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1. Long-term cardiac outcomes of patients with HER2-positive breast cancer treated in the adjuvant lapatinib and/or trastuzumab Treatment Optimization Trial

Author

Eiger, Daniel, Pondé, Noam, Agbor-Tarh, Dominique, Moreno-Aspitia, Alvaro, Piccart-Gebhart, Martine, Hilbers, Florentine FS, Werner, Olena, Chumsri, Saranya, Dueck, Amylou A.C., Kroep, Judith, Gomez, H.L., Lang, Istvan, Rodeheffer, R., Ewer, M., Suter, Thomas, de Azambuja, Evandro, Eiger, Daniel, Pondé, Noam, Agbor-Tarh, Dominique, Moreno-Aspitia, Alvaro, Piccart-Gebhart, Martine, Hilbers, Florentine FS, Werner, Olena, Chumsri, Saranya, Dueck, Amylou A.C., Kroep, Judith, Gomez, H.L., Lang, Istvan, Rodeheffer, R., Ewer, M., Suter, Thomas, and de Azambuja, Evandro

Abstract

Background: Cardiotoxicity is the most significant adverse event associated with trastuzumab (T), the main component of HER2-positive breast cancer (BC) treatment. Less is known about the cardiotoxicity of dual HER2 blockade with T plus lapatinib (L), although this regimen is used in the metastatic setting. Methods: This is a sub-analysis of the ALTTO trial comparing adjuvant treatment options for patients with early HER2-positive BC. Patients randomised to either T or concomitant T + L were eligible. Cardiac events (CEs) rates were compared according to treatment arm. Results: With 6.9 years of median follow-up (FU) and 4190 patients, CE were observed in 363 (8.6%): 166 (7.9%) of patient in T + L arm vs. 197 (9.3%) in T arm (OR = 0.85 [95% CI, 0.68–1.05]). During anti-HER2 treatment 270 CE (6.4%) occurred while 93 (2.2%) were during FU (median time to onset = 6.6 months [IQR = 3.4–11.7]). While 265 CEs were asymptomatic (73%), 94 were symptomatic (26%) and four were cardiac deaths (1%). Recovery was observed in 301 cases (83.8%). Identified cardiac risk factors were: baseline LVEF < 55% (vs > 64%, OR 3.1 [95% CI 1.54–6.25]), diabetes mellitus (OR 1.85 [95% CI 1.25–2.75]), BMI > 30 kg/m2 (vs < 25 mg/kg2, OR 2.21 [95% CI 1.40–3.49]), cumulative dose of doxorubicin ≥240 mg/m2 (OR 1.36 [95% CI 1.01–1.82]) and of epirubicin≥ 480 mg/m2 (OR 2.33 [95% CI 1.55–3.51]). Conclusions: Dual HER2 blockade with T + L is a safe regimen from a cardiac perspective, but cardiac-focused history for proper patient selection is crucial. Trial registration number: ClinicalTrials.gov Identifier: NCT00490139 (registration date: 22/06/2007); EudraCT Number: 2006–000562–36 (registration date: 04/05/2007); Sponsor Protocol Number: BIG2–06 /EGF106708/N063D., SCOPUS: ar.j, DecretOANoAutActif, info:eu-repo/semantics/published

Published
2020

9. Erratum

Author

Howarth, D. M., Forstrom, L. A., Samudrala, V., Sinak, L. J., McGregor, C. G., and Rodeheffer, R. J.

Published
1996

12. Abstract P4-21-09: Cardiac biomarkers for early detection and prediction of trastuzumab and/or lapatinib-induced cardiotoxicity in patients with HER2 positive early breast cancer (BIG 1-06)

Author

de Azambuja, E, primary, Bradbury, I, additional, Ewer, M, additional, Campbell, C, additional, Zardavas, D, additional, Ameels, H, additional, Baselga, J, additional, Huober, J, additional, Izquierdo, M, additional, Bozovic-Spasojevic, I, additional, Maetens, M, additional, Harbeck, N, additional, Pusztai, L, additional, Piccart, M, additional, Rodeheffer, R, additional, and Sutter, T, additional

Published
2017
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13. Coronary-artery bypass surgery in patients with left ventricular dysfunction

