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)
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)
Review
Cardiac & Cardiovascular Systems
Barry A. Borlaug, Michael D. Jensen, Dalane W. Kitzman, Carolyn S. P. Lam, Masaru Obokata, Oliver J. Rider
Summary: Obesity and heart failure with preserved ejection fraction (HFpEF) are two intertwining epidemics, and obesity may have widespread effects on the cardiovascular system, leading to symptomatic HFpEF. Understanding the pathophysiological mechanisms of obese HFpEF is crucial for developing new therapeutic approaches.
CARDIOVASCULAR RESEARCH
(2023)
Article
Cardiac & Cardiovascular Systems
Walter J. Paulus, Michael R. Zile
Summary: According to the comorbidity-inflammation paradigm, comorbidities, especially metabolic ones, are believed to drive the development and severity of heart failure with preserved ejection fraction. Recent evidence includes myocardial infiltration, inducible nitric oxide synthase expression, patient phenogroups, and direct connections between comorbidities, inflammatory biomarkers, and abnormal myocardial structure/function.
CIRCULATION RESEARCH
(2021)
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
Jason Roh, Joseph A. Hill, Abhilasha Singh, Maria Valero-Munoz, Flora Sam
Summary: Heart failure with preserved ejection fraction (HFpEF) is a major challenge in cardiovascular medicine. Limited success has been achieved in developing therapies due to the incomplete understanding of its pathophysiology and the heterogeneity of clinical phenotypes. This review proposes a preclinical research strategy that focuses on model diversification to better align with our evolving understanding of HFpEF heterogeneity. The importance of developing clinically relevant models and the insights provided by currently available models are discussed.
CIRCULATION RESEARCH
(2022)
Article
Cardiac & Cardiovascular Systems
Hidemi Sorimachi, Masaru Obokata, Naoki Takahashi, Yogesh N. Reddy, Christopher C. Jain, Frederik H. Verbrugge, Katlyn E. Koepp, Sundeep Khosla, Michael D. Jensen, Barry A. Borlaug
Summary: The study found that excess visceral adipose tissue plays a distinct and important role in the pathophysiology of HFpEF, especially in women. Further research is needed to better understand the mechanisms and treatment implications of visceral fat in HFpEF.
EUROPEAN HEART JOURNAL
(2021)
Article
Cardiac & Cardiovascular Systems
Hidemi Sorimachi, Kazunori Omote, Massar Omar, Dejana Popovic, Frederik H. Verbrugge, Yogesh N. Reddy, Grace Lin, Masaru Obokata, John M. Miles, Michael D. Jensen, Barry A. Borlaug
Summary: Central obesity is more common than general obesity in HFpEF, and there are significant sex differences in its relationships with metabolic abnormalities and hemodynamic perturbations, with greater impact in women.
EUROPEAN JOURNAL OF HEART FAILURE
(2022)
Article
Cardiac & Cardiovascular Systems
Hidemi Sorimachi, Masaru Obokata, Naoki Takahashi, Yogesh N. Reddy, Christopher C. Jain, Frederik H. Verbrugge, Katlyn E. Koepp, Sundeep Khosla, Michael D. Jensen, Barry A. Borlaug
Summary: Sex-specific differences in visceral adipose tissue are associated with the haemodynamic severity of HFpEF in women but not men. Increased visceral adipose tissue in women is significantly correlated with higher PCWP during exercise, while this relationship is not observed in men.
EUROPEAN HEART JOURNAL
(2021)
Article
Cardiac & Cardiovascular Systems
Alice M. Jackson, Rasmus Rorth, Jiankang Liu, Soren Lund Kristensen, Inder S. Anand, Brian L. Claggett, John G. F. Cleland, Vijay K. Chopra, Akshay S. Desai, Junbo Ge, Jianjian Gong, Carolyn S. P. Lam, Martin P. Lefkowitz, Aldo P. Maggioni, Felipe Martinez, Milton Packer, Marc A. Pfeffer, Burkert Pieske, Margaret M. Redfield, Adel R. Rizkala, Jean L. Rouleau, Petar M. Seferovic, Jasper Tromp, Dirk J. Van Veldhuisen, Mehmet B. Yilmaz, Faiez Zannad, Michael R. Zile, Lars Kober, Mark C. Petrie, Pardeep S. Jhund, Scott D Solomon, John J. McMurray
Summary: This study examined the characteristics and outcomes of patients with diabetes or pre-diabetes in HFpEF and found that pre-diabetes is common in these patients and is associated with worse clinical status and higher risk of heart failure hospitalizations.
EUROPEAN JOURNAL OF HEART FAILURE
(2022)
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
Theresa Anderson, Thomas M. Cascino, Todd M. Koelling, Daniel Perry, Gillian Grafton, Denise K. Houston, Bharathi Upadhya, Dalane W. Kitzman, Scott L. Hummel
Summary: In patients with HFpEF, commonly used predictive equations systematically overestimate measured RMR. Direct measurement of RMR may be needed to effectively tailor dietary guidance for this population.
CIRCULATION-HEART FAILURE
(2021)
Article
Cardiac & Cardiovascular Systems
Virginia S. Hahn, Christopher Petucci, Min-Soo Kim, Kenneth C. Bedi, Hanghang Wang, Sumita Mishra, Navid Koleini, Edwin J. Yoo, Kenneth B. Margulies, Zoltan Arany, Daniel P. Kelly, David A. Kass, Kavita Sharma
Summary: In patients with heart failure with preserved ejection fraction (HFpEF), despite high prevalence of obesity and diabetes, myocardial fatty acid metabolism is lower and branched-chain amino acid (BCAA) metabolism is higher compared with heart failure with reduced ejection fraction (HFrEF), suggesting inadequate fuel utilization in HFpEF.
Article
Cardiac & Cardiovascular Systems
Wengen Zhu, Weihao Liang, Zi Ye, Yuzhong Wu, Xin He, Ruicong Xue, Zexuan Wu, Yuanyuan Zhou, Jingjing Zhao, Yugang Dong, Chen Liu
Summary: The study suggests that higher levels of physical activity are associated with a lower risk of atrial fibrillation in HFpEF patients.
NUTRITION METABOLISM AND CARDIOVASCULAR DISEASES
(2021)
Article
Cardiac & Cardiovascular Systems
Matthew Anderson, Clifton Forrest Parrott, Mark J. Haykowsky, Peter H. Brubaker, Fan Ye, Bharathi Upadhya
Summary: Nearly half of heart failure disease burden is attributed to HF with preserved ejection fraction (HFpEF). Patients with HFpEF suffer from severe exercise intolerance, which is associated with skeletal muscle abnormalities such as reduced muscle mass, decreased oxidative muscle fibers, abnormal fat infiltration, and impaired nitric oxide bioavailability. Exercise training and caloric restriction have shown to improve outcomes in HFpEF patients, emphasizing the importance of targeting skeletal muscle to improve exercise intolerance.
HEART FAILURE REVIEWS
(2023)
Article
Cardiac & Cardiovascular Systems
Amit Saha, Kershaw Patel, Colby Ayers, Christie M. Ballantyne, Adolfo Correa, Christopher Defilippi, Michael E. Hall, Robert J. Mentz, Stephen L. Seliger, Wondwosen Yimer, Javed Butler, Jarett D. Berry, James A. De Lemos, Ambarish Pandey
Summary: Among Black adults, persistent or worsening levels of cardiac troponin I (hs-cTnI) are associated with an increased risk of heart failure (HF). Participants with incident, stable or improved, or worsened hs-cTnI elevation had higher HF risk compared to those without elevated hs-cTnI.
JOURNAL OF CARDIAC FAILURE
(2023)
Article
Cardiac & Cardiovascular Systems
Rhys. L. Beaudry, John. D. Akins, Rauchelle. E. Richey, R. Matthew Brothers, Michael. D. Nelson, Satyam Sarma, Wesley. J. Tucker, Mark. J. Haykowsky
Summary: The purpose of this study was to compare the acute hemodynamic responses during single-leg knee extension exercise between female breast cancer survivors previously treated with anthracycline chemotherapy and age- and sex-matched control subjects. The results showed that leg blood flow was preserved during submaximal exercise in long-term breast cancer survivors, with no significant difference compared to the control group.
