European Journal of Heart Failure最新文献

{"title":"Knowledge is power, can it be leveraged to improve heart failure care?","authors":"Charles F. Sherrod, Nobuhiro Ikemura, John A. Spertus","doi":"10.1002/ejhf.3027","DOIUrl":"10.1002/ejhf.3027","url":null,"abstract":"This article refers to ‘Knowledge about self-efficacy and outcomes in patients with heart failure and reduced ejection fraction’ by M. Yang et al. ,","PeriodicalId":164,"journal":{"name":"European Journal of Heart Failure","volume":"25 10","pages":"1840-1841"},"PeriodicalIF":18.2,"publicationDate":"2023-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10577698","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impella and venoarterial extracorporeal membrane oxygenation in cardiogenic shock complicating acute myocardial infarction","authors":"Margriet Bogerd,&nbsp;Sanne ten Berg,&nbsp;Elma J. Peters,&nbsp;Alexander P.J. Vlaar,&nbsp;Annemarie E. Engström,&nbsp;Luuk C. Otterspoor,&nbsp;Christian Jung,&nbsp;Dirk Westermann,&nbsp;Janine Pöss,&nbsp;Holger Thiele,&nbsp;Benedikt Schrage,&nbsp;José P.S. Henriques","doi":"10.1002/ejhf.3025","DOIUrl":"10.1002/ejhf.3025","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>This study aimed to give contemporary insight into the use of Impella and venoarterial extracorporeal membrane oxygenation (VA-ECMO) in acute myocardial infarction-related cardiogenic shock (AMICS) and into associated outcomes, adverse events, and resource demands.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods and results</h3>\u0000 \u0000 <p>This nationwide observational cohort study describes all AMICS patients treated with Impella (ABIOMED, Danvers, MA, USA) and/or VA-ECMO in 2020–2021. Impella and/or VA-ECMO were used in 20% of all AMICS cases (<i>n</i> = 4088). Impella patients were older (34% vs. 13% &gt;75 years, <i>p</i> &lt; 0.001) and less frequently presented after an out-of-hospital cardiac arrest (18% vs. 40%, <i>p</i> &lt; 0.001). In-hospital mortality was lower in the Impella versus VA-ECMO cohort (61% vs. 67%, <i>p</i> = 0.001). Adverse events occurred less frequently in Impella-supported patients: acute haemorrhagic anaemia (36% vs. 68%, <i>p</i> &lt; 0.001), cerebrovascular accidents (4% vs. 11%, <i>p</i> &lt; 0.001), thromboembolisms of the extremities (5% vs. 8%, <i>p</i> &lt; 0.001), systemic inflammatory response syndrome (21% vs. 25%, <i>p</i> = 0.004), acute kidney injury (44% vs. 53%, <i>p</i> &lt; 0.001), and acute liver failure (7% vs. 12%, <i>p</i> &lt; 0.001). Impella patients were discharged home directly more often (20% vs. 11%, <i>p</i> &lt; 0.001) whereas VA-ECMO patients were more often discharged to another care facility (22% vs. 19%, <i>p</i> = 0.031). Impella patients had shorter hospital stays and lower hospital costs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This is the largest, most recent European cohort study describing outcomes, adverse events, and resource demands based on claims data in patients with Impella and/or VA-ECMO. Overall, adverse event rates and resource consumption were high. Given the current lack of beneficial evidence, our study reinforces the need for prospectively established, high-quality evidence to guide clinical decision-making.</p>\u0000 </section>\u0000 </div>","PeriodicalId":164,"journal":{"name":"European Journal of Heart Failure","volume":"25 11","pages":"2021-2031"},"PeriodicalIF":18.2,"publicationDate":"2023-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ejhf.3025","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10283830","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comorbidities and clinical response to cardiac resynchronization therapy: Patient-level meta-analysis from eight clinical trials","authors":"Marat Fudim,&nbsp;Frederik Dalgaard,&nbsp;Daniel J. Friedman,&nbsp;William T. Abraham,&nbsp;John G.F. Cleland,&nbsp;Anne B. Curtis,&nbsp;Michael R. Gold,&nbsp;Valentina Kutyifa,&nbsp;Cecilia Linde,&nbsp;Fatima Ali-Ahmed,&nbsp;Anthony Tang,&nbsp;Antonio Olivas-Martinez,&nbsp;Lurdes Y.T. Inoue,&nbsp;Sana M. Al-Khatib,&nbsp;Gillian D. Sanders","doi":"10.1002/ejhf.3029","DOIUrl":"10.1002/ejhf.3029","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>Patients with heart failure usually have several other medical conditions that might alter the effects of interventions. We investigated whether the burden of comorbidity modified the clinical response to cardiac resynchronization therapy (CRT).