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Review
. 2017 May;22(3):329-336.
doi: 10.1007/s10741-017-9614-7.

Influenza infection and heart failure-vaccination may change heart failure prognosis?

Nikolaos P E Kadoglou  1   2 , Frank Bracke  3 , Tim Simmers  3 , Sotirios Tsiodras  4 , John Parissis  5
Affiliations
Review

Influenza infection and heart failure-vaccination may change heart failure prognosis?

Nikolaos P E Kadoglou et al. Heart Fail Rev. 2017 May.

Abstract

The interaction of influenza infection with the pathogenesis of acute heart failure (AHF) and the worsening of chronic heart failure (CHF) is rather complex. The deleterious effects of influenza infection on AHF/CHF can be attenuated by specific immunization. Our review aimed to summarize the efficacy, effectiveness, safety, and dosage of anti-influenza vaccination in HF. In this literature review, we searched MEDLINE and EMBASE from January 1st 1966 to December 31st, 2016, for studies examining the association between AHF/CHF, influenza infections, and anti-influenza immunizations. We used broad criteria to increase the sensitivity of the search. HF was a prerequisite for our search. The search fields used included "heart failure," "vaccination," "influenza," "immunization" along with variants of these terms. No restrictions on the type of study design were applied. The most common clinical scenario is exacerbation of pre-existing CHF by influenza infection. Scarce evidence supports a potential positive association of influenza infection with AHF. Vaccinated patients with pre-existing CHF have reduced all-cause morbidity and mortality, but effects are not consistently documented. Immunization with higher antigen quantity may confer additional protection, but such aggressive approach has not been generally advocated. Further studies are needed to delineate the role of influenza infection on AHF/CHF pathogenesis and maintenance. Annual anti-influenza vaccination appears to be an effective measure for secondary prevention in HF. Better immunization strategies and more efficacious vaccines are urgently necessary.

Keywords: Decompensation; Dose; Heart failure; Hospitalization; Immunization; Influenza infection; Mortality; Vaccination.

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Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Pathophysiologic mechanisms of chronic heart failure development and its acute decompensation. The potential preventive effect of anti-influenza vaccination. RAAS renin-angiotensin-aldosterone system; SNS sympathetic nervous system, LV left ventricle
See this image and copyright information in PMC

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