Article
Cardiac & Cardiovascular Systems
Sebastian Rosch, Karl-Patrik Kresoja, Christian Besler, Karl Fengler, Anne Rebecca Schoeber, Maximilian von Roeder, Christian Luecke, Matthias Gutberlet, Karin Klingel, Holger Thiele, Karl-Philipp Rommel, Philipp Lurz
Summary: In this study, patients with heart failure with preserved ejection fraction (HFpEF) were stratified based on left ventricular ejection fraction (LVEF), resulting in distinct morphologic and pathophysiologic subphenotypes. Patients with LVEF ranging from 50% to 60% demonstrated reduced contractility, impaired ventriculo-arterial coupling, and higher extracellular volume fraction, while patients with LVEF >60% exhibited a hypercontractile state with excessive left ventricular afterload and diminished preload reserve.
Article
Cardiac & Cardiovascular Systems
Martin R. Cowie, Jakob Schoepe, Stefan Wagenpfeil, Luigi Tavazzi, Michael Boehm, Piotr Ponikowski, Stefan D. Anker, Gerasimos S. Filippatos, Michel Komajda
Summary: The international QUALIFY Registry suggests that few patients with HFrEF achieve target doses of disease-modifying medication, especially older patients and those with co-morbidity. Urgent quality improvement initiatives are required.
Review
Medicine, General & Internal
Nikolaos Karamichalakis, Andrew Xanthopoulos, Filippos Triposkiadis, Ioannis Paraskevaidis, Elias Tsougos
Summary: The article points out that there is an unmet need for the treatment of HFpEF. This is mainly due to the fact that HFpEF represents a category of diseases with entirely different characteristics, leading to controversies regarding the definition of the LVEF normal range and LVEF cut-offs. Current HFpEF trials have shown that neurohormonal and SGLT2 inhibitors are effective in HF patients over a wide LVEF range, suggesting that these treatments should be considered for HFpEF patients with hypertension.
JOURNAL OF CLINICAL MEDICINE
(2022)
Review
Medicine, General & Internal
Eldad Rahamim, Dean Nachman, Oren Yagel, Merav Yarkoni, Gabby Elbaz-Greener, Offer Amir, Rabea Asleh
Summary: Heart failure with reduced ejection fraction (HFrEF) is a clinical condition associated with impaired cardiac contractility, characterized by pathological left ventricular (LV) remodeling and progressive dilatation, leading to adverse clinical outcomes. Recent novel pharmacological therapies, such as ARNI, SGLT2i, vericiguat, and omecamtiv mecarbil, have shown improved clinical benefits when added to standard care, leading to a significant paradigm shift in the medical treatment of HFrEF. These therapies have emerged at an exciting rate, with landmark clinical trials demonstrating their additive clinical benefits in patients with HFrEF and providing a suggestive paradigm of pharmacological therapy according to the 2021 ESC guidelines.
JOURNAL OF CLINICAL MEDICINE
(2021)
Letter
Medicine, General & Internal
Debdatta Bhattacharyya, Ayan Kar, Saurabh Dhumale, Filippos K. Triposkiadis, Andrew Xanthopoulos, Efstathios K. Iliodromitis, James Amato, Hiddo J. L. Heerspink, Lesley Inker, Tom Greene, Stefan D. Anker, Javed Butler, Milton Packer
Summary: In patients with heart failure and preserved ejection fraction, Empagliflozin reduced the incidence of primary outcome events compared to other drugs, but had higher rates of cardiovascular death, death from any cause, and hospitalization for heart failure compared to spironolactone.
NEW ENGLAND JOURNAL OF MEDICINE
(2022)
Letter
Medicine, General & Internal
Elric Zweck, Ralf Westenfeld, Bjorn Redfors, Elmir Omerovic, Robin A. P. Weir, Domenico Gabrielli, Fabrizio Oliva, Giuseppe Zuccala, Scott D. Solomon, Muthiah Vaduganathan, John J. V. McMurray
Summary: Solomon et al. report on the DELIVER trial, which showed that dapagliflozin reduced risks of heart failure-related outcomes in patients with a mildly reduced or preserved left ventricular ejection fraction. These findings are expected to influence guidelines and clinical practice. The trial also confirmed dapagliflozin's efficacy in patients with a left ventricular ejection fraction of 60% or above.
