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Preserved ejection fraction

Eiichiro Yamamoto, Yoshihiro Hirata, Takanori Tokitsu, Hiroaki Kusaka, Noriaki Tabata, Kenichi Tsujita, Megumi Yamamuro, Koichi Kaikita, Hiroshi Watanabe, Seiji Hokimoto, Toru Maruyama, Hisao Ogawa
AIMS: Although inflammation plays an important role in the pathogenesis of heart failure (HF), the precise pathophysiological role of inflammation in HF with preserved left ventricular ejection fraction (HFpEF) still remains unclear. Hence, we examined the clinical significance of plasma neopterin, an inflammatory biomarker, in HFpEF patients. METHODS AND RESULTS: In the present study, we recruited consecutive HFpEF patients hospitalized in Kumamoto University Hospital, and further measured plasma neopterin by high-performance liquid chromatography and serum derivatives of reactive oxidative metabolites (DROM), a new biomarker of reactive oxygen species...
March 2016: ESC Heart Failure
Osami Kawarada, Ryota Kitajima, Yasuo Sugano, Teruo Noguchi, Toshihisa Anzai, Hisao Ogawa, Satoshi Yasuda
Recurrent congestive heart failure related to renal artery disease is an important clinical entity that is typically observed in bilateral renal artery stenosis or solitary functioning kidney. However, the relationship between heart failure and unilateral renal artery disease, especially that with total occlusion, remains unclear. We report a successful management by unilateral renal artery total occlusion stenting with an evidence of improvement of left ventricular filling and pulmonary artery pressure in case of a patient suffering from medical therapy resistant recurrent congestive heart failure with preserved ejection fraction...
December 2015: ESC Heart Failure
Ravi B Patel, Muthiah Vaduganathan, Sanjiv J Shah, Javed Butler
Atrial fibrillation (AF) and heart failure (HF) often coexist, and the outcomes of patients who have both AF and HF are considerably worse than those with either condition in isolation. Heart failure with preserved ejection fraction (HFpEF) is a heterogeneous clinical entity and accounts for approximately one-half of current HF. At least one-third of patients with HFpEF are burdened by comorbid AF. The current understanding of the relationship between AF and HFpEF is limited, but the clinical implications are potentially important...
October 20, 2016: Pharmacology & Therapeutics
Denise Mathes, Johannes Weirather, Peter Nordbeck, Anahi-Paula Arias-Loza, Matthias Burkard, Christina Pachel, Thomas Kerkau, Niklas Beyersdorf, Stefan Frantz, Ulrich Hofmann
OBJECTIVE: The present study analyzed the effect of CD4(+) Forkhead box protein 3 negative (Foxp3(-)) T-cells and Foxp3(+) CD4(+) T-cells on infarct size in a mouse myocardial ischemia-reperfusion model. APPROACH AND RESULTS: We examined the infarct size as a fraction of the area-at-risk as primary study endpoint in mice after 30minutes of coronary ligation followed by 24hours of reperfusion. CD4(+) T-cell deficient MHC-II KO mice showed smaller histologically determined infarct size (34...
October 19, 2016: Journal of Molecular and Cellular Cardiology
David W Schopfer, Daniel E Forman
Cardiac rehabilitation (CR) is a comprehensive lifestyle program that can have particular benefit for older patients with heart failure (HF). Prevalence of HF is increasingly common among older adults. Mounting effects of cardiovascular risk factors in older age as well as the added effects of geriatric syndromes such as multimorbidity, frailty, and sedentariness contribute to the high incidence of HF as well as to management difficulty. Cardiac rehabilitation can play a decisive role in improving function, quality of life, symptoms, morbidity, and mortality, and also address the idiosyncratic complexities of care that often arise in old age...
October 18, 2016: Journal of Cardiac Failure
Michael Coll Barroso, Frank Kramer, Stephen J Greene, Daniel Scheyer, Till Köhler, Martin Karoff, Melchior Seyfarth, Mihai Gheorghiade, Wilfried Dinh
BACKGROUND: Insulin-like growth factor binding protein-7 (IGFBP-7) modulates the biological activities of insulin-like growth factor-1 (IGF-1). Previous studies demonstrated the prognostic value of IGFBP-7 and IGF-1 among patients with systolic heart failure (HF). This study aimed to evaluate the IGF1/IGFBP-7 axis in HF patients with preserved ejection fraction (HFpEF). METHODS: Serum IGF-1 and IGFBP-7 levels were measured in 300 eligible consecutive patients who underwent comprehensive cardiac assessment...
October 21, 2016: BMC Cardiovascular Disorders
Scott L Hummel
No abstract text is available yet for this article.
October 17, 2016: Journal of Cardiac Failure
Wojciech Kosmala, Aleksandra Rojek, Monika Przewlocka-Kosmala, Leah Wright, Andrzej Mysiak, Thomas H Marwick
BACKGROUND: Impaired functional capacity is a hallmark of patients with heart failure with preserved ejection fraction (HFpEF). Despite the association of HFpEF with reduced myocardial compliance attributed to fibrosis, spironolactone has not been shown to alter outcomes-perhaps reflecting the heterogeneity of underlying pathological mechanisms. OBJECTIVES: The authors sought to identify improvement in exercise capacity with spironolactone in the subset of patients with HFpEF with exercise-induced increase in ratio between early mitral inflow velocity and mitral annular early diastolic velocity (E/e') reflecting elevation of left ventricular (LV) filling pressure...
