Managing heart failure with preserved ejection fraction

Davidson, Alexander; Raviendran, Nivashinie; Murali, Charisma Nair; Myint, Phyo Kyaw

doi:10.21037/atm.2020.03.18

Cited by 7 publications

(11 citation statements)

References 46 publications

(68 reference statements)

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“…HF is more common in the elderly population, and the prognosis is poor [17]. It causes patients to reduce or lose their ability to take care of themselves and brings a heavy economic burden to patients, family, and society [18].…”

Section: Discussionmentioning

confidence: 99%

The Identification of Key Genes and Biological Pathways in Heart Failure by Integrated Bioinformatics Analysis

Yang

Bai

et al. 2021

Computational and Mathematical Methods in Medicine

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Purpose. Heart failure (HF) is a clinical syndrome caused by ventricular insufficiency. In order to further explore the biomarkers related to HF, we apply the high-throughput database. Materials and Methods. The GSE21610 was applied for the differentially expressed gene (DEG) analysis. The Database for Annotation, Visualization, and Integrated Discovery (DAVID) was performed to assess Gene ontology (GO) and the Kyoto Encyclopedia of Genes and Genomes (KEGG) analyses. The Gene Set Enrichment Analysis (GSEA) was used for gene expression profile GSE21610. The Protein-Protein Interaction (PPI) network and modules were also constructed for research. These hub gene function pathways were estimated in HF progression. Result. We have identified 434 DEGs in total, including 304 downregulated DEGs and 130 upregulated DEGs. GO and KEGG illustrated that DEGs in HF were significantly enriched in G protein-coupled receptor binding, peroxisome, and cAMP signaling pathway. GSEA results showed gene set GSE21610 was gathered in lipid digestion, defense response to fungus, and intestinal lipid absorption. Finally, through analyzing the PPI network, we screened hub genes CDH1, TFRC, CCL2, BUB1B, and CD19 by the Cytoscape software. Conclusion. This study uses a series of bioinformatics technologies to obtain hug genes and key pathways related to HF. These analysis results provide us with new ideas for finding biomarkers and treatment methods for HF.

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Section: Discussionmentioning

confidence: 99%

The Identification of Key Genes and Biological Pathways in Heart Failure by Integrated Bioinformatics Analysis

Yang

Bai

et al. 2021

Computational and Mathematical Methods in Medicine

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“…As a classification of HF, HFrEF is a major public health concern that has substantial morbidity and mortality; however, recent developments such as SGLT2 inhibitors, vericiguat, and transcatheter mitral valve repair all incrementally improve prognosis beyond what was possible through foundational neurohormonal therapies[ 2 ]. On the other hand, one of the most common reasons for prolonged hospital admission is poor management of HF symptoms from decompensated HFpEF[ 17 ]. The high morbidity and mortality rates associated with HFpEF are compounded by poor understanding of the underpinning pathophysiology[ 17 ].…”

Section: Hfmentioning

confidence: 99%

“…On the other hand, one of the most common reasons for prolonged hospital admission is poor management of HF symptoms from decompensated HFpEF[ 17 ]. The high morbidity and mortality rates associated with HFpEF are compounded by poor understanding of the underpinning pathophysiology[ 17 ].…”

Section: Hfmentioning

confidence: 99%

“…Neprilysin plays a role as its mechanism, degrading the gross excess of circulating NPs in HF patients[ 7 ]. Compared to enalapril, SAC/VAL leads to reductions in symptoms of HF, cardiovascular death or HF hospitalization, sudden cardiac death, and disease progression, and improved QOL, in patients undergoing evidence-based contemporary medical therapy for HFrEF, and the NP assays for B-type NP (BNP) and N-terminal-proBNP (NT-proBNP) assays have been shown to have similar diagnostic accuracy for the differentiation of HF from other etiologies of shortness of breath[ 11 , 17 , 32 , 34 - 36 ]. In real-world settings, SAC/VAL was found to be associated with improved survival and reduced HF-related hospitalization compared to enalapril in Asian HF patients, with consistent effectiveness even in older populations[ 37 ].…”