NEW ENGLAND JOURNAL OF MEDICINE
(2023)
Article
Cardiac & Cardiovascular Systems
Chris J. Kapelios, Lars H. Lund, Lina Benson, Ulf Dahlstrom, Giuseppe M. C. Rosano, Paul J. Hauptman, Gianluigi Savarese
Summary: This study aimed to assess the association between clinical characteristics and digoxin use, as well as the association between digoxin use and mortality/morbidity in patients with HF with reduced ejection fraction (HFrEF) stratified by history of atrial fibrillation (AF). The study found that digoxin use was associated with lower mortality/morbidity in patients with AF, but with higher mortality/morbidity in patients without AF.
EUROPEAN HEART JOURNAL-CARDIOVASCULAR PHARMACOTHERAPY
(2022)
Article
Cardiac & Cardiovascular Systems
Khawaja M. M. Talha, Javed Butler, Stephen J. J. Greene, Rahul Aggarwal, Stefan D. D. Anker, Brian L. Claggett, Scott D. D. Solomon, John J. V. McMurray, Muthiah Vaduganathan, Gregg C. C. Fonarow
Summary: The expansion of SGLT-2 inhibitor use in patients with HF and LVEF more than 40% following the EMPEROR-Preserved and the DELIVER trials has significant implications in the US. This study quantified the potential impact of reducing worsening HF events with SGLT-2 inhibitors in individuals with LVEF more than 40% at the population level in the US. The findings suggest that optimal implementation of SGLT-2 inhibitor therapy in this population could prevent/postpone approximately 250,000 worsening HF events over 3 years in the US.
Article
Cardiac & Cardiovascular Systems
Shinsuke Takeuchi, Takashi Kohno, Ayumi Goda, Yasuyuki Shiraishi, Mike Saji, Yuji Nagatomo, Toshikazu D. Tanaka, Makoto Takei, Shintaro Nakano, Kyoko Soejima, Shun Kohsaka, Tsutomu Yoshikawa
Summary: The suitability of the SGLT2 inhibitor empagliflozin for heart failure patients in the real-world setting is unclear despite its benefits. The applicability of trial findings in patients with malnutrition is important due to the unique pharmacological profile of SGLT2 inhibitors and the increasing aging population with heart failure.
INTERNATIONAL JOURNAL OF CARDIOLOGY
(2023)
Article
Peripheral Vascular Disease
Alexandros Kasiakogias, Enrico Agabiti Rosei, Miguel Camafort, Georg Ehret, Luca Faconti, Joao Pedro Ferreira, Jana Brguljan, Andrzej Januszewicz, Thomas Kahan, Athanasios Manolis, Konstantinos Tsioufis, Thomas Weber, Thomas G. von Lueder, Otto A. Smiseth, Kristian Wachtell, Sverre E. Kjeldsen, Faiez Zannad, Giuseppe Mancia, Reinhold Kreutz
Summary: Hypertension is a major risk factor for HFpEF, and while specific guideline-directed medical therapy is not established, control of blood pressure is widely regarded as central to prevention and clinical care.
JOURNAL OF HYPERTENSION
(2021)
Article
Cardiac & Cardiovascular Systems
Jonathan W. Cunningham, Muthiah Vaduganathan, Brian L. Claggett, Ian J. Kulac, Akshay S. Desai, Pardeep S. Jhund, Rudolf A. de Boer, David DeMets, Adrian F. Hernandez, Silvio E. Inzucchi, Mikhail N. Kosiborod, Carolyn S. P. Lam, Felipe Martinez, Sanjiv J. Shah, Martina M. McGrath, Eileen O'Meara, Ulrica Wilderang, Daniel Lindholm, Magnus Petersson, Anna Maria Langkilde, John J. McMurray, Scott D. Solomon
Summary: This study investigates the clinical outcomes and response to dapagliflozin in patients with HF, finding that dapagliflozin safely reduces the risk of worsening HF or cardiovascular death in patients recently hospitalized for HF.
