Heart failure with reduced ejection fraction and chronic kidney disease: a focus on therapies and interventions.

Autor: Taha HSE; Cardiology Department, Kasr Al-Ainy Faculty of Medicine, Cairo University, Giza, Egypt., Momtaz M; Nephrology & Internal Medicine, Internal Medicine Department, Kasr Al-Ainy Faculty of Medicine, Cairo University, Giza, Egypt., Elamragy AA; Cardiology Department, Kasr Al-Ainy Faculty of Medicine, Cairo University, Giza, Egypt., Younis O; Cardiology Department, National Heart Institute, 5 Ibn Al Nafees Square, Al Kit Kat, Giza, 12651, Egypt. dr.omar_younis@outlook.com., Fahim MAS; Cardiology Department, Kasr Al-Ainy Faculty of Medicine, Cairo University, Giza, Egypt.
Jazyk: angličtina
Zdroj: Heart failure reviews [Heart Fail Rev] 2025 Jan; Vol. 30 (1), pp. 159-175. Date of Electronic Publication: 2024 Oct 18.
DOI: 10.1007/s10741-024-10453-3
Abstrakt: In heart failure with reduced ejection fraction (HFrEF), the presence of concomitant chronic kidney disease (CKD) predicts poorer cardiovascular outcomes, more aggravated heart failure (HF) status, and higher mortality. Physicians might be reluctant to initiate life-saving anti-HF medications out of fear of worsening renal function and a higher incidence of adverse events. Moreover, international guidelines do not give clear recommendations on managing this subgroup of patients as well as advanced CKD was always an exclusion criterion in most major HF trials. Nevertheless, in this review, we will highlight several recent clinical trials and post-hoc analyses of major trials that showed the safety and efficacy of the different therapies in HFrEF patients with CKD, besides several small-scale cohorts that tested guideline-directed medical therapies in End Stage Kidney Disease (ESKD). Regarding interventions in this subgroup of patients, we will provide up-to-date data on implantable cardioverter defibrillators, cardiac resynchronization therapy, and coronary revascularization, in addition to mitral valve transcatheter edge-to-edge repair and implantable pulmonary artery pressure sensors.
Competing Interests: Declarations. Competing interests: The authors declare no competing interests.
(© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)
Databáze: MEDLINE
Externí odkaz: