Cardiac contractility modulation in heart failure with reduced ejection fraction treatment

Heart failure with reduced left ventricular ejection fraction (LV EF) (HFrEF) is a significant issue of health care due to increasing indexes of morbidity and mortality. The emergence of a number of drugs and implantable devices for the treatment of HFrEF has allowed improvement of patients’ well-being and prognosis. However, high mortality and recurrent decompensated heart failure remain a substantial issue and stimulate the search for new methods of CHF treatment. Cardiac contractility modulation (CCM) is a method of managing patients with HFrEF. Available data from randomized clinical trials (RCT) indicate the efficacy of CCM in improvement of patients’ well-being and quality of life. The question remains open: what effect does CCM have on LV reverse remodeling? Experimental data and results of observational studies suggest a possibility of reverse remodeling by CCM; however, this has not been confirmed in RCT. Also, it remains unclear how CCM influences the frequency of hospitalizations for decompensated heart failure and the death rate of patients with HFrEF. Results of both RCTs and observational studies have shown a moderate improvement of quality of life associated with CCM. Furthermore, RCTs have not found any increase in LV EF due to the therapy, nor has a meta-analysis of RCTs revealed any improvement of the prognosis associated with CCM. Further RCTs are needed to evaluate the effect of CCM on reverse remodeling, survival rate, and to determine the place of CCM in the treatment of patients with CHF

Position paper. The role of iron deficiency in patients with chronic heart failure and current corrective approaches

Further to the discussions, a position paper with the following main provisions was elaborated: 1. Iron Deficiency (ID) must be regarded as an independent clinically significant concomitant condition, with the prevalence reaching 50% among Chronic Heart Failure (CHF) patients in Russia. 2. According to observation studies iron deficiency in patients with CHF adversely affects functional performance and is associated with increased hospitalization rates and mortality. 3. ID must be excluded in all CHF patients, regardless of haemoglobin levels; the severity of ID should be evaluated. Blood ferritin concentration and transferrin saturation (TSAT, transferrin saturation coefficient) are currently optimal parameters for defining ID. 4. According to current data, therapy aimed only at increasing blood haemoglobin concentrations does not seem to have advantages in influencing the prognosis and clinical manifestations of CHF, while the elimination of ID in CHF patients leads to significant clinical benefits even in the absence of anaemia. 5. According to recently available data (the results of Randomized Clinical Trials, RCTs), the intravenous use of ferric carboxymaltose should be considered the most consistent approach for the treatment of ID in CHF patients. © 2020 Seoul National University. All rights reserved

The use of diuretics in chronic heart failure. Position paper of the Russian Heart Failure Society [Экспертное мнение по применению диуретиков при хронической сердечной недостаточности Общество специалистов по сердечной недостаточности]

The document focuses on key issues of diuretic therapy in CHF from the standpoint of current views on the pathogenesis of edema syndrome, its diagnosis, and characteristics of using diuretics in various clinical situations

Consensus of Russian experts on the evaluation of arterial stiffness in clinical practice

Recently, there was plenty studies published on the arterial stiffness assessment, and importance of this was proved as an independent prediction parameter, together with standard cardiovascular risk factors. In current document, we collect and structure the available clinical and scientific data from abroad and Russian studies. The aim of current publication is the need to bring a reader the importance of demanded in clinical practice ways of arterial wall stiffness assessment, information about conditions when it is important to the assessment, and available restrictions, as the issues remaining unresolved

Consensus of Russian experts on the evaluation of arterial stiffness in clinical practice [Согласованное мнение российских экспертов по оценке артериальной жесткости в клинической практике]

Recently, there was plenty studies published on the arterial stiffness assessment, and importance of this was proved as an independent prediction parameter, together with standard cardiovascular risk factors. In current document, we collect and structure the available clinical and scientific data from abroad and Russian studies. The aim of current publication is the need to bring a reader the importance of demanded in clinical practice ways of arterial wall stiffness assessment, information about conditions when it is important to the assessment, and available restrictions, as the issues remaining unresolved. © 2016 Vserossiiskoe Obshchestvo Kardiologov. All rights reserved

Consensus of Russian experts on the evaluation of arterial stiffness in clinical practice

Recently, there was plenty studies published on the arterial stiffness assessment, and importance of this was proved as an independent prediction parameter, together with standard cardiovascular risk factors. In current document, we collect and structure the available clinical and scientific data from abroad and Russian studies. The aim of current publication is the need to bring a reader the importance of demanded in clinical practice ways of arterial wall stiffness assessment, information about conditions when it is important to the assessment, and available restrictions, as the issues remaining unresolved