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Epicardial adipose tissue in obesity with heart failure with preserved ejection fraction: Cardiovascular magnetic resonance biomarker study
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作者 Ju-Wei Shao Bing-Hua Chen +3 位作者 Kamil Abu-Shaban Ahmad Baiyasi Lian-Ming Wu Jing Ma 《World Journal of Cardiology》 2024年第3期149-160,共12页
BACKGROUND Obesity has become a serious public health issue,significantly elevating the risk of various complications.It is a well-established contributor to Heart failure with preserved ejection fraction(HFpEF).Evalu... BACKGROUND Obesity has become a serious public health issue,significantly elevating the risk of various complications.It is a well-established contributor to Heart failure with preserved ejection fraction(HFpEF).Evaluating HFpEF in obesity is crucial.Epicardial adipose tissue(EAT)has emerged as a valuable tool for validating prognostic biomarkers and guiding treatment targets.Hence,assessing EAT is of paramount importance.Cardiovascular magnetic resonance(CMR)imaging is acknowledged as the gold standard for analyzing cardiac function and mor-phology.We hope to use CMR to assess EAT as a bioimaging marker to evaluate HFpEF in obese patients.AIM To assess the diagnostic utility of CMR for evaluating heart failure with preserved ejection fraction[HFpEF;left ventricular(LV)ejection fraction≥50%]by measuring the epicardial adipose tissue(EAT)volumes and EAT mass in obese patients.METHODS Sixty-two obese patients were divided into two groups for a case-control study based on whether or not they had heart failure with HFpEF.The two groups were defined as HFpEF+and HFpEF-.LV geometry,global systolic function,EAT volumes and EAT mass of all subjects were obtained using cine magnetic resonance sequences.RESULTS Forty-five patients of HFpEF-group and seventeen patients of HFpEF+group were included.LV mass index(g/m2)of HFpEF+group was higher than HFpEF-group(P<0.05).In HFpEF+group,EAT volumes,EAT volume index,EAT mass,EAT mass index and the ratio of EAT/[left atrial(LA)left-right(LR)diameter]were higher compared to HFpEF-group(P<0.05).In multivariate analysis,Higher EAT/LA LR diameter ratio was associated with higher odds ratio of HFpEF.CONCLUSION EAT/LA LR diameter ratio is highly associated with HFpEF in obese patients.It is plausible that there may be utility in CMR for assessing obese patients for HFpEF using EAT/LA LR diameter ratio as a diagnostic biomarker.Further prospective studies,are needed to validate these proof-of-concept findings. 展开更多
关键词 Heart failure with preserved ejection fraction Epicardial adipose tissue OBESITY Cardiac magnetic resonance
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Heart failure with preserved ejection fraction and the first law of thermodynamics
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作者 Robert M Peters 《World Journal of Cardiology》 2024年第10期608-610,共3页
In heart failure with preserved ejection fraction,significant left ventricular diastolic abnormalities are present,despite a normal systolic ejection fraction.This article will consider whether this is consistent with... In heart failure with preserved ejection fraction,significant left ventricular diastolic abnormalities are present,despite a normal systolic ejection fraction.This article will consider whether this is consistent with the law of conservation of energy,also know as the first law of thermodynamics. 展开更多
关键词 Diastolic dysfunction Heart failure with preserved ejection fraction THERMODYNAMICS
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Health-related quality of life among congestive heart failure patients with preserved and reduced ejection fraction
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作者 Dian Hudiyawati Kartinah Afidatul Mujannidah 《Frontiers of Nursing》 2024年第1期111-117,共7页
Objective:To determine factors that affect the health-related quality of life(HRQOL)of congestive heart failure(CHF)patients with preserved and reduced ejection fraction.Methods:A cross-sectional study design was used... Objective:To determine factors that affect the health-related quality of life(HRQOL)of congestive heart failure(CHF)patients with preserved and reduced ejection fraction.Methods:A cross-sectional study design was used for this study.The stratified random sampling was applied for each subgroup.HRQOL was measured with the Minnesota Living with Hear t Failure Questionnaire.The data were analyzed using chi-square,Spearman's correlation analysis,and independent t-test.Results:A number of 67 respondents participated in the recent study.The total mean scores of HRQOL were significantly different(P=0.001)between heart failure(HF)patients with reduced and preserved ejection fractions,41.07±7.54 and 54.97±4.36,respectively.It related with the physical(mean±standard deviation[SD]=10.4±2.14;t=-10.08,95%CI=-12.46 to-8.34;P-value=0.001)and psychological(mean±SD=3.5±0.5;t=-6.68,95%CI=-4.55 to-2.45;P-value=0.001)domain.Strong correlation was found between age(r=-0.898,P<0.05),NYHA functional classes(r=-0.858,P<0.01),duration of HF(r=-0.807,P<0.01),family support(r=0.927,P<0.01),and quality of life(Qo L).Conclusions:HRQOL in HF patients with reduced ejection fraction was higher than in those with preserved ejection fraction.Family suppor t is a fur ther determinant factor that has a positive correlation to the Qo L. 展开更多
关键词 ejection fraction family support heart failure quality of life social support
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Heterogeneity in cardiorenal protection by Sodium glucose cotransporter 2 inhibitors in heart failure across the ejection fraction strata:Systematic review and meta-analysis
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作者 Saeed Taheri 《World Journal of Nephrology》 2023年第5期182-200,共19页
