has been facilitated by an increasing socioeconomic and research influence. The quality of HF services in Italy could be raised by improving the network and connections between HF specialists, general practitioners (GPs), caregivers, and other specialists frequently working in this field.

本论文报告了意大利心脏病学会现有心力衰竭中心的模式组织、卫生保健水平以及医疗和研究活动类型。值得注意的是,我们根据当地医院资源和诊断治疗和管理资源的类型,在心力衰竭工作组成员和相关医院和地区站点之间进行了一项关于护理质量和援助水平的内部调查。已经确定了32个医院流动结构,这些中心平均分布在全国范围内,意大利北部和南部地区之间的集中程度相似。我们区分了三个不同层次的组织:(1)基础地区诊所,在那里,怀疑或已经诊断出心力衰竭(HF)的患者最初被识别和筛查;(2)中间诊所,心衰患者可以由心衰专家进行常规随访,并由包括影像学和心律失常专家以及介入性心脏病专家在内的专职工作人员提供支持;(3)由所有技术和人力资源组成的先进诊所,能够保证重复有创评估,持续有创监测,专门的远程医疗结构,专注于更先进的心衰管理,结合心脏移植或机械辅助方案。不同类型的援助由主要由意大利心脏病学会开展的相关研究活动或由心衰专家成员安排的自发研究提供支持。在过去的几十年里,心衰中心的数量随着心衰诊断和相关住院人数的增加而增加。不断增加的社会经济和研究影响促进了流动结构的扩大。意大利可以通过改善心衰专家、全科医生(gp)、护理人员和经常在该领域工作的其他专家之间的网络和联系来提高心衰服务的质量。
{"title":"Heart failure outpatient clinics resources in Italy: a viewpoint of Italian Society of Cardiology organization.","authors":"Alberto Palazzuoli, Piergiuseppe Agostoni, Savina Nodari, Stefania Paolillo, Pasquale Perrone Filardi","doi":"10.1007/s10741-024-10480-0","DOIUrl":"https://doi.org/10.1007/s10741-024-10480-0","url":null,"abstract":"<p><p>The current paper reports the model organization, level of health care, and type of medical and research activities related to the existing heart failure centers of the Italian Society of Cardiology. Of note, we conduced an internal survey among the members of heart failure working group and related hospital and territorial sites about the quality of care and assistance levels according to the local hospital resources and type of diagnostic therapeutic and management resources. Thirty-two hospital ambulatorial structures have been identified, the centers were equally distributed within the national ground, with similar concentration between north and south regions of the Italian country. We distinguished three different levels of organization: (1) basal territorial clinics in which patients with suspected or already diagnosed heart failure (HF) are initially identified and screened; (2) intermediate clinics in which HF patients can be routinary followed by HF specialists supported by a dedicated staff including imaging and arrythmologist experts, and interventional cardiologist; (3) advanced clinics composed by all the technical and staff resources capable of guarantying repetitive invasive assessment, continuous invasive monitoring, dedicated telemedicine structures focused on more advanced HF management integrated by heart transplantation or mechanical assistance programs. Different type of assistance is supported by a relevant number of research activity primarily conducted by the Italian Society of Cardiology or spontaneous studies arranged by HF specialist members. The number of HF centers has increased over the past few decades in proportion to the progressive rise in HF diagnoses and associated hospitalization. The expansion of ambulatory structures has been facilitated by an increasing socioeconomic and research influence. The quality of HF services in Italy could be raised by improving the network and connections between HF specialists, general practitioners (GPs), caregivers, and other specialists frequently working in this field.</p>","PeriodicalId":12950,"journal":{"name":"Heart Failure Reviews","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142947711","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Changing the paradigm in heart failure: shifting from treatment to prevention. 改变心力衰竭的模式:从治疗转向预防。
IF 4.5 2区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2025-01-01 Epub Date: 2024-10-23 DOI: 10.1007/s10741-024-10454-2
Alex J Chang, Yilin Liang, Michael P Girouard, Ankeet S Bhatt, Alexander T Sandhu, Andrew J Sauer, Stephen J Greene, Josephine Harrington, Alan S Go, Andrew P Ambrosy

