Characterization of Malnutrition in Atrial Functional Mitral Regurgitation.

Background: In this study we sought to characterize the prevalence, clinical characteristics, and outcomes of malnutrition in patients with atrial functional mitral regurgitation (AFMR).

Methods: This multicentre, observational study included 802 patients diagnosed with AFMR. The eriatric utritional isk ndex (GNRI) was used as a nutritional risk metric.

Transcatheter edge-to-edge repair vs medical therapy in atrial functional mitral regurgitation: a propensity score-based comparison from the OCEAN-Mitral and REVEAL-AFMR registries.

Background And Aims: Atrial functional mitral regurgitation (AFMR) commonly affects elderly and frail individuals. The prognostic impact of transcatheter edge-to-edge repair (TEER) for AFMR has not been investigated.

Methods: Patients with AFMR who underwent TEER were selected from the OCEANMitral registry, and medically managed controls were selected from the REVEALAFMR registry, using an identical AFMR definition.

Clinical utility of the left atrial strain analysis.

The importance of left atrial (LA) function is recognized, especially when left ventricular function fails or atrial fibrillation occurs and heart failure (HF) develops. A compensatory mechanism of LA function unremittingly operates to maintain cardiac performance and prevent the occurrence of HF. LA function consists of three components: booster pump, reservoir, and conduit function.

Prevalence, Pathophysiology, and Prognostic Importance of Malnutrition Risk in Early-Stage Patients With Heart Failure and Preserved Ejection Fraction.

Background And Objectives: Malnutrition is common and is associated with poor clinical outcomes in clinically overt patients with heart failure and preserved ejection fraction (HFpEF). However, its prevalence and pathophysiologic and prognostic relevance remain unclear in early-stage HFpEF. This study sought to assess the association between malnutrition risk, exercise capacity, cardiac and peripheral reserve limitations, and clinical outcomes in patients with early HFpEF, defined as those without a history of HF hospitalization.

High Prevalence of Thyroid Gland Dysfunction after Pulmonary Arterial Hypertension Treatment According to Real-World Data.

Continuous intravenous epoprostenol or treprostinil therapy is essential for the treatment of severe pulmonary arterial hypertension (PAH). However, it has several side effects, including thyroid gland dysfunction. This study aimed to estimate the prevalence rate of thyroid gland dysfunction.

Diagnostic Approaches to Heart Failure With Preserved Ejection Fraction (HFpEF) - Identification of Unrecognized HFpEF.

The development of life-saving pharmacotherapies such as the sodium-glucose cotransporter-2 inhibitors has changed heart failure with preserved ejection fraction (HFpEF) into a treatable disease. This paradigm shift in treatment has made the diagnosis of HFpEF more important. However, HFpEF is underdiagnosed in primary and secondary/tertiary care settings due to its diagnostic difficulties.

Pathophysiological and Prognostic Importance of an ExtraCardiac Comorbidity Burden in Patients with Heart Failure with Preserved Ejection Fraction.

Background: Extracardiac comorbidities are highly prevalent in patients with heart failure with preserved ejection fraction (HFpEF). We investigated the pathophysiological contribution of an extracardiac comorbidity burden to cardiac function, exercise capacity, and prognosis in patients with HFpEF.

Methods: A total of 775 patients (372 HFpEF patients and 403 control subjects) underwent exercise echocardiography, with simultaneous expired gas analysis.

Pathophysiologic and prognostic relevance of mid-upper arm circumference index in heart failure with preserved ejection fraction.

Background: Malnutrition is common in heart failure with preserved ejection fraction (HFpEF). Despite the increasing awareness, nutritional assessment and intervention may be underutilized in practice, needing a simple screening tool to identify patients at high nutritional risk. This study sought to determine the association of mid-upper arm circumference indexed to height (MUACi) with nutritional measures, exercise capacity, and clinical outcomes in HFpEF.

An evidence-based tool for screening for heart failure with preserved ejection fraction in primary care: The BREATH score.

Background: Heart failure with preserved ejection fraction (HFpEF) remains underdiagnosed in primary care settings, where echocardiography is not available. This study aimed to develop and validate a scoring system that does not include echocardiographic variables for HFpEF screening among patients with shortness of breath.

Methods: A total of 622 consecutive patients referred for exercise stress echocardiography were evaluated (283 HFpEF and 339 controls).

