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New Advances in Cardiorenal Syndrome
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New Advances in Cardiorenal Syndrome

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Cardiology".

Deadline for manuscript submissions: closed (15 November 2023) | Viewed by 21005

Special Issue Editor

Dr. Rainer Ullrich Pliquett

E-Mail Website
Guest Editor
1. Dept Internal Med II, Martin Luther UniversityHalle Wittenberg, 06108 Halle, Germany
2. Dept Nephrol and Diabetol, Carl Thiem Hospital, 03048 Cottbus, Germany
Interests: cardiology; heart failure; hypertension; diabetes mellitus; chronic heart failure; blood pressure; atherosclerosis; chronic kidney disease
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Cardiorenal syndrome has become a pressing issue as far as hospitalizations are concerned, even those for chronic heart failure alone incur a subsequent increased risk for end-stage renal disease (ESRD) later on. When using the term cardiorenal syndrome, the coincident diagnoses of chronic or acute heart failure in the presence of chronic kidney disease and/or acute kidney injury are considered as one syndrome, because both organ dysfunctions may affect each other in a vicious cycle. In 2008, a classification of cardiorenal syndrome was introduced, approved by the American Heart Association in 2019, this classification clearly having improved the standards of cardiorenal syndrome. However, validation studies of this classification are lacking, the clinical applicability is questioned, and new developments in the area of cardiorenal syndrome, such as the role of infection, need to be considered.

In a new Special Issue on cardiorenal syndrome, the Journal of Clinical Medicine summarizes new advances in the understanding of the cardiorenal syndrome, highlighting the description, pathophysiological underpinnings and pathomechanisms, every published article expected to add knowledge to the overall picture of cardiorenal syndrome and its therapeutic implications.

Dr. Rainer Ullrich Pliquett
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • cardiorenal syndrome
  • pathomechanism
  • inflammation
  • heart failure
  • chronic kidney disease
  • acute kidney injury

Related Special Issue

Published Papers (6 papers)

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Editorial

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3 pages, 182 KiB  
Editorial
New Advances in Cardiorenal Syndrome—Ready for Prime Time?
by Rainer U. Pliquett
J. Clin. Med. 2022, 11(12), 3460; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm11123460 - 16 Jun 2022
Viewed by 1119
Abstract
Cardiorenal Syndrome has become one pressing issue as far as hospitalizations are concerned [...] Full article
(This article belongs to the Special Issue New Advances in Cardiorenal Syndrome)

