Category Archives: Eur J Heart Fail

What is the added value of the waist-to-hip ratio on top of the BIOSTAT risk prediction model in patients with heart failure? Reply.

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What is the added value of the waist-to-hip ratio on top of the BIOSTAT risk prediction model in patients with heart failure? Reply.
Eur J Heart Fail. 2018 Oct 08;:
Authors: Streng KW, Lang CC, Voo… Continue reading

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Risk stratification in acute heart failure: reply.

Risk stratification in acute heart failure: reply.
Eur J Heart Fail. 2018 Mar 07;:
Authors: Demissei BG, Voors AA
PMID: 29512236 [PubMed – as supplied by publisher]

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Myocardial oedema and congestive heart failure: one piece of the puzzle? Reply.

Myocardial oedema and congestive heart failure: one piece of the puzzle? Reply.
Eur J Heart Fail. 2018 Jan 10;:
Authors: Gorter TM, de Boer RA
PMID: 29319924 [PubMed – as supplied by publisher]

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Ischaemia in heart failure with preserved ejection fraction; is it important?

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Ischaemia in heart failure with preserved ejection fraction; is it important?
Eur J Heart Fail. 2016 Apr 20;
Authors: van Veldhuisen DJ, de Boer RA
PMID: 27095562 [PubMed – as supplied by publ… Continue reading

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Optimizing clinical use of biomarkers in high-risk acute heart failure patients.

Optimizing clinical use of biomarkers in high-risk acute heart failure patients.

Eur J Heart Fail. 2015 Dec 3;

Authors: Demissei BG, Cleland JG, O’Connor CM, Metra M,…

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Plasma kidney injury molecule-1 in heart failure: renal mechanisms and clinical outcome.

Plasma kidney injury molecule-1 in heart failure: renal mechanisms and clinical outcome.

Eur J Heart Fail. 2015 Oct 28;

Authors: Emmens JE, Ter Maaten JM, Matsue Y, Metra…

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Biomarkers and low risk in heart failure. Data from COACH and TRIUMPH.

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Biomarkers and low risk in heart failure. Data from COACH and TRIUMPH.

Eur J Heart Fail. 2015 Oct 14;

Authors: Meijers WC, de Boer RA, van…

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The clinical course of health status and association with outcomes in patients hospitalized for heart failure: insights from ASCEND-HF.

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The clinical course of health status and association with outcomes in patients hospitalized for heart failure: insights from ASCEND-HF.

Eur J Heart Fail….

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Increased risk of stroke with darbepoetin alfa in anaemic heart failure patients with diabetes and chronic kidney disease.

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Increased risk of stroke with darbepoetin alfa in anaemic heart failure patients with diabetes and chronic kidney disease.
Eur J Heart Fail. 2015 Oct 1;
Authors: Bello NA, Lewis EF, Desai AS, Anand IS… Continue reading

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Signature of circulating microRNAs in patients with acute heart failure.

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Signature of circulating microRNAs in patients with acute heart failure.
Eur J Heart Fail. 2015 Sep 8;
Authors: Ovchinnikova ES, Schmitter D, Vegter EL, Ter Maaten JM, Valente MA, Liu LC, van der Hars… Continue reading

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Growth differentiation factor 15 (GDF-15) in patients admitted for acute heart failure: results from the RELAX-AHF study.

Growth differentiation factor 15 (GDF-15) in patients admitted for acute heart failure: results from the RELAX-AHF study.

Eur J Heart Fail. 2015 Sep 3;

Authors: Cotter G, Voors AA, Prescott MF, Felker GM, Filippatos G, Greenberg BH, Pang PS, Ponikowski P, Milo O, Hua TA, Qian M, Severin TM, Teerlink JR, Metra M, Davison BA

Abstract
BACKGROUND: Growth differentiation factor 15 (GDF-15) was found to be upregulated in patients with chronic heart failure (HF) and associated with disease severity, however, data on patients with acute heart failure (AHF) is lacking.
METHODS AND RESULTS: Levels of GDF-15 were measured at pre-specified time-points (baseline and at days 2, 5, 14, and 60) in patients enrolled in the placebo-controlled RELAXin in Acute Heart Failure (RELAX-AHF) study, which examined the effect of serelaxin in 1161 patients with AHF, systolic blood pressure >125 mmHg, and mild to moderate renal impairment. Neither baseline nor changes in GDF-15 were associated with the degree of dyspnoea or dyspnoea relief. After adjustment for baseline characteristics, baseline GDF-15 was not associated with the composite endpoint of heart failure or renal failure (HF/RF) readmission at 60 days/cardiovascular (CV) death or CV death at 180 days. In contrast, larger increases in GDF-15 levels at days 2 and 14 were associated with a greater risk of 60-day HF/RF rehospitalizations/CV death and CV death at 180 days. Serelaxin treatment was associated with significantly larger decreases of GDF-15 at days 2 and 5 than placebo.
CONCLUSIONS: In AHF patients enrolled in the RELAX-AHF study, increases in GDF-15 levels, but not baseline measurements, were associated with a greater likelihood of adverse outcomes. Serelaxin administration was associated with greater decreases in GDF-15 compared with placebo.

PMID: 26333529 [PubMed – as supplied by publisher]

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Serial high sensitivity cardiac troponin T measurement in acute heart failure: insights from the RELAX-AHF study.

Serial high sensitivity cardiac troponin T measurement in acute heart failure: insights from the RELAX-AHF study.

Eur J Heart Fail. 2015 Sep 3;

Authors: Michael Felker G, Mentz RJ, Teerlink JR, Voors AA, Pang PS, Ponikowski P, Greenberg BH, Filippatos G, Davison BA, Cotter G, Prescott MF, Hua TA, Lopez-Pintado S, Severin T, Metra M

Abstract
AIMS: Troponin elevation is common in acute heart failure (AHF) and may be useful for prognostication; however, available data are mixed and many previous studies used older, less sensitive assays. We examined the association between serial measurements of high-sensitivity cardiac troponin T (hs-cTnT) and outcomes in RELAX-AHF.
METHODS AND RESULTS: Hs-cTnT was measured at baseline and days 2, 5, and 14. We assessed the relationship between baseline, peak and peak change hs-cTnT with dyspnoea relief by visual analogue scale, cardiovascular death, or HF/renal hospitalization to 60 days and cardiovascular mortality to 180 days. Models were adjusted for clinical variables and treatment assignment. Whether baseline troponin status affected the treatment effect of serelaxin was assessed using interactions terms. In 1074 patients, the median baseline troponin was 0.033 µg/L, and 90% of patients were above the 99th upper reference limit (URL). Patients with hs-cTnT >median were more likely to be men with ischaemic heart disease, worse renal function, and higher N-terminal pro-brain natriuretic peptide. Higher baseline or peak hs-cTnT and greater peak change were associated with worse outcomes independent of adjustment for covariates, but relationships were generally strongest for 180-day cardiovascular mortality (hazard ratio per doubling of baseline hs-cTnT = 1.36, 95% confidence interval 1.15-1.60). Troponin was most strongly associated with death from heart failure or from other cardiovascular causes. The treatment effect of serelaxin did not differ by baseline troponin levels.
CONCLUSION: Hs-cTnT was elevated above the 99% URL in the majority of AHF patients. Baseline, peak, and peak change hs-cTnT were associated with worse outcomes, with the strongest relationship with 180-day cardiovascular mortality.

PMID: 26333655 [PubMed – as supplied by publisher]

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Clinical outcomes according to QRS duration and morphology in the Eplerenone in Mild Patients: Hospitalization and SurvIval Study in Heart Failure (EMPHASIS-HF).

Clinical outcomes according to QRS duration and morphology in the Eplerenone in Mild Patients: Hospitalization and SurvIval Study in Heart Failure (EMPHASIS-HF).

