Is vascular remodelling in patients with chronic heart failure exaggerated?

Pietschner, Robert; Bosch, Aida; Kannenkeril, Dennis; Striepe, Kristina; Schiffer, Mario; Achenbach, Stephan; Schmieder, Roland E.; Kolwelter, Julie

doi:10.1002/ehf2.14174

Cited by 6 publications

(2 citation statements)

References 34 publications

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“…Importantly, CNV-seq and ES revealed genetic abnormalities in almost 1/3 of foetal CHD cases suggesting that these methods can significantly advance diagnostic efforts, and thus, they will probably provide clinically relevant information for pregnancy management in the future. 55 Besides genetic predispositions, epigenetic factors are considered to be detrimental during the course of HF specific myocardial remodelling via cardiomyocyte loss, interstitial fibrosis, vascular remodelling, 56 and for both the left and the right ventricles. 57 Short non-coding RNA molecules, called microRNAs (miRNAs) have the potential to regulate gene expression at the post-transcriptional level and thereby to contribute to the HF specific phenotype.…”

Section: Preclinical and Translational Investigationsmentioning

confidence: 99%

“…Besides genetic predispositions, epigenetic factors are considered to be detrimental during the course of HF specific myocardial remodelling via cardiomyocyte loss, interstitial fibrosis, vascular remodelling, 56 and for both the left and the right ventricles 57 . Short non‐coding RNA molecules, called microRNAs (miRNAs) have the potential to regulate gene expression at the post‐transcriptional level and thereby to contribute to the HF specific phenotype.…”

Section: Preclinical and Translational Investigationsmentioning

confidence: 99%

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Editors' highlight picks from 2023 in ESC heart failure

Bäck,

von Haehling,

Papp

et al. 2024

ESC Heart Failure

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Heart failure is a devastating syndrome affecting an increasingly high number of patients worldwide. Its aetiology and pathogenesis are complex with the involvement of factors ranging from the genetic material through valvular dysfunctions to numerous organs beyond the entire cardiovascular system. Based on continuous efforts of the heart failure scientific community we have witnessed major advances in many related disciplines during the last year. For example, epidemiological aspects—paving the road for improved risk prevention—have been thoroughly analysed for various geographical regions. Additionally, evidence‐based approaches now allow the introduction of novel guideline recommended medical therapies (i.e. sodium‐glucose transporter 2 inhibitors, and iron supplementation) while basic and translational research aim to explore additional molecular targets for future heart failure diagnostics and medications. All above aspects are addressed in this article, where a selection of articles published in the ESC Heart Failure journal in 2023 are highlighted. The editors are confident that the scientific contributions of ESC Heart Failure effectively served a highly relevant area of cardiovascular research last year.

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Section: Preclinical and Translational Investigationsmentioning

confidence: 99%

Section: Preclinical and Translational Investigationsmentioning

confidence: 99%

Editors' highlight picks from 2023 in ESC heart failure

Bäck,

von Haehling,

Papp

et al. 2024

ESC Heart Failure

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Is vascular remodelling in patients with chronic heart failure exaggerated?

et al. 2022

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Background Vascular remodelling of large arteries increases afterload of the left ventricle. The aim of this study was to analyse whether vascular remodelling and function under laboratory and 24‐hour ambulatory conditions is impaired in patients with chronic heart failure (CHF) independently of cardiovascular risk factors. Methods and results In this monocentric cross‐sectional observational study, 105 patients with CHF and an ejection fraction ≤49% (CHF+) were compared to 118 subjects without CHF (CHF−). After adjustment for age, gender, arterial hypertension, hyperlipidaemia, type 2 diabetes, obesity and smoking, vascular function and structure parameters, as assessed by pulse wave analysis (SphygmoCor) and the UNEX EF device, respectively, between the CHF+ and the CHF− group differed for resting pulse wave velocity (PWV) ( P = 0.010), 24‐h ambulatory PWV ( P = 0.011), central systolic blood pressure (cSBP) ( P = <0.001), 24‐h ambulatory cSBP ( P = <0.001), resting central augmentation index ( P = 0.002), and brachial intima–media thickness ( P = 0.022). In CHF+ patients, higher levels of NT‐proBNP, taken as a marker for the severity of CHF, were related to a higher PWV ( r = 0.340, P = <0.001), a higher cSBP (r = 0.292, P = 0.005), and a trend to higher central pulse pressure (cPP) ( r = 0.198, P = 0.058), higher 24‐h brachial PP ( r = 0.322, P = 0.002), and 24‐h total peripheral resistance ( s = 0.227, P = 0.041) after full adjustment for covariates. Conclusions In CHF+ patients we observed augmented vascular remodelling and functional impairment compared with CHF− patients independently of cardiovascular risk factors, age, and gender, and the extent of vascular remodelling and impairment was related to the severity of CHF.

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Central blood pressure and arterial stiffness in patients admitted with acute decompensated heart failure

Zenkina,

Troitskaya,

Kobalava

et al. 2024

Arter. gipertenz.

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Objective. To evaluate central systolic blood pressure (cSBP) and arterial stiffness (AS) in patients admitted with acute decompensated heart failure (ADHF) according to different phenotypes of ejection fraction (EF) and to assess their changes after 6 months of stable guideline-directed medical therapy. Design and methods. In 54 patients (61% males, median age 69,5 (62; 77) years, median EF 51% (interquartile range (IQR) 38; 55%), median N-terminal pro-B-type natriuretic peptide (NTproBNP) 623 (500; 1842) pg/ml; heart failure (HF) with reduced EF in 37%, HF with mildly reduced EF in 13%, HF with preserved EF in 50%), apart from routine tests, we assessed cSBP and AS with applanation tonometry (SphygmoCor). cSBP above individual reference values, central pulse pressure (PP) ≥ 50 mmHg, carotid-femoral pulse wave velocity (cfPWV) > 10 m/s, cfPWV above individual reference values, and aortic-brachial stiffness mismatch (stiffness gradient as cfPWV/carotid-radial (cr)PWV) ≥ 1) were considered abnormal. The statistical analysis was performed in the groups with EF ≥ 50% and < 50% р < 0,05 was considered significant. Results. Brachial systolic blood pressure (bSBP) in the whole group was 117 (106; 130) mmHg; cSBP 109,5 (96; 120) mmHg. Uncontrolled blood pressure was observed in 40%, hypotension — in 3%. There were no differences between groups according to EF. cSBP elevation was observed in 33% (28,5% in EF ≥ 50% and 38,4% in EF < 50%; р > 0,05), and in 27,1% with normal bSBP. There were no significant differences in AS parameters between groups according to EF. Elevation of at least 1 marker of AS was present in 78,5%, cfPWV > 10 ms — in 50%, cfPWV above individual reference values— in 55,5%, central PP ≥ 50 mmHg — in 16,6%, high AS gradient — in 70,3%. Abnormal AS gradient was observed in 48,1% of patients with normal cfPWV. Patients with more severe congestion according to bioimpedance vector analysis (BIVA) had lower cfPWV compared to less severe congestion: 9 (6,7; 10,2) vs 11,6 (6,9; 15,1) m/s, р = 0,04. There was significant correlation between the amount of extracellular fluid by BIVA and cfPWV (r = –0,36, p < 0,05). There was significant increase in cSBP, PP, cfPWV and augmentation index and decrease in PP amplification in the whole group after 6 months. Conclusions. Patients admitted with ADHF have high frequency of cSBP elevation regardless of EF and blood pressure control. The most common marker of AS increase was cfPWV elevation above individual reference values and abnormal stiffness gradient. Patients with less congestion by BIVA had higher cfPWV. After 6 months there was increase in cSBP and parameters of AS.

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Is vascular remodelling in patients with chronic heart failure exaggerated?

Cited by 6 publications

References 34 publications

Editors' highlight picks from 2023 in ESC heart failure

Editors' highlight picks from 2023 in ESC heart failure

Is vascular remodelling in patients with chronic heart failure exaggerated?

Central blood pressure and arterial stiffness in patients admitted with acute decompensated heart failure

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