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods and results</h3>\u0000 \u0000 <p>Original patient-level data from eight randomized trials exploring the effects of CRT versus no CRT were pooled (BLOCK-HF, MIRACLE, MIRACLE-ICD, MIRACLE-ICD II, RAFT, COMPANION, MADIT-CRT and REVERSE). A prior history of the following comorbidities was considered: episodic or persistent atrial fibrillation (<i>n</i> = 920), coronary artery disease (<i>n</i> = 3732), diabetes (<i>n</i> = 2171), and hypertension (<i>n</i> = 3353). Patients were classified into three groups based on the number of comorbidities: 0, 1–2, or ≥3. The outcomes of interest were time to all-cause mortality and time to the composite outcome of heart failure hospitalization (HFH) or all-cause mortality. Outcomes were evaluated within each comorbidity group using a Bayesian hierarchical Weibull survival regression model. Of 6324 patients, 970 (15%) had no comorbidities, 4052 (64%) had 1–2 and 1302 (21%) had ≥3 comorbidities. The adjusted hazard ratio (aHR) for CRT versus no CRT for all-cause mortality in the overall cohort was 0.79 (95% credible interval [CI] 0.68–0.93) (<i>p</i> = 0.010); for no comorbidities the aHR was 0.54 (95% CI 0.34–0.86), for 1–2 comorbidities was 0.81 (95% CI 0.67–0.97) and for ≥3 comorbidities was 0.83 (95% CI 0.64–1.07) (no significant interaction between CRT and comorbidity burden: <i>p</i> = 0.13). For the endpoint of HFH or all-cause mortality, the aHR for the overall cohort was 0.74 (95% CI 0.65–0.84) (<i>p</i> = 0.001), for no comorbidities was 0.69 (95% CI 0.50–0.94), for 1–2 comorbidities was 0.77 (95% CI 0.66–0.90) and for ≥3 comorbidities was 0.68 (95% CI 0.55–0.82) (no significant interaction between CRT and comorbidity burden: <i>p</i> = 0.081).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In a meta-analysis of patient-level data from eight major trials, the totality of evidence suggests that CRT reduces HFH and/or all-cause mortality even when several comorbid diseases are present.</p>\u0000 \u0000 <p>Clinical Trial Registration: NCT00271154, NCT00251251, NCT00267098, NCT00180271.</p>\u0000 </section>\u0000 </div>","PeriodicalId":164,"journal":{"name":"European Journal of Heart Failure","volume":"26 4","pages":"1039-1046"},"PeriodicalIF":18.2,"publicationDate":"2023-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10604780","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations between baseline heart rate and blood pressure and time to events in heart failure with reduced ejection fraction patients: Data from the QUALIFY international registry","authors":"Amr Abdin,&nbsp;Stefan D. Anker,&nbsp;Martin R. Cowie,&nbsp;Gerasimos S. Filippatos,&nbsp;Piotr Ponikowski,&nbsp;Luigi Tavazzi,&nbsp;Jakob Schöpe,&nbsp;Stefan Wagenpfeil,&nbsp;Michel Komajda,&nbsp;Michael Böhm","doi":"10.1002/ejhf.3023","DOIUrl":"10.1002/ejhf.3023","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>A high resting heart rate (RHR) and low systolic blood pressure (SBP) are a risk factor and a risk indicator, respectively, for poor heart failure (HF) outcomes. This analysis evaluated the associations between baseline RHR and SBP with outcomes and treatment patterns in patients with HF and reduced ejection fraction (HFrEF) in the QUALIFY (QUality of Adherence to guideline recommendations for LIFe-saving treatment in heart failure surveY) international registry.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods and results</h3>\u0000 \u0000 <p>Between September 2013 and December 2014, 7317 HFrEF patients with a previous HF hospitalization within 1–15 months were enrolled in the QUALIFY registry. Complete follow-up data were available for 5138 patients. The relationships between RHR and SBP and outcomes were assessed using a Cox proportional hazards model and were analysed according to baseline values as high RHR (H-RHR) ≥75 bpm versus low RHR (L-RHR) &lt;75 bpm and high SBP (H-SBP) ≥110 mmHg versus low SBP (L-SBP) &lt;110 mmHg and analysed according to each of the following four phenotypes: H-RHR/L-SBP, L-RHR/L-SBP, H-RHR/H-SBP and L-RHR/H-SBP (reference group). Compared to the reference group, H-RHR/L-SBP