Article
Cardiac & Cardiovascular Systems
Li Shen, Pardeep Singh Jhund, Kieran Francis Docherty, Muthiah Vaduganathan, Mark Colquhoun Petrie, Akshay Suvas Desai, Lars Kober, Morten Schou, Milton Packer, Scott David Solomon, Xingwei Zhang, John Joseph Valentine McMurray
Summary: Previous guidelines for treating heart failure with reduced ejection fraction recommended initiating therapy in a chronological order based on trial history. However, this study suggests that accelerating treatment titration and optimizing treatment ordering may improve patient outcomes.
EUROPEAN HEART JOURNAL
(2022)
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
Javed Butler, Milton Packer, Gerasimos Filippatos, Joao Pedro Ferreira, Cordula Zeller, Janet Schnee, Martina Brueckmann, Stuart J. Pocock, Faiez Zannad, Stefan D. Anker
Summary: The impact of empagliflozin on heart failure outcomes was consistent and clinically meaningful in patients with ejection fractions <25% to <65%, but attenuated in those with ejection fraction >= 65%.
EUROPEAN HEART JOURNAL
(2022)
Article
Cardiac & Cardiovascular Systems
Anastasios Kartas, Athanasios Samaras, Evangelos Akrivos, Eleni Vrana, Andreas S. Papazoglou, Dimitrios Moysidis, Anastasios Papanastasiou, Amalia Baroutidou, Michail Botis, Evangelos Liampas, Ioannis Vouloagkas, Efstratios Karagiannidis, Haralambos Karvounis, John Parissis, Apostolos Tzikas, George Giannakoulas
Summary: In patients with both heart failure and atrial fibrillation, the presence of heart failure was independently associated with a higher risk of death, with mortality risk increasing significantly as left ventricular ejection fraction decreased.
Article
Cardiac & Cardiovascular Systems
Ambarish Pandey, Matthew W. Segar, Sumitabh Singh, Gordon Reeves, Christopher O'Connor, Ileana Pina, David Whellan, William Kraus, Robert Mentz, Dalane Kitzman
Summary: This study investigates the impact of baseline frailty on the efficacy of aerobic exercise training in patients with heart failure. The results show that aerobic exercise training significantly reduces the risk of all-cause hospitalization in frail patients, but the effect is not significant for non-frail patients.
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
Dimitrios Farmakis, Jasper Tromp, Smaragdi Marinaki, Wouter Ouwerkerk, Christiane E. E. Angermann, Vasiliki Bistola, Ulf Dahlstrom, Kenneth Dickstein, Georg Ertl, Mathieu Ghadanfar, Mahmoud Hassanein, Achim Obergfell, Sergio V. V. Perrone, Eftihia Polyzogopoulou, Anja Schweizer, Ioannis Boletis, John G. F. Cleland, Sean P. P. Collins, Carolyn S. P. Lam, Gerasimos Filippatos
Summary: This study analyzed healthcare resource utilization in patients with heart failure of different ejection fraction types and found high utilization across all three groups. Despite clinical differences, patients with HFmrEF and HFpEF had better long-term cardiovascular outcomes compared to HFrEF. However, the risk for non-cardiovascular events was similar among the groups.
EUROPEAN JOURNAL OF HEART FAILURE
(2023)
Article
Cardiac & Cardiovascular Systems
Phillip H. Lam, Kalliopi Keramida, Gerasimos S. Filippatos, Neha Gupta, Charles Faselis, Prakash Deedwania, Brandon George, Ami Iskandrian, John G. Cleland, Gaurav Choudhary, Wen-Chih Wu, Charity J. Morgan, Gregg C. Fonarow, Ali Ahmed
Summary: A low right ventricular ejection fraction (RVEF) is a marker of poor outcomes in patients with heart failure with reduced ejection fraction (HFrEF). The effect of beta-blockers on outcomes in HFrEF may be modified by RVEF, but further research is needed to confirm these findings.
JOURNAL OF CARDIAC FAILURE
(2022)
Article
Cardiac & Cardiovascular Systems
Catherine G. Ireland, Rachel L. Damico, Todd M. Kolb, Stephen C. Mathai, Monica Mukherjee, Stefan L. Zimmerman, Ami A. Shah, Fredrick M. Wigley, Brian A. Houston, Paul M. Hassoun, David A. Kass, Ryan J. Tedford, Steven Hsu
Summary: The study found that measuring RV contractile reserve during exercise by changes in RV Ees and dilation can better predict occult RV dysfunction, with RV ejection fraction during exercise proving to be a robust surrogate. This parameter was found to predict clinical outcomes more effectively than resting measures of RV function.
