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https://www.readbyqxmd.com/read/28217978/the-association-of-chronic-kidney-disease-and-microalbuminuria-with-heart-failure-with-preserved-vs-reduced-ejection-fraction
#1
Matthew Nayor, Martin G Larson, Na Wang, Rajalakshmi Santhanakrishnan, Douglas S Lee, Connie W Tsao, Susan Cheng, Emelia J Benjamin, Ramachandran S Vasan, Daniel Levy, Caroline S Fox, Jennifer E Ho
AIMS: Chronic kidney disease (CKD) and microalbuminuria are associated with incident heart failure (HF), but their relative contributions to HF with preserved vs. reduced EF (HFpEF and HFrEF) are unknown. We sought to evaluate the associations of CKD and microalbuminuria with incident HF subtypes in the community-based Framingham Heart Study (FHS). METHODS AND RESULTS: We defined CKD as glomerular filtration rate <60 mL/min/1.73 m(2) , and microalbuminuria as a urine albumin to creatinine ratio (UACR) ≥17 mg/g in men and ≥25 mg/g in women...
February 20, 2017: European Journal of Heart Failure
https://www.readbyqxmd.com/read/28217313/ghrelin-and-hormonal-markers-under-exercise-training-in-patients-with-heart-failure-with-preserved-ejection-fraction-results-from-the-ex-dhf-pilot-study
#2
Tobias Daniel Trippel, Volker Holzendorf, Martin Halle, Götz Gelbrich, Kathleen Nolte, Andre Duvinage, Silja Schwarz, Tinka Rutscher, Julian Wiora, Rolf Wachter, Christoph Herrmann-Lingen, Hans-Dirk Duengen, Gerd Hasenfuß, Burkert Pieske, Frank Edelmann
BACKGROUND: Over 50% of patients with symptomatic heart failure (HF) experience HF with preserved ejection fraction (HFpEF). Exercise training (ET) is effective in improving cardiorespiratory fitness and dimensions of quality of life in patients with HFpEF. A systemic pro-inflammatory state induced by comorbidities as the cause of myocardial structural and functional alterations has been proposed in HFpEF. ET modifies myocardial structure and has been related to inflammatory state. We investigated Ghrelin, related adipokines, markers of inflammation, and neuro-hormonal activation in patients undergoing a structured ET vs...
February 2017: ESC Heart Failure
https://www.readbyqxmd.com/read/28214792/suppression-of-tumorigenicity-2-in-heart-failure-with-preserved-ejection-fraction
#3
Omar F AbouEzzeddine, Paul M McKie, Shannon M Dunlay, Susanna R Stevens, G Michael Felker, Barry A Borlaug, Horng H Chen, Russell P Tracy, Eugene Braunwald, Margaret M Redfield
BACKGROUND: Soluble suppression of tumorigenicity 2 (sST2) receptor is a biomarker that is elevated in certain systemic inflammatory diseases. Comorbidity-driven microvascular inflammation is postulated to play a key role in heart failure with preserved ejection fraction (HFpEF) pathophysiology, but data on how sST2 relates to clinical characteristics or inflammatory conditions or biomarkers in HFpEF are limited. We sought to determine circulating levels and clinical correlates of sST2 in HFpEF...
February 18, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28210939/deep-phenotyping-of-systemic-arterial-hemodynamics-in-hfpef-part-1-physiologic-and-technical-considerations
#4
REVIEW
Julio A Chirinos
A better understanding of the pathophysiology of heart failure with a preserved left ventricular ejection fraction (HFpEF) is important. Detailed phenotyping of pulsatile hemodynamics has provided important insights into the pathophysiology of left ventricular remodeling and fibrosis, diastolic dysfunction, microvascular disease, and impaired oxygen delivery to peripheral skeletal muscle, all of which contribute to exercise intolerance, the cardinal feature of HFpEF. Furthermore, arterial pulsatile hemodynamic mechanisms likely contribute to the frequent presence of comorbidities, such as renal failure and dementia, in this population...
