Kooperativer Bibliotheksverbund

Berlin Brandenburg

and
and

Your email was sent successfully. Check your inbox.

An error occurred while sending the email. Please try again.

Proceed reservation?

Export
Filter
Type of Medium
Language
Year
  • 1
    In: Circulation, 2018, Vol.138(Suppl_1 Suppl 1), pp.A13347-A13347
    Description: Introduction: Microvascular inflammation has been postulated to play a key role in heart failure with preserved ejection fraction (HFpEF), especially in the presence of diabetes. In contrast to the wealth of preclinical data, clinical data on microvascular complications of diabetes in patients with HFpEF versus HF with reduced (HFrEF) are scarce.Methods: We investigated the prevalence, association with outcome and cardiac structure and function of the microvascular (neuropathy, nephropathy and retinopathy) complications of diabetes in 2,656 prospectively enrolled patients with diabetes and HF (536 with HFpEF) from the Asian Sudden Cardiac Death in Heart Failure (ASIAN-HF) registry.Results: A total of 601 (23%) patients had microvascular complications; nephropathy being the most prevalent followed by retinopathy (42%) and neuropathy (28%). Patients with HFpEF (LVEF ≥50%) more often had microvascular disease (28 vs. 21%), irrespective of confounders including duration of diabetes (Figure A; P 〈0.001). Compared to patients without diabetes, patients with diabetes and microvascular complications had higher filling pressures (E/e’〉15, OR 2.36; 95%CI 1.49-3.76), regardless of EF (Pinteraction〉0.1) and less left ventricular hypertrophy on echocardiography (Odds ratio [OR] 0.46; 95%CI 0.31- 0.67). Microvascular disease (vs no diabetes) was associated with higher rates of hospitalization for HF and/or mortality (hazard ratio [HR] 1.60, 95% CI 1.19, 2.15), irrespective of HF phenotype (Figure B; Pinteraction 〉0.5).Conclusion: Microvascular disease is more common in patients with diabetes and HFpEF, compared with diabetes and HFrEF, and correlates with higher filling pressures and worse clinical outcomes. These data support a key pathophysiologic role of microvascular disease in heart failure, particularly HFpEF.
    ISSN: 0009-7322
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
  • 2
    In: Circulation, 2018, Vol.138(24), pp.2763-2773
    Description: BACKGROUND:: Heart failure with preserved ejection fraction (HFpEF), traditionally considered a disease of the elderly, may also affect younger patients. However, little is known about HFpEF in the young. METHODS:: We prospectively enrolled 1203 patients with HFpEF (left ventricular ejection fraction ≥50%) from 11 Asian regions. We grouped HFpEF patients into very young (〈55 years of age; n=157), young (55–64 years of age; n=284), older (65–74 years of age; n=355), and elderly (≥75 years of age; n=407) and compared clinical and echocardiographic characteristics, quality of life, and outcomes across age groups and between very young individuals with HFpEF and age- and sex-matched control subjects without heart failure. RESULTS:: Thirty-seven percent of our HFpEF population was 〈65 years of age. Younger age was associated with male preponderance and a higher prevalence of obesity (body mass index ≥30 kg/m; 36% in very young HFpEF versus 16% in elderly) together with less renal impairment, atrial fibrillation, and hypertension (all P〈0.001). Left ventricular filling pressures and prevalence of left ventricular hypertrophy were similar in very young and elderly HFpEF. Quality of life was better and death and heart failure hospitalization at 1 year occurred less frequently (P〈0.001) in the very young (7%) compared with elderly (21%) HFpEF. Compared with control subjects, very young HFpEF had a 3-fold higher death rate and twice the prevalence of hypertrophy. CONCLUSIONS:: Young and very young patients with HFpEF display similar adverse cardiac remodeling compared with their older counterparts and very poor outcomes compared with control subjects without heart failure. Obesity may be a major driver of HFpEF in a high proportion of HFpEF in the young and very young.