BACKGROUND Gliflozins or Sodium glucose cotransporter 2 inhibitors(SGLT2i)are relatively novel antidiabetic medications that have recently been shown to represent favorable effects on patients’cardiorenal outcomes.Ho... BACKGROUND Gliflozins or Sodium glucose cotransporter 2 inhibitors(SGLT2i)are relatively novel antidiabetic medications that have recently been shown to represent favorable effects on patients’cardiorenal outcomes.However,there is shortage of data on potential disparities in this therapeutic effect across different patient subpopulations.AIM To investigate differential effects of SGLT2i on the cardiorenal outcomes of heart failure patients across left ventricular ejection fraction(LVEF)levels.METHODS Literature was searched systematically for the large randomized double-blind controlled trials with long enough follow up periods reporting cardiovascular and renal outcomes in their patients regarding heart failure status and LVEF levels.Data were then meta-analyzed after stratification of the pooled data across the LVEF strata and New York Heart Associations(NYHA)classifications for heart failure using Stata software version 17.0.RESULTS The literature search returned 13 Large clinical trials and 13 post hoc analysis reports.Meta-analysis of the effects of gliflozins on the primary composite outcome showed no significant difference in efficacy across the heart failure subtypes,but higher efficacy were detected in patient groups at lower NYHA classifications(I2=46%,P=0.02).Meta-analyses across the LVEF stratums revealed that a baseline LVEF lower than 30%was associated with enhanced improvement in the primary composite outcome compared to patients with higher LVEF levels at the borderline statistical significance(HR:0.70,95%CI:0.60 to 0.79 vs 0.81,95%CI:0.75 to 0.87;respectively,P=0.06).Composite renal outcome was improved significantly higher in patients with no heart failure than in heart failure patients with preserved ejection fraction(HFpEF)(HR:0.60,95%CI:0.49 to 0.72 vs 0.94,95%CI:0.74 to 1.13;P=0.04).Acute renal injury occurred significantly less frequently in heart failure patients with reduced ejection fraction who received gliflozins than in HFpEF(HR:0.67,95%CI:51 to 0.82 vs 0.94,95%CI:0.82 to 1.06;P=0.01).Volume depletion was consistently increased in response to SGLT2i in all the subgroups.CONCLUSION Heart failure patients with lower LVEF and lower NYHA sub-classifications were found to be generally more likely to benefit from therapy with gliflozins.Further research are required to identify patient subgroups representing the highest benefits or adverse events in response to SGLT2i. 展开更多
关键词 Sodium glucose cotransporter 2 inhibitors Cardiovascular Renal outcome efficacy Heart failure with preserved ejection fraction Heart failure with reduced ejection fraction
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Interaction between the left ventricular ejection fraction and left ventricular strain and its relationship with coronary stenosis 被引量:2
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作者 Hai-Yan Gui Shu-Wen Liu Dong-Fang Zhu 《World Journal of Clinical Cases》 SCIE 2023年第10期2246-2253,共8页
BACKGROUND Coronary artery stenosis(CAS)is the most common type of heart disease and the leading cause of death in both men and women globally.CAS occurs when the arteries that supply blood to the heart muscle harden ... BACKGROUND Coronary artery stenosis(CAS)is the most common type of heart disease and the leading cause of death in both men and women globally.CAS occurs when the arteries that supply blood to the heart muscle harden and become narrower due to plaque buildup-cholesterol and other material-on their inner walls.As a result,the heart muscle cannot receive the blood or oxygen it needs.Most heart attacks happen when a blood clot suddenly cuts off the hearts'blood supply,causing permanent heart damage.AIM To analyze the relationship between the left ventricular ejection fraction(LVEF),left ventricular strain(LVS),and coronary stenosis.METHODS A total of 190 participants were enrolled in this trail.The control group comprised 93 healthy individuals,and observation group comprised 97 patients with coronary heart disease who were hospitalized between July 2020 and September 2021.Coronary lesions were assessed using the Gensini score,and the LVEF and LVS were measured using magnetic resonance imaging(MRI).The interaction between the LVEF and LVS was examined using a linear regression model.The relationship between LVEF and coronary stenosis was examined using Spearman’s correlation.RESULTS The LVEF of the observation group was lower than that of the control group.The left ventricular end-systolic volume(LVESV)and left ventricular end-diastolic volume(LVEDV)of the observation group were significantly higher than those of the control group(P<0.05).The longitudinal and circumferential strains(LS,CS)of the observation group were significantly higher than those of the control group;however,the radial strain(RS)of the observation group was significantly lower than that of the control group(P<0.05).LVS,LS,and CS were significantly negatively correlated with the LVEF,and RS was positively correlated with the LVEF.There were significant differences in the LVEF,LVESV,and LVEDV of patients with different Gensini scores;the LVEF significantly decreased and the LVESV and LVEDV increased with increasing Gensini scores(P<0.05).In the observation group,the LVEF was negatively correlated and the LVESV and LVEDV were positively correlated with coronary stenosis(P<0.05).CONCLUSION The LVEF measured using MRI is significantly linearly correlated with LVS and negatively correlated with coronary stenosis. 展开更多
关键词 Magnetic resonance imaging Left ventricular ejection fraction Left ventricular strain Coronary stenosis Left ventricular end-diastolic volume Left ventricular end-systolic volume
