Publications by authors named "Stephan Von Haehling"
Mechanisms and pharmacotherapy of cancer cachexia-associated anorexia.
Pharmacol Res Perspect
February 2025
Cachexia is a multifactorial metabolic syndrome characterized by weight and skeletal muscle loss caused by underlying illnesses such as cancer, heart failure, and renal failure. Inflammation, insulin resistance, increased muscle protein degradation, decreased food intake, and anorexia are the primary pathophysiological drivers of cachexia. Cachexia causes physical deterioration and functional impairment, loss of quality of life, lower response to active treatment, and ultimately morbidity and mortality, while the difficulties in tackling cachexia in its advanced phases and the heterogeneity of the syndrome among patients require an individualized and multidisciplinary approach from an early stage.
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- * Germany has taken a leading role in implementing telemedicine for CHF, resulting in improved patient quality of life and fewer hospitalizations, supported by governmental backing and substantial research evidence.
- * This review analyzes the evolution of telemonitoring for CHF in Germany, highlighting key studies and the journey towards integrating telemedicine into standard care for high-risk patients.
New cardiovascular biomarkers in patients with advanced cancer - A prospective study comparing MR-proADM, MR-proANP, copeptin, high-sensitivity troponin T and NT-proBNP.
Eur J Heart Fail
November 2024
Article Synopsis
- Traditional cardiovascular biomarkers like hsTnT and NT-proBNP are crucial for monitoring cardiac function and prognosis in cancer patients, but newer biomarkers such as MR-proADM, copeptin, and MR-proANP may provide better predictive power.
- A study involving 442 hospitalized cancer patients showed that while several biomarkers predicted all-cause mortality, only MR-proADM remained a significant independent predictor after adjusting for various factors.
- MR-proADM demonstrated the highest predictive accuracy, with a specific cutoff of 0.94 nmol/L signaling a higher risk of mortality, particularly in older patients with advanced cancer stages and poorer overall health.
Article Synopsis
- Mineral abnormalities, including dyskalaemia, hyponatraemia, hypomagnesaemia, and iron deficiency, are common in heart failure (HF) and are linked to worse health outcomes and increased mortality rates.
- The imbalance in these minerals is influenced by factors like neurohumoral activation, effects of HF medications, and chronic conditions like kidney disease.
- Iron deficiency, affecting up to 60% of HF patients, is particularly serious, but iron replacement therapy has shown benefits, especially in patients with reduced and preserved ejection fractions.
Pharmacological management of heart failure: a patient-centred approach.
Expert Opin Pharmacother
November 2024
Introduction: Heart failure (HF) is a global health challenge that requires a multidisciplinary approach. Despite recent advances in pharmacological and interventional therapy, morbidity and mortality in these patients remain high. For this reason, and because of its interplay with other cardiovascular and non-cardiovascular diseases, HF represents a major area of research, with new trials being published every year and international guidelines constantly updated.
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- * The main causes of sarcopenia include aging, chronic diseases, lack of exercise, and inadequate nutrition, particularly low protein intake, which affects the balance between muscle growth and breakdown.
- * Nutritional strategies like animal and plant-based protein supplements, along with other compounds like leucine and creatine, have shown promise in improving sarcopenia outcomes, though the effectiveness of some other supplements is still uncertain.
Background: Iron deficiency is worldwide the most frequently occurring deficiency of a trace element. Meanwhile, the indications are increasing that iron deficiency plays a relevant role in many cardiovascular diseases and that treatment is accessible with intravenous administration of iron.
Objective And Methods: The aim of this article is to elucidate the clinical comorbidities, diagnostic dilemmas and treatment possibilities of iron deficiency in cardiovascular diseases.
Aims: Diabetes mellitus (DM) and heart failure (HF) share vascular, skeletal and metabolic abnormalities that can reduce exercise capacity. We investigated whether exercise capacity differ in patients with type 2 DM compared to those without DM with HF of similar severity.
Methods And Results: The Studies Investigating Co-morbidities Aggravating HF (SICA-HF) prospectively enrolled 615 patients with chronic HF, 259 (42.
For World Heart Day on September 24, 2024, the World Heart Federation urges nations to endorse national strategies for enhancing cardiovascular health. While advancements show promise in reducing atherosclerosis, addressing healthcare inequalities and ensuring equitable access to tools remain crucial. This collection of voices touches on the intricate relationship between type 2 diabetes and cardiovascular disease, highlights innovative treatments for rare cardiomyopathies and heart failure, and explores the potentially transformative role of artificial intelligence in cardiovascular medicine, showcasing the dedication and innovation that are shaping the future of heart health.
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- Sarcopenia is a condition that leads to the loss of muscle mass and function, particularly affecting older adults and those with chronic illnesses, and current treatments like diet and exercise aren't always effective or sustainable.
- This meta-analysis aims to determine the effects of bimagrumab, a monoclonal antibody, on improving physical performance and body composition in sarcopenia patients.
