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Biomedicines
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Feature Reviews in Heart Failure (HF)
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Feature Reviews in Heart Failure (HF)

A special issue of Biomedicines (ISSN 2227-9059). This special issue belongs to the section "Molecular and Translational Medicine".

Deadline for manuscript submissions: closed (30 September 2023) | Viewed by 9631

Special Issue Editors

Dr. Robert Zymliński

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Guest Editor
Department of Heart Diseases, Wroclaw Medical University, Borowska 213, 50-556 Wroclaw, Poland
Interests: heart failure (HF); HFrEF; pathogenesis; sodium-glucose co transporter; ferric carboxymaltose; vericiguat; omecamtiv
Special Issues, Collections and Topics in MDPI journals
Dr. Paweł Krzesiński

E-Mail Website1 Website2
Co-Guest Editor
Department of Cardiology and Internal Diseases, Military Institute of Medicine, Szaserów Street 128, 04-141 Warsaw, Poland
Interests: heart failure; hemodynamics; congestion; diagnosis of hemodynamic disturbances in heart failure; cardiorenal syndrome, hypertension; telemedicine
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Heart failure (HF) is common and is associated with high morbidity, mortality and high health expenditure. Traditionally, the ability of HF therapies has been examined by their effect on death and time to first unscheduled hospitalization. Treatment of HF patients with reduced ejection fraction (HFrEF) has significantly evolved over the last few years. Currently new evidence based supporting novel therapies are introduced. It should be pointed out that never before there been such an opportunity to positively impact outcome with drug therapy for patients with HFrEF. Within last years, treating HFrEF patients was based on beta-blockers (BB) or ivabradine if sinus heart rhythm is not well controlled, angiotensin-converting enzyme inhibitors (ACEi), or angiotensin receptor blockers (ARB) in case of ACEi intolerance, mineralocorticoid receptor antagonists (MRA), digoxin, diuretics, and devices. However in less than one decade, more therapies with diverse mechanisms of action (MOA) have been developed with great impact on prognosis and quality of life if are early introduced.  The novel particles such as sacubitril/valsartan, sodium–glucose co-transporter 2 inhibitors (SGLT2i), ferric carboxymaltose, vericiguat and omecamtiv mecarbil, have been recommended in European Society of Cardiology Guidelines for heart failure treatment to achieve positive impact on mortality and/or morbidity in HFrEF patients.

Also notable progress has been accomplished in device-based therapy used in chronic HF (CHF) and acute HF (AHF) including unique decongestion techniques, advancements in ventricle restoration strategies, device based strategies to improve cardiac output, kidney perfusion, monitoring systems are developed. However, despite the obvious progress in HFrEF assessment substantial challenges have arisen in HF, especially in HFpEF and acute HF (AHF), including the optimal diagnostic and therapeutic strategy.

Because there still it is a great need of interest we cordially invite authors and investigators within this complex field to submit review articles pertaining this special issue. Reviews have to most up-to-date and focus on the development of recent 10 years.

Dr. Robert Zymliński
Dr. Paweł Krzesiński
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Biomedicines is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Published Papers (4 papers)