Heart failure (HF) poses a major global health challenge with rising prevalence, significant morbidity and mortality, and substantial associated healthcare costs. With aging of the population and an increasing burden of comorbidities, the complex interplay between cardiovascular, kidney, and metabolic risk factors have been thrust into the spotlight and have broadened the traditional focus from HF treatment to an increased emphasis on prevention. In recognition of the evolving HF landscape, the American Heart Association released the PREVENT models which are comprehensive risk assessment tools that estimate 10- and 30-year risk of incident cardiovascular disease and its subtypes, including atherosclerotic cardiovascular disease (ASCVD) and, for the first time, HF. While it is an accurate risk estimation tool and represents a step forward in improving risk stratification for primary prevention of HF, there remain several limitations and unknowns like model performance across disaggregated racial and ethnic groups, the role of traditional ASCVD vs. HF-specific risk factors, HF prediction among those with known ASCVD, and the use of traditional regression techniques in lieu of potentially more powerful machine learning-based modeling approaches. Furthermore, it remains unclear how to optimize risk estimation in clinical care. The emergence of multiple novel pharmacological therapies that prevent incident HF, including sodium-glucose co-transporter 2 (SGLT2) inhibitors, glucagon-like peptide 1 (GLP1) receptor agonists, and nonsteroidal mineralocorticoid receptor antagonists (MRAs), highlights the importance of accurate HF risk prediction. To provide HF prevention with these effective but costly therapies, we must understand the optimal strategy in sequencing and combining these therapies and prioritize patients at highest risk. Such implementation requires both accurate risk stratification and a better understanding of how to communicate risk to patients and providers. This state-of-the-art review aims to provide a comprehensive overview of recent trends in HF prevention, including risk assessment, care management strategies, and emerging and novel treatments.

心力衰竭(HF)是一项重大的全球性健康挑战,发病率不断上升,发病率和死亡率显著上升,相关的医疗成本巨大。随着人口老龄化和合并症负担的增加,心血管、肾脏和代谢风险因素之间复杂的相互作用已成为焦点,并将传统的重点从心力衰竭治疗扩大到更加重视预防。考虑到不断变化的心房颤动状况,美国心脏协会发布了 PREVENT 模型,这是一种全面的风险评估工具,用于估算 10 年和 30 年内心血管疾病及其亚型(包括动脉粥样硬化性心血管疾病 (ASCVD))的发病风险,并首次用于估算心房颤动的发病风险。虽然它是一种准确的风险估计工具,在改善心房颤动一级预防的风险分层方面向前迈进了一步,但仍存在一些局限性和未知因素,如模型在不同种族和民族群体中的表现、传统 ASCVD 与心房颤动特异性风险因素的作用、已知 ASCVD 患者的心房颤动预测、使用传统回归技术而不是可能更强大的基于机器学习的建模方法。此外,如何优化临床护理中的风险评估仍不清楚。钠-葡萄糖共转运体 2 (SGLT2) 抑制剂、胰高血糖素样肽 1 (GLP1) 受体激动剂和非甾体类矿化皮质激素受体拮抗剂 (MRA) 等多种新型药物疗法可预防高血压的发生,它们的出现凸显了准确预测高血压风险的重要性。为了利用这些有效但昂贵的疗法预防高血压,我们必须了解这些疗法的最佳排序和组合策略,并优先考虑风险最高的患者。这种实施既需要准确的风险分层,也需要更好地了解如何将风险传达给患者和医疗服务提供者。这篇最新综述旨在全面概述高血压预防的最新趋势,包括风险评估、护理管理策略以及新兴的新型疗法。
{"title":"Changing the paradigm in heart failure: shifting from treatment to prevention.","authors":"Alex J Chang, Yilin Liang, Michael P Girouard, Ankeet S Bhatt, Alexander T Sandhu, Andrew J Sauer, Stephen J Greene, Josephine Harrington, Alan S Go, Andrew P Ambrosy","doi":"10.1007/s10741-024-10454-2","DOIUrl":"10.1007/s10741-024-10454-2","url":null,"abstract":"<p><p>Heart failure (HF) poses a major global health challenge with rising prevalence, significant morbidity and mortality, and substantial associated healthcare costs. With aging of the population and an increasing burden of comorbidities, the complex interplay between cardiovascular, kidney, and metabolic risk factors have been thrust into the spotlight and have broadened the traditional focus from HF treatment to an increased emphasis on prevention. In recognition of the evolving HF landscape, the American Heart Association released the PREVENT models which are comprehensive risk assessment tools that estimate 10- and 30-year risk of incident cardiovascular disease and its subtypes, including atherosclerotic cardiovascular disease (ASCVD) and, for the first time, HF. While it is an accurate risk estimation tool and represents a step forward in improving risk stratification for primary prevention of HF, there remain several limitations and unknowns like model performance across disaggregated racial and ethnic groups, the role of traditional ASCVD vs. HF-specific risk factors, HF prediction among those with known ASCVD, and the use of traditional regression techniques in lieu of potentially more powerful machine learning-based modeling approaches. Furthermore, it remains unclear how to optimize risk estimation in clinical care. The emergence of multiple novel pharmacological therapies that prevent incident HF, including sodium-glucose co-transporter 2 (SGLT2) inhibitors, glucagon-like peptide 1 (GLP1) receptor agonists, and nonsteroidal mineralocorticoid receptor antagonists (MRAs), highlights the importance of accurate HF risk prediction. To provide HF prevention with these effective but costly therapies, we must understand the optimal strategy in sequencing and combining these therapies and prioritize patients at highest risk. Such implementation requires both accurate risk stratification and a better understanding of how to communicate risk to patients and providers. This state-of-the-art review aims to provide a comprehensive overview of recent trends in HF prevention, including risk assessment, care management strategies, and emerging and novel treatments.