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The influence of pressure injury risk on the association between left ventricular ejection fraction and all-cause mortality in patients with acute myocardial infarction 80 years or older 被引量:1
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作者 Bao-tao Huang Yi-heng Cheng +5 位作者 Bo-sen Yang Yi-ke Zhang Fang-yang Huang Yong Peng Xiao-bo Pu Mao Chen 《World Journal of Emergency Medicine》 SCIE CAS CSCD 2023年第2期112-121,共10页
BACKGROUND: We aimed to investigate whether the pressure injury risk mediates the association of left ventricular ejection fraction(LVEF) with all-cause death in patients with acute myocardial infarction(AMI) aged 80 ... BACKGROUND: We aimed to investigate whether the pressure injury risk mediates the association of left ventricular ejection fraction(LVEF) with all-cause death in patients with acute myocardial infarction(AMI) aged 80 years or older.METHODS: This retrospective cohort study included 677 patients with AMI aged 80 years or older from a tertiary-level hospital. Pressure injury risk was assessed using the Braden scale at admission, and three risk groups(low/minimal, intermediate, high) were defined according to the overall score of six different variables. LVEF was measured during the index hospitalization for AMI. All-cause death after hospital discharge was the primary outcome.RESULTS: Over a median follow-up period of 1,176 d(interquartile range [IQR], 722–1,900 d), 226(33.4%) patients died. Multivariate Cox regression analysis showed that reduced LVEF was associated with an increased risk of all-cause death only in the high-risk group of pressure injury(adjusted hazard ratios [HR]=1.81, 95% confidence interval [CI]: 1.03–3.20;P=0.040), but not in the low/minimal-(adjusted HR=1.29, 95%CI: 0.80–2.11;P=0.299) or intermediate-risk groups(adjusted HR=1.14, 95%CI: 0.65–2.02;P=0.651). Significant interactions were detected between pressure injury risk and LVEF(adjusted P=0.003). The cubic spline with hazard ratio plot revealed a distinct shaped curve relation between LVEF and all-cause death among different pressure injury risk groups.CONCLUSIONS: In older patients with AMI, the risk of pressure injury mediated the association between LVEF and all-cause death. The classification of older patients for both therapy and prognosis assessment appears to be improved by the incorporation of pressure injury risk assessment into AMI care management. 展开更多
关键词 Pressure injuries Left ventricular ejection fraction DEATH GERIATRICS Myocardial infarction
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Targeting epicardial adipose tissue:A potential therapeutic strategy for heart failure with preserved ejection fraction with type 2 diabetes mellitus 被引量:1
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作者 Yu-Jiao Shi Guo-Ju Dong Ming Guo 《World Journal of Diabetes》 SCIE 2023年第6期724-740,共17页
Heart failure with preserved ejection fraction(HFpEF)is a heterogeneous syndrome with various comorbidities,multiple cardiac and extracardiac pathophysiologic abnormalities,and diverse phenotypic presentations.Since H... Heart failure with preserved ejection fraction(HFpEF)is a heterogeneous syndrome with various comorbidities,multiple cardiac and extracardiac pathophysiologic abnormalities,and diverse phenotypic presentations.Since HFpEF is a heterogeneous disease with different phenotypes,individualized treatment is required.HFpEF with type 2 diabetes mellitus(T2DM)represents a specific phenotype of HFpEF,with about 45%-50% of HFpEF patients suffering from T2DM.Systemic inflammation associated with dysregulated glucose metabolism is a critical pathological mechanism of HFpEF with T2DM,which is intimately related to the expansion and dysfunction(inflammation and hypermetabolic activity)of epicardial adipose tissue(EAT).EAT is well established as a very active endocrine organ that can regulate the pathophysiological processes of HFpEF with T2DM through the paracrine and endocrine mechanisms.Therefore,suppressing abnormal EAT expansion may be a promising therapeutic strategy for HFpEF with T2DM.Although there is no treatment specifically for EAT,lifestyle management,bariatric surgery,and some pharmaceutical interventions(anti-cytokine drugs,statins,proprotein convertase subtilisin/kexin type 9 inhibitors,metformin,glucagon-like peptide-1 receptor agonists,and especially sodium-glucose cotransporter-2 inhibitors)have been shown to attenuate the inflammatory response or expansion of EAT.Importantly,these treatments may be beneficial in improving the clinical symptoms or prognosis of patients with HFpEF.Accordingly,well-designed randomized controlled trials are needed to validate the efficacy of current therapies.In addition,more novel and effective therapies targeting EAT are needed in the future. 展开更多
关键词 Epicardial adipose tissue Heart failure with preserved ejection fraction Type 2 diabetes mellitus Inflammation Anti-hyperglycemic drugs Sodium-glucose cotransporter-2 inhibitors
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Impact of vericiguat on heart failure with reduced ejection fraction:a review 被引量:1
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作者 Manisha Vohra Mohammad Amir +2 位作者 Ian Osoro Amit Sharma Ranjeet Kumar 《Global Health Journal》 2023年第3期123-129,共7页
