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3. Contemporary guideline‐directed medical therapy in de novo, chronic, and worsening heart failure patients: First data from the TITRATE‐HF study

Author

Malgie, Jishnu, primary, Wilde, Mariëlle I., additional, Clephas, Pascal R.D., additional, Emans, Mireille E., additional, Koudstaal, Stefan, additional, Schaap, Jeroen, additional, Mosterd, Arend, additional, van Ramshorst, Jan, additional, Wardeh, Alexander J., additional, van Wijk, Sandra, additional, van den Heuvel, Mieke, additional, Wierda, Eric, additional, Borleffs, C. Jan Willem, additional, Saraber, Colette, additional, Beeres, Saskia L.M.A., additional, van Kimmenade, Roland, additional, Jansen Klomp, Wouter, additional, Denham, Robert, additional, da Fonseca, Carlos A., additional, Klip, IJsbrand T., additional, Manintveld, Olivier C., additional, van der Boon, Robert M.A., additional, van Ofwegen, Clara E.E., additional, Yilmaz, Ayten, additional, Pisters, Ron, additional, Linssen, Gerard C.M., additional, Faber, Nikola, additional, van Heerebeek, Loek, additional, van de Swaluw, Julio E.C., additional, Bouhuijzen, Lex J., additional, Post, Marco C., additional, Kuijper, Aaf F.M., additional, Wu, Ka wai, additional, van Beek, Eugène A., additional, Hesselink, Tim, additional, Kleijn, Lennaert, additional, Kurvers, Maurice J.M., additional, Tio, René A., additional, Langerveld, Jorina, additional, van Dalen, Bas M., additional, van Eck, J.W. Martijn, additional, Handoko, M. Louis, additional, Hermans, Walter R.M., additional, Koornstra‐Wortel, Hetty J.J., additional, Szymanski, Mariusz K., additional, Rooker, Dennis, additional, Tandjung, Kenneth, additional, Eijsbouts, Sabine C.M., additional, Asselbergs, Folkert W., additional, van der Meer, Peter, additional, Brunner‐La Rocca, Hans‐Peter, additional, de Boer, Rudolf A., additional, and Brugts, Jasper J., additional

Published
2024
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5. Health burden in type 2 diabetes and prediabetes in The Maastricht Study

Author

Veugen, Marja G. J., Onete, Veronica G., Henry, Ronald M. A., Brunner-La Rocca, Hans-Peter, Koster, Annemarie, Dagnelie, Pieter C., Schaper, Nicolaas C., Sep, Simone J. S., van der Kallen, Carla J. H., van Boxtel, Martin P. J., Reesink, Koen D., Schouten, Johannes S., Savelberg, Hans H. C. M., Köhler, Sebastian, Verhey, Frans R., van den Bergh, Joop P. W., Schram, Miranda T., and Stehouwer, Coen D. A.

Published
2022
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6. Guideline implementation, drug sequencing, and quality of care in heart failure:design and rationale of TITRATE-HF

Author

Clephas, Pascal R.D., Malgie, Jishnu, Schaap, Jeroen, Koudstaal, Stefan, Emans, Mireille, Linssen, Gerard C.M., de Boer, Grytsje A., van Heerebeek, Loek, Borleffs, C. Jan Willem, Manintveld, Olivier C., van Empel, Vanessa, van Wijk, Sandra, van den Heuvel, Mieke, da Fonseca, Carlos, Damman, Kevin, van Ramshorst, Jan, van Kimmenade, Roland, van de Ven, Arjen R.T., Tio, René A., van Veghel, Dennis, Asselbergs, Folkert W., de Boer, Rudolf A., van der Meer, Peter, Greene, Stephen J., Brunner-La Rocca, Hans Peter, Brugts, Jasper J., Clephas, Pascal R.D., Malgie, Jishnu, Schaap, Jeroen, Koudstaal, Stefan, Emans, Mireille, Linssen, Gerard C.M., de Boer, Grytsje A., van Heerebeek, Loek, Borleffs, C. Jan Willem, Manintveld, Olivier C., van Empel, Vanessa, van Wijk, Sandra, van den Heuvel, Mieke, da Fonseca, Carlos, Damman, Kevin, van Ramshorst, Jan, van Kimmenade, Roland, van de Ven, Arjen R.T., Tio, René A., van Veghel, Dennis, Asselbergs, Folkert W., de Boer, Rudolf A., van der Meer, Peter, Greene, Stephen J., Brunner-La Rocca, Hans Peter, and Brugts, Jasper J.

Abstract

Aims: Current heart failure (HF) guidelines recommend to prescribe four drug classes in patients with HF with reduced ejection fraction (HFrEF). A clear challenge exists to adequately implement guideline-directed medical therapy (GDMT) regarding the sequencing of drugs and timely reaching target dose. It is largely unknown how the paradigm shift from a serial and sequential approach for drug therapy to early parallel application of the four drug classes will be executed in daily clinical practice, as well as the reason clinicians may not adhere to new guidelines. We present the design and rationale for the real-world TITRATE-HF study, which aims to assess sequencing strategies for GDMT initiation, dose titration patterns (order and speed), intolerance for GDMT, barriers for implementation, and long-term outcomes in patients with de novo, chronic, and worsening HF. Methods and results: A total of 4000 patients with HFrEF, HF with mildly reduced ejection fraction, and HF with improved ejection fraction will be enrolled in >40 Dutch centres with a follow-up of at least 3 years. Data collection will include demographics, physical examination and vital parameters, electrocardiogram, laboratory measurements, echocardiogram, medication, and quality of life. Detailed information on titration steps will be collected for the four GDMT drug classes. Information will include date, primary reason for change, and potential intolerances. The primary clinical endpoints are HF-related hospitalizations, HF-related urgent visits with a need for intravenous diuretics, all-cause mortality, and cardiovascular mortality. Conclusions: TITRATE-HF is a real-world multicentre longitudinal registry that will provide unique information on contemporary GDMT implementation, sequencing strategies (order and speed), and prognosis in de novo, worsening, and chronic HF patients.

Published
2024

7. Serial cardiac biomarkers, pulmonary artery pressures and traditional parameters of fluid status in relation to prognosis in patients with chronic heart failure: Design and rationale of the BioMEMS study.

Author

Allach, Youssra, Barry‐Loncq de Jong, Mylene, Clephas, Pascal R.D., van Gent, Marco W.F., Brunner‐La Rocca, Hans‐Peter, Szymanski, Mariusz K., van Halm, Vokko P., Handoko, M. Louis, Kok, Wouter E.M., Asselbergs, Folkert W., van Kimmenade, Roland R.J., Manintveld, Olivier C., van Mieghem, Nicolas M.D.A., Beeres, Saskia L.M.A., Rienstra, Michiel, Post, Marco C., van Heerebeek, Loek, Borleffs, C. Jan Willem, Tukkie, Raymond, and Mosterd, Arend

Subjects
PULMONARY artery, HEART failure, HEART failure patients, CARDIOVASCULAR disease related mortality, DESIGN failures, PROGNOSIS
Abstract

Aims: Heart failure (HF), a global pandemic affecting millions of individuals, calls for adequate predictive guidance for improved therapy. Congestion, a key factor in HF‐related hospitalizations, further underscores the need for timely interventions. Proactive monitoring of intracardiac pressures, guided by pulmonary artery (PA) pressure, offers opportunities for efficient early‐stage intervention, since haemodynamic congestion precedes clinical symptoms. Methods: The BioMEMS study, a substudy of the MONITOR‐HF trial, proposes a multifaceted approach integrating blood biobank data with traditional and novel HF parameters. Two additional blood samples from 340 active participants in the MONITOR‐HF trial were collected at baseline, 3‐, 6‐, and 12‐month visits and stored for the BioMEMS biobank. The main aims are to identify the relationship between temporal biomarker patterns and PA pressures derived from the CardioMEMS‐HF system, and to identify the biomarker profile(s) associated with the risk of HF events and cardiovascular death. Conclusion: Since the prognostic value of single baseline measurements of biomarkers like N‐terminal pro‐B‐type natriuretic peptide is limited, with the BioMEMS study we advocate a dynamic, serial approach to better capture HF progression. We will substantiate this by relating repeated biomarker measurements to PA pressures. This design rationale presents a comprehensive review on cardiac biomarkers in HF, and aims to contribute valuable insights into personalized HF therapy and patient risk assessment, advancing our ability to address the evolving nature of HF effectively. [ABSTRACT FROM AUTHOR]

