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
Safia Chatur, Muthiah Vaduganathan, Brian Claggett, Orly Vardeny, Akshay S. Desai, Pardeep S. Jhund, Rudolf A. de Boer, Carolyn S. P. Lam, Mikhail N. Kosiborod, Sanjiv J. Shah, Felipe Martinez, Silvio E. Inzucchi, Adrian F. Hernandez, Tariq Haddad, Sumeet S. Mitter, Zi Michael Miao, Magnus Petersson, Anna Maria Langkilde, John J. McMurray, Scott D. Solomon
Summary: In this study, the safety and efficacy of dapagliflozin were evaluated according to different diuretic therapies and its influence on diuretic use. The results showed that dapagliflozin had consistent clinical benefits in terms of reducing heart failure worsening and cardiovascular death across different diuretic categories and doses, with a similar safety profile. Dapagliflozin also significantly reduced the need for loop diuretics over time.
EUROPEAN HEART JOURNAL
(2023)
Article
Medicine, General & Internal
Andrea Lopez-Lopez, Raul Franco-Gutierrez, Alberto Jose Perez-Perez, Margarita Regueiro-Abel, Juliana Elices-Teja, Charigan Abou-Jokh-Casas, Carlos Gonzalez-Juanatey
Summary: The study aimed to determine the incidence of hyperkalemia in HFrEF patients over a span of five years and investigate its predictors and impact on mortality. The results showed a hyperkalemia occurrence of 16.8% and a hyperkalemia-free survival rate of 82.1% over five years. Multivariate analysis revealed baseline potassium, creatinine clearance, right ventricular function, and diabetes mellitus as factors associated with hyperkalemia. The overall five-year survival rate was 76.4%. Normal-high potassium levels were inversely associated with mortality. Therefore, hyperkalemia is common in HFrEF patients and affects the optimization of neurohormonal treatment, while normal-high potassium levels appear to be safe and not associated with increased mortality.
JOURNAL OF CLINICAL MEDICINE
(2023)
Article
Cardiac & Cardiovascular Systems
Masami Nishino, Yasuyuki Egami, Shodai Kawanami, Hiroki Sugae, Kohei Ukita, Akito Kawamura, Hitoshi Nakamura, Koji Yasumoto, Masaki Tsuda, Naotaka Okamoto, Yasuharu Matsunaga-Lee, Masamichi Yano, Jun Tanouchi, Takahisa Yamada, Yoshio Yasumura, Masahiro Seo, Shunsuke Tamaki, Takaharu Hayashi, Akito Nakagawa, Yusuke Nakagawa, Yohei Sotomi, Daisaku Nakatani, Shungo Hikoso, Yasushi Sakata
Summary: Polypharmacy is common in elderly patients with heart failure with preserved ejection fraction (HFpEF), although drug treatment has limited clinical benefit. This study investigates the impact of cardiovascular polypharmacy on octogenarians with HFpEF and finds that it is associated with increased risk of heart failure rehospitalization.
INTERNATIONAL JOURNAL OF CARDIOLOGY
(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.
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
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)
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
Xin He, Bin Dong, Ruicong Xue, Jingjing Zhao, Zexuan Wu, Yuzhong Wu, Yuanyuan Zhou, Dexi Wu, Yugang Dong, Jiangui He, Chen Liu
Summary: This study revealed that HFrEF and HFpEF have distinct responses to aggressive diuresis in acute heart failure, suggesting the need for separate clinical trials tailored to each type of heart failure to optimize treatment outcomes.
Review
Critical Care Medicine
Chakradhari Inampudi, Daniel Silverman, Marc A. Simon, Peter J. Leary, Kavita Sharma, Brian A. Houston, Jean-Luc Vachiery, Francois Haddad, Ryan J. Tedford
Summary: HFpEF, the most common form of heart failure, is often associated with PH, which may be difficult to distinguish from different forms of PH but accurate diagnosis is crucial for divergent therapeutic pathways. HFpEF associated with PH can be subdivided into IpcPH and CpcPH, with the latter having a worse prognosis.
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.
Review
Cardiac & Cardiovascular Systems
Marco Guazzi, Robert Naeije
Summary: The health burden of heart failure with preserved ejection fraction is increasingly recognized, but effective treatment options remain limited. Research suggests the use of diagnostic scores, big data, and phenomapping for further progress, while also emphasizing right ventricular dysfunction as a key factor in the progression of heart failure with preserved ejection fraction.
CIRCULATION-HEART FAILURE
(2021)
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
Cardiac & Cardiovascular Systems
Safia Chatur, Brian L. Claggett, Orly Vardeny, Karola Jering, Akshay S. Desai, Marc A. Pfeffer, Martin Lefkowitz, John J. McMurray, Scott D. Solomon, Muthiah Vaduganathan
Summary: In HFpEF, the use of SACUBITRIL/VALSARTAN may reduce the risk of heart failure events and have an impact on diuretic requirements. The safety profile of SACUBITRIL/VALSARTAN remains consistent regardless of baseline diuretic dose.
EUROPEAN JOURNAL OF HEART FAILURE
(2023)
Article
Cardiac & Cardiovascular Systems
Massar Omar, Jesper Jensen, Daniel Burkhoff, Peter H. Frederiksen, Caroline Kistorp, Lars Videbaek, Mikael Kjaer Poulsen, Finn Gustafsson, Lars Kober, Barry A. Borlaug, Morten Schou, Jacob Eifer Moller
Summary: This study investigated the effect of empagliflozin on stressed blood volume in patients with heart failure. The results showed that empagliflozin treatment for 12 weeks significantly reduced stressed blood volume in heart failure patients. This suggests a potential positive impact of empagliflozin on cardiac function in heart failure patients.
CIRCULATION-HEART FAILURE
(2022)