Introduction:Heart failure is a major public health issue with a prevalence of about 26 million people worldwide.Reduced nitric oxide availability,lower soluble guanylate cyclase(sGC)activity,and decreased cyclic guan... Introduction:Heart failure is a major public health issue with a prevalence of about 26 million people worldwide.Reduced nitric oxide availability,lower soluble guanylate cyclase(sGC)activity,and decreased cyclic guanosine monophosphate(cGMP)production are the causes of HF's development.Vericiguat prescribed under the brand name Verquvo was approved by U.S.Food and Drug Administration(FDA)in January 2021.It is a novel agent and the first sGC stimulator which helps to treat patients suffering from heart failure with reduced ejection fraction(HFrEF).Objective:The mechanism of action(cGMP pathway)of vericiguat,its clinical trials,its use in the treatment of heart failure,and its possible future aspects in therapeutic recommendations are all covered in this review.It will also raise awareness amongst healthcare professionals about the pharmacokinetic and pharmacodynamic parameters,dosing,administration,and drug-related problems of this new drug.Methods:Various databases for drug review were used in this review like PubMed,Medline,Google scholar,Drug bank,U.s.FDA,Medscape,and European society of cardiology guidelines.A total of 58 articles were screened out of which 39 articles were included in this review.Results:This review discusses vericiguat's mechanism of action(cGMP pathway),clinical studies,application in the treatment of heart failure,and potential future considerations in therapeutic recommendations.It will also educate healthcare professionals about the new drug's pharmacokinetics and pharmacodynamics,dose,administration,and drug-related problems.Conclusion:After hospitalization for HFrEF,the 5-year survival rate is just 25%,and disease morbidity and death are stil significant.As adjunctive therapy for individuals with heart failure and a low ejection fraction,vericiguat has a moderate level of effectiveness.Vericiguat's efficacy as an adjunct therapy to different drugs used to cure HF has to be further investigated.Vericiguat's safety and dosage in patients who have severe renal or hepatic illness need to be studied further. 展开更多
关键词 Vericiguat Heart failure with reduced ejection fraction Soluble guanylate cyclase stimulator Nitric oxide Cyclicguanosinemonophosphate
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Therapies for patients with coexisting heart failure with reduced ejection fraction and non-alcoholic fatty liver disease
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作者 Jose Arriola-Montenegro Renato Beas +5 位作者 Renato Cerna-Viacava Andres Chaponan-Lavalle Karla Hernandez Randich Diego Chambergo-Michilot Herson Flores Sanga Pornthira Mutirangura 《World Journal of Cardiology》 2023年第7期328-341,共14页
Heart failure with reduced ejection fraction(HFrEF)and nonalcoholic fatty liver disease(NAFLD)are two common comorbidities that share similar pathophysiological mechanisms.There is a growing interest in the potential ... Heart failure with reduced ejection fraction(HFrEF)and nonalcoholic fatty liver disease(NAFLD)are two common comorbidities that share similar pathophysiological mechanisms.There is a growing interest in the potential of targeted therapies to improve outcomes in patients with coexisting HFrEF and NAFLD.This manuscript reviews current and potential therapies for patients with coexisting HFrEF and NAFLD.Pharmacological therapies,including angiotensinconverting enzyme inhibitors/angiotensin receptor blockers,mineralocorticoids receptor antagonist,and sodium-glucose cotransporter-2 inhibitors,have been shown to reduce fibrosis and fat deposits in the liver.However,there are currently no data showing the beneficial effects of sacubitril/valsartan,ivabradine,hydralazine,isosorbide nitrates,digoxin,or beta blockers on NAFLD in patients with HFrEF.This study highlights the importance of considering HFrEF and NAFLD when developing treatment plans for patients with these comorbidities.Further research is needed in patients with coexisting HFrEF and NAFLD,with an emphasis on novel therapies and the importance of a multidisciplinary approach for managing these complex comorbidities. 展开更多
关键词 Non-alcoholic fatty liver disease Heart Failure Heart failure reduced ejection fraction Novel therapies Cardiovascular disease
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Clinical efficacy of dapagliflozin in the treatment of type 2 diabetes mellitus with heart failure with mildly reduced ejection fraction
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作者 XU Lin-hui WANG Wan-hong +1 位作者 ZHANG Yi SHI Bo 《Journal of Hainan Medical University》 CAS 2023年第9期40-45,共6页
Objective:To observe the clinical efficacy of dapagliflozin in the treatment of type 2 diabetes mellitus(T2DM)complicated with heart failure with mildly reduced ejection fraction(HFmrEF,40%≤LVEF<50%).Methods:A tot... Objective:To observe the clinical efficacy of dapagliflozin in the treatment of type 2 diabetes mellitus(T2DM)complicated with heart failure with mildly reduced ejection fraction(HFmrEF,40%≤LVEF<50%).Methods:A total of 84 patients with T2DM complicated with HFmrEF hospitalized in our hospital from October 2019 to October 2021 were selected,and random number table method was used to divide into the control group and the study group each 42 cases.Both groups used basal hypoglycemic and standardized anti-heart failure therapy,and the study group was treated with dapagliflozin simultaneously.Nine months later,the following indexes were compared between the two groups before and after treatment:the cardiac function indicators:N-terminal pro brain natriuretic peptide(NT-proBNP),left ventricular ejection fraction(LVEF);exercise endurance:6-minute walk distance(6MWD),NYHA cardiac function class,the score of the Minnesota living with heart failure questionnaire(MLHFQ)and the incidence of major adverse cardiovascular events(MACE).Results:Nine months later,the two groups showed decreased NT-proBNP level,increased LVEF,prolonged 6MWD,improved NYHA cardiac function grade,decreased MLHFQ score,and statistically significant differences within both groups compared with before treatment(P<0.05),after treatment significant differences were displayed between the two groups(P<0.05).Less patients had MACE events and adverse drug reactions in the study group compared with the control group.Conclusion:Dapagliflozin in the treatment of T2DM patients with HFmrEF can improve cardiac function indicators,improve exercise endurance,improve NYHA cardiac function class,improve patient's quality of life,and reduce the incidence of MACE events,with no obvious side effects. 展开更多