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Research

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16 pages, 1521 KiB  
Article
Spot Urinary Creatinine Concentration in Patients with Chronic Heart Failure Identifies a Distinct Muscle-Wasting Phenotype with a Strikingly Different Risk of Mortality
by Jolanta Malinowska-Borowska, Marta Buczkowska, Sylwia Duda, Apolonia Stefaniak, Jacek Niedziela, Jolanta Urszula Nowak, Jadwiga Nessler, Karol Adam Kamiński, Mariusz Gąsior and Piotr Rozentryt
Biomedicines 2023, 11(9), 2342; https://doi.org/10.3390/biomedicines11092342 - 23 Aug 2023
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Abstract
Background. There is a raising awareness that heart failure (HF) is a highly heterogeneous, multiorgan syndrome with an increasing global prevalence and still poor prognosis. The comorbidities of HF are one of the key reasons for presence of various phenotypes with different clinical [...] Read more.
Background. There is a raising awareness that heart failure (HF) is a highly heterogeneous, multiorgan syndrome with an increasing global prevalence and still poor prognosis. The comorbidities of HF are one of the key reasons for presence of various phenotypes with different clinical profile and outcome. Heterogeneity of skeletal muscles (SMs) quantity and function may have an impact on patient’s phenotype. Aim. We intended to compare clinical characteristics of phenotypes defined by a combination of various SM mass taken as a fat-free compartment from DEXA scans and different levels of SUCR (Spot Urinary Creatinine). All-cause mortality with mortality predicted by MAGGIC in such phenotypes were compared. Methods. In 720 HF patients with reduced ejection fraction (age: 52.3 ± 10 years, female: 14%, NYHA: 2.7 ± 0.7, LVEF: 24.3 ± 7.3%), admitted to the hospital for heart transplantation candidacy assessment, morning SUCR along with body composition scanning (DEXA) was performed. All study participants were dichotomized twice, first by low or normal appendicular muscle mass index (ASMI) and second by SUCR (Spot Urinary Creatinine) < and ≥of 1.34 g/L. Four study groups (phenotypes) were created as combinations of lower or higher SUCR and low or normal ASMI. Results. Low ASMI was found in 242 (33.6%) patients, while the remaining 478 had normal muscle mass. In 446 patients (61.9%), SUCR was <1.34 g/L. During 3 years of follow-up, 223 (31.0%) patients died (all-cause). The phenotype of lower both ASMI and SUCR was associated with the highest mortality. The death rate in phenotype with both low ASMI and SUCR exceeded by 70% the risk estimated by MAGGIC. This difference was significant as judged by the 95% confidence interval for MAGGIC estimation. In Cox regression analysis adjusted for MAGGIC and parameters known to increase risk, the relative risk of patients with phenotype of low both ASMI and SUCR was elevated by 45–55% as compared to patients with all other phenotypes. The protective role of higher SUCR in patients with muscle wasting was, therefore, confirmed in Cox analysis. Conclusions. Measurement of SUCR in HF patients can identify clinical phenotypes with skeletal muscle wasting but strikingly different risk of death that is actually not captured by MAGGIC score. The higher level of SUCR was associated with similar risk independently of presence of muscle wasting. As the analysis of SUCR is cheap and easy to perform, it should be further tested as a potentially useful biomarker, which may precisely phenotype HF patients independently of their skeletal muscle status. Full article
(This article belongs to the Special Issue Feature Reviews in Heart Failure (HF))
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Review

