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https://www.readbyqxmd.com/read/29228101/spironolactone-and-resistant-hypertension-in-heart-failure-with-preserved-ejection-fraction
#1
P Rossignol, B Claggett, J Liu, O Vardeny, B Pitt, F Zannad, S Solomon
Background: Recent evidence suggests that the mineralocorticoid receptor antagonist spironolactone should be the preferred fourth line antihypertensive treatment in resistant hypertension (RHTN). Whether spironolactone improves blood pressure (BP) control in heart failure with preserved ejection fraction (HFpEF) and RHTN is unknown. Methods: We identified patients with RHTN, defined as baseline systolic blood pressure (SBP) between 140 and 160 mmHg on 3 or more medications, in the Americas cohort of the TOPCAT trial, in which patients with HFpEF were randomized to spironolactone vs...
December 7, 2017: American Journal of Hypertension
https://www.readbyqxmd.com/read/29226491/predictors-and-outcomes-of-heart-failure-with-mid-range-ejection-fraction
#2
Vijeta Bhambhani, Jorge R Kizer, Joao A C Lima, Pim van der Harst, Hossein Bahrami, Matthew Nayor, Christopher R de Filippi, Danielle Enserro, Michael J Blaha, Mary Cushman, Thomas J Wang, Ron T Gansevoort, Caroline S Fox, Hanna K Gaggin, Willem J Kop, Kiang Liu, Ramachandran S Vasan, Bruce M Psaty, Douglas S Lee, Frank P Brouwers, Hans L Hillege, Traci M Bartz, Emelia J Benjamin, Cheeling Chan, Matthew Allison, Julius M Gardin, James L Januzzi, Daniel Levy, David M Herrington, Wiek H van Gilst, Alain G Bertoni, Martin G Larson, Rudolf A de Boer, John S Gottdiener, Sanjiv J Shah, Jennifer E Ho
AIMS: While heart failure with preserved (HFpEF) and reduced ejection fraction (HFrEF) are well described, determinants and outcomes of heart failure with mid-range ejection fraction (HFmrEF) remain unclear. We sought to examine clinical and biochemical predictors of incident HFmrEF in the community. METHODS AND RESULTS: We pooled data from four community-based longitudinal cohorts, with ascertainment of new heart failure (HF) classified into HFmrEF [ejection fraction (EF) 41-49%], HFpEF (EF ≥50%), and HFrEF (EF ≤40%)...
December 11, 2017: European Journal of Heart Failure
https://www.readbyqxmd.com/read/29222043/catheter-ablation-of-atrial-fibrillation-in-patients-with-heart-failure-and-preserved-ejection-fraction
#3
Eric Black-Maier, Xinru Ren, Benjamin A Steinberg, Cynthia L Green, Adam S Barnett, Normita Sta Rosa, Sana M Al-Khatib, Brett D Atwater, James P Daubert, Camille Frazier-Mills, Augustus O Grant, Donald D Hegland, Kevin P Jackson, Larry R Jackson, Jason I Koontz, Robert K Lewis, Albert Y Sun, Kevin L Thomas, Tristam D Bahnson, Jonathan P Piccini
BACKGROUND: Few studies have examined outcomes of catheter ablation for atrial fibrillation (AF) in patients with heart failure with preserved ejection fraction (HFpEF). OBJECTIVE: Compare outcomes of AF ablation in patients with HFpEF versus HF with reduced ejection fraction (HFrEF). METHODS: We performed a retrospective study of 230 patients with HF who underwent AF ablation, including 97 (42.2%) with HFrEF and 133 (57.8%) with HFpEF. Outcomes included adverse events, symptoms (Mayo AF Symptom Inventory [MAFSI]), New York Heart Association (NYHA) functional class, and freedom from recurrent atrial arrhythmia at 12-months...
