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Biomedicines
Special Issues
Heart Failure: New Diagnostic and Therapeutic Approaches
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Heart Failure: New Diagnostic and Therapeutic Approaches

A special issue of Biomedicines (ISSN 2227-9059). This special issue belongs to the section "Molecular and Translational Medicine".

Deadline for manuscript submissions: 28 February 2025 | Viewed by 5828

Special Issue Editor

Dr. Anand Prakash Singh

E-Mail Website
Guest Editor
Institute for Heart and Brain Health, University of Michigan, Ann Arbor, MI 48109, USA
Interests: cardiotoxicity; cardio oncology; heart failure; pharmacovigilance; targeted therapy; protein kinase inhibitors; cardiac inflammation; immune checkpoint inhibitors; cell junctions

Special Issue Information

Dear Colleagues,

Heart failure is a complex disease that is influenced by several causes and sophisticated pathophysiological pathways. Regrettably, its occurrence is steadily increasing in a concerning manner. Effective therapy of this condition relies heavily on existing treatments. However, the situation has changed, making traditional procedures insufficient. To effectively manage and reduce the impact of heart failure, a comprehensive and interdisciplinary approach is required, which includes addressing multiple aspects of the condition. The advancement of heart failure therapy involves investigating unexplored areas, such as molecular, cellular, biomaterial, and genetic pathways, in order to develop more efficient treatments. However, achieving a comprehensive therapy regimen requires conducting thorough and high-quality basic research and clinical investigations. These efforts not only confirm the safety and effectiveness of proposed treatments but also establish a stronger and more dependable method for addressing this difficult condition. In this Special Issue, we are seeking basic and translational studies providing rationale for new treatments for heart failure. This Special Issue will also consider studies showing the potential cardiotoxic effects of treatment regimens for other disease conditions that impact heart function.

Dr. Anand Prakash Singh
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.

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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
  • clinical treatment
  • basic cardiac research
  • future perspective
  • heart failure therapy
  • cardiotoxicity

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Published Papers (5 papers)