</p>","PeriodicalId":12950,"journal":{"name":"Heart Failure Reviews","volume":" ","pages":"177-189"},"PeriodicalIF":4.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142499207","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Dietary sodium intake restriction in patients with heart failure: an overview of systematic reviews. 心力衰竭患者的饮食钠摄入限制:系统综述。
IF 4.5 2区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2025-01-01 Epub Date: 2024-10-19 DOI: 10.1007/s10741-024-10452-4
Congying Liu, Yating Wang, Heli Zhang, Sumei Tong

This study aimed to identify, assess, and summarize systematic reviews on dietary sodium intake restrictions for patients with heart failure. Literature searches were conducted on Pubmed, CINAHL, ScienceDirect, Cochrane Library, China National Knowledge Infrastructure, and the Wanfang Database up to January 2024. The methodological quality of the included reviews was assessed using the quality assessment tool from the Australian JBI Center for Evidence-Based Healthcare (2016). The results of systematic reviews and meta-analyses were synthesized and presented according to different outcome indicators. Nine systematic reviews were included in this study. The current evidence does not support the fact that dietary sodium intake restrictions for patients with heart failure have a positive impact on mortality rates, rehospitalization rates, and quality of life. Conversely, strict dietary sodium intake restrictions (≤ 2000 mg/day) may increase the risk of death, rehospitalization, and symptom exacerbation. Dietary sodium intake restriction may not have a positive impact on clinical outcomes in patients with heart failure. Nevertheless, more evidence is required to explore the differences in the impact of various levels of dietary sodium restriction on the outcomes and symptom management indicators of patients with heart failure.

本研究旨在识别、评估和总结有关心力衰竭患者饮食钠摄入限制的系统性综述。在 Pubmed、CINAHL、ScienceDirect、Cochrane 图书馆、中国国家知识基础设施和万方数据库(截至 2024 年 1 月)上进行了文献检索。采用澳大利亚 JBI 循证医疗中心(2016)的质量评估工具对纳入的综述进行了方法学质量评估。根据不同的结果指标,对系统综述和荟萃分析的结果进行了综合和展示。本研究共纳入了九篇系统综述。目前的证据并不支持限制心力衰竭患者的饮食钠摄入量会对死亡率、再住院率和生活质量产生积极影响。相反,严格限制饮食钠摄入量(≤ 2000 毫克/天)可能会增加死亡、再次住院和症状加重的风险。限制饮食钠摄入量可能不会对心衰患者的临床预后产生积极影响。不过,还需要更多证据来探讨不同程度的饮食钠限制对心衰患者预后和症状管理指标的影响差异。
{"title":"Dietary sodium intake restriction in patients with heart failure: an overview of systematic reviews.","authors":"Congying Liu, Yating Wang, Heli Zhang, Sumei Tong","doi":"10.1007/s10741-024-10452-4","DOIUrl":"10.1007/s10741-024-10452-4","url":null,"abstract":"<p><p>This study aimed to identify, assess, and summarize systematic reviews on dietary sodium intake restrictions for patients with heart failure. Literature searches were conducted on Pubmed, CINAHL, ScienceDirect, Cochrane Library, China National Knowledge Infrastructure, and the Wanfang Database up to January 2024. The methodological quality of the included reviews was assessed using the quality assessment tool from the Australian JBI Center for Evidence-Based Healthcare (2016). The results of systematic reviews and meta-analyses were synthesized and presented according to different outcome indicators. Nine systematic reviews were included in this study. The current evidence does not support the fact that dietary sodium intake restrictions for patients with heart failure have a positive impact on mortality rates, rehospitalization rates, and quality of life. Conversely, strict dietary sodium intake restrictions (≤ 2000 mg/day) may increase the risk of death, rehospitalization, and symptom exacerbation. Dietary sodium intake restriction may not have a positive impact on clinical outcomes in patients with heart failure. Nevertheless, more evidence is required to explore the differences in the impact of various levels of dietary sodium restriction on the outcomes and symptom management indicators of patients with heart failure.</p>","PeriodicalId":12950,"journal":{"name":"Heart Failure Reviews","volume":" ","pages":"143-157"},"PeriodicalIF":4.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142463820","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Contextualizing the results of HELIOS-B in the broader landscape of clinical trials for the treatment of transthyretin cardiac amyloidosis. 在治疗转甲状腺素心脏淀粉样变性病的临床试验的大背景下理解 HELIOS-B 的结果。
