Publications by authors named "Maria A Pabon"
Background: Patients with heart failure with improved ejection fraction (HFimpEF) remain understudied and face residual risks comparable with those with a left ventricular ejection fraction (LVEF) consistently >40% (no prior heart failure with reduced ejection fraction). The implications of achieved LVEF after improvement on prognosis and treatment response remains unclear.
Objectives: This study examines whether the degree of LVEF improvement influences prognosis and the therapeutic effects of dapagliflozin in HFimpEF.
Outcomes in pregnant patients with congenital heart disease by rurality.
J Perinat Med
August 2025
Objectives: To examine the association between rurality, major adverse cardiac events (MACE), adverse pregnancy outcomes (APO) and neonatal outcomes in pregnant women with CHD (congenital heart disease).
Methods: A retrospective cohort study using the HCUP-NIS database (Healthcare Cost and Utilization Project-National Inpatient Sample) from 2016 to 2021 was conducted with pregnant CHD patients by location of residence (urban vs. rural).
Background: Recurrent pericarditis affects up to 30% of patients after an initial episode, with the majority of recurring episodes occurring within 18 months. Younger age, subacute presentations, and initial treatment with steroids rather than colchicine are risk factors. Incorporation of multimodality imaging is essential in the diagnosis and management of recurrent pericarditis, particularly in complex cases.
View Article and Find Full Text PDFHeart Failure With Improved Ejection Fraction: Definitions, Epidemiology, and Management.
J Am Coll Cardiol
June 2025
Heart failure with improved ejection fraction (HFimpEF) has gained increasing recognition as a distinct phenotype within the spectrum of heart failure, characterized by previously reduced left ventricular ejection fraction (≤40%) that subsequently improves to >40%. HFimpEF remains relatively understudied, and uncertainty persists regarding its long-term prognosis and optimal management. Contemporary registries and clinical trials suggest a rising prevalence, likely reflecting both the increased implementation of guideline-directed medical therapy and evolving consensus definitions for its identification.
View Article and Find Full Text PDFImportance: Patients with chronic heart failure (HF) and left ventricular ejection fraction (LVEF) less than 40% who experience LVEF improvement to 40% or higher (HFimpEF) may still face residual risks.
Objective: To assess the clinical profiles, risk, and treatment response to finerenone in participants with HFimpEF.
Design, Setting, And Participants: A total of 6001 patients with HE, LVEF of 40% or higher, New York Heart Association class II to IV symptoms, and elevated natriuretic peptide levels, were enrolled between September 14, 2020, and January 10, 2023.
Background: Mineralocorticoid receptor antagonists (MRA) modulate cardiac and systemic pathways such as fibrosis and inflammation, which may contribute to the onset of atrial fibrillation (AF) or atrial flutter (AFL).
Objectives: In this participant-level pooled analysis of 3 large clinical trials, the authors evaluated the effect of the nonsteroidal MRA finerenone on incident AF/AFL across the cardio-kidney-metabolic (CKM) spectrum.
Methods: In this prespecified analysis, we pooled participants from 2 trials of chronic kidney disease and type 2 diabetes (FIDELIO-DKD and FIGARO-DKD) and a trial of heart failure (HF) with mildly reduced or preserved ejection fraction (FINEARTS-HF).
Background: The Controlling Nutritional Status (CONUT) and Geriatric Nutritional Risk Index (GNRI) are indices that identify individuals at risk of malnutrition. Our study sought to examine the incidence and prognostic implications of abnormal CONUT and/or GNRI in patients with heart failure with preserved ejection fraction.
Methods And Results: The CONUT score and GNRI were serially analyzed in this post hoc analysis of the PARAGON-HF (Prospective Comparison of Angiotensin Receptor-Neprilysin Inhibitor With Angiotensin-Receptor Blockers Global Outcomes in Heart Failure With Preserved Ejection Fraction) trial.
Background: Hypertensive disorders of pregnancy (HDPs) (preeclampsia/eclampsia and gestational hypertension) are a leading cause of maternal and perinatal morbidity and mortality and are associated with long-term maternal cardiovascular disease. High genetic risk and poor cardiovascular health (CVH) are each associated with HDPs, but whether genetic risk for HDP is modified by CVH status in early pregnancy is unknown.
Objectives: In this study, the authors sought to test the independent and joint associations of genetic risk and first-trimester CVH with development of HDP.
Importance: The mode of death in patients with heart failure with mildly reduced ejection fraction (HFmrEF) or heart failure with preserved ejection fraction (HFpEF) remains poorly understood and may vary by EF.
Objective: To evaluate the mode of death according to EF and the treatment effect of finerenone on cause-specific mortality in patients with HFmrEF/HFpEF.
Design, Setting, And Participants: This was a prespecified secondary analysis of the Finerenone Trial to Investigate Efficacy and Safety Superior to Placebo in Patients With Heart Failure (FINEARTS-HF) randomized clinical trial, which evaluated clinical outcomes in 6001 patients with HF and EF greater than or equal to 40% randomly assigned to finerenone or placebo.
Electrocardiographic Changes in Pregnant Patients With Congenital Heart Disease.
Ann Noninvasive Electrocardiol
January 2025
Background: Electrocardiograms (EKGs) are routinely performed in pregnant patients with pre-existing cardiovascular disease. However, in pregnant patients with congenital heart disease (CHD), EKG changes during gestation have not been explored.
Methods: We performed a retrospective study of pregnant patients with CHD enrolled in the STORCC initiative.
