Abstract:
AIM:The exercise Doppler echocardiographic stress test can be of interest in the management of asymptomatic patients with primary mitral regurgitation (MR). The resting brain natriuretic peptide (BNP) level is a good surrogate marker of the consequences of MR and is a powerful predictor of outcome. The incremental prognostic value of BNP response during exercise is unknown. We aimed to identify the determinants of exercise BNP level and to evaluate its prognostic value in asymptomatic patients with primary MR. METHODS AND RESULTS:Comprehensive resting and exercise transthoracic Doppler echocardiography was performed in 113 consecutive asymptomatic patients with moderate to severe degenerative MR and preserved left ventricular (LV) function. Blood samples were collected both at rest and during exercise. The BNP level significantly increased from rest to exercise (P < 0.0001). The independent determinants of exercise BNP were resting E/Ea ratio (P = 0.043), indexed left atrial volume (P = 0.022), and exercise LV global longitudinal strain (P = 0.001). There was a significant graded relationship between increasing BNP level at exercise (according to tertiles) and increased incidence of cardiac events (death, heart failure, mitral valve surgery driven by symptoms, or LV dilatation/dysfunction onset) (1 year, 11 ± 5% vs. 14 ± 6% vs. 43.5 ± 9%; 2 years, 21 ± 7% vs. 40 ± 8% vs. 67 ± 9%; in tertiles 1, 2 and 3, respectively). On multivariable analysis, after adjustment for demographic and echocardiographic data and for resting BNP level, exercise BNP remained significantly associated with increased risk of cardiac events during the follow-up (hazard ratio 2.8 and 3.4, P = 0.041 and 0.023, for tertiles 2 and 3, as compared with tertile 1). CONCLUSIONS:In asymptomatic patients with primary MR, exercise BNP level provides incremental prognostic value beyond what is achieved by demographic and echocardiographic data and resting BNP level. Patients with elevated exercise BNP should be considered at high risk of reduced cardiac event-free survival.
journal_name
Eur J Heart Failjournal_title
European journal of heart failureauthors
Magne J,Mahjoub H,Pibarot P,Pirlet C,Pierard LA,Lancellotti Pdoi
10.1093/eurjhf/hfs114subject
Has Abstractpub_date
2012-11-01 00:00:00pages
1293-302issue
11eissn
1388-9842issn
1879-0844pii
hfs114journal_volume
14pub_type
杂志文章abstract::Heart failure and sleep apnoea are major health problems with an increasingly recognized association; evidence suggests that sleep apnoea may play a role in the progression of heart failure. However, confounding factors such as obesity, hypertension and coronary heart disease make this relationship uncertain and an in...
journal_title:European journal of heart failure
pub_type: 杂志文章,评审
doi:10.1016/j.ejheart.2005.07.013
更新日期:2006-05-01 00:00:00
abstract:BACKGROUND:Suppression of the renin-angiotensin-aldosterone system (RAAS) is therapeutically valuable in chronic heart failure (CHF). RAAS inhibition can be achieved in a number of ways though an orally active renin inhibitor (RI) has never been studied before. We describe the neurohumoral effects of an RI. METHODS AN...
journal_title:European journal of heart failure
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.ejheart.2007.09.002
更新日期:2007-11-01 00:00:00
abstract:AIMS:The aim of the study was to evaluate the efficacy and clinical outcome of peritoneal dialysis (PD) treatment in patients with severe refractory heart failure (HF) and chronic kidney disease (CKD). METHODS AND RESULTS:The PD treatment was performed in 118 patients [49.2% New York Heart Association (NYHA) III and 5...
journal_title:European journal of heart failure
pub_type: 杂志文章
doi:10.1093/eurjhf/hfs035
更新日期:2012-05-01 00:00:00
abstract:BACKGROUND AND AIMS:Sleep disordered breathing (SDB), especially Cheyne-Stokes respiration (CSR) is common in patients with chronic heart failure (CHF). Adaptive servoventilation (ASV) was recently introduced to treat CSR in CHF. The aim of this study was to investigate the effects of ASV on CSR and CHF parameters. ME...
