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Development and validation of the HARMS2-AF lifestyle risk score to predict incident AF. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Lifestyle risk factors (RFs) are a modifiable target in atrial fibrillation (AF) management. However, the relative contribution of individual lifestyle RFs to AF incidence has not been described.
Purpose
Development and validation of a novel AF-lifestyle risk score to determine AF risk in the general population.
Methods
The UK Biobank (UKB) is a large prospective cohort with outcomes measured >10 years. In the UKB, we performed regression analysis of AF lifestyle RFs which were then evaluated in a multivariable model and a weighted score was developed. Next, the risk score was externally validated in the Framingham Heart Study (FHS) population. Kaplan-Meier estimates ascertained the 10-year risk of AF development.
Results
In the UKB, AF incidence was 5.3% among 302,926 participants, with a median time to AF 7.3 years (IQR 4.3–9.8). Hypertension, sleep apnoea, male sex, age, obesity (BMI>30 kg/m2), alcohol and smoking were predictive variables (all p<0.001); physical inactivity (OR 1.02,95% CI 0.97–1.10, p=0.3), diabetes (OR 0.98,95% CI 0.91–1.06, p=0.2) and BMI 27–30 kg/m2 (OR 1.02, 95% CI 0.97–1.07, p=0.424) were not significant. The HARMS2-AF score (Figure 1) had similar predictive performance (AUC=0.782, LogLoss 0.178, Brier Score 0.046) to the unweighted regression model (AUC 0.808) in the UKB. Validation in the FHS (AF incidence 6.7% of 7206 participants) maintained excellent predictive performance with an AUC of 0.747 (95% CI 0.724–0.769, Figure 2). A higher HARMS2-AF score (>5 points) was associated with a heightened 10-year AF risk (score 5–9: OR 9.35, score 10–14: OR 33.34).
Conclusions
The HARMS2-AF score is a novel lifestyle risk score which may help identify individuals at risk of AF and assists in general population screening.
Funding Acknowledgement
Type of funding sources: None.
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Clinical risk prediction for left atrial appendage thrombus among patients with atrial fibrillation. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Exclusion of left atrial appendage thrombus (LAAT) by transoesophageal echocardiography (TOE) is recommended in patients with inadequate anticoagulation prior to direct cardioversion (DCR) or catheter ablation for atrial fibrillation/flutter (AF/AFL). LAAT risk factors in this population remain poorly defined.
Purpose
Determine LAAT predictors in AF/AFL patients undergoing pre-procedural TOE.
Methods
We evaluated available clinical and transthoracic echocardiographic (TTE) parameters in AF/AFL patients undergoing TOE between 1999–2022 in our institution in Melbourne, Australia. Regression analysis identified predictors of LAAT, which were applied to a weighted score developed in the derivation cohort (70%) and validated in the remaining 30%.
Results
Of 627 patients (age 62±12 years, 27% female, AF 84%,AFL 16%, left ventricular ejection fraction (LVEF) 44±20%), 24% had LAAT and 13.8% dense spontaneous echo contrast precluding DCR. Anticoagulation was NOAC 56.5%, warfarin 32.1% and none in 11.4%. In the LAAT cohort, thrombus resolution occurred in 39% on serial transoesophageal imaging with a median time to resolution of 131 days (IQR 54–398).
Diabetes (p=0.004), prior stroke (p=0.009), coronary disease (p=0.015), renal impairment (p<0.001) and CHADS2VASc >2 (73% vs. 55%, p<0.001) were higher in the LAAT cohort. Age (p=0.093), gender (p=0.689), BMI (p=0.828), anticoagulant type (p=0.316) and diabetes (p=0.107) were not univariate predictors, whereas anticoagulation duration (<30 days), creatinine and TTE markers of remodeling (LVEF, LAVI, RVSP and TAPSE) were independent predictors on univariate and multivariate regression; CHADS2VASc was not significant after adjustment (p=0.090). The weighted risk model included continuous (age, creatinine, LVEF, LAVI, TAPSE and RVSP) and categorical (anticoagulation duration) variables with excellent predictive performance: AUC 0.872 (95% CI 0.798–0.946), PPV 91%, NPV 70% and accuracy 80%.
Conclusion
A novel LAAT risk model comprising clinical and echocardiographic parameters enhances risk prediction over CHADS2VASc in AF/AFL and may guide the need for pre-procedural TOE imaging.
Funding Acknowledgement
Type of funding sources: None.
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Post Procedural Atrial Fibrillation and Flutter in Patients Undergoing Transcatheter Aortic Valve Implantation, Analysis of the ACE-TAVI Registry. Heart Lung Circ 2022. [DOI: 10.1016/j.hlc.2022.06.611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
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4
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Haemodynamic and Metabolic Adaptations in Coronary Microvascular Disease (CMD). Heart Lung Circ 2022. [DOI: 10.1016/j.hlc.2022.06.592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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5
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The Impact of Diabetes on Haemodynamic and Cardiometabolic Responses in Heart Failure With Preserved Ejection Fraction. Heart Lung Circ 2022. [DOI: 10.1016/j.hlc.2022.06.132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
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6
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Ellipticity Is Associated With Non-Cardiac Mortality Following Transcatheter Aortic Valve Implantation. Heart Lung Circ 2022. [DOI: 10.1016/j.hlc.2022.06.583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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7
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Coronary Artery Disease Risk Prediction in Patients With Severe Aortic Stenosis Undergoing TAVI. Heart Lung Circ 2022. [DOI: 10.1016/j.hlc.2022.06.572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
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8
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Machine Learning Techniques Can Identify a High Risk Phenotype of Aortic Stenosis Undergoing Transcatheter Aortic Valve Implantation. Heart Lung Circ 2022. [DOI: 10.1016/j.hlc.2022.06.605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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9
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The Alfred, Cabrini and Epworth Transcatheter Aortic Valve Implantation (ACE-TAVI) Registry: Description and Short-Term Clinical Outcomes. Heart Lung Circ 2022. [DOI: 10.1016/j.hlc.2022.06.627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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10
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Development and Validation of the HARMS2-AF Lifestyle Risk Score to Predict Incident AF. Heart Lung Circ 2022. [DOI: 10.1016/j.hlc.2022.06.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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11
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Development of an AF Lifestyle Score for Risk Prediction in Incident AF. Heart Lung Circ 2022. [DOI: 10.1016/j.hlc.2022.06.157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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12
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What do Australian health consumers believe about commercial advertisements and testimonials? a survey on health service advertising. BMC Public Health 2021; 21:74. [PMID: 33413201 PMCID: PMC7791787 DOI: 10.1186/s12889-020-10078-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Accepted: 12/15/2020] [Indexed: 11/21/2022] Open
Abstract
Background There has been little examination of consumer attitudes towards the commercial advertising of healthcare services in Australia and how marketing is used by consumers in their health decision-making. In this research, we examined how consumers reported commercial advertising helped them to understand the health services available to them and the influence that marketing had upon their choices. Methods A survey instrument using a Likert scale to indicate agreement or disagreement with 21 questions was developed using qualitative interviews before being distributed online within Australia. Sampling of participants was stratified by age, gender and location. The results were subjected to statistical analysis with Spearman Rank Correlation test being used for bivariate analysis. Results One thousand five hundred sixty-four complete surveys were collected. The results revealed certain consumer beliefs, for example; the title of ‘Dr’ was believed to indicate skill and high levels of training (81.0%), with 80.3% agreeing incorrectly that use of the title was strictly regulated. Participants reported to have a higher confidence in their own abilities (71.2%) than the public (52.8%) in assessing health advertising. The level of self-confidence increased with higher education level and decreased by age (p < 0.05). Testimonials were reported to be lacking in reliability (67.7%) and that they should not be used in healthcare in the same manner as they are used in other industries. Only 44.8% of participants reported that they felt confident to spot a review that was not written by a genuine user of a service. Conclusions The data demonstrated that many health consumers felt that while commercial health advertising was helpful, it was also confusing, with many participants also holding mistaken beliefs around other elements of commercial health advertising. While the advertising of healthcare services might have educational effects and be superficially empowering, advertising is primarily intended to sell, not educate. This research demonstrates that there is significant potential for healthcare advertising to mislead. Future developments in regulatory health advertising policy, and the related ethical frameworks developed by professional healthcare associations, need to consider how the consumers of healthcare services might be better protected from misleading and predatory advertising practices. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-020-10078-9.
