Coronavirus 2019 Disease (COVID‐19), Systemic Inflammation, and Cardiovascular Disease

n/

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

: 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

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

Type of hospitalisations and in-hospital outcomes in the Italian coronary care unit network at the time of COVID-19 pandemic: the BLITZ-COVID19 Registry

The aim of the study was to describe the epidemiology and outcome of patients hospitalised during the COVID-19 pandemic in intensive cardiac care units (ICCs)

Association of left atrial structure and function with heart failure in older adults

Background: Limited data exist to characterize novel measures of left atrial (LA) structure and function in older adults without prevalent heart failure (HF). Objectives: To assess reference range of LA measures, their associations with N-terminal pro-brain-natriuretic-peptide (NTproBNP) and the related risk for incident HF or death. Methods: We analyzed LA structure [LA maximal and minimal volume indexed by body surface area (LAViMax and LAViMin)] and function [LA emptying fraction, LA reservoir, conduit and contraction strain] in 4901 participants from the Atherosclerosis Risk in Communities (ARIC) study (mean age 75±5 years, 40% male and 19% black) without prevalent HF. We assessed gender-specific 10th and 90th percentile ARIC-based reference limits in 301 participants free of prevalent cardiovascular disease, and related LA measures to NTproBNP and incident HF or death (median follow-up of 5.5 years) in the whole ARIC cohort. Results: Approximately 20% of the overall population had LA abnormalities according to the ARIC-based reference limit. Each LA measure was associated with NTproBNP and, except for LAViMax, with incident HF or death after multivariable adjustment. Results were consistent in participants with normal LAViMax (p for interaction>0.05). LA measures were prognostic for both incident HFpEF or death and incident HFrEF or death. When added to HF risk factors and NTproBNP (baseline C-statistics=0.74) all LA measures, except for LAViMax, significantly enhanced the prognostic accuracy. Conclusion: Novel measures of LA structure and function, but not standard assessment by LAViMax, are associated with increased risk of incident HF or death regardless of measures of LV function and NTproBNP

Coronavirus 2019 Disease (COVID‐19), Systemic Inflammation, and Cardiovascular Disease

Acute respiratory failure associated with the Severe Acute Respiratory Syndrome coronavirus 2 (SARS‐CoV‐2), has rapidly spread worldwide and presents critical challenges for the public health and medical communities. The World Health Organization (WHO) has declared SARS‐CoV‐2 a public health emergency of international concern, with a global estimate of over 7 million human infections and more than 400000 deaths worldwide as of June 12, 2020. A 2020 report by the China Medical Treatment Expert Group for Coronavirus disease 2010 (COVID‐19) (2) showed that the clinical spectrum of the viral infection is dominated by fever (up to 88.7% of patients during hospitalization) and cough (67.8% of patients) followed by symptoms such as headache, fatigue, or shortness of breath