3 research outputs found

    The Role of Congestion Biomarkers in Heart Failure with Reduced Ejection Fraction

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    : In heart failure with reduced ejection fraction, edema and congestion are related to reduced cardiac function. Edema and congestion are further aggravated by chronic kidney failure and pulmonary abnormalities. Furthermore, together with edema/congestion, sodium/water retention is an important sign of the progression of heart failure. Edema/congestion often anticipates clinical symptoms, such as dyspnea and hospitalization; it is associated with a reduced quality of life and a major risk of mortality. It is very important for clinicians to predict the signs of congestion with biomarkers and, mainly, to understand the pathophysiological findings that underlie edema. Not all congestions are secondary to heart failure, as in nephrotic syndrome. This review summarizes the principal evidence on the possible roles of the old and new congestion biomarkers in HFrEF patients (diagnostic, prognostic, and therapeutic roles). Furthermore, we provide a description of conditions other than congestion with increased congestion biomarkers, in order to aid in reaching a differential diagnosis. To conclude, the review focuses on how congestion biomarkers may be affected by new HF drugs (gliflozins, vericiguat, etc.) approved for HFrEF

    Novelties in the pharmacological approaches for chronic heart failure: new drugs and cardiovascular targets

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    Despite recent advances in chronic heart failure (HF) management, the prognosis of HF patients is poor. This highlights the need for researching new drugs targeting, beyond neurohumoral and hemodynamic modulation approach, such as cardiomyocyte metabolism, myocardial interstitium, intracellular regulation and NO-sGC pathway. In this review we report main novelties on new possible pharmacological targets for HF therapy, mainly on new drugs acting on cardiac metabolism, GCs-cGMP pathway, mitochondrial function and intracellular calcium dysregulation

    Impact of vaccination on electrocardiograms of hospitalized patients for Covid-19

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    Introduction: We sought to assess the impact of SarsCov-2 vaccination on admission12-lead electrocardiogram of hospitalized patients. Methods: We retrospectively analyzed and compared admission 12-lead electrocardiograms of all patients hospitalized in dedicated Internal Medicine Unit for Covid-19 both in pre-vaccination period (PV) and after vaccination (V). Results: 667 consecutive Covid-19 in-patients were enrolled in the study: PV hospitalized patients were older (68vs57 years, p < 0.01), had higher rates of atrial fibrillation/flutter (13%vs2.5%, p < 0.01), any arrhythmia (26%vs8%, p < 0.01), and ST-T abnormalities (22%vs7.4%, p < 0.01). Mortality rates in hospitalized Covid-19 patients were higher before vaccination period (20%vs4%, p < 0.01). Minimal vaccination coverage of population (V period) was inversely and independently associated with in-hospital mortality (odds ratio 0.09, 95%CI 0.01–0.68, p < 0.05). Conclusions: SarsCov-2 vaccination campaign and even partial coverage of local population was associated with less frequent abnormalities at admission ECG in hospitalized non-critically hill Covid-19 patients and lower mortality