1,721,036 research outputs found
Letter by monzo and melenovsky regarding article, "metabolomic profiling of the effects of dapagliflozin in heart failure with reduced ejection fraction. DEFINE-HF"
No full textFebbre reumatica acuta
No full textBreve descrizione della epidemiologia, fisiopatologia, diagnosi e terapia medico-chirurgica della malattia reumatic
Tumori cardiaci
No full textBreve descrizione della epidemiologia, fisiopatologia, diagnosi e terapia medico-chirurgica dei tumori cardiac
Myocardial metabolism evaluation and ketones utilization in the failing human heart
Full text linkBackground: Under normal circumstances, free fatty acids (FFAs) are the predominant energetic substrate of the heart. In experimental and end-stage models of heart failure (HF) a quantitative switch from a predominance of FFAs utilization to the more energy favourable ketone bodies has been demonstrated. The aim of this study was to identify and quantify the heart substrates utilization in mild to moderate human HF.
Methods: β-hydroxybutyrate, lactate, triacyclglycerols, glucose and FFAs concentrations in arterial, coronary sinus (CS), and central venous beds were measured after an overnight fast to derive myocardial substrates utilization in HF patients and controls scheduled for cardiac device implanting procedures.
Results: A total of 15 HF patients and 11 controls were enrolled. Arterial and CS metabolites concentration were similar between the groups. A significant reduction in the myocardial FFAs extraction was showed in HF patients compared to controls (HF 0.07 +- 0.23 mmol/L vs non-HF 0.25 +- 0.16 mmol/L, p=0.03), together with an inverse association between FFAs and neurohormonal and echocardiographic HF hallmarks. Opposite, β-hydroxybutyrate, lactate, triacyclglycerols and glucose extractions were relatively unchanged between groups. The net cardiac extraction of β-hydroxybutyrate was directly associated to HF duration. When diabetic and non-diabetic patients were compared among HF population, the results were substantially similar, with a slight trend in reduction of FFAs net extraction (HF 0.03 +- 0.30 mmol/L vs non-HF 0.26 +- 0.12 mmol/L, p=0.09).
Conclusions: In our study ketone bodies utilization was unchanged between mild to moderate HF patients and controls. We showed a reduced myocardial FFAs extraction consistent with a downregulation of beta-oxidation in the failing heart in HF population. Future studies are needed to clarify mechanisms that regulate the metabolic switch and its timing
Cenni di regolamentazione, classificazione e terapia farmacologica delle malattie dell'apparato cardiovascolare
No full textSodium–glucose co-transporter 2 inhibitors for the treatment of cardio-renal syndrome
No full textThe 2021 guidelines of the European Society of Cardiology on the diagnosis and therapy of heart failure (HF) introduced relevant changes in the pharmacological treatment of chronic HF. Among these, certainly the most significant was the introduction in the therapeutic flow-chart (with the highest recommendation level) of the sodium glucose co-transporter 2 (SGLT2) inhibitors. In fact, SGLT2 inhibitors are responsible for major paradigm shifts in the care of patients with or at high risk for HF, progression of chronic kidney disease, or both. SGLT2 inhibition demonstrated to improve cardiovascular outcomes in patients with HF over a wide range of ejection fractions, regardless of diabetic status, and have a strong nephroprotective effect. There are several important interactions between heart disease and kidneys disease. Indeed, acute or chronic dysfunction of the heart or kidneys can induce acute or chronic dysfunction in the other organ. The term ‘cardiorenal syndrome’ has been applied to these interactions. Since kidneys dysfunction in the setting of HF has a strong prognostic relevance, drugs that can slow down the decline of renal function are of utmost importance. Here, we discuss about the beneficial effects of SGLT2 inhibitors on the kidneys function in patients with HF and how these effects can improve both renal and cardiovascular outcomes
Insufficienza cardiaca
No full textBreve descrizione della epidemiologia, fisiopatologia, diagnosi e terapia medico-chirurgica dell'insufficienza cardiac
Echocardiographic visualization of retroaortic anomalous coronary artery
Full text linkThe anomalous aortic origin of the left coronary artery from the right coronary sinus is a rare congenital anomaly. Transthoracic echocardiography (TTE) has limited accuracy to detect coronary anomalies in adults. A highly specific TTE finding (RAC sign) has been recently described as strongly associated to retroaortic anomalous coronary course. Cardiologists should be aware of the appearance and significance of the RAC sign, so that it is not ignored or misdiagnosed
Organizzazione e funzione del Gruppo Operativo Interdisciplinare Scompenso Cardiaco: la risposta sostenibile di un moderno sistema di cure a un problema emergente di sanità pubblica
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