December 5, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/29210202/amount-or-intensity-potential-targets-of-exercise-interventions-in-patients-with-heart-failure-with-preserved-ejection-fraction
#4
Anna Bobenko, Inke Bartels, Marlene Münch, Tobias Trippel, Ruhdja Lindhorst, Kathleen Nolte, Christoph Herrmann-Lingen, Martin Halle, André Duvinage, Hans-Dirk Düngen, Götz Gelbrich, Carsten Tschöpe, Gerd Hasenfuss, Rolf Wachter, Burkert Pieske, Frank Edelmann
AIMS: Heart failure with preserved ejection fraction (HFpEF) remains a common condition with no pharmacological treatment. Physical activity (PA) improves symptoms and quality of life (QoL), but no clear recommendations exist on PA in HFpEF patients. We investigated the association of PA (amount/intensity) on clinical phenotype in HFpEF. METHODS AND RESULTS: The Aldosterone in Diastolic Heart Failure trial investigated spironolactone vs. placebo in stable HFpEF patients...
December 6, 2017: ESC Heart Failure
https://www.readbyqxmd.com/read/29201436/therapeutic-benefits-of-phosphodiesterase-5-inhibition-in-chronic-heart-failure-a-meta-analysis
#5
Renato De Vecchis, Arturo Cesaro, Carmelina Ariano
Background: Phosphodiesterase-5 inhibitors (PDE5i) have been shown to be beneficial for patients with pulmonary arterial hypertension. However, several studies would have documented a useful effect of PDE5i even for pulmonary hypertension secondary to left-sided chronic heart failure (CHF). Methods: We performed a meta-analysis including randomized controlled trials (RCTs) which had compared PDE5i (mostly sildenafil) and placebo in CHF patients. Results: Fourteen studies enrolling a total of 928 patients were incorporated in the meta-analysis...
September 2017: Interventional Medicine & Applied Science
https://www.readbyqxmd.com/read/29197548/right-heart-dysfunction-in-heart-failure-with-preserved-ejection-fraction-the-impact-of-atrial-fibrillation
#6
Thomas M Gorter, Joost P van Melle, Michiel Rienstra, Barry A Borlaug, Yoran M Hummel, Isabelle C Van Gelder, Elke S Hoendermis, Adriaan A Voors, Dirk J Van Veldhuisen, Carolyn S P Lam
BACKGROUND: Right ventricular (RV) dysfunction and atrial fibrillation (AF) frequently coexist in heart failure with preserved ejection fraction (HFpEF). The mechanisms underlying the association between AF and RV dysfunction are incompletely understood. METHODS AND RESULTS: 102 patients were identified. RV function was assessed using multiple echocardiographic parameters and dysfunction was present if ≥2 parameters were below the recommended cutoff. RV function, right atrial (RA) reservoir strain and RA emptying fraction, were compared between AF and sinus rhythm...
November 29, 2017: Journal of Cardiac Failure
https://www.readbyqxmd.com/read/29193462/contribution-of-cardiac-and-extra-cardiac-disease-burden-to-risk-of-cardiovascular-outcomes-varies-by-ejection-fraction-in-heart-failure
#7
Emil Wolsk, Brian Claggett, Lars Køber, Stuart Pocock, Salim Yusuf, Karl Swedberg, John J V McMurray, Christopher B Granger, Marc A Pfeffer, Scott D Solomon
AIMS: Patients with heart failure (HF) often have multiple co-morbidities that contribute to the risk of adverse cardiovascular (CV) and non-CV outcomes. We assessed the relative contribution of cardiac and extra-cardiac disease burden and demographic factors to CV outcomes in HF patients with reduced (HFrEF) or preserved (HFpEF) left ventricular ejection fraction (LVEF). METHODS AND RESULTS: We utilized data from the CHARM trial, which enrolled HF patients across the ejection fraction spectrum...
November 30, 2017: European Journal of Heart Failure
https://www.readbyqxmd.com/read/29191321/abdominal-obesity-is-associated-with%C3%A2-an%C3%A2-increased-risk-of-all-cause-mortality-in-patients-with-hfpef
#8
RANDOMIZED CONTROLLED TRIAL
Tetsuro Tsujimoto, Hiroshi Kajio
BACKGROUND: There is a lack of studies that evaluate the association between abdominal obesity and subsequent outcomes in patients with heart failure with preserved ejection fraction (HFpEF). OBJECTIVES: The present study aimed to assess the association between abdominal obesity and risk of all-cause mortality in patients with HFpEF. METHODS: The present study used data from the TOPCAT (Treatment of Preserved Cardiac Function Heart Failure with an Aldosterone Antagonist) trial...
December 5, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/29188804/device-therapy-interatrial-shunt-device-for-hfpef
#9
Gregory B Lim
No abstract text is available yet for this article.
November 30, 2017: Nature Reviews. Cardiology
https://www.readbyqxmd.com/read/29186452/gender-and-cardiovascular-disease-are-sex-biased-mirna-networks-a-driving-force-behind-heart-failure-with-preserved-ejection-fraction-in-women
#10
Barend W Florijn, Roel Bijkerk, Eric van der Veer, Anton Jan van Zonneveld
CVD is the primary cause of death among men and women worldwide. Nevertheless, our comprehension of how CVD progresses in women and elicits clinical outcomes is lacking, leading CVD to be under-diagnosed and under-treated in women. A clear example of this differential presentation of CVD pathophysiologies in females is the strikingly higher prevalence of heart failure with preserved ejection fraction (HFpEF). Women with a history of preeclampsia, or those that present co-morbidities such as obesity, hypertension and diabetes mellitus are at increased risk to develop HFpEF...
November 24, 2017: Cardiovascular Research
https://www.readbyqxmd.com/read/29185443/a-feline-hfpef-model-with-pulmonary-hypertension-and-compromised-pulmonary-function
#11
Markus Wallner, Deborah M Eaton, Remus M Berretta, Giulia Borghetti, Jichuan Wu, Sandy T Baker, Eric A Feldsott, Thomas E Sharp, Sadia Mohsin, Mark A Oyama, Dirk von Lewinski, Heiner Post, Marla R Wolfson, Steven R Houser
Heart Failure with preserved Ejection Fraction (HFpEF) represents a major public health problem. The causative mechanisms are multifactorial and there are no effective treatments for HFpEF, partially attributable to the lack of well-established HFpEF animal models. We established a feline HFpEF model induced by slow-progressive pressure overload. Male domestic short hair cats (n = 20), underwent either sham procedures (n = 8) or aortic constriction (n = 12) with a customized pre-shaped band. Pulmonary function, gas exchange, and invasive hemodynamics were measured at 4-months post-banding...
November 29, 2017: Scientific Reports
https://www.readbyqxmd.com/read/29180305/pulmonary-vascular-resistance-during-exercise-predicts-long-term-outcomes-in-heart-failure-with-preserved-ejection-fraction
#12
Wei Huang, Rudolf K F Oliveira, Han Lei, David M Systrom, Aaron B Waxman
BACKGROUND: In heart failure with preserved ejection fraction (HFpEF), the prognostic value of pulmonary vascular dysfunction (PV-dysfunction), identified by elevated PVR at peak exercise, is not completely understood. We evaluated the long-term prognostic implications of PV-dysfunction in HFpEF during exercise in consecutive patients undergoing invasive cardiopulmonary exercise testing for unexplained dyspnea. METHODS: Patients with HFpEF were classified into two main groups: resting-HFpEF (rHFpEF;n=104, 62% female, 61-yrs) with a pulmonary arterial wedge pressure (PAWP)>15mmHg at rest; and exercise-HFpEF (eHFpEF;n=81) with a PAWP<15mmHg at rest, but >20mmHg during exercise...
November 24, 2017: Journal of Cardiac Failure
https://www.readbyqxmd.com/read/29173610/endothelial-nitric-oxide-synthase-induced-hypertrophy-and-vascular-dysfunction-contribute-to-the-left-ventricular-dysfunction-in-caveolin-1-mice
#13
Annette Ebner, Nadine Kuerbis, Aljoscha Brandt, Birgit Zatschler, Sönke Weinert, David M Poitz, Bernd Ebner, Antje Augstein, Carsten Wunderlich, Ali El-Armouche, Ruth H Strasser
BACKGROUND: Caveolin-1 (Cav1)-/- mice display impaired development of left ventricular pressure and increased left ventricular wall thickness but no dilated ventricle; these are typical findings in patients with heart failure with preserved ejection fraction (HfpEF). Aiming to clarify if dysfunctional endothelial nitric oxide synthase (eNOS) influences cardiomyocyte contractility, cardiac conduction system, or afterload/vascular resistance, we studied Cav1-/-/eNOS-/- mice. METHODS: Cardiac function was assessed in vivo by pressure-volume-catheterization of the left ventricle, echocardiography and electrocardiography...
December 2017: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/29167119/revisiting-the-physiological-effects-of-exercise-training-on-autonomic-regulation-and-chemoreflex-control-in-heart-failure-does-ejection-fraction-matter
#14
David Cristobal Andrade, Alexis Arce-Alvarez, Camilo Toledo, Hugo S Diaz, Claudia Lucero, Rodrigo Quintanilla, Harold D Schultz, Noah J Marcus, Markus Amman, Rodrigo Del Rio
Heart failure (HF) is a global public health problem that, independent of its etiology (reduced (HFrEF) or preserved ejection fraction (HFpEF)), is characterized by functional impairments of cardiac function, chemoreflex hypersensitivity, baroreflex sensitivity (BRS) impairment, and abnormal autonomic regulation, all of which contribute to increased morbidity and mortality. Exercise training (ExT) has been identified as a nonpharmacological therapy capable of restoring normal autonomic function and improving survival in patients with HFrEF...
November 22, 2017: American Journal of Physiology. Heart and Circulatory Physiology
https://www.readbyqxmd.com/read/29154426/microvascular-dysfunction-and-cardiac-fibrosis-in-heart-failure-with-preserved-ejection-fraction-a-case-report
#15
Nikhil Narang, Diego Medvedofsky, Kathryn Dryer, Sanjiv J Shah, Charles J Davidson, Amit R Patel, John E A Blair
We report the case of a 55-year-old woman with heart failure with preserved ejection fraction (HFpEF), who presented with hypertensive urgency and pulmonary oedema. The patient was medically optimized and underwent cardiac catheterization revealing pulmonary hypertension, elevated pulmonary capillary wedge pressure, normal cardiac index, and non-obstructive coronary disease. Invasive evaluation of coronary flow revealed blunted coronary flow reserve and increased index of microvascular resistance. Cardiac magnetic resonance imaging demonstrated reduced global myocardial perfusion and diffuse interstitial fibrosis...
November 2017: ESC Heart Failure
https://www.readbyqxmd.com/read/29154416/left-ventricular-global-longitudinal-strain-in-patients-with-heart-failure-with-preserved-ejection-fraction-outcomes-following-an-acute-heart-failure-hospitalization
#16
Jonathan Buggey, Fawaz Alenezi, Hyun Ju Yoon, Matthew Phelan, Adam D DeVore, Michel G Khouri, Phillip J Schulte, Eric J Velazquez
AIMS: While abnormal resting LV GLS has been described in patients with chronic heart failure with preserved ejection fraction (HFpEF), its prognostic significance when measured during an acute heart failure hospitalization remains unclear. We assessed the association between left ventricular global longitudinal strain (LV GLS) and outcomes in patients hospitalized with acute HFpEF. METHODS AND RESULTS: We studied patients discharged alive for acute HFpEF from Duke University Medical Center between 2007 and 2010...
November 2017: ESC Heart Failure
https://www.readbyqxmd.com/read/29153571/association-of-abnormal-left-ventricular-functional-reserve-with-outcome-in-heart-failure-with-preserved-ejection-fraction
#17
Wojciech Kosmala, Monika Przewlocka-Kosmala, Aleksandra Rojek, Andrzej Mysiak, Andrzej Dabrowski, Thomas H Marwick
OBJECTIVES: This study sought to determine the prognostic value of abnormal diastolic and systolic responses to exercise (on the basis of exertional E/e' and global longitudinal strain rate [GSR]) in a well-characterized population of patients with heart failure with preserved ejection fraction (HFpEF). BACKGROUND: Impaired cardiovascular functional reserve is believed to contribute to adverse outcomes in HFpEF. However, the exact characteristics of pathophysiological profiles associated with increased clinical risk are still poorly defined...
November 10, 2017: JACC. Cardiovascular Imaging
https://www.readbyqxmd.com/read/29150163/the-management-of-diagnosed-heart-failure-in-older-people-in-primary-care
#18
REVIEW
Nicholas R Jones, F D Richard Hobbs, Clare J Taylor
Heart failure (HF) is a common condition affecting predominantly older people. Symptoms include breathlessness and fatigue, and can significantly reduce quality of life. HF rarely occurs in isolation, with most patients having several co-existing diseases requiring multiple medications. There is a large evidence base for treatment of HF with reduced ejection fraction, or HFrEF; however, many of the trials did not include older people with multimorbidity so their findings should be applied to this group with some caution...
December 2017: Maturitas
https://www.readbyqxmd.com/read/29148148/an-integrative-translational-approach-to-study-heart-failure-with-preserved-ejection-fraction-a-position-paper-from-the-working-group-on-myocardial-function-of-the-european-society-of-cardiology
#19
REVIEW
Andre P Lourenço, Adelino F Leite-Moreira, Jean-Luc Balligand, Johann Bauersachs, Dana Dawson, Rudolf A de Boer, Leon J de Windt, Inês Falcão-Pires, Ricardo Fontes-Carvalho, Stefan Franz, Mauro Giacca, Denise Hilfiker-Kleiner, Emilio Hirsch, Christoph Maack, Manuel Mayr, Burkert Pieske, Thomas Thum, Carlo G Tocchetti, Dirk L Brutsaert, Stephane Heymans
As heart failure with preserved ejection fraction (HFpEF) rises to epidemic proportions, major steps in patient management and therapeutic development are badly needed. With the current position paper we seek to update our view on HFpEF as a highly complex systemic syndrome, from risk factors and mechanisms to long-term clinical manifestations. We will revise recent advances in animal model development, experimental set-ups and basic and translational science approaches to HFpEF research, highlighting their drawbacks and advantages...
November 16, 2017: European Journal of Heart Failure
https://www.readbyqxmd.com/read/29148144/systolic-blood-pressure-and-cardiovascular-outcomes-in-heart-failure-with-preserved-ejection-fraction-an-analysis-of-the-topcat-trial
#20
Senthil Selvaraj, Brian Claggett, Sanjiv J Shah, Inder Anand, Jean L Rouleau, Akshay S Desai, Eldrin F Lewis, Bertram Pitt, Nancy K Sweitzer, Marc A Pfeffer, Scott D Solomon
AIMS: Recent guidelines have advocated for stricter systolic blood pressure (SBP) control in heart failure with preserved ejection fraction (HFpEF), though data regarding the optimal SBP in HFpEF are sparse. METHODS AND RESULTS: We analysed participants from the Americas from the Treatment of Preserved Cardiac Function Heart Failure with an Aldosterone Antagonist (TOPCAT) study with available baseline and 8-week visit SBP data (n = 1645). We related baseline SBP to several efficacy and safety outcomes...
November 16, 2017: European Journal of Heart Failure
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