journal_title:European journal of heart failure
pub_type: 杂志文章
doi:10.1016/j.ejheart.2008.04.007
更新日期:2008-06-01 00:00:00
abstract:AIMS:Post-discharge morbidity and mortality for acute heart failure (AHF) patients remains high. Although the adverse effects of neurohormonal activation are well known in chronic HF, the prognostic significance of serum aldosterone in patients hospitalized for AHF has not been well studied. METHODS AND RESULTS:A seco...
journal_title:European journal of heart failure
pub_type: 杂志文章
doi:10.1093/eurjhf/hft100
更新日期:2013-11-01 00:00:00
abstract:INTRODUCTION:Patients with chronic heart failure (CHF) experience breathlessness and fatigue on exercise. One of the abnormalities seen on maximal exercise testing is an increased ventilatory response to exercise (VE/VCO(2) slope). The cause of this is unknown, but is likely to be due to a combination of interacting pe...
journal_title:European journal of heart failure
pub_type: 杂志文章
doi:10.1016/j.ejheart.2003.11.008
更新日期:2004-10-01 00:00:00
abstract:AIMS:Growth differentiation factor-15 (GDF-15) is associated with adverse prognosis in cardiovascular (CV) and non-CV diseases. We evaluated the association of GDF-15 with CV and non-CV outcomes in the PARADIGM-HF trial. METHODS AND RESULTS:In 1935 patients with heart failure and reduced ejection fraction (HFrEF) in P...
journal_title:European journal of heart failure
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1002/ejhf.1301
更新日期:2018-12-01 00:00:00
abstract::Ambulatory blood pressure monitoring has established its use in the definition of white coat hypertension and monitoring of treatment of essential hypertension. Any role for ambulatory blood pressure monitoring in heart failure is not well defined. However, from the limited studies available, ambulatory blood pressure...
journal_title:European journal of heart failure
pub_type: 杂志文章,评审
doi:10.1016/j.ejheart.2004.05.010
更新日期:2005-03-02 00:00:00
abstract:AIMS:Differentiation of heart failure with reduced (HFrEF) or preserved (HFpEF) ejection fraction independent of echocardiography is challenging in the community. Diagnostic strategies based on monitoring circulating microRNA (miRNA) levels may prove to be of clinical value in the near future. The aim of this study was...
journal_title:European journal of heart failure
pub_type: 杂志文章
doi:10.1002/ejhf.244
更新日期:2015-04-01 00:00:00
abstract::Impaired cardiac function is frequently accompanied by peripheral vascular dysfunction and a pro-inflammatory condition, which may be associated with elevated levels of angiotensin II. We hypothesized that the magnitude of flow mediated dilatation (FMD) of the brachial artery of post myocardial infarction patients wil...
journal_title:European journal of heart failure
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.ejheart.2005.10.011
更新日期:2006-08-01 00:00:00
abstract:AIMS:Endothelial dysfunction has been shown to correlate with severity of congestive heart failure (CHF) and recent data suggest morphological changes of peripheral vasculature to be associated with the syndrome. We therefore investigated the hypothesis that vascular remodeling is associated with functional changes in ...
journal_title:European journal of heart failure
pub_type: 杂志文章
doi:10.1016/j.ejheart.2004.04.008
更新日期:2005-01-01 00:00:00
abstract:AIMS:To investigate temporal trends in the risk of heart failure (HF) complicating acute myocardial infarction (AMI) and to determine whether these trends differ by gender or age. METHODS AND RESULTS:The national Swedish hospital discharge and death registries from 1993 to 2004 were used to calculate age- and gender-s...
journal_title:European journal of heart failure
pub_type: 杂志文章
doi:10.1093/eurjhf/hfq205
更新日期:2011-02-01 00:00:00
abstract:BACKGROUND:Although discontinuation of chronic ACE inhibitor (ACEi) therapy after myocardial infarction (MI) is common in clinical practice, some clinical studies reported an increased incidence of ischemia-related events after withdrawal. To further address this issue, we assessed hemodynamic, neurohormonal and vascul...
