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Nutrients
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Hydration Status and Cardiovascular Diseases
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Hydration Status and Cardiovascular Diseases

A special issue of Nutrients (ISSN 2072-6643). This special issue belongs to the section "Nutrition and Public Health".

Deadline for manuscript submissions: closed (30 November 2022) | Viewed by 18221

Special Issue Editors

Dr. Paweł Krzesiński

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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
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
Prof. Dr. Stanisław Niemczyk

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Guest Editor
Department of Internal Medicine, Nephrology and Dialysis, Military Institute of Medicine, Szaserów Street 128, Warsaw, 04-141 Poland
Interests: nephrology; transplantology; endocrinology; geriatrics; hydration status; nutritional status; renal failure; ESRD; cardiovascular dysfunction; acute kidney injury; vasculitis; protein energy wasting; hormonal disorders in renal failure; hemodialysis; peritoneal dialysis
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

We are pleased to invite contributions of original research articles and reviews concerning the importance of hydration status in cardiovascular diseases. This is a subject of pivotal importance, as water balance is fundamental for maintaining human homeostasis.

Fluid overload is a common clinical feature in cardiovascular diseases and contributes to debilitating symptoms, worsened quality of life, and poor prognosis. The assessment and management of hydration are key nursing issues, and intervention on fluid balance is a principle for therapy of many cardiac disorders. Additionally, consequences of hypohydration may be harmful, causing limited exercise performance, cognitive dysfunction, orthostatic intolerance, or event acute organ hypoperfusion. The pathophysiology underlying fluid depletion or retention is complex and multifactorial, and can provoke augmented reflex sympatho-excitation in response to mismatch in fluid balance. From a clinical perspective, a precise assessment of volume and hydration status remains a significant challenge, particularly identifying the status of “euvolemia” following the treatment and nutritional strategy.

Comorbidities can strongly influence self-regulating processes of hydration in patients with cardiovascular disorders. That is why worsening non-cardiac diseases may provoke secondary hemodynamic collapse. The pathophysiology of these phenomena is not fully explained, and some gaps in our knowledge still exist. To properly manage hydration deviations, we also need better diagnostic tools, effective therapies, and modalities for the close monitoring of fluid status. This problem is very complicated, especially in the group of patients with chronic renal failure undergoing dialysis.

In this Special Issue, we aim to collect up-to-date studies presenting novel results and future perspectives in the area of hydration status in cardiovascular diseases. We welcome the submission of original research articles, reviews, and expert opinions. The primary conditions of interest are heart failure, hypertension, and renal failure, especially in context of management in acute settings.

Dr. Paweł Krzesiński
Dr. Robert Zymliński
Prof. Dr. Stanisław Niemczyk
Guest Editors

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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. Nutrients is an international peer-reviewed open access semimonthly 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 2900 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.

Keywords

  • heart failure
  • hypertension
  • renal failure
  • chronic renal disease
  • intensive care
  • congestion
  • fluid content
  • diuresis
  • natriuresis
  • hypohydration
  • blood pressure
  • heart rate
  • hemodialysis
  • peritoneal dialysis
  • body composition
  • overhydration
  • cardiovascular drugs
  • lund ultrasound
  • bioimpedance
  • biomarkers
  • artificial intelligence

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Published Papers (6 papers)