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY
(2022)
Review
Medicine, General & Internal
Hidekatsu Fukuta, Hiromi Hagiwara, Takeshi Kamiya
Summary: This meta-analysis aims to evaluate the efficacy and safety of SGLT-2 inhibitors in patients with HFpEF, focusing on outcomes such as HF severity and health-related quality of life.
Article
Cardiac & Cardiovascular Systems
Christopher A. Miller, Abdallah Al-Mohammad, Janine Beezer, Emma Columbine, David Cotterell, Simon Fisher, Nick Hartshorne-Evans, Laurence Humphreys-Davies, Rebecca Hyland, R. Thomas Lumbers, Gerry P. McCann, Maria F. Paton, Mark C. Petrie, Shaun Robinson, Cathie Sudlow, Richard Cleverley, Andy Smith, Mike Wardle, Sarah Worsnop, Charlotte Manisty, James Moon, Steffen E. Petersen, Satheesh Balakrishnan Nair, Andrew Clegg, Jivendra Gosai, Mayooran Shanmuganathan, Catriona Bhagra, Christi Deaton, Joanne Bateman, Jennifer Llewellyn, Rhys Williams, Asok Venkatamaran, Rebekah Schiff, Andrew L. Clark, Martin R. Wilkins, Lee-Anne Penn, Sinead O'Driscoll, Ajay M. Shah, Rosita Zakeri, Kevin O'Gallagher, Manuel Mayr, Kate Gatenby, John P. Greenwood, Sven Plein, Prathap Kanagala, Fardad Soltani, Rachael Arnold, Swapna Kunhunny, Adam K. Mcdiarmid, Azfar Zaman, Colin Berry, Marc R. Dweck, Chim Lang, Ify Mordi, Pankaj Garg, Matthew Dewhurst, Karen Hann, David P. Ripley, Thomas Green, Fady Magdy, Stefan Neubauer, Oliver Rider, Sanjay K. Prasad, Chiara Bucciarelli-Ducci, Andrew J. Ludman, Ameet Bakhai, Thomas Jackson, David Austin, Patricia Campbell, Lisa J. Anderson, Andrew Flett, Paul Haydock, Peysh Patel, Rick Steeds, Prithwish Banerjee, Raj Chahal, Iain Squire, Susanna Dodd, Niels Peek, Jamil Mayet, Pierre Le Page, Mike Chapman
Summary: The UK HFpEF study aims to develop a comprehensive data resource to identify disease endotypes and improve diagnostic strategies, risk stratification, and targeted therapeutics.
Article
Cardiac & Cardiovascular Systems
Michiel T. H. M. Henkens, Jerremy Weerts, Job A. J. Verdonschot, Anne G. Raafs, Sophia Stroeks, Maurits A. Sikking, Hesam Amin, Sanne G. J. Mourmans, Chrit B. G. Geraeds, Sandra Sanders-van Wijk, Arantxa Barandiaran Aizpurua, Nicole H. M. K. Uszko-Lencer, Ingrid P. C. Krapels, Petra F. G. Wolffs, Han G. Brunner, Rick E. W. Leeuwen, Wouter Verhesen, Simon M. Schalla, Antonius W. M. Stipdonk, Christian Knackstedt, Xiaofei Li, Myrurgia A. Abdul Hamid, Pieter Paassen, Mark R. Hazebroek, Kevin Vernooy, Hans-Peter Brunner-La Rocca, Vanessa P. M. Empel, Stephane R. B. Heymans
Summary: The Maastricht Cardiomyopathy registry aims to improve diagnosis, risk stratification, and management of cardiomyopathy phenotypes beyond the limits of left ventricular ejection fraction. The registry collects patient characteristics, diagnostic measurements, treatment information, biobanking, quality of life assessment, and regular follow-up. It uses a data-driven approach and a hypothesis-driven approach to answer research questions.