journal_title:European journal of heart failure
pub_type: 杂志文章
doi:10.1016/j.ejheart.2005.04.014
更新日期:2006-03-01 00:00:00
abstract:AIM:To investigate the role of MMP-2 and MMP-9 in cardiac remodelling induced by tobacco smoke exposure in rats. METHODS:Rats were allocated into two groups: C (n=9): control animals; ETS (n=9): exposed to tobacco smoke. After 4months, the animals underwent echocardiography, morphometric study and determination of MMP...
journal_title:European journal of heart failure
pub_type: 杂志文章
doi:10.1016/j.ejheart.2007.09.004
更新日期:2007-11-01 00:00:00
abstract:AIMS:The prognostic value of signs of congestion in patients suspected of having chronic heart failure (CHF) is unknown. Our objectives were to define their prevalence and specificity in diagnosing CHF and to determine their prognostic value in patients in a community heart failure clinic. METHODS AND RESULTS:Analysis...
journal_title:European journal of heart failure
pub_type: 杂志文章,多中心研究
doi:10.1093/eurjhf/hfr128
更新日期:2011-12-01 00:00:00
abstract:BACKGROUND:In acute heart failure syndromes (AHFS), the prognostic value of left ventricular ejection fraction (LVEF), although widely accepted, has been recently challenged. In contrast, blood pressure is increasingly gaining ground over LVEF as predictor of mortality. Therefore, it is not clear whether both LVEF and ...
journal_title:European journal of heart failure
pub_type: 临床试验,杂志文章
doi:10.1016/j.ejheart.2007.06.001
更新日期:2007-09-01 00:00:00
abstract:AIMS:Several studies have shown that older patients with heart failure with reduced ejection fraction (HFrEF) are undertreated. The aim of this study was to evaluate the association of up-titration of angiotensin-converting enzyme inhibitors (ACEI), angiotensin receptor blockers (ARB) and beta-blockers on outcome acros...
journal_title:European journal of heart failure
pub_type: 杂志文章
doi:10.1002/ejhf.1799
更新日期:2020-03-25 00:00:00
abstract::Patients with obesity, a reduced exercise capacity, increased cardiac filling pressures and a measured left ventricular ejection fraction in the normal range do not have a homogeneous disorder, but instead, exhibit one of three phenotypes. First, many obese people exhibit sodium retention, plasma volume expansion and ...
journal_title:European journal of heart failure
pub_type: 杂志文章,评审
doi:10.1002/ejhf.1377
更新日期:2019-02-01 00:00:00
abstract:AIMS:Guidelines recommend down-titration of loop diuretics (LD) once euvolaemia is achieved. In outpatients with heart failure (HF), we investigated LD dose changes in daily cardiology practice, agreement with guideline recommendations, predictors of successful LD down-titration and association between dose changes and...
journal_title:European journal of heart failure
pub_type: 杂志文章
doi:10.1002/ejhf.1796
更新日期:2020-08-01 00:00:00
abstract::The ELITE-II, BEST and CHAMP Trials were reported for the first time at the American Heart Association in November 1999. These trials provide valuable new information to guide clinical practice in the management of heart failure and of myocardial infarction, although none mandate a major change from current clinical p...
journal_title:European journal of heart failure
pub_type: 杂志文章
doi:10.1016/s1388-9842(00)00053-2
更新日期:2000-03-01 00:00:00
abstract::The incidence and prevalence of cardiovascular disease increases progressively with advancing age. Cardiovascular disease is a major cause of morbidity and mortality in Western Countries. In the near future, as the population ages, it is expected that the population prevalence of cardiovascular disease will increase d...
journal_title:European journal of heart failure
pub_type: 杂志文章,评审
doi:10.1016/j.ejheart.2008.08.007
更新日期:2008-11-01 00:00:00
abstract::The TRUE-AHF is a randomized, double-blind, parallel-group, placebo-controlled trial which is evaluating the effects of a 48-h infusion of ularitide (15 ng/kg/min) on the short- and long-term clinical course of patients with acute heart failure. Noteworthy features of the study include the early enrolment of patients ...
journal_title:European journal of heart failure
pub_type: 杂志文章,多中心研究
doi:10.1002/ejhf.698
更新日期:2017-05-01 00:00:00
abstract:AIMS:Reliable detectors of worsening renal function (WRF) in Emergency Department (ED) patients with acute heart failure (AHF) are limited. We hypothesized that initial urinary neutrophil gelatinase-associated lipocalcin (NGAL) levels, and changes in urinary NGAL levels after initial ED AHF therapy, would be associated...
journal_title:European journal of heart failure
pub_type: 杂志文章
doi:10.1093/eurjhf/hfs087
更新日期:2012-09-01 00:00:00
abstract:AIMS:Mutations in the lamin A/C gene (LMNA) cause a variety of clinical phenotypes, including dilated cardiomyopathy. LMNA is one of the most prevalent mutated genes in dilated cardiomyopathy, and is associated with a high risk of arrhythmias, sudden cardiac death, and heart failure. There are few data on the impact of...
journal_title:European journal of heart failure
pub_type: 杂志文章,多中心研究
doi:10.1093/eurjhf/hfs191
更新日期:2013-04-01 00:00:00
abstract::Patients with mild-moderate chronic heart failure (CHF) often have raised levels of serum uric acid (UA). This is due, amongst other factors, to reduced UA excretion by the kidneys, which is partly explained by restriction of sodium intake and treatment with diuretics. The decline in renal function that parallels wors...
journal_title:European journal of heart failure
pub_type: 杂志文章,评审
doi:10.1016/j.ejheart.2004.03.020
更新日期:2005-06-01 00:00:00
abstract:BACKGROUND:The role of the right ventricle has been relatively neglected proportionate to its importance. We sought to evaluate the impact of right ventricular (RV) and NT-proBNP on the outcome of patients with heart failure (HF) and functional mitral regurgitation (MR). METHODS AND PATIENTS:Outpatients with left vent...
journal_title:European journal of heart failure
pub_type: 杂志文章
doi:10.1016/j.ejheart.2008.04.003
更新日期:2008-06-01 00:00:00
abstract:AIM:To evaluate the long-term outcome of patients with Takotsubo syndrome (TTS) and severely reduced left ventricular ejection fraction (LVEF ≤ 35%) at presentation. METHODS AND RESULTS:The study population included 326 patients (mean age 69.5 ± 10.7 years, 28 male) with TTS enrolled in the Takotsubo Italian Network, ...
journal_title:European journal of heart failure
pub_type: 杂志文章
doi:10.1002/ejhf.1373
更新日期:2019-06-01 00:00:00
abstract:AIMS:The proteasome prevents the intracellular accumulation of proteins and its impairment can lead to structural and functional alterations, as noted for the coronary vasculature in a previous study. Utilizing the same model, this study was designed to test the hypothesis that chronic proteasome inhibition (PSI) also ...
journal_title:European journal of heart failure
pub_type: 杂志文章
doi:10.1093/eurjhf/hft034
更新日期:2013-06-01 00:00:00
abstract:AIMS:Angiotensin receptor-neprilysin inhibitors (ARNis) acts an ARB and neprilysin inhibitor. Diabetes mellitus significantly increases the risk of cardiovascular disease and heart failure (HF). Therefore, we evaluated the effects and mechanisms of ARNi in HF with reduced ejection fraction (HFrEF) in streptozotocin-ind...
journal_title:European journal of heart failure
pub_type: 杂志文章
doi:10.1002/ejhf.474
更新日期:2016-04-01 00:00:00
abstract:BACKGROUND:Plasma concentrations of atrial natriuretic peptides are correlated with atrial pressures, as are left ventricular ejection fraction and left ventricular filling abnormalities. AIMS:This study investigated the relation of atrial natriuretic peptides to both left ventricular systolic and diastolic function i...
journal_title:European journal of heart failure
pub_type: 杂志文章
doi:10.1016/s1388-9842(98)00005-1
更新日期:1999-03-01 00:00:00