Characteristics, determinants, and prognostic impact of severe tricuspid regurgitation in patients with atrial functional mitral regurgitation: Insights from the REVEAL-AFMR registry.

Aims: Tricuspid regurgitation (TR) is often seen in patients with atrial functional mitral regurgitation (AFMR). The aim of this study was to investigate the characteristics, determinants, and prognostic impact of severe TR coexisting with AFMR.

Methods And Results: In 26 facilities in Japan, patients with significant AFMR defined with moderate or severe functional mitral regurgitation with dilated left atrium and preserved left ventricular function were enrolled.

Echocardiographic cardiac damage classification and clinical outcomes in atrial functional mitral regurgitation.

Background: Atrial functional mitral regurgitation (AFMR) arises from left atrial (LA) dilation, commonly associated with atrial fibrillation, and leads to progressive cardiac damage. This study evaluated the prognostic value of a novel echocardiographic cardiac damage classification system for patients with moderate or severe AFMR.

Methods: In a retrospective multicentre study, 1007 patients with AFMR were stratified into four groups based on echocardiographic findings: group 1, LA damage (dilation); group 2, left ventricular damage (reduced ejection fraction and/or dilation); group 3, right heart damage (tricuspid regurgitation and/or pulmonary hypertension); and group 4, combined left and right heart damage.

A scoring system for diagnosing heart failure with preserved ejection fraction based on exercise echocardiography.

Aims: Exercise stress echocardiography (ESE) is often used to identify heart failure with preserved ejection fraction (HFpEF) in patients presenting dyspnoea. However, diagnostic criteria have not been standardized. Here, we sought to develop ESE-based criteria to diagnose HFpEF in dyspnoeic patients.

Evidence-Based Application of Natriuretic Peptides in the Evaluation of Chronic Heart Failure With Preserved Ejection Fraction in the Ambulatory Outpatient Setting.

Background: Plasma NT-proBNP (N-terminal pro-B-type natriuretic peptide) is commonly used to diagnose heart failure with preserved ejection fraction (HFpEF), but its diagnostic performance in the ambulatory/outpatient setting is unknown because previous studies lacked objective reference standards.

Methods: Among patients with chronic dyspnea, diagnosis of HFpEF or noncardiac dyspnea was determined conclusively by exercise catheterization in a derivation cohort (n=414), multicenter validation cohort 1 (n=560), validation cohort 2 (n=207), and a nonobese Japanese validation cohort 3 (n=77). Optimal NT-proBNP cut points for HFpEF rule out (optimizing sensitivity) and rule in (optimizing specificity) were derived and tested, stratified by obesity and atrial fibrillation.

Role of exercise stress echocardiography in systemic sclerosis: pathophysiological and prognostic significance of the systemic sclerosis with a heart failure and preserved ejection fraction phenotype.

Aims: Left ventricular (LV) diastolic dysfunction and heart failure with preserved ejection fraction (HFpEF) are common cardiac complications of patients with systemic sclerosis (SSc). Exercise stress echocardiography is often used in symptomatic patients with SSc to detect abnormal increases in pulmonary pressures during exercise, but the pathophysiologic and prognostic significance of exercise stress echocardiography to assess the presence of HFpEF in these patients is unclear.

Methods And Results: Patients with SSc (n = 140) underwent ergometry exercise stress echocardiography with simultaneous expired gas analysis.

Collaboration between dyspnea clinic and primary care physicians to identify heart failure with preserved ejection fraction in the community: Results from the Maebashi City HF project.

Background: Despite increasing awareness in general practice, heart failure with preserved ejection fraction (HFpEF) remains under-diagnosed in the community due to diagnostic difficulties. Dedicated dyspnea clinics are responsible for diagnosing HFpEF and efficient referral from primary care physicians is the key to enhance its role.

Methods: This retrospective analysis was performed to assess the effectiveness of a one-year collaborative project between our dyspnea clinic and the Maebashi Medical Association.

Qualitative and quantitative assessment of atrial functional mitral regurgitation: analysis from the REVEAL-AFMR registry.

Aims: The prevalence, characteristics, and prognosis of atrial functional mitral regurgitation (AFMR) based on severity remain unclear. No studies have systematically evaluated quantitative thresholds, such as effective regurgitant orifice area (EROA) or regurgitant volume, in relation to outcomes in AFMR. This multicentre study aimed to clarify the clinical implications of both qualitative and quantitative assessments of AFMR severity.