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Y Y Li, W R Zhu, K Chai, J F Yang, F Fang, S R He, C Q Yang, H Wang
Objective: To determine the frequency and extent of left ventricular amyloid deposition in patients aged over 85 years with heart failure and preserved ejection fraction (HFpEF). Methods: A total of 43 patients aged 85 to 100 years old were enrolled in this study based on the autopsy database of Beijing Hospital from February 1, 2003 to October 31, 2016. The frequency and extent of left ventricular amyloid deposition and myocardial fibrosis were determined in left ventricular specimens from patients with antemortem diagnosis of HFpEF without clinically apparent amyloid ( n= 28) and from control subjects ( n= 15) post Congo red staining and Masson's trichrome staining...
June 24, 2018: Zhonghua Xin Xue Guan Bing za Zhi
Annamaria Iorio, Michele Senni, Giulia Barbati, Stephen J Greene, Stefano Poli, Elena Zambon, Concetta Di Nora, Giovanni Cioffi, Luigi Tarantini, Antonello Gavazzi, Gianfranco Sinagra, Andrea Di Lenarda
AIM: To assess adverse outcomes attributable to non-cardiac co-morbidities and to compare their effects by left ventricular ejection fraction (LVEF) group [LVEF <50% (heart failure with reduced ejection fraction, HFrEF), LVEF ≥50% (heart failure with preserved ejection fraction, HFpEF)] in a contemporary, unselected chronic heart failure population. METHODS AND RESULTS: This community-based cohort enrolled patients from October 2009 to December 2013. Adjusted hazard ratio (HR) and the population attributable fraction (PAF) were used to compare the contribution of 15 non-cardiac co-morbidities to adverse outcome...
June 19, 2018: European Journal of Heart Failure
Malgorzata Kobusiak-Prokopowicz, Justyna Krzysztofik, Konrad Kaaz, Beata Jolda-Mydlowska, Andrzej Mysiak
The aim of the study was to assess MMP-2 (matrix metalloproteinase-2) and TIMP-2 (tissue inhibitor of metalloproteinase-2) serum levels in patients with diverse types of heart failure (HF) and chronic kidney disease (CKD). 101 patients with chronic HF were enrolled. Each patient has assessed the serum levels of MMP-2, TIMP-2, and NT-proBNP. Patients were initially classified into 2 groups based on their LVEF. 43 patients were classified into the HFREF group (HF with Reduced Ejection Fraction) and 58 characterized as HFPEF (HF with Preserved Ejection Fraction)...
2018: Open Medicine (Warsaw, Poland)
Jonathan Buggey, Brian D Hoit
PURPOSE OF REVIEW: To summarize recent literature on the use of left atrial strain in the diagnosis and management of patients with heart failure. RECENT FINDINGS: Left atrial dysfunction is a hallmark of diastolic dysfunction and heart failure, in particular, heart failure with preserved ejection fraction (HFpEF). Recently, myocardial deformation analysis via strain and strain rate measurements have been applied to the left atrium. These measurements have been shown to aid in the diagnosis of heart failure and be accurate predictors of cardiac pressures, diastolic dysfunction, exercise performance, and clinical outcomes such as cardiac hospitalizations and mortality...
June 14, 2018: Current Opinion in Cardiology
Robert Klempfner, Boaz Tzur, Avi Sabbag, Amira Nahshon, Nelly Gang, Ilan Hay, Tamir Kamerman, Hanoch Hod, Ilan Goldenberg, David Rott
BACKGROUND: About half of all patients with heart failure are diagnosed with heart failure preserved ejection fraction (HFpEF). Until now, studies have failed to show that medical treatment improves the prognosis of patients with HFpEF. OBJECTIVES: To evaluate changes in exercise capacity of patients with HFpEF compared to those with heart failure with reduced ejection fraction (HFrEF) following an exercise training program. METHODS: Patient data was retrieved from a multi-center registry of patients with heart failure who participated in a cardiac rehabilitation program...
June 2018: Israel Medical Association Journal: IMAJ
Melissa A Daubert, David J Whellan, Holger Woehrle, Gudaye Tasissa, Kevin J Anstrom, JoAnn Lindenfeld, Adam Benjafield, Amy Blase, Naresh Punjabi, Mona Fiuzat, Olaf Oldenburg, Christopher M O'Connor
BACKGROUND: Sleep-disordered breathing (SDB), including central and obstructive sleep apnea, is a marker of poor prognosis in heart failure (HF) and may worsen cardiac dysfunction over time. Treatment of SDB with adaptive servoventilation (ASV) may reverse pathologic cardiac remodeling in HF patients. METHODS: The Cardiovascular Improvements with Minute Ventilation-targeted Adaptive Servo-Ventilation Therapy in Heart Failure (CAT-HF) trial randomized patients with acute decompensated HF and confirmed SDB to either optimal medical therapy (OMT) or treatment with ASV and OMT...