Eur J Heart Fail. 2015 Jul;17(7):707-16

Authors: Cannon JA, Collier TJ, Shen L, Swedberg K, Krum H, Van Veldhuisen DJ, Vincent J, Pocock SJ, Pitt B, Zannad F, McMurray JJ

Abstract
AIMS: We examined the relationship between different degrees of QRS prolongation and different QRS morphologies and clinical outcomes in patients with heart failure, reduced ejection fraction (HF-REF), and mild symptoms in the Eplerenone in Mild Patients Hospitalization and SurvIval Study in Heart Failure trial (EMPHASIS-HF). We also evaluated the effect of eplerenone in these patients according to QRS duration/morphology.
METHODS AND RESULTS: Patients were categorized as: QRS duration (ms) (i) <120 (n = 1375); (ii) 120-149 (n = 517); and (iii) ≥150 (n = 383), and QRS morphology (i) normal (n = 1252); (ii) left bundle branch block (BBB) (n = 608); and (iii) right BBB/intraventricular conduction defect (IVCD) (n = 415). The outcomes examined were the composite of cardiovascular death or heart failure hospitalization and all-cause mortality. Both abnormal QRS duration and QRS morphology were associated with higher risk, e.g. the rates of the composite outcome were: 10.2, 17.6, and 15.5 per 100 patient-years in the <120, 120-149, and ≥150 ms groups, respectively. Eplerenone reduced the risk of the primary outcome and mortality, compared with placebo, consistently across the QRS duration/morphology subgroups.
CONCLUSION: We found that even moderate prolongation of QRS duration and right BBB/IVCD were associated with a high risk of adverse outcomes in HF-REF. Eplerenone was similarly effective, irrespective of QRS duration/morphology.

PMID: 26139584 [PubMed – in process]

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BNP in heart failure: even leucocytes cannot escape its influence.

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BNP in heart failure: even leucocytes cannot escape its influence.
Eur J Heart Fail. 2015 Jun;17(6):536-538
Authors: Karper JC, Westenbrink BD
PMID: 26096205 [PubMed – as supplied by publisher… Continue reading

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Early vs. late worsening heart failure during acute heart failure hospitalization: insights from the PROTECT trial.

Early vs. late worsening heart failure during acute heart failure hospitalization: insights from the PROTECT trial.

Eur J Heart Fail. 2015 Jun 17;

Authors: Mentz RJ, Metra M, Cotter G, Milo O, McKendry C, Chiswell K, Davison BA, Cleland JG, Bloomfield DM, Dittrich HC, Fiuzat M, Ponikowski P, Givertz MM, Voors AA, Teerlink JR, O’Connor CM

Abstract
BACKGROUND: Worsening heart failure (WHF) symptoms despite initial therapy during admission for acute heart failure (AHF) is associated with worse outcomes. The association between the time of the WHF event and the intensity of WHF therapy with outcomes is unknown.
METHODS AND RESULTS: In the PROTECT trial of 2033 AHF patients, we investigated the association between time of occurrence of WHF and intensity of therapy, with subsequent outcomes. WHF was defined by standardized, physician-determined assessment. Early WHF was defined as occurring on days 2-3 and late on days 4-7. Low intensity included restarting/increasing diuretics or vasodilators and high intensity included initiation of inotropes, vasopressors, inodilators, or mechanical support. Outcomes were death or cardiovascular/renal hospitalization over 60 days and death over 180 days. Of the 1879 patients with complete follow-up after day 7, 12.7% (n = 238) experienced WHF: 47.9% early and 52.1% late. Treatment intensity was low in 72.3% and high in 24.8% (2.9% missing). After adjusting for baseline predictors of outcome, WHF was associated with a trend toward increased 60-day death or cardiovascular/renal hospitalization [hazard ratio (HR) 1.26; 95% confidence interval (CI) 0.99-1.60; P = 0.063] and increased 180-day death (HR 1.77; 95% CI 1.33-2.34; P < 0.001). There was no evidence of a differential association between the time of occurrence of WHF and outcomes. High-intensity therapy was not significantly associated with increased event rates (180-day mortality: HR 1.44; 95% CI 0.80-2.59 vs. low).
CONCLUSIONS: Inhospital WHF was associated with increased 180-day death. The time of occurrence and intensity of WHF therapy may provide less prognostic information than whether or not WHF occurred.