JOURNAL OF CARDIOPULMONARY REHABILITATION AND PREVENTION
(2023)
Article
Nutrition & Dietetics
Rebecca A. G. Christensen, Mark J. Haykowsky, Michelle Nadler, Carla M. Prado, Stephanie D. Small, Julia N. Rickard, Edith Pituskin, D. Ian Paterson, John R. Mackey, Richard B. Thompson, Amy Ashley Kirkham
Summary: Metabolic dysfunction and excess adipose tissue accumulation are harmful side effects of breast cancer treatment. Time-restricted eating (TRE), healthy eating, and reduced sedentary time during chemotherapy may help mitigate these effects. A randomized control trial will be conducted to evaluate the impact of a multimodal intervention, including TRE, on visceral fat accumulation and cardiometabolic dysfunction in breast cancer survivors.
BRITISH JOURNAL OF NUTRITION
(2023)
Article
Cardiac & Cardiovascular Systems
Stephen J. Foulkes, Erin J. Howden, Mark J. Haykowsky, Yoland Antill, Agus Salim, Sophie S. Nightingale, Sherene Loi, Piet Claus, Kristel Janssens, Amy M. Mitchell, Leah Wright, Ben T. Costello, Anniina Lindqvist, Lauren Burnham, Imogen Wallace, Robin M. Daly, Steve F. Fraser, Andre La Gerche
Summary: Exercise training for 12 months in breast cancer survivors receiving anthracycline-based chemotherapy can improve cardiorespiratory fitness and prevent cardiac dysfunction, but does not have a lasting effect on functional disability.
Article
Endocrinology & Metabolism
Amy A. Kirkham, Katherine L. Ford, Bruna Ramos Da Silva, Jordan Topolnyski, Carla M. Prado, Anil A. Joy, D. Ian Paterson, Normand Boule, Edith Pituskin, Mark J. Haykowsky, Richard B. Thompson
Summary: This study evaluated the feasibility and preliminary efficacy of telephone-based delivery of weekday-only time-restricted eating. The results showed that telephone-delivered weekday TRE was a feasible, acceptable, low-symptom, and low-cost intervention. However, despite clinically relevant changes occurring within individual participants, there were no significant changes in overall metabolic syndrome, lipid profile, or hemoglobin A(1c) and no changes in hepatic steatosis and thigh myosteatosis. Dietary intake changes included reduced energy and protein, while physical activity and sleep did not change.
Article
Physiology
Kanokwan Bunsawat, Heather L. Clifton, Stephen M. Ratchford, Jennifer R. Vranish, Jeremy K. Alpenglow, Mark J. Haykowsky, Joel D. Trinity, John J. Ryan, Paul J. Fadel, D. Walter Wray
Summary: The study found that patients with HFpEF have a reduced pressor response to static muscle contractions compared to healthy controls, which may be partly due to a blunted muscle metaboreflex. These findings indicate a disease-related dysregulation in neural cardiovascular control during exercise in patients with HFpEF.
JOURNAL OF APPLIED PHYSIOLOGY
(2023)
Article
Neurosciences
Andrew P. Oneglia, Lidia S. Szczepaniak, Manall F. Jaffery, Daisha J. Cipher, Jeffrey G. McDonald, Mark J. Haykowsky, Kerrie L. Moreau, Deborah J. Clegg, Vlad Zaha, Michael D. Nelson
Summary: Mounting evidence suggests that myocardial steatosis contributes to left ventricular diastolic dysfunction. However, there is a lack of definitive evidence in humans due to confounding comorbidities. Therefore, a 48-hour food restriction model was used to acutely increase myocardial triglyceride content in 27 young healthy volunteers. The results showed that myocardial steatosis impairs diastolic-systolic coupling and may contribute to the progression of heart disease.
JOURNAL OF PHYSIOLOGY-LONDON
(2023)
Article
Oncology
Bruna Ramos Da Silva, Amy A. Kirkham, Katherine L. Ford, Mark J. Haykowsky, D. Ian Paterson, Anil A. Joy, Edith Pituskin, Richard Thompson, Carla M. Prado
Summary: This study investigated the effects of weekday time-restricted eating (TRE) on body composition. The results showed that TRE led to a decrease in body weight and total fat mass, and had a positive impact on body composition in individuals with obesity.
