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Heart Failure and Its Complications: Advances in Clinical Diagnosis and...
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Heart Failure and Its Complications: Advances in Clinical Diagnosis and Management

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Cardiology".

Deadline for manuscript submissions: 30 September 2024 | Viewed by 3052

Special Issue Editor

Dr. Michael J. Bonios

E-Mail Website
Guest Editor
Heart Failure and Transplant Units, Onassis Cardiac Surgery Center, 17674 Athens, Greece
Interests: heart failure; complications; arrhythmias; pharmacological therapy; devices; mechanical circulatory support
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Heart failure is a complex syndrome that progresses through various stages, each presenting its own unique challenges. As the disease advances, the risk of complications such as pump failure, arrhythmias, thromboembolic events, and infections increases. Fortunately, advancements in the therapeutic armamentarium against heart failure have provided more effective medical therapies and novel diagnostic and treatment devices that cater to both early and advanced stages of the condition. However, it is important to acknowledge that both medical and device therapies are accompanied by side effects and complications that can significantly impact patient outcomes.

In light of these considerations, we invite you to contribute original articles to this Special Issue entitled, "Heart Failure and Its Complications: Advances in Clinical Diagnosis and Management". The research areas for exploration may include, but are not limited to:

  • Evaluation of medical therapy and its associated side effects;
  • Investigation of arrhythmias, infections, and thromboembolic events in heart failure patients;
  • Assessment of complications related to implantable cardioverter defibrillators and cardiac resynchronization device therapy;
  • Complications in patients with cardiogenic shock and temporary mechanical circulatory devices;
  • Durable mechanical circulatory support devices and their complications;
  • Study of heart failure and its correlation with cachexia, cognitive impairment, anxiety, and depression.

We look forward to receiving your contributions.

Dr. Michael J. Bonios
Guest Editor

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. Journal of Clinical Medicine 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.

Keywords

  • heart failure
  • complications
  • arrhythmias
  • pharmacological therapy
  • devices
  • mechanical circulatory support

Published Papers (3 papers)

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Research

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11 pages, 968 KiB  
Article
Prognostic Impact of the UMIPIC Program in the Follow Up in Patients with Heart Failure and Cardiorenal Syndrome
by Manuel Méndez-Bailón, Noel Lorenzo-Villalba, Álvaro González-Franco, Luis Manzano, Jesús Casado-Cerrada, José M. Cerqueiro, José Pérez-Silvestre, José Carlos Arévalo-Lorido, Alicia Conde-Martel, Melitón Francisco Dávila-Ramos, Margarita Carrera-Izquierdo, Emmanuel Andrès and Manuel Montero-Pérez-Barquero
J. Clin. Med. 2023, 12(23), 7261; https://doi.org/10.3390/jcm12237261 - 23 Nov 2023
Viewed by 662
Abstract
Background: Individuals suffering from heart failure (HF) and cardiorenal syndrome (CRS) represent a special group of patients considering their age, multiple health issues, and treatment challenges. These factors make them more susceptible to frequent hospital stays and a higher mortality rate. UMIPIC is [...] Read more.
Background: Individuals suffering from heart failure (HF) and cardiorenal syndrome (CRS) represent a special group of patients considering their age, multiple health issues, and treatment challenges. These factors make them more susceptible to frequent hospital stays and a higher mortality rate. UMIPIC is a multidisciplinary care model program for patients with heart failure follow up provided by internists and nurses who are experts in this entity. Our study delved into the effectiveness of this specialized care program (UMIPIC) in mitigating these risks for HF and CRS patients. Methods: We analyzed the medical records of 3255 patients diagnosed with HF and CRS types 2 and 4, sourced from the RICA registry. These patients were divided into two distinct groups: those enrolled in the UMIPIC program (1205 patients) and those under standard care (2050 patients). Using propensity score matching, we ensured that both groups were comparable. The study focused on tracking hospital admissions and mortality rates for one year after an HF-related hospital stay. Results: Patients in the UMIPIC group experienced fewer hospital readmissions due to HF compared to their counterparts (20% vs. 32%; Hazard Ratio [HR] = 0.48; 95% Confidence Interval [95% CI]: 0.40–0.57; p < 0.001). They also showed a lower mortality rate (24% vs. 36%; HR = 0.64; 95% CI: 0.54–0.75; p < 0.001). Furthermore, the UMIPIC group had fewer total hospital admissions (36% vs. 47%; HR = 0.58; 95% CI: 0.51–0.66; p < 0.001). Conclusions: The UMIPIC program, centered on holistic and ongoing care, effectively reduces both hospital admissions and mortality rates for HF and CRS patients after a one-year follow-up period. Full article
(This article belongs to the Special Issue Heart Failure and Its Complications: Advances in Clinical Diagnosis and Management)
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Review

