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https://www.readbyqxmd.com/read/28100428/heart-failure-with-preserved-ejection-fraction-has-a-better-long-term-prognosis-than-heart-failure-with-reduced-ejection-fraction-in-old-patients-in-a-5-year-follow-up-retrospective-study
#1
Silvana Kontogeorgos, Erik Thunström, Magnus C Johansson, Michael Fu
BACKGROUND: The issue of whether prognosis is similar between heart failure with preserved ejection fraction (HFpEF) and heart failure with reduced ejection fraction (HFrEF) remains unresolved. Because of the problem of inconsistency in the diagnostic criteria and because there is currently no lifesaving therapy available for HFpEF, it seems to be the right time to study the outcome of a clearly defined HFpEF compared with HFrEF in contemporary heart failure (HF) therapy. This study investigates 5-year-mortality and its prognostic factors in old patients with HFpEF compared with those with HFrEF...
January 5, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28090298/in-situ-expression-of-bcl-2-in-pulmonary-artery-endothelial-cells-associates-with-pulmonary-arterial-hypertension-relative-to-heart-failure-with-preserved-ejection-fraction
#2
Raymond L Benza, Gretchen Williams, Changgong Wu, Kelly J Shields, Amresh Raina, Srinivas Murali, Michael J Passineau
We have previously reported that pulmonary artery endothelial cells (PAECs) can be harvested from the tips of discarded Swan-Ganz catheters after right heart catheterization (RHC). In this study, we tested the hypothesis that the existence of an antiapoptotic phenotype in PAECs obtained during RHC is a distinctive feature of pulmonary arterial hypertension (PAH; World Health Organization group 1) and might be used to differentiate PAH from other etiologies of pulmonary hypertension. Specifically, we developed a flow cytometry-based measure of Bcl-2 activity, referred to as the normalized endothelial Bcl-2 index (NEBI)...
December 2016: Pulmonary Circulation
https://www.readbyqxmd.com/read/28090229/the-impact-exerted-on-clinical-outcomes-of-patients-with-chronic-heart-failure-by-aldosterone-receptor-antagonists-a-meta-analysis-of-randomized-controlled-trials
#3
Renato De Vecchis, Claudio Cantatrione, Damiana Mazzei, Augusto Barone, Nicola Maurea
BACKGROUND: Aldosterone receptor antagonists (ARAs) have been associated with improved clinical outcomes in patients with heart failure with reduced left ventricular ejection fraction (HFREF), but not in those with heart failure with preserved left ventricular ejection fraction (HFpEF). With the aim to study this topic more deeply, we carried out a meta-analysis of selective and non-selective ARAs in HFREF and HFpEF. METHODS: We searched PubMed and Scopus databases...
February 2017: Journal of Clinical Medicine Research
https://www.readbyqxmd.com/read/28087180/a-comparison-of-hfref-vs-hfpef-s-clinical-workload-and-cost-in-the-first-year-following-hospitalization-and-enrollment-in-a-disease-management-program
#4
T M Murphy, D F Waterhouse, S James, C Casey, E Fitzgerald, E O'Connell, C Watson, J Gallagher, M Ledwidge, K McDonald
BACKGROUND: Admission with heart failure (HF) is a milestone in the progression of the disease, often resulting in higher intensity medical care and ensuing readmissions. Whilst there is evidence supporting enrolling patients in a heart failure disease management program (HF-DMP), not all reported HF-DMPs have systematically enrolled patients with HF with preserved ejection fraction (HFpEF) and there is a scarcity of literature differentiating costs based on HF-phenotype. METHODS: 1292 consenting, consecutive patients admitted with a primary diagnosis of HF were enrolled in a hospital based HF-DMP and categorized as HFpEF (EF≥45%) or HFrEF (EF<45%)...
December 23, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/28062131/fluid-status-and-outcome-in-patients-with-heart-failure-and-preserved-ejection-fraction
#5
Benedikt Koell, Caroline Zotter-Tufaro, Franz Duca, Andreas A Kammerlander, Stefan Aschauer, Daniel Dalos, Marlies Antlanger, Manfred Hecking, Marcus Säemann, Julia Mascherbauer, Diana Bonderman
BACKGROUND: Most heart failure with preserved ejection fraction (HFpEF) patients, at some point, present to an emergency department with typical symptoms of volume overload. Clinically, most respond well to standard diuretic therapy, sometimes at the cost of renal function. The study sought to define the prognostic significance of fluid status versus renal function in patients with HFpEF. METHODS: One hundred sixty-two consecutive patients with HFpEF were enrolled in our prospective registry...