PMID: 26083764 [PubMed – as supplied by publisher]

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Maintenance of serum potassium with sodium zirconium cyclosilicate (ZS-9) in heart failure patients: results from a phase 3 randomized, double-blind, placebo-controlled trial.

Maintenance of serum potassium with sodium zirconium cyclosilicate (ZS-9) in heart failure patients: results from a phase 3 randomized, double-blind, placebo-controlled trial.

Eur J Heart Fail. 2015 May 23;

Authors: Anker SD, Kosiborod M, Zannad F, Piña IL, McCullough PA, Filippatos G, Van Der Meer P, Ponikowski P, Rasmussen HS, Lavin PT, Singh B, Yang A, Deedwania P

Abstract
AIMS: Hyperkalaemia in heart failure (HF) patients limits use of cardioprotective renin-angiotensin-aldosterone-system inhibitors (RAASi). Sodium zirconium cyclosilicate (ZS-9) is a selective K(+) ion trap (SKIT), whose mechanism of action may allow for potassium binding in the upper GI as early as the duodenum following oral administration. ZS-9 previously demonstrated the ability to reduce elevated potassium levels into the normal range with a median time of normalization of 2.2h and sustain normal potassium levels for 28 days in HARMONIZE-a Phase 3, double-blind, randomized, placebo-controlled trial. Here we evaluated management of serum potassium with daily ZS-9 over 28 days in HF patients from HARMONIZE, including those receiving RAASi therapies.
METHODS AND RESULTS: HF patients with evidence of hyperkalaemia (serum potassium≥5.1 mmol/L; N=94) were treated with open-label ZS-9 for 48h. Patients (n=87; 60 receiving RAASi) who achieved normokalaemia (potassium 3.5-5.0 mmol/L) were randomized to daily ZS-9 (5, 10, or 15g) or placebo for 28 days. Mean potassium and proportion of patients maintaining normokalaemia during days 8-29 post-randomization were evaluated. Despite RAASi doses being kept constant, patients on 5g, 10g, and 15g ZS-9 maintained lower potassium (4.7, 4.5, and 4.4 mmol/L, respectively) than the placebo group (5.2 mmol/L; P<0.01 vs. each ZS-9 group); greater proportions of ZS-9 patients (83%, 89%, and 92%, respectively) maintained normokalaemia than placebo (40%; P<0.01 vs. each ZS-9 group). Safety profile was consistent with previously reported overall study population.
CONCLUSION: Compared with placebo, all 3 ZS-9 doses lowered potassium and effectively maintained normokalaemia for 28 days in HF patients without adjusting concomitant RAASi, while maintaining a safety profile consistent with the overall study population.

PMID: 26011677 [PubMed – as supplied by publisher]

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Recommendations on pre-hospital & hospital management of acute heart failure: a consensus paper from the Heart Failure Association of the European Society of Cardiology, the European Society of Emergency Medicine and the Society of Academic Emergency Medicine.

Recommendations on pre-hospital & hospital management of acute heart failure: a consensus paper from the Heart Failure Association of the European Society of Cardiology, the European Society of Emergency Medicine and the Society of Academi… Continue reading

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Heart failure and brain failure: two of a kind?

Heart failure and brain failure: two of a kind?
Eur J Heart Fail. 2015 Apr 28;
Authors: Festen S, de Rooij SE
PMID: 25924209 [PubMed – as supplied by publisher]

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State of the Art: Newer biomarkers in heart failure.

State of the Art: Newer biomarkers in heart failure.
Eur J Heart Fail. 2015 Apr 16;
Authors: de Boer RA, Daniels LB, Maisel AS, Januzzi JL
Abstract
Since natriuretic peptides were successfully integra… Continue reading

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Chagas, a cardiomyopathy emerging from obscurity.

Chagas, a cardiomyopathy emerging from obscurity.
Eur J Heart Fail. 2015 Apr;17(4):355-7
Authors: Westenbrink BD, Kingma JH
PMID: 25828906 [PubMed – in process]

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