Metabolic disorders in heart failure and cancer

Lena, Alessia; Coats, Andrew J.S.; Anker, Markus S.

doi:10.1002/ehf2.12389

Cited by 39 publications

(38 citation statements)

References 110 publications

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“…60,61,63,201 They were all shown to have a major impact on clinical presentation, response to treatment and outcomes. [202][203][204][205] , It is well-established that frailty has a key role in HF. The only exception are SGLT2 inhibitors whose administration to diabetic patients at high risk of CV events was associated with a lower rate of the primary outcomes and HF hospitalizations.…”

Section: Comorbiditiesmentioning

confidence: 99%

“…Losing muscle with or without weight loss impairs functional capacity, quality of life, and outcome to a larger extent than weight loss alone. [202][203][204][205] , It is well-established that frailty has a key role in HF. It is most commonly defined as meeting three out of five phenotypic criteria: low physical activity, unintentional weight loss, slow walking speed, weak grip strength, and/or exhaustion.…”

Section: Comorbiditiesmentioning

confidence: 99%

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Highlights in heart failure

et al. 2019

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Heart failure (HF) remains a major cause of mortality, morbidity, and poor quality of life. It is an area of active research. This article is aimed to give an update on recent advances in all aspects of this syndrome. Major changes occurred in drug treatment of HF with reduced ejection fraction (HFrEF). Sacubitril/valsartan is indicated as a substitute to ACEi/ARBs after PARADIGM-HF (hazard ratio [HR], 0.80; 95% confidence interval [CI], 0.73 to 0.87 for sacubitril/valsartan vs. enalapril for the primary endpoint and Wei, Lin and Weissfeld HR 0.79, 95% CI 0.71-0.89 for recurrent events). Its initiation was then shown as safe and potentially useful in studies in patients hospitalized for acute HF. More recently, DAPA-HF trial showed the beneficial effects of the sodium-glucose transporter type 2 (SGLT2) inhibitor dapaglifozin vs. placebo, added to optimal standard therapy [HR, 0.74; 95% CI, 0.65 to 0.85;0.74; 95% CI, 0.65 to 0.85 for the primary endpoint]. Trials with other SGLT 2 inhibitors and in other patients, such as those with HF with preserved ejection fraction (HFpEF) or with recent decompensation, are ongoing. Multiple studies showed the unfavourable prognostic significance of abnormalities in serum potassium levels. Potassium lowering agents may allow initiation and titration of mineralocorticoid antagonists in a larger proportion of patients. Meta-analyses suggest better outcomes with ferric carboxymaltose in patients with iron deficiency. Drugs effective in HFrEF may be useful also in HF with mid-range ejection fraction. Better diagnosis and phenotype characterization seem warranted in HF with preserved ejection fraction. These and other burning aspects of HFpEF research are summarized and reviewed in this article.A multiparametric approach is often proposed for risk stratification of HF patients. The prognostic accuracy of the metabolic exercise test data combined with cardiac and kidney indexes risk score was found as superior to the HF Survival Score and Seattle HF model risk scores in a cohort of 6112 1106 D. Tomasoni et al.

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Section: Comorbiditiesmentioning

confidence: 99%

Section: Comorbiditiesmentioning

confidence: 99%

Highlights in heart failure

et al. 2019

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“…2 These patients often suffer from multiple different co-morbidities that may develop as consequences from anti-cancer therapies. Frequent problems include, but are not limited to, chronic kidney disease, 3,4 liver dysfunction, 5,6 gastrointestinal disease, 7,8 anaemia, 9,10 fatigue, 11,12 infections, 13,14 anorexia 15,16 , muscle wasting, 17,18 pain, 19,20 and heart failure (HF). 21,22 Depending on the cancer diagnosis and the type of anti-cancer treatment, cardiotoxicity rates may vary from 0% to 48% of patients, with HF being a predominant presentation.…”

Section: Introductionmentioning

confidence: 99%

Recent advances in cardio‐oncology: a report from the ‘Heart Failure Association 2019 and World Congress on Acute Heart Failure 2019’

et al. 2019

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While anti-cancer therapies, including chemotherapy, immunotherapy, radiotherapy, and targeted therapy, are constantly advancing, cardiovascular toxicity has become a major challenge for cardiologists and oncologists. This has led to an increasing demand of cardio-oncology units in Europe and a growing interest of clinicians and researchers. The Heart Failure 2019 meeting of the Heart Failure Association of the European Society of Cardiology in Athens has therefore created a scientific programme that included four dedicated sessions on the topic along with several additional lectures. The major points that were discussed at the congress included the implementation and delivery of a cardio-oncology service, the collaboration among cardio-oncology experts, and the risk stratification, prevention, and early recognition of cardiotoxicity. Furthermore, sessions addressed the numerous different anti-cancer therapies associated with cardiotoxic effects and provided guidance on how to treat cancer patients who develop cardiovascular disease before, during, and after treatment.

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“…Heart failure and cancer share many common risk factors (e.g. obesity and smoking), many common symptoms (dyspnoea, fatigue, oedema, weight loss) and many similar complications, including depression, anaemia, iron deficiency and cachexia . Cancer and its treatment may cause heart failure or aggravate pre‐existing cardiac dysfunction.…”

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confidence: 99%

“…obesity and smoking), many common symptoms (dyspnoea, fatigue, oedema, weight loss) and many similar complications, including depression, anaemia, iron deficiency and cachexia. 6 Cancer and its treatment may cause heart failure or aggravate pre-existing cardiac dysfunction. There may also be biological mechanisms by which heart failure enhances tumour growth, 7 whilst clonal haematopoiesis of indeterminate potential (CHIP) provides a common stem for the development of heart failure and cancer.…”

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confidence: 99%