July 2018: American Heart Journal
Louise Y Sun, Jack V Tu, Anan Bader Eddeen, Peter P Liu
BACKGROUND: Heart failure (HF) with reduced ejection fraction (rEF) is a widely regarded prognosticator after coronary artery bypass grafting. HF with preserved ejection fraction (pEF) accounts for up to half of all HF cases and is associated with considerable morbidity and mortality in hospitalized cohorts. However, HFpEF outcomes have not been elucidated in cardiac surgical patients. We investigated the prevalence and outcomes of HFpEF and HFrEF in women and men following coronary artery bypass grafting...
June 16, 2018: Journal of the American Heart Association
Eva Steinmann, Hans-Peter Brunner-La Rocca, Micha T Maeder, Beat A Kaufmann, Matthias Pfisterer, Peter Rickenbacher
BACKGROUND: Whether the clinical presentation and in particular prevalence of symptoms and signs of heart failure (HF) is different in elderly versus younger patients and in those with reduced (HFrEF) versus preserved (HFpEF) left ventricular ejection fraction (LVEF) is a matter of ongoing debate. AIMS: To compare detailed clinical characteristics of these important subgroups and to develop a prediction rule for the differentiation of HFpEF and HFrEF based on clinical parameters...
June 13, 2018: European Journal of Internal Medicine
Daisuke Kamimura, Takeki Suzuki, Wanmei Wang, Matthew deShazo, John E Hall, Michael D Winniford, Iftikhar J Kullo, Thomas H Mosley, Kenneth R Butler, Michael E Hall
Our previous experimental animal data suggest a beneficial effect of leptin on LV structure and function. We hypothesized that leptin levels are associated with lower LV mass and myocardial stiffness which are important risk factors for the development of heart failure with preserved ejection fraction (HFpEF). We evaluated 1172 blacks, in which the prevalence of HFpEF is quite high, with preserved LV ejection fraction (EF > 50%) from the Genetic Epidemiology Network of Arteriopathy Study (mean age 62...
June 15, 2018: Hypertension Research: Official Journal of the Japanese Society of Hypertension
Carolyn S P Lam, Adriaan A Voors, Rudolf A de Boer, Scott D Solomon, Dirk J van Veldhuisen
This review aims to provide a translational perspective on recent developments in heart failure with preserved ejection fraction (HFpEF), linking mechanistic insights to potential therapies. A key concept in this review is that HFpEF is a haemodynamic condition wherein the heart fails to keep up with the circulatory demands of the body, or does so at the expense of raised left ventricular filling pressures. We, therefore, propose that the 'final common pathway' for development of congestion, i.e. basic haemodynamic mechanisms of increased left ventricular end-diastolic pressure, left atrial hypertension, pulmonary venous congestion, and plasma volume expansion, represents important initial targets for therapy in HFpEF...
June 13, 2018: European Heart Journal
Mingzhu Xu, Lihua Yan, Jialiang Xu, Xiangjun Yang, Tingbo Jiang
Patients with acute myocardial infarction (AMI) complicated by heart failure with preserved ejection fraction (HFpEF) are likely to have more adverse cardiovascular events and higher mortality. The purpose of this study was to examine the predictors and outcomes in AMI patients complicated by HFpEF.We examined the demographics, clinical data, and clinical outcomes in 405 consecutive subjects who firstly presented with AMI after undergoing emergency percutaneous coronary intervention from January 2013 to June 2016...
June 2018: Medicine (Baltimore)
Anouk Bokslag, Constantijn Franssen, Lisa J Alma, Igor Kovacevic, Floortje van Kesteren, Pim W Teunissen, Otto Kamp, Wessel Ganzevoort, Peter L Hordijk, Christianne J M de Groot, Walter J Paulus
BACKGROUND: Systemic inflammation, endothelial dysfunction and deficient vascularization of either uterus or myocardium are mechanistic hallmarks of early-onset preeclampsia and heart failure with preserved ejection fraction (HFpEF). HFpEF is especially prevalent in elderly women and preceded in middle age by preclinical left ventricular (LV) diastolic dysfunction. To detect if preeclampsia predisposes to HFpEF at later age, echocardiographic indices of LV function and of LV structure and biomarkers of systemic inflammation and of endothelial dysfunction were compared in middle-aged women with a history of early-onset preeclampsia or uncomplicated pregnancy...
2018: PloS One
Justin L Grodin, Jeffrey M Testani, Ambarish Pandey, Kamalanathan Sambandam, Mark H Drazner, James C Fang, W H Wilson Tang
AIMS: Prior cohorts demonstrating the importance of serum chloride levels in heart failure either excluded or had partial representation of patients with heart failure with preserved ejection fraction (HFpEF). We aimed to examine the relationship between serum chloride concentration and outcomes in HFpEF. METHODS AND RESULTS: We included participants from the Treatment of Preserved Cardiac Function Heart Failure with an Aldosterone Antagonist Trial (TOPCAT) who met the following criteria: met inclusion by the natriuretic peptide stratum, had recorded serum chloride levels, and were from the Americas (n = 942)...
