Latest news with #HFpEF
Medscape
21-07-2025
- Health
- Medscape
Higher BMI, Bigger Gains: Tirzepatide's Effects on HFpEF
TOPLINE: In patients with obesity-related heart failure with preserved ejection fraction (HFpEF), tirzepatide reduced the risk for worsening heart failure or cardiovascular death regardless of their baseline BMI or fat distribution, with larger gains observed among those with higher BMI. Those who lost more weight with tirzepatide showed greater improvements in exercise capacity and symptom severity. METHODOLOGY: The SUMMIT trial previously showed significant benefits of tirzepatide, a long-acting glucose-dependent insulinotropic polypeptide and GLP-1 receptor agonist, in patients with obesity-related HFpEF. In this secondary analysis, researchers looked at whether the effects of tirzepatide varied with the severity and distribution of a patient's obesity or by the extent of weight loss achieved after treatment. The trial included 731 patients aged 40 years or older (mean age, 65.2 years; 53.8% women) with obesity-related HFpEF (defined by the New York Heart Association's functional classes II-IV) and a BMI of 30 or higher. Participants were randomly assigned to subcutaneously receive either 2.5 mg/wk of tirzepatide (n = 364) or a placebo (n = 367). Patients were categorized into tertiles of their baseline BMI and waist to height ratio. Primary endpoints were the time to first adjudicated cardiovascular death or an event of worsening HF and a change in the symptom status measured using the Kansas City Cardiomyopathy Questionnaire Clinical Summary Score (KCCQ-CSS) at 52 weeks. Secondary endpoints included changes in exercise capacity (measured using the 6-minute walk distance), body weight, and blood pressure. TAKEAWAY: Patients in the highest tertile of BMI were younger and most likely to be women and had more severe HF, a greater volume overload, and more severe inflammation. Those with a higher waist to height ratio showed similar patterns, as well as shorter 6-minute walk distances and more severe kidney disease. Use of tirzepatide vs placebo reduced the risk for cardiovascular death or worsening HF across all BMI ranges and waist to height ratios. Tirzepatide was associated with greater improvement in the 6-minute walk distance in patients in the highest range for BMI (37.5 m) than in those in the middle (26.3 m) and lower (9.9 m) ranges (P for trend = .025); improvements in weight loss and systolic blood pressure followed similar patterns. After 52 weeks on tirzepatide, those who lost more weight had bigger gains in their 6-minute walk distance and changes in the KCCQ-CSS (P < .0001 for both). The same benefits were seen in those with larger drops in waist circumference. IN PRACTICE: 'These data provide further evidence supporting the importance of excess body fat, particularly visceral fat, as driving HF severity in patients with the obesity phenotype of HFpEF,' the researchers reported. 'While these findings reinforce the role of incretin therapies in HFpEF management, these data, perhaps more importantly, highlight the urgent need for precision strategies to define obesity and direct therapy to those who will benefit most,' experts wrote in an editorial accompanying the journal article. SOURCE: This study was led by Barry A. Borlaug, MD, of Mayo Clinic in Rochester, Minnesota. It was published online on July 21, 2025, in the Journal of the American College of Cardiology. The researchers presented the findings at the American College of Cardiology (ACC) Scientific Session 2025. LIMITATIONS: Categorizing patients into tertiles of their BMI or waist to height ratio may have masked some trends. The trial included a higher proportion of women and participants from Latin America, limiting generalizability. Imaging-based methods could possibly offer more precise measurements of obesity. DISCLOSURES: The original trial was funded by Eli Lilly and Company. The lead author reported receiving grants from the National Heart, Lung, and Blood Institute and US Department of Defense, receiving research grants from and consulting for several pharmaceutical companies, and being a named inventor for tools and approach for procedure to treat HF. Several other authors reported being employees of or consultants for Eli Lilly and Company and several other companies. This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.
