scholarly journals Depression in Patients with Cardiovascular Disease

2012 ◽  
Vol 2012 ◽  
pp. 1-10 ◽  
Author(s):  
Dimos Mastrogiannis ◽  
Gregory Giamouzis ◽  
Efthimios Dardiotis ◽  
George Karayannis ◽  
Artemis Chroub-Papavaiou ◽  
...  
Keyword(s):  
Heart Failure ◽  
Cardiovascular Disease ◽  
Treatment Options ◽  
Medical Intervention ◽  
Lifestyle Changes ◽  
Screening Tools ◽  
Healthcare Personnel ◽  
Cardiac Events ◽  
Pathophysiological Mechanisms ◽  
Prevalence Of Depression

It has been widely suggested that depression negatively affects patients with cardiovascular disease. There are several pathophysiological mechanisms as well as behavioral processes linking depression and cardiac events. Improvements in nursing and medical care have prolonged survival of this patient population; however, this beneficial outcome has led to increased prevalence of depression. Since mortality rates in chronic heart failure patients remain extremely high, it might be as equally important to screen for depression and there are several valid and reliable screening tools that healthcare personnel could easily employ to identify patients at greater risk. Consultation should be provided by a multidisciplinary team, consisting of cardiologists, psychiatrists, and hospital or community nurses so as to carefully plan, execute, and evaluate medical intervention and implement lifestyle changes. We aim to systematically review the existing knowledge regarding current definitions, prognostic implications, pathophysiological mechanisms, and current and future treatment options in patients with depression and cardiovascular disease, specifically those with heart failure.

Prevention of atrial fibrillation – non-modifiable and modifiable risk factors for AF

2020 ◽  
Vol 2 (55) ◽  
pp. 14-19
Author(s):  
Agnieszka Wojdyła-Hordyńska ◽  
Grzegorz Hordyński
Keyword(s):  
Risk Factors ◽  
Heart Failure ◽  
Atrial Fibrillation ◽  
Cardiovascular Disease ◽  
Cardiovascular Diseases ◽  
Sudden Cardiac Death ◽  
Cardiac Death ◽  
Combined Treatment ◽  
Lifestyle Changes ◽  
Modifiable Risk Factors

Atrial fibrillation is one of the most common arrhythmias, with a significant increase in incidence in recent years. AF is a major cause of stroke, heart failure, sudden cardiac death, and cardiovascular disease. Timely intervention and modification of risk factors increase chance to stop the disease. Aggressive, multilevel prevention tactics are a component of combined treatment, including – in addition to lifestyle changes, anticoagulant therapy, pharmacotherapy and invasive anti-arrhythmic treatment – prevention of cardiovascular diseases, hypertension, ischemia, valvular disease and heart failure.

Mineralocorticoid receptors and the heart, multiple cell types and multiple mechanisms: a focus on the cardiomyocyte

2013 ◽  
Vol 125 (9) ◽  
pp. 409-421 ◽  
Author(s):  
Laura A. Bienvenu ◽  
Melissa E. Reichelt ◽  
Lea M. D. Delbridge ◽  
Morag J. Young
Keyword(s):  
Heart Failure ◽  
Cardiovascular Disease ◽  
Sex Differences ◽  
Side Effects ◽  
Therapeutic Option ◽  
Cell Types ◽  
Receptor Activation ◽  
Cardiac Events ◽  
Cardiac Tissues ◽  
Targeted Interventions

