Between 2013 and 2016 there were approximately 6.2 million adults in the United States living with heart failure; nearly half had an ejection fraction that was preserved. Despite the high prevalence of heart failure with preserved ejection fraction (HFpEF), our understanding of this disease is limited and it still carries significant morbidity and mortality worldwide. At present, physicians are burdened by the inconclusive benefits of currently available treatment options. Recently the scientific community has seen an influx of new pathophysiology studies and outcome trials that have reshaped our understanding of HFpEF as a complex, multi-systemic disease. Pharmacological trials involving beta-blockers, angiotensin II receptor antagonists, aldosterone antagonists, and angiotensin-neprilysin inhibitors have demonstrated encouraging results, but have yet to reach the significance of advancements made in the treatment of heart failure with reduced ejection fraction. This review aims to summarize landmark clinical trials that have influenced current treatment guidelines, and reports on emerging evidence supporting/ refuting new treatment modalities including pharmacotherapy, lifestyle modification and device therapy.
Amyloid deposition in the setting of multiple myeloma (MM) is a well-documented phenomenon. In this paper, we present the rare case of a 62-year-old male who presented with decompensated heart failure in the setting of cardiac amyloid deposition as the initial presentation of MM. The patient presented to the emergency department with two weeks of worsening lower extremity edema. Laboratory exam revealed elevated troponin I, elevated B-type natriuretic peptide (BNP), macrocytosis, increased urine protein/creatinine ratio, and a monoclonal peak on both serum protein electrophoresis (SPEP) and urine protein electrophoresis (UPEP). Transthoracic echocardiogram (TTE) revealed findings suggestive of amyloidosis. Abdominal fat pad biopsy confirmed amyloid deposition. The patient did not have other symptoms typically seen in multiple myeloma, such as fatigue or weakness, bone pain, or weight loss. In conclusion, we present a rare case of decompensated heart failure in the setting of amyloidosis as the initial presentation of multiple myeloma.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.