February 16, 2017: Journal of Cardiovascular Translational Research
https://www.readbyqxmd.com/read/28209765/renin-angiotensin-system-inhibition-worsening-renal-function-and-outcome-in-heart-failure-patients-with-reduced-and-preserved-ejection-fraction-a-meta-analysis-of-published-study-data
#5
Iris E Beldhuis, Koen W Streng, Jozine M Ter Maaten, Adriaan A Voors, Peter van der Meer, Patrick Rossignol, John J V McMurray, Kevin Damman
BACKGROUND: Renin-angiotensin aldosterone system (RAAS) inhibitors significantly improve outcome in heart failure (HF) patients with reduced ejection fraction (HFREF), irrespective of the occurrence of worsening renal function (WRF). However, in HF patients with preserved ejection fraction (HFPEF), RAAS inhibitors have not been shown to improve outcome but are still frequently prescribed. METHODS AND RESULTS: Random effect meta-analysis was performed to investigate the relationship between RAAS inhibitor therapy, WRF in both HF phenotypes, and mortality...
February 2017: Circulation. Heart Failure
https://www.readbyqxmd.com/read/28209386/dietary-therapy-in-heart-failure-with-preserved-ejection-fraction-and-or-left-ventricular-diastolic-dysfunction-in-patients-with-metabolic-syndrome
#6
REVIEW
Helene von Bibra, Alexander Ströhle, Martin St John Sutton, Nicolai Worm
BACKGROUND: Heart failure is an ongoing epidemic of left ventricular (LV) dilatation and/or dysfunction due to the increasing prevalence of predisposing risk factors such as age, physical inactivity, (abdominal) obesity, and type-2-diabetes. Approximately half of these patients have diastolic heart failure (HFpEF). The prognosis of HFpEF is comparable to that of systolic heart failure, but without any known effective treatment. DIASTOLIC DYSFUNCTION: A biomathematically corrected diagnostic approach is presented that quantifies diastolic dysfunction via the predominant age dependency of LV diastolic function and unmasks (metabolic) risk factors, that are independent of age and, therefore, potential targets for therapy...
January 5, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28205040/clinical-phenotyping-of-heart-failure-with-biomarkers-current-and-future-perspectives
#7
REVIEW
Vichai Senthong, Jennifer L Kirsop, W H Wilson Tang
INTRODUCTION: Heart failure (HF) is a complex clinical syndrome with diverse risk factors and etiologies, differing underlying pathophysiology, and large phenotypic heterogeneity. RECENT FINDINGS: Advances in imaging techniques coupled with clinical trials that targeted only in those with impaired left ventricular ejection fraction (LVEF) have largely shaped the current management strategy for HF that focuses predominantly in patients with systolic HF. In contrast, there are no effective treatments for HF with preserved ejection fraction (HFpEF)...
February 15, 2017: Current Heart Failure Reports
https://www.readbyqxmd.com/read/28199339/presence-of-%C3%A2-isolated%C3%A2-tricuspid-regurgitation-should-prompt-the-suspicion-of-heart-failure-with-preserved-ejection-fraction
#8
Julia Mascherbauer, Andreas A Kammerlander, Caroline Zotter-Tufaro, Stefan Aschauer, Franz Duca, Daniel Dalos, Susanne Winkler, Matthias Schneider, Jutta Bergler-Klein, Diana Bonderman
BACKGROUND: Diastolic dysfunction of the left ventricle is common but frequently under-diagnosed. Particularly in advanced stages affected patients may present with significant functional tricuspid regurgitation (TR) as the most prominent sign on echocardiography. The underlying left ventricular pathology may eventually be missed and symptoms of heart failure are attributed to TR, with respective therapeutic consequences. The aim of the present study was to determine prevalence and mechanisms underlying TR evolution in heart failure with preserved ejection fraction (HFpEF)...
