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https://www.readbyqxmd.com/read/29450487/systolic-blood-pressure-and-outcomes-in-patients-with-heart-failure-with-preserved-ejection-fraction
#1
Apostolos Tsimploulis, Phillip H Lam, Cherinne Arundel, Steven N Singh, Charity J Morgan, Charles Faselis, Prakash Deedwania, Javed Butler, Wilbert S Aronow, Clyde W Yancy, Gregg C Fonarow, Ali Ahmed
Importance: Lower systolic blood pressure (SBP) levels are associated with poor outcomes in patients with heart failure. Less is known about this association in heart failure with preserved ejection fraction (HFpEF). Objective: To determine the associations of SBP levels with mortality and other outcomes in HFpEF. Design, Setting, and Participants: A propensity score-matched observational study of the Medicare-linked Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients with Heart Failure (OPTIMIZE-HF) registry included 25 354 patients who were discharged alive; 8873 (35...
February 14, 2018: JAMA Cardiology
https://www.readbyqxmd.com/read/29449367/load-independent-systolic-and-diastolic-right-ventricular-function-in-heart-failure-with-preserved-ejection-fraction-as-assessed-by-resting-and-handgrip-exercise-pressure-volume-loops
#2
Karl-Philipp Rommel, Maximilian von Roeder, Christian Oberueck, Konrad Latuscynski, Christian Besler, Stephan Blazek, Thomas Stiermaier, Karl Fengler, Volker Adams, Marcus Sandri, Axel Linke, Gerhard Schuler, Holger Thiele, Philipp Lurz
BACKGROUND: Although systolic right ventricular (RV) dysfunction has been shown to be a potent predictor for adverse outcomes in patients with heart failure with preserved ejection fraction (HFpEF), RV functional abnormalities in the course of the syndrome are not well characterized. We, therefore, sought to assess load-independent and load-dependent systolic and diastolic characteristics of RV function in stable outpatients with HFpEF. METHODS AND RESULTS: We invasively obtained RV and left ventricular pressure-volume loops in 24 HFpEF patients and 9 patients without heart failure symptoms with a conductance catheter during basal conditions and handgrip exercise...
February 2018: Circulation. Heart Failure
https://www.readbyqxmd.com/read/29447438/serum-uric-acid-is-associated-with-incidence-of-heart-failure-with-preserved-ejection-fraction-and-cardiovascular-events-in-patients-with-arterial-hypertension
#3
Jun Gu, Yu-Qi Fan, Hui-Li Zhang, Jun-Feng Zhang, Chang-Qian Wang
The objective of the present study was to evaluate clinical implications of serum uric acid (UA) on the progression of heart failure with preserved ejection fraction (HFpEF) in hypertensive patients. A total of 1009 adult patients with left ventricular hypertrophy and suspected left ventricular diastolic dysfunction were enrolled at our hospital from January 2008 to December 2011. With a median follow-up of 7.2 years, 136 (13.2%) patients developed new-onset HFpEF and 151 (15.0%) had major adverse cardiovascular events (MACEs)...
February 15, 2018: Journal of Clinical Hypertension
https://www.readbyqxmd.com/read/29437146/histone-deacetylase-activity-governs-diastolic-dysfunction-through-a-nongenomic-mechanism
#4
Mark Y Jeong, Ying H Lin, Sara A Wennersten, Kimberly M Demos-Davies, Maria A Cavasin, Jennifer H Mahaffey, Valmen Monzani, Chandrasekhar Saripalli, Paolo Mascagni, T Brett Reece, Amrut V Ambardekar, Henk L Granzier, Charles A Dinarello, Timothy A McKinsey
There are no approved drugs for the treatment of heart failure with preserved ejection fraction (HFpEF), which is characterized by left ventricular (LV) diastolic dysfunction. We demonstrate that ITF2357 (givinostat), a clinical-stage inhibitor of histone deacetylase (HDAC) catalytic activity, is efficacious in two distinct murine models of diastolic dysfunction with preserved EF. ITF2357 blocked LV diastolic dysfunction due to hypertension in Dahl salt-sensitive (DSS) rats and suppressed aging-induced diastolic dysfunction in normotensive mice...