Section: Effects Of Arni On Chfmentioning

confidence: 99%

“…On the other hand, there seems to be no evidence of a difference between SAC/VAL and valsartan in patients with HFpEF[ 17 , 39 ]. Therefore, there are, at present, no universal treatment strategies recommended for HFpEF; instead, management should take an individualized approach, with consideration given to each patient’s comorbidities[ 17 ]. Additionally, modern guidelines should emphasize this lack of evidence for the combined use of ARB and BB for HFrEF, with the exception of candesartan[ 42 ].…”

Section: Effects Of Arni On Chfmentioning

confidence: 99%

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Angiotensin receptor blocker neprilysin inhibitors

Usuda

Higashikawa

Hotchi

et al. 2021

WJC

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Heart failure (HF) is a clinical syndrome that results from a structural or functional cardiac disorder that reduces the ability of the ventricle of the heart to fill with, or eject, blood. It is a multifaceted clinical condition that affects up to 2% of the population in the developed world, and is linked to significant morbidity and mortality; it is therefore considered a major concern for public health. Regarding the mechanism of HF, three neurohumoral factors - the renin-angiotensin-aldosterone system, the sympathetic nervous system, and natriuretic peptides — are related to the pathology of chronic HF (CHF), and the targets of treatment. Angiotensin receptor blocker and neprilysin inhibitor (angiotensin-receptor neprilysin inhibitor), namely sacubitril/valsartan (SAC/VAL), has been introduced as a treatment for CHF. SAC/VAL is an efficacious, safe, and cost-effective therapy that improves quality of life and longevity in patients with HF with reduced ejection fraction (HFrEF), and reduces hospital admissions. An in-hospital initiation strategy offers a potential new avenue to improve the clinical uptake of SAC/VAL. In the last five years, SAC/VAL has been established as a cornerstone component of comprehensive disease-modifying medical therapy in the management of chronic HFrEF. On the other hand, further work, with carefully designed and controlled preclinical studies, is necessary for understanding the molecular mechanisms, effects, and confirmation of issues such as long-term safety in both human and animal models.

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Emerging Horizons in Heart Failure with Preserved Ejection Fraction: The Role of SGLT2 Inhibitors

et al. 2022

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Heart failure with preserved ejection fraction (HFpEF) is a condition with increasing disease burden. Prevalence of HFpEF is increasing, reflecting an increasingly elderly and comorbid population, as well as reinforcing the need for more treatments for this disease. The pathophysiology of HFpEF is complex. Some inflammatory processes seen in HFpEF are shared with diabetes mellitus (DM) and there is an association seen between the two conditions. It is therefore no wonder that treatments for diabetes may have some effect on heart failure outcomes. Current treatment strategies in HFpEF are limited, with treatments focusing on symptom control rather than morbidity or mortality benefit. However, there are now promising results from the EMPEROR-Preserved study that show significantly reduced cardiovascular death or hospitalisation for heart failure (HHF) in patients taking empagliflozin, compared to those taking placebo. These results indicate a promising future for sodium-glucose co-transporter 2 (SGLT2) inhibitors in HFpEF. The ongoing DELIVER trial (investigating the use of dapagliflozin in HFpEF) is awaited but could provide further evidence of support for SGLT2 inhibitors in HFpEF. With hospital admissions for HFpEF increasing in the UK, the economic impact of treatments that reduce HHF is vast. The European Society of Cardiology (ESC) recently added SGLT2 inhibitors to their guidelines for treatment of heart failure with reduced ejection fraction (HFrEF) following DAPA-HF and EMPEROR-Reduced trials and we suggest that similar changes be made to guidelines to support the use of SGLT2 inhibitors in the management of HFpEF in upcoming months.

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Managing heart failure with preserved ejection fraction

Cited by 7 publications

References 46 publications

The Identification of Key Genes and Biological Pathways in Heart Failure by Integrated Bioinformatics Analysis

The Identification of Key Genes and Biological Pathways in Heart Failure by Integrated Bioinformatics Analysis

Angiotensin receptor blocker neprilysin inhibitors

Emerging Horizons in Heart Failure with Preserved Ejection Fraction: The Role of SGLT2 Inhibitors

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