JOURNAL OF HEART AND LUNG TRANSPLANTATION
(2021)
Article
Cardiac & Cardiovascular Systems
Yu-Sheng Lin, Jeng-Yu Jan, Jung-Jung Chang, Ming-Shyan Lin, Teng-Yao Yang, Po-Chang Wang, Mien-Cheng Chen
Summary: This study aimed to evaluate the effect of ivabradine in HFrEF patients with paroxysmal AF, and the results showed that ivabradine treatment was associated with an increased risk of HF hospitalization.
Article
Cardiac & Cardiovascular Systems
Riccardo M. Inciardi, Martin Abanda, Amil M. Shah, Maja Cikes, Brian Claggett, Hicham Skali, Muthiah Vaduganathan, Narayana Prasad, Sheldon Litwin, Bela Merkely, Annamaria Kosztin, Klaudia Vivien Nagy, Sanjiv J. Shah, Wilfred Mullens, Michael R. Zile, Carolyn S. P. Lam, Marc A. Pfeffer, John J. V. McMurray, Scott D. Solomon, PARAGON HF Investigators
Summary: This study aimed to evaluate the clinical implications of right ventricular function and its association with NT-proBNP, as well as its risk for adverse events in patients with HFpEF. The results demonstrated that worsening RV function and its ratio to pulmonary pressure were significantly associated with an increased risk of HF hospitalizations and cardiovascular death in these patients.
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY
(2023)
Article
Endocrinology & Metabolism
Carolyn S. P. Lam, Avraham Karasik, Cheli Melzer-Cohen, Matthew A. Cavender, Shun Kohsaka, Anna Norhammar, Marcus Thuresson, Hungta Chen, Eric Wittbrodt, Peter Fenici, Mikhail Kosiborod
Summary: The study showed that in patients with type 2 diabetes, initiating SGLT2 inhibitors was associated with a lower risk of heart failure hospitalization or death compared to other glucose-lowering drugs, regardless of baseline left ventricular ejection fraction (EF) levels. The lower risk of heart failure hospitalization and death with SGLT2 inhibitors was consistent in patients with both reduced and preserved EF.
DIABETES OBESITY & METABOLISM
(2021)
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)
Article
Cardiac & Cardiovascular Systems
Umut Kocabas, Isil Ergin, Tarik Kivrak, Guelsuem Meral Yilmaz Oztekin, Veysel Ozan Tanik, Ibrahim Ozdemir, Fulya Avci Demir, Mustafa Dogdus, Taner Sen, Meltem Altinsoy, Songuel Ustundag, Orsan Deniz Urgun, Umit Yasar Sinan, Begum Uygur, Mehtap Yeni, Emre Ozcalik
Summary: The SMYRNA study aims to identify the factors for the non-use of guideline-directed medical therapy (GDMT) and to determine its prognostic significance in patients with heart failure with reduced ejection fraction (HFrEF). The study found that suboptimal GDMT is associated with an increased risk of hospitalization for heart failure or cardiovascular death in HFrEF patients.
Article
Cardiac & Cardiovascular Systems
Thijs P. Kerstens, Jerremy Weerts, Arie P. J. van Dijk, Gert Weijers, Christian Knackstedt, Thijs M. H. Eijsvogels, David Oxborough, Vanessa P. M. van Empel, Dick H. J. Thijssen
Summary: In this study, the association between LV-SVL parameters and adverse events in patients with HFpEF was examined. Early diastolic slope was found to be significantly associated with adverse events, while the association between LV peak strain and adverse events disappeared after correction for potential confounders.
EUROPEAN HEART JOURNAL-CARDIOVASCULAR IMAGING
(2023)
Article
Rheumatology
Mercedes E. Quinones, Joyce K. Joseph, Sharon Dowell, Hans J. Moore, Pamela E. Karasik, Gregg C. Fonarow, Ross D. Fletcher, Yan Cheng, Qing Zeng-Treitler, Cherinne Arundel, Angelike P. Liappis, Helen M. Sheriff, Sijian Zhang, Daniel D. Taub, Michael S. Heimall, Charles Faselis, Gail S. Kerr, Ali Ahmed
Summary: This study examined the long-term risk of hydroxychloroquine use in patients with rheumatoid arthritis. The results showed that there was no association between hydroxychloroquine use and LQTS risk during the first 2 years of therapy. However, the risk increased significantly after 5 years of treatment. Nevertheless, the overall risk was low and attenuated with longer follow-up. These findings support the long-term safety of hydroxychloroquine in patients with rheumatoid arthritis.