Published
2024
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8. NT-proBNP for Risk Prediction in Heart Failure: Identification of Optimal Cutoffs Across Body Mass Index Categories

Author

Vergaro, Giuseppe, Gentile, Francesco, Meems, Laura M.G., Aimo, Alberto, Januzzi, James L., Jr., Richards, A. Mark, Lam, Carolyn S.P., Latini, Roberto, Staszewsky, Lidia, Anand, Inder S., Cohn, Jay N., Ueland, Thor, Gullestad, Lars, Aukrust, Pål, Brunner-La Rocca, Hans-Peter, Bayes-Genis, Antoni, Lupón, Josep, Yoshihisa, Akiomi, Takeishi, Yasuchika, Egstrup, Michael, Gustafsson, Ida, Gaggin, Hanna K., Eggers, Kai M., Huber, Kurt, Gamble, Greg D., Ling, Lieng H., Leong, Kui Tong Gerard, Yeo, Poh Shuah Daniel, Ong, Hean Yee, Jaufeerally, Fazlur, Ng, Tze P., Troughton, Richard, Doughty, Robert N., Devlin, Gerry, Lund, Mayanna, Giannoni, Alberto, Passino, Claudio, de Boer, Rudolf A., and Emdin, Michele

Published
2021
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9. Proteomic and Mechanistic Analysis of Spironolactone in Patients at Risk for HF

Author

Ferreira, João Pedro, Verdonschot, Job, Wang, Ping, Pizard, Anne, Collier, Timothy, Ahmed, Fozia Z., Brunner-La-Rocca, Hans-Peter, Clark, Andrew L., Cosmi, Franco, Cuthbert, Joe, Díez, Javier, Edelmann, Frank, Girerd, Nicolas, González, Arantxa, Grojean, Stéphanie, Hazebroek, Mark, Khan, Javed, Latini, Roberto, Mamas, Mamas A., Mariottoni, Beatrice, Mujaj, Blerim, Pellicori, Pierpaolo, Petutschnigg, Johannes, Pieske, Burkert, Rossignol, Patrick, Rouet, Philippe, Staessen, Jan A., Cleland, John G.F., Heymans, Stephane, and Zannad, Faiez

Published
2021
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10. Organ dysfunction, injury and failure in acute heart failure: from pathophysiology to diagnosis and management. A review on behalf of the Acute Heart Failure Committee of the Heart Failure Association (HFA) of the European Society of Cardiology (ESC).

Author

Harjola, Veli-Pekka, Mullens, Wilfried, Banaszewski, Marek, Bauersachs, Johann, Brunner-La Rocca, Hans-Peter, Chioncel, Ovidiu, Collins, Sean, Doehner, Wolfram, Filippatos, Gerasimos, Flammer, Andreas, Fuhrmann, Valentin, Lainscak, Mitja, Lassus, Johan, Legrand, Matthieu, Masip, Josep, Mueller, Christian, Papp, Zoltán, Parissis, John, Platz, Elke, Rudiger, Alain, Ruschitzka, Frank, Schäfer, Andreas, Seferovic, Petar, Skouri, Hadi, Yilmaz, Mehmet, and Mebazaa, Alexandre

Subjects
Heart failure, Multiple organ failure, Venous congestion, Acute Disease, Cardiology, Diagnostic Imaging, Disease Management, Europe, Heart Failure, Humans, Multiple Organ Failure, Societies, Medical
Abstract

Organ injury and impairment are commonly observed in patients with acute heart failure (AHF), and congestion is an essential pathophysiological mechanism of impaired organ function. Congestion is the predominant clinical profile in most patients with AHF; a smaller proportion presents with peripheral hypoperfusion or cardiogenic shock. Hypoperfusion further deteriorates organ function. The injury and dysfunction of target organs (i.e. heart, lungs, kidneys, liver, intestine, brain) in the setting of AHF are associated with increased risk for mortality. Improvement in organ function after decongestive therapies has been associated with a lower risk for post-discharge mortality. Thus, the prevention and correction of organ dysfunction represent a therapeutic target of interest in AHF and should be evaluated in clinical trials. Treatment strategies that specifically prevent, reduce or reverse organ dysfunction remain to be identified and evaluated to determine if such interventions impact mortality, morbidity and patient-centred outcomes. This paper reflects current understanding among experts of the presentation and management of organ impairment in AHF and suggests priorities for future research to advance the field.

Published
2017

11. Optimizing heart failure pathways to enhance patient care: the Program to Optimize Heart Failure Patient Pathways (PRO‐HF).

Author

Patwala, Ashish, Barker, Diane, Da Costa, Antoine, Bayard, Geoffrey, Brunner‐La Rocca, Hans‐Peter, Fontes‐Carvalho, Ricardo, De la Fuente, Luis, Goralski, Marc, Mahon, Niall G., Roque, David, Santos, Mario, Yousef, Zaheer, Ben Hamouda, Hela, Teal, Mark, Christory, François, Ahmed, Fozia Zahir, and Mebazaa, Alexandre

Abstract

Aims: Many European healthcare providers struggle to adopt multidisciplinary, integrated care pathways for people with heart failure (HF) as recommended by the European Society of Cardiology. PRO‐HF (Program to Optimize Heart Failure Patient Pathways) was developed to help clinicians identify strengths, gaps, and shortcomings in their HF pathways and support tailored interventions to optimize pathways and enhance patient care. We report initial findings from baseline assessments of HF pathway characteristics and challenges from 10 hospitals in six European countries (France, Ireland, Portugal, Spain, The Netherlands, and United Kingdom). Methods and results: Baseline assessments were holistic appraisals of full HF services to calibrate current status and development needs and assist management teams in prioritizing improvement projects. Assessments were performed using a comprehensive checklist of measures covering the HF patient journey from diagnosis to ongoing follow‐up. These included a digital survey sent to full HF care teams and one‐to‐one interviews. The digital survey focused on four key areas (HF outpatient clinic; remote patient management; efficient device implantation and inpatient pathways; and network maximization) and 16 dimensions of excellence. Priority areas and themes for action identified in baseline assessments were (i) provision of HF specialist care; (ii) data capture and analysis; (iii) institutional care protocols; (iv) hospital‐wide strategies; and (v) multidisciplinary teams (MDTs). Suboptimal specialist care of emergency inpatients was an issue at all hospitals and prioritized at 8/10. Availability and accessibility of data on patients, activities, and outcomes was an issue at all hospitals and prioritized by 4/10. A lack of clear protocols, templates, and tools for some HF activities created variability in patient care (e.g., HF specialist consultations, diagnostic testing, follow‐up appointments, medications, and device eligibility) and inefficient use of clinician time. This made it difficult to initiate new technologies (e.g., remote patient monitoring) due to the risk of overburdening staff. MDTs were frequently understaffed. Multiple interventions were identified to address gaps and shortcomings that could be tailored to specific needs of individual hospitals (e.g., inpatient pathway optimization, creation/optimization of HF outpatient clinics, development of an HF performance dashboard, enhancement of protocol adherence, streamlining cardiac resynchronisation therapy pathways, and MDT coordination). Conclusions: PRO‐HF provides a valuable opportunity to identify gaps and significant shortcomings in HF pathways in European hospitals. Preliminary findings from hospitals that have initiated suggested changes to address these challenges are encouraging, though longer‐term follow‐up from more hospitals is needed to confirm the impact of PRO‐HF on HF pathway optimization and patient care. [ABSTRACT FROM AUTHOR]

Published
2024
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12. Proteomic profiles of left atrial volume and its influence on response to spironolactone: Findings from the HOMAGE trial and STANISLAS cohort.

