Mechanistic Study Delves Into Heart Failure Benefits Noted With Empagliflozin EMPA-HEART Cardiolink-6 - EMPA-HEART

The EMPA-HEART trial showed that empagliflozin resulted in beneficial effects on left ventricular remodeling at 6 months among patients with type 2 diabetes mellitus and stable coronary artery disease (CAD) but normal ejection fraction and without a clear heart failure history. The findings were presented by Dr. Subodh Verma at the American Heart Association Annual Scientific Sessions (AHA 2018) in Chicago, Illinois. Continue reading

TRED-HF: Tread With Caution While Withdrawing Heart Failure Medication in Recovered Dilated Cardiomyopathy Withdrawal of pharmacological treatment for heart failure in patients with recovered dilated cardiomyopathy: an open-label, pilot, randomised trial

The results of the TRED-HF trial published in The Lancet showed that withdrawal of heart failure medications among patients with dilated cardiomyopathy (DCM) who had recovered their LV function resulted in the relapse of HF. According to Halliday and his colleagues, until robust predictors of relapse are defined, treatment should continue indefinitely. Continue reading

Canakinumab: A New Hope for Post MI Patients with Increased hsCRP in the Prevention of Heart Failure The exploratory analysis of the CANTOS trial showed that canakinumab can decrease hear failure hospitalizations in ischemic patients in a dose-dependent manner

Canakinumab (an IL-B inhibitor) is associated with decreased heart failure (HF) hospitalizations and the composite of heart failure hospitalization and heart-failure related mortality in patients with a history of myocardial infarction (MI) and elevated high-sensitivity C-reactive protein (hsCRP), according to a new study published in Circulation. Continue reading

Superior Efficacy of Sacubitril-Valsartan Compared to Enalapril for lowering NT Pro-BNP in Patients Hospitalized for HFrEF Pioneering a new strategy for managing acute decompensation in HFrEF (Results from the PIONEER-HF trial)

Results from a multi-center, randomized, double-blind, double dummy, parallel group clinical trial which enrolled 881 patients with heart failure (HF) with reduced ejection fraction (HFrEF-left ventricular ejection fraction of 40% or less) have shown superior efficacy of Sacubitril–Valsartan combination (Entresto; Novartis) in reducing N-terminal pro-B-type natriuretic peptide compared to Enalapril alone. The patients were hospitalized for acute decompensation of HF, and treatment with Sacubitril–Valsartan achieved a greater reduction in N-terminal pro-B-type natriuretic peptide (NT-proBNP) concentrations without any significant offsetting serious adverse events. Findings from the trial were presented at the 2018 AHA Scientific Session and simultaneously published in the New England Journal of Medicine (NEJM). Continue reading

Does a Low Salt Diet Improve Heart Failure Prognosis? Reduced Salt Intake for Heart Failure: A Systematic Review

A systematic review conducted by Kamal R. Mahtani et al in JAMA looked into the evidence of salt restriction recommendation on heart failure prognosis. The investigators evaluated previous trials but could not find a conclusive relationship between salt consumption and heart failure prognosis. Continue reading

Cardiogenic Shock in Takotsubo Syndrome: Incidence, Predictors, and Outcomes Results from the RETAKO registery

Cardiogenic shock (CS) is not a rare complication in patients with Takotsubo syndrome (TTS). Moreover, it is associated with an increased risk of adverse outcomes in the short- and long-term follow-up, according to a new study published in the Journal of the American College of Cardiology. Continue reading

Worse Clinical Outcomes of Atrial Fibrillation in Patients with HFpEF Compared to HFrEF Prognostic implications of atrial fibrillation in heart failure with reduced, mid-range, and preserved ejection fraction: a report from 14 964 patients in the European Society of Cardiology Heart Failure Long-Term Registry

A multinational prospective cohort study performed by Barak Zafrir et al. and published in the European Heart Journal concluded that worse cardiovascular outcomes of atrial fibrillation (AF) were associated with heart failure with preserved ejection fraction (HFpEF) and heart failure with middle range ejection fraction (HFmrEF) but not associated with heart failure with reduced ejection fraction (HFrEF). Continue reading

SGLT-2 Inhibitors Associated with Lower Heart Failure Hospitalization Tighter glycemic control is not associated with lower risk of HF hospitalization: A Meta-Analysis

A new meta-analysis published in the Journal of American College of Cardiology showed that sodium glucose co-transporter (SGLT)-2 inhibitors are more effective than glucagon-like peptide (GLP)-1 agonists and dipeptidyl peptidase (DPP)-4 inhibitors in reducing the risk of Heart Failure (HF) hospitalization in patients with type 2 diabetes mellitus. Continue reading

Pulmonary Artery Denervation Improves Pulmonary HTN in Heart Failure Pulmonary Artery Denervation Significantly Increases 6-minute Walk Distance for Patients with Combined Pre- and Post-capillary Pulmonary Hypertension Associated with the Left Heart Failure: PADN-5 Study

