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Ferreira MB, Kobayashi M, Costa RQ, Fonseca T, Brandão M, Oliveira JC, Marinho A, Cyrne Carvalho H, Rodrigues P, Zannad F, Rossignol P, Barros AS, Ferreira JP. Unsupervised clustering to differentiate rheumatoid arthritis patients based on proteomic signatures. Scand J Rheumatol 2023; 52:619-626. [PMID: 37083270 DOI: 10.1080/03009742.2023.2196781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Accepted: 03/27/2023] [Indexed: 04/22/2023]
Abstract
OBJECTIVE Patients with rheumatoid arthritis (RA) have different presentations and prognoses. Cluster analysis based on proteomic signatures creates independent phenogroups of patients with different pathophysiological backgrounds. We aimed to identify distinct pathophysiological clusters of RA patients based on circulating proteomic biomarkers. METHOD This was a cohort study including 399 RA patients. Clustering was performed on 94 circulating proteins (92 CVDII Olink®, high-sensitivity troponin T, and C-reactive protein). Unsupervised clustering was performed using a partitioning cluster algorithm. RESULTS The clustering algorithm identified two distinct clusters: cluster 1 (n = 223) and cluster 2 (n = 176). Compared with cluster 1, cluster 2 included older patients with a higher burden of comorbidities (cardiovascular and RA related), more erosive and longer RA duration, more dyspnoea and fatigue, walking a shorter distance in the Six-Minute Walk Test, with more severe diastolic dysfunction, and a 4.5-fold higher risk of death or hospitalization for cardiovascular reasons. Tumour necrosis factor (TNF) receptor superfamily-related pathways were mainly responsible for the model's discriminative ability. CONCLUSION Using unsupervised cluster analysis based on proteomic phenotypes, we identified two clusters of RA patients with distinct biomarkers profiles, clinical characteristics, and different outcomes that could reflect different pathophysiological backgrounds. TNF receptor superfamily-related proteins may be used to distinguish subgroups.
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Affiliation(s)
- M B Ferreira
- UMIB - Unidade Multidisciplinar de Investigação Biomédica, ICBAS - Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, Portugal
- Internal Medicine Department, Hospital da Luz Arrábida, Porto, Portugal
| | - M Kobayashi
- Université de Lorraine, INSERM, Centre d'Investigations Cliniques Plurithématique 1433, Inserm U1116, CHRU de Nancy and F-CRIN INI-CRCT, Nancy, France
| | - R Q Costa
- Internal Medicine Department, Centro Hospitalar de Entre o Douro e Vouga, Aveiro, Portugal
| | - T Fonseca
- Internal Medicine Department, Centro Hospitalar Universitário do Porto, Porto, Portugal
- Unidade de Imunologia Clínica, Centro Hospitalar Universitário do Porto, Porto, Portugal
| | - M Brandão
- Unidade de Imunologia Clínica, Centro Hospitalar Universitário do Porto, Porto, Portugal
| | - J C Oliveira
- Clinical Chemistry Service, Centro Hospitalar Universitário do Porto, Porto, Portugal
| | - A Marinho
- UMIB - Unidade Multidisciplinar de Investigação Biomédica, ICBAS - Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, Portugal
- Unidade de Imunologia Clínica, Centro Hospitalar Universitário do Porto, Porto, Portugal
| | - H Cyrne Carvalho
- UMIB - Unidade Multidisciplinar de Investigação Biomédica, ICBAS - Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, Portugal
- Cardiology Department, Centro Hospitalar Universitário do Porto, Porto, Portugal
| | - P Rodrigues
- Cardiology Department, Centro Hospitalar Universitário do Porto, Porto, Portugal
| | - F Zannad
- Université de Lorraine, INSERM, Centre d'Investigations Cliniques Plurithématique 1433, Inserm U1116, CHRU de Nancy and F-CRIN INI-CRCT, Nancy, France
| | - P Rossignol
- Université de Lorraine, INSERM, Centre d'Investigations Cliniques Plurithématique 1433, Inserm U1116, CHRU de Nancy and F-CRIN INI-CRCT, Nancy, France
| | - A S Barros
- UnIC@RISE, Department of Surgery and Physiology, Faculty of Medicine of the University of Porto, Porto, Portugal
- Heart Failure Clinic, Centro Hospitalar de Vila Nova de Gaia/Espinho, Portugal
| | - J P Ferreira
- Université de Lorraine, INSERM, Centre d'Investigations Cliniques Plurithématique 1433, Inserm U1116, CHRU de Nancy and F-CRIN INI-CRCT, Nancy, France
- UnIC@RISE, Department of Surgery and Physiology, Faculty of Medicine of the University of Porto, Porto, Portugal
- Heart Failure Clinic, Centro Hospitalar de Vila Nova de Gaia/Espinho, Portugal
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Holm H, Magnusson M, Jujić A, Pugliese NR, Bozec E, Lamiral Z, Huttin O, Zannad F, Rossignol P, Girerd N. Ventricular-arterial coupling (VAC) in a population-based cohort of middle-aged individuals: The STANISLAS cohort. Atherosclerosis 2023; 374:11-20. [PMID: 37159989 DOI: 10.1016/j.atherosclerosis.2023.04.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 04/15/2023] [Accepted: 04/21/2023] [Indexed: 05/11/2023]
Abstract
BACKGROUND AND AIMS Data exploring normal values of different ventricular-arterial coupling (VAC) parameters and their association with anthropometric and cardiovascular (CV) factors are scarce. We aim to report values of two different methods of VAC assessment according to age and sex and explore their association with CV factors within a large population-based cohort of middle-aged individuals. METHODS For 1333 (mean age 48 ± 14) individuals participating in the 4th visit of the STANISLAS cohort, VAC was assessed by two methods [1]: arterial elastance (Ea)/end-systolic elastance (Ees) and [2] Pulse wave velocity (PWV)/Global longitudinal strain (GLS). RESULTS The mean values of Ea/Ees and PWV/GLS were 1.06 ± 0.20 and 0.42 ± 0.12, respectively. The two methods of VAC assessment were poorly correlated (Pearson's correlation coefficient r = 0.14 (0.08; 0.19)). Increased PWV/GLS was associated with older age and a higher degree of cardiovascular risk factors (i.e., BMI, blood pressure, LDL, diabetes, hypertension) in the whole population as well as in the parent generation. In contrast, higher Ea/Ees were associated with decreasing age, and lower prevalence of risk factors in the whole cohort but neutrally associated with risk factors in the parent generation. CONCLUSIONS Higher PWV/GLS is significantly associated with CV factors regardless of age. In contrast, worse Ea/Ees is associated with a better CV risk profile when considering individuals aged 30 to 70 but neutrally associated with CV factors when considering only older patients. These results may suggest that PWV/GLS should preferably be used to explore VAC. In addition, age-individualized threshold of Ea/Ees should be used.
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Affiliation(s)
- H Holm
- Department of Clinical Sciences, Lund University, Malmö, Sweden; Department of Cardiology, Skåne University Hospital, Malmö, Sweden.
| | - M Magnusson
- Department of Clinical Sciences, Lund University, Malmö, Sweden; Department of Cardiology, Skåne University Hospital, Malmö, Sweden; Wallenberg Center for Molecular Medicine, Lund University, Lund, Sweden; Hypertension in Africa Research Team (HART), North-West University, Potchefstroom, South Africa
| | - A Jujić
- Department of Clinical Sciences, Lund University, Malmö, Sweden; Department of Cardiology, Skåne University Hospital, Malmö, Sweden
| | | | - E Bozec
- Université de Lorraine, Inserm, Centre d'Investigations Cliniques-1433, and Inserm, CHRU Nancy, F-CRIN INI-CRCT, Nancy, France
| | - Z Lamiral
- Université de Lorraine, Inserm, Centre d'Investigations Cliniques-1433, and Inserm, CHRU Nancy, F-CRIN INI-CRCT, Nancy, France
| | - O Huttin
- Université de Lorraine, Inserm, Centre d'Investigations Cliniques-1433, and Inserm, CHRU Nancy, F-CRIN INI-CRCT, Nancy, France
| | - F Zannad
- Université de Lorraine, Inserm, Centre d'Investigations Cliniques-1433, and Inserm, CHRU Nancy, F-CRIN INI-CRCT, Nancy, France
| | - P Rossignol
- Université de Lorraine, Inserm, Centre d'Investigations Cliniques-1433, and Inserm, CHRU Nancy, F-CRIN INI-CRCT, Nancy, France
| | - N Girerd
- Université de Lorraine, Inserm, Centre d'Investigations Cliniques-1433, and Inserm, CHRU Nancy, F-CRIN INI-CRCT, Nancy, France
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3
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Rossignol P, Duarte K, Bresso E, A Å, Devignes MD, Eriksson N, Girerd N, Glerup R, Jardine AG, Holdaas H, Lamiral Z, Leroy C, Massy Z, März W, Krämer B, Wu PH, Schmieder R, Soveri I, Christensen JH, Svensson M, Zannad F, Fellström B. NT-proBNP and stem cell factor plasma concentrations are independently associated with cardiovascular outcomes in end-stage renal disease hemodialysis patients. Eur Heart J Open 2022; 2:oeac069. [PMID: 36600882 PMCID: PMC9797490 DOI: 10.1093/ehjopen/oeac069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 09/14/2022] [Accepted: 10/24/2022] [Indexed: 11/11/2022]
Abstract
Aims End-stage renal disease (ESRD) treated by chronic hemodialysis (HD) is associated with poor cardiovascular (CV) outcomes, with no available evidence-based therapeutics. A multiplexed proteomic approach may identify new pathophysiological pathways associated with CV outcomes, potentially actionable for precision medicine. Methods and results The AURORA trial was an international, multicentre, randomized, double-blind trial involving 2776 patients undergoing maintenance HD. Rosuvastatin vs. placebo had no significant effect on the composite primary endpoint of death from CV causes, nonfatal myocardial infarction or nonfatal stroke. We first compared CV risk-matched cases and controls (n = 410) to identify novel biomarkers using a multiplex proximity extension immunoassay (276 proteomic biomarkers assessed with OlinkTM). We replicated our findings in 200 unmatched cases and 200 controls. External validation was conducted from a multicentre real-life Danish cohort [Aarhus-Aalborg (AA), n = 331 patients] in which 92 OlinkTM biomarkers were assessed. In AURORA, only N-terminal pro-brain natriuretic peptide (NT-proBNP, positive association) and stem cell factor (SCF) (negative association) were found consistently associated with the trial's primary outcome across exploration and replication phases, independently from the baseline characteristics. Stem cell factor displayed a lower added predictive ability compared with NT-ProBNP. In the AA cohort, in multivariable analyses, BNP was found significantly associated with major CV events, while higher SCF was associated with less frequent CV deaths. Conclusions Our findings suggest that NT-proBNP and SCF may help identify ESRD patients with respectively high and low CV risk, beyond classical clinical predictors and also point at novel pathways for prevention and treatment.
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Affiliation(s)
- P Rossignol
- Corresponding author. Tel: +33383157322, Fax: +33383157324,
| | - K Duarte
- Université de Lorraine, Inserm, Centre d’Investigations Cliniques- 1433, and Inserm U1116, CHRU Nancy, F-CRIN INI-CRCT, 4, rue du Morvan, 54500 Nancy, France
| | - E Bresso
- Université de Lorraine, Inserm, Centre d’Investigations Cliniques- 1433, and Inserm U1116, CHRU Nancy, F-CRIN INI-CRCT, 4, rue du Morvan, 54500 Nancy, France,LORIA (CNRS, Inria NGE, Université de Lorraine), F-CRIN INI-CRCT, Vandœuvre-lès-Nancy, France
| | - Åsberg A
- Department of Transplantation Medicine Oslo University Hospital–Rikshospitalet, Oslo, Norway,Norway and Department of Pharmaceutical Biosciences, School of Pharmacy, University of Oslo, Oslo, Norway
| | - M D Devignes
- LORIA (CNRS, Inria NGE, Université de Lorraine), F-CRIN INI-CRCT, Vandœuvre-lès-Nancy, France
| | - N Eriksson
- UCR Uppsala Clinical Research Center, Uppsala Science Park, Uppsala, Sweden
| | - N Girerd
- Université de Lorraine, Inserm, Centre d’Investigations Cliniques- 1433, and Inserm U1116, CHRU Nancy, F-CRIN INI-CRCT, 4, rue du Morvan, 54500 Nancy, France
| | - R Glerup
- Department of Nephrology, Aalborg University Hospital, Aalborg, Denmark
| | - A G Jardine
- Renal Research Group, British Heart Foundation Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | | | - Z Lamiral
- Université de Lorraine, Inserm, Centre d’Investigations Cliniques- 1433, and Inserm U1116, CHRU Nancy, F-CRIN INI-CRCT, 4, rue du Morvan, 54500 Nancy, France
| | - C Leroy
- Université de Lorraine, Inserm, Centre d’Investigations Cliniques- 1433, and Inserm U1116, CHRU Nancy, F-CRIN INI-CRCT, 4, rue du Morvan, 54500 Nancy, France
| | - Z Massy
- CESP, Center for Research in Epidemiology and Population Health, University Paris-Saclay, University Paris-Sud, UVSQ, Villejuif, France,Division of Nephrology, Ambroise Paré University Hospital, APHP, Boulogne, Billancourt and FCRIN INI-CRCT, Paris, France
| | - W März
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria,Mannheim Institute of Public Health, Social and Preventive Medicine, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany,SYNLAB Academy, SYNLAB Holding Deutschland GmbH, Mannheim and Augsburg, Germany
| | - B Krämer
- Medical Clinic V, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - P H Wu
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden,Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - R Schmieder
- Department of Nephrology and Hypertension, University Hospital Erlangen, Erlangen, Germany
| | - I Soveri
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - J H Christensen
- Department of Nephrology, Aalborg University Hospital, Aalborg, Denmark
| | - M Svensson
- Department of Nephrology, Aarhus University Hospital, Aarhus, Denmark
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Boehm M, Anker SD, Mahfoud F, Filippatos G, Ferreira JP, Pocock SJ, Brueckmann M, Linetzky B, Schueler E, Wanner C, Zannad F, Packer M, Butler J. Association of heart rate with heart failure outcomes and the effects of empagliflozin in patients with preserved ejection fraction – EMPEROR-Preserved trial. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background and objective
High resting heart rate (HR) associates with cardiovascular death (CVD) and heart failure hospitalisation (HFH) in patients with reduced ejection fraction (HFrEF), but data are sparse in patients with preserved (HFpEF) or mildly reduced (HFmrEF) ejection fraction. Empagliflozin reduced the risk of CVD and HFH in HFpEF in the EMPEROR-Preserved trial. This study analyses the influence of HR on outcomes in patients with left ventricular ejection fraction (LVEF) >40% in EMPEROR-Preserved and evaluates the effects of empagliflozin across HR categories.
