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heart failure with preserved ejection

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https://www.readbyqxmd.com/read/28214792/suppression-of-tumorigenicity-2-in-heart-failure-with-preserved-ejection-fraction
#1
Omar F AbouEzzeddine, Paul M McKie, Shannon M Dunlay, Susanna R Stevens, G Michael Felker, Barry A Borlaug, Horng H Chen, Russell P Tracy, Eugene Braunwald, Margaret M Redfield
BACKGROUND: Soluble suppression of tumorigenicity 2 (sST2) receptor is a biomarker that is elevated in certain systemic inflammatory diseases. Comorbidity-driven microvascular inflammation is postulated to play a key role in heart failure with preserved ejection fraction (HFpEF) pathophysiology, but data on how sST2 relates to clinical characteristics or inflammatory conditions or biomarkers in HFpEF are limited. We sought to determine circulating levels and clinical correlates of sST2 in HFpEF...
February 18, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28214151/association-of-types-of-dyspnea-including-bendopnea-with-cardiopulmonary-disease-in-primary-care
#2
Diana María Martínez Cerón, Maria Luiza Garcia Rosa, Antônio Jose Lagoeiro Jorge, Wolney de Andrade Martins, Evandro Tinoco Mesquita, Monica Di Calafriori Freire, Dayse Mary da Silva Correia, Hye Chung Kang
INTRODUCTION: Dyspnea is the symptom most commonly reported by patients with heart failure (HF) and/or pulmonary disease, the obese and the elderly. Recently 'bendopnea' (shortness of breath when bending forward) has been described in patients with HF. OBJECTIVE: To determine the association of exertional dyspnea, orthopnea, paroxysmal nocturnal dyspnea and bendopnea with chronic disease, especially heart failure, and their phenotypes in primary care. METHODS: This cross-sectional study included 633 individuals aged between 45 and 99 years enrolled in a primary care program in Niteroi, Brazil...
February 14, 2017: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
https://www.readbyqxmd.com/read/28212137/long-term-prognosis-after-acute-heart-failure-a-differential-impact-of-age-in-different-age-strata
#3
Paulo Bettencourt, Pedro Rodrigues, Helena Moreira, Pedro Marques, Patricia Lourenco
BACKGROUND: Increasing age predicts ominous prognosis in heart failure. Age influences the success of therapeutic approaches and interacts with other prognostic predictors. We aimed to study the impact of age in long-term survival in different age strata. METHODS: Patients were prospectively included in an acute heart failure registry; those with acute coronary syndromes and those with primary valvular disease were excluded. Outcome studied was all-cause mortality...
February 15, 2017: Journal of Cardiovascular Medicine
https://www.readbyqxmd.com/read/28210939/deep-phenotyping-of-systemic-arterial-hemodynamics-in-hfpef-part-1-physiologic-and-technical-considerations
#4
REVIEW
Julio A Chirinos
A better understanding of the pathophysiology of heart failure with a preserved left ventricular ejection fraction (HFpEF) is important. Detailed phenotyping of pulsatile hemodynamics has provided important insights into the pathophysiology of left ventricular remodeling and fibrosis, diastolic dysfunction, microvascular disease, and impaired oxygen delivery to peripheral skeletal muscle, all of which contribute to exercise intolerance, the cardinal feature of HFpEF. Furthermore, arterial pulsatile hemodynamic mechanisms likely contribute to the frequent presence of comorbidities, such as renal failure and dementia, in this population...
February 16, 2017: Journal of Cardiovascular Translational Research
https://www.readbyqxmd.com/read/28209765/renin-angiotensin-system-inhibition-worsening-renal-function-and-outcome-in-heart-failure-patients-with-reduced-and-preserved-ejection-fraction-a-meta-analysis-of-published-study-data
#5
Iris E Beldhuis, Koen W Streng, Jozine M Ter Maaten, Adriaan A Voors, Peter van der Meer, Patrick Rossignol, John J V McMurray, Kevin Damman
BACKGROUND: Renin-angiotensin aldosterone system (RAAS) inhibitors significantly improve outcome in heart failure (HF) patients with reduced ejection fraction (HFREF), irrespective of the occurrence of worsening renal function (WRF). However, in HF patients with preserved ejection fraction (HFPEF), RAAS inhibitors have not been shown to improve outcome but are still frequently prescribed. METHODS AND RESULTS: Random effect meta-analysis was performed to investigate the relationship between RAAS inhibitor therapy, WRF in both HF phenotypes, and mortality...
