Therapies for patients with coexisting heart failure with reduced ejection fraction and non-alcoholic fatty liver disease

Heart failure with reduced ejection fraction (HFrEF) and nonalcoholic fatty liver disease (NAFLD) are two common comorbidities that share similar pathophysiological mechanisms. There is a growing interest in the potential of targeted therapies to improve outcomes in patients with coexisting HFrEF and NAFLD. This manuscript reviews current and potential therapies for patients with coexisting HFrEF and NAFLD. Pharmacological therapies, including angiotensin-converting enzyme inhibitors/angiotensin receptor blockers, mineralocorticoids receptor antagonist, and sodium-glucose cotransporter-2 inhibitors, have been shown to reduce fibrosis and fat deposits in the liver. However, there are currently no data showing the beneficial effects of sacubitril/valsartan, ivabradine, hydralazine, isosorbide nitrates, digoxin, or beta blockers on NAFLD in patients with HFrEF. This study highlights the importance of considering HFrEF and NAFLD when developing treatment plans for patients with these comorbidities. Further research is needed in patients with coexisting HFrEF and NAFLD, with an emphasis on novel therapies and the importance of a multidisciplinary approach for managing these complex comorbidities

Therapies for patients with coexisting heart failure with reduced ejection fraction and non-alcoholic fatty liver disease

Heart failure with reduced ejection fraction (HFrEF) and nonalcoholic fatty liver disease (NAFLD) are two common comorbidities that share similar pathophysiological mechanisms. There is a growing interest in the potential of targeted therapies to improve outcomes in patients with coexisting HFrEF and NAFLD. This manuscript reviews current and potential therapies for patients with coexisting HFrEF and NAFLD. Pharmacological therapies, including angiotensin-converting enzyme inhibitors/angiotensin receptor blockers, mineralocorticoids receptor antagonist, and sodium-glucose cotransporter-2 inhibitors, have been shown to reduce fibrosis and fat deposits in the liver. However, there are currently no data showing the beneficial effects of sacubitril/valsartan, ivabradine, hydralazine, isosorbide nitrates, digoxin, or beta blockers on NAFLD in patients with HFrEF. This study highlights the importance of considering HFrEF and NAFLD when developing treatment plans for patients with these comorbidities. Further research is needed in patients with coexisting HFrEF and NAFLD, with an emphasis on novel therapies and the importance of a multidisciplinary approach for managing these complex comorbidities.Revisión por pare

Association between supplementation with vitamin A, iron and micronutrients with adequate psychomotor development in children from 9 to 36 months in Peru

Background: Worldwide, it is estimated that 52.9 million children <5 years of age experience delayed psychomotor development, which is associated with multiple factors. Our primary objective is to evaluate whether there is an association between supplementation with Vitamin A, Iron, and Micronutrients and Adequate Psychomotor Development in children aged 9–36 months at the national level in Peru. Methods: The study was an observational, analytical, cross-sectional study based on the secondary analysis of the Demographic and Family Health Survey databases from 2018 to 2020. The independent variables include the consumption of Vitamin A, Iron, and Micronutrients. The dependent variables encompass Motor Development in children aged 9–18 months, Psychological Development in children aged 9–18 months, and Psychological Development in children aged 19–36 months. Results: The study included a total of 24 838 participants. In the adjusted regression model, the factors associated with adequate motor development between 9 and 18 months of age were: region of residence, overcrowding, and exclusive breastfeeding. For adequate cognitive development between 9 and 18 months of age, the associated factors were: vitamin A consumption, mother's education, child sex, delivery complications, and complete vaccinations. Regarding adequate psychological development in children aged 19–36 months, the associated factors were: mother's education, maternal employment, child sex, and birth weight. Conclusions: There was no association found between nutritional supplementation and adequate development, except for the relationship between Vitamin A consumption and adequate psychological development in children aged 9–18 months. Therefore, further research, such as cohort studies and clinical trials, is suggested to corroborate this association.Revisión por pare