Congestive Heart Failure

Congestive Heart Failure

Heart

Facts about Congestive Heart Failure

  • CVDs are the number 1 cause of death globally: more people die annually from CVDs than from any other cause.
  • Over three quarters of CVD deaths take place in low- and middle-income countries.
  • Out of the 16 million deaths under the age of 70 due to noncommunicable diseases, 82% are in low and middle income countries and 37% are caused by CVDs.
  • Nearly 5 million Americans are currently living with congestive heart failure (CHF).
  • Approximately 550,000 new cases are diagnosed in the U.S. each year.
  • Congestive heart failure affects people of all ages, from children and young adults to the middle-aged and the elderly.
  • Almost 1.4 million persons with CHF are under 60 years of age.
  • CHF is present in 2 percent of persons age 40 to 59.
  • More than 5 percent of persons age 60 to 69 have CHF.

Research scope in Congestive Heart Failure

  • Curcumin has the potential to protect against cardiac hypertrophy, inflammation, and fibrosis through suppression of p300-HAT activity and downstream GATA4, NF-kappaB, and TGF-beta-Smad signaling pathways.
  • Hyperphosphorylation of RyR2 induces Ca(2+) leak during diastole, which can cause fatal arrhythmias and lead to heart failure. This makes RyR2 an important therapeutic target.
  • BMP4 is a novel therapeutic target for pathological cardiac hypertrophy/heart failure.
  • Na(+)current is effectively blocked by AMIO and represents a new target for the drug in patients with chronic heart failure (HF).

Treatment for Congestive Heart Failure

  • rhGH therapy may have beneficial cardiovascular effects in CHF caused by LV systolic dysfunction.
  • Beta-blockade reduces all-cause mortality in patients with CHF
  • Curcumin is an inhibitor of p300 histone acetyltransferase activity, which is associated with the deterioration of heart failure. 
  • Evidence suggests that mineralocorticoid receptor antagonists (MRAs) can improve clinical outcomes but increase the risk of hyperkalaemia in patients with DM and HF.
  • Iron supplementation significantly reduced the risk of (a) hospitalization for HF and (b) the combined endpoint of hospitalization for HF and death, without increasing the risk of adverse events in patients with symptomatic systolic HF and ID.

Prevention of Congestive Heart Failure

  • There is a dose-dependent inverse relationship between fish consumption and HF incidence. Fish intake once or more times a week could reduce HF incidence.
  • Yoga enhances peak VO2 and HRQOL in patients with CHF and could be considered for inclusion in cardiac rehabilitation programs.
  • Circulating and dietary magnesium are inversely associated with CVD risk
  • Infrequent and light-to-moderate drinking is associated with a lower risk of heart failure.
  • Selenium concentrations were inversely associated with coronary heart disease risk in observational studies. 

Risk factors for Congestive Heart Failure

  • Anemia is associated with an increased risk of mortality and rate of hospitalization for heart failure.
  • Use of saxagliptin significantly increases the risk of HF by 21% especially among patients with high CV risk while no signals were detected with other agents.
  • Overweight and obesity and abdominal adiposity are associated with increased risk of heart failure
  • An inverse association between bone mineral density and the risk of heart failure in apparently healthy individuals. 
  • PTH in the development of HF even in the absence of overt hyperparathyroidism.

Systematic reviews

  • Tolvaptan is likely to be a promising diuretic for the treatment of HF…more
  • Pooled analyses of available randomized controlled trials suggest that CoQ₁₀ may improve the EF in patients with CHF…more
  • Discontinuation of beta-blockers in patients admitted with ADHF was associated with significantly increased in-hospital mortality…more
  • ARBs are superior in reducing all-cause mortality or HF hospitalization in patients with symptomatic HF, particularly when compared with ACEIs…more

References

Risk factor

  • Congest Heart Fail. 2009 May-Jun;15(3):123-30
  • Int J Cardiol. 2016 May 15;211:88-95
  • Circulation. 2016 Feb 16;133(7):639-49
  • JACC Heart Fail. 2014 Aug;2(4):380-9
  • Eur J Heart Fail. 2010 Nov;12(11):1186-92

Research scope

  • J Clin Invest. 2008 Mar;118(3):879-93
  • Recent Pat Cardiovasc Drug Discov. 2007 Jun;2(2):110-8
  • Heart Fail Rev. 2014 Nov;19(6):781-8
  • J Mol Cell Cardiol. 2001 May;33(5):923-32

Prevention

  • Chin Med J (Engl). 2013 Mar;126(5):942-8
  • Arq Bras Cardiol. 2014 Nov;103(5):433-439
  • Am J Clin Nutr. 2013 Jul;98(1):160-73
  • Phys Sportsmed. 2010 Oct;38(3):84-9  
  • Am J Clin Nutr. 2006 Oct; 84(4): 762–773.

Treatment

  • Endocr Pract. 2008 Jan-Feb;14(1):40-9
  • J Am Coll Cardiol. 1997 Jul;30(1):27-34
  • Biol Pharm Bull. 2012;35(2):139-44
  • BMC Cardiovasc Disord. 2016 Jan 29;16:28
  • Can J Cardiol. 2016 Feb;32(2):151-9

First use of dissolving stent in Washington state

Two patients in Washington recently became the very first to receive dissolving coronary stents, a technological advancement just approved by the FDA. Stents are small scaffolding used to prop open blood vessels that have become blocked. Cardiologists have used them for decades, but up until recently, they’ve used metal stents. Generally metal stents are safe and patients have good experiences, but sometimes people can experience clotting and scarring. “Metal stents are generally safe, they are the gold standard, they work really well, but there are certain circumstances where you can get too much scar tissue in the stents and that can be a problem sometimes,” UW Medicine Regional Heart Center Interventional Cardiologist Dr. James McCabe said. Metal stents cannot be removed, and that’s why doctors knew they had to consider a change. That’s why UW Medicine moved forward with the dissolving stent. More : http://www.king5.com/news/local/

DeviceSmall Device Gives Big Help For Those With Congestive Heart Failure

Congestive Heart Failure is treatable but can lead to several other health risks if its not monitored carefully. There’s a new device called a CardioMEMS that helps doctors and medical staff monitor patients remotely. The first patient in the 4-States to receive the device has had it for one week now. Lewis Brooks from Carthage tells News Talk KZRG about it. “So they thought this device would help monitor this and keep me out of the hospital.” Brooks has already had an adjustment of his medication in the first week of reporting. He’ll continue to be monitored to ensure a hospital visit or stay isn’t necessary. Dr. William Craig Director of Cardiovascular Services at Mercy Hospital Joplin says the first procedure is a success and he’s looking forward to helping many more.More at: http://www.newstalkkzrg.com/

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