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The Gut Microbiome of Heart Failure With Preserved Ejection Fraction. Heart Lung Circ 2021. [DOI: 10.1016/j.hlc.2021.06.108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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14
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Development of a Novel Web-based Standardised Workflow to Assist With Device Selection in Patients Undergoing Transcatheter Aortic Valve Implantation. Heart Lung Circ 2021. [DOI: 10.1016/j.hlc.2021.06.464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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15
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The Role of Comorbidities to Predict Failure of Functional Improvement at One Year Following Transcatheter Aortic Valve Implantation. Heart Lung Circ 2021. [DOI: 10.1016/j.hlc.2021.06.508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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16
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Impact of catheter ablation on HFpEF in people with comorbid atrial fibrillation and HFpEF using invasive haemodynamic testing. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
The impact of catheter ablation (CA) for atrial fibrillation (AF) in patients with heart failure with preserved ejection fraction (HFpEF) is unknown.
Objectives
To determine whether CA for AF reverses adverse haemodynamic changes associated with HFpEF.
Methods
Consecutive consenting patients with EF ≥50% scheduled for index CA underwent baseline exercise right heart catheterisation (exRHC), cardiac output (CO) measurement, cardiac MRI, echocardiogram, QOL questionnaires and BNP testing. HFpEF was defined by resting pulmonary capillary wedge pressure (PCWP) ≥15mmHg or peak exercise PCWP ≥25 mmHg during exRHC. Patients with HFpEF were offered follow-up exRHC ≥6 months post-CA.
Results
Of 252 patients scheduled for CA between April 2017 and Sept 2019, 131 (51.9%) qualified for inclusion, 65 (49.6%) consented to exRHC and 11 (16.9%) were excluded due to a subsequent decrease in EF (10) and uncontrolled hypertension (1). Fifty-four underwent exRHC, with 35 (65%) meeting criteria for HFpEF. Of them 26 (74.3%) who underwent CA, 20 (77%) had a follow up exRHC at 12±6 months follow-up, showing an overall decrease in peak exercise PCWP from 30.3±4.2 to 26.8±4.7 mmHg (p<0.05). Patients without arrhythmia recurrence showed significant improvements in peak exercise PCWP (29.2±3.7 to 22.9±2.0 mmHg (p<0.01). Their cardiac output increased from 10.3±3.0 to 12.1±4.0 mmHg p=0.1), and BNP decreased from (94.6±101.6 to 38.0±34.0 mmHg (p=0.06),whereas those with arrhythmia recurrence did not. Overall, 9 patients (45.0%) no longer met criteria for HFpEF.
Conclusion
There is a high prevalence of HFpEF in people referred for AF ablation. Successful CA for AF reverses the adverse haemodynamic changes associated with HFpEF
Changes in PCWP following AF ablation
Funding Acknowledgement
Type of funding source: Public grant(s) – National budget only. Main funding source(s): NHMRC, NHF, RACP
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Prevalence and correlates of normal body mass index central obesity among people with cardiovascular diseases in Australia. Public Health 2020; 183:126-131. [PMID: 32497780 DOI: 10.1016/j.puhe.2020.03.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Revised: 03/13/2020] [Accepted: 03/19/2020] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Obesity is one of the most common risk factors for cardiometabolic diseases in Australia and worldwide. Recent studies show that people with normal body mass index (BMI) but with central obesity are at increased risk of morbidity and mortality from cardiometabolic diseases. This risk has not been explained well. The aim of this study was to examine the magnitude, correlates and effects of normal BMI central obesity in the Australian adult population. STUDY DESIGN Longitudinal study with data linkage. METHODS We used the Baker Biobank, which contains sociodemographic, behavioural, clinical and mortality data. Data were collected between 2000 and 2011 from 6530 adults who were between 18 and 69 years of age. Biobank data were linked to the National Death Index. A matrix of BMI and waist-to-height ratio (WHtR) and waist-to-hip ratio (WHR) were used to create adiposity categories. For analysis, we used descriptive statistics, logistic regression and cox regression models. RESULTS The overall prevalence of normal BMI central obesity was 13.4% by WHtR and 14.4% by WHR. Gender, age, BMI and physical activity were associated with normal BMI central obesity. Higher odds of multimorbidity and increased hazards of all-cause and cardiovascular mortality were associated with WHR. CONCLUSION WHtR and WHR, when each used with BMI, provided similar estimates of prevalence of normal BMI central obesity. However, WHR is a better predictor of all-cause and cardiovascular mortality.
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Pulmonary Onset of Adult Onset Still's Disease Complicated with Kikuchi Lymphadenitis. Case Rep Rheumatol 2020; 2020:8327068. [PMID: 32148996 PMCID: PMC7053467 DOI: 10.1155/2020/8327068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2019] [Revised: 01/03/2020] [Accepted: 01/09/2020] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Adult onset Still's disease (AOSD) is a rare inflammatory disorder with a variety of clinical presentations. Even though pneumonitis and pleurisy are known to occur in AOSD, pulmonary onset presentations are exceedingly rare. Case Presentation. We present a 40-year-old male, presenting with fever and bilateral alveolar shadows with pleural effusions mimicking community-acquired severe pneumonia. He was initially treated as severe pneumonia with poor response to broad spectrum antibiotics. Subsequently, he was managed as AOSD-induced pneumonitis, as he fulfilled Yamaguchi criteria. Few weeks later, he developed macular rash and arthralgia with generalized lymphadenopathy with lymph node histology, showing Kikuchi lymphadenitis. He responded well to steroids and had a complete recovery. CONCLUSION Non-infective causes of pneumonitis should be suspected in the setting of poorly resolving pneumonias, especially when microbiological and serological investigations does not support an infective etiology. Presence of systemic symptoms with arthralgia, rash, and disproportionately elevated ferritin level supports the diagnosis of AOSD. Kikuchi lymphadenitis is a reported association with AOSD, and there could be a causal link between the two disorders.
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19
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876 Relationship of Pulse Pressure to Outcomes Following Transcatheter Aortic Valve Implantation. Heart Lung Circ 2020. [DOI: 10.1016/j.hlc.2020.09.883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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20
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307 Comparison of Left Ventriculography and Transthoracic Echocardiography in the Assessment of Left Ventricular Systolic Function Post Myocardial Infarction - A Single Centre Retrospective Analysis. Heart Lung Circ 2020. [DOI: 10.1016/j.hlc.2020.09.314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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21
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840 Impact of Sex on Outcomes Following Transcatheter Aortic Valve Implantation. Heart Lung Circ 2020. [DOI: 10.1016/j.hlc.2020.09.847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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22
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768 Machine Learning Prediction Tools for All-Cause Readmissions in Patients Hospitalised for Heart Failure Using Routinely Collected Medical Record Data. Heart Lung Circ 2020. [DOI: 10.1016/j.hlc.2020.09.775] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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780 A Pilot Project to Assess the Safety of Same Day Discharge for Percutaneous Coronary Intervention. Heart Lung Circ 2020. [DOI: 10.1016/j.hlc.2020.09.787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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130The effect of parity on exercise physiology in women with heart failure with preserved ejection fraction. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz747.0046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Introduction
Women are overrepresented amongst patients with HFpEF, however the underpinning mechanism for this asymmetric distribution is unclear. Pregnancy has been demonstrated to contribute to cardiovascular risk, and represents a potential gender specific risk factor for HFpEF.
Purpose
To investigate the relationship between parity and severity of HFpEF on invasive haemodynamic and echocardiographic studies.
Methods
Patients referred for investigation of dyspnoea with exercise right heart catheterisation from 2008–19 were included and classified as HFpEF with an ejection fraction (EF) ≥50% and a resting PCWP ≥15mmHg or exercise PCWP ≥25mmHg. All patients underwent detailed haemodynamic and echocardiographic assessment, and an obstetric history including socioeconomic data were obtained using a questionnaire.
Results
58 women were included, and categorised as having either 0–2 births, or ≥3 births, dividing the cohort equally. Women with ≥3 births achieved a lower peak exercise workload than those with 0–2 births (46 [31–68] vs. 38 [24–51] W, p=0.04). Women with ≥3 births had a greater rise in pulmonary capillary wedge pressure indexed to workload with exercise (0.5 [0.3–0.8] vs. 0.3 [0.2–0.5] mmHg/W, p=0.03), paralleled by a greater rise in right atrial pressure (10 [8–12] vs. 7 [3–11] mmHg, p=0.01), pictured. Pulmonary vascular resistance was also higher in women with ≥3 births (1.9 [1.6–2.4] vs. 1.6 [1.4–1.9] mmHg/L/min rest, p=0.046, and 1.9 [2.4–2.4] vs. 1.4 [1–1.8] mmHg/L/min exercise, p=0.024). Left ventricular ejection fraction was lower at rest (60 [57–61] vs. 63 [60–66] %, p=0.008) and during exercise (65 [62–67] vs. 68 [66–70] %, p=0.038) in women with higher parity. Otherwise, echocardiographic parameters did not differ according to parity. There were no significant differences between parity groups in baseline characteristics, including age, body mass index, systemic blood pressure, natriuretic peptides or dyspnea class. Similarly, comorbidities and socioeconomic status did not differ.
Conclusion(s)
Higher parity is associated with impairments in multiple physiologic parameters of HFpEF severity in women, including diastolic reserve, pulmonary vascular resistance, and systolic function. This may indicate a role for pregnancy in the development of HFpEF, and suggests that multiparous women should be targeted for intensification of preventative measures for HFpEF.
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P2608Impact of sub-clinical systolic dysfunction on exercise hemodynamics in HFpEF: time to integrate diastolic and systolic indices. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
A potential role for subclinical systolic impairment as a contributor to the pathophysiology and outcomes of heart failure with preserved ejection fraction (HFpEF) has been proposed recently. However, the precise relationship of indices of systolic dysfunction with exercise hemodynamics in HFpEF is not known. In this study, we characterize the relationship between left ventricular mechanical function assessed by strain imaging with the key hemodynamic features of HFpEF at rest and during exercise.
Methods
Simultaneous echocardiography and exercise right heart catheterization was performed in 90 subjects (68 HFpEF, 22 control) referred for assessment of dyspnea. HFpEF was defined as left ventricular ejection fraction (LVEF) ≥50% with a pulmonary capillary wedge pressure (PCWP) ≥15mmHg at rest and/or ≥25mmHg at maximal exertion. Measures of left ventricular strain were taken using speckle tracking and analyzed together with natriuretic peptides and rest and exercise hemodynamics.
Results
At rest, HFpEF patients had impaired GLS compared to NCD subjects (−18.4±2.5 vs −21.2±3.5%, p≤0.001. Ejection fraction was similar (62±6 vs 61±6%, p=0.81). With worsening global longitudinal strain, patients with HFpEF displayed a worse cardiac index at both rest and exercise (p<0.001 for both), but similar filling pressure (p=0.85). The tertile with the worst strain had the highest level of natriuretic peptide. The association of strain with peak cardiac index was independent of LVEF, BNP, age, LAVI, LVMI, and systolic blood pressure.
Conclusions
Despite a preserved ejection fraction, a proportion of patients with HFpEF display impaired GLS, which correlates with a worse cardiac output. Impaired GLS was not associated with higher filling pressures at rest or exercise.
Acknowledgement/Funding
National Heart Foundation of Australia
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Alcohol Abstinence in Moderate Drinkers with Atrial Fibrillation: Results from the Alcohol-AF Randomised Controlled Trial. Heart Lung Circ 2019. [DOI: 10.1016/j.hlc.2019.06.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Unsupervised Machine Learning Identifies Treatment Response to Spironolactone in Patients with Heart Failure with Preserved Ejection Fraction: A TOPCAT Substudy. Heart Lung Circ 2019. [DOI: 10.1016/j.hlc.2019.06.146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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28
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Association Between Heart Rate Variability and Echocardiographic Parameters in Heart Failure with Reduced and Preserved Ejection Fraction. Heart Lung Circ 2019. [DOI: 10.1016/j.hlc.2019.06.065] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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29
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Impact of Sub-Clinical Systolic Dysfunction on Exercise Haemodynamics in HFpEF. Heart Lung Circ 2019. [DOI: 10.1016/j.hlc.2019.06.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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30
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Extended Release Oral Milrinone for the Treatment of Heart Failure with Preserved Ejection Fraction. Heart Lung Circ 2019. [DOI: 10.1016/j.hlc.2019.06.384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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31
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Predictors and Consequences of Optimal Mechanical Unloading in LVAD Recipients. Heart Lung Circ 2019. [DOI: 10.1016/j.hlc.2019.06.120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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32
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Low Brain Natriuretic Peptide in Hemodynamically Proven Heart Failure Preserved Ejection Fraction: An Invasive-Echocardiographic Characterisation Study. Heart Lung Circ 2019. [DOI: 10.1016/j.hlc.2019.06.110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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33
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The Effect of Parity on Exercise Physiology in Women with Heart Failure with Preserved Ejection Fraction. Heart Lung Circ 2019. [DOI: 10.1016/j.hlc.2019.06.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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34
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The Overlap between Cancer and Cardiovascular Diseases Mortality. Heart Lung Circ 2019. [DOI: 10.1016/j.hlc.2019.06.137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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35
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Inclusion of Left Atrial Strain Evaluation with the “H2FPEF Score” Enhances Diagnostic Accuracy for Heart Failure with Preserved Ejection Fraction. Heart Lung Circ 2019. [DOI: 10.1016/j.hlc.2019.06.100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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36
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Persistent Renal Dysfunction Preceding Left-Ventricular Assist Device Implantation Predicts Increased Mortality and Diminished Left-Ventricular Unloading. Heart Lung Circ 2019. [DOI: 10.1016/j.hlc.2019.06.119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Non-Invasive Blood Pressure Monitoring Underestimates Exercise-Induced Hypertension in Heart Failure with Preserved Ejection Fraction (HFpEF). Heart Lung Circ 2019. [DOI: 10.1016/j.hlc.2019.06.116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Abstract
Introduction: Increasing attention is being given to the roles of data management and data sharing in the advancement of research. This study was undertaken to explore opinions and past experiences of established dental researchers as related to data sharing and data management. Methods: Researchers were recruited from the International Association for Dental Research scientific groups to complete a survey consisting of Likert-type, multiple-choice, and open-ended questions. Results: All 42 respondents indicated that data sharing should be promoted and facilitated, but many indicated reservations or concerns about the proper use of data and the protection of research subjects. Many had used data from data repositories and received requests for data originating from their studies. Opinions varied regarding restrictions such as requirements to share data and the time limits of investigator rights to keep data. Respondents also varied in their methods of data management and storage, with younger respondents and those with higher direct costs of their research tending to use dedicated experts to manage their data. Discussion: The expressed respondent support for research data sharing, with the noted concerns, complements the idea of developing managed data clearinghouses capable of promoting, managing, and overseeing the data-sharing process. Knowledge Transfer Statement: Researchers can use the results of this study to evaluate and improve management and sharing of research data. By encouraging and facilitating the data-sharing process, research can advance more efficiently, and research findings can be implemented into practice more rapidly to improve patient care and the overall oral health of populations.
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1096Mid regional atrial natriuretic peptide is an independent predictor of peak pulmonary capillary wedge pressure in patients with heart failure with preserved ejection fraction. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.1096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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P775Acute coronary syndromes: mechanistic insights and risk prediction through lipoprotein lipidomics. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy564.p775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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P5655Influence of left atrial strain and stiffness on haemodynamics in heart failure with preserved ejection fraction. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.p5655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Continuous-flow LVAD Therapy: A ‘Forme-fruste’ of Diastolic Heart Failure. J Heart Lung Transplant 2018. [DOI: 10.1016/j.healun.2018.01.344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Partial trisomy 16q21➔qter due to an unbalanced segregation of a maternally inherited balanced translocation 46,XX,t(15;16)(p13;q21): a case report and review of literature. BMC Pediatr 2018; 18:4. [PMID: 29310616 PMCID: PMC5759277 DOI: 10.1186/s12887-017-0980-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2016] [Accepted: 12/29/2017] [Indexed: 11/30/2022] Open
Abstract
Background Partial trisomy is often the result of an unbalanced segregation of a parental balanced translocation. Partial trisomy16q is characterized by a common, yet non-specific group of craniofacial dysmorphic features, and systemic malformations with limited post-natal survival. Most of the cases of partial trisomy 16q described in the scientific literature have reported only one, or less frequently two cardiac defects in the affected babies. Herein, we report a case of partial trisomy 16q21➔qter with multiple and complex cardiac defects that have not previously been reported in association with this condition. Case presentation We report the phenotypic and cytogenetic features of a Sri Lankan female infant with partial trisomy 16q21➔qter. The baby had a triangular face with downslanting eyes, low set ears and a cleft palate. Systemic abnormalities included multiple cardiac defects, namely double outlet right ventricle, ostium secundum atrial septal defect, mild pulmonary stenosis, small patent ductus arteriosus, and bilateral superior vena cavae. An anteriorly placed anus was also observed. The proband was trisomic for 16q21➔qter chromosomal region with a karyotype, 46,XX,der(15)t(15;16)(p13;q21)mat. The chromosomal anomaly was the result of an unbalanced segregation of a maternal balanced translocation; 46,XX,t(15;16)(p13;q21). Partial trisomy 16q was established by fluorescence in-situ hybridization analysis. Conclusions The craniofacial dysmorphic features and the presence of cardiac and anorectal malformation in the proband are consistent with the phenotypic spectrum of partial trisomy 16q reported in the scientific literature. More proximal breakpoints in chromosome 16q are known to be associated with multiple cardiac abnormalities and poor long-term survival of affected cases. This report presents a unique case with multiple, complex cardiac defects that have not previously been described in association with a distal breakpoint in 16q. These findings have important diagnostic and prognostic implications.
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Sex Differences in Echocardiographic Parameters and Survival in the Treatment of Preserved Cardiac Function Heart Failure with an Aldosterone Antagonist (TOPCAT) Trial. Heart Lung Circ 2018. [DOI: 10.1016/j.hlc.2018.06.193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Association of Rest and Exercise Left Ventricular Strain with Exercise Haemodynamics in Patients with Heart Failure with Preserved Ejection Fraction. Heart Lung Circ 2018. [DOI: 10.1016/j.hlc.2018.06.081] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Implications of Diastolic Filling Parameters on Spironolactone Response in Heart Failure With Preserved Ejection Fraction: Observations from the TOPCAT Study. Heart Lung Circ 2018. [DOI: 10.1016/j.hlc.2018.06.149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Abnormal Diastology Predicts Long-Term Functional Outcome and Rehospitalisation in Patients Undergoing Transcatheter Aortic Valve Implantation. Heart Lung Circ 2018. [DOI: 10.1016/j.hlc.2018.06.881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Phenomapping Patients After Percutaneous Coronary Intervention Using Novel Machine Learning Techniques: Insights Into the Melbourne Interventional Group Registry. Heart Lung Circ 2018. [DOI: 10.1016/j.hlc.2018.06.1032] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Veno-Arterial Extracorporeal Membrane Oxygenation Reduces Left Ventricular Dimensions in Patients with Cardiogenic Shock. Heart Lung Circ 2018. [DOI: 10.1016/j.hlc.2018.06.225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Impaired Left Atrial Strain Predicts Abnormal Haemodynamics in Heart Failure with Preserved Ejection Fraction. Heart Lung Circ 2018. [DOI: 10.1016/j.hlc.2018.06.028] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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