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Preserved ejection fraction

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https://www.readbyqxmd.com/read/29150163/the-management-of-diagnosed-heart-failure-in-older-people-in-primary-care
#1
REVIEW
Nicholas R Jones, F D Richard Hobbs, Clare J Taylor
Heart failure (HF) is a common condition affecting predominantly older people. Symptoms include breathlessness and fatigue, and can significantly reduce quality of life. HF rarely occurs in isolation, with most patients having several co-existing diseases requiring multiple medications. There is a large evidence base for treatment of HF with reduced ejection fraction, or HFrEF; however, many of the trials did not include older people with multimorbidity so their findings should be applied to this group with some caution...
December 2017: Maturitas
https://www.readbyqxmd.com/read/29148148/an-integrative-translational-approach-to-study-heart-failure-with-preserved-ejection-fraction-a-position-paper-from-the-working-group-on-myocardial-function-of-the-european-society-of-cardiology
#2
REVIEW
Andre P Lourenço, Adelino F Leite-Moreira, Jean-Luc Balligand, Johann Bauersachs, Dana Dawson, Rudolf A de Boer, Leon J de Windt, Inês Falcão-Pires, Ricardo Fontes-Carvalho, Stefan Franz, Mauro Giacca, Denise Hilfiker-Kleiner, Emilio Hirsch, Christoph Maack, Manuel Mayr, Burkert Pieske, Thomas Thum, Carlo G Tocchetti, Dirk L Brutsaert, Stephane Heymans
As heart failure with preserved ejection fraction (HFpEF) rises to epidemic proportions, major steps in patient management and therapeutic development are badly needed. With the current position paper we seek to update our view on HFpEF as a highly complex systemic syndrome, from risk factors and mechanisms to long-term clinical manifestations. We will revise recent advances in animal model development, experimental set-ups and basic and translational science approaches to HFpEF research, highlighting their drawbacks and advantages...
November 16, 2017: European Journal of Heart Failure
https://www.readbyqxmd.com/read/29148144/systolic-blood-pressure-and-cardiovascular-outcomes-in-heart-failure-with-preserved-ejection-fraction-an-analysis-of-the-topcat-trial
#3
Senthil Selvaraj, Brian Claggett, Sanjiv J Shah, Inder Anand, Jean L Rouleau, Akshay S Desai, Eldrin F Lewis, Bertram Pitt, Nancy K Sweitzer, Marc A Pfeffer, Scott D Solomon
AIMS: Recent guidelines have advocated for stricter systolic blood pressure (SBP) control in heart failure with preserved ejection fraction (HFpEF), though data regarding the optimal SBP in HFpEF are sparse. METHODS AND RESULTS: We analysed participants from the Americas from the Treatment of Preserved Cardiac Function Heart Failure with an Aldosterone Antagonist (TOPCAT) study with available baseline and 8-week visit SBP data (n = 1645). We related baseline SBP to several efficacy and safety outcomes...
November 16, 2017: European Journal of Heart Failure
https://www.readbyqxmd.com/read/29145282/autosomal-dominant-polycystic-kidney-disease-combined-with-hypertrophic-cardiomyopathy-a-case-report
#4
Yingjing Shen, Chenggang Xu
INTRODUCTION: This report describes the novel sampling of autosomal dominant polycystic kidney disease (ADPKD) combined with hypertrophic cardiomyopathy (HCM). SYMPTOMS AND CLINICAL FINDINGS: A 48-year-old Chinese man presented with anasarca, hypourocrinia, gross hematuria, and weight gain by 10 kg subsequently developed acute kidney injury after struck by acute respiratory distress syndrome, really a threat to his heart. DIAGNOSES: Abdominal ultrasound revealed multiple small cysts in both kidneys, with the right kidney measuring 11...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29142810/the-role-of-ivabradine-in-diastolic-heart-failure-with-preserved-ejection-fraction-a-doppler-echocardiographic-study
#5
Federico Cacciapuoti, Valerio Massimo Magro, Michele Caturano, Diana Lama, Fulvio Cacciapuoti
Background: Ivabradine (IVA) is effective in patients with coronary artery disease (CAD) or systolic heart failure in sinus rhythm. Its action consists in reducing heart rate (HR) and improving the time of left ventricular (LV) diastolic filling. The aim of this study was to evaluate the effects of IVA added to conventional therapy on patients with diastolic heart failure (DHF) and preserved ejection fraction (HFpEF). Methods: We evaluated 25 patients with DHF in the New York Heart Association (NYHA) Class II-III and sinus rhythm...