NUTRITION AND CANCER-AN INTERNATIONAL JOURNAL
(2023)
Article
Cardiac & Cardiovascular Systems
Gordon McGregor, Richard Powell, Brian Begg, Stefan T. Birkett, Simon Nichols, Stuart Ennis, Scott McGuire, Jonathon Prosser, Olivier Fiassam, Siew Wan Hee, Thomas Hamborg, Prithwish Banerjee, Ned Hartfiel, Joanna M. Charles, Rhiannon T. Edwards, Aimee Drane, Danish Ali, Faizel Osman, Hejie He, Tom Lachlan, Mark J. Haykowsky, Lee Ingle, Rob Shave
Summary: This study aims to assess the clinical effectiveness and safety of low-volume high-intensity interval training (HIIT) compared with moderate-intensity steady-state (MISS) exercise training in patients with coronary artery disease. The results showed that low-volume HIIT improved cardiorespiratory fitness more than MISS and had a higher safety profile. Therefore, low-volume HIIT can be considered as an important adjunct or alternative to MISS in cardiac rehabilitation programs.
EUROPEAN JOURNAL OF PREVENTIVE CARDIOLOGY
(2023)
Article
Cardiac & Cardiovascular Systems
Andreas B. Gevaert, Birgit Boehm, Haley Hartmann, Inge Goovaerts, Tibor Stoop, Caroline M. Van De Heyning, Paul J. Beckers, Flavia Baldassarri, Stephan Mueller, Renate Oberhoffer, Andre Duvinage, Mark J. Haykowsky, Ulrik Wisloff, Volker Adams, Burkert Pieske, Martin Halle, Emeline M. Van Craenenbroeck
Summary: This study investigated the effects of MICT and HIIT on vascular function and repair in HFpEF. The results showed that these training methods did not change vascular function or cellular endothelial repair. This did not significantly contribute to the improvement of VO2peak in HFpEF patients.
JACC-HEART FAILURE
(2023)
Correction
Medicine, General & Internal
Tamara L. Dorfman, Mandy Archibald, Mark Haykowsky, Shannon D. Scott
SYSTEMATIC REVIEWS
(2023)
Review
Medicine, General & Internal
Tamara L. Dorfman, Mandy Archibald, Mark Haykowsky, Shannon D. Scott
Summary: This article mainly introduces the psychosocial consequences of congenital heart disease (CHD) for children and adolescents living with CHD and their primary caregivers. Children and adolescents with CHD undergo multiple traumatizing invasive surgical and medical procedures, face disabilities resulting from CHD, unfair scrutiny, marginalization, and are at risk for mental health issues. Primary caregivers of children and adolescents with CHD also experience increased stress, fear, anxiety, depression, and financial burden. The objective of this scoping review is to determine the current state of knowledge on negative psychosocial consequences and inform research aimed at developing interventions to decrease these consequences.
SYSTEMATIC REVIEWS
(2023)
Article
Nutrition & Dietetics
Bruna Ramos Da Silva, Amy A. Kirkham, Katherine L. Ford, Mark J. Haykowsky, D. Ian Paterson, Anil A. Joy, Edith Pituskin, Richard Thompson, Carla M. Prado
Summary: The aim of this study was to evaluate the association between phase angle (PhA) obtained from bioelectrical impedance analysis (BIA) and health-related physical fitness (including cardiorespiratory fitness, skeletal muscle volume, and myosteatosis) among older breast cancer survivors. The results showed that higher values of PhA were associated with better health-related physical fitness among this population.
CLINICAL NUTRITION ESPEN
(2023)
Letter
Cardiac & Cardiovascular Systems
Sauyeh K. Zamani, Satyam Sarma, James P. Macnamara, Linda S. Hynan, Mark J. Haykowsky, Christopher M. Hearon, Denis Wakeham, Tiffany Brazile, Benjamin D. Levine, Vlad G. Zaha, Michael D. Nelson