Author

Velazquez, E, Lee, K, Deja, Ma:, J, A, Sopko, G, Marchenko, A, Ali, I, Pohost, G, Gradinac, S, Abraham, W, Yii, M, Prabhakaran, D, Szwed, H, Ferrazzi, P, Petrie, M, O'Connor, C, Panchavinnin, P, She, L, Bonow, R, Rankin, G, Jones, R, Rouleau, J, Cherniavsky, A, Romanov, A, Wos, S, Deja, M, Golba, K, Malinowski, M, Kosevic, D, Vukovic, M, Djokovic, L, Krzeminska Pakula, M, Jaszewski, R, Drozdz, J, Chrzanowski, L, Rajda, M, Howlett, J, Macfarlane, M, Jain, A, Shah, H, Rakshak, D, Saxena, A, Zembala, M, Przybylski, R, Kukulski, T, Wasilewski, J, Wiechowski, S, Brykczynski, M, Kurowski, M, Mokrzycki, K, Sadowski, J, Kapelak, B, Sobczyk, D, Plicner, D, Wrobel, K, Piegas, L, Paulista, P, Farsky, P, Veiga Kantorowitz, C, Sadowski, Z, Juraszynski, Z, Dabrowski, R, Rogowski, J, Pawlaczyk, R, Rynkiewicz, A, Betlejewski, P, Siepe, M, Geibel Zehender, A, Cuerten, C, Higgins, R, Crestanello, J, Binkley, P, Jones, D, Sun, B, Smith, P, Milano, C, Adams, P, Hill, J, Beaver, T, Leach, D, Airan, B, Das, S, Prior, D, Mack, J, Rao, V, Iwanochko, R, Renton, J, Phuangkaew, N, Bochenek, A, Krejca, M, Trusz Gluza, M, Wita, K, Gavazzi, A, Senni, M, Natarajan, S, Padmanabhan, C, Racine, N, Bouchard, D, Ducharme, A, Brown, H, Alotti, N, Lupkovics, G, Kumar, S, Agarwal, S, Sinha, N, Rai, H, Andersson, B, Janssen, A, Lamy, A, Demers, C, Rizzo, T, Doenst, T, Garbade, J, Thiele, H, Richter, M, Murday, A, Shaw, M, Raju, K, Mannam, G, Reddy, G, Rao, K, Nicolau, J, Stolf, N, Vieira, A, Chua, Y, Lim, C, Kwok, B, Gan, Y, Cleland, J, Cale, A, Thackray, S, Lammiman, M, Michler, R, Swayze, R, Maurer, G, Grimm, M, Lang, I, Adlbrecht, C, Daly, R, Rodeheffer, R, Nelson, S, Larbalestier, R, Wang, X, Haddad, H, Hendry, P, Donaldson, J, Menicanti, L, Di Donato, M, Castelvecchio, S, Sirvydis, V, Voluckiene, E, Di Benedetto, G, Attisano, T, Favaloro, R, Favaloro, L, Diez, M, Riccitelli, M, Picone, V, Koslowski, P, Gaito, M, Al mohammad, A, Braidley, P, Steele, H, Nawarawong, W, Woragidpoonpol, S, Kuanprasert, S, Mekara, W, Kon, N, Hammon, J, Wells, G, Tilley, W, Drazner, M, Di Maio, M, Peschka, S, Pasquale, D, Knight, C, J, Aylward, P, Thomas, C, Gullestad, L, Sorensen, G, Kaul, U, Gupta, R, Schmedtje, Jj, Arnold, S, Wilson, V, Grayburn, P, Hamman, B, Hebeler, R, Aston, S, Birjiniuk, V, Harrington, M, Dupree, C, Sheridan, B, Schuler, C, Helou, J, Denis, I, Bigalli, D, Gutierrez, F, Russo, N, Batlle, C, White, H, Alison, P, Stewart, R, Borthwick, L, Philippides, G, Shemin, R, Fitzgerald, C, Dagenais, F, Dussault, G, Kamath, P, Busmann, C, Ferrari, G, Botto, M, Horkay, F, Hartyanszky, I, Bartha, E, Simor, T, Papp, L, Toth, L, Varga Szemes, A, Szekely, L, Keltai, M, Edes, I, Szathmarine, V, Yakub, M, Sarip, S, Maitland, A, Isaac, D, Holland, M, Bogats, G, Csepregi, L, Maia, L, Soares, M, Mouco, O, Souza, A, da Rocha, A, Brito, J, Pitella, F, Camara, A, Horowitz, J, Knight, J, Rose, J, Mcrae, Rj, Geiss, D, Clemson, B, Pierson, M, Kron, I, Kern, J, Bergin, J, Phillips, J, Rich, J, Herre, J, Pine, L, Chin, D, Spyt, T, Logtens, E, Amuchastegui, L, Bracco, D, Ruengsakulrach, P, Pitiguagool, V, Sukhum, P, Srinualta, D, Hayward, C, Herrera, C, Zimmermann, R, Patterson, G, Stephens, W, Dignan, R, French, J, Sequalino, N, Vaishnav, S, Panda, R, Chavan, A, Benetis, R, Jankauskiene, L, Kalil, R, Nesralla, I, Santos, M, de Moraes, M, Friedrich, I, Buerke, M, Paraforos, A, Konda, S, Leone, C, Murphy, E, Ravichandran, P, Avalos, K, Hetzer, R, Knosalla, C, Hoffmann, K, Landolfo, K, Landolfo, C, Park, M, Chiariello, L, Nardi, P, Stapleton, D, Hoey, K, Hasaniya, N, Wang, N, Bijou, R, Naka, Y, Ascheim, D, Mikati, I, Arnold, M, Mckenzie, N, Smith, J, Gheorghiade, M, Fullerton, D, Roberts, L, Carson, P, Miller, A, Pina, I, Selzman, C, Wertheimer, J, Goldstein, S, Cohn, F, Hlatky, M, Kennedy, K, Rankin, S, Robbins, R, Zaret, B, Barfield, T, Desvigne Nickens, P, Oh, J, Panza, J, Apte, P, Doyle, M, Forder, J, Ocon, M, Pai, R, Reddy, V, Santos, N, Tripathi, R, Varadarajan, P, Pellikka, P, Miller, Fj, Lin, G, Borgeson, D, Ommen, S, Casaclang Verzosa, G, Miller, D, Springer, R, Blahnik, F, Manahan, B, Welper, J, Wiste, H, Mark, D, Anstrom, K, Baloch, K, Burnette, A, Cowper, P, Davidson Ray, N, Drew, L, Harding, T, Hunt, V, Knight, D, Patterson, A, Redick, T, Sanderford, B, Feldman, A, Bristow, M, Chan, T, Maisel, A, Mann, D, Mcnamara, D, Holly, T, Berman, D, Leonard, S, Helmer, D, Woods, M, Mcnulty, M, Asch, F, Rumsey, M, Bieganski, S, Roberts, B, Handschumacher, M, Mccormick, A, Albright, J, Dandridge, R, Rittenhouse, L, Wagstaff, D, Williams, M, Bailey, D, Glover, D, Parrish, L, Wakeley, N, Jackson, V, Nicholson, B, Mcdaniel, A, Al Khalidi, H, Greene, D, and Moore, V