December 21, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/28052978/the-diabetic-hfpef-phenotype-is-it-real-and-is-it-worth-targeting-therapeutically
#6
Brian R Lindman
For investigators, physicians, and patients, the inability to identify therapies to improve clinical outcomes, particularly mortality, in patients with heart failure with preserved ejection fraction (HFpEF) has been particularly vexing and stands in stark contrast to the progress made in the treatment of patients with heart failure with reduced ejection fraction (HFrEF). This has prompted a return to the proverbial drawing board, forcing a reconsideration of long-held assumptions and paradigms. Despite different underlying etiologies, patients with HFrEF are generally responsive to several classes of medications that target the neurohormonal axis...
January 4, 2017: Circulation
https://www.readbyqxmd.com/read/28052977/clinical-and-echocardiographic-characteristics-and-cardiovascular-outcomes-according-to-diabetes-status-in-patients-with-heart-failure-and-preserved-ejection-fraction-a-report-from-the-irbesartan-in-heart-failure-with-preserved-ejection-fraction-trial-i-preserve
#7
Søren L Kristensen, Ulrik M Mogensen, Pardeep S Jhund, Mark C Petrie, David Preiss, Sithu Win, Lars Køber, Robert S McKelvie, Michael R Zile, Inder S Anand, Michel Komajda, John S Gottdiener, Peter E Carson, John J V McMurray
BACKGROUND: -In patients with HF and preserved ejection fraction (HFpEF), little is known about the characteristics of and outcomes in those with and without diabetes. METHODS: -We examined clinical and echocardiographic characteristics and outcomes in the Irbesartan in Heart Failure with Preserved Ejection Fraction trial (I-Preserve), according to history of diabetes. Cox regression models were used to estimate hazard ratios (HR) for cardiovascular outcomes adjusted for known predictors, including age, sex, natriuretic peptides, and comorbidity...
January 4, 2017: Circulation
https://www.readbyqxmd.com/read/28039229/the-role-of-diastolic-stress-testing-in-the-evaluation-for-hfpef-a-simultaneous-invasive-echocardiographic-study
#8
Masaru Obokata, Garvan C Kane, Yogesh N V Reddy, Thomas P Olson, Vojtech Melenovsky, Barry A Borlaug
BACKGROUND: -Diagnosis of heart failure (HF) with preserved ejection fraction (HFpEF) is challenging and relies largely on demonstration of elevated cardiac filling pressures (pulmonary capillary wedge pressure, PCWP). Current guidelines recommend use of natriuretic peptides (NT-proBNP) and rest/exercise echocardiography (E/e' ratio) to make this determination. Data to support this practice is conflicting. METHODS: -Simultaneous echocardiographic-catheterization studies were prospectively conducted at rest and during exercise in subjects with invasively-proven HFpEF (n=50) and participants with dyspnea but no identifiable cardiac pathology (n=24)...
December 30, 2016: Circulation
https://www.readbyqxmd.com/read/28035527/new-and-emerging-therapies-and-targets-beta-3-agonists
#9
Lauriane Y M Michel, Jean-Luc Balligand
While crucial for the acute physiologic response to stress, the adrenergic system may become maladaptive upon prolonged stimulation in the course of development of heart failure. This has been the basis for the development of beta-blocking therapies, targeting mainly beta1-2 adrenoreceptors (B1-2AR). The third isotype, B3AR, was more recently identified in cardiac myocytes and endothelial cells from human (and many other animal species), where its distinctive coupling to nitric oxide and antioxidant pathways suggested potential protective properties that were unexploited so far...
December 30, 2016: Handbook of Experimental Pharmacology
https://www.readbyqxmd.com/read/28034849/comparison-of-neuropsychological-patterns-in-nigerians-with-different-heart-failure-phenotypes
#10
Philip B Adebayo, Adeseye A Akintunde, Anthonia J Adebayo, Stephen O Asaolu, Morenike Audu, Olugbenga E Ayodele
OBJECTIVE: The aim of this study was to determine the influence of left ventricular dysfunction type on the pattern of neuropsychological dysfunctions among heart failure (HF) subjects. METHOD: A sub-analysis of the data of subjects recruited in a cross-sectional survey of cognitive dysfunction among Nigerians with HF was performed. Cognitive performance on the Community Screening Interview for Dementia (CSI'D), Word List Learning Delayed Recall (WLLDR), Boston Naming Test (BNT), and Modified Token Test (MTT) were compared between heart failure with reduced ejection fraction (HFrEF) and heart failure with preserved ejection fraction (HFpEF)...