    Keywords: Adults – Health Aspects ; Cardiac Output – Research ; Heart Failure – Research;
    ISSN: 0009-7322
    E-ISSN: 15244539
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
  • 3
    In: Circulation, 2018, Vol.138(Suppl_1 Suppl 1), pp.A10338-A10338
    Description: Introduction: The clinical and echocardiographic correlates of atrial fibrillation (AF) among patients with heart failure and preserved versus reduced ejection fraction (HFpEF vs HFrEF) have not been not well studied in Asia.Hypothesis: There are regional differences in AF among Asian patients with HF.Methods: A total of 4541 patients with HFrEF (EF〈40%) and 963 patients with HFpEF (EF≥50%) were enrolled from Northeast Asia (Korea, Japan, Taiwan, Hong Kong, and China), South Asia (India) and Southeast Asia (Thailand, Malaysia, Philippines, Indonesia, Singapore) in the prospective Asian Sudden Cardiac Death in Heart Failure (ASIAN-HF) study. AF was defined by history or baseline ECG. Outcomes (death or hospitalisation) were independently adjudicated.Results: Prevalence of AF was 22% in HFrEF (mean age 60±13, 78% male) and 38% in HFpEF (mean age 68±12, 47% male). Clinical correlates that differentially associated with AF in HFpEF vs HFrEF included age, region, and chronic kidney disease; whereas echocardiographic correlates that differentially associated with AF in HFpEF vs HFrEF included left atrial volume (Figure 1A).South Asians had the lowest prevalence of AF (6%, 12% in HFrEF, HFpEF) compared to Northeast Asians (39%, 49%) and Southeast Asians (21%, 37%)(p〈0.001). Odds of AF were higher in Northeast Asians (adjusted OR 2.07, 95% CI 1.79-2.40) and lower in South Asians (adjusted OR 0.23, 95% CI 0.18-0.30) when compared to Southeast Asians. Differential odds of AF by region were mediated by both clinical and echocardiographic correlates (Figure 1B).There were striking differences in ethnic associations by region, where Indians from Southeast Asia had a higher odds of AF than Indians from South Asia (OR 2.49, 95% CI 1.68-3.70), and Chinese from Southeast Asia had lower odds of AF than Chinese from Northeast Asia (OR 0.80, 95% CI 0.66-0.98).AF increased the risk of the composite outcome of all-cause mortality and HF hospitalisations (adjusted OR 1.28, 95% CI 1.09-1.51), with similar prognostic impact in HFpEF and HFrEF (Pinteraction0.39).Conclusions: These findings highlight the regional differences in AF among Asian patients with HF. South Asians with HF have a strikingly low prevalence of AF, a difference deserving of further study.
    Keywords: Atrial Fibrillation -- Development And Progression ; Atrial Fibrillation -- Care And Treatment ; Ethnicity -- Health Aspects ; Prevalence Studies (Epidemiology);
    ISSN: 0009-7322
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
  • 4
    Language: English
    In: Journal of the American College of Cardiology, 04 September 2018, Vol.72(10), pp.1081-1090
    Description: Information on the pathophysiological differences between heart failure with reduced ejection fraction (HFrEF) versus heart failure with preserved ejection fraction (HFpEF) is needed The purpose of this study was to establish biological pathways specifically related to HFrEF and HFpEF. The authors performed a network analysis to identify unique biomarker correlations in HFrEF and HFpEF using 92 biomarkers from different pathophysiological domains in a cohort of 1,544 heart failure (HF) patients. Data were independently validated in 804 patients with HF. Networks were enriched with existing knowledge on protein–protein interactions and translated into biological pathways uniquely related to HFrEF, HF with a midrange ejection fraction, and HFpEF. In the index cohort (mean age 74 years; 34% female), 718 (47%) patients had HFrEF (left ventricular ejection fraction [LVEF] 〈40%) and 431 (27%) patients had HFpEF (LVEF ≥50%). A total of 8 (12%) correlations were unique for HFrEF and 6 (9%) were unique to HFpEF. Central proteins in HFrEF were N-terminal B-type natriuretic peptide, growth differentiation factor-15, interleukin-1 receptor type 1, and activating transcription factor 2, while central proteins in HFpEF were integrin subunit beta-2 and catenin beta-1. Biological pathways in HFrEF were related to DNA binding transcription factor activity, cellular protein metabolism, and regulation of nitric oxide biosynthesis. Unique pathways in patients with HFpEF were related to cytokine response, extracellular matrix organization, and inflammation. Biological pathways of patients with HF with a midrange ejection fraction were in between HFrEF and HFpEF. Network analysis showed that biomarker profiles specific for HFrEF are related to cellular proliferation and metabolism, whereas biomarker profiles specific for HFpEF are related to inflammation and extracellular matrix reorganization. (The BIOlogy Study to TAilored Treatment in Chronic Heart Failure [BIOSTAT-CHF]; EudraCT 2010-020808-29)
