Scholars@Duke
Gary Michael Felker

Gary Michael Felker

Professor of Medicine
Medicine, Cardiology
michael.felker@duke.edu
Duke Box 3850, Durham, NC 27710
7th FL 2400 Pratt St, Durham, NC 27705

Selected Publications

Artificial Intelligence in Cardiovascular Clinical Trials.

Journal Article J Am Coll Cardiol · November 12, 2024 Randomized clinical trials are the gold standard for establishing the efficacy and safety of cardiovascular therapies. However, current pivotal trials are expensive, lengthy, and insufficiently diverse. Emerging artificial intelligence (AI) technologies ca ... Full text Link to item Cite

Centrally adjudicated vs. investigator-reported outcomes in randomized heart failure trials.

Journal Article Eur Heart J · November 9, 2024 BACKGROUND AND AIMS: Heart failure endpoints in cardiovascular outcome trials are commonly identified through centralized adjudication of investigator-reported events. It remains unclear whether central adjudication improves the accuracy of treatment effec ... Full text Link to item Cite

Remote Follow-up in a Heart Failure Pragmatic Trial: Insights From the CONNECT-HF.

Journal Article J Card Fail · November 2024 BACKGROUND: Randomized controlled trials typically require study-specific visits, which can burden participants and sites. Remote follow-up, such as centralized call centers for participant-reported or site-reported, holds promise for reducing costs and en ... Full text Link to item Cite

Implications of trial eligibility in patients with heart failure with mildly reduced or preserved ejection fraction.

Journal Article ESC Heart Fail · October 2024 AIMS: Clinical trials in heart failure with mildly reduced or preserved ejection fraction (HFmrEF/HFpEF) commonly have detailed eligibility criteria. This may contribute to challenges with efficient enrolment and questions regarding the generalizability of ... Full text Link to item Cite

Distinct Comorbidity Clusters in Patients With Acute Heart Failure: Data From RELAX-AHF-2.

Journal Article JACC Heart Fail · October 2024 BACKGROUND: Multimorbidity frequently occurs in patients with acute heart failure (AHF). The co-occurrence of comorbidities often follows specific patterns. OBJECTIVES: This study investigated multimorbidity subtypes and their associations with clinical ou ... Full text Link to item Cite

Time to Sustained Recovery Among Outpatients With COVID-19 Receiving Montelukast vs Placebo: The ACTIV-6 Randomized Clinical Trial.

Journal Article JAMA Netw Open · October 1, 2024 IMPORTANCE: The effect of montelukast in reducing symptom duration among outpatients with mild to moderate COVID-19 is uncertain. OBJECTIVE: To assess the effectiveness of montelukast compared with placebo in treating outpatients with mild to moderate COVI ... Full text Link to item Cite

Comparing Analytical Methods for Composite End Points in Clinical Trials: Insights from the Vericiguat Global Study in Subjects with Heart Failure With Reduced Ejection Fraction Trial.

Journal Article J Card Fail · September 7, 2024 BACKGROUND: In VICTORIA (Vericiguat Global Study in Subjects with Heart Failure with Reduced Ejection Fraction), participants with heart failure (HF) and reduced ejection fraction, vericiguat decreased the primary composite outcome (time to first HF hospit ... Full text Link to item Cite

IL-6 inhibition with clazakizumab in patients receiving maintenance dialysis: a randomized phase 2b trial.

Journal Article Nat Med · August 2024 Inflammation mediated by interleukin-6 (IL-6) is strongly associated with cardiovascular risk. Here we evaluated clazakizumab, a monoclonal antibody targeting the IL-6 ligand, in a phase 2b dose-finding study. Adults with cardiovascular disease and/or diab ... Full text Link to item Cite

Severe obesity among patients with left ventricular assist devices.

Journal Article Am Heart J · August 2024 BACKGROUND: Patients with obesity and advanced heart failure requiring left ventricular assist device (LVAD) support are more likely to experience LVAD complications and may be disproportionately Black and/or female when compared to patients without obesit ... Full text Link to item Cite

Cardiac Troponin and Treatment Effects of Omecamtiv Mecarbil: Results From the GALACTIC-HF Study.

Journal Article J Card Fail · June 2024 BACKGROUND: Omecamtiv mecarbil improves outcomes in patients with heart failure and reduced ejection fraction (HFrEF). We examined the relationship between baseline troponin levels, change in troponin levels over time and the treatment effect of omecamtiv ... Full text Link to item Cite

Putting More Weight on Obesity Trials in Heart Failure.

Journal Article Curr Heart Fail Rep · June 2024 PURPOSE OF REVIEW: To review ongoing and planned clinical trials of weight loss among individuals with or at high risk of heart failure. RECENT FINDINGS: Intentional weight loss via semaglutide among persons with heart failure and preserved ejection fracti ... Full text Link to item Cite

Sacubitril/valsartan and cardiovascular biomarkers among patients with recent COVID-19 infection: The PARACOR-19 randomized clinical trial.

Journal Article Eur J Heart Fail · June 2024 AIMS: The PARACOR-19 randomized controlled trial (RCT) was designed to examine the effects of sacubitril/valsartan on markers of cardiac injury, inflammation, structure, and function among patients who have recovered from acute coronavirus disease 2019 (CO ... Full text Link to item Cite

Isovolumic Contraction Velocity in Heart Failure With Reduced Ejection Fraction and Effect of Sacubitril/Valsartan: the PROVE-HF Study.

Journal Article J Card Fail · May 2024 OBJECTIVES: To assess tissue Doppler-derived mitral annular isovolumic contraction velocity (ICV) after starting sacubitril/valsartan (sac/val) for the treatment of heart failure with reduced ejection fraction (HFrEF) and left ventricular [LV] EF < 40%). B ... Full text Link to item Cite

Utilizing Quality of Life Adjusted Days Alive and Out of Hospital in Heart Failure Clinical Trials.

Journal Article Circ Cardiovasc Qual Outcomes · May 2024 BACKGROUND: In heart failure (HF) trials, there has been an emphasis on utilizing more patient-centered outcomes, including quality of life (QoL) and days alive and out of hospital. We aimed to explore the impact of QoL adjusted days alive and out of hospi ... Full text Link to item Cite

Left Ventricular Ejection Fraction and the Future of Heart Failure Phenotyping.

Journal Article JACC Heart Fail · March 2024 Heart failure (HF) is a complex syndrome traditionally classified by left ventricular ejection fraction (LVEF) cutpoints. Although LVEF is prognostic for risk of events and predictive of response to some HF therapies, LVEF is a continuous variable and cutp ... Full text Link to item Cite

Prognostic Impact of Repeated NT-proBNP Measurements in Patients With Heart Failure With Reduced Ejection Fraction.

Journal Article JACC Heart Fail · March 2024 BACKGROUND: Although clinical studies have demonstrated the association between a single N-terminal pro-B-type natriuretic peptide (NT-proBNP) measurement and clinical outcomes in chronic heart failure, the biomarker is frequently measured serially in clin ... Full text Link to item Cite

Tricuspid Regurgitation and Clinical Outcomes in Heart Failure With Reduced Ejection Fraction.

Journal Article JACC Heart Fail · March 2024 BACKGROUND: Tricuspid regurgitation (TR) is common and is associated with poor outcomes in patients with heart failure (HF). However, data with adjudicated events from fully characterized patients with heart failure with reduced ejection fraction (HFrEF) a ... Full text Link to item Cite

Worth Their Weight? An Update on New and Emerging Pharmacologic Agents for Obesity and Their Potential Role for Persons with Cardiac Conditions.

Journal Article Curr Cardiol Rep · March 2024 PURPOSE OF REVIEW: Obesity is associated with cardiovascular (CV) conditions, including but not limited to atherosclerotic disease, heart failure, and atrial fibrillation. Despite this, the impact of intentional weight loss on CV outcomes for persons with ... Full text Link to item Cite

The Effect of Omecamtiv Mecarbil in Hospitalized Patients as Compared With Outpatients With HFrEF: An Analysis of GALACTIC-HF.

Journal Article J Card Fail · January 2024 BACKGROUND: In the Global Approach to Lowering Adverse Cardiac Outcomes Through Improving Contractility in Heart Failure (GALACTIC-HF) trial, omecamtiv mecarbil, compared with placebo, reduced the risk of worsening heart failure (HF) events, or cardiovascu ... Full text Link to item Cite

Managing Obesity in Heart Failure: A Chance to Tip the Scales?

Journal Article JACC Heart Fail · January 2024 Obesity is associated with incident heart failure (HF), independent of other cardiovascular risk factors. Despite rising rates of both obesity and incident HF, the associations remain poorly understood between: 1) obesity and HF outcomes; and 2) weight los ... Full text Link to item Cite

Impact of vasodilators on diuretic response in patients with congestive heart failure: A mechanistic trial of cimlanod (BMS-986231).

Journal Article Eur J Heart Fail · January 2024 AIM: To investigate the effects of Cimlanod, a nitroxyl donor with vasodilator properties, on water and salt excretion after an administration of an intravenos bolus of furosemide. METHODS AND RESULTS: In this randomized, double-blind, mechanistic, crossov ... Full text Link to item Cite

Standardized Definitions for Evaluation of Acute Decompensated Heart Failure Therapies: HF-ARC Expert Panel Paper.

Journal Article JACC Heart Fail · January 2024 Acute decompensated heart failure (ADHF) is one of the most common reasons for hospitalizations or urgent care and is associated with poor outcomes. Therapies shown to improve outcomes are limited, however, and innovation in pharmacologic and device-based ... Full text Link to item Cite

Higher-Dose Fluvoxamine and Time to Sustained Recovery in Outpatients With COVID-19: The ACTIV-6 Randomized Clinical Trial.

Journal Article JAMA · December 26, 2023 IMPORTANCE: The effect of higher-dose fluvoxamine in reducing symptom duration among outpatients with mild to moderate COVID-19 remains uncertain. OBJECTIVE: To assess the effectiveness of fluvoxamine, 100 mg twice daily, compared with placebo, for treatin ... Full text Link to item Cite

Endpoint adjudication in cardiovascular clinical trials.

Journal Article Eur Heart J · December 7, 2023 Endpoint adjudication (EA) is a common feature of contemporary randomized controlled trials (RCTs) in cardiovascular medicine. Endpoint adjudication refers to a process wherein a group of expert reviewers, known as the clinical endpoint committee (CEC), ve ... Full text Link to item Cite

Sex Differences in Heart Failure With Reduced Ejection Fraction in the GALACTIC-HF Trial.

Journal Article JACC Heart Fail · December 2023 BACKGROUND: Women with heart failure with reduced ejection fraction (HFrEF) receive less guideline-recommended therapy and experience worse quality of life than men. OBJECTIVES: The authors sought to assess differences in baseline characteristics, outcomes ... Full text Link to item Cite

Polypharmacy and Optimization of Guideline-Directed Medical Therapy in Heart Failure: The GUIDE-IT Trial.

Journal Article JACC Heart Fail · November 2023 BACKGROUND: Polypharmacy is common among patients with heart failure with reduced ejection fraction (HFrEF). However, its impact on the use of optimal guideline-directed medical therapy (GDMT) is not well established. OBJECTIVES: This study sought to evalu ... Full text Link to item Cite

Importance of the 'area under the curve' from serial NT-proBNP measurements during treatment with sacubitril/valsartan.

Journal Article ESC Heart Fail · October 2023 AIMS: Serial assessment of natriuretic peptides is widely utilized in heart failure clinics. Uncertainty exists regarding the value of multiple natriuretic peptide measurements and how they might be best interpreted. METHODS AND RESULTS: Six hundred thirty ... Full text Link to item Cite

Adaptive versus conventional cardiac resynchronisation therapy in patients with heart failure (AdaptResponse): a global, prospective, randomised controlled trial.

Journal Article Lancet · September 30, 2023 BACKGROUND: Continuous automatic optimisation of cardiac resynchronisation therapy (CRT), stimulating only the left ventricle to fuse with intrinsic right bundle conduction (synchronised left ventricular stimulation), might offer better outcomes than conve ... Full text Link to item Cite

Inhaled Fluticasone Furoate for Outpatient Treatment of Covid-19.

Journal Article N Engl J Med · September 21, 2023 BACKGROUND: The effectiveness of inhaled glucocorticoids in shortening the time to symptom resolution or preventing hospitalization or death among outpatients with mild-to-moderate coronavirus disease 2019 (Covid-19) is unclear. METHODS: We conducted a dec ... Full text Link to item Cite

Electronic health record characterization and outcomes of heart failure with preserved ejection fraction.

Conference Am Heart J · September 2023 BACKGROUND: Electronic health record (EHR)-based identification of heart failure with preserved ejection fraction (HFpEF) in the clinical setting may facilitate screening for clinical trials by improving the understanding of its epidemiology and outcomes; ... Full text Link to item Cite

Mineralocorticoid receptor antagonist initiation during admission is associated with improved outcomes irrespective of ejection fraction in patients with acute heart failure.

Journal Article Eur J Heart Fail · September 2023 AIMS: Heart failure (HF) guidelines recommend initiation and optimization of guideline-directed medical therapy, including mineralocorticoid receptor antagonists (MRAs), before hospital discharge. However, scientific evidence for this recommendation is lac ... Full text Link to item Cite

Serum Proteomic Analysis of Peripartum Cardiomyopathy Reveals Distinctive Dysregulation of Inflammatory and Cholesterol Metabolism Pathways.

Journal Article JACC Heart Fail · September 2023 BACKGROUND: The pathophysiology of peripartum cardiomyopathy (PPCM) and its distinctive biological features remain incompletely understood. High-throughput serum proteomic profiling, a powerful tool to gain insights into the pathophysiology of diseases at ... Full text Link to item Cite

Classification of Heart Failure Events by Severity: Insights From the VICTORIA Trial.

Journal Article J Card Fail · August 2023 BACKGROUND: Hospitalization due to heart failure (HFH) is a major source of morbidity, consumes significant economic resources and is a key endpoint in HF clinical trials. HFH events vary in severity and implications, but they are typically considered equi ... Full text Link to item Cite

Changes in mid-regional pro-adrenomedullin during treatment with sacubitril/valsartan.

Journal Article Eur J Heart Fail · August 2023 AIMS: Adrenomedullin is a vasodilatory peptide with a role in microcirculatory and endothelial homeostasis. Adrenomedullin is a substrate for neprilysin and may therefore play a role in beneficial effects of sacubitril/valsartan (Sac/Val) treatment. METHOD ... Full text Link to item Cite

Disconnect between the effects of serelaxin on renal function and outcome in acute heart failure.

Journal Article Clin Res Cardiol · July 2023 BACKGROUND: We aimed to study whether improvement in renal function by serelaxin in patients who were hospitalized for acute heart failure (HF) might explain any potential effect on clinical outcomes. METHODS: We included 6318 patients from the RELAXin in ... Full text Link to item Cite

Circulating Angiokines Are Associated With Reverse Remodeling and Outcomes in Chronic Heart Failure.

Journal Article J Card Fail · June 2023 BACKGROUND: We sought to determine whether circulating modifiers of endothelial function are associated with cardiac structure and clinical outcomes in patients with heart failure with reduced ejection fraction (HFrEF). METHODS: We measured 25 proteins rel ... Full text Link to item Cite

Long-term outcomes of phenoclusters in severe tricuspid regurgitation.

Journal Article Eur Heart J · June 1, 2023 AIMS: Severe tricuspid regurgitation (TR) exhibits high 1-year morbidity and mortality, yet long-term cardiovascular risk overall and by subgroups remains unknown. This study characterizes 5-year outcomes and identifies distinct clinical risk profiles of s ... Full text Link to item Cite

Clinical Profile, Health Care Costs, and Outcomes of Patients Hospitalized for Heart Failure With Severely Reduced Ejection Fraction.

Journal Article J Am Heart Assoc · May 16, 2023 Background Many patients with heart failure (HF) have severely reduced ejection fraction but do not meet threshold for consideration of advanced therapies (ie, stage D HF). The clinical profile and health care costs associated with these patients in US pra ... Full text Link to item Cite

Omecamtiv Mecarbil in Black Patients With Heart Failure and Reduced Ejection Fraction: Insights From GALACTIC-HF.

Journal Article JACC Heart Fail · May 2023 BACKGROUND: Omecamtiv mecarbil improves cardiovascular outcomes in patients with heart failure (HF) with reduced ejection fraction (EF). Consistency of drug benefit across race is a key public health topic. OBJECTIVES: The purpose of this study was to eval ... Full text Link to item Cite

Natriuretic peptides: role in the diagnosis and management of heart failure: a scientific statement from the Heart Failure Association of the European Society of Cardiology, Heart Failure Society of America and Japanese Heart Failure Society.

Journal Article Eur J Heart Fail · May 2023 Natriuretic peptides, brain (B-type) natriuretic peptide (BNP) and N-terminal prohormone of brain natriuretic peptide (NT-proBNP) are globally and most often used for the diagnosis of heart failure (HF). In addition, they can have an important complementar ... Full text Link to item Cite

Natriuretic Peptides: Role in the Diagnosis and Management of Heart Failure: A Scientific Statement From the Heart Failure Association of the European Society of Cardiology, Heart Failure Society of America and Japanese Heart Failure Society.

Journal Article J Card Fail · May 2023 Natriuretic peptides, brain (B-type) natriuretic peptide (BNP) and N-terminal prohormone of brain natriuretic peptide (NT-proBNP) are globally and most often used for the diagnosis of heart failure (HF). In addition, they can have an important complementar ... Full text Link to item Cite

Echocardiographic Features Beyond Ejection Fraction and Associated Outcomes in Patients With Heart Failure With Mildly Reduced or Preserved Ejection Fraction.

Journal Article Circ Heart Fail · May 2023 BACKGROUND: Heart failure (HF) guidelines recommend assessment of left ventricular ejection fraction (LVEF) to classify patients and guide therapy implementation. However, LVEF alone may be insufficient to adequately characterize patients with HF, especial ... Full text Link to item Cite

Trajectory of Decongestion and Mortality in Young Adults with Acute Heart Failure.

Journal Article Curr Probl Cardiol · April 2023 Although the prevalence of HF in young adults (age <50 years) is increasing, there are limited data on the trajectory of decongestion and short-term outcomes in young adults with acute heart failure (AHF). We pooled patients from 3 randomized trials of AHF ... Full text Link to item Cite

Medication-Attributable Adverse Events in Heart Failure Trials.

Journal Article JACC Heart Fail · April 2023 BACKGROUND: Initiation and up-titration of guideline-directed medical therapies (GDMTs) for heart failure with reduced ejection fraction (HFrEF) remains suboptimal, in part because of concerns regarding tolerability and adverse events (AEs). OBJECTIVES: Th ... Full text Link to item Cite

Impact of mitral regurgitation in patients with acute heart failure: insights from the RELAX-AHF-2 trial.

Journal Article Eur J Heart Fail · April 2023 AIMS: The impact of mitral regurgitation (MR) in patients hospitalized for acute heart failure (AHF) is not well established. We assessed the role of MR in patients enrolled in the Relaxin in Acute Heart Failure 2 (RELAX-AHF-2) trial. METHODS AND RESULTS: ... Full text Link to item Cite

Effect of Higher-Dose Ivermectin for 6 Days vs Placebo on Time to Sustained Recovery in Outpatients With COVID-19: A Randomized Clinical Trial.

Journal Article JAMA · March 21, 2023 IMPORTANCE: It is unknown whether ivermectin, with a maximum targeted dose of 600 μg/kg, shortens symptom duration or prevents hospitalization among outpatients with mild to moderate COVID-19. OBJECTIVE: To evaluate the effectiveness of ivermectin at a max ... Full text Link to item Cite

Efficacy of omecamtiv mecarbil in heart failure with reduced ejection fraction according to N-terminal pro-B-type natriuretic peptide level: insights from the GALACTIC-HF trial.

Journal Article Eur J Heart Fail · February 2023 AIM: N-terminal pro-B-type natriuretic peptide (NT-proBNP) is predictive of both outcomes and response to treatment in patients with heart failure with reduced ejection fraction (HFrEF). The aim of this study was to examine the effect of the cardiac myosin ... Full text Link to item Cite

Effect of Fluvoxamine vs Placebo on Time to Sustained Recovery in Outpatients With Mild to Moderate COVID-19: A Randomized Clinical Trial.

Journal Article JAMA · January 24, 2023 IMPORTANCE: The effectiveness of fluvoxamine to shorten symptom duration or prevent hospitalization among outpatients with mild to moderate symptomatic COVID-19 is unclear. OBJECTIVE: To evaluate the efficacy of low-dose fluvoxamine (50 mg twice daily) for ... Full text Link to item Cite

Characteristics and clinical outcomes of patients with acute heart failure with a supranormal left ventricular ejection fraction.

Journal Article Eur J Heart Fail · January 2023 AIM: Recent data suggest that guideline-directed medical therapy of patients with heart failure (HF) with reduced ejection fraction (HFrEF) might improve clinical outcomes in patients with HF up to a left ventricular ejection fraction (LVEF) of 55-65%, whe ... Full text Link to item Cite

Prediction of Left Ventricular Ejection Fraction Change Following Treatment With Sacubitril/Valsartan.

Journal Article JACC Heart Fail · January 2023 BACKGROUND: Sacubitril/valsartan (Sac/Val) improves left ventricular ejection fraction (LVEF) in heart failure (HF) with reduced ejection fraction regardless of previous treatments. Improvements in LVEF may change eligibility for primary implantable cardio ... Full text Link to item Cite

Effects of omecamtiv mecarbil in heart failure with reduced ejection fraction according to blood pressure: the GALACTIC-HF trial.

Journal Article Eur Heart J · December 21, 2022 AIM: Patients with heart failure with reduced ejection fraction and low systolic blood pressure (SBP) have high mortality, hospitalizations, and poorly tolerate evidence-based medical treatment. Omecamtiv mecarbil may be particularly helpful in such patien ... Full text Link to item Cite

Effect of Ivermectin 600 μg/kg for 6 days vs Placebo on Time to Sustained Recovery in Outpatients with Mild to Moderate COVID-19: A Randomized Clinical Trial.

Journal Article medRxiv · December 15, 2022 BACKGROUND: Whether ivermectin, with a maximum targeted dose of 600 μg/kg, shortens symptom duration or prevents hospitalization among outpatients with mild to moderate coronavirus disease 2019 (COVID-19) remains unknown. Our objective was to evaluate the ... Full text Link to item Cite

Heart Failure Duration and Mechanistic Efficacy of Sacubitril/Valsartan in Heart Failure With Reduced Ejection Fraction.

Journal Article J Card Fail · December 2022 BACKGROUND: Although sacubitril/valsartan (Sac/Val) is indicated for the treatment of heart failure with reduced ejection fraction (HFrEF), gaps in care continue to exist for those with newer onset HFrEF vs those with longer durations of disease. METHODS A ... Full text Link to item Cite

Functional and Symptomatic Clinical Trial Endpoints: The HFC-ARC Scientific Expert Panel.

Journal Article JACC Heart Fail · December 2022 The Heart Failure Academic Research Consortium is a partnership between the Heart Failure Collaboratory (HFC) and the Academic Research Consortium (ARC) composed of patients, academic investigators from the United States and Europe, the U.S. Food and Drug ... Full text Link to item Cite

Age Differences in Effects of Sacubitril/Valsartan on Cardiac Remodeling, Biomarkers, and Health Status.

Journal Article JACC Heart Fail · December 2022 BACKGROUND: Sacubitril/valsartan (Sac/Val) improves outcomes in patients with heart failure with reduced ejection fraction (HFrEF). OBJECTIVES: In this study, the authors sought to explore age differences in effects of Sac/Val on biomarkers, Kansas City Ca ... Full text Link to item Cite

Comparative Effect of Angiotensin Receptor Neprilysin Inhibition on B-type Natriuretic Peptide Levels Measured by Three Different Assays: The PROVE-HF Study.

Journal Article Clin Chem · November 3, 2022 BACKGROUND: Several different B-type natriuretic peptide (BNP) assays are used clinically for diagnostic and prognostic evaluation of heart failure (HF). BNP binds weakly to neprilysin and is cleaved in multiple areas adjacent to the binding sites for the ... Full text Link to item Cite

A Randomized Controlled Trial of Mobile Health Intervention in Patients With Heart Failure and Diabetes.

Journal Article J Card Fail · November 2022 BACKGROUND: Mobile health (mHealth) platforms can affect health behaviors but have not been rigorously tested in randomized trials. OBJECTIVES: We sought to evaluate the effectiveness of a pragmatic mHealth intervention in patients with heart failure (HF) ... Full text Link to item Cite

Fluvoxamine for Outpatient Treatment of COVID-19: A Decentralized, Placebo-controlled, Randomized, Platform Clinical Trial.

Journal Article medRxiv · November 1, 2022 BACKGROUND: The effectiveness of fluvoxamine to shorten symptom duration or prevent hospitalization among outpatients in the US with mild to moderate symptomatic coronavirus disease 2019 (COVID-19) is unclear. DESIGN: ACTIV-6 is an ongoing, decentralized, ... Full text Link to item Cite

Diaphragmatic Function in Cardiovascular Disease: JACC Review Topic of the Week.

Journal Article J Am Coll Cardiol · October 25, 2022 In addition to the diaphragm's role as the primary respiratory muscle, it also plays an under-recognized role in cardiac function. It serves as a pump facilitating venous and lymph return, modulating left ventricular afterload hemodynamics and pericardial ... Full text Link to item Cite

Effect of Ivermectin vs Placebo on Time to Sustained Recovery in Outpatients With Mild to Moderate COVID-19: A Randomized Clinical Trial.

Journal Article JAMA · October 25, 2022 IMPORTANCE: The effectiveness of ivermectin to shorten symptom duration or prevent hospitalization among outpatients in the US with mild to moderate symptomatic COVID-19 is unknown. OBJECTIVE: To evaluate the efficacy of ivermectin, 400 μg/kg, daily for 3 ... Full text Link to item Cite

Dose-Response to Sacubitril/Valsartan in Patients With Heart Failure and Reduced Ejection Fraction.

Journal Article J Am Coll Cardiol · October 18, 2022 BACKGROUND: Doses of sacubitril/valsartan (Sac/Val) achieved in clinical trials of heart failure with reduced ejection fraction (HFrEF) are often not reached in clinical practice. OBJECTIVES: The purpose of this study was to investigate associations among ... Full text Link to item Cite

Quantitative Blood Volume Analysis and Hemodynamic Measures of Vascular Compliance in Patients With Worsening Heart Failure.

Journal Article J Card Fail · September 2022 BACKGROUND: The role of blood volume (BV) expansion vs a change in vascular compliance in worsening heart failure (HF) remains under debate. We aimed to assess the relationship between BV and resting and stress hemodynamics in worsening HF and to further e ... Full text Link to item Cite

Are We Getting Any Closer to Understanding Congestion?

Journal Article JACC Heart Fail · September 2022 Full text Link to item Cite

Heart Failure Strategically Focused Research Network: Summary of Results and Future Directions.

Journal Article Journal of the American Heart Association · September 2022 Heart failure remains among the most common and morbid health conditions. The Heart Failure Strategically Focused Research Network (HF SFRN) was funded by the American Heart Association to facilitate collaborative, high-impact research in the field of hear ... Full text Cite

Catastrophic Disruptions in Clinical Trials.

Journal Article Circulation · August 2, 2022 Full text Link to item Cite

Health System-Level Performance in Prescribing Guideline-Directed Medical Therapy for Patients With Heart Failure With Reduced Ejection Fraction: Results From the CONNECT-HF Trial.

Journal Article J Card Fail · August 2022 BACKGROUND: Health system-level interventions to improve use of guideline-directed medical therapy (GDMT) often fail in the acute care setting. We sought to identify factors associated with high performance in adoption of GDMT among health systems in CONNE ... Full text Link to item Cite

Effect of Omecamtiv Mecarbil on Exercise Capacity in Chronic Heart Failure With Reduced Ejection Fraction: The METEORIC-HF Randomized Clinical Trial.

Journal Article JAMA · July 19, 2022 IMPORTANCE: Exercise limitation is a cardinal manifestation of heart failure with reduced ejection fraction (HFrEF) but is not consistently improved by any of the current guideline-directed medical therapies. OBJECTIVE: To determine whether omecamtiv mecar ... Full text Link to item Cite

Influence of atrial fibrillation on efficacy and safety of omecamtiv mecarbil in heart failure: the GALACTIC-HF trial.

Journal Article Eur Heart J · June 14, 2022 AIMS: In GALACTIC-HF, the cardiac myosin activator omecamtiv mecarbil compared with placebo reduced the risk of heart failure events or cardiovascular death in patients with heart failure with reduced ejection fraction. We explored the influence of atrial ... Full text Link to item Cite

Plasma metabolites associated with functional and clinical outcomes in heart failure with reduced ejection fraction with and without type 2 diabetes.

Journal Article Sci Rep · June 2, 2022 Heart failure with reduced ejection fraction (HFrEF) is increasingly treated with medications for type 2 diabetes mellitus (T2DM). Whether metabolic derangements in HFrEF and T2DM are associated with differential outcomes remains unclear. Therefore, unders ... Full text Link to item Cite

Clinical Prediction Models for Heart Failure Hospitalization in Type 2 Diabetes: A Systematic Review and Meta-Analysis.

Journal Article J Am Heart Assoc · May 17, 2022 Background Clinical prediction models have been developed for hospitalization for heart failure in type 2 diabetes. However, a systematic evaluation of these models' performance, applicability, and clinical impact is absent. Methods and Results We searched ... Full text Link to item Cite

Developments in Exercise Capacity Assessment in Heart Failure Clinical Trials and the Rationale for the Design of METEORIC-HF.

Journal Article Circ Heart Fail · May 2022 Heart failure with reduced ejection fraction (HFrEF) is a highly morbid condition for which exercise intolerance is a major manifestation. However, methods to assess exercise capacity in HFrEF vary widely in clinical practice and in trials. We describe adv ... Full text Link to item Cite

Frailty, Guideline-Directed Medical Therapy, and Outcomes in HFrEF: From the GUIDE-IT Trial.

Journal Article JACC Heart Fail · April 2022 OBJECTIVES: In this study, we sought to evaluate the association of frailty with the use of optimal guideline-directed medical therapy (GDMT) and outcomes in heart failure with reduced ejection fraction (HFrEF). BACKGROUND: The burden of frailty in HFrEF i ... Full text Link to item Cite

Clinical Outcomes With Metformin and Sulfonylurea Therapies Among Patients With Heart Failure and Diabetes.

Journal Article JACC Heart Fail · March 2022 OBJECTIVES: The authors sought to characterize associations between initiation of metformin and sulfonylurea therapy and clinical outcomes among patients with comorbid heart failure (HF) and diabetes (overall and by ejection fraction [EF] phenotype). BACKG ... Full text Open Access Link to item Cite

Clinical trajectory of patients with a worsening heart failure event and reduced ventricular ejection fraction.

Journal Article Am Heart J · March 2022 BACKGROUND: Recent data suggest that patients with heart failure with reduced ejection fraction (HFrEF) and worsening heart failure (WHF) have potential for greater benefit from newer HF therapies. We investigated characteristics and outcomes of patients w ... Full text Link to item Cite

The influence of comorbidities on achieving an N-terminal pro-b-type natriuretic peptide target: a secondary analysis of the GUIDE-IT trial.

Journal Article ESC Heart Fail · February 2022 AIMS: N-terminal pro-b-type natriuretic peptide (NT-proBNP) values may be influenced by patient factors beyond the severity of illness, including atrial fibrillation (AF), renal dysfunction, or increased body mass index (BMI). We hypothesized that these fa ... Full text Link to item Cite

Worsening renal function in acute heart failure in the context of diuretic response.

Journal Article Eur J Heart Fail · February 2022 BACKGROUND: For patients with acute heart failure (AHF), substantial diuresis after administration of loop diuretics is generally associated with better clinical outcomes but may cause creatinine to rise, suggesting renal function decline. We investigated ... Full text Link to item Cite

Assessment of Omecamtiv Mecarbil for the Treatment of Patients With Severe Heart Failure: A Post Hoc Analysis of Data From the GALACTIC-HF Randomized Clinical Trial.

Journal Article JAMA Cardiol · January 1, 2022 IMPORTANCE: Heart failure with reduced ejection fraction is a progressive clinical syndrome, and many patients' condition worsen over time despite treatment. Patients with more severe disease are often intolerant of available medical therapies. OBJECTIVE: ... Full text Link to item Cite

Effect of Treatment With Sacubitril/Valsartan in Patients With Advanced Heart Failure and Reduced Ejection Fraction: A Randomized Clinical Trial.

Journal Article JAMA Cardiol · January 1, 2022 IMPORTANCE: The use of sacubitril/valsartan is not endorsed by practice guidelines for use in patients with New York Heart Association class IV heart failure with a reduced ejection fraction because of limited clinical experience in this population. OBJECT ... Full text Link to item Cite

Assessing race and ethnicity differences in outcomes based on GDMT and target NT-proBNP in patients with heart failure with reduced ejection fraction: An analysis of the GUIDE-IT study.

Journal Article Prog Cardiovasc Dis · 2022 BACKGROUND: The GUIDE-IT trial was, a multicenter, randomized, parallel group, unblinded study that randomized patients to having heart failure therapy titrated to achieve an NT-proBNP <1000 pg/mL or to usual clinical care. METHODS AND RESULTS: We performe ... Full text Link to item Cite

CLASSIFICATION AND IMPLICATIONS OF HEART FAILURE EVENTS FROM THE VICTORIA TRIAL

Conference JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY · 2022 Cite

The Impact of Depression on Outcomes in Patients With Heart Failure and Reduced Ejection Fraction Treated in the GUIDE-IT Trial.

Journal Article J Card Fail · December 2021 BACKGROUND: It remains unclear why depression is associated with adverse outcomes in patients with heart failure (HF). We examine the relationship between depression and clinical outcomes among patients with HF with reduced ejection fraction managed with g ... Full text Link to item Cite

Association of Early Blood Pressure Decrease and Renal Function With Prognosis in Acute Heart Failure.

Journal Article JACC Heart Fail · December 2021 OBJECTIVES: The aim of this study was to investigate the association between systolic blood pressure (SBP) drop, worsening renal function (WRF), and prognosis in patients with acute heart failure (AHF). BACKGROUND: A large drop in SBP early after hospital ... Full text Link to item Cite

Characteristics and Outcomes of Patients With Heart Failure With Reduced Ejection Fraction After a Recent Worsening Heart Failure Event.

Conference J Am Heart Assoc · September 7, 2021 Background Contemporary trials of patients with heart failure with reduced ejection fraction (HFrEF) required a recent worsening heart failure (WHF) event for inclusion. We aimed to describe characteristics and outcomes of patients with HFrEF and a recent ... Full text Link to item Cite

Early diuretic strategies and the association with In-hospital and Post-discharge outcomes in acute heart failure.

Journal Article Am Heart J · September 2021 BACKGROUND: Decongestion is a primary goal during hospitalizations for decompensated heart failure (HF). However, data surrounding the preferred route and strategy of diuretic administration are limited with varying results in prior studies. METHODS: This ... Full text Link to item Cite

Don't Be So Fast to Discard That Clean Catch!

Journal Article JACC Heart Fail · September 2021 Full text Link to item Cite

Circulating long chain acylcarnitines and outcomes in diabetic heart failure: an HF-ACTION clinical trial substudy.

Journal Article Cardiovasc Diabetol · August 3, 2021 BACKGROUND: Whether differences in circulating long chain acylcarnitines (LCAC) are seen in heart failure (HF) patients with and without diabetes mellitus (DM), and whether these biomarkers report on exercise capacity and clinical outcomes, remains unknown ... Full text Link to item Cite

Growth differentiation factor-15, treatment with liraglutide, and clinical outcomes among patients with heart failure.

Journal Article ESC Heart Fail · August 2021 AIMS: Associations between growth differentiation factor-15 (GDF-15), cardiovascular outcomes, and exercise capacity among patients with a recent hospitalization for heart failure (HHF) and heart failure with reduced ejection fraction (HFrEF) are unknown. ... Full text Link to item Cite

Effect of a Hospital and Postdischarge Quality Improvement Intervention on Clinical Outcomes and Quality of Care for Patients With Heart Failure With Reduced Ejection Fraction: The CONNECT-HF Randomized Clinical Trial.

Journal Article JAMA · July 27, 2021 IMPORTANCE: Adoption of guideline-directed medical therapy for patients with heart failure is variable. Interventions to improve guideline-directed medical therapy have failed to consistently achieve target metrics, and limited data exist to inform efforts ... Full text Link to item Cite

Effect of Ejection Fraction on Clinical Outcomes in Patients Treated With Omecamtiv Mecarbil in GALACTIC-HF.

Journal Article J Am Coll Cardiol · July 13, 2021 BACKGROUND: In GALACTIC-HF (Global Approach to Lowering Adverse Cardiac outcomes Through Improving Contractility in Heart Failure) (n = 8,256), the cardiac myosin activator, omecamtiv mecarbil, significantly reduced the primary composite endpoint (PCE) of ... Full text Link to item Cite

Haemodynamic effects of the nitroxyl donor cimlanod (BMS-986231) in chronic heart failure: a randomized trial.

Journal Article Eur J Heart Fail · July 2021 AIMS: Nitroxyl provokes vasodilatation and inotropic and lusitropic effects in animals via post-translational modification of thiols. We aimed to compare effects of the nitroxyl donor cimlanod (BMS-986231) with those of nitroglycerin (NTG) or placebo on ca ... Full text Link to item Cite

Splanchnic nerve modulation in heart failure: mechanistic overview, initial clinical experience, and safety considerations.

Journal Article Eur J Heart Fail · July 2021 Volume recruitment from the splanchnic compartment is an important physiological response to stressors such as physical activity and blood loss. In the setting of heart failure (HF), excess fluid redistribution from this compartment leads to increased card ... Full text Link to item Cite

Intercountry Differences in Guideline-Directed Medical Therapy and Outcomes Among Patients With Heart Failure.

Journal Article JACC Heart Fail · July 2021 OBJECTIVES: The aim of this study was to examine patterns of care and clinical outcomes among patients with heart failure with reduced ejection fraction (HFrEF) in the United States and Canada. BACKGROUND: In the GUIDE-IT (Guiding Evidence Based Therapy Us ... Full text Link to item Cite

Interleukin-6 and Outcomes in Acute Heart Failure: An ASCEND-HF Substudy.

Journal Article J Card Fail · June 2021 BACKGROUND: The inflammatory cytokine IL-6 has been previously implicated in the pathophysiology of acute decompensated heart failure (HF). Prior observations in acute HF patients have suggested that IL-6 may be associated with outcomes and modulated by ne ... Full text Link to item Cite

Association Between Angiotensin Receptor-Neprilysin Inhibition, Cardiovascular Biomarkers, and Cardiac Remodeling in Heart Failure With Reduced Ejection Fraction.

Journal Article Circ Heart Fail · June 2021 BACKGROUND: Sacubitril/valsartan (S/V) treatment is associated with reverse cardiac remodeling and reductions in biomarkers reflecting ventricular wall stress and myocardial injury, such as NT-proBNP (N-terminal pro-B-type natriuretic peptide), hs-cTnT (hi ... Full text Link to item Cite

Omecamtiv Mecarbil in Systolic Heart Failure.

Journal Article N Engl J Med · May 20, 2021 Full text Link to item Cite

Differences in NT-proBNP Response and Prognosis in Men and Women With Heart Failure With Reduced Ejection Fraction.

Journal Article J Am Heart Assoc · May 18, 2021 Background NT-proBNP (N-terminal pro-B-type natriuretic peptide) is a prognostic biomarker in heart failure (HF) with reduced ejection fraction. However, it is unclear whether there is a sex difference in NT-proBNP response and whether the therapeutic goal ... Full text Link to item Cite

Mechanisms and Models in Heart Failure: A Translational Approach.

Journal Article Circ Res · May 14, 2021 Despite multiple attempts to develop a unifying hypothesis that explains the pathophysiology of heart failure with a reduced ejection fraction (HFrEF), no single conceptual model has withstood the test of time. In the present review, we discuss how the res ... Full text Link to item Cite

Splanchnic Nerve Block Mediated Changes in Stressed Blood Volume in Heart Failure.

Journal Article JACC Heart Fail · April 2021 OBJECTIVES: The authors estimated changes of stressed blood volume (SBV) induced by splanchnic nerve block (SNB) in patients with either decompensated or ambulatory heart failure with reduced ejection fraction (HFrEF). BACKGROUND: The splanchnic vascular c ... Full text Link to item Cite

Effects of Atrial Fibrillation on Heart Failure Outcomes and NT-proBNP Levels in the GUIDE-IT Trial.

Journal Article Mayo Clin Proc Innov Qual Outcomes · April 2021 OBJECTIVE: To evaluate effects of atrial fibrillation (AF) on cardiac biomarkers and outcomes in a trial population of patients with heart failure (HF) with reduced ejection fraction treated with optimal guideline-directed medical therapy. METHODS: We perf ... Full text Link to item Cite

Universal Definition and Classification of Heart Failure: A Report of the Heart Failure Society of America, Heart Failure Association of the European Society of Cardiology, Japanese Heart Failure Society and Writing Committee of the Universal Definition of Heart Failure.

Journal Article J Card Fail · March 1, 2021 In this document, we propose a universal definition of heart failure (HF) as the following: HF is a clinical syndrome with symptoms and or signs caused by a structural and/or functional cardiac abnormality and corroborated by elevated natriuretic peptide l ... Full text Link to item Cite

Universal definition and classification of heart failure: a report of the Heart Failure Society of America, Heart Failure Association of the European Society of Cardiology, Japanese Heart Failure Society and Writing Committee of the Universal Definition of Heart Failure: Endorsed by the Canadian Heart Failure Society, Heart Failure Association of India, Cardiac Society of Australia and New Zealand, and Chinese Heart Failure Association.

Journal Article Eur J Heart Fail · March 2021 In this document, we propose a universal definition of heart failure (HF) as a clinical syndrome with symptoms and/or signs caused by a structural and/or functional cardiac abnormality and corroborated by elevated natriuretic peptide levels and/or objectiv ... Full text Link to item Cite

Universal Definition and Classification of Heart Failure.

Journal Article J Card Fail · February 7, 2021 In this document, we propose a universal definition of heart failure (HF) as the following: HF is a clinical syndrome with symptoms and or signs caused by a structural and/or functional cardiac abnormality and corroborated by elevated natriuretic peptide l ... Full text Link to item Cite

Atrial Natriuretic Peptide and Treatment With Sacubitril/Valsartan in Heart Failure With Reduced Ejection Fraction.

Journal Article JACC Heart Fail · February 2021 OBJECTIVES: This study sought to assess associations between longitudinal change in atrial natriuretic peptide (ANP) and reverse cardiac remodeling following initiation of sacubitril/valsartan in patients with heart failure with reduced ejection fraction ( ... Full text Link to item Cite

Effects of a Novel Nitroxyl Donor in Acute Heart Failure: The STAND-UP AHF Study.

Journal Article JACC Heart Fail · February 2021 OBJECTIVES: The primary objective was to identify well-tolerated doses of cimlanod in patients with acute heart failure (AHF). Secondary objectives were to identify signals of efficacy, including biomarkers, symptoms, and clinical events. BACKGROUND: Nitro ... Full text Link to item Cite

Implications of peripheral oedema in heart failure with preserved ejection fraction: a heart failure network analysis.

Journal Article ESC Heart Fail · February 2021 AIMS: Heart failure with preserved ejection fraction (HFpEF) is a heterogeneous condition, and tissue congestion manifested by oedema is not present in all patients. We compared clinical characteristics, exercise capacity, and outcomes in patients with HFp ... Full text Link to item Cite

Reverse Cardiac Remodeling Following Initiation of Sacubitril/Valsartan in Patients With Heart Failure With and Without Diabetes.

Journal Article JACC Heart Fail · February 2021 OBJECTIVE: This study sought to determine whether patients with heart failure and reduced ejection fraction (HFrEF) with type 2 diabetes mellitus (T2DM) have similar reverse cardiac remodeling with sacubitril/valsartan as patients without T2DM. BACKGROUND: ... Full text Link to item Cite

Cardiac Myosin Activation with Omecamtiv Mecarbil in Systolic Heart Failure.

Journal Article N Engl J Med · January 14, 2021 BACKGROUND: The selective cardiac myosin activator omecamtiv mecarbil has been shown to improve cardiac function in patients with heart failure with a reduced ejection fraction. Its effect on cardiovascular outcomes is unknown. METHODS: We randomly assigne ... Full text Link to item Cite

Improvement of Health Status Following Initiation of Sacubitril/Valsartan in Heart Failure and Reduced Ejection Fraction.

Conference JACC Heart Fail · January 2021 BACKGROUND: Treatment of heart failure with reduced ejection fraction (EF) may improve patient-reported health outcomes. OBJECTIVES: The purpose of this study was to determine timing and magnitude of change in Kansas City Cardiomyopathy Questionnaire (KCCQ ... Full text Link to item Cite

Association of left ventricular ejection fraction with worsening renal function in patients with acute heart failure: insights from the RELAX-AHF-2 study.

Journal Article Eur J Heart Fail · January 2021 AIMS: Whether risk of worsening renal function (WRF) during acute heart failure (AHF) hospitalization or the association between in-hospital WRF and post-discharge outcomes vary according to left ventricular ejection fraction (LVEF) is uncertain. We assess ... Full text Link to item Cite

Treatment of HF in an Era of Multiple Therapies: Statement From the HF Collaboratory.

Journal Article JACC Heart Fail · January 2021 The treatment of heart failure with reduced ejection fraction (HFrEF) has changed considerably over time, particularly with the sequential development of therapies aimed at antagonism of maladaptive biologic pathways, including inhibition of the sympatheti ... Full text Link to item Cite

Clinical Outcomes Among Patients With Severe Tricuspid Valve Regurgitation

Conference JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY · 2021 Cite

Ultrafiltration in Acute Heart Failure: Implications of Ejection Fraction and Early Response to Treatment From CARRESS-HF.

Journal Article J Am Heart Assoc · December 15, 2020 Background Ultrafiltration is not commonly used because of higher incidence of worsening renal function without improved decongestion. We examined differential outcomes of high versus low fluid removal and preserved versus reduced ejection fraction (EF) in ... Full text Open Access Link to item Cite

Cause of Death in Patients With Acute Heart Failure: Insights From RELAX-AHF-2.

Journal Article JACC Heart Fail · December 2020 OBJECTIVES: This study sought to better understand the discrepant results of 2 trials of serelaxin on acute heart failure (AHF) and short-term mortality after AHF by analyzing causes of death of patients in the RELAX-AHF-2 (Efficacy, Safety and Tolerabilit ... Full text Link to item Cite

Effects of Omecamtiv Mecarbil on Symptoms and Health-Related Quality of Life in Patients With Chronic Heart Failure: Results From the COSMIC-HF Study.

Journal Article Circ Heart Fail · December 2020 BACKGROUND: Chronic heart failure with reduced ejection fraction impairs health-related quality of life (HRQL). Omecamtiv mecarbil (OM)-a novel activator of cardiac myosin-improves left ventricular systolic function and remodeling and reduces natriuretic p ... Full text Link to item Cite

Conduct of Clinical Trials in the Era of COVID-19: JACC Scientific Expert Panel.

Journal Article J Am Coll Cardiol · November 17, 2020 The coronavirus disease-2019 (COVID-19) pandemic has profoundly changed clinical care and research, including the conduct of clinical trials, and the clinical research ecosystem will need to adapt to this transformed environment. The Heart Failure Academic ... Full text Link to item Cite

Abstract 17244: Obesity and Serial NT-proBNP Levels in Heart Failure: Insights From the GUIDE-IT Trial

Conference Circulation · November 17, 2020 Background: The prognostic implications of achieving NT-proBNP concentrations ≤1000 pg/mL among obese patients having heart failure with reduced ejection fraction (HFrEF) are not completely known. We ... Full text Cite

In-Hospital Therapy for Heart Failure With Reduced Ejection Fraction in the United States.

Journal Article JACC Heart Fail · November 2020 OBJECTIVES: This study sought to characterize in-hospital treatment patterns and associated patient outcomes among patients hospitalized for heart failure (HF) in U.S. clinical practice. BACKGROUND: Hospitalizations for HF are common and associated with po ... Full text Link to item Cite

Sex-based differences in biomarkers, health status, and reverse cardiac remodelling in patients with heart failure with reduced ejection fraction treated with sacubitril/valsartan.

Journal Article Eur J Heart Fail · November 2020 AIMS: We sought to determine sex-based differences in biomarkers, self-reported health status, and magnitude of longitudinal changes in measures of reverse cardiac remodelling among patients with heart failure with reduced ejection fraction (HFrEF, left ve ... Full text Link to item Cite

Omecamtiv mecarbil in chronic heart failure with reduced ejection fraction: GALACTIC-HF baseline characteristics and comparison with contemporary clinical trials.

Journal Article Eur J Heart Fail · November 2020 AIMS: The safety and efficacy of the novel selective cardiac myosin activator, omecamtiv mecarbil, in patients with heart failure with reduced ejection fraction (HFrEF) is being tested in the Global Approach to Lowering Adverse Cardiac outcomes Through Imp ... Full text Link to item Cite

Racial and Ethnic Differences in Biomarkers, Health Status, and Cardiac Remodeling in Patients With Heart Failure With Reduced Ejection Fraction Treated With Sacubitril/Valsartan.

Journal Article Circulation. Heart failure · November 2020 BackgroundAmong patients with heart failure and reduced ejection fraction (left ventricular (LV) ejection fraction ≤40%), sacubitril/valsartan (S/V) treatment is associated with improved health status and reverse cardiac remodeling. Data regarding ... Full text Cite

Racial Differences in Serial NT-proBNP Levels in Heart Failure Management: Insights From the GUIDE-IT Trial.

Journal Article Circulation · September 8, 2020 NTproBNP ≤1000 has favorable prognostic implications in HF, but the prognosis is worse for Black patients at any level of achieved NTproBNP ... Full text Link to item Cite

Treatment with 24 hour istaroxime infusion in patients hospitalised for acute heart failure: a randomised, placebo-controlled trial.

Journal Article Eur J Heart Fail · September 2020 AIM: Istaroxime is a first-in-class agent which acts through inhibition of the sarcolemmal Na+ /K+ pump and activation of the SERCA2a pump. This study assessed the effects of a 24 h infusion of istaroxime in patients hospitalised for acute heart failure (A ... Full text Link to item Cite

Splanchnic Nerve Block for Chronic Heart Failure.

Journal Article JACC Heart Fail · September 2020 OBJECTIVES: We hypothesized that splanchnic nerve blockade (SNB) would attenuate increased exercise-induced cardiac filling pressures in patients with chronic HF. BACKGROUND: Chronic heart failure (HF) is characterized by limited exercise capacity driven i ... Full text Link to item Cite

Regional adiposity and heart failure with preserved ejection fraction.

Journal Article Eur J Heart Fail · September 2020 The role of obesity in the pathogenesis of heart failure (HF), and in particular HF with preserved ejection fraction (HFpEF), has drawn significant attention in recent years. The prevalence of both obesity and HFpEF has increased worldwide over the past de ... Full text Link to item Cite

Challenges and Potential Improvements to Patient Access to Pharmaceuticals: Examples From Cardiology.

Journal Article Circulation · August 25, 2020 Patient access to a drug after US regulatory approval is controlled by complex interactions between governmental and third-party payers, pharmacy benefit managers, distributers, manufacturers, health systems, and pharmacies that together mediate the receip ... Full text Link to item Cite

Annexin A1 is a Potential Novel Biomarker of Congestion in Acute Heart Failure.

Journal Article J Card Fail · August 2020 OBJECTIVES: This study sought to identify the role of annexin A1 (AnxA1) as a congestion marker in acute heart failure (AHF) and to identify its putative role in predicting clinical outcomes. BACKGROUND: AnxA1 is a protein that inhibits inflammation follow ... Full text Link to item Cite

Obese-Inflammatory Phenotypes in Heart Failure With Preserved Ejection Fraction.

Journal Article Circ Heart Fail · August 2020 BACKGROUND: Comorbidity-driven microvascular inflammation is posited as a unifying pathophysiologic mechanism for heart failure with preserved ejection fraction (HFpEF). Obesity is proinflammatory and common in HFpEF. We hypothesized that unique obesity-in ... Full text Link to item Cite

Assessment of Limitations to Optimization of Guideline-Directed Medical Therapy in Heart Failure From the GUIDE-IT Trial: A Secondary Analysis of a Randomized Clinical Trial.

Journal Article JAMA Cardiol · July 1, 2020 IMPORTANCE: Despite evidence that guideline-directed medical therapy (GDMT) improves outcomes in patients with heart failure (HF) and reduced ejection fraction, many patients are undertreated. The Guiding Evidence-Based Therapy Using Biomarker Intensified ... Full text Link to item Cite

Racial Differences in Diuretic Efficiency, Plasma Renin, and Rehospitalization in Subjects With Acute Heart Failure.

Journal Article Circ Heart Fail · July 2020 BACKGROUND: Black patients have higher rates of hospitalization for acute heart failure than other race/ethnic groups. We sought to determine whether diuretic efficiency is associated with racial differences in risk for rehospitalization after acute heart ... Full text Link to item Cite

Biomarkers in Advanced Heart Failure: Implications for Managing Patients With Mechanical Circulatory Support and Cardiac Transplantation.

Journal Article Circ Heart Fail · July 2020 Biomarkers have a well-defined role in the diagnosis and management of chronic heart failure, but their role in patients with left ventricular assist devices and cardiac transplant is uncertain. In this review, we summarize the available literature in this ... Full text Link to item Cite

Comparative Effectiveness of Primary Prevention Implantable Cardioverter-Defibrillators in Older Heart Failure Patients With Diabetes Mellitus.

Journal Article J Am Heart Assoc · June 16, 2020 Background There are conflicting data regarding the benefit of primary prevention implantable cardioverter-defibrillators (ICDs) in patients with diabetes mellitus and heart failure (HF) with reduced ejection fraction. We aimed to assess the comparative ef ... Full text Link to item Cite

Endpoints in Heart Failure Drug Development: History and Future.

Journal Article JACC Heart Fail · June 2020 Heart failure (HF) patients experience a high burden of symptoms and functional limitations, and morbidity and mortality remain high despite successful therapies. The majority of HF drugs in the United States are approved for reducing hospitalization and m ... Full text Link to item Cite

Natriuretic Peptides as Inclusion Criteria in Clinical Trials: A JACC: Heart Failure Position Paper.

Journal Article JACC Heart Fail · May 2020 This study investigated the use of natriuretic peptides as inclusion criteria and to develop recommendations regarding their use. B-type natriuretic peptide (BNP) and N-terminal pro-B-type natriuretic peptide (NT-proBNP) are commonly used as inclusion crit ... Full text Link to item Cite

Effects of Liraglutide on Worsening Renal Function Among Patients With Heart Failure With Reduced Ejection Fraction: Insights From the FIGHT Trial.

Journal Article Circ Heart Fail · May 2020 BACKGROUND: The FIGHT (Functional Impact of GLP-1 [glucagon-like peptide-1] for Heart Failure Treatment) trial randomized 300 patients with heart failure with reduced ejection fraction (HFrEF) and a recent hospitalization for heart failure to liraglutide v ... Full text Link to item Cite

Omecamtiv Mecarbil in Chronic Heart Failure With Reduced Ejection Fraction: Rationale and Design of GALACTIC-HF.

Journal Article JACC Heart Fail · April 2020 A central factor in the pathogenesis of heart failure (HF) with reduced ejection fraction is the initial decrease in systolic function. Prior attempts at increasing cardiac contractility with oral drugs have uniformly resulted in signals of increased morta ... Full text Link to item Cite

Relationship between left ventricular ejection fraction and cardiovascular outcomes following hospitalization for heart failure: insights from the RELAX-AHF-2 trial.

Journal Article Eur J Heart Fail · April 2020 AIMS: Although left ventricular ejection fraction (LVEF) is routinely used to categorize patients with heart failure (HF), whether it predicts outcomes after hospitalization for acute heart failure (AHF) is uncertain. Consequently, we assessed the relation ... Full text Link to item Cite

A Biomarker Approach to Understanding HFpEF.

Journal Article J Am Coll Cardiol · March 24, 2020 Full text Link to item Cite

SACUBITRIL-VALSARTAN FOLLOWING HOSPITAL DISCHARGE FOR HEART FAILURE

Conference JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY · March 24, 2020 Link to item Cite

Diuretic Therapy for Patients With Heart Failure: JACC State-of-the-Art Review.

Journal Article J Am Coll Cardiol · March 17, 2020 Expansion of extracellular fluid volume is central to the pathophysiology of heart failure. Increased extracellular fluid leads to elevated intracardiac filling pressures, resulting in a constellation of signs and symptoms of heart failure referred to as c ... Full text Link to item Cite

Adverse Renal Response to Decongestion in the Obese Phenotype of Heart Failure With Preserved Ejection Fraction.

Journal Article J Card Fail · February 2020 BACKGROUND: Patients with heart failure (HF) with preserved ejection fraction (HFpEF) and obesity display a number of pathophysiologic features that may render them more or less vulnerable to negative effects of decongestion on renal function, including gr ... Full text Link to item Cite

Eligibility of sodium-glucose co-transporter-2 inhibitors among patients with diabetes mellitus admitted for heart failure.

Journal Article ESC Heart Fail · February 2020 AIMS: Sodium-glucose co-transporter (SGLT)-2 inhibitors have been shown to reduce the risk of cardiovascular death and heart failure (HF) hospitalization in patients with type 2 diabetes mellitus (DM) and high cardiovascular risk in two large clinical outc ... Full text Link to item Cite

Care Optimization Through Patient and Hospital Engagement Clinical Trial for Heart Failure: Rationale and design of CONNECT-HF.

Journal Article Am Heart J · February 2020 Many therapies have been shown to improve outcomes for patients with heart failure (HF) in controlled settings, but there are limited data available to inform best practices for hospital and post-discharge quality improvement initiatives. The CONNECT-HF st ... Full text Link to item Cite

Are existing and emerging biomarkers associated with cardiorespiratory fitness in patients with chronic heart failure?

Journal Article Am Heart J · February 2020 BACKGROUND: Cardiorespiratory fitness (CRF) is closely linked to health status and clinical outcomes in heart failure (HF) patients. We aimed to test whether biomarkers can reflect CRF and its change over time. METHODS: This post hoc analysis used data fro ... Full text Link to item Cite

Effects of serelaxin in patients admitted for acute heart failure: a meta-analysis.

Journal Article Eur J Heart Fail · February 2020 AIMS: The effectiveness and safety of 48 h intravenous 30 μg/kg/day serelaxin infusion in acute heart failure (AHF) has been studied in six randomized, controlled clinical trials. METHODS AND RESULTS: We conducted a fixed-effect meta-analysis including all ... Full text Link to item Cite

Provider Perspectives on the Feasibility and Utility of Routine Patient-Reported Outcomes Assessment in Heart Failure: A Qualitative Analysis.

Journal Article J Am Heart Assoc · January 21, 2020 Background Patient-reported outcomes (PROs) objectively measure health-related quality of life and provide prognostic information. Advances in technology now allow for rapid, patient-friendly PRO assessment and scoring, yet the adoption of PROs in clinic h ... Full text Link to item Cite

Circulating Neprilysin in Patients With Heart Failure and Preserved Ejection Fraction.

Journal Article JACC Heart Fail · January 2020 BACKGROUND: In heart failure with reduced ejection fraction (HFrEF), elevated soluble neprilysin (sNEP) levels are associated with an increased risk of cardiovascular death, and its inhibition with sacubitril/valsartan has improved survival. OBJECTIVES: Th ... Full text Link to item Cite

Rhythm Control Versus Rate Control in Patients With Atrial Fibrillation and Heart Failure With Preserved Ejection Fraction: Insights From Get With The Guidelines-Heart Failure.

Journal Article J Am Heart Assoc · December 17, 2019 Background Limited data exist to guide treatment for patients with heart failure with preserved ejection fraction and atrial fibrillation, including the important decision regarding rate versus rhythm control. Methods and Results We analyzed the Get With T ... Full text Link to item Cite

Clinical Implications of the New York Heart Association Classification.

Journal Article J Am Heart Assoc · December 3, 2019 Background The New York Heart Association (NYHA) classification has served as a fundamental tool for risk stratification of heart failure (HF) and determines clinical trial eligibility and candidacy for drugs and devices. However, its ability to adequately ... Full text Link to item Cite

Hepatorenal dysfunction identifies high-risk patients with acute heart failure: insights from the RELAX-AHF trial.

Journal Article ESC Heart Fail · December 2019 AIMS: Episodes of acute heart failure (AHF) may lead to end-organ dysfunction. In this post hoc analysis of the Relaxin in Acute Heart Failure trial, we used the MELD-XI (Model of End-Stage Liver Dysfunction) score to examine hepatorenal dysfunction in pat ... Full text Link to item Cite

Is plasma renin activity associated with worse outcomes in acute heart failure? A secondary analysis from the BLAST-AHF trial.

Journal Article Eur J Heart Fail · December 2019 AIMS: Neurohormonal activation characterizes chronic heart failure (HF) and is a well-established therapeutic target. Neurohormonal activation may also play a key role in acute HF (AHF). We aim to describe the association between plasma renin activity (PRA ... Full text Link to item Cite

Best Practices for Prognostic Evaluation of a Patient With Transthyretin Amyloid Cardiomyopathy.

Journal Article JACC CardioOncol · December 2019 Transthyretin amyloid cardiomyopathy (ATTR-CM) has emerged as an increasingly identified etiology of heart failure. Fortunately, the disease now has an approved therapy, with many others under development. Assessment of prognosis in ATTR-CM is critical to ... Full text Open Access Link to item Cite

Design of a "Lean" Case Report Form for Heart Failure Therapeutic Development.

Journal Article JACC Heart Fail · November 2019 The development of treatments for heart failure (HF) is challenged by burdensome clinical trials. Reducing the need for extensive data collection and increasing opportunities for data compatibility between trials may improve efficiency and reduce resource ... Full text Link to item Cite

Association of Change in N-Terminal Pro-B-Type Natriuretic Peptide Following Initiation of Sacubitril-Valsartan Treatment With Cardiac Structure and Function in Patients With Heart Failure With Reduced Ejection Fraction.

Journal Article JAMA · September 17, 2019 IMPORTANCE: In patients with heart failure and reduced ejection fraction (HFrEF), treatment with sacubitril-valsartan reduces N-terminal pro-b-type natriuretic peptide (NT-proBNP) concentrations. The effect of sacubitril-valsartan on cardiac remodeling is ... Full text Link to item Cite

Natriuretic Peptide Response and Outcomes in Chronic Heart Failure With Reduced Ejection Fraction.

Journal Article J Am Coll Cardiol · September 3, 2019 BACKGROUND: The GUIDE-IT (GUIDing Evidence Based Therapy Using Biomarker Intensified Treatment in Heart Failure) trial demonstrated that a strategy to "guide" application of guideline-directed medical therapy (GDMT) by reducing amino-terminal pro-B-type na ... Full text Link to item Cite

Prognostic Implications of Changes in Amino-Terminal Pro-B-Type Natriuretic Peptide in Acute Decompensated Heart Failure: Insights From ASCEND-HF.

Journal Article Journal of cardiac failure · September 2019 BackgroundAmino-terminal pro-B-type natriuretic peptide (NTproBNP) is closely associated with prognosis in acute decompensated heart failure (ADHF). As a result, there has been great interest measuring it during the course of treatment. The progno ... Full text Cite

Spironolactone in Acute Heart Failure Patients With Renal Dysfunction and Risk Factors for Diuretic Resistance: From the ATHENA-HF Trial.

Journal Article Can J Cardiol · September 2019 BACKGROUND: Acute heart failure (HF) patients with renal insufficiency and risk factors for diuretic resistance may be most likely to derive incremental improvement in congestion with the addition of spironolactone. METHODS: The Aldosterone Targeted Neuroh ... Full text Link to item Cite

Effects of Serelaxin in Patients with Acute Heart Failure.

Journal Article N Engl J Med · August 22, 2019 BACKGROUND: Serelaxin is a recombinant form of human relaxin-2, a vasodilator hormone that contributes to cardiovascular and renal adaptations during pregnancy. Previous studies have suggested that treatment with serelaxin may result in relief of symptoms ... Full text Link to item Cite

Rationale and design for the development of a novel nitroxyl donor in patients with acute heart failure.

Journal Article Eur J Heart Fail · August 2019 Hospitalisation for acute heart failure remains a major public health problem with high prevalence, morbidity, mortality, and cost. Prior attempts to develop new therapies for this condition have not been successful. Nitroxyl (HNO) plays a unique role in c ... Full text Link to item Cite

Clinical factors related to morbidity and mortality in high-risk heart failure patients: the GUIDE-IT predictive model and risk score.

Journal Article Eur J Heart Fail · June 2019 BACKGROUND: Most heart failure (HF) risk scores have been derived from cohorts of stable HF patients and may not incorporate up to date treatment regimens or deep phenotype characterization that change baseline risk over the short- and long-term follow-up ... Full text Link to item Cite

Renal Effects of Intensive Volume Removal in Heart Failure Patients With Preexisting Worsening Renal Function.

Journal Article Circ Heart Fail · June 2019 Background The relationship between intensive volume removal in acute decompensated heart failure patients with preexisting worsening renal function (WRF) and renal tubular injury, postdischarge renal function, and clinical outcomes is unknown. Methods and ... Full text Link to item Cite

Breastfeeding, Cellular Immune Activation, and Myocardial Recovery in Peripartum Cardiomyopathy.

Journal Article JACC Basic Transl Sci · June 2019 The etiology of peripartum cardiomyopathy remains unknown. One hypothesis is that an increase in the 16-kDa form of prolactin is pathogenic and suggests that breastfeeding may worsen peripartum cardiomyopathy by increasing prolactin, while bromocriptine, w ... Full text Link to item Cite

Physical Activity, Quality of Life, and Biomarkers in Atrial Fibrillation and Heart Failure With Preserved Ejection Fraction (from the NEAT-HFpEF Trial).

Journal Article Am J Cardiol · May 15, 2019 Although atrial fibrillation/atrial flutter (AF/AFL) and heart failure with preserved ejection fraction (HFpEF) frequently coexist, the influence of AF/AFL on physical activity, N-terminal pro-B-type natriuretic peptide (NT-proBNP), and quality of life in ... Full text Link to item Cite

Utilizing mobile technologies to improve physical activity and medication adherence in patients with heart failure and diabetes mellitus: Rationale and design of the TARGET-HF-DM Trial.

Journal Article Am Heart J · May 2019 Heart failure (HF) and diabetes mellitus (DM) are major public health issues that place significant burden on patients and health care systems. Patients with both HF and DM are at higher risk of adverse cardiovascular and HF outcomes than those with either ... Full text Link to item Cite

Splanchnic nerve blockade in chronic heart failure (Splanchnic HF-2)

Conference EUROPEAN JOURNAL OF HEART FAILURE · May 1, 2019 Link to item Cite

Maternal Obesity Affects Cardiac Remodeling and Recovery in Women with Peripartum Cardiomyopathy.

Journal Article Am J Perinatol · April 2019 OBJECTIVE: To examine the association between maternal obesity on left ventricular (LV) size and recovery in women with peripartum cardiomyopathy (PPCM). STUDY DESIGN: This was a prospective analysis of 100 women enrolled within 13 weeks of PPCM diagnosis ... Full text Link to item Cite

ANNEXIN A1 A NOVEL BIOMARKER FOR CONGESTION IN ACUTE HEART FAILURE?

Conference Journal of the American College of Cardiology · March 2019 Full text Cite

SOLUBLE NEPRILYSIN IN PATIENTS WITH HEART FAILURE WITH PRESERVED EJECTION FRACTION

Conference Journal of the American College of Cardiology · March 2019 Full text Cite

NT-proBNP Goal Achievement Is Associated With Significant Reverse Remodeling and Improved Clinical Outcomes in HFrEF.

Journal Article JACC Heart Fail · February 2019 OBJECTIVES: This study aims to assess the association between biomarker-guided therapy and left ventricular (LV) remodeling. BACKGROUND: In patients with heart failure with reduced ejection fraction (HFrEF), it is unclear if lowering natriuretic peptides r ... Full text Link to item Cite

High-Density Lipoprotein Particle Subfractions in Heart Failure With Preserved or Reduced Ejection Fraction.

Journal Article J Am Coll Cardiol · January 22, 2019 BACKGROUND: Circulating high-density lipoprotein particle (HDL-P) subfractions impact atherogenesis, inflammation, and endothelial function, all of which are implicated in the pathobiology of heart failure (HF). OBJECTIVES: The authors sought to identify k ... Full text Link to item Cite

History of Atrial Fibrillation and Trajectory of Decongestion in Acute Heart Failure.

Journal Article JACC Heart Fail · January 2019 OBJECTIVES: This study sought to characterize the course of decongestion among patients hospitalized for acute heart failure (AHF) by history of atrial fibrillation (AF) and/or atrial flutter (AFL). BACKGROUND: AF/AFL and chronic heart failure (HF) commonl ... Full text Link to item Cite

High-Sensitivity Troponin I in Hospitalized and Ambulatory Patients With Heart Failure With Preserved Ejection Fraction: Insights From the Heart Failure Clinical Research Network.

Conference J Am Heart Assoc · December 18, 2018 Background We sought to study the prevalence of high-sensitivity troponin and its association with cardiac structure and outcomes in ambulatory and hospitalized patients with heart failure with a preserved ejection fraction ( HF p EF ). Methods and Results ... Full text Link to item Cite

Liraglutide and weight loss among patients with advanced heart failure and a reduced ejection fraction: insights from the FIGHT trial.

Conference ESC Heart Fail · December 2018 AIMS: Obesity is present in up to 45% of patients with heart failure (HF). Liraglutide, a glucagon-like peptide-1 (GLP-1) receptor antagonist, facilitates weight loss in obese patients. The efficacy of liraglutide as a weight loss agent among patients with ... Full text Link to item Cite

Economic and Quality-of-Life Outcomes of Natriuretic Peptide-Guided Therapy for Heart Failure.

Journal Article J Am Coll Cardiol · November 27, 2018 BACKGROUND: The GUIDE-IT (GUIDing Evidence Based Therapy Using Biomarker Intensified Treatment in Heart Failure) trial prospectively compared the efficacy of an N-terminal pro-B-type natriuretic peptide (NT-proBNP)-guided heart failure treatment strategy ( ... Full text Link to item Cite

Effect of Inorganic Nitrite vs Placebo on Exercise Capacity Among Patients With Heart Failure With Preserved Ejection Fraction: The INDIE-HFpEF Randomized Clinical Trial.

Journal Article JAMA · November 6, 2018 IMPORTANCE: There are few effective treatments for heart failure with preserved ejection fraction (HFpEF). Short-term administration of inorganic nitrite or nitrate preparations has been shown to enhance nitric oxide signaling, which may improve aerobic ca ... Full text Link to item Cite

Clinical Significance of Early Fluid and Weight Change During Acute Heart Failure Hospitalization.

Journal Article J Card Fail · September 2018 AIMS: To explore the association of changes in weight and fluid during treatment for acute heart failure (AHF) with clinical endpoints. METHODS AND RESULTS: Weight and net fluid changes recorded at 72-96 hours in 708 AHF patients enrolled in Diuretic Optim ... Full text Link to item Cite

Heart Failure With Preserved Ejection Fraction Expert Panel Report: Current Controversies and Implications for Clinical Trials.

Journal Article JACC Heart Fail · August 2018 The number of persons with heart failure has continued to rise over the last several years. Approximately one-half of those living with heart failure have heart failure with preserved ejection fraction, but critical unsolved questions remain across the spe ... Full text Open Access Link to item Cite

Circulating Cardiac Troponin I Levels Measured by a Novel Highly Sensitive Assay in Acute Decompensated Heart Failure: Insights From the ASCEND-HF Trial.

Journal Article J Card Fail · August 2018 BACKGROUND: Circulating cardiac troponin levels (cTn), representative of myocardial injury, are commonly elevated in heart failure (HF) and related to adverse clinical events. However, whether cTn represents a spectrum of risk in HF is unclear. METHODS: Ba ... Full text Link to item Cite

Dose Response of β-Blockers in Adrenergic Receptor Polymorphism Genotypes.

Journal Article Circulation. Genomic and precision medicine · August 2018 Background In heart failure (HF) with reduced ejection fraction, 2 clinical trials, the BEST (β-Blocker Evaluation of Survival Trial) and HF-ACTION (Heart Failure: A Controlled Trial Investigating Outcomes of Exercise Training), have reported an effectiven ... Full text Cite

Implantable cardioverter-defibrillators in heart failure patients with reduced ejection fraction and diabetes.

Journal Article Eur J Heart Fail · June 2018 AIM: There is limited information on the outcomes after primary prevention implantable cardioverter-defibrillator (ICD) implantation in patients with heart failure (HF) and diabetes. This analysis evaluates the effectiveness of a strategy of ICD plus medic ... Full text Link to item Cite

Trends in Noncardiovascular Comorbidities Among Patients Hospitalized for Heart Failure: Insights From the Get With The Guidelines-Heart Failure Registry.

Journal Article Circ Heart Fail · June 2018 BACKGROUND: The increase in medical complexity among patients hospitalized with heart failure (HF) may be reflected by an increase in concomitant noncardiovascular comorbidities. Among patients hospitalized with HF, the temporal trends in the prevalence of ... Full text Link to item Cite

Worsening Renal Function in Patients With Acute Heart Failure Undergoing Aggressive Diuresis Is Not Associated With Tubular Injury.

Journal Article Circulation · May 8, 2018 BACKGROUND: Worsening renal function (WRF) in the setting of aggressive diuresis for acute heart failure treatment may reflect renal tubular injury or simply indicate a hemodynamic or functional change in glomerular filtration. Well-validated tubular injur ... Full text Link to item Cite

Machine Learning Methods Improve Prognostication, Identify Clinically Distinct Phenotypes, and Detect Heterogeneity in Response to Therapy in a Large Cohort of Heart Failure Patients.

Journal Article J Am Heart Assoc · April 12, 2018 BACKGROUND: Whereas heart failure (HF) is a complex clinical syndrome, conventional approaches to its management have treated it as a singular disease, leading to inadequate patient care and inefficient clinical trials. We hypothesized that applying advanc ... Full text Link to item Cite

Outpatient Worsening Heart Failure as a Target for Therapy: A Review.

Journal Article JAMA Cardiol · March 1, 2018 IMPORTANCE: Hospitalizations for worsening heart failure (WHF) represent an enormous public health and financial burden, with physicians, health systems, and payers placing increasing emphasis on hospitalization prevention. In addition, maximizing time out ... Full text Link to item Cite

Site enrollment rate, outcomes, and study drug effects in a multicenter trial. Results from RELAX-AHF.

Journal Article Int J Cardiol · February 15, 2018 BACKGROUND: Site selection is critical in acute heart failure trials. We assessed whether the enrollment rate per site affects patients' characteristics, outcomes and treatment response. METHODS AND RESULTS: A total of 1161 patients enrolled at 96 sites in ... Full text Link to item Cite

Diuretic Treatment in Heart Failure.

Journal Article N Engl J Med · February 15, 2018 Full text Link to item Cite

Interaction of Body Mass Index on the Association Between N-Terminal-Pro-b-Type Natriuretic Peptide and Morbidity and Mortality in Patients With Acute Heart Failure: Findings From ASCEND-HF (Acute Study of Clinical Effectiveness of Nesiritide in Decompensated Heart Failure).

Journal Article J Am Heart Assoc · February 3, 2018 BACKGROUND: Higher body mass index (BMI) is associated with lower circulating levels of N-terminal-pro-b-type natriuretic peptide (NT-proBNP). The Interaction between BMI and NT-proBNP with respect to clinical outcomes is not well characterized in patients ... Full text Link to item Cite

Relationship between baseline systolic blood pressure and long-term outcomes in acute heart failure patients treated with TRV027: an exploratory subgroup analysis of BLAST-AHF.

Journal Article Clin Res Cardiol · February 2018 INTRODUCTION: TRV027, a 'biased' ligand of the angiotensin II type 1 receptor (AT1R), did not affect a composite clinical outcome at 30 days in a phase 2b acute heart failure (AHF) trial (BLAST-AHF). METHODS: Post-hoc analyses from BLAST-AHF (n = 618) exam ... Full text Link to item Cite

Aetiology, timing and clinical predictors of early vs. late readmission following index hospitalization for acute heart failure: insights from ASCEND-HF.

Journal Article Eur J Heart Fail · February 2018 AIMS: Patients hospitalized for heart failure (HF) are at high risk for 30-day readmission. This study sought to examine the timings and causes of readmission within 30 days of an HF hospitalization. METHODS AND RESULTS: Timing and cause of readmission in ... Full text Link to item Cite

What's Next for Acute Heart Failure Research?

Journal Article Acad Emerg Med · January 2018 Each year over one million patients with acute heart failure (AHF) present to a United States emergency department (ED). The vast majority are hospitalized for further management. The length of stay and high postdischarge event rate in this cohort have cha ... Full text Link to item Cite

Circulating T-Cell Subsets, Monocytes, and Natural Killer Cells in Peripartum Cardiomyopathy: Results From the Multicenter IPAC Study.

Journal Article J Card Fail · January 2018 OBJECTIVE: The aim of this work was to evaluate the hypothesis that the distribution of circulating immune cell subsets, or their activation state, is significantly different between peripartum cardiomyopathy (PPCM) and healthy postpartum (HP) women. BACKG ... Full text Link to item Cite

Diuretic Treatment in Heart Failure (vol 377, pg 1964, 2017)

Journal Article NEW ENGLAND JOURNAL OF MEDICINE · 2018 Cite

Diuretic Treatment in Heart Failure.

Journal Article N Engl J Med · November 16, 2017 Full text Link to item Cite

Utility of Growth Differentiation Factor-15, A Marker of Oxidative Stress and Inflammation, in Chronic Heart Failure: Insights From the HF-ACTION Study.

Journal Article JACC Heart Fail · October 2017 OBJECTIVES: This study sought to determine the relationship between growth differentiation factor (GDF)-15 and clinical outcomes in ambulatory patients with heart failure and reduced ejection fraction (HFrEF). BACKGROUND: The prognostic utility of GDF-15, ... Full text Link to item Cite

Efficacy and Safety of Spironolactone in Acute Heart Failure: The ATHENA-HF Randomized Clinical Trial.

Journal Article JAMA Cardiol · September 1, 2017 IMPORTANCE: Persistent congestion is associated with worse outcomes in acute heart failure (AHF). Mineralocorticoid receptor antagonists administered at high doses may relieve congestion, overcome diuretic resistance, and mitigate the effects of adverse ne ... Full text Link to item Cite

Effect of Natriuretic Peptide-Guided Therapy on Hospitalization or Cardiovascular Mortality in High-Risk Patients With Heart Failure and Reduced Ejection Fraction: A Randomized Clinical Trial.

Journal Article JAMA · August 22, 2017 IMPORTANCE: The natriuretic peptides are biochemical markers of heart failure (HF) severity and predictors of adverse outcomes. Smaller studies have evaluated adjusting HF therapy based on natriuretic peptide levels ("guided therapy") with inconsistent res ... Full text Link to item Cite

Biased ligand of the angiotensin II type 1 receptor in patients with acute heart failure: a randomized, double-blind, placebo-controlled, phase IIB, dose ranging trial (BLAST-AHF).

Journal Article Eur Heart J · August 7, 2017 AIMS: Currently, no acute heart failure (AHF) therapy definitively improves outcomes. Reducing morbidity and mortality from acute heart failure (AHF) remains an unmet need. TRV027 is a novel 'biased' ligand of the angiotensin II type 1 receptor (AT1R), sel ... Full text Link to item Cite

A multimarker multi-time point-based risk stratification strategy in acute heart failure: results from the RELAX-AHF trial.

Journal Article Eur J Heart Fail · August 2017 AIMS: We evaluated the added prognostic value of a multi-time point-based multimarker panel of biomarkers in patients with acute heart failure (AHF). METHODS AND RESULTS: Seven circulating biomarkers [NT-proBNP, high sensitivity cardiac troponin T (hs-cTnT ... Full text Link to item Cite

Sildenafil Treatment in Heart Failure With Preserved Ejection Fraction: Targeted Metabolomic Profiling in the RELAX Trial.

Journal Article JAMA Cardiol · August 1, 2017 IMPORTANCE: Phosphodiesterase-5 inhibition with sildenafil compared with a placebo had no effect on the exercise capacity or clinical status of patients with heart failure with preserved ejection fraction (HFpEF) in the PhosphodiesteRasE-5 Inhibition to Im ... Full text Link to item Cite

Effects of serelaxin on the outcome of patients with or without substantial peripheral edema: A subgroup analysis from the RELAX-AHF trial.

Journal Article Am Heart J · August 2017 BACKGROUND: Acute heart failure (AHF) is a heterogeneous disorder, with most of the patients presenting with breathlessness along with varying degrees of peripheral edema. The presence of peripheral edema suggests that volume overload is the cause of decom ... Full text Link to item Cite

Trajectory of Congestion Metrics by Ejection Fraction in Patients With Acute Heart Failure (from the Heart Failure Network).

Journal Article Am J Cardiol · July 1, 2017 Differences in the clinical course of congestion by underlying ejection fraction (EF) have not been well-characterized in acute heart failure (AHF). A post hoc analysis was performed using pooled data from the Diuretic Optimization Strategies Evaluation in ... Full text Link to item Cite

Implications of Alternative Hepatorenal Prognostic Scoring Systems in Acute Heart Failure (from DOSE-AHF and ROSE-AHF).

Journal Article Am J Cardiol · June 15, 2017 Because hepatic dysfunction is common in patients with heart failure (HF), the Model for End-Stage Liver Disease (MELD) may be attractive for risk stratification. Although alternative scores such as the MELD-XI or MELD-Na may be more appropriate in HF popu ... Full text Link to item Cite

Serelaxin in acute heart failure patients with and without atrial fibrillation: a secondary analysis of the RELAX-AHF trial.

Journal Article Clin Res Cardiol · June 2017 BACKGROUND: Atrial fibrillation (AFib) is a common comorbidity in HF and affects patients' outcome. We sought to assess the effects of serelaxin in patients with and without AFib. METHODS: In a post hoc analysis of the RELAX-AHF trial, we compared the effe ... Full text Link to item Cite

Comparison of Clinical Characteristics and Outcomes of Patients With Versus Without Diabetes Mellitus and With Versus Without Angina Pectoris (from the Duke Databank for Cardiovascular Disease).

Journal Article Am J Cardiol · June 1, 2017 Angina pectoris (AP) has different prognostic implications in various populations. Patients with diabetes mellitus (DM) may experience neuropathy such that AP may not be perceived in the setting of coronary artery disease (CAD). The prognostic utility of A ... Full text Link to item Cite

Accelerometer-Measured Daily Activity in Heart Failure With Preserved Ejection Fraction: Clinical Correlates and Association With Standard Heart Failure Severity Indices.

Conference Circ Heart Fail · June 2017 BACKGROUND: Daily physical activity assessed by accelerometers represents a novel method to assess the impact of interventions on heart failure (HF) patients' functional status. We hypothesized that daily activity varies by patient characteristics and corr ... Full text Link to item Cite

Serelaxin in addition to standard therapy in acute heart failure: rationale and design of the RELAX-AHF-2 study.

Journal Article Eur J Heart Fail · June 2017 Patients admitted for acute heart failure (AHF) experience high rates of in-hospital and post-discharge morbidity and mortality despite current therapies. Serelaxin is recombinant human relaxin-2, a hormone with vasodilatory and end-organ protective effect ... Full text Link to item Cite

Role of Biomarkers for the Prevention, Assessment, and Management of Heart Failure: A Scientific Statement From the American Heart Association.

Journal Article Circulation · May 30, 2017 BACKGROUND AND PURPOSE: Natriuretic peptides have led the way as a diagnostic and prognostic tool for the diagnosis and management of heart failure (HF). More recent evidence suggests that natriuretic peptides along with the next generation of biomarkers m ... Full text Link to item Cite

Effect of Oral Iron Repletion on Exercise Capacity in Patients With Heart Failure With Reduced Ejection Fraction and Iron Deficiency: The IRONOUT HF Randomized Clinical Trial.

Journal Article JAMA · May 16, 2017 IMPORTANCE: Iron deficiency is present in approximately 50% of patients with heart failure with reduced left ventricular ejection fraction (HFrEF) and is an independent predictor of reduced functional capacity and mortality. However, the efficacy of inexpe ... Full text Link to item Cite

Day vs night: Does time of presentation matter in acute heart failure? A secondary analysis from the RELAX-AHF trial.

Journal Article Am Heart J · May 2017 BACKGROUND: Signs and symptoms of heart failure can occur at any time. Differences between acute heart failure (AHF) patients who present at nighttime vs daytime and their outcomes have not been well studied. Our objective was to determine if there are dif ... Full text Link to item Cite

Myocardial Damage Detected by Late Gadolinium Enhancement Cardiac Magnetic Resonance Is Uncommon in Peripartum Cardiomyopathy.

Journal Article J Am Heart Assoc · April 3, 2017 BACKGROUND: In peripartum cardiomyopathy, the prevalence of focal myocardial damage detected by late gadolinium enhancement (LGE) cardiovascular magnetic resonance is important to elucidate mechanisms of myocardial injury and cardiac dysfunction. LGE equat ... Full text Link to item Cite

Sex differences in early dyspnea relief between men and women hospitalized for acute heart failure: insights from the RELAX-AHF study.

Journal Article Clin Res Cardiol · April 2017 AIMS: Women with heart failure are typically older, and more often have hypertension and a preserved left ventricular ejection fraction as compared with men. We sought to analyze if these sex differences influence the course and outcome of acute heart fail ... Full text Link to item Cite

Efficacy and Safety of Tolvaptan in Patients Hospitalized With Acute Heart Failure.

Journal Article J Am Coll Cardiol · March 21, 2017 BACKGROUND: The oral vasopressin-2 receptor antagonist tolvaptan causes aquaresis in patients with volume overload, potentially facilitating decongestion and improving the clinical course of patients with acute heart failure (AHF). OBJECTIVES: The TACTICS- ... Full text Link to item Cite

Suppression of Tumorigenicity 2 in Heart Failure With Preserved Ejection Fraction.

Journal Article J Am Heart Assoc · February 18, 2017 BACKGROUND: Soluble suppression of tumorigenicity 2 (sST2) receptor is a biomarker that is elevated in certain systemic inflammatory diseases. Comorbidity-driven microvascular inflammation is postulated to play a key role in heart failure with preserved ej ... Full text Link to item Cite

Body Weight Change During and After Hospitalization for Acute Heart Failure: Patient Characteristics, Markers of Congestion, and Outcomes: Findings From the ASCEND-HF Trial.

Journal Article JACC Heart Fail · January 2017 OBJECTIVES: This study sought to examine the relationships between in-hospital and post-discharge body weight changes and outcomes among patients hospitalized for acute heart failure (AHF). BACKGROUND: Body weight changes during and after hospitalization f ... Full text Link to item Cite

Plasma Levels of MicroRNA-155 Are Upregulated with Long-Term Left Ventricular Assist Device Support.

Journal Article ASAIO J · 2017 Left ventricular assist device (LVAD) therapy unloads the failing heart but exposes the human body to unique pathophysiologic demands such as continuous blood flow and complete univentricular support, which are associated with increased risk of adverse cli ... Full text Link to item Cite

Novel approach to classifying patients with pulmonary arterial hypertension using cluster analysis.

Journal Article Pulm Circ · 2017 Pulmonary arterial hypertension (PAH) patients have distinct disease courses and responses to treatment, but current diagnostic and treatment schemes provide limited insight. We aimed to see if cluster analysis could distinguish clinical phenotypes in PAH. ... Full text Link to item Cite

A Multi-Marker Approach for Risk Stratification in Patients With Chronic Heart Failure: Insights From the HF-ACTION Trial

Conference · 2017 Introduction: It is unclear whether multi-marker approaches improve risk stratification among patients with heart failure (HF). We evaluated the prognostic utility of a multi-marker approach with biomarkers of HF status; Growth-differentiation factor-15 (G ... Cite

Chronic Oral Study of Myosin Activation to Increase Contractility in Heart Failure (COSMIC-HF): a phase 2, pharmacokinetic, randomised, placebo-controlled trial.

Journal Article Lancet · December 10, 2016 BACKGROUND: Impaired contractility is a feature of heart failure with reduced ejection fraction. We assessed the pharmacokinetics and effects on cardiac function and structure of the cardiac myosin activator, omecamtiv mecarbil. METHODS: In this randomised ... Full text Link to item Cite

Composite End Points in Acute Heart Failure Research: Data Simulations Illustrate the Limitations.

Journal Article Can J Cardiol · November 2016 Composite end points are frequently used in clinical trials of investigational treatments for acute heart failure, eg, to boost statistical power and reduce the overall sample size. By incorporating multiple and varying types of clinical outcomes they prov ... Full text Link to item Cite

Biomarker-based risk prediction in the community.

Journal Article Eur J Heart Fail · November 2016 AIMS: Guided by predictive characteristics of cardiovascular biomarkers, we explored the clinical implications of a simulated biomarker-guided heart failure (HF) and major adverse cardiovascular events (MACE) prevention strategy in the community. METHODS A ... Full text Link to item Cite

Serum Bicarbonate in Acute Heart Failure: Relationship to Treatment Strategies and Clinical Outcomes.

Journal Article J Card Fail · September 2016 BACKGROUND: Though commonly noted in clinical practice, it is unknown if decongestion in acute heart failure (AHF) results in increased serum bicarbonate. METHODS AND RESULTS: For 678 AHF patients in the DOSE-AHF, CARRESS-HF, and ROSE-AHF trials, we assess ... Full text Link to item Cite

Effects of serelaxin in acute heart failure patients with renal impairment: results from RELAX-AHF.

Journal Article Clin Res Cardiol · September 2016 BACKGROUND: Serelaxin showed beneficial effects on clinical outcome and trajectories of renal markers in patients with acute heart failure. We aimed to study the interaction between renal function and the treatment effect of serelaxin. METHODS: In the curr ... Full text Link to item Cite

Rationale and Design of the ATHENA-HF Trial: Aldosterone Targeted Neurohormonal Combined With Natriuresis Therapy in Heart Failure.

Journal Article JACC Heart Fail · September 2016 Although therapy with mineralocorticoid receptor antagonists (MRAs) is recommended for patients with chronic heart failure (HF) with reduced ejection fraction and in post-infarction HF, it has not been studied well in acute HF (AHF) despite being commonly ... Full text Link to item Cite

Effects of Liraglutide on Clinical Stability Among Patients With Advanced Heart Failure and Reduced Ejection Fraction: A Randomized Clinical Trial.

Journal Article JAMA · August 2, 2016 IMPORTANCE: Abnormal cardiac metabolism contributes to the pathophysiology of advanced heart failure with reduced left ventricular ejection fraction (LVEF). Glucagon-like peptide 1 (GLP-1) agonists have shown cardioprotective effects in early clinical stud ... Full text Link to item Cite

Clinical and Research Considerations for Patients With Hypertensive Acute Heart Failure: A Consensus Statement from the Society of Academic Emergency Medicine and the Heart Failure Society of America Acute Heart Failure Working Group.

Journal Article J Card Fail · August 2016 Management approaches for patients in the emergency department (ED) who present with acute heart failure (AHF) have largely focused on intravenous diuretics. Yet, the primary pathophysiologic derangement underlying AHF in many patients is not solely volume ... Full text Link to item Cite

Clinical and Research Considerations for Patients With Hypertensive Acute Heart Failure: A Consensus Statement from the Society for Academic Emergency Medicine and the Heart Failure Society of America Acute Heart Failure Working Group.

Journal Article Acad Emerg Med · August 2016 Management approaches for patients in the emergency department (ED) who present with acute heart failure (AHF) have largely focused on intravenous diuretics. Yet, the primary pathophysiologic derangement underlying AHF in many patients is not solely volume ... Full text Link to item Cite

Implications of Using Different Definitions on Outcomes in Worsening Heart Failure.

Journal Article Circ Heart Fail · August 2016 BACKGROUND: In-hospital worsening heart failure (WHF) is an important event that has inconsistent definitions used across trials. We used data from 2 acute heart failure (HF) trials from the National Institutes of Health HF Network, DOSE (Diuretic Optimiza ... Full text Link to item Cite

Differential Response to Low-Dose Dopamine or Low-Dose Nesiritide in Acute Heart Failure With Reduced or Preserved Ejection Fraction: Results From the ROSE AHF Trial (Renal Optimization Strategies Evaluation in Acute Heart Failure).

Journal Article Circ Heart Fail · August 2016 BACKGROUND: The ROSE AHF trial (Renal Optimization Strategies Evaluation in Acute Heart Failure) found that when compared with placebo, neither low-dose dopamine (2 µg/kg per minute) nor low-dose nesiritide (0.005 μg/kg per minute without bolus) enhanced d ... Full text Link to item Cite

Sex differences in early dyspnea relief in acute heart failure

Conference EUROPEAN HEART JOURNAL · August 1, 2016 Link to item Cite

Metabolomic Profiling Identifies Novel Circulating Biomarkers of Mitochondrial Dysfunction Differentially Elevated in Heart Failure With Preserved Versus Reduced Ejection Fraction: Evidence for Shared Metabolic Impairments in Clinical Heart Failure.

Journal Article J Am Heart Assoc · July 29, 2016 BACKGROUND: Metabolic impairment is an important contributor to heart failure (HF) pathogenesis and progression. Dysregulated metabolic pathways remain poorly characterized in patients with HF and preserved ejection fraction (HFpEF). We sought to determine ... Full text Open Access Link to item Cite

Use of High-Sensitivity Troponin T to Identify Patients With Acute Heart Failure at Lower Risk for Adverse Outcomes: An Exploratory Analysis From the RELAX-AHF Trial.

Journal Article JACC Heart Fail · July 2016 OBJECTIVES: The aim of this study was to determine if a baseline high-sensitivity troponin T (hsTnT) value ≤99th percentile upper reference limit (0.014 μg/l ["low hsTnT"]) identifies patients at low risk for adverse outcomes. BACKGROUND: Approximately 85% ... Full text Link to item Cite

Nesiritide in patients hospitalized for acute heart failure: does timing matter? Implication for future acute heart failure trials.

Journal Article Eur J Heart Fail · June 2016 AIMS: It remains unclear if early administration of i.v. nesiritide in patients hospitalized with acute heart failure (AHF) is associated with improved clinical outcomes. METHODS AND RESULTS: We analysed data from 7007 patients enrolled in ASCEND-HF to exa ... Full text Link to item Cite

Relaxin-2 and Soluble Flt1 Levels in Peripartum Cardiomyopathy: Results of the Multicenter IPAC Study.

Journal Article JACC Heart Fail · May 2016 OBJECTIVES: This study explored the association of vascular hormones with myocardial recovery and clinical outcomes in peripartum cardiomyopathy (PPCM). BACKGROUND: PPCM is an uncommon disorder with unknown etiology. Angiogenic imbalance may contribute to ... Full text Link to item Cite

Coenzyme Q10 and Heart Failure: A State-of-the-Art Review.

Journal Article Circ Heart Fail · April 2016 Heart failure (HF) with either preserved or reduced ejection fraction is associated with increased morbidity and mortality. Evidence-based therapies are often limited by tolerability, hypotension, electrolyte disturbances, and renal dysfunction. Coenzyme Q ... Full text Link to item Cite

Acute Treatment With Omecamtiv Mecarbil to Increase Contractility in Acute Heart Failure: The ATOMIC-AHF Study.

Journal Article J Am Coll Cardiol · March 29, 2016 BACKGROUND: Omecamtiv mecarbil (OM) is a selective cardiac myosin activator that increases myocardial function in healthy volunteers and in patients with chronic heart failure. OBJECTIVES: This study evaluated the pharmacokinetics, pharmacodynamics, tolera ... Full text Link to item Cite

Calcium upregulation by percutaneous administration of gene therapy in patients with cardiac disease (CUPID 2): a randomised, multinational, double-blind, placebo-controlled, phase 2b trial.

Journal Article Lancet · March 19, 2016 BACKGROUND: Sarcoplasmic/endoplasmic reticulum Ca(2+)-ATPase (SERCA2a) activity is deficient in the failing heart. Correction of this abnormality by gene transfer might improve cardiac function. We aimed to investigate the clinical benefits and safety of g ... Full text Link to item Cite

Cardiac transplantation for older patients: Characteristics and outcomes in the septuagenarian population.

Journal Article J Heart Lung Transplant · March 2016 BACKGROUND: With increasing age of patients with heart failure, it is important to understand the potential role for orthotopic heart transplant (OHT) in elderly patients. We examined recipient and donor characteristics and long-term outcomes of older reci ... Full text Link to item Cite

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

Journal Article Eur J Heart Fail · March 2016 AIMS: A longitudinal and comprehensive analysis of health-related quality of life (HRQOL) was performed during hospitalization for heart failure (HF) or soon after discharge. METHODS AND RESULTS: A post-hoc analysis was performed of the ASCEND-HF trial. Th ... Full text Link to item Cite

Increased mortality with elevated plasma endothelin-1 in acute heart failure: an ASCEND-HF biomarker substudy.

Journal Article Eur J Heart Fail · March 2016 AIMS: Endothelin-1 (ET-1) is an endogenous vasoconstrictor implicated in pulmonary and systemic hypertension, as well as ventricular dysfunction, through effects on vascular smooth muscle, the kidneys, and cardiomyocytes. We aimed to determine the associat ... Full text Link to item Cite

Hemodynamic Predictors of Heart Failure Morbidity and Mortality: Fluid or Flow?

Journal Article J Card Fail · March 2016 BACKGROUND: Patients with advanced heart failure may continue for prolonged times with persistent hemodynamic abnormalities; intermediate- and long-term outcomes of these patients are unknown. METHODS AND RESULTS: We used ESCAPE (Evaluation Study of Conges ... Full text Link to item Cite

Prevalence of AAV1 neutralizing antibodies and consequences for a clinical trial of gene transfer for advanced heart failure.

Journal Article Gene Ther · March 2016 Adeno-associated virus serotype 1 (AAV1) has many advantages as a gene therapy vector, but the presence of pre-existing neutralizing antibodies (NAbs) is an important limitation. This study was designed to determine: (1) characteristics of AAV NAbs in huma ... Full text Link to item Cite

Prognostic Implications of Long-Chain Acylcarnitines in Heart Failure and Reversibility With Mechanical Circulatory Support.

Journal Article J Am Coll Cardiol · January 26, 2016 BACKGROUND: Heart failure (HF) is characterized by perturbations in energy homeostasis and metabolism. The reversibility and prognostic value of circulating markers associated with these changes remain unclear. OBJECTIVES: This study sought to describe the ... Full text Link to item Cite

A Test in Context: Critical Evaluation of Natriuretic Peptide Testing in Heart Failure.

Journal Article J Am Coll Cardiol · January 26, 2016 Circulating natriuretic peptide measurements have been used extensively over the past 15 years to diagnose and monitor patients with heart failure. We are still learning how complex the dynamics of natriuretic peptides can be in the interpretation of test ... Full text Link to item Cite

Intensification of Medication Therapy for Cardiorenal Syndrome in Acute Decompensated Heart Failure.

Journal Article J Card Fail · January 2016 BACKGROUND: Worsening renal function in heart failure may be related to increased venous congestion, decreased cardiac output, or both. Diuretics are universally used in acute decompensated heart failure, but they may be ineffective and may lead to azotemi ... Full text Link to item Cite

Mode of Death After Acute Heart Failure Hospitalization　- A Clue to Possible Mechanisms.

Journal Article Circ J · 2016 Heart failure continues to be a leading cause of hospitalization worldwide, and acute heart failure (AHF) carries significant risk for short-term morbidity and mortality. Despite many trials of potential new therapies for AHF, there have been very few adva ... Full text Link to item Cite

Prognostic Value of Baseline and Changes in Circulating Soluble ST2 Levels and the Effects of Nesiritide in Acute Decompensated Heart Failure.

Journal Article JACC Heart Fail · January 2016 OBJECTIVES: The study sought to investigate the association between soluble growth stimulation expressed gene 2 (sST2) level and adverse outcomes in acute heart failure (HF). BACKGROUND: Several studies have demonstrated the prognostic utility of sST2 leve ... Full text Link to item Cite

Clinical Implications of Cluster Analysis-Based Classification of Acute Decompensated Heart Failure and Correlation with Bedside Hemodynamic Profiles.

Journal Article PLoS One · 2016 BACKGROUND: Classification of acute decompensated heart failure (ADHF) is based on subjective criteria that crudely capture disease heterogeneity. Improved phenotyping of the syndrome may help improve therapeutic strategies. OBJECTIVE: To derive cluster an ... Full text Link to item Cite

Pulmonary Hypertension in the Era of Mechanical Circulatory Support.

Journal Article ASAIO J · 2016 Left heart disease (LHD) represents the most common cause of pulmonary hypertension (PH), and is associated with worse prognosis compared with LHD without PH. In addition, PH due to LHD may prevent patients from receiving heart transplantation, because of ... Full text Link to item Cite

Isosorbide Mononitrate in Heart Failure with Preserved Ejection Fraction.

Journal Article N Engl J Med · December 10, 2015 BACKGROUND: Nitrates are commonly prescribed to enhance activity tolerance in patients with heart failure and a preserved ejection fraction. We compared the effect of isosorbide mononitrate or placebo on daily activity in such patients. METHODS: In this mu ... Full text Link to item Cite

Late-Breaking Clinical Trial Abstracts

Conference Circulation · December 8, 2015 Full text Cite

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

Journal Article Eur J Heart Fail · December 2015 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 ... Full text Link to item Cite

In-hospital worsening heart failure.

Journal Article Eur J Heart Fail · November 2015 Acute worsening heart failure (WHF) is seen in a sizable portion of patients hospitalized for heart failure, and is increasingly being recognized as an entity that is associated with an adverse in-hospital course. WHF is generally defined as worsening hear ... Full text Link to item Cite

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

Journal Article Eur J Heart Fail · November 2015 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: Le ... Full text Link to item Cite

The Impact of Worsening Heart Failure in the United States.

Journal Article Heart Fail Clin · October 2015 In-hospital worsening heart failure represents a clinical scenario wherein a patient hospitalized for acute heart failure experiences a worsening of their condition, requiring escalation of therapy. Worsening heart failure is associated with worse in-hospi ... Full text Open Access Link to item Cite

Circulating Kidney Injury Molecule-1 Levels in Acute Heart Failure: Insights From the ASCEND-HF Trial (Acute Study of Clinical Effectiveness of Nesiritide in Decompensated Heart Failure).

Journal Article JACC Heart Fail · October 2015 OBJECTIVES: This study sought to determine the relationship of KIM-1 levels with adverse clinical outcomes in acute decompensated heart failure (ADHF). BACKGROUND: Kidney injury molecule (KIM)-1 is a biomarker expressed by the nephron in acute tubular inju ... Full text Link to item Cite

Tolvaptan in Patients Hospitalized With Acute Heart Failure: Rationale and Design of the TACTICS and the SECRET of CHF Trials.

Journal Article Circ Heart Fail · September 2015 Congestion is a primary reason for hospitalization in patients with acute heart failure (AHF). Despite inpatient diuretics and vasodilators targeting decongestion, persistent congestion is present in many AHF patients at discharge and more severe congestio ... Full text Link to item Cite

Comparison of 2-Year Outcomes of Extended Criteria Cardiac Transplantation Versus Destination Left Ventricular Assist Device Therapy Using Continuous Flow.

Journal Article Am J Cardiol · August 15, 2015 Alternatives have emerged for patients ineligible for cardiac transplantation under standard criteria. The purpose of our study was to compare outcomes in patients ineligible for cardiac transplantation under standard criteria, treated either with extended ... Full text Link to item Cite

Worsening heart failure during hospitalization for acute heart failure: Insights from the Acute Study of Clinical Effectiveness of Nesiritide in Decompensated Heart Failure (ASCEND-HF).

Journal Article Am Heart J · August 2015 BACKGROUND: Despite initial in-hospital treatment of acute heart failure (HF), some patients experience worsening HF (WHF). There are limited data about the outcomes and characteristics of patients who experience in-hospital WHF. METHODS AND RESULTS: We as ... Full text Link to item Cite

Reply: Mode of Death Prevention by Serelaxin.

Journal Article J Am Coll Cardiol · July 7, 2015 Full text Link to item Cite

Relief and Recurrence of Congestion During and After Hospitalization for Acute Heart Failure: Insights From Diuretic Optimization Strategy Evaluation in Acute Decompensated Heart Failure (DOSE-AHF) and Cardiorenal Rescue Study in Acute Decompensated Heart Failure (CARESS-HF).

Journal Article Circ Heart Fail · July 2015 BACKGROUND: Congestion is the most frequent cause for hospitalization in acute decompensated heart failure. Although decongestion is a major goal of acute therapy, it is unclear how the clinical components of congestion (eg, peripheral edema, orthopnea) co ... Full text Open Access Link to item Cite

Evaluation of the Incremental Prognostic Utility of Increasingly Complex Testing in Chronic Heart Failure.

Journal Article Circ Heart Fail · July 2015 BACKGROUND: Current heart failure (HF) risk prediction models do not consider how individual patient assessments occur in incremental steps; furthermore, each additional diagnostic evaluation may add cost, complexity, and potential morbidity. METHODS AND R ... Full text Link to item Cite

Effects of Xanthine Oxidase Inhibition in Hyperuricemic Heart Failure Patients: The Xanthine Oxidase Inhibition for Hyperuricemic Heart Failure Patients (EXACT-HF) Study.

Journal Article Circulation · May 19, 2015 BACKGROUND: Oxidative stress may contribute to heart failure (HF) progression. Inhibiting xanthine oxidase in hyperuricemic HF patients may improve outcomes. METHODS AND RESULTS: We randomly assigned 253 patients with symptomatic HF, left ventricular eject ... Full text Link to item Cite

Heart failure therapeutics on the basis of a biased ligand of the angiotensin-2 type 1 receptor. Rationale and design of the BLAST-AHF study (Biased Ligand of the Angiotensin Receptor Study in Acute Heart Failure).

Journal Article JACC Heart Fail · March 2015 The BLAST-AHF (Biased Ligand of the Angiotensin Receptor Study in Acute Heart Failure) study is designed to test the efficacy and safety of TRV027, a novel biased ligand of the angiotensin-2 type 1 receptor, in patients with acute heart failure (AHF). AHF ... Full text Link to item Cite

Galectin-3 in heart failure with preserved ejection fraction. A RELAX trial substudy (Phosphodiesterase-5 Inhibition to Improve Clinical Status and Exercise Capacity in Diastolic Heart Failure).

Journal Article JACC Heart Fail · March 2015 OBJECTIVES: This study hypothesized that elevated galectin-3 (Gal-3) levels would identify patients with more advanced heart failure (HF) with preserved ejection fraction (HFpEF) as assessed by key pathophysiological domains. BACKGROUND: Gal-3 is implicate ... Full text Link to item Cite

Decongestion strategies and renin-angiotensin-aldosterone system activation in acute heart failure.

Journal Article JACC Heart Fail · February 2015 OBJECTIVES: The purpose of this study was to assess the relationship between biomarkers of renin-angiotensin-aldosterone system (RAAS) activation and decongestion strategies, worsening renal function, and clinical outcomes. BACKGROUND: High-dose diuretic t ... Full text Open Access Link to item Cite

Early management of patients with acute heart failure: state of the art and future directions. A consensus document from the society for academic emergency medicine/heart failure society of America acute heart failure working group.

Journal Article J Card Fail · January 2015 Heart failure (HF) afflicts nearly 6 million Americans, resulting in one million emergency department (ED) visits and over one million annual hospital discharges. An aging population and improved survival from cardiovascular diseases is expected to further ... Full text Link to item Cite

Effects of left ventricular assist device support on biomarkers of cardiovascular stress, fibrosis, fluid homeostasis, inflammation, and renal injury.

Journal Article JACC Heart Fail · January 2015 OBJECTIVES: The purpose of this study was to examine changes in a broad panel of biomarkers following left ventricular assist device (LVAD) support in advanced heart failure (HF). BACKGROUND: LVAD therapy mechanically unloads the failing heart and may resu ... Full text Link to item Cite

Comparative assessment of short-term adverse events in acute heart failure with cystatin C and other estimates of renal function: results from the ASCEND-HF trial.

Journal Article JACC Heart Fail · January 2015 OBJECTIVES: The purpose of this study was to investigate the predictive values of baseline and changes in cystatin C (CysC) and its derived equations for short-term adverse outcomes and the effect of nesiritide therapy on CysC in acute decompensated heart ... Full text Link to item Cite

The diastolic pulmonary gradient does not predict survival in patients with pulmonary hypertension due to left heart disease.

Journal Article JACC. Heart failure · January 2015 ObjectivesThis study sought to evaluate if diastolic pulmonary gradient (DPG) can predict survival in patients with pulmonary hypertension due to left heart disease (PH-LHD).BackgroundPatients with combined post- and pre-capillary PH-LHD ... Full text Cite

Early management of patients with acute heart failure: state of the art and future directions--a consensus document from the SAEM/HFSA acute heart failure working group.

Journal Article Acad Emerg Med · January 2015 Heart failure (HF) afflicts nearly 6 million Americans, resulting in 1 million emergency department (ED) visits and over 1 million annual hospital discharges. The majority of inpatient admissions originate in the ED; thus, it is crucial that emergency phys ... Full text Link to item Cite

Improving care for patients with acute heart failure: before, during and after hospitalization.

Journal Article ESC Heart Fail · December 2014 Acute heart failure (AHF) is a common and serious condition that contributes to about 5% of all emergency hospital admissions in Europe and the USA. Here, we present the recommendations from structured discussions among an author group of AHF experts in 20 ... Full text Link to item Cite

Diuretic response in patients with acute decompensated heart failure: characteristics and clinical outcome--an analysis from RELAX-AHF.

Journal Article Eur J Heart Fail · November 2014 AIMS: We studied the characteristics and clinical outcome related to diuretic response and the effects of serelaxin in patients hospitalized for acute heart failure (AHF). METHODS AND RESULTS: RELAX-AHF was a double-blind, placebo-controlled trial, enrolli ... Full text Link to item Cite

Clinical implications of chronic heart failure phenotypes defined by cluster analysis.

Journal Article J Am Coll Cardiol · October 28, 2014 BACKGROUND: Classification of chronic heart failure (HF) is on the basis of criteria that may not adequately capture disease heterogeneity. Improved phenotyping may help inform research and therapeutic strategies. OBJECTIVES: This study used cluster analys ... Full text Link to item Cite

Effect of serelaxin on mode of death in acute heart failure: results from the RELAX-AHF study.

Journal Article J Am Coll Cardiol · October 14, 2014 BACKGROUND: Little is known about mode of death after acute heart failure (AHF) hospitalization. In the RELAX-AHF (Efficacy and Safety of Relaxin for the Treatment of Acute Heart Failure) study, serelaxin, the recombinant form of human relaxin-2, reduced p ... Full text Link to item Cite

Charting a roadmap for heart failure biomarker studies.

Journal Article JACC Heart Fail · October 2014 Heart failure is a syndrome with a pathophysiological basis that can be traced to dysfunction in several interconnected molecular pathways. Identification of biomarkers of heart failure that allow measurement of the disease on a molecular level has resulte ... Full text Link to item Cite

Fluid removal in acute heart failure: diuretics versus devices.

Journal Article Curr Opin Crit Care · October 2014 PURPOSE OF REVIEW: Fluid removal and relief of congestion are central to treatment of acute heart failure. Diuretics have been the decongestive mainstay but their known limitations have led to the exploration of alternative strategies. This review compares ... Full text Link to item Cite

Rationale and design of the GUIDE-IT study: Guiding Evidence Based Therapy Using Biomarker Intensified Treatment in Heart Failure.

Journal Article JACC Heart Fail · October 2014 OBJECTIVES: The GUIDE-IT (Guiding Evidence Based Therapy Using Biomarker Intensified Treatment in Heart Failure) study is designed to determine the safety, efficacy, and cost-effectiveness of a strategy of adjusting therapy with the goal of achieving and m ... Full text Link to item Cite

Characteristics and outcomes of patients with heart failure and discordant findings by right-sided heart catheterization and cardiopulmonary exercise testing.

Journal Article Am J Cardiol · October 1, 2014 There are limited data integrating findings on right-sided cardiac catheterization and cardiopulmonary exercise testing in ambulatory patients with heart failure. In this study, 187 outpatients with HF referred to the Duke Medical Center for consideration ... Full text Link to item Cite

Liver function, in-hospital, and post-discharge clinical outcome in patients with acute heart failure-results from the relaxin for the treatment of patients with acute heart failure study.

Journal Article J Card Fail · June 2014 BACKGROUND: Elevated plasma concentrations of liver function tests are prevalent in patients with chronic heart failure (HF). Little is known about liver function in patients with acute HF. We aimed to assess the prevalence and prognostic value of serial m ... Full text Link to item Cite

Biomarkers of myocardial stress and fibrosis as predictors of mode of death in patients with chronic heart failure.

Journal Article JACC Heart Fail · June 2014 OBJECTIVES: The aim of this study was to determine whether biomarkers of myocardial stress and fibrosis improve prediction of the mode of death in patients with chronic heart failure. BACKGROUND: The 2 most common modes of death in patients with chronic he ... Full text Link to item Cite

High-sensitivity C-reactive protein in acute heart failure: insights from the ASCEND-HF trial.

Journal Article J Card Fail · May 2014 BACKGROUND: Inflammation is associated with progression of chronic heart failure (HF). Few data exist on high-sensitivity C-reactive protein (hsCRP) levels and their importance in acute HF. METHODS AND RESULTS: In this biomarker substudy of the ASCEND-HF t ... Full text Link to item Cite

Decongestion in acute heart failure.

Journal Article Eur J Heart Fail · May 2014 Congestion is a major reason for hospitalization in acute heart failure (HF). Therapeutic strategies to manage congestion include diuretics, vasodilators, ultrafiltration, vasopressin antagonists, mineralocorticoid receptor antagonists, and potentially als ... Full text Link to item Cite

Serelaxin in acute heart failure patients with preserved left ventricular ejection fraction: results from the RELAX-AHF trial.

Journal Article Eur Heart J · April 2014 AIMS: Serelaxin is effective in relieving dyspnoea and improving multiple outcomes in acute heart failure (AHF). Many AHF patients have preserved ejection fraction (HFpEF). Given the lack of evidence-based therapies in this population, we evaluated the eff ... Full text Link to item Cite

GALECTIN-3 IN HEART FAILURE WITH PRESERVED EJECTION FRACTION: A RELAX SUBSTUDY

Conference Journal of the American College of Cardiology · April 2014 Full text Cite

Current evidence on treatment of patients with chronic systolic heart failure and renal insufficiency: practical considerations from published data.

Journal Article J Am Coll Cardiol · March 11, 2014 Chronic kidney disease (CKD) is increasingly prevalent in patients with chronic systolic heart failure. Therefore, evidence-based therapies are more and more being used in patients with some degree of renal dysfunction. However, most pivotal randomized cli ... Full text Link to item Cite

Thrombolytic therapy for thrombosis of continuous flow ventricular assist devices.

Journal Article J Card Fail · February 2014 BACKGROUND: Despite chronic systemic anticoagulation, advanced heart failure patients treated with a continuous-flow left ventricular assist device (LVAD) remain at risk for pump thrombosis. Pump thrombosis may initially be suspected in the setting of clin ... Full text Link to item Cite

The effects of exercise on cardiovascular biomarkers in patients with chronic heart failure.

Journal Article Am Heart J · February 2014 BACKGROUND: Exercise training is recommended for chronic heart failure (HF) patients to improve functional status and reduce risk of adverse outcomes. Elevated plasma levels of amino-terminal pro-brain natriuretic peptide (NT-proBNP), high-sensitivity C-re ... Full text Link to item Cite

Design of a phase 2b trial of intracoronary administration of AAV1/SERCA2a in patients with advanced heart failure: the CUPID 2 trial (calcium up-regulation by percutaneous administration of gene therapy in cardiac disease phase 2b).

Journal Article JACC Heart Fail · February 2014 OBJECTIVES: Impaired cardiac isoform of sarco(endo)plasmic reticulum Ca(2+) ATPase (SERCA2a) activity is a key abnormality in heart failure patients with reduced ejection fraction. The CUPID 2 (Calcium Up-Regulation by Percutaneous Administration of Gene T ... Full text Link to item Cite

Relationship between galectin-3 levels and mineralocorticoid receptor antagonist use in heart failure: analysis from HF-ACTION.

Journal Article J Card Fail · January 2014 BACKGROUND: Galectin-3 (Gal-3) is a marker of myocardial fibrosis, and elevated levels are associated with adverse outcomes. Mineralocorticoid receptor antagonists (MRAs) modulate cardiac fibrosis in heart failure (HF) patients and have been shown to impro ... Full text Link to item Cite

Valvular heart disease in patients supported with left ventricular assist devices.

Journal Article Circ Heart Fail · January 2014 Patients with advanced HF and coexisting VHD who undergo LVAD implantation constitute a growing population and pose unique challenges in clinical and surgical management. Contemporary continuous-flow LVADs alter blood flow dynamics and cardiovascular physi ... Full text Link to item Cite

Natriuretic peptide-guided heart failure management.

Journal Article Eur Heart J · January 2014 The natriuretic peptides are important tools to establish diagnosis and prognosis in heart failure (HF). With application of therapies for HF, changes in both B-type natriuretic peptide (BNP) and its amino terminal cleavage fragment (NT-proBNP) parallel th ... Full text Link to item Cite

Low-dose dopamine or low-dose nesiritide in acute heart failure with renal dysfunction: the ROSE acute heart failure randomized trial.

Journal Article JAMA · December 18, 2013 IMPORTANCE: Small studies suggest that low-dose dopamine or low-dose nesiritide may enhance decongestion and preserve renal function in patients with acute heart failure and renal dysfunction; however, neither strategy has been rigorously tested. OBJECTIVE ... Full text Link to item Cite

Association of novel biomarkers of cardiovascular stress with left ventricular hypertrophy and dysfunction: implications for screening.

Journal Article J Am Heart Assoc · November 7, 2013 BACKGROUND: Currently available screening tools for left ventricular (LV) hypertrophy (LVH) and systolic dysfunction (LVSD) are either expensive (echocardiography) or perform suboptimally (B-type natriuretic peptide [BNP]). It is unknown whether newer biom ... Full text Link to item Cite

Ten-year experience with extended criteria cardiac transplantation.

Journal Article Circ Heart Fail · November 2013 BACKGROUND: Extended criteria cardiac transplant (ECCT) programs expand the transplant pool by matching donors and recipients typically excluded from the transplant process because of age or comorbidity. There is a paucity of data examining long-term outco ... Full text Link to item Cite

Soluble ST2 in ambulatory patients with heart failure: Association with functional capacity and long-term outcomes.

Journal Article Circ Heart Fail · November 2013 BACKGROUND: ST2 is involved in cardioprotective signaling in the myocardium and has been identified as a potentially promising biomarker in heart failure (HF). We evaluated ST2 levels and their association with functional capacity and long-term clinical ou ... Full text Link to item Cite

Natriuretic peptides and primary prevention: the new world?

Journal Article J Am Coll Cardiol · October 8, 2013 Full text Link to item Cite

Effects of serelaxin in subgroups of patients with acute heart failure: results from RELAX-AHF.

Journal Article Eur Heart J · October 2013 AIM: Patients hospitalized for acute heart failure (AHF) differ with respect of many clinical characteristics which may influence their prognosis and response to treatment. We have assessed possible differences in the effects of serelaxin on dyspnoea relie ... Full text Link to item Cite

Learning from recent trials and shaping the future of acute heart failure trials.

Journal Article Am Heart J · October 2013 The last decade of acute heart failure (HF) research is characterized by disappointments in large phase 2 and 3 pharmacologic studies of therapeutics including calcium-sensitizing agents and antagonists of endothelin, vasopressin, and adenosine. As a resul ... Full text Link to item Cite

Biomarker-guided therapies in heart failure: a forum for unified strategies.

Journal Article J Card Fail · August 2013 The complexity of standard medical treatment for heart failure is growing, and such therapy typically involves 5 or more different medications. Given these pressures, there is increasing interest in harnessing cardiovascular biomarkers for clinical applica ... Full text Link to item Cite

Noncardiac comorbidities and acute heart failure patients.

Journal Article Heart Fail Clin · July 2013 The acute heart failure (AHF) population is a heterogeneous group with multiple interrelated noncardiovascular comorbidities. Chronic obstructive pulmonary disease, renal disease, diabetes, sleep apnea, and anemia affect the clinical characteristics and ou ... Full text Link to item Cite

Cardiohepatic interactions in heart failure: an overview and clinical implications.

Journal Article J Am Coll Cardiol · June 18, 2013 Heart failure (HF) is a major public health problem leading to frequent hospitalizations, impaired quality of life, and shortened life expectancy. Heart failure leads to a chronic inability to meet metabolic requirements of end organs or skeletal muscle. C ... Full text Link to item Cite

Effects of serelaxin on blood pressure: results from the RELAX-AHF Trial

Journal Article EUROPEAN JOURNAL OF HEART FAILURE · May 1, 2013 Link to item Cite

Predictors of early dyspnoea relief in acute heart failure and the association with 30-day outcomes: findings from ASCEND-HF.

Journal Article Eur J Heart Fail · April 2013 AIMS: To examine the characteristics associated with early dyspnoea relief during acute heart failure (HF) hospitalization, and its association with 30-day outcomes. METHODS AND RESULTS: ASCEND-HF was a randomized trial of nesiritide vs. placebo in 7141 pa ... Full text Link to item Cite

Effect of phosphodiesterase-5 inhibition on exercise capacity and clinical status in heart failure with preserved ejection fraction: a randomized clinical trial.

Journal Article JAMA · March 27, 2013 IMPORTANCE: Studies in experimental and human heart failure suggest that phosphodiesterase-5 inhibitors may enhance cardiovascular function and thus exercise capacity in heart failure with preserved ejection fraction (HFPEF). OBJECTIVE: To determine the ef ... Full text Link to item Cite

C-REACTIVE PROTEIN IN ACUTE DECOMPENSATED HEART FAILURE: INSIGHTS FROM ASCEND-HF

Conference Journal of the American College of Cardiology · March 2013 Full text Cite

NT-PROBNP IN ACUTE DECOMPENSATED HEART FAILURE: FINDINGS FROM THE ASCEND-HF STUDY

Conference Journal of the American College of Cardiology · March 2013 Full text Cite

Association between adrenergic receptor genotypes and beta-blocker dose in heart failure patients: analysis from the HF-ACTION DNA substudy.

Journal Article Eur J Heart Fail · March 2013 AIMS: Beta-blockers reduce morbidity and mortality in chronic heart failure (HF) patients with reduced ejection fraction. However, there is heterogeneity in the response to these drugs, perhaps due to genetic variations in the β1-adrenergic receptor (ADRβ1 ... Full text Link to item Cite

Markers of decongestion, dyspnea relief, and clinical outcomes among patients hospitalized with acute heart failure.

Journal Article Circ Heart Fail · March 2013 BACKGROUND: Congestion is a primary driver of symptoms in patients with acute heart failure, and relief of congestion is a critical goal of therapy. Monitoring of response to therapy through the assessment of daily weights and net fluid loss is the current ... Full text Link to item Cite

Patient- and trial-specific barriers to participation in cardiovascular randomized clinical trials.

Journal Article J Am Coll Cardiol · February 19, 2013 OBJECTIVES: The purpose of this study was to quantitatively examine the association of patient- and trial-specific factors with participation in cardiovascular randomized clinical trials. BACKGROUND: Randomized clinical trials are central to evidenced-base ... Full text Link to item Cite

Approaches to decongestion in patients with acute decompensated heart failure.

Journal Article Curr Cardiol Rep · February 2013 Loop diuretics remain a mainstay in the pharmacologic treatment of acute decompensated heart failure (ADHF). Recent randomized trial results have challenged existing clinical dogma about the optimal manner of intravenous diuretic administration in hospital ... Full text Link to item Cite

Effect of serelaxin on cardiac, renal, and hepatic biomarkers in the Relaxin in Acute Heart Failure (RELAX-AHF) development program: correlation with outcomes.

Journal Article J Am Coll Cardiol · January 15, 2013 OBJECTIVES: The aim of this study was to assess the effects of serelaxin on short-term changes in markers of organ damage and congestion and relate them to 180-day mortality in patients with acute heart failure. BACKGROUND: Hospitalization for acute heart ... Full text Link to item Cite

Serelaxin, recombinant human relaxin-2, for treatment of acute heart failure (RELAX-AHF): a randomised, placebo-controlled trial.

Journal Article Lancet · January 5, 2013 Featured Publication BACKGROUND: Serelaxin, recombinant human relaxin-2, is a vasoactive peptide hormone with many biological and haemodynamic effects. In a pilot study, serelaxin was safe and well tolerated with positive clinical outcome signals in patients with acute heart f ... Full text Link to item Cite

Acute Decompensated Heart Failure

Journal Article · January 1, 2013 Full text Cite

Dysphagia in the setting of left ventricular assist device hemolysis.

Journal Article ASAIO J · 2013 A 69-year-old man with advanced heart failure treated with a continuous-flow left ventricular assist device presented for evaluation of dark urine and severe dysphagia. Because of evidence of ongoing intravascular hemolysis with device dysfunction, there w ... Full text Link to item Cite

Ultrafiltration in decompensated heart failure with cardiorenal syndrome.

Journal Article N Engl J Med · December 13, 2012 Featured Publication BACKGROUND: Ultrafiltration is an alternative strategy to diuretic therapy for the treatment of patients with acute decompensated heart failure. Little is known about the efficacy and safety of ultrafiltration in patients with acute decompensated heart fai ... Full text Link to item Cite

The RELAXin in Acute Heart Failure (RELAX-AHF) Trial

Conference CIRCULATION · December 4, 2012 Link to item Cite

Effect of admission oral diuretic dose on response to continuous versus bolus intravenous diuretics in acute heart failure: an analysis from diuretic optimization strategies in acute heart failure.

Journal Article Am Heart J · December 2012 BACKGROUND: Results from the DOSE-AHF study suggest that an initial continuous infusion of loop diuretics is not superior to bolus dosing with regard to clinical endpoints in acute heart failure. We hypothesized that outpatient furosemide dose was associat ... Full text Link to item Cite

Troponin I in acute decompensated heart failure: insights from the ASCEND-HF study.

Journal Article Eur J Heart Fail · November 2012 Featured Publication AIMS: We examined the prognostic importance of cardiac troponin I (cTnI) in a cohort of patients enrolled in the ASCEND-HF study of nesiritide in acute decompensated heart failure (ADHF). Circulating troponins are a prognostic marker in patients with ADHF. ... Full text Link to item Cite

Obesity and the response to intensified diuretic treatment in decompensated heart failure: a DOSE trial substudy.

Journal Article J Card Fail · November 2012 BACKGROUND: Obesity could attenuate diuretic effectiveness in treatment of acute decompensated heart failure (HF). METHODS AND RESULTS: The DOSE trial randomized 308 subjects with acute HF to low- versus high-intensification intravenous diuretic therapy. W ... Full text Link to item Cite

Reply

Journal Article Journal of the American College of Cardiology · October 23, 2012 Full text Cite

Management of the cardiorenal syndrome in acute heart failure.

Journal Article Curr Treat Options Cardiovasc Med · August 2012 Interactions between the heart and kidney in the setting of acute heart failure are complex and have a substantial impact on patient care and outcomes. Further research is needed to better distinguish the different causes of kidney injury, allow its early ... Full text Link to item Cite

Troponin T levels in patients with acute heart failure: clinical and prognostic significance of their detection and release during hospitalisation.

Journal Article Clin Res Cardiol · August 2012 AIMS: Myocardial injury during an episode of acute heart failure (AHF) may be important for patents' outcome. We hypothesised that an increase of cardiac troponin levels (cTnT) during hospitalisation, in patients with undetectable levels on admission (cTnT ... Full text Link to item Cite

Diuretics and ultrafiltration in acute decompensated heart failure.

Journal Article J Am Coll Cardiol · June 12, 2012 Congestion and volume overload are the hallmarks of acute decompensated heart failure (ADHF), and loop diuretics have historically been the cornerstone of treatment. The demonstrated efficacy of loop diuretics in managing congestion is balanced by the reco ... Full text Link to item Cite

Comparison of Clinical characteristics and long-term outcomes of patients with ischemic cardiomyopathy with versus without angina pectoris (from the Duke Databank for Cardiovascular Disease).

Journal Article Am J Cardiol · May 1, 2012 Myocardial ischemic origin is a significant independent predictor of mortality in patients with heart failure (HF). The implications of angina pectoris (AP) in HF are less well characterized. The aim of this study was to compare the clinical characteristic ... Full text Link to item Cite

186 Long Term Mechanical Circulatory Support: What Are the Final Options?

Conference The Journal of Heart and Lung Transplantation · April 2012 Full text Cite

Novel biomarkers in chronic heart failure.

Journal Article Nat Rev Cardiol · March 27, 2012 Understanding of chronic heart failure (HF) has progressed from a syndrome of disordered hemodynamics caused by alterations in the structure of the heart to one that involves intertwined molecular pathways in disarray. Accordingly, the assessment and treat ... Full text Link to item Cite

Loop diuretics in heart failure.

Journal Article Heart Fail Rev · March 2012 Congestion is a major component of the clinical syndrome of heart failure, and diuretic therapy remains the cornerstone of congestion management. Despite being widely used, there is very limited evidence from prospective randomized studies to guide the pre ... Full text Link to item Cite

Cardiorenal rescue study in acute decompensated heart failure: rationale and design of CARRESS-HF, for the Heart Failure Clinical Research Network.

Journal Article J Card Fail · March 2012 BACKGROUND: Worsening renal function is common among patients hospitalized for acute decompensated heart failure (ADHF). When this occurs, subsequent management decisions often pit the desire for effective decongestion against concerns about further worsen ... Full text Link to item Cite

Design of the RELAXin in acute heart failure study.

Journal Article Am Heart J · February 2012 BACKGROUND: Acute heart failure (AHF) remains a major public health burden with a high prevalence and poor prognosis. Relaxin is a naturally occurring peptide hormone that increases cardiac output, arterial compliance, and renal blood flow during pregnancy ... Full text Link to item Cite

Significance of hyponatremia in heart failure.

Journal Article Heart Fail Rev · January 2012 Heart failure is one of the most common, costly, disabling and growing diseases (McMurray and Pfeffer in Lancet 365(9474):1877-1889, 2005). Hyponatremia, conventionally defined as a serum-sodium concentration equal or less than 135 mmol/l (American Heart A ... Full text Link to item Cite

Galectin-3 in ambulatory patients with heart failure: results from the HF-ACTION study.

Journal Article Circ Heart Fail · January 2012 Featured Publication BACKGROUND: Galectin-3 is a soluble ß-galactoside-binding lectin released by activated cardiac macrophages. Elevated levels of galectin-3 have been found to be associated with adverse outcomes in patients with heart failure. We evaluated the association be ... Full text Link to item Cite

Hyponatremia and long-term outcomes in chronic heart failure--an observational study from the Duke Databank for Cardiovascular Diseases.

Journal Article J Card Fail · January 2012 BACKGROUND: Hyponatremia is a well known predictor of short-term outcomes in heart failure (HF); however, its impact on long-term survival in HF patients with systolic dysfunction is not well established. METHODS AND RESULTS: Using the Duke Databank for Ca ... Full text Link to item Cite

Reduction in body weight but worsening renal function with late ultrafiltration for treatment of acute decompensated heart failure.

Journal Article Cardiology · 2012 OBJECTIVES: The safety, effectiveness and indications for ultrafiltration (UF) are not well established. We hypothesized that UF would not worsen renal function in patients with heart failure (HF) who were not responding to medical therapy. METHODS: Data w ... Full text Link to item Cite

Link between decisions regarding resuscitation and preferences for quality over length of life with heart failure.

Journal Article Eur J Heart Fail · January 2012 AIMS: Survival preferences, ascertained from time-trade-off utilities, have not been studied in heart failure patients who designate a 'do not resuscitate' (DNR) status. Therefore, the aim of this study was to determine the association of heart failure pat ... Full text Link to item Cite

Troponin T levels in patients with acute heart failure: Clinical and prognostic significance of their detection and release during hospitalisation

Journal Article Clinical Research in Cardiology · 2012 Aims Myocardial injury during an episode of acute heart failure (AHF) may be important for patents' outcome. We hypothesised that an increase of cardiac troponin levels (cTnT) during hospitalisation, in patients with undetectable levels on admission (cTnT ... Full text Cite

Mechanisms of bleeding and approach to patients with axial-flow left ventricular assist devices.

Journal Article Circ Heart Fail · November 2011 Axial-flow LVADs have become an integral tool in the management of end-stage heart failure. Consequently, nonsurgical bleeding has emerged as a major source of morbidity and mortality in this fragile population. The mechanisms responsible for these adverse ... Full text Link to item Cite

Biomarkers as surrogate end points in heart failure trials.

Journal Article Heart Fail Clin · October 2011 Despite the continued growth of heart failure as a major public health problem, the development of new therapies for heart failure has slowed and recent studies have been neutral, suggesting the need for a reappraisal of the clinical research enterprise. S ... Full text Link to item Cite

Clinical impact of concomitant tricuspid valve procedures during left ventricular assist device implantation.

Journal Article Ann Thorac Surg · October 2011 BACKGROUND: Almost 50% of patients referred for implantable left ventricular assist device (LVAD) have significant tricuspid regurgitation (TR). Preoperative TR is associated with negative outcomes but the clinical benefit of concomitant tricuspid valve pr ... Full text Link to item Cite

Permutation criteria to evaluate multiple clinical endpoints in a proof-of-concept study: lessons from Pre-RELAX-AHF.

Journal Article Clin Res Cardiol · September 2011 BACKGROUND: Clinically relevant endpoints cannot be routinely targeted with reasonable power in a small study. Hence, proof-of-concept studies are often powered to a primary surrogate endpoint. However, in acute heart failure (AHF) effects on surrogates ha ... Full text Link to item Cite

Early drop in systolic blood pressure and worsening renal function in acute heart failure: renal results of Pre-RELAX-AHF.

Journal Article Eur J Heart Fail · September 2011 AIMS: We aimed to determine the relation between baseline systolic blood pressure (SBP), change in SBP, and worsening renal function (WRF) in acute heart failure (AHF) patients enrolled in the Pre-RELAX-AHF trial. METHODS AND RESULTS: The Pre-RELAX-AHF stu ... Full text Link to item Cite

Admission, discharge, or change in B-type natriuretic peptide and long-term outcomes: data from Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients with Heart Failure (OPTIMIZE-HF) linked to Medicare claims.

Journal Article Circ Heart Fail · September 2011 BACKGROUND: B-type natriuretic peptide (BNP) has been associated with short- and long-term postdischarge prognosis among hospitalized patients with heart failure. It is unknown if admission, discharge, or change from admission to discharge BNP measure is t ... Full text Link to item Cite

Effect of nesiritide in patients with acute decompensated heart failure.

Journal Article N Engl J Med · July 7, 2011 BACKGROUND: Nesiritide is approved in the United States for early relief of dyspnea in patients with acute heart failure. Previous meta-analyses have raised questions regarding renal toxicity and the mortality associated with this agent. METHODS: We random ... Full text Link to item Cite

Diuretic Strategies in Patients with Acute Heart Failure REPLY

Journal Article NEW ENGLAND JOURNAL OF MEDICINE · May 26, 2011 Link to item Cite

Patterns of leukocyte counts on admissions for acute heart failure--presentation and outcome--results from a community based registry.

Journal Article Int J Cardiol · April 1, 2011 OBJECTIVE: To determine the correlation between differential white blood cell (WBC) count and characteristics and outcome of acute heart failure (AHF) syndromes. BACKGROUND: Previous studies suggested that different white blood cell count patterns are rela ... Full text Link to item Cite

HYPONATREMIA AND LONG-TERM OUTCOMES IN HEART FAILURE

Conference Journal of the American College of Cardiology · April 2011 Full text Cite

42 The Importance of Low-Titer Anti-HLA Antibodies in Cardiac Transplantation

Conference The Journal of Heart and Lung Transplantation · April 2011 Full text Cite

Diuretic strategies in patients with acute decompensated heart failure.

Journal Article N Engl J Med · March 3, 2011 Featured Publication BACKGROUND: Loop diuretics are an essential component of therapy for patients with acute decompensated heart failure, but there are few prospective data to guide their use. METHODS: In a prospective, double-blind, randomized trial, we assigned 308 patients ... Full text Link to item Cite

Advanced heart failure.

Journal Article Prog Cardiovasc Dis · 2011 Full text Link to item Cite

Natriuretic Peptide-guided therapy for heart failure.

Journal Article Circ J · 2011 Chronic heart failure (HF) remains a major medical problem in the developed world, with rapidly rising prevalence, substantial morbidity, and high costs. The concept of titrating chronic HF therapies using physiologic markers, so called "biomarker guided t ... Full text Link to item Cite

Prospective evaluation of the association between cardiac troponin T and markers of disturbed erythropoiesis in patients with heart failure.

Journal Article Am Heart J · December 2010 BACKGROUND: Elevated cardiac troponin T is a well-documented marker of cardiomyocyte damage and poor prognosis in patients with heart failure. We prospectively evaluated the relationship between this marker and hematopoietic disturbances in heart failure. ... Full text Link to item Cite

United States stock market performance and acute myocardial infarction rates in 2008-2009 (from the Duke Databank for Cardiovascular Disease).

Journal Article Am J Cardiol · December 1, 2010 We sought to examine the relation between the United States economic decrease in 2008 and cardiovascular events as measured by local acute myocardial infarction (AMI) rates. Mental stress and traumatic events have been shown to be associated with increased ... Full text Link to item Cite

Acute Decompensated Heart Failure

Journal Article · December 1, 2010 Full text Cite

Acute heart failure: multiple clinical profiles and mechanisms require tailored therapy.

Journal Article Int J Cardiol · October 8, 2010 Acute heart failure (HF) is the most common diagnosis at discharge in patients aged >65years. It carries a dismal prognosis with a high in-hospital mortality and very high post-discharge mortality and re-hospitalization rates. It is a complex clinical synd ... Full text Link to item Cite

Coenzyme Q10 and statins in heart failure: the dog that didn't bark.

Journal Article J Am Coll Cardiol · October 5, 2010 Featured Publication Full text Link to item Cite

Dyspnoea and worsening heart failure in patients with acute heart failure: results from the Pre-RELAX-AHF study.

Journal Article Eur J Heart Fail · October 2010 Featured Publication AIMS: Although dyspnoea is the most common cause of admission for acute heart failure (AHF), more needs to be known about its clinical course and prognostic significance. METHODS AND RESULTS: The Pre-RELAX-AHF study randomized 232 subjects with AHF to plac ... Full text Link to item Cite

Troponin elevation in heart failure prevalence, mechanisms, and clinical implications.

Journal Article J Am Coll Cardiol · September 28, 2010 Featured Publication Circulating biomarkers have become increasingly important in diagnosing and risk stratifying patients with heart failure (HF). While the natriuretic peptides have received much focus, there is increasing interest in the role of circulating cardiac troponin ... Full text Link to item Cite

A global rank end point for clinical trials in acute heart failure.

Journal Article Circ Heart Fail · September 2010 Featured Publication Full text Link to item Cite

Multi-marker strategies in heart failure: clinical and statistical approaches.

Journal Article Heart Fail Rev · July 2010 Advances in genomics and proteomics promise to transform biomarker research, in which the major challenges will not be the discovery of new markers but rather the optimal selection and validation of a subgroup of clinically useful markers from the large po ... Full text Link to item Cite

Biomarker guided therapy for heart failure: focus on natriuretic peptides.

Journal Article Heart Fail Rev · July 2010 The management of heart failure remains challenging despite many therapeutic advances. Rigorous clinical trial evidence supports administration of multiple therapies, but utilization of evidence-based treatment remains inconsistent and suboptimal. Disease ... Full text Link to item Cite

Diuretic management in heart failure.

Journal Article Congest Heart Fail · July 2010 Many of the primary clinical manifestations of heart failure are due to fluid retention and congestion, and therefore treatments targeting congestion play a central role in heart failure management. Diuretic therapy remains the cornerstone of congestion tr ... Full text Link to item Cite

Validation and potential mechanisms of red cell distribution width as a prognostic marker in heart failure.

Journal Article J Card Fail · March 2010 BACKGROUND: Adverse outcomes have recently been linked to elevated red cell distribution width (RDW) in heart failure. Our study sought to validate the prognostic value of RDW in heart failure and to explore the potential mechanisms underlying this associa ... Full text Link to item Cite

Red blood cell distribution width and 1-year mortality in acute heart failure.

Journal Article Eur J Heart Fail · February 2010 Featured Publication AIMS: Red blood cell distribution width (RDW) predicts mortality in chronic heart failure (HF) and stable coronary artery disease. The prognostic value of RDW in more acute settings such as acute HF, and its relative prognostic value compared with more est ... Full text Link to item Cite

A secondary analysis of the CHOIR trial shows that comorbid conditions differentially affect outcomes during anemia treatment.

Journal Article Kidney Int · February 2010 Featured Publication The CHOIR trial in anemic patients with chronic kidney disease compared epoetin-alfa treatment with low (11.3 g/l) and high (13.5 g/l) hemoglobin targets on the composite end point of death, hospitalization for heart failure, stroke, and myocardial infarct ... Full text Link to item Cite

Low lymphocyte ratio as a novel prognostic factor in acute heart failure: results from the Pre-RELAX-AHF study.

Journal Article Cardiology · 2010 BACKGROUND: Previous studies have suggested that a lower lymphocyte ratio (Ly%) in the white blood cell (WBC) differential count is related to worse outcomes in patients with acute heart failure (AHF) and other cardiovascular disorders. METHODS: In the Pre ... Full text Link to item Cite

Clinical Trial Design in Heart Failure

Journal Article · January 1, 2010 Full text Cite

Prospective evaluation of the association between hemoglobin concentration and quality of life in patients with heart failure.

Journal Article Am Heart J · December 2009 Featured Publication BACKGROUND: Reduced hemoglobin has been associated with adverse outcomes in heart failure, but the relationship of hemoglobin to health-related quality of life in outpatients with this syndrome has not been well studied. METHODS: We used data from the pros ... Full text Link to item Cite

How to use diuretics in heart failure.

Journal Article Curr Treat Options Cardiovasc Med · December 2009 Systemic and pulmonary congestion is a central aspect of both acute and chronic heart failure and directly leads to many of the clinical manifestations of these syndromes. Therefore, diuretic therapy to treat congestion plays a fundamental role in heart fa ... Full text Link to item Cite

Vasodilators in the treatment of acute heart failure: what we know, what we don't.

Journal Article Heart Fail Rev · December 2009 Although we have recently witnessed substantial progress in management and outcome of patients with chronic heart failure, acute heart failure (AHF) management and outcome have not changed over almost a generation. Vasodilators are one of the cornerstones ... Full text Link to item Cite

Relaxin, a pleiotropic vasodilator for the treatment of heart failure.

Journal Article Heart Fail Rev · December 2009 Relaxin is a naturally occurring peptide hormone that plays a central role in the hemodynamic and renovascular adaptive changes that occur during pregnancy. Triggering similar changes could potentially be beneficial in the treatment of patients with heart ... Full text Link to item Cite

Relationship between anemia and health care costs in heart failure.

Journal Article J Card Fail · December 2009 Featured Publication BACKGROUND: Anemia is associated with higher morbidity and mortality in patients with heart failure (HF), but its implications for heath care costs are not well described. METHODS AND RESULTS: We analyzed data on 1056 patients with symptomatic HF seen at D ... Full text Link to item Cite

Impact of left ventricular assist device bridging on posttransplant outcomes.

Journal Article Ann Thorac Surg · November 2009 Featured Publication BACKGROUND: Bridge to heart transplantation with a left ventricular assist device (LVAD) can be a promising therapy for patients who are not effectively stabilized with conservative measures. However, referral for LVAD therapy may be limited secondary to r ... Full text Link to item Cite

N-terminal pro-brain natriuretic peptide and exercise capacity in chronic heart failure: data from the Heart Failure and a Controlled Trial Investigating Outcomes of Exercise Training (HF-ACTION) study.

Journal Article Am Heart J · October 2009 Featured Publication OBJECTIVES: To examine the relationship between N-terminal pro-brain natriuretic peptide (NT-proBNP) and exercise capacity in a large contemporary cohort of patients with chronic heart failure. BACKGROUND: Natriuretic peptides such as NT-proBNP are importa ... Full text Link to item Cite

Early worsening heart failure in patients admitted with acute heart failure--a new outcome measure associated with long-term prognosis?

Journal Article Fundam Clin Pharmacol · October 2009 A major limitation in acute heart failure (AHF) research has been the lack of an outcome measure paralleling re-infarction in acute coronary syndromes. The aim of the present study was to assess the time course, prognostic factors and outcome of early wors ... Full text Link to item Cite

Biomarker-guided therapy in chronic heart failure: a meta-analysis of randomized controlled trials.

Journal Article Am Heart J · September 2009 Featured Publication BACKGROUND: Measurement of circulating natriuretic peptides has been shown to play an important role in diagnosis and prognosis in patients with chronic heart failure. Whether serial natriuretic peptide measurements to aid in the titration of therapy can i ... Full text Link to item Cite

Early in-ospital worsening heart failure predicts adverse outcome in patients

Journal Article EUROPEAN HEART JOURNAL · September 1, 2009 Link to item Cite

Using genetic information to select treatment for patients with heart failure: has the time come?

Journal Article Per Med · July 2009 Personalized medicine is the concept of patient care becoming individualized based on distinctive characteristics. Pharmacogenetics is an application of personalized medicine, which may allow us to predict response to treatment based on an individual's gen ... Full text Link to item Cite

End points for clinical trials in acute heart failure syndromes.

Journal Article J Am Coll Cardiol · June 16, 2009 Featured Publication Acute heart failure syndromes (AHFS) remain a major cause of morbidity and mortality, in part because the development of new therapies for these disorders has been marked by frequent failure and little success. The heterogeneity of current approaches to AH ... Full text Link to item Cite

Prospective assessment of the occurrence of anemia in patients with heart failure: results from the Study of Anemia in a Heart Failure Population (STAMINA-HFP) Registry.

Journal Article Am Heart J · May 2009 Featured Publication BACKGROUND: Although a potentially important pathophysiologic factor in heart failure, the prevalence and predictors of anemia have not been well studied in unselected patients with heart failure. METHODS: The Study of Anemia in a Heart Failure Population ... Full text Link to item Cite

Relaxin for the treatment of patients with acute heart failure (Pre-RELAX-AHF): a multicentre, randomised, placebo-controlled, parallel-group, dose-finding phase IIb study.

Journal Article Lancet · April 25, 2009 Featured Publication BACKGROUND: Most patients admitted for acute heart failure have normal or increase blood pressure. Relaxin is a natural human peptide that affects multiple vascular control pathways, suggesting potential mechanisms of benefit for such patients. We assessed ... Full text Link to item Cite

Biomarker Guided Therapy in Chronic Heart Failure: A Meta-Analysis of Randomized Controlled Trials

Journal Article JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY · March 10, 2009 Link to item Cite

Relationship Between Anemia Status and Health Care Costs in Patients With Symptomatic Heart Failure

Journal Article JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY · March 10, 2009 Link to item Cite

Liver function abnormalities and outcome in patients with chronic heart failure: data from the Candesartan in Heart Failure: Assessment of Reduction in Mortality and Morbidity (CHARM) program.

Journal Article Eur J Heart Fail · February 2009 Featured Publication AIMS: The prevalence and importance of liver function test (LFT) abnormalities in a large contemporary cohort of heart failure patients have not been systematically evaluated. METHODS AND RESULTS: We characterized the LFTs of 2679 patients with symptomatic ... Full text Link to item Cite

Loop diuretics in acute decompensated heart failure: necessary? Evil? A necessary evil?