MR (mineralocorticoid receptor) activation in the heart plays a central role in the development of cardiovascular disease, including heart failure. The MR is present in many cell types within the myocardium, including cardiomyocytes, macrophages and the coronary vasculature. The specific role of the MR in each of these cell types in the initiation and progression of cardiac pathophysiology is not fully understood. Cardiomyocyte MRs are increasingly recognized to play a role in regulating cardiac function, electrical conduction and fibrosis, through direct signal mediation and through paracrine MR-dependent activity. Although MR blockade in the heart is an attractive therapeutic option for the treatment of heart failure and other forms of heart disease, current antagonists are limited by side effects owing to MR inactivation in other tissues (including renal targets). This has led to increased efforts to develop therapeutics that are more selective for cardiac MRs and which may have reduced the occurrence of side effects in non-cardiac tissues. A major clinical consideration in the treatment of cardiovascular disease is of the differences between males and females in the incidence and outcomes of cardiac events. There is clinical evidence that female sensitivity to endogenous MRs is more pronounced, and experimentally that MR-targeted interventions may be more efficacious in females. Given that sex differences have been described in MR signalling in a range of experimental settings and that the MR and oestrogen receptor pathways share some common signalling intermediates, it is becoming increasingly apparent that the mechanisms of MRs need to be evaluated in a sex-selective manner. Further research targeted to identify sex differences in cardiomyocyte MR activation and signalling processes has the potential to provide the basis for the development of cardiac-specific MR therapies that may also be sex-specific.

scholarly journals Effectiveness of Intensive Cardiac Rehabilitation in High-Risk Patients with Cardiovascular Disease in Real-World Practice

Nutrients ◽  
2021 ◽  
Vol 13 (11) ◽  
pp. 3883
Author(s):  
Iwona Świątkiewicz ◽  
Salvatore Di Somma ◽  
Ludovica De Fazio ◽  
Valerio Mazzilli ◽  
Pam R. Taub
Keyword(s):  
Heart Failure ◽  
Blood Pressure ◽  
Cardiovascular Disease ◽  
High Risk ◽  
Cardiac Rehabilitation ◽  
Real World ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Cardiac Events ◽  
Supervised Exercise

Structured lifestyle interventions through cardiac rehabilitation (CR) are critical to improving the outcome of patients with cardiovascular disease (CVD) and cardiometabolic risk factors. CR programs’ variability in real-world practice may impact CR effects. This study evaluates intensive CR (ICR) and standard CR (SCR) programs for improving cardiometabolic, psychosocial, and clinical outcomes in high-risk CVD patients undergoing guideline-based therapies. Both programs provided lifestyle counseling and the same supervised exercise component. ICR additionally included a specialized plant-based diet, stress management, and social support. Changes in body weight (BW), low-density lipoprotein cholesterol (LDL-C), and exercise capacity (EC) were primary outcomes. A total of 314 patients (101 ICR and 213 SCR, aged 66 ± 13 years, 75% overweight/obese, 90% coronary artery disease, 29% heart failure, 54% non-optimal LDL-C, 43% depressive symptoms) were included. Adherence to ICR was 96% vs. 68% for SCR. Only ICR resulted in a decrease in BW (3.4%), LDL-C (11.3%), other atherogenic lipids, glycated hemoglobin, and systolic blood pressure. Both ICR and SCR increased EC (52.2% and 48.7%, respectively) and improved adiposity indices, diastolic blood pressure, cholesterol intake, depression, and quality of life, but more for ICR. Within 12.6 ± 4.8 months post-CR, major adverse cardiac events were less likely in the ICR than SCR group (11% vs. 17%), especially heart failure hospitalizations (2% vs. 8%). A comprehensive ICR enhanced by a plant-based diet and psychosocial management is feasible and effective for improving the outcomes in high-risk CVD patients in real-world practice.

Cardiovascular Effects of Hypoglycemic Agents in Diabetes Mellitus.

2020 ◽  
Vol 15 ◽  
Author(s):  
Anna Pietraszek
Keyword(s):  
Diabetes Mellitus ◽  
Heart Failure ◽  
Cardiovascular Disease ◽  
Secondary Prevention ◽  
Cardiovascular Effects ◽  
Lifestyle Changes ◽  
Hypoglycemic Agents ◽  
Glucose Transporter 2 ◽  
Cardiovascular Morbidity And Mortality ◽  
Dipeptidyl Peptidase 4 Inhibitors