IF 4.5 2区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2025-01-01 Epub Date: 2024-10-01 DOI: 10.1007/s10741-024-10444-4
Andrew A Girard, Brett W Sperry

This focused review will highlight the results of HELIOS-B, the first randomized outcomes trial evaluating a gene silencing treatment for transthyretin cardiac amyloidosis (ATTR-CM). In HELIOS-B, vutrisiran was tested against placebo and demonstrated a 28% reduction in the composite of all-cause mortality and recurrent cardiovascular events. Additionally, there were clinically significant benefits on the 6-min walk test, Kansas City Cardiomyopathy Questionnaire, and NYHA class. Discontinuation rates and adverse events were similar between treatment and control arms, suggesting that vutrisiran is well tolerated. In this review, these promising results are explored and compared with other treatment trials in ATTR-CM.

HELIOS-B 是首个评估转甲状腺素心脏淀粉样变性(ATTR-CM)基因沉默疗法的随机结果试验。在 HELIOS-B 试验中,vutrisiran 与安慰剂进行了对比试验,结果显示,全因死亡率和复发性心血管事件的综合死亡率降低了 28%。此外,在6分钟步行测试、堪萨斯城心肌病问卷调查和NYHA分级方面也有显著的临床疗效。治疗组和对照组的停药率和不良反应相似,表明武曲西兰的耐受性良好。本综述探讨了这些令人鼓舞的结果,并与其他 ATTR-CM 治疗试验进行了比较。
{"title":"Contextualizing the results of HELIOS-B in the broader landscape of clinical trials for the treatment of transthyretin cardiac amyloidosis.","authors":"Andrew A Girard, Brett W Sperry","doi":"10.1007/s10741-024-10444-4","DOIUrl":"10.1007/s10741-024-10444-4","url":null,"abstract":"<p><p>This focused review will highlight the results of HELIOS-B, the first randomized outcomes trial evaluating a gene silencing treatment for transthyretin cardiac amyloidosis (ATTR-CM). In HELIOS-B, vutrisiran was tested against placebo and demonstrated a 28% reduction in the composite of all-cause mortality and recurrent cardiovascular events. Additionally, there were clinically significant benefits on the 6-min walk test, Kansas City Cardiomyopathy Questionnaire, and NYHA class. Discontinuation rates and adverse events were similar between treatment and control arms, suggesting that vutrisiran is well tolerated. In this review, these promising results are explored and compared with other treatment trials in ATTR-CM.</p>","PeriodicalId":12950,"journal":{"name":"Heart Failure Reviews","volume":" ","pages":"69-73"},"PeriodicalIF":4.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11805581/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142361451","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Epigenetics of cardiomyopathies: the next frontier. 心肌病的表观遗传学:下一个前沿。
IF 4.5 2区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2025-01-01 Epub Date: 2024-11-26 DOI: 10.1007/s10741-024-10460-4
Aida Hajdarpašić, Martijn Tukker, Wouter Te Rijdt, Sharida Mohamedhoesein, Wouter C Meijers, Kadir Caliskan

Cardiomyopathies (CMP) are a diverse group of myocardial diseases that cause structural, functional, and pathological changes to the heart. Alterations at the molecular level associated with the clinical phenotype and progression of CMPs cannot be solely explained by the genetic mutations, even in inherited cardiomyopathies. Epigenetics and environmental factors are likely to significantly modify the clinical manifestations of CMPs, resulting in variable clinical expression and different age-related penetrance. This review examines the role of dysfunctional DNA methylation, histone modifications, chromatin remodelling, and noncoding RNAs in the development and exacerbation of CMPs, highlighting their potential as diagnostic markers and therapeutic targets, including the use of histone deacetylase inhibitors. Additionally, it explores how environmental exposures can influence epigenetic changes and potentially be used for preventive strategies and personalized care in CMP patients. Monozygotic twin studies and intergenerational studies are discussed as valuable tools for understanding the interplay between genetics, epigenetics, and environmental factors. Lastly, this review addresses current challenges and future perspectives, such as the need for greater specificity in epigenetic therapies, minimizing off-target effects, and investigating sex differences in CMP research and treatment.

