Reframing the association and significance of co‐morbidities in heart failure

Abstract

Several co-existing diseases and/or conditions (co-morbidities) are present in patients with heart failure (HF), with diverse clinical relevance. Multiple mechanisms may underlie the co-existence of HF and co-morbidities, including direct causation, associated risk factors, heterogeneity, and independence. The complex inter-relationship of co-morbidities and their impact on the cardiovascular system contribute to the features of HF, both with reduced (HFrEF) and preserved ejection fraction (HFpEF). The purpose of this work is to provide an overview of the contribution of major cardiac and non-cardiac co-morbidities to HF development and outcomes, in the context of both HFpEF and HFrEF. Accordingly, epidemiological evidence linking co-morbidities to HF and the effect of prevalent and incident co-morbidities on HF outcome will be reviewed.

Atrial remodelling in heart failure: recent developments and relevance for heart failure with preserved ejection fraction

“…The prevalence of diabetes is similar in HFpEF and HFrEF88 and independently associated with LAE 89. A higher prevalence of obesity has been reported in HFpEF (51%) vs. HFrEF (37%88).…”

“…Others have reported similar prevalence of CKD in HFpEF and HFrEF 88. CKD‐associated renal arterial hypertension has been identified as a trigger of maladaptive LA remodelling in a model of early‐stage HFpEF 10…”

“…A higher prevalence of obesity has been reported in HFpEF (51%) vs. HFrEF (37%88). LA enlargement correlates with epicardial fat thickness90 and visceral fat mass 91.…”

Impact of Plasma Kynurenine Level on Functional Capacity and Outcome in Heart Failure ― Results From Studies Investigating Co-morbidities Aggravating Heart Failure (SICA-HF) ―

“…1,2 HF patients with reduced functional capacity have low quality of life 3 and poor prognosis. 4 The pathophysiology under reduced functional capacity in HF is considered to be multifactorial 5- 7 and it includes dysfunction in right/left ventricle (RV/LV), vasculature, skeletal muscle, lung, and others. 8- 10 The Studies Investigating Co-morbidities Aggravating Heart Failure (SICA-HF) was a multi-national, pathophysiological observation study into HF and its comorbidities.…”

Cardiac Hemosiderosis in Transfusion DependentThalassemia: A Mini-Review

“…12 Presence of other transfusion related comorbidities such as diabetes, hepatic disease, and other endocrinopathies such as thyroid disease may pave the way to the heart disease in TDT. 14 In particular, TDT patients affected with diabetes mellitus (DM) showed significantly higher possibilities for developing heart failure, arrhythmia, and cardiac fibrosis. 15 TDT patients with DM also had significantly lower cardiac T2* value respective to those without this condition indicating a heavier iron load of the heart in presence of DM.…”