scholarly journals Cardiac Obesity and Cardiac Cachexia: Is There a Pathophysiological Link?

2019 ◽  
Vol 2019 ◽  
pp. 1-7 ◽  
Author(s):  
K. Selthofer-Relatić ◽  
A. Kibel ◽  
D. Delić-Brkljačić ◽  
I. Bošnjak
Keyword(s):  
Heart Failure ◽  
Hypertensive Heart Disease ◽  
Visceral Obesity ◽  
Vascular Diseases ◽  
Clinical Settings ◽  
Special Role ◽  
Cardiac Cachexia ◽  
Reduced Ejection Fraction ◽  
Artery Disease ◽  
And Function

Obesity is a risk factor for cardiometabolic and vascular diseases like arterial hypertension, diabetes mellitus type 2, dyslipidaemia, and atherosclerosis. A special role in obesity-related syndromes is played by cardiac visceral obesity, which includes epicardial adipose tissue and intramyocardial fat, leading to cardiac steatosis; hypertensive heart disease; atherosclerosis of epicardial coronary artery disease; and ischemic cardiomyopathy, cardiac microcirculatory dysfunction, diabetic cardiomyopathy, and atrial fibrillation. Cardiac expression of these changes in any given patient is unique and multimodal, varying in clinical settings and level of expressed changes, with heart failure development depending on pathophysiological mechanisms with preserved, midrange, or reduced ejection fraction. Progressive heart failure with misbalanced metabolic and catabolic processes will change muscle, bone, and fat mass and function, with possible changes in the cardiac fat state from excessive accumulation to reduction and cardiac cachexia with a worse prognosis. The question we address is whether cardiac obesity or cardiac cachexia is to be more feared.

scholarly journals 2011 appropriate use criteria audit of an echocardiography lab in South Western Nigeria

2021 ◽  
Vol 2 (2) ◽  
Author(s):  
Opeyemi O. Oni ◽  
Moshood A. Adeoye ◽  
Adewole Adebiyi ◽  
Akinyemi Aje ◽  
Olaniyi Oyebowale ◽  
...  
Keyword(s):  
Heart Failure ◽  
Heart Disease ◽  
Hypertensive Heart Disease ◽  
Clinical Information ◽  
Left Ventricular ◽  
Appropriate Use Criteria ◽  
Appropriate Use ◽  
Reduced Ejection Fraction ◽  
Lv Mass ◽  
And Function

Cardiovascular diseases are the major cause of death worldwide. Since its discovery in the 20th century, Echocardiography (ECHO) has become one of the pivotal tools in assessing cardiac structure and function. With the increase in requests for ECHO, there has risen an unwanted problem - inappropriate requests for ECHO. There has therefore arisen the need to audit ECHO labs for the appropriateness of ECHO requests. The patients referred from the outpatient clinics and in-patient wards for ECHO from June 1st, 2015 till September 30th, 2016 were recruited. Their request form data, clinical information, and ECHO results were analyzed as appropriate. The 2011 appropriate use criteria for Transthoracic ECHO was utilized. The most common indication out of the 2174 ECHOs reviewed was hypertension (16%), closely followed by hypertensive heart disease (12.4%). The percentage of appropriate, inappropriate, and uncertain indications according to the 2011 appropriate use criteria (AUC) for transthoracic echocardiography were 41.4%, 31.1%, and 0.1% respectively. Less than ten percent (9.3%) of the indications could not be classified by the 2011 AUC while 18.1% of the ECHOs had no indication. When indications of Hypertension, Hypertensive Heart Disease (HHD) and heart failure were compared, heart failure was significantly associated with eccentric Left Ventricular Hypertrophy (LVH), larger LV mass, lower BMI, larger cardiac dimensions, reduced ejection fraction, lower trans mitral A velocities than the other two indications. Concentric LVH was showed a trend towards being most in those with HHD (p= 0.072). The percentage of appropriate indications was low in this study as compared to others, largely because of large inappropriate indications. There is a need to ensure appropriate indications are filled for ECHO request forms. The 2011 AUC may need to be reviewed to expand the appropriate group of indications.

scholarly journals Usefulness of Seattle Heart Failure Model in Heart Failure Patients with Reduced Ejection Fraction in the Clinical Settings