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12 pages, 1481 KiB  
Review
Unlocking the Potential of Acetazolamide: A Literature Review of an Adjunctive Approach in Heart Failure Management
by Michael Sabina, Zein Barakat, Adrian Feliciano, Andrew Lamb and M Mrhaf Alsamman
J. Clin. Med. 2024, 13(1), 288; https://doi.org/10.3390/jcm13010288 - 04 Jan 2024
Viewed by 1280
Abstract
Background: Heart failure (HF) patients often experience persistent fluid overload despite standard diuretic therapy. The adjunctive use of acetazolamide, a carbonic anhydrase inhibitor, in combination with loop diuretics has shown promise in improving decongestion and diuretic efficacy. This literature review aims to analyze [...] Read more.
Background: Heart failure (HF) patients often experience persistent fluid overload despite standard diuretic therapy. The adjunctive use of acetazolamide, a carbonic anhydrase inhibitor, in combination with loop diuretics has shown promise in improving decongestion and diuretic efficacy. This literature review aims to analyze six studies evaluating the effectiveness of acetazolamide as an additive treatment for acute decompensated heart failure (ADHF) and its impact on various outcomes. Methods: We searched the PubMed database using the terms “acetazolamide heart failure”. We refined our search with specific filters (as shown our PRISMA flow diagram) and exclusion criteria, narrowing down our results to five studies. We included an extra study via expert recommendation, ultimately including six studies for comprehensive analysis. Results: The review highlights the positive effects of acetazolamide on decongestion, natriuresis, and diuresis in HF patients. However, it also showcases the limitations of these trials. Discussion: While the reviewed studies demonstrate the potential benefits of acetazolamide in enhancing decongestion and diuretic efficiency, there are limitations to consider, including small sample sizes, lack of blinding, and limited external validity. Further research is needed to confirm these findings, compare acetazolamide with other diuretic combinations, and explore its effects in a broader population of heart failure patients, including those in the United States. The use of acetazolamide in HF management warrants continued investigation to optimize its role in improving decongestion and patient outcomes. Full article
(This article belongs to the Special Issue Heart Failure and Its Complications: Advances in Clinical Diagnosis and Management)
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Other

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14 pages, 5016 KiB  
Systematic Review
The Efficacy and Safety of Sacubitril/Valsartan Compared to Valsartan in Patients with Heart Failure and Mildly Reduced and Preserved Ejection Fractions: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
by Sharath Kommu and Richard L. Berg
J. Clin. Med. 2024, 13(6), 1572; https://doi.org/10.3390/jcm13061572 - 09 Mar 2024
Viewed by 742
Abstract
Background: Sacubitril/valsartan improves heart failure (HF) outcomes in patients with heart failure with reduced ejection fraction (HFrEF). However, randomized controlled trials (RCTs) in patients with heart failure and mildly reduced ejection fraction (HFmrEF) and heart failure with preserved ejection fraction (HFpEF) have [...] Read more.
Background: Sacubitril/valsartan improves heart failure (HF) outcomes in patients with heart failure with reduced ejection fraction (HFrEF). However, randomized controlled trials (RCTs) in patients with heart failure and mildly reduced ejection fraction (HFmrEF) and heart failure with preserved ejection fraction (HFpEF) have shown inconsistent results. We conducted this meta-analysis to comprehensively evaluate the efficacy and safety of sacubitril/valsartan compared to valsartan within this specific patient population. Methods: We searched the MEDLINE database and ClinicalTrials.gov and identified four RCTs that could be included in our analysis, with 3375 patients in the sacubitril/valsartan group and 3362 in the valsartan group. Results: Our study shows that, in patients with HFmrEF and HFpEF, sacubitril/valsartan was superior to valsartan in some of the key HF outcomes, such as the Kansas City Cardiomyopathy Questionnaire Clinical Summary Score (KCCQ CSS), with a small but significant mean difference of 1.13 (95% confidence interval or CI of 0.15 to 2.11, p-value 0.024), an improvement in the New York Heart Association (NYHA) class (odds ratio or OR of 1.32, 95% CI 1.11 to 1.58, p-value 0.002), and the composite outcome of hospitalizations for HF and cardiovascular death, with a relative risk (RR) of 0.86 (95% CI 0.75 to 0.99, p-value 0.04). However, there was no additional benefit with sacubitril/valsartan compared to valsartan for the outcomes of cardiovascular death and all-cause mortality. In terms of side effects, sacubitril/valsartan was associated with a higher risk of hypotension when compared to valsartan (OR 1.67, 95% CI 1.27 to 2.19, p-value < 0.0001), but did not show an increased risk of hyperkalemia or worsening renal function. Conclusions: In individuals with HFmrEF or HFpEF, sacubitril/valsartan can result in improvements in the HF outcomes of the KCCQ CSS, the NYHA class, and the composite outcome of hospitalization for HF and cardiovascular death when compared to valsartan. While there was a higher risk of hypotension with sacubitril/valsartan compared to valsartan, there was no corresponding increase in the risk of hyperkalemia or worsening renal function. Full article
(This article belongs to the Special Issue Heart Failure and Its Complications: Advances in Clinical Diagnosis and Management)
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