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241 results on '"Almendral, J. A."'

1. Deterministic and stochastic cooperation transitions in evolutionary games on networks

Author

Khalil, Nagi, Leyva, I., Almendral, J. A., and Sendiña-Nadal, I.

Subjects
Nonlinear Sciences - Adaptation and Self-Organizing Systems, Condensed Matter - Statistical Mechanics
Abstract

Although the cooperative dynamics emerging from a network of interacting players has been exhaustively investigated, it is not yet fully understood when and how network reciprocity drives cooperation transitions. In this work, we investigate the critical behavior of evolutionary social dilemmas on structured populations by using the framework of master equations and Monte Carlo simulations. The developed theory describes the existence of absorbing, quasi-absorbing, and mixed strategy states and the transition nature, continuous or discontinuous, between the states as the parameters of the system change. In particular, when the decision-making process is deterministic, in the limit of zero effective temperature of the Fermi function, we find that the copying probabilities are discontinuous functions of the system's parameters and of the network degrees sequence. This may induce abrupt changes in the final state for any system size, in excellent agreement with the Monte Carlo simulation results. Our analysis also reveals the existence of continuous and discontinuous phase transitions for large systems as the temperature increases, which is explained in the mean-field approximation. Interestingly, for some game parameters, we find optimal "social temperatures" maximizing/minimizing the cooperation frequency/density., Comment: 14 pages, 5 figures

Published
2022
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2. Diverse strategic identities induce dynamical states in evolutionary games

Author

Sendiña-Nadal, I., Leyva, I., Perc, M., Papo, D., Jusup, M., Wang, Z., Almendral, J. A., Manshour, P., and Boccaletti, S.

Subjects
Physics - Physics and Society, Quantitative Biology - Populations and Evolution
Abstract

Evolutionary games provide the theoretical backbone for many aspects of our social life: from cooperation to crime, from climate inaction to imperfect vaccination and epidemic spreading, from antibiotics overuse to biodiversity preservation. An important, and so far overlooked, aspect of reality is the diverse strategic identities of individuals. While applying the same strategy to all interaction partners may be an acceptable assumption for simpler forms of life, this fails to account} for the behavior of more complex living beings. For instance, we humans act differently around different people. Here we show that allowing individuals to adopt different strategies with different partners yields a very rich evolutionary dynamics, including time-dependent coexistence of cooperation and defection, system-wide shifts in the dominant strategy, and maturation in individual choices. Our results are robust to variations in network type and size, and strategy updating rules. Accounting for diverse strategic identities thus has far-reaching implications in the mathematical modeling of social games., Comment: 9 pages, 4 figures

Published
2020
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3. Emergent explosive synchronization in adaptive complex networks

Author

Avalos-Gaytán, Vanesa, Almendral, J. A., Leyva, I., Battiston, F., Nicosia, V., Latora, V., and Boccaletti, S.

Subjects
Physics - Physics and Society, Condensed Matter - Statistical Mechanics, Nonlinear Sciences - Adaptation and Self-Organizing Systems
Abstract

Adaptation plays a fundamental role in shaping the structure of a complex network and improving its functional fitting. Even when increasing the level of synchronization in a biological system is considered as the main driving force for adaptation, there is evidence of negative effects induced by excessive synchronization. This indicates that coherence alone can not be enough to explain all the structural features observed in many real-world networks. In this work, we propose an adaptive network model where the dynamical evolution of the node states towards synchronization is coupled with an evolution of the link weights based on an anti-Hebbian adaptive rule, which accounts for the presence of inhibitory effects in the system. We found that the emergent networks spontaneously develop the structural conditions to sustain explosive synchronization. Our results can enlighten the shaping mechanisms at the heart of the structural and dynamical organization of some relevant biological systems, namely brain networks, for which the emergence of explosive synchronization has been observed.

Published
2017
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4. Explosive transitions in complex networks' structure and dynamics: percolation and synchronization

Author

Boccaletti, S., Almendral, J. A., Guan, S., Leyva, I., Liu, Z., Sendiña-Nadal, I., Wang, Z., and Zou, Y.

Subjects
Nonlinear Sciences - Adaptation and Self-Organizing Systems
Abstract

Percolation and synchronization are two phase transitions that have been extensively studied since already long ago. A classic result is that, in the vast majority of cases, these transitions are of the second-order type, i.e. continuous and reversible. Recently, however, explosive phenomena have been reported in com- plex networks' structure and dynamics, which rather remind first-order (discontinuous and irreversible) transitions. Explosive percolation, which was discovered in 2009, corresponds to an abrupt change in the network's structure, and explosive synchronization (which is concerned, instead, with the abrupt emergence of a collective state in the networks' dynamics) was studied as early as the first models of globally coupled phase oscillators were taken into consideration. The two phenomena have stimulated investigations and de- bates, attracting attention in many relevant fields. So far, various substantial contributions and progresses (including experimental verifications) have been made, which have provided insights on what structural and dynamical properties are needed for inducing such abrupt transformations, as well as have greatly enhanced our understanding of phase transitions in networked systems. Our intention is to offer here a monographic review on the main-stream literature, with the twofold aim of summarizing the existing results and pointing out possible directions for future research.

Published
2016
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5. Synchronization centrality and explosive synchronization in complex networks

Author

Navas, A., Villacorta-Atienza, J. A., Leyva, I., Almendral, J. A., Sendiña-Nadal, I., and Boccaletti, S.

Subjects
Nonlinear Sciences - Adaptation and Self-Organizing Systems
Abstract

Synchronization of networked oscillators is known to depend fundamentally on the interplay between the dynamics of the graph's units and the microscopic arrangement of the network's structure. For non identical elements, the lack of quantitative tools has hampered so far a systematic study of the mechanisms behind such a collective behavior. We here propose an effective network whose topological properties reflect the interplay between the topology and dynamics of the original network. On that basis, we are able to introduce the "synchronization centrality", a measure which quantifies the role and importance of each network's node in the synchronization process. In particular, we use such a measure to assess the propensity of a graph to synchronize explosively, thus indicating a unified framework for most of the different models proposed so far for such an irreversible transition. Taking advantage of the predicting power of this measure, we furthermore discuss a strategy to induce the explosive behavior in a generic network, by acting only upon a small fraction of its nodes.

Published
2015
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6. Assortative mixing enhances the irreversible nature of explosive synchronization in growing scale-free networks

Author

Sendiña-Nadal, I., Leyva, I., Navas, A., Villacorta-Atienza, J. A., Almendral, J. A., Wang, Z., and Boccaletti, S.

Subjects
Nonlinear Sciences - Adaptation and Self-Organizing Systems
Abstract

We discuss the behavior of large ensembles of phase oscillators networking via scale-free topologies in the presence of a positive correlation between the oscillators' natural frequencies and network's degrees. In particular, we show that the further presence of degree-degree correlation in the network structure has important consequences on the nature of the phase transition characterizing the passage from the phase-incoherent to the phase-coherent network's state. While high levels of positive and negative mixing consistently induce a second-order phase transition, moderate values of assortative mixing, such as those ubiquitously characterizing social networks in the real world, greatly enhance the irreversible nature of explosive synchronization in growing scale-free networks. This latter effect corresponds to a maximization of the area and of the width of the hysteretic loop that differentiates the forward and backward transitions to synchronization.

Published
2014
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8. Explosive synchronization in weighted complex networks

Author

Leyva, I., Sendiña-Nadal, I., Almendral, J. A., Navas, A., Olmi, S., and Boccaletti, S.

Subjects
Nonlinear Sciences - Adaptation and Self-Organizing Systems, Physics - Physics and Society
Abstract

The emergence of dynamical abrupt transitions in the macroscopic state of a system is currently a subject of the utmost interest. Given a set of phase oscillators networking with a generic wiring of connections and displaying a generic frequency distribution, we show how combining dynamical local information on frequency mismatches and global information on the graph topology suggests a judicious and yet practical weighting procedure which is able to induce and enhance explosive, irreversible, transitions to synchronization. We report extensive numerical and analytical evidence of the validity and scalability of such a procedure for different initial frequency distributions, for both homogeneous and heterogeneous networks, as well as for both linear and non linear weighting functions. We furthermore report on the possibility of parametrically controlling the width and extent of the hysteretic region of coexistence of the unsynchronized and synchronized states.

Published
2013
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9. Explosive transitions to synchronization in networked phase oscillators

Author

Leyva, I., Sendiña-Nadal, I., Almendral, J., Navas, A., Zanin, M., Papo, D., Buldú, J. M., and Boccaletti, S.

Subjects
Condensed Matter - Disordered Systems and Neural Networks, Nonlinear Sciences - Chaotic Dynamics
Abstract

We introduce a condition for an ensemble of networked phase oscillators to feature an abrupt, first-order phase transition from an unsynchronized to a synchronized state. This condition is met in a very wide spectrum of situations, and for various oscillators' initial frequency distributions. We show that the occurrence of such transitions is always accompanied by the spontaneous emergence of frequency-degree correlations in random network architectures. We also discuss ways to relax the condition, and to further extend the possibility for the first-order transition to occur, and illustrate how to engineer magnetic-like states of synchronization. Our findings thus indicate how to search for abrupt transitions in real-world applications., Comment: (02Oct12) Submitted to Phys Rev Lett

Published
2012
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10. Synchronization interfaces and overlapping communities in complex networks

Author

Li, D., Leyva, I., Almendral, J. A., Sendina-Nadal, I., Buldu, J. M., Havlin, S., and Boccaletti, S.

