Management of Heart Failure

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Cardiology".

Deadline for manuscript submissions: 30 May 2025 | Viewed by 17935

Special Issue Editors


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Guest Editor
Faculty of Medicine, Transilvania University, 500036 Braşov, Romania
Interests: acute cardiovascular care; electrophysiology; device implantation; heart failure

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Guest Editor
Clinical Emergency Hospital Bucharest, University of Medicine Carol Davila, Bucharest, Romania
Interests: CIEDs (including those for chronic HF prevention/treatment); complex arrhythmia ablation (VT/VF including SHD, AFib, scar-related atrial tachyarrhythmia, and arrhythmia in congenital heart disease); pediatric electrophysiology
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Guest Editor
1. Department of Cardiology, “Victor Babes” University of Medicine and Pharmacy, 2 Eftimie Murgu Square, 300041 Timisoara, Romania
2. Research Center of the Institute of Cardiovascular Diseases Timisoara, 13A Gheorghe Adam Street, 300310 Timisoara, Romania
Interests: echocardiography; left atria function; device implantation; complex arrhythmia ablation; heart failure
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Heart failure represents a significant medical condition that imposes a substantial burden on both individuals and healthcare systems worldwide. This burden consists of high rates of hospitalization, reduced quality of life, and increased mortality rates.

The proper evaluation and treatment of heart failure are important to improve quality of life and extend survival.

The management of heart failure is still heterogenous, the adherence to guidelines is still poor, and there is large variability in the medical approach in different countries. Meanwhile, new non-pharmacologic therapies have emerged and gained popularity in certain countries.

In this Special Issue we would like to focus on the comprehensive evaluation and management of heart failure, including non-pharmacological therapy, like heart surgery, electrophysiology procedures, device implantation, and percutaneous coronary interventions, starting with ethical concerns and moving to practical issues.

We also wish to integrate the role of clinical medicine’s assistance and its function in adhering to social-distancing guidelines, and we would like to invite the submission of research articles and reviews.

We encourage young researchers, doctoral students, and post-doc fellows to submit their research to this Special Issue to gain visibility and recognition of their work.

Prof. Dr. Diana Țînț
Dr. Radu Gabriel Vătăşescu
Dr. Dragos Cozma
Guest Editors

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Keywords

  • heart failure
  • revascularization
  • device implantation
  • resynchronization therapy
  • implantable cardiac defibrillator
  • contractility modulation
  • mitra-clip
  • telemedicine

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Published Papers (3 papers)