2017: PloS One
https://www.readbyqxmd.com/read/28197277/scoring-system-based-on-electrocardiogram-features-to-predict-the-type-of-heart-failure-in-patients-with-chronic-heart-failure
#9
Purnasidha Bagaswoto Hendry, Lucia Krisdinarti, Maharani Erika
BACKGROUND: Heart failure (HF) is divided into heart failure with reduced ejection fraction (HFrEF) and heart failure with preserved ejection fraction (HFpEF). Mortality from HF is inversely related to left ventricular function. Additional studies are required to distinguish between these two types of HF. A previous study showed that HFrEF is less likely when electrocardiogram (ECG) findings are normal. This study aims to create a scoring system based on ECG findings that will predict the type of HF...
June 2016: Cardiology Research
https://www.readbyqxmd.com/read/28196483/aortic-stiffening-precedes-onset-of-heart-failure-with-preserved-ejection-fraction-in-patients-with-asymptomatic-diastolic-dysfunction
#10
Ilya Karagodin, Omer Aba-Omer, Rodney Sparapani, Jennifer L Strande
BACKGROUND: Identifying which patients with diastolic dysfunction will progress to heart failure with preserved ejection fraction (HFpEF) remains challenging. The goal of this study is to determine whether increased vascular stiffness as identified on 2D transthoracic echocardiography (TTE) serves as a biomarker for the development of HFpEF in patients with diastolic dysfunction. METHODS: The study design is a matched retrospective case-control study. Subjects with diastolic dysfunction were divided into two groups based on whether they had a clinical diagnosis of HFpEF...
February 14, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28194841/impaired-left-ventricular-global-longitudinal-strain-in-patients-with-heart-failure-with-preserved-ejection-fraction-insights-from-the-relax-trial
#11
Adam D DeVore, Steven McNulty, Fawaz Alenezi, Mads Ersboll, Justin M Vader, Jae K Oh, Grace Lin, Margaret M Redfield, Gregory Lewis, Marc J Semigran, Kevin J Anstrom, Adrian F Hernandez, Eric J Velazquez
BACKGROUND: While abnormal left ventricular (LV) global longitudinal strain (GLS) has been described in patients with heart failure with preserved ejection fraction (HFpEF), its prevalence and clinical significance are poorly understood. METHODS AND RESULTS: Patients enrolled in the RELAX trial of sildenafil in HFpEF (LV ejection fraction ≥50%) in whom two-dimensional, speckle-tracking LV GLS was possible (n = 187) were analysed. The distribution of LV GLS and its associations with clinical characteristics, LV structure and function, biomarkers, exercise capacity and quality of life were assessed...
February 14, 2017: European Journal of Heart Failure
https://www.readbyqxmd.com/read/28185703/bnp-and-obesity-in-acute-decompensated-heart-failure-with-preserved-vs-reduced-ejection-fraction-the-atherosclerosis-risk-in-communities-surveillance-study
#12
Umair Khalid, Lisa Miller Wruck, Pedro Miguel Quibrera, Biykem Bozkurt, Vijay Nambi, Salim S Virani, Hani Jneid, Sunil Agarwal, Patricia P Chang, Laura Loehr, Sukhdeep Singh Basra, Wayne Rosamond, Christie M Ballantyne, Anita Deswal
BACKGROUND: Levels of B-type natriuretic peptide (BNP), a prognostic marker in patients with heart failure (HF), are lower among HF patients with obesity or preserved Left Ventricular Ejection Fraction (LVEF). We examined the distribution and prognostic value of BNP across BMI categories in acute decompensated heart failure (ADHF) patients with preserved vs. reduced LVEF. METHODS: We analyzed data from the Atherosclerosis Risk in Communities (ARIC) HF surveillance study which sampled and adjudicated ADHF hospitalizations in patients aged ≥55years from 4 US communities (2005-2009)...