Subjects
Condensed Matter - Statistical Mechanics, Nonlinear Sciences - Adaptation and Self-Organizing Systems, Physics - Physics and Society
Abstract

We show that a complex network of phase oscillators may display interfaces between domains (clusters) of synchronized oscillations. The emergence and dynamics of these interfaces are studied in the general framework of interacting phase oscillators composed of either dynamical domains (influenced by different forcing processes), or structural domains (modular networks). The obtained results allow to give a functional definition of overlapping structures in modular networks, and suggest a practical method to identify them. As a result, our algorithm could detect information on both single overlapping nodes and overlapping clusters., Comment: 5 pages, 4 figures

Published
2008
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11. The interplay of university and industry through the FP5 network

Author

Almendral, J. A., Oliveira, J. G., López, L., Sanjuán, M. A. F., and Mendes, J. F. F.

Subjects
Physics - Physics and Society, Condensed Matter - Statistical Mechanics, Physics - Data Analysis, Statistics and Probability
Abstract

To improve the quality of life in a modern society it is essential to reduce the distance between basic research and applications, whose crucial roles in shaping today's society prompt us to seek their understanding. Existing studies on this subject, however, have neglected the network character of the interaction between university and industry. Here we use state-of-the-art network theory methods to analyze this interplay in the so-called Framework Programme--an initiative which sets out the priorities for the European Union's research and technological development. In particular we study in the 5th Framework Programme (FP5) the role played by companies and scientific institutions and how they contribute to enhance the relationship between research and industry. Our approach provides quantitative evidence that while firms are size hierarchically organized, universities and research organizations keep the network from falling into pieces, paving the way for an effective knowledge transfer., Comment: 21 pages (including Appendix), 8 figures. Published online at http://stacks.iop.org/1367-2630/9/183

Published
2007
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12. Sparse repulsive coupling enhances synchronization in complex networks

Author

Leyva, I., Sendiña-Nadal, I., Almendral, J. A., and Sanjuán, M. A. F.

Subjects
Condensed Matter - Disordered Systems and Neural Networks
Abstract

Through the last years, different strategies to enhance synchronization in complex networks have been proposed. In this Letter, we show that the synchronization in a small-world network of attractively coupled non-identical neurons is strongly improved by adding a tiny fraction of phase-repulsive couplings. By a purely topological analysis that does not depend on the dynamical model, we link the emerging dynamical behavior to the structural properties of the sparsely coupled repulsive network., Comment: 4 pages, 4 figures

Published
2006
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15. Proteomics and recurrence of atrial fibrillation: a pilot study nested in the PREDIMAR trial

Author

Razquin, C, primary, Fernandez-Irigoyen, J, additional, Barrio-Lopez, M T, additional, Ramos, P, additional, Macias, R, additional, Ibanez-Criado, A, additional, Santamaria, E, additional, Goni, L, additional, Castellanos, E, additional, Ibanez-Criado, J L, additional, Tercedor, L, additional, Garcia-Bolao, I, additional, Martinez-Gonzalez, M A, additional, Almendral, J, additional, and Ruiz-Canela, M, additional

Published
2023
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17. Parvovirus Variation for Disease: A Difference with RNA Viruses?

Author

López-Bueno, A., Villarreal, L. P., Almendral, J. M., Compans, R.W., editor, Cooper, M.D., editor, Honjo, T., editor, Koprowski, H., editor, Melchers, F., editor, Oldstone, M.B.A., editor, Olsnes, S., editor, Potter, M., editor, Vogt, P.K., editor, Wagner, H., editor, and Domingo, Esteban, editor

Published
2006
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23. Differing prognostic value of pulse pressure in patients with heart failure with reduced or preserved ejection fraction: results from the MAGGIC individual patient meta-analysis

Author

Jackson, Colette E., Castagno, Davide, Maggioni, Aldo P., Køber, Lars, Squire, Iain B., Swedberg, Karl, Andersson, Bert, Richards, A. Mark, Bayes-Genis, Antoni, Tribouilloy, Christophe, Dobson, Joanna, Ariti, Cono A., Poppe, Katrina K., Earle, Nikki, Whalley, Gillian, Pocock, Stuart J., Doughty, Robert N., McMurray, John J.V., Berry, C., Doughty, R., Granger, C., Køber, L., Massie, B., McAlister, F., McMurray, J., Pocock, S., Poppe, K., Swedberg, K., Somaratne, J., Whalley, G., Ahmed, A., Andersson, B., Bayes-Genis, A., Berry, C., Cowie, M., Cubbon, R., Doughty, R., Ezekowitz, J., Gonzalez-Juanatey, J., Gorini, M., Gotsman, I., Grigorian-Shamagian, L., Guazzi, M., Kearney, M., Køber, L., Komajda, M., di Lenarda, A., Lenzen, M., Lucci, D., Macín, S., Madsen, B., Maggioni, A., Martínez-Sellés, M., McAlister, F., Oliva, F., Poppe, K., Rich, M., Richards, M., Senni, M., Squire, I., Taffet, G., Tarantini, L., Tribouilloy, C., Troughton, R., Tsutsui, H., Whalley, G., Doughty, R., Earle, N., Gamble, G.D., Poppe, K., Whalley, G., Ariti, C., Dobson, J., Pocock, S., Poppe, K., Doughty, R.N., Whalley, G., Andersson, B., Hall, C., Richards, A.M., Troughton, R., Lainchbury, J., Berry, C., Hogg, K., Norrie, J., Stevenson, K., Brett, M., McMurray, J., Pfeffer, M.A., Swedberg, K., Granger, C.B., Held, P., McMurray, J.J.V., Michelson, E.L., Olofsson, B., Östergren, J., Yusuf, S., Køber, L., Torp-Pedersen, C., Lenzen, M.J., Scholte op Reimer, W.J.M., Boersma, E., Vantrimpont, P.J.M.J., Follath, F., Swedberg, K., Cleland, J., Komajda, M., Gotsman, I., Zwas, D., Planer, D., Azaz-Livshits, T., Admon, D., Lotan, C., Keren, A., Grigorian-Shamagian, L., Varela-Roman, A., Mazón-Ramos, P., Rigeiro-Veloso, P., Bandin-Dieguez, M.A., Gonzalez-Juanatey, J.R., Guazzi, M., Myers, J., Arena, R., McAlister, F.A., Ezekowitz, J., Armstrong, P.W., Cujec, Bibiana, Paterson, Ian, Cowie, M.R., Wood, D.A., Coats, A.J.S., Thompson, S.G., Suresh, V., Poole-Wilson, P.A., Sutton, G.C., Martínez-Sellés, M., Robles, J.A.G., Prieto, L., Muñoa, M.D., Frades, E., Díaz-Castro, O., Almendral, J., Tarantini, L., Faggiano, P., Senni, M., Lucci, D., Bertoli, D., Porcu, M., Opasich, C., Tavazzi, L., Maggioni, A.P., Kirk, V., Bay, M., Parner, J., Krogsgaard, K., Herzog, T.M., Boesgaard, S., Hassager, C., Nielsen, O.W., Aldershvile, J., Nielsen, H., Kober, L., Macín, S.M., Perna, E.R., Cimbaro Canella, J.P., Alvarenga, P., Pantich, R., Ríos, N., Farias, E.F., Badaracco, J.R., Madsen, B.K., Hansen, J.F., Stokholm, K.H., Brons, J., Husum, D., Mortensen, L.S., Bayes-Genis, A., Vazquez, R., Puig, T., Fernandez-Palomeque, C., Bardají, A., Pascual-Figal, D., Ordoñez-Llanos, J., Valdes, M., Gabarrus, A., Pavon, R., Pastor, L., Gonzalez-Juanatey, J.R., Almendral, J., Fiol, M., Nieto, V., Macaya, C., Cinca, J., Cygankiewitz, I., Bayes de Luna, A., Newton, J.D., Blackledge, H.M., Squire, I.B., Wright, S.P., Whalley, G.A., Doughty, R.N., Kerzner, R., Gage, B.F., Freedland, K.E., Rich, M.W., Huynh, B.C., Rovner, A., Freedland, K.E., Carney, R.M., Rich, M.W., Taffet, G.E., Teasdale, T.A., Bleyer, A.J., Kutka, N.J., Luchi, R.J., Tribouilloy, C., Rusinaru, D., Mahjoub, H., Soulière, V., Lévy, F., Peltier, M., Tsutsui, H., Tsuchihashi, M., Takeshita, A., MacCarthy, P.A., Kearney, M.T., Nolan, J., Lee, A.J., Prescott, R.J., Shah, A.M., Brooksby, W.P., Fox, K.A.A., Varela-Roman, A., Gonzalez-Juanatey, J.R., Basante, P., Trillo, R., Garcia-Seara, J., Martinez-Sande, J.L., and Gude, F.

