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Diagnostics
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Advances and Challenges in Diagnosis and Management of Heart Failure
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Advances and Challenges in Diagnosis and Management of Heart Failure

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Pathology and Molecular Diagnostics".

Deadline for manuscript submissions: closed (31 July 2023) | Viewed by 4099

Special Issue Editors

Prof. Dr. Inna P. Gladysheva

E-Mail Website
Guest Editor
Department of Internal Medicine, University of Arizona College of Medicine–Phoenix, Phoenix, AZ 85004, USA
Interests: molecular and pathophysiologic mechanisms of cardiomyopathy; heart failure and concurrent complications
Special Issues, Collections and Topics in MDPI journals
Dr. Ryan D. Sullivan

E-Mail Website
Guest Editor
Department of Internal Medicine, University of Arizona College of Medicine – Phoenix, Phoenix, AZ 85004, USA
Interests: cardiovascular imaging; cardiomyopathy; thrombosis; heart failure; translational models
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Despite improved therapies and advancements in diagnostics, heart failure prevalence continues to rise globally and remains an irreversible condition that may require heart transplantation or mechanical circulatory sup­port. This Special Issue aims to address the challenges and recent advances of diagnostics, pharmacologic therapies, and prevention of heart failure with reduced, middle range, and preserved ejection fraction and associated comorbidities. We are also interested in the mechanistical understanding of heart failure progression and new therapeutic targets.

Special interests:

  • HF with reduced, middle-range, preserved, and improved ejection fraction;
  • Precision medicine to personalize care;
  • Epidemiology and causes of heart failure;
  • Cardiac imaging;
  • Role of biomarkers;
  • Genetic cardiomyopathy;
  • Cardiac remodeling and fibrosis;
  • Decongestion strategies;
  • Dietary sodium restriction;
  • Pharmacological treatment for different stages of heart failure progression (at risk for HF; pre-HF, HF, advanced HF);
  • Comorbidities: mechanisms and management;
  • Sex differences.

This Special Issue follows a past and very successful collection on “Diagnosis and Management of Heart Failure” (https://www.mdpi.com/journal/diagnostics/special_issues/Heart_Failure_Diagnosis). Contributions from clinical and translational research on innovative concepts in diagnosis, mechanisms, and management of heart failure are welcomed. Authors can submit original articles, reviews, or short communications.

Prof. Dr. Inna P. Gladysheva
Dr. Ryan D. Sullivan
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

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. Diagnostics 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 2600 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.

Published Papers (3 papers)

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Research

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10 pages, 823 KiB  
Article
Pulmonary Artery Systolic Pressure and Cava Vein Status in Acute Heart Failure with Preserved Ejection Fraction: Clinical and Prognostic Implications
by Gaetano Ruocco, Filippo Pirrotta, Christian Mingiano, Guido Cavati, Cristina Tavera and Alberto Palazzuoli
Diagnostics 2023, 13(4), 692; https://doi.org/10.3390/diagnostics13040692 - 12 Feb 2023
Viewed by 1143
Abstract
Background: Peak tricuspid regurgitation (TR) velocity and inferior cava vein (ICV) distention are two recognized features of increased pulmonary artery pressure (PASP) and right atrial pressure, respectively. Both parameters are related to pulmonary and systemic congestion and adverse outcomes. However, few data exist [...] Read more.
Background: Peak tricuspid regurgitation (TR) velocity and inferior cava vein (ICV) distention are two recognized features of increased pulmonary artery pressure (PASP) and right atrial pressure, respectively. Both parameters are related to pulmonary and systemic congestion and adverse outcomes. However, few data exist about the assessment of PASP and ICV in acute patients affected by heart failure with preserved ejection fraction (HFpEF). Thus, we investigated the relationship existing among clinical and echocardiographic features of congestion, and we analyzed the prognostic impact of PASP and ICV in acute HFpEF patients. Methods and Results: We analyzed clinical congestion PASP and ICV value in consecutive patients admitted in our ward by echocardiographic examination using peak Doppler velocity tricuspid regurgitation and ICV diameter and collapse for the assessment of PASP and ICV dimension, respectively. A total of 173 HFpEF patients were included in the analysis. The median age was 81 and median left ventricular ejection fraction (LVEF) was 55% [50–57]. Mean values of PASP was 45 mmHg [35–55] and mean ICV was 22 [20–24] mm. Patients with adverse events during follow-up showed significantly higher values of PASP (50 [35–55] vs. 40 [35–48] mmHg, (p = 0.005) and increased values of ICV (24 [22–25] vs. 22 [20–23] mm, p < 0.001). Multivariable analysis showed prognostic power of ICV dilatation (HR 3.22 [1.58–6.55], p = 0.001) and clinical congestion score ≥ 2 (HR 2.35 [1.12–4.93], p = 0.023), but PASP increase did not reach statistical significance (p = 0.874). The combination of PASP > 40 mmHg and ICV > 21 mm was capable of identifying patients with increased events (45% vs. 20%). Conclusions: ICV dilatation provides additional prognostic information with respect to PASP in patients with acute HFpEF. A combined model adding PASP and ICV assessment to clinical evaluation is a useful tool for predicting HF related events. Full article
(This article belongs to the Special Issue Advances and Challenges in Diagnosis and Management of Heart Failure)
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14 pages, 2984 KiB  
Article
Left Ventricle Wall Motion Analysis with Real-Time MRI Feature Tracking in Heart Failure Patients: A Pilot Study
by Yu (Yulee) Li, Jason Craft, Yang (Josh) Cheng, Kathleen Gliganic, William Schapiro and Jie (Jane) Cao
Diagnostics 2022, 12(12), 2946; https://doi.org/10.3390/diagnostics12122946 - 25 Nov 2022
Viewed by 1183
Abstract
Volumetric measurements with cardiac magnetic resonance imaging (MRI) are effective for evaluating heart failure (HF) with systolic dysfunction that typically induces a lower ejection fraction (EF) than normal (<50%) while they are not sensitive to diastolic dysfunction in HF patients with preserved EF [...] Read more.
Volumetric measurements with cardiac magnetic resonance imaging (MRI) are effective for evaluating heart failure (HF) with systolic dysfunction that typically induces a lower ejection fraction (EF) than normal (<50%) while they are not sensitive to diastolic dysfunction in HF patients with preserved EF (≥50%). This work is to investigate whether HF evaluation with cardiac MRI can be improved with real-time MRI feature tracking. In a cardiac MRI study, we recruited 16 healthy volunteers, 8 HF patients with EF < 50% and 10 HF patients with preserved EF. Using real-time feature tracking, a cardiac MRI index, torsion correlation, was calculated which evaluated the correlation of torsional and radial wall motion in the left ventricle (LV) over a series of sequential cardiac cycles. The HF patients with preserved EF and the healthy volunteers presented significant difference in torsion correlation (one-way ANOVA, p < 0.001). In the scatter plots of EF against torsion correlation, the HF patients with EF < 50%, the HF patients with preserved EF and the healthy volunteers were well differentiated, indicating that real-time MRI feature tracking provided LV function assessment complementary to volumetric measurements. This study demonstrated the potential of cardiac MRI for evaluating both systolic and diastolic dysfunction in HF patients. Full article
(This article belongs to the Special Issue Advances and Challenges in Diagnosis and Management of Heart Failure)
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Review