October 25, 2016: Journal of the American College of Cardiology
Xianxiu Wan, Jian-Jun Wen, Sue-Jie Koo, Lisa Yi Liang, Nisha Jain Garg
Chronic chagasic cardiomyopathy (CCM) is presented by increased oxidative/inflammatory stress and decreased mitochondrial bioenergetics. SIRT1 senses the redox changes and integrates mitochondrial metabolism and inflammation; and SIRT1 deficiency may be a major determinant in CCM. To test this, C57BL/6 mice were infected with Trypanosoma cruzi (Tc), treated with SIRT1 agonists (resveratrol or SRT1720), and monitored during chronic phase (~150 days post-infection). Resveratrol treatment was partially beneficial in controlling the pathologic processes in Chagas disease...
October 2016: PLoS Pathogens
Mariann Gyöngyösi, Georgiana-Aura Giurgea, Bonni Syeda, Silvia Charwat, Beatrice Marzluf, Julia Mascherbauer, Andras Jakab, Abelina Zimba, Márta Sárközy, Noemi Pavo, Heinz Sochor, Senta Graf, Irene Lang, Gerald Maurer, Jutta Bergler-Klein
OBJECTIVE: The long-term (5-year) outcome of early (3-6 weeks after acute myocardial infarction [AMI], BM-MNC Early group) and late (3-4 months after AMI, BM-MNC Late group) combined (percutaneous intramyocardial and intracoronary) delivery of autologous bone marrow mononuclear cells (BM-MNCs) was evaluated in patients with ejection fractions (EF) between 30-45% post-AMI. METHODS: Major adverse cardiac and cerebrovascular events (MACCE) and hospitalization were recorded...
2016: PloS One
Candice Morrissey
Diastolic dysfunction ranging from impaired relaxation of the left ventricle to heart failure with preserved ejection fraction (HFpEF) is a common finding in the cardiac surgery population. It is important for the peri-operative echocardiographer to have a developed understanding of the pathophysiology of diastolic dysfunction and the echocardiographic features that determine where on the spectrum of diastolic function and dysfunction a patient lies.
October 2016: Annals of Cardiac Anaesthesia
Julia O Reynolds, Ann P Quick, Qiongling Wang, David L Beavers, Leonne E Philippen, Jordan Showell, Giselle Barreto-Torres, Donna J Thuerauf, Shirin Doroudgar, Christopher C Glembotski, Xander H T Wehrens
BACKGROUND: Junctophilin-2 (JPH2) is the primary structural protein for the coupling of transverse (T)-tubule associated cardiac L-type Ca channels and type-2 ryanodine receptors on the sarcoplasmic reticulum within junctional membrane complexes (JMCs) in cardiomyocytes. Effective signaling between these channels ensures adequate Ca-induced Ca release required for normal cardiac contractility. Disruption of JMC subcellular domains, a common feature of failing hearts, has been attributed to JPH2 downregulation...
October 8, 2016: International Journal of Cardiology
Rosita Zakeri, Gilles Moulay, Qiang Chai, Ozgur Ogut, Saad Hussain, Hiroyuki Takahama, Tong Lu, Xiao-Li Wang, Wolfgang A Linke, Hon-Chi Lee, Margaret M Redfield
BACKGROUND: Left atrial (LA) compliance and contractility influence left ventricular stroke volume. We hypothesized that diminished LA compliance and contractile function occur early during the development of heart failure with preserved ejection fraction (HFpEF) and impair overall cardiac performance. METHODS AND RESULTS: Cardiac magnetic resonance imaging, echocardiography, left ventricular and LA pressure-volume studies, and tissue analyses were performed in a model of early HFpEF (elderly dogs, renal wrap-induced hypertension, exogenous aldosterone; n=9) and young control dogs (sham surgery; n=13)...
October 2016: Circulation. Heart Failure
Catarina Francisco, João Sérgio Neves, Inês Falcão-Pires, Adelino Leite-Moreira
Adiponectin is the most abundant adipokine and exhibits anti-inflammatory, antiatherogenic and antidiabetic properties. Unlike other adipokines, it inversely correlates with body weight and obesity-linked cardiovascular complications. Diastolic dysfunction is the main mechanism responsible for approximately half of all heart failure cases, the so-called heart failure with preserved ejection fraction (HFpEF), but therapeutic strategies specifically directed towards these patients are still lacking. In the last years, a link between adiponectin and diastolic dysfunction has been suggested...
