Pathophysiology in the Failing Heart

A special issue of Biomolecules (ISSN 2218-273X). This special issue belongs to the section "Molecular Medicine".

Deadline for manuscript submissions: closed (10 June 2023) | Viewed by 7124

Special Issue Editors

Cardiology Department, Medical University of Białystok, Poland, 15-276 Białystok, 24A Sklodowskiej str.
Interests: ischaemic heart disease, heart failure, echocardiography, pulmonary hypertension
Department of Pathophysiology, Medical University, 20-090 Lublin, Poland
Interests: hydrogen sulfide; nitric oxide; paraoxonase; plasma lipoproteins; lipid-lowering drugs; statins; leptin; adiponectin; adipokines

Special Issue Information

Dear Colleagues,

We are pleased to invite you to take part in this Special Issue of Biomolecules dedicated to heart failure and its pathophysiology.

Heart failure is a growing medical and social problem. The number of patients being treated for heart failure is steadily increasing. It seems important to search for markers allowing the estimation of the survival of heart failure patients. The development of research on cardiovascular pathophysiology should have an impact on clinical management. Currently, the main biochemical parameter used by clinicians is NTproBNP. Finding new markers affecting prognosis may improve patient management, reduce hospitalizations and improve patient quality of life.

This Special Issue will focus on the pathophysiological processes of heart failure, the understanding of which will have an impact on prognosis.

In this Special Issue, original research and review articles are welcome. Research areas may include (but are not limited to): unknown pathophysiological processes leading to heart failure, as well as new promising biomarkers and treatment options.

We look forward to receiving your contributions.

Prof. Małgorzata Knapp
Prof. Dr. Jerzy Beltowski
Guest Editors

Manuscript Submission Information

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Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2700 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
  • pathophysiology
  • biomarkers

Published Papers (4 papers)

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Research

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11 pages, 261 KiB  
Article
L-arginine and Its Derivatives Correlate with Exercise Capacity in Patients with Advanced Heart Failure
by Anna Drohomirecka, Joanna Waś, Natalia Wiligórska, Tomasz M. Rywik, Krzysztof Komuda, Dorota Sokołowska, Anna Lutyńska and Tomasz Zieliński
Biomolecules 2023, 13(3), 423; https://doi.org/10.3390/biom13030423 - 23 Feb 2023
Cited by 1 | Viewed by 1170
Abstract
Methylated arginine metabolites interrupt nitric oxide synthesis, which can result in endothelium dysfunction and inadequate vasodilation. Since little is known about the dynamics of arginine derivatives in patients with heart failure (HF) during physical exercise, we aimed to determine this as well as [...] Read more.
Methylated arginine metabolites interrupt nitric oxide synthesis, which can result in endothelium dysfunction and inadequate vasodilation. Since little is known about the dynamics of arginine derivatives in patients with heart failure (HF) during physical exercise, we aimed to determine this as well as its impact on the patient outcomes. Fifty-one patients with HF (left ventricle ejection fraction-LVEF ≤ 35%, mean 21.7 ± 5.4%) underwent the cardiopulmonary exercise test (CPET). Plasma concentrations of L-arginine, citrulline, ornithine, asymmetric dimethylarginine (ADMA), and symmetric dimethylarginine (SDMA) were measured before and directly after CPET. All patients were followed for a mean of 23.5 ± 12.6 months. The combined endpoint was: any death, urgent heart transplantation, or urgent LVAD implantation. L-arginine concentrations increased significantly after CPET (p = 0.02), when ADMA (p = 0.01) and SDMA (p = 0.0005) decreased. The parameters of better exercise capacity were positively correlated with post-CPET concentration of L-arginine and inversely with post-CPET changes in ADMA, SDMA, and baseline and post-CPET SDMA concentrations. Baseline and post-CPET SDMA concentrations increased the risk of endpoint occurrence (HR 1.02, 95% CI 1.009–1.03, p = 0.04 and HR 1.02, 95% CI 1.01–1.03, p = 0.02, respectively). In conclusion, in patients with HF, extensive exercise is accompanied by changes in arginine derivatives that can reflect endothelium function. These observations may contribute to the explanation of the pathophysiology of exercise intolerance in HF. Full article
(This article belongs to the Special Issue Pathophysiology in the Failing Heart)
14 pages, 5145 KiB  
Article
Machine Learning Approach to Understand Worsening Renal Function in Acute Heart Failure
by Szymon Urban, Mikołaj Błaziak, Maksym Jura, Gracjan Iwanek, Barbara Ponikowska, Jolanta Horudko, Agnieszka Siennicka, Petr Berka, Jan Biegus, Piotr Ponikowski and Robert Zymliński
Biomolecules 2022, 12(11), 1616; https://doi.org/10.3390/biom12111616 - 02 Nov 2022
Cited by 2 | Viewed by 1673
Abstract
Acute heart failure (AHF) is a common and severe condition with a poor prognosis. Its course is often complicated by worsening renal function (WRF), exacerbating the outcome. The population of AHF patients experiencing WRF is heterogenous, and some novel possibilities for its analysis [...] Read more.
Acute heart failure (AHF) is a common and severe condition with a poor prognosis. Its course is often complicated by worsening renal function (WRF), exacerbating the outcome. The population of AHF patients experiencing WRF is heterogenous, and some novel possibilities for its analysis have recently emerged. Clustering is a machine learning (ML) technique that divides the population into distinct subgroups based on the similarity of cases (patients). Given that, we decided to use clustering to find subgroups inside the AHF population that differ in terms of WRF occurrence. We evaluated data from the three hundred and twelve AHF patients hospitalized in our institution who had creatinine assessed four times during hospitalization. Eighty-six variables evaluated at admission were included in the analysis. The k-medoids algorithm was used for clustering, and the quality of the procedure was judged by the Davies–Bouldin index. Three clinically and prognostically different clusters were distinguished. The groups had significantly (p = 0.004) different incidences of WRF. Inside the AHF population, we successfully discovered that three groups varied in renal prognosis. Our results provide novel insight into the AHF and WRF interplay and can be valuable for future trial construction and more tailored treatment. Full article
(This article belongs to the Special Issue Pathophysiology in the Failing Heart)
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13 pages, 2369 KiB  
Article
Systemic Biomarkers and Unique Pathways in Different Phenotypes of Heart Failure with Preserved Ejection Fraction
by Hao Chen, Milorad Tesic, Valentina N. Nikolic, Milan Pavlovic, Rada M. Vucic, Ana Spasic, Hristina Jovanovic, Ivana Jovanovic, Stephanie E. L. Town, Matthew P. Padula and Lana McClements
Biomolecules 2022, 12(10), 1419; https://doi.org/10.3390/biom12101419 - 04 Oct 2022
Cited by 3 | Viewed by 2145
Abstract
Heart failure with preserved ejection fraction (HFpEF) accounts for around 50% of all heart failure cases. It is a heterogeneous condition with poorly understood pathogenesis. Here, we aimed to identify unique pathogenic mechanisms in acute and chronic HFpEF and hypertrophic cardiomyopathy (HCM). We [...] Read more.
Heart failure with preserved ejection fraction (HFpEF) accounts for around 50% of all heart failure cases. It is a heterogeneous condition with poorly understood pathogenesis. Here, we aimed to identify unique pathogenic mechanisms in acute and chronic HFpEF and hypertrophic cardiomyopathy (HCM). We performed unbiased, comprehensive proteomic analyses of plasma samples from gender- and BMI-matched patients with acute HFpEF (n = 8), chronic HFpEF (n = 9) and HCM (n = 14) using liquid chromatography–mass spectrometry. Distinct molecular signatures were observed in different HFpEF forms. Clusters of biomarkers differentially abundant between HFpEF forms were predominantly associated with microvascular inflammation. New candidate protein markers were also identified, including leucine-rich alpha-2-glycoprotein 1 (LRG1), serum amyloid A1 (SAA1) and inter-alpha-trypsin inhibitor heavy chain 3 (ITIH3). Our study is the first to apply systematic, quantitative proteomic screening of plasma samples from patients with different subtypes of HFpEF and identify candidate biomarkers for improved management of acute and chronic HFpEF and HCM. Full article
(This article belongs to the Special Issue Pathophysiology in the Failing Heart)
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Review