Review

Jump to: Editorial

15 pages, 301 KiB  
Review
Altered Autonomic Function in Metabolic Syndrome: Interactive Effects of Multiple Components
by Joseph Mannozzi, Louis Massoud, Jon Stavres, Mohamed-Hussein Al-Hassan and Donal S. O’Leary
J. Clin. Med. 2024, 13(3), 895; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm13030895 - 03 Feb 2024
Viewed by 703
Abstract
Metabolic syndrome (MetS) describes a set of disorders that collectively influence cardiovascular health, and includes hypertension, obesity, insulin resistance, diabetes, and dyslipidemia. All these components (hypertension, obesity, dyslipidemia, and prediabetes/diabetes) have been shown to modify autonomic function. The major autonomic dysfunction that has [...] Read more.
Metabolic syndrome (MetS) describes a set of disorders that collectively influence cardiovascular health, and includes hypertension, obesity, insulin resistance, diabetes, and dyslipidemia. All these components (hypertension, obesity, dyslipidemia, and prediabetes/diabetes) have been shown to modify autonomic function. The major autonomic dysfunction that has been documented with each of these components is in the control of sympathetic outflow to the heart and periphery at rest and during exercise through modulation of the arterial baroreflex and the muscle metaboreflex. Many studies have described MetS components in singularity or in combination with the other major components of metabolic syndrome. However, many studies lack the capability to study all the factors of metabolic syndrome in one model or have not focused on studying the effects of how each component as it arises influences overall autonomic function. The goal of this review is to describe the current understanding of major aspects of metabolic syndrome that most likely contribute to the consequent/associated autonomic alterations during exercise and discuss their effects, as well as bring light to alternative mechanisms of study. Full article
(This article belongs to the Special Issue New Advances in Cardiorenal Syndrome)
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10 pages, 1422 KiB  
Review
Potential Neuromodulation of the Cardio-Renal Syndrome
by Irving H. Zucker, Zhiqiu Xia and Han-Jun Wang
J. Clin. Med. 2023, 12(3), 803; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm12030803 - 19 Jan 2023
Cited by 1 | Viewed by 2540
Abstract
The cardio-renal syndrome (CRS) type 2 is defined as a progressive loss of renal function following a primary insult to the myocardium that may be either acute or chronic but is accompanied by a decline in myocardial pump performance. The treatment of patients [...] Read more.
The cardio-renal syndrome (CRS) type 2 is defined as a progressive loss of renal function following a primary insult to the myocardium that may be either acute or chronic but is accompanied by a decline in myocardial pump performance. The treatment of patients with CRS is difficult, and the disease often progresses to end-stage renal disease that is refractory to conventional therapy. While a good deal of information is known concerning renal injury in the CRS, less is understood about how reflex control of renal sympathetic nerve activity affects this syndrome. In this review, we provide insight into the role of the renal nerves, both from the afferent or sensory side and from the efferent side, in mediating renal dysfunction in CRS. We discuss how interventions such as renal denervation and abrogation of systemic reflexes may be used to alleviate renal dysfunction in the setting of chronic heart failure. We specifically focus on a novel cardiac sensory reflex that is sensitized in heart failure and activates the sympathetic nervous system, especially outflow to the kidney. This so-called Cardiac Sympathetic Afferent Reflex (CSAR) can be ablated using the potent neurotoxin resinferitoxin due to the high expression of Transient Receptor Potential Vanilloid 1 (TRPV1) receptors. Following ablation of the CSAR, several markers of renal dysfunction are reversed in the post-myocardial infarction heart failure state. This review puts forth the novel idea of neuromodulation at the cardiac level in the treatment of CRS Type 2. Full article
(This article belongs to the Special Issue New Advances in Cardiorenal Syndrome)
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19 pages, 2144 KiB  
Review
Heart Failure and Cardiorenal Syndrome: A Narrative Review on Pathophysiology, Diagnostic and Therapeutic Regimens—From a Cardiologist’s View
by Angelos C. Mitsas, Mohamed Elzawawi, Sophie Mavrogeni, Michael Boekels, Asim Khan, Mahmoud Eldawy, Ioannis Stamatakis, Dimitrios Kouris, Baraa Daboul, Oliver Gunkel, Boris Bigalke, Ludger van Gisteren, Saif Almaghrabi and Michel Noutsias
J. Clin. Med. 2022, 11(23), 7041; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm11237041 - 28 Nov 2022
Cited by 7 | Viewed by 8167
Abstract
In cardiorenal syndrome (CRS), heart failure and renal failure are pathophysiologically closely intertwined by the reciprocal relationship between cardiac and renal injury. Type 1 CRS is most common and associated with acute heart failure. A preexistent chronic kidney disease (CKD) is common and [...] Read more.
