Heart failure affects quality of life and life expectancy of tens of millions of individuals. There are no available economic and effective treatments for end-stage heart failure. Hydrogels are novel tissue engineering materials, which have the potential to ameliorate myocardium remodeling, increase cardiac output, improve quality of life and prolong life span by implantation into myocardium. The preclinical experiments and clinical trials have greatly explored the function of hydrogels in heart failure. In this review, we summarized the approaches of implantation, mechanism and clinical outcomes of the hydrogels.
Congestive heart failure is a complication of myocardial infarction threatening human health. Although the pharmacotherapy is effective, it is still a worldwide challenge to thoroughly repair the injured myocardium induced by myocardial infarction. It has been demonstrated that mesenchymal stem cells (MSCs) can repair infarcted myocardium. Much evidence shows that MSCs can generate new myocardial cells in both human and animals' hearts. This review aims at discussing the therapeutic progress of the congestive heart failure treated with MSCs.
Objective To systematically review the efficacy and safety of different SGLT2 inhibitors in the treatment of heart failure. Methods The Cochrane Library, Web of Science, PubMed and EMbase databases were searched for randomized controlled trials on the efficacy and safety of SGLT2 inhibitors in patients with heart failure from inception to July 2, 2021. Two researchers independently screened literature, extracted data and evaluated the risk of bias of the included studies. Network meta-analysis was then performed using Stata 16.0 software. Results A total of 16 randomized controlled trials, including 15 312 patients, involving 5 interventions, namely dapagliflozin, empagliflozin, canagliflozin, sotagliflozin and ertugliflozin were included. Results of network meta-analysis showed that there was no significant difference in the compound outcome of hospitalization for heart failure or cardiovascular death, hospitalization for heart failure, all-cause mortality, risk of cardiovascular mortality and serious adverse reactions among patients with heart failure among 5 different SGLT2 inhibitors (P>0.05). Compared with placebo, both selective and non-selective SGLT2 inhibitors improved the risk of hospitalization for heart failure, hospitalization for heart failure, or compound cardiovascular mortality (P<0.05), while only selective SGLT2 inhibitors improved the risk of cardiovascular mortality, all-cause mortality, and serious adverse events (P<0.05). However, there was no significant difference between them (P>0.05). The area under the cumulative ordering probability curve of selective and non-selective SGLT2 inhibitors ranked first and second, except for the combined outcome of heart failure or cardiovascular death. Conclusion The current evidence indicates that there is no significant difference in the efficacy and safety of the 5 different SGLT2 inhibitors in the treatment of heart failure, and there is no significant difference between selective SGLT2 inhibitors and non-selective SGLT2 inhibitors. Due to the limited quantity and quality of included studies, more high-quality studies are needed to verify the above conclusion.
Abstract: The ventricle assist device has emerged as an important therapeutic option in the treatment of both acute and chronic heart failure. The blood pumps which are the major components of ventricle assist devices have also progressed to the third generation. The magnetic and/or liquid levitation technologies have been applied into the third generation blood pumps. The impellers which drive blood are levitated in the blood pumps. The third generation blood pumps are mainly composed of the levitation system and the driving system. The development of the third generation blood pumps has three stages: the stage of foreign motor indirectly driving the impeller with the levitation and driving system separated, the stage of motor directly driving the impeller with the levitation and driving system separated, and the stage of levitation system integrated with the driving system. As the impellers do not contact with other structures, the third generation blood pumps possess the advantages of low thrombosis, less hemolysis and high energy efficiency ratio. Currently most of the third generation blood pumps are in the research stage, but a few number of them are used in clinical trials or applying stage. In this article, the history, classification, mechanism and research situation of the third generation blood pumps are reviewed.
Heart failure (HF) is a symptoms caused by various diseases. As the myocardial contractility and/or diastolic weakening, the cardiac output decreased, when it can not satisfy the needs of the body, a series of symptoms and signs occurs. HF is an end-stage performance of heart disease, and is also a major factor of mortality. The morbidity of heart failure increased as peoples enter the aging. Despite the continuous improvement of drug treatment,the morbidity and mortality of HF remains high. At present, nondrug treatment of heart failure get more and more attention to clinicians. Surgical methods gets more innovation.Medical intervention has been introducted new auxiliary facilities, and genetics and stem cell technology bring new hope to it’s treatment. This article reviews the HF surgery, nterventional treatment and its related gene and cell therapy and research recently.
Sodium-glucose cotransporter (SGLT) -2 inhibitors is a new type of oral sugar-lowering drug. Instead of relying on insulin, it lowers blood sugar by inhibiting the reabsorption of near-curvy tube glucose, which is drained from the urine. SGLT-2 inhibitors not only have a sugar-lowering effect, but also benefit significantly in cardiovascular disease, and this drug has the advantages of permeable diuretic, reducing capacity load, and improving ventricular remodeling. SGLT-2 inhibitors can improve the diastolic function of patients with heart failure with preserved ejection fraction (HFpEF) and reduce the risk of adverse cardiovascular events. SGLT-2 inhibitors can benefit patients with HFpEF. Therefore, this article will discuss the progress of SGLT-2 inhibitors in HFpEF.
ObjectiveTo summarize the individualized selection of surgical treatment strategies and the key points of perioperative management for patients with heart valve disease complicated with severe chronic heart failure.MethodsThe clinical characteristics of 5 male patients with valvular heart disease complicated with severe chronic heart failure (CHF) were analyzed retrospectively from June 2017 to October 2018 in Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, with an average age of 60.21 years.ResultsFive patients were given angiotensin receptor and neprilysin inhibitor (ARNI)-based anti-heart failure treatment after admission. The operation mode of these patients was decided to be valve replacement under cardiopulmonary bypass after individualized evaluation of patients’ improving symptoms. Three patients were treated with intra-aortic balloon pump (IABP) and continuous renal replacement therapy (CRRT) early after operation to assist patients in improving cardiac function. Five patients recovered oral anti-heart failure after awakening. All patients were discharged smoothly 2 weeks after operation.ConclusionIndividualized evaluation is needed for the choice of operation timing and mode, standardized preoperative treatment for heart failure, shortening the aortic blocking time during cardiopulmonary bypass, and early application of left ventricular adjuvant drugs or instruments are all important measures to help patients recover smoothly.
The implantation of a left ventricular assist device (LVAD) is an important therapeutic tool for patients with end-stage heart failure, which can either help patients transit to the heart transplantation stage or serve as destination therapy until the end of their lives. In recent years, the third generation of LVAD has evolved rapidly and several brands have been marketed both domestically and internationally. The number of LVAD implantations has been increasing and the long-term survival rate of implanted patients has improved, so this device has a broad development perspective. This article summarizes the current status, usage standards and precautions, and common complications after implantation of LVAD, as well as looks forward to the future development of LVAD, hoping to be helpful for researchers who are new to this field.