Long-term Healthcare Utilization and Outcomes in Patients Hospitalized for Heart Failure with and without Atrial Fibrillation.

The long-term association between AF and clinical outcomes, healthcare resource utilization, and healthcare costs among patients with HF remains underexplored. We conducted an exploratory analysis of 5-year outcomes among patients enrolled in the Patient-Centered Care Transitions in HF (PACT-HF) stepped-wedge cluster randomized trial who were hospitalized for HF and discharged alive between February 2015 and March 2016. Patients were stratified by baseline AF status.

Cardiovascular risk factors management in older adults: a clinical consensus statement from the European Association of Preventive Cardiology of the ESC and the ESC Council for Cardiology Practice.

Cardiovascular disease (CVD) currently ranks first in global mortality and morbidity and its prevalence increases with age. The most common risk factors for CVD are hypertension, diabetes mellitus, dyslipidaemias, adipositas, smoking, and physical inactivity, Also, depression, anaemia and frailty can be considered important risk factors for CVD. Incidence and prevalence of risk factors and comorbidities increase with age.

Exercise Echocardiography for Risk Stratification in Unexplained Dyspnea: The Incremental Value of the Mean Pulmonary Artery Pressure/Slope.

Background: Patients with unexplained dyspnea and an elevated mean pulmonary artery pressure (mPAP)/cardiac output (CO) slope on invasive hemodynamic assessment during exercise have worse clinical outcomes. The aim of this study was to evaluate the incremental prognostic value of the noninvasive mPAP/CO slope in addition to heart failure with preserved ejection fraction (HFpEF) probability scores and diastolic stress testing in patients with unexplained dyspnea.

Methods: In a multicenter cohort study involving six Belgian dyspnea clinics, patients with unexplained dyspnea underwent exercise echocardiography for mPAP/CO slope assessment.

Multi-microRNA diagnostic panel for heart failure with preserved ejection fraction in preclinical and clinical settings.

Aims: Heart failure with preserved ejection fraction (HFpEF) is a complex syndrome accounting for half of heart failure cases. Although natriuretic peptides are the most accepted and extensively used biomarkers for heart failure, their diagnostic accuracy for HFpEF remains debatable. Here, we aimed to identify a panel of circulating microRNAs (miRNAs) as potential novel biomarkers for diagnosis of HFpEF in a preclinical model, subsequently validated in human HFpEF patients.

Effects of exercise training on nitric oxide metabolites in heart failure with reduced or preserved ejection fraction: a secondary analysis of the SMARTEX-HF and OptimEx-Clin trials.

Aims: Exercise has been shown to affect the nitric oxide (NO) pathway, which is involved in the pathophysiology of endothelial dysfunction in heart failure (HF) with reduced (HFrEF) and preserved ejection fraction (HFpEF). However, the effects of different exercise modes on NO metabolites in patients with HF are uncertain.

Methods And Results: Blood samples from two randomized controlled HF trials evaluating (i) high-intensity interval training (HIIT), (ii) moderate continuous training (MCT), or (iii) a control group (CG) in HFrEF (SMARTEX-HF) and HFpEF (OptimEx-Clin) were analysed for NO metabolites L-arginine, homoarginine (hArg), asymmetric and symmetric dimethylarginine (ADMA; SDMA).

Activation of Neutrophil Extracellular Trap Formation in Patients with Heart Failure and a Preserved Ejection Fraction.

Introduction: Pathophysiological differences between heart failure (HF) with preserved ejection fraction (HFpEF) and HF with reduced ejection fraction (HFrEF) remain poorly understood. Therefore, we performed pathway analyses from whole-blood transcriptomics to distinguish HFpEF from HFrEF.

Methods And Results: Lexogen's QuantSeq was used to carry out whole-blood transcriptomics in 500 patients with HF (HFpEF n = 250, HFrEF n = 250).

Cardiac contractility modulation as bailout in a patient with phospholamban p.Arg14del related cardiomyopathy intolerant to medication: a case report.

Background: Cardiac contractility modulation (CCM) is a novel device-based therapeutic option in patients with heart failure with reduced ejection fraction who are not eligible for cardiac resynchronization therapy. Cardiac contractility modulation enhances cardiac contractility by delivering high-voltage non-excitatory electrical impulses during the absolute refractory period. Cardiac contractility modulation is known to improve left ventricular ejection fraction (LVEF), quality of life, and exercise capacity in heart failure (HF) patients.

Training-induced change of diastolic function in heart failure with preserved ejection fraction.

Aims: Exercise training improves aerobic capacity (V̇Opeak) in patients with heart failure and preserved ejection fraction (HFpEF), but underlying mechanisms remain unclear. We aimed to evaluate whether exercise training could improve systolic and diastolic function during exercise.

Methods: This was a substudy of the multicentre Optimizing Exercise Training in HFpEF (OptimEx-Clin) trial, in which 180 patients with HFpEF were randomized 1:1:1 to guideline control, moderate continuous training or high-intensity interval training.

Impact of Exercise on Atrial Functional Mitral Regurgitation and Its Determinants: An Exercise Echocardiographic Study.