February 7, 2018: Science Translational Medicine
https://www.readbyqxmd.com/read/29431256/heart-failure-with-mid-range-ejection-fraction-in-charm-characteristics-outcomes-and-effect-of-candesartan-across-the-entire-ejection-fraction-spectrum
#5
Lars H Lund, Brian Claggett, Jiankang Liu, Carolyn S Lam, Pardeep S Jhund, Giuseppe M Rosano, Karl Swedberg, Salim Yusuf, Christopher B Granger, Marc A Pfeffer, John J V McMurray, Scott D Solomon
AIMS: We tested the hypothesis that candesartan improves outcomes in heart failure (HF) with mid-range ejection fraction [HFmrEF; ejection fraction (EF) 40-49%]. METHODS AND RESULTS: In 7598 patients enrolled in the CHARM Programme (HF across the spectrum of EF), we assessed characteristics, outcomes and treatment effect of candesartan according to EF. Patients with HFmrEF (n = 1322, 17%) were similar to those with HF with reduced EF (HFrEF; n = 4323, 57%) with respect to some characteristics, and intermediate between HFrEF and HF with preserved EF (HFpEF; n = 1953, 26%) with respect to others...
February 12, 2018: European Journal of Heart Failure
https://www.readbyqxmd.com/read/29430747/left-atrial-rather-than-left-ventricular-impaired-mechanics-are-associated-with-the-pro-fibrotic-st2-marker-and-outcomes-in-heart-failure-with-preserved-ejection-fraction
#6
A I Nagy, C Hage, B Merkely, E Donal, J-C Daubert, C Linde, L H Lund, A Manouras
AIMS: Left ventricular (LV) mechanics have been extensively investigated in heart failure with preserved ejection fraction (HFpEF) overshadowing for a long time the potential role of left atrium (LA) in that setting. Soluble suppression of tumorigenicity-2 receptor (ST2) is a novel biomarker of pro-fibrotic burden in HF. We hypothesized that due to the thinner LA wall, the fibrotic myocardial changes in HFpEF as indicated by elevated ST2 levels might more readily be reflected by impairments in the LA rather than the LV performance...
February 12, 2018: Journal of Internal Medicine
https://www.readbyqxmd.com/read/29428439/using-nt-probnp-for-eligibility-and%C3%A2-enrichment-in-trials-in-hfpef-hfmref-%C3%A2-and-hfref
#7
Gianluigi Savarese, Nicola Orsini, Camilla Hage, Ola Vedin, Francesco Cosentino, Giuseppe M C Rosano, Ulf Dahlström, Lars H Lund
OBJECTIVES: The purpose of this study was to assess the association between N-terminal pro-B-type natriuretic peptide (NT-proBNP) and cardiovascular (CV) versus non-CV events and between NT-proBNP and potential treatment effects in heart failure (HF) with preserved, mid-range, and reduced ejection fraction (HFpEF, HFmrEF, and HFrEF, respectively) and clinically relevant subgroups. BACKGROUND: Optimizing patient eligibility criteria in HF trials requires biomarkers that enrich for CV but not for non-CV events and select patients most likely to respond to the tested intervention...
February 1, 2018: JACC. Heart Failure
https://www.readbyqxmd.com/read/29428434/impact-of-body-mass-index-on-heart-failure-by-race-ethnicity-from-get-with-the-guidelines-heart-failure-gwtg-hf-registry
#8
Tiffany M Powell-Wiley, Julius Ngwa, Selomie Kebede, Di Lu, Phillip J Schulte, Deepak L Bhatt, Clyde Yancy, Gregg C Fonarow, Michelle A Albert
OBJECTIVES: This study sought to evaluate the influence of race/ethnicity on the relationship between body mass index (BMI) and mortality in heart failure with preserved ejection fraction (HFpEF) and HF with reduced EF (HFrEF) patients. BACKGROUND: Prior studies demonstrated an "obesity paradox" among overweight and obese patients, where they have a better HF prognosis than normal weight patients. Less is known about the relationship between BMI and mortality among diverse patients with HF, particularly given disparities in obesity and HF prevalence...
February 1, 2018: JACC. Heart Failure
https://www.readbyqxmd.com/read/29424571/coronary-microvascular-dysfunction-in-patients-with-heart-failure-with-preserved-ejection-fraction
#9
Kathryn Dryer, Mark Gajjar, Nikhil Narang, Margaret Lee, Jonathan Paul, Atman P Shah, Sandeep Nathan, Javed Butler, Charles J Davidson, William F Fearon, Sanjiv J Shah, John Edward Abellera Blair
BACKGROUND: There are multiple proposed mechanisms for the pathophysiology of heart failure (HF) with preserved ejection fraction (HFpEF). We hypothesize that coronary microvascular dysfunction is common in these patients. METHODS AND RESULTS: In a prospective, observational study, patients undergoing cardiac catheterization with HFpEF (left ventricular (LV) ejection fraction {greater than or equal to} 50% and with clinical HF), were compared to similar patients without HFpEF...
