Heart failure reviews
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Heart failure reviews · Sep 2012
ReviewAge-related cardiovascular disease and the beneficial effects of calorie restriction.
Aging is a well-recognized risk factor in the development of cardiovascular disease, which is the primary cause of death and disability in the elderly population. The normal process of aging is associated with progressive deterioration in structure and function of the heart and vasculature. These age-related changes likely act as both a catalyst and accelerator in the development of cardiovascular disease. ⋯ Calorie restriction has emerged as one of the most effective and reproducible interventions for extending lifespan, as well as protecting against obesity, metabolic disorders, and cardiovascular disease. Herein, we review the multiple beneficial effects that calorie restriction and resveratrol exert on the cardiovascular system with a particular focus on aging. Although calorie restriction and resveratrol have proven to be very effective in preventing and treating the development of cardiovascular disease in animal models, studies continue as to whether these profound beneficial effects can translate to humans to improve cardiovascular health.
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Heart failure reviews · Mar 2012
ReviewAnemia in chronic heart failure: can we treat? What to treat?
Even though anemia is a significant comorbidity regularly observed in patients with chronic heart failure (HF), only in recent years systematic therapeutic research has been started. This article aims to review the aspects of anemia in chronic HF that are relevant for making treatment decisions, beginning with the definition of anemia and its incidence and prevalence of anemia in patients with chronic HF. Considering the etiology and prognostic impact of anemia in chronic HF, several treatment options will be considered. ⋯ According to the results seen in the FAIR-HF trial, iron supplementation should be particularly considered to improve symptoms and quality of life. Intravenous iron application may result in higher compliance and much faster treatment response than oral iron. The RED-HF study will show whether use of darbepoetin alfa in anemic patients with chronic HF will reduce the combined endpoint of death for any reason or hospitalization for heart failure.
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Heart failure reviews · Mar 2012
ReviewTreatment of congestion in heart failure with diuretics and extracorporeal therapies: effects on symptoms, renal function, and prognosis.
In the United States and Europe, approximately 90% of heart failure hospitalizations are due to symptoms and signs of sodium and fluid excess. Congestion is associated with heart failure progression. Venous congestion, rather than a reduced cardiac output, may be the primary hemodynamic factor driving worsening renal function in patients with acutely decompensated heart failure. ⋯ These studies have also shown a favorable effect on neurohormonal activation. When compared with intravenous diuretics, ultrafiltration similarly changed dyspnea scores but reduced re-hospitalizations (28 of 87 patients (32%) versus 16 of 89 patients (18%), P < 0.037) in a randomized controlled trial of patients with decompensated heart failure. Future larger controlled clinical trials should evaluate further the effect of ultrafiltration on patients' outcomes, including survival.
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Heart failure reviews · Jan 2012
ReviewPathophysiology and pathogenesis of post-resuscitation myocardial stunning.
The prognosis for cardiac arrest victims remains dismal, as only 17% survives to hospital discharge. Post-resuscitation myocardial stunning is the mechanical dysfunction that persists after the restoration of spontaneous circulation. Our knowledge regarding myocardial stunning has grown dramatically over the years, and several hypotheses have been proposed in order to explain its pathophysiology; however, the interrelationships among various mechanisms remain unclear. ⋯ In this review, the pathophysiological disturbances occurring from the onset of cardiac arrest until the restoration of spontaneous circulation are addressed. Then, the pathophysiology of myocardial stunning during the post-resuscitation period is critically reviewed in 4 parts, the immediate, the early, the intermediate, and the recovery post-arrest phase. This article covers a huge gap in the existing literature regarding the pathophysiology of post-resuscitation period and provides a better understanding of the pathophysiology and pathogenesis of post-resuscitation myocardial stunning.
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Heart failure reviews · Mar 2011
ReviewSympathetic-parasympathetic interaction in health and disease: abnormalities and relevance in heart failure.
Sympathetic-parasympathetic interaction plays a major role in the evolution and outcome of many cardiovascular disorders. Nonetheless, a thorough understanding of this relationship and of its potential implications for prognosis and management still escapes many cardiologists. ⋯ It examines indirect but highly reliable markers of this interaction as they can be studied in the clinical setting of ischemic heart disease and of heart failure, focusing primarily on the experimental and clinical studies of baroreflex sensitivity. It concludes by drawing inferences likely to lead to a novel approach to the management of heart failure, resulting from the knowledge gained about the vagal control of the heart and based on electrical vagal stimulation.