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Background Cardiorenal syndrome (CRS) refers to the bidirectional interactions between the acutely or chronically dysfunctioning heart and kidney that lead to poor outcomes. Due to the evolving literature on renal impairment and heart failure with preserved ejection fraction (HfpEF), this review aimed to highlight the pathophysiological pathways, diagnosis using imaging and biomarkers and management of CRS in patients with HFpEF. Further studies are needed to validate the use of novel biomarkers, especially for early diagnosis and prognostication.
View Article and Find Full Text PDFCardiac Presynaptic Sympathetic Nervous Function Evaluated by Cardiac PET in Patients with Chronotropic Incompetence Without Heart Failure.
J Nucl Med
January 2025
Department of Cardiology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan.
Chronotropic incompetence (CTI), the inability of the heart to increase its rate with increased activity, leads to exercise intolerance and predicts overall mortality. We previously reported that cardiac β-adrenergic receptor downregulation occurs in patients with CTI without heart failure (HF), indicating postsynaptic sympathetic nervous dysfunction. However, cardiac presynaptic sympathetic nervous system function in CTI is not fully understood.
View Article and Find Full Text PDFThe Right Ventricle and Exercise Capacity in Adults with Repaired Tetralogy of Fallot: Passive Bystander or Active Participant?
J Am Soc Echocardiogr
December 2024
Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN; Mayo Clinic School of Medicine, Mayo Clinic College of Medicine and Science, Mayo Clinic, Rochester, MN.
Exercise intolerance is a hallmark symptom in adults with repaired tetralogy of Fallot (TOF). This may be attributed to the disease-related impairment in RV systolic function, augmentation in right ventricular (RV) load, and their combined effect on altering left ventricular (LV) hemodynamics. To further elucidate these mechanisms, we examined oxygen uptake (VO) by indirect-calorimetry and cardiac hemodynamics by echocardiography in 34 TOF (48 ± 14 yrs) and 29 healthy controls (41 ± 15 yrs), at rest and during exercise.
View Article and Find Full Text PDFAssociation of Physiological Reserve Obtained from Cardiopulmonary Exercise Testing and Frailty with All-Cause Mortality in Hemodialysis Patients.
Clin J Am Soc Nephrol
December 2024
Department of Nephrology, Graduate School of Medicine, Juntendo University, Tokyo, Japan.
Background: Potential impairment of exercise capacity is prevalent even in patients undergoing hemodialysis without frailty. Cardiopulmonary exercise testing (CPET) can detect physiological reserves such as cardiopulmonary, muscle, and autonomic function. We hypothesized that these indices could accurately determine the prognosis of patients on hemodialysis and analyzed them based on their relationship to frailty.
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