ARTHRITIS CARE & RESEARCH
(2023)
Article
Cardiac & Cardiovascular Systems
Elizabeth Bierbower, Nayrana Griffith, Venkatesh K. Raman, Vijaywant Brar, Jeffrey Roseman, Prakash Deedwania, Gregg C. Fonarow, Richard M. Allman, Charles Faselis, Sijian Zhang, George Howard, Ali Ahmed, Phillip H. Lam
Summary: Heart failure (HF) is a risk factor for incident stroke, and the time to first stroke is shorter in older adults with HF. However, this extra risk appears to be primarily mediated by four cardiovascular diseases that are also risk factors for HF. These findings highlight the importance of primary prevention of these HF risk factors to reduce the extra risk of stroke in HF patients.
AMERICAN JOURNAL OF CARDIOLOGY
(2023)
Article
Health Care Sciences & Services
Yijun Shao, Ali Ahmed, Edward Y. Zamrini, Yan Cheng, Joseph L. Goulet, Qing Zeng-Treitler
Summary: Deep neural network (DNN) is a powerful technology used in disease risk prediction models. We developed a novel method called interaction scores for measuring the covariate interactions captured by DNN models. The method is model-agnostic and can be applied to other types of machine learning models.
JOURNAL OF PERSONALIZED MEDICINE
(2023)
Article
Clinical Neurology
Yan Cheng, Edward Zamrini, Charles Faselis, Douglas Redd, Yijun Shao, Charity J. Morgan, Helen M. Sheriff, Ali Ahmed, Peter Kokkinos, Qing Zeng-Treitler
Summary: This study found that cardiorespiratory fitness is associated with the incidence of Alzheimer's disease and related dementias. Moderate and high levels of cardiorespiratory fitness are related to a lower risk of dementia.
ALZHEIMERS & DEMENTIA
(2023)
Letter
Cardiac & Cardiovascular Systems
Judy M. Luu, Pankaj Malhotra, Galen Cook-Wiens, Carl J. Pepine, Eileen M. Handberg, Steven E. Reis, Nathaniel Reichek, Vera Bittner, Janet Wei, Sheryl F. Kelsey, Reddy Sailaja Marpuri, George Sopko, C. Noel Bairey Merz
Article
Pharmacology & Pharmacy
Jay Patel, Negin Rassekh, Gregg C. Fonarow, Prakash Deedwania, Farooq H. Sheikh, Ali Ahmed, Phillip H. Lam
Summary: Guideline-directed medical therapy (GDMT) is the cornerstone of pharmacological treatment for patients with heart failure with reduced ejection fraction (HFrEF) and includes four main drug classes: renin-angiotensin system inhibitors, evidence-based beta-blockers, mineralocorticoid inhibitors, and sodium glucose cotransporter 2 inhibitors. The recommendation for GDMT use is based on multiple large randomized controlled trials that have shown improved clinical outcomes in HFrEF patients. However, there is underutilization of GDMT due to a lack of knowledge on how to initiate and titrate these medications safely and effectively. This review article aims to describe the different drug classes in GDMT and provide guidance on initiation and titration in both inpatient and outpatient settings.
Article
Cardiac & Cardiovascular Systems
Alexander Smith, Sant Kumar, Hans J. Moore, Ami E. Iskandrian, Navin C. Nanda, Venkatesh K. Raman, Steven Singh, Ross D. Fletcher, Prakash Deedwania, Gregg C. Fonarow, Michael D. Greenberg, Ali Ahmed, Phillip H. Lam
Summary: This study aimed to examine whether the effect of implantable cardioverter-defibrillators (ICDs) on mortality in heart failure patients varied based on the noninvasive imaging method used to measure left ventricular ejection fraction (LVEF). The study found that there was no evidence that the effect of ICD on mortality varied based on the imaging method used.
Article
Medicine, General & Internal
Mo-Kyung Sin, Yan Cheng, Jeffrey M. Roseman, Caitlin Latimer, Ali Ahmed, Edward Zamrini
Summary: This study focuses on the characteristics and predictors of resilience to cognitive impairment in individuals with neuropathological evidence of Alzheimer's disease (AD). The study found that resilience to cognitive impairment was uncommon in older adults with AD neuropathology. Older age, diuretic use, and APOE-e2 carrier status were independently associated with higher odds of the resilience phenotype.
