Diagnostic algorithm for HFpEF: how much is the recent consensus applicable in clinical practice?

Tadić, Marijana; Cuspidi, Cesare; Calicchio, Francesca; Mancia, Giuseppe

doi:10.1007/s10741-020-09966-4

Cited by 11 publications

(15 citation statements)

References 42 publications

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“…Javaheri et al, observed significant association of increased circulating concentrations of C16:0 and C18:0 ceramides in participants with HFpEF (142). This study was especially informative, as HFpEF is difficult to diagnose and controversy still exists as to diagnostic algorithms (143). Similarly, another study showed that levels of ceramide and SM with 16-carbon acyl chain length were directly associated with higher risk of mortality deaths from CVD (144).…”

Section: Sphingolipids As Emerging Biomarkers In Assessing Cardiovascmentioning

confidence: 59%

Sphingolipids in the Heart: From Cradle to Grave

2020

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Cardiovascular diseases are the leading cause of mortality worldwide and this has largely been driven by the increase in metabolic disease in recent decades. Metabolic disease alters metabolism, distribution, and profiles of sphingolipids in multiple organs and tissues; as such, sphingolipid metabolism and signaling have been vigorously studied as contributors to metabolic pathophysiology in various pathological outcomes of obesity, including cardiovascular disease. Much experimental evidence suggests that targeting sphingolipid metabolism may be advantageous in the context of cardiometabolic disease. The heart, however, is a structurally and functionally complex organ where bioactive sphingolipids have been shown not only to mediate pathological processes, but also to contribute to essential functions in cardiogenesis and cardiac function. Additionally, some sphingolipids are protective in the context of ischemia/reperfusion injury. In addition to mechanistic contributions, untargeted lipidomics approaches used in recent years have identified some specific circulating sphingolipids as novel biomarkers in the context of cardiovascular disease. In this review, we summarize recent literature on both deleterious and beneficial contributions of sphingolipids to cardiogenesis and myocardial function as well as recent identification of novel sphingolipid biomarkers for cardiovascular disease risk prediction and diagnosis.

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Section: Sphingolipids As Emerging Biomarkers In Assessing Cardiovascmentioning

confidence: 59%

Sphingolipids in the Heart: From Cradle to Grave

2020

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“…Recently, scoring systems have been developed to improve the diagnostic accuracy for HFpEF, and increasing evidences suggested invasive or non-invasive exercise testings in those with at least intermediate HFpEF probability 7 . The H 2 FPEF and HFA–PEFF noninvasive scoring systems for the diagnostic workup of HFpEF have been reported 8 , 9 , which are considered as reliable methods in diagnosis and treatment of cardiovascular diseases (CVDs) 10 . The H 2 FPEF score enables discrimination of HFpEF from noncardiac causes of dyspnea, relying on clinical characteristics (age > 60 years, obesity, atrial fibrillation, treatment with ≥ 2 antihypertensives) and echocardiographic measurements (E/E’ ratio > 9, pulmonary artery systolic pressure (PASP) > 35 mmHg) 8 .…”

Section: Introductionmentioning

confidence: 99%

HFpEF as systemic disease, insight from a diagnostic prediction model reminiscent of systemic inflammation and organ interaction in HFpEF patients

Zhou,

Xia,

et al. 2024

Sci Rep

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Systemic inflammation and reciprocal organ interactions are associated with the pathophysiology of heart failure with preserved ejection fraction (HFpEF). However, the clinical value, especially the diagnositc prediction power of inflammation and extra-cardiac organ dysfunction for HfpEF is not explored. In this cross-sectional study, 1808 hospitalized patients from January 2014 to June 2022 in ChiHFpEF cohort were totally enrolled according to inclusion and exclusion criteria. A diagnostic model with markers from routine blood test as well as liver and renal dysfunction for HFpEF was developed using data from ChiHFpEF-cohort by logistic regression and assessed by receiver operating characteristic curve (ROC) and Brier score. Then, the model was validated by the tenfold cross-validation and presented as nomogram and a web-based online risk calculator as well. Multivariate and LASSO regression analysis revealed that age, hemoglobin, neutrophil to lymphocyte ratio, AST/ALT ratio, creatinine, uric acid, atrial fibrillation, and pulmonary hypertension were associated with HFpEF. The predictive model exhibited reasonably accurate discrimination (ROC, 0.753, 95% CI 0.732–0.772) and calibration (Brier score was 0.200). Subsequent internal validation showed good discrimination and calibration (AUC = 0.750, Brier score was 0.202). In additoin to participating in pathophysiology of HFpEF, inflammation and multi-organ interactions have diagnostic prediction value for HFpEF. Screening and optimizing biomarkers of inflammation and multi-organ interactions stand for a new field to improve noninvasive diagnostic tool for HFpEF.

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“…Definitions of the societies of cardiology [ 4 ] divide the HF population into two large categories as a function of the left ventricular ejection fraction (LVEF): HF with LVEF < 50%, which is further subdivided into HF with mildly reduced LVEF from 40 to 49% (HFmrEF) and HF with reduced LVEF < 40% (HFrEF), while HF patients with a preserved LVEF ≥ 50% (HFpEF) make up the other large category. Today, HFpEF already comprises more than half of the total HF population [ 5 , 6 ], and this proportion is supposed to rise in the near future, since the annual HFpEF incidence has increased by about 1% relative to the incidence of HF with LVEF < 50% in the last years [ 7 , 8 ].…”

Section: Introductionmentioning

confidence: 99%

The Cardiomyocyte in Heart Failure with Preserved Ejection Fraction—Victim of Its Environment?

Rocca

Heeswijk

Richiardi

et al. 2022

Cells

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Heart failure (HF) with preserved left ventricular ejection fraction (HFpEF) is becoming the predominant form of HF. However, medical therapy that improves cardiovascular outcome in HF patients with almost normal and normal systolic left ventricular function, but diastolic dysfunction is missing. The cause of this unmet need is incomplete understanding of HFpEF pathophysiology, the heterogeneity of the patient population, and poor matching of therapeutic mechanisms and primary pathophysiological processes. Recently, animal models improved understanding of the pathophysiological role of highly prevalent and often concomitantly presenting comorbidity in HFpEF patients. Evidence from these animal models provide first insight into cellular pathophysiology not considered so far in HFpEF disease, promising that improved understanding may provide new therapeutical targets. This review merges observation from animal models and human HFpEF disease with the intention to converge cardiomyocytes pathophysiological aspects and clinical knowledge.

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Diagnostic algorithm for HFpEF: how much is the recent consensus applicable in clinical practice?

Cited by 11 publications

References 42 publications

Sphingolipids in the Heart: From Cradle to Grave

Sphingolipids in the Heart: From Cradle to Grave

HFpEF as systemic disease, insight from a diagnostic prediction model reminiscent of systemic inflammation and organ interaction in HFpEF patients

The Cardiomyocyte in Heart Failure with Preserved Ejection Fraction—Victim of Its Environment?

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