心肌病(CMP)是一类多种多样的心肌疾病,会导致心脏结构、功能和病理改变。即使是遗传性心肌病,与 CMP 临床表型和进展相关的分子水平的变化也不能完全用基因突变来解释。表观遗传学和环境因素可能会显著改变 CMPs 的临床表现,从而导致不同的临床表现和不同的年龄相关渗透性。本综述探讨了 DNA 甲基化功能障碍、组蛋白修饰、染色质重塑和非编码 RNA 在 CMPs 的发生和恶化中的作用,强调了它们作为诊断标记和治疗靶点的潜力,包括组蛋白去乙酰化酶抑制剂的使用。此外,该研究还探讨了环境暴露如何影响表观遗传变化,并可能用于 CMP 患者的预防策略和个性化护理。文中讨论了单卵双生子研究和代际研究,它们是了解遗传学、表观遗传学和环境因素之间相互作用的宝贵工具。最后,本综述探讨了当前面临的挑战和未来展望,例如需要提高表观遗传疗法的特异性、尽量减少脱靶效应以及调查 CMP 研究和治疗中的性别差异。
{"title":"Epigenetics of cardiomyopathies: the next frontier.","authors":"Aida Hajdarpašić, Martijn Tukker, Wouter Te Rijdt, Sharida Mohamedhoesein, Wouter C Meijers, Kadir Caliskan","doi":"10.1007/s10741-024-10460-4","DOIUrl":"10.1007/s10741-024-10460-4","url":null,"abstract":"<p><p>Cardiomyopathies (CMP) are a diverse group of myocardial diseases that cause structural, functional, and pathological changes to the heart. Alterations at the molecular level associated with the clinical phenotype and progression of CMPs cannot be solely explained by the genetic mutations, even in inherited cardiomyopathies. Epigenetics and environmental factors are likely to significantly modify the clinical manifestations of CMPs, resulting in variable clinical expression and different age-related penetrance. This review examines the role of dysfunctional DNA methylation, histone modifications, chromatin remodelling, and noncoding RNAs in the development and exacerbation of CMPs, highlighting their potential as diagnostic markers and therapeutic targets, including the use of histone deacetylase inhibitors. Additionally, it explores how environmental exposures can influence epigenetic changes and potentially be used for preventive strategies and personalized care in CMP patients. Monozygotic twin studies and intergenerational studies are discussed as valuable tools for understanding the interplay between genetics, epigenetics, and environmental factors. Lastly, this review addresses current challenges and future perspectives, such as the need for greater specificity in epigenetic therapies, minimizing off-target effects, and investigating sex differences in CMP research and treatment.</p>","PeriodicalId":12950,"journal":{"name":"Heart Failure Reviews","volume":" ","pages":"257-270"},"PeriodicalIF":4.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11646213/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142715729","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
BNP and NT-proBNP as prognostic biomarkers for the prediction of adverse outcomes in HFpEF patients: A systematic review and meta-analysis. BNP和NT-proBNP作为预后生物标志物,用于预测高房颤患者的不良预后:系统综述和荟萃分析。
IF 4.5 2区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2025-01-01 Epub Date: 2024-10-07 DOI: 10.1007/s10741-024-10442-6
Lama A Ammar, Gaelle P Massoud, Charbel Chidiac, George W Booz, Raffaele Altara, Fouad A Zouein

