HFpEF Is the Substrate for Stroke in Obesity and Diabetes Independent of Atrial Fibrillation

Publication date: January 2020Source: JACC: Heart Failure, Volume 8, Issue 1Author(s): Milton PackerAbstractBoth obesity and type 2 diabetes are important risk factors for the development of heart failure with a preserved ejection fraction (HFpEF), and both disorders increase the risk of systemic thromboembolic events. Traditionally, the risk of stroke has been explained by the strong association of these disorders with atrial fibrillation (AF). However, adiposity and diabetes are risk factors for systemic thromboembolism, even in the absence of AF, because both can lead to the development of an inflammatory and fibrotic atrial and ventricular myopathy, the 2 major elements of HFpEF. Atrial myopathy: 1) exacerbates pulmonary venous hypertension and exertional dyspnea; 2) leads to decreased flow, thrombogenesis, and systemic thromboembolization; and 3) often clinically manifests as AF; however, the relationship between AF and thromboembolism is unclear. Atrial fibrosis predisposes to thrombus formation, even in the absence of AF, and most thromboembolic events bear a poor temporal relationship to the occurrence of AF, whereas HFpEF (and the accompanying atrial disease) predicts stroke in patients with or without AF. Furthermore, rhythm control does not reduce the risk of stroke, although it reduces the burden of AF. These observations support the primacy of atrial myopathy as a critical component of HFpEF, rather than AF, as the mediator of systemic thromboembolism in obesity ...
Source: JACC: Heart Failure - Category: Cardiology Source Type: research

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Source: Journal of Cardiac Surgery - Category: Cardiovascular & Thoracic Surgery Authors: Tags: ORIGINAL ARTICLE Source Type: research
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Source: SafetyLit - Category: International Medicine & Public Health Tags: Age: Elder Adults Source Type: news
Condition:   Diabetes Mellitus Interventions:   Other: Administration of standardized questionnaires;   Device: Physical activity tracker;   Other: Dietary log Sponsor:   McGill University Health Centre/Research Institute of the McGill University Health Centre Recruiting
Source: ClinicalTrials.gov - Category: Research Source Type: clinical trials
Conditions:   Cardiovascular Diseases;   Sarcopenic Obesity Interventions:   Other: High-Protein Mediterranean Diet;   Other: Resistance Exercise;   Other: Standard Dietary Advice;   Other: Standard Cardiac Rehabilitation Exercise Sponsors:   Liverpool John Moores University;   University of Chester Not yet recruiting
Source: ClinicalTrials.gov - Category: Research Source Type: clinical trials
Condition:   Stroke Interventions:   Device: WBPC;   Device: Without WBPC Sponsor:   Changhua Christian Hospital Completed
Source: ClinicalTrials.gov - Category: Research Source Type: clinical trials
Conditions:   Psoriasis;   Atherosclerotic Cardiovascular Disease;   Obesity;   Dyslipidemia;   Cardiometabolic Diseases Interventions:   Dietary Supplement: Niagen;   Other: Placebo Sponsor:   National Heart, Lung, and Blood Institute (NHLBI) Recruiting
Source: ClinicalTrials.gov - Category: Research Source Type: clinical trials
Condition:   Diabetes Mellitus, Type 2 Interventions:   Other: Mobile Application-Based Diabetes Education;   Other: Health Coaching Sponsor:   Indonesia University Active, not recruiting
Source: ClinicalTrials.gov - Category: Research Source Type: clinical trials
Condition:   Chronic Thromboembolic Pulmonary Hypertension Interventions:   Drug: Macitentan;   Drug: Placebo Sponsor:   Actelion Not yet recruiting
Source: ClinicalTrials.gov - Category: Research Source Type: clinical trials
Publication date: Available online 6 November 2019Source: JACC: Heart FailureAuthor(s): Milton PackerAbstractBoth obesity and type 2 diabetes are important risk factors for the development of heart failure with a preserved ejection fraction (HFpEF), and both disorders increase the risk of systemic thromboembolic events. Traditionally, the risk of stroke has been explained by the strong association of these disorders with atrial fibrillation (AF). However, adiposity and diabetes are risk factors for systemic thromboembolism, even in the absence of AF, because both can lead to the development of an inflammatory and fibrotic ...
Source: JACC: Heart Failure - Category: Cardiology Source Type: research
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Source: Fight Aging! - Category: Research Authors: Tags: Newsletters Source Type: blogs
More News: Atrial Fibrillation | Cardiology | Diabetes | Diabetes Type 2 | Eating Disorders & Weight Management | Endocrinology | Heart | Heart Failure | Hypertension | Obesity | Pulmonary Thromboembolism | Stroke | Thrombosis