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Reduced ejection fraction

Minako Shimizu, Shigehiro Doi, Ayumu Nakashima, Takayuki Naito, Takao Masaki
PURPOSE: This study examined the clinical significance of N-terminal pro brain natriuretic peptide level as a cardiac marker in Japanese hemodialysis patients. METHODS: This was a multicenter cross-sectional study involving 1428 Japanese hemodialysis patients. Ultrasonic cardiography data at post-hemodialysis were obtained from 395 patients. We examined whether serum N-terminal pro brain natriuretic peptide levels were associated with cardiac parameters and assessed cut-off values and investigated factors associated with a reduced ratio of N-terminal pro brain natriuretic peptide levels pre- and post-hemodialysis...
March 2018: International Journal of Artificial Organs
Sini M Kinnunen, Marja Tölli, Mika J Välimäki, Erhe Gao, Zoltan Szabo, Jaana Rysä, Mónica P A Ferreira, Pauli Ohukainen, Raisa Serpi, Alexandra Correia, Ermei Mäkilä, Jarno Salonen, Jouni Hirvonen, Hélder A Santos, Heikki Ruskoaho
Transcription factors are fundamental regulators of gene transcription, and many diseases, such as heart diseases, are associated with deregulation of transcriptional networks. In the adult heart, zinc-finger transcription factor GATA4 is a critical regulator of cardiac repair and remodelling. Previous studies also suggest that NKX2-5 plays function role as a cofactor of GATA4. We have recently reported the identification of small molecules that either inhibit or enhance the GATA4-NKX2-5 transcriptional synergy...
March 15, 2018: Scientific Reports
Teresa Oloriz, Francesca Baratto, Nicola Trevisi, Melania Barbaro, Caterina Bisceglia, Giuseppe D'Angelo, Miki Yamase, Gabriele Paglino, Andrea Radinovic, Paolo Della Bella
BACKGROUND: Catheter ablation of ventricular tachycardia (VT) is effective to prevent arrhythmia episode-related implantable cardioverter defibrillator shocks. However, recurrences in noninducible patients at programmed ventricular stimulation (PVS) are substantial. METHODS AND RESULTS: From May 2013 to September 2015, 218 PVSs were performed 6 days (5-7) after ablation (186 noninvasive programmed stimulations and 32 invasive PVS) in 210 consecutive patients (ischemic, 48%; median left ventricular ejection fraction, 37%; syncope, 35% with trauma associated 6%), while patients were awake and under β-blocker therapy...
March 2018: Circulation. Arrhythmia and Electrophysiology
Benedikt Schrage, Daniel Kalbacher, Michael Schwarzl, Nicole Rübsamen, Christoph Waldeyer, Peter Moritz Becher, Eike Tigges, Daniel Burkhoff, Stefan Blankenberg, Edith Lubos, Ulrich Schäfer, Dirk Westermann
BACKGROUND: Percutaneous mitral valve edge-to-edge repair (pMVR) with a MitraClip is beneficial for the clinical symptoms of patients irrespective of the ejection fraction (EF). Nevertheless, the consequences on hemodynamics are poorly understood. Therefore, we used data from noninvasive pressure-volume loops to investigate the left ventricular (LV) remodeling of patients after pMVR dependent on their baseline EF. METHODS AND RESULTS: In 130 patients with successful pMVR, the end-diastolic pressure-volume relationship (EDPVR) and end-systolic pressure-volume relationship were estimated noninvasively from echocardiographic data...
March 15, 2018: Journal of the American Heart Association
Andrew R Kompa, Jiayu Lu, Thomas J Weller, Darren J Kelly, Henry Krum, Thomas G von Lueder, Bing H Wang
BACKGROUND: Angiotensin receptor neprilysin inhibitor (ARNi) enhances beneficial natriuretic peptides by inhibiting their breakdown through neprilysin. Although the first-in-class ARNi sacubitril/valsartan (LCZ696) reduced mortality and morbidity in heart failure (HF) with reduced ejection fraction (EF) compared to angiotensin converting enzyme inhibitor (ACEi), mechanistic data on ARNi are scarce. ARNi may be superior to ACEi in attenuating adverse cardiac remodeling and dysfunction post-myocardial infarction (MI)...