October 2017: Journal of Cardiovascular Echography
https://www.readbyqxmd.com/read/29142012/a-transcatheter-interatrial-shunt-device-for-the-treatment-of-heart-failure-with-preserved-ejection-fraction-reduce-lap-hf-i-a-phase-2-randomized-sham-controlled-trial
#6
Ted Feldman, Laura Mauri, Rami Kahwash, Sheldon Litwin, Mark J Ricciardi, Pim van der Harst, Martin Penicka, Peter S Fail, David M Kaye, Mark C Petrie, Anupam Basuray, Scott L Hummel, Rhondalyn Forde-McLean, Christopher D Nielsen, Scott Lilly, Joseph M Massaro, Daniel Burkhoff, Sanjiv J Shah
Background -In non-randomized, open-label studies, a transcatheter interatrial shunt device (IASD, Corvia Medical) was associated with lower pulmonary capillary wedge pressure (PCWP), less symptoms, and greater quality of life and exercise capacity in patients with heart failure (HF) and mid-range or preserved ejection fraction (EF ≥ 40%). We conducted the first randomized, sham-controlled trial to evaluate the IASD in HF with EF ≥ 40%. Methods -REDUCE LAP-HF I was a phase 2, randomized, parallel-group, blinded multicenter trial in patients with New York Heart Association (NYHA) class III or ambulatory class IV HF, EF ≥ 40%, exercise PCWP ≥ 25 mmHg, and PCWP-right atrial pressure gradient ≥ 5 mmHg...
November 15, 2017: Circulation
https://www.readbyqxmd.com/read/29141781/heart-failure-with-preserved-borderline-and-reduced-ejection-fraction-5-year-outcomes
#7
Kevin S Shah, Haolin Xu, Roland A Matsouaka, Deepak L Bhatt, Paul A Heidenreich, Adrian F Hernandez, Adam D Devore, Clyde W Yancy, Gregg C Fonarow
BACKGROUND: Patients with heart failure (HF) have a poor prognosis and are categorized by ejection fraction (EF). OBJECTIVES: This study sought to characterize differences in outcomes in patients hospitalized with heart failure with preserved ejection fraction (HFpEF) (EF ≥50%), heart failure with borderline ejection fraction (HFbEF) (EF 41% to 49%), and heart failure with reduced ejection fraction (HFrEF) (EF ≤40%). METHODS: Data from GWTG-HF (Get With The Guidelines-Heart Failure) were linked to Medicare data for longitudinal follow-up...
October 31, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/29140729/gene-expression-and-gene-associations-during-the-development-of-heart-failure-with-preserved-ejection-fraction-in-the-dahl-salt-sensitive-model-of-hypertension
#8
Jeffrey Yim, Hyokeun Cho, Simon W Rabkin
Gene expression and associations were examined in a model of heart failure with preserved ejection fraction (HFpEF), a condition with minimal effective treatment. Genes with at least two studies showing significant changes in Dahl rat with heart failure were examined by meta-analysis. Significantly increased in expression were iNOS, p47phox, ADM, ANP, OPN, ACE, MCP-1, GP91PHOX, ICAM-1, TGF-β1, CTGF, ET-1, p22phox, ETB, BNP, ETA, MMP13, Col1a1, MMP2, TIMP1, Col3a1, Il-1β, β-MHC, ECE1, MMP14, AGT, and MMP9...