Heart failure with preserved ejection fraction (HFpEF) presents a challenge in clinical practice due to its complexity and impact on morbidity and mortality. The aim of this systematic review and meta-analysis (SR/MA) was to evaluate the value of B-Type Natriuretic Peptide (BNP) and NT-proBNP in predicting overall adverse outcomes, cardiovascular events, and mortality, in patients with HFpEF. This SR/MA included observational studies and randomized controlled trials (RCTs) that reported the use of BNP and NT-proBNP as prognostic biomarkers for adverse outcomes in HFpEF patients. A comprehensive literature search was conducted using PubMed, EMBASE, and Google, without language restrictions, from inception until June 2024. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. The quality and risk of bias of the included studies were assessed using the Newcastle-Ottawa Scale (NOS). Twenty-two studies involving 10,158 HFpEF patients were included. The analysis showed that BNP is a significant predictor of overall adverse events in HFpEF patients, with an overall HR of 1.34 (95% CI: 1.20-1.52). Similarly, BNP was a significant predictor of cardiovascular events and mortality in HFpEF patients with a HR of 1.36 (95% CI 1.12-1.64) and HR of 1.44 (95% CI: 1.04-1.84), respectively. When analyzing data for NT-proBNP predictive potential, 3 studies confirmed that NT-proBNP is a significant independent prognostic indicator for adverse events, with an overall HR of 1.80 (95% CI: 1.38-2.35). Comparable results were seen for mortality, with higher NT-proBNP levels associated with increased mortality risk and the MA showing a HR of 1.65 (95% CI: 1.55-1.76). This systematic review highlights the valuable prognostic role of BNP and NT-proBNP in predicting overall adverse outcome, cardiovascular events, and mortality in HFpEF patients. Our findings underscore the importance of further research to establish standardized thresholds and investigate BNP and NT-proBNP's potential in predicting morbidity and mortality.

由于射血分数保留型心力衰竭(HFpEF)的复杂性及其对发病率和死亡率的影响,它给临床实践带来了挑战。本系统综述和荟萃分析(SR/MA)旨在评估 B 型钠尿肽(BNP)和 NT-proBNP 在预测 HFpEF 患者总体不良预后、心血管事件和死亡率方面的价值。本 SR/MA 研究纳入了观察性研究和随机对照试验 (RCT),这些研究报告了 BNP 和 NT-proBNP 作为预后生物标志物对 HFpEF 患者不良预后的作用。我们使用 PubMed、EMBASE 和 Google 进行了全面的文献检索,没有语言限制,检索时间从开始到 2024 年 6 月。研究遵循了系统综述和荟萃分析首选报告项目(PRISMA)指南。采用纽卡斯尔-渥太华量表(NOS)评估了纳入研究的质量和偏倚风险。共纳入 22 项研究,涉及 10,158 名 HFpEF 患者。分析表明,BNP 是预测 HFpEF 患者总体不良事件的重要指标,总体 HR 为 1.34(95% CI:1.20-1.52)。同样,BNP 也能显著预测 HFpEF 患者的心血管事件和死亡率,HR 分别为 1.36(95% CI 1.12-1.64)和 1.44(95% CI:1.04-1.84)。在分析 NT-proBNP 预测潜力的数据时,3 项研究证实,NT-proBNP 是不良事件的重要独立预后指标,总 HR 为 1.80(95% CI:1.38-2.35)。死亡率方面也有类似的结果,NT-proBNP 水平越高,死亡率风险越高,MA 显示 HR 为 1.65(95% CI:1.55-1.76)。本系统综述强调了 BNP 和 NT-proBNP 在预测 HFpEF 患者的总体不良预后、心血管事件和死亡率方面的重要作用。我们的研究结果强调了进一步研究建立标准化阈值和调查 BNP 和 NT-proBNP 预测发病率和死亡率潜力的重要性。
{"title":"BNP and NT-proBNP as prognostic biomarkers for the prediction of adverse outcomes in HFpEF patients: A systematic review and meta-analysis.","authors":"Lama A Ammar, Gaelle P Massoud, Charbel Chidiac, George W Booz, Raffaele Altara, Fouad A Zouein","doi":"10.1007/s10741-024-10442-6","DOIUrl":"10.1007/s10741-024-10442-6","url":null,"abstract":"<p><p>Heart failure with preserved ejection fraction (HFpEF) presents a challenge in clinical practice due to its complexity and impact on morbidity and mortality. The aim of this systematic review and meta-analysis (SR/MA) was to evaluate the value of B-Type Natriuretic Peptide (BNP) and NT-proBNP in predicting overall adverse outcomes, cardiovascular events, and mortality, in patients with HFpEF. This SR/MA included observational studies and randomized controlled trials (RCTs) that reported the use of BNP and NT-proBNP as prognostic biomarkers for adverse outcomes in HFpEF patients. A comprehensive literature search was conducted using PubMed, EMBASE, and Google, without language restrictions, from inception until June 2024. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. The quality and risk of bias of the included studies were assessed using the Newcastle-Ottawa Scale (NOS). Twenty-two studies involving 10,158 HFpEF patients were included. The analysis showed that BNP is a significant predictor of overall adverse events in HFpEF patients, with an overall HR of 1.34 (95% CI: 1.20-1.52). Similarly, BNP was a significant predictor of cardiovascular events and mortality in HFpEF patients with a HR of 1.36 (95% CI 1.12-1.64) and HR of 1.44 (95% CI: 1.04-1.84), respectively. When analyzing data for NT-proBNP predictive potential, 3 studies confirmed that NT-proBNP is a significant independent prognostic indicator for adverse events, with an overall HR of 1.80 (95% CI: 1.38-2.35). Comparable results were seen for mortality, with higher NT-proBNP levels associated with increased mortality risk and the MA showing a HR of 1.65 (95% CI: 1.55-1.76). This systematic review highlights the valuable prognostic role of BNP and NT-proBNP in predicting overall adverse outcome, cardiovascular events, and mortality in HFpEF patients. Our findings underscore the importance of further research to establish standardized thresholds and investigate BNP and NT-proBNP's potential in predicting morbidity and mortality.</p>","PeriodicalId":12950,"journal":{"name":"Heart Failure Reviews","volume":" ","pages":"45-54"},"PeriodicalIF":4.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142380701","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
In-hospital initiation of sodium-glucose co-transporter-2 inhibitors in patients with acute heart failure. 急性心力衰竭患者在院内开始使用钠-葡萄糖协同转运体-2 抑制剂。
IF 4.5 2区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2025-01-01 Epub Date: 2024-10-15 DOI: 10.1007/s10741-024-10446-2
Muhammad Sameer Arshad, Adeena Jamil, Stephen J Greene, Harriette G C Van Spall, Gregg C Fonarow, Javed Butler, Muhammad Shahzeb Khan

Sodium-glucose cotransporter-2 (SGLT2) inhibitors provide cardiovascular and kidney benefits to patients with heart failure (HF) and/or chronic kidney disease (CKD), regardless of diabetes status and left ventricular ejection fraction (LVEF). Despite robust data demonstrating the efficacy of SGLT-2 inhibitors in both ambulatory and hospital settings, real-world evidence suggests slow and varied adoption of SGLT2 inhibitors among patients hospitalized for HF. Barriers to implementation of SGLT2i may include clinicians' concerns regarding potential adverse events such as diabetic ketoacidosis (DKA), volume depletion, and symptomatic hypoglycemia; or concerns regarding physiologically expected reductions in eGFR. Guidelines lack specific, practical safety data and definitive recommendations regarding in-hospital initiation and continuation of SGLT2i in patients hospitalized with HF. In this review, we discuss the safety of in-hospital SGLT2 inhibitor initiation based on recent trials and highlight the clinical implications of their early use in patients hospitalized for HF.