was associated with the worst outcomes for the combined primary endpoint of cardiovascular death and HF hospitalization (hazard ratio [HR] 1.83, 95% confidence interval [CI] 1.51–2.21, <i>p</i> &lt; 0.001), cardiovascular death (HR 2.70, 95% CI 1.69–4.33, <i>p</i> &lt; 0.001), and HF hospitalization (HR 1.62, 95% CI 1.30–2.01, <i>p</i> &lt; 0.001). Low-risk patients with L-RHR/H-SBP achieved more frequently ≥50% of target doses of angiotensin-converting enzyme inhibitors (ACEIs) and beta-blockers (BBs) than the other groups. However, 48% and 46% of low-risk patients were not well treated with ACEIs and BBs, respectively (≤50% of target dose or no treatment).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In patients with HFrEF and recent hospitalization, elevated RHR and lower SBP identify patients at increased risk for cardiovascular endpoints. While SBP and RHR are often recognized as barriers that deter physicians from treating with high doses of recommended drugs, they are not the only reason leaving many patients suboptimally treated.</p>\u0000 </section>\u0000 </div>","PeriodicalId":164,"journal":{"name":"European Journal of Heart Failure","volume":"25 11","pages":"1985-1993"},"PeriodicalIF":18.2,"publicationDate":"2023-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ejhf.3023","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10631503","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"REMIniscence of aldosterone's role in myocardial remodelling","authors":"Benedikt N. Beer,&nbsp;Benedikt Schrage","doi":"10.1002/ejhf.3026","DOIUrl":"10.1002/ejhf.3026","url":null,"abstract":"","PeriodicalId":164,"journal":{"name":"European Journal of Heart Failure","volume":"25 10","pages":"1753-1754"},"PeriodicalIF":18.2,"publicationDate":"2023-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10170025","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sodium–glucose cotransporter 2 inhibitors in hospitalized heart failure patients: No time like now","authors":"Rajat Kalra","doi":"10.1002/ejhf.3022","DOIUrl":"10.1002/ejhf.3022","url":null,"abstract":"","PeriodicalId":164,"journal":{"name":"European Journal of Heart Failure","volume":"25 10","pages":"1806-1807"},"PeriodicalIF":18.2,"publicationDate":"2023-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10196463","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationship between baseline electrocardiographic measurements and outcomes in patients with high-risk heart failure: Insights from the VerICiguaT Global Study in Subjects with Heart Failure with Reduced Ejection Fraction (VICTORIA) trial","authors":"Haran Yogasundaram,&nbsp;Yinggan Zheng,&nbsp;Eric Ly,&nbsp;Justin Ezekowitz,&nbsp;Piotr Ponikowski,&nbsp;Carolyn S.P. Lam,&nbsp;Christopher O'Connor,&nbsp;Robert O. Blaustein,&nbsp;Lothar Roessig,&nbsp;Tracy Temple,&nbsp;Cynthia M. Westerhout,&nbsp;Paul W. Armstrong,&nbsp;Roopinder K. Sandhu,&nbsp;for the VICTORIA Study Group","doi":"10.1002/ejhf.3021","DOIUrl":"10.1002/ejhf.3021","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>Whether electrocardiographic (ECG) measurements predict mortality in chronic heart failure with reduced ejection fraction (HFrEF) is unknown.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods and results</h3>\u0000 \u0000 <p>We studied 4880 patients from the Vericiguat Global Study in Subjects with Heart Failure with Reduced Ejection Fraction (VICTORIA) trial with a baseline 12-lead ECG. Associations between ECG measurements and mortality were estimated as hazard ratios (HR) and adjusted for the Meta-Analysis Global Group in Chronic Heart Failure (MAGGIC) risk score, N-terminal pro-B-type natriuretic peptide, and index event. Select interactions between ECG measurements, patient characteristics and mortality were examined. Over a median of 10.8 months, there were 824 cardiovascular (CV) deaths (214 sudden) and 1005 all-cause deaths. Median age was 68 years (interquartile range [IQR] 60–76), 24% were women, median ejection fraction was 30% (IQR 23–35), 41% had New York Heart Association class III/IV, and median MAGGIC score was 24 (IQR 19–28). After multivariable adjustment, significant associations existed between heart rate (per 5 bpm: HR 1.02), QRS duration (per 10 ms: HR 1.02), absence of left ventricular hypertrophy (HR 0.64) and CV death, and similarly so with all-cause death (HR 1.02; HR 1.02; HR 0.61<i>,</i> respectively). Contiguous pathologic Q waves were significantly associated with sudden death (HR 1.46), and right ventricular hypertrophy with all-cause death (HR 1.44). The only sex-based interaction observed was for pathologic Q waves on CV (men: HR 1.05; women: HR 1.64, <i>p</i>_interaction = 0.024) and all-cause death (men: HR 0.99; women: HR 1.57; <i>p</i>_interaction = 0.010). Whereas sudden death doubled in females, it did not differ among males (male: HR 1.25, 95% confidence interval [CI] 0.87–1.79; female: HR 2.50, 95% CI 1.23–5.06; <i>p</i>_interaction = 0.141).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Routine ECG measurements provide additional prognostication of mortality in high-risk HFrEF patients, particularly in women with contiguous pathologic Q waves.</p>\u0000 </section>\u0000 </div>","PeriodicalId":164,"journal":{"name":"European Journal of Heart Failure","volume":"25 10","pages":"1822-1830"},"PeriodicalIF":18.2,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10199292","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acyl ghrelin infusion increases circulating growth hormone in patients with heart failure and reduced ejection fraction","authors":"Camilla Hage,&nbsp;Marcus Ståhlberg,&nbsp;Tonje Thorvaldsen,&nbsp;Ulrika L. Faxén,&nbsp;Gianluigi Pironti,&nbsp;Dominic-Luc Webb,&nbsp;Per M. Hellström,&nbsp;Daniel C. Andersson,&nbsp;Lars H. Lund","doi":"10.1002/ejhf.3019","DOIUrl":"10.1002/ejhf.3019","url":null,"abstract":"&lt;p&gt;Ghrelin is a 28 amino-acid anabolic peptide hormone released from the stomach in response to fasting and weight loss. It stimulates appetite and release of growth hormone (GH) via the GH secretagogue receptor 1a (GHSR-1a) in healthy individuals. Both ghrelin and the GHSR1a are expressed in the myocardium. When acylated (activated) ghrelin binds to GHSR1a it activates signalling pathways associated with cardiomyocyte survival, contractility and suppression of inflammation&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; suggesting both GH dependent and independent mechanisms.&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt; In patients with heart failure (HF), GH is dysregulated, with relative GH deficiency and GH resistance.&lt;span&gt;&lt;sup&gt;3&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;In the Karolinska Acyl Ghrelin Trial (ClinicalTrials.gov NCT05277415), a recent double-blind randomized trial in HF with reduced ejection fraction (HFrEF), intravenous acyl ghrelin but not placebo increased cardiac output by 28%.&lt;span&gt;&lt;sup&gt;4&lt;/sup&gt;&lt;/span&gt; We assessed acyl ghrelin versus placebo on GH release and the pharmacodynamics of acyl ghrelin treatment on the GH response in this study. In brief, 31 patients with chronic HFrEF were randomized to human acyl ghrelin (0.1 μg/kg/min; &lt;i&gt;n&lt;/i&gt; = 15) or placebo (NaCl; &lt;i&gt;n&lt;/i&gt; = 16) intravenously over 120 min. Blood sampling was performed prior to (T0) and after 60 (T60) and 120 (T120) min infusion, and 30 min after stopping infusion (T150) (detailed methods in online supplementary &lt;i&gt;Appendix&lt;/i&gt; &lt;i&gt;S1&lt;/i&gt;).&lt;/p&gt;&lt;p&gt;In patients randomized to acyl ghrelin, high GH response was defined as above and low GH response as equal to or below median of the area under the curve for GH (AUC&lt;sub&gt;GH&lt;/sub&gt;). Baseline characteristics according to GH response (high vs. low) are expressed as median and quartiles [Q1-Q3] or number and percentages (%). GH responses according to timepoints were analysed by cross-correlation. Associations between baseline characteristics and below/above median AUC&lt;sub&gt;GH&lt;/sub&gt; were assessed by univariable logistic regression. Difference in GH and insulin concentration between intervention/placebo groups and below/above median AUC&lt;sub&gt;GH&lt;/sub&gt; was assessed by repeated measures analysis of variance. The Karolinska Acyl Ghrelin Trial was approved by the regional ethics committee and complies with the Declaration of Helsinki. All participants provided written informed consent.