PubMed Health⌕ Search

SEARCH · PubMed Health

Results for “heart failure”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 19 recordsLinked to original sources
PubMed1977

[Systemic lupus erythematosus and congestive heart failure. Heart histological and ultrastructural study (author's transl)].

Histological and ultrastructural studies were performed on myocardial biopsies and aortic and mitral valve leaflets obtained during an operation on a patient with Systemic Lupus Erythematosus (S.L.E.). Congestive heart failure and valvular dysfunction appeared five years after the diagnosis of S.L.E. was made. On histological study, aortic and mitral valve leaflets are uniformly thickened by fibrous tissue with a nodular appearance. No active endocarditis was associated with the fibrous scarring. Atrial myocardium and papillary muscle countain a fibrous net-work discret in the former, extensive in the latter. The scattered foci of fibrosis in the papillary muscle surround vessels without obliteration or parietal necrosis. Ultrastructurally their lumina appears narrowed by prominent endothelial cells with cytoplasmic aggregates of tubuloreticular structures (T.R.S.). These tubules are also present in some endocardial endothelial cells but are rare in the normal intrapapillary or atrial vessels that are not associated with a scar. Myocardial fibrous foci enclose atrophic and severely degenerated cardiac muscle cells; other cells situated at the periphery of the foci are normal in size or hypertrophic and moderately degenerated. The most altered muscle cells show an important loss of myofibrils, a proliferation of sarcoplasmic reticulum in myofibril free spaces, or necrosis with macrophagic resorption. Focal changes with loss of myofilaments, Z material streaming and concentric lamellar bodies are found in moderately degenerate cardiac muscle cells. The remaining papillary muscle cells and the atrial cells are all hypertrophied without degeneration. These changes suggest that focal myocardial fibrosis and associated cardiac muscle cell degeneration may be responsible for impaired cardiac performance in some patients with S.L.E. According to the constant topographic relation between the narrowed vessels whose endothelial cells contain T.R.S. and the surrounding fibrous foci, we believe that the myocardial fibrous patches may correspond to scarring of microinfarcts related to active S.L.E. vascularitis.

Aortic Valve↗
PubMed1979

Postpartum cardiac failure--heart failure due to volume overload?

Ventricular function has been studied in 43 patients with the peripartum cardiac failure (PPCF) syndrome which occurs around Zaria. All patients had an echocardiogram on admission and 10 patients had right heart catheterization. Despite the gross edema, left ventricular function assessed by echocardiography and systolic time intervals was relatively good and the estimated cardiac output were high. At catheterization, although the pressures were high, the cardiac outputs were greater than normal in four out of six patients. No patient had a low cardiac output. These findings are not compatible with a severe heart muscle disorder, or cardiomyopathy. We suggest that the primary event in PPCF of Zaria is fluid retention which leads to a form of high output cardiac failure. The postpartum practices in this area (taking high sodium diets and lying on heated beds) almost certainly cause the fluid to accumulate initially, but the heart may be unable to meet the demands either because of preexisting heart muscle disease or, more likely, because of a rise of the peripheral resistance due to the volume expansion, overburdens such dilated hearts and leads to myocardial damage. Since there are similarities between this condition and PPCF in temperate climates, it is possible that there is a common mechanism which the traditional practices of this area have unveiled.

Adolescent↗
PubMed2026

Select Contemporary Statistical Concepts in Heart Failure Clinical Trials: Insights From the Heart Failure Collaboratory.