December 28, 2016: Archives of Clinical Neuropsychology: the Official Journal of the National Academy of Neuropsychologists
https://www.readbyqxmd.com/read/28032312/molecular-approaches-in-hfpef-micrornas-and-ipsc-derived-cardiomyocytes
#11
REVIEW
Alison J Kriegel, Melanie Gartz, Muhammad Z Afzal, Willem J de Lange, J Carter Ralphe, Jennifer L Strande
Heart failure with preserved left ventricular ejection fraction (HFpEF) has emerged as one of the largest unmet needs in cardiovascular medicine. HFpEF is increasing in prevalence and causes significant morbidity, mortality, and health care resource utilization. Patients have multiple co-morbidities which contribute to the disease complexity. To date, no effective treatment for HFpEF has been identified. The paucity of cardiac biopsies from this patient population and the absence of well-accepted animal models limit our understanding of the underlying molecular mechanisms of HFpEF...
December 28, 2016: Journal of Cardiovascular Translational Research
https://www.readbyqxmd.com/read/28031211/model-based-cost-effectiveness-analysis-of-b-type-natriuretic-peptide-guided-care-in-patients-with-heart-failure
#12
Syed Mohiuddin, Barnaby Reeves, Maria Pufulete, Rachel Maishman, Mark Dayer, John Macleod, Theresa McDonagh, Sarah Purdy, Chris Rogers, William Hollingworth
OBJECTIVE: Monitoring B-type natriuretic peptide (BNP) to guide pharmacotherapy might improve survival in patients with heart failure with reduced ejection fraction (HFrEF) or preserved ejection fraction (HFpEF). However, the cost-effectiveness of BNP-guided care is uncertain and guidelines do not uniformly recommend it. We assessed the cost-effectiveness of BNP-guided care in patient subgroups defined by age and ejection fraction. METHODS: We used a Markov model with a 3-month cycle length to estimate the lifetime health service costs, quality-adjusted life years (QALYs) and incremental net monetary benefits (iNMBs) of BNP-guided versus clinically guided care in 3 patient subgroups: (1) HFrEF patients <75 years; (2) HFpEF patients <75 years; and (3) HFrEF patients ≥75 years...
December 28, 2016: BMJ Open
https://www.readbyqxmd.com/read/28030747/factors-associated-with-and-prognostic-implications-of-cardiac-troponin-elevation-in-decompensated-heart-failure-with-preserved-ejection-fraction-findings-from-the-american-heart-association-get-with-the-guidelines-heart-failure-program
#13
Ambarish Pandey, Harsh Golwala, Shubin Sheng, Adam D DeVore, Adrian F Hernandez, Deepak L Bhatt, Paul A Heidenreich, Clyde W Yancy, James A de Lemos, Gregg C Fonarow
Importance: Elevated levels of cardiac troponins are associated with adverse clinical outcomes among patients with heart failure (HF) and reduced ejection fraction. However, the clinical significance of troponin elevation in the setting of decompensated HF with preserved ejection fraction (HFpEF) is not well established. Objective: To determine the clinical predictors of troponin elevation and its association with in-hospital and long-term outcomes among patients with decompensated HFpEF...
December 28, 2016: JAMA Cardiology
https://www.readbyqxmd.com/read/28029640/reductions-in-n-terminal-pro-brain-natriuretic-peptide-levels-are-associated-with-lower-mortality-and-heart-failure-hospitalization-rates-in-patients-with-heart-failure-with-mid-range-and-preserved-ejection-fraction
#14
Gianluigi Savarese, Camilla Hage, Nicola Orsini, Ulf Dahlström, Pasquale Perrone-Filardi, Giuseppe M C Rosano, Lars H Lund
BACKGROUND: In heart failure with mid-range ejection fraction (HFmrEF) and preserved ejection fraction (HFpEF), feasible surrogate end points are needed for phase II trials. The aim was to assess whether a reduction in N-terminal pro-B-type natriuretic peptide (NT-proBNP) is associated with improved mortality/morbidity in an unselected population of HFmrEF and HFpEF patients. METHODS AND RESULTS: In the Swedish Heart Failure Registry, HFmrEF (EF=40%-49%) and HFpEF (EF≥50%) patients reporting at least 2 consecutive outpatient NT-proBNP assessments were prospectively studied...
November 2016: Circulation. Heart Failure
https://www.readbyqxmd.com/read/28029411/atrial-fibrillation-and-heart-failure-factors-influencing-the-choice-of-oral-anticoagulant
#15
REVIEW
Louise A E Brown, Christopher J Boos
Atrial fibrillation (AF) and heart failure (HF) frequently coexist. AF is identified in approximately one third of patients with HF and is linked to increased morbidity and mortality than from either condition alone. AF is relatively more common in HF with preserved ejection fraction (HFpEF) than with reduced ejection fraction (HFrEF). Nevertheless, the risk of stroke and systemic embolism (SSE) is significantly increased with both HF types and the absolute risk is heavily influenced by the presence and severity of associated additional stroke risk factors...