Background: Despite substantial improvements over the years, diabetes mellitus is still associated with cardiovascular disease, heart failure and excess mortality. Objective: The objective of this article is to examine existing data on how to reduce the excess cardiovascular morbidity and mortality in diabetes. Lifestyle changes, control of glycemia, blood pressure and lipid levels are described in brief. The main scope of this article is, however, the glucose-independent cardiovascular effect of antidiabetic pharmacological agents (mainly other than insulin). Methods: The article is a narrative review based on a systematic review of recently published reviews/meta-analyses within the subtopics, complemented with data from individual included and other trials when relevant. Results and Discussion: Older date data suggesting a cardioprotective role of Metformin (a cheap and safe drug) seem not to be challenged in a convincing manner. The cardiovascular effects of thiazolidinediones, sulphonylureas and glinides are debatable. More recent large scale cardiovascular outcome trials suggest a neutral profile of dipeptidyl peptidase 4 inhibitors, however, compelling evidence of cardioprotective effects of glucagon-like 1 receptor antagonists and sodium-glucose transporter 2 inhibitors is present. Conclusion: Both play a role in secondary prevention of atherosclerotic cardiovascular disease. Additionally, sodiumglucose transporter 2 inhibitors play a role in both primary and secondary prevention of heart failure, yet at a price of the rare, but potentially dangerous, euglyceamic diabetic ketoacidosis.

scholarly journals P2X7

2020 ◽  
Author(s):  
Brandon G. Shokoples ◽  
Pierre Paradis ◽  
Ernesto L. Schiffrin
Keyword(s):  
Heart Failure ◽  
Cardiovascular Disease ◽  
Ischemia Reperfusion Injury ◽  
Purinergic Receptor ◽  
Ischemia Reperfusion ◽  
Low Grade ◽  
Cardiac Events ◽  
Blood Pressure Elevation ◽  
Pyrin Domain ◽  
Safety Margins

Chronic low-grade inflammation contributes to the development of several diseases, including cardiovascular disease. Adequate strategies to target inflammation in cardiovascular disease are in their infancy and remain an avenue of great interest. The purinergic receptor P2X7 is a ubiquitously expressed receptor that predominately mediates inflammation and cellular death. P2X7 is a ligand-gated cation channel that is activated in response to high concentrations of extracellular ATP, triggering the assembly and activation of the NLRP3 (nuclear oligomerization domain like receptor family pyrin domain containing 3) inflammasome and subsequent release of proinflammatory cytokines IL (interleukin)-1β and IL-18. Increased P2X7 activation and IL-1β and IL-18 concentrations have been implicated in the development of many cardiovascular conditions including hypertension, atherosclerosis, ischemia/reperfusion injury, and heart failure. P2X7 receptor KO (knockout) mice exhibit a significant attenuation of the inflammatory response, which corresponds with reduced disease severity. P2X7 antagonism blunts blood pressure elevation in hypertension and progression of atherosclerosis in animal models. IL-1β and IL-18 inhibition has shown efficacy in clinical trials reducing major adverse cardiac events, including myocardial infarction, and heart failure. With several P2X7 antagonists available with proven safety margins, P2X7 antagonism could represent an untapped potential for therapeutic intervention in cardiovascular disorders.

Epidemiology of cardiovascular disease in the last decade: treatment options and implications for perfusion in the 21st century

Perfusion ◽  
2003 ◽  
Vol 18 (2) ◽  
pp. 73-77 ◽  
Author(s):  
Joseph J Sistino
Keyword(s):  
Heart Failure ◽  
Cardiovascular Disease ◽  
Heart Surgery ◽  
Operative Procedure ◽  
Treatment Options ◽  
Population Projections ◽  
Discharge Data ◽  
The Past ◽  
Number Of Patients ◽  
The Usa