Evolving statistical concepts and innovative trial designs for heart failure (HF) clinical trials seek to improve the conduct, efficiency, and likelihood of meaningful evidence generation crucial for advancing therapeutic development and optimizing patient care. HF trials with conventional statistical frameworks often require large sample sizes, long follow-up times, and high cost to generate sufficient evidence. Novel statistical methodologies would be of interest if they could address these issues while retaining or enhancing the clinical relevance and reliability of results. The HFC (Heart Failure Collaboratory), comprising clinical investigators, clinicians, statisticians, patients, government representatives, payors, and industry collaborators, leads efforts to improve HF research methodologies. HFC discussions have included statistical concepts such as the estimand framework, HR drift, and analytic methods, including the win ratio and restricted mean survival time, that have not been used frequently in HF trials. The estimand framework encourages precise definition and alignment of trial objectives with trial design. The win ratio method attempts to incorporate and prioritize multiple clinically meaningful outcomes by using a hierarchy of clinical importance. The restricted mean survival time provides an alternative to the HR as a measure of therapeutic effect by quantifying the mean time gained or lost during a fixed time after randomization. This paper provides a critical review of some evolving HF trial design methodologies and statistical concepts for the HF community as discussed within the HFC. Our goal is to foster collaboration among diverse stakeholders and advance the development of effective treatments and improve patient care outcomes.

Heart Failure↗
PubMed1979

[Meproscillarin in patients with renal failure and concomitant heart failure (author's transl)].

Meproscillarin is a glycoside with a high bioavailability (about 70%) and an elimination independent of the renal function. It was to be investigated whether a good cardiac effectiveness can be demonstrated during oral long-term application of meproscillarin to patients with renal failure. 29 patients with renal failure of varying degree and concomitant heart failure were daily given an oral dose of 0.75 mg of meproscillarin over 14 days. The effectiveness of the glycoside was measured as change of the electromechanical systole (QS2c) and the quotient of the diameter of heart and thorax (C/T) from the 1st--15th day. The plasma levels of the glycoside were determined on the 1st, 8th, and 15th day. There was a significant shortening of QS2c (by mean = 27 ms, P less than 0.005) and a marked decrease in the size of the heart (P less than 0.0025); heart rate and PQ-interval were only insignificantly influenced. Plasma levels of 0.95 ng/ml were found after 8 days of treatment compared to 1.25 ng/ml after 15 days. As the pharmacokinetics of the glycoside is practically not influenced by the renal function, meproscillarin represents an alternative in the treatment of patients with heart failure and impaired renal function.

Adult↗
PubMed1978

Studies on heart failure in old age (Part II). Hemodynamic effects of propranolol and isoproterenol in elderly patients with heart failure.

Hemodynamic responses to propranolol and isoproterenol were examined in elderly patients with heart failure. The results obtained are as follows: 1. Patients with mild heart failure showed greater reduction than control group in heart rate and cardiac output after intravenous propranolol. These enhanced hemodynamic responses to propranolol would be the evidence of increased adrenergic activity even in mild heart failure. 2. Intravenous propranolol in the small dosage of 0.03 mg/kg showed only a negligible hemodynamic deterioration even in patients with heart failure. 3. Hemodynamic responses to beta-adrenergic stimulator, isoproterenol, were depressed in severe heart failure.

Aged↗
PubMed2026

Multi-ancestry genetic architecture of heart failure subtypes.

Heart failure (HF) affects 6.7 million people in the US and includes two major subtypes, HF with reduced ejection fraction (HFrEF) and HF with preserved ejection fraction (HFpEF), with distinct genetic architectures. We meta-analyze genome-wide association studies (GWAS) of 38,781 HFrEF cases, 38,163 HFpEF cases, and 526,135 controls across European, African, Hispanic, and Asian ancestries using the Million Veteran Program and Vanderbilt University DNA Databank (BioVU). We identify 46 genome-wide significant loci for HFrEF (9 novel) and 3 loci for HFpEF (1 novel). Four HFrEF loci are detected in African ancestry participants near CD36, SPI1, TRIM48, and SPNS3, with lead SNPs showing low risk-allele frequencies in European populations. In the all-cause HF meta-analysis (200,070 cases, 2,076,466 controls), we identify 136 loci (12 novel). Gene-based tests, tissue enrichment, transcriptome-wide association, and fine-mapping implicate vascular, metabolic, and TGF-β/Smad signaling pathways and nominate candidate causal genes, clarifying shared and subtype-specific risk across ancestries.

