Systemic lupus erythematosus (SLE) is a disease that significantly increases cardiovascular risk. Although cardiovascular diseases are one of the leading causes of death in SLE patients, the correlation between SLE and heart failure (HF) remains unexplored. Myocardial dysfunction in SLE patients is frequently asymptomatic or nonspecific, which makes it difficult to identify HF using standard diagnostic techniques. In addition, there are serious difficulties in its early diagnosis. In this review, we summarize the latest reports on the epidemiology of heart failure in SLE patients. Current evidence on the impact of SLE treatment on the development of HF, as well as potential risk factors that increase the risk of HF, is presented. Potential methods of treatment and early detection of HF with special attention to potential biomarkers are also provided. Further research is needed to better understand the mechanisms of the correlation between HF and SLE and to develop effective treatment strategies.

Background: Frailty syndrome significantly worsens the prognosis of elderly people. Sarcopenia and malnutrition are integral parts of aging, but there is a lack of knowledge about the overlap of these states, as well as their diagnostic methods and treatments. This study aimed to assess the malnutrition and sarcopenia scale in patients with frailty syndrome and the viability of evaluating the concentrations of the following potential biomarkers: albumin, total protein, and fibrinogen. Methods: A total of 170 patients >65 years were assessed for frailty using the Fried frailty scale. The risk of sarcopenia was measured using the SARC-F scale, and the risk of malnutrition was measured using the Mini Nutritional Assessment (MNA) scale. Serum albumin, protein, and fibrinogen levels were measured. The following fat-free body mass and respiratory parameters were measured: peak expiratory flow (PEF) and forced expiratory volume-one second (FEV1). Results: A total of 53 patients were classified as robust (31%), 96 as prefrail (57%), and 21 as frail (12%) according to Fried frailty criteria. Frail patients had significantly reduced serum albumin and increased fibrinogen compared to the prefrail and robust groups (p < 0.05). A total of 38% of frail patients were at risk of sarcopenia, and 52% were at risk of malnutrition. Frail patients had lower PEF and FEV1 values, with decreases in respiratory parameters correlating with fat-free body mass and muscle strength. Conclusions: Frail patients are at substantial risk of malnutrition and sarcopenia. The MNA and SARC-F scales, combined with routine screening of elderly patients with frailty, may effectively identify patients with the highest risk.

Diabetes-related pathophysiological processes contribute to endothelial dysfunction, arterial stiffening (AS), hypertension, vascular remodeling, and impaired myocardial perfusion. This study aimed to assess the relationship between arterial wall parameters and sST2 concentration as potential risk factors in type 2 diabetes (T2DM) and investigate sex-related differences. To achieve this, we enrolled 100 patients with suspected or exacerbated coronary artery disease (CAD) and divided them into a T2DM group (n = 58) and a control group (n = 42). Endothelial reactivity (lnRHI), ABI, sST2 levels, and carotid–femoral (cfPWV) and carotid–radial pulse wave velocity (crPWV) were assessed. Coronary angiography was performed in every patient, and epicardial flow and myocardial perfusion were evaluated using QuBE and FLASH. Our results showed that the coronary angiographic findings were similar in both groups. However, T2DM patients had a significantly higher central AS (cfPWV 10.8 ± 2 vs. 9.9 ± 2.7 m/s, p < 0.05) and vascular age (70.0 ± 12.3 vs. 61.3 ± 15.4 years, p < 0.05), while peripheral AS, RHI, and ABI showed no differences. CfPWV correlated with renal function; higher HbA1c and sST2 levels were additionally associated with advanced vascular age. Notably, central AS and vascular age were higher in men with T2DM but not in women. These findings indicate that T2DM patients exhibit increased central AS and vascular aging, influenced by sST2 levels, suggesting fibrosis as a target for precision medicine in T2DM.

. Background: Frailty syndrome significantly worsens the prognosis of elderly people. An integral part of aging is sarcopenia and malnutrition. There is a lack of knowledge about the overlap of these states, as well as diagnostic methods and treatment. Methods: 170 patients >65 years were assessed for frailty using the Fried frailty scale. The risk of sarcopenia was measured using the SARC-F scale, and the risk of malnutrition was measured using the Mini Nutritional Assessment (MNA) scale. Serum albumin, protein, and fibrinogen levels were measured. Fat-free body mass and respiratory parameters were measured: peak expiratory flow (PEF) and forced expiratory volume- one second (FEV1). Results: 53 patients were classified as robust (31%), 96 as prefrail (57%), and 21 as frail (12%). Frail patients had significantly reduced serum albumin and increased fibrinogen compared to the pre-frail and robust groups (p<0.05). 38% of frail patients are at risk of sarcopenia, and 52% are at risk of malnutrition. Frail patients have lower PEF and FEV1 values. The decrease in respiratory parameters correlates with fat-free body mass and muscle strength. Conclusions: Patients with frailty are the group at most significant risk of malnutrition and sarcopenia compared to their healthy peers and patients in the prefrail stage. MNA and SARC-F scales combined with routine screening of elderly patients with frailty may allow for effective identification of patients at risk of malnutrition and sarcopenia.

Background: There exists some inconsistent evidence on the relationship between altered cardiac morphology, its function, and frailty. Therefore, this study aimed to assess the associations among frailty, lean body mass, central arterial stiffness, and cardiac structure and geometry in older people with a normal ejection fraction. Methods: A total of 205 patients >65 years were enrolled into this ancillary analysis of the FRAPICA study and were assessed for frailty with the Fried phenotype scale. Left ventricular dimensions and geometry were assessed with two-dimensional echocardiography. Fat-free mass was measured using three-site skinfold method. Parametric and non-parametric statistics and analysis of covariance were used for statistical calculations. Results: Frail patients were older and women comprised the majority of the frail group. Frail men and women had comparable weight, height, fat-free mass, blood pressure, central blood pressure, and carotid–femoral pulse wave velocity to their non-frail counterparts. There was a linear correlation between the sum of frailty criteria and left ventricular end-diastolic diameter (Spearman R = −0.17; p < 0.05) and relative wall thickness (Spearman R = 0.23; p < 0.05). In the analysis of covariance, frailty and gender were independently associated with left ventricular mass (gender: β of −0.37 and 95% CI of −0.50–−0.24 at p < 0.001), the left ventricular mass index (gender: β of −0.23 and 95% CI of −0.37–−0.09 at p < 0.001), and relative wall thickness (frailty: β of −0.15 and 95% CI of −0.29–−0.01 at p < 0.05; gender: β of 0.23 and 95% CI of 0.09–0.36 at p < 0.01). Frailty was associated with a shift in heart remodeling toward concentric remodeling/hypertrophy. Conclusions: Frailty is independently associated with thickening of the left ventricular walls and a diminished left ventricular end-diastolic diameter, which are features of concentric remodeling or hypertrophy. This association appears to be more pronounced in women. Such adverse cardiac remodeling may represent another phenotypic feature linked to frailty according to the phenotype frailty criteria.

Prävalenz von leichten kognitiven Störungen und Demenzen in der ambulanten Routineversorgung in Deutschland 2009–2016 Jens Bohlken, Dominik von Stillfried, Mandy Schulz. Psychiat Praxdoi:10.1055/a-1012-9502 Im oben genannten Artikel wurde eine Jahreszahl in der Zusammenfassung/Abstract falsch angegeben. Richtig ist: In Deutschland wird ein Anwachsen der Patienten mit Demenz von 1,7 Mio. (2017) auf über 3 Mio. (2050) erwartet. In Germany, the number of patients with dementia is expected to increase from 1.7 (2017) to more than 3 million people (2050).