November 15, 2017: Clinical and Experimental Hypertension: CHE
https://www.readbyqxmd.com/read/29131295/the-intracardiac-concentrations-of-the-n-terminal-pro-b-type-natriuretic-peptide-nt-probnp-and-the-determinants-of-its-secretion-in-patients-with-atrial-fibrillation
#9
Witold Streb, Katarzyna Mitręga, Magdalena Szymała, Aleksandra Woźniak, Tomasz Podolecki, Zbigniew Kalarus
BACKGROUND: N-terminal-pro Brain Natriuretic Peptide (NT-proBNP) is elevated not only in heart failure (HF) but also in atrial fibrillation (AF). The role and secretion pattern of NT-proBNP in AF is still undetermined. AIM: The study aimed to assess NT-proBNP concentrations in patients with and without preserved left ventricular ejection fraction (LV-EF) depending on the type of AF. It was also intended to define the main source of NT-proBNP production within the heart...
November 13, 2017: Kardiologia Polska
https://www.readbyqxmd.com/read/29127185/advances-in-computational-modelling-for-personalised-medicine-after-myocardial-infarction
#10
REVIEW
Kenneth Mangion, Hao Gao, Dirk Husmeier, Xiaoyu Luo, Colin Berry
Myocardial infarction (MI) is a leading cause of premature morbidity and mortality worldwide. Determining which patients will experience heart failure and sudden cardiac death after an acute MI is notoriously difficult for clinicians. The extent of heart damage after an acute MI is informed by cardiac imaging, typically using echocardiography or sometimes, cardiac magnetic resonance (CMR). These scans provide complex data sets that are only partially exploited by clinicians in daily practice, implying potential for improved risk assessment...
November 10, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/29125704/left-atrial-ejection-force-predicts-the-outcome-after-catheter-ablation-for-paroxysmal-atrial-fibrillation
#11
Hideyuki Kishima, Takanao Mine, Satoshi Takahashi, Kenki Ashida, Masaharu Ishihara, Tohru Masuyama
INTRODUCTION: Left atrium (LA) systolic dysfunction is observed in the early stages of atrial fibrillation (AF) prior to LA anatomical change. We investigated whether LA systolic dysfunction predicts recurrent AF after catheter ablation (CA) in patients with paroxysmal AF. METHODS AND RESULTS: We studied 106 patients who underwent CA for paroxysmal AF. LA systolic function was assessed with the LA emptying volume = Maximum LA volume (LAVmax) - Minimum LA volume (LAVmin), LA emptying fraction = [(LAVmax - LAVmin) / LAVmax] × 100, and LA ejection force calculated with Manning`s method [LA ejection force = (0...
November 10, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/29124734/evolution-of-a-geriatric-syndrome-pathophysiology-and-treatment-of-heart-failure-with-preserved-ejection-fraction
#12
Bharathi Upadhya, Barbara Pisani, Dalane W Kitzman
The majority of older adults who develop heart failure (HF), particularly older women, have a preserved left ventricular ejection fraction (HFpEF). The prevalence of this syndrome is increasing, and the prognosis is not improving, unlike that of HF with reduced ejection fraction (HFrEF). Individuals with HFpEF have severe symptoms of effort intolerance, poor quality of life, frequent hospitalizations, and greater likelihood of death. Despite the importance of HFpEF, there are numerous major gaps in our understanding of its pathophysiology and management...
November 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/29124471/clinical-outcome-and-functional-characteristics-of-patients-with-asymptomatic-low-flow-low-gradient-severe-aortic-stenosis-with-preserved-ejection-fraction-are-closer-to-high-gradient-severe-than-to-moderate-aortic-stenosis
#13
Mohammad Kavianipour, Amir Farkhooy, Frank A Flachskampf
Asymptomatic "paradoxic" severe low-flow low-gradient aortic stenosis with preserved ejection fraction (PAS) constitutes a challenging condition where the optimal management and follow-up remain elusive. We evaluated the clinical outcome in patients with PAS as compared to asymptomatic patients with moderate (MAS) or classical severe aortic stenosis (CAS). Consecutive asymptomatic moderate or severe aortic stenosis patients without concomitant other heart or lung disease (n = 121) were invited. Participants (n = 74) were assigned to three subgroups with regard to degree of aortic stenosis: MAS (n = 25), CAS (n = 22) and PAS (n = 27)...