May 1, 2018: International Journal of Cardiology
Susanne Röger, Stefanie L Rosenkaimer, Anna Hohneck, Siegfried Lang, Ibrahim El-Battrawy, Boris Rudic, Erol Tülümen, Ksenija Stach, Jürgen Kuschyk, Ibrahim Akin, Martin Borggrefe
BACKGROUND: The wearable cardioverter-defibrillator (WCD) has emerged as a valuable tool to temporarily protect patients at risk for sudden cardiac death (SCD). The aim of this study was to determine the value of the WCD for therapy optimization of heart failure patients. METHODS: One hundred five consecutive patients that received WCD between 4/2012 and 9/2016 were included in the study. All patients were followed for clinical outcome and echocardiographic parameters during WCD therapy and had continued follow-up after WCD therapy, irrespective of subsequent implantable cardioverter-defibrillator (ICD) implantation...
March 15, 2018: BMC Cardiovascular Disorders
Kotaro Nochioka, Yasuhiko Sakata, Hiroaki Shimokawa
Renin-angiotensin-aldosterone system (RAAS) and sympathetic nervous system play crucial roles in heart failure with reduced ejection fraction (HFrEF). Clinical trials provide strong evidence of prognostic benefits for combination therapy with angiotensin-converting enzyme inhibitor (ACEI) and β-blocker in the treatment of HFrEF. Angiotensin receptor blocker (ARB) is not superior to ACEI in improving mortality and an alternative for patients who are intolerant to ACEI. Prognostic evidence for triple therapy which combined angiotensin receptor blocker (ARB) and ACEI in addition to β-blocker therapy, is still controversial in HFrEF...
March 15, 2018: Advances in Experimental Medicine and Biology
Kenichi Matsushita, Kazumasa Harada, Tetsuro Miyazaki, Takamichi Miyamoto, Kiyoshi Iida, Shuzou Tanimoto, Mayuko Yagawa, Makoto Takei, Yuji Nagatomo, Toru Hosoda, Hideaki Yoshino, Takeshi Yamamoto, Ken Nagao, Morimasa Takayama
The relationship between glycemic control and outcome in patients with heart failure (HF) remains contentious. A recent study showed that patients with HF with mid-range ejection fraction (HFmrEF) more frequently had comorbid diabetes relative to other patients. Herein, we examined the association between glycosylated hemoglobin (HbA1c) and in-hospital mortality in acute HF patients with reduced, mid-range, and preserved EF. A multicenter retrospective study was conducted on 5205 consecutive patients with acute HF...
March 14, 2018: Heart and Vessels
Rebecca R Vanderpool, Melissa Saul, Mehdi Nouraie, Mark T Gladwin, Marc A Simon
Importance: Heart failure with preserved ejection fraction (HFpEF) is highly prevalent, yet there are no specific therapies, possibly due to phenotypic heterogeneity. The development of pulmonary hypertension (PH) in patients with HFpEF is considered a high-risk phenotype in need of targeted therapies, but there have been limited hemodynamic and outcomes data. Objective: To identify the hemodynamic characteristics and outcomes of PH-HFpEF. Design, Setting, and Participants: Cohort study of participants who had a right heart catheterization from January 2005 to September 2012 (median [interquartile range] follow-up time, 1578 [554-2513] days) were analyzed...
March 14, 2018: JAMA Cardiology
Marta Scatena, Melissa F Jackson, Mei Y Speer, Elizabeth M Leaf, Mary C Wallingford, Cecilia M Giachelli
OBJECTIVE: Calcific aortic valve disease (CAVD) is a major cause of aortic stenosis (AS) and cardiac insufficiency. Patients with type II diabetes mellitus (T2DM) are at heightened risk for CAVD, and their valves have greater calcification than nondiabetic valves. No drugs to prevent or treat CAVD exist, and animal models that might help identify therapeutic targets are sorely lacking. To develop an animal model mimicking the structural and functional features of CAVD in people with T2DM, we tested a diabetogenic, procalcific diet and its effect on the incidence and severity of CAVD and AS in the, LDLr-/- ApoB100/100 mouse model...