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18 pages, 754 KiB  
Review
A Methodological Perspective on the Function and Assessment of Peripheral Chemoreceptors in Heart Failure: A Review of Data from Clinical Trials
by Maksym Jura, Mateusz Garus, Kornelia Krakowska, Szymon Urban, Mikołaj Błaziak, Gracjan Iwanek, Robert Zymliński, Jan Biegus and Bartłomiej Paleczny
Biomolecules 2022, 12(12), 1758; https://doi.org/10.3390/biom12121758 - 26 Nov 2022
Cited by 1 | Viewed by 1457
Abstract
Augmented peripheral chemoreceptor sensitivity (PChS) is a common feature of many sympathetically mediated diseases, among others, and it is an important mechanism of the pathophysiology of heart failure (HF). It is related not only to the greater severity of symptoms, especially to dyspnea [...] Read more.
Augmented peripheral chemoreceptor sensitivity (PChS) is a common feature of many sympathetically mediated diseases, among others, and it is an important mechanism of the pathophysiology of heart failure (HF). It is related not only to the greater severity of symptoms, especially to dyspnea and lower exercise tolerance but also to a greater prevalence of complications and poor prognosis. The causes, mechanisms, and impact of the enhanced activity of peripheral chemoreceptors (PChR) in the HF population are subject to intense research. Several methodologies have been established and utilized to assess the PChR function. Each of them presents certain advantages and limitations. Furthermore, numerous factors could influence and modulate the response from PChR in studied subjects. Nevertheless, even with the impressive number of studies conducted in this field, there are still some gaps in knowledge that require further research. We performed a review of all clinical trials in HF human patients, in which the function of PChR was evaluated. This review provides an extensive synthesis of studies evaluating PChR function in the HF human population, including methods used, factors potentially influencing the results, and predictors of increased PChS. Full article
(This article belongs to the Special Issue Pathophysiology in the Failing Heart)
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