Article
Cardiac & Cardiovascular Systems
Senthil Selvaraj, Muthiah Vaduganathan, Brian L. Claggett, Zi Michael Miao, James C. Fang, Orly Vardeny, Akshay S. Desai, Sanjiv J. Shah, Carolyn S. P. Lam, Felipe A. Martinez, Silvio E. Inzucchi, Rudolf A. de Boer, Magnus Petersson, Anna Maria Langkilde, John J. McMurray, Scott D. Solomon
Summary: The study found positive treatment effects of Dapagliflozin on systolic blood pressure and cardiovascular outcomes in heart failure patients. However, the changes in blood pressure did not completely account for the treatment effects. The study also revealed increased risk in patients with low and high blood pressure, with variations in different endpoints.
JACC-HEART FAILURE
(2023)
Article
Medicine, General & Internal
Stefan D. Anker, Javed Butler, Gerasimos Filippatos, Joao P. Ferreira, Edimar Bocchi, Michael Boehm, Hans-Peter Brunner-La Rocca, Dong-Ju Choi, Vijay Chopra, Eduardo Chuquiure-Valenzuela, Nadia Giannetti, Juan Esteban Gomez-Mesa, Stefan Janssens, James L. Januzzi, Jose R. Gonzalez-Juanatey, Bela Merkely, Stephen J. Nicholls, Sergio V. Perrone, Ileana L. Pina, Piotr Ponikowski, Michele Senni, David Sim, Jindrich Spinar, Iain Squire, Stefano Taddei, Hiroyuki Tsutsui, Subodh Verma, Dragos Vinereanu, Jian Zhang, Peter Carson, Carolyn Su Ping Lam, Nikolaus Marx, Cordula Zeller, Naveed Sattar, Waheed Jamal, Sven Schnaidt, Janet M. Schnee, Martina Brueckmann, Stuart J. Pocock, Faiez Zannad, Milton Packer
Summary: Empagliflozin reduces the risk of cardiovascular death or hospitalization for heart failure in patients with heart failure and a preserved ejection fraction, regardless of the presence or absence of diabetes.
NEW ENGLAND JOURNAL OF MEDICINE
(2021)
Article
Cardiac & Cardiovascular Systems
Gerasimos Filippatos, Javed Butler, Dimitrios Farmakis, Faiez Zannad, Anne Pernille Ofstad, Joao Pedro Ferreira, Jennifer B. Green, Julio Rosenstock, Sven Schnaidt, Martina Brueckmann, Stuart J. Pocock, Milton Packer, Stefan D. Anker
Summary: In patients with heart failure and preserved ejection fraction, empagliflozin significantly reduces the risk of heart failure outcomes, regardless of diabetes status at baseline.
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
Peripheral Vascular Disease
Fang-Fei Wei, Yuzhong Wu, Ruicong Xue, Xiao Liu, Xin He, Bin Dong, Zhe Zhen, Xuwei Chen, Weihao Liang, Jingjing Zhao, Jiangui He, Yugang Dong, Jan A. Staessen, Chen Liu
Summary: The association between pulse pressure and left ventricular traits and adverse outcomes in patients with heart failure with preserved ejection fraction remains a topic of debate. This study found that pulse pressure was independently associated with left ventricular traits and adverse outcomes, beyond the effect of mean arterial pressure. The findings suggest that incorporating pulse pressure into risk estimation may improve clinical management and inform preventive strategies for heart failure with preserved ejection fraction.
Article
Cardiac & Cardiovascular Systems
Karl-Patrik Kresoja, Karl-Philipp Rommel, Karl Fengler, Maximilian von Roeder, Christian Besler, Christian Luecke, Matthias Gutberlet, Steffen Desch, Holger Thiele, Michael Boehm, Philipp Lurz
Summary: Arterial hypertension is a common comorbidity in patients with HFpEF, leading to adverse hemodynamics. RDN may improve hemodynamics in HFpEF patients, reducing LV stiffness and diastolic pressures.