Published
2015
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25. Heart failure in younger patients: the Meta-analysis Global Group in Chronic Heart Failure (MAGGIC)

Author

Wong, Chih M., Hawkins, Nathaniel M., Petrie, Mark C., Jhund, Pardeep S., Gardner, Roy S., Ariti, Cono A., Poppe, Katrina K., Earle, Nikki, Whalley, Gillian A., Squire, Iain B., Doughty, Robert N., McMurray, John J.V., Berry, C., Doughty, R., Granger, C., Køber, L., Massie, B., McAlister, F., McMurray, J., Pocock, S., Poppe, K., Swedberg, K., Somaratne, J., Whalley, G., Ahmed, A., Andersson, B., Bayes-Genis, A., Berry, C., Cowie, M., Cubbon, R., Doughty, R., Ezekowitz, J., Gonzalez-Juanatey, J., Gorini, M., Gotsman, I., Grigorian-Shamagian, L., Guazzi, M., Kearney, M., Køber, L., Komajda, M., di Lenarda, A., Lenzen, M., Lucci, D., Macín, S., Madsen, B., Maggioni, A., Martínez-Sellés, M., McAlister, F., Oliva, F., Poppe, K., Rich, M., Richards, M., Senni, M., Squire, I., Taffet, G., Tarantini, L., Tribouilloy, C., Troughton, R., Tsutsui, H., Whalley, G., Doughty, R., Earle, N., Gamble, G.D., Poppe, K., Whalley, G., Ariti, C., Dobson, J., Pocock, S., Poppe, K., Doughty, R.N., Whalley, G., Andersson, B., Hall, C., Richards, A.M., Troughton, R., Lainchbury, J., Berry, C., Hogg, K., Norrie, J., Stevenson, K., Brett, M., McMurray, J., Pfeffer, M.A., Swedberg, K., Granger, C.B., Held, P., McMurray, J.J.V., Michelson, E.L., Olofsson, B., Östergren, J., Yusuf, S., Køber, L., Torp-Pedersen, C., Ahmed, Ali, Lenzen, M.J., Scholte op Reimer, W.J.M., Boersma, E., Vantrimpont, P.J.M.J., Follath, F., Swedberg, K., Cleland, J., Komajda, M., Gotsman, I., Zwas, D., Planer, D., Azaz-Livshits, T., Admon, D., Lotan, C., Keren, A., Grigorian-Shamagian, L., Varela-Roman, A., Mazón-Ramos, P., Rigeiro-Veloso, P., Bandin-Dieguez, M.A., Gonzalez-Juanatey, J.R., Guazzi, M., Myers, J., Arena, R., McAlister, F.A., Ezekowitz, J., Armstrong, P.W., Cujec, Bibiana, Paterson, Ian, Cowie, M.R., Wood, D.A., Coats, A.J.S., Thompson, S.G., Suresh, V., Poole-Wilson, P.A., Sutton, G.C., Martínez-Sellés, M., Robles, J.A.G., Prieto, L., Muñoa, M.D., Frades, E., Díaz-Castro, O., Almendral, J., Tarantini, L., Faggiano, P., Senni, M., Lucci, D., Bertoli, D., Porcu, M., Opasich, C., Tavazzi, L., Maggioni, A.P., Kirk, V., Bay, M., Parner, J., Krogsgaard, K., Herzog, T.M., Boesgaard, S., Hassager, C., Nielsen, O.W., Aldershvile, J., Nielsen, H., Kober, L., Macín, S.M., Perna, E.R., Cimbaro Canella, J.P., Alvarenga, P., Pantich, R., Ríos, N., Farias, E.F., Badaracco, J.R., Madsen, B.K., Hansen, J.F., Stokholm, K.H., Brons, J., Husum, D., Mortensen, L.S., Bayes-Genis, A., Vazquez, R., Puig, T., Fernandez-Palomeque, C., Bardají, A., Pascual-Figal, D., Ordoñez-Llanos, J., Valdes, M., Gabarrus, A., Pavon, R., Pastor, L., Gonzalez-Juanatey, J.R., Almendral, J., Fiol, M., Nieto, V., Macaya, C., Cinca, J., Bayes de Luna, A., Newton, J.D., Blackledge, H.M., Squire, I.B., Wright, S.P., Whalley, G.A., Doughty, R.N., Kerzner, R., Gage, B.F., Freedland, K.E., Rich, M.W., Huynh, B.C., Rovner, A, Freedland, KE, Carney, RM, Rich, MW, Taffet, GE, Teasdale, T.A., Bleyer, A.J., Kutka, N.J., Luchi, R.J., Tribouilloy, C., Rusinaru, D., Mahjoub, H., Soulière, V., Lévy, F., Peltier, M., Tsutsui, H., Tsuchihashi, M., Takeshita, A., MacCarthy, P.A., Kearney, M.T., Nolan, J., Lee, A.J., Prescott, R.J., Shah, A.M., Brooksby, W.P., Fox, K.A.A., Varela-Roman, A., Gonzalez-Juanatey, J.R., Basante, P., Trillo, R., Garcia-Seara, J., Martinez-Sande, J.L., and Gude, F.

Published
2014
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30. The Atrial Fibrillation Ablation Pilot Study: an European Survey on Methodology and results of catheter ablation for atrial fibrillation conducted by the European Heart Rhythm Association

Author

Arbelo, Elena, Brugada, Josep, Hindricks, Gerhard, Maggioni, Aldo P., Tavazzi, Luigi, Vardas, Panos, Laroche, Cécile, Anselme, Frédéric, Inama, Giuseppe, Jais, Pierre, Kalarus, Zbigniew, Kautzner, Josef, Lewalter, Thorsten, Mairesse, Georges H., Perez-Villacastin, Julian, Riahi, Sam, Taborsky, Milos, Theodorakis, George, Trines, Serge A., Brugada, Josep, Arbelo, Elena, Hindriks, Gerhard, Maggioni, Aldo P., Morgan, John, Tavazzi, Luigi, Vardas, Panos, Alonso, Angeles, Ferrari, Roberto, Komajda, Michel, Tavazzi, Luigi, Wood, David, Vardas, Panos, Brugada, Josep, Mairesse, Georges, Taborsky, Milos, Kautzner, Josef, Lewalter, Thorsten, Riahi, Sam, Jais, Pierre, Anselme, Frédéric, Theodorakis, George, Inama, Giuseppe, Trines, Serge, Kalarus, Zbigniew, Villacastin, Julian Perez, Maggioni, Aldo P., Manini, Malika, Gracia, Gérard, Laroche, Cécile, Missiamenou, Viviane, Taylor, Charles, Konte, Marème, Fiorucci, Emanuela, Lefrancq, Elin Folkesson, Glémot, Myriam, McNeill, Patti-Ann, Bois, Timothée, Heidbüchel, H., Nuyens, D., Boland, J., Dinraths, V., Herzet, J.-M., Hoffer, E., Malmendier, D., Massoz, M., Pourbaix, S., Ballant, E., Blommaert, D., Deceuninck, O., Dormal, F., Xhaet, O., De Potter, T., Geelen, P., Derycker, K., Duytschaever, M., Tavernier, R., Vandekerckhove, Y., Vankats, D., Bulava, A., Hanis, J., Sitek, D., Blahova, M., Cihak, R., Hanyasova, L., Jansova, H., Peichl, P., Tanzerova, M., Wichterle, D., Duda, J., Haman, L., Parizek, P., Coling, L., Neuzil, P., Petru, J., Sediva, L., Skoda, J., Chovancik, J., Fiala, M., Neuwirth, R., Karlsdottir, A., Pehrson, S., Gerdes, C., Jensen, H.K., Lukac, P., Nielsen, J. C., Hansen, J., Johannessen, A., Hansen, P. S., Pedersen, A.K., Heath, F.P., Hjortshoj, S., Thogersen, A.M., Da Costa, A., Martel, I., Romeyer-Bouchard, C., Sadki, N., Schmid, A., Haissaguerre, M., Hocini, M., Knecht, S., Sacher, F., Ait Said, M., Cauchemez, B., Ledoux, F., Thomas, O., Cebron, J.-P., Decarsin, N., Gras, D., Hervouet, S., Durand, C., Durand-Dubief, A., Poty, H., Babuty, D., Pierre, B., Albenque, J.-P., Boveda, S., Combes, N., Mas, R., Hermida, J-S., Kubala, M., Godin, B., Savouré, A., Soublin, Y., Defaye, P., Jacon, P., Brigadeau, F., Corbut, S., Flament-Balzola, F., Kacet, S., Klug, D., Lacroix, D., Copie, X., Gilles, L., Hocine, Z., Paziaud, O., Piot, O., Crocq, C., Kaballu, G., Le Moal, V., Lotton, P., Mabo, P., Pavin, D., Andronache, M., De Chillou, C., Magnin-Poull, I., Deharo, J.-C., Durand, C., Franceschi, F., Peyrouse, E., Prevot, S., Etchegoin, M., Extramiana, F., Leenhardt, A., Messali, A., Heine, T., Schneider, A., Winter, N., Brachmann, J., Ritscher, G., Schertel-Gruenler, B., Simon, H., Sinha, A.-M., Turschner, O., Wystrach, A., Stemberg, M., Kuck, K.-H., Metzner, A., Tilz, R., Wissner, E., Heitmann, K., Willems, S., Andresen, D., Mueller, S., Volkmer, M., Schmidt, B., Kostopoulou, A., Livanis, E., Voudris, V., Efremidis, M., Letsas, K., Tsikrikas, S., Christoforatou, E., Ioannidis, P., Katsivas, A., Kourouklis, S., Andrikopoulos, G., Rassias, I., Tzeis, S., Dakos, G., Paraskevaidis, S., Stavropoulos, G., Theofilogiannakos, E., Vassilikos, V.P., Bongiorni, M.G., Zucchelli, G., Raviele, A., Themistoclakis, S., Pratola, C., Tritto, M., Della Bella, P., Mazzone, P., Moltrasio, M., Tondo, C., Calo, L., De Luca, L., Guarracini, F., Lioy, E., Dozza, L., Frigoli, E., Giannelli, L., Pappone, C., Saviano, M., Schiavina, G., Vicedomini, G.G., De Ponti, R., Doni, L. A., Marazzi, R., Salerno-Uriarte, J.A., Tamborini, C., Anselmino, M., Ferraris, F., Gaita, F., Bertaglia, E., Brandolino, G., Zoppo, F., De Groot, N., Janse, P., Jordaens, L., Pison, L., Roos, C., Van Gelder, I., Manusama, R., Meijer, A., Van der Voort, P., Trines, S., Compier, Marieke G., Kazmierczak, J., Kornacewicz-Jach, Z., Wielusinski, M., Baran, J., Kulakowski, P., Dzidowski, M., Fuglewicz, A., Nowak, K., Pruszkowska-Skrzep, P., Wozniak, A., Nowak, S., Trusz-Gluza, M., Almendral, J., Atienza, F., Castellanos, E., De Diego, C., Ortiz, M., Moreno Planas, J., Perez Castellano, N., Benezet, J., Farre Muncharaz, J., Rubio Campal, J.M., Hernandez Madrid, A., Matia, R., Arana, E., Pedrote, A., Cozar, R., Peinado, R., Valverde, I., Arbelo, E., Berruezo, A., Calvo, N., Guiu, E., Husseini, S., and Mont Girbau, L.

