Morphological and functional cardiac consequences of rapid hypertension treatment: a cohort study

Jordan, Andrew N.; Fulford, Jon; Gooding, Karen M.; Anning, Christine; Wilkes, Lindsay; Ball, Claire; Pamphilon, Nicola; Mawson, D; Clark, Christopher E; Shore, Angela C.; Sharp, Andrew; Bellenger, Nicholas G.

doi:10.1186/s12968-021-00805-5

Cited by 5 publications

(3 citation statements)

References 38 publications

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“…Despite our selection of primarily patients with hypertension (>90%), LVMI (determined with cardiac MRI analysis in the core laboratory) was relatively low and did not progress substantially in the placebo group. This finding is consistent with more recent literature on hypertension 26 , 27 and is likely explained by the intensification of antihypertensive treatments according to recent guidelines. Indeed, approximately half of the patients in each treatment group were taking an angiotensin-converting enzyme inhibitor, and approximately a third were taking an angiotensin receptor blocker; both medication classes have known antihypertrophic effects.…”

Section: Discussionsupporting

confidence: 93%

Repurposing the β₃-Adrenergic Receptor Agonist Mirabegron in Patients With Structural Cardiac Disease

Balligand,

Brito,

Brosteanu

et al. 2023

JAMA Cardiol

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ImportanceLeft ventricular (LV) hypertrophy contributes to the onset and progression of heart failure (HF), particularly for patients with pre-HF (stage B) for whom no treatment has yet proven effective to prevent transition to overt HF (stage C). The β3-adrenergic receptors (β3ARs) may represent a new target, as their activation attenuates LV remodeling.ObjectiveTo determine whether activation of β3ARs by repurposing a β3AR agonist, mirabegron, is safe and effective in preventing progression of LV hypertrophy and diastolic dysfunction among patients with pre- or mild HF.Design, Setting, and ParticipantsThe Beta3-LVH prospective, triple-blind, placebo-controlled phase 2b randomized clinical trial enrolled patients between September 12, 2016, and February 26, 2021, with a follow-up of 12 months. The trial was conducted at 10 academic hospitals in 8 countries across Europe (Germany, Poland, France, Belgium, Italy, Portugal, Greece, and the UK). Patients aged 18 years or older with or without HF symptoms (maximum New York Heart Association class II) were screened for the presence of LV hypertrophy (increased LV mass index [LVMI] of ≥95 g/m2 for women or ≥115 g/m2 for men) or maximum wall thickness of 13 mm or greater using echocardiography. Data analysis was performed in August 2022.InterventionParticipants were randomly assigned (1:1) to mirabegron (50 mg/d) or placebo, stratified by the presence of atrial fibrillation and/or type 2 diabetes, for 12 months.Main Outcomes and MeasuresThe primary end points were LVMI determined using cardiac magnetic resonance imaging and LV diastolic function (early diastolic tissue Doppler velocity [E/e′] ratio assessed using Doppler echocardiography) at 12 months. Patients with at least 1 valid measurement of either primary end point were included in the primary analysis. Safety was assessed for all patients who received at least 1 dose of study medication.ResultsOf the 380 patients screened, 296 were enrolled in the trial. There were 147 patients randomized to mirabegron (116 men [79%]; mean [SD] age, 64.0 [10.2] years) and 149 to placebo (112 men [75%]; mean [SD] age, 62.2 [10.9] years). All patients were included in the primary intention-to-treat analysis. At 12 months, the baseline and covariate-adjusted differences between groups included a 1.3-g/m2 increase in LVMI (95% CI, −0.15 to 2.74; P = .08) and a −0.15 decrease in E/e′ (95% CI, −0.69 to 0.4; P = .60). A total of 213 adverse events (AEs) occurred in 82 mirabegron-treated patients (including 31 serious AEs in 19 patients) and 215 AEs occurred in 88 placebo-treated patients (including 30 serious AEs in 22 patients). No deaths occurred during the trial.ConclusionsIn this study, mirabegron therapy had a neutral effect on LV mass or diastolic function over 12 months among patients who had structural heart disease with no or mild HF symptoms.Trial RegistrationClinicalTrials.gov Identifier: NCT02599480