Methods
Patients (n=5988) with HFpEF (LVEF >40%) were categorised to HR <70 beats per minute (bpm), 70–75 bpm and >75 bpm. The composite of CVD or HFH (primary outcome), first HFH, CVD, recurrent HFH and all-cause mortality were studied in the HR groups and in patients separated by sinus rhythm (SR) or atrial fibrillation (AF) and true HFpEF (EF ≥50%) or HFmrEF (EF 40–49%).
Results
Empagliflozin did not influence HR over time. At HR >75 bpm, the primary outcome (hazard ratio: 1.31, 1.13–1.52, p=0.0003), time to first HFH (hazard ratio: 1.25, 1.04–1.49, p=0.02), recurrent HFH (hazard ratio: 1.29, 1.05–1.60, p=0.02), CVD (hazard ratio: 1.49, 1.21–1.84, p=0.0001) and all-cause mortality (hazard ratio: 1.49, 1.28–1.73, p<0.0001) were increased compared to HR of <70 bpm with HR 70–75 bpm showing intermediate results. The influence of HR on the primary outcome was only observed in SR (p trend=0.005), but not in AF (p trend=0.55). Patients with true HFpEF (≥50%) or HFmrEF (40–49%) showed similar effects. The treatment effects of empagliflozin to reduce the primary outcome, time to first HFH and recurrent HFH were not modified by HR.
Conclusions
HR in SR, but not in AF, predicts heart failure outcomes in HFpEF and HFmrEF, but the effects of empagliflozin were not modified by HR.
Funding Acknowledgement
Type of funding sources: Private company. Main funding source(s): Boehringer Ingelheim & Eli Lilly and Company Diabetes Alliance
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Affiliation(s)
- M Boehm
- University Hospital of Saarland, Clinic for Internal Medicine III, Cardiology, Angiology and Intensive Care Medicine , Homburg/Saar , Germany
| | - S D Anker
- Department of Cardiology (CVK); Charité Universitätsmedizin Berlin , Berlin , Germany
| | - F Mahfoud
- University Hospital of Saarland, Clinic for Internal Medicine III, Cardiology, Angiology and Intensive Care Medicine , Homburg/Saar , Germany
| | - G Filippatos
- National & Kapodistrian University of Athens School of Medicine, Athens University Hospital Attikon , Athens , Greece
| | | | - S J Pocock
- London School of Hygiene and Tropical Medicine , London , United Kingdom
| | - M Brueckmann
- Boehringer Ingelheim International GmbH , Ingelheim , Germany
| | - B Linetzky
- Eli Lilly Interamerica Inc. , Buenos Aires , Argentina
| | | | - C Wanner
- Wuerzburg University Clinic , Wuerzburg , Germany
| | - F Zannad
- Université de Lorraine , Nancy , France
| | - M Packer
- Baylor University Medical Center , Dallas , United States of America
| | - J Butler
- Baylor Scott & White Health , Dallas , United States of America
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5
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Silbernagel G, Duarte K, Sadiku S, Fauler G, Maerz W, Schmieder R, Jardine A, Massy Z, Girerd N, Fellström B, Scharnagl H, Zannad F. High cholesterol absorption is associated with increased cardiovascular risk in hemodialysis patients: Insights from the AURORA study. Atherosclerosis 2022. [DOI: 10.1016/j.atherosclerosis.2022.06.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
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Mandry D, Girerd N, Lamiral Z, Huttin O, Filippetti L, Micard E, Beaumont M, Ncho Mottoh MPB, Pace N, Zannad F, Rossignol P, Marie PY. Relationship Between Left Ventricular Ejection Fraction Variation and Systemic Vascular Resistance: A Prospective Cardiovascular Magnetic Resonance Study. Front Cardiovasc Med 2022; 8:803567. [PMID: 35004914 PMCID: PMC8739894 DOI: 10.3389/fcvm.2021.803567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Accepted: 12/07/2021] [Indexed: 11/13/2022] Open
Abstract
Introduction: This cardiovascular magnetic resonance (CMR) study aims to determine whether changes in systemic vascular resistance (SVR), obtained from CMR flow sequences, might explain the significant long-term changes in left ventricular (LV) ejection fraction (EF) observed in subjects with no cardiac disease history. Methods: Cohort subjects without any known cardiac disease but with high rates of hypertension and obesity, underwent CMR with phase-contrast sequences both at baseline and at a median follow-up of 5.2 years. Longitudinal changes in EF were analyzed for any concomitant changes in blood pressure and vascular function, notably the indexed SVR given by the formula: mean brachial blood pressure / cardiac output x body surface area. Results: A total of 118 subjects (53 ± 12 years, 52% women) were included, 26% had hypertension, and 52% were obese. Eighteen (15%) had significant EF variations between baseline and follow-up (7 increased EF and 11 decreased EF). Longitudinal changes in EF were inversely related to concomitant changes in mean and diastolic blood pressures (p = 0.030 and p = 0.027, respectively) and much more significantly to SVR (p < 0.001). On average, these SVR changes were -8.08 ± 9.21 and +8.14 ± 8.28 mmHg.min.m2.L-1, respectively, in subjects with significant increases and decreases in EF, and 3.32 ± 7.53 mmHg.min.m2.L-1 in subjects with a stable EF (overall p < 0.001). Conclusions: Significant EF variations are not uncommon during the long-term CMR follow-up of populations with no evident health issues except for uncomplicated hypertension and obesity. However, most of these variations are linked to SVR changes and may therefore be unrelated to any intrinsic change in LV contractility. This underscores the benefits of specifically assessing LV afterload when EF is monitored in populations at risk of vascular dysfunction. Clinical Trial Registration: ClinicalTrials.gov, identifier: NCT01716819 and NCT02430805.
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Affiliation(s)
- Damien Mandry
- CHRU-Nancy, Université de Lorraine, Department of Radiology, Nancy, France.,Université de Lorraine, INSERM, UMR-1254, Nancy, France
| | - Nicolas Girerd
- Université de Lorraine, INSERM, UMR-1116, Nancy, France.,CHRU-Nancy, Université de Lorraine, Department of Cardiology, Nancy, France.,Université de Lorraine, CHRU-Nancy, INSERM, CIC 1433, Nancy, France
| | - Zohra Lamiral
- Université de Lorraine, CHRU-Nancy, INSERM, CIC 1433, Nancy, France
| | - Olivier Huttin
- Université de Lorraine, INSERM, UMR-1116, Nancy, France.,CHRU-Nancy, Université de Lorraine, Department of Cardiology, Nancy, France
| | - Laura Filippetti
- CHRU-Nancy, Université de Lorraine, Department of Cardiology, Nancy, France
| | - Emilien Micard
- Université de Lorraine, CHRU-Nancy, INSERM, CIC 1433, Nancy, France
| | - Marine Beaumont
- Université de Lorraine, INSERM, UMR-1254, Nancy, France.,Université de Lorraine, CHRU-Nancy, INSERM, CIC 1433, Nancy, France
| | | | - Nathalie Pace
- CHRU-Nancy, Université de Lorraine, Department of Cardiology, Nancy, France
| | - Faïez Zannad
- Université de Lorraine, INSERM, UMR-1116, Nancy, France.,CHRU-Nancy, Université de Lorraine, Department of Cardiology, Nancy, France.,Université de Lorraine, CHRU-Nancy, INSERM, CIC 1433, Nancy, France
| | - Patrick Rossignol
- Université de Lorraine, INSERM, UMR-1116, Nancy, France.,Université de Lorraine, CHRU-Nancy, INSERM, CIC 1433, Nancy, France.,FCRIN INI-CRCT, Nancy, France
| | - Pierre-Yves Marie
- Université de Lorraine, INSERM, UMR-1116, Nancy, France.,CHRU-Nancy, Université de Lorraine, Department of Nuclear Medicine and Nancyclotep, Nancy, France
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Mandry D, Girerd N, Lamiral Z, Huttin O, Filippetti L, Micard E, Ncho Mottoh MPB, Böhme P, Chemla D, Zannad F, Rossignol P, Marie PY. Arterial and Cardiac Remodeling Associated With Extra Weight Gain in an Isolated Abdominal Obesity Cohort. Front Cardiovasc Med 2021; 8:771022. [PMID: 34805324 PMCID: PMC8602697 DOI: 10.3389/fcvm.2021.771022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2021] [Accepted: 10/18/2021] [Indexed: 12/16/2022] Open
Abstract
Introduction: This study aims to assess the changes in cardiovascular remodeling attributable to bodyweight gain in a middle-aged abdominal obesity cohort. A remodeling worsening might explain the increase in cardiovascular risk associated with a dynamic of weight gain. Methods: Seventy-five middle-aged subjects (56 ± 5 years, 38 women) with abdominal obesity and no known cardiovascular disease underwent MRI-based examinations at baseline and at a 6.1 ± 1.2-year follow-up to monitor cardiovascular remodeling and hemodynamic variables, most notably the effective arterial elastance (Ea). Ea is a proxy of the arterial load that must be overcome during left ventricular (LV) ejection, with increased EA resulting in concentric LV remodeling. Results: Sixteen obese subjects had significant weight gain (>7%) during follow-up (WG+), whereas the 59 other individuals did not (WG-). WG+ and WG- exhibited significant differences in the baseline to follow-up evolutions of several hemodynamic parameters, notably diastolic and mean blood pressures (for mean blood pressure, WG+: +9.3 ± 10.9 mmHg vs. WG-: +1.7 ± 11.8 mmHg, p = 0.022), heart rate (WG+: +0.6 ± 9.4 min-1 vs. -8.9 ± 11.5 min-1, p = 0.003), LV concentric remodeling index (WG: +0.08 ± 0.16 g.mL-1 vs. WG-: -0.02 ± 0.13 g.mL-1, p = 0.018) and Ea (WG+: +0.20 ± 0.28 mL mmHg-1 vs. WG-: +0.01 ± 0.30 mL mmHg-1, p = 0.021). The evolution of the LV concentric remodeling index and Ea were also strongly correlated in the overall obese population (p < 0.001, R2 = 0.31). Conclusions: A weight gain dynamic is accompanied by increases in arterial load and load-related concentric LV remodeling in an isolated abdominal obesity cohort. This remodeling could have a significant impact on cardiovascular risk.
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Affiliation(s)
- Damien Mandry
- Department of Radiology, CHRU-Nancy, Université de Lorraine, Nancy, France.,INSERM, UMR-1254, Université de Lorraine, Nancy, France
| | - Nicolas Girerd
- INSERM, UMR-1116, Université de Lorraine, Nancy, France.,Department of Cardiology, CHRU-Nancy, Université de Lorraine, Nancy, France.,CHRU-Nancy, INSERM, CIC 1433, Université de Lorraine, Nancy, France
| | - Zohra Lamiral
- CHRU-Nancy, INSERM, CIC 1433, Université de Lorraine, Nancy, France
| | - Olivier Huttin
- INSERM, UMR-1116, Université de Lorraine, Nancy, France.,Department of Cardiology, CHRU-Nancy, Université de Lorraine, Nancy, France
| | - Laura Filippetti
- Department of Cardiology, CHRU-Nancy, Université de Lorraine, Nancy, France
| | - Emilien Micard
- CHRU-Nancy, INSERM, CIC 1433, Université de Lorraine, Nancy, France
| | | | - Philip Böhme
- Department of Endocrinology, Diabetology, Nutrition, CHRU-Nancy, Nancy, France
| | - Denis Chemla
- Explorations Fonctionnelles, Hôpital Kremlin Bicêtre, APHP, Paris, France.,INSERM, UMR- 999, Hôpital Marie-Lannelongue, Le Plessis-Robinson, France
| | - Faïez Zannad
- INSERM, UMR-1116, Université de Lorraine, Nancy, France.,Department of Cardiology, CHRU-Nancy, Université de Lorraine, Nancy, France.,CHRU-Nancy, INSERM, CIC 1433, Université de Lorraine, Nancy, France
| | - Patrick Rossignol
- INSERM, UMR-1116, Université de Lorraine, Nancy, France.,CHRU-Nancy, INSERM, CIC 1433, Université de Lorraine, Nancy, France.,FCRIN INI-CRCT, Nancy, France
| | - Pierre-Yves Marie
- INSERM, UMR-1116, Université de Lorraine, Nancy, France.,CHRU-Nancy, Université de Lorraine, Nuclear Medicine & Nancyclotep Platform, Nancy, France
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8
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Wei S, Le N, Zhu JW, Breathett K, Greene SJ, Mamas MA, Zannad F, Van Spall HGC. Trial leadership by women is associated with racial diversity among heart failure clinical trial participants: a systematic bibliometric review 2000–2020. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.3175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
For the results of randomized controlled trials (RCTs) to be generalizable, they should report on and include the broad range of patients who have the disease.
Purpose
We assessed temporal trends and trial factors associated with 1) the reporting of race or ethnicity data and 2) the enrolment of Black, Indigenous, and people of colour (BIPOC) in Heart Failure (HF) RCTs.
Methods
We searched MEDLINE, EMBASE, and CINAHL for RCTs that recruited adults with HF and were published in journals with an impact factor ≥10 between January 1, 2000 and June 17, 2020. We extracted data in duplicate and used the Cochran-Armitage and Jonchkeere-Terpstra tests to examine temporal trends. We used multivariable regression to assess the independent association between trial factors and the outcomes of interest.
Results
A total of 414 RCTs met inclusion criteria, of which a vast majority (90.6%; 95% CI 87.4–93.2%) were coordinated in either Europe or North America. Only 157 of the 414 RCTs (37.9%; 95% CI 33.2–42.8%) reported race/ethnicity data; among the 158,200 participants in these trials, only 29,512 (18.7%; 95% CI 18.5–18.9%) were BIPOC. There was a significant increase in the reporting of race or ethnicity data (from 26.9% in 2000–2001 to 54.2% in 2019–2020, p<0.001) and in enrollment of BIPOC (from 16.5% in 2000–2001 to 23.9% in 2019–2020, p=0.038) between 2000–2020. Trial leadership by a woman was associated with twice the adjusted odds of reporting of race or ethnicity data (OR 2.0; 95% CI 1.1–3.8; p=0.028) and an 8.4% (95% CI 1.9–15.0%; p=0.012) adjusted increase in enrollment of BIPOC. The race/ethnicity of trial leaders was not available for analysis.
Conclusions
Among HF RCTs published between 2000–2020, <38% reported data on race or ethnicity, although this increased over time. Among trials reporting such data, <19% of participants were BIPOC, with modest increases in enrollment over time. Trials led by women had greater adjusted odds of reporting race/ethnicity data and enrollment of BIPOC.
Funding Acknowledgement
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): CIHR
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Affiliation(s)
- S Wei
- McMaster University, Department of Medicine, Hamilton, Canada
| | - N Le
- McMaster University, Department of Medicine, Hamilton, Canada
| | - J W Zhu
- McMaster University, Department of Medicine, Hamilton, Canada
| | - K Breathett
- University of Arizona, Division of Cardiovascular Medicine, Tucson, United States of America
| | - S J Greene
- Duke University Medical Center, Division of Cardiology, Durham, United States of America
| | - M A Mamas
- Keele University, Cardiovascular Research Group, Stoke-on-Trent, United Kingdom
| | - F Zannad
- University of Lorraine, Centre d'Investigations Cliniques, Nancy, France
| | - H G C Van Spall
- McMaster University, Department of Medicine, Hamilton, Canada
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9
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Zhu J, Le N, Wei S, Zuhlke L, Lopes R, Zannad F, Van Spall HGC. Global representation of heart failure clinical trial leaders and collaborators: a systematic bibliometric review 2000–2020. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.3174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Aims
Heart Failure (HF) has a disproportionate burden in low- and middle-income countries. The geographic representation of those who lead HF randomized clinical trials (RCTs) may not reflect the geographic burden of disease. We assessed temporal trends and trial characteristics associated with leadership outside Europe and North America, and explored whether there was a geographic association between trial leadership and participant enrolment.
Methods and results
We searched MEDLINE, EMBASE, and CINAHL for HF RCTs published in journals with an impact factor ≥10 between January 1, 2000, and June 17, 2020. We used the Jonckheere-Terpstra test to assess temporal trends and multivariable logistic regression models to determine associations between predictor and outcome variables.
There were 414 eligible RCTs. Only 80 of 828 trial leaders (9.7%; 95% CI: 7.8% to 11.8%), and 453 of 4656 collaborators (9.7%; 95% CI: 8.8% to 10.6%) were from regions outside Europe and North America, with no temporal change in geographic representation. The odds of trial leadership outside Europe and North America were significantly lower with industry versus public funding (OR: 0.33; 95% CI: 0.15 to 0.75; P=0.008). Trial leadership outside Europe and North America was associated with enrolment of patients outside Europe and North America (OR: 10.0; 95% CI 5.6–19.0; P<0.001).
Conclusion
Trial leadership outside Europe and North America is rare, particularly in industry funded trials, and is associated with participant enrolment in regions with disproportionate disease burden. Building research capacity and networks in under-represented regions could increase generalizability of trial results.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- J Zhu
- McMaster University, Medicine, Hamilton, Canada
| | - N Le
- McMaster University, Medicine, Hamilton, Canada
| | - S Wei
- McMaster University, Medicine, Hamilton, Canada
| | - L Zuhlke
- Groote Schuur Hospital, Cape Town, South Africa
| | - R Lopes
- Duke University Medical Center, Durham, United States of America
| | - F Zannad
- University of Lorraine, Nancy, France
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10
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Sharma A, Inzucchi S, Testani J, Ofstad A, Fitchett D, Mattheus M, Verma S, Zannad F, Wanner C, Kraus B. ASSOCIATION OF KIDNEY AND CARDIOVASCULAR OUTCOMES IN PATIENTS WITH TYPE 2 DIABETES MELLITUS: INSIGHTS FROM THE EMPA-REG OUTCOME TRIAL. Can J Cardiol 2021. [DOI: 10.1016/j.cjca.2021.07.130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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11
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Alessi S, Merkling T, Girerd N, Boivin JM, Chau K, Lopez-Sublet M, Laville M, Zannad F, Rossignol P, Wagner S. Étude de trajectoires d’indice de masse corporelle et de tour de taille sur 18 ans et leur impact sur les marqueurs de la fonction et atteinte rénale dans la cohorte STANISLAS. Rev Epidemiol Sante Publique 2021. [DOI: 10.1016/j.respe.2020.11.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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12
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Hamilton A, Sharma A, Inzucchi S, Testani J, Ofstad A, Fitchett D, Mattheus M, Verma S, Zannad F, Wanner C, Kraus B. Association of Kidney and Cardiovascular Outcomes in Patients With Type 2 Diabetes Mellitus: Insights From the EMPA-REG OUTCOME Trial. Heart Lung Circ 2021. [DOI: 10.1016/j.hlc.2021.06.259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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13
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Hall T, Orn S, Zannad F, Rossignol P, Duarte K, Solomon S, Atar D, Agewall S, Dickstein K, Girerd N. The association of smoking to cardiovascular death differs according to age and sex following myocardial infarction complicated by heart failure or left ventricular dysfunction. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Smoking is associated with higher morbidity and mortality following myocardial infarction (MI), but reports of the impact on cardiovascular (CV) death in aged and female patients experiencing MI complicated with left ventricular dysfunction or overt heart failure are limited.
Methods
In an individual patient data meta-analysis of high-risk MI patients, the association of smoking to CV death was investigated. Cox proportional hazard models exploring smoking status and risk according to age and sex were performed to study the relationship of smoking to independently adjudicated CV death endpoints.
Results
28,771 patients from the CAPRICORN, EPHESUS, OPTIMAAL and VALIANT trials were assessed. 18,325 (64%) reported smoking (9185 (32%) current and 9051 (32%) past), 2662 (9%) were above ≥80 years and 8607 (30%) were women. Overall, using non-smokers as referent, the association of smoking to CV mortality was neutral (HR=1.07, 0.98 to 1.16, p=0.12 for active smoking and HR=1.10, 1.02 to 1.18, p=0.01 for past smoking). The associations for active and past smokers with outcome, adjusted for age and sex in the overall study sample and according to different age and sex categories, are presented in figure 1. In analyses that included interaction terms, the association for active smokers depended on age and sex; the risk of CV mortality was weakened in women (interaction HR=0.81, 0.69 to 0.96, p=0.01) and older age (interaction HR per 10 years increase=0.88, 0,82 to 0.95, p=0.001). In contrast, the association to CV death for past smokers was not modified by sex or age (p=0.86 and p=0.17 respectively).
Conclusions
The association of smoking to CV death differed according to age and sex in MI complicated with left ventricular dysfunction or overt heart failure. Significant association of active and/or past smoking with increased risk of CV death was mainly observed in the 60–69 years category. The underlying reasons of the lack of association of smoking with outcome in older patients in this specific context should be explored further in future studies.
Figure 1
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- T.S Hall
- Oslo University Hospital Ulleval, Oslo, Norway
| | - S Orn
- Stavanger University Hospital, Stavanger, Norway
| | - F Zannad
- University Hospital of Nancy, Nancy, France
| | | | - K Duarte
- University Hospital of Nancy, Nancy, France
| | - S Solomon
- Brigham and Women's Hospital, Boston, United States of America
| | - D Atar
- Oslo University Hospital Ulleval, Oslo, Norway
| | - S Agewall
- Oslo University Hospital Ulleval, Oslo, Norway
| | - K Dickstein
- Stavanger University Hospital, Stavanger, Norway
| | - N Girerd
- University Hospital of Nancy, Nancy, France
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14
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Abraham W, Lindenfeld J, Weaver F, Zannad F, Zile M, Galle E, Schafer J, Bahu M. Symptomatic endpoint responder rates to BAROSTIM Therapy. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Patients with heart failure with reduced ejection fraction (HFrEF) have varying responses to symptomatic endpoints with device-based HF therapies.
Purpose
Evaluate the symptomatic response to baroreflex activation therapy (BAT) at six months.
Methods
In a trial of subjects with NYHA Class II (recently III) or III HFrEF, left ventricular EF≤35%, guideline directed medical HF therapy (GDMT), no indication for cardiac resynchronization therapy, and NT-proBNP<1600 pg/ml, 264 subjects were randomized to BAROSTIM therapy plus GDMT (BAT group) or GDMT alone (Control group). Six-minute hall walk (6MHW), Minnesota Living with HF (QOL) and NYHA Class were analyzed. Clinically relevant responders were defined by 6-month improvement in 6MHW>10%, QOL>5 points or improvement in at least one NYHA class; super responders were defined by 6-month improvement in 6MHW>20%, QOL>10 points or improvement to NYHA class I.
Results
Both clinically relevant and super responders were significantly higher in BAT versus Control subjects for all symptomatic endpoints. In BAT subjects, 72% had clinically relevant improvements in ≥2 endpoints compared to 29% of Control subjects (p<0.001), and 28% of BAT subjects had super responder improvements in ≥2 endpoints versus 10% of Control subjects (p<0.001).
Conclusion
Among subjects with symptomatic HFrEF, treatment with BAT resulted in clinically relevant and super responder rates. The BAT clinically relevant and super responder rates are similar to those seen with CRT, in CRT-indicated patients.
Funding Acknowledgement
Type of funding source: Private company. Main funding source(s): CVRx, Inc.
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Affiliation(s)
- W.T Abraham
- The Ohio State University, Division of Cardiovascular Medicine, Columbus, United States of America
| | - J Lindenfeld
- Vanderbilt University Medical Center, Heart and Vascular Institute, Nashville, United States of America
| | - F Weaver
- University of Southern California, Division of Vascular Surgery and Endovascular Therapy, Keck School of Medicine, Los Angeles, United States of America
| | - F Zannad
- University of Lorraine, Clinical Investigation Center, Nancy, France
| | - M Zile
- Medical University of South Carolina, Department of Medicine, Division of Cardiology, Charleston, United States of America
| | - E Galle
- CVRx, Minneapolis, United States of America
| | - J Schafer
- NAMSA, Inc., Department of Statistics, Minneapolis, United States of America
| | - M Bahu
- Biltmore Cardiology, Electrophysiology, Phoenix, United States of America
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15
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Hui S, Sharma A, Docherty K, McMurray J, Pitt B, Dickstein K, Pfeffer M, Girerd N, Rossignol P, Ferreira J, Zannad F. Non-fatal cardiovascular events preceding sudden cardiac death in patients with an acute myocardial infarction complicated by heart failure: insights from the High-Risk-Myocardial-Infarction database. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Sudden cardiac death (SCD) is responsible for 20–40% of mortality following acute myocardial infarction (AMI). The risk of SCD is even higher among patients with AMI complicated by heart failure (HF) (either clinically apparent HF or left ventricular dysfunction). The temporal relationship between an AMI complicated by HF and subsequent SCD and the association of non-fatal cardiovascular (CV) events following AMI with SCD has yet to be described.
Purpose
Among patients with AMI complicated by HF, we evaluated the probability and temporal association of subsequent non-fatal cardiovascular (CV) events (HF hospitalization, recurrent MI, or stroke) and SCD.
Methods
The High-Risk Myocardial Infarction (HRMI) database contains 28,771 patients with signs of HF or reduced LV ejection fraction (<40%) after AMI. Among patients with an AMI complicated by HF, we used adjudicated cause of death from the HRMI Database to identify: 1) the temporal distribution of SCD among patients following an index AMI; 2) the probability of having SCD following a non-fatal CV event following the index AMI.
Results
Median follow-up was 1.9 years. Mean age was 65.0±11.5 years and 70% were male. The incidence of CV death was 7.9 per 100 patient-year [py] and for SCD was 3.1 per 100py (40% of CV deaths). SCD rates were highest in the early period (<90 days) after AMI and decreased over time. Recurrent MI preceded 9.6% of SCD after a median time of 145 days; HF hospitalization preceded 17.0% of SCD after a median 144 days; and stroke preceded 2.7% of SCD after a median of 138 days (vs. non-sudden CV death: MI 46.6% at 1 days, HF hospitalization: 30.9% at 67 days, stroke 12.9% at 9 days). The incidence of SCD preceded by HF hospitalization was significantly higher than SCD without preceding HF hospitalization.
Conclusion
Among patients with AMI complicated by HF, SCD predominantly occurred in the early “high-risk” period after AMI; SCD rates decreased afterwards. Patients with non-fatal HF hospitalizations during follow-up may have a higher subsequent SCD risk. Preventing HF onset after MI may help decreasing SCD.
Proportion of sudden cardiac death
Funding Acknowledgement
Type of funding source: Public Institution(s). Main funding source(s): Lucien Award, McGill University
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Affiliation(s)
- S Hui
- McGill University Health Centre, Division of Cardiology, Montreal, Canada
| | - A Sharma
- McGill University Health Centre, Division of Cardiology, Montreal, Canada
| | - K Docherty
- University of Glasgow, BHF Cardiovascular Research Centre, Glasgow, United Kingdom
| | - J.J.V McMurray
- University of Glasgow, BHF Cardiovascular Research Centre, Glasgow, United Kingdom
| | - B Pitt
- University of Michigan, Medicine, Ann Arbor, United States of America
| | - K Dickstein
- Stavanger University Hospital, Cardiology, Stavanger, Norway
| | - M.A Pfeffer
- Brigham and Women'S Hospital, Harvard Medical School, Division of Cardiovascular Medicine, Boston, United States of America
| | - N Girerd
- University Hospital of Brabois, Centre d'Investigation Clinique 1433 Plurithématique, Nancy, France
| | - P Rossignol
- University Hospital of Brabois, Centre d'Investigation Clinique 1433 Plurithématique, Nancy, France
| | - J.P Ferreira
- University Hospital of Brabois, Centre d'Investigation Clinique 1433 Plurithématique, Nancy, France
| | - F Zannad
- University Hospital of Brabois, Centre d'Investigation Clinique 1433 Plurithématique, Nancy, France
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16
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Tromp J, Clagget B, Jhund P, Kober L, Widimsky J, Chopra V, Ge J, Maggioni A, Martinez F, Zannad F, Lefkowitz M, Shi V, McMurray J, Solomon S, Lam C. Global differences in heart failure with preserved ejection fraction: the paragon-hf trial. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Heart failure with preserved ejection fraction (HFpEF) is a global public health problem with important regional differences. We investigated these differences in the PARAGON-HF trial, the largest, most inclusive global HFpEF trial.