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27 pages, 2407 KiB  
Review
The Importance of Optimal Hydration in Patients with Heart Failure—Not Always Too Much Fluid
by Andrzej Wittczak, Maciej Ślot and Agata Bielecka-Dabrowa
Biomedicines 2023, 11(10), 2684; https://doi.org/10.3390/biomedicines11102684 - 30 Sep 2023
Cited by 1 | Viewed by 2859
Abstract
Heart failure (HF) is a leading cause of morbidity and mortality and a major public health problem. Both overhydration and dehydration are non-physiological states of the body that can adversely affect human health. Congestion and residual congestion are common in patients hospitalized for [...] Read more.
Heart failure (HF) is a leading cause of morbidity and mortality and a major public health problem. Both overhydration and dehydration are non-physiological states of the body that can adversely affect human health. Congestion and residual congestion are common in patients hospitalized for HF and are associated with poor prognosis and high rates of rehospitalization. However, the clinical problem of dehydration is also prevalent in healthcare and community settings and is associated with increased morbidity and mortality. This article provides a comprehensive review of the issue of congestion and dehydration in HF, including HF guidelines, possible causes of dehydration in HF, confirmed and potential new diagnostic methods. In particular, a full database search on the relationship between dehydration and HF was performed and all available evidence in the literature was reviewed. The novel hypothesis of chronic subclinical hypohydration as a modifiable risk factor for HF is also discussed. It is concluded that maintaining euvolemia is the cornerstone of HF management. Physicians have to find a balance between decongestion therapy and the risk of dehydration. Full article
(This article belongs to the Special Issue Feature Reviews in Heart Failure (HF))
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32 pages, 1208 KiB  
Review
The Impact of Pharmacotherapy for Heart Failure on Oxidative Stress—Role of New Drugs, Flozins
by Patryk Bodnar, Michalina Mazurkiewicz, Tomasz Chwalba, Ewa Romuk, Anna Ciszek-Chwalba, Wojciech Jacheć and Celina Wojciechowska
Biomedicines 2023, 11(8), 2236; https://doi.org/10.3390/biomedicines11082236 - 9 Aug 2023
Cited by 2 | Viewed by 1629
Abstract
Heart failure (HF) is a multifactorial clinical syndrome involving many complex processes. The causes may be related to abnormal heart structure and/or function. Changes in the renin-angiotensin-aldosterone system, the sympathetic nervous system, and the natriuretic peptide system are important in the pathophysiology of [...] Read more.
Heart failure (HF) is a multifactorial clinical syndrome involving many complex processes. The causes may be related to abnormal heart structure and/or function. Changes in the renin-angiotensin-aldosterone system, the sympathetic nervous system, and the natriuretic peptide system are important in the pathophysiology of HF. Dysregulation or overexpression of these processes leads to changes in cardiac preload and afterload, changes in the vascular system, peripheral vascular dysfunction and remodeling, and endothelial dysfunction. One of the important factors responsible for the development of heart failure at the cellular level is oxidative stress. This condition leads to deleterious cellular effects as increased levels of free radicals gradually disrupt the state of equilibrium, and, as a consequence, the internal antioxidant defense system is damaged. This review focuses on pharmacotherapy for chronic heart failure with regard to oxidation–reduction metabolism, with special attention paid to the latest group of drugs, SGLT2 inhibitors—an integral part of HF treatment. These drugs have been shown to have beneficial effects by protecting the antioxidant system at the cellular level. Full article
(This article belongs to the Special Issue Feature Reviews in Heart Failure (HF))
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37 pages, 2286 KiB  
Review
Emerging Therapy for Diabetic Cardiomyopathy: From Molecular Mechanism to Clinical Practice
by Chin-Feng Hsuan, Sean I. F. Teng, Chih-Neng Hsu, Daniel Liao, Allen Jiun-Wei Chang, Hsiao-Lin Lee, Siow-Wey Hee, Yi-Cheng Chang and Lee-Ming Chuang
Biomedicines 2023, 11(3), 662; https://doi.org/10.3390/biomedicines11030662 - 22 Feb 2023
Cited by 4 | Viewed by 3720
Abstract
Diabetic cardiomyopathy is characterized by abnormal myocardial structure or performance in the absence of coronary artery disease or significant valvular heart disease in patients with diabetes mellitus. The spectrum of diabetic cardiomyopathy ranges from subtle myocardial changes to myocardial fibrosis and diastolic function [...] Read more.
Diabetic cardiomyopathy is characterized by abnormal myocardial structure or performance in the absence of coronary artery disease or significant valvular heart disease in patients with diabetes mellitus. The spectrum of diabetic cardiomyopathy ranges from subtle myocardial changes to myocardial fibrosis and diastolic function and finally to symptomatic heart failure. Except for sodium–glucose transport protein 2 inhibitors and possibly bariatric and metabolic surgery, there is currently no specific treatment for this distinct disease entity in patients with diabetes. The molecular mechanism of diabetic cardiomyopathy includes impaired nutrient-sensing signaling, dysregulated autophagy, impaired mitochondrial energetics, altered fuel utilization, oxidative stress and lipid peroxidation, advanced glycation end-products, inflammation, impaired calcium homeostasis, abnormal endothelial function and nitric oxide production, aberrant epidermal growth factor receptor signaling, the activation of the renin–angiotensin–aldosterone system and sympathetic hyperactivity, and extracellular matrix accumulation and fibrosis. Here, we summarize several important emerging treatments for diabetic cardiomyopathy targeting specific molecular mechanisms, with evidence from preclinical studies and clinical trials. Full article
(This article belongs to the Special Issue Feature Reviews in Heart Failure (HF))
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