2015 ◽  
Vol 21 (10) ◽  
pp. S171
Author(s):  
Kotaro Miyaji ◽  
Sandeep Shakkya ◽  
Naoki Hayakawa ◽  
Hiroki Suzuki ◽  
Satoshi Kodera ◽  
...  
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Clinical Settings ◽  
Failure Model ◽  
Reduced Ejection Fraction ◽  
Heart Failure Patients ◽  
Heart Failure Model

Abstract 395: A Synonymous Coding SNP Alters SCN5A Regulation by miR-24 and Associates With Non-Arrhythmic Death in Heart Failure

2017 ◽  
Vol 121 (suppl_1) ◽  
Author(s):  
Xiaoming Zhang ◽  
Jin-Young Yoon ◽  
Michael Morley ◽  
Patrick Breheny ◽  
Heather Bloom ◽  
...  
Keyword(s):  
Heart Failure ◽  
Sudden Cardiac Death ◽  
Cardiac Death ◽  
Clinical Signs ◽  
Heart Rhythm ◽  
Coding Sequence ◽  
Reduced Ejection Fraction ◽  
Arrhythmic Death ◽  
And Function ◽  
Myocardial Gene Expression

Mutations disrupting SCN5A coding sequence cause inherited arrhythmias and cardiomyopathy, and SNPs linked to SCN5A splicing, localization and function associate with heart failure-related sudden cardiac death. However, the clinical relevance of SNPs that modulate SCN5A expression levels remains understudied. Recently, we generated a transcriptome-wide map of microRNA (miR) binding sites in human heart and evaluated their interface with polymorphisms. Among >500 common SNPs residing within miR target regions, we identified a synonymous SNP (rs1805126) adjacent to a miR-24 site within SCN5A coding sequence. This SNP is known to reproducibly associate with heart rhythm measurements, but is not considered to be “causal”. Here, we show that miR-24 potently suppresses SCN5A and that rs1805126 modulates this regulation. In further exploring the clinical significance of this, we found that rs1805126 minor allele homozygosity associates with decreased cardiac SCN5A expression and increased mortality in heart failure patients. Unexpectedly, this risk was not linked with arrhythmic sudden cardiac death, but rather, with clinical signs of worsening heart failure (e.g. reduced ejection fraction) and myocardial gene expression changes related to bioenergetics, inflammation and extracellular remodeling. Together, these data attribute a molecular mechanism to this firmly-established GWAS SNP and highlight a novel and surprising link between common variations in SCN5A expression and non-arrhythmic death in heart failure.

HFrEF other treatment: revascularization

ESC CardioMed ◽  
2018 ◽  
pp. 1881-1884
Author(s):  
Eric Velazquez ◽  
Mark C. Petrie
Keyword(s):  
Quality Of Life ◽  
Heart Failure ◽  
Coronary Artery Disease ◽  
Controlled Clinical Trial ◽  
Randomized Controlled Clinical Trial ◽  
Common Cause ◽  
Reduced Ejection Fraction ◽  
Artery Disease

Although coronary artery disease is the most common cause of heart failure with reduced ejection fraction (HFrEF), the role of revascularization as a treatment strategy to improve survival, reduce morbidity, and enhance the quality of life has only begun to be investigated in recent years. To date, a sole randomized controlled clinical trial has been completed. This chapter summarizes what is currently known and what is unknown with respect to revascularization for the treatment of HFrEF.

scholarly journals Left Atrial Remodeling and Function in Advanced Heart Failure With Preserved or Reduced Ejection Fraction

2015 ◽  
Vol 8 (2) ◽  
pp. 295-303 ◽  
Author(s):  
Vojtech Melenovsky ◽  
Seok-Jae Hwang ◽  
Margaret M. Redfield ◽  
Rosita Zakeri ◽  
Grace Lin ◽  
...  
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Left Atrial ◽  
Advanced Heart Failure ◽  
Atrial Remodeling ◽  
Left Atrial Remodeling ◽  
Reduced Ejection Fraction ◽  
And Function

scholarly journals Complex Percutaneous Coronary Intervention Salvages a Patient with Recurrent Acute Coronary Syndrome and Ischaemic Heart Failure with Multiple Life Threatening Co-morbidities: A Case Report