February 15, 2018: Cardiovascular Pathology: the Official Journal of the Society for Cardiovascular Pathology
Ying-Chun Shih, Chao-Ling Chen, Yan Zhang, Rebecca L Mellor, Evelyn M Kanter, Yun Fang, Hua-Chi Wang, Chen-Ting Hung, Jing-Yi Nong, Hui-Ju Chen, Tzu-Han Lee, Yi-Shuan Tseng, Chiung-Nien Chen, Chau-Chung Wu, Shuei-Liong Lin, Kathryn A Yamada, Jeanne M Nerbonne, Kai-Chien Yang
<u>Rationale:</u> Cardiac fibrosis plays a critical role in the pathogenesis of heart failure (HF). Excessive accumulation of extracellular matrix (ECM) resulting from cardiac fibrosis impairs cardiac contractile function and increases arrhythmogenicity. Current treatment options for cardiac fibrosis, however, are limited and there is a clear need to identify novel mediators of cardiac fibrosis to facilitate the development of better therapeutics. Exploiting co-expression gene network analysis on RNA sequencing data from failing human heart, we identified thioredoxin domain containing 5 (TXNDC5), a cardiac fibroblast (CF)-enriched endoplasmic reticulum (ER) protein, as a potential novel mediator of cardiac fibrosis and we completed experiments to test this hypothesis directly...
March 13, 2018: Circulation Research
Jeehoon Kang, Jin Joo Park, Young-Jin Cho, Il-Young Oh, Hyun-Ah Park, Sang Eun Lee, Min-Seok Kim, Hyun-Jai Cho, Hae-Young Lee, Jin Oh Choi, Kyung-Kuk Hwang, Kye Hun Kim, Byung-Su Yoo, Seok-Min Kang, Sang Hong Baek, Eun-Seok Jeon, Jae-Joong Kim, Myeong-Chan Cho, Shung Chull Chae, Byung-Hee Oh, Dong-Ju Choi
BACKGROUND: Worsening renal function (WRF) is associated with adverse outcomes in patients with heart failure. We investigated the predictors and prognostic value of WRF during admission, in patients with preserved ejection fraction (HFpEF) versus those with reduced ejection fraction (HFrEF). METHODS AND RESULTS: A total of 5625 patients were enrolled in the KorAHF (Korean Acute Heart Failure) registry. WRF was defined as an absolute increase in creatinine of ≥0...
March 13, 2018: Journal of the American Heart Association
Philipp E Bartko, Noemi Pavo, Ana Pérez-Serradilla, Henrike Arfsten, Stephanie Neuhold, Raphael Wurm, Irene M Lang, Guido Strunk, Jacob P Dal-Bianco, Robert A Levine, Martin Hülsmann, Georg Goliasch
Aims: Secondary mitral regurgitation (MR) drives adverse remodelling towards late heart failure stages. Little is known about the evolution of MR under guideline-directed therapy (GDT) and its relation to cardiac remodelling and outcome. We therefore aimed to assess incidence, impact, and predictors of progressive secondary MR in patients under GDT. Methods and results: We prospectively enrolled 249 patients with chronic heart failure and reduced ejection fraction receiving GDT in this long-term observational study...
March 9, 2018: European Heart Journal Cardiovascular Imaging
Raza M Alvi, Noor Tariq, Atul Malhotra, Magid Awadalla, Virginia Triant, Markella V Zanni, Tomas G Neilan
Background: Sleep apnea (SA) is common and has prognostic significance among broad groups of patients with heart failure (HF). Among persons living with HIV (PLHIV), both SA and HF are reported. However, there are no data characterizing the presence, associations and prognostic significance of SA among PLHIV with HF. Methods: We conducted a single center study of PLHIV admitted with HFrEF (LVEF of <50%) and analyzed the relationship of SA with 30-day HF hospital readmission rate, cardiovascular (CV) and all-cause mortality...
