A multisystem pathophysiological approach to heart failure with preserved ejection fraction in the elderly: searching for new therapeutic strategies

• Grant number: 15/17642-0
• Support Opportunities: Scholarships abroad - Research Internship - Post-doctor
• Start date: January 13, 2016
• End date: January 12, 2017
• Field of knowledge: Health Sciences - Medicine - Medical Clinics
• Principal Investigator: Maria Urbana Pinto Brandão Rondon
• Grantee: Edgar Toschi Dias
• Supervisor: Nicola Montano
• Host Institution: Instituto do Coração Professor Euryclides de Jesus Zerbini (INCOR). Hospital das Clínicas da Faculdade de Medicina da USP (HCFMUSP). Secretaria da Saúde (São Paulo - Estado). São Paulo , SP, Brazil
• Institution abroad: Università degli Studi di Milano, Italy
• Associated to the scholarship: 13/07651-7 - Prognostic value of the oscillatory pattern of muscle sympathetic nerve activity in patients with heart failure, BP.PD

Abstract

Heart failure (HF) is the first cause of mortality in aged people and it is estimated that prevalence of HF is 8.4% for people aged 75 years or older. The most recent epidemiological studies suggest that the prevalence and hospitalizations related to HF with preserved ejection fraction (HFpEF) is rising, and the growing elderly population guarantees further worsening of these trends. To date, there are no approved therapies to reduce hospitalization or mortality for HFpEF. The best described pathophysiological mechanisms of HF rely on the neuro-hormonal activation, which includes renin-angiotensin-aldosterone system activity and an autonomic nervous system (ANS) derangement, particularly a sympathetic overactivity. In addition, over the last years, a growing interest has been focused on the possible role of inflammation and immunity. Last, but not least, there is increasing evidence that epigenetic mechanisms, such as histone modifications, DNA methylation and RNA-based alterations, play a relevant role in HF progression. However, so far it is still unknown whether the ANS derangement, inflammatory response and gene mutations share common pathways also in HFpEF. Thus, to evaluate whether autonomic deregulation and inflammation are cross-linked in HFpEF, and which molecular pathways play a key role in the pathogenesis and the progression of HFpEF, we will study a population of hospitalized elderly subjects with a diagnosis of HFpEF. A one-year follow-up will be performed to evaluate the most predictive variables for re-hospitalization, cardiovascular acute events and mortality in HFpEF patients.

Scientific publications

(6)

(References retrieved automatically from Web of Science and SciELO through information on FAPESP grants and their corresponding numbers as mentioned in the publications by the authors)

TOSCHI-DIAS, EDGAR; MONTANO, NICOLA; TOBALDINI, ELEONORA; TREVIZAN, PATRICIA F.; GROEHS, V, RAPHAELA; ANTUNES-CORREA, LIGIA M.; NOBRE, THAIS S.; LOBO, DENISE M.; SALES, ALLAN R. K.; UENO-PARDI, LINDA M.; et al. Oscillatory Pattern of Sympathetic Nerve Bursts Is Associated With Baroreflex Function in Heart Failure Patients With Reduced Ejection Fraction. FRONTIERS IN NEUROSCIENCE, v. 15, AUG 31 2021. (10/50048-1, 15/17642-0, 13/07651-7, 15/22814-5)

TOBALDINI, ELEONORA; TOSCHI-DIAS, EDGAR; TRIMARCHI, PIETRO DAVIDE; BRENA, NICOLA; COMANDUCCI, ANGELA; CASAROTTO, SILVIA; MONTANO, NICOLA; DEVALLE, GUYA. Cardiac autonomic responses to nociceptive stimuli in patients with chronic disorders of consciousness. CLINICAL NEUROPHYSIOLOGY, v. 129, n. 5, p. 1083-1089, MAY 2018. (15/17642-0, 13/07651-7)

SUFFRITTI, C.; TOBALDINI, E.; SCHIAVON, R.; STRADA, S.; MAGGIONI, L.; MEHTA, S.; SANDRONE, G.; TOSCHI-DIAS, E.; CICARDI, M.; MONTANO, N.. Complement and contact system activation in acute congestive heart failure patients. CLINICAL AND EXPERIMENTAL IMMUNOLOGY, v. 190, n. 2, p. 251-257, NOV 2017. (15/17642-0, 13/07651-7)

TOSCHI-DIAS, EDGAR; TOBALDINI, ELEONORA; SOLBIATI, MONICA; COSTANTINO, GIORGIO; SANLORENZO, ROBERTO; DORIA, STEFANIA; IRTELLI, FLORIANA; MENCACCI, CLAUDIO; MONTANO, NICOLA. Sudarshan Kriya Yoga improves cardiac autonomic control in patients with anxiety-depression disorders. Journal of Affective Disorders, v. 214, p. 74-80, MAY 2017. (15/17642-0, 13/07651-7)

TOSCHI-DIAS, EDGAR; RONDON, MARIA URBANA P. B.; COGLIATI, CHIARA; PAOLOCCI, NAZARENO; TOBALDINI, ELEONORA; MONTANO, NICOLA. Contribution of Autonomic Reflexes to the Hyperadrenergic State in Heart Failure. FRONTIERS IN NEUROSCIENCE, v. 11, MAR 30 2017. (15/17642-0, 13/07651-7)

GROEHS, RAPHAELA V.; NEGRAO, MARCELO V.; HAJJAR, LUDHMILA A.; JORDAO, CAMILA P.; CARVALHO, BRUNA P.; TOSCHI-DIAS, EDGAR; ANDRADE, ANA C.; HODAS, FABIANA P.; ALVES, MARIA J. N. N.; SARMENTO, ADRIANA O.; et al. Adjuvant Treatment with5-Fluorouraciland Oxaliplatin Does Not Influence Cardiac Function, Neurovascular Control, and Physical Capacity in Patients with Colon Cancer. ONCOLOGIST, v. 25, n. 12, AUG 2020. (13/07651-7, 15/22814-5, 15/05427-8, 15/17642-0)