Published
2014
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32. Lessons learned in attempting catheter-based interatrial electrical disconnection for nonpharmacologic rate control of atrial fibrillation or flutter

Author

Ibáñez JL, Ibáñez A, Barrio T, Ortiz M, Ajo R, Castellanos E, Heras S, Brouzet T, Sánchez J, Ajo M, Garcia E, Martínez JG, Sogorb F, and Almendral J

Subjects
Atrioventricular node modulation, Atrial fibrillation, Atrioventricular node modulation, Interatrial electrical connections ablation, Left atrial flutter, Interatrial electrical connections ablation, Atrial fibrillation, Left atrial flutter
Abstract

Purpose Ablation of atrioventricular (AV) conduction and pacemaker implantation is the therapy of last resort for symptomatic atrial tachyarrythmias when rhythm and rate control fail, but is far from ideal. To evaluate whether interatrial electrical disconnection as a result of catheter ablation is feasible and of potential clinical utility as a means of non-pharmacological heart rate control. Methods Eleven patients with medically refractory atrial fibrillation or left atrial flutter and symptomatic rapid ventricular response were included. The ablation strategy consisted primarily of right atrial ablation of the interatrial electrical connections, which were located by electroanatomical activation maps performed during coronary sinus stimulation. Successive activation maps were performed as each connection was blocked. If the procedure was considered unsuccessful AV nodal ablation was performed. Results The coronary sinus ostium was earliest in 10/11 and could be ablated in 5/10 patients. Interatrial conduction block was only achieved in one patient (9.1%). An unexpected AV nodal modulation with an increase in the Wenckebach cycle length (> 50 ms) occurred in 8/11 patients. These patients remained without pacemaker implantation and only 1/8 required AV nodal ablation during the 1-year follow-up. Quality of life questionnaires indicated significant improvement in patients with AV nodal modulation. Conclusion Interatrial electrical disconnection by right atrial catheter ablation is a not feasible with present day technology. The extensive right atrial septal ablation performed resulted in significant AV nodal modulation in most patients, which persisted and resulted in improvement in quality of life.

Published
2020

36. Differential effects of sevoflurane and propofol on swine cardiac conduction system

Author

Zaballos M, Del Blanco B, Sevilla R, de Diego C, Anadon M, Jimeno C, and Almendral J

Subjects
Sevoflurane, swine heart conduction system, propofol, cardiac electrophysiology
Abstract

Objective To compare the effects of sevoflurane and propofol on the porcine cardiac conduction system. Study design A prospective, comparative study of electrophysiological properties of anaesthetics agents in an experimental porcine model. Animals A total of 36 hybrid Landrace-Large White pigs. Methods After premedication with 20 mg kg(-1) of intramuscular ketamine, anaesthesia was induced with 4.5 mg kg(-1)propofol intravenously. In 18 consecutive animals, anaesthesia was maintained with propofol (13 mg kg(-1) hour(-1)) and in the remaining 18 animals with 2.66% sevoflurane. The femoral artery and vein were canalized for invasive monitoring, analytical blood gas sampling and intracardiac catheter insertion. Following instrumentation and after a period of stabilization, a customary electrophysiological evaluation was performed. We compared the electrophysiology of the sinus and atrioventricular node (AV) node under sevoflurane or propofol anaesthesia, and the effects of both anaesthetics on atrial and ventricular refractoriness. Results There was a significant difference in sinus node recovery time between sevoflurane and propofol (907 +/- 231 versus 753 +/- 146 ms, p = 0.02). Sevoflurane in comparison with propofol significantly prolonged specialized AV conduction times, represented by an increased Wenckebach cycle length (272 +/- 54 versus 235 +/- 40 ms, p = 0.03) and AV nodal refractoriness (327 +/- 34 versus 287 +/- 30 ms, p = 0.002). In addition, sevoflurane prolonged ventricular refractoriness (298 +/- 27 versus 255 +/- 38 ms, p = 0.007) and the QT corrected interval (0.50 +/- 0.05 versus 0.46 +/- 0.09 ms, p = 0.005). Conclusions and clinical relevance Sevoflurane in comparison with propofol, depresses several parameters of sinus and AV nodal function and prolongs the ventricular refractoriness of the porcine cardiac conduction system. These findings should be taken into consideration for the choice of anaesthetic agents in clinical and experimental settings.

Published
2019

37. Validating the Newly Reported ASA Score

Author

Alam, A., primary, Mukherjee, A., additional, Xu, J., additional, Pagan, E., additional, Hiltner, E., additional, Rios, E., additional, Pollack, S., additional, Iyer, D., additional, Mody, K., additional, Kassotis, J., additional, James, D., additional, Jermyn, R., additional, and Almendral, J., additional

Published
2019
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39. Experimental complexity in physical, social and biological systems

Author

Aguirre, Jacobo, Almendral, J. A., Buldú, Javier M., Criado, R., Gutiérrez, R., Leyva, I., Romance, M., Sendiña-Nadal, I., Aguirre, Jacobo, Almendral, J. A., Buldú, Javier M., Criado, R., Gutiérrez, R., Leyva, I., Romance, M., and Sendiña-Nadal, I.

Abstract

There are a myriad of examples of dynamical systems displaying chaos and complex behavior, from the simple double pendulum, to the much more complex human brain or any social organization. They are typically characterized by the presence of nonlinear interactions governing their often unpredictable dynamical evolution, which makes it impossible to provide a simple description of their behavior even under controlled laboratory conditions. The very first (published) evidence of chaos in an experimental system was reported in 1977 by Jack Hudson and collaborators, who observed sustained time-dependent nonperiodic oscillations in the Belousov–Zhabotinsky reaction in a continuous-flow stirred reactor [1].

Published
2019

40. Prognostic significance of anaemia in patients with heart failure with preserved and reduced ejection fraction: Results from the MAGGIC individual patient data meta-analysis

