Comparison of Predictors of Heart Failure With Preserved Versus Reduced Ejection Fraction in a Multiracial Cohort of Preclinical Left Ventricular Diastolic Dysfunction

Zhang, Lili; Liebelt, Jared; Madan, Nidhi; Shan, Jufang; Taub, Cynthia C.

doi:10.1016/j.amjcard.2017.03.005

Cited by 19 publications

(21 citation statements)

References 23 publications

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“…In recent years, numerous studies have been conducted concerning the heterogeneous and complex syndrome known as heart failure (HF). In particular, heart failure with reduced ejection fraction (EF) and heart failure with preserved ejection fraction (HFpEF) were defined [100][101][102][103]. The majority of the population is affected by heart failure with preserved ejection fraction, prevalent in the ageing population.…”

Section: The Potential For N-3 Pufas Supplementation In Heart Failurementioning

confidence: 99%

The Anti-Inflammatory and Antioxidant Properties of n-3 PUFAs: Their Role in Cardiovascular Protection

et al. 2020

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Polyunsaturated fatty acids (n-3 PUFAs) are long-chain polyunsaturated fatty acids with 18, 20 or 22 carbon atoms, which have been found able to counteract cardiovascular diseases. Eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), in particular, have been found to produce both vaso- and cardio-protective response via modulation of membrane phospholipids thereby improving cardiac mitochondrial functions and energy production. However, antioxidant properties of n-3 PUFAs, along with their anti-inflammatory effect in both blood vessels and cardiac cells, seem to exert beneficial effects in cardiovascular impairment. In fact, dietary supplementation with n-3 PUFAs has been demonstrated to reduce oxidative stress-related mitochondrial dysfunction and endothelial cell apoptosis, an effect occurring via an increased activity of endogenous antioxidant enzymes. On the other hand, n-3 PUFAs have been shown to counteract the release of pro-inflammatory cytokines in both vascular tissues and in the myocardium, thereby restoring vascular reactivity and myocardial performance. Here we summarize the molecular mechanisms underlying the anti-oxidant and anti-inflammatory effect of n-3 PUFAs in vascular and cardiac tissues and their implication in the prevention and treatment of cardiovascular disease.

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Section: The Potential For N-3 Pufas Supplementation In Heart Failurementioning

confidence: 99%

The Anti-Inflammatory and Antioxidant Properties of n-3 PUFAs: Their Role in Cardiovascular Protection

et al. 2020

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“…Additionally, on initial presentation, a higher percentage of HFpEF patients exhibited edema and had pulmonary crepitations present [25]. In one preclinical left ventricular diastolic dysfunction cohort study, the authors found that HFrEF patients were predominantly male with high percentage of cerebrovascular disease and low baseline of LVEF, while HFpEF patients more often had pulmonary diseases with renal impairment and anemia [26]. A recent study involving a multinational registry of Asian HF patients involving 46 medical centers across Asia observed a similar burden of comorbidity in HFrEF and HFpEF as seen in Western countries.…”

Section: The Challenges Of Hfref and Hfpefmentioning

confidence: 99%

Heart Failure with Reduced Ejection Fraction (HFrEF) and Preserved Ejection Fraction (HFpEF): The Diagnostic Value of Circulating MicroRNAs

Chen

Wong

Liew

et al. 2019

Cells

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Circulating microRNAs offer attractive potential as epigenetic disease biomarkers by virtue of their biological stability and ready accessibility in liquid biopsies. Numerous clinical cohort studies have revealed unique microRNA profiles in different disease settings, suggesting utility as markers with diagnostic and prognostic applications. Given the complex network of microRNA functions in modulating gene expression and post-transcriptional modifications, the circulating microRNA landscape in disease may reflect pathophysiological status, providing valuable information for delineating distinct subtypes and/or stages of complex diseases. Heart failure (HF) is an increasingly significant global health challenge, imposing major economic liability and health care burden due to high hospitalization, morbidity, and mortality rates. Although HF is defined as a syndrome characterized by symptoms and findings on physical examination, it may be further differentiated based on left ventricular ejection fraction (LVEF) and categorized as HF with reduced ejection fraction (HFrEF) and HF with preserved ejection fraction (HFpEF). The presenting clinical syndromes in HFpEF and HFrEF are similar but mortality differs, being somewhat lower in HFpEF than in HFrEF. However, while HFrEF is responsive to an array of therapies, none has been shown to improve survival in HFpEF. Herein, we review recent HF cohort studies focusing on the distinct microRNA profiles associated with HF subtypes to reveal new insights to underlying mechanisms and explore the possibility of exploiting these differences for diagnostic/prognostic applications.

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“…Thus, we did not include those studies in our analysis. Finally, there were 74 studies 27–100 and 38 studies 85,101–137 in which we could estimate RRs for new‐onset and recurrent HF, respectively, in relation to DM. One study 85 examined both new‐onset and recurrent HF risk.…”

Section: Resultsmentioning

confidence: 99%

“…Among the 74 studies of the risk for incident new-onset HF, in four, [28][29][30][31] Meta-analysis of diabetes and heart failure and the risk of HF was not examined as a whole. One study 27 only included systolic HF as an endpoint (i.e.…”

Section: Overall Analysis Of New-onset Heart Failure Risk In Relationmentioning

confidence: 99%

“…Figure 1 is a forest plot of the RR for new-onset HF in participants with DM compared with those without DM. Of the 69 included studies, 13 studies 32,35,36,38,44,50,60,65,80,84,[88][89][90] presented data on RR by gender; of these, seven studies 32,35,50,87- Figure 2A is a forest plot of seven studies [28][29][30][31]34,42,55 that examined HFpEF and eight studies [28][29][30][31]34,42,55,56 that examined HFrEF risk in relation to DM. The RR (95% CI) was 2.22 (2.02-2.43) for HFpEF and 2.73 (2.71-2.75) for HFrEF.…”

Section: Overall Analysis Of New-onset Heart Failure Risk In Relationmentioning

confidence: 99%

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Diabetes mellitus and risk of new‐onset and recurrent heart failure: a systematic review and meta‐analysis

et al. 2020

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Despite mounting evidence of the positive relationship between diabetes mellitus (DM) and heart failure (HF), the entire context of the magnitude of risk for HF in relation to DM remains insufficiently understood. The principal reason is because new-onset HF (HF occurring in participants without a history of HF) and recurrent HF (HF re-occurring in patients with a history of HF) are not discriminated. This meta-analysis aims to comprehensively and separately assess the risk of new-onset and recurrent HF depending on the presence or absence of DM. We systematically searched cohort studies that examined the relationship between DM and new-onset or recurrent HF using EMBASE and MEDLINE (from 1 Jan 1950 to 28 Jul 2019). The risk ratio (RR) for HF in individuals with DM compared with those without DM was pooled with a random-effects model. Seventy-four and 38 eligible studies presented data on RRs for new-onset and recurrent HF, respectively. For new-onset HF, the pooled RR [95% confidence interval (CI)] of 69 studies that examined HF as a whole [i.e. combining HF with preserved ejection fraction (HFpEF) and HF with reduced ejection fraction (HFrEF)] was 2.14 (1.96-2.34). The large between-study heterogeneity (I 2 = 99.7%, P < 0.001) was significantly explained by mean age [pooled RR (95% CI) 2.60 (2.38-2.84) for mean age < 60 years vs. pooled RR (95% CI) 1.95 (1.79-2.13) for mean age ≥ 60 years] (P < 0.001). Pooled RRs (95% CI) of seven and eight studies, respectively, that separately examined HFpEF and HFrEF risk were 2.22 (2.02-2.43) for HFpEF and 2.73 (2.71-2.75) for HFrEF. The risk magnitudes between HFpEF and HFrEF were not significantly different in studies that examined both HFpEF and HFrEF risks (P = 0.86). For recurrent HF, pooled RR (95% CI) of the 38 studies was 1.39 (1.33-1.45). The large between-study heterogeneity (I 2 = 80.1%, P < 0.001) was significantly explained by the proportion of men [pooled RR (95% CI) 1.53 (1.40-1.68) for < 65% men vs. 1.32 (1.25-1.39) for ≥65% men (P = 0.01)] or the large pooled RR for studies of only participants with HFpEF [pooled RR (95% CI), 1.73 (1.32-2.26) (P = 0.002)]. Results indicate that DM is a significant risk factor for both new-onset and recurrent HF. It is suggested that the risk magnitude is large for new-onset HF especially in young populations and for recurrent HF especially in women or individuals with HFpEF. DM is associated with future HFpEF and HFrEF to the same extent.

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Comparison of Predictors of Heart Failure With Preserved Versus Reduced Ejection Fraction in a Multiracial Cohort of Preclinical Left Ventricular Diastolic Dysfunction

Cited by 19 publications

References 23 publications

The Anti-Inflammatory and Antioxidant Properties of n-3 PUFAs: Their Role in Cardiovascular Protection

The Anti-Inflammatory and Antioxidant Properties of n-3 PUFAs: Their Role in Cardiovascular Protection

Heart Failure with Reduced Ejection Fraction (HFrEF) and Preserved Ejection Fraction (HFpEF): The Diagnostic Value of Circulating MicroRNAs

Diabetes mellitus and risk of new‐onset and recurrent heart failure: a systematic review and meta‐analysis

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