Health Line
14-07-2025
- Health
- Health Line
Types of Heart Failure Explained
Key takeaways Heart failure can affect the left side or right side of the heart, or both sides. It impacts how well the heart pumps blood to meet the body's needs. Left-sided heart failure is the most common type of heart failure. There are two main types of left-sided heart failure: diastolic and systolic. Diastolic heart failure is also known as heart failure with preserved ejection fraction (HFpEF), and systolic heart failure is also called heart failure with reduced ejection fraction (HFrEF). The Centers for Disease Control and Prevention (CDC) estimates that heart failure affects 6.2 million adults in the United States. It's most common in people 65 years old and over. If you have heart failure, your heart can't pump enough blood to meet the demands of the other tissues and organs in your body. Your outlook and recommended treatment plan depend on the underlying cause of your heart failure as well as the severity of your condition. Left-sided heart failure If you have left-sided heart failure, the left ventricle or lower left chamber of the heart has difficulty pumping oxygenated blood from the lungs to the rest of the body. This causes blood to back up in your pulmonary veins, which carry blood from your lungs to your heart. Left-sided heart failure may cause the following symptoms: fatigue shortness of breath difficulty breathing coughing swelling in the legs There are two main subcategories of left-sided heart failure: diastolic and systolic. Both affect the left ventricle. Diastolic heart failure Diastolic heart failure is also known as heart failure with preserved ejection fraction (HFpEF). According to a 2017 review, roughly half of people worldwide with heart failure have diastolic heart failure. And the number of individuals with this type of heart failure is increasing. In this type of heart failure, the muscle of your left ventricle stiffens and can no longer relax properly. This prevents your heart from filling with enough oxygenated blood from your lungs to pump to the rest of your body. HFpEF is often linked to: obesity poorly controlled hypertension diabetes obstructive sleep apnea Systolic heart failure The same 2017 review estimates that the other half of people with heart failure have systolic heart failure. It's also called heart failure with reduced ejection fraction (HFrEF). In this condition, the muscle of your left ventricle becomes weakened and can no longer contract properly. As a result, your heart doesn't pump with enough force to push oxygenated blood through your body successfully. HFrEF is commonly linked to coronary artery disease or blockages in the arteries around the heart. Right-sided heart failure Right-sided heart failure is less common than left-sided heart failure. It's most commonly caused by damage to the right side of the heart due to left-sided heart failure. But it can be caused by other conditions, such as leaky heart valves. If you have right-sided heart failure, your right ventricle can't pump enough blood from your heart to be oxygenated by your lungs. As a result, the blood backs up in your veins. This can push fluid from your veins into surrounding tissues, which may cause swelling in your feet, ankles, legs, or abdomen. Fluid buildup may lead to weight gain. Right-sided heart failure may also cause: fatigue increased urination loss of appetite nausea weight gain swelling of the legs Biventricular heart failure Biventricular heart failure affects both sides of your heart. It can cause symptoms of both right-sided and left-sided heart failure, such as: fatigue shortness of breath, difficulty breathing, or coughing swelling in your ankles, legs, abdomen, or other body parts increased urination loss of appetite nausea weight gain Many people with heart failure can start out with left-sided heart failure and go on to develop biventricular heart failure. This is due to the effects of left-sided heart failure on the right side of the heart. Chronic heart failure When heart failure develops over the course of multiple months or years, it's called chronic heart failure. Most cases of heart failure are chronic. Chronic heart failure may result from other chronic health conditions or risk factors that weaken or damage your heart. The odds of developing chronic heart failure increase if you have: high blood pressure coronary artery disease heart valve problems congenital heart defects severe lung disease diabetes obesity sleep apnea The symptoms of chronic heart failure tend to develop gradually and can be subtle. It's important to pay attention to small changes in exercise tolerance and report them to your doctor. Getting early treatment can help improve your outlook. Acute heart failure When heart failure develops suddenly, it's called acute heart failure. This type of heart failure is less common than chronic heart failure. Some potential causes of acute heart failure include: heart attack infection or inflammation of your heart side effects from certain medications drug or alcohol misuse genetics blood clots that develop in the pulmonary artery The symptoms of acute heart failure may develop quickly, over the course of a few hours or days. Common symptoms include: fatigue shortness of breath edema (swelling) in the limbs chest pain shortness of breath when lying down needing extra pillows to sleep on Acute heart failure is often a life threatening condition. If you think you're experiencing symptoms of acute heart failure, it's essential to get treatment right away.