Author

Berry, C, Poppe, K, Gamble, G, Earle, N, Ezekowitz, J, Squire, I, Mcmurray, J, Mcalister, F, Komajda, M, Swedberg, K, Maggioni, A, Ahmed, A, Whalley, G, Doughty, R, Tarantini, L, Granger, C, Køber, L, Massie, B, Pocock, S, Somaratne, J, Andersson, B, Bayes-Genis, A, Cowie, M, Cubbon, R, Gonzalez-Juanatey, J, Gorini, M, Gotsman, I, Grigorian-Shamagian, L, Guazzi, M, Kearney, M, Di Lenarda, A, Lenzen, M, Lucci, D, Macín, S, Madsen, B, Martínez-Sellés, M, Oliva, F, Rich, M, Richards, M, Senni, M, Taffet, G, Tribouilloy, C, Troughton, R, Tsutsui, H, Ariti, C, Dobson, J, Hall, C, Lainchbury, J, Hogg, K, Norrie, J, Stevenson, K, Brett, M, Pfeffer, M, Held, P, Michelson, E, Olofsson, B, Östergren, J, Yusuf, S, Torp-Pedersen, C, Scholte op Reimer, W, Boersma, E, Vantrimpont, P, Follath, F, Cleland, J, Zwas, D, Planer, D, Azaz-Livshits, T, Admon, D, Lotan, C, Keren, A, Varela-Roman, A, Mazón-Ramos, P, Rigeiro-Veloso, P, Bandin-Dieguez, M, Myers, J, Arena, R, Armstrong, P, Cujec, B, Paterson, I, Wood, D, Coats, A, Thompson, S, Suresh, V, Poole-Wilson, P, Sutton, G, Robles, J, Prieto, L, Muñoa, M, Frades, E, Díaz-Castro, O, Almendral, J, Faggiano, P, Bertoli, D, Porcu, M, Opasich, C, Tavazzi, L, Kirk, V, Bay, M, Parner, J, Krogsgaard, K, Herzog, T, Boesgaard, S, Hassager, C, Nielsen, O, Aldershvile, J, Nielsen, H, Kober, L, Perna, E, Cimbaro Canella, J, Alvarenga, P, Pantich, R, Ríos, N, Farias, E, Badaracco, J, Hansen, J, Stokholm, K, Brons, J, Husum, D, Mortensen, L, Vazquez, R, Puig, T, Fernandez-Palomeque, C, Bardají, A, Pascual-Figal, D, Ordoñez-Llanos, J, Valdes, M, Gabarrus, A, Pavon, R, Pastor, L, Fiol, M, Nieto, V, Macaya, C, Cinca, J, Cygankiewitz, I, Bayes De Luna, A, Newton, J, Blackledge, H, Wright, S, Kerzner, R, Gage, B, Freedland, K, Huynh, B, Rovner, A, Carney, R, Teasdale, T, Bleyer, A, Kutka, N, Luchi, R, Rusinaru, D, Mahjoub, H, Soulière, V, Lévy, F, Peltier, M, Tsuchihashi, M, Takeshita, A, Maccarthy, P, Nolan, J, Lee, A, Prescott, R, Shah, A, Brooksby, W, Fox, K, Basante, P, Trillo, R, Garcia-Seara, J, Martinez-Sande, J, Gude, F, Berry C, Poppe KK, Gamble GD, Earle NJ, Ezekowitz JA, Squire IB, McMurray JJV, McAlister FA, Komajda M, Swedberg K, Maggioni AP, Ahmed A, Whalley GA, Doughty RN, Tarantini L, Granger C, Køber L, Massie B, Pocock S, Somaratne J, Andersson B, Bayes-Genis A, Cowie M, Cubbon R, Gonzalez-Juanatey J, Gorini M, Gotsman I, Grigorian-Shamagian L, Guazzi M, Kearney M, Di Lenarda A, Lenzen M, Lucci D, Macín S, Madsen B, Martínez-Sellés M, Oliva F, Rich M, Richards M, Senni M, Taffet G, Tribouilloy C, Troughton R, Tsutsui H, Ariti C, Dobson J, Hall C, Lainchbury J, Hogg K, Norrie J, Stevenson K, Brett M, Pfeffer MA, Held P, Michelson EL, Olofsson B, Östergren J, Yusuf S, Torp-Pedersen C, Scholte op Reimer W, Boersma E, Vantrimpont PJMJ, Follath F, Cleland J, Zwas D, Planer D, Azaz-Livshits T, Admon D, Lotan C, Keren A, Varela-Roman A, Mazón-Ramos P, Rigeiro-Veloso P, Bandin-Dieguez MA, Myers J, Arena R, Armstrong PW, Cujec B, Paterson I, Wood DA, Coats AJS, Thompson SG, Suresh V, Poole-Wilson PA, Sutton GC, Robles JAG, Prieto L, Muñoa MD, Frades E, Díaz-Castro O, Almendral J, Faggiano P, Bertoli D, Porcu M, Opasich C, Tavazzi L, Kirk V, Bay M, Parner J, Krogsgaard K, Herzog TM, Boesgaard S, Hassager C, Nielsen OW, Aldershvile J, Nielsen H, Kober L, Perna ER, Cimbaro Canella JP, Alvarenga P, Pantich R, Ríos N, Farias EF, Badaracco JR, Hansen JF, Stokholm KH, Brons J, Husum D, Mortensen LS, Vazquez R, Puig T, Fernandez-Palomeque C, Bardají A, Pascual-Figal D, Ordoñez-Llanos J, Valdes M, Gabarrus A, Pavon R, Pastor L, Fiol M, Nieto V, Macaya C, Cinca J, Cygankiewitz I, Bayes De Luna A, Newton JD, Blackledge HM, Wright SP, Kerzner R, Gage BF, Freedland KE, Huynh BC, Rovner A, Carney RM, Teasdale TA, Bleyer AJ, Kutka NJ, Luchi RJ, Rusinaru D, Mahjoub H, Soulière V, Lévy F, Peltier M, Tsuchihashi M, Takeshita A, MacCarthy PA, Nolan J, Lee AJ, Prescott RJ, Shah AM, Brooksby WP, Fox KAA, Basante P, Trillo R, Garcia-Seara J, Martinez-Sande JL, Gude F, Berry, C, Poppe, K, Gamble, G, Earle, N, Ezekowitz, J, Squire, I, Mcmurray, J, Mcalister, F, Komajda, M, Swedberg, K, Maggioni, A, Ahmed, A, Whalley, G, Doughty, R, Tarantini, L, Granger, C, Køber, L, Massie, B, Pocock, S, Somaratne, J, Andersson, B, Bayes-Genis, A, Cowie, M, Cubbon, R, Gonzalez-Juanatey, J, Gorini, M, Gotsman, I, Grigorian-Shamagian, L, Guazzi, M, Kearney, M, Di Lenarda, A, Lenzen, M, Lucci, D, Macín, S, Madsen, B, Martínez-Sellés, M, Oliva, F, Rich, M, Richards, M, Senni, M, Taffet, G, Tribouilloy, C, Troughton, R, Tsutsui, H, Ariti, C, Dobson, J, Hall, C, Lainchbury, J, Hogg, K, Norrie, J, Stevenson, K, Brett, M, Pfeffer, M, Held, P, Michelson, E, Olofsson, B, Östergren, J, Yusuf, S, Torp-Pedersen, C, Scholte op Reimer, W, Boersma, E, Vantrimpont, P, Follath, F, Cleland, J, Zwas, D, Planer, D, Azaz-Livshits, T, Admon, D, Lotan, C, Keren, A, Varela-Roman, A, Mazón-Ramos, P, Rigeiro-Veloso, P, Bandin-Dieguez, M, Myers, J, Arena, R, Armstrong, P, Cujec, B, Paterson, I, Wood, D, Coats, A, Thompson, S, Suresh, V, Poole-Wilson, P, Sutton, G, Robles, J, Prieto, L, Muñoa, M, Frades, E, Díaz-Castro, O, Almendral, J, Faggiano, P, Bertoli, D, Porcu, M, Opasich, C, Tavazzi, L, Kirk, V, Bay, M, Parner, J, Krogsgaard, K, Herzog, T, Boesgaard, S, Hassager, C, Nielsen, O, Aldershvile, J, Nielsen, H, Kober, L, Perna, E, Cimbaro Canella, J, Alvarenga, P, Pantich, R, Ríos, N, Farias, E, Badaracco, J, Hansen, J, Stokholm, K, Brons, J, Husum, D, Mortensen, L, Vazquez, R, Puig, T, Fernandez-Palomeque, C, Bardají, A, Pascual-Figal, D, Ordoñez-Llanos, J, Valdes, M, Gabarrus, A, Pavon, R, Pastor, L, Fiol, M, Nieto, V, Macaya, C, Cinca, J, Cygankiewitz, I, Bayes De Luna, A, Newton, J, Blackledge, H, Wright, S, Kerzner, R, Gage, B, Freedland, K, Huynh, B, Rovner, A, Carney, R, Teasdale, T, Bleyer, A, Kutka, N, Luchi, R, Rusinaru, D, Mahjoub, H, Soulière, V, Lévy, F, Peltier, M, Tsuchihashi, M, Takeshita, A, Maccarthy, P, Nolan, J, Lee, A, Prescott, R, Shah, A, Brooksby, W, Fox, K, Basante, P, Trillo, R, Garcia-Seara, J, Martinez-Sande, J, Gude, F, Berry C, Poppe KK, Gamble GD, Earle NJ, Ezekowitz JA, Squire IB, McMurray JJV, McAlister FA, Komajda M, Swedberg K, Maggioni AP, Ahmed A, Whalley GA, Doughty RN, Tarantini L, Granger C, Køber L, Massie B, Pocock S, Somaratne J, Andersson B, Bayes-Genis A, Cowie M, Cubbon R, Gonzalez-Juanatey J, Gorini M, Gotsman I, Grigorian-Shamagian L, Guazzi M, Kearney M, Di Lenarda A, Lenzen M, Lucci D, Macín S, Madsen B, Martínez-Sellés M, Oliva F, Rich M, Richards M, Senni M, Taffet G, Tribouilloy C, Troughton R, Tsutsui H, Ariti C, Dobson J, Hall C, Lainchbury J, Hogg K, Norrie J, Stevenson K, Brett M, Pfeffer MA, Held P, Michelson EL, Olofsson B, Östergren J, Yusuf S, Torp-Pedersen C, Scholte op Reimer W, Boersma E, Vantrimpont PJMJ, Follath F, Cleland J, Zwas D, Planer D, Azaz-Livshits T, Admon D, Lotan C, Keren A, Varela-Roman A, Mazón-Ramos P, Rigeiro-Veloso P, Bandin-Dieguez MA, Myers J, Arena R, Armstrong PW, Cujec B, Paterson I, Wood DA, Coats AJS, Thompson SG, Suresh V, Poole-Wilson PA, Sutton GC, Robles JAG, Prieto L, Muñoa MD, Frades E, Díaz-Castro O, Almendral J, Faggiano P, Bertoli D, Porcu M, Opasich C, Tavazzi L, Kirk V, Bay M, Parner J, Krogsgaard K, Herzog TM, Boesgaard S, Hassager C, Nielsen OW, Aldershvile J, Nielsen H, Kober L, Perna ER, Cimbaro Canella JP, Alvarenga P, Pantich R, Ríos N, Farias EF, Badaracco JR, Hansen JF, Stokholm KH, Brons J, Husum D, Mortensen LS, Vazquez R, Puig T, Fernandez-Palomeque C, Bardají A, Pascual-Figal D, Ordoñez-Llanos J, Valdes M, Gabarrus A, Pavon R, Pastor L, Fiol M, Nieto V, Macaya C, Cinca J, Cygankiewitz I, Bayes De Luna A, Newton JD, Blackledge HM, Wright SP, Kerzner R, Gage BF, Freedland KE, Huynh BC, Rovner A, Carney RM, Teasdale TA, Bleyer AJ, Kutka NJ, Luchi RJ, Rusinaru D, Mahjoub H, Soulière V, Lévy F, Peltier M, Tsuchihashi M, Takeshita A, MacCarthy PA, Nolan J, Lee AJ, Prescott RJ, Shah AM, Brooksby WP, Fox KAA, Basante P, Trillo R, Garcia-Seara J, Martinez-Sande JL, and Gude F

Abstract

Background: Anaemia is common among patients with heart failure (HF) and is an important prognostic marker. Aim: We sought to determine the prognostic importance of anaemia in a large multinational pooled dataset of prospectively enrolled HF patients, with the specific aim to determine the prognostic role of anaemia in HF with preserved and reduced ejection fraction (HF-PEF and HF-REF, respectively). Design: Individual person data meta-analysis. Methods: Patients with haemoglobin (Hb) data fromthe MAGGIC dataset were used. Anaemia was defined as Hb < 120 g/l in women and <130 g/l inmen. HF-PEF was defined as EF ≥ 50%; HF-REF was EF < 50%. Cox proportional hazardmodelling, with adjustment for clinically relevant variables, was undertaken to investigate factors associated with 3-year all-causemortality. Results: Thirteen thousand two hundred and ninety-five patients with HF from 19 studies (9887 with HF-REF and 3408 with HF-PEF). The prevalence of anaemia was similar among those with HF-REF and HF-PEF (42.8 and 41.6% respectively). Compared with patients with normal Hb values, those with anaemia were older, were more likely to have diabetes, ischaemic aetiology, New York Heart Association class IV symptoms, lower estimated glomerular filtration rate and were more likely to be taking diuretic and less likely to be taking a beta-blocker. Patients with anaemia had higher all-cause mortality (adjusted hazard ratio [aHR] 1.38, 95% confidence interval [CI] 1.25-1.51), independent of EF group: aHR 1.67 (1.39-1.99) in HFPEF and aHR 2.49 (2.13-2.90) in HF-REF. Conclusions: Anaemia is an adverse prognostic factor in HF irrespective of EF. The prognostic importance of anaemia was greatest in patients with HF-REF.