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Research

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14 pages, 4751 KiB  
Article
Changes in the Release of Endothelial Extracellular Vesicles CD144+, CCR6+, and CXCR3+ in Individuals with Acute Myocardial Infarction
by Alexa Moreno, Pedro Alarcón-Zapata, Enrique Guzmán-Gútierrez, Claudia Radojkovic, Héctor Contreras, Estefanía Nova-Lampeti, Felipe A. Zúñiga, Llerenty Rodriguez-Alvárez, Carlos Escudero, Paola Lagos and Claudio Aguayo
Biomedicines 2024, 12(9), 2119; https://doi.org/10.3390/biomedicines12092119 - 18 Sep 2024
Viewed by 661
Abstract
Acute myocardial infarction (AMI) results from vulnerable plaque rupture, causing ischemic cardiomyocyte necrosis and intense inflammation. Paradoxically, this inflammation releases factors that aid heart repair. Recent findings suggest a role for extracellular vesicles (EVs) in intercellular communication during post-AMI cardiac repair. However, EVs’ [...] Read more.
Acute myocardial infarction (AMI) results from vulnerable plaque rupture, causing ischemic cardiomyocyte necrosis and intense inflammation. Paradoxically, this inflammation releases factors that aid heart repair. Recent findings suggest a role for extracellular vesicles (EVs) in intercellular communication during post-AMI cardiac repair. However, EVs’ tissue origin and chemokine profile in the blood of patients with AMI remains unclear. This study characterized the tissue origin and chemokine receptor profile of EVs in the coronary and peripheral blood of patients with AMI. The results reveal that vesicles isolated from coronary and peripheral blood plasma are enriched in tetraspanin (CD9) and express CD81+, CD90+, and CD144+. The vesicle size ranged between 145 and 162 nm, with the control group exhibiting smaller vesicles (D10) than the AMI group. Furthermore, all vesicles expressed CCR6 and CXCR3, whereas a small percentage expressed CCR4. In addition, a decrease in CXCR3 and CCR6 expression was observed in coronary and peripheral AMI blood vesicles compared with the control; however, no difference was found between AMI coronary and AMI peripheral blood vesicles. In conclusion, our study demonstrates, for the first time, changes in the number of extracellular vesicles expressing CD144+, CXCR3, and CCR6 in the peripheral circulation of patients with AMI. Extracellular vesicles present in the circulation of patients with AMI hold excellent promise as a potential diagnostic tool. Full article
(This article belongs to the Special Issue Heart Failure: New Diagnostic and Therapeutic Approaches)
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11 pages, 2592 KiB  
Article
The Impact of Frailty Components and Preoperative Mechanical Cardiac Support Changes with Time after Heart Transplantation
by Rita Szentgróti, Dmitry Khochanskiy, Balázs Szécsi, Flóra Németh, András Szabó, Kinga Koritsánszky, Alexandra Vereb, Zsuzsanna Cserép, Balázs Sax, Béla Merkely and Andrea Székely
Biomedicines 2024, 12(5), 1114; https://doi.org/10.3390/biomedicines12051114 - 17 May 2024
Viewed by 986
Abstract
Background: Frailty has been proven to be associated with mortality after orthotopic heart transplantation (OHT). The aim of our study was to determine the impact of frailty on mortality in the current era using pretransplant mechanical cardiac support (MCS). Methods: We retrospectively calculated [...] Read more.
Background: Frailty has been proven to be associated with mortality after orthotopic heart transplantation (OHT). The aim of our study was to determine the impact of frailty on mortality in the current era using pretransplant mechanical cardiac support (MCS). Methods: We retrospectively calculated the frailty scores of 471 patients undergoing OHT in a single institution between January 2012 and August 2022. The outcome was all-cause mortality. Results: The median survival time was 1987 days (IQR: 1487 days) for all patients. In total, 266 (56.5%) patients were categorized as nonfrail, 179 (38.0%) as prefrail, and 26 (5.5%) as frail. The survival rates were 0.73, 0.54, and 0.28 for nonfrail, prefrail, and frail patients, respectively. The frailty score was associated with mortality [HR: 1.34 (95% CI: 1.22–1.47, p < 0.001)]. Among the components of the frailty score, age above 50 years, creatinine ≥ 3.0 mg/dL or prior dialysis, and hospitalization before OHT were independently associated with mortality. Continuous-flow left ventricular assist devices (CF-LVAD) were associated with an increased risk for all-cause mortality [AHR: 1.80 (95% CI: 1.01–3.24, p = 0.047)]. Conclusions: The components of the frailty score were not equally associated with mortality. Frailty and pretransplant MCS should be included in the risk estimation. Full article
(This article belongs to the Special Issue Heart Failure: New Diagnostic and Therapeutic Approaches)
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13 pages, 481 KiB  
Article
Effect of SGLT2-Inhibitors on Polygraphic Parameters in Elderly Patients Affected by Heart Failure, Type 2 Diabetes Mellitus, and Sleep Apnea
by Giuseppe Armentaro, Corrado Pelaia, Valentino Condoleo, Giandomenico Severini, Giulia Crudo, Mario De Marco, Carlo Alberto Pastura, Valeria Tallarico, Rita Pezzella, Domenico Aiello, Sofia Miceli, Raffaele Maio, Gianluigi Savarese, Giuseppe M. C. Rosano and Angela Sciacqua
Biomedicines 2024, 12(5), 937; https://doi.org/10.3390/biomedicines12050937 - 23 Apr 2024
Cited by 3 | Viewed by 1361
Abstract
Obstructive sleep apneas (OSAs) and central sleep apneas (CSAs) are the most common comorbidities in Heart Failure (HF) that are strongly associated with all-cause mortality. Several therapeutic approaches have been used to treat CSA and OSA, but none have been shown to significantly [...] Read more.
Obstructive sleep apneas (OSAs) and central sleep apneas (CSAs) are the most common comorbidities in Heart Failure (HF) that are strongly associated with all-cause mortality. Several therapeutic approaches have been used to treat CSA and OSA, but none have been shown to significantly improve HF prognosis. Our study evaluated the effects of a 3-months treatment with sodium-glucose cotransporter type 2 inhibitor (SGLT2i) on polygraphic parameters in patients with sleep apnea (SA) and HF, across the spectrum of ejection fraction, not treated with continuous positive air pressure (CPAP). A group of 514 consecutive elderly outpatients with HF, type 2 diabetes mellitus (T2DM) and SA, eligible for treatment with SGLT2i, were included in the investigation before starting any CPAP therapy. The two groups were compared with the t-test and Mann–Whitney test for unpaired data when appropriate. Then, a simple logistic regression model was built using 50% reduction in AHI as the dependent variable and other variables as covariates. A multivariate stepwise logistic regression model was constructed using the variables that linked with the dependent variable to calculate the odds ratio (OR) for the independent predictors associated with the reduction of 50% in AHI. The treated group experienced significant improvements in polygraphic parameters between baseline values and follow-up with reduction in AHI (28.4 ± 12.9 e/h vs. 15.2 ± 6.5 e/h; p < 0.0001), ODI (15.4 ± 3.3 e/h vs. 11.1 ± 2.6 e/h; p < 0.0001), and TC90 (14.1 ± 4.2% vs. 8.2 ± 2.0%; p < 0.0001), while mean SpO2 improved (91. 3 ± 2.3 vs. 93.8 ± 2.5); p < 0.0001. These benefits were not seen in the untreated population. The use of SGLT2i in patients suffering from HF and mixed-type SA not on CPAP therapy significantly contributes to improving polygraphic parameters. Full article
(This article belongs to the Special Issue Heart Failure: New Diagnostic and Therapeutic Approaches)
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15 pages, 549 KiB  
Article
Unraveling the Predictors for Delirium and ICU Stay Duration in Patients with Heart Failure and Reduced Ejection Fraction (HFrEF) Undergoing Coronary Artery Bypass Grafting—A Multicentric Analysis
by Christian Jörg Rustenbach, Stefan Reichert, Rafal Berger, Julia Schano, Attila Nemeth, Helene Haeberle, Christophe Charotte, Tulio Caldonazo, Ibrahim Saqer, Shekhar Saha, Philipp Schnackenburg, Ilija Djordjevic, Ihor Krasivskyi, Stefanie Wendt, Lina Maria Serna-Higuita, Torsten Doenst, Christian Hagl, Thorsten Wahlers, Christian Schlensak and Rodrigo Sandoval Boburg
Biomedicines 2024, 12(4), 749; https://doi.org/10.3390/biomedicines12040749 - 28 Mar 2024
Viewed by 1295
Abstract
Objective: This study assesses predictors for postoperative delirium (POD) and ICU stay durations in HFrEF patients undergoing CABG, focusing on ONCAB versus OPCAB surgical methods. Summary Background Data: In cardiac surgery, especially CABG, POD significantly impacts patient recovery and healthcare resource utilization. With [...] Read more.
Objective: This study assesses predictors for postoperative delirium (POD) and ICU stay durations in HFrEF patients undergoing CABG, focusing on ONCAB versus OPCAB surgical methods. Summary Background Data: In cardiac surgery, especially CABG, POD significantly impacts patient recovery and healthcare resource utilization. With varying incidences based on surgical techniques, this study provides an in-depth analysis of POD in the context of HFrEF patients, a group particularly susceptible to this complication. Methods: A retrospective analysis of 572 patients who underwent isolated CABG surgery with a preoperative ejection fraction under 40% was conducted at four German university hospitals. Patients were categorized into ONCAB and OPCAB groups for comparative analysis. Results: Age and Euro Score II were significant predictors of POD. The ONCAB group showed higher incidences of re-sternotomy (OR: 3.37), ECLS requirement (OR: 2.29), and AKI (OR: 1.49), whereas OPCAB was associated with a lower incidence of delirium. Statistical analysis indicated a significant difference in ICU stay durations between the two groups, influenced by surgical complexity and postoperative complications. Conclusions: This study underscores the importance of surgical technique in determining postoperative outcomes in HFrEF patients undergoing CABG. OPCAB may offer advantages in reducing POD incidence. These findings suggest the need for tailored surgical decisions and comprehensive care strategies to enhance patient recovery and optimize healthcare resources. Full article
(This article belongs to the Special Issue Heart Failure: New Diagnostic and Therapeutic Approaches)
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Review

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13 pages, 3959 KiB  
Review
Diagnostic and Therapeutic Approaches for Heart Failure in Long-Term Survivors of Childhood Cancer
by Consuelo Fernandez-Aviles, Rafael Gonzalez-Manzanares, Soledad Ojeda, Juan C. Castillo, Ainhoa Robles-Mezcua, Manuel Anguita, Dolores Mesa and Manuel Pan
Biomedicines 2024, 12(8), 1875; https://doi.org/10.3390/biomedicines12081875 - 16 Aug 2024
Viewed by 783
Abstract
The improvement in survival rates in pediatric malignancies has led to an increase in the number of cancer survivors who are at risk of developing cardiotoxicity and heart failure. Cardiac dysfunction in these patients can occur asymptomatically, and the diagnosis in a symptomatic [...] Read more.
The improvement in survival rates in pediatric malignancies has led to an increase in the number of cancer survivors who are at risk of developing cardiotoxicity and heart failure. Cardiac dysfunction in these patients can occur asymptomatically, and the diagnosis in a symptomatic phase is associated with reduced treatment response and worse prognosis. For this reason, it is essential to establish protocols to follow up on these patients and identify those at risk of cardiotoxicity in order to start early and effective therapies. This review aims to summarize the latest findings in the diagnosis and treatment of cancer therapy-related cardiac disease in long-term survivors of childhood cancer, with a focus on heart failure. Full article
(This article belongs to the Special Issue Heart Failure: New Diagnostic and Therapeutic Approaches)
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