关键词 DAPAGLIFLOZIN Type 2 diabetes mellitus Heart failure with mildly reduced ejection fraction
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The Clinical Association of Left Atrial Function with Left Ventricular Ejection Fraction
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作者 Vignendra Ariyarajah Hiten Patel +2 位作者 Atif Shaikh Khurram Liaqat Sirin Apiyasawat 《World Journal of Cardiovascular Surgery》 2023年第3期45-54,共10页
The left atrium (LA) has been recognized as a morphophysiological barometer of left ventricular (LV) diastolic dysfunction. Because in the myocardial ischemia cascade where LV diastolic dysfunction often precedes LV s... The left atrium (LA) has been recognized as a morphophysiological barometer of left ventricular (LV) diastolic dysfunction. Because in the myocardial ischemia cascade where LV diastolic dysfunction often precedes LV systolic dysfunction, the LA which fashions as an early marker of diastolic anomaly, could equally reflect a declining LV function and/or be a good predictor of potential sequelae. We assessed this association of LA function with reduced LV systolic function among hospitalized patients. Among patients with reduced LV ejection fraction, LA passive ejection fraction was lower (0.172 ± 0.12 vs. 0.232 ± 0.14, p = 0.013) whereas LA kinetic energy was higher (6.48 ± 6.3 vs. 4.57 ± 3.5, p = 0.005). Echocardiographic assessment of LA function, therefore, appears correlated with LVEF and could be important when risk stratifying hospitalized patients. 展开更多
关键词 Left Atrial Function Left Atrial Kinetic Energy Left Ventricular Function Left Ventricular ejection fraction ECHOCARDIOGRAPHY
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Risks of incident heart failure with preserved ejection fraction in Chinese patients hospitalized for cardiovascular diseases 被引量:4
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作者 Jun-Xia ZHANG Yi-Xian LIU +4 位作者 Chun-Lei XIA Peng CHU Xin-Liang QU Lin-Lin ZHU Shao-Liang CHEN 《Journal of Geriatric Cardiology》 SCIE CAS CSCD 2019年第12期885-893,共9页
Background Endogenous aldehyde damages DNA and potentiates an ageing phenotype. The aldehyde dehydrogenase 2(ALDH2) rs671 polymorphism has a prevalence of 30%–50% in Asian populations. In this study, we aimed to anal... Background Endogenous aldehyde damages DNA and potentiates an ageing phenotype. The aldehyde dehydrogenase 2(ALDH2) rs671 polymorphism has a prevalence of 30%–50% in Asian populations. In this study, we aimed to analyze risk factors contributing to the development of heart failure with preserved ejection fraction(HFpEF) along with the genetic exposure in Chinese patients hospitalized with cardiovascular diseases(CVD). Methods From July 2017 to October 2018, a total of 770 consecutive Chinese patients with normal left ventricular ejection fractions(LVEF) and established CVD(hypertension, coronary heart diseases, or diabetes) were enrolled in this prospective cross-sectional study. HFpEF was defined by the presence of at least one of symptom(dyspnoea and fatigue) or sign(rales and ankle swelling) related to heart failure;N-terminal pro-B-Type natriuretic peptide(NT pro-BNP ≥ 280 pg/mL);LVEF ≥ 50%;and at least one criterion related to elevated ventricular filling pressure or diastolic dysfunction(left atrial diameter > 40 mm, E/E’ ≥ 13, E’/A’ < 1 or concurrent atrial fibrillation). Logistic regression was performed to yield adjusted odds ratios(ORs) for HFp EF incidence associated with traditional and/or genetic exposures. Results Finally, among 770 patients with CVD, 92(11.9%) patients were classified into the HFpEF group according to the diagnostic criteria. The mean age of the participants was 67 ± 12 years, and 278(36.1%) patients were females. A total of 303(39.4%) patients were ALDH2*2 variant carriers. In the univariate analysis, eight exposures were found to be associated with HFpEF: atrial fibrillation, ALDH2*2 variants, hypertension, age, anaemia, smoking, alcohol consumption and sex. Multivariable logistic regression showed that 4 ‘A’ variables(atrial fibrillation, ALDH2*2 variants, age and anaemia) were significantly associated with an increased risk of HFpEF. Atrial fibrillation was associated with a 3.8-fold increased HFpEF risk(95% CI: 2.21–6.61, P < 0.001), and the other three exposures associated with increased HFpEF risk were the ALDH2*2 variant(OR = 2.41, 95% CI: 1.49–3.87, P < 0.001), age(OR = 2.14, 95% CI: 1.27–3.60, P = 0.004), and anaemia(OR = 1.79, 95% CI: 1.05–3.03, P = 0.032). These four variables predicted HFpEF incidence in Chinese CVD patients(C-statistic = 0.745, 95% CI: 0.691–0.800, P < 0.001). Conclusions 4 A traits(atrial fibrillation, ALDH2*2 variants, age and anaemia) were associated with an increased risk of HFpEF in Chinese CVD patients. Our results provide potential clues to the aetiology, pathophysiology and therapeutic targets of HFpEF. 展开更多
关键词 Aldehyde dehydrogenase 2 Cardiovascular diseases Diastolic dysfunction Heart failure with preserved ejection fraction Riskfactor
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Correction of hypovitaminosis D improved global longitudinal strain earlier than left ventricular ejection fraction in cardiovascular older adults after orthopaedic surgery 被引量:1
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作者 Matteo Briguglio Luigi Gianturco +6 位作者 Daniele Stellat Chiara Colombo Marika Bonadies Oscar Salat Mauro Anselmi Giuseppe Banff Maurizio Turiel 《Journal of Geriatric Cardiology》 SCIE CAS CSCD 2018年第8期519-522,共4页