Author

Kobayashi, Masatake, Ferreira, João Pedro, Duarte, Kevin, Bresso, Emmanuel, Huttin, Olivier, Bozec, Erwan, Brunner La Rocca, Hans‐Peter, Delles, Christian, Clark, Andrew L., Edelmann, Frank, González, Arantxa, Heymans, Stephane, Pellicori, Pierpaolo, Petutschnigg, Johannes, Verdonschot, Job A.J., Rossignol, Patrick, Cleland, John G.F., Zannad, Faiez, and Girerd, Nicolas

Subjects
BRAIN natriuretic factor, LEFT heart atrium, SOMATOMEDIN, PROTEOMICS, SPIRONOLACTONE
Abstract

Aims: High left ventricular filling pressure increases left atrial volume and causes myocardial fibrosis, which may decrease with spironolactone. We studied clinical and proteomic characteristics associated with left atrial volume indexed by body surface area (LAVi), and whether LAVi influences the response to spironolactone on biomarker expression and clinical variables. Methods and results: In the HOMAGE trial, where people at risk of heart failure were randomized to spironolactone or control, we analysed 421 participants with available LAVi and 276 proteomic measurements (Olink) at baseline, month 1 and 9 (mean age 73 ± 6 years; women 26%; LAVi 32 ± 9 ml/m2). Circulating proteins associated with LAVi were also assessed in asymptomatic individuals from a population‐based cohort (STANISLAS; n = 1640; mean age 49 ± 14 years; women 51%; LAVi 23 ± 7 ml/m2). In both studies, greater LAVi was significantly associated with greater left ventricular masses and volumes. In HOMAGE, after adjustment and correction for multiple testing, greater LAVi was associated with higher concentrations of matrix metallopeptidase‐2 (MMP‐2), insulin‐like growth factor binding protein‐2 (IGFBP‐2) and N‐terminal pro‐B‐type natriuretic peptide (NT‐proBNP) (false discovery rates [FDR] <0.05). These associations were externally replicated in STANISLAS (all FDR <0.05). Among these biomarkers, spironolactone decreased concentrations of MMP‐2 and NT‐proBNP, regardless of baseline LAVi (pinteraction > 0.10). Spironolactone also significantly reduced LAVi, improved left ventricular ejection fraction, lowered E/e', blood pressure and serum procollagen type I C‐terminal propeptide (PICP) concentration, a collagen synthesis marker, regardless of baseline LAVi (pinteraction > 0.10). Conclusion: In individuals without heart failure, LAVi was associated with MMP‐2, IGFBP‐2 and NT‐proBNP. Spironolactone reduced these biomarker concentrations as well as LAVi and PICP, irrespective of left atrial size. [ABSTRACT FROM AUTHOR]

Published
2024
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13. Guideline implementation, drug sequencing, and quality of care in heart failure: design and rationale of TITRATE‐HF

Author

Clephas, Pascal R. D., primary, Malgie, Jishnu, additional, Schaap, Jeroen, additional, Koudstaal, Stefan, additional, Emans, Mireille, additional, Linssen, Gerard C. M., additional, de Boer, Grytsje A., additional, van Heerebeek, Loek, additional, Borleffs, C. Jan Willem, additional, Manintveld, Olivier C., additional, van Empel, Vanessa, additional, van Wijk, Sandra, additional, van den Heuvel, Mieke, additional, da Fonseca, Carlos, additional, Damman, Kevin, additional, van Ramshorst, Jan, additional, van Kimmenade, Roland, additional, van de Ven, Arjen R. T., additional, Tio, René A., additional, van Veghel, Dennis, additional, Asselbergs, Folkert W., additional, de Boer, Rudolf A., additional, van der Meer, Peter, additional, Greene, Stephen J., additional, Brunner‐La Rocca, Hans‐Peter, additional, and Brugts, Jasper J., additional

Published
2023
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14. Use of loop diuretics in patients with chronic heart failure: an observational overview

Author

Scholte, Niels TB, primary, Aydin, Dilan, additional, Linssen, Gerard CM, additional, Koudstaal, Stefan, additional, Rademaker, Philip C, additional, Geerlings, Peter R, additional, van Gent, Marco WF, additional, Aksoy, Ismail, additional, Oosterom, Liane, additional, Boersma, Eric, additional, Brunner-La Rocca, Hans-Peter, additional, and Brugts, Jasper J, additional

Published
2023
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16. Initial Imaging-Guided Strategy Versus Routine Care in Patients With Non–ST-Segment Elevation Myocardial Infarction

Author

Smulders, Martijn W., Kietselaer, Bas L.J.H., Wildberger, Joachim E., Dagnelie, Pieter C., Brunner–La Rocca, Hans-Peter, Mingels, Alma M.A., van Cauteren, Yvonne J.M., Theunissen, Ralph A.L.J., Post, Mark J., Schalla, Simon, van Kuijk, Sander M.J., Das, Marco, Kim, Raymond J., Crijns, Harry J.G.M., and Bekkers, Sebastiaan C.A.M.

Published
2019
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17. Artificial intelligence supported patient self-care in chronic heart failure: a paradigm shift from reactive to predictive, preventive and personalised care

Author

Barrett, Matthew, Boyne, Josiane, Brandts, Julia, Brunner-La Rocca, Hans-Peter, De Maesschalck, Lieven, De Wit, Kurt, Dixon, Lana, Eurlings, Casper, Fitzsimons, Donna, Golubnitschaja, Olga, Hageman, Arjan, Heemskerk, Frank, Hintzen, André, Helms, Thomas M., Hill, Loreena, Hoedemakers, Thom, Marx, Nikolaus, McDonald, Kenneth, Mertens, Marc, Müller-Wieland, Dirk, Palant, Alexander, Piesk, Jens, Pomazanskyi, Andrew, Ramaekers, Jan, Ruff, Peter, Schütt, Katharina, Shekhawat, Yash, Ski, Chantal F., Thompson, David R., Tsirkin, Andrew, van der Mierden, Kay, Watson, Chris, and Zippel-Schultz, Bettina

Published
2019
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19. sST2 Predicts Outcome in Chronic Heart Failure Beyond NT−proBNP and High-Sensitivity Troponin T

Author

Emdin, Michele, Aimo, Alberto, Vergaro, Giuseppe, Bayes-Genis, Antoni, Lupón, Josep, Latini, Roberto, Meessen, Jennifer, Anand, Inder S., Cohn, Jay N., Gravning, Jørgen, Gullestad, Lars, Broch, Kaspar, Ueland, Thor, Nymo, Ståle H., Brunner-La Rocca, Hans-Peter, de Boer, Rudolf A., Gaggin, Hanna K., Ripoli, Andrea, Passino, Claudio, and Januzzi, James L., Jr.