JOURNAL OF CLINICAL MEDICINE
(2023)
Article
Medicine, General & Internal
Mo-Kyung Sin, Yan Cheng, Jeffrey M. Roseman, Edward Zamrini, Ali Ahmed
Summary: Cerebral microinfarcts are associated with cognitive impairment and dementia. Small vessel diseases such as cerebral arteriolosclerosis and cerebral amyloid angiopathy (CAA) have been found to be significantly correlated with the presence, numbers, and location (cortical and subcortical) of microinfarcts. However, the association with arteriolosclerosis is stronger than that with CAA.
JOURNAL OF CLINICAL MEDICINE
(2023)
Article
Medicine, General & Internal
Samir Patel, Phillip H. Lam, Evangelos I. Kanonidis, Amiya A. Ahmed, Venkatesh K. Raman, Wen-Chih Wu, Patrick Rossignol, Cherinne Arundel, Charles Faselis, Ioannis E. Kanonidis, Prakash Deedwania, Richard M. Allman, Farooq H. Sheikh, Gregg C. Fonarow, Bertram Pitt, Ali Ahmed
Summary: The study shows that renin-angiotensin system inhibitors are beneficial for patients with heart failure with reduced ejection fraction and advanced kidney disease. These drugs reduce the risk of heart failure readmission and all-cause mortality.
AMERICAN JOURNAL OF MEDICINE
(2023)
Article
Urology & Nephrology
Samir Patel, Eduardo Trujillo A. Rivera, Venkatesh K. Raman, Charles Faselis, Virginia Wang, Jeffrey C. Fink, Jeffrey M. Roseman, Charity J. Morgan, Sijian Zhang, Helen M. Sheriff, Michael S. Heimall, Wen-Chih Wu, Qing Zeng-Treitler, Ali Ahmed
Summary: This study examined the impact of the COVID-19 pandemic on the delivery of maintenance hemodialysis treatment and death rates in patients with end-stage kidney disease (ESKD) in Veterans Health Administration (VHA) facilities. The findings suggest that there was no disruption in the delivery of maintenance hemodialysis treatment during the pandemic, and the modest increase in death rates is unlikely to be due to missed dialysis.
AMERICAN JOURNAL OF NEPHROLOGY
(2023)
Article
Geriatrics & Gerontology
Mo-Kyung Sin, Jung-Ah Lee, Patrick J. M. Murphy, Charles Faselis, Ali Ahmed
Summary: Aging-associated upper extremity weakness is associated with adverse health outcomes in older adults. However, the association between impaired upper extremity function and cause-specific mortality is less known. This study found that upper extremity weakness is weakly associated with all-cause mortality, primarily driven by a higher risk of non-cardiovascular mortality.
ARCHIVES OF GERONTOLOGY AND GERIATRICS
(2023)
Letter
Cardiac & Cardiovascular Systems
Shaun G. Goodman, Philippe Gabriel Steg, Yann Poulouin, Deepak L. Bhatt, Vera A. Bittner, Rafael Diaz, Genevieve Garon, Robert A. Harrington, J. Wouter Jukema, Garen Manvelian, Wanda Stipek, Michael Szarek, Harvey D. White, Gregory G. Schwartz
JOURNAL OF THE AMERICAN HEART ASSOCIATION
(2023)
Article
Health Care Sciences & Services
Yijun Shao, Yan Cheng, Stuart J. Nelson, Peter Kokkinos, Edward Y. Zamrini, Ali Ahmed, Qing Zeng-Treitler
Summary: Transformer is a cutting-edge deep neural network architecture that has revolutionized natural language processing. To adapt Transformer to the healthcare domain, a new DNN architecture called Hybrid Value-Aware Transformer (HVAT) has been designed, which can effectively learn from both longitudinal and non-longitudinal clinical data. HVAT is unique in its ability to incorporate numerical values associated with clinical codes/concepts and utilize a flexible longitudinal data representation. A prototype HVAT model trained on a case-control dataset achieved high performance in predicting Alzheimer's disease and related dementias, demonstrating the potential of HVAT for clinical data learning tasks.
JOURNAL OF PERSONALIZED MEDICINE
(2023)
Meeting Abstract
Cardiac & Cardiovascular Systems
Samir Patel, Wen-Chih Hank Wu, Sijian Zhang, Venkatesh K. Raman, Prakash C. Deedwania, Paul A. Heidenreich, Jeffrey Jeffrey, Craig Fink, Charles Faselis, Phillip Hong Lam, Helen Sheriff, Gregg C. Fonarow, Qing Zeng, Ali Ahmed
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY
(2023)