Cardiovascular disease (CVD) rates determine, to a large extent, the adult patient population that undergoes heart surgery. Many new treatment options have surfaced over the last decade which delay surgical intervention. The purpose of this study is to review the epidemiology of CVD in the USA over the past decade and project treatment patterns for the future. This information is important for the perfusion profession because it will influence the numbers of perfusionists required to staff open-heart centers in this country. Discharge data from hospitals in the USA were reviewed to determine numbers and rates of patients treated for CVD referenced to age and specific types of CVD. Operative procedure codes were reviewed to determine the volume and rates of cardiac surgical procedures, including catheterization and angioplasty, in the USA between 1990 and 2000. The results of this epidemiological review demonstrate that the surgical treatment rates for ischemic heart disease have not increased significantly over the past 10 years, except in the over-65 population. The large increase in the number of patients admitted for congestive heart failure (CHF) (39.4%) during this time period due to an aging population afford the perfusion profession an opportunity to become more involved in treatment options, such as cardiac assist devices. Cardiac surgeons are facing many of the same challenges that we face as perfusionists due to interventional cardiology, and should focus more attention on improving treatment for the heart failure population in the next decade. The continuation of perfusion education programs at their current rate of output seems justified, based on population projections and the increased incidence of CVD in the elderly population.

scholarly journals Hypothalamic Amenorrhea: Causes, Complications, & Controversies

2017 ◽  
Vol 6 (1) ◽  
pp. 24-32
Author(s):  
Taylor Collins ◽  
Krista L Rompolski
Keyword(s):  
Treatment Options ◽  
Standard Of Care ◽  
Reproductive Hormones ◽  
Gonadotropin Releasing Hormone ◽  
Lifestyle Changes ◽  
Hypothalamic Amenorrhea ◽  
Releasing Hormone ◽  
Novel Treatments ◽  
Prevalence Of Depression ◽  
Reversible Condition

Hypothalamic amenorrhea (HA) is considered a reversible condition characterized by the absence of menses for 3 months or more, due to suppressed secretions of gonadotropin releasing hormone affecting the entire hypothalamic-pituitary-ovarian axis. HA can be triggered by excessive stress, weight loss or excessive exercise, however, the etiology is still largely unknown. Serious, long-term complications include severe hypoestrogenism and infertility, in addition to a variety of hormonal aberrations. Hypoestrogenism also leads to diminished bone health, cardiovascular problems, and mood changes that lead to a higher prevalence of depression and anxiety. It is important that HA is diagnosed in a timely manner in order to begin therapeutic strategies that aim to resume menses and return to normal levels of circulating reproductive hormones. When attempts to resume menstruation naturally through lifestyle changes are unsuccessful, other pharmaceutical options are available. Treatment options range from estrogen-replacement therapy to the administration of gonadotropin releasing hormone, depending on the reproductive goals of the woman. More research is needed on novel treatments in order to determine the most effective standard of care.

Abstract P011: ST2 As A Risk Predictor For Cardiovascular Disease, Heart Failure And Mortality In The Prospective Finrisk97 Population Cohort

Circulation ◽  
2014 ◽  
Vol 129 (suppl_1) ◽  
Author(s):  
Maria F Hughes ◽  
Sebastian Appelbaum ◽  
Aki S Havulinna ◽  
Annika Jagodzinski ◽  
Francisco Ojeda ◽  
...  
Keyword(s):  
Risk Factors ◽  
Heart Failure ◽  
Cardiovascular Disease ◽  
General Population ◽  
Significant Risk ◽  
Cox Proportional Hazards ◽  
Cardiac Events ◽  
Cvd Risk ◽  
Population Cohort ◽  
Framingham Risk