CIRCULATION-HEART FAILURE
(2021)
Article
Peripheral Vascular Disease
Fang-Fei Wei, Yuanyuan Zhou, Lutgarde Thijs, Ruicong Xue, Bin Dong, Xin He, Weihao Liang, Yuzhong Wu, Jingzhou Jiang, Weiping Tan, Jiangui He, Jan A. Staessen, Yugang Dong, Jingjing Zhao, Chen Liu
Summary: In patients with heart failure with preserved ejection fraction, greater systolic and diastolic blood pressure variability is associated with adverse health outcomes independent of blood pressure level. Sensitivity analyses stratified by sex, age, and region confirmed these associations.
Article
Cardiac & Cardiovascular Systems
Ali Javaheri, Ahmed Diab, Lei Zhao, Chenao Qian, Jordana B. B. Cohen, Payman Zamani, Anupam Kumar, Zhaoqing Wang, Christina Ebert, Joseph Maranville, Erika Kvikstad, Michael Basso, Vanessa van Empel, A. Mark Richards, Robert N. N. Doughty, Ernst Rietzschel, Karl Kammerhoff, Joseph Gogain, Peter Schafer, Dietmar A. A. Seiffert, David A. A. Gordon, Francisco Ramirez-Valle, Douglas L. L. Mann, Thomas P. P. Cappola, Julio A. A. Chirinos
Summary: This study utilized proteomic analysis to identify proteins and pathways impacted by spironolactone therapy in heart failure with preserved ejection fraction. The results showed significant changes in several proteins, including the upregulation of CARD18 and the downregulation of HGF, PLTP, IGF2R, and SWP70. Pathway analysis revealed that spironolactone was associated with apelin signaling, stellate cell activation, glycoprotein 6 signaling, and other pathways. Collagens were found to be consistently affected by spironolactone, increasing in the placebo group but decreasing in the spironolactone group. The study suggests that spironolactone may have potential antiapoptotic effects in heart failure with preserved ejection fraction, which warrants further investigation.
CIRCULATION-HEART FAILURE
(2022)
Article
Cardiac & Cardiovascular Systems
Iris E. Beldhuis, Peder L. Myhre, Michael Bristow, Brian Claggett, Kevin Damman, James C. Fang, Jerome L. Fleg, Sonja McKinlay, Eldrin F. Lewis, Eileen O'Meara, Bertram Pitt, Sanjiv J. Shah, Orly Vardeny, Adriaan A. Voors, Marc A. Pfeffer, Scott D. Solomon, Akshay S. Desai
Summary: Among patients with HFpEF, spironolactone increased the risk of WRF compared to placebo, but rates of cardiovascular death were lower with spironolactone in both patients with and without WRF.
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY
(2021)
Article
Cardiac & Cardiovascular Systems
Javed Butler, Gerasimos Filippatos, Tariq Jamal Siddiqi, Joao Pedro Ferreira, Martina Brueckmann, Edimar Bocchi, Michael Bohm, Vijay K. Chopra, Nadia Giannetti, Tomoko Iwata, James L. Januzzi, Sanjay Kaul, Ileana L. Pina, Piotr Ponikowski, Ursula Rauch-Krohnert, Sanjiv J. Shah, Michele Senni, Mikhail Sumin, Subodh Verma, Jian Zhang, Stuart J. Pocock, Faiez Zannad, Milton Packer, Stefan D. Anker
Summary: This study evaluated the influence of sex on the effects of empagliflozin in patients with HF and preserved ejection fraction. The results showed that empagliflozin reduced the risk of cardiovascular death or hospitalization for HF to a similar degree in both men and women. Sex did not modify the relationship between empagliflozin and outcomes across ejection fraction groups.
Article
Cardiac & Cardiovascular Systems
Akito Nakagawa, Yoshio Yasumura, Chikako Yoshida, Takahiro Okumura, Jun Tateishi, Junichi Yoshida, Shunsuke Tamaki, Masamichi Yano, Takaharu Hayashi, Yusuke Nakagawa, Takahisa Yamada, Daisaku Nakatani, Shungo Hikoso, Yasushi Sakata
Summary: The study found that patients with preserved admission SBP had a higher risk for adverse outcomes of cardiac death and heart failure re-hospitalization in HFpEF. Compared to patients with elevated admission SBP, those with preserved SBP had a higher risk of poor prognosis.