2021 ◽  
Author(s):  
Brajesh Kunwar ◽  
Farah Ingle ◽  
Atul Ingle ◽  
Chandrasekhar Tulagseri
Keyword(s):  
Heart Failure ◽  
Acute Coronary Syndrome ◽  
Coronary Artery ◽  
Artery Bypass ◽  
Kidney Injury ◽  
Vascular Diseases ◽  
Coronary Intervention ◽  
Middle Income ◽  
Coronary Syndrome ◽  
Artery Disease

More than 422 million people are suffering from Diabetes Mellitus (DM) worldwide. Majority of the affected population resides in lower and middle income countries. This chronic, metabolic disease gradually does serious damage to heart, blood vessels, eyes, kidneys and nerves; eventually causing cardiovascular diseases, peripheral vascular diseases, retinopathy, nephropathy and neuropathy. Here, a rare case of a 58-year-old male was present who had history of uncontrolled DM with dry gangrene in right forefoot, acute kidney injury and Coronary Artery Disease (CAD) involving Left Main (LM) bifurcation presented with recurrent acute coronary syndrome with heart failure. Patient in view of multiple co-morbidities was unfit for Coronary Artery Bypass Grafting (CABG) was managed successfully with complex coronary intervention involving LM bifurcation.

Abstract P169: Difference of Risk Factors for Controlled Blood Pressure in Three Types of Heart Failure

Hypertension ◽  
2017 ◽  
Vol 70 (suppl_1) ◽  
Author(s):  
Hong Seok Lee ◽  
Nunez Belen ◽  
Hans Cativo ◽  
Amrut Savadkar ◽  
Visco Ferdinand ◽  
...  
Keyword(s):  
Risk Factors ◽  
Heart Failure ◽  
Ejection Fraction ◽  
Ventricular Hypertrophy ◽  
Multiple Logistic Regression Analysis ◽  
Left Ventricular ◽  
Reduced Ejection Fraction ◽  
Different Types ◽  
Artery Disease ◽  
The Relationship

Background: Hypertension is the most important modifiable risk factor for worsening heart failure (HF) because hypertension increases cardiac work, which results in worsening left ventricular hypertrophy and development of coronary artery disease. We will determine risk fctors of BP control in different types of heart failure according to JNC 8 guideline. Method: Based on ACC/AHA guidelines, heart failure is classified as a reduced ejection fraction(HFrEF, EF <40), preserved ejection fraction (HFpEF, EF>50) and heart failure with an improved ejection fraction(HFpEF(i),EF≥40). 732 patients enrolled in our heart failure program were analyzed retrospectively. And 672 patients who had been followed from Jan 1 st ,2013 to June 30st 2015 were included. Multiple logistic regression analysis was performed to determine the relationship between hypertension and heart failure after adjusting for potential confounders. Results: Patients with three types of heart failure had different BP control rate. It was 67.5% (308/456) ,76.5%(104/136), 77.5%(62/80) in HFrEF, HFrEF, and HFpEF(i) based on JNC 8 guideline, respectively. Mean systolic BP was 127.1±17 mmHg in HFrEF, 129.0±21 mmHg in HFpEF and 124.4±18 mmHg in HFpEF(i). Obesity [Odds ratio (OR): 0.12,95% Confidence Interval(CI): 0.048-0.284] , ACE inhibitor or ARB [OR: 2.66, CI: 1.50-3.42] and lasix [OR: 1.90,CI: 1.07-3.40] and aspirin [OR 0.53, CI: 0.37-0.96] were noted to be related to controlled BP in HFrEF. Aspirin [OR 0.17, CI: 0.05-0.60] was significantly associated with controlled BP in HFpEF. And beta-blocker [OR: 0.07, CI: 0.01-0.62] and anti-lipid medication [OR: 4.76, CI: 1.73-5.89] were associated with BP control in HFpEF(i). Conclusion: In each type of heart failure, there was difference of risk factors related to BP control. Different medications were associated with control of BP in different types of heart failure. Patients may need to modify risk factors including types of medication to control BP according to types of heart failure. It might be leading to better heart failure management.

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