The findings of the Pulmonary artery denervation (PADN) trial, presented at the TCT conference on Sept 23rd have shown that PADN is associated with significant improvements in hemodynamic and clinical outcomes including 6-minute walk distance (6MWD) and pulmonary vascular resistance (PVR) in patients with combined pre- and post-capillary pulmonary hypertension CpcPH. The results of this study were simultaneously published in JACC: Interventions. Continue reading

Landmark COAPT trial Demonstrates the Benefit of Transcatheter Mitral-Valve Repair Using MitraClip in Patients with Heart Failure TCT 2018: Findings of the Cardiovascular Outcomes Assessment of the MitraClip Percutaneous Therapy for Heart Failure Patients with Functional Mitral Regurgitation (COAPT) trial

The spectacular results of the Cardiovascular Outcomes Assessment of the MitraClip Percutaneous Therapy for Heart Failure Patients with Functional Mitral Regurgitation (COAPT) trial, presented at TCT 2018, show that transcatheter mitral valve approximation using the MitraClip, on a background of maximally tolerated guideline-directed medical therapy (GDMT) was superior to GDMT alone in the reduction of Heart Failure (HF) hospitalization and mortality in symptomatic HF patients with grade 3-4+ Mitral regurgitation (MR). These landmark findings were simultaneously published today in the New England Journal of Medicine. Continue reading

Coronary Microvascular Dysfunction: A Promising Therapeutic Target in Heart Failure with Preserved EF? PROMIS-HFpEF: Results from ESC 2018

PROMIS-HFpEF (PRevalence Of MIcrovascular dySfunction in Heart Failure with Preserved Ejection Fraction) is an echocardiographic trial showcasing a high prevalence of coronary microvascular dysfunction (CMD) in HFpEF and its association with systemic endothelial dysfunction (RHI, UACR) and markers of HF severity (NT-proBNP and RV dysfunction). The results of the trial were recently published in the European Heart Journal. Continue reading

Transcatheter Interatrial shunt device appears safe at 1 year for heart failure with preserved ejection fraction ESC 2018: REDUCE LAP HF-1, 1 year results from phase 2

The 1-year results of a phase 2, sham-controlled RCT have confirmed the safety of a transcatheter interatrial shunt device (IASD; Corvia Medical) with no significant cardiovascular or renal events as compared to those receiving sham control treatment. It has also confirmed the long-term patency of the device. The findings were presented at the ESC and have also been simultaneously published in JAMA Cardiology. Continue reading

Pre-PCI Impella Device Improves Outcome in Acute MI complicated by Cardiogenic Shock (AMICS)

A non-randomized study published in the American Heart Journal showed increased survival rates in patients with Impella device being used as the first support strategy for patients with acute myocardial infarction complicated by cardiogenic shock (AMICS) when invasive hemodynamic monitoring was used, and at centers with higher Impella implantation volume. Continue reading

Tafamidis, A Real Hope for People with Transthyretin Cardiomyopathy?

On Thursday, March 29th, Pfizer announced positive topline results from ATTR-ACT trial of tafamidis in patients with transthyretin cardiomyopathy. According to Pfizer, “Tafamidis met its primary endpoint, demonstrating a statistically significant reduction in the composite of all-cause mortality and frequency of cardiovascular-related hospitalizations compared to placebo at 30 months. The preliminary safety data showed that tafamidis was generally well tolerated in this population and no new safety signals were identified”. Continue reading

Association of High-Sensitivity Cardiac Troponins (hs-cTn) and the Risk of New-onset Heart Failure

A recent study, published in the Journal of American College of Cardiology, concluded that there is a strong association of high sensitivity cardiac troponin (hs-cTn) with the risk of new-onset heart failure (HF), independent of population at risk, cardiovascular risk factors, and natriuretic peptide levels. Continue reading

ICON RELOADED: A New Future for NT-proBNP

A multicenter, international, North American study published in the Journal of the American College of Cardiology has indicated that N-terminal pro–B-type natriuretic peptide (NT-proBNP) testing may be valuable in the identification or exclusion of heart failure in emergency department patients with shortness of breath.

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HeartMate 3: Magnetic Pump in Advanced Heart Failure

According to a new study published in the New England Journal of Medicine, a fully magnetically levitated centrifugal- flow pump has been found to be superior to a mechanical-bearing axial-flow pump in advanced heart failure patients in terms of survival free of disabling stroke or reoperation for removal in case of device malfunction.

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MOMENTUM III: HeartMate III demonstrated 2-year Survival Benefit Compared to HeartMate II

Dr. Mehra and Dr. Gibson Discuss

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MOMENTUM III: HeartMate III demonstrated 2-year Survival Benefit Compared to HeartMate II Dr. Mehra and Dr. Gibson Discuss

ARISTOTLE: Digoxin in AFib with and without heart failure Dr. Renato Lopes and Dr. C. Michael Gibson Discuss