In cardiorenal syndrome (CRS), heart failure and renal failure are pathophysiologically closely intertwined by the reciprocal relationship between cardiac and renal injury. Type 1 CRS is most common and associated with acute heart failure. A preexistent chronic kidney disease (CKD) is common and contributes to acute kidney injury (AKI) in CRS type 1 patients (acute cardiorenal syndrome). The remaining CRS types are found in patients with chronic heart failure (type 2), acute and chronic kidney diseases (types 3 and 4), and systemic diseases that affect both the heart and the kidney (type 5). Establishing the diagnosis of CRS requires various tools based on the type of CRS, including non-invasive imaging modalities such as TTE, CT, and MRI, adjuvant volume measurement techniques, invasive hemodynamic monitoring, and biomarkers. Albuminuria and Cystatin C (CysC) are biomarkers of glomerular filtration and integrity in CRS and have a prognostic impact. Comprehensive “all-in-one” magnetic resonance imaging (MRI) approaches, including cardiac magnetic resonance imaging (CMR) combined with functional MRI of the kidneys and with brain MRI are proposed for CRS. Hospitalizations due to CRS and mortality are high. Timely diagnosis and initiation of effective adequate therapy, as well as multidisciplinary care, are pertinent for the improvement of quality of life and survival. In addition to the standard pharmacological heart failure medication, including SGLT2 inhibitors (SGLT2i), renal aspects must be strongly considered in the context of CRS, including control of the volume overload (diuretics) with special caution on diuretic resistance. Devices involved in the improvement of myocardial function (e.g., cardiac resynchronization treatment in left bundle branch block, mechanical circulatory support in advanced heart failure) have also shown beneficial effects on renal function. Full article
(This article belongs to the Special Issue New Advances in Cardiorenal Syndrome)
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11 pages, 2458 KiB  
Review
The Emerging Role of Combined Brain/Heart Magnetic Resonance Imaging for the Evaluation of Brain/Heart Interaction in Heart Failure
by George Markousis-Mavrogenis, Michel Noutsias, Angelos G. Rigopoulos, Aikaterini Giannakopoulou, Stergios Gatzonis, Roser Maria Pons, Antigoni Papavasiliou, Vasiliki Vartela, Maria Bonou, Genovefa Kolovou, Constantina Aggeli, Aikaterini Christidi, Flora Bacopoulou, Dimitris Tousoulis and Sophie Mavrogeni
J. Clin. Med. 2022, 11(14), 4009; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm11144009 - 11 Jul 2022
Cited by 4 | Viewed by 2327
Abstract
Heart failure (HF) patients frequently develop brain deficits that lead to cognitive dysfunction (CD), which may ultimately also affect survival. There is an important interaction between brain and heart that becomes crucial for survival in patients with HF. Our aim was to review [...] Read more.
Heart failure (HF) patients frequently develop brain deficits that lead to cognitive dysfunction (CD), which may ultimately also affect survival. There is an important interaction between brain and heart that becomes crucial for survival in patients with HF. Our aim was to review the brain/heart interactions in HF and discuss the emerging role of combined brain/heart magnetic resonance imaging (MRI) evaluation. A scoping review of published literature was conducted in the PubMed EMBASE (OVID), Web of Science, Scopus and PsycInfo databases. Keywords for searches included heart failure, brain lesion, brain, cognitive, cognitive dysfunction, magnetic resonance imaging cardiovascular magnetic resonance imaging electroencephalogram, positron emission tomography and echocardiography. CD testing, the most commonly used diagnostic approach, can identify neither subclinical cases nor the pathophysiologic background of CD. A combined brain/heart MRI has the capability of diagnosing brain/heart lesions at an early stage and potentially facilitates treatment. Additionally, valuable information about edema, fibrosis and cardiac remodeling, provided with the use of cardiovascular magnetic resonance, can improve HF risk stratification and treatment modification. However, availability, familiarity with this modality and cost should be taken under consideration before final conclusions can be drawn. Abnormal CD testing in HF patients is a strong motivating factor for applying a combined brain/heart MRI to identify early brain/heart lesions and modify risk stratification accordingly. Full article
(This article belongs to the Special Issue New Advances in Cardiorenal Syndrome)
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9 pages, 2336 KiB  
Review
Cardiorenal Syndrome: An Updated Classification Based on Clinical Hallmarks
by Rainer U. Pliquett
J. Clin. Med. 2022, 11(10), 2896; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm11102896 - 20 May 2022
Cited by 13 | Viewed by 4790
Abstract
Cardiorenal syndrome (CRS) is defined as progressive, combined cardiac and renal dysfunction. In this mini review, a historical note on CRS is presented, the pathomechanisms and clinical hallmarks of both chronic heart failure and chronic kidney disease are discussed, and an updated classification [...] Read more.
Cardiorenal syndrome (CRS) is defined as progressive, combined cardiac and renal dysfunction. In this mini review, a historical note on CRS is presented, the pathomechanisms and clinical hallmarks of both chronic heart failure and chronic kidney disease are discussed, and an updated classification of CRS is proposed. The current consensus classification relies on the assumed etiology and the course of the disease, i.e., acute or chronic CRS. Five types are described: type-I CRS presenting as acute cardiac failure leading to acute renal failure; type-II CRS presenting as chronic cardiac failure leading to chronic renal failure; type-III CRS presenting as acute kidney injury aggravating heart failure; type-IV CRS presenting as chronic kidney failure aggravating heart failure; and type-V CRS presenting as concurrent, chronic cardiac and renal failure. For an updated classification, information on the presence or absence of valvular heart disease and on the presence of hyper- or hypovolemia is added. Thus, CRS is specified as “acute” (type-I, type-III or type-V CRS) or “chronic” (type-II, type-IV or type-V) CRS, as “valvular” or “nonvalvular” CRS, and as “hyper-” or “hypovolemia-associated” CRS if euvolemia is absent. To enable the use of this updated classification, validation studies are mandated. Full article
(This article belongs to the Special Issue New Advances in Cardiorenal Syndrome)
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