钠-葡萄糖共转运体-2(SGLT2)抑制剂可为心力衰竭(HF)和/或慢性肾病(CKD)患者带来心血管和肾脏方面的益处,而与糖尿病状态和左心室射血分数(LVEF)无关。尽管有大量数据显示 SGLT-2 抑制剂在门诊和住院环境中均有疗效,但现实世界的证据表明,在因心力衰竭住院的患者中,SGLT2 抑制剂的应用进展缓慢且不尽相同。实施 SGLT2i 的障碍可能包括临床医生对潜在不良事件的担忧,如糖尿病酮症酸中毒(DKA)、容量耗竭和症状性低血糖;或对 eGFR 生理预期下降的担忧。关于高血压住院患者在院内开始和继续使用 SGLT2i,指南缺乏具体、实用的安全性数据和明确的建议。在本综述中,我们将根据最近的试验讨论院内启动 SGLT2 抑制剂的安全性,并强调在心房颤动住院患者中早期使用 SGLT2 抑制剂的临床意义。
{"title":"In-hospital initiation of sodium-glucose co-transporter-2 inhibitors in patients with acute heart failure.","authors":"Muhammad Sameer Arshad, Adeena Jamil, Stephen J Greene, Harriette G C Van Spall, Gregg C Fonarow, Javed Butler, Muhammad Shahzeb Khan","doi":"10.1007/s10741-024-10446-2","DOIUrl":"10.1007/s10741-024-10446-2","url":null,"abstract":"<p><p>Sodium-glucose cotransporter-2 (SGLT2) inhibitors provide cardiovascular and kidney benefits to patients with heart failure (HF) and/or chronic kidney disease (CKD), regardless of diabetes status and left ventricular ejection fraction (LVEF). Despite robust data demonstrating the efficacy of SGLT-2 inhibitors in both ambulatory and hospital settings, real-world evidence suggests slow and varied adoption of SGLT2 inhibitors among patients hospitalized for HF. Barriers to implementation of SGLT2i may include clinicians' concerns regarding potential adverse events such as diabetic ketoacidosis (DKA), volume depletion, and symptomatic hypoglycemia; or concerns regarding physiologically expected reductions in eGFR. Guidelines lack specific, practical safety data and definitive recommendations regarding in-hospital initiation and continuation of SGLT2i in patients hospitalized with HF. In this review, we discuss the safety of in-hospital SGLT2 inhibitor initiation based on recent trials and highlight the clinical implications of their early use in patients hospitalized for HF.</p>","PeriodicalId":12950,"journal":{"name":"Heart Failure Reviews","volume":" ","pages":"89-101"},"PeriodicalIF":4.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142463824","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
期刊
Heart Failure Reviews
全部 Acc. Chem. Res. ACS Applied Bio Materials ACS Appl. Electron. Mater. ACS Appl. Energy Mater. ACS Appl. Mater. Interfaces ACS Appl. Nano Mater. ACS Appl. Polym. Mater. ACS BIOMATER-SCI ENG ACS Catal. ACS Cent. Sci. ACS Chem. Biol. ACS Chemical Health & Safety ACS Chem. Neurosci. ACS Comb. Sci. ACS Earth Space Chem. ACS Energy Lett. ACS Infect. Dis. ACS Macro Lett. ACS Mater. Lett. ACS Med. Chem. Lett. ACS Nano ACS Omega ACS Photonics ACS Sens. ACS Sustainable Chem. Eng. ACS Synth. Biol. Anal. Chem. BIOCHEMISTRY-US Bioconjugate Chem. BIOMACROMOLECULES Chem. Res. Toxicol. Chem. Rev. Chem. Mater. CRYST GROWTH DES ENERG FUEL Environ. Sci. Technol. Environ. Sci. Technol. Lett. Eur. J. Inorg. Chem. IND ENG CHEM RES Inorg. Chem. J. Agric. Food. Chem. J. Chem. Eng. Data J. Chem. Educ. J. Chem. Inf. Model. J. Chem. Theory Comput. J. Med. Chem. J. Nat. Prod. J PROTEOME RES J. Am. Chem. Soc. LANGMUIR MACROMOLECULES Mol. Pharmaceutics Nano Lett. Org. Lett. ORG PROCESS RES DEV ORGANOMETALLICS J. Org. Chem. J. Phys. Chem. J. Phys. Chem. A J. Phys. Chem. B J. Phys. Chem. C J. Phys. Chem. Lett. Analyst Anal. Methods Biomater. Sci. Catal. Sci. Technol. Chem. Commun. Chem. Soc. Rev. CHEM EDUC RES PRACT CRYSTENGCOMM Dalton Trans. Energy Environ. Sci. ENVIRON SCI-NANO ENVIRON SCI-PROC IMP ENVIRON SCI-WAT RES Faraday Discuss. Food Funct. Green Chem. Inorg. Chem. Front. Integr. Biol. J. Anal. At. Spectrom. J. Mater. Chem. A J. Mater. Chem. B J. Mater. Chem. C Lab Chip Mater. Chem. Front. Mater. Horiz. MEDCHEMCOMM Metallomics Mol. Biosyst. Mol. Syst. Des. Eng. Nanoscale Nanoscale Horiz. Nat. Prod. Rep. New J. Chem. Org. Biomol. Chem. Org. Chem. Front. PHOTOCH PHOTOBIO SCI PCCP Polym. Chem.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1