Humans↗
PubMed2026

Genetic Determinants of Early Heart Failure in Hypoplastic Left Heart Syndrome: A Prospective NC-DEFINE Study.

BACKGROUND: Survivors of hypoplastic left heart syndrome (HLHS), the most severe form of congenital heart disease, are at high risk for heart failure (HF). HF in early life is a major contributor to mortality in this vulnerable population. However, reliable approaches to identify infants at highest risk for early HF are currently lacking. OBJECTIVES: The purpose of this study was to evaluate whether ultra-rare variants in cardiomyopathy-associated genes are associated with HF risk in HLHS. METHODS: Neonates with HLHS were prospectively enrolled within the first 21 days of life at Duke University Health System. Children and adults with HLHS who were older than 21 days were enrolled from Duke University Health System and the University of North Carolina into an ambispective cohort. External HLHS cohorts from Nationwide Children's Hospital and Vanderbilt University Medical Center were evaluated to assess for reproducibility across institutions. Participants underwent genome sequencing, and ultra-rare variants in dilated cardiomyopathy-associated genes (minor allele frequency &#x2264;0.01%) were evaluated. The primary outcome was HF, categorized as severe (ventricular assist device implantation, heart transplantation, or death) or medically managed (reduced systemic ventricular ejection fraction and/or HF diagnosis requiring initiation or escalation of HF therapy). Associations between variant status and HF risk were assessed using Cox regression. RESULTS: Among 35 neonates in the prospective cohort, 7 (20.0%) developed severe HF, 10 (28.6%) developed medically managed HF, and 18 (51.4%) remained HF free. The presence of a likely pathogenic/pathogenic variant was associated with a marked 9-fold increased risk of severe HF compared with genotype-negative individuals (P = 0.02). Most severe HF events occurred within the first month of life (67%). Similar associations between likely pathogenic/pathogenic variants and severe HF were observed in the Nationwide Children's Hospital and Vanderbilt University Medical Center cohorts (11- and 3-fold increased risk, respectively; all P < 0.05). Associations were attenuated in the ambispective cohort (all P > 0.05), which consisted of individuals significantly older than the prospective cohort (P < 0.0001). CONCLUSIONS: This study provides the first prospective evidence linking dilated cardiomyopathy-associated variants to early-onset HF in HLHS. These findings suggest that genetic variation may contribute to myocardial vulnerability in HLHS, highlighting the potential for genetic screening to enable early risk stratification and guide precision medicine approaches in this high-risk population.

Humans↗
PubMedDate not supplied

Myocardial hypertrophy. Light microscopic findings on the myocardium. Blood supply. Ventricular dilatation and heart failure.

The heart is an organ with an almost constant number of muscle cells under physiological conditions. But beyond the critical heart weight (500 g) there is an increase in the number of muscle fibers (hyperplasia) and a similar increase in the number of capillaries. The relation of 1 capillary to 1 muscle fiber remains constant. During physiological growth there is a rather close correlation between the growth of human coronary arteries and the growth of the myocardium. Under pathological conditions the growth of coronary arteries is slower than that of the myocardium. In many animal species investigated up to now there is a rather close correlation between the diameter of coronary arteries and the diameter of the heart. As a rule, hearts with chronic insufficiency are dilated. They work under unfavourable geometrical conditions. The post-mortem ventricular volume is influenced to a very great degree by rigor mortis.

Animals↗
PubMed1976

Treatment of congestive heart failure.

In treating heart failure, the physician must remain cognizant of pathophysiology as he prescribes and monitors therapy. In addition to seeking underlying and precipitating causes of the patient's heart failure, he must treat the congestive state by enhancing myocardial contractility, controlling excessive fluid retention, and reducing afterload. Figure 7 summarizes the theoretical shifts on a patient's left ventricular function curves that might occur with therapy. Left ventricular function might move from point A to point B with diuretic therapy, but overdiuresis could aggravate symptoms of low cardiac output, including postural hypotension. Digitalis would effect a shift from A to C. Isosorbide dinitrate would produce a shift from A to D in a patient not on digitalis and from C to D in a patient already receiving digitalis. Isosorbide dinitrate, in conjunction with more usual therapeutic measures, has proved clinically beneficial in the treatment of heart failure.

