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
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
Barry A. Borlaug, Kavita Sharma, Sanjiv J. Shah, Jennifer E. Ho
Summary: The incidence and prevalence of heart failure with preserved ejection fraction (HFpEF) is increasing due to aging, obesity, sedentariness, and cardiometabolic disorders. Despite recent advances in understanding its pathophysiological effects and introduction of new diagnosis approaches, HFpEF remains under-recognized. This is concerning as effective treatments have been identified. This article provides an in-depth examination of the epidemiology, pathophysiology, diagnosis, and treatment of HFpEF. (J Am Coll Cardiol 2023;81:1810-1834) (c) 2023 by the American College of Cardiology Foundation.
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY
(2023)
Article
Cardiac & Cardiovascular Systems
Dan Tong, Gabriele G. Schiattarella, Nan Jiang, Francisco Altamirano, Pamela A. Szweda, Abdallah Elnwasany, Dong I. Lee, Heesoo Yoo, David A. Kass, Luke I. Szweda, Sergio Lavandero, Eric Verdin, Thomas G. Gillette, Joseph A. Hill
Summary: The study demonstrated through a mouse model that HFpEF is associated with myocardial mitochondrial dysfunction, and NAD(+) supplementation is considered a promising therapeutic approach.
CIRCULATION RESEARCH
(2021)
Article
Cardiac & Cardiovascular Systems
Thassio Mesquita, Rui Zhang, Jae Hyung Cho, Rui Zhang, Yen-Nien Lin, Lizbeth Sanchez, Joshua Goldhaber, Joseph K. Yu, Jialiu A. Liang, Weixin Liu, Natalia A. Trayanova, Eugenio Cingolani
Summary: Chronotropic incompetence and sinoatrial node (SAN) dysfunction are common problems in patients with heart failure, but the underlying mechanisms are not yet fully understood. This study identified intrinsic abnormalities in SAN structure and function as the cause of chronotropic incompetence in heart failure patients with preserved ejection fraction (HFpEF).
Article
Cardiac & Cardiovascular Systems
Yogesh N. Reddy, Barry A. Borlaug, Bernard J. Gersh
Summary: Atrial fibrillation is the most common arrhythmia in heart failure patients and can be both the cause and consequence of clinical heart failure. Some patients may benefit from maintaining sinus rhythm with catheter ablation. There is a close relationship between atrial fibrillation, left atrial myopathy, mitral regurgitation, and heart failure with preserved ejection fraction, with potential clinical benefits to catheter ablation therapy. Treatment of atrial fibrillation also requires consideration of the degree of atrial myopathy and chronicity of atrial fibrillation.
Review
Pediatrics
Sophie Quennelle, Damien Bonnet
Summary: Diastolic dysfunction refers to an abnormality of the left ventricle that impairs heart filling. HFpEF, which accounts for a large proportion of acute heart failure hospitalizations in adults, is poorly recognized and understood in children. The diagnosis of diastolic dysfunction in children is challenging and the underlying causes differ from those in adults. This review focuses on the causes, prognostic factors, and diagnosis difficulties of HFpEF in children, providing a simplified diagnostic algorithm.
FRONTIERS IN PEDIATRICS
(2023)
Article
Cardiac & Cardiovascular Systems
Jan Verwerft, Lucie Soens, Jokke Wynants, Marc Meysman, Siddharth Jogani, Danielle Plein, Sarah Stroobants, Lieven Herbots, Frederik H. Verbrugge
Summary: This study provides a detailed description of hemodynamic and metabolic alterations in heart failure patients with preserved ejection fraction (HFpEF) through systematic assessment using cardiopulmonary exercise testing combined with exercise echocardiography. The study reveals various cardiac alterations and recommends further diagnostic testing and potential treatment changes in the majority of cases.
EUROPEAN HEART JOURNAL
(2023)
Article
Cardiac & Cardiovascular Systems
Jesse D. Cochran, Yoshimitsu Yura, Mark C. Thel, Heather Doviak, Ariel H. Polizio, Yuka Arai, Yohei Arai, Keita Horitani, Eunbee Park, Nicholas W. Chavkin, Anupreet Kour, Soichi Sano, Nitin Mahajan, Megan Evans, Mahalia Huba, Nadia Martinez Naya, Hanna Sun, Young Ho Ban, Karen K. Hirschi, Stefano Toldo, Antonio Abbate, Todd E. Druley, Frederick L. Ruberg, Mathew S. Maurer, Justin A. Ezekowitz, Jason R. B. Dyck, Kenneth Walsh
Summary: The study identified an enrichment of TET2-mediated CH in patients with HFpEF, which was associated with exacerbated diastolic dysfunction. Patients with HFpEF, aged >= 70 years and CH, exhibited a worse prognosis in terms of 5-year cardiovascular-related hospitalization rate compared with those without CH.
Article
Cardiac & Cardiovascular Systems
Dominique Williams, Molly J. Stout, Joshua Rosenbloom, Margaret A. Olsen, Karen E. Joynt Maddox, Elena Deych, Victor G. Davila-Roman, Kathryn J. Lindley
Summary: Preeclampsia/eclampsia is an independent risk factor for future hospitalizations for heart failure with preserved ejection fraction (HFpEF), with a median time to onset of 32.2 months and median age at HFpEF onset of 34.0 years. Traditional (hypertension, diabetes mellitus) and sociodemographic (Black race, rurality, low income) risk factors were also associated with HFpEF and secondary outcomes.
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY
(2021)
Review
Cardiac & Cardiovascular Systems
Sherif F. Nagueh
Summary: HFpEF is a prevalent form of heart failure with various cardiac and non-cardiac manifestations, diagnosis of which relies on multiple measurements. Despite increasing understanding of its pathophysiology, specific treatment for HFpEF patients remains elusive.
CARDIOVASCULAR RESEARCH
(2021)
Article
Medicine, General & Internal
Narut Prasitlumkum, Ronpichai Chokesuwattanaskul, Wisit Cheungpasitporn, Jakrin Kewcharoen, Charat Thongprayoon, Tarun Bathini, Saraschandra Vallabhajosyula, Krit Jongnarangsin
Summary: This study compared the efficacy of rhythm control and rate control in patients with HFpEF and AF, finding that rhythm control was associated with lower overall mortality rates. Further studies are needed to confirm these findings.
JOURNAL OF CLINICAL MEDICINE
(2021)
Review
Medicine, General & Internal
Agnieszka Kaplon-Cieslicka, Lars H. Lund
Summary: Heart failure with preserved ejection fraction (HFpEF) could soon be the most common type of acute heart failure, but there is still a lack of specific diagnostic criteria and definition. Acute HFpEF may be overdiagnosed in patients presenting with acute dyspnoea.
ANNALS OF MEDICINE
(2021)
Article
Cardiac & Cardiovascular Systems
Satyam Sarma, Erin Howden, Justin Lawley, Mitchel Samels, Benjamin D. Levine
Summary: Patients with HFpEF have lower peak oxygen consumption and heart rate compared to senior controls, but there were no significant differences in peak heart rate response during static handgrip exercise and metaboreceptor function between the two groups. The key reflex autonomic pathways regulating exercise heart rate responsiveness are intact in HFpEF despite lower peak exercise heart rates.