Background Cardiovascular diseases and insufficient levels of vitamin D are risk factors for adverse surgical outcomes, and they are both commonly present among older adults undergoing orthopaedic surgery. Giving the ... Background Cardiovascular diseases and insufficient levels of vitamin D are risk factors for adverse surgical outcomes, and they are both commonly present among older adults undergoing orthopaedic surgery. Giving the cardiovascular effects of vitamin D, pre-operative diagnosis of hypovitaminosis D would be a valuable step for the implementation of supplementation protocols. We investigated if the nor- malization of serum 25 [OH] D could ameliorate cardiac performance of older adults suffering from cardiovascular diseases. Methods We enrolled 47 older adults scheduled for major orthopaedic surgery and suffering from hypovitaminosis D. Patients underwent 6-months cal- cifediol supplementation with a starting dose at first post-operative day of 50 ~tg/die in liquid preparation. Down-titration to 20 Ixg/die at 3-months assessment was planned. Cardiac performance was evaluated by measuring left ventricular ejection fraction (LVEF) and global longitudinal strain (GLS) during pre-operative assessments and at 1-month, 3-months, 6-months follow-ups. Results Six months of cal- cifediol supplementation were associated with a significant improvement of both LVEF (+ 3.94%; 95% CI: -4.0789 to -0.8232; P 〈 0.01) and GLS (+ 18.56%; Z = -5.895; P 〈 0.0001). Conclusions Calcifediol supplementation normalized serum 25 [OH] D concentration after 1-month treatment. GLS offered better insights into myocardial contractile amelioration than LVEF, thus being useful for detecting earlier subclinical changes that may anticipate hemodynamic modifications. 展开更多
关键词 Global longitudinal strain Left ventricular ejection fraction Orthopedic surgery Transthoracic echocardiography Vitamin D
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Heart failure with reduced,mildly reduced,or preserved left ventricular ejection fraction:Has reasoning been lost? 被引量:1
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作者 Andrew Xanthopoulos Grigorios Giamouzis +1 位作者 John Skoularigis Filippos Triposkiadis 《World Journal of Cardiology》 2022年第7期438-445,共8页
Left ventricular(LV)ejection fraction(LVEF),defined as LV stroke volume divided by end-diastolic volume,has been systematically used for the diagnosis,classification,and management of heart failure(HF)over the last th... Left ventricular(LV)ejection fraction(LVEF),defined as LV stroke volume divided by end-diastolic volume,has been systematically used for the diagnosis,classification,and management of heart failure(HF)over the last three decades.HF is classified as HF with reduced LVEF,HF with midrange or mildly reduced LVEF,and HF with preserved LVEF using arbitrary,continuously changing LVEF cutoffs.A prerequisite for using this LVEF-based terminology is knowledge of the LVEF normal range,which is lacking and may lead to erroneous conclusions in HF,especially at the higher end of the LVEF spectrum. 展开更多
关键词 Arbitrary Cut off Guidelines Limitations Normal left ventricular ejection fraction range Phenotypic persistence
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Thirty-day readmission in patients with heart failure with preserved ejection fraction:Insights from the nationwide readmission database 被引量:1
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作者 Anil Kumar Jha Chandra P Ojha +1 位作者 Anand M Krishnan Timir K Paul 《World Journal of Cardiology》 2022年第9期473-482,共10页
BACKGROUND There are rising numbers of patients who have heart failure with preserved ejection fraction(HFpEF).Poorly understood pathophysiology of heart failure with preserved and reduced ejection fraction and due to... BACKGROUND There are rising numbers of patients who have heart failure with preserved ejection fraction(HFpEF).Poorly understood pathophysiology of heart failure with preserved and reduced ejection fraction and due to a sparsity of studies,the management of HFpEF is challenging.AIM To determine the hospital readmission rate within 30 d of acute or acute on chronic heart failure with preserved ejection fraction and its effect on mortality and burden on health care in the United States.METHODS We performed a retrospective study using the Agency for Health-care Research and Quality Health-care Cost and Utilization Project,Nationwide Readmissions Database for the year 2017.We collected data on hospital readmissions of 60514 adults hospitalized for acute or acute on chronic HFpEF.The primary outcome was the rate of all-cause readmission within 30 d of discharge.Secondary outcomes were cause of readmission,mortality rate in readmitted and index patients,length of stay,total hospitalization costs and charges.Independent risk factors for readmission were identified using Cox regression analysis.RESULTS The thirty day readmission rate was 21%.Approximately 9.17%of readmissions were in the setting of acute on chronic diastolic heart failure.Hypertensive chronic kidney disease with heart failure(1245;9.7%)was the most common readmission diagnosis.Readmitted patients had higher in-hospital mortality(7.9%vs 2.9%,P=0.000).Our study showed that Medicaid insurance,higher Charlson co-morbidity score,patient admitted to a teaching hospital and longer hospital stay were significant variables associated with higher readmission rates.Lower readmission rate was found in residents of small metropolitan or micropolitan areas,older age,female gender,and private insurance or no insurance were associated with lower risk of readmission.CONCLUSION We found that patients hospitalized for acute or acute on chronic HFpEF,the thirty day readmission rate was 21%.Readmission cases had a higher mortality rate and increased healthcare resource utilization.The most common cause of readmission was cardio-renal syndrome. 展开更多
关键词 Heart failure with preserved ejection fraction Diastolic heart failure READMISSION National readmission database Health care resource utilization
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Heart failure with preserved ejection fraction: A distinct heart failure phenotype?