Benzothiadiazines↗
PubMed2026

New Evidence in Heart Failure: 2026 Update.

Heart failure (HF) remains a major cause of morbidity, mortality, impaired quality of life and healthcare expenditure worldwide. The global burden of HF continues to increase due to population aging, improved survival, and the growing prevalence of cardiovascular, renal, and metabolic comorbidities. Simultaneously, the pace of scientific progress in HF has accelerated considerably. Recent advances have refined our understanding of HF epidemiology, prognosis, and disease trajectories, including emerging concepts of HF improvement, remission, and recovery. The Second Universal Definition of HF has also updated the classification framework, moving beyond the traditional ejection fraction-based categories. HF is now broadly classified into two major phenotypes: heart failure with reduced ejection fraction (HFrEF) and heart failure with preserved ejection fraction (HFpEF). Novel mechanistic insights highlight the role of inflammation, immune activation, metabolic dysfunction, mitochondrial biology, and multisystem interactions in HF progression. There has also been significant progress in the characterization and management of major comorbidities, including chronic kidney disease (CKD), diabetes, obesity, atrial fibrillation (AF), pulmonary hypertension, frailty, malnutrition, and cancer. Diagnostic innovations include novel biomarkers, multi-omics technologies, artificial intelligence-based approaches, advanced imaging techniques, congestion assessment tools, and emerging digital health solutions. Important advances have occurred in specific HF aetiologies, including cardiomyopathies, cardiac amyloidosis (CA), myocarditis, arrhythmia-induced cardiomyopathy (AiCM), and Chagas cardiomyopathy. Therapeutic developments continue to reshape HF management across the spectrum of left ventricular ejection fraction. Recent evidence has focused on optimization of guideline-directed medical therapy in HFrEF, expansion of evidence-based therapies in HFpEF, and growing roles for sodium-glucose cotransporter-2 inhibitors, finerenone, incretin-based therapies, and transcatheter valve interventions. Collectively, these advances support the transition from a predominantly phenotype-based approach towards a more personalized and biologically informed model of HF care, with the potential to further improve outcomes across the entire HF spectrum.

Journal Article↗
PubMed2026

A reproducible computational transcriptomic framework for cell-type-resolved fibroinflammatory-AKT remodeling in human heart failure.

BACKGROUND: Human heart failure involves multicellular transcriptional remodeling, but public transcriptomic studies often remain disconnected from cell-type localization and perturbational interpretation. METHODS: We developed a reproducible computational workflow integrating human left-ventricular bulk transcriptomes, donor-level cell-type pseudobulk results from a human heart-failure single-cell/single-nucleus atlas, external snRNA-seq support, curated module scoring, focused ligand-receptor prioritization and LINCS/L1000 perturbational matching. RESULTS: Cross-cohort analysis identified 14,358 same-direction HF-associated genes, including 1633 replicated HF-up and 785 replicated HF-down genes. Donor-level pseudobulk analysis localized disease remodeling to cardiomyocyte, fibroblast and myeloid compartments. Activated fibroblast and inflammatory myeloid programs defined a fibroinflammatory remodeling axis connected to context-dependent AKT-associated transcriptional shifts. External snRNA-seq support was strongest for fibroblast activation and AKT-associated remodeling, with etiology-dependent heterogeneity across validation resources. L1000FWD screening prioritized safety-aware perturbational hypotheses, including glimepiride and simvastatin as interpretable candidates requiring experimental validation. CONCLUSIONS: This study provides a computational transcriptomic framework linking reproducible human HF signatures, cell-type-resolved fibroinflammatory remodeling and perturbational genomic prioritization without claiming drug efficacy or AKT causality.

Humans↗