Published
2018
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20. Webtool to enhance the accuracy of diagnostic algorithms for HFpEF: a prospective cross‐over study

Author

Weerts, Jerremy, primary, Amin, Hesam, additional, Barandiarán Aizpurua, Arantxa, additional, Gevaert, Andreas B., additional, Handoko, M. Louis, additional, Dauw, Jeroen, additional, Tun, Han Naung, additional, Rommel, Karl‐Philipp, additional, Verbrugge, Frederik H., additional, Kresoja, Karl‐Patrik, additional, Sanders‐van Wijk, Sandra, additional, Brunner‐La Rocca, Hans‐Peter, additional, Bayés‐Genís, Antoni, additional, Lumens, Joost, additional, Knackstedt, Christian, additional, and van Empel, Vanessa P.M., additional

Published
2023
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21. Biomarkers of Collagen Metabolism Are Associated with Left Ventricular Function and Prognosis in Dilated Cardiomyopathy: A Multi-Modal Study

Author

Raafs, Anne G., primary, Adriaans, Bouke P., additional, Henkens, Michiel T. H. M., additional, Verdonschot, Job A. J., additional, Abdul Hamid, Myrurgia A., additional, Díez, Javier, additional, Knackstedt, Christian, additional, van Empel, Vanessa P. M., additional, Brunner-La Rocca, Hans-Peter, additional, González, Arantxa, additional, Wildberger, Joachim E., additional, Heymans, Stephane R. B., additional, and Hazebroek, Mark R., additional

Published
2023
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23. Challenges in heart failure care in four European countries: a comparative study

Author

Steiner, Bianca, primary, Neumann, Anne, additional, Pelz, Yannick, additional, Ski, Chantal F, additional, Hill, Loreena, additional, Thompson, David R, additional, Fitzsimons, Donna, additional, Dixon, Lana J, additional, Brandts, Julia, additional, Verket, Marlo, additional, Schütt, Katharina, additional, Eurlings, Casper G M J, additional, Boyne, Josiane J J, additional, Gingele, Arno J, additional, De Maesschalck, Lieven, additional, Murphy, Marguerite, additional, Furtado da Luz, Ermelinda, additional, Barrett, Matthew, additional, Windle, Karen, additional, Hoedemakers, Thom, additional, Helms, Thomas M, additional, Brunner-La Rocca, Hans-Peter, additional, and Zippel-Schultz, Bettina, additional

Published
2023
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24. Identifying distinct clinical clusters in heart failure with mildly reduced ejection fraction

Author

Meijs, Claartje, Brugts, Jasper J., Lund, Lars H., Linssen, Gerard C. M., Brunner-La Rocca, Hans-Peter, Dahlström, Ulf, Vaartjes, Ilonca, Koudstaal, Stefan, Asselbergs, Folkert W., Savarese, Gianluigi, Uijl, Alicia, Meijs, Claartje, Brugts, Jasper J., Lund, Lars H., Linssen, Gerard C. M., Brunner-La Rocca, Hans-Peter, Dahlström, Ulf, Vaartjes, Ilonca, Koudstaal, Stefan, Asselbergs, Folkert W., Savarese, Gianluigi, and Uijl, Alicia

Abstract

Introduction: Heart failure (HF) is a heterogeneous syndrome, and the specific sub-category HF with mildly reduced ejection fraction (EF) range (HFmrEF; 41-49% EF) is only recently recognised as a distinct entity. Cluster analysis can characterise heterogeneous patient populations and could serve as a stratification tool in clinical trials and for prognostication. The aim of this study was to identify clusters in HFmrEF and compare cluster prognosis.Methods and results: Latent class analysis to cluster HFmrEF patients based on their characteristics was performed in the Swedish HF registry (n = 7316). Identified clusters were validated in a Dutch cross-sectional HF registrybased dataset CHECK-HF (n =1536). In Sweden, mortality and hospitalisation across the clusters were compared using a Cox proportional hazard model, with a Fine-Gray sub-distribution for competing risks and adjustment for age and sex. Six clusters were discovered with the following prevalence and hazard ratio with 95% confidence intervals (HR [95%CI]) vs. cluster 1: 1) low-comorbidity (17%, reference), 2) ischaemic-male (13%, HR 0.9 [95% CI 0.7-1.1]), 3) atrial fibrillation (20%, HR 1.5 [95% CI 1.2-1.9]), 4) device/wide QRS (9%, HR 2.7 [95% CI 2.2-3.4]), 5) metabolic (19%, HR 3.1 [95% CI 2.5-3.7]) and 6) cardio-renal phenotype (22%, HR 2.8 [95% CI 2.2-3.6]). The cluster model was robust between both datasets.Conclusion: We found robust clusters with potential clinical meaning and differences in mortality and hospitalisation. Our clustering model could be valuable as a clinical differentiation support and prognostic tool in clinical trial design., Funding Agencies|Swedish National Board of Health and Welfare; Swedish Association of Local Authorities and Regions; Swedish Society of Cardiology; Swedish Heart-Lung Foundation; Servier, the Netherlands; EU/EFPIA Innovative Medicines Initiative 2 Joint Undertaking BigData@Heart; Swedish Research Council; Swedish Heart Lung Foundation [116074]; Stockholm County Council [2013-23897-104604-23, 523-2014-2336]; UCL Hospitals NIHR Biomedical Research Centre [20150557, 20170841]; Dutch Heart Foundation [20140220, 20170112]

Published
2023
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25. Use of loop diuretics in patients with chronic heart failure:An observational overview

Author

Scholte, Niels T.B., Aydin, Dilan, Linssen, Gerard C.M., Koudstaal, Stefan, Rademaker, Philip C., Geerlings, Peter R., Van Gent, Marco W.F., Aksoy, Ismail, Oosterom, Liane, Boersma, Eric, Brunner-La Rocca, Hans Peter, Brugts, Jasper J., Scholte, Niels T.B., Aydin, Dilan, Linssen, Gerard C.M., Koudstaal, Stefan, Rademaker, Philip C., Geerlings, Peter R., Van Gent, Marco W.F., Aksoy, Ismail, Oosterom, Liane, Boersma, Eric, Brunner-La Rocca, Hans Peter, and Brugts, Jasper J.

Abstract

Introduction:This study aimed to evaluate the use and dose of loop diuretics (LDs) across the entire ejection fraction (EF) spectrum in a large, € real-world' cohort of chronic heart failure (HF) patients. Methods:A total of 10 366 patients with chronic HF from 34 Dutch outpatient HF clinics were analysed regarding diuretic use and diuretic dose. Data regarding daily diuretic dose were stratified by furosemide dose equivalent (FDE)>80 mg or ≤80 mg. Multivariable logistic regression models were used to assess the association between diuretic dose and clinical features. Results:In this cohort, 8512 (82.1%) patients used diuretics, of which 8179 (96.1%) used LDs. LD use was highest among HF with reduced EF (HFrEF) patients (81.1%) followed by HF with mild-reduced EF (76.1%) and HF with preserved ejection fraction EF (73.8%, p<0.001). Among all LDs users, the median FDE was 40 mg (IQR: 40-80). The results of the multivariable analysis showed that New York Heart Association classes III and IV and diabetes mellitus were one of the strongest determinants of an FDE >80 mg, across all HF categories. Renal impairment was associated with a higher FDE across the entire EF spectrum. Conclusion: In this large registry of real-world HF patients, LD use was highest among HFrEF patients. Advanced symptoms, diabetes mellitus and worse renal function were significantly associated with a higher diuretic dose regardless of left ventricular ejection fraction.

Published
2023

26. Guideline-directed medical therapy for HFrEF:sequencing strategies and barriers for life-saving drug therapy

Author

Malgie, Jishnu, Clephas, Pascal R.D., Brunner-La Rocca, Hans Peter, de Boer, Rudolf A., Brugts, Jasper J., Malgie, Jishnu, Clephas, Pascal R.D., Brunner-La Rocca, Hans Peter, de Boer, Rudolf A., and Brugts, Jasper J.

