Biological Phenotypes of Heart Failure With Preserved Ejection Fraction
Review Article | By Lewis GA, Schelbert EB, Miller CA et al.
Heart failure with preserved ejection fraction (HFpEF) involves multiple pathophysiological mechanisms, which result in the heterogeneous phenotypes that are evident clinically, and which have potentially confounded previous HFpEF trials. A greater understanding of the in vivo human processes involved, and in particular, which are the causes and which are the downstream effects, may allow the syndrome ...
Cardiopulmonary Exercise Testing: What Is its Value?
Review Article | By Guazzi M, Bandera F, Ozemek C et al.
Compared with traditional exercise tests, cardiopulmonary exercise testing (CPET) provides a thorough assessment of exercise integrative physiology involving the pulmonary, cardiovascular, muscular, and cellular oxidative systems. Due to the prognostic ability of key variables, CPET applications in cardiology have grown impressively to include all forms of exercise intolerance, with a predominant focus on heart failure with reduced or with...
Review Article | By Costanzo MR, Ronco C, Abraham WT et al.
More than 1 million heart failure hospitalizations occur annually, and congestion is the predominant cause. Rehospitalizations for recurrent congestion portend poor outcomes independently of age and renal function. Persistent congestion trumps serum creatinine increases in predicting adverse heart failure outcomes. No decongestive pharmacological therapy has reduced these harmful consequences. Simplified ultrafiltration devices permit fluid removal i...
Original Research | By Stokke TM, Hasselberg NE, Remme EW et al.
BACKGROUND - Preserved left ventricular (LV) ejection fraction (EF) and reduced myocardial strain are reported in patients with hypertrophic cardiomyopathy, ischemic heart disease, diabetes mellitus, and more. OBJECTIVES - The authors performed a combined mathematical and echocardiographic study to understand the inconsistencies between EF and strains. METH...
Heart Failure With Preserved, Borderline, and Reduced Ejection Fraction: 5-Year Outcomes
Original Research | By Shah KS, Xu H, Fonarow GC et al.
BACKGROUND - Patients with heart failure (HF) have a poor prognosis and are categorized by ejection fraction (EF). OBJECTIVES - This study sought to characterize differences in outcomes in patients hospitalized with heart failure with preserved ejection fraction (HFpEF) (EF ≥50%), heart failure with borderlin...
Original Research | By Lloyd JW, Nishimura RA, Eleid MF et al.
BACKGROUND - Low-gradient severe aortic stenosis (LGSAS) with preserved ejection fraction (EF) is incompletely understood. The influence of arterial afterload and diastolic dysfunction on the hemodynamic presentation of LGSAS remains unknown. OBJECTIVES - The authors sought to determine the acute hemodynamic response to sodium nitr...
Implantable Hemodynamic Monitoring for Heart Failure Patients
Review Article | By Abraham WT, Perl L.
Rates of heart failure hospitalization remain unacceptably high. Such hospitalizations are associated with substantial patient, caregiver, and economic costs. Randomized controlled trials of noninvasive telemedical systems have failed to demonstrate reduced rates of hospitalization. The failure of these technologies may be due to the limitations of the signals measured. Intracardiac and pulmonary artery pressure-guided mana...
Left Ventricular Assist Device as a Bridge to Recovery for Patients With Advanced Heart Failure
Original Research | By Jakovljevic DG, Yacoub MH, Schueler S et al.
BACKGROUND - Left ventricular assist devices (LVADs) have been used as an effective therapeutic option in patients with advanced heart failure, either as a bridge to transplantation, as destination therapy, or in some patients, as a bridge to recovery. OBJECTIVES - This study evaluated whether patients undergoing an LVAD ...
Left Ventricular Assist Devices for Lifelong Support
Review Article | By Pinney SP, Anyanwu AC, Lala A et al.
Continuous-flow left ventricular assist devices (LVADs) have revolutionized advanced heart failure care. These compact, fully implantable heart pumps are capable of providing meaningful increases in survival, functional capacity, and quality of life. Implantation volumes continue to grow, but several challenges remain to be overcome before LVADs will be considered as the therapy of choice for all patients with advanced hear...
Mode of Death in Heart Failure With Preserved Ejection Fraction
Review Article | By Vaduganathan M, Patel RB, Butler J et al.
Little is known about specific modes of death in patients with heart failure with preserved ejection fraction(HFpEF). Herein, the authors critically appraise the current state of data and offer potential future directions. They conducted a systematic review of 1,608 published HFpEF papers from January 1, 1985, to December 31, 2015, which yielded 8 randomized clinical trials and 24 epidemiological st...