Heart failure with preserved ejection fraction: current status and challenges for the future

Velden, Jolanda van der; Wall, E. E. van der; Paulus, Walter J.

doi:10.1007/s12471-016-0808-8

Cited by 8 publications

(6 citation statements)

References 8 publications

(9 reference statements)

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“…Approximately half the patients with HF have normal contractility. This medical condition of HF with preserved ejection fraction (HFpEF) is characterized by cardiac hypertrophy and increased stiffness of the heart, which compromise ventricular relaxation and reduce stroke volume 2 , 3 . Metabolic diseases such as obesity, diabetes and hypertension often contribute to the development of HFpEF 4 .…”

Section: Introductionmentioning

confidence: 99%

Early cardiac-chamber-specific fingerprints in heart failure with preserved ejection fraction detected by FTIR and Raman spectroscopic techniques

Tombolesi

Altara

Silva

et al. 2022

Sci Rep

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The pathophysiology of heart failure with preserved ejection fraction (HFpEF) is a matter of investigation and its diagnosis remains challenging. Although the mechanisms that are responsible for the development of HFpEF are not fully understood, it is well known that nearly 80% of patients with HFpEF have concomitant hypertension. We investigated whether early biochemical alterations were detectable during HFpEF progression in salt-induced hypertensive rats, using Fourier-transformed infrared (FTIR) and Raman spectroscopic techniques as a new diagnostic approach. Greater protein content and, specifically, greater collagen deposition were observed in the left atrium and right ventricle of hypertensive rats, together with altered metabolism of myocytes. Additionally, Raman spectra indicated a conformational change, or different degree of phosphorylation/methylation, in tyrosine-rich proteins. A correlation was found between tyrosine content and cardiac fibrosis of both right and left ventricles. Microcalcifications were detected in the left and right atria of control animals, with a progressive augmentation from six to 22 weeks. A further increase occurred in the left ventricle and right atrium of 22-week salt-fed animals, and a positive correlation was shown between the mineral deposits and the cardiac size of the left ventricle. Overall, FTIR and Raman techniques proved to be sensitive to early biochemical changes in HFpEF and preceded clinical humoral and imaging markers.

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Section: Introductionmentioning

confidence: 99%

Early cardiac-chamber-specific fingerprints in heart failure with preserved ejection fraction detected by FTIR and Raman spectroscopic techniques

Tombolesi

Altara

Silva

et al. 2022

Sci Rep

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show abstract

“…Possible mechanisms underlying these altered cardiac dynamics could be related to inflammation and mitochondrial function, 41 structural changes (e.g. myocardial fibrosis and steatosis), 42 , 43 altered titin phosphorylation, 44 and/or altered calcium hemostasis. 45 Although the (combination of) mechanisms underlying the observed changes in early diastole remain to be elucidated in future research, our data suggest that the SVL, especially during early diastole, might be of added prognostic value in HFpEF.…”

Section: Discussionmentioning

confidence: 99%

Association of left ventricular strain–volume loop characteristics with adverse events in patients with heart failure with preserved ejection fraction

Kerstens

Weerts

Dijk

et al. 2023

European Heart Journal - Cardiovascular Imaging

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Aims Patients with heart failure with preserved ejection fraction (HFpEF) are characterized by impaired diastolic function. Left ventricular (LV) strain–volume loops (SVL) represent the relation between strain and volume during the cardiac cycle and provide insight into systolic and diastolic function characteristics. In this study, we examined the association of SVL parameters and adverse events in HFpEF. Methods and results In 235 patients diagnosed with HFpEF, LV-SVL were constructed based on echocardiography images. The endpoint was a composite of all-cause mortality and Heart Failure (HF)-related hospitalization, which was extracted from electronic medical records. Cox-regression analysis was used to assess the association of SVL parameters and the composite endpoint, while adjusting for age, sex, and NYHA class. HFpEF patients (72.3% female) were 75.8 ± 6.9 years old, had a BMI of 29.9 ± 5.4 kg/m2, and a left ventricular ejection fraction of 60.3 ± 7.0%. Across 2.9 years (1.8–4.1) of follow-up, 73 Patients (31%) experienced an event. Early diastolic slope was significantly associated with adverse events [second quartile vs. first quartile: adjusted hazards ratio (HR) 0.42 (95%CI 0.20–0.88)] after adjusting for age, sex, and NYHA class. The association between LV peak strain and adverse events disappeared upon correction for potential confounders [adjusted HR 1.02 (95% CI 0.96–1.08)]. Conclusion Early diastolic slope, representing the relationship between changes in LV volume and strain during early diastole, but not other SVL-parameters, was associated with adverse events in patients with HFpEF during 2.9 years of follow-up.

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“…Approximately half the patients with HF have normal contractility. This medical condition of HF with preserved ejection fraction (HFpEF) is characterized by cardiac hypertrophy and increased stiffness of the heart, which compromise ventricular relaxation and reduce stroke volume [31,35]. Metabolic diseases such as obesity, diabetes and hypertension often contribute to the development of HFpEF [2].…”

Section: Introductionmentioning

confidence: 99%

Cardiac-chamber-specific Fingerprints in Heart Failure with Preserved Ejection Fraction. Early Detection of Pathological Conditions by FTIR and Raman Spectroscopic Techniques

Tombolesi

Altara

Silva

et al. 2021

Preprint

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Background The pathophysiology of heart failure with preserved ejection fraction (HFpEF) is a matter of investigation and its diagnosis remains challenging. Although the mechanisms that are responsible for the development of HFpEF are not fully understood, it is well known that nearly 80% of patients with HFpEF have concomitant hypertension.Methods We investigated whether early biochemical alterations were detectable during HFpEF progression in salt-induced hypertensive rats, using Fourier-transformed infrared (FTIR) and Raman spectroscopic techniques as a new diagnostic approach. Results Greater protein content and, specifically, greater collagen deposition were observed in the left atrium and right ventricle of hypertensive rats, together with altered metabolism of myocytes. Additionally, Raman spectra indicated a conformational change, or different degree of phosphorylation/methylation, in tyrosine-rich proteins. A correlation was found between tyrosine content and cardiac fibrosis of both right and left ventricles. Microcalcifications were detected in the left and right atria of control animals, with a progressive augmentation from six to 22 weeks. A further increase occurred in the left ventricle and right atrium of 22-week salt-fed animals, and a positive correlation was shown between the mineral deposits and the cardiac size of the left ventricle. Conclusions Overall, FTIR and Raman techniques proved to be sensitive to early biochemical changes in HFpEF and preceded clinical humoral and imaging markers.

show abstract

Heart failure with preserved ejection fraction: current status and challenges for the future

Cited by 8 publications

References 8 publications

Early cardiac-chamber-specific fingerprints in heart failure with preserved ejection fraction detected by FTIR and Raman spectroscopic techniques

Early cardiac-chamber-specific fingerprints in heart failure with preserved ejection fraction detected by FTIR and Raman spectroscopic techniques

Association of left ventricular strain–volume loop characteristics with adverse events in patients with heart failure with preserved ejection fraction

Cardiac-chamber-specific Fingerprints in Heart Failure with Preserved Ejection Fraction. Early Detection of Pathological Conditions by FTIR and Raman Spectroscopic Techniques

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