Abstract

Multiple landmark trials have helped to advance the treatment of heart failure with reduced ejection fraction (HFrEF) significantly over the past decade. These trials have led to the introduction of four main drug classes into the 2021 ESC guideline, namely angiotensin-receptor neprilysin inhibitors/angiotensin-converting-enzyme inhibitors, beta-blockers, mineralocorticoid receptor antagonists, and sodium-glucose cotransporter-2 inhibitors. The life-saving effect of these therapies has been shown to be additive and becomes apparent within weeks, which is why maximally tolerated or target doses of all drug classes should be strived for as quickly as possible. Recent evidence, such as the STRONG-HF trial, demonstrated that rapid drug implementation and up-titration is superior to the traditional and more gradual step-by-step approach where valuable time is lost to up-titration. Accordingly, multiple rapid drug implementation and sequencing strategies have been proposed to significantly reduce the time needed for the titration process. Such strategies are urgently needed since previous large-scale registries have shown that guideline-directed medical therapy (GDMT) implementation is a challenge. This challenge is reflected by generally low adherence rates, which can be attributed to factors considering the patient, health care system, and local hospital/health care provider. This review of the four medication classes used to treat HFrEF seeks to present a thorough overview of the data supporting current GDMT, discuss the obstacles to GDMT implementation and up-titration, and identify multiple sequencing strategies that could improve GDMT adherence. Graphical Abstract: Sequencing strategies for GDMT implementation. GDMT: guideline-directed medical therapy; ACEi: angiotensin-converting enzyme inhibitor; ARB: Angiotensin II receptor blocker; ARNi: angiotensin receptor–neprilysin inhibitor; BB: beta-blocker; MRA: mineralocorticoid receptor antagonist; SGLT2i: sodium–glu

Published
2023

27. Heart failure treatment in patients with and without obesity with an ejection fraction below 50%

Author

Aga, Yaar S., Radhoe, Sumant P., Aydin, Dilan, Linssen, G. C.M., Rademaker, Philip C., Geerlings, Peter R., van Gent, Marco W.F., Aksoy, Ismail, Oosterom, Liane, Brunner-La Rocca, Hans Peter, van Dalen, Bas M., Brugts, Jasper J., Aga, Yaar S., Radhoe, Sumant P., Aydin, Dilan, Linssen, G. C.M., Rademaker, Philip C., Geerlings, Peter R., van Gent, Marco W.F., Aksoy, Ismail, Oosterom, Liane, Brunner-La Rocca, Hans Peter, van Dalen, Bas M., and Brugts, Jasper J.

Abstract

Background: The aim of this study was to assess heart failure (HF) treatment in patients with and without obesity in a large contemporary real-world Western European cohort. Methods: Patients with a left ventricular ejection fraction (LVEF) <50% and available information on body mass index (BMI) were selected from the CHECK-HF registry. The CHECK-HF registry included chronic HF patients in the period between 2013 and 2016 in 34 Dutch outpatient clinics. Patients were divided into BMI categories. Differences in HF medical treatment were analysed, and multivariable logistic regression analysis (dichotomized as BMI <30 kg/m2 and ≥30 kg/m2) was performed. Results: Seven thousand six hundred seventy-one patients were included, 1284 (16.7%) had a BMI ≥30 kg/m2, and 618 (8.1%) had a BMI ≥35 kg/m2. Median BMI was 26.4 kg/m2. Patients with obesity were younger and had a higher rate of comorbidities such as diabetes mellitus, hypertension and obstructive sleep apnoea (OSAS). Prescription rates of guideline-directed medical therapy (GDMT) increased significantly with BMI. The differences were most pronounced for mineralocorticoid receptor antagonists (MRAs) and diuretics. Patients with obesity more often received the guideline-recommended target dose. In multivariable logistic regression, obesity was significantly associated with a higher likelihood of receiving ≥100% of the guideline-recommended target dose of beta-blockers (OR 1.34, 95% CI 1.10–1.62), renin–angiotensin system (RAS)-inhibitors (OR 1.34, 95% CI 1.15–1.57) and MRAs (OR 1.40, 95% CI 1.04–1.87). Conclusions: Guideline-recommended HF drugs are more frequently prescribed and at a higher dose in patients with obesity as compared to HF patients without obesity.

Published
2023

28. Phenotypic patient profiling for improved implementation of guideline-directed medical therapy:An exploratory analysis in a large real-world chronic heart failure cohort

Author

Radhoe, Sumant P., Clephas, Pascal R.D., Linssen, Gerard C.M., Oortman, Remko M., Smeele, Frank J., Van Drimmelen, Annemarie A., Schaafsma, Henk Jan, Westendorp, Paul H., Brunner-La Rocca, Hans Peter, Brugts, Jasper J., Radhoe, Sumant P., Clephas, Pascal R.D., Linssen, Gerard C.M., Oortman, Remko M., Smeele, Frank J., Van Drimmelen, Annemarie A., Schaafsma, Henk Jan, Westendorp, Paul H., Brunner-La Rocca, Hans Peter, and Brugts, Jasper J.

Abstract

Aims: Implementation of guideline-recommended pharmacological treatment in heart failure (HF) patients remains challenging. In 2021, the European Heart Failure Association (HFA) published a consensus document in which patient profiles were created based on readily available patient characteristics and suggested that treatment adjusted to patient profile may result in better individualized treatment and improved guideline adherence. This study aimed to assess the distribution of these patient profiles and their treatment in a large real-world chronic HF cohort. Methods and results: The HFA combined categories of heart rate, blood pressure, presence of atrial fibrillation, chronic kidney disease, and hyperkalemia into eleven phenotypic patient profiles. A total of 4,455 patients with chronic HF and a left ventricular ejection fraction ≤40% with complete information on all characteristics were distributed over these profiles. In total, 1,640 patients (36.8%) could be classified into one of the HFA profiles. Three of these each comprised >5% of the population and consisted of patients with a heart rate >60 beats per minute with normal blood pressure (>90/60 mmHg) and no hyperkalemia. Conclusion: Nearly forty percent of a real-world chronic HF population could be distributed over the eleven patient profiles as suggested by the HFA. Phenotype-specific treatment recommendations are clinically relevant and important to further improve guideline implementation.

Published
2023

29. Multimarker Analysis of Serially Measured GDF-15, NT-proBNP, ST2, GAL-3, cTnI, Creatinine, and Prognosis in Acute Heart Failure

Author

Gürgöze, Muhammed T., Van Vark, Laura C., Baart, Sara J., Kardys, Isabella, Akkerhuis, K. Martijn, Manintveld, Olivier C., Postmus, Douwe, Hillege, Hans L., Lesman-Leegte, Ivonne, Asselbergs, Folkert W., Brunner-La-Rocca, Hans Peter, Van Den Bos, Ewout J., Orsel, Joke G., De Ridder, Stijn P.J., Pinto, Yigal M., Boersma, Eric, Gürgöze, Muhammed T., Van Vark, Laura C., Baart, Sara J., Kardys, Isabella, Akkerhuis, K. Martijn, Manintveld, Olivier C., Postmus, Douwe, Hillege, Hans L., Lesman-Leegte, Ivonne, Asselbergs, Folkert W., Brunner-La-Rocca, Hans Peter, Van Den Bos, Ewout J., Orsel, Joke G., De Ridder, Stijn P.J., Pinto, Yigal M., and Boersma, Eric

Abstract

Background: Studies on serially measured GDF-15 (growth differentiation factor 15) in acute heart failure (HF) are limited. Moreover, several pathophysiological pathways contribute to HF. Therefore, we aimed to explore the (additional) prognostic value of serially measured GDF-15 using a multi-marker approach to more accurately predict HF risk. Methods: TRIUMPH (Translational Initiative on Unique and Novel Strategies for Management of Patients With Heart Failure) is a prospective cohort of 496 patients with acute HF who were enrolled in 14 hospitals in the Netherlands between 2009 and 2014. Blood sampling was scheduled at 7 moments during 1-year follow-up. GDF-15, NT-proBNP (N-terminal pro-B-type natriuretic peptide), ST2 (suppression of tumorigenicity 2), galectin-3, troponin I, and creatinine were measured in a central laboratory. We associated repeated measurements of these biomarkers with the composite primary end point of all-cause mortality and HF rehospitalization, using multivariable joint modeling. Results: Median age was 74 years, and 37% were women. Median baseline GDF-15 was 4632 pg/mL. The primary end point was reached in 188 (40%) patients. The average estimated GDF-15 level increased weeks before the primary end point was reached. The hazard ratio per 1 SD difference in log-GDF-15 was 2.14 (95% CI, 1.78-2.57) unadjusted, 1.96 (1.49-2.53) after adjustment for clinical confounders and 1.44 (1.05-1.91) when jointly modeled with all biomarkers. The adjusted HRs for NT-proBNP were 2.38 (1.78-3.33) and 1.52 (1.15-2.08), respectively. The multimarker model combining GDF-15, NT-proBNP, and troponin I provided a favorable risk discrimination (area under the curve=0.785). Conclusions: Sequentially measured GDF-15 independently and dynamically predicts risk of adverse outcomes during 1-year follow-up after index admission for acute HF. NT-proBNP remains a robust predictor among potential candidates.

Published
2023

30. Meta-Analysis of Soluble Suppression of Tumorigenicity-2 and Prognosis in Acute Heart Failure

Author

Aimo, Alberto, Vergaro, Giuseppe, Ripoli, Andrea, Bayes-Genis, Antoni, Pascual Figal, Domingo A., de Boer, Rudolf A., Lassus, Johan, Mebazaa, Alexandre, Gayat, Etienne, Breidthardt, Tobias, Sabti, Zaid, Mueller, Christian, Brunner-La Rocca, Hans-Peter, Tang, W.H. Wilson, Grodin, Justin L., Zhang, Yuhui, Bettencourt, Paulo, Maisel, Alan S., Passino, Claudio, Januzzi, James L., and Emdin, Michele

Published
2017
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34. Novel concept to guide systolic heart failure medication by repeated biomarker testing—results from TIME-CHF in context of predictive, preventive, and personalized medicine

Author

Davarzani, Nasser, Sanders-van Wijk, Sandra, Maeder, Micha T., Rickenbacher, Peter, Smirnov, Evgueni, Karel, Joël, Suter, Thomas, de Boer, Rudolf A., Block, Dirk, Rolny, Vinzent, Zaugg, Christian, Pfisterer, Matthias E., Peeters, Ralf, Brunner-La Rocca, Hans-Peter, and for the TIME-CHF investigators

Published
2018
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35. Phenotypic patient profiling for improved implementation of guideline-directed medical therapy: An exploratory analysis in a large real-world chronic heart failure cohort

Author

Radhoe, Sumant P., primary, Clephas, Pascal R. D., additional, Linssen, Gerard C. M., additional, Oortman, Remko M., additional, Smeele, Frank J., additional, Van Drimmelen, Annemarie A., additional, Schaafsma, Henk-Jan, additional, Westendorp, Paul H., additional, Brunner-La Rocca, Hans-Peter, additional, and Brugts, Jasper J., additional

Published
2023
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36. Multimarker Analysis of Serially Measured GDF-15, NT-proBNP, ST2, GAL-3, cTnI, Creatinine, and Prognosis in Acute Heart Failure

Author

Gürgöze, Muhammed T., primary, van Vark, Laura C., additional, Baart, Sara J., additional, Kardys, Isabella, additional, Akkerhuis, K. Martijn, additional, Manintveld, Olivier C., additional, Postmus, Douwe, additional, Hillege, Hans L., additional, Lesman-Leegte, Ivonne, additional, Asselbergs, Folkert W., additional, Brunner-la-Rocca, Hans-Peter, additional, van den Bos, Ewout J., additional, Orsel, Joke G., additional, de Ridder, Stijn P.J., additional, Pinto, Yigal M., additional, and Boersma, Eric, additional

Published
2023
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37. Bringing the hospital to home: Patient-reported outcome measures of a digital health-supported home hospitalisation platform to support hospital care at home for heart failure patients

Author

Scherrenberg, Martijn, primary, Leenen, Jobbe PL, additional, van der Velde, Astrid E, additional, Boyne, Josiane, additional, Bruins, Wendy, additional, Vranken, Julie, additional, Brunner-La Rocca, Hans-Peter, additional, De Kluiver, Ed P, additional, and Dendale, Paul, additional

Published
2023
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38. sj-pdf-1-jcb-10.1177_0271678X221149937 - Supplemental material for Twenty-four hour blood pressure variability and the prevalence and the progression of cerebral white matter hyperintensities

Author

Starmans, Naomi LP, Wolters, Frank J, Leeuwis, Annebet E, Bron, Esther E, Brunner La Rocca, Hans-Peter, Staals, Julie, Biessels, Geert Jan, and Kappelle, L Jaap

Subjects
110320 Radiology and Organ Imaging, FOS: Clinical medicine, FOS: Biological sciences, Medicine, Cell Biology, 110305 Emergency Medicine, 110306 Endocrinology, Biochemistry, 69999 Biological Sciences not elsewhere classified, 110904 Neurology and Neuromuscular Diseases, Neuroscience
Abstract

Supplemental material, sj-pdf-1-jcb-10.1177_0271678X221149937 for Twenty-four hour blood pressure variability and the prevalence and the progression of cerebral white matter hyperintensities by Naomi LP Starmans, Frank J Wolters, Annebet E Leeuwis, Esther E Bron, Hans-Peter Brunner La Rocca, Julie Staals, Geert Jan Biessels, L Jaap Kappelle and for the Heart-Brain Connection Consortium in Journal of Cerebral Blood Flow & Metabolism

Published
2023
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39. EPMA-World Congress 2015: Bonn, Germany. 3-5 September 2015

