July 2016 at a glance: the critical role of co-morbidities.

Abstract

This issue has the Heart Failure Association (HFA) of the European Society of Cardiology (ESC) nurse curriculum.1 The role of nurses in the care of heart failure (HF) patients is more and more important.2, 3 This curriculum by the HFA sets the standards of the knowledge, skills and professional duties of HF nurses in the ESC countries. Co-morbidities have a major role in the clinical presentation, prognosis and treatment of the patients with HF.4-6 This issue is focused on them. Iron deficiency (ID) is a major determinant of the clinical course and prognosis of HF patients. Differently from other co-morbidities, its direct correction can improve their symptoms, quality of life and clinical course. In this issue, one article reviews the effects of iron on the skeletal muscles.7 Two meta-analyses summarize the results of randomized controlled trials of iron therapy in anaemic adult patients with no chronic kidney disease (CKD) and in patients with HF, respectively.8, 9 A research shows the independent prognostic value of ID in patients hospitalized for acute HF.10 The association of high serum erythropoietin levels and worse outcomes in patients with acute HF and, with respect to HF development, in subjects with albuminuria, is shown by two different studies in this issue of our journal.11, 12 Other articles regard CKD, liver dysfunction, chronic obstructive pulmonary disease, obesity and frailty. In a study, diabetes changed the prognostic value of obesity in the patients with HF. Differently from non-diabetics, diabetics did not benefit from the obesity paradox and their mortality was not related to their body mass index.13