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作者 Filippos Triposkiadis Grigorios Giamouzis +1 位作者 John Skoularigis Andrew Xanthopoulos 《World Journal of Clinical Cases》 SCIE 2022年第32期12052-12055,共4页
The present work discusses the serious confusion resulting from the arbitrary nomenclature of heart failure with preserved ejection fraction(HFpEF),the presumed underlying pathophysiology,and the supposed features.A c... The present work discusses the serious confusion resulting from the arbitrary nomenclature of heart failure with preserved ejection fraction(HFpEF),the presumed underlying pathophysiology,and the supposed features.A consequence of this misconception is that HFpEF trials have recruited patients with entirely different characteristics rendering the extrapolation of the results of one study to the other infeasible and dramatically affecting diagnosis and treatment. 展开更多
关键词 Heart failure PRESERVED NOMENCLATURE Left ventricular ejection fraction PATHOPHYSIOLOGY Phenotypic persistence
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The Relationship between Abnormal Circadian Blood Pressure Rhythm and Risk of Readmission in Patients with Heart Failure with Preserved Ejection Fraction
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作者 Diqing Wang Zhengfei He +1 位作者 Sihua Chen Jianlin Du 《Cardiovascular Innovations and Applications》 2021年第2期275-282,共8页
Objective:Abnormal circadian blood pressure rhythm has been revealed to be associated with hypertensive target organ damage and cardiovascular events,but its association with readmission risk in patients with heart fa... Objective:Abnormal circadian blood pressure rhythm has been revealed to be associated with hypertensive target organ damage and cardiovascular events,but its association with readmission risk in patients with heart failure with preserved ejection fraction(HFpEF)remains unknown.We conducted a retrospective study to explore the relationship between circadian blood pressure rhythm and readmission risk in HFpEF patients.Methods:We retrospectively collected baseline and follow-up data on HFpEF patients who underwent ambulatory blood pressure monitoring(ABPM)from May 2015 to October 2019.Patient circadian blood pressure rhythms defi ned by ABPM were grouped as dipper,nondipper,or riser patterns.Univariate and multivariate linear regression analyses were performed to assess the association between circadian blood pressure rhythm and readmission risk.Results:A total of 122 patients were enrolled in this study.The mean age and ejection fraction were 69.87 years and 61.44%,respectively,with mean the N-terminal pro-B-type natriuretic peptide(NT-proBNP)level being 1048.15 pg/mL.There were signifi cant differences in the 24-hour systolic blood pressure(SBP),sleep SBP,and sleep diastolic blood pressure(DBP)among the three groups,where the 24-hour SBP,sleep SBP,and sleep DBP in the riser pattern group were markedly higher than in the dipper pattern group.Notably,serum NT-proBNP levels,the proportion of patients readmitted for heart failure and the mean number of admissions differed markedly among three groups.Instructively,multivariate linear regression analysis showed that the riser pattern was a signifi cant and independent risk factor for increased serum NT-proBNP level(β=929.16,95%confi dence interval 178.79–1679.53,P=0.016).In multivariate logistic regression analysis,the riser pattern was demonstrated to be a signifi cant risk factor for readmission(odds ratio 11.23,95%confi dence interval 2.01–62.67,P=0.006)in HFpEF patients.Conclusion:The riser blood pressure pattern is a potential risk factor for elevated serum NT-proBNP level and readmission in HFpEF patients. 展开更多
关键词 Heart failure with preserved ejection fraction circadian blood pressure rhythm ambulatory blood pressure monitoring riser pattern N-terminal pro-B-type natriuretic peptide READMISSION
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Dapagliflozin in Heart Failure with Reduced Ejection Fraction:A Real-World Study
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作者 Zhengyang Hao Yanzhou Zhang 《Cardiovascular Innovations and Applications》 2022年第2期219-223,共5页
Aims:We aimed to observe the improvements in cardiac function indexes and the occurrence of adverse events in patients with heart failure with reduced ejection fraction(HFrEF)after dapagliflozin administration in a rea... Aims:We aimed to observe the improvements in cardiac function indexes and the occurrence of adverse events in patients with heart failure with reduced ejection fraction(HFrEF)after dapagliflozin administration in a real-world setting.Methods:We retrospectively included 201 patients with HFrEF who were treated at a tertiary hospital in Zhengzhou and started to take dapagliflozin(10 mg/d)from March 2020 to June 2021.Their New York Heart Association(NYHA)functional class,cardiac ultrasound indexes,laboratory indexes,and vital signs between baseline and the last follow-up visit were compared,and their adverse events during the follow-up period were recorded.Results:The follow-up period was 173(67–210)days.The cardiac function indexes of patients at follow-up,com-pared with baseline,indicated significant improvement(proportion of NYHA functional class I and II:40.8%vs.56.2%;left ventricular ejection fraction:28.4±5.3%vs.34.7±5.9%;left ventricular end-diastolic diameter:70.1±6.4 mm vs.64.7±5.6 mm;N-terminal pro-B-type natriuretic peptide:5421.9±2864.4 pg/mL vs.2842.8±1703.4 pg/mL at baseline vs.at follow-up;all P<0.05).The rates of hypotension,deterioration of renal function,and genital infection during the follow-up period were 6.5%,4.0%,and 3.5%,respectively.Conclusions:We believe that dapagliflozin is safe and effective in patients with HFrEF in the real world. 展开更多