Published
2016

41. Effects of angiotensin-neprilysin inhibition compared to angiotensin inhibition on ventricular arrhythmias in reduced ejection fraction patients under continuous remote monitoring of implantable defibrillator devices

Author

de Diego C, Gonzalez-Torres L, Nunez J, Inda R, Martin-Langerwerf D, Sangio A, Chochowski P, Casasnovas P, Blazquez J, and Almendral J

Subjects
Remote monitoring, Sacubitril-valsartan, Heart failure, cardiovascular diseases, Resynchronization, Arrhythmia, Implantable cardioverter-defibrillator
Abstract

BACKGROUND Angiotensin-neprilysin inhibition compared to angiotensin inhibition decreased sudden cardiac death in patients with reduced ejection fraction heart failure (rEFHF). The precise mechanism remains unclear. OBJECTIVE The purpose of this study was to explore the effect of angiotensin-neprilysin inhibition on ventricular arrhythmias compared to angiotensin inhibition in rEFHF patients with an implantable cardioverter-defibrillator (ICD) and remote monitoring. METHODS We prospectively included 120 patients with ICD and (1) New York Heart Association functional class >= II; (2) left ventricular ejection fraction

Published
2018

46. The survival of patients with heart failure with preserved or reduced left ventricular ejection fraction: an individual patient data meta-analysis

Author

Berry, C, Doughty, R, Granger, C, Kober, L, Massie, B, Mcalister, F, Mcmurray, J, Pocock, S, Poppe, K, Swedberg, K, Somaratne, J, Whalley, G, Ahmed, A, Andersson, B, Bayes-Genis, A, Cowie, M, Cubbon, R, Ezekowitz, J, Gonzalez-Juanatey, J, Gorini, M, Gotsman, I, Grigorian-Shamagian, L, Guazzi, M, Kearney, M, Komajda, M, di Lenarda, A, Lenzen, M, Lucci, D, Macin, S, Madsen, B, Maggioni, A, Martinez-Selles, M, Oliva, F, Rich, M, Richards, M, Senni, M, Squire, I, Taffet, G, Tarantini, L, Tribouilloy, C, Troughton, R, Tsutsui, H, Earle, N, Perera, K, Dobson, J, Hall, C, Richards, A, Lainchbury, J, Hogg, K, Norrie, J, Stevenson, K, Brett, M, Pfeffer, M, Held, P, Michelson, E, Olofsson, B, Ostergren, J, Yusuf, S, Torp-Pedersen, C, Reimer, W, Boersma, E, Vantrimpont, P, Follath, F, Cleland, J, Zwas, D, Planer, D, Azaz-Livshits, T, Admon, D, Lotan, C, Keren, A, Varela-Roman, A, Mazon-Ramos, P, Rigeiro-Veloso, P, Bandin-Dieguez, M, Myers, J, Arena, R, Armstrong, P, Cujec, B, Paterson, I, Wood, D, Coats, A, Thompson, S, Suresh, V, Poole-Wilson, P, Sutton, G, Robles, J, Prieto, L, Munoa, M, Frades, E, Diaz-Castro, O, Almendral, J, Faggiano, P, Bertoli, D, Porcu, M, Opasich, C, Tavazzi, L, Kirk, V, Bay, M, Parner, J, Krogsgaard, K, Herzog, T, Boesgaard, S, Hassager, C, Nielsen, O, Aldershvile, J, Nielsen, H, Perna, E, Canella, J, Alvarenga, P, Pantich, R, Rios, N, Farias, E, Badaracco, J, Hansen, J, Stokholm, K, Brons, J, Husum, D, Mortensen, L, Vazquez, R, Puig, T, Fernandez-Palomeque, C, Bardaji, A, Pascual-Figal, D, Ordonez-Llanos, J, Valdes, M, Gabarrus, A, Pavon, R, Pastor, L, Fiol, M, Nieto, V, Macaya, C, Cinca, J, de Luna, A, Newton, J, Blackledge, H, Wright, S, Kerzner, R, Gage, B, Freedland, K, Huynh, B, Rovner, A, Carney, R, Teasdale, T, Bleyer, A, Kutka, N, Luchi, R, Rusinaru, D, Mahjoub, H, Souliere, V, Levy, F, Peltier, M, Tsuchihashi, M, Takeshita, A, Maccarthy, P, Nolan, J, Lee, A, Prescott, R, Shah, A, Brooksby, W, Fox, K, Basante, P, Trillo, R, Garcia-Seara, J, Martinez-Sande, J, Gude, F, Berry C, Doughty RN, Granger C, Kober L, Massie B, McAlister F, McMurray J, Pocock S, Poppe K, Swedberg K, Somaratne J, Whalley GA, Ahmed A, Andersson B, Bayes-Genis A, Cowie M, Cubbon R, Ezekowitz J, Gonzalez-Juanatey J, Gorini M, Gotsman I, Grigorian-Shamagian L, Guazzi M, Kearney M, Komajda M, di Lenarda A, Lenzen M, Lucci D, Macin S, Madsen B, Maggioni A, Martinez-Selles M, Oliva F, Rich M, Richards M, Senni M, Squire I, Taffet G, Tarantini L, Tribouilloy C, Troughton R, Tsutsui H, Earle N, Perera K, Dobson J, Whalley G, Hall C, Richards AM, Lainchbury J, Hogg K, Norrie J, Stevenson K, Brett M, Pfeffer MA, Granger CB, Held P, McMurray JJV, Michelson EL, Olofsson B, Ostergren J, Yusuf S, Torp-Pedersen C, Lenzen MJ, Reimer WJMS, Boersma E, Vantrimpont PJMJ, Follath F, Cleland J, Zwas D, Planer D, Azaz-Livshits T, Admon D, Lotan C, Keren A, Varela-Roman A, Mazon-Ramos P, Rigeiro-Veloso P, Bandin-Dieguez MA, Gonzalez-Juanatey JR, Myers J, Arena R, McAlister FA, Armstrong PW, Cujec B, Paterson I, Cowie MR, Wood DA, Coats AJS, Thompson SG, Suresh V, Poole-Wilson PA, Sutton GC, Robles JAG, Prieto L, Munoa MD, Frades E, Diaz-Castro O, Almendral J, Faggiano P, Bertoli D, Porcu M, Opasich C, Tavazzi L, Maggioni AP, Kirk V, Bay M, Parner J, Krogsgaard K, Herzog TM, Boesgaard S, Hassager C, Nielsen OW, Aldershvile J, Nielsen H, Macin SM, Perna ER, Canella JPC, Alvarenga P, Pantich R, Rios N, Farias EF, Badaracco JR, Madsen BK, Hansen JF, Stokholm KH, Brons J, Husum D, Mortensen LS, Vazquez R, Puig T, Fernandez-Palomeque C, Bardaji A, Pascual-Figal D, Ordonez-Llanos J, Valdes M, Gabarrus A, Pavon R, Pastor L, Fiol M, Nieto V, Macaya C, Cinca J, de Luna AB, Newton JD, Blackledge HM, Squire IB, Wright SP, Kerzner R, Gage BF, Freedland KE, Rich MW, Huynh BC, Rovner A, Carney RM, Taffet GE, Teasdale TA, Bleyer AJ, Kutka NJ, Luchi RJ, Rusinaru D, Mahjoub H, Souliere V, Levy F, Peltier M, Tsuchihashi M, Takeshita A, MacCarthy PA, Kearney MT, Nolan J, Lee AJ, Prescott RJ, Shah AM, Brooksby WP, Fox KAA, Basante P, Trillo R, Garcia-Seara J, Martinez-Sande JL, Gude F, Berry, C, Doughty, R, Granger, C, Kober, L, Massie, B, Mcalister, F, Mcmurray, J, Pocock, S, Poppe, K, Swedberg, K, Somaratne, J, Whalley, G, Ahmed, A, Andersson, B, Bayes-Genis, A, Cowie, M, Cubbon, R, Ezekowitz, J, Gonzalez-Juanatey, J, Gorini, M, Gotsman, I, Grigorian-Shamagian, L, Guazzi, M, Kearney, M, Komajda, M, di Lenarda, A, Lenzen, M, Lucci, D, Macin, S, Madsen, B, Maggioni, A, Martinez-Selles, M, Oliva, F, Rich, M, Richards, M, Senni, M, Squire, I, Taffet, G, Tarantini, L, Tribouilloy, C, Troughton, R, Tsutsui, H, Earle, N, Perera, K, Dobson, J, Hall, C, Richards, A, Lainchbury, J, Hogg, K, Norrie, J, Stevenson, K, Brett, M, Pfeffer, M, Held, P, Michelson, E, Olofsson, B, Ostergren, J, Yusuf, S, Torp-Pedersen, C, Reimer, W, Boersma, E, Vantrimpont, P, Follath, F, Cleland, J, Zwas, D, Planer, D, Azaz-Livshits, T, Admon, D, Lotan, C, Keren, A, Varela-Roman, A, Mazon-Ramos, P, Rigeiro-Veloso, P, Bandin-Dieguez, M, Myers, J, Arena, R, Armstrong, P, Cujec, B, Paterson, I, Wood, D, Coats, A, Thompson, S, Suresh, V, Poole-Wilson, P, Sutton, G, Robles, J, Prieto, L, Munoa, M, Frades, E, Diaz-Castro, O, Almendral, J, Faggiano, P, Bertoli, D, Porcu, M, Opasich, C, Tavazzi, L, Kirk, V, Bay, M, Parner, J, Krogsgaard, K, Herzog, T, Boesgaard, S, Hassager, C, Nielsen, O, Aldershvile, J, Nielsen, H, Perna, E, Canella, J, Alvarenga, P, Pantich, R, Rios, N, Farias, E, Badaracco, J, Hansen, J, Stokholm, K, Brons, J, Husum, D, Mortensen, L, Vazquez, R, Puig, T, Fernandez-Palomeque, C, Bardaji, A, Pascual-Figal, D, Ordonez-Llanos, J, Valdes, M, Gabarrus, A, Pavon, R, Pastor, L, Fiol, M, Nieto, V, Macaya, C, Cinca, J, de Luna, A, Newton, J, Blackledge, H, Wright, S, Kerzner, R, Gage, B, Freedland, K, Huynh, B, Rovner, A, Carney, R, Teasdale, T, Bleyer, A, Kutka, N, Luchi, R, Rusinaru, D, Mahjoub, H, Souliere, V, Levy, F, Peltier, M, Tsuchihashi, M, Takeshita, A, Maccarthy, P, Nolan, J, Lee, A, Prescott, R, Shah, A, Brooksby, W, Fox, K, Basante, P, Trillo, R, Garcia-Seara, J, Martinez-Sande, J, Gude, F, Berry C, Doughty RN, Granger C, Kober L, Massie B, McAlister F, McMurray J, Pocock S, Poppe K, Swedberg K, Somaratne J, Whalley GA, Ahmed A, Andersson B, Bayes-Genis A, Cowie M, Cubbon R, Ezekowitz J, Gonzalez-Juanatey J, Gorini M, Gotsman I, Grigorian-Shamagian L, Guazzi M, Kearney M, Komajda M, di Lenarda A, Lenzen M, Lucci D, Macin S, Madsen B, Maggioni A, Martinez-Selles M, Oliva F, Rich M, Richards M, Senni M, Squire I, Taffet G, Tarantini L, Tribouilloy C, Troughton R, Tsutsui H, Earle N, Perera K, Dobson J, Whalley G, Hall C, Richards AM, Lainchbury J, Hogg K, Norrie J, Stevenson K, Brett M, Pfeffer MA, Granger CB, Held P, McMurray JJV, Michelson EL, Olofsson B, Ostergren J, Yusuf S, Torp-Pedersen C, Lenzen MJ, Reimer WJMS, Boersma E, Vantrimpont PJMJ, Follath F, Cleland J, Zwas D, Planer D, Azaz-Livshits T, Admon D, Lotan C, Keren A, Varela-Roman A, Mazon-Ramos P, Rigeiro-Veloso P, Bandin-Dieguez MA, Gonzalez-Juanatey JR, Myers J, Arena R, McAlister FA, Armstrong PW, Cujec B, Paterson I, Cowie MR, Wood DA, Coats AJS, Thompson SG, Suresh V, Poole-Wilson PA, Sutton GC, Robles JAG, Prieto L, Munoa MD, Frades E, Diaz-Castro O, Almendral J, Faggiano P, Bertoli D, Porcu M, Opasich C, Tavazzi L, Maggioni AP, Kirk V, Bay M, Parner J, Krogsgaard K, Herzog TM, Boesgaard S, Hassager C, Nielsen OW, Aldershvile J, Nielsen H, Macin SM, Perna ER, Canella JPC, Alvarenga P, Pantich R, Rios N, Farias EF, Badaracco JR, Madsen BK, Hansen JF, Stokholm KH, Brons J, Husum D, Mortensen LS, Vazquez R, Puig T, Fernandez-Palomeque C, Bardaji A, Pascual-Figal D, Ordonez-Llanos J, Valdes M, Gabarrus A, Pavon R, Pastor L, Fiol M, Nieto V, Macaya C, Cinca J, de Luna AB, Newton JD, Blackledge HM, Squire IB, Wright SP, Kerzner R, Gage BF, Freedland KE, Rich MW, Huynh BC, Rovner A, Carney RM, Taffet GE, Teasdale TA, Bleyer AJ, Kutka NJ, Luchi RJ, Rusinaru D, Mahjoub H, Souliere V, Levy F, Peltier M, Tsuchihashi M, Takeshita A, MacCarthy PA, Kearney MT, Nolan J, Lee AJ, Prescott RJ, Shah AM, Brooksby WP, Fox KAA, Basante P, Trillo R, Garcia-Seara J, Martinez-Sande JL, and Gude F

