Heart failure and comorbidities: renal failure, diabetes, atrial fibrillation, and inflammation

Download the Issue @ a Glance podcast Subscribe to the EHJ Podcast ![Graphic][1] Heart failure is a clinical syndrome that involves many organs outside the heart, most importantly the kidney.1,2 In a timely Clinical Review article entitled ‘The kidney in heart failure: an update ’, Kevin Damman from the University Medical Center Groningen in The Netherlands3 reminds us of this fact. Renal dysfunction occurs frequently in all types of heart failure and, when present, is associated with higher mortality and morbidity.4 While the pathophysiology is multifactorial, the most important factors are a reduced renal perfusion and venous congestion. Recent interest has focused on worsening renal function,5 a condition strongly related to mortality. Unfortunately, to date, clinicians have been unable to identify specifically those patients with a grim prognosis following worsening renal function. Although much has been learned regarding cardiorenal interaction in heart failure, many questions remain unanswered. Further research is needed for an updated classification of the cardiorenal syndrome, and to improve preventive and treatment strategies preserving renal function and improving outcome in heart failure patients. As heart failure is the final common pathway of most forms of heart disease, early prevention is important. In a Clinical Review article entitled ‘ Exercise and the heart: the good, the bad, and the ugly ’ , Sanjay Sharma from St. George's University London6 discusses the fact that individuals engaging in regular exercise have a favourable cardiovascular risk profile, and reduce their risk of myocardial infarction and eventually heart failure. Exercise promotes longevity and also reduces the risk of certain malignancies, retards the onset of dementia, and has antidepressant effects. Most of these benefits are attributable to moderate exercise. The cardiovascular adaptation for generating a large and sustained increase in cardiac output during prolonged exercise includes a … [1]: /embed/inline-graphic-1.gif