Journal Article Circ Heart Fail · January 2009 Featured Publication Acute decompensated heart failure (ADHF) is a common and highly morbid cardiovascular disorder. Most hospitalizations for ADHF are related to symptoms of congestion, and the vast majority of ADHF patients are treated with intravenous loop diuretics. Despit ... Full text Link to item Cite

Rapid clinical assessment of patients with acute heart failure: first blood pressure and oxygen saturation--is that all we need?

Journal Article Cardiology · 2009 UNLABELLED: The risk stratification of patients with acute heart failure (AHF) has been addressed repeatedly in recent years. Low oxygen saturation (SaO2) and systolic blood pressure (SBP) are signs of impending respiratory and circulatory failure that can ... Full text Link to item Cite

In reply

Journal Article JAMA · November 12, 2008 Full text Cite

Infectious complications in extended criteria heart transplantation.

Journal Article J Heart Lung Transplant · November 2008 BACKGROUND: We have previously shown that extended criteria heart transplant recipient mortality is higher than standard list mortality, but this is not associated with an increased incidence of either primary graft dysfunction or acute rejection. We hypot ... Full text Link to item Cite

Improvements in signs and symptoms during hospitalization for acute heart failure follow different patterns and depend on the measurement scales used: an international, prospective registry to evaluate the evolution of measures of disease severity in acute heart failure (MEASURE-AHF).

Journal Article J Card Fail · November 2008 BACKGROUND: The natural evolution of signs and symptoms during acute heart failure (AHF) is poorly characterized. METHODS AND RESULTS: We followed a prospective international cohort of 182 patients hospitalized with AHF. Patient-reported dyspnea and genera ... Full text Link to item Cite

Discordance between patient-predicted and model-predicted life expectancy among ambulatory patients with heart failure.

Journal Article JAMA · June 4, 2008 Featured Publication CONTEXT: Patients with chronic heart failure have impaired long-term survival, but their own expectations regarding prognosis have not been well studied. OBJECTIVES: To quantify expectations for survival in patients with heart failure, to compare patient e ... Full text Link to item Cite

A global ranking approach to end points in trials of mechanical circulatory support devices.

Journal Article J Card Fail · June 2008 BACKGROUND: Although previous studies of mechanical circulatory support devices (MCSDs) have used all-cause mortality as a primary end point, trends in device technology and implementation will increasingly necessitate the use of composite end points for M ... Full text Link to item Cite

Advances in the surgical treatment of heart failure.

Journal Article Curr Opin Cardiol · May 2008 PURPOSE OF REVIEW: Despite advancements in medical therapy, morbidity and mortality remain high. Surgical treatment of heart failure has been the subject of renewed focus, with a particular emphasis on applying the principles of evidence-based medicine to ... Full text Link to item Cite

Acute decompensated heart failure

Chapter · February 10, 2008 The Washington Manual of Critical Care is a concise pocket manual for physicians and nurses. ... Cite

Hyponatraemia in acute heart failure is a marker of increased mortality but not when associated with hyperglycaemia.

Journal Article Eur J Heart Fail · February 2008 UNLABELLED: Previous studies suggest that hyponatraemia is a marker of neurohormonal activation and increased mortality in patients with acute heart failure (AHF). Although diabetes is a common co-morbidity in heart failure, no prior study has considered t ... Full text Link to item Cite

Inotropes in the management of acute heart failure.

Journal Article Crit Care Med · January 2008 Impaired cardiac contractility is a fundamental component of the heart failure syndrome, initiating the cycle of vasoconstriction, neurohormonal and inflammatory activation, and adverse ventricular remodeling that leads to heart failure progression. Based ... Full text Link to item Cite

The pathophysiology of acute heart failure--is it all about fluid accumulation?

Journal Article Am Heart J · January 2008 Despite significant advancement in chronic heart failure (HF), no breakthroughs have occurred in the last 2 decades in our understanding of the pathophysiology, classification, and treatment of acute HF (AHF). Traditional thinking, which has been that this ... Full text Link to item Cite

Red cell distribution width as a novel prognostic marker in heart failure: data from the CHARM Program and the Duke Databank.

Journal Article J Am Coll Cardiol · July 3, 2007 OBJECTIVES: The goal of this study was to identify potentially novel laboratory markers of risk in chronic heart failure patients. BACKGROUND: Although a variety of prognostic markers have been described in heart failure, a systematic assessment of routine ... Full text Link to item Cite

Short-term clinical effects of tolvaptan, an oral vasopressin antagonist, in patients hospitalized for heart failure: the EVEREST Clinical Status Trials.

Journal Article JAMA · March 28, 2007 CONTEXT: Heart failure causes more than 1 million US hospitalizations yearly, mostly related to congestion. Tolvaptan, an oral, nonpeptide, selective vasopressin V2-receptor antagonist, shows promise in this condition. OBJECTIVE: To evaluate short-term eff ... Full text Link to item Cite

Acute heart failure associated with high admission blood pressure--a distinct vascular disorder?

Journal Article Eur J Heart Fail · February 2007 BACKGROUND: Although blood pressure (BP) is elevated in patients with acute heart failure (AHF), first admission BP has not been meticulously recorded before treatment in previous studies. METHODS: During three consecutive months, all AHF admissions (335 p ... Full text Link to item Cite

Racial differences in the characteristics of patients admitted for acute decompensated heart failure and their relation to outcomes: results from the OPTIME-CHF trial.

Journal Article J Card Fail · December 2006 BACKGROUND: Recent data suggest that differences in response to therapy and survival exist between African Americans and Caucasians with heart failure. Whether these differences exist in acute decompensated heart failure (ADHF) is uncertain. METHODS AND RE ... Full text Link to item Cite

Natriuretic peptides in the diagnosis and management of heart failure.

Journal Article CMAJ · September 12, 2006 The natriuretic peptides are a family of related hormones that play a crucial role in cardiovascular homeostasis. They have recently emerged as potentially important clinical markers in heart failure. Recent data have suggested an important role for these ... Full text Link to item Cite

Topical anesthesia with EMLA reduces pain during endomyocardial biopsy: a randomized trial.

Journal Article J Heart Lung Transplant · September 2006 Cardiac transplant recipients often anticipate and suffer varying degrees of discomfort during surveillance endomyocardial biopsy (EMBx). We performed a randomized, blinded, placebo-controlled trial to determine whether topical anesthetic was associated wi ... Full text Link to item Cite

Marginal cardiac allografts do not have increased primary graft dysfunction in alternate list transplantation.

Journal Article Circulation · July 4, 2006 BACKGROUND: Clinical success with modern heart transplantation (HT) has led to the development of an alternate list (AL) HT strategy, matching marginal cardiac allografts with recipients who do not meet standard criteria for HT. Marginal allografts may be ... Full text Link to item Cite

Same bridge, new destinations rethinking paradigms for mechanical cardiac support in heart failure.

Journal Article J Am Coll Cardiol · March 7, 2006 Mechanical cardiac support with ventricular assist devices is an established therapy for a variety of clinical scenarios, including postcardiotomy shock, "bridge to transplant," and "destination therapy." At present, device development, clinical trial desi ... Full text Link to item Cite

The Valsalva maneuver: a bedside "biomarker" for heart failure.

Journal Article Am J Med · February 2006 Accurate assessment of volume status remains an important clinical goal in the management of patients with heart failure. Although physical examination can provide clues to volume status, its sensitivity and reproducibility are limited. Other noninvasive m ... Full text Link to item Cite

Anemia in patients with heart failure and preserved systolic function.

Journal Article Am Heart J · February 2006 BACKGROUND: Anemia has been shown to be a predictor of mortality in patients with heart failure and impaired left ventricular systolic function (ISF). Although heart failure in the setting of preserved systolic function (PSF) is an important clinical probl ... Full text Link to item Cite

241

Conference The Journal of Heart and Lung Transplantation · February 2006 Full text Cite

Implantable left ventricular assist devices: new hope for patients with end-stage heart failure.

Journal Article N C Med J · 2006 INTRODUCTION: Recently, the Food and Drug Administration approved implantable left ventricular assist devices (LVAD) as destination therapy (DT) for end-stage heart failure patients who are ineligible for cardiac transplantation. OBJECTIVE AND STUDY DESIGN ... Link to item Cite

Inflammatory biomarkers in heart failure.

Journal Article Congest Heart Fail · 2006 Multiple lines of evidence support the "cytokine hypothesis," which suggests that inflammation plays an important role in the development and progression of heart failure. Circulating markers of inflammation, such as tumor necrosis factor alpha, interleuki ... Full text Link to item Cite

Anaemia and coronary artery disease severity in patients with heart failure.

Journal Article Eur J Heart Fail · January 2006 BACKGROUND: Anaemia is common in heart failure (HF) and associated with higher mortality. Exacerbation of myocardial ischemia in patients with heart failure, coronary disease, and anaemia patients has been suggested as a potential mechanism underlying this ... Full text Link to item Cite

Recurrence of cardiac sarcoidosis in a heart transplant recipient.

Journal Article J Heart Lung Transplant · November 2005 We present the case of a young man who received a left ventricular assist device (LVAD) as a bridge to transplantation for end-stage heart failure, in whom the diagnosis of sarcoid cardiomyopathy was made at the time of LVAD implantation. He subsequently u ... Full text Link to item Cite

Outcomes with an alternate list strategy for heart transplantation.

Journal Article J Heart Lung Transplant · November 2005 BACKGROUND: Heart transplantation (HT) is an effective therapy for end-stage heart failure, but its impact is limited by the scarcity of donor organs and stringent selection criteria for both donors and recipients. The creation of an alternate list to matc ... Full text Link to item Cite

Lower serum sodium is associated with increased short-term mortality in hospitalized patients with worsening heart failure: results from the Outcomes of a Prospective Trial of Intravenous Milrinone for Exacerbations of Chronic Heart Failure (OPTIME-CHF) study.

Journal Article Circulation · May 17, 2005 BACKGROUND: The prognostic value of serum sodium in patients hospitalized for worsening heart failure has not been well defined. METHODS AND RESULTS: The Outcomes of a Prospective Trial of Intravenous Milrinone for Exacerbations of Chronic Heart Failure (O ... Full text Link to item Cite

Rationale and design of the multicenter, randomized, double-blind, placebo-controlled study to evaluate the Efficacy of Vasopressin antagonism in Heart Failure: Outcome Study with Tolvaptan (EVEREST).

Journal Article J Card Fail · May 2005 BACKGROUND: Hospitalizations for worsening heart failure due to fluid overload (congestion) are common. Agents that treat congestion without causing electrolyte abnormalities or worsening renal function are needed. Tolvaptan is an oral vasopressin (V 2 ) a ... Full text Link to item Cite

The African-American heart failure trial: a new look at old drugs.

Journal Article Future Cardiol · May 2005 Evaluation of: Combination of isosorbide dinitrate and hydralazine in blacks with heart failure. Taylor AL, Zieche S, Yancy C et al.: N. Engl. J. Med. 351, 2049-2057 (2004). The African-American Heart Failure Trial (AHeFT) evaluated the efficacy of a fixed ... Full text Link to item Cite

Reply

Journal Article Journal of the American College of Cardiology · May 2005 Full text Cite

Mortality associated with use of hepatitis C positive donors in alternate list heart transplantation

Conference The Journal of Heart and Lung Transplantation · February 2005 Full text Cite

Acute heart failure: Nomenclature, pathophysiology, and outcome measures

Chapter · January 1, 2005 Acute heart failure (AHF) is the most common reason for hospital admission in patients over the age of 65, accounting for 1 000 000 admissions, over 6 000 000 hospital days, and $12 billion in costs.1, 2 The prognosis of patients admitted with AHF is disma ... Full text Cite

Anemia in acute and chronic heart failure

Chapter · January 1, 2005 Although anemia is common in heart failure, controversy remains about whether its high prevalence in heart failure patients is directly related to heart failure itself or other comorbid conditions. In general, anemia is common in patients with chronic medi ... Full text Cite

Inotropes and other new therapies for acute heart failure

Chapter · January 1, 2005 In this context, this chapter reviews the current understanding of the role of positive inotropic agents in the management of ADHF. Understanding the role of pharmacologic therapies for AHF requires an appreciation of the appropriate goals of therapy for t ... Full text Cite

Biologic markers in acute heart failure

Chapter · January 1, 2005 The major source of plasma BNP is the cardiac ventricles. This is unlike ANP, whose major storage sites include both the atria and ventricles.3 Unlike ANP, which is mainly released from its storage granules in response to atrial wall tension, BNP (as the n ... Full text Cite

Depressive symptoms in heart transplant recipients in an alternate list program

Journal Article The Journal of Heart and Lung Transplantation · 2005 Cite

Risk stratification after hospitalization for decompensated heart failure.

Journal Article J Card Fail · December 2004 BACKGROUND: Decompensated heart failure (HF) is among the most common indications for hospitalization in the United States, but little is known about features on admission that predict adverse events. We used data from the Outcomes of a Prospective Trial o ... Full text Link to item Cite

Using BNP levels in the assessment of dyspnea

Journal Article Journal of Respiratory Diseases · October 1, 2004 Cite

Anemia as a risk factor and therapeutic target in heart failure.

Journal Article J Am Coll Cardiol · September 1, 2004 Anemia has recently been recognized as an important comorbid condition and potentially novel therapeutic target in patients with heart failure (HF). Anemia is common in HF patients, with a prevalence ranging from 4% to 55% depending on the population studi ... Full text Link to item Cite

The impact of arrhythmias in acute heart failure.

Journal Article J Card Fail · August 2004 BACKGROUND: Arrhythmias are common in chronic heart failure and affect outcomes. The incidence and significance of new arrhythmias in acute heart failure, however, are largely unknown. METHODS AND RESULTS: The Outcomes of a Prospective Trial of Intravenous ... Full text Link to item Cite

Mortality in primary and secondary myocarditis.

Journal Article Am Heart J · April 2004 BACKGROUND: Lymphocytic myocarditis presents as a primary disorder or in association with a systemic disease. Whether primary and secondary myocarditis have the same prognosis is unknown. METHODS: Patients (n = 171) referred to the Johns Hopkins Cardiomyop ... Full text Link to item Cite

Effect of angiotensin-converting enzyme inhibitors, beta blockers, statins, and aspirin on C-reactive protein levels in outpatients with heart failure.

Journal Article Am J Cardiol · March 15, 2004 C-reactive protein (CRP) levels were measured in a cohort of 96 outpatients with heart failure. Baseline angiotensin-converting enzyme inhibitor plus beta-blocker use were associated with lower levels of CRP; no relation was found between CRP levels and as ... Full text Link to item Cite

Cardiac transplantation at Duke University Medical Center.

Journal Article Clin Transpl · 2004 Since beginning cardiac transplantation in 1985, Duke University Medical Center has performed 485 de novo heart transplants in adult recipients. Our program has broadened the access of patients to transplantation through the aggressive use of ventricular a ... Link to item Cite

Survival after coronary revascularization, with and without mitral valve surgery, in patients with ischemic mitral regurgitation.

Journal Article Circulation · September 9, 2003 BACKGROUND: The most appropriate treatment for patients with ischemic mitral regurgitation (IMR) is often debated. We compared the survival rates of patients with IMR undergoing different treatment strategies, namely: medical therapy, percutaneous coronary ... Full text Link to item Cite

Usefulness of anemia as a predictor of death and rehospitalization in patients with decompensated heart failure.

Journal Article Am J Cardiol · September 1, 2003 We investigated the prevalence of anemia and its relation to clinical events in patients with decompensated heart failure enrolled in the OPTIME-CHF study. Our data demonstrate that anemia is common in patients hospitalized with decompensated heart failure ... Full text Link to item Cite

Heart failure etiology and response to milrinone in decompensated heart failure: results from the OPTIME-CHF study.

Journal Article J Am Coll Cardiol · March 19, 2003 OBJECTIVES: The goal of this study was to assess the interaction between heart failure (HF) etiology and response to milrinone in decompensated HF. BACKGROUND: Etiology has prognostic and therapeutic implications in HF, but its relationship to response to ... Full text Link to item Cite

Relation of frequency and severity of mitral regurgitation to survival among patients with left ventricular systolic dysfunction and heart failure.

Journal Article Am J Cardiol · March 1, 2003 The goal of this study was to examine the frequency of mitral regurgitation (MR) in patients with left ventricular (LV) systolic dysfunction and to relate its presence and severity to long-term survival. Remodeling of the left ventricle after myocyte injur ... Full text Link to item Cite

The problem of decompensated heart failure: nomenclature, classification, and risk stratification.

Journal Article Am Heart J · February 2003 Despite its high prevalence and significant rates of associated morbidity and mortality, the syndrome of decompensated heart failure remains poorly defined and vastly understudied. Few high-quality epidemiologic studies, randomized controlled trials, or pu ... Full text Link to item Cite

Clinical outcomes in patients on beta-blocker therapy admitted with worsening chronic heart failure.

Journal Article Am J Cardiol · January 15, 2003 Beta blockers have been shown to reduce morbidity and mortality in patients with heart failure without evidence of overt congestion. No data are available describing outcomes of patients admitted with exacerbated chronic heart failure who are receiving bet ... Full text Link to item Cite

Reply

Journal Article Journal of the American College of Cardiology · July 2002 Full text Cite

Pulmonary hypertension and risk of death in cardiomyopathy: patients with myocarditis are at higher risk.

Journal Article Circulation · April 9, 2002 BACKGROUND: Pulmonary hypertension is a clinically useful predictor of death in patients with heart failure. Whether pulmonary hypertension has the same prognostic value among specific underlying causes of cardiomyopathy is unknown. Using a diverse cohort ... Full text Link to item Cite

A standardized definition of ischemic cardiomyopathy for use in clinical research.

Journal Article J Am Coll Cardiol · January 16, 2002 OBJECTIVES: We sought to evaluate the association between the extent of coronary artery disease (CAD) and survival in patients with symptomatic heart failure (HF) and to create the most prognostically powerful clinical definition of ischemic cardiomyopathy ... Full text Link to item Cite

Inotropic therapy for heart failure: an evidence-based approach.

Journal Article Am Heart J · September 2001 BACKGROUND: Agents that increase cardiac contractility (positive inotropes) have beneficial hemodynamic effects in patients with acute and chronic heart failure but have frequently led to increased mortality when given on a long-term basis. Despite this fa ... Full text Link to item Cite

Rational use of inotropic therapy in heart failure.

Journal Article Curr Cardiol Rep · March 2001 Despite their theoretic appeal, agents that increase cardiac contractility (positive inotropes) have consistently been shown to increase mortality when given chronically to patients with heart failure. The routine use of inotropes as heart failure therapy ... Full text Link to item Cite

Myocarditis and long-term survival in peripartum cardiomyopathy.

Journal Article Am Heart J · November 2000 BACKGROUND: The reported mortality rate of peripartum cardiomyopathy (PPCM) is high, although the potential for spontaneous recovery of ventricular function is well established. The prevalence of myocarditis in PPCM has varied widely between studies. The p ... Full text Link to item Cite

Echocardiographic findings in fulminant and acute myocarditis.

Journal Article J Am Coll Cardiol · July 2000 OBJECTIVES: We sought to use echocardiography to assess the presentation and potential for recovery of left ventricular (LV) function of patients with fulminant myocarditis compared with those with acute myocarditis. BACKGROUND: The clinical course of pati ... Full text Link to item Cite

Underlying causes and long-term survival in patients with initially unexplained cardiomyopathy.

Journal Article N Engl J Med · April 13, 2000 BACKGROUND: Previous studies of the prognosis of patients with heart failure due to cardiomyopathy categorized patients according to whether they had ischemic or nonischemic disease. The prognostic value of identifying more specific underlying causes of ca ... Full text Link to item Cite

Reply.

Other J Infect Dis · February 2000 Full text Link to item Cite

Life-cycle inventory of a modern municipal solid waste landfill

Journal Article Waste Management & Research: The Journal for a Sustainable Circular Economy · December 1999 The Environmental Research and Education Foundation (EREF), in conjunction with Ecobalance and researchers from the University of Wisconsin and North Carolina State, is nearing completion of a comprehensive 2-year project on the life-cycle invento ... Full text Cite

The spectrum of dilated cardiomyopathy. The Johns Hopkins experience with 1,278 patients.

Journal Article Medicine (Baltimore) · July 1999 This report describes the evaluation of 1,278 patients referred to The Johns Hopkins Hospital with dilated cardiomyopathy. After a careful history and physical examination, selected laboratory tests, and endomyocardial biopsy, a specific diagnosis was made ... Full text Link to item Cite

Treatment of subcutaneous and intracranial brain tumor xenografts with O6-benzylguanine and 1,3-bis(2-chloroethyl)-1-nitrosourea.

Journal Article Cancer Chemother Pharmacol · 1993 O6-Alkylguanine-DNA alkyltransferase (AT) is a cellular protein that protects cells from the cytotoxic effects of nitrosoureas by repairing alkyl lesions at the O6 position of guanine. We have studied the ability of O6-benzylguanine to deplete AT activity ... Full text Link to item Cite

Enhancement of nitrosourea activity in medulloblastoma and glioblastoma multiforme.

Journal Article J Natl Cancer Inst · December 16, 1992 BACKGROUND: Although chemotherapy offers promise of increased survival for children with medulloblastoma and glioblastoma multiforme, drug resistance occurs frequently, resulting in tumor progression and death. Resistance to nitrosoureas and methylating ag ... Full text Link to item Cite