Author

Abraham, Jella-Andrea, Golubnitschaja, Olga, Akhmetov, Ildar, Andrews, Russell J., Quintana, Leonidas, Andrews, Russell J., Baban, Babak, Liu, Jun Yao, Qin, Xu, Wang, Tailing, Mozaffari, Mahmood S., Bati, Viktoriia V., Meleshko, Tamara V., Levchuk, Olga B., Boyko, Nadiya V., Bauer, Joanna, Boerner, Ewa, Podbielska, Halina, Bomba, Alojz, Petrov, Viktor O., Drobnych, Volodymyr G., Bubnov, Rostyslav V., Bykova, Oksana M., Boyko, Nadiya V., Brunner-La Rocca, Hans-Peter, Fleischhacker, Lutz, Golubnitschaja, Olga, Heemskerk, Frank, Helms, Thomas, Jaarsma, Tiny, Kinkorová, Judita, Ramaekers, Jan, Ruff, Peter, Schnur, Ivana, Vanoli, Emilio, Verdu, Jose, Brunner-La Rocca, Hans-Peter, Bubnov, Rostyslav V., Grabovetskyi, Sergiy A., Mykhalchenko, Olena M., Tymoshok, Natalia O., Shcherbakov, Oleksandr B., Semeniv, Igor P., Spivak, Mykola Y., Bubnov, Rostyslav V., Ostapenko, Tetyana V., Bubnov, Rostyslav V., Kobyliak, Nazarii M., Zholobak, Nadiya M., Spivak, Mykola Ya., Cauchi, John Paul, Cherepakhin, Dmitrii, Bakay, Marina, Borovikov, Artem, Suchkov, Sergey, Cieślik, Barbara, Migasiewicz, Agnieszka, Podbielska, Maria-Luiza, Pelleter, Markus, Giemza, Agnieszka, Podbielska, Halina, Cirak, Sebahattin, Del Re, Marzia, Bordi, Paola, Citi, Valentina, Palombi, Marta, Pinto, Carmine, Tiseo, Marcello, Danesi, Romano, Einhorn, Lukas, Fazekas, Judit, Muhr, Martina, Schoos, Alexandra, Panakova, Lucia, Herrmann, Ina, Manzano-Szalai, Krisztina, Oida, Kumiko, Fiebiger, Edda, Singer, Josef, Jensen-Jarolim, Erika, Elnar, Arpiné A., Ouamara, Nadia, Boyko, Nadiya, Coumoul, Xavier, Antignac, Jean-Philippe, Le Bizec, Bruno, Eppe, Gauthier, Renaut, Jenny, Bonn, Torsten, Guignard, Cédric, Ferrante, Margherita, Chiusano, Maria Liusa, Cuzzocrea, Salvatore, O’Keeffe, Gerard, Cryan, John, Bisson, Michelle, Barakat, Amina, Hmamouchi, Ihsane, Zawia, Nasser, Kanthasamy, Anumantha, Kisby, Glen E., Alves, Rui, Pérez, Oscar Villacañas, Burgard, Kim, Spencer, Peter, Bomba, Norbert, Haranta, Martin, Zaitseva, Nina, May, Irina, Grojean, Stéphanie, Body-Malapel, Mathilde, Harari, Florencia, Harari, Raul, Yeghiazaryan, Kristina, Golubnitschaja, Olga, Calabrese, Vittorio, Nemos, Christophe, Soulimani, Rachid, Evsevyeva, Maria E., Mishenko, Elena A., Kumukova, Zurida V., Chudnovsky, Evgeniy V., Smirnova, Tatyana A., Evsevyeva, Maria E., Ivanova, Ludmila V., Eremin, Michail V., Rostovtseva, Maria V., Evsevyeva, Maria E., Eremin, Michail V., Koshel, Vladimir I., Sergeeva, Oksana V., Konovalova, Nadesgda M., Girotra, Shantanu, Golubnitschaja, Olga, Golubnitschaja, Olga, Debald, Manuel, Kuhn, Walther, Yeghiazaryan, Kristina, Bubnov, Rostyslav V., Goncharenko, Vadym M., Lushchyk, Ulyana, Grech, Godfrey, Konieczka, Katarzyna, Golubnitschaja, Olga, Erwich, Jan Jaap, Costigliola, Vincenzo, Yeghiazaryan, Kristina, Gembruch, Ulrich, Goncharenko, Vadym M., Beniuk, Vasyl O., Kalenska, Olga V., Bubnov, Rostyslav V., Goncharenko, Vadym M., Beniuk, Vasyl O., Bubnov, Rostyslav V., Melnychuk, Olga, Gorbacheva, Irina A., Orekhova, Lyudmila Y., Tachalov, Vadim V., Grechanyk, Olena I., Abdullaiev, Rizvan Ya., Bubnov, Rostyslav V., Hagan, Suzanne, Martin, Eilidh, Pearce, Ian, Oliver, Katherine, Haytac, Cenk, Salimov, Fariz, Yoksul, Servin, Kunin, Anatoly A., Moiseeva, Natalia S., Herrera-Imbroda, Bernardo, del Río-González, Sergio, Lara, Maria Fernanda, Angulo, Antonia, Machuca Santa-Cruz, Francisco Javier, Herrera-Imbroda, Bernardo, del Río-González, Sergio, Lara, Maria Fernanda, Ionescu, John, Isamulaeva, Alfiya Z., Kunin, Anatoly A., Magomedov, Shamil Sh., Isamulaeva, Aida I., Josifova, Tatjana, Kapalla, Marko, Kubáň, Juraj, Golubnitschaja, Olga, Costigliola, Vincenzo, Costigliola, Vincenzo, Kapalla, Marko, Kubáň, Juraj, Golubnitschaja, Olga, Kent, Anthony, Fisher, Tom, Dias, Tilak, Kinkorová, Judita, Topolčan, Ondřej, Kohl, Matthias, Kunin, Anatoly A., Moiseeva, Natalia S., Kurchenko, Andrii I., Beniuk, Vasyl A., Goncharenko, Vadym M., Bubnov, Rostyslav V., Boyko, Nadiya V., Strokan, Andriy M., Kzhyshkowska, Julia, Gudima, Alexandru, Stankevich, Ksenia S., Filimonov, Victor D., Klüter, Harald, Mamontova, Evgeniya M., Tverdokhlebov, Sergei I., Lushchyk, Ulyana B., Novytskyy, Viktor V., Babii, Igor P., Lushchyk, Nadiya G., Riabets, Lyudmyla S., Legka, Ivanna I., Marcus-Kalish, Mira, Mitelpunkt, Alexis, Galili, Tal, Shachar, Neta, Benjamini, Yoav, Migasiewicz, Agnieszka, Pelleter, Markus, Bauer, Joanna, Dereń, Ewelina, Podbielska, Halina, Moiseeva, Natalia S., Kunin, Anatoly A., Kunin, Dmitry A., Moiseeva, Natalia S., Ippolitov, Yury A., Kunin, Dmitry A., Morozov, Alexei N., Chirkova, Natalia V., Aliev, Nakhid T., Mozaffari, Mahmood S., Liu, Jun Yao, Baban, Babak, Mozaffari, Mahmood S., Liu, Jun Yao, Abdelsayed, Rafik, Shi, Xing-Ming, Baban, Babak, Novák, Jaroslav, Štork, Milan, Zeman, Václav, Oosterhuis, Wytze P., Theodorsson, Elvar, Orekhova, Lyudmila Y., Kudryavtseva, Tatyana V., Isaeva, Elena R., Tachalov, Vadim V., Loboda, Ekaterina S., Pazzagli, Mario, Malentacchi, Francesca, Mancini, Irene, Brandslund, Ivan, Vermeersch, Pieter, Schwab, Matthias, Marc, Janja, van Schaik, Ron H. N., Siest, Gerard, Theodorsson, Elvar, Di Resta, Chiara, Pleva, Matus, Juhar, Jozef, Pleva, Matus, Juhar, Jozef, Polívka jr., Jiří, Janků, Filip, Pešta, Martin, Doležal, Jan, Králíčková, Milena, Polívka, Jiří, Polívka, Jiří, Lukešová, Alena, Müllerová, Nina, Ševčík, Petr, Rohan, Vladimír, Richter, Kneginja, Miloseva, Lence, Niklewski, Günter, Richter, Kneginja, Acker, Jens, Niklewski, Guenter, Safonicheva, Olga, Costigliola, Vincenzo, Safonicheva, Olga, Sautin, Maxim, Sinelnikova, Janna, Suchkov, Sergey, Secer, Songül, von Bandemer, Stephan, Shapira, Niva, Shcherbakov, Aleksandr, Kunin, Anatoly A., Moiseeva, Natalia S., Shumilovich, Bogdan R., Lipkind, Zhanna, Vorobieva, Yulia, Kunin, Dmitry A., Sudareva, Anastasiia V., Smokovski, Ivica, Milenkovic, Tatjana, Solís-Herrera, Arturo, Arias-Esparza, María del Carmen, Suchkov, Sergey, Sridhar, Krishna Chander, Golubnitschaja, Olga, Studneva, Maria, Song, Sihong, Creeden, James, Мandrik, Мark, Suchkov, Sergey, Theodorsson, Elvar, Tofail, Syed A. M., Topolčan, Ondřej, Kinkorová, Judita, Fiala, Ondřej, Karlíková, Marie, Svobodová, Šárka, Kučera, Radek, Fuchsová, Radka, Třeška, Vladislav, Šimánek, Václav, Pecen, Ladislav, Šoupal, Jan, Svačina, Štěpán, Tretyak, Evgeniya, Studneva, Maria, Suchkov, Sergey, Trovato, Francesca M., Martines, Giuseppe Fabio, Brischetto, Daniela, Catalano, Daniela, Musumeci, Giuseppe, Trovato, Guglielmo M., Tsangaris, George Th., Anagnostopoulos, Athanasios K., Tsangaris, George Th., Anagnostopoulos, Athanasios K., Verdú, José, Gutiérrez, German, Rovira, Jordi, Martinez, Marta, Fleischhacker, Lutz, Green, Donna, Garson, Arthur, Tamburini, Elena, Cuomo, Stefano, Martinez-Leon, Juan, Abrisqueta, Teresa, Brunner-La Rocca, Hans-Peter, Jaarsma, Tiny, Arredondo, Teresa, Vera, Cecilia, Fico, Giuseppe, Golubnitschaja, Olga, Arribas, Fernando, Onderco, Martina, Vara, Isabel, Verdú, José, Sambo, Francesco, Di Camillo, Barbara, Cobelli, Claudio, Facchinetti, Andrea, Fico, Giuseppe, Bellazzi, Riccardo, Sacchi, Lucia, Dagliati, Arianna, Segnani, Daniele, Tibollo, Valentina, Ottaviano, Manuel, Gabriel, Rafael, Groop, Leif, Postma, Jacqueline, Martinez, Antonio, Hakaste, Liisa, Tuomi, Tiinamaija, Zarkogianni, Konstantia, Volchek, Igor, Pototskaya, Nina, Petrov, Andrey, Volchek, Igor, Pototskaya, Nadezhda, Petrov, Andrey, Voog-Oras, Ülle, Jagur, Oksana, Leibur, Edvitar, Niibo, Priit, Jagomägi, Triin, Nguyen, Minh Son, Pruunsild, Chris, Piikov, Dagmar, Saag, Mare, Wang, Wei, Wang, Wei, Weinhäusel, Andreas, Pulverer, Walter, Wielscher, Matthias, Hofner, Manuela, Noehammer, Christa, Soldo, Regina, Hettegger, Peter, Gyurjan, Istvan, Kulovics, Ronald, Schönthaler, Silvia, Beikircher, Gabriel, Kriegner, Albert, Pabinger, Stephan, Vierlinger, Klemens, Yüzbaşıoğlu, Ayşe, Özgüç, Meral, EFLM, on behalf of ZENITH consortium, and on behalf of MOSAIC consortium

