Heart Failure

Jan 2nd, 2024 

Endocrinology and Cardiovascular Disease

Testosterone Levels in CHF

The study aimed to investigate the relationship between serum testosterone levels and congestive heart failure (CHF) in a large sample of US male adults. This cross-sectional analysis, using data from the NHANES 2011-2016, included a population of 6,841 male participants. The primary intervention was the analysis of serum testosterone levels. While a control group was not explicitly mentioned, the study involved 6,841 patients in total. The results indicated that higher serum testosterone levels are associated with a decreased risk of CHF. Clinically, this suggests a potential role of serum testosterone in cardiovascular health, especially in older males (1).

 

Comorbidity Impact on Outcomes

Predictors of Cardiovascular Readmissions

This retrospective observational study focused on the impact of comorbidities on cardiovascular readmissions in heart failure patients. It included 5,029 patients with heart failure and various comorbidities. The intervention involved an analysis of the impact of these comorbidities. A control group was not specified in this study. The results showed that certain comorbidities are associated with an increased risk of readmission. However, the area under the curve (AUC) in the receiver operating characteristic (ROC) analysis was low. This finding underlines the significance of specific comorbidities in the readmission risk of heart failure patients, highlighting the importance of comprehensive management (2).

 

Prognostic Tools in Heart Failure

Proteomic Risk Assessment in HF

In a community-based cohort study, the aim was to develop and validate a protein risk score for mortality in patients with heart failure. The study included 1,351 patients. The intervention was the development of a protein risk score using proteomics. A control group was not specified in this design. The protein risk score demonstrated good calibration and predicted mortality risk, outperforming existing clinical models. This study provides a novel tool for risk stratification in heart failure patients, potentially improving clinical outcomes (3).

 

Nonischemic Cardiomyopathy

Cardiac Magnetic Resonance in NICM

In a retrospective study involving 103 patients with nonischemic cardiomyopathy (NICM), the research focused on evaluating left atrial conduit strain via cardiac magnetic resonance (CMR). The study did not specify a control group. The results identified left atrial conduit strain as an independent predictor of left ventricular reverse remodeling (LVRR). This finding suggests a new predictor for assessing LVRR in NICM patients, which could be crucial for patient management and treatment planning (4).

 

HFpEF

Effects of Pacing on Cardiac Structure

Within a randomized clinical trial named myPACE, an exploratory study was conducted to examine the effects of continuous accelerated pacing on cardiac structure in heart failure patients with preserved ejection fraction (HFpEF). The study population consisted of 36 patients, divided into 16 patients in the myPACE group and 20 in the usual care group. The intervention was accelerated personalized pacing at 75 beats per minute, compared to a standard lower rate setting of 60 beats per minute. The results showed a reduction in septal wall thickness and left ventricular mass to volume ratio in the myPACE group, with a minor reduction in left ventricular ejection fraction. This suggests potential structural heart changes due to accelerated pacing in HFpEF patients, which could have implications for treatment strategies (5).

Pulmonary Hypertension Prediction in HFpEF

In a prospective study involving 113 patients with HFpEF, the objective was to identify echocardiographic parameters for predicting pulmonary hypertension (PH). The study compared patients with HFpEF with and without PH. The results revealed TAPSE/PASP and TAS'/PASP as effective predictors of PH. This study identifies important echocardiographic markers for PH in HFpEF patients, which could aid in early diagnosis and better management of the condition (6).

 

  1. Zhan X, Liu Y, Chen T, Wan H, Xiong S, Li S, et al. The association between serum testosterone level and congestive heart failure in US male adults: data from National Health and Nutrition Examination Survey (NHANES) 2011-2016. Reprod Biol Endocrinol. 2024;22(1):4.

  2. Scholten M, Davidge J, Agvall B, Halling A. Comorbidities in heart failure patients that predict cardiovascular readmissions within 100 days-An observational study. PLoS One. 2024;19(1):e0296527.

  3. Kuku KO, Shearer JJ, Hashemian M, Oyetoro R, Park H, Dulek B, et al. Development and Validation of a Protein Risk Score for Mortality in Heart Failure : A Community Cohort Study. Ann Intern Med. 2024.

  4. Chen K, Chang L, Huang R, Wang Z, Mu D, Wang L. Left atrial conduit strain derived from cardiac magnetic resonance is an independent predictor of left ventricular reverse remodeling in patients with nonischemic cardiomyopathy. BMC Med Imaging. 2024;24(1):2.

  5. Wahlberg KJ, Infeld M, Plante TB, Novelli AE, Habel N, Burkhoff D, et al. Effects of Continuous Accelerated Pacing on Cardiac Structure and Function in Patients With Heart Failure With Preserved Ejection Fraction: Insights From the myPACE Randomized Clinical Trial. J Am Heart Assoc. 2024;13(1):e032873.

  6. Chen ZW, Chung YW, Cheng JF, Huang CY, Chen SY, Lin LY, et al. Right Ventricular-Vascular Uncoupling Predicts Pulmonary Hypertension in Clinically Diagnosed Heart Failure With Preserved Ejection Fraction. J Am Heart Assoc. 2024;13(1):e030025.