Yahoo
17-06-2025
- Business
- Yahoo
Corvia Medical raises $55m to complete confirmatory heart shunt trial
Corvia Medical has raised $55m to complete an ongoing clinical trial of its atrial shunt system for heart failure. The US-based company's trial began in 2022 and is currently underway at more than 65 institutions across three continents with 750 patients enrolled, according to the trial's listing on Increasing Corvia's current funding to around $150m, the latest set of funds originated from the company's existing investment syndicate of Third Rock Ventures, General Catalyst Partners, AccelMed, Lumira Ventures, along with two strategic investors. Corvia anticipates the double-blind, randomised, sham-controlled confirmatory RESPONDER-HF (NCT05425459) trial of the Corvia atrial shunt system, which is being evaluated to treat heart failure with preserved and mildly reduced ejection fraction (HFpEF/HFmrEF), to generate the final clinical data required to support a regulatory filing with the US Food and Drug Administration (FDA). The atrial shunt works by creating a small passage between the heart's left and right atria, enabling blood to flow from the high-pressure left side to the lower-pressure right side. Trial patients randomised to the treatment arm will undergo a fluoroscopically and intra-cardiac echocardiography (ICE), or transoesophageal echocardiography (TEE) guided trans-septal puncture and with the Corvia atrial shunt implant procedure. In addition, patients randomised to the control arm will undergo ICE from the femoral vein or TEE for examination of the atrial septum and left atrium. Upon completion, patients will be evaluated at pre-specified time intervals and followed for five years. Corvia CEO George Fazio said: "We are profoundly grateful for the unwavering support of our longstanding investors as we advance toward FDA submission of the Corvia atrial shunt. "Their commitment furthers our mission to bring this transformative heart failure treatment to millions of patients worldwide." The funding will provide Corvia with the resources needed to navigate the approval process for the Corvia shunt system and introduce the therapy to the market, added Corvia board chair Paul LaViolette. Research indicates that around 65 million people worldwide have heart failure, with a majority affected by HFpEF. In October 2023, Corvia announced positive safety and efficacy results from its REDUCE LAP-HF II (NCT03088033) randomised Phase III trial of its atrial shunt. In comparison to the sham control, patients showed a 50% reduction in the rate of heart failure events and a sustained improvement in quality of life as measured on the Kansas City Cardiomyopathy Questionnaire (KCCQ). "Corvia Medical raises $55m to complete confirmatory heart shunt trial" was originally created and published by Medical Device Network, a GlobalData owned brand. The information on this site has been included in good faith for general informational purposes only. It is not intended to amount to advice on which you should rely, and we give no representation, warranty or guarantee, whether express or implied as to its accuracy or completeness. You must obtain professional or specialist advice before taking, or refraining from, any action on the basis of the content on our site.
Medscape
09-06-2025
- Health
- Medscape
Two-Step Approach Cuts HFpEF Diagnostic Complexity
Assessing left atrial volume and natriuretic peptides (LA/NP) can identify heart failure with preserved ejection fraction (HFpEF) with an 88% specificity and 97% positive predictive value. The strategy reduces the need for additional diagnostics by decreasing intermediate Heart Failure Association pre-test assessment, echocardiography & natriuretic peptide, functional testing, final etiology (HFA-PEFF) or H₂FPEF (Heavy, two or more hypertensive drugs, atrial fibrillation, pulmonary hypertension, elder age > 60 years, elevated filling pressures) algorithm scores by 27%-56%. METHODOLOGY: Researchers developed the diagnostic approach to rule in HFpEF using LA indexed for height 2 (LAViH 2 ; cut-off above 35.5 mL/m 2 in sinus rhythm or above 38.6 mL/m 2 in atrial fibrillation) and natriuretic peptides (as per the HFA-PEFF major criterion) with data from 443 patients with suspected HFpEF and validated in two independent cohorts. (LAViH ; cut-off above 35.5 mL/m in sinus rhythm or above 38.6 mL/m in atrial fibrillation) and natriuretic peptides (as per the HFA-PEFF major criterion) with data from 443 patients with suspected HFpEF and validated in two independent cohorts. End-systolic LA was manually traced in echocardiographic apical four- and two-chamber views and indexed for both body surface area and height 2 , with height 2 -indexed values showing better diagnostic performance in patients with obesity. , with height -indexed values showing better diagnostic performance in patients with obesity. Researchers developed the simplified approach by determining abnormal values for each measure of LA based on the highest value in control individuals, stratified by sinus rhythm/atrial fibrillation, and using elevated natriuretic peptides based on the HFA-PEFF