- The analysis reviewed seven randomized controlled trials, finding that bimagrumab significantly increased thigh muscle volume and fat-free body mass in subjects.
Article Synopsis
- Left ventricular hypertrophy (LVH) is linked to higher risks of cardiovascular disease and mortality, particularly in patients with chronic kidney disease (CKD) and type 2 diabetes (T2D) who commonly experience hypertension and LVH.
- This pooled analysis from the FIDELITY studies aimed to investigate the effects of the drug finerenone, a nonsteroidal mineralocorticoid receptor antagonist, on cardiovascular and kidney health in CKD and T2D patients, those with and without baseline LVH.
- Results indicated that while finerenone significantly reduced the risk of heart failure hospitalization in patients with LVH compared to those without, its overall impact on cardiovascular and kidney outcomes was not significantly different based on baseline LV
Article Synopsis
- The FAIR-HFpEF study tested intravenous ferric carboxymaltose (FCM) against a placebo in 200 patients with heart failure with preserved ejection fraction (HFpEF) and iron deficiency (ID) to see if it improved their walking distance and overall health.
- The trial was halted early due to slow participant recruitment, but preliminary results showed that those receiving FCM had a significant improvement in their 6-minute walking test compared to the placebo group, along with fewer serious adverse events.
- Despite these promising findings, the study's small size makes it inconclusive for determining overall symptom relief or quality of life benefits, suggesting the need for further research with more participants.
Background: Activation of the immune system contributes to cardiovascular diseases. The role of human-specific long noncoding RNAs in cardioimmunology is poorly understood.
Methods: Single-cell sequencing in peripheral blood mononuclear cells revealed a novel human-specific long noncoding RNA called (heart failure-associated transcript 4).
Targeting obesity for therapeutic intervention in heart failure patients.
Expert Rev Cardiovasc Ther
June 2024
Introduction: Heart failure with preserved ejection fraction (HFpEF) is a highly heterogeneous syndrome, making it challenging to improve prognosis with pharmacotherapy. Obesity is one of the leading phenotypes of HFpEF, and its prevalence continues to grow worldwide. Consequently, obesity-targeted interventions have attracted attention as a novel treatment strategy for HFpEF.
View Article and Find Full Text PDFIn an ageing society, the importance of maintaining healthy life expectancy has been emphasized. As a result of age-related decline in functional reserve, frailty is a state of increased vulnerability and susceptibility to adverse health outcomes with a serious impact on healthy life expectancy. The decline in skeletal muscle mass and function, also known as sarcopenia, is key in the development of physical frailty.
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- The 2023 ESC update to the HF guidelines emphasizes two new drugs, SGLT2 inhibitors and finerenone, for preventing heart failure in patients with diabetic chronic kidney disease, and supports the use of SGLT2 inhibitors across all levels of left ventricular ejection fraction.
- Quadruple therapy in patients with reduced ejection fraction is beneficial, and the "high-intensity care" approach, involving rapid medication adjustments and close monitoring post-acute heart failure, leads to better outcomes.
- Recent trials suggest that semaglutide can improve quality of life and physical activity in obese patients with preserved ejection fraction, while findings on additional diuretics and therapies, especially for different
The aetiology of heart failure with preserved ejection fraction (HFpEF) is heterogenous and overlaps with that of several comorbidities like atrial fibrillation, diabetes mellitus, chronic kidney disease, valvular heart disease, iron deficiency, or sarcopenia. The diagnosis of HFpEF involves evaluating cardiac dysfunction through imaging techniques and assessing increased left ventricular filling pressure, which can be measured directly or estimated through various proxies including natriuretic peptides. To better narrow down the differential diagnosis of HFpEF, European and American heart failure guidelines advocate the use of different algorithms including comorbidities that require diagnosis and rigorous treatment during the evaluation process.
View Article and Find Full Text PDFBackground: Growth hormone (GH) resistance is characterized by high GH levels but low levels of insulin-like growth factor-I (IGF-I) and growth hormone binding protein (GHBP) and, for patients with chronic disease, is associated with the development of cachexia.
Objectives: We investigated whether GH resistance is associated with changes in left ventricular (LV) mass (cardiac wasting) in patients with cancer.
Methods: We measured plasma IGF-I, GH, and GHBP in 159 women and 148 men with cancer (83% stage III/IV).
Article Synopsis
- Sarcopenia is when people lose muscle mass and strength as they get older, and there's no clear agreement on what it exactly means worldwide.
- A group called the Global Leadership Initiative in Sarcopenia (GLIS) worked to define sarcopenia better by getting experts from around the world to share their opinions.
- They found that most experts agreed that things like muscle mass and strength are really important to understanding sarcopenia and that it becomes more common as people age.
While bodyweight reduction should be a primary intervention target in obese heart failure with preserved ejection fraction (HFpEF) patients, no pharmacological treatments have shown evidence. The STEP HFpEF trial showed that semaglutide significantly improved various aspects of heart failure-related clinical outcomes in obese HFpEF patients, along with remarkable weight loss.
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