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Section: Discussionsupporting

confidence: 93%

Repurposing the β₃-Adrenergic Receptor Agonist Mirabegron in Patients With Structural Cardiac Disease

Balligand,

Brito,

Brosteanu

et al. 2023

JAMA Cardiol

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“…For instance, a cohort study demonstrated a significant reduction in radial strain (RS) after 18 weeks of treatment. Not only this period was shorter than the earliest structural and functional changes detected by echocardiography (24 weeks), but FT-CMR was also able to detect significant RS (short axis) and CS changes, in agreement with reduced LVEDV and LV radial thickness as a consequent of reduced LVH [ 8 ]. Global LS (GLS) along with CMR-obtained lateral mitral annular plane systolic excursion (MAPSE) have been identified as independent predictors of mortality in patients with hypertension [ 9 ].…”

Section: Hypertensionmentioning

confidence: 99%

Feature tracking cardiac magnetic resonance imaging to assess cardiac manifestations of systemic diseases

et al. 2023

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Feature-tracking cardiac magnetic resonance (FT-CMR), with the ability to quantify myocardial deformation, has a unique role in the evaluation of subclinical myocardial abnormalities. This review aimed to evaluate the clinical use of cardiac FT-CMR-based myocardial strain in patients with various systemic diseases with cardiac involvement, such as hypertension, diabetes, cancer-therapy-related toxicities, amyloidosis, systemic scleroderma, myopathies, rheumatoid arthritis, thalassemia major, and coronavirus disease 2019 (COVID-19). We concluded that FT-CMR-derived strain can improve the accuracy of risk stratification and predict cardiac outcomes in patients with systemic diseases prior to symptomatic cardiac dysfunction. Furthermore, FT-CMR is particularly useful for patients with diseases or conditions which are associated with subtle myocardial dysfunction that may not be accurately detected with traditional methods. Compared to patients with cardiovascular diseases, patients with systemic diseases are less likely to undergo regular cardiovascular imaging to detect cardiac defects, whereas cardiac involvement in these patients can lead to major adverse outcomes; hence, the importance of cardiac imaging modalities might be underestimated in this group of patients. In this review, we gathered currently available data on the newly introduced role of FT-CMR in the diagnosis and prognosis of various systemic conditions. Further research is needed to define reference values and establish the role of this sensitive imaging modality, as a robust marker in predicting outcomes across a wide spectrum of patients.

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“…van Cauteren Cardiovascular magnetic resonance accurately detects obstructive coronary artery disease in suspected non-ST elevation myocardial infarction: a sub-analysis of the CARMENTA Trial [ 34 ] David Marlevi False lumen pressure estimation in type B aortic dissection using 4D flow cardiovascular magnetic resonance: comparisons with aortic growth [ 35 ] Theo Pezel Long-term prognostic value of stress perfusion cardiovascular magnetic resonance in patients without known coronary artery disease [ 25 ] Reza Hajhosseiny Clinical comparison of sub-mm high-resolution non-contrast coronary CMR angiography against coronary CT angiography in patients with low-intermediate risk of coronary artery disease: a single center trial [ 36 ] Satoshi Nakamura Long-term prognostic value of whole-heart coronary magnetic resonance angiography [ 37 ] Ying Zhang Comparing cardiovascular magnetic resonance strain software packages by their abilities to discriminate outcomes in patients with heart failure with preserved ejection fraction [ 27 ] Aakash N. Gupta Direct mitral regurgitation quantification in hypertrophic cardiomyopathy using 4D flow CMR jet tracking: evaluation in comparison to conventional CMR [ 38 ] Luuk H.G.A. Hopman Impaired left atrial reservoir and conduit strain in patients with atrial fibrillation and extensive left atrial fibrosis [ 39 ] Andrew N. Jordan Morphological and functional cardiac consequences of rapid hypertension treatment: a cohort study [ 40 ] Shingo Kato Prognostic value of resting coronary sinus flow determined by phase-contrast cine cardiovascular magnetic resonance in patients with known or suspected coronary artery disease [ 41 ] Alastair J. Rankin Myocardial changes on 3T cardiovascular magnetic resonance imaging in response to haemodialysis with fluid removal [ 42 ] Bold manuscripts were also selected for 2021 JCMR Journal Club presentations …”

Section: Continuing Medical Education (Cme) Jcmr J...mentioning

confidence: 99%

2021â€“2022 state of our JCMR

Manning

2022

Journal of Cardiovascular Magnetic Resonance

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In 2021, there were 136 articles published in the Journal of Cardiovascular Magnetic Resonance (JCMR), including 122 original research papers, six reviews, four technical notes, one Society for Cardiovascular Magnetic Resonance (SCMR) guideline, one SCMR position paper, one study protocol, and one obituary (Nathaniel Reichek). The volume was up 53% from 2020 (n = 89) with a corresponding 21% decrease in manuscript submissions from 435 to 345. This led to an increase in the acceptance rate from 24 to 32%. The quality of the submissions continues to be high. The 2021 JCMR Impact Factor (which is released in June 2022) markedly increased from 5.41 to 6.90 placing us in the top quartile of Society and cardiac imaging journals. Our 5 year impact factor similarly increased from 6.52 to 7.25. Fifteen years ago, the JCMR was at the forefront of medical and medical society journal migration to the Open-Access format. The Open-Access system has dramatically increased the availability and JCMR citation. Full-text article requests in 2021 approached 1.5 M!. As I have mentioned, it takes a village to run a journal. JCMR is very fortunate to have a group of very dedicated Associate Editors, Guest Editors, Journal Club Editors, and Reviewers. I thank each of them for their efforts to ensure that the review process occurs in a timely and responsible manner. These efforts have allowed the JCMR to continue as the premier journal of our field. My role, and the entire editorial process would not be possible without the ongoing high dedication and efforts of our managing editor, Jennifer Rodriguez. Her premier organizational skills have allowed for streamlining of the review process and marked improvement in our time-to-decision (see later). As I conclude my 6th and final year as your editor-in-chief, I thank you for entrusting me with the JCMR editorship and appreciate the time I have had at the helm. I am very confident that our Journal will reach new heights under the stewardship of Dr. Tim Leiner, currently at the Mayo Clinic with a seamless transition occurring as I write this in late November. I hope that you will continue to send your very best, high quality CMR manuscripts to JCMR, and that our readers will continue to look to JCMR for the very best/state-of-the-art CMR publications.

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Morphological and functional cardiac consequences of rapid hypertension treatment: a cohort study

Cited by 5 publications

References 38 publications

Repurposing the β₃-Adrenergic Receptor Agonist Mirabegron in Patients With Structural Cardiac Disease

Repurposing the β₃-Adrenergic Receptor Agonist Mirabegron in Patients With Structural Cardiac Disease

Feature tracking cardiac magnetic resonance imaging to assess cardiac manifestations of systemic diseases

2021â€“2022 state of our JCMR

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Morphological and functional cardiac consequences of rapid hypertension treatment: a cohort study

Cited by 5 publications

References 38 publications

Repurposing the β3-Adrenergic Receptor Agonist Mirabegron in Patients With Structural Cardiac Disease

Repurposing the β3-Adrenergic Receptor Agonist Mirabegron in Patients With Structural Cardiac Disease

Feature tracking cardiac magnetic resonance imaging to assess cardiac manifestations of systemic diseases

2021â€“2022 state of our JCMR

Contact Info

Product

Resources

About

Repurposing the β₃-Adrenergic Receptor Agonist Mirabegron in Patients With Structural Cardiac Disease

Repurposing the β₃-Adrenergic Receptor Agonist Mirabegron in Patients With Structural Cardiac Disease