Abstract

Aims: A substantial proportion of patients with heart failure have preserved left ventricular ejection fraction (HF-PEF). Previous studies have reportedmixed resultswhether survival is similar to those patientswith heart failure and reduced EF (HF-REF). Methods and results: We compared survival in patients with HF-PEF with that in patients with HF-REF in a meta-analysis using individual patient data. Preserved EF was defined as an EF ≥ 50%. The 31 studies included 41 972 patients: 10 347 with HF-PEF and 31 625 with HF-REF. Compared with patients with HF-REF, those with HF-PEF were older (mean age 71 vs. 66 years), were more often women (50 vs. 28%), and have a history of hypertension (51 vs. 41%). Ischaemic aetiology was less common (43 vs. 59%) in patients with HF-PEF. There were 121 [95% confidence interval (CI): 117, 126] deaths per 1000 patient-years in those with HF-PEF and 141 (95% CI: 138, 144) deaths per 1000 patient-years in those with HF-REF. Patients with HF-PEF had lower mortality than those with HF-REF (adjusted for age, gender, aetiology, and history of hypertension, diabetes, and atrial fibrillation); hazard ratio 0.68 (95% CI: 0.64, 0.71). The risk of death did not increase notably until EF fell below 40%. Conclusion: Patients with HF-PEF have a lower risk of death than patients with HF-REF, and this difference is seen regardless of age, gender, and aetiology of HF. However, absolute mortality is still high in patients with HF-PEF highlighting the need for a treatment to improve prognosis.

Published
2012

47. The survival of patients with heart failure with preserved or reduced left ventricular ejection fraction: an individual patient data meta-analysis

Author

Berry C, Doughty RN, Granger C, Kober L, Massie B, McAlister F, McMurray J, Pocock S, Poppe K, Swedberg K, Somaratne J, Whalley GA, Ahmed A, Andersson B, Bayes-Genis A, Cowie M, Cubbon R, Ezekowitz J, Gonzalez-Juanatey J, Gorini M, Gotsman I, Grigorian-Shamagian L, Guazzi M, Kearney M, Komajda M, di Lenarda A, Lenzen M, Lucci D, Macin S, Madsen B, Maggioni A, Martinez-Selles M, Oliva F, Rich M, Richards M, Senni M, Squire I, Taffet G, Tarantini L, Tribouilloy C, Troughton R, Tsutsui H, Earle N, Perera K, Dobson J, Whalley G, Hall C, Richards AM, Lainchbury J, Hogg K, Norrie J, Stevenson K, Brett M, Pfeffer MA, Granger CB, Held P, McMurray JJV, Michelson EL, Olofsson B, Ostergren J, Yusuf S, Torp-Pedersen C, Lenzen MJ, Reimer WJMS, Boersma E, Vantrimpont PJMJ, Follath F, Cleland J, Zwas D, Planer D, Azaz-Livshits T, Admon D, Lotan C, Keren A, Varela-Roman A, Mazon-Ramos P, Rigeiro-Veloso P, Bandin-Dieguez MA, Gonzalez-Juanatey JR, Myers J, Arena R, McAlister FA, Armstrong PW, Cujec B, Paterson I, Cowie MR, Wood DA, Coats AJS, Thompson SG, Suresh V, Poole-Wilson PA, Sutton GC, Robles JAG, Prieto L, Munoa MD, Frades E, Diaz-Castro O, Almendral J, Faggiano P, Bertoli D, Porcu M, Opasich C, Tavazzi L, Maggioni AP, Kirk V, Bay M, Parner J, Krogsgaard K, Herzog TM, Boesgaard S, Hassager C, Nielsen OW, Aldershvile J, Nielsen H, Macin SM, Perna ER, Canella JPC, Alvarenga P, Pantich R, Rios N, Farias EF, Badaracco JR, Madsen BK, Hansen JF, Stokholm KH, Brons J, Husum D, Mortensen LS, Vazquez R, Puig T, Fernandez-Palomeque C, Bardaji A, Pascual-Figal D, Ordonez-Llanos J, Valdes M, Gabarrus A, Pavon R, Pastor L, Fiol M, Nieto V, Macaya C, Cinca J, de Luna AB, Newton JD, Blackledge HM, Squire IB, Wright SP, Kerzner R, Gage BF, Freedland KE, Rich MW, Huynh BC, Rovner A, Carney RM, Taffet GE, Teasdale TA, Bleyer AJ, Kutka NJ, Luchi RJ, Rusinaru D, Mahjoub H, Souliere V, Levy F, Peltier M, Tsuchihashi M, Takeshita A, MacCarthy PA, Kearney MT, Nolan J, Lee AJ, Prescott RJ, Shah AM, Brooksby WP, Fox KAA, Basante P, Trillo R, Garcia-Seara J, Martinez-Sande JL, Gude F, Berry, C, Doughty, R, Granger, C, Kober, L, Massie, B, Mcalister, F, Mcmurray, J, Pocock, S, Poppe, K, Swedberg, K, Somaratne, J, Whalley, G, Ahmed, A, Andersson, B, Bayes-Genis, A, Cowie, M, Cubbon, R, Ezekowitz, J, Gonzalez-Juanatey, J, Gorini, M, Gotsman, I, Grigorian-Shamagian, L, Guazzi, M, Kearney, M, Komajda, M, di Lenarda, A, Lenzen, M, Lucci, D, Macin, S, Madsen, B, Maggioni, A, Martinez-Selles, M, Oliva, F, Rich, M, Richards, M, Senni, M, Squire, I, Taffet, G, Tarantini, L, Tribouilloy, C, Troughton, R, Tsutsui, H, Earle, N, Perera, K, Dobson, J, Hall, C, Richards, A, Lainchbury, J, Hogg, K, Norrie, J, Stevenson, K, Brett, M, Pfeffer, M, Held, P, Michelson, E, Olofsson, B, Ostergren, J, Yusuf, S, Torp-Pedersen, C, Reimer, W, Boersma, E, Vantrimpont, P, Follath, F, Cleland, J, Zwas, D, Planer, D, Azaz-Livshits, T, Admon, D, Lotan, C, Keren, A, Varela-Roman, A, Mazon-Ramos, P, Rigeiro-Veloso, P, Bandin-Dieguez, M, Myers, J, Arena, R, Armstrong, P, Cujec, B, Paterson, I, Wood, D, Coats, A, Thompson, S, Suresh, V, Poole-Wilson, P, Sutton, G, Robles, J, Prieto, L, Munoa, M, Frades, E, Diaz-Castro, O, Almendral, J, Faggiano, P, Bertoli, D, Porcu, M, Opasich, C, Tavazzi, L, Kirk, V, Bay, M, Parner, J, Krogsgaard, K, Herzog, T, Boesgaard, S, Hassager, C, Nielsen, O, Aldershvile, J, Nielsen, H, Perna, E, Canella, J, Alvarenga, P, Pantich, R, Rios, N, Farias, E, Badaracco, J, Hansen, J, Stokholm, K, Brons, J, Husum, D, Mortensen, L, Vazquez, R, Puig, T, Fernandez-Palomeque, C, Bardaji, A, Pascual-Figal, D, Ordonez-Llanos, J, Valdes, M, Gabarrus, A, Pavon, R, Pastor, L, Fiol, M, Nieto, V, Macaya, C, Cinca, J, de Luna, A, Newton, J, Blackledge, H, Wright, S, Kerzner, R, Gage, B, Freedland, K, Huynh, B, Rovner, A, Carney, R, Teasdale, T, Bleyer, A, Kutka, N, Luchi, R, Rusinaru, D, Mahjoub, H, Souliere, V, Levy, F, Peltier, M, Tsuchihashi, M, Takeshita, A, Maccarthy, P, Nolan, J, Lee, A, Prescott, R, Shah, A, Brooksby, W, Fox, K, Basante, P, Trillo, R, Garcia-Seara, J, Martinez-Sande, J, and Gude, F