October 18, 2016: Cardiovascular Drugs and Therapy
Javed Butler, Carine E Hamo, James E Udelson, Bertram Pitt, Clyde Yancy, Sanjiv J Shah, Patrice Desvigne-Nickens, Harold S Bernstein, Richard L Clark, Christophe Depre, Wilfried Dinh, Andrew Hamer, Patricia Kay-Mugford, Frank Kramer, Martin Lefkowitz, Kelly Lewis, Juan Maya, Simon Maybaum, Mahesh J Patel, Pia S Pollack, Lothar Roessig, Sarit Rotman, Afshin Salsali, J Jason Sims, Michele Senni, Giuseppe Rosano, Preston Dunnmon, Norman Stockbridge, Stefan D Anker, Michael R Zile, Mihai Gheorghiade
The epidemiological, clinical, and societal implications of the heart failure (HF) epidemic cannot be overemphasized. Approximately half of all HF patients have HF with preserved ejection fraction (HFpEF). HFpEF is largely a syndrome of the elderly, and with aging of the population, the proportion of patients with HFpEF is expected to grow. Currently, there is no drug known to improve mortality or hospitalization risk for these patients. Besides mortality and hospitalization, it is imperative to realize that patients with HFpEF have significant impairment in their functional capacity and their quality of life on a daily basis, underscoring the need for these parameters to ideally be incorporated within a regulatory pathway for drug approval...
November 2016: Circulation. Heart Failure
Tingyan Xu, Jingping Sun, Alex Pui-Wai Lee, Yan Yang, Xingsheng Yang, Yan Li, Cheuk-Man Yu, Jiguang Wang
OBJECTIVE: Hypertension (HTN) leads to left ventricular (LV) remodeling, which results in diastolic dysfunction in the presence of preserved ejection fraction (EF). The goal of this study was to explore the subclinical left ventricular systolic dysfunction and mechanism of preserved EF using layer-specific quantification of myocardial deformation in patients with HTN. DESIGN AND METHOD: The routine 2D (frame rate >50 Hz) data sets were acquired using GE E9 system in 120 hypertensive patients (73 male, 54 ± 13years, blood pressure = 165 ± 20/ 96 ± 117 mmHg) and 120 age and gender matched normal subjects (124 ± 9/80 ± 8mmHg)...
September 2016: Journal of Hypertension
Darae Kim, Chi Young Shim, Geu-Ru Hong, In Jeong Cho, Hyuk-Jae Chang, Jong-Won Ha, Namsik Chung
OBJECTIVE: The aim of this study was to comprehensively assess mechanical adaptation of LV in subclinical patients with hypertension(HTN) using a layer specific speckle-tracking echocardiography. DESIGN AND METHOD: Conventional transthoracic echocardiography (TTE) with 2D-layer specific speckle-tracking echocardiography was performed on 218 HTN patients with preserved LV ejection fraction (EF > 50%). Endocardial, epicardial, and transmural global longitudinal strain (GLS), global circumferential strains (GCS), and peak LV torsion were measured...
September 2016: Journal of Hypertension
Audrey Adji, Thomas Weber, Caroline O'Brien, Michael O'Rourke, Alberto Avolio
OBJECTIVE: Previous studies have shown the reciprocal effects of wave reflection on aortic pressure and aortic flow waves. Invasive (Electro-Magnetic (EM)) and non-invasive (Cardiac Magnetic Resonance (CMR)) studies of aortic blood flow have shown characteristic aging changes as reduction in late systolic flow, which corresponds in time to the late systolic boost of aortic pressure. These are not always apparent in Doppler flow tracings. DESIGN AND METHOD: This study aimed to better understand the mechanisms of aortic pressure and flow changes due to early wave reflection and stiffening of arteries...
September 2016: Journal of Hypertension
Enrico Agabiti Rosei
Current Hypertension Guidelines emphasize the importance of assessing the presence of preclinical organ damage. In fact, an extensive evaluation of organ damage may increase the number of patients classified at high CV risk and therefore strongly influence the clinical management of patients. Hypertensive heart disease remains to date the form of organ damage for which there is the greatest amount of evidence of a strong independent prognostic significance. In the presence of a chronic pressure overload, a parallel addition of sarcomers takes place with an increase in myocyte width, which in turn increases left ventricular wall thickness; myocyte hypertrophy is also associated with apoptosis, collagen deposition and ventricular fibrosis with an impairment of coronary hemodynamics as well, thus profoundly influencing functional properties of the left (and right) ventricle...
September 2016: Journal of Hypertension
Patricia Reant, Alexandre Metras, Dominique Detaille, Annabel Reynaud, Philippe Diolez, Beatrice Jaspard-Vinassa, Raymond Roudaut, Alexandre Ouattara, Laurent Barandon, Pierre Dos Santos, Stephane Lafitte
BACKGROUND: Left ventricular (LV) afterload could be associated with reduced myocardial contractility. The aim of this study was to evaluate the relative impact of increased afterload on LV myocardial deformation indices in chronic aortic constriction, with regard to hypertrophy, myocardial fibrosis, and mitochondrial function, and to differentiate acute versus chronic afterload effect. METHODS: Young pigs underwent aortic banding (n = 11) or sham (n = 7) operations...
October 14, 2016: Journal of the American Society of Echocardiography
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