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)
Article
Pharmacology & Pharmacy
Jun-Feng Li, Xiang Qu, Zhan Gao, Chang-Xi Chen, Feng-Yu Zhang, Ling Cheng, Xi Zhou, Hao Zhou
Summary: This study aimed to compare the association between dosing of spironolactone and outcomes in patients with heart failure with preserved ejection fraction (HFpEF) combined with chronic kidney disease (CKD), and determine the optimal dosage of spironolactone. The results showed that low-dose spironolactone (≤40 mg) had the best efficacy and safety in HFpEF patients with CKD.
FRONTIERS IN PHARMACOLOGY
(2023)
Article
Cardiac & Cardiovascular Systems
Masatoshi Minamisawa, Brian Claggett, Kota Suzuki, Sheila M. Hegde, Amil M. Shah, Akshay S. Desai, Eldrin F. Lewis, Sanjiv J. Shah, Nancy K. Sweitzer, James C. Fang, Inder S. Anand, Eileen O'Meara, Jean-Lucien Rouleau, Bertram Pitt, Marc A. Pfeffer, Scott D. Solomon, Orly Vardeny
Summary: The study revealed that hyper-polypharmacy was associated with an elevated risk of hospitalization for any reason and any serious adverse events in patients with heart failure with preserved ejection fraction, but not significantly associated with mortality.
CIRCULATION-HEART FAILURE
(2021)
Editorial Material
Cardiac & Cardiovascular Systems
Sanjiv J. Shah
EUROPEAN HEART JOURNAL
(2022)
Editorial Material
Cardiac & Cardiovascular Systems
Ravi B. Patel, Sanjiv J. Shah
JOURNAL OF CARDIAC FAILURE
(2022)
Editorial Material
Cardiac & Cardiovascular Systems
Sanjiv J. Shah
CIRCULATION-HEART FAILURE
(2022)
Article
Cardiac & Cardiovascular Systems
Senthil Selvaraj, Stephen J. Greene, Iyanuoluwa Ayodele, Brooke Alhanti, Larry A. Allen, Sabra C. Lewsey, Srinath Adusumalli, Nosheen Reza, Adrian F. Hernandez, Clyde W. Yancy, Anupam B. Jena, Gregg C. Fonarow, Deepak L. Bhatt
Summary: This study investigated the impact of patient age on quality of care in heart failure and found that discharge date relative to 80th birthday did not affect healthcare quality or outcomes.
CIRCULATION-HEART FAILURE
(2023)
Article
Cardiac & Cardiovascular Systems
James P. Curtain, Carly Adamson, Toru Kondo, Jawad Butt, Akshay S. Desai, Faiez Zannad, Jean L. Rouleau, Luis E. Rohde, Lars Kober, Inder S. Anand, Dirk J. van Veldhuisen, Michael R. Zile, Martin P. Lefkowitz, Scott D. Solomon, Milton Packer, Mark C. Petrie, Pardeep S. Jhund, John J. McMurray
Summary: This study examined the incidence of ventricular tachycardia (VT) and ventricular fibrillation (VF) in patients with heart failure and their relationship with mortality. The results showed that VT/VF events were uncommon but strongly associated with mortality in heart failure patients. These events seem to be markers of disease severity rather than risk of sudden death.
EUROPEAN HEART JOURNAL
(2023)
Letter
Cardiac & Cardiovascular Systems
Senthil Selvaraj, Scott D. Solomon
JACC-HEART FAILURE
(2023)
Article
Cardiac & Cardiovascular Systems
Debra D. Dixon, Lauren Beussink-Nelson, Rahul Deo, Sanjiv J. Shah
Summary: Unsupervised machine learning has been used to identify novel subgroups of heart failure with preserved ejection fraction (HFpEF), and further investigation of pathophysiological differences between these subgroups is needed to determine potential treatment options.
AMERICAN JOURNAL OF CARDIOLOGY
(2023)
Article
Cardiac & Cardiovascular Systems
Kashvi Gupta, John A. Spertus, Mary Birmingham, Kensey L. Gosch, Mansoor Husain, Dalane W. Kitzman, Bertram Pitt, Sanjiv J. Shah, James L. Januzzi, Ildiko Lingvay, Javed Butler, Mikhail Kosiborod, David E. Lanfear
Summary: The health status of Black patients with heart failure is worse compared to White patients. Sodium-glucose cotransporter 2 inhibitors (SGLT2is) can reduce cardiovascular mortality and improve health status in heart failure patients, but it is unclear if the effect is similar across races. The study found that SGLT2i improves health status equally for Black and White patients.