Published
2016
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40. A machine learning‐derived echocardiographic algorithm identifies people at risk of heart failure with distinct cardiac structure, function, and response to spironolactone: Findings from the HOMAGE trial.

Author

Kobayashi, Masatake, Huttin, Olivier, Ferreira, João Pedro, Duarte, Kevin, González, Arantxa, Heymans, Stephane, Verdonschot, Job A.J., Brunner‐La Rocca, Hans‐Peter, Pellicori, Pierpaolo, Clark, Andrew L., Petutschnigg, Johannes, Edelmann, Frank, Cleland, John G., Rossignol, Patrick, Zannad, Faiez, and Girerd, Nicolas

Subjects
ECHOCARDIOGRAPHY, HEART failure, SPIRONOLACTONE, BODY surface area, AT-risk people
Abstract

Aim: An echocardiographic algorithm derived by machine learning (e′VM) characterizes pre‐clinical individuals with different cardiac structure and function, biomarkers, and long‐term risk of heart failure (HF). Our aim was the external validation of the e′VM algorithm and to explore whether it may identify subgroups who benefit from spironolactone. Methods and results: The HOMAGE (Heart OMics in AGEing) trial enrolled participants at high risk of developing HF randomly assigned to spironolactone or placebo over 9 months. The e′VM algorithm was applied to 416 participants (mean age 74 ± 7 years, 25% women) with available echocardiographic variables (i.e. e′ mean, left ventricular end‐diastolic volume and mass indexed by body surface area [LVMi]). The effects of spironolactone on changes in echocardiographic and biomarker variables were assessed across e′VM phenotypes. A majority (>80%) had either a 'diastolic changes' (D), or 'diastolic changes with structural remodelling' (D/S) phenotype. The D/S phenotype had the highest LVMi, left atrial volume, E/e', natriuretic peptide and troponin levels (all p < 0.05). Spironolactone significantly reduced E/e' and B‐type natriuretic peptide (BNP) levels in the D/S phenotype (p < 0.01), but not in other phenotypes (p > 0.10; pinteraction <0.05 for both). These interactions were not observed when considering guideline‐recommended echocardiographic structural and functional abnormalities. The magnitude of effects of spironolactone on LVMi, left atrial volume and a type I collagen marker was numerically higher in the D/S phenotype than the D phenotype but the interaction test did not reach significance. Conclusions: In the HOMAGE trial, the e′VM algorithm identified echocardiographic phenotypes with distinct responses to spironolactone as assessed by changes in E/e' and BNP. [ABSTRACT FROM AUTHOR]

Published
2023
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43. Myocardial Fibrosis Assessment Using T1 and ECV Mapping With Histologic Validation in Chronic Dilated Cardiomyopathy

Author

Raafs, Anne G., primary, Adriaans, Bouke P., additional, Henkens, Michiel T.H.M., additional, Verdonschot, Job A.J., additional, Ramaekers, Mitch J.F.G., additional, Gommers, Suzanne, additional, Abdul Hamid, Myrurgia A., additional, Schalla, Simon, additional, Knackstedt, Christian, additional, van Empel, Vanessa.P.M., additional, Brunner-la Rocca, Hans-Peter, additional, Wildberger, J.E., additional, Bekkers, Sebastiaan C.A.M., additional, and Hazebroek, Mark R., additional

Published
2022
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44. Use of artificial intelligence to assess the risk of coronary artery disease without additional (non-invasive) testing: validation in a low-risk to intermediate-risk outpatient clinic cohort

Author

Eurlings, Casper G M J, primary, Bektas, Sema, additional, Sanders-van Wijk, Sandra, additional, Tsirkin, Andrew, additional, Vasilchenko, Vasily, additional, Meex, Steven J R, additional, Failer, Michael, additional, Oehri, Caroline, additional, Ruff, Peter, additional, Zellweger, Michael J, additional, and Brunner-La Rocca, Hans-Peter, additional

Published
2022
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45. Interatrial Block Predicts Life‐Threatening Arrhythmias in Dilated Cardiomyopathy

Author

Henkens, Michiel T. H. M., primary, López Martínez, Helena, additional, Weerts, Jerremy, additional, Sammani, Arjan, additional, Raafs, Anne G., additional, Verdonschot, Job A. J., additional, van de Leur, Rutger R., additional, Sikking, Maurits A., additional, Stroeks, Sophia, additional, van Empel, Vanessa P. M., additional, Brunner‐La Rocca, Hans‐Peter, additional, van Stipdonk, Antonius M. W., additional, Farmakis, Dimitrios, additional, Hazebroek, Mark R., additional, Vernooy, Kevin, additional, Bayés‐de‐Luna, Antoni, additional, Asselbergs, Folkert W., additional, Bayés‐Genís, Antoni, additional, and Heymans, Stephane R. B., additional

Published
2022
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46. Cross-Sectional Associations Between Cardiac Biomarkers, Cognitive Performance, and Structural Brain Changes Are Modified by Age: The Maastricht Study

Author

Veugen, Marja G.J., Henry, Ronald M.A., Brunner-La Rocca, Hans-Peter, Dagnelie, Pieter C., Schram, Miranda T., van Agtmaal, Marnix J.M., van der Kallen, Carla J.H., Sep, Simone J.S., van Boxtel, Martin P.J., Bekers, Otto, Meex, Steven J.R., Jansen, Jacobus F.A., Kroon, Abraham A., and Stehouwer, Coen D.A.

Published
2018
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49. Prognostic Value of High-Sensitivity Troponin T in Chronic Heart Failure: An Individual Patient Data Meta-Analysis

Author

Aimo, Alberto, Januzzi, James L., Jr, Vergaro, Giuseppe, Ripoli, Andrea, Latini, Roberto, Masson, Serge, Magnoli, Michela, Anand, Inder S., Cohn, Jay N., Tavazzi, Luigi, Tognoni, Gianni, Gravning, Jørgen, Ueland, Thor, Nymo, Ståle H., Brunner-La Rocca, Hans-Peter, Genis, Antoni Bayes, Lupón, Josep, de Boer, Rudolf A., Yoshihisa, Akiomi, Takeishi, Yasuchika, Egstrup, Michael, Gustafsson, Ida, Gaggin, Hanna K., Eggers, Kai M., Huber, Kurt, Tentzeris, Ioannis, Tang, Wai H.W., Grodin, Justin, Passino, Claudio, and Emdin, Michele

Published
2018
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