January 31, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28181258/cardiac-diastolic-and-autonomic-dysfunction-are-aggravated-by-central-chemoreflex-activation-in-hfpef-rats
#13
Camilo Toledo, David C Andrade, Claudia Lucero, Alexis Arce-Alvarez, Hugo S Díaz, Valentín Aliaga, Harold D Schultz, Noah J Marcus, Mónica Manríquez, Marcelo Faúndez, Rodrigo Del Rio
Heart failure (HF) patients with preserved ejection fraction (HFpEF) display irregular breathing, sympatho-vagal imbalance, arrhythmias, and diastolic dysfunction. It has been shown that tonic activation of central and peripheral chemoreflex pathway plays a pivotal role in the pathophysiology of HF with reduced ejection fraction. In contrast, no studies to date have addressed chemoreflex function or its effect on cardiac function in HFpEF. Therefore, we tested whether peripheral and central chemoreflexes are hyperactive in HFpEF and if chemoreflex activation exacerbates cardiac dysfunction and autonomic imbalance...
February 8, 2017: Journal of Physiology
https://www.readbyqxmd.com/read/28163048/heart-failure-with-preserved-ejection-fraction-diagnosis-and-management
#14
REVIEW
Ohad Oren, Sheldon Goldberg
Heart Failure with Preserved Ejection Fraction (HFpEF) is a prevalent condition with substantial individual and societal burden. Elucidation of the mechanisms of HFpEF is not complete. Recently, intriguing theories about the phenotypic importance of HFpEF (i.e. underlying diabetes mellitus, atrial fibrillation, obesity) have been suggested. However, it has yet to be determined if a targeted approach of that kind would help ameliorate symptoms or slow disease progression. In this article, we review the current status of understanding of HFpEF, focusing on the challenges and uncertainties regarding diagnosis and treatment...
February 2, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/28154958/combination-of-high-sensitivity-troponin-i-and-n-terminal-pro-b-type-natriuretic-peptide-predicts-future-hospital-admission-for-heart-failure-in-high-risk-hypertensive-patients-with-preserved-left-ventricular-ejection-fraction
#15
Ryunosuke Okuyama, Junnichi Ishii, Hiroshi Takahashi, Hideki Kawai, Takashi Muramatsu, Masahide Harada, Akira Yamada, Sadako Motoyama, Shigeru Matsui, Hiroyuki Naruse, Masayoshi Sarai, Midori Hasegawa, Eiichi Watanabe, Atsushi Suzuki, Mutsuharu Hayashi, Hideo Izawa, Yukio Yuzawa, Yukio Ozaki
Additional risk stratification may provide more aggressive and focalized preventive treatment to high-risk hypertensive patients according to the Japanese hypertension guidelines. We prospectively investigated the predictive value of high-sensitivity troponin I (hsTnI), both independently and in combination with N-terminal pro-B-type natriuretic peptide (NT-proBNP), for incident heart failure (HF) in high-risk hypertensive patients with preserved left ventricular ejection fraction (LVEF). Baseline hsTnI and NT-proBNP levels and echocardiography data were obtained for 493 Japanese hypertensive outpatients (mean age, 68...
February 2, 2017: Heart and Vessels
https://www.readbyqxmd.com/read/28153111/mode-of-death-in-heart-failure-with-preserved-ejection-fraction
#16
REVIEW
Muthiah Vaduganathan, Ravi B Patel, Alexander Michel, Sanjiv J Shah, Michele Senni, Mihai Gheorghiade, Javed Butler
Little is known about specific modes of death in patients with heart failure with preserved ejection fraction (HFpEF). Herein, the authors critically appraise the current state of data and offer potential future directions. They conducted a systematic review of 1,608 published HFpEF papers from January 1, 1985, to December 31, 2015, which yielded 8 randomized clinical trials and 24 epidemiological studies with mode-of-death data. Noncardiovascular modes of death represent an important competing risk in HFpEF...
