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Guaricci AI, Sturdà F, Russo R, Basile P, Baggiano A, Mushtaq S, Fusini L, Fazzari F, Bertandino F, Monitillo F, Carella MC, Simonini M, Pontone G, Ciccone MM, Grandaliano G, Vezzoli G, Pesce F. Assessment and management of heart failure in patients with chronic kidney disease. Heart Fail Rev 2024; 29:379-394. [PMID: 37728751 PMCID: PMC10942934 DOI: 10.1007/s10741-023-10346-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/04/2023] [Indexed: 09/21/2023]
Abstract
Heart failure (HF) and chronic kidney disease (CKD) are two pathological conditions with a high prevalence in the general population. When they coexist in the same patient, a strict interplay between them is observed, such that patients affected require a clinical multidisciplinary and personalized management. The diagnosis of HF and CKD relies on signs and symptoms of the patient but several additional tools, such as blood-based biomarkers and imaging techniques, are needed to clarify and discriminate the main characteristics of these diseases. Improved survival due to new recommended drugs in HF has increasingly challenged physicians to manage patients with multiple diseases, especially in case of CKD. However, the safe administration of these drugs in patients with HF and CKD is often challenging. Knowing up to which values of creatinine or renal clearance each drug can be administered is fundamental. With this review we sought to give an insight on this sizable and complex topic, in order to get clearer ideas and a more precise reference about the diagnostic assessment and therapeutic management of HF and CKD.
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Affiliation(s)
- Andrea Igoren Guaricci
- University Cardiologic Unit, Interdisciplinary Department of Medicine, Polyclinic University Hospital, University of Bari Aldo Moro, Piazza Giulio Cesare 11, 70121, Bari, Italy.
| | - Francesca Sturdà
- University Cardiologic Unit, Interdisciplinary Department of Medicine, Polyclinic University Hospital, University of Bari Aldo Moro, Piazza Giulio Cesare 11, 70121, Bari, Italy
| | - Roberto Russo
- Department of Precision and Regenerative Medicine and Ionian Area, University of Bari Aldo Moro, 70124, Bari, Italy
| | - Paolo Basile
- University Cardiologic Unit, Interdisciplinary Department of Medicine, Polyclinic University Hospital, University of Bari Aldo Moro, Piazza Giulio Cesare 11, 70121, Bari, Italy
| | - Andrea Baggiano
- Department of Perioperative Cardiology and Cardiovascular Imaging, Centro Cardiologico Monzino, IRCCS, 20138, Milan, Italy
| | - Saima Mushtaq
- Department of Perioperative Cardiology and Cardiovascular Imaging, Centro Cardiologico Monzino, IRCCS, 20138, Milan, Italy
| | - Laura Fusini
- Department of Perioperative Cardiology and Cardiovascular Imaging, Centro Cardiologico Monzino, IRCCS, 20138, Milan, Italy
| | - Fabio Fazzari
- Department of Perioperative Cardiology and Cardiovascular Imaging, Centro Cardiologico Monzino, IRCCS, 20138, Milan, Italy
| | - Fulvio Bertandino
- University Cardiologic Unit, Interdisciplinary Department of Medicine, Polyclinic University Hospital, University of Bari Aldo Moro, Piazza Giulio Cesare 11, 70121, Bari, Italy
| | - Francesco Monitillo
- University Cardiologic Unit, Interdisciplinary Department of Medicine, Polyclinic University Hospital, University of Bari Aldo Moro, Piazza Giulio Cesare 11, 70121, Bari, Italy
| | - Maria Cristina Carella
- University Cardiologic Unit, Interdisciplinary Department of Medicine, Polyclinic University Hospital, University of Bari Aldo Moro, Piazza Giulio Cesare 11, 70121, Bari, Italy
| | - Marco Simonini
- Nephrology and Dialysis Unit, IRCCS San Raffaele Scientific Institute, 20132, Milan, Italy
| | - Gianluca Pontone
- Department of Perioperative Cardiology and Cardiovascular Imaging, Centro Cardiologico Monzino, IRCCS, 20138, Milan, Italy
| | - Marco Matteo Ciccone
- University Cardiologic Unit, Interdisciplinary Department of Medicine, Polyclinic University Hospital, University of Bari Aldo Moro, Piazza Giulio Cesare 11, 70121, Bari, Italy
| | - Giuseppe Grandaliano
- Department of Medical and Surgical Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Giuseppe Vezzoli
- Department of Nephrology and Dialysis, Vita Salute San Raffaele University, 20132, Milan, Italy
| | - Francesco Pesce
- Department of Precision and Regenerative Medicine and Ionian Area, University of Bari Aldo Moro, 70124, Bari, Italy
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Sun L, Zhu W, Xu Y, Gao M, Sun S, Li J. Clinical study of two-dimensional speckle tracking to evaluate abnormal myocardial motion due to coronary lesions. Echocardiography 2024; 41:e15744. [PMID: 38284681 DOI: 10.1111/echo.15744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 12/21/2023] [Accepted: 12/30/2023] [Indexed: 01/30/2024] Open
Abstract
OBJECTIVE To investigate the predictive ability of global longitudinal strain (GLS) and mechanical dispersion for coronary stenosis and provide a more reliable noninvasive method for diagnosis of obstructive coronary artery disease(OCAD). METHODS Sixty-seven patients diagnosed with suspected CAD were included in the study. Patients with coronary stenosis greater than 50% were assigned as OCAD, while the others were assigned as non obstructive coronary artery disease(NOCAD). General information was collected and patients underwent speckle tracking echocardiogram(STE). RESULTS Spearman's correlation analysis showed that GLS and mechanical dispersion were positively correlated with the degree of coronary stenosis (r = 0.383, 0.342, p < 0.05), and there was also a positive correlation between GLS and mechanical dispersion (r = 0.327, p < 0.05). GLS, longitudinal strain (LS) of each chamber, and mechanical dispersion were higher in the OCAD group than in the NOCAD group (p < 0.05). Univariate regression analysis showed that GLS, each lumen LS and mechanical dispersion were statistically significant (p < 0.05). Multifactorial regression analysis showed that elevated GLS (p = 0.007) and elevated mechanical dispersion (p = 0.030) were independent risk factors for OCAD. The ROC curves showed that GLS predicted OCAD (AUC area 0.745, 95% CI 0.624 to 0.865) versus mechanical discrete prediction of OCAD (AUC area 0.702, 95% CI 0.569 to 0.834) were more diagnostic than conventional cardiac ultrasound observations of ventricular wall motion abnormalities (AUC area 0.566, 95% CI 0.463 to 0.669). CONCLUSIONS Combining GLS with mechanical dispersion can rapidly assess OCAD in a very short period, which has strong promotion value and in-depth research value.
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Affiliation(s)
- Lin Sun
- Departments of Cardiology, Hospital of Harbin Medical University, Harbin, China
| | - Weiwei Zhu
- Departments of Cardiology, Hospital of Harbin Medical University, Harbin, China
| | - Yidan Xu
- Departments of Cardiology, Hospital of Harbin Medical University, Harbin, China
| | - Ming Gao
- Departments of Cardiology, Hospital of Harbin Medical University, Harbin, China
| | - Shaoqing Sun
- Department of Cardiology, Hangzhou Lin'an District Hospital of Traditional Chinese Medicine Hangzhou, Zhejiang, China
| | - Jingjie Li
- Departments of Cardiology, Hospital of Harbin Medical University, Harbin, China
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