November 9, 2017: International Journal of Cardiovascular Imaging
https://www.readbyqxmd.com/read/29121924/impact-of-overweight-on-left-ventricular-function-in-type-2-diabetes-mellitus
#14
Makiko Suto, Hidekazu Tanaka, Yasuhide Mochizuki, Jun Mukai, Hiroki Takada, Fumitaka Soga, Kumiko Dokuni, Yutaka Hatani, Keiko Hatazawa, Hiroki Matsuzoe, Hiroyuki Sano, Hiroyuki Shimoura, Junichi Ooka, Kensuke Matsumoto, Yushi Hirota, Wataru Ogawa, Ken-Ichi Hirata
BACKGROUND: Coexistence of left ventricular (LV) longitudinal myocardial systolic dysfunction with LV diastolic dysfunction could lead to heart failure with preserved ejection fraction (HFpEF). Diabetes mellitus (DM) is known as a significant factor associated with HFpEF. Although the mechanisms of DM-related LV myocardial injury are complex, it has been postulated that overweight contributes to the development of LV myocardial injury in type 2 diabetes mellitus (T2DM) patients. However, the precise impact of overweight on LV longitudinal myocardial systolic function in T2DM patients remains unclear...
November 9, 2017: Cardiovascular Diabetology
https://www.readbyqxmd.com/read/29120957/deletion-of-protein-kinase-b2-preserves-cardiac-function-by-blocking-interleukin-6-mediated-injury-and-restores-blood-pressure-during-angiotensin-ii-high-salt-diet-induced-hypertension
#15
Shuai Yang, Dandan Chen, Fan Chen, Xinmei Zhao, Yubin Zhang, Zhe Li, Liang Jin, Yitao Xu, Daniel Sanchis, Junmei Ye
OBJECTIVE: Protein kinase B2 (AKT2) is implicated in cardiomyocyte survival during various stress conditions. However, the role of AKT2 in heart function, cardiac hypertrophy and blood pressure (BP) control during hypertension is not fully understood. Therefore, we sought to determine whether the deletion of AKT2 protects cardiac function during angiotensin II/high-salt-diet (AngII/HSD) treatment and find out the signaling pathway. METHODS: Male C57BL/6J (wild type), AKT2 knockout and interleukin (IL)-6 knockout mice were fed a 4% NaCl diet for 5 weeks...
November 8, 2017: Journal of Hypertension
https://www.readbyqxmd.com/read/29119456/heterogeneity-of-longitudinal-and-circumferential-contraction-in-relation-to-late-gadolinium-enhancement-in-hypertrophic-cardiomyopathy-patients-with-preserved-left-ventricular-ejection-fraction
#16
Keita Sakamoto, Noriko Oyama-Manabe, Osamu Manabe, Tadao Aikawa, Yasuka Kikuchi, Harue Sasai-Masuko, Masanao Naya, Kohsuke Kudo, Fumi Kato, Nagara Tamaki, Hiroki Shirato
PURPOSE: To evaluate heterogeneity of myocardial contraction in relation to extensive late gadolinium enhancement (LGE) in hypertrophic cardiomyopathy (HCM) patients with preserved left ventricular ejection fraction, using fast strain-encoded magnetic resonance imaging. MATERIALS AND METHODS: Twenty-two HCM patients and 24 age-matched control subjects were included in this retrospective study. The regional and global peak values of longitudinal and circumferential strain (LSregional, LSglobal, CSregional, CSglobal), and their regional heterogeneities were evaluated using coefficients of variation (LSCoV, CSCoV) in relation to LGE...
November 9, 2017: Japanese Journal of Radiology
https://www.readbyqxmd.com/read/29111980/impact-of-continuation-of-metformin-prior-to-elective-coronary-angiography-on-acute-contrast-nephropathy-in-patients-with-normal-or-mildly-impaired-renal-functions
#17
Veysel Oktay, İlknur Calpar Çıralı, Ümit Yaşar Sinan, Ahmet Yıldız, Murat Kazım Ersanlı
OBJECTIVE: Discontinuation of metformin treatment in patients scheduled for elective coronary angiography (CAG) is controversial because of post-procedural risks including acute contrast-induced nephropathy (CIN) and lactic acidosis (LA). This study aims to discuss the safety of continuing metformin treatment in patients undergoing elective CAG with normal or mildly impaired renal functions. METHODS: Our study was designed as a single-centered, randomized, and observational study including 268 patients undergoing elective CAG with an estimated glomerular filtration rate of >60 mL/min/1...