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Research

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16 pages, 1590 KiB  
Article
Changes of Hemodynamic Parameters after Intradialytic Glucose Injection
by Longin Niemczyk, Katarzyna Romejko, Katarzyna Szamotulska, Daniel Schneditz and Stanisław Niemczyk
Nutrients 2023, 15(2), 437; https://doi.org/10.3390/nu15020437 - 14 Jan 2023
Cited by 3 | Viewed by 2634
Abstract
Background: Intradialytic hypotension (IDH) is a frequent complication of hemodialysis (HD). Current methods of IDH prevention are insufficient. Methods: We analyzed the intradialytic time course of systolic (SBP), diastolic (DBP), mean arterial (MAP), pulse pressure (PP), and heart rate (HR) in a group [...] Read more.
Background: Intradialytic hypotension (IDH) is a frequent complication of hemodialysis (HD). Current methods of IDH prevention are insufficient. Methods: We analyzed the intradialytic time course of systolic (SBP), diastolic (DBP), mean arterial (MAP), pulse pressure (PP), and heart rate (HR) in a group of chronic kidney disease (CKD) patients. First, 30 min into HD, a 40% glucose solution was injected into the venous line of the extracorporeal circulation at a dose of 0.5 g/kg of dry weight. Pressures and HR were measured in frequent intervals. Relative volume overload was determined by bioimpedance spectroscopy. Results: Thirty-five participants were studied. SBP increased after 5, 10, and 20 min of glucose infusion. DBP increased after 2 and 3 h and also at the end of HD. PP increased after 5, 10, and 20 min of glucose infusion and fell after the 2nd and 3rd hour and also at the end of HD. MAP increased after 2 and 3 h of glucose injection and at the end of HD. Significant interactions of the time course of SBP, DBP, MAP, with HR at baseline and of the time course of PP with fluid overload were observed. Symptomatic hypotensive episodes were absent. Conclusions: Glucose infusions during HD prevent symptomatic IDH and do not cause severe hypertensive episodes. Full article
(This article belongs to the Special Issue Hydration Status and Cardiovascular Diseases)
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9 pages, 442 KiB  
Article
Increased Thoracic Fluid as the Most Distinctive Cardiovascular Hemodynamic Alteration in Men with Prolactinoma
by Agnieszka Jurek, Paweł Krzesiński, Grzegorz Gielerak, Przemysław Witek, Grzegorz Zieliński, Anna Kazimierczak, Robert Wierzbowski, Małgorzata Banak and Beata Uziębło-Życzkowska
Nutrients 2022, 14(24), 5369; https://doi.org/10.3390/nu14245369 - 17 Dec 2022
Cited by 5 | Viewed by 2330
Abstract
Hyperprolactinemia in males with prolactin-secreting adenomas, or prolactinomas, may be associated with endothelial dysfunction and co-existing cardiovascular risk factors. As a noninvasive technique of assessing cardiac function, impedance cardiography (ICG) may be useful in the early detection of hemodynamic dysfunction. The aim of [...] Read more.
Hyperprolactinemia in males with prolactin-secreting adenomas, or prolactinomas, may be associated with endothelial dysfunction and co-existing cardiovascular risk factors. As a noninvasive technique of assessing cardiac function, impedance cardiography (ICG) may be useful in the early detection of hemodynamic dysfunction. The aim of the present study was to analyze and compare the hemodynamic profiles of patients with prolactinoma versus controls. A total of 20 men with prolactinoma (PR group) (mean age 43 years) and 20 men from the control group (CG) were evaluated in this prospective, observational comparative clinical study. The study subjects were propensity score-matched in terms of clinical characteristics—age, mean blood pressure [MBP], arterial hypertension [AH] rates, and body mass index [BMI]. ICG assessments of hemodynamic profiles were conducted with the use of a Niccomo™ device and included stroke volume index (SI), cardiac index (CI), systemic vascular resistance index (SVRI), velocity index (VI), acceleration index (ACI), Heather index (HI), and thoracic fluid content (TFC). AH was well-controlled in both study groups (116/76 mmHg PR vs. 119/76 mmHg CG). In comparison with CG patients, ICG revealed PR group patients to have higher rates of high thoracic fluid content (TFC) (>35 1/kOhm; p = 0.035) and lower SI values (<35 mL/m2, p = 0.072). There was a convergent tendency towards lower values of other cardiac function parameters (SI, CI, VI, ACI, and HI). Prolactinoma-associated endocrine abnormalities are related to hemodynamic profile alterations, including higher rates of increased TFC and the risk of worsened cardiac function. Full article
(This article belongs to the Special Issue Hydration Status and Cardiovascular Diseases)
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13 pages, 1065 KiB  
Article
Cardiovascular Response to Intravenous Glucose Injection during Hemodialysis with Assessment of Entropy Alterations
by Longin Niemczyk, Katarzyna Buszko, Daniel Schneditz, Anna Wojtecka, Katarzyna Romejko, Marek Saracyn and Stanisław Niemczyk
Nutrients 2022, 14(24), 5362; https://doi.org/10.3390/nu14245362 - 16 Dec 2022
Cited by 4 | Viewed by 2449
Abstract
Background: The quality of autonomic blood pressure (BP) control can be assessed by the entropy of serial BP data. The aim of this study was to evaluate the effect of hemodialysis (HD) and glucose infusion (GI) on amplitude aware permutation entropy (AAPE) of [...] Read more.