Subjects
Male, medicine.medical_specialty, Prognosi, Heart failure, Lower risk, Risk Factors, Cause of Death, Internal medicine, medicine, Humans, Meta-analysi, Aged, Randomized Controlled Trials as Topic, Ejection fraction, business.industry, Hazard ratio, Stroke Volume, Atrial fibrillation, medicine.disease, Confidence interval, Meta-analysis, Cardiology, Etiology, Female, Cardiology and Cardiovascular Medicine, business
Abstract

Aims A substantial proportion of patients with heart failure have preserved left ventricular ejection fraction (HF-PEF). Previous studies have reported mixed results whether survival is similar to those patients with heart failure and reduced EF (HF-REF). Methods and results We compared survival in patients with HF-PEF with that in patients with HF-REF in a meta-analysis using individual patient data. Preserved EF was defined as an EF ≥ 50%. The 31 studies included 41 972 patients: 10 347 with HF-PEF and 31 625 with HF-REF. Compared with patients with HF-REF, those with HF-PEF were older (mean age 71 vs. 66 years), were more often women (50 vs. 28%), and have a history of hypertension (51 vs. 41%). Ischaemic aetiology was less common (43 vs. 59%) in patients with HF-PEF. There were 121 [95% confidence interval (CI): 117, 126] deaths per 1000 patient-years in those with HF-PEF and 141 (95% CI: 138, 144) deaths per 1000 patient-years in those with HF-REF. Patients with HF-PEF had lower mortality than those with HF-REF (adjusted for age, gender, aetiology, and history of hypertension, diabetes, and atrial fibrillation); hazard ratio 0.68 (95% CI: 0.64, 0.71). The risk of death did not increase notably until EF fell below 40%. Conclusion Patients with HF-PEF have a lower risk of death than patients with HF-REF, and this difference is seen regardless of age, gender, and aetiology of HF. However, absolute mortality is still high in patients with HF-PEF highlighting the need for a treatment to improve prognosis.

Published
2012

48. The survival of patients with heart failure with preserved or reduced left ventricular ejection fraction: an individual patient data meta-analysis

Author

Granger, C, Massie, B, Somaratne, J, Ahmed, A, Cowie, M, Gonzalez-Juanatey, J, Gorini, M, Kearney, M, di Lenarda, A, Lenzen, M, Macin, S, Madsen, B, Maggioni, A, McAlister, F, Oliva, F, Rich, M, Richards, M, Squire, I, Taffet, G, Earle, N, Perera, K, Dobson, J, Pocock, S, Poppe, K, Whalley, G, Andersson, B, Hall, C, Richards, AM, Troughton, R, Lainchbury, J, Berry, C, Hogg, K, Norrie, J, Stevenson, K, Brett, M, McMurray, J, Pfeffer, MA, Granger, CB, Held, P, McMurray, JJV, Michelson, EL, Olofsson, B, Ostergren, J, Yusuf, S, Torp-Pedersen, C, Lenzen, MJ, Reimer, WJMS, Boersma, E, Vantrimpont, PJMJ, Follath, F, Swedberg, K, Cleland, J, Komajda, M, Gotsman, I, Zwas, D, Planer, D, Azaz-Livshits, T, Admon, D, Lotan, C, Keren, A, Grigorian-Shamagian, L, Mazon-Ramos, P, Rigeiro-Veloso, P, Bandin-Dieguez, MA, Guazzi, M, Myers, J, Arena, R, McAlister, FA, Ezekowitz, J, Armstrong, PW, Cujec, B, Paterson, I, Cowie, MR, Wood, DA, Coats, AJS, Thompson, SG, Suresh, V, Poole-Wilson, PA, Sutton, GC, Martinez-Selles, M, Robles, JAG, Prieto, L, Munoa, MD, Frades, E, Diaz-Castro, O, Tarantini, L, Faggiano, P, Senni, M, Lucci, D, Bertoli, D, Porcu, M, Opasich, C, Tavazzi, L, Maggioni, AP, Kirk, V, Bay, M, Parner, J, Krogsgaard, K, Herzog, TM, Boesgaard, S, Hassager, C, Nielsen, OW, Aldershvile, J, Nielsen, H, Kober, L, Macin, SM, Perna, ER, Canella, JPC, Alvarenga, P, Pantich, R, Rios, N, Farias, EF, Badaracco, JR, Madsen, BK, Hansen, JF, Stokholm, KH, Brons, J, Husum, D, Mortensen, LS, Bayes-Genis, A, Vazquez, R, Puig, T, Fernandez-Palomeque, C, Bardaji, A, Pascual-Figal, D, Ordonez-Llanos, J, Valdes, M, Gabarrus, A, Pavon, R, Pastor, L, Almendral, J, Fiol, M, Nieto, V, Macaya, C, Cinca, J, de Luna, AB, Newton, JD, Blackledge, HM, Squire, IB, Wright, SP, Whalley, GA, Doughty, RN, Kerzner, R, Gage, BF, Huynh, BC, Rovner, A, Freedland, KE, Carney, RM, Rich, MW, Taffet, GE, Teasdale, TA, Bleyer, AJ, Kutka, NJ, Luchi, RJ, Tribouilloy, C, Rusinaru, D, Mahjoub, H, Souliere, V, Levy, F, Peltier, M, Tsutsui, H, Tsuchihashi, M, Takeshita, A, MacCarthy, PA, Kearney, MT, Cubbon, R, Nolan, J, Lee, AJ, Prescott, RJ, Shah, AM, Brooksby, WP, Fox, KAA, Varela-Roman, A, Gonzalez-Juanatey, JR, Basante, P, Trillo, R, Garcia-Seara, J, Martinez-Sande, JL, and Gude, F

Subjects
Meta-analysis, Heart failure, Prognosis
Abstract

A substantial proportion of patients with heart failure have preserved left ventricular ejection fraction (HF-PEF). Previous studies have reported mixed results whether survival is similar to those patients with heart failure and reduced EF (HF-REF). We compared survival in patients with HF-PEF with that in patients with HF-REF in a meta-analysis using individual patient data. Preserved EF was defined as an EF epsilon 50. The 31 studies included 41 972 patients: 10 347 with HF-PEF and 31 625 with HF-REF. Compared with patients with HF-REF, those with HF-PEF were older (mean age 71 vs. 66 years), were more often women (50 vs. 28), and have a history of hypertension (51 vs. 41). Ischaemic aetiology was less common (43 vs. 59) in patients with HF-PEF. There were 121 [95 confidence interval (CI): 117, 126] deaths per 1000 patient-years in those with HF-PEF and 141 (95 CI: 138, 144) deaths per 1000 patient-years in those with HF-REF. Patients with HF-PEF had lower mortality than those with HF-REF (adjusted for age, gender, aetiology, and history of hypertension, diabetes, and atrial fibrillation); hazard ratio 0.68 (95 CI: 0.64, 0.71). The risk of death did not increase notably until EF fell below 40. Patients with HF-PEF have a lower risk of death than patients with HF-REF, and this difference is seen regardless of age, gender, and aetiology of HF. However, absolute mortality is still high in patients with HF-PEF highlighting the need for a treatment to improve prognosis.

Published
2012

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