The Year in Heart Failure

Tang, W.H. Wilson; Francis, Gary S.

doi:10.1016/j.jacc.2008.08.026

Cited by 4 publications

(2 citation statements)

References 106 publications

(75 reference statements)

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“…It is known that neurohumoral and cytokine activations contribute to the inflammatory and oxidative characteristics of CHF patients23. We speculate that these chronically activated pathways in at risk CHF patients result in a dramatic response to induced VF rescue ICD shock.…”

Section: Discussionmentioning

confidence: 79%

Transient Local Injury Current in Right Ventricular Electrogram After Implantable Cardioverter-Defibrillator Shock Predicts Heart Failure Progression

Tereshchenko

Faddis

Fetics

et al. 2009

Journal of the American College of Cardiology

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Objectives This study aimed to identify an early marker of functional impairment after an ICD shock as a predictor of heart failure progression. Background The ICD population has substantial risk of death due to progressive pump failure. Methods Near field (NF) bipolar right ventricular (RV) electrograms (EGMs) during induced ventricular fibrillation (VF) and 10 seconds after rescue ICD shock were analyzed in 310 patients (mean age 59±14.5 years, 219 male [71%]) with structural heart disease, NYHA class I–III, and implanted with a single- or dual-chamber Medtronic ICD for primary (245 patients, 79%) or secondary prevention of sudden cardiac arrest. A local injury current (LIC) on NF RV EGM was defined as a deviation of EGM potential ≥1 mV or ≥15% of the preceding R wave peak-to-peak amplitude. Results During mean follow-up of 29.3±15.0 months, the combined endpoint of death or hospitalization due to CHF exacerbation was documented in 40 patients (12.9%, or 5.3% per person-year of follow-up). LIC was observed in 106 patients. In multivariate risk analysis, after adjustment for baseline prognostic factors (ejection fraction, history of atrial fibrillation, diabetes mellitus) and appropriate ICD shocks during follow-up, patients with observed LIC after induced VF rescue ICD shock at ICD implantation were more likely to die or to be hospitalized (hazard ratio, 2.69; 95%CI, 1.41 –5.14; P=0.003). Conclusions Transient LIC on bipolar NF RV EGM after induced VF rescue ICD shock is associated with increased risk of CHF progression, future hospitalizations due to CHF exacerbation, and subsequent heart failure death.

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Section: Discussionmentioning

confidence: 79%

Transient Local Injury Current in Right Ventricular Electrogram After Implantable Cardioverter-Defibrillator Shock Predicts Heart Failure Progression

Tereshchenko

Faddis

Fetics

et al. 2009

Journal of the American College of Cardiology

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“…Heart failure continues to be a major and growing public health issue and remains the leading cause of hospitalization; it is associated with an approximately 45% post-discharge mortality and readmission rate within 3 months. [ 1 , 2 ] Despite treatment using pharmacologic and mechanical (device) interventions, the clinical outcome of patients with preserved ejection fraction heart failure (HFpEF) remains suboptimal[ 3 ], with a hospitalization rate and poor prognosis[ 4 – 6 ] as malignant as systolic dysfunction heart failure (HFrEF, median survival: 2.1 years). [ 7 ] B-type natriuretic peptide (BNP) is a reliable biomarker for diagnosing heart failure and has demonstrated predictive value for hospitalization and mortality both in HFpEF and HFrEF.…”

Section: Introductionmentioning

confidence: 99%

Segmental arterial stiffness in relation to B-type natriuretic peptide with preserved systolic heart function

et al. 2017

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BackgroundCentral arterial stiffness has been shown to play a key role in cardiovascular disease. However, evidence regarding such arterial stiffness from various arterial segments in relation to B-type natriuretic peptide (BNP) remains elusive.MethodsA total of 1255 participants (47.8% men; mean age: 62.6 ± 12.3 [SD] years) with preserved left ventricular function (ejection fraction ≥50%) and ≥1 risk factors were consecutively studied. Arterial pulse wave velocity (PWV) by automatic device (VP-2000; Omron Healthcare) for heart-femoral (hf-PWV), brachial-ankle (ba-PWV), and heart-carotid (hc-PWV) segments were obtained and related to BNP concentrations (Abbott Diagnostics, Abbott Park, IL, USA).ResultsSubjects in the highest hf-PWV quartile were older and had worse renal function and higher blood pressure (all P < 0.05). Elevated PWV (m/s) was correlated with elevated BNP (pg/ml) (beta coefficient = 19.3, 12.4, 5.9 for hf-PWV, ba-PWV, hc-PWV respectively, all p < 0.05). After accounting for clinical co-variates and left ventricle mass index (LVMI), both hf-PWV and ba-PWV were correlated with higher BNP (beta coefficient = 8.3, 6.4 respectively, P < 0.01 for each). Adding both hf-PWV and ba-PWV to LVMI significantly expanded ROC in predicting abnormal BNP>100 pg/ml (both P < 0.01), but only hf-PWV presented significant integrated discrimination improvement to predict risk for BNP concentrations (0.7%, P = 0.029).ConclusionA significant segmental PWV associated with biomarker BNP concentrations suggests that arterial stiffness is associated with myocardial damage.

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The Role of Translational Medicine and Predictive Biomarkers in the Development of Novel, Innovative Treatments for the Management of Chronic Heart Failure:APharmaceutical Industry Perspective

Douglas¹,

Feuerstein²

2010

Burger's Medicinal Chemistry and Drug Discovery

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Chronic heart failure (CHF) represents one of the few cardiovascular diseases with an incidence that continues to rise. While the socio‐economic burden associated with this malignant disease remains high, recent attempts to develop novel, differentiated therapies for the management of CHF (ET‐1, TNFα, dual ACE/NEP inhibitors) have met with failure due to lack of differentiated efficacy and/or safety concerns. Such disappointments have drawn attention to the difficulties faced today in (a) the selection of the most appropriate, innovative targets for the management of this disease; (b) the development of predictive biomarkers that validate the target, define compound pharmacodynamic/‐kinetic (safety/efficacy) relationships, catalog disease modification, and/or assist in patient selection/stratification; and (c) optimal CHF clinical trial design. The present commentary discusses the role of Translational Medicine in the preclinical and clinical CHF Drug Discovery process and details how this emerging scientific discipline can be best used to minimize investment risk/cost.

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The Year in Heart Failure

Cited by 4 publications

References 106 publications

Transient Local Injury Current in Right Ventricular Electrogram After Implantable Cardioverter-Defibrillator Shock Predicts Heart Failure Progression

Transient Local Injury Current in Right Ventricular Electrogram After Implantable Cardioverter-Defibrillator Shock Predicts Heart Failure Progression

Segmental arterial stiffness in relation to B-type natriuretic peptide with preserved systolic heart function

The Role of Translational Medicine and Predictive Biomarkers in the Development of Novel, Innovative Treatments for the Management of Chronic Heart Failure:APharmaceutical Industry Perspective

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