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Research

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12 pages, 247 KiB  
Article
Transfusion Requirements for Severe Anemia in Acute Cardiovascular Patients—A Single Center Retrospective Study in Constanta County Cardiology Department
by Sevigean Ali, Iulia Andreea Badea, Mihaela Botnarciuc, Lavinia Carmen Daba, Andreea Alexandru, Liliana-Ana Tuta, Irinel Raluca Parepa, Alina Mihaela Stanigut and Mihaela Ionescu
J. Clin. Med. 2024, 13(23), 7235; https://doi.org/10.3390/jcm13237235 - 28 Nov 2024
Viewed by 797
Abstract
Background: Anemia is common in hospitalized cardiac patients and affects prognosis and cardiovascular mortality in patients with acute decompensated heart failure. Aim: to investigate the impact of anemia severity, blood transfusion practices, and the evolution and outcome in patients with acute cardiovascular events. [...] Read more.
Background: Anemia is common in hospitalized cardiac patients and affects prognosis and cardiovascular mortality in patients with acute decompensated heart failure. Aim: to investigate the impact of anemia severity, blood transfusion practices, and the evolution and outcome in patients with acute cardiovascular events. Methods: We performed a retrospective analysis of the patients hospitalized in the Cardiology Department of Constanta County Hospital who required blood derivatives transfusions, between 1 January 2021 and 31 December 2021. Results: Out of the total 270 patients, 170 received a single unit of resuspended erythrocyte concentrate within the same month, while 100 required multiple transfusions, receiving between 2 and 5 units during a single hospitalization, to correct anemia. Before transfusions, the mean hemoglobin (Hb) level was 7.60 g/dL, with values ranging from 6.50 g/dL to 9.10 g/dL. Men show a higher prevalence (64%) than women (36%), likely due to gender differences in susceptibility to heart conditions. Patients with associated acute or chronic renal failure consistently experience higher in-hospital mortality in all left ventricular ejection fraction (LVEF) subgroups. Conclusions: Anemia in heart failure patients is linked to worsening symptoms, decreased kidney function, and higher hospitalization and mortality rates. The findings aim to inform and optimize clinical decision making, particularly regarding transfusion strategies and risk management in this high-risk population. Full article
(This article belongs to the Special Issue Management of Heart Failure)
14 pages, 1020 KiB  
Article
The Added Value of Advanced Echocardiography for the Morpho-Functional and Prognostic Evaluation of the Right Heart in Dilated Cardiomyopathy: Do Not Forget about the Right Atrium
by Călin-Dinu Hădăreanu, Diana-Ruxandra Hădăreanu, Flavia-Mihaela Stoiculescu, Victor-Cornel Raicea, Georgică-Costinel Târtea, Cristina Florescu, Răzvan Ilie Radu and Ionuț Donoiu
J. Clin. Med. 2024, 13(5), 1400; https://doi.org/10.3390/jcm13051400 - 28 Feb 2024
Cited by 1 | Viewed by 1542
Abstract
(1) Introduction and Aims: Right ventricular (RV) remodeling significantly impacts the prognosis of dilated cardiomyopathy (DCM) patients, and right atrial (RA) size and function are still often neglected in DCM patients. Accordingly, our aims were to (i) evaluate right heart subclinical changes and [...] Read more.
(1) Introduction and Aims: Right ventricular (RV) remodeling significantly impacts the prognosis of dilated cardiomyopathy (DCM) patients, and right atrial (RA) size and function are still often neglected in DCM patients. Accordingly, our aims were to (i) evaluate right heart subclinical changes and (ii) the prognostic value of RA compared to left atrial (LA) size and function in patients with DCM by advanced echocardiography. (2) Materials and Methods: Sixty-eight patients with DCM (with a mean age of 60 years; 35 men) were evaluated by comprehensive transthoracic echocardiography, compared to 62 age- and sex-matched healthy controls (with a mean age of 61 years; 32 men), and followed up for 12.4 ± 5 months. (3) Results: DCM patients have RV and RA global longitudinal dysfunction by 2DSTE, higher RA minimum volumes and tricuspid annulus areas despite having normal RV volumes, ejection fractions, and RA maximum volumes by 3DE compared to the controls. The RA strain and RV strain are correlated with each other. The RA reservoir strain (with an AUC = 0.769) has an increased value for outcome prediction compared to that of the LA strain. (4) Conclusion: Patients with DCM have RV longitudinal dysfunction and decreased RA function, in the absence of clinical RV involvement or atrial arrhythmias, and the RA strain is associated with an increased risk of hospitalization and cardiac death. Full article
(This article belongs to the Special Issue Management of Heart Failure)
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Review

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29 pages, 1210 KiB  
Review
Diuretic Treatment in Heart Failure: A Practical Guide for Clinicians
by Lingling Wu, Mario Rodriguez, Karim El Hachem and Chayakrit Krittanawong
J. Clin. Med. 2024, 13(15), 4470; https://doi.org/10.3390/jcm13154470 - 30 Jul 2024
Cited by 2 | Viewed by 14734
Abstract
Congestion and fluid retention are the hallmarks of decompensated heart failure and the major reason for the hospitalization of patients with heart failure. Diuretics have been used in heart failure for decades, and they remain the backbone of the contemporary management of heart [...] Read more.
Congestion and fluid retention are the hallmarks of decompensated heart failure and the major reason for the hospitalization of patients with heart failure. Diuretics have been used in heart failure for decades, and they remain the backbone of the contemporary management of heart failure. Loop diuretics is the preferred diuretic, and it has been given a class I recommendation by clinical guidelines for the relief of congestion symptoms. Although loop diuretics have been used virtually among all patients with acute decompensated heart failure, there is still very limited clinical evidence to guide the optimized diuretics use. This is a sharp contrast to the rapidly growing evidence of the rest of the guideline-directed medical therapy of heart failure and calls for further studies. The loop diuretics possess a unique pharmacology and pharmacokinetics that lay the ground for different strategies to increase diuretic efficiency. However, many of these approaches have not been evaluated in randomized clinical trials. In recent years, a stepped and protocolized diuretics dosing has been suggested to have superior benefits over an individual clinician-based strategy. Diuretic resistance has been a major challenge to decongestion therapy for patients with heart failure and is associated with a poor clinical prognosis. Recently, therapy options have emerged to help overcome diuretic resistance to loop diuretics and have been evaluated in randomized clinical trials. In this review, we aim to provide a comprehensive review of the pharmacology and clinical use of loop diuretics in the context of heart failure, with attention to its side effects, and adjuncts, as well as the challenges and future direction. Full article
(This article belongs to the Special Issue Management of Heart Failure)
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