Subjects
Male, medicine.medical_specialty, Coronary Artery Disease, Kaplan-Meier Estimate, 030204 cardiovascular system & hematology, law.invention, Coronary artery disease, 03 medical and health sciences, Coronary artery bypass surgery, Ventricular Dysfunction, Left, 0302 clinical medicine, Randomized controlled trial, law, Internal medicine, medicine, Clinical endpoint, Humans, 03.02. Klinikai orvostan, cardiovascular diseases, 030212 general & internal medicine, Coronary Artery Bypass, Aged, Proportional Hazards Models, Heart Failure, Intention-to-treat analysis, Proportional hazards model, business.industry, Hazard ratio, Settore MED/23 - Chirurgia Cardiaca, General Medicine, Middle Aged, medicine.disease, Combined Modality Therapy, 3. Good health, Surgery, Intention to Treat Analysis, Hospitalization, surgical procedures, operative, Cardiovascular Diseases, Heart failure, Cardiology, Female, business
Abstract

The role of coronary-artery bypass grafting (CABG) in the treatment of patients with coronary artery disease and heart failure has not been clearly established.Between July 2002 and May 2007, a total of 1212 patients with an ejection fraction of 35% or less and coronary artery disease amenable to CABG were randomly assigned to medical therapy alone (602 patients) or medical therapy plus CABG (610 patients). The primary outcome was the rate of death from any cause. Major secondary outcomes included the rates of death from cardiovascular causes and of death from any cause or hospitalization for cardiovascular causes.The primary outcome occurred in 244 patients (41%) in the medical-therapy group and 218 (36%) in the CABG group (hazard ratio with CABG, 0.86; 95% confidence interval [CI], 0.72 to 1.04; P=0.12). A total of 201 patients (33%) in the medical-therapy group and 168 (28%) in the CABG group died from an adjudicated cardiovascular cause (hazard ratio with CABG, 0.81; 95% CI, 0.66 to 1.00; P=0.05). Death from any cause or hospitalization for cardiovascular causes occurred in 411 patients (68%) in the medical-therapy group and 351 (58%) in the CABG group (hazard ratio with CABG, 0.74; 95% CI, 0.64 to 0.85; P

Published
2011

14. Myocardial viability and survival in ischemic left ventricular dysfunction

Author

Bonow, R, Maurer, G, Lee, K, Holly, T, