Comorbidities in Heart Failure: Challenges in Clinical Diagnosis and Management

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Pathology and Molecular Diagnostics".

Deadline for manuscript submissions: closed (29 February 2024) | Viewed by 1398

Special Issue Editors


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Guest Editor
3rd Cardiology Department, Cardiovascular Prevention and Digital Cardiology Lab, Aristotle University of Thessaloniki, Hippokration General Hospital, 541 24 Thessaloniki, Greece
Interests: cardiovascular prevention; heart failure; sports cardiology; digital cardiology; mHealth; artificial intelligence
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Guest Editor
3rd Department of Cardiology, National and Kapodistrian University of Athens Medical School, Sotiria Chest Disease Hospital, 115 27 Athens, Greece
Interests: atherosclerosis; endothelium; heart failure; cardiovascular imaging; epidemiology

Special Issue Information

Dear Colleagues,

Heart failure is a multifaceted cardiovascular disorder affecting millions of people worldwide. One crucial aspect often overlooked is the presence of comorbidities, which significantly impact disease progression, outcomes, and treatment efficacy. Comorbid conditions, such as diabetes, hypertension, chronic kidney disease, and mental health disorders, can complicate heart failure management, challenging clinicians in providing optimal care. Understanding the intricate relationships and mechanisms linking heart failure and comorbidities is essential for developing targeted interventions and improving patient outcomes.

This Special Issue aims to explore the complex interplay between heart failure and comorbidities, shedding light on their prevalence, impact, and underlying pathophysiological mechanisms. We invite original research, systematic reviews, and clinical studies that delve into the epidemiology, risk factors, and shared pathways linking heart failure with diverse comorbid conditions. Authors are encouraged to present novel approaches and evidence-based strategies for managing heart failure patients with comorbidities effectively. By disseminating the latest research, we hope to advance knowledge, foster collaboration between disciplines, and ultimately enhance clinical management to improve the lives of individuals living with heart failure and comorbidities.

Note: This Special Issue welcomes contributions from researchers, clinicians, and experts in the fields of cardiology, epidemiology, endocrinology, nephrology, mental health, and related disciplines. The following are the themes for submitted papers to focus on: epidemiology and burden of comorbidities in heart failure; pathophysiological mechanisms and shared pathways focusing on the underlying mechanisms that link heart failure with comorbid conditions; clinical management strategies and guidelines for effectively managing heart failure patients with comorbidities; impact of comorbidities on heart failure outcomes; novel interventions and therapies; patient-centered care and health policy implications related to heart failure and comorbidities; and role of cardiac imaging and biomarkers in assessing heart failure patients with comorbidities. Please kindly note that manuscripts with pure therapeutic content will not be processed.

Dr. Constantinos Bakogiannis
Dr. Evangelos Oikonomou
Guest Editors

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Keywords

  • heart failure
  • comorbidities
  • cardiovascular diseases
  • diabetes
  • hypertension
  • chronic kidney disease
  • clinical management
  • patient outcomes
  • personalized medicine

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Published Papers (1 paper)

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Research

13 pages, 1107 KiB  
Article
Ambulatory Risk Stratification for Worsening Heart Failure in Patients with Reduced and Preserved Ejection Fraction Using Diagnostic Parameters Available in Implantable Cardiac Monitors
by Shantanu Sarkar, Jodi Koehler and Neethu Vasudevan
Diagnostics 2024, 14(7), 771; https://doi.org/10.3390/diagnostics14070771 - 5 Apr 2024
Viewed by 1087
Abstract
Background: Ambulatory risk stratification for worsening heart failure (HF) using diagnostics measured by insertable cardiac monitors (ICM) may depend on the left ventricular ejection fraction (LVEF). We evaluated risk stratification performance in patients with reduced versus preserved LVEF. Methods: ICM patients with a [...] Read more.
Background: Ambulatory risk stratification for worsening heart failure (HF) using diagnostics measured by insertable cardiac monitors (ICM) may depend on the left ventricular ejection fraction (LVEF). We evaluated risk stratification performance in patients with reduced versus preserved LVEF. Methods: ICM patients with a history of HF events (HFEs) were included from the Optum® de-identified Electronic Health Record dataset merged with ICM device-collected data during 2007–2021. ICM measures nighttime heart rate (NHR), heart rate variability (HRV), atrial fibrillation (AF) burden, rate during AF, and activity duration (ACT) daily. Each diagnostic was categorized into high, medium, or low risk using previously defined features. HFEs were HF-related inpatient, observation unit, or emergency department stays with IV diuresis administration. Patients were divided into two cohorts: LVEF ≤ 40% and LVEF > 40%. A marginal Cox proportional hazards model compared HFEs for different risk groups. Results: A total of 1020 ICM patients with 18,383 follow-up months and 301 months with HFEs (1.6%) were included. Monthly evaluations with a high risk were 2.3, 4.2, 5.0, and 4.5 times (p < 0.001 for all) more likely to have HFEs in the next 30 days compared to those with a low risk for AF, ACT, NHR, and HRV, respectively. HFE rates were higher for patients with LVEF > 40% compared to LVEF ≤ 40% (2.0% vs. 1.3%), and the relative risk between high-risk and low-risk for each diagnostic parameter was higher for patients with LVEF ≤ 40%. Conclusions: Diagnostics measured by ICM identified patients at risk for impending HFEs. Patients with preserved LVEF showed a higher absolute risk, and the relative risk between risk groups was higher in patients with reduced LVEF. Full article
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