Cardiovascular and noncardiovascular comorbidities in patients with chronic heart failure

Metra, Marco; Zacà, Valerio; Parati, Gianfranco; Agostoni, Piergiuseppe; Bonadies, Maria; Ciccone, Marco Matteo; Dei, Alessandra; Iacoviello, Massimo; Lagioia, Rocco; Lombardi, Carolina; Maio, Raffaele; Magrì, Damiano; Musca, G; Padeletti, Margherita; Perticone, Francesco; Pezzali, Natalia; Piepoli, Massimo F; Sciacqua, Angela; Zanolla, Luisa; Nodari, Savina; Filardi, Pasquale Perrone; Dei, Livio

doi:10.2459/jcm.0b013e32834058d1

Cited by 68 publications

(49 citation statements)

References 94 publications

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“…According to this classification, the development of renal dysfunction in the setting of acute HF leads to type I CRS (acute CRS). This condition occurs in 30 to 60% of the patients admitted for acute decompensated HF and identifies a subgroup of patients with worse prognosis [3,4]. Thus, acute CRS prevention and treatment might be considered among the main targets of acute HF management.…”

Section: Introductionmentioning

confidence: 99%

Can we prevent or treat renal dysfunction in acute heart failure?

et al. 2011

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Most patients with heart failure (HF) already have or develop renal dysfunction; this might contribute to their poor outcome. Current treatment for HF can also contribute to worsen renal function. High furosemide doses are traditionally associated with worsening renal function (WRF), but patients with fluid overload may benefit of aggressive fluid removal. Unfortunately, promising therapies like vasopressin antagonists and adenosine antagonists have not been demonstrated to improve outcomes. Likewise, correction of low renal blood flow through dopamine, inotropic agents, or vasodilators does not seem to be associated with a clear benefit. However, transient WRF associated with acute HF treatment may not necessarily portend a poor prognosis. In this review, we focus on the strategies to detect renal dysfunction in acute HF, the underlying pathophysiological mechanisms, and the potential treatments.

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Section: Introductionmentioning

confidence: 99%

Can we prevent or treat renal dysfunction in acute heart failure?

et al. 2011

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“…[1][2][3]6 Heart failure is highly prevalent (25 % in chronic heart failure and up to 40 % in acute heart failure) in patients with diabetes mellitus. Its prevalence is four-times higher than that of the general population, suggesting a pathogenetic role of diabetes in heart failure.…”

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confidence: 99%

Heart Failure in Patients with Diabetes Mellitus

Rosano

Vitale

Seferović

2017

Cardiac Failure Review

154

103

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Diabetes mellitus is highly prevalent amongst patients with heart failure, especially those with heart failure and preserved ejection fraction (HFpEF), and patients with the two conditions have a higher risk of mortality compared with patients without diabetes or heart failure.1-3 Diabetic patients have an increased risk of developing heart failure because of the abnormal cardiac handling of glucose and free fatty acids (FFAs), and because of the effect of the metabolic derangements of diabetes on the cardiovascular system. Furthermore, the metabolic risk of diabetes in heart failure is heightened by the effect of most anti-diabetic medications, as the use of certain anti-diabetic agents increase the risk of mortality and hospitalisation for heart failure both in patients with and without heart failure. 4 This effect may be related to a direct effect of the glucose-lowering molecules on the cardiovascular system and/or to a negative effect of excessive glucose lowering, since lenient glycaemic control with newer therapeutic agents has shown to reduce significantly mortality, morbidity and risk of developing heart failure in diabeticpatients with proven cardiovascular disease. 5A wealth of epidemiological evidence demonstrates that diabetes mellitus is independently associated with the risk of developing heart failure, with the risk increasing by more than twofold in men and by more than fivefold in women. [1][2][3]6 Heart failure is highly prevalent (25 % in chronic heart failure and up to 40 % in acute heart failure) in patients with diabetes mellitus. Its prevalence is four-times higher than that of the general population, suggesting a pathogenetic role of diabetes in heart failure. This pathogenetic role is also suggested by the fact that patients with diabetes and without heart failure have an increased risk of developing heart failure compared with a matched population (29 versus 18 %, respectively).In patients with diabetes mellitus, advanced age, duration of the disease, insulin use, presence of coronary artery disease and elevated serum creatinine are all independent risk factors for the development of heart failure. 7When the two diseases are considered individually, heart failure has a much poorer prognosis than diabetes mellitus, therefore heart failure has to be a priority for treatment in patients presenting with the two conditions, and the diabetic patient with heart failure should be managed by the heart failure team. This review will focus on the relationship between heart failure and type 2 diabetes mellitus. AbstractDiabetes and heart failure are closely related: patients with diabetes have an increased risk of developing heart failure and those with heart failure are at higher risk of developing diabetes. Furthermore, antidiabetic medications increase the risk of mortality and hospitalisation for heart failure in patients with and without pre-existing heart failure. When the two diseases are considered individually, heart failure has a much poorer prognosis than diabetes mellitus; therefore he...

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“…Paroxysmal nocturnal dyspnea and nycturia are frequently observed in HF patients and they can represent additional causes of sleep disruption significantly affecting sleep quality and duration in HF patients [16].…”

Section: Srbd and Hypertensionmentioning

confidence: 99%