Introduction: ST2 is a receptor for the inflammatory cytokine IL33. The ST2-IL33 pathway has been associated with development of atherosclerosis and coronary artery disease in humans although the mechanism is not fully established. Increased ST2 levels have been associated with heart failure and death in patients with acute myocardial infarction and in the general population where it has also been associated with diabetes. We hypothesized that ST2 levels can identify people in the general population with elevated risk of subsequent cardiovascular disease (CVD) and add to existing risk prediction algorithms. Methods: We measured high sensitivity soluble ST2 (Presage) in 7,551 men and women (25-74 years) from the FINRISK97 prospective population cohort. Cox proportional hazards modeling using age as the time scale evaluated the ability of sST2 to predict cardiovascular endpoints including fatal and non-fatal cardiovascular disease (coronary heart disease, stroke, heart failure), incident diabetes and death over 14 years follow up. Missing data (~10%) was multiply imputed and participants with prevalent disease at baseline were excluded for corresponding endpoints of disease. Discrimination and reclassification statistics (c-index, NRI) for 10 year absolute risks were calculated with internal (10-fold) cross validation to compare the ability of ST2 to improve upon Framingham risk factors, N-terminal pro-brain natriuretic peptide (NTProBNP) and renal function (eGFR), established markers of CVD risk. Results: sST2 concentrations significantly predicted all-cause death (hazard ratio (HR) comparing the highest quartile with the lowest was 1.28 95% confidence interval (C.I.) 1.04-1.57 (1024 events), major adverse cardiac events (MACE) (HR 1.22 (95% C.I. 1.001-1.49) (1068 events) and stroke (1.44 (95% C.I. 0.99-2.1) (370 events) after adjustment for Framingham risk factors, NTProBNP and eGFR. sST2 showed suggestive but non-significant association with heart failure (HR 1.21 (95% C.I. 0.92-1.58) (577 events) after similar adjustment. Similarly, sST2 showed a trend toward elevated but non-significant risk for diabetes (HR 1.14 (95% C.I. 0.87-1.49) (377 events) after adjustment for age, area, sex, smoking, systolic blood pressure, antihypertensive medication, glucose and prevalent CVD. No improvement in the c-index was observed for models adding sST2 to Framingham and other risk factors. Clinical NRI was improved in fully adjusted models for death 9% ( p =1x10 -6 ) and stroke 4% ( p =0.028) with reclassification benefit mainly for non-cases. IDI was improved for MACE ( p =0.02) and stroke ( p =0.02). Conclusions: In a healthy general population from Finland (FINRISK97), sST2 improves prediction of death, MACE and stroke beyond Framingham covariates, NTProBNP and eGFR but does not improve prediction of heart failure.

scholarly journals Modern view on heart failure with preserved ejection fraction

2020 ◽  
pp. 14-19
Author(s):  
Д.В. Шумаков ◽  
Д.И. Зыбин ◽  
В.П. Пронина ◽  
О.Ю. Зыбина ◽  
М.А. Попов
Keyword(s):  
Heart Failure ◽  
Early Diagnosis ◽  
Ejection Fraction ◽  
Pathological Condition ◽  
Treatment Options ◽  
Diagnosis And Treatment ◽  
Preserved Ejection Fraction ◽  
Pathophysiological Mechanisms ◽  
Future Treatment ◽  
Advanced Stages

Сердечная недостаточность с сохраненной фракцией выброса является одной из распространенных форм сердечной недостаточности. Это патологическое состояние остается серьезной проблемой для специалистов. Многие важные аспекты синдрома остаются неясными, включая патофизиологические механизмы, раннюю диагностику и лечение. Болезнь чаще протекает бессимптомно и выявляется на поздних стадиях. В статье отражены вопросы патофизиологии, диагностики и будущие направления в лечении сердечной недостаточности с сохраненной фракцией выброса. Heart failure with preserved ejection fraction is the most common form of heart failure. This pathological condition has always been aserious problem for specialists. Many important aspects of the syndrome remain unclear, including pathophysiological mechanisms, early diagnosis and treatment. The disease is often asymptomatic and is diagnosed in the advanced stages. The article reviews the issues of pathophysiology, diagnosis and future treatment options for heart failure with preserved ejection fraction.

Exercise, cardiovascular disease, and chronic heart failure

2001 ◽  
Vol 82 (3B) ◽  
pp. 0s76-0s81 ◽  
Author(s):  
Reed Humphrey ◽  
Matthew N. Bartels
Keyword(s):  
Heart Failure ◽  
Cardiovascular Disease ◽  
Chronic Heart Failure
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