February 9, 2018: American Journal of Physiology. Heart and Circulatory Physiology
https://www.readbyqxmd.com/read/29423950/guideline-directed-medical-therapy-and-survival-following-hospitalization-in-patients-with-heart-failure
#10
Richard H Tran, Ahmed Aldemerdash, Patricia Chang, Carla A Sueta, Brystana Kaufman, Josephine Asafu-Adjei, Orly Vardeny, Eliza Daubert, Khalid A Alburikan, Anna M Kucharska-Newton, Sally C Stearns, Jo E Rodgers
BACKGROUND: Modification of guideline-directed medical therapy (GDMT) in hospitalized patients with heart failure (HF) has not been extensively evaluated. METHODS: The community surveillance arm of the Atherosclerosis Risk in Communities Study identified 6959 HF hospitalizations from 2005 to 2011. Predictors of GDMT modification and survival were assessed using multivariable logistic regression and Cox proportional hazards models. RESULTS: For 5091 hospitalizations, patient mean age was 75 years old, 53% were female, 69% were Caucasian, and 81% had acute decompensated HF (ADHF)...
February 9, 2018: Pharmacotherapy
https://www.readbyqxmd.com/read/29415801/bio-profiling-and-bio-prognostication-of-chronic-heart-failure-with-mid-range-ejection-fraction
#11
Pedro Moliner, Josep Lupón, Jaume Barallat, Marta de Antonio, Mar Domingo, Julio Núñez, Elisabet Zamora, Amparo Galán, Javier Santesmases, Cruz Pastor, Antoni Bayes-Genis
BACKGROUND: Recent ESC guidelines on heart failure (HF) have introduced a new phenotype based on left ventricular ejection fraction (LVEF), called the mid-range (HFmrEF). This phenotype falls between the classical reduced (HFrEF) and preserved (HFpEF) HF phenotypes. We aimed to characterize the HFmrEF biomarker profile and outcomes. METHODS: 1069 consecutive ambulatory patients were included in the study (age 66.2 ± 12.8 years); 800 with HFrEF (74.8%), 134 with HFmrEF (12...
January 31, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29414252/heart-failure-with-preserved-ejection-fraction
#12
James D Gladden, Antoine H Chaanine, Margaret M Redfield
Heart failure (HF) is a clinical syndrome of diverse etiologies and can be associated with preserved, reduced, or mid-range ejection fraction (EF). In the community, heart failure with preserved ejection fraction (HFpEF) is emerging as the most common form of HF. There remains considerable uncertainty regarding its pathogenesis, diagnosis, and optimal therapeutic approach. Hypotheses have been advanced to explain the underlying pathophysiology responsible for HFpEF, but to date, no specific therapy based on these hypotheses has been proven to improve outcomes in HFpEF...
January 29, 2018: Annual Review of Medicine
https://www.readbyqxmd.com/read/29413499/pulmonary-function-predicts-mortality-and-hospitalizations-in-outpatients-with-heart-failure-and-preserved-ejection-fraction
#13
Rut Andrea, Alejandra López-Giraldo, Carlos Falces, Teresa López, Laura Sanchis, Concepción Gistau, Manel Sabaté, Marta Sitges, Josep Brugada, Àlvar Agustí
BACKGROUND: Heart failure with preserved ejection fraction (HFPEF) is the most frequent form of heart failure in ambulatory patients with new-onset symptoms. We previously showed that lung function abnormalities are highly prevalent in HFPEF patients. In this observational, longitudinal study, we tested the hypothesis that the presence of airflow limitation and/or arterial hypoxemia predicts mortality and/or cardiovascular hospitalizations during follow-up in HFPEF outpatients. MATERIALS AND METHODS: HFPEF was diagnosed following the international recommendations...
January 2018: Respiratory Medicine
https://www.readbyqxmd.com/read/29413375/smartphone-mom-and-hfpef
#14
EDITORIAL
Christopher M O'Connor
No abstract text is available yet for this article.
February 2018: JACC. Heart Failure
https://www.readbyqxmd.com/read/29413366/relative-impairments-in-hemodynamic-exercise-reserve-parameters-in-heart-failure-with-preserved-ejection%C3%A2-fraction-a-study-level-pooled-analysis
#15
Ambarish Pandey, Rohan Khera, Bryan Park, Mark Haykowsky, Barry A Borlaug, Gregory D Lewis, Dalane W Kitzman, Javed Butler, Jarett D Berry
OBJECTIVES: The aim of this study was to compare the relative impairment in different exercise hemodynamic reserve parameters in patients with heart failure with preserved ejection fraction (HFpEF) and control patients using a study-level meta-analysis. BACKGROUND: A cardinal manifestation of chronic HFpEF is severely decreased exercise capacity. Developing effective therapies for exercise intolerance in HFpEF requires optimal understanding of the factors underlying exercise intolerance...
