Does My Patient with Multiple Comorbidities Have Heart Failure with Preserved Ejection Fraction, and Does It Matter?

Heart Failure with Preserved Ejection Fraction (HFpEF) is a common diagnosis and accounts for half or more of all cases of heart failure. Despite its high prevalence and significant morbidity, the pathophysiology of HFpEF remains incompletely understood. Patients diagnosed with HFpEF often have significant cardiac and extra-cardiac comorbidities. Given the availability of evidence-based treatments for common comorbidities, but not for HFpEF, the necessity of diagnosing HFpEF among symptomatic elderly patients with multiple comorbidities is unclear. This commentary raises the question of whether the search for the diagnosis of HFpEF should instead be refocused to the management of common comorbidities without necessitating the heart failure diagnosis.
Source: Journal of the American Board of Family Medicine - Category: Primary Care Authors: Tags: Special Communications Source Type: research

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Authors: De Vecchis R, Paccone A, Di Maio M Abstract BACKGROUND: Clinical efficacy of sacubitril/ valsartan - administered for the recommended indication of patients with reduced(
Source: Minerva Cardioangiologica - Category: Cardiology Tags: Minerva Cardioangiol Source Type: research
Conclusions: The models developed using insurance claims data could reliably predict the risk of MACRO in patients with T2DM and enabled patients at higher-risk of DKD to be identified in the absence of baseline diabetic nephropathy, CKD, or proteinuria. These models could help establish strategies to reduce the risk of MACRO in T2DM patients. PMID: 31625766 [PubMed - as supplied by publisher]
Source: Current Medical Research and Opinion - Category: Research Tags: Curr Med Res Opin Source Type: research
This study enrolled 32 heart failure patients and 28 control subjects. Total cfDNA levels were not different between groups (P=0.343). Bisulfite-digital PCR using unmethylated FAM101A locus demonstrated cardiomyocyte-specific cfDNA was significantly elevated in heart failure patients compared to controls (median 0.99 [IQR, 0.77-1.98] vs 0 [0-0.91] copies/mL, P=0.003). Cardiomyocyte-specific cfDNA significantly discriminated heart failure from controls (AUC, 0.716, P=0.003), and was positively correlated with troponin I (r=0.438, P=0.003) but not with B-type natriuretic peptide (r=0.275, P=0.058). cfDNA may be a novel bioma...
Source: Canadian Journal of Cardiology - Category: Cardiology Source Type: research
Authors: Walsh JL, AlJaroudi WA, Lamaa N, Abou Hassan OK, Jalkh K, Elhajj IH, Sakr G, Isma'eel H Abstract Objectives. In heart failure, invasive angiography is often employed to differentiate ischaemic from non-ischaemic cardiomyopathy. We aim to examine the predictive value of echocardiographic strain features alone and in combination with other features to differentiate ischaemic from non-ischaemic cardiomyopathy, using artificial neural network (ANN) and logistic regression modelling. Design. We retrospectively identified 204 consecutive patients with an ejection fraction
Source: Scandinavian Cardiovascular Journal - Category: Cardiology Tags: Scand Cardiovasc J Source Type: research
ConclusionsRisk stratification for cardiac amyloidosis with the newly developed “HeiRisk” score may be superior to other staging systems for patients with advanced heart failure due to amyloid cardiomyopathy.
Source: Clinical Research in Cardiology - Category: Cardiology Source Type: research
We created a translational model of chronic heart failure in rats that developed in 3 months after reproducing experimental anterior transmural myocardial infarction. The model simulated the basic clinicodiagnostic criteria of this disease: impaired contractility and dilatation of heart ventricles, signs of venous congestion, elevated plasma content of biochemical markers, and abnormal overexpression of AT1aR and β-adrenoceptors.
Source: Bulletin of Experimental Biology and Medicine - Category: Biology Source Type: research
Transthyretin amyloidosis can be either the wild-type (ATTR-wt) or the hereditary form (ATTR-m) with autosomal dominant inheritance. ATTR seems to be an underdiagnosed disease, despite now being recognized as one of the most frequent causes of heart failure (HF) with preserved ejection fraction. The confirmation of diagnosis includes a genetic analysis as a critical step to distinguish between ATTR-wt and hereditary amyloidosis. The present study aimed to evaluate the potential application of High-Resolution Melting (HRM) analysis for identifying gene mutations in patients with suspected ATTR-m.
Source: International Journal of Cardiology - Category: Cardiology Authors: Source Type: research
Renal dysfunction is a harbinger of poor prognosis in heart failure (HF),1 portending a greater risk of death than the degree of left ventricular dysfunction or New York Heart Association functional class.2 Deranged renal function is not only a marker of illness severity; it may independently hasten the progression of heart failure by accelerating maladaptive physiological pathways1,2 while decreasing the likelihood that patients will receive optimal medical therapy for heart failure.3 This is particularly germane to patients hospitalized with acutely decompensated heart failure (ADHF), the majority of whom present with ab...
Source: Journal of Cardiac Failure - Category: Cardiology Authors: Tags: Brief Report Source Type: research
FRIDAY, Oct. 18, 2019 -- For Asian patients with heart failure, those who are lean-fat with a high waist-to-height ratio (WHtR) and low body mass index (BMI) have the worst outcomes, according to a study published online Sept. 24 in PLOS...
Source: - Pharma News - Category: Pharmaceuticals Source Type: news
In this study, we aimed to evaluate the differential impact of DM2 on all-cause mortality in men vs women with HFpEF after admission for acute HF.MethodsWe prospectively included 1019 consecutive HFpEF patients discharged after admission for acute HF in a single tertiary referral hospital. Multivariate Cox regression analysis was used to evaluate the interaction between sex and DM2 regarding the risk of long-term all-cause mortality. Risk estimates were calculated as hazard ratios (HR).ResultsThe mean age of the cohort was 75.6 ± 9.5 years and 609 (59.8%) were women. The proportion of DM2 was similar betwe...
Source: Revista Espanola de Cardiologia - Category: Cardiology Source Type: research
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