Background: The quality of autonomic blood pressure (BP) control can be assessed by the entropy of serial BP data. The aim of this study was to evaluate the effect of hemodialysis (HD) and glucose infusion (GI) on amplitude aware permutation entropy (AAPE) of hemodynamic variables during HD in chronic kidney disease patients with and without type-2 diabetes mellitus (DM). Methods: Twenty-one patients without DM (NDO) and ten with DM were studied. Thirty minutes after the start of HD, a 40% glucose solution was administered. Hemodynamic data were extracted from continuous recordings using the Portapres® system. Results: AAPE decreased during HD in all patients and all hemodynamic signals with the exception of AAPE of mean and diastolic BP in DM patients. GI led to an increase in AAPE for cardiac output in all patients, while AAPE for heart rate and ejection time increased only in DM studies, and AAPE for systolic, diastolic, and mean arterial pressure, as well as total peripheral resistance, increased only in NDO patients. Conclusions: The reduction in entropy during HD indicates impaired autonomic control in response to external perturbations. This state is partially reversed by the infusion of glucose with differences in central and peripheral responsiveness in DM and NDO patients. Full article
(This article belongs to the Special Issue Hydration Status and Cardiovascular Diseases)
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13 pages, 300 KiB  
Article
Left Ventricular Diastolic Dysfunction in Chronic Kidney Disease Patients Not Treated with Dialysis
by Katarzyna Romejko, Aleksandra Rymarz, Katarzyna Szamotulska, Zbigniew Bartoszewicz, Tomasz Rozmyslowicz and Stanisław Niemczyk
Nutrients 2022, 14(21), 4664; https://doi.org/10.3390/nu14214664 - 4 Nov 2022
Cited by 9 | Viewed by 2907
Abstract
Background: Left ventricular diastolic dysfunction (LVDD) is observed in the early stages of chronic kidney disease (CKD) and may lead to heart failure with preserved ejection fraction (HFpEF). The purpose of our study was to investigate the association between metabolic, nutritional and inflammatory [...] Read more.
Background: Left ventricular diastolic dysfunction (LVDD) is observed in the early stages of chronic kidney disease (CKD) and may lead to heart failure with preserved ejection fraction (HFpEF). The purpose of our study was to investigate the association between metabolic, nutritional and inflammatory parameters and LVDD in CKD and non-CKD patients. Methods: Two groups of patients were recruited to the study: 93 men with CKD and eGFR lower than 60 mL/min/1.73 m2 and 40 men without kidney function decrease with eGFR ≥ 60 mL/min/1.73 m2. Transthoracic echocardiography was performed to evaluate the diastolic function of the left ventricle. Bioimpedance spectroscopy (BIS) was used to measure overhydration and lean body mass. We also measured the serum concentrations of albumin, glucose, haemoglobin A1c (HgbA1c), fibrinogen, C-reactive protein (CRP), tumor necrosis factor-alpha (TNF-alpha) and osteoprotegerin (OPG). Results: We observed that elevated serum fibrinogen and glucose concentrations were associated with LVDD independently of CKD status. Serum fibrinogen concentrations increased with the advancement of LVDD. Low albumin concentrations in CKD were related with LVDD. In the control group, lower muscle mass presented as lean tissue index (LTI) and lean tissue mass (LTM), and overhydration were associated with LVDD. In the group of patients without kidney function decrease the OPG concentrations were significantly higher in those with LVDD, and they rose with the advancement of LVDD. Conclusions: Elevated inflammatory parameters, increased serum glucose concentrations and worse nutritional status are the states that may impair the diastolic function of the left ventricle in CKD and non-CKD patients. Serum OPG levels are elevated in patients without kidney function decrease and LVDD and its concentrations rise with the advancement of LVDD. Full article
(This article belongs to the Special Issue Hydration Status and Cardiovascular Diseases)
10 pages, 294 KiB  
Article
Serum Osteoprotegerin Is an Independent Marker of Left Ventricular Hypertrophy, Systolic and Diastolic Dysfunction of the Left Ventricle and the Presence of Pericardial Fluid in Chronic Kidney Disease Patients
by Katarzyna Romejko, Aleksandra Rymarz, Katarzyna Szamotulska, Zbigniew Bartoszewicz and Stanisław Niemczyk
Nutrients 2022, 14(14), 2893; https://doi.org/10.3390/nu14142893 - 14 Jul 2022
Cited by 8 | Viewed by 2132
Abstract
Background: Osteoprotegerin (OPG) is a molecule which belongs to the tumor necrosis factor receptor superfamily. OPG concentration is elevated in patients with left ventricle hypertrophy, heart failure and acute myocardial infarction. OPG concentrations rise in chronic kidney disease (CKD). The aim of this [...] Read more.
Background: Osteoprotegerin (OPG) is a molecule which belongs to the tumor necrosis factor receptor superfamily. OPG concentration is elevated in patients with left ventricle hypertrophy, heart failure and acute myocardial infarction. OPG concentrations rise in chronic kidney disease (CKD). The aim of this study was to investigate the association between OPG concentrations and cardiovascular complications, such as left ventricle hypertrophy, systolic and diastolic dysfunction of left ventricle and dysfunction of right ventricle in chronic kidney disease patients not treated with dialysis. The relation between OPG and the amount of pericardial fluid was also examined. Methods: One hundred and one men with CKD stage 3–5 not treated with dialysis were included in the study. Overhydration, body fat mass and lean body mass were measured using bioimpedance spectroscopy (BIS). Echocardiography was performed to evaluate the amount of pericardial fluid and to measure the thickness of the interventricular septum (IVS), systolic and diastolic function of left ventricle, as well as systolic function of right ventricle. Results: We observed a significant positive association between OPG and the thickness of the interventricular septum, the size of the left atrium (LA) and the presence of pericardial fluid. A negative relationship was observed between OPG and ejection fraction (EF). Conclusions: Our results suggest that OPG can be an independent marker of left ventricular hypertrophy, systolic and diastolic dysfunction of left ventricle and the presence of pericardial fluid in chronic kidney disease patients. Full article
(This article belongs to the Special Issue Hydration Status and Cardiovascular Diseases)