    Keywords: Biomarkers ; Hfpef ; Hfref ; Network Analysis ; Pathophysiology ; Medicine
    ISSN: 0735-1097
    E-ISSN: 1558-3597
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
  • 5
    Language: English
    In: Journal of the American College of Cardiology, 17 March 2015, Vol.65(10), pp.A991-A991
    Description: To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/S0735-1097(15)60991-3 Byline: Jasper Tromp, IJsbrand Klip, Sven Meyer, Rudolf De Boer, Tiny Jaarsma, Hans Hillege, Dirk van Veldhuisen, Adriaan Voors, Peter Vandermeer Author Affiliation: University Medical Centre Groningen, Department of Cardiology, Groningen, The Netherlands Linkoping University, Department of Social and Welfare Studies, Norrkoping, Sweden Article Note: (footnote) Poster Contributions Poster Hall B1 Sunday, March 15, 2015, 3:45 p.m.-4:30 p.m. Session Title: Imaging and Biomarkers in Heart Failure Abstract Category: 14. Heart Failure and Cardiomyopathies: Clinical Presentation Number: 1217-214
    Keywords: Medicine
    ISSN: 0735-1097
    E-ISSN: 1558-3597
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
  • 6
    Language: English
    In: The American Journal of Cardiology, 15 September 2018, Vol.122(6), pp.999-1007
    Description: Patients with chronic kidney disease (CKD) and/or end-stage renal disease are less active and experience significant functional limitations. The impact of a structured aerobic exercise intervention on outcomes in ambulatory heart failure (HF) patients with comorbid CKD is unknown. enrolled 2,331 outpatients with HF and a reduced ejection fraction (i.e., ≤35%) from April 2003 to February 2007 and randomized them to aerobic exercise training versus usual care. Patients were grouped according to the presence of CKD, defined as an estimated glomerular filtration rate 〈60 ml/min/1.73 m . A total of 2,091 patients (90%) had serum creatinine measured and were included in the final analytical cohort. The prevalence of CKD was 41% at baseline. In patients with and without CKD, respectively, the incidence of all-cause death and hospitalization was 75% and 63% over a median follow-up of 30 months. After adjusting for potential confounders, CKD was associated with increased risk of the composite of all-cause mortality and hospitalization (hazard ratio 1.18, 95% confidence interval 1.04 to 1.33; p value ≤0.01). With the exception of a marginally greater improvement in exercise duration in response to aerobic exercise training (estimate ± standard error: 0.9 ± 0.2 minutes vs 1.4 ± 0.1 minutes; p value = 0.01), there was no interaction between treatment arm and CKD on functional status, health-related quality of life, or clinical outcomes (p value ≥0.05 for all interactions). In conclusion, the prevalence of CKD was high in ambulatory reduced ejection fraction patients and was associated with a poorer overall prognosis but not a differential response to aerobic exercise training.
    Keywords: Medicine
    ISSN: 0002-9149
    E-ISSN: 1879-1913
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
  • 7
    Language: English
    In: The American Journal of Cardiology, 01 January 2018, Vol.121(1), pp.107-112
    Description: The aim of this study is to assess the prevalence of cardiac involvement in hereditary transthyretin-derived (ATTRm) amyloidosis at the time of diagnosis and to determine the diagnostic and clinical value of N-terminal pro-B-type natriuretic peptide (NT-proBNP). The University Medical Center Groningen is the national center of expertise for amyloidosis. All consecutive patients between 1994 and 2016 with ATTRm amyloidosis were followed prospectively. Baseline was set at the time of the first positive biopsy. All patients underwent a standard cardiac and neurologic work-up. Cardiac involvement was defined by otherwise unexplained left and/or right ventricular wall hypertrophy on cardiac ultrasound and/or advanced conduction disturbances. Seventy-seven patients had ATTRm amyloidosis and were included in the study. The V30M mutation was present in 30 patients (39%). In both the V30M and the non-V30M groups, the neurologic presentation dominated (77% vs 51%), whereas cardiac presentation was infrequent (7% vs 15%). Clinical work-up showed that cardiac involvement was present at baseline in 51% of all patients irrespective of genotype and was associated with increased overall mortality (hazard ratio 5.95, 95% confidence interval 2.12 to 16.7), independent from clinical confounders. At a cutoff level of 125 ng/L, NT-proBNP had a sensitivity of 92% for establishing cardiac involvement. In conclusion, irrespective of the frequent noncardiac presentation of ATTRm amyloidosis, cardiac involvement is already present at diagnosis in half of the patients and is associated with increased mortality. NT-proBNP is a useful marker to determine cardiac involvement in this disease.