Methods
We studied differences in clinical characteristics, outcomes and regional treatment effects of Sacubitril/Valsartan in 4796 patients with HFpEF from the PARAGON-HF trial, grouped according to geographic region.
Results
Regional differences in patient characteristics and comorbidities were observed (Figure 1): patients from Western Europe were oldest (75±7 years) with the highest prevalence of atrial fibrillation (36%); Central/Eastern European patients were youngest (71±8 years) with the highest prevalence of coronary artery disease (CAD, 49%); North American patients had the highest prevalence of obesity (64%) with metabolic syndrome; Latin American patients were youngest and had a high prevalence of obesity (53%); Asia-Pacific patients had a high prevalence of diabetes (44%) despite low prevalence of obesity (26%). Rates of the primary composite endpoint of total hospitalizations for HF and death from cardiovascular causes was lowest in patients from Central Europe (9 per 100 patient years) and highest in patients from North America (28 per 100 patient years), which was primarily driven by a greater number of total hospitalizations for HF and independent of confounders. In the total population, sacubitril–valsartan did not result in a significantly lower rate of total hospitalizations for heart failure and death from cardiovascular causes with no significant heterogeneity in treatment response to sacubitril-valsartan across regions.
Conclusion
This first report on regional differences in the largest prospective global trial in HFpEF suggests substantial regional heterogeneity with respect to phenotype, outcomes and quality of life.
Figure 1
Funding Acknowledgement
Type of funding source: Private company. Main funding source(s): Study funded by Novartis
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Affiliation(s)
- J Tromp
- National Heart Centre Singapore, Cardiology, Singapore, Singapore
| | - B.L Clagget
- Brigham and Women'S Hospital, Harvard Medical School, Boston, United States of America
| | - P Jhund
- University of Glasgow, Glasgow, United Kingdom
| | - L Kober
- Rigshospitalet - Copenhagen University Hospital, Copenhagen, Denmark
| | - J Widimsky
- First Faculty of Medicine and General Teaching Hospital, Prague, Czechia
| | - V Chopra
- Medanta Medicity, Gurugram, India
| | - J Ge
- Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, Shanghai, China
| | - A.P Maggioni
- Associazione Nazionale Medici Cardiologi Ospedalieri Research Center, Florence, Italy
| | - F Martinez
- State University of Cordoba, Cordoba, Argentina
| | - F Zannad
- Clinical Investigation Centre Pierre Drouin (CIC-P), Nancy, France
| | | | - V.C Shi
- Novartis, East Hanover, United States of America
| | | | - S.D Solomon
- Brigham and Women'S Hospital, Harvard Medical School, Boston, United States of America
| | - C.S.P Lam
- Brigham and Women'S Hospital, Harvard Medical School, Boston, United States of America
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17
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Elharram M, Sharma A, White W, Bakris G, Rossignol P, Mehta C, Ferreira J, Zannad F. Impact of timing of randomization after an acute coronary syndrome and subsequent events in patients with type 2 diabetes mellitus: an analysis of the EXAMINE trial. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.3067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
The timing of enrolment following an acute coronary syndrome (ACS) may influence cardiovascular (CV) outcomes and potentially treatment effect in clinical trials. Using a large contemporary trial in patients with type 2 diabetes mellitus (T2DM) post-ACS, we examined the impact of timing of enrolment on subsequent CV outcomes.
Methods
EXAMINE was a randomized trial of alogliptin versus placebo in 5380 patients with T2DM and a recent ACS. The primary outcome was a composite of CV death, non-fatal myocardial infarction [MI], or non-fatal stroke. The median follow-up was 18 months. In this post hoc analysis, we examined the occurrence of subsequent CV events by timing of enrollment divided by tertiles of time from ACS to randomization: 8–34, 35–56, and 57–141 days.
Results
Patients randomized early (compared to the latest times) had less comorbidities at baseline including a history of heart failure (HF; 24.7% vs. 33.0%), prior coronary artery bypass graft (9.6% vs. 15.9%), or atrial fibrillation (5.9% vs. 9.4%). Despite the reduced comorbidity burden, the risk of the primary outcome was highest in patients randomized early compared to the latest time (adjusted hazard ratio [aHR] 1.47; 95% CI 1.21–1.74) (Figure 1). Similarly, patients randomized early had an increased risk of recurrent MI (aHR 1.51; 95% CI 1.17–1.96) and HF hospitalization (1.49; 95% CI 1.05–2.10).
Conclusion
In a contemporary cohort of T2DM with a recent ACS, early randomization following the ACS increases the risk of CV events including recurrent MI and HF hospitalization. This should be taken into account when designing future clinical trials.
Figure 1
Funding Acknowledgement
Type of funding source: Private grant(s) and/or Sponsorship. Main funding source(s): Takeda Pharmaceutical
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Affiliation(s)
- M Elharram
- McGill University Health Centre, Montreal, Canada
| | - A Sharma
- McGill University Health Centre, Montreal, Canada
| | - W White
- University of Connecticut, Farmington, United States of America
| | - G Bakris
- The University of Chicago, Chicago, United States of America
| | | | - C Mehta
- Harvard Medical School, Cambridge, United States of America
| | | | - F Zannad
- University of Lorraine, Nancy, France
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18
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Dewan P, Jhund P, Anand I, Desai A, Gong J, Lefkowitz M, Pieske B, Rizkala A, Shah S, Van Veldhuisen D, Zannad F, Zile M, Solomon S, McMurray J. Effect of sacubitril/valsartan on cognitive function in patients with HFpEF: a prespecified analysis of PARAGON-HF. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
A theoretical concern has been raised about detrimental effects of sacubitril/valsartan (sac/val) on cognitive function as neprilysin is one of many pathways involved in clearance of amyloid beta peptides from brain tissue.
Purpose
To examine effect of sac/val, compared with valsartan, on cognitive function in patients with heart failure (HF) and preserved ejection fraction (HFpEF).
Methods
In the PARAGON-HF trial, cognitive function was tested in a subgroup of patients at baseline and follow-up, using Mini-Mental State Examination [MMSE] having a maximum score of 30 (higher scores reflect better cognitive function). Change in MMSE score from baseline to 96 wks was a prespecified exploratory endpoint. Other post hoc analyses included “cognitive decline” (fall in MMSE ≥3 pts) and assessment of cognition-related adverse events (AEs).
Results
Among 2895 patients (60% of total) in PARAGON-HF with baseline MMSE measurement, mean (SD) score was 27.4 (3.0) in patients receiving sac/val (1453) and 27.4 (2.9) in patients receiving valsartan (1442). There was no difference between sac/val and valsartan in MMSE score change from baseline to wk 96: sac/val −0.02 (SE 0.07) and valsartan 0.00 (0.07); between-treatment difference −0.02 (95% CI: −0.22 to 0.18); p-value = 0.83. Cognitive decline at 96 weeks occurred in 115 of 1071 evaluable patients (10.7%) in sac/val group and 121 of 1053 patients (11.5%) in valsartan group; risk ratio 0.97 (0.75–1.26), p-value = 0.82. Cognition-related AEs were more frequent, than in PARADIGM-HF (likely as patients in PARAGON-HF were older) but, as in PARADIGM-HF, did not differ between sac/val and comparator treatment (Table).
Conclusions
Cognitive change, measured by MMSE, did not differ between treatment with sac/val & valsartan in patients with HFpEF.
Funding Acknowledgement
Type of funding source: Private company. Main funding source(s): PARAGON-HF study was funded by Novartis Pharma.
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Affiliation(s)
- P Dewan
- University of Glasgow, Glasgow, United Kingdom
| | - P.S Jhund
- University of Glasgow, Glasgow, United Kingdom
| | - I.S Anand
- University of Minnesota, Minneapolis, United States of America
| | - A.S Desai
- Brigham and Women'S Hospital, Harvard Medical School, Boston, United States of America
| | - J Gong
- Novartis, East Hanover, United States of America
| | | | - B Pieske
- German Center for Cardiovascular Research, Berlin, Germany
| | - A.R Rizkala
- Novartis, East Hanover, United States of America
| | - S.J Shah
- Northwestern Medicine Central DuPage Hospital, Chicago, United States of America
| | | | - F Zannad
- University of Lorraine, Nancy, France
| | - M.R Zile
- Medical University of South Carolina, Charleston, United States of America
| | - S.D Solomon
- Brigham and Women'S Hospital, Harvard Medical School, Boston, United States of America
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19
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Dewan P, Jhund P, Anand I, Desai A, Pieske B, Rizkala A, Shah S, Shi V, Van Veldhuisen D, Zannad F, Zile M, Solomon S, McMurray J. Reduced cognitive function is associated with poor outcomes in HFpEF: a post hoc analysis from PARAGON-HF. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Little is known about the prevalence and consequences of cognitive impairment in patients with heart failure and preserved ejection fraction (HFpEF).
Purpose
To describe the prevalence of cognitive impairment in HFpEF and the association between cognitive function and outcomes in patients with HFpEF.
Methods
In the Prospective Comparison of ARNI With ARB Global Outcomes in Heart Failure With Preserved Ejection Fraction trial (PARAGON-HF), cognitive function was tested in a subgroup of patients at baseline and during follow-up, using the Mini-Mental State Examination [MMSE] which has a maximum score of 30, with a higher score reflecting better cognitive function. Patients were divided into 3 groups according to baseline score: ≤24 representing cognitive impairment, 25–27 reflecting borderline cognitive impairment and ≥28 normal cognition. The primary endpoint used in this analysis was a composite of first heart failure hospitalization (HFH) or cardiovascular death (CVD). We examined the relationship between baseline MMSE score and this outcome, its components and all-cause mortality. We adjusted for other standard prognostic variables, including NT-proBNP (see Table footnote).
Results
Among the 2895 patients (60% of total) in PARAGON-HF with a baseline MMSE measurement, 415 (14.3%) had a score ≤24, 671 (23.2%) a score 25–27 and 1809 (62.5%) a score ≥28. Over a median follow-up of 35 (IQR 30–41) months, the unadjusted and adjusted risks of the primary composite (Table), its components and all-cause death (Figure) were higher in patients with lower baseline MMSE scores.
Conclusions
Even mild cognitive impairment, as measured by the MMSE, is predictive of adverse outcomes in HFpEF
Funding Acknowledgement
Type of funding source: Private company. Main funding source(s): PARAGON-HF was funded by Novartis Pharma
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Affiliation(s)
- P Dewan
- University of Glasgow, Glasgow, United Kingdom
| | - P.S Jhund
- University of Glasgow, Glasgow, United Kingdom
| | - I.S Anand
- University of Minnesota, Minneapolis, United States of America
| | - A.S Desai
- Brigham and Women'S Hospital, Harvard Medical School, Boston, United States of America
| | - B Pieske
- German Center for Cardiovascular Research, Berlin, Germany
| | - A.R Rizkala
- Novartis, East Hanover, United States of America
| | - S.J Shah
- Northwestern Medicine Central DuPage Hospital, Chicago, United States of America
| | - V.C Shi
- Novartis, East Hanover, United States of America
| | | | - F Zannad
- University of Lorraine, Nancy, France
| | - M.R Zile
- Medical University of South Carolina, Charleston, United States of America
| | - S.D Solomon
- Brigham and Women'S Hospital, Harvard Medical School, Boston, United States of America
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20
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Zannad F, Abraham W, Lindenfeld J, Weaver F, Galle E, Rogers T, Zile M. Quality of life response to BAROSTIM Therapy. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Patients with heart failure with reduced ejection fraction (HFrEF) have poor quality of life as measured by both physical and emotional dimensions.
Purpose
Evaluate the quality of life in subjects with and without baroreflex activation therapy (BAT) at six months.
Methods
In a multicenter randomized trial conducted in subjects with NYHA class II (recently III) or III HFrEF, left ventricular ejection fraction ≤35%, stable optimal guideline directed medical HF therapy (GDMT), no Class 1 indication for cardiac resynchronization therapy (CRT), and NT-proBNP<1600 pg/ml, a total of 264 subjects were randomized to BAROSTIM therapy plus GDMT (BAT group) or GDMT alone (Control group). Quality of life was measured at baseline and six months using the Minnesota Living with HF Questionnaire (MLWHF) and the EuroQol 5-Dimension Long (EQ-5D) tool. From the MLWHF questionnaire, both a physical and an emotional dimension was analyzed using subsets of the 21 questions. From the EQ-5D, the five individual dimensions and the overall health status (0–100, where 100 is best) was analyzed.
Results
Of the 264 randomized subjects, 120 BAT and 125 Control subjects had 6-month quality of life data. As shown in the table, treatment with BAT resulted in significant improvements in quality of life overall, as well as in the specific dimensions of the quality of life questionnaires, compared to the Control subjects.
Conclusion
Among subjects with symptomatic HFrEF, treatment with BAT resulted in significant improvement in quality of life at six months.
Funding Acknowledgement
Type of funding source: Private company. Main funding source(s): CVRx, Inc.
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Affiliation(s)
- F Zannad
- University of Lorraine, Clinical Investigation Center, Nancy, France
| | - W.T Abraham
- The Ohio State University, Division of Cardiovascular Medicine, Columbus, United States of America
| | - J Lindenfeld
- Vanderbilt University Medical Center, Heart and Vascular Institute, Nashville, United States of America
| | - F Weaver
- University of Southern California, Division of Vascular Surgery and Endovascular Therapy, Keck School of Medicine, Los Angeles, United States of America
| | - E Galle
- CVRx, Minneapolis, United States of America
| | - T Rogers
- NAMSA Inc., Department of Statistics, Minneapolis, United States of America
| | - M Zile
- Medical University of South Carolina, Department of Medicine, Division of Cardiology, Charleston, United States of America
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21
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Shi C, van der Wal HH, Silljé HHW, Dokter MM, van den Berg F, Huizinga L, Vriesema M, Post J, Anker SD, Cleland JG, Ng LL, Samani NJ, Dickstein K, Zannad F, Lang CC, van Haelst PL, Gietema JA, Metra M, Ameri P, Canepa M, van Veldhuisen DJ, Voors AA, de Boer RA. Tumour biomarkers: association with heart failure outcomes. J Intern Med 2020; 288:207-218. [PMID: 32372544 PMCID: PMC7496322 DOI: 10.1111/joim.13053] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Revised: 02/18/2020] [Accepted: 02/25/2020] [Indexed: 12/18/2022]
Abstract
BACKGROUND There is increasing recognition that heart failure (HF) and cancer are conditions with a number of shared characteristics. OBJECTIVES To explore the association between tumour biomarkers and HF outcomes. METHODS In 2,079 patients of BIOSTAT-CHF cohort, we measured six established tumour biomarkers: CA125, CA15-3, CA19-9, CEA, CYFRA 21-1 and AFP. RESULTS During a median follow-up of 21 months, 555 (27%) patients reached the primary end-point of all-cause mortality. CA125, CYFRA 21-1, CEA and CA19-9 levels were positively correlated with NT-proBNP quartiles (all P < 0.001, P for trend < 0.001) and were, respectively, associated with a hazard ratio of 1.17 (95% CI 1.12-1.23; P < 0.0001), 1.45 (95% CI 1.30-1.61; P < 0.0001), 1.19 (95% CI 1.09-1.30; P = 0.006) and 1.10 (95% CI 1.05-1.16; P < 0.001) for all-cause mortality after correction for BIOSTAT risk model (age, BUN, NT-proBNP, haemoglobin and beta blocker). All tumour biomarkers (except AFP) had significant associations with secondary end-points (composite of all-cause mortality and HF hospitalization, HF hospitalization, cardiovascular (CV) mortality and non-CV mortality). ROC curves showed the AUC of CYFRA 21-1 (0.64) had a noninferior AUC compared with NT-proBNP (0.68) for all-cause mortality (P = 0.08). A combination of CYFRA 21-1 and NT-proBNP (AUC = 0.71) improved the predictive value of the model for all-cause mortality (P = 0.0002 compared with NT-proBNP). CONCLUSIONS Several established tumour biomarkers showed independent associations with indices of severity of HF and independent prognostic value for HF outcomes. This demonstrates that pathophysiological pathways sensed by these tumour biomarkers are also dysregulated in HF.
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Affiliation(s)
- C Shi
- From the, Department of Cardiology, Uni, University Medical Center Groningen, Groningen, the Netherlands.,University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - H H van der Wal
- From the, Department of Cardiology, Uni, University Medical Center Groningen, Groningen, the Netherlands.,University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - H H W Silljé
- From the, Department of Cardiology, Uni, University Medical Center Groningen, Groningen, the Netherlands.,University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - M M Dokter
- From the, Department of Cardiology, Uni, University Medical Center Groningen, Groningen, the Netherlands.,University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - F van den Berg
- From the, Department of Cardiology, Uni, University Medical Center Groningen, Groningen, the Netherlands.,University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - L Huizinga
- From the, Department of Cardiology, Uni, University Medical Center Groningen, Groningen, the Netherlands.,University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - M Vriesema
- From the, Department of Cardiology, Uni, University Medical Center Groningen, Groningen, the Netherlands.,University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - J Post
- From the, Department of Cardiology, Uni, University Medical Center Groningen, Groningen, the Netherlands.,University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - S D Anker
- Department of Cardiology, Berlin-Brandenburg Center for Regenerative Therapies, German Centre for Cardiovascular Research (DZHK) Partner site Berlin, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - J G Cleland
- National Heart & Lung Institute, Royal Brompton & Harefield Hospitals, Imperial College, London, UK.,Robertson Institute of Biostatistics and Clinical Trials Unit, University of Glasgow, Glasgow, UK
| | - L L Ng
- Department of Cardiovascular Sciences, University of Leicester, Leicester, UK.,NIHR Leicester Biomedical Research Centre, Glenfield Hospital, Leicester, UK
| | - N J Samani
- Department of Cardiovascular Sciences, University of Leicester, Leicester, UK.,NIHR Leicester Biomedical Research Centre, Glenfield Hospital, Leicester, UK
| | - K Dickstein
- University of Bergen, Stavanger University Hospital, Stavanger, Norway
| | - F Zannad
- Clinical Investigation Center 1433, French Clinical Research Infrastructure Network, Investigation Network Initiative-Cardiovascular and Renal Clinical Trialists, Centre Hospitalier Regional et Universitaire de Nancy, Vandoeuvre les Nancy, France
| | - C C Lang
- Division of Molecular and Clinical Medicine, Ninewells Hospital and Medical School, University of Dundee, Dundee, UK
| | - P L van Haelst
- F. Hoffmann-La Roche Ltd. Diagnostics Division, Basel, Switzerland
| | - J A Gietema
- Department of Medical Oncology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - M Metra
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, Institute of Cardiology, University of Brescia, Brescia, Italy
| | - P Ameri
- Cardiovascular Disease Unit, IRCCS Ospedale Policlinico San Martino, Genova, Italy.,IRCCS Italian Cardiovascular Network, Department of Internal Medicine, University of Genova, Genova, Italy
| | - M Canepa
- Cardiovascular Disease Unit, IRCCS Ospedale Policlinico San Martino, Genova, Italy.,IRCCS Italian Cardiovascular Network, Department of Internal Medicine, University of Genova, Genova, Italy
| | - D J van Veldhuisen
- From the, Department of Cardiology, Uni, University Medical Center Groningen, Groningen, the Netherlands.,University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - A A Voors
- From the, Department of Cardiology, Uni, University Medical Center Groningen, Groningen, the Netherlands.,University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - R A de Boer
- From the, Department of Cardiology, Uni, University Medical Center Groningen, Groningen, the Netherlands.,University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
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22
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Hamdidouche I, Gosse P, Cremer A, Lorthioir A, Delsart P, Courand PY, Denolle T, Halimi JM, Girerd X, Ormezzano O, Rossignol P, Pereira H, Azizi M, Amar L, Bobrie G, Monge M, Pagny JY, Sapoval M, Claisse G, Midulla M, Mounier-Vehier C, Dauphin R, Fauvel JP, Lantelme P, Rouvière O, Grenier N, Lebras Y, Trillaud H, Dourmap C, Heautot JF, Larralde A, Paillard F, Cluzel P, Rosenbaum D, Alison D, Popovic B, Zannad F, Baguet JP, Thony F, Bartoli JM, Vaïsse B, Drouineau J, Herpin D, Sosner P, Tasu JP, Velasco S, Ribstein J, Kovacsik H, Bouhanick B, Chamontin B, Rousseau H, Le Jeune S, Lopez-Sublet M, Mourad JJ, Bellmann L, Esnault V, Ferrari E, Chatellier G. Clinic Versus Ambulatory Blood Pressure in Resistant Hypertension: Impact of Antihypertensive Medication Nonadherence. Hypertension 2019; 74:1096-1103. [DOI: 10.1161/hypertensionaha.119.13520] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Clinic-ambulatory blood pressure (BP) difference is influenced by patients- and device-related factors and inadequate clinic-BP measurement. We investigated whether nonadherence to antihypertensive medications may also influence this difference in a post hoc analysis of the DENERHTN trial (Renal Denervation for Hypertension). We pooled the data of 77 out of 106 evaluable patients with apparent resistant hypertension who received a standardized antihypertensive treatment and had both ambulatory BP and drug-screening results available at baseline after 1 month of standardized triple therapy and at 6 months on a median of 5 antihypertensive drugs. After drug assay samplings on study visits, patients took their antihypertensive treatment under supervision immediately after the start of the ambulatory BP recording, and supine clinic BP was measured 24 hours post-dosing; both allowed to calculate the clinic minus daytime ambulatory systolic BP (SBP) difference (clinic-SBP–day-SBP). A total of 29 (37.7%) were found nonadherent to medications at baseline and 38 (49.4%) at 6 months. At baseline, the mean clinic-SBP–day-SBP difference in the nonadherent group was 12.7 mm Hg (95% CI, 7.8–17.7 mm Hg,
P
<0.001). In contrast, clinic SBP was almost identical to day-SBP in the adherent group (clinic-SBP–day-SBP difference, 0.1 mm Hg; 95% CI, −3.3 to 3.5 mm Hg;
P
=0.947). Similar observations were made at 6 months. Using receiver operating characteristics curves, we found that a 6 mm Hg cutoff of clinic-SBP–day-SBP difference had 67% sensitivity and 69% specificity to predict nonadherence to the triple therapy at baseline. In conclusion, a large clinic-SBP–day-SBP difference may help discriminating between adherence and nonadherence to treatment in patients with resistant hypertension.
Clinical Trial Registration—
URL:
https://www.clinicaltrials.gov
. Unique identifier: NCT01570777.
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Affiliation(s)
- Idir Hamdidouche
- From the INSERM, Centre d’Investigations Cliniques- Plurithématique 1418, Paris, France (I.H., H.P., M.A.)
| | - Philippe Gosse
- ESH Hypertension excellence center, Hopital Saint André, University hospital of Bordeaux, France (P.G., A.C.)
| | | | - Aurelien Lorthioir
- AP-HP, Hypertension unit and DMU CARTE, Hôpital Européen Georges-Pompidou, Paris, France (A.L., H.P., M.A.)
| | - Pascal Delsart
- CHU Lille, Institut Cœur Poumon, Bd Pr Leclercq, France (P.D.)
| | - Pierre-Yves Courand
- Cardiology department, European Society of Hypertension Excellence Center, Hôpital de la Croix-Rousse et Hôpital Lyon Sud, Hospices Civils de Lyon, France (P.-Y.C.)
- Université de Lyon, CREATIS; CNRS UMR5220; INSERM U1044; INSA-Lyon; Université Claude Bernard Lyon 1, France (P.-Y.C.)
| | - Thierry Denolle
- Hĉpital Arthur Gardiner, Centre d’Excellence en HTA Rennes- Dinard, France (T.D.)
| | - Jean-Michel Halimi
- Service de nephrologie-immunologie clinique, Hopital universitaire de Tours, et EA4245 Université Francois Rabelais, France (J.-M.H.)
| | - Xavier Girerd
- Unité de Prévention Cardio Vasculaire, Groupe Hospitalier Universitaire Pitié-Salpêtrière–Institut IE3M, Paris, France (X.G)
| | - Olivier Ormezzano
- Department of Cardiology, University Hospital and INSERM U1039, Bioclinic Radiopharmaceutics Laboratory, Grenoble, France (O.O.)
| | - Patrick Rossignol
- Université de Lorraine, Inserm, Centre d’Investigations Cliniques- Plurithématique 14-33, and Inserm U1116, CHRU, F-CRIN INI-CRCT (Cardiovascular and Renal Clinical Trialists), Nancy, France (P.R.)
| | - Helena Pereira
- From the INSERM, Centre d’Investigations Cliniques- Plurithématique 1418, Paris, France (I.H., H.P., M.A.)
- AP-HP, Hypertension unit and DMU CARTE, Hôpital Européen Georges-Pompidou, Paris, France (A.L., H.P., M.A.)
- AP-HP Clinical and Epidemiological Unit, Hopital Europeen Georges Pompidou, Paris, France (H.P.)
| | - Michel Azizi
- From the INSERM, Centre d’Investigations Cliniques- Plurithématique 1418, Paris, France (I.H., H.P., M.A.)
- AP-HP, Hypertension unit and DMU CARTE, Hôpital Européen Georges-Pompidou, Paris, France (A.L., H.P., M.A.)
- Université de Paris, Paris, France (M.A.)
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23
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Tromp J, Ouwerkerk W, Demissei BG, Anker SD, Cleland JG, Dickstein K, Filippatos G, van der Harst P, Hillege HL, Lang CC, Metra M, Ng LL, Ponikowski P, Samani NJ, van Veldhuisen DJ, Zannad F, Zwinderman AH, Voors AA, van der Meer P. Novel endotypes in heart failure: effects on guideline-directed medical therapy. Eur Heart J 2018; 39:4269-4276. [DOI: 10.1093/eurheartj/ehy712] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2017] [Accepted: 10/14/2018] [Indexed: 12/28/2022] Open
Affiliation(s)
- J Tromp
- Department of Cardiology, University of Groningen, Hanzeplein 1, GZ, Groningen, the Netherlands
- National Heart Centre Singapore, 5 Hospital Drive, Singapore
- Duke-NUS Medical School, 8 College Road, Singapore
| | - W Ouwerkerk
- National Heart Centre Singapore, 5 Hospital Drive, Singapore
- Department of Epidemiology, Biostatistics & Bioinformatics, Academic Medical Center, Amsterdam, Meibergdreef 9, AZ, The Netherlands
| | - B G Demissei
- Department of Cardiology, University of Groningen, Hanzeplein 1, GZ, Groningen, the Netherlands
| | - S D Anker
- Division of Cardiology and Metabolism—Heart Failure, Cachexia & Sarcopenia, Department of Cardiology (CVK); Berlin-Brandenburg Center for Regenerative Therapies (BCRT), at Charité University Medicine, Charitépl. 1 Berlin, Germany
- Department of Cardiology and Pneumology, University Medicine Göttingen (UMG), DZHK (German Center for Cardiovascular Research), Robert-Koch-Straße 40, Göttingen, Germany
| | - J G Cleland
- National Heart & Lung Institute, Royal Brompton & Harefield Hospitals, Imperial College, Sydney St, Chelsea, London, UK
- Robertson Institute of Biostatistics and Clinical Trials Unit, University of Glasgow, University Avenue, Glasgow, UK
| | - K Dickstein
- University of Bergen, Stavanger University Hospital, Gerd-Ragna Bloch Thorsens gate 8, Stavanger, Norway
| | - G Filippatos
- School of Medicine, Department of Cardiology, Heart Failure Unit, Athens University Hospital Attikon, National and Kapodistrian University of Athens, 1, Rimini Str, Haidari, Athens Greece
| | - P van der Harst
- Department of Cardiology, University of Groningen, Hanzeplein 1, GZ, Groningen, the Netherlands
| | - H L Hillege
- Department of Cardiology, University of Groningen, Hanzeplein 1, GZ, Groningen, the Netherlands
| | - C C Lang
- Division of Molecular & Clinical Medicine, University of Dundee, Dundee, UK
| | - M Metra
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, Institute of Cardiology, University of Brescia, Piazza del Mercato, 15, Brescia, Italy
| | - L L Ng
- Department of Cardiovascular Sciences, University of Leicester, Glenfield Hospital, Groby Road, Leicester, UK
- NIHR Leicester Biomedical Research Centre, Glenfield Hospital, Groby Road, Leicester, UK
| | - P Ponikowski
- Department of Heart Diseases, Wroclaw Medical University, Rudolfa Weigla 5, Wroclaw, Poland
- Cardiology Department, Military Hospital, Rudolfa Weigla, Wroclaw, Poland
| | - N J Samani
- Department of Cardiovascular Sciences, University of Leicester, Glenfield Hospital, Groby Road, Leicester, UK
- NIHR Leicester Biomedical Research Centre, Glenfield Hospital, Groby Road, Leicester, UK
| | - D J van Veldhuisen
- Department of Cardiology, University of Groningen, Hanzeplein 1, GZ, Groningen, the Netherlands
| | - F Zannad
- CHU de Nancy, Inserm CIC 1433, Université de Lorrain, CHRU de Nancy, F-CRIN INI-CRCT Nancy, France
| | - A H Zwinderman
- Department of Epidemiology, Biostatistics & Bioinformatics, Academic Medical Center, Amsterdam, Meibergdreef 9, AZ, The Netherlands
| | - A A Voors
- Department of Cardiology, University of Groningen, Hanzeplein 1, GZ, Groningen, the Netherlands
| | - P van der Meer
- Department of Cardiology, University of Groningen, Hanzeplein 1, GZ, Groningen, the Netherlands
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24
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Hall TS, Von Lueder TG, Zannad F, Rossignol P, Duarte K, Chouihed T, Dickstein K, Atar D, Agewall S, Girerd N. P6392Left ventricular ejection fraction and adjudicated, cause-specific hospitalizations after myocardial infarction complicated by heart failure or left ventricular dysfunction. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.p6392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- T S Hall
- Oslo University Hospital, Oslo, Norway
| | | | - F Zannad
- University Hospital of Nancy, Nancy, France
| | | | - K Duarte
- University Hospital of Nancy, Nancy, France
| | - T Chouihed
- University Hospital of Nancy, Nancy, France
| | - K Dickstein
- Stavanger University Hospital, Stavanger, Norway
| | - D Atar
- Oslo University Hospital, Oslo, Norway
| | - S Agewall
- Oslo University Hospital, Oslo, Norway
| | - N Girerd
- University Hospital of Nancy, Nancy, France
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25
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Ferreira JP, Abreu P, McMurray JJV, Van Veldhuisen DJ, Swedberg K, Pocock S, Vincent J, Lins K, Pitt B, Zannad F. P910Beware of making dose comparisons for efficacy in post-hoc analyses of achieved dose in up-titrating studies: lessons from the EMPHASIS trial. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy564.p910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- J P Ferreira
- Clinical Investigation Centre Pierre Drouin (CIC-P), Nancy, France
| | - P Abreu
- Cardiovascular Research Foundation, New York, United States of America
| | - J J V McMurray
- Cardiovascular Research Centre of Glasgow, Glasgow, United Kingdom
| | | | | | - S Pocock
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - J Vincent
- Cardiovascular Research Foundation, New York, United States of America
| | - K Lins
- Cardiovascular Research Foundation, New York, United States of America
| | - B Pitt
- University of Michigan, Ann Arbor, United States of America
| | - F Zannad
- Clinical Investigation Centre Pierre Drouin (CIC-P), Nancy, France
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26
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Rossello X, Ariti C, Pocock SJ, McMurray JJV, Van Veldhuisen DJ, Swedberg K, Pitt B, Zannad F. 203Impact of mineralocorticoid receptor antagonists on sudden cardiac death in patients with heart failure and left ventricular systolic dysfunction: a meta-analysis of three randomized controlled trials. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy564.203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- X Rossello
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - C Ariti
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - S J Pocock
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| | | | | | - K Swedberg
- University of Gothenburg, Gothenburg, Sweden
| | - B Pitt
- University of Michigan, Michigan, United States of America
| | - F Zannad
- University of Lorraine, Nancy, France
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27
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Toupance S, Kearney-Schwartz A, Temmar M, Lakomy C, Labat C, Rossignol P, Zannad F, Aviv A, Benetos A. [OP.8A.02] SHORT TELOMERES, BUT NOT TELOMERE ATTRITION RATES, ARE ASSOCIATED WITH CAROTID ATHEROSCLEROSIS. J Hypertens 2017. [DOI: 10.1097/01.hjh.0000523191.02791.71] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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28
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Agewall S, Tjessum L, Rossignol P, Zannad F, Atar D, Von Lueder T, Lamiral Z, Machu J, Kjekshus J, Girerd N. P4392Heart rate prediction of outcome in heart failure following myocardial infarction depend on heart rhythm status. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx504.p4392] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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29
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Wachter R, Abraham W, Lindenfeld J, Weaver F, Zannad F, Wilks S, Schafer J, Zile M. P1475Positive effects of baroreflex activation therapy in heart failure with reduced ejection fraction are independent of baseline blood pressure. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx502.p1475] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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30
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Ouwerkerk W, Voors A, Anker S, Cleland J, Dickstein K, Filippatos G, van der Harst P, Hillege H, Lang C, ter Maaten J, Ng L, Ponikowski P, Samani N, van Veldhuisen D, Zannad F, Metra M, Zwinderman A. Determinants and clinical outcome of uptitration of ACE-inhibitors and beta-blockers in patients with heart failure: a prospective European study. Eur Heart J 2017; 38:1883-1890. [DOI: 10.1093/eurheartj/ehx026] [Citation(s) in RCA: 233] [Impact Index Per Article: 33.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2016] [Accepted: 01/10/2017] [Indexed: 11/13/2022] Open
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Olivier A, Girerd N, Michel JB, Ketelslegers JM, Fay R, Vincent J, Bramlage P, Pitt B, Zannad F, Rossignol P. Combined baseline and one-month changes in big endothelin-1 and brain natriuretic peptide plasma concentrations predict clinical outcomes in patients with left ventricular dysfunction after acute myocardial infarction: Insights from the Eplerenone Post-Acute Myocardial Infarction Heart Failure Efficacy and Survival Study (EPHESUS) study. Int J Cardiol 2017; 241:344-350. [PMID: 28284500 DOI: 10.1016/j.ijcard.2017.02.018] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2016] [Revised: 01/14/2017] [Accepted: 02/03/2017] [Indexed: 12/16/2022]
Abstract
OBJECTIVE Increased levels of neuro-hormonal biomarkers predict poor prognosis in patients with acute myocardial infarction (AMI) complicated by left ventricular systolic dysfunction (LVSD). The predictive value of repeated (one-month interval) brain natriuretic peptides (BNP) and big-endothelin 1 (BigET-1) measurements were investigated in patients with LVSD after AMI. METHODS In a sub-study of the Eplerenone Post-Acute Myocardial Infarction Heart Failure Efficacy and Survival Study (EPHESUS trial), BNP and BigET-1 were measured at baseline and at 1month in 476 patients. RESULTS When included in the same Cox regression model, baseline BNP (p=0.0003) and BigET-1 (p=0.026) as well as the relative changes (after 1month) from baseline in BNP (p=0.049) and BigET-1 (p=0.045) were predictive of the composite of cardiovascular death or hospitalization for worsening heart failure. Adding baseline and changes in BigET-1 to baseline and changes in BNP led to a significant increase in prognostic reclassification as assessed by integrated discrimination improvement index (5.0%, p=0.01 for the primary endpoint). CONCLUSIONS Both increased baseline and changes after one month in BigET-1 concentrations were shown to be associated with adverse clinical outcomes, independently from BNP baseline levels and one month changes, in patients after recent AMI complicated with LVSD. This novel result may be of clinical interest since such combined biomarker assessment could improve risk stratification and open new avenues for biomarker-guided targeted therapies. KEY MESSAGES In the present study, we report for the first time in a population of patients with reduced LVEF after AMI and signs or symptoms of congestive HF, that increased baseline values of BNP and BigET-1 as well as a further rise of these markers over the first month after AMI, were independently predictive of future cardiovascular events. This approach may therefore be of clinical interest with the potential of improving risk stratification after AMI with reduced LVEF while further opening new avenues for biomarker-guided targeted therapies.
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Affiliation(s)
- A Olivier
- Inserm, CIC-P 14-33, U 116, CHU Nancy, France; University of Lorraine, France; F-CRIN INI-CRCT, Nancy, France; Department of Cardiovascular Disease, Institut Lorrain du Coeur et des Vaisseaux, Nancy University Hospital, Nancy, France.
| | - N Girerd
- Inserm, CIC-P 14-33, U 116, CHU Nancy, France; University of Lorraine, France; F-CRIN INI-CRCT, Nancy, France
| | - J B Michel
- Inserm, UMRS 1148 University Paris Diderot, Paris, France
| | | | - R Fay
- Inserm, CIC-P 14-33, U 116, CHU Nancy, France; University of Lorraine, France; F-CRIN INI-CRCT, Nancy, France
| | | | - P Bramlage
- Institute for Cardiovascular Pharmacology and Epidemiology, Mahlow, Germany
| | - B Pitt
- University of Michigan, School of Medicine, Ann Arbor, MI, USA
| | - F Zannad
- Inserm, CIC-P 14-33, U 116, CHU Nancy, France; University of Lorraine, France; F-CRIN INI-CRCT, Nancy, France; Department of Cardiovascular Disease, Institut Lorrain du Coeur et des Vaisseaux, Nancy University Hospital, Nancy, France
| | - P Rossignol
- Inserm, CIC-P 14-33, U 116, CHU Nancy, France; University of Lorraine, France; F-CRIN INI-CRCT, Nancy, France
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Huttin O, Mandry D, Eschalier R, Zhang L, Micard E, Odille F, Beaumont M, Fay R, Felblinger J, Camenzind E, Zannad F, Girerd N, Marie PY. Cardiac remodeling following reperfused acute myocardial infarction is linked to the concomitant evolution of vascular function as assessed by cardiovascular magnetic resonance. J Cardiovasc Magn Reson 2017; 19:2. [PMID: 28063459 PMCID: PMC5219670 DOI: 10.1186/s12968-016-0314-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2016] [Accepted: 12/07/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Left ventricular (LV) remodeling following acute myocardial infarction (MI) is difficult to predict at an individual level although a possible interfering role of vascular function has yet to be considered to date. This study aimed to determine the extent to which this LV remodeling is influenced by the concomitant evolution of vascular function and LV loading conditions, as assessed by phase-contrast Cardiovascular Magnetic Resonance (CMR) of the ascending aorta. METHODS CMR was performed in 121 patients, 2-4 days after reperfusion of a first ST-segment elevation myocardial infarction and 6 months thereafter. LV remodeling was: (i) assessed by the 6-month increase in end-diastolic volume (EDV) and/or ejection fraction (EF) and (ii) correlated with the indexed aortic stroke volume (mL.m-2), determined by a CMR phase-contrast sequence, along with derived functional vascular parameters (total peripheral vascular resistance (TPVR), total arterial compliance index, effective arterial elastance). RESULTS At 6 months, most patients were under angiotensin enzyme converting inhibitors (86%) and beta-blockers (84%) and, on average, all functional vascular parameters were improved whereas blood pressure levels were not. An increase in EDV only (EDV+/EF-) was documented in 17% of patients at 6 months, in EF only (EDV-/EF+) in 31%, in both EDV and EF (EDV+/EF+) in 12% and neither EDV nor EF (EDV-/EF-) in 40%. The increase in EF was mainly and independently linked to a concomitant decline in TPVR (6-month change in mmHg.min.m2.L-1, EDV-/EF-: +1 ± 8, EDV+/EF-: +3 ± 9, EDV-/EF+: -7 ± 6, EDV+/EF+: -15 ± 20, p < 0.001) while the absence of any EF improvement was associated with high persisting rates of abnormally high TPVR at 6 months (EDV-/EF-: 31%, EDV+/EF-: 38%, EDV-/EF+: 5%, EDV+/EF+: 13%, p = 0.007). By contrast, the 6-month increase in EDV was mainly dependent on cardiac as opposed to vascular parameters and particularly on the presence of microvascular obstruction at baseline (EDV-/EF-: 37%, EDV+/EF-: 76%, EDV-/EF+: 38%, EDV+/EF+: 73%, p = 0.003). CONCLUSION LV remodeling following reperfused MI is strongly influenced by the variable decrease in systemic vascular resistance under standard care vasodilating medication. The CMR monitoring of vascular resistance may help to tailor these medications for improving vascular resistance and consequently, LV ejection fraction. TRIAL REGISTRATION NCT01109225 on ClinicalTrials.gov site (April, 2010).
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Affiliation(s)
- Olivier Huttin
- CHRU-Nancy, Department of Cardiology, Nancy, F-54000, France
- INSERM, UMR-1116, Nancy, F-54000, France
| | - Damien Mandry
- INSERM, UMR-947, Nancy, F-54000, France
- CHRU-Nancy, Department of Radiology, Nancy, F-54000, France
- Faculty of Medicine, Université de Lorraine, Nancy, F-54000, France
| | - Romain Eschalier
- CHU-Clermont-Ferrand, Department of Cardiology, Clermont-Ferrand, F-63000, France
- Université d'Auvergne, UMR6284, Clermont-Ferrand, F-63000, France
| | - Lin Zhang
- INSERM, UMR-947, Nancy, F-54000, France
- Faculty of Medicine, Université de Lorraine, Nancy, F-54000, France
| | - Emilien Micard
- INSERM, UMR-947, Nancy, F-54000, France
- Faculty of Medicine, Université de Lorraine, Nancy, F-54000, France
- INSERM CIC 1433, Nancy, F-54000, France
| | - Freddy Odille
- INSERM, UMR-947, Nancy, F-54000, France
- Faculty of Medicine, Université de Lorraine, Nancy, F-54000, France
- INSERM CIC 1433, Nancy, F-54000, France
| | - Marine Beaumont
- INSERM, UMR-947, Nancy, F-54000, France
- Faculty of Medicine, Université de Lorraine, Nancy, F-54000, France
- INSERM CIC 1433, Nancy, F-54000, France
| | | | - Jacques Felblinger
- INSERM, UMR-947, Nancy, F-54000, France
- Faculty of Medicine, Université de Lorraine, Nancy, F-54000, France
- INSERM CIC 1433, Nancy, F-54000, France
| | - Edoardo Camenzind
- CHRU-Nancy, Department of Cardiology, Nancy, F-54000, France
- INSERM, UMR-1116, Nancy, F-54000, France
- Faculty of Medicine, Université de Lorraine, Nancy, F-54000, France
| | - Faïez Zannad
- INSERM, UMR-1116, Nancy, F-54000, France
- Faculty of Medicine, Université de Lorraine, Nancy, F-54000, France
- INSERM CIC 1433, Nancy, F-54000, France
| | - Nicolas Girerd
- INSERM, UMR-1116, Nancy, F-54000, France
- Faculty of Medicine, Université de Lorraine, Nancy, F-54000, France
- INSERM CIC 1433, Nancy, F-54000, France
| | - Pierre Y Marie
- INSERM, UMR-1116, Nancy, F-54000, France.
- Faculty of Medicine, Université de Lorraine, Nancy, F-54000, France.
- CHRU-Nancy, Hôpitaux de BRABOIS, Service de Médecine Nucléaire, Allée du Morvan, 54500, Vandœuvre, France.
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Stoltz J, Zannad F, Laprevote-Heully M, Morin D, Streiff F, Larcan A, Gilgenkrantz J. Hemorheological disturbances in patients with myocardial pre-infarction. Clin Hemorheol Microcirc 2016. [DOI: 10.3233/ch-1985-5509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- J.F. Stoltz
- U.284 INSERM et Centre Régional de Transfusion Sanguine, Brabois, 54500 Vandoeuvre-les-Nancy, France
| | - F. Zannad
- Service de Cardiologie – Soins Intensifs, CHR de Nancy, Hôpital Central, 54037 Nancy Cédex, France
| | - M.C. Laprevote-Heully
- U.284 INSERM et Centre Régional de Transfusion Sanguine, Brabois, 54500 Vandoeuvre-les-Nancy, France
| | - D. Morin
- U.284 INSERM et Centre Régional de Transfusion Sanguine, Brabois, 54500 Vandoeuvre-les-Nancy, France
| | - F. Streiff
- U.284 INSERM et Centre Régional de Transfusion Sanguine, Brabois, 54500 Vandoeuvre-les-Nancy, France
| | - A. Larcan
- U.284 INSERM et Centre Régional de Transfusion Sanguine, Brabois, 54500 Vandoeuvre-les-Nancy, France
| | - J.M. Gilgenkrantz
- Service de Cardiologie – Soins Intensifs, CHR de Nancy, Hôpital Central, 54037 Nancy Cédex, France
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Marie PY, Mandry D, Huttin O, Micard E, Bonnemains L, Girerd N, Beaumont M, Fay R, Joly L, Rossignol P, Benetos A, Felblinger J, Zannad F. Comprehensive monitoring of cardiac remodeling with aortic stroke volume values provided by a phase-contrast MRI sequence. J Hypertens 2016; 34:967-73. [DOI: 10.1097/hjh.0000000000000889] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Youcef G, Olivier A, Nicot N, Muller A, Deng C, Labat C, Fay R, Rodriguez-Guéant RM, Leroy C, Jaisser F, Zannad F, Lacolley P, Vallar L, Pizard A. Preventive and chronic mineralocorticoid receptor antagonism is highly beneficial in obese SHHF rats. Br J Pharmacol 2016; 173:1805-19. [PMID: 26990406 DOI: 10.1111/bph.13479] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2015] [Revised: 02/17/2016] [Accepted: 02/23/2016] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND AND PURPOSE Mineralocorticoid receptor (MR) activation contributes to heart failure (HF) progression. Its overactivity in obesity is thought to accelerate cardiac remodelling and HF development. Given that MR antagonists (MRA) are beneficial in chronic HF patients, we hypothesized that early MRA treatment may target obesity-related disorders and consequently delay the development of HF. EXPERIMENTAL APPROACH Twenty spontaneously hypertensive HF dyslipidaemic obese SHHF(cp/cp) rats and 18 non-dyslipidaemic lean SHHF(+/+) controls underwent regular monitoring for their metabolic and cardiovascular phenotypes with or without MRA treatment [eplerenone (eple), 100 mg∙kg(-1) ∙day(-1) ] from 1.5 to 12.5 months of age. KEY RESULTS Eleven months of eple treatment in obese rats (SHHF(cp/cp) eple) reduced the obesity-related metabolic disorders observed in untreated SHHF(cp/cp) rats by reducing weight gain, triglycerides and total cholesterol levels and by preserving adiponectinaemia. The MRA treatment predominantly preserved diastolic and systolic functions in obese rats by alleviating the eccentric cardiac hypertrophy observed in untreated SHHF(cp/cp) animals and preserving ejection fraction (70 ± 1 vs. 59 ± 1%). The MRA also improved survival independently of these pressure effects. CONCLUSION AND IMPLICATIONS Early chronic eple treatment resulted in a delay in cardiac remodelling and HF onset in both SHHF(+/+) and SHHF(cp/cp) rats, whereas SHHF(cp/cp) rats further benefited from the MRA treatment through a reduction in their obesity and dyslipidaemia. These findings suggest that preventive MRA therapy may provide greater benefits in obese patients with additional risk factors of developing cardiovascular complications.
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Affiliation(s)
- G Youcef
- UMRS U1116 Inserm, Nancy, France.,Fédération de Recherche 3209, Nancy, France.,Université de Lorraine, Nancy, France.,Genomics Research Unit, Luxembourg Institute of Health, Luxembourg
| | - A Olivier
- UMRS U1116 Inserm, Nancy, France.,Fédération de Recherche 3209, Nancy, France.,Université de Lorraine, Nancy, France.,CHU Nancy, Nancy, France
| | - N Nicot
- Genomics Research Unit, Luxembourg Institute of Health, Luxembourg
| | - A Muller
- Genomics Research Unit, Luxembourg Institute of Health, Luxembourg
| | - C Deng
- Fédération de Recherche 3209, Nancy, France.,Université de Lorraine, Nancy, France.,UMR 7365 CNRS, Nancy, France
| | - C Labat
- UMRS U1116 Inserm, Nancy, France.,Fédération de Recherche 3209, Nancy, France.,Université de Lorraine, Nancy, France
| | - R Fay
- CHU Nancy, Nancy, France.,CIC 1433 Inserm, Pierre Drouin, Nancy, France
| | - R-M Rodriguez-Guéant
- Fédération de Recherche 3209, Nancy, France.,Université de Lorraine, Nancy, France.,CHU Nancy, Nancy, France.,U954 Inserm, Nancy, France
| | - C Leroy
- UMRS U1116 Inserm, Nancy, France.,CIC 1433 Inserm, Pierre Drouin, Nancy, France
| | - F Jaisser
- CHU Nancy, Nancy, France.,CIC 1433 Inserm, Pierre Drouin, Nancy, France
| | - F Zannad
- UMRS U1116 Inserm, Nancy, France.,Fédération de Recherche 3209, Nancy, France.,Université de Lorraine, Nancy, France.,CHU Nancy, Nancy, France.,CIC 1433 Inserm, Pierre Drouin, Nancy, France
| | - P Lacolley
- UMRS U1116 Inserm, Nancy, France.,Fédération de Recherche 3209, Nancy, France.,Université de Lorraine, Nancy, France.,CHU Nancy, Nancy, France
| | - L Vallar
- Genomics Research Unit, Luxembourg Institute of Health, Luxembourg
| | - A Pizard
- UMRS U1116 Inserm, Nancy, France.,Fédération de Recherche 3209, Nancy, France.,Université de Lorraine, Nancy, France.,CHU Nancy, Nancy, France.,CIC 1433 Inserm, Pierre Drouin, Nancy, France
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Smith S, Rossignol P, Willis S, Zannad F, Mentz R, Pocock S, Bisognano J, Nadim Y, Geller N, Ruble S, Linde C. Neural modulation for hypertension and heart failure. Int J Cardiol 2016; 214:320-30. [PMID: 27085120 DOI: 10.1016/j.ijcard.2016.03.078] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2016] [Accepted: 03/19/2016] [Indexed: 01/08/2023]
Abstract
Hypertension (HTN) and heart failure (HF) have a significant global impact on health, and lead to increased morbidity and mortality. Despite recent advances in pharmacologic and device therapy for these conditions, there is a need for additional treatment modalities. Patients with sub-optimally treated HTN have increased risk for stroke, renal failure and heart failure. The outcome of HF patients remains poor despite modern pharmacological therapy and with established device therapies such as CRT and ICDs. Therefore, the potential role of neuromodulation via renal denervation, baro-reflex modulation and vagal stimulation for the treatment of resistant HTN and HF is being explored. In this manuscript, we review current evidence for neuromodulation in relation to established drug and device therapies and how these therapies may be synergistic in achieving therapy goals in patients with treatment resistant HTN and heart failure. We describe lessons learned from recent neuromodulation trials and outline strategies to improve the potential for success in future trials. This review is based on discussions between scientists, clinical trialists, and regulatory representatives at the 11th annual CardioVascular Clinical Trialist Forum in Washington, DC on December 5-7, 2014.
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Affiliation(s)
- S Smith
- The Ohio State University Wexner Medical Center, Department of Internal Medicine and Division of Cardiology, Columbus, OH, USA.
| | - P Rossignol
- Inserm, CIC 1433, Centre Hospitalier Universitaire, Universite´ de Lorraine, F-CRIN INI-CRCT, Nancy, France
| | - S Willis
- The Ohio State University Wexner Medical Center, Department of Internal Medicine and Division of Cardiology, Columbus, OH, USA
| | - F Zannad
- Inserm, CIC 1433, Centre Hospitalier Universitaire, Universite´ de Lorraine, F-CRIN INI-CRCT, Nancy, France
| | - R Mentz
- Department of Medicine, Division of Cardiology, Duke University Medical Center, Durham, NC, USA
| | - S Pocock
- Medical Statistics Unit LSHTM, London, UK
| | - J Bisognano
- University of Rochester Medical Center, Department of Medicine, Cardiology, Rochester, NY, USA
| | - Y Nadim
- CVRx, Inc, Minneapolis, MN, USA
| | - N Geller
- Office of Biostatistics Research, Division of Cardiovascular Sciences, NHLBI, National Institutes of Health, Bethesda, MD, USA
| | - S Ruble
- Boston Scientific CRV, St. Paul, MN, USA
| | - C Linde
- Institution of Internal Medicine, Karolinska Institutet and Department of Cardiology, Karolinska University Hospital, Stockholm, Sweden.
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Girerd N, Zannad F, Rossignol P. Review of heart failure treatment in type 2 diabetes patients: It's at least as effective as in non-diabetic patients! Diabetes & Metabolism 2015; 41:446-55. [DOI: 10.1016/j.diabet.2015.06.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/13/2015] [Revised: 06/25/2015] [Accepted: 06/28/2015] [Indexed: 01/26/2023]
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Rossignol P, Girerd N, Gregory D, Massaro J, Konstam M, Zannad F. Increased visit-to-visit blood pressure variability is associated with worse cardiovascular outcomes in low ejection fraction heart failure patients: Insights from the HEAAL study. Int J Cardiol 2015; 187:183-9. [DOI: 10.1016/j.ijcard.2015.03.169] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2015] [Accepted: 03/16/2015] [Indexed: 11/30/2022]
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Watfa G, Heck O, Micard E, Lamiral Z, Hossu G, Felblinger J, Rossignol P, Benetos A, Zannad F, Bracard S. P076: Analysis of MRI-DTI diffusion values as an alternative to the Fazekas score. Eur Geriatr Med 2014. [DOI: 10.1016/s1878-7649(14)70251-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Toupance S, Watfa G, Lakomy C, Kearney-Schwartz A, Labat C, Rossignol P, Lacolley P, Zannad F, Benetos A. P148: Fixed ranking of leukocyte telomere length in elderly people: Preliminary results from 8 year follow-up of the ADELAHYDE cohort. Eur Geriatr Med 2014. [DOI: 10.1016/s1878-7649(14)70323-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Boivin JM, Boutte E, Fay R, Rossignol P, Zannad F. Home blood pressure monitoring: a few minutes of rest before measurement may not be appropriate. Am J Hypertens 2014; 27:932-8. [PMID: 24561656 DOI: 10.1093/ajh/hpu001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Home blood pressure measurement (HBPM) is recommended for the diagnosis and follow-up of hypertensive patients. While measurement protocols emphasize a rest period before taking the measurement, this directive has not been supported by any specific study to date. This analysis aimed to determine whether the respect or nonrespect of rest before HBPM could introduce a difference between daytime ambulatory blood pressure measurement (ABPM) and HBPM; whether this rest is observed "in real life" among educated hypertensive patients. METHODS In this open, prospective study we compared HBPM, with and without rest, and ABPM among 52 office/clinically controlled hypertensive patients. HBPM was performed during 3 days (French HAS instructions); 24-hour ABPM was performed within 3 days of HBPM. All patients who regularly performed HBPM before the study were asked how they practiced HBPM in real life. RESULTS There was a differential impact of rest on differences observed in daytime ABPM and HBPM. Systolic HBPM decreased with rest, while diastolic HBPM did not significantly increase. HBPM systolic BP (SBP) without rest was not significantly different from daytime ABPM SBP (P = 0.27). HBPM SBP without rest was lower than daytime and 24-hour systolic ABPM. Diastolic HBPM after rest was not significantly different from daytime diastolic ABPM (P = 0.09). None of the 38 patients who regularly performed HBPM were compliant with a period of rest before beginning the measurements. CONCLUSIONS Rest before HBPM induces a bias that underestimates SBP vs. daytime ABPM and perhaps complicates patient adherence to HBPM protocols.
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Affiliation(s)
- Jean-Marc Boivin
- Lorraine University, Nancy, France; Family Medicine Department, Medicine Faculty, Nancy, France; Centre d'Investigation Clinique Plurithématique (CIC-P) Inserm Centre Hospitalo-Universitaire (CHU) Pierre Drouin, Nancy, France.
| | - Emilie Boutte
- Lorraine University, Nancy, France; Family Medicine Department, Medicine Faculty, Nancy, France
| | - Renaud Fay
- Centre d'Investigation Clinique Plurithématique (CIC-P) Inserm Centre Hospitalo-Universitaire (CHU) Pierre Drouin, Nancy, France
| | - Patrick Rossignol
- Lorraine University, Nancy, France; Centre d'Investigation Clinique Plurithématique (CIC-P) Inserm Centre Hospitalo-Universitaire (CHU) Pierre Drouin, Nancy, France
| | - Faïez Zannad
- Lorraine University, Nancy, France; Centre d'Investigation Clinique Plurithématique (CIC-P) Inserm Centre Hospitalo-Universitaire (CHU) Pierre Drouin, Nancy, France
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Xu H, Huang X, Riserus U, Cederholm T, Lindholm B, Arnlov J, Carrero JJ, Leiba A, Vivante A, Bulednikov Y, Golan E, Skorecki K, Shohat T, Mjoen G, Zannad F, Jardine A, Schmieder R, Fellstrom B, Holdaas H, Zager P, Miskulin D, Gassman J, Kendrick C, Ploth D, Jhamb M, Jankowski V, Schulz A, Mischak H, Zidek W, Jankowski J, Lee YK, Cho A, Kim JK, Choi MJ, Kim SJ, Yoon JW, Koo JR, Kim HJ, Noh JW, Itano S, Satoh M, Kidokoro K, Sasaki T, Kashihara N, Koutroumpas G, Sarafidis P, Georgianos P, Karpetas A, Protogerou A, Syrganis C, Malindretos P, Raptopoulou K, Panagoutsos S, Pasadakis P, Zager P, Miskulin D, Gassman J, Kendrick C, Jhamb M, Ploth D, Vink EE, De Boer A, Verloop WL, Spiering W, Voskuil M, Vonken EJ, Hoogduin JM, Leiner T, Bots ML, Blankestijn PJ, Sarafidis PA, Karpetas AV, Georgianos PI, Bikos A, Sklavenitis-Pistofidis R, Tzimou R, Raptis V, Vakianis P, Tersi M, Liakopoulos V, Lasaridis AN, Protogerou A, Ribeiro S, Fernandes J, Garrido P, Sereno J, Vala H, Bronze Da Rocha E, Belo L, Costa E, Reis F, Santos-Silva A, Kalaitzidis R, Skapinakis P, Karathanos V, Karasavvidou D, Katatsis G, Pappas K, Hatzidakis S, Siamopoulos K, Margulis F, Sabbatiello R, Castro C, Ramallo S, Martinez M, Schiavelli R, Ganem D, Nakhoul F, Roth A, Farber E, Kim CS, Kim HY, Kang YU, Choi JS, Bae EH, Ma SK, Kim SW, Koutroumpas G, Sarafidis P, Georgianos P, Karpetas A, Protogerou A, Malindretos P, Syrganis C, Tzanis G, Panagoutsos S, Pasadakis P, Jankowski M, Kasztan M, Kowalski R, Piwkowska A, Rogacka D, Szczepa Ska-Konkel M, Angielski S, Evangelou D, Naka K, Kalaitzidis R, Lakkas L, Bechlioulis A, Gkirdis I, Nakas G, Zarzoulas F, Kotsia A, Balafa O, Tzeltzes G, Pappas K, Katsouras C, Dounousi E, Michalis L, Siamopoulos K, Maciorkowska D, Zbroch E, Koc-Zorawska E, Malyszko J, Karabay Bayazit A, Yuksekkaya I, Aynaci S, Anarat A, Nakai K, Fujii H, Ishida R, Utaka C, Awata R, Goto S, Ito J, Nishi S, Elsurer R, Afsar B, Lepar Z, Radulescu D, David C, Peride I, Niculae A, Checherita IA, Ciocalteu A, Sungur CI, Kanbay M, Siriopol D, Nistor I, Elcioglu OC, Telci O, Johnson R, Covic A, Vettoretti S, Gallazzi E, Meazza R, Gagliardi V, Villarini A, Alfieri CM, Floreani R, Messa P, Vettoretti S, Alfieri CM, Gallazzi E, Gagliardi V, Villarini A, Meazza R, Floreani R, Messa P, Kotovskaya Y, Villevalde S, Kobalava Z, Circiumaru A, Rusu E, Zilisteanu D, Atasie T, Cirstea F, Ecobici M, Voiculescu M, Rosca M, Tanase C, Baoti I, Vidjak V, Prka in I, Bulum T, Arslan E, Sarlak H, Cakar M, Demirbas S, Akhan M, Kurt O, Balta S, Yesilkaya S, Bulucu F, Chan CK, Lin YH, Wu VC, Wu KD, De Beus E, Bots ML, Van Zuilen AD, Wetzels JF, Blankestijn PJ, Mohaupt M, Straessle K, Baumann M, Raio L, Sirbek D, Nascimento MA, Mouro MG, Punaro GR, Mello MT, Tufik S, Higa EMS. HYPERTENSION. Nephrol Dial Transplant 2014. [DOI: 10.1093/ndt/gfu142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Rothuizen TC, Ocak G, Verschuren JJ, Dekker FW, Rabelink TJ, Jukema JW, Rotmans JI, Silva V, Raimann JG, Grassmann A, Marcelli D, Usvyat L, Canaud B, Kotanko P, Pecoits-Filho R, Consortium M, Strippoli GF, Sue YM, Tang CH, Chen TH, Hong CY, Ochi A, Ishimura E, Masuda M, Tsujimoto Y, Okuno S, Tabata T, Nishizawa Y, Inaba M, Moon Ki H, Do Hyoung K, Min Jee H, Hyun K, Wang Soo L, Su-Hyun K, Selim G, Stojceva-Taneva O, Tozija L, Dzekova-Vidimliski P, Trajceska L, Gelev S, Amitov V, Petronievic Z, Sikole A, Kee YK, Kim YL, Han JH, Oh HJ, Park JT, Han SH, Yoo TH, Kang SW, Okute Y, Shoji T, Sonoda M, Kuwamura Y, Tsujimoto Y, Tabata T, Shioi A, Tahara H, Emoto M, Inaba M, El Amrani M, Asserraji M, Benyahia M, Galloway PA, Yiu V, Hiemstra TF, Nilssen C, Zannad F, Jardine A, Schmieder R, Fellstrom B, Holdaas H, Mjoen G, Eftimovska - Otovic N, Babalj - Banskolieva E, Bogdanoska - Kostadinoska S, Grozdanovski R, Silva BC, Freitas GR, Silva VB, Abensur H, Luders C, Pereira BJ, Castro MC, Oliveira RB, Moyses RM, Elias RM, Perez De Jose A, Abad S, Vega A, Reque J, Quiroga B, Lopez-Gomez JM, Sasaki K, Yamguchi K, Hesaka A, Iwahashi E, Sakai S, Fujimoto T, Minami S, Fujita Y, Yokoyama K, Kidir V, Ersoy I, Altuntas A, Inal S, Do an A, Sezer MT, Azar H, Chacra D, Dabar G, Chelala D, Zhao L, Huang S, Liang T, Tang H, Turkmen K, Demirtas L, Akbas EM, Buyuklu M, Bakirci E, Kocyigit I, Ozcelik O, Guney I, Mumajesi S, Velaj A, Idrizi A, Pasko N, Cadri V, Barbullushi M, Bolleku E, Strakosh A, Cenaj A, Kacori V, Zekollari E, Rista E, Dusha D, Belba A, Thereska N, Gelev S, Toshev S, Trajceska L, Pavleska S, Selim G, Dzekova P, Shikole A, Naess H, Fellstrom B, Jardine AG, Schmieder RE, Zannad F, Holdaas H, Mjoen G, Sasaki K, Yamguchi S, Hesaka A, Iwahashi E, Sakai S, Fujimoto T, Minami S, Fujita Y, Yokoyama K, Bilevich O, Bunova S, Semchenko S, Schwermer K, Hoppe K, Klysz P, Baum E, Sikorska D, Radziszewska D, Sawatiuk P, Olejniczak P, Pawlaczyk K, Lindholm B, Oko A, El Amrani M, Asserraji M, Rbaibi A, El Kharass A, Benyahia M, Rroji ( Molla) M, Seferi S, Cafka M, Spahia N, Likaj E, Thereska N, Barbullushi M, Pelletier CC, Jolivot A, Kalbacher E, Panaye M, Bureau Du Colombier P, Juillard L, Burmeister JE, Mosmann CB, Bastos JP, Burmeister BO, Munaro G, Pereira JD, Youssef DW, Rosito GA. DIALYSIS CARDIOVASCULAR COMPLICATIONS 2. Nephrol Dial Transplant 2014. [DOI: 10.1093/ndt/gfu175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Rossignol P, Dobre D, Gregory D, Massaro J, Kiernan M, Konstam M, Zannad F. Incident hyperkalemia may be an independent therapeutic target in low ejection fraction heart failure patients: Insights from the HEAAL study. Int J Cardiol 2014; 173:380-7. [DOI: 10.1016/j.ijcard.2014.02.034] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2013] [Revised: 11/25/2013] [Accepted: 02/22/2014] [Indexed: 10/25/2022]
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Habib S, De Borne PV, Niederhoffer N, Sauleau E, Albuisson E, Rossignol P, Zannad F, Bousquet P. 0253: Sympathetic overactivity: a very early manifestation of metabolic syndrome. Archives of Cardiovascular Diseases Supplements 2014. [DOI: 10.1016/s1878-6480(14)71291-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Buonafine M, Tarjus A, Gravez B, Amador C, Moghrabi E, Latouche C, Rossignol P, Zannad F, Farman N, López-Andrés N, Jaisser F. 0470: Role of Lipocalin 2 (LCN2) in cardiovascular remodeling induced by aldosterone. Archives of Cardiovascular Diseases Supplements 2014. [DOI: 10.1016/s1878-6480(14)71290-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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McMurray J, Adamopoulos S, Anker S, Auricchio A, Böhm M, Dickstein K, Falk V, Filippatos G, Fonseca C, Gomez-Sanchez M, Jaarsma T, Køber L, Lip G, Maggioni A, Parkhomenko A, Pieske B, Popescu B, Rønnevik P, Rutten F, Schwitter J, Seferovic P, Stepinska J, Trindade P, Voors A, Zannad F, Zeiher A. Corrigendum to: ‘ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure 2012’ [Eur J Heart Fail 2012;14: 803-869]. Eur J Heart Fail 2014. [DOI: 10.1093/eurjhf/hft016] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Eschalier R, Rossignol P, Kearney-Schwartz A, Adamopoulos C, Karatzidou K, Fay R, Mandry D, Marie PY, Zannad F. Features of cardiac remodeling, associated with blood pressure and fibrosis biomarkers, are frequent in subjects with abdominal obesity. Hypertension 2014; 63:740-6. [PMID: 24446063 DOI: 10.1161/hypertensionaha.113.02419] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Incidence and prevalence of abdominal obesity (AO) are growing exponentially. Subjects with AO are at higher risk of developing heart failure. The purpose of the study was to investigate early changes in cardiac and arterial structure and function and extracellular matrix biomarkers in normotensive healthy subjects with AO. Subjects with AO and age- and sex-matched controls underwent echocardiography, MRI (cardiac remodeling index), carotid intima-media thickness, pulse wave velocity, and blood fibrosis biomarkers measurements. We enrolled 87 subjects with AO and 53 controls. Although normotensive, subjects with AO had higher systolic blood pressure (BP; 122±11 versus 116±11 mm Hg; P=0.003), left ventricular mass (94±24 versus 84±21 g; P=0.034), and cardiac remodeling index (0.67±0.16 versus 0.60±0.10 g/mL; P=0.026) but unchanged carotid intima-media thickness and pulse wave velocity. Diastolic dysfunction (E' <10 cm/s) could be detected in 38% of subjects with AO (4% in controls). Left ventricular remodeling, as assessed by cardiac remodeling index, was positively and independently associated with higher BP (systolic BP and mean arterial pressure but not diastolic BP) and AO. Higher BP, AO, and procollagen-III-N-terminal peptide (≥2.4 ng/mL) concentrations (odds ratio, 4.15 [1.42-12.2]; P=0.01) were positively associated with diastolic dysfunction. Early cardiac structural remodeling, fibrosis, and diastolic dysfunction were detectable in healthy subjects with AO. Higher BP, procollagen-III-N-terminal peptide, and AO were independently associated with early cardiac structural and functional changes. It is to be investigated whether in subjects with AO, an early BP reduction, even if normotensive, combined with weight loss may avoid adverse cardiac remodeling and protect against progression to heart failure.
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Affiliation(s)
- Romain Eschalier
- CIC Plurithématique, Institut Lorrain du cœur et des vaisseaux, 4 rue du Morvan, 54500 Vandœuvre lès Nancy, France.
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Eschalier R, McMurray J, Swedberg K, Veldhuisen van D, Krum H, Pocock S, Shi H, Vincent J, Rossignol P, Zannad F, Pitt B. SAFETY AND EFFICACY OF EPLERENONE IN PATIENTS AT HIGH RISK FOR HYPERKALEMIA AND/OR WORSENING RENAL FUNCTION. ANALYSES OF THE EMPHASIS-HF STUDY SUBGROUPS (EPLERENONE IN MILD PATIENTS HOSPITALIZATION AND SURVIVAL STUDY IN HEART FAILURE). Racionalʹnaâ farmakoterapiâ v kardiologii 2014. [DOI: 10.20996/1819-6446-2014-10-1-106-115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Fresco C, Miani D, Artico J, Daneluzzi C, Urso R, Lucci D, Dahlstrom U, Tavazzi L, Zannad F, Maggioni AP. Predictive value of CHA2DS and CHA2DS2VASC scores on mortality in different groups of heart failure patients. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht309.p2731] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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