June 12, 2018: European Journal of Heart Failure
Parag Goyal, Zaid I Almarzooq, Jim Cheung, Hooman Kamel, Udhay Krishnan, Dmitriy N Feldman, Evelyn M Horn, Luke K Kim
BACKGROUND: Atrial fibrillation (AF) and heart failure often occur concomitantly, representing a clinical phenotype at high-risk for poor outcomes. Differences in the characteristics, management, and in-hospital outcomes of AF among those with heart failure with preserved ejection fraction (HFpEF) and those with heart failure with reduced ejection fraction (HFrEF) are not well characterized. METHODS AND RESULTS: Using the National Inpatient Sample, we identified hospitalizations in 2008-2012 for HFpEF and for HFrEF, with and without AF based on ICD-9-CM codes...
September 1, 2018: International Journal of Cardiology
Rebecca Napier, Steven E McNulty, David T Eton, Margaret M Redfield, Omar AbouEzzeddine, Shannon M Dunlay
OBJECTIVES: This study sought to compare the performance of 2 health-related quality of life (HRQOL) questionnaires in patients with heart failure with preserved ejection fraction (HFpEF). BACKGROUND: The ability to accurately assess HRQOL over time is important in the care of patients with heart failure. The validity and reliability of HRQOL tools including the Minnesota Living with Heart Failure Questionnaire (MLHFQ) and the Kansas City Cardiomyopathy Questionnaire (KCCQ) has not been fully determined or compared in patients with HFpEF...
May 31, 2018: JACC. Heart Failure
Peter E Carson
No abstract text is available yet for this article.
May 31, 2018: JACC. Heart Failure
Ganapathi Sanjay, Panniyammakal Jeemon, Anubha Agarwal, Sunitha Viswanathan, Madhu Sreedharan, Vijayaraghavan Govindan, Bahuleyan Charantharalyil Gopalan, R Biju, Tiny Nair, N Prathapkumar, G Krishnakumar, N Rajalekshmi, Krishnan Suresh, Lawrence P Park, Mark D Huffman, Sivadasanpillai Harikrishnan
BACKGROUND: Long-term data on outcomes of participants hospitalized with heart failure (HF) from low and middle-income countries are limited. METHODS AND RESULTS: In the Trivandrum Heart Failure Registry (THFR) in 2013, 1205 participants from 18 hospitals in Trivandrum, India were enrolled. Data were collected on demographics, clinical presentation, treatment and outcomes. We performed survival analyses, compared groups and evaluated the association between HF type and mortality, adjusting for covariates that predicted mortality in a global HF risk score...
June 6, 2018: Journal of Cardiac Failure
Alfredo Monteverde, Valeria Carlino, Giulia Ganci, Giuseppe Taormina, Mario Barbagallo
Heart failure, in its diverse forms based on the value of the ejection fraction, is associated to high mortality and the frequent need for hospitalization, with a consequent heavy burden on healthcare resources. For an appropriate treatment of heart failure with preserved ejection fraction (HFpEF), there are no specific drugs effective for this condition. Those indicated in HF with reduced EF (HFrEF) are of more benefit in that form of HF, according to the guidelines of the European Society of Cardiology of 2016: ACE-inhibitors, beta-blockers, anti-aldosterones are all indicated with a class of recommendation/level of evidence IA; therapy with loop diuretics is indicated in the case of clinical congestion (IB)...
June 7, 2018: Monaldi Archives for Chest Disease, Archivio Monaldi Per le Malattie del Torace
Jan F Nauta, Yoran M Hummel, Peter van der Meer, Carolyn S P Lam, Adriaan A Voors, Joost P van Melle
AIMS: Five echocardiographic parameters-left atrial volume index, left ventricular mass index, tricuspid regurgitation velocity, myocardial tissue velocity, and the ratio of early mitral inflow to tissue velocity of the mitral annulus (E/e')-are recommended in both the current European Society of Cardiology heart failure guidelines and the American Society of Echocardiography/European Association of Cardiovascular Imaging recommendations for the evaluation of left ventricular diastolic function...
June 7, 2018: European Journal of Heart Failure
Bharathi Upadhya, Mark J Haykowsky, Dalane W Kitzman
Heart failure (HF) with preserved ejection fraction (HFpEF) is the most common form of HF. Among elderly women, HFpEF comprises more than 80% of incident HF cases. Adverse outcomes-exercise intolerance, poor quality of life, frequent hospitalizations, and reduced survival-approach those of classic HF with reduced EF (HFrEF). However, despite its importance, our understanding of the pathophysiology of HFpEF is incomplete, and despite intensive efforts, optimal therapy remains uncertain, as most trials to date have been negative...
June 7, 2018: Heart Failure Reviews
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