major criterion. TAKEAWAY: The LA/NP approach identified 60% of HFpEF patients with an 88% specificity and a 97% positive predictive value in the derivation cohort, with similar results in the validation cohorts (76%-80% specificity, 92%-97% positive predictive value). The validation cohorts confirmed the LA/NP approach, with a 21%-57% reduction in intermediate scores, demonstrating consistent diagnostic accuracy across different clinical HFpEF profiles. Replacing LAViH2 with LA reservoir strain showed comparable results, suggesting flexibility in the echocardiographic parameters that can be used in this simplified diagnostic approach. IN PRACTICE: 'Using the LA/NP approach as a first step in patients suspected for HfpEF before using the HFA-PEFF or H 2 FPEF algorithm as a second step may substantially reduce the need for additional diagnostics to diagnose HfpEF,' the researchers wrote. SOURCE: The study was led by Jerremy Weerts, MSc, MD, of Maastricht University Medical Center in Maastricht, the Netherlands. It was published online in European Journal of Heart Failure and presented at the Heart Failure Association of the European Society of Cardiology (HFA-ESC) 2025 meeting. LIMITATIONS: The analyses were performed retrospectively in three independent, prospective cohorts from university hospitals, each with a high prevalence of diagnosed HFpEF, which may affect the performance of the LA/NP approach in less selected populations. The use of different natriuretic peptide assays across cohorts limited the derivation of new cut-off values for the LA/NP approach. Right heart catheterization was not performed in all patients, although this reflects daily clinical practice and aligns with large clinical trials in HFpEF. DISCLOSURES: Weerts reported receiving grants from Corvia Medical, CSL Vifor, and Boehringer Ingelheim, unrelated to the submitted work. The study was supported by the Dutch Heart Foundation (grant numbers CVON2017-21-SHE PREDICTS HF and CVON2015-10-Early HFpEF) and the Health Foundation Limburg. Additional disclosures are noted in the original article.
Medscape
13-05-2025
- Health
- Medscape
Few Patients With Diastolic Dysfunction Progress to HFpEF
In a 4.3-year follow-up study, few asymptomatic patients with preclinical left ventricular diastolic dysfunction (LVDD) progressed to heart failure with preserved ejection fraction (HFpEF), with a higher incidence noted in women. High blood pressure and decreased kidney function were associated with elevated levels of N-terminal pro–B-type natriuretic peptide (NT-proBNP). METHODOLOGY: The progression of LVDD may lead to the development of HFpEF over time. Despite the similar prevalence of LVDD in both sexes, HFpEF is more common in women than in men. Researchers evaluated longitudinal changes in markers of LVDD severity and HFpEF in men and women from a cohort of individuals who were at a high cardiovascular risk. They included 146 individuals with preclinical LVDD and no symptoms of HF at baseline (mean age, 63 years; 58% women) and reassessed them after a median follow-up duration of 4.3 years. Follow-up measurements included blood pressure, biomarkers such as NT-proBNP, kidney function, and echocardiography. HFpEF was assessed on the basis of signs, symptoms, and echocardiographic abnormalities. An LV ejection fraction below 50% was considered HF with reduced ejection fraction. TAKEAWAY: Overall, 10% of individuals developed HF, with 13 classified as those with HFpEF (nine women and four men). The annual incidence of HFpEF was 2%. Median NT-proBNP plasma levels increased from 71 to 100 pg/mL over the follow-up period. A significant rise was observed in terms of the presence of major functional abnormalities in both men and women and the presence of major morphologic abnormalities in women ( P for sex interaction = .03). for sex interaction = .03). Each SD decrease in the estimated glomerular filtration rate resulted in higher NT-proBNP levels in men and women (beta for change over time, 0.12; 95% CI, 0.01-0.22). Overall, a rise in systolic or diastolic BP led to an increase in NT-proBNP levels over time, with a higher systolic BP in women and a higher diastolic BP in men associated with an increase in NT-proBNP levels. IN PRACTICE: "High blood pressure and decreased kidney function were associated with higher levels of NT-proBNP. This highlights the need to further explore cardiorenal protection as a method to prevent HFpEF," the authors of the study wrote. SOURCE: This study was led by Anne Margje Lisa Naomi van Ommen, Utrecht University, Utrecht, the Netherlands. It was published online on May 04, 2025, in Open Heart . LIMITATIONS: The moderate sample size resulted in insufficient power to draw definitive conclusions about sex differences. A potential risk for measurement biases existed. The relatively low prevalence of comorbidities and the potential selection bias towards healthier individuals may have limited the generalisability of the findings. DISCLOSURES: This study received financial support from the Dutch CardioVascular Alliance, supported by the Dutch Heart Foundation. The authors declared having no competing interests.