Article
Cardiac & Cardiovascular Systems
Stephen J. Greene, Sujung Choi, Steven J. Lippmann, Robert J. Mentz, Melissa A. Greiner, N. Chantelle Hardy, Bradley G. Hammill, Nancy Luo, Marc D. Samsky, Paul A. Heidenreich, Warren K. Laskey, Clyde W. Yancy, Pamela N. Peterson, Lesley H. Curtis, Adrian F. Hernandez, Gregg C. Fonarow, Emily C. O'Brien
Summary: In older patients hospitalized for HFrEF in the US, the study found that discharge prescription of sacubitril/valsartan was independently associated with lower all-cause mortality, lower all-cause hospitalization, and lower heart failure hospitalization compared with angiotensin-converting enzyme inhibitors/angiotensin II receptor blockers. These findings support the use of sacubitril/valsartan to improve postdischarge outcomes in routine clinical practice.
JOURNAL OF THE AMERICAN HEART ASSOCIATION
(2021)
Article
Cardiac & Cardiovascular Systems
Neil M. Kalwani, Jamie Calma, George M. Varghese, Anshal Gupta, Jimmy Zheng, Cati Brown-Johnson, Alexis Amano, Stacie Vilendrer, Marcy Winget, Steven M. Asch, Paul Heidenreich, Alexander Sandhu
Summary: This study aims to improve the health status of heart failure patients by routinely assessing their patient-reported health status and sharing the results with their treating clinicians. The study will evaluate the change in health status over 1 year, as well as the impact on heart failure therapy patterns and healthcare utilization. Additionally, it will assess patient experience and the accuracy of clinician-assessed health status.
AMERICAN HEART JOURNAL
(2023)
Article
Cardiac & Cardiovascular Systems
Alexander T. Sandhu, Jimmy Zheng, Neil M. Kalwani, Anshal Gupta, Jamie Calma, Megan Skye, Roy Lan, Brian Yu, John A. Spertus, Paul A. Heidenreich
Summary: This study examined whether collecting patient-reported health status improves the accuracy of clinician assessments in heart failure clinic. The results showed that using the Kansas City Cardiomyopathy Questionnaire-12 (KCCQ-12) improved clinicians' accuracy of health status assessment and patients felt that their clinicians better understood their symptoms.
CIRCULATION-HEART FAILURE
(2023)
Review
Cardiac & Cardiovascular Systems
Veena Manja, Ananya Nrusimha, Ya Gao, Aleesha Sheikh, Mark McGovern, Paul A. Heidenreich, Alex Tarlochan Singh Sandhu, Steven Asch
Summary: This systematic review found that the prevalence of Methamphetamine-associated heart failure (MethHF) is increasing, affecting various racial/ethnic/sociodemographic groups with a male predominance. The study highlights the importance of methamphetamine abstinence, female sex, and guideline-directed heart failure therapy in improving outcomes. However, there is heterogeneity in study design, population, comparator, and outcome assessment, preventing the combination of results and resulting in low certainty in the evidence. Prospective studies are urgently needed to accurately assess the epidemiology, clinical features, disease trajectory, and outcomes of MethHF.
Letter
Cardiac & Cardiovascular Systems
Celina Yong, Aashna Suvarna, Robert Harrington, Santosh Gummidipundi, Harlan M. Krumholz, Roxana Mehran, Paul Heidenreich
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY
(2023)
Article
Cardiac & Cardiovascular Systems
Celeste Witting, Jimmy Zheng, Rebecca L. Tisdale, Evan Shannon, Shun Kohsaka, Eldrin F. Lewis, Paul Heidenreich, Alexander Sandhu
Summary: This study examined the rates of guideline-directed medical therapy (GDMT) in patients with recently diagnosed heart failure and explored the disparities based on sociodemographic characteristics. The findings showed that racial and ethnic minorities had similar or higher rates of GDMT compared to White patients. However, patients living in socially vulnerable neighborhoods and farther from specialty care were less likely to receive appropriate doses of treatment.