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15 pages, 7207 KiB  
Review
New Non-Invasive Imaging Technologies in Cardiac Transplant Follow-Up: Acquired Evidence and Future Options
by Valeria Pergola, Giulia Mattesi, Elena Cozza, Nicola Pradegan, Chiara Tessari, Carlo Maria Dellino, Maria Teresa Savo, Filippo Amato, Annagrazia Cecere, Martina Perazzolo Marra, Francesco Tona, Andrea Igoren Guaricci, Giorgio De Conti, Gino Gerosa, Sabino Iliceto and Raffaella Motta
Diagnostics 2023, 13(17), 2818; https://doi.org/10.3390/diagnostics13172818 - 31 Aug 2023
Cited by 2 | Viewed by 1290
Abstract
Heart transplantation (HT) is the established treatment for end-stage heart failure, significantly enhancing patients’ survival and quality of life. To ensure optimal outcomes, the routine monitoring of HT recipients is paramount. While existing guidelines offer guidance on a blend of invasive and non-invasive [...] Read more.
Heart transplantation (HT) is the established treatment for end-stage heart failure, significantly enhancing patients’ survival and quality of life. To ensure optimal outcomes, the routine monitoring of HT recipients is paramount. While existing guidelines offer guidance on a blend of invasive and non-invasive imaging techniques, certain aspects such as the timing of echocardiographic assessments and the role of echocardiography or cardiac magnetic resonance (CMR) as alternatives to serial endomyocardial biopsies (EMBs) for rejection monitoring are not specifically outlined in the guidelines. Furthermore, invasive coronary angiography (ICA) is still recommended as the gold-standard procedure, usually performed one year after surgery and every two years thereafter. This review focuses on recent advancements in non-invasive and contrast-saving imaging techniques that have been investigated for HT patients. The aim of the manuscript is to identify imaging modalities that may potentially replace or reduce the need for invasive procedures such as ICA and EMB, considering their respective advantages and disadvantages. We emphasize the transformative potential of non-invasive techniques in elevating patient care. Advanced echocardiography techniques, including strain imaging and tissue Doppler imaging, offer enhanced insights into cardiac function, while CMR, through its multi-parametric mapping techniques, such as T1 and T2 mapping, allows for the non-invasive assessment of inflammation and tissue characterization. Cardiac computed tomography (CCT), particularly with its ability to evaluate coronary artery disease and assess graft vasculopathy, emerges as an integral tool in the follow-up of HT patients. Recent studies have highlighted the potential of nuclear myocardial perfusion imaging, including myocardial blood flow quantification, as a non-invasive method for diagnosing and prognosticating CAV. These advanced imaging approaches hold promise in mitigating the need for invasive procedures like ICA and EMB when evaluating the benefits and limitations of each modality. Full article
(This article belongs to the Special Issue Advances and Challenges in Diagnosis and Management of Heart Failure)
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