    Keywords: Medicine
    ISSN: 0002-9149
    E-ISSN: 1879-1913
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
  • 8
    Language: English
    In: Circulation, Nov 25, 2014, Vol.130(22)
    Keywords: Heart Failure -- Risk Factors ; Heart Failure -- Care And Treatment ; Embryonic Stem Cells -- Research ; Gene Expression -- Research ; Oxidative Stress -- Risk Factors
    ISSN: 0009-7322
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
  • 9
    Language: English
    In: Journal of the American College of Cardiology, 21 March 2017, Vol.69(11), pp.933-933
    Description: To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/S0735-1097(17)34322-X Byline: Jasper Tromp (a)(b), Katherine T.H. Teng (a)(b), Wan Ting Tay (a)(b), Inder Anand (a)(b), Shu Zhang (a)(b), Wataru Shimizu (a)(b), Calambur Narasimhan (a)(b), S.W. Park (a)(b), Cheuk-Man Yu (a)(b), Tachapong Ngarmukos (a)(b), Razali Omar (a)(b), Eugene B. Reyes (a)(b), Chung-Lieh Hung (a)(b), Lieng Ling (a)(b), Jonathan Yap (a)(b), Michael Ross MacDonald (a)(b), Mark Richards (a)(b), Carolyn Lam (a)(b) Author Affiliation: (a) National Heart Centre, Singapore, Singapore (b) Cardiovascular Research Institute, Singapore, Singapore Article Note: (footnote) Poster Contributions Poster Hall, Hall C Sunday, March 19, 2017, 9:45 a.m.-10:30 a.m. Session Title: The Evolving World of LVADs, Transplant and Other Novel Discoveries Abstract Category: 13. Heart Failure and Cardiomyopathies: Clinical Presentation Number: 1294-266
    Keywords: Medicine
    ISSN: 0735-1097
    E-ISSN: 1558-3597
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
  • 10
    Language: English
    In: American Journal of Cardiology, 2017, Vol. 119(2), pp. 290-296
    Description: Serum potassium is routinely measured at admission for acute heart failure (AHF), but information on association with clinical variables and prognosis is limited. Potassium measurements at admission were available in 1,867 patients with AHF in the original cohort of 2,033 patients included in the Patients Hospitalized with acute heart failure and Volume Overload to Assess Treatment Effect on Congestion and Renal FuncTion trial. Patients were grouped according to low potassium (amp;lt;3.5 mEq/l), normal potassium (3.5 to 5.0 mEq/l), and high potassium (amp;gt;5.0 mEq/l) levels. Results were verified in a validation cohort of 1,023 patients. Mean age of patients was 71 +/- 11 years, and 66% were men. Low potassium was present in 115 patients (6%), normal potassium in 1,576 (84%), and high potassium in 176 (9%). Potassium levels increased during hospitalization (0.18 +/- 0.69 mEq/l). Patients with high potassium more often used angiotensin-converting enzyme inhibitors and mineralocorticoid receptor antagonists before admission, had impaired baseline renal function and a better diuretic response (p = 0.005), independent of mineralocorticoid receptor antagonist usage. During 180-day follow-up, a total of 330 patients (18%) died. Potassium levels at admission showed a univariate linear association with mortality (hazard ratio [log] 2.36, 95% confidence interval 1.07 to 5.23; p = 0.034) but not after multivariate adjustment. Changes of potassium levels during hospitalization or potassium levels at discharge were not associated with outcome after multivariate analysis. Results in the validation cohort were similar to the index cohort. In conclusion, high potassium levels at admission are associated with an impaired renal function but a better diuretic response. Changes in potassium levels are common, and overall levels increase during hospitalization. In conclusion, potassium levels at admission or its change during hospitalization are not associated with mortality after multivariate adjustment. (C) 2016 The Authors. Published by Elsevier Inc. This is an open access article under the CC BY license (http://creativeconunons.org/licenses/by/4.0/).
    Keywords: Medical And Health Sciences ; Clinical Medicine ; Cardiac And Cardiovascular Systems ; Medicin Och Hälsovetenskap ; Klinisk Medicin ; Kardiologi
    ISBN: 0003928969000
    ISSN: 0002-9149
    E-ISSN: 18791913
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
Close ⊗
This website uses cookies and the analysis tool Matomo. Further information can be found on the KOBV privacy pages