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anemia HFPEF

Charles B Eaton, Mary Pettinger, Jacques Rossouw, Lisa Warsinger Martin, Randi Foraker, Abdullah Quddus, Simin Liu, Nina S Wampler, Wen-Chih Hank Wu, JoAnn E Manson, Karen Margolis, Karen C Johnson, Matthew Allison, Giselle Corbie-Smith, Wayne Rosamond, Khadijah Breathett, Liviu Klein
BACKGROUND: Heart failure is an important and growing public health problem in women. Risk factors for incident hospitalized heart failure with preserved ejection fraction (HFpEF) compared with heart failure with reduced ejection fraction (HFrEF) in women and differences by race/ethnicity are not well characterized. METHODS AND RESULTS: We prospectively evaluated the risk factors for incident hospitalized HFpEF and HFrEF in a multiracial cohort of 42 170 postmenopausal women followed up for a mean of 13...
October 2016: Circulation. Heart Failure
Parag Goyal, Zaid I Almarzooq, Evelyn M Horn, Maria G Karas, Irina Sobol, Rajesh V Swaminathan, Dmitriy N Feldman, Robert M Minutello, Harsimran S Singh, Geoffrey W Bergman, S Chiu Wong, Luke K Kim
BACKGROUND: Hospitalizations for heart failure with preserved ejection fraction (HFpEF) are increasing. There are limited data examining national trends in patients hospitalized with HFpEF. METHODS: Using the Nationwide Inpatient Sample, we examined 5,046,879 hospitalizations with a diagnosis of acute heart failure in 2003-2012, stratifying hospitalizations by HFpEF and heart failure with reduced ejection fraction (HFrEF). Patient and hospital characteristics, in-hospital mortality, and length of stay were examined...
June 2016: American Journal of Medicine
Wayne L Miller, Brian P Mullan
OBJECTIVES: This study aimed to characterize volume profiles and their differences in heart failure (HF) patients with preserved (HFpEF) and reduced (HFrEF) ventricular systolic function. BACKGROUND: The extent and distribution of volume overload and the associated implications for volume management have not been studied in decompensated HFpEF compared with HFrEF. METHODS: Total blood volume (TBV) was quantitated using a standardized computer-based radiolabeled albumin dilution technique...
June 2016: JACC. Heart Failure
Shane Nanayakkara, David M Kaye
PURPOSE: The purpose of this article was to review the clinical management of patients with heart failure with preserved ejection fraction (HFPEF). METHODS: For this critical review, electronic databases (MEDLINE, EMBASE, PubMed) were searched for relevant basic research studies and randomized clinical trials recently published or presented at major meetings. Details of in-progress or planned studies were obtained from the website. The range of publication dates was the year 2000 to 2015...
October 1, 2015: Clinical Therapeutics
Robert J Mentz, Jacob P Kelly, Thomas G von Lueder, Adriaan A Voors, Carolyn S P Lam, Martin R Cowie, Keld Kjeldsen, Ewa A Jankowska, Dan Atar, Javed Butler, Mona Fiuzat, Faiez Zannad, Bertram Pitt, Christopher M O'Connor
Heart failure patients are classified by ejection fraction (EF) into distinct groups: heart failure with preserved ejection fraction (HFpEF) or heart failure with reduced ejection fraction (HFrEF). Although patients with heart failure commonly have multiple comorbidities that complicate management and may adversely affect outcomes, their role in the HFpEF and HFrEF groups is not well-characterized. This review summarizes the role of noncardiac comorbidities in patients with HFpEF versus HFrEF, emphasizing prevalence, underlying pathophysiologic mechanisms, and outcomes...
December 2, 2014: Journal of the American College of Cardiology
Melissa C Caughey, Christy L Avery, Hanyu Ni, Scott D Solomon, Kunihiro Matsushita, Lisa M Wruck, Wayne D Rosamond, Laura R Loehr
Anemia is associated with poor prognosis in patients hospitalized with acute decompensated heart failure (ADHF). Whether the impact of anemia differs by heart failure with preserved ejection fraction (HFpEF) or heart failure with reduced ejection fraction (HFrEF) is uncertain. We examined hospital surveillance data captured by the Atherosclerosis Risk in Communities Study from January 1, 2005, to December 31, 2010. Diagnoses of ADHF were validated by standardized physician review of the medical record. Anemia was classified using the World Health Organization criteria (<12 g/dl for women and <13 g/dl for men), and HF type was determined by the ejection fraction (<40% for HFrEF and ≥40% for HFpEF)...
December 15, 2014: American Journal of Cardiology
Sirish Vullaganti, Jeff Goldsmith, Sergio Teruya, Julissa Alvarez, Stephen Helmke, Mathew S Maurer
BACKGROUND: Previous data from a recently conducted prospective, single blind randomized clinical trial among community dwelling older patients with heart failure with a preserved ejection fraction (HFPEF) and anemia randomized to treatment with epoetin alfa (erythropoiesis-stimulating agents, ESA) vs. placebo did not demonstrate significant benefits of therapy regarding left ventricular (LV) structure, functional capacity, or quality of life (QOL). However, several patients randomized to the treatment arm were non-responders with a suboptimal increase in hemoglobin...