Letter
Cardiac & Cardiovascular Systems
Senthil Selvaraj, Mikhail N. Kosiborod, Svati H. Shah
Article
Cardiac & Cardiovascular Systems
Toru Kondo, Karola S. Jering, Pardeep S. Jhund, Inder S. Anand, Akshay S. Desai, Carolyn S. P. Lam, Aldo P. Maggioni, Felipe A. Martinez, Milton Packer, Mark C. Petrie, Marc A. Pfeffer, Margaret M. Redfield, Jean L. Rouleau, Dirk J. van Veldhuisen, Faiez Zannad, Michael R. Zile, Scott D. Solomon, John J. V. McMurray
Summary: This study validated a simple risk model for predicting stroke risk in heart failure patients with preserved ejection fraction but without atrial fibrillation. The results showed that the risk for stroke increased with increasing risk score, suggesting the use of anticoagulation therapy in high-risk patients.
CIRCULATION-HEART FAILURE
(2023)
Article
Cardiac & Cardiovascular Systems
John W. Ostrominski, Muthiah Vaduganathan, Senthil Selvaraj, Brian L. Claggett, Zi Michael Miao, Akshay S. Desai, Pardeep S. Jhund, Mikhail N. Kosiborod, Carolyn S. P. Lam, Silvio E. Inzucchi, Felipe A. Martinez, Rudolf A. de Boer, Adrian F. Hernandez, Sanjiv J. Shah, Magnus Petersson, Anna Maria Langkilde, John J. V. Mcmurray, Scott D. Solomon
Summary: This study analyzed the potential role of dapagliflozin in treating apparent treatment-resistant hypertension (aTRH) in heart failure patients. The results showed that dapagliflozin consistently improved cardiovascular outcomes and was well-tolerated in patients with aTRH.
Article
Cardiac & Cardiovascular Systems
Toru Kondo, Pooja Dewan, Inder S. Anand, Akshay S. Desai, Milton Packer, Michael R. Zile, Marc A. Pfeffer, Scott D. Solomon, William T. Abraham, Sanjiv J. Shah, Carolyn S. P. Lam, Pardeep S. Jhund, John J. V. Mcmurray
Summary: By analyzing LVEF data in HF patients, we found that there is a threshold between 40% and 50% LVEF, below which the pattern of patient characteristics changes, and event rates begin to increase. This provides support for the current prognosis-based definition of HF with mildly reduced ejection fraction based on upper LVEF thresholds.
Article
Cardiac & Cardiovascular Systems
Mingming Yang, Toru Kondo, Jawad H. Butt, William T. Abraham, Inder S. Anand, Akshay S. Desai, Lars Kober, Milton Packer, Marc A. Pfeffer, Jean L. Rouleau, Marc S. Sabatine, Scott D. Solomon, Karl Swedberg, Michael R. Zile, Pardeep S. Jhund, John J. McMurray
Summary: Patients with heart failure who have a history of stroke are at a high risk of subsequent cardiovascular events, regardless of ejection fraction. This study investigated the prevalence of stroke history in patients with heart failure and found that they had more vascular comorbidity and worse heart failure compared to those without stroke history. Targeting underutilization of guideline-recommended treatments might improve outcomes in this high-risk population.
EUROPEAN HEART JOURNAL
(2023)
Article
Geriatrics & Gerontology
Jorge R. Kizer, Sheena Patel, Peter Ganz, Anne B. Newman, Shalender Bhasin, Se-Jin Lee, Peggy M. Cawthon, Nathan K. LeBrasseur, Sanjiv J. Shah, Bruce M. Psaty, Russell P. Tracy, Steven R. Cummings
Summary: This study suggests that serum follistatin and FSTL-3, but not GDF-11 or GDF-8, are associated with incident heart failure in older adults, implicating transforming growth factor-beta superfamily pathways as potential therapeutic targets.
JOURNALS OF GERONTOLOGY SERIES A-BIOLOGICAL SCIENCES AND MEDICAL SCIENCES
(2023)