JACC-HEART FAILURE
(2023)
Article
Cardiac & Cardiovascular Systems
Ryo Nakamaru, Yasuyuki Shiraishi, Alexander T. Sandhu, Paul A. Heidenreich, Satoshi Shoji, Takashi Kohno, Makoto Takei, Yuji Nagatomo, Shintaro Nakano, Shun Kohsaka, Tsutomu Yoshikawa
Summary: The long-term outcome in heart failure patients after hospitalization varies depending on age and left ventricular ejection fraction (LVEF). Cardiovascular death (CVD) rates are higher in older patients and in those with lower LVEF. Non-CVD rates increase with age and are higher in the HFpEF category. Treating heart failure in older patients, especially those with HFpEF, requires more than just mitigating cardiovascular outcomes.
Article
Medicine, General & Internal
Nazima Allaudeen, Christopher F. Millhouse, David B. Huberman, Hui Wang, Paul A. Heidenreich
Summary: Despite the benefits of palliative care consultation, it is not widely used. Hospital admission provides a crucial opportunity to provide this service.
Editorial Material
Cardiac & Cardiovascular Systems
Paul A. Heidenreich
JACC-CARDIOVASCULAR IMAGING
(2023)
Article
Cardiac & Cardiovascular Systems
Krishna Pundi, Alexander C. Perino, Jun Fan, Natasha Din, Karolina Szummer, Paul Heidenreich, Mintu P. Turakhia
Summary: High CHA2DS2-VASc and HAS-BLED scores are strongly associated with frailty. However, in frail patients, oral anticoagulant use is associated with a reduction in 1-year mortality, but not a significant decrease in the risk of stroke or major bleeding. Therefore, more prospective studies are needed to support clinical decision-making.
AMERICAN HEART JOURNAL
(2023)
Editorial Material
Cardiac & Cardiovascular Systems
Paul Heidenreich
Editorial Material
Cardiac & Cardiovascular Systems
Paul A. Heidenreich, Francois Haddad, Victoria N. Parikh
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY
(2023)
Meeting Abstract
Cardiac & Cardiovascular Systems
Krishna Pundi, Jun Fan, Natasha Din, Alex Sandhu, Paul A. Heidenreich, Mintu Turakhia
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY
(2023)
Review
Cardiac & Cardiovascular Systems
Salim S. Virani, Karen Aspry, Dave L. Dixon, Keith C. Ferdinand, Paul A. Heidenreich, Elizabeth J. Jackson, Terry A. Jacobson, Janice L. McAlister, David R. Neff, Martha Gulati, Christie M. Ballantyne
Summary: Despite the established role of LDL-C as a major risk factor for CVD, national quality assurance metrics no longer include LDL-C measurement as a required performance metric. This article reviews the history of LDL-C as a quality and performance metric and presents rationales for re-establishing LDL-C measurement to improve cholesterol control and reduce CVD morbidity and mortality, healthcare disparities, and costs.
AMERICAN JOURNAL OF PREVENTIVE CARDIOLOGY
(2023)
Article
Health Care Sciences & Services
Ella Atsavapranee, Paul Heidenreich, Mystique Smith-Bentley, Alpa Vyas, Lisa Shieh
Summary: This study examined the impact of room type on patients' likelihood to recommend Stanford Health Care. It found that patients in private rooms were more likely to recommend the hospital compared to those in semi-private rooms. Service lines with only private rooms had the highest likelihood of receiving top responses. The study also showed that the new hospital had higher top box scores, indicating the influence of room type and hospital environment on patients' likelihood to recommend.
JOURNAL OF PATIENT EXPERIENCE
(2023)
Correction
Cardiac & Cardiovascular Systems
Daniela Tomasoni, Marianna Adamo, Biykem Bozkurt, Paul Heidenreich, Theresa McDonagh, Giuseppe M. C. Rosano, Sean A. Virani, Shelley Zieroth, Marco Metra
EUROPEAN HEART JOURNAL SUPPLEMENTS
(2023)