February 2018: JACC. Heart Failure
https://www.readbyqxmd.com/read/29411216/pharmacological-treatments-for-heart-failure-with-preserved-ejection-fraction-a-systematic-review-and-indirect-comparison
#16
REVIEW
Kwadwo Osei Bonsu, Poukwan Arunmanakul, Nathorn Chaiyakunapruk
Pharmacological interventions for heart failure with preserved ejection fraction (HFpEF) have failed to reduce mortality and hospitalization. Evidence for mineralocorticoid antagonists (MRAs), β-adrenoceptor blockers (β-blockers), and angiotensin-converting enzyme inhibitors/angiotensin receptor blockers (ACEIs/ARBs)-to reduce clinical outcomes in HFpEF remains unclear. We conducted a systematic search of MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, and Clinical Trials.gov for randomized controlled trials (RCTs) assessing pharmacological treatments in HFpEF diagnosed according the recommendations of the European Society of Cardiology (ESC) 2016 guidelines from inception to August, 2017...
February 7, 2018: Heart Failure Reviews
https://www.readbyqxmd.com/read/29407095/determinants-of-exercise-intolerance-in-heart-failure-with-preserved-ejection-fraction-a-systematic-review-and-meta-analysis
#17
David Montero, Candela Diaz-Cañestro
BACKGROUND: Severe exercise intolerance (EI), demonstrated by impaired peak oxygen consumption, intrinsically characterizes heart failure with preserved ejection fraction (HFpEF). Controversy exists on the determinants of EI in patients with HFpEF according to case-control studies. The purpose of this study is to systematically review and clarify the main (Fick) determinants of EI in HFpEF. METHODS: We conducted a systematic search of MEDLINE, Scopus and Web of Science since their inceptions until January 2017 for articles assessing peak cardiac output and/or arteriovenous oxygen difference (a-vO2diffpeak) with incremental exercise in patients diagnosed with HFpEF and age-matched control individuals...
March 1, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29407092/different-relationships-between-pulse-pressure-and-mortality-in-heart-failure-with-reduced-mid-range-and-preserved-ejection-fraction
#18
Tiew-Hwa Katherine Teng, Wan Ting Tay, Ulf Dahlstrom, Lina Benson, Carolyn S P Lam, Lars H Lund
OBJECTIVES/BACKGROUND: In heart failure (HF), pulse pressure (PP) may reflect both vascular stiffness and left ventricular function, but its prognostic role in relation to ejection fraction (EF) is poorly understood. METHODS: In the Swedish Heart Failure Registry, we investigated the association between PP and 1-year mortality in patients with HF and reduced (HFrEF, <40%), mid-range (HFmrEF, 40-49%) and preserved EF (HFpEF, ≥50%), using multivariable logistic regression and restricted cubic splines...
March 1, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29405511/a-flattening-oxygen-consumption-trajectory-phenotypes-disease-severity-and-poor-prognosis-in-patients-with-heart-failure-with-reduced-mid-range-and-preserved-ejection-fraction
#19
Dejana Popovic, Ross Arena, Marco Guazzi
BACKGROUND: In heart failure (HF), a flattening oxygen consumption (VO2 ) trajectory during cardiopulmonary exercise test (CPET) reflects an acutely compromised cardiac output. We hypothesized that a flattening VO2 trajectory is helpful in phenotyping disease severity and prognosis in HF with either reduced (HFrEF), mid-range (HFmrEF), or preserved (HFpEF) ejection fraction. METHODS AND RESULTS: Overall, 319 HF patients (198 HFrEF, 80 HFmrEF, and 41 HFpEF) underwent CPET...
February 6, 2018: European Journal of Heart Failure
https://www.readbyqxmd.com/read/29404975/the-emerging-role-of-cardiac-magnetic-resonance-imaging-in-the-evaluation-of-patients-with-hfpef
#20
REVIEW
Jessica Webb, Lauren Fovargue, Kristin Tøndel, Bradley Porter, Benjamin Sieniewicz, Justin Gould, Christopher Aldo Rinaldi, Tevfik Ismail, Amedeo Chiribiri, Gerald Carr-White
PURPOSE OF REVIEW: To give an update on the emerging role of cardiac magnetic resonance imaging in the evaluation of patients with heart failure with preserved ejection fraction (HFpEF). This is important as the diagnosis of HFpEF remains challenging and cardiac imaging is pivotal in establishing the function of the heart and whether there is evidence of structural heart disease or diastolic dysfunction. Echocardiography is widely available, although the gold standard in quantifying heart function is cardiac magnetic resonance (CMR) imaging...
February 5, 2018: Current Heart Failure Reports
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