Semaglutide in Heart Failure With Preserved Ejection Fraction: Exploring Recent Evidence in Therapeutic Potential for the Obese Population.

Heart failure with preserved ejection fraction (HFpEF) is an increasingly prevalent condition, particularly among the aging population in the United States, and is associated with significant challenges due to its complex pathophysiology and limited therapeutic options. Historically, few pharmacological therapies have successfully mitigated HFpEF, making the emergence of effective treatments particularly significant. This review evaluates recent evidence on the therapeutic potential of semaglutide for managing HFpEF, especially in the obese population. Results from the STEP-HFpEF and STEP-HFpEF DM trials demonstrate that semaglutide, a glucagon-like peptide-1 receptor agonist originally developed for type 2 diabetes but now also approved for obesity treatment, significantly improves clinical outcomes such as symptom scores, body weight, exercise capacity, and inflammation markers in the obese population suffering from HFpEF. These improvements are attributed to both the weight loss induced by semaglutide and its direct effects on the congestive pathophysiology of HFpEF. The efficacy of semaglutide offers new hope for addressing a condition that has long lacked effective pharmacological interventions.

Low-Carbohydrate/Ketogenic Diet and Coronary Artery Disease: A Brief Review of the Limited Evidence Between Them.

Nowadays there is a lot of interest among the general population regarding the ketogenic diet (KD) and its health benefits. Most people following this diet have a reduced intake of carbohydrates which gets replaced by calories coming from fat and protein. Even though KD has shown some limited health benefits, there is no consensus on long-term effects and cardiovascular safety profile, especially the relation of KD to coronary artery disease (CAD). This concern comes predominantly from increased fat intake in KD and other similar diets with decreased carbohydrate intake. One study has shown a link between type 1 diabetes and increased coronary artery calcium scores but, in addition to many other limitations, after adjusting for other cardiovascular risk factors, the association was not significant. Results from a subanalysis of the CARDIA prospective study found that progression of CAD measured by coronary artery calcium was more pronounced in people with low-carbohydrate intake, especially when the compensatory calorie intake was from animal sources as compared to plant-based sources. In addition, other studies have tried to find a link between this type of diet and other traditional cardiovascular risk factors that have been traditionally associated with CAD, especially comparing low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, and triglyceride (TAG) levels without clear clinical significance. Other studies found an association between KD and all-cause mortality, but no association with cardiovascular mortality. Lastly, there is an association between animal-based KD and all-cause mortality in patients who have already suffered a myocardial infarction. These findings are modified when accounting for saturated fat intake, which may give us an insight into possible mechanisms to explain these differences.

Intracranial Hemorrhage Induced Takotsubo Cardiomyopathy: A Case Report.

Takotsubo cardiomyopathy, also known as stress-induced cardiomyopathy or "broken heart syndrome," is a reversible cardiac disorder characterized by left ventricular dysfunction without significant obstructive coronary artery disease. It is classically secondary to emotional stress in postmenopausal women but can also be secondary to physical stress. This report presents a unique case of takotsubo cardiomyopathy induced by intracranial hemorrhage in an 80-year-old female who presented with syncope.

A Rare Presentation of Levetiracetam-Induced Torsades De Pointes.

Torsades de pointes occurs in the presence of a prolonged QTc interval, which has many congenital and acquired causes. Levetiracetam is a widely used anti-epileptic medication secondary to its favorable safety profile. We present a rare case of a 59-year-old male who developed torsades de pointes and cardiac arrest after levetiracetam administration. To our knowledge, there is only one other case report documenting torsades de pointes after levetiracetam administration, and our case report will be the first documenting cardiac arrest after levetiracetam administration.

An Incidental Finding of Eagle Syndrome Post-Losartan-Induced Angioedema.

Eagle syndrome is a condition that can present with a wide range of clinical manifestations, including orofacial pain, altered sensation, dysphagia, tinnitus, and ear pain, and is caused by the abnormal elongation of the styloid process or the mineralization of the stylohyoid ligament. We present a case of an incidental finding of Eagle syndrome in a 48-year-old African American patient with losartan-induced angioedema. The patient complained of a foreign body sensation in his throat and mild dysphagia, and a computed tomography scan of his neck showed ossification of bilateral stylohyoid ligaments. This case report highlights the importance of being on the lookout for other pathologies when ordering imaging for primary diagnoses.

Losartan-Induced Angioedema: A Case Report.

Angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers are both classes of drugs used in the management of hypertension, heart failure, chronic kidney disease, and proteinuria. While angioedema induced by ACE inhibitors has been well-documented, angioedema induced by angiotensin receptor blockers (ARBs) has not. We present the case of losartan-induced angioedema requiring tracheostomy in a 48-year-old African American male. To our knowledge, there have only been twenty case reports published to date about losartan-induced angioedema. Although in the immediate short-term, our patient made a complete recovery, he had a sudden cardiac arrest a few months after the incident of angioedema and died.