March 9, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Thomas Uray, Andrew Lamade, Jonathan Elmer, Tomas Drabek, Jason P Stezoski, Amalea Missé, Keri Janesko-Feldman, Robert H Garman, Niel Chen, Patrick M Kochanek, Cameron Dezfulian
OBJECTIVES: Cardiac arrest etiology may be an important source of between-patient heterogeneity, but the impact of etiology on organ injury is unknown. We tested the hypothesis that asphyxial cardiac arrest results in greater neurologic injury than cardiac etiology cardiac arrest (ventricular fibrillation cardiac arrest), whereas ventricular fibrillation cardiac arrest results in greater cardiovascular dysfunction after return of spontaneous circulation. DESIGN: Prospective observational human and randomized animal study...
March 10, 2018: Critical Care Medicine
Peter H Khalil, Ghazal Kabbach, Debabrata Mukherjee, Sarmad Said
Heart Failure (HF) is one of the main health care burdens in the United States and in the world. Many drugs are approved and used in practice for management of this condition; including beta blockers, diuretics, aldosterone antagonists, angiotensin converting enzyme inhibitors (ACEI's), and angiotensin receptor blockers (ARBs). Recently, the Food and Drug Administration (FDA) approved a drug with brand name Entresto (Sacubitril/Valsartan or LCZ696), an angiotensin receptor neprilysin inhibitor for the use in Heart Failure with Reduced Ejection Fraction (HFrEF) patients instead of ACEI's and ARBs...
March 13, 2018: Cardiovascular & Hematological Agents in Medicinal Chemistry
Asaad A Khan, George D Dangas
Several chronic total occlusions (CTOs) may be undilatable despite successful wire passage; several techniques can be used for lesion preparation, such as high-pressure balloon inflations, rotational atherectomy laser, cutting balloon, and scoring balloons. Presence of moderate to severe calcification and lesion length over 40 mm in association with comorbidities, such as diabetes mellitus and reduced ejection fraction, may contribute to making a CTO lesion undilatable. Still, appropriate therapy selection for a patient with CTO should be individualized and procedure safety attended to...
March 1, 2018: Catheterization and Cardiovascular Interventions
Alberto Palazzuoli, Gaetano Ruocco, Matteo Beltrami, Ranuccio Nuti, John G Cleland
BACKGROUND: Lung ultrasound (LUS) can be used to assess pulmonary congestion by imaging B-lines ('comets') for patients with acute heart failure (AHF). OBJECTIVES: Investigate relationship of B-lines, plasma concentrations of B-type natriuretic peptide (BNP), and echocardiographic left ventricular (LV) function measured at admission and discharge and their relationship to prognosis for AHF with preserved (HFpEF) or reduced (HFrEF) LV ejection fraction. METHODS: Patients with AHF had the above tests done at admission and discharge...
March 12, 2018: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
Ralph A H Stewart, Dominika Szalewska, Amanda Stebbins, Hussein R Al-Khalidi, John G H Cleland, Andrzej Rynkiewicz, Mark H Drazner, Harvey D White, Daniel B Mark, Ambuj Roy, Dragana Kosevic, Miroslaw Rajda, Marek Jasinski, Chua Yeow Leng, Wiwun Tungsubutra, Patrice Desvigne-Nickens, Eric J Velazquez, Mark C Petrie
Background: In patients with ischaemic left ventricular dysfunction, coronary artery bypass surgery (CABG) may decrease mortality, but it is not known whether CABG improves functional capacity. Objective: To determine whether CABG compared with medical therapy alone (MED) increases 6 min walk distance in patients with ischaemic left ventricular dysfunction and coronary artery disease amenable to revascularisation. Methods: The Surgical Treatment in Ischemic Heart disease trial randomised 1212 patients with ischaemic left ventricular dysfunction to CABG or MED...
2018: Open Heart
Krunoslav Michael Sveric, Stefan Ulbrich, Mohamed Rady, Christian Pflücke, Silvio Quick, Stefanie Katzke, Karim Ibrahim, Ruth H Strasser, Stefanie Jellinghaus
Objectives: Non-ischaemic dilated cardiomyopathy (DCM) is characterised by a highly variable disease progression. Stress echocardiography and cardiopulmonary exercise testing (CPET) are beneficial in risk assessment, but are labour intensive. Repetitive squatting and standing without weights is a simple exercise (EX). The aim of this study was to investigate the prognostic role of left ventricular (LV) contractile recruitment (CR) after a simple EX of repetitive squatting through three-dimensional (3D) echocardiography...
2018: Open Heart
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