ABSTRACT
Transthyretin amyloidosis (ATTR) is a threatening and severe genetic disease characterized by damages to organs and systems caused by a pathological protein transthyretin produced in the liver. Clinical manifestations of this disease vary from injuries of the nervous system to injuries of the cardiovascular system. Prognosis for ATTR-amyloidosis remains unfavorable. The absence of pathognomonic symptoms complicates diagnostics of this disease, which tends to simulate other conditions. At present, medicines exist, which are pathogenetic in the treatment of ATTR-amyloidosis. The article describes a clinical case of ATTR-amyloidosis with primary heart injury complicated with functional class III chronic heart failure during the tafamidis treatment.
Subject(s)
Amyloid Neuropathies, Familial , Benzoxazoles/therapeutic use , Amyloid Neuropathies, Familial/drug therapy , Humans , PrealbuminABSTRACT
PURPOSE: To assess the suppression of tumorogenicity 2 (ST2) and copeptin significance for risk stratification of patient (pts) with acute decompensated heart failure (ADHF) during long-term follow-up compared with traditional risk factors. METHODS: We included in a prospective study 159 pts with ADHF. Blood samples to determine copeptin, sST2, NT-proBNP and hsTnT concentration were collected at admission and at discharge from the hospital. Serial determination of biomarker concentration was performed at 3, 6 and 12 months of follow-up. The combined primary end point of the trial included cardiovascular (CV) death, hospitalization due to HF, episodes of HF deterioration requiring additional intravenous diuretics and CV death with successful resuscitation. RESULTS: During 1-year follow-up (295.3±113.2 days) 56 pts (35.2%) had 78 (49.1%) cardiovascular events. Biomarker concentrations in low risk pts (without CV events) were significantly lower compared with high risk pts (with CV events). Discharge copeptin and NT-proBNP values were comparable for pts risk stratification: AUC=0.727 (95% CI 0.637-0.816), Ñ.
Subject(s)
Heart Failure , Biomarkers , Glycopeptides , Humans , Natriuretic Peptide, Brain , Prognosis , Prospective StudiesABSTRACT
The review presents data on alterations of mitochondrial oxidative metabolism occuring due to heart failure, mechanisms of cytoprotective agent trimetazidine associated with a partial inhibition of the fatty acid oxidation and increased metabolism of pyruvate, reduction of cardiomyocyte apoptosis and oxidative stress are described. The results of clinical studies showing the effectiveness of trimetazidine therapy in ischemic heart decease are reported, as well as the latest data on the effects of prolonged use of trimetazidine on prognosis in patients with heart failure.
Subject(s)
Heart Failure/drug therapy , Trimetazidine/therapeutic use , Vasodilator Agents/therapeutic use , Chronic Disease , HumansABSTRACT
Mineralocorticoid receptor antagonists (MCRA) are part of standard medical therapy for heart failure (HF). The clinical efficacy of MCRA in patients with systolic HF has been proven by randomized clinical trials. The efficacy of this drug group in patients with chronic HF with preserved left ventricular systolic function and the advent and practical introductions of safer new-generation MCRA remain to be answered.
Subject(s)
Heart Failure, Systolic , Spironolactone/analogs & derivatives , Spironolactone/pharmacology , Ventricular Function, Left/drug effects , Eplerenone , Heart Failure, Systolic/diagnosis , Heart Failure, Systolic/drug therapy , Heart Failure, Systolic/physiopathology , Humans , Mineralocorticoid Receptor Antagonists/pharmacology , Prognosis , Randomized Controlled Trials as Topic , Treatment OutcomeABSTRACT
The number of patients with heart failure and atrial fibrillation is huge. Population of patients with heart failure in combination with atrial fibrillation is characterized by poor quality of life and adverse outcomes. In this review we summarized data on the guideline adherence and prevalence of long-term anticoagulant therapy in patients with atrial fibrillation and heart failure.