关键词 Dapagliflozin Heart failure with reduced ejection fraction Real world
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Machine learning algorithm using publicly available echo database for simplified“visual estimation”of left ventricular ejection fraction
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作者 Michael Blaivas Laura Blaivas 《World Journal of Experimental Medicine》 2022年第2期16-25,共10页
BACKGROUND Left ventricular ejection fraction calculation automation typically requires complex algorithms and is dependent of optimal visualization and tracing of endocardial borders.This significantly limits usabili... BACKGROUND Left ventricular ejection fraction calculation automation typically requires complex algorithms and is dependent of optimal visualization and tracing of endocardial borders.This significantly limits usability in bedside clinical applications,where ultrasound automation is needed most.AIM To create a simple deep learning(DL)regression-type algorithm to visually estimate left ventricular(LV)ejection fraction(EF)from a public database of actual patient echo examinations and compare results to echocardiography laboratory EF calculations.METHODS A simple DL architecture previously proven to perform well on ultrasound image analysis,VGG16,was utilized as a base architecture running within a long short term memory algorithm for sequential image(video)analysis.After obtaining permission to use the Stanford EchoNet-Dynamic database,researchers randomly removed approximately 15%of the approximately 10036 echo apical 4-chamber videos for later performance testing.All database echo examinations were read as part of comprehensive echocardiography study performance and were coupled with EF,end systolic and diastolic volumes,key frames and coordinates for LV endocardial tracing in csv file.To better reflect point-of-care ultrasound(POCUS)clinical settings and time pressure,the algorithm was trained on echo video correlated with calculated ejection fraction without incorporating additional volume,measurement and coordinate data.Seventy percent of the original data was used for algorithm training and 15%for validation during training.The previously randomly separated 15%(1263 echo videos)was used for algorithm performance testing after training completion.Given the inherent variability of echo EF measurement and field standards for evaluating algorithm accuracy,mean absolute error(MAE)and root mean square error(RMSE)calculations were made on algorithm EF results compared to Echo Lab calculated EF.Bland-Atlman calculation was also performed.MAE for skilled echocardiographers has been established to range from 4%to 5%.RESULTS The DL algorithm visually estimated EF had a MAE of 8.08%(95%CI 7.60 to 8.55)suggesting good performance compared to highly skill humans.The RMSE was 11.98 and correlation of 0.348.CONCLUSION This experimental simplified DL algorithm showed promise and proved reasonably accurate at visually estimating LV EF from short real time echo video clips.Less burdensome than complex DL approaches used for EF calculation,such an approach may be more optimal for POCUS settings once improved upon by future research and development. 展开更多
关键词 Deep learning Artificial intelligence Point-of-care-ultrasound ejection fraction CARDIAC ECHOCARDIOGRAPHY
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Progress in the Pathogenesis and Treatment of Heart Failure with Preserved Ejection Fraction
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作者 Xinyu Song Zhixiang Zhang 《Proceedings of Anticancer Research》 2021年第5期26-29,共4页
Heart failure with preserved ejection fraction(HFpEF)is a special and common clinical heart failure with left ventricular diastolic dysfunction.It has attracted much attention at home and abroad in recent years becaus... Heart failure with preserved ejection fraction(HFpEF)is a special and common clinical heart failure with left ventricular diastolic dysfunction.It has attracted much attention at home and abroad in recent years because of its high heterogeneity and complex pathogenesis.Compared with heart failure with reduced ejection fraction(HFrEF),HFpEF has complex clinical manifestations,many complications,limited clinical treatment,and poor prognosis.In recent years,the research on the pathogenesis and treatment of HFpEF has made certain progress,but there are no specific guidelines for clinical practice.By combing the latest research at home and abroad,the pathogenesis and treatment of HFpEF are systematically reviewed in order to provide a relevant basis for reference its clinical treatment. 展开更多
关键词 Heart failure with preserved ejection fraction PATHOGENESIS Treatment progress
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