&lt;/p&gt;&lt;p&gt;At baseline, fasting GH did not differ between intervention (&lt;i&gt;n&lt;/i&gt; = 15) and placebo groups (&lt;i&gt;n&lt;/i&gt; = 15; one patient excluded due to premature interruption of placebo infusion) (0.4 [0.2–1.5] vs. 0.3 [0.1–1.2] μg/L; &lt;i&gt;p&lt;/i&gt; = 0.422). Displayed in &lt;i&gt;Figure&lt;/i&gt; 1A, GH increased rapidly during infusion in the acyl ghrelin-treated group (T60: 26 [20–38] μg/L), began to decline even before stopping infusion (T120: 9.1 [6.9–13] μg/L), and declined further after stopping infusion (T150: 2.4 [1.7–4.1] μg/L) compared to placebo (T60: 0.5 [0.3–0.9]; T120: 0.6 [0.4–0.9]; T150: 0.7 [0.3–1.2] μg/L; &lt;i&gt;p&lt;/i&gt; acy","PeriodicalId":164,"journal":{"name":"European Journal of Heart Failure","volume":"25 11","pages":"2093-2095"},"PeriodicalIF":18.2,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ejhf.3019","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10240374","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Haemodynamic and metabolic phenotyping of patients with aortic stenosis and preserved ejection fraction: A specific phenotype of heart failure with preserved ejection fraction?","authors":"Nicolò De Biase,&nbsp;Matteo Mazzola,&nbsp;Lavinia Del Punta,&nbsp;Valerio Di Fiore,&nbsp;Marco De Carlo,&nbsp;Cristina Giannini,&nbsp;Giulia Costa,&nbsp;Francesco Paneni,&nbsp;Alessandro Mengozzi,&nbsp;Lorenzo Nesti,&nbsp;Luna Gargani,&nbsp;Stefano Masi,&nbsp;Nicola Riccardo Pugliese","doi":"10.1002/ejhf.3018","DOIUrl":"10.1002/ejhf.3018","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>Degenerative aortic valve stenosis with preserved ejection fraction (ASpEF) and heart failure with preserved ejection fraction (HFpEF) display intriguing similarities. This study aimed to provide a non-invasive, comparative analysis of ASpEF versus HFpEF at rest and during exercise.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods and results</h3>\u0000 \u0000 <p>We prospectively enrolled 148 patients with HFpEF and 150 patients with degenerative moderate-to-severe ASpEF, together with 66 age- and sex-matched healthy controls. All subjects received a comprehensive evaluation at rest and 351/364 (96%) performed a combined cardiopulmonary exercise stress echocardiography test. Patients with ASpEF eligible for transcatheter aortic valve replacement (<i>n</i> = 125) also performed cardiac computed tomography (CT). HFpEF and ASpEF patients showed similar demographic distribution and biohumoral profiles. Most patients with ASpEF (134/150, 89%) had severe high-gradient aortic stenosis; 6/150 (4%) had normal-flow, low-gradient ASpEF, while 10/150 (7%) had low-flow, low-gradient ASpEF. Both patient groups displayed significantly lower peak oxygen consumption (VO₂), peak cardiac output, and peak arteriovenous oxygen difference compared to controls (all <i>p</i> &lt; 0.01). ASpEF patients showed several extravalvular abnormalities at rest and during exercise, similar to HFpEF (all <i>p</i> &lt; 0.01 vs. controls). Epicardial adipose tissue (EAT) thickness was significantly greater in ASpEF than HFpEF and was inversely correlated with peak VO₂ in all groups. In ASpEF, EAT was directly related to echocardiography-derived disease severity and CT-derived aortic valve calcium burden.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Functional capacity is similarly impaired in ASpEF and HFpEF due to both peripheral and central components. Further investigation is warranted to determine whether extravalvular alterations may affect disease progression and prognosis in ASpEF even after valve intervention, which could support the concept of ASpEF as a specific sub-phenotype of HFpEF.</p>\u0000 </section>\u0000 </div>","PeriodicalId":164,"journal":{"name":"European Journal of Heart Failure","volume":"25 11","pages":"1947-1958"},"PeriodicalIF":18.2,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10232728","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exercise hypoxaemia in heart failure with preserved ejection fraction.","authors":"Alain Cohen-Solal,&nbsp;Damien Logeart","doi":"10.1002/ejhf.2989","DOIUrl":"10.1002/ejhf.2989","url":null,"abstract":"in","PeriodicalId":164,"journal":{"name":"European Journal of Heart Failure","volume":" ","pages":"1604-1605"},"PeriodicalIF":18.2,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10012967","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}