Atrial functional mitral regurgitation (AFMR) is a distinct form of mitral regurgitation in patients with atrial fibrillation and heart failure with preserved ejection fraction. Its pathophysiology remains elusive, and data on exercise-related AFMR are scarce. We sought to investigate the impact of acute exercise on AFMR severity and to identify its determinants.

Comparison of exercise training modalities and change in peak oxygen consumption in heart failure with preserved ejection fraction: a secondary analysis of the OptimEx-Clin trial.

Aims: Exercise training (ET) is an effective therapy in heart failure with preserved ejection fraction (HFpEF), but the influence of different ET characteristics is unclear. We aimed to evaluate the associations between ET frequency, duration, intensity [% heart rate reserve (%HRR)] and estimated energy expenditure (EEE) with the change in peak oxygen consumption (V̇O2) over 3 months of moderate continuous training (MCT, 5×/week) or high-intensity interval training (HIIT, 3×/week) in HFpEF.

Methods And Results: ET duration and heart rate (HR) were recorded with a smartphone application.

Circulating MicroRNA as Biomarkers of Anthracycline-Induced Cardiotoxicity: State-of-the-Art Review.

Close monitoring for cardiotoxicity during anthracycline chemotherapy is crucial for early diagnosis and therapy guidance. Currently, monitoring relies on cardiac imaging and serial measurement of cardiac biomarkers like cardiac troponin and natriuretic peptides. However, these conventional biomarkers are nonspecific indicators of cardiac damage.

Divergent cardiac and renal effects of miR-181c-5p inhibition in a rodent heart failure model.

Aims: MiR-181c-5p overexpression associates with heart failure (HF) and cardiac damage, but the underlying pathophysiology remains unclear. This study investigated the effect of miR-181c-5p inhibition on cardiac function and fibrosis in a rodent model of diastolic dysfunction, and evaluated additional effects on kidney as relevant comorbid organ.

Methods And Results: Diastolic dysfunction was induced in male C57/BL6J mice ( = 20) by combining high-fat diet, L-NG-nitroarginine methyl ester, and angiotensin II administration, and was compared to sham controls ( = 18).

Heart failure with severely reduced ejection fraction after liver transplantation: a case report and review of the literature.

Background: Liver transplantation (LT) is a strenuous event for the cardiovascular system. Cardiovascular events (CVE), including heart failure (HF), arrhythmias and myocardial ischemia, are important causes of peri- and post-liver transplantation morbidity and mortality.

Case Presentation: We describe the case of a 45-year-old male patient who developed heart failure with severely reduced ejection fraction (HFrEF) after receiving liver transplantation (LT) for end-stage post-alcoholic liver cirrhosis.

Fluorescent In Situ Hybridization for miRNA Combined with Staining of Proteins.

The last decades have illustrated the importance of microRNAs (miRNAs) in various biological and pathological processes. The combined visualization of miRNAs using fluorescent in situ hybridization (FISH) and proteins using immunofluorescence (IF) can reveal their spatiotemporal distribution in relation to the cell and tissue morphology and can provide interesting insights into miRNA-protein interactions. However, standardized protocols for co-localization of miRNAs and proteins are currently lacking, and substantial technical obstacles still need to be addressed.

Webtool to enhance the accuracy of diagnostic algorithms for HFpEF: a prospective cross-over study.

Aims: Diagnosis of heart failure with preserved ejection fraction (HFpEF) can be challenging. This study aimed to evaluate the potential of a webtool to enhance the scoring accuracy when applying the complex HFA-PEFF and H FPEF algorithms, which are commonly used for diagnosing HFpEF.

Methods And Results: We developed an online tool, the HFpEF calculator, that enables the automatic calculation of current HFpEF algorithms.

Left ventricular functional recovery after atrial fibrillation catheter ablation in heart failure: a prediction model.

Aims: Management of patients with atrial fibrillation (AF) and concomitant heart failure (HF) remains complex. The Antwerp score, based on four parameters [QRS >120 ms (2 points), known aetiology (2 points), paroxysmal AF (1 point), severe atrial dilation (1 point)] adequately estimated the probability of left ventricular ejection fraction (LVEF) recovery after AF ablation in a single-centre cohort. The present study aims to externally validate this prediction model in a large European multi-centre cohort.

Effect of Training on Vascular Function and Repair in Heart Failure With Preserved Ejection Fraction.

Background: Exercise training improves peak oxygen uptake (V.Opeak) in heart failure with preserved ejection fraction (HFpEF). Multiple adaptations have been addressed, but the role of circulating endothelium-repairing cells and vascular function have not been well defined.

Epigenetics in the primary and secondary prevention of cardiovascular disease: influence of exercise and nutrition.

Increasing evidence links changes in epigenetic systems, such as DNA methylation, histone modification, and non-coding RNA expression, to the occurrence of cardiovascular disease (CVD). These epigenetic modifications can change genetic function under influence of exogenous stimuli and can be transferred to next generations, providing a potential mechanism for inheritance of behavioural intervention effects. The benefits of exercise and nutritional interventions in the primary and secondary prevention of CVD are well established, but the mechanisms are not completely understood.