Rationale and design of the <scp>ESC</scp> Heart Failure <scp>III</scp> Registry – Implementation and discovery

Lund, Lars H.; Crespo‐Leiro, Maria Generosa; Laroche, Cecile; Garcia‐Pinilla, Jose M.; Bennis, Ahmed; Vataman, Eleonora B.; Polovina, Marija; Radovanovic, Slavica; Apostolovic, Svetlana R.; Ašanin, Milika; Gackowski, Andrzej; Kaplon‐Cieslicka, Agnieszka; Cabac‐Pogorevici, Irina; Anker, Stefan D.; Chioncel, Ovidiu; Coats, Andrew J.S.; Filippatos, Gerasimos; Lainscak, Mitja; Mcdonagh, Theresa; Mebazaa, Alexandre; Metra, Marco; Piepoli, Massimo; Rosano, Giuseppe M.; Ruschitzka, Frank; Savarese, Gianluigi; Seferović, Petar M.; Iung, Bernard; Popescu, Bogdan A.; Maggioni, Aldo P.; ,

doi:10.1002/ejhf.3087

Cited by 3 publications

(1 citation statement)

References 71 publications

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“…Data suggest that both the incidence and prevalence of HFpEF are on the rise, largely due to demographic aging and the increasing presence of multiple comorbidities [1 ▪▪ ,2 ▪▪ ]. HFpEF now accounts for at least 50% of hospitalizations for heart failure, and as such is a source of marked morbidity, mortality and economic pressure [3,4]. Indeed, a 30-day all-cause readmission rate of 21% and a 5-year mortality of 75% has been observed in recent HFpEF registries [5,6].…”

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confidence: 99%

Obesity/cardiometabolic phenotype of heart failure with preserved ejection fraction: mechanisms to recent trials

Verma,

Dhingra,

Connelly

2024

Current Opinion in Cardiology

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Purpose of review Heart failure with preserved ejection fraction (HFpEF) is a leading and growing cause of morbidity and mortality globally. Of the various phenotypes identified, the obesity (or cardiometabolic) phenotype appears to be most common. The purpose of this review is to provide the clinician with an abridged understanding of recent developments that have elucidated obesity/visceral adiposity as a central mechanism linking inflammation/immune dysregulation to the development of the HFpEF syndrome. Recent clinical trials examining the efficacy of pharmacological treatments that target obesity in HFpEF will also be discussed. Recent findings Recent data indicate that visceral adiposity and insulin resistance in HFpEF serve as key mechanisms driving inflammation and immune dysregulation, which play a critical role in the development of cardiac stiffness, diastolic dysfunction and fibrosis in HFpEF. In obesity, alterations in macrophage polarization, changes in innate and adaptive immune systems and altered myocardial energetics promote metabolic inflammation in HFpEF. Finally, emerging data suggest that inflammatory biomarkers, specifically, IL-6, may provide useful information about HFpEF severity and symptom burden in obesity. Summary The obesity phenotype of HFpEF is seen in upward of 80% with HFpEF. Obesity is not just a bystander, but plays an essential role in the pathobiology and clinical course of HFpEF. Targeting overweight/obesity in HFpEF with GLP-1 receptor agonists holds promise in these patients.

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Section: Text Of the Reviewmentioning

confidence: 99%

Obesity/cardiometabolic phenotype of heart failure with preserved ejection fraction: mechanisms to recent trials

Verma,

Dhingra,

Connelly

2024

Current Opinion in Cardiology

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December 2023 at a glance: Focus on medical therapy in chronic and acute heart failure

Tomasoni,

Adamo,

Metra

2023

European J of Heart Fail

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Acute HF is still associated with poor prognosis and efforts are needed to improve its prognosis. 21,22 A pre-defined sex-specific analysis of the GALACTIC (Goal directed afterload reduction acute congestive cardiac decompensation study) trial showed that a strategy of early intensive and sustained vasodilatation with rapid up-titration of renin-angiotensin-aldosterone system (RAAS) inhibitors versus usual care was less successful in women versus men both in the overall cohort and in patients with HFrEF. 23 In a previous analysis no significant treatment-by-sex interactions were found in the STRONG-HF trial. 24 Implementation of GDMT affects kidney function. 8 An analysis of STRONG-HF described the association between changes in renal function and efficacy of rapid up-titration of GDMT according to the high-intensity care (HIC) strategy. The HIC group had less HF readmissions or death regardless of baseline eGFR at 180 days. An early decrease in eGFR at 1 week was associated with

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Heart failure in Europe: Guideline‐directed medical therapy use and decision making in chronic and acute, pre‐existing and de novo, heart failure with reduced, mildly reduced, and preserved ejection fraction – the ESC EORP Heart Failure III Registry

Lund,

Crespo‐Leiro,

Laroche

et al. 2024

European J of Heart Fail

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AimsWe analysed baseline characteristics and guideline‐directed medical therapy (GDMT) use and decisions in the European Society of Cardiology (ESC) Heart Failure (HF) III Registry.Methods and resultsBetween 1 November 2018 and 31 December 2020, 10 162 patients with acute HF (AHF, 39%, age 70 [62–79], 36% women) or outpatient visit for HF (61%, age 66 [58–75], 33% women), with HF with reduced (HFrEF, 57%), mildly reduced (HFmrEF, 17%) or preserved (HFpEF, 26%) ejection fraction were enrolled from 220 centres in 41 European or ESC‐affiliated countries. With AHF, 97% were hospitalized, 2.2% received intravenous treatment in the emergency department, and 0.9% received intravenous treatment in an outpatient clinic. AHF was seen by most by a general cardiologist (51%) and outpatient HF most by a HF specialist (48%). A majority had been hospitalized for HF before, but 26% of AHF and 6.1% of outpatient HF had de novo HF. Baseline use, initiation and discontinuation of GDMT varied according to AHF versus outpatient HF, de novo versus pre‐existing HF, and by ejection fraction. After the AHF event or outpatient HF visit, use of any renin–angiotensin system inhibitor, angiotensin receptor–neprilysin inhibitor, beta‐blocker, mineralocorticoid receptor antagonist and loop diuretics was 89%, 29%, 92%, 78%, and 85% in HFrEF; 89%, 9.7%, 90%, 64%, and 81% in HFmrEF; and 77%, 3.1%, 80%, 48%, and 80% in HFpEF.ConclusionUse and initiation of GDMT was high in cardiology centres in Europe, compared to previous reports from cohorts and registries including more primary care and general medicine and regions more local or outside of Europe and ESC‐affiliated countries.

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Rationale and design of the ESC Heart Failure III Registry – Implementation and discovery

Cited by 3 publications

References 71 publications

Obesity/cardiometabolic phenotype of heart failure with preserved ejection fraction: mechanisms to recent trials

Obesity/cardiometabolic phenotype of heart failure with preserved ejection fraction: mechanisms to recent trials

December 2023 at a glance: Focus on medical therapy in chronic and acute heart failure

Heart failure in Europe: Guideline‐directed medical therapy use and decision making in chronic and acute, pre‐existing and de novo, heart failure with reduced, mildly reduced, and preserved ejection fraction – the ESC EORP Heart Failure III Registry

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