155 research outputs found
Functional Mitral Regurgitation and Heart Failure With Preserved Ejection Fraction: Clinical Implications and Management
No full text: Heart failure with preserved ejection fraction (HFpEF) is highly prevalent and associated with worse cardiovascular outcomes. The pathophysiology of HFpEF mostly relies on the development of elevated left ventricle filling pressure, diastolic dysfunction, and atrial dilatation and impairment. This dynamic process may eventually lead to the development of functional mitral regurgitation (MR), characterized by mitral annular dilatation and consequent leaflet remodeling, in the context of preserved left ventricular ejection fraction. These observations highlight the possible common pathophysiology of MR and HFpEF. However, less is known about the prevalence and the clinical value of MR in the context of HFpEF. This review aims to provide an overview of the association and interplay between functional MR and HFpEF, discuss the underlying mechanisms that are common to these diseases, and summarize potential targeted pharmacological treatments
The creation of collective identity in James's nonfiction after World War I
No full textConference paper presented at the 9th International Henry James Society Conference, Kyoto, Japan (July 5-8, 2023).Not peer reviewedPresentatio
Long term safety and outcomes after atrial shunting for heart failure with preserved or mildly reduced ejection fraction: 5-year and 3-year follow-up in the REDUCE LAP-HF I and II trials
No full text
HFpEF treatment: pharmacological therapy
No full textHeart failure with preserved ejection fraction (HFpEF) is a diverse syndrome characterized by signs and symptoms of heart failure with relatively preserved ejection fraction. Despite the established efficacy of numerous classes of drugs and devices in heart failure with reduced ejection fraction, no specific therapy has yet proven to reduce morbidity and mortality in HFpEF. Currently, treatment of HFpEF remains empiric, and includes diuretic therapy for decongestion, treatment of hypertension, diagnosis and treatment of ischaemia, rate control for atrial fibrillation, and treatment of co-morbidities. While outcomes trials in HFpEF have tested renin–angiotensin–aldosterone inhibitors, and none have met their primary endpoint, there is some evidence that in appropriate patients, the mineralocorticoid receptor antagonist spironolactone may be helpful to reduce heart failure hospitalizations. Several other medications have been tested in phase II trials. Sildenafil, isosorbide mononitrate, and the soluble guanylate cyclase stimulator vericiguat did not show benefit in phase II trials. In contrast, sacubitril/valsartan was associated with a significant decrease in N-terminal pro-B-type natriuretic peptide values and improvement in left atrial size in a phase II trial. A large phase III trial to confirm these findings is under way.</p
Added value of cardiac deformation imaging in differential diagnosis of left ventricular hypertrophy
No full textHypertrophic cardiomyopathy is clinically defined by the presence of increased left ventricular (LV) wall thickness that is not solely explained by abnormal loading conditions. The aetiology is diverse, but in 60% of patients the disease is an autosomal dominant trait caused by cardiac sarcomere protein gene mutation (HCM). In 10% of cases, the cause is inherited metabolic and neuromuscular disease, chromosomic abnormalities and genetic syndromes, whereas, in the remaining 30% of patients the aetiology remains unknown.We are indebted to Maja Cikes, MD, PhD from University of Zagreb for her contributions to this line of research and her continuous support to the authors. This work was partially supported by Spanish Ministry of Economy and Competitiveness (grant TIN2014-52923-R; Maria de Maeztu Units of Excellence Programme - MDM-2015-0502), FEDER, Grants from Fundacio La Marató de TV3 (040310) and Horizon 2020 European Commission Project H2020-MSCA-ITN-2016 (764738)
2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure Developed by the Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC) With the special contribution of the Heart Failure Association (HFA) of the ESC
Get PDFpeer reviewedDocument Reviewers: Rudolf A. de Boer (CPG Review Coordinator) (Netherlands), P. Christian Schulze (CPG Review Coordinator) (Germany), Magdy Abdelhamid (Egypt), Victor Aboyans (France), Stamatis Adamopoulos (Greece), Stefan D. Anker (Germany), Elena Arbelo (Spain), Riccardo Asteggiano (Italy), Johann Bauersachs (Germany), Antoni Bayes-Genis (Spain), Michael A. Borger (Germany), Werner Budts (Belgium), Maja Cikes (Croatia), Kevin Damman (Netherlands), Victoria Delgado (Netherlands), Paul Dendale (Belgium), Polychronis Dilaveris (Greece), Heinz Drexel (Austria), Justin Ezekowitz (Canada), Volkmar Falk (Germany), Laurent Fauchier (France), Gerasimos Filippatos (Greece), Alan Fraser (United Kingdom), Norbert Frey (Germany), Chris P. Gale (United Kingdom), Finn Gustafsson (Denmark), Julie Harris (United Kingdom), Bernard Iung (France), Stefan Janssens (Belgium), Mariell Jessup (United States of America), Aleksandra Konradi (Russia), Dipak Kotecha (United Kingdom), Ekaterini Lambrinou (Cyprus), Patrizio Lancellotti (Belgium), Ulf Landmesser (Germany), Christophe Leclercq (France), Basil S. Lewis (Israel), Francisco Leyva (United Kingdom), AleVs Linhart (Czech Republic), Maja-Lisa Løchen (Norway), Lars H. Lund (Sweden), Donna Mancini (United States of America), Josep Masip (Spain), Davor Milicic (Croatia), Christian Mueller (Switzerland), Holger Nef (Germany), Jens-Cosedis Nielsen (Denmark), Lis Neubeck (United Kingdom), Michel Noutsias (Germany), Steffen E. Petersen (United Kingdom), Anna Sonia Petronio (Italy), Piotr Ponikowski (Poland), Eva Prescott (Denmark), Amina Rakisheva (Kazakhstan), Dimitrios J. Richter (Greece), Evgeny Schlyakhto (Russia), Petar Seferovic (Serbia), Michele Senni (Italy), Marta Sitges (Spain), Miguel Sousa-Uva (Portugal), Carlo G. Tocchetti (Italy), Rhian M. Touyz (United Kingdom), Carsten Tschoepe (Germany), Johannes Waltenberger (Germany/Switzerland) All experts involved in the development of these guidelines have submitted declarations of interest. These have been compiled in a report and published in a supplementary document simultaneously to the guidelines. The report is also available on the ESC website www.escardio.org/guidelines For the Supplementary Data which include background information and detailed discussion of the data that have provided the basis for the guidelines see European Heart Journal online
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