February 7, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28132965/fluctuation-of-dynamic-diastolic-function-relative-to-static-cardiac-structure%C3%A3-new-insights-into-the-underlying-mechanism-of-heart-failure-with-preserved-ejection-fraction-in-elderly-patients
#17
Shiro Hoshida, Yukinori Shinoda, Kuniyasu Ikeoka, Tomoko Minamisaka, Hidetada Fukuoka, Hirooki Inui, Tetsuya Watanabe
BACKGROUND: The mechanisms of heart failure with preserved ejection fraction (HFpEF) need to be clarified immediately.Methods and Results:We examined diastolic function relative to arterial elasticity among hypertensive patients with preserved EF. Diastolic elastance (EdI)/effective arterial elastance (EaI), EdI/EaI=E/e'/(0.9×systolic blood pressure [SBP]) was significantly more impaired in women than in men among patients ≥75 years. The higher EdI/EaI value in elderly women implies they are intermittently exposed to higher left ventricular filling pressure relative to SBP during daily life...
January 28, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28132957/risk-of-heart-failure-with-preserved-ejection-fraction-in-older-women-after-contemporary-radiotherapy-for-breast-cancer
#18
Hirofumi Saiki, Ivy A Petersen, Christopher G Scott, Kent R Bailey, Shannon M Dunlay, Randi R Finley, Kathryn J Ruddy, Elizabeth Yan, Margaret M Redfield
BACKGROUND: -Cardiomyocytes are resistant to radiation. However, cardiac radiation exposure causes coronary microvascular endothelial inflammation, a perturbation implicated in the pathogenesis of heart failure (HF) and particularly, HF with preserved ejection fraction (HFpEF). Radiotherapy for breast cancer results in variable cardiac radiation exposure and may increase the risk of HF. METHODS: -We conducted a population-based case-control study of incident HF in 170 female residents of Olmsted County, Minnesota (59 cases and 111 controls) who underwent contemporary (1998-2013) radiotherapy for breast cancer utilizing computed tomography-assisted radiotherapy planning...
January 29, 2017: Circulation
https://www.readbyqxmd.com/read/28129699/advances-in-the-pharmacotherapy-of-chronic-heart-failure-with-preserved-ejection-fraction-an-ideal-opportunity-for-precision-medicine
#19
Vincenzo B Polsinelli, Sanjiv J Shah
Heart failure with preserved ejection fraction (HFpEF), which comprises approximately 50% of all heart failure patients, is a challenging and complex clinical syndrome that is often thought to lack effective treatments. Areas covered: Despite the common mantra that HFpEF has no effective treatments, closer inspection of HFpEF clinical trials reveals that several of the drugs tested are associated with benefits in exercise capacity and quality of life, and reduction in heart failure hospitalization. Here we review major randomized controlled trials in HFpEF, focusing on renin-angiotensin-aldosterone system antagonists, organic nitrates, digoxin, beta-blockers, and phosphodiesterase-5 inhibitors...
January 27, 2017: Expert Opinion on Pharmacotherapy
https://www.readbyqxmd.com/read/28119130/no-decline-in-the-risk-of-heart-failure-following-incident-atrial-fibrillation-a-community-study-assessing-trends-overall-and-by-ejection-fraction
#20
Alanna M Chamberlain, Bernard J Gersh, Alvaro Alonso, Stephen L Kopecky, Jill M Killian, Susan A Weston, Véronique L Roger
BACKGROUND: Patients with atrial fibrillation (AF) experience an increased risk of heart failure (HF). However, data are lacking on current trends in the risk of HF after AF. OBJECTIVE: To describe the temporal trends in HF occurrence after AF in a community cohort of patients with incident AF from 2000-2013. METHODS: Cox regression examined the association of year of AF diagnosis with HF and the predictors of developing HF after AF. RESULTS: Among 3491 AF patients without prior HF, 750 (21%) developed incident HF over a mean follow-up of 3...
January 21, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
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