Current Insights and Future Directions in the Treatment of Heart Failure with Preserved Ejection Fraction

Chiorescu, Roxana Mihaela; Lazar, Roxana-Daiana; Ruda, Alexandru; Buda, Andreea Paula; Chiorescu, Stefan; Mocan, Mihaela; Blendea, Dan

doi:10.3390/ijms25010440

Cited by 3 publications

References 90 publications

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Diagnostic and prognostic value of microRNA423-5p in patients with heart failure

Guo,

Zhou,

Huang

et al. 2024

J Cardiothorac Surg

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Objectives MicroRNAs are considered as a class of potential biomarkers for HF. This study aimed to retrospectively evaluate the diagnostic and prognostic value of microRNA423-5p in patients with HF. Methods The observational group comprised 98 patients diagnosed with HF due to coronary atherosclerotic heart disease ( n = 45), hypertension ( n = 26), or cardiac valve insufficiency ( n = 27). Conversely, the control group consisted of 30 healthy volunteers without any history of HF. These patients were further classified into heart function class II ( n = 33), class III ( n = 32), and class IV ( n = 33) according to the NYHA classification. Of these patients, 33 were diagnosed with HF with mid-range ejection fraction (HFmrEF) and the remaining 65 with HF with reduced ejection fraction (HFrEF). The diagnostic and prognostic significance of microRNA423-5p in patients with HF was assessed through laboratory parameter assessments (microRNA423-5p and B-type natriuretic peptide test, BNP), cardiac ultrasound evaluations (left ventricular ejection fraction, LVEF), and subsequent follow-up assessments. Results In this study, we found that patients with HF exhibited notably elevated levels of microRNA423-5p and BNP, as well as significantly lower LVEF values. A significant positive correlation between microRNA423-5p and BNP indicators was validated. In addition, our study also revealed an elevation in the level of microRNA423-5p correlating with the progression of the HF. The combined evaluation of LEVF, BNP, and microRNA423-5p demonstrated superior diagnostic efficacy in comparison to the solitary use of BNP. Conclusions Elevated levels of microRNA423-5p in the serum of patients with HF suggest its potential utility as a novel biomarker for both the diagnosis and prognosis of this condition.

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Diagnostic and prognostic value of microRNA423-5p in patients with heart failure

Guo,

Zhou,

Huang

et al. 2024

J Cardiothorac Surg

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Diagnostic and prognostic value of microRNA423-5p in patients with heart failure

Guo,

Zhou,

Huang

et al. 2024

Preprint

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Objectives MicroRNAs are considered as a class of potential biomarkers for heart failure. This study aimed to retrospectively evaluate the diagnostic and prognostic value of microRNA423-5p in patients with heart failure. Methods A total of 98 patients diagnosed with heart failure were enrolled in the observation group, while 30 healthy volunteers without heart failure were enrolled for the control group. The prognostic significance of microRNA423-5p in patients with heart failure was assessed through laboratory parameter assessments, cardiac ultrasound evaluations, and subsequent follow-up assessments. Results In comparison to the control group, the observation group exhibited notably elevated levels of microRNA423-5p and BNP, as well as significantly lower left ventricular ejection fraction (LVEF) values (P < 0.05). Additionally, within the observation group, a positive correlation was observed between higher heart function ratings and increased levels of microRNA423-5p and B-type natriuretic peptide (BNP), along with a more pronounced decrease in LVEF values (P < 0.05). Spearman correlation analysis revealed a significant positive correlation between microRNA423-5p and BNP indicators (rs = 0.850, P < 0.001). The observation group was monitored for a period of one year, with hospitalization due to recurrent heart failure or all-cause mortality serving as the designated follow-up endpoint. The event group exhibited elevated levels of microRNA423-5p and BNP, along with a decreased LVEF (P < 0.05). The ROC curve analysis indicated that both microRNA423-5p + BNP + LVEF and microRNA423-5p + BNP exhibited strong predictive capabilities, with respective areas under the curve of 0.839 and 0.814. Conclusions Elevated levels of microRNA423-5p in the serum of patients with heart failure suggest its potential utility as a novel biomarker for both the diagnosis and prognosis of this condition.

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Metabolic Consequences of Advanced Chronic Heart Failure and its Modification by Implantation of a Durable Left Ventricular Assist Device

Hlaváček,

Haluzík,

Mahrík

et al. 2024

Rev. Cardiovasc. Med.

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Heart failure (HF) is a clinical syndrome characterized by the inability of the heart to provide adequate perfusion to tissues and organs, resulting in typical symptoms such as fatigue, dyspnea, dyspepsia, or swelling due to decreased cardiac output. With its increasing prevalence, heart failure has become one of the leading causes of morbidity and mortality worldwide, imposing a significant burden on the population by reducing long-term life expectancy and raising hospital costs. Indeed, over 20 million people worldwide suffer from heart failure, with a 5-year mortality rate of 60–70%. As heart failure progresses, various structural and metabolic changes occur within the myocardium and organ systems. In the past two decades, therapeutic options for heart failure patients have significantly expanded. In addition to novel pharmacological treatment, advanced surgical methods such as heart transplantation (HTx) and the implantation of durable left ventricular assist devices (LVADs) are available for patients with end-stage heart failure. This review discusses the pathophysiological aspects and metabolic consequences of heart failure and metabolic changes, as well as the benefits and challenges of implanting a left ventricular assist device. Furthermore, future targets for heart failure diagnostics and therapy will be highlighted.

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Current Insights and Future Directions in the Treatment of Heart Failure with Preserved Ejection Fraction

Cited by 3 publications

References 90 publications

Diagnostic and prognostic value of microRNA423-5p in patients with heart failure

Diagnostic and prognostic value of microRNA423-5p in patients with heart failure

Diagnostic and prognostic value of microRNA423-5p in patients with heart failure

Metabolic Consequences of Advanced Chronic Heart Failure and its Modification by Implantation of a Durable Left Ventricular Assist Device

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