June 2014: Journal of Geriatric Cardiology: JGC
Chirag Bavishi, Sameer Ather, Arvind Bambhroliya, Hani Jneid, Salim S Virani, Biykem Bozkurt, Anita Deswal
Hyponatremia in heart failure (HF) is an established predictor of adverse outcomes in hospitalized patients with reduced ejection fraction (EF). However, there is a paucity of data in ambulatory patients with HF with preserved ejection fraction (HFpEF). We examined the prevalence, risk factors, and long-term outcomes of hyponatremia (serum sodium ≤135 mEq/L) in ambulatory HFpEF and HF with reduced EF (HFrEF) in a national cohort of 8,862 veterans treated in Veterans Affairs clinics. Multivariable logistic regression models were used to identify factors associated with hyponatremia, and multivariable Cox proportional hazard models were used for analysis of outcomes...
June 1, 2014: American Journal of Cardiology
Erwan Donal, Lars H Lund, Emmanuel Oger, Camilla Hage, Hans Persson, Amélie Reynaud, Pierre-Vladimir Ennezat, Fabrice Bauer, Catherine Sportouch-Dukhan, Elodie Drouet, Jean-Claude Daubert, Cecilia Linde
BACKGROUND: Karolinska Rennes (KaRen) is a prospective observational study to characterize heart failure patients with preserved ejection fraction (HFpEF) and to identify prognostic factors for long-term mortality and morbidity. AIMS: To report characteristics and echocardiography at entry and after 4-8 weeks of follow-up. METHODS: Patients were included following an acute heart failure presentation with B-type natriuretic peptide (BNP)>100 ng/L or N-terminal pro-BNP (NT-proBNP)>300 ng/L and left ventricular ejection fraction (LVEF)>45%...
February 2014: Archives of Cardiovascular Diseases
Margarita Borovka, Sergio Teruya, Julissa Alvarez, Stephen Helmke, Mathew S Maurer
BACKGROUND: Hyporesponders to erythropoietin-stimulating agents (ESAs) have been associated with an increased subsequent risk of death or cardiovascular events. We hypothesized that subjects who are hyporesponsive to erythropoietin alfa would have higher plasma volumes and lower red cell deficits than subjects who are responsive to therapy. METHODS: As part of a prospective, single blind, randomized, placebo-controlled study comparing erythropoietin alfa with placebo in older adults (n = 56) with heart failure and a preserved ejection fraction (HFPEF), we performed blood volume analysis with the use of an indicator dilution technique with (131)iodine-labeled albumin...
October 2013: Journal of Cardiac Failure
Mario Kasner, Aleksandar S Aleksandrov, Dirk Westermann, Dirk Lassner, Michael Gross, Stephan von Haehling, Stefan D Anker, Heinz-Peter Schultheiss, Carsten Tschöpe
BACKGROUND: Functional iron deficiency (FID) is an independent risk factor for poor outcome in advanced heart failure with reduced EF, but its role in heart failure with preserved EF (HFPEF) remains unclear. We aimed to investigate the impact of FID on cardiac performance determined by pressure-volume loop analysis in HFPEF. METHODS: 26 HFPEF patients who showed an increase in LV stiffness by pressure-volume (PV) loop analysis obtained by conductance-catheterization, performed exercise testing, echocardiographic examination including tissue Doppler and determination of iron metabolism: serum iron, ferritin and transferrin saturation...
October 12, 2013: International Journal of Cardiology
Hidehiro Kaneko, Shinya Suzuki, Junji Yajima, Yuji Oikawa, Koichi Sagara, Takayuki Otsuka, Shunsuke Matsuno, Hiroto Kano, Tokuhisa Uejima, Akira Koike, Kazuyuki Nagashima, Hajime Kirigaya, Hitoshi Sawada, Tadanori Aizawa, Takeshi Yamashita
BACKGROUND: Clinical data on the mortality and morbidity of unselected Japanese patients with heart failure (HF) are limited. In this study, we aimed to determine the clinical characteristics, long-term outcomes, and prognostic factors of Japanese HF patients with preserved or reduced left ventricular ejection fraction (LVEF). METHODS AND RESULTS: We used a single hospital-based cohort from the Shinken Database 2004-2011 that comprised all new patients (n=17,517) visiting the Cardiovascular Institute Hospital...
August 2013: Journal of Cardiology
Philip Green, Benson A Babu, Sergio Teruya, Stephen Helmke, Martin Prince, Mathew S Maurer
Anemia, a common comorbidity in older adults with heart failure and a preserved ejection fraction (HFPEF), is associated with worse outcomes. The authors quantified the effect of anemia treatment on left ventricular (LV) structure and function as measured by cardiac magnetic resonance (CMR) imaging. A prospective, randomized single-blind clinical trial (NCT NCT00286182) comparing the safety and efficacy of epoetin alfa vs placebo for 24 weeks in which a subgroup (n=22) had cardiac magnetic resonance imaging (MRI) at baseline and after 3 and 6 months to evaluate changes in cardiac structure and function...
July 2013: Congestive Heart Failure
Selma F Mohammed, Barry A Borlaug, Véronique L Roger, Sultan A Mirzoyev, Richard J Rodeheffer, Julio A Chirinos, Margaret M Redfield
BACKGROUND: Patients with heart failure and preserved ejection fraction (HFpEF) display increased adiposity and multiple comorbidities, factors that in themselves may influence cardiovascular structure and function. This has sparked debate as to whether HFpEF represents a distinct disease or an amalgamation of comorbidities. We hypothesized that fundamental cardiovascular structural and functional alterations are characteristic of HFpEF, even after accounting for body size and comorbidities...
November 2012: Circulation. Heart Failure
Sameer Ather, Wenyaw Chan, Biykem Bozkurt, David Aguilar, Kumudha Ramasubbu, Amit A Zachariah, Xander H T Wehrens, Anita Deswal
OBJECTIVES: The aim of this study was to evaluate the prevalence and prognostic impacts of noncardiac comorbidities in patients with heart failure (HF) with preserved ejection fraction (HFpEF) compared with those with HF with reduced ejection fraction (HFrEF). BACKGROUND: There is a paucity of information on the comparative prognostic significance of comorbidities between patients with HFpEF and those with HFrEF. METHODS: In a national ambulatory cohort of veterans with HF, the comorbidity burden of 15 noncardiac comorbidities and the impacts of these comorbidities on hospitalization and mortality were compared between patients with HFpEF and those with HFrEF...
March 13, 2012: Journal of the American College of Cardiology
Hajime Satomura, Hiroshi Wada, Kenichi Sakakura, Norifumi Kubo, Nahoko Ikeda, Yoshitaka Sugawara, Junya Ako, Shin-ichi Momomura
BACKGROUND: Little has been known about clinical features and prognosis of very old patients with heart failure with preserved ejection fraction (HFPEF). The aim of this study was to compare clinical features and clinical outcomes between HFPEF and heart failure with reduced ejection fraction (HFREF) in patients older than 80 years. METHODS: We enrolled a total of 113 patients over 80 years old, who were admitted for heart failure between 2006 and 2009. We retrospectively analyzed the clinical features including laboratory data and echocardiography parameters...
March 2012: Journal of Cardiology
Arman Altincatal, Robert B Macarthur, Sergio Teruya, Stephen Helmke, Mathew S Maurer
AIMS: Erythropoietin stimulating agents (ESAs) is an active area of clinical investigation in heart failure (HF) but can cause hypertension and higher hemoglobin concentrations (Hb) that have been associated with adverse outcomes. We evaluated a dosing algorithm and potential confounders' effect on Hb and blood pressure (BP) in a clinical trial. METHODS: In an ongoing randomized, placebo controlled, single blind clinical trial of ESA (epoetin alfa) in anemic patients with HF and a preserved ejection fraction (HFPEF), Hb was measured weekly as was BP, weight and concomitant medical therapy...
April 2013: Cardiovascular Therapeutics
Frank Edelmann, Raoul Stahrenberg, Götz Gelbrich, Kathleen Durstewitz, Christiane E Angermann, Hans-Dirk Düngen, Thomas Scheffold, Christian Zugck, Bernhard Maisch, Vera Regitz-Zagrosek, Gerd Hasenfuss, Burkert M Pieske, Rolf Wachter
BACKGROUND: Comorbidities negatively affect prognosis more strongly in heart failure with preserved (HFpEF) than with reduced (HFrEF) ejection fraction. Their comparative impact on physical impairment in HFpEF and HFrEF has not been evaluated so far. METHODS AND RESULTS: The frequency of 12 comorbidities and their impact on NYHA class and SF-36 physical functioning score (SF-36 PF) were evaluated in 1,294 patients with HFpEF and 2,785 with HFrEF. HFpEF patients had lower NYHA class (2...
September 2011: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
Bassel Noumi, Sergio Teruya, Say Salomon, Stephen Helmke, Mathew S Maurer
Racial differences in the prevalence of anemia in patients with heart failure have been noted. The diagnosis of anemia in heart failure patients can be confounded by many factors. Plasma volume expansion is one of the most prominent confounders. The authors investigated the difference of anemia prevalence using two different diagnostic techniques: peripheral hemoglobin recommended by the World Health Organization criteria and blood volume (BV) analysis. Racial disparities in the prevalence of anemia using both measures were compared...
January 2011: Congestive Heart Failure
Dmitry Abramov, Rose S Cohen, Stuart D Katz, Donna Mancini, Mathew S Maurer
Anemia is a significant co-morbidity in patients with heart failure (HF) irrespective of the ejection fraction and is routinely quantified by hemoglobin concentration. Hemodilution as a cause of anemia has been described in systolic HF. The aim of this study was to further investigate the effects of plasma volume in patients with HF by (1) assessing the prevalence of dilutional anemia in patients with anemia and preserved ejection fractions and (2) exploring the relation between hemoglobin and red cell volume in these patients...
October 15, 2008: American Journal of Cardiology
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