September 30, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/28028584/the-prognostic-significance-of-atrial-fibrillation-in-heart-failure-with-preserved-ejection-function-insights-from-karen-a-prospective-and-multicenter-study
#16
Christian Bosseau, Erwan Donal, Lars H Lund, Emmanuel Oger, Camilla Hage, Geneviève Mulak, Jean-Claude Daubert, Cecilia Linde
The prognostic value of atrial fibrillation (AF) in heart failure with preserved ejection fraction (HFPEF) remains controversial. We sought to study the prognostic value of AF in a prospective cohort and to characterize the HFPEF patients with AF. KaRen was a prospective, multicenter, international, observational study intended to characterize HFPEF; 538 patients presenting with an acute decompensated cardiac failure and a left ventricular EF > 45% were included. EKG and echocardiogram performed 4-8 week following the index hospitalization were analyzed in core centers...
December 27, 2016: Heart and Vessels
https://www.readbyqxmd.com/read/28026030/evaluation-of-left-ventricular-diastolic-function-profile-in-patients-with-pulmonary-hypertension-due-to-heart-failure-with-preserved-ejection-fraction
#17
Pejman Raeisi-Giglou, Louis Lam, Balaji K Tamarappoo, Jennie Newman, Raed A Dweik, Adriano R Tonelli
BACKGROUND: Echocardiography plays an important role in the diagnostic work up of heart failure with preserved ejection fraction (HFpEF). We sought to determine the left ventricular (LV) diastolic profile by echocardiography in patients diagnosed with pulmonary hypertension (PH) due to PH-HFpEF. HYPOTHESIS: The study of LV diastolic function by echocardiography has limitations in patients with HFpEF and PH, and certain LV diastolic determinations convey a worse prognosis...
December 27, 2016: Clinical Cardiology
https://www.readbyqxmd.com/read/28025460/riser-pattern-is-a-novel-predictor-of-adverse-events-in-heart-failure-patients-with-preserved-ejection-fraction
#18
Takahiro Komori, Kazuo Eguchi, Toshinobu Saito, Satoshi Hoshide, Kazuomi Kario
BACKGROUND: The cardiovascular prognosis of heart failure with preserved ejection fraction (HFpEF) has been shown to be similar to that of heart failure with reduced ejection fraction (HFrEF). It is unknown which factors predict cardiovascular outcome in HFpEF. We tested the hypothesis that the abnormal pattern of circadian blood pressure (BP) rhythm known as the riser BP pattern is associated with adverse outcomes in HFpEF.Methods and Results:We performed a prospective, observational cohort study of hospitalized HF patients who underwent ambulatory BP monitoring (ABPM)...
December 23, 2016: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28017395/left-atrial-function-dynamics-during%C3%A2-exercise-in-heart-failure-pathophysiological-implications-on-the-right-heart-and-exercise-ventilation-inefficiency
#19
Tadafumi Sugimoto, Francesco Bandera, Greta Generati, Eleonora Alfonzetti, Claudio Bussadori, Marco Guazzi
OBJECTIVES: The hypothesis of this study was that left atrial (LA) dynamic impairment during exercise may trigger right ventricular (RV)-to-pulmonary circulation (PC) uncoupling and ventilation inefficiency. BACKGROUND: LA function plays a key role in the hemodynamics of heart failure with reduced ejection fraction (HFrEF) and heart failure with preserved ejection fraction (HFpEF). Extensive investigation of LA dynamics, however, has been performed exclusively at rest...
December 12, 2016: JACC. Cardiovascular Imaging
https://www.readbyqxmd.com/read/28017355/atrial-fibrillation-in-heart-failure-with-preserved-ejection-fraction-association-with-exercise-capacity-left-ventricular-filling-pressures-natriuretic-peptides-and-left-atrial-volume
#20
Carolyn S P Lam, Michiel Rienstra, Wan Ting Tay, Licette C Y Liu, Yoran M Hummel, Peter van der Meer, Rudolf A de Boer, Isabelle C Van Gelder, Dirk J van Veldhuisen, Adriaan A Voors, Elke S Hoendermis
OBJECTIVES: This study sought to study the association of atrial fibrillation (AF) with exercise capacity, left ventricular filling pressure, natriuretic peptides, and left atrial size in heart failure with preserved ejection fraction (HFpEF). BACKGROUND: The diagnosis of heart failure with preserved ejection fraction (HFpEF) in patients with AF remains a challenge because both contribute to impaired exercise capacity, and increased natriuretic peptides and left atrial volume...
November 30, 2016: JACC. Heart Failure
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