Background: Preeclampsia is a hypertensive disorder of pregnancy characterized by systemic endothelial dysfunction. The pathophysiology of preeclampsia remains incompletely understood. This study used human venous endothelial cell (EC) transcriptional profiling to investigate potential novel mechanisms underlying EC dysfunction in preeclampsia.
View Article and Find Full Text PDFAims: The temporal changes in clinical profiles and outcomes of high-risk myocardial infarction survivors enrolled in clinical trials are poorly described. This study compares mortality rates, baseline characteristics, and the prognostic impact of therapies among participants of the VALIANT and PARADISE-MI trials.
Methods And Results: Exclusively VALIANT participants who matched the inclusion criteria of the PARADISE-MI trial were included in the analysis.
Aims: To evaluate clinical outcomes, echocardiographic features, and the efficacy and safety of sacubitril/valsartan compared to valsartan across age groups in the PARAGON-HF trial.
Methods And Results: A total of 4796 participants ≥50 years of age with chronic heart failure (HF) and left ventricular ejection fraction (LVEF) ≥45% were divided into three age groups: <65 years (n = 825), 65-74 years (n = 1772), and ≥75 years (n = 2199). Echocardiograms of 1097 patients were analysed in a standardized fashion at a core imaging laboratory.
Article Synopsis
- - The study investigated how race influences the effects of the heart failure treatment sacubitril/valsartan, comparing its safety and efficacy among White, Asian, and Black patients based on data from two large clinical trials (PARADIGM-HF and PARAGON-HF).
- - Results showed that Black and Asian patients had a higher risk of heart failure hospitalization or cardiovascular death compared to White patients, even though the treatment was effective for all racial groups, with no significant difference in efficacy observed across races.
- - Severe angioedema (swelling) was more common in Black patients receiving sacubitril/valsartan compared to those on alternative treatments, highlighting potential racial disparities in treatment response and safety.
Article Synopsis
- The study investigates differences between men and women in heart function after a heart attack (MI) to understand why women have higher rates of hospitalization for heart failure.
- It analyzes echocardiographic data from 544 patients in the PARADISE-MI trial to assess heart function pre and post-MI, focusing on parameters like left ventricular ejection fraction (LVEF) and chamber sizes.
- Although women showed better heart function indicators at the start, the study found that the changes over 8 months and the relationship between heart function metrics and clinical outcomes were similar for both sexes.
Article Synopsis
- Patients with heart failure and improved ejection fraction (HFimpEF) face significant health risks during hospitalizations, showing higher rates of complicated hospital admissions compared to patients with consistently higher ejection fractions (LVEF >40%).
- In a study involving 6263 patients, those with HFimpEF accounted for 18% and experienced more severe hospital events despite similar lengths of stay and in-hospital mortality rates as patients with stable LVEF.
- The outcomes indicated that 66% of HFimpEF patients experienced a decrease in their LVEF to ≤40%, pointing to potential ongoing heart function decline despite previous improvements.
Article Synopsis
- Preeclampsia is a pregnancy-related condition characterized by high blood pressure and a disruption in the balance of certain proteins, potentially leading to cardiovascular risks due to microvascular dysfunction.
- Researchers compared cardiac function in women with severe preeclampsia to those with normal pregnancies and nonpostpartum controls using advanced imaging techniques to assess myocardial flow and resistance.
- Results indicated that women who had preeclampsia showed significantly decreased blood flow and increased vascular resistance, highlighting reduced coronary microvascular function soon after delivery, which could have long-term health implications.
Article Synopsis
- Hypotension, a common side effect of sacubitril/valsartan, was analyzed in heart failure patients with mildly reduced or preserved ejection fraction in the PARAGON-HF trial.
- The study found that 13% of participants and a higher proportion in the sacubitril/valsartan group experienced hypotension, which led to increased risks of cardiovascular events and hospitalizations.
- Results indicated that patients with a left ventricular ejection fraction (LVEF) ≥60% were particularly at higher risk of hypotension when treated with sacubitril/valsartan compared to valsartan.
Article Synopsis
- Preeclampsia is a pregnancy-related condition characterized by high blood pressure and microvascular dysfunction, potentially increasing cardiovascular risks post-pregnancy.
- A study compared women with severe preeclampsia to those with normal pregnancies and non-postpartum controls using cardiac imaging to assess heart function and blood flow.
- Results showed that women who experienced preeclampsia had significantly reduced heart function and increased vascular resistance, indicating potential long-term cardiovascular issues, warranting further investigation for preventive measures.
Article Synopsis
- Hypertensive disorders of pregnancy (HDP) are linked to long-term cardiovascular risks for women, though the reasons are not fully understood.
- A study involving 5,168 Hispanic/Latina women revealed that 14% had a history of de novo HDP, which was associated with lower left ventricle ejection fraction and higher risks of abnormal cardiac geometry.
- Findings indicate that previous HDP can lead to measurable cardiac issues in women, with current hypertension only partially explaining these effects.
This review summarizes the evaluation for underlying rheumatic conditions in patients presenting with acute pericarditis, treatment considerations for specific rheumatic conditions, and the role of imaging in diagnosis and monitoring. Pericarditis may be one of the initial presentations of a rheumatic disease or identified in a patient with known rheumatic disease. There is also growing evidence for using anti-inflammatory and immunosuppressive agents for treating recurrent pericarditis, which can overlap with the treatment of rheumatic diseases.
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