February 2017: Circulation. Heart Failure
https://www.readbyqxmd.com/read/28209386/dietary-therapy-in-heart-failure-with-preserved-ejection-fraction-and-or-left-ventricular-diastolic-dysfunction-in-patients-with-metabolic-syndrome
#6
REVIEW
Helene von Bibra, Alexander Ströhle, Martin St John Sutton, Nicolai Worm
BACKGROUND: Heart failure is an ongoing epidemic of left ventricular (LV) dilatation and/or dysfunction due to the increasing prevalence of predisposing risk factors such as age, physical inactivity, (abdominal) obesity, and type-2-diabetes. Approximately half of these patients have diastolic heart failure (HFpEF). The prognosis of HFpEF is comparable to that of systolic heart failure, but without any known effective treatment. DIASTOLIC DYSFUNCTION: A biomathematically corrected diagnostic approach is presented that quantifies diastolic dysfunction via the predominant age dependency of LV diastolic function and unmasks (metabolic) risk factors, that are independent of age and, therefore, potential targets for therapy...
January 5, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28205040/clinical-phenotyping-of-heart-failure-with-biomarkers-current-and-future-perspectives
#7
REVIEW
Vichai Senthong, Jennifer L Kirsop, W H Wilson Tang
INTRODUCTION: Heart failure (HF) is a complex clinical syndrome with diverse risk factors and etiologies, differing underlying pathophysiology, and large phenotypic heterogeneity. RECENT FINDINGS: Advances in imaging techniques coupled with clinical trials that targeted only in those with impaired left ventricular ejection fraction (LVEF) have largely shaped the current management strategy for HF that focuses predominantly in patients with systolic HF. In contrast, there are no effective treatments for HF with preserved ejection fraction (HFpEF)...
February 15, 2017: Current Heart Failure Reports
https://www.readbyqxmd.com/read/28202885/tolvaptan-reduces-the-risk-of-worsening-renal-function-in-patients-with-acute-decompensated-heart-failure-and-preserved-left-ventricular-ejection-fraction%C3%A3-prospective-randomized-controlled-study
#8
Shunsuke Tamaki, Yoshihiro Sato, Takahisa Yamada, Takashi Morita, Yoshio Furukawa, Yusuke Iwasaki, Masato Kawasaki, Atsushi Kikuchi, Takumi Kondo, Tatsuhisa Ozaki, Masahiro Seo, Iyo Ikeda, Eiji Fukuhara, Makoto Abe, Jun Nakamura, Masatake Fukunami
BACKGROUND: Although the mainstay of treatment for acute decompensated heart failure (ADHF) is decongestion by diuretic therapy, it is often associated with worsening renal function (WRF). The effect of tolvaptan, a selective V2 receptor antagonist, on WRF in ADHF patients with preserved left ventricular ejection fraction (LVEF) is unknown.Methods and Results:We enrolled 50 consecutive ADHF patients whose LVEF on admission was ≥45%. Patients were randomly assigned to either tolvaptan add-on (n=26) or conventional diuretic therapy (n=24)...
February 16, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28199339/presence-of-%C3%A2-isolated%C3%A2-tricuspid-regurgitation-should-prompt-the-suspicion-of-heart-failure-with-preserved-ejection-fraction
#9
Julia Mascherbauer, Andreas A Kammerlander, Caroline Zotter-Tufaro, Stefan Aschauer, Franz Duca, Daniel Dalos, Susanne Winkler, Matthias Schneider, Jutta Bergler-Klein, Diana Bonderman
BACKGROUND: Diastolic dysfunction of the left ventricle is common but frequently under-diagnosed. Particularly in advanced stages affected patients may present with significant functional tricuspid regurgitation (TR) as the most prominent sign on echocardiography. The underlying left ventricular pathology may eventually be missed and symptoms of heart failure are attributed to TR, with respective therapeutic consequences. The aim of the present study was to determine prevalence and mechanisms underlying TR evolution in heart failure with preserved ejection fraction (HFpEF)...
2017: PloS One
https://www.readbyqxmd.com/read/28197277/scoring-system-based-on-electrocardiogram-features-to-predict-the-type-of-heart-failure-in-patients-with-chronic-heart-failure
#10
Purnasidha Bagaswoto Hendry, Lucia Krisdinarti, Maharani Erika
BACKGROUND: Heart failure (HF) is divided into heart failure with reduced ejection fraction (HFrEF) and heart failure with preserved ejection fraction (HFpEF). Mortality from HF is inversely related to left ventricular function. Additional studies are required to distinguish between these two types of HF. A previous study showed that HFrEF is less likely when electrocardiogram (ECG) findings are normal. This study aims to create a scoring system based on ECG findings that will predict the type of HF...