Review

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14 pages, 1392 KiB  
Review
What Promotes Acute Kidney Injury in Patients with Myocardial Infarction and Multivessel Coronary Artery Disease—Contrast Media, Hydration Status or Something Else?
by Joanna Maksimczuk, Agata Galas and Paweł Krzesiński
Nutrients 2023, 15(1), 21; https://doi.org/10.3390/nu15010021 - 21 Dec 2022
Cited by 13 | Viewed by 4926
Abstract
Multivessel coronary artery disease (MVCAD) is found in approximately 50% of patients with acute myocardial infarction (AMI) undergoing percutaneous coronary intervention (PCI). Although we have data showing the benefits of revascularization of significant non-culprit coronary lesions in patients with AMI, the optimal timing [...] Read more.
Multivessel coronary artery disease (MVCAD) is found in approximately 50% of patients with acute myocardial infarction (AMI) undergoing percutaneous coronary intervention (PCI). Although we have data showing the benefits of revascularization of significant non-culprit coronary lesions in patients with AMI, the optimal timing of angioplasty remains unclear. The most common reason for postponing subsequent percutaneous treatment is the fear of contrast-induced acute kidney injury (CI-AKI). Acute kidney injury (AKI) is common in patients with AMI undergoing PCI, and its etiology appears to be complex and incompletely understood. In this review, we discuss the definition, pathophysiology and risk factors of AKI in patients with AMI undergoing PCI. We present the impact of AKI on the course of hospitalization and distant prognosis of patients with AMI. Special attention was paid to the phenomenon of AKI in patients undergoing multivessel revascularization. We analyze the correlation between increased exposure to contrast medium (CM) and the risk of AKI in patients with AMI to provide information useful in the decision-making process about the optimal timing of revascularization of non-culprit lesions. In addition, we present diagnostic tools in the form of new biomarkers of AKI and discuss ways to prevent and mitigate the course of AKI. Full article
(This article belongs to the Special Issue Hydration Status and Cardiovascular Diseases)
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