October 31, 2017: Anatolian Journal of Cardiology
https://www.readbyqxmd.com/read/29111304/who-are-they-patients-with-heart-failure-in-american-skilled-nursing-facilities
#18
Lin Li, Bill M Jesdale, Anne Hume, Giovanni Gambassi, Robert J Goldberg, Kate L Lapane
BACKGROUND: Heart failure (HF) is common among skilled nursing facility (SNF) residents, yet patients with HF in the SNF setting have not been well described. METHODS: Using Minimum Data Set 3.0 cross-linked to Medicare data (2011-2012), we studied 150,959 HF patients admitted to 13,858 SNFs throughout the USA. ICD-9 codes were used to differentiate patients with HF with preserved ejection fraction (HFpEF), reduced ejection fraction (HFrEF), or unspecified HF. RESULTS: The median age of the study population was 82 years, 68% were women, 34% had HFpEF, and 27% had HFrEF...
October 27, 2017: Journal of Cardiology
https://www.readbyqxmd.com/read/29111106/2017-comprehensive-update-of-the-canadian-cardiovascular-society-guidelines-for-the-management-of-heart-failure
#19
Justin A Ezekowitz, Eileen O'Meara, Michael A McDonald, Howard Abrams, Michael Chan, Anique Ducharme, Nadia Giannetti, Adam Grzeslo, Peter G Hamilton, George A Heckman, Jonathan G Howlett, Sheri L Koshman, Serge Lepage, Robert S McKelvie, Gordon W Moe, Miroslaw Rajda, Elizabeth Swiggum, Sean A Virani, Shelley Zieroth, Abdul Al-Hesayen, Alain Cohen-Solal, Michel D'Astous, Sabe De, Estrellita Estrella-Holder, Stephen Fremes, Lee Green, Haissam Haddad, Karen Harkness, Adrian F Hernandez, Simon Kouz, Marie-Hélène LeBlanc, Frederick A Masoudi, Heather J Ross, Andre Roussin, Bruce Sussex
Since the inception of the Canadian Cardiovascular Society heart failure (HF) guidelines in 2006, much has changed in the care for patients with HF. Over the past decade, the HF Guidelines Committee has published regular updates. However, because of the major changes that have occurred, the Guidelines Committee believes that a comprehensive reassessment of the HF management recommendations is presently needed, with a view to producing a full and complete set of updated guidelines. The primary and secondary Canadian Cardiovascular Society HF panel members as well as external experts have reviewed clinically relevant literature to provide guidance for the practicing clinician...
November 2017: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/29107324/daytime-variation-of-perioperative-myocardial-injury-in-cardiac-surgery-and-its-prevention-by-rev-erb%C3%AE-antagonism-a-single-centre-propensity-matched-cohort-study-and-a-randomised-study
#20
David Montaigne, Xavier Marechal, Thomas Modine, Augustin Coisne, Stéphanie Mouton, Georges Fayad, Sandro Ninni, Cédric Klein, Staniel Ortmans, Claire Seunes, Charlotte Potelle, Alexandre Berthier, Celine Gheeraert, Catherine Piveteau, Rebecca Deprez, Jérome Eeckhoute, Hélène Duez, Dominique Lacroix, Benoit Deprez, Bruno Jegou, Mohamed Koussa, Jean-Louis Edme, Philippe Lefebvre, Bart Staels
BACKGROUND: On-pump cardiac surgery provokes a predictable perioperative myocardial ischaemia-reperfusion injury which is associated with poor clinical outcomes. We determined the occurrence of time-of-the-day variation in perioperative myocardial injury in patients undergoing aortic valve replacement and its molecular mechanisms. METHODS: We studied the incidence of major adverse cardiac events in a prospective observational single-centre cohort study of patients with severe aortic stenosis and preserved left ventricular ejection fraction (>50%) who were referred to our cardiovascular surgery department at Lille University Hospital (Lille, France) for aortic valve replacement and underwent surgery in the morning or afternoon...
October 26, 2017: Lancet
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