June 2016: Cardiology Research
https://www.readbyqxmd.com/read/28196483/aortic-stiffening-precedes-onset-of-heart-failure-with-preserved-ejection-fraction-in-patients-with-asymptomatic-diastolic-dysfunction
#11
Ilya Karagodin, Omer Aba-Omer, Rodney Sparapani, Jennifer L Strande
BACKGROUND: Identifying which patients with diastolic dysfunction will progress to heart failure with preserved ejection fraction (HFpEF) remains challenging. The goal of this study is to determine whether increased vascular stiffness as identified on 2D transthoracic echocardiography (TTE) serves as a biomarker for the development of HFpEF in patients with diastolic dysfunction. METHODS: The study design is a matched retrospective case-control study. Subjects with diastolic dysfunction were divided into two groups based on whether they had a clinical diagnosis of HFpEF...
February 14, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28194841/impaired-left-ventricular-global-longitudinal-strain-in-patients-with-heart-failure-with-preserved-ejection-fraction-insights-from-the-relax-trial
#12
Adam D DeVore, Steven McNulty, Fawaz Alenezi, Mads Ersboll, Justin M Vader, Jae K Oh, Grace Lin, Margaret M Redfield, Gregory Lewis, Marc J Semigran, Kevin J Anstrom, Adrian F Hernandez, Eric J Velazquez
BACKGROUND: While abnormal left ventricular (LV) global longitudinal strain (GLS) has been described in patients with heart failure with preserved ejection fraction (HFpEF), its prevalence and clinical significance are poorly understood. METHODS AND RESULTS: Patients enrolled in the RELAX trial of sildenafil in HFpEF (LV ejection fraction ≥50%) in whom two-dimensional, speckle-tracking LV GLS was possible (n = 187) were analysed. The distribution of LV GLS and its associations with clinical characteristics, LV structure and function, biomarkers, exercise capacity and quality of life were assessed...
February 14, 2017: European Journal of Heart Failure
https://www.readbyqxmd.com/read/28188451/patients-with-cheyne-stokes-respiration-and-heart-failure-patient-tolerance-after-three-month-discontinuation-of-treatment-with-adaptive-servo-ventilation
#13
Arild Hetland, Tøri Vigeland Lerum, Kristina H Haugaa, Thor Edvardsen
The recent SERVE HF study concluded that patients with chronic heart failure (CHF) and Cheyne-Stokes respiration (CSR) have increased mortality when treated with adaptive servo-ventilation (ASV). We, therefore, wanted to explore if these patients tolerated discontinuation of ASV treatment. The study was a prospective post-ASV treatment observational design with a 3-month follow-up period. 14 patients from our outpatient clinic, all male, were originally diagnosed with CHF and Cheyne-Stokes respiration, which is a clinical form of central sleep apnea...
February 11, 2017: Heart and Vessels
https://www.readbyqxmd.com/read/28185703/bnp-and-obesity-in-acute-decompensated-heart-failure-with-preserved-vs-reduced-ejection-fraction-the-atherosclerosis-risk-in-communities-surveillance-study
#14
Umair Khalid, Lisa Miller Wruck, Pedro Miguel Quibrera, Biykem Bozkurt, Vijay Nambi, Salim S Virani, Hani Jneid, Sunil Agarwal, Patricia P Chang, Laura Loehr, Sukhdeep Singh Basra, Wayne Rosamond, Christie M Ballantyne, Anita Deswal
BACKGROUND: Levels of B-type natriuretic peptide (BNP), a prognostic marker in patients with heart failure (HF), are lower among HF patients with obesity or preserved Left Ventricular Ejection Fraction (LVEF). We examined the distribution and prognostic value of BNP across BMI categories in acute decompensated heart failure (ADHF) patients with preserved vs. reduced LVEF. METHODS: We analyzed data from the Atherosclerosis Risk in Communities (ARIC) HF surveillance study which sampled and adjudicated ADHF hospitalizations in patients aged ≥55years from 4 US communities (2005-2009)...
January 31, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28185233/sympathetic-drive-stimulating-diastolic-dysfunction
#15
EDITORIAL
Saad S Ahmad, Myron C Gerson
Diastolic heart failure accounts for half of the heart failure population and its pathophysiology remains an area of active research. The renin angiotensin and aldosterone axis has been the focus of clinical trials to treat patients with heart failure with preserved ejection fraction, however with limited yield in terms of clinical success. Sympathetic activity has been considered a plausible cause for the molecular changes that lead to diastolic dysfunction. Based on this understanding the study by Gimelli et al uses MIBG to evaluate for association between diastolic dysfunction and sympathetic denervation...
February 9, 2017: Journal of Nuclear Cardiology: Official Publication of the American Society of Nuclear Cardiology
https://www.readbyqxmd.com/read/28184100/clinical-question-in-congestive-heart-failure-patients-with-preserved-ejection-fraction-does-spironolactone-improve-cardiac-outcomes
#16
Leslie Williams, Cheyn Onarecker
CLINICAL QUESTION: In congestive heart failure patients with preserved ejection fraction, does spironolactone improve cardiac outcomes? ANSWER: No. A randomized controlled trial of patients with heart failure and an ejection fraction > 45% showed that spironolactone did not significantly reduce the incidence of the primary composite outcome of death from cardiovascular causes, aborted cardiac arrest, or hospitalization for the management of heart failure. LEVEL OF EVIDENCE FOR THE ANSWER: A...
September 2016: Journal of the Oklahoma State Medical Association
https://www.readbyqxmd.com/read/28181258/cardiac-diastolic-and-autonomic-dysfunction-are-aggravated-by-central-chemoreflex-activation-in-hfpef-rats
#17
Camilo Toledo, David C Andrade, Claudia Lucero, Alexis Arce-Alvarez, Hugo S Díaz, Valentín Aliaga, Harold D Schultz, Noah J Marcus, Mónica Manríquez, Marcelo Faúndez, Rodrigo Del Rio
Heart failure (HF) patients with preserved ejection fraction (HFpEF) display irregular breathing, sympatho-vagal imbalance, arrhythmias, and diastolic dysfunction. It has been shown that tonic activation of central and peripheral chemoreflex pathway plays a pivotal role in the pathophysiology of HF with reduced ejection fraction. In contrast, no studies to date have addressed chemoreflex function or its effect on cardiac function in HFpEF. Therefore, we tested whether peripheral and central chemoreflexes are hyperactive in HFpEF and if chemoreflex activation exacerbates cardiac dysfunction and autonomic imbalance...
February 8, 2017: Journal of Physiology
https://www.readbyqxmd.com/read/28181009/biomarkers-of-heart-failure-with-preserved-and-reduced-ejection-fraction
#18
Michele Senni, Emilia D'Elia, Michele Emdin, Giuseppe Vergaro
Biomarkers are increaingly being used in the management of heart failure not only for the purpose of screening, diagnosis, and risk stratification, but also as a guide to evaluate the response to treatment in the individual patient and as an entry criterion and/or a surrogate marker of efficacy in clinical trials testing novel drugs. In this chapter, we review the role of established biomarkers for heart failure management, according to the main classification of HF phenotypes, based on the measurement of left ventricular ejection fraction, including heart failure with reduced (<40%), preserved (≥50%), and, as recently proposed, mid-range (40-49%) ejection fraction...
February 9, 2017: Handbook of Experimental Pharmacology
https://www.readbyqxmd.com/read/28176630/novel-drugs-for-hypertension-and-heart-failure-struggling-for-a-place-under-the-sun
#19
Charles Faselis, Chrysoula Boutari, Michael Doumas, Konstantinos Imprialos, Konstantinos Stavropoulos, Peter Kokkinos
BACKGOUND: Current drug therapy for the management of arterial hypertension and heart failure has provided substantial benefits but has also some limitations. LCZ696, a dual inhibitor of angiotensin receptor blockers and neprilysin, and finerenone, a non-steroidal mineralocorticoid receptor antagonist, are two recently developed novel agents for the management of these conditions. METHODS: This review aims to present the pathophysiological basis for the use of these two novel drugs, critically discuss available clinical data, and provide future perspectives...
February 6, 2017: Current Pharmaceutical Design
https://www.readbyqxmd.com/read/28163048/heart-failure-with-preserved-ejection-fraction-diagnosis-and-management
#20
REVIEW
Ohad Oren, Sheldon Goldberg
Heart Failure with Preserved Ejection Fraction (HFpEF) is a prevalent condition with substantial individual and societal burden. Elucidation of the mechanisms of HFpEF is not complete. Recently, intriguing theories about the phenotypic importance of HFpEF (i.e. underlying diabetes mellitus, atrial fibrillation, obesity) have been suggested. However, it has yet to be determined if a targeted approach of that kind would help ameliorate symptoms or slow disease progression. In this article, we review the current status of understanding of HFpEF, focusing on the challenges and uncertainties regarding diagnosis and treatment...
February 2, 2017: American Journal of Medicine
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