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Heart failure preserved ejection fraction

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https://www.readbyqxmd.com/read/27905877/mineralocorticoid-receptor-antagonists-for-heart-failure-systematic-review-and-meta-analysis
#1
Nicolas M Berbenetz, Marko Mrkobrada
BACKGROUND: Mineralocorticoid receptor antagonists (MRAs) have been associated with improved patient outcomes in patients with heart failure with reduced ejection fraction (HFrEF) but not preserved ejection fraction (HFpEF). We conducted a systematic review and meta-analysis of selective and nonselective MRAs in HFrEF and HFpEF. METHODS: We searched Cochrane Central Register of Controlled Trials, MEDLINE and EMBASE. We included randomized controlled trials (RCT) of MRAs in adults with HFpEF or HFrEF if they reported data on major adverse cardiac events or drug safety...
December 1, 2016: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/27904018/impact-of-plasma-kynurenine-level-on-functional-capacity-and-outcome-in-heart-failure%C3%A3-results-from-studies-investigating-co-morbidities-aggravating-heart-failure-sica-hf
#2
Masaaki Konishi, Nicole Ebner, Jochen Springer, Joerg C Schefold, Wolfram Doehner, Thomas Bernd Dschietzig, Stefan D Anker, Stephan von Haehling
BACKGROUND: Kynurenine is a circulating metabolite from the essential amino acid tryptophan. Accelerated degradation of kynurenine in skeletal muscle has been reported to provide an anti-inflammatory effect. The aim of this study was to investigate the association between blood kynurenine and muscle mass/function in patients with heart failure (HF), in whom diseased muscle mass/function plays a pathophysiological role.Methods and Results:Plasma kynurenine was assessed in 249 patients with HF (67±11 years, 21% women) and in 45 controls from the SICA-HF study...
November 30, 2016: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/27900617/new-and-evolving-concepts-regarding-the-prognosis-and-treatment-of-cardiac-amyloidosis
#3
REVIEW
Stefano Perlini, Roberta Mussinelli, Francesco Salinaro
Systemic amyloidoses are rare and proteiform diseases, caused by extracellular accumulation of insoluble misfolded fibrillar proteins. Prognosis is dictated by cardiac involvement, which is especially frequent in light chain (AL) and in transthyretin variants (ATTR, both mutated, (ATTRm), and wild-type, (ATTRwt)). Recently, ATTRwt has emerged as a potentially relevant cause of a heart failure with preserved ejection fraction (HFpEF). Cardiac amyloidosis is an archetypal example of restrictive cardiomyopathy, with signs and symptoms of global heart failure and diastolic dysfunction...
November 29, 2016: Current Heart Failure Reports
https://www.readbyqxmd.com/read/27900610/novel-sgc-stimulators-and-sgc-activators-for-the-treatment-of-heart-failure
#4
Stefanie Breitenstein, Lothar Roessig, Peter Sandner, Kelly S Lewis
The burden of heart failure (HF) increases worldwide with an aging population, and there is a high unmet medical need in both, heart failure with reduced ejection fraction (HFrEF) and with preserved ejection fraction (HFpEF). The nitric oxide (NO) pathway is a key regulator in the cardiovascular system and modulates vascular tone and myocardial performance. Disruption of the NO-cyclic guanosine monophosphate (cGMP) signaling axis and impaired cGMP formation by endothelial dysfunction could lead to vasotone dysregulation, vascular and ventricular stiffening, fibrosis, and hypertrophy resulting in a decline of heart as well as kidney function...
November 30, 2016: Handbook of Experimental Pharmacology
https://www.readbyqxmd.com/read/27900534/heart-failure-management-in-the-elderly-a%C3%A2-public-health-challenge
#5
REVIEW
Natasa Cvetinovic, Goran Loncar, Jerneja Farkas
Heart failure (HF) is a rapidly growing public health problem and the leading cause of morbidity, mortality, and hospitalization in populations > 65 years. The elderly HF patients have an increased prevalence of HF with preserved ejection fraction and comorbidities, may present with atypical symptoms and signs, have a higher risk for adverse drug reactions, and worse prognosis as compared with younger patients. Moreover, there is a lack of evidence-based therapies for this population because they are underrepresented in the clinical trials...
November 29, 2016: Wiener Klinische Wochenschrift
https://www.readbyqxmd.com/read/27895488/advances-in-the-management-of-heart-failure-the-role-of-ivabradine
#6
REVIEW
Ursula Müller-Werdan, Georg Stöckl, Karl Werdan
A high resting heart rate (≥70-75 b.p.m.) is a risk factor for patients with heart failure (HF) with reduced ejection fraction (EF), probably in the sense of accelerated atherosclerosis, with an increased morbidity and mortality. Beta-blockers not only reduce heart rate but also have negative inotropic and blood pressure-lowering effects, and therefore, in many patients, they cannot be given in the recommended dose. Ivabradine specifically inhibits the pacemaker current (funny current, If) of the sinoatrial node cells, resulting in therapeutic heart rate lowering without any negative inotropic and blood pressure-lowering effect...
2016: Vascular Health and Risk Management
https://www.readbyqxmd.com/read/27891745/cardiac-extracellular-matrix-is-associated-with-adverse-outcome-in-patients-with-chronic-heart-failure
#7
Franz Duca, Caroline Zotter-Tufaro, Andreas A Kammerlander, Adelheid Panzenböck, Stefan Aschauer, Daniel Dalos, Benedikt Köll, Benedikt Börries, Hermine Agis, Renate Kain, Klaus Aumayr, Florian Klinglmüller, Julia Mascherbauer, Diana Bonderman
AIMS: Accumulation of extracellular matrix (ECM) is known to play a crucial role in the pathophysiology of heart failure (HF). However, its prognostic relevance is poorly investigated. METHODS AND RESULTS: A total of 73 HF patients who underwent LV endomyocardial biopsy were enrolled in our study. ECM area was quantified by TissueFAXS and ImageJ software. Patients were followed-up at 6-month intervals. The study endpoint was defined as hospitalization for a cardiac reason and/or cardiac death...
November 27, 2016: European Journal of Heart Failure
https://www.readbyqxmd.com/read/27889803/reducing-rbm20-activity-improves-diastolic-dysfunction-and-cardiac-atrophy
#8
Florian Hinze, Christoph Dieterich, Michael H Radke, Henk Granzier, Michael Gotthardt
: Impaired diastolic filling is a main contributor to heart failure with preserved ejection fraction (HFpEF), a syndrome with increasing prevalence and no treatment. Both collagen and the giant sarcomeric protein titin determine diastolic function. Since titin's elastic properties can be adjusted physiologically, we evaluated titin-based stiffness as a therapeutic target. We adjusted RBM20-dependent cardiac isoform expression in the titin N2B knockout mouse with increased ventricular stiffness...
November 26, 2016: Journal of Molecular Medicine: Official Organ of the "Gesellschaft Deutscher Naturforscher und Ärzte"
https://www.readbyqxmd.com/read/27887692/mechanisms-of-effort-intolerance-in-patients-with-heart-failure-and-borderline-ejection-fraction
#9
Yan Topilsky, Zach Rozenbaum, Shafik Khoury, Gregg S Pressman, Yaniv Gura, Jack Sherez, Avi Man, Jason Shimiaie, Sanford Edwards, Joshua Berookhim, Thierry Le Tourneau, Amir Halkin, Simon Biner, Gad Keren, Galit Aviram
Combining echocardiography and cardiopulmonary stress testing allows noninvasive assessment of hemodynamics, and oxygen extraction (A-VO2 difference). We evaluated mechanisms of effort intolerance in patients with heart failure with borderline (40% to 49%) left ventricular ejection fraction (EF) (HF and Borderline Ejection fraction). We included 89 consecutive patients with HF and Borderline Ejection fraction (n = 25; 63.6 ± 14 years, 64% men), control subjects (n = 22), patients with HF with preserved EF (n = 26; EF ≥50%), and patients with HF with reduced EF (n = 16; <40%)...
November 1, 2016: American Journal of Cardiology
https://www.readbyqxmd.com/read/27886615/hfpef-and-hfref-exhibit-different-phenotypes-as-assessed-by-leptin-and-adiponectin
#10
Ulrika Ljung Faxén, Camilla Hage, Anna Andreasson, Erwan Donal, Jean-Claude Daubert, Cecilia Linde, Kerstin Brismar, Lars H Lund
BACKGROUND: Heart failure with reduced ejection fraction (HFrEF) exhibits a "reverse metabolic profile". Whether this profile exists in HF with preserved ejection fraction (HFpEF) is unknown. We tested the hypothesis that HFpEF and HFrEF are similar regarding concentrations of and prognostic impact of leptin and adiponectin. METHODS: In patients with HFpEF(n=79), HFrEF(n=84), and controls(n=71), we analyzed serum leptin and adiponectin concentrations, their correlations, and associations with outcome...
November 9, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27878925/left-ventricular-deformation-at-rest-predicts-exercise-induced-elevation-in-pulmonary-artery-wedge-pressure-in-patients-with-unexplained-dyspnoea
#11
Tor Biering-Sørensen, Mário Santos, Jose Rivero, Shane D McCullough, Erin West, Alexander R Opotowsky, Aaron B Waxman, David M Systrom, Amil M Shah
AIMS: Impaired left ventricular (LV) deformation despite preserved LV ejection fraction (LVEF) is common and predicts outcomes in heart failure with preserved LVEF. We hypothesized that impaired LV deformation at rest is a marker of impaired cardiac systolic and diastolic reserve, and aimed to determine whether resting longitudinal (LS) and circumferential strain (CS) are associated with invasively measured haemodynamic response to exercise in patients with dyspnoea and a normal LVEF...
November 22, 2016: European Journal of Heart Failure
https://www.readbyqxmd.com/read/27876471/cobalamin-and-folate-protect-mitochondrial-and-contractile-functions-in-a-murine-model-of-cardiac-pressure-overload
#12
Jérôme Piquereau, Maryline Moulin, Giada Zurlo, Philippe Mateo, Mélanie Gressette, Jean-Louis Paul, Christophe Lemaire, Renée Ventura-Clapier, Vladimir Veksler, Anne Garnier
PGC-1α, a key regulator of energy metabolism, seems to be a relevant therapeutic target to rectify the energy deficit observed in heart failure (HF). Since our previous work has shown positive effects of cobalamin (Cb) on PGC-1α cascade, we investigate the protective role of Cb in pressure overload-induced myocardial dysfunction. Mice were fed with normal diet (ND) or with Cb and folate supplemented diet (SD) 3weeks before and 4weeks after transverse aortic constriction (TAC). At the end, left ventricle hypertrophy and drop of ejection fraction were significantly lower in SD mice than in ND mice...
November 19, 2016: Journal of Molecular and Cellular Cardiology
https://www.readbyqxmd.com/read/27873502/efficacy-and-safety-of-intravenous-urapidil-for-older-hypertensive-patients-with-acute-heart-failure-a-multicenter-randomized-controlled-trial
#13
Wei Yang, Yu Jie Zhou, Yan Fu, Jian Qin, Shu Qin, Xiao Min Chen, Jin Cheng Guo, De Zhao Wang, Hong Zhan, Jing Li, Jing Yu He, Qi Hua
PURPOSE: Urapidil is putatively effective for patients with hypertension and acute heart failure, although randomized controlled trials thereon are lacking. We investigated the efficacy and safety of intravenous urapidil relative to that of nitroglycerin in older patients with hypertension and heart failure in a randomized controlled trial. MATERIALS AND METHODS: Patients (>60 y) with hypertension and heart failure were randomly assigned to receive intravenous urapidil (n=89) or nitroglycerin (n=91) for 7 days...
January 2017: Yonsei Medical Journal
https://www.readbyqxmd.com/read/27873389/sildenafil-unbridled-optimism-and-heart-failure-with-preserved-ejection-fraction
#14
EDITORIAL
Yogesh N V Reddy, Barry A Borlaug
No abstract text is available yet for this article.
November 21, 2016: European Journal of Heart Failure
https://www.readbyqxmd.com/read/27873388/effects-of-sildenafil-on-cardiac-structure-and-function-cardiopulmonary-exercise-testing-and-health-related-quality-of-life-measures-in-heart-failure-patients-with-preserved-ejection-fraction-and-pulmonary-hypertension
#15
Licette C Y Liu, Yoran M Hummel, Peter van der Meer, Rolf M F Berger, Kevin Damman, Dirk J van Veldhuisen, Adriaan A Voors, Elke S Hoendermis
AIMS: We recently showed that sildenafil did not improve pulmonary pressures and exercise capacity in a cohort of patients with heart failure and preserved ejection fraction (HFpEF) and predominantly postcapillary pulmonary hypertension. Here, we present the effects of sildenafil on cardiac structure and function, cardiopulmonary exercise testing, laboratory parameters and health-related quality of life measures. METHODS AND RESULTS: Fifty-two HFpEF patients with pulmonary hypertension (mean pulmonary artery pressure >25 mmHg; pulmonary artery wedge pressure >15 mmHg) were randomized to sildenafil 60 mg three times a day or placebo and treated for 12 weeks...
November 21, 2016: European Journal of Heart Failure
https://www.readbyqxmd.com/read/27873135/left-atrium-the-last-bulwark-before-overt-heart-failure
#16
Matteo Cameli, Giulia Elena Mandoli, Sergio Mondillo
Heart failure (HF) with preserved ejection fraction (HFpEF) has emerged as an important public health issue in recent years. It represents the most common type of HF in ambulatory setting, and it has been recognized as a different entity from the reduced ejection fraction (EF) form. In HFpEF, continuous growing attention has been focused on the role of the left atrium (LA) in preserving good ventricular function and asymptomatic condition of the patient since the very first stages of diastolic dysfunction (DD)...
November 22, 2016: Heart Failure Reviews
https://www.readbyqxmd.com/read/27872509/diagnostic-utility-of-ang-in-coronary-heart-disease-complicating-chronic-heart-failure-a-cross-sectional-study
#17
Peng Yu, Ming Liu, Xue Yang, Ying Yu, Ji Zhao, Lei Zhang, Rui Tong, Hong Jiang, Yunzeng Zou, Junbo Ge
Angiogenin (ANG) has been shown to be elevated in several cardiovascular diseases. To detect its levels and diagnostic capacity in coronary heart disease (CHD) patients complicating chronic heart failure (CHF), we performed this cross-sectional study and enrolled 616 CHD patients and 53 healthy controls. According to complicating CHF or not, the patients were divided into CHF group (n = 203) and CHD disease controls (n = 413), in which the CHF group was subdivided as heart failure with reduced ejection fraction (HFrEF) group or heart failure with preserved ejection fraction (HFpEF) group on the basis of left ventricular ejection fraction (LVEF), or as different NYHA class group...
2016: Disease Markers
https://www.readbyqxmd.com/read/27871223/patients-with-hfpef-and-hfref-have-different-clinical-characteristics-but-similar-prognosis-a-retrospective-cohort-study
#18
Tamrat Befekadu Abebe, Eyob Alemayehu Gebreyohannes, Yonas Getaye Tefera, Tadesse Melaku Abegaz
BACKGROUND: Globally, heart failure (HF) has been recognized as one of the major cardiovascular disorder with high morbidity, mortality and considerable social impact. In Sub Saharan African countries, HF has turned out as a leading form of cardiovascular diseases, and has considerable socioeconomic impact. However, there are differences in clinical characteristics and survival status among patients with preserved (HFpEF) and reduced (HFrEF) ejection fraction. The aim of this study is to outline the clinical characteristics and medication profile, assess the survival status and prognostic factors of Ethiopian HF patients with HFrEF and HFpEF...
November 21, 2016: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/27870971/modes-of-death-in-patients-with-heart-failure-and-preserved-ejection-fraction
#19
Stefan Aschauer, Caroline Zotter-Tufaro, Franz Duca, Andreas Kammerlander, Daniel Dalos, Julia Mascherbauer, Diana Bonderman
BACKGROUND: Recent studies suggest that reduced right ventricular function is an important predictor of outcome in patients with heart failure and preserved ejection fraction (HFpEF). Because affected patients suffer from a broad spectrum of non-cardiac co-morbidities, it remains unclear, whether they actually die from right heart failure (RHF) or as a consequence of other conditions. METHODS: Consecutive patients with a confirmed diagnosis of HFpEF were enrolled in this prospective registry...
November 18, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27867290/ranolazine-is-an-effective-and-safe-treatment-of-adults-with-symptomatic-premature-ventricular-contractions-due-to-triggered-ectopy
#20
Gary L Murray
Early and delayed afterdepolarizations (EAD/DAD) cause triggered ventricular ectopy. Because ranolazine (RAN) suppresses EAD/DAD, we postulated that RAN might be effective in reducing premature ventricular contractions (PVCs). To assess the effect of RAN in patients with symptomatic PVCs due to triggered ectopy and its safety and tolerability. A total of 59 patients with symptomatic PVCs were identified from full-disclosure Holters. Doses of 500 and 1,000 mg offlabel RAN, daily, were given to 34 and 66% patients, respectively, and repeat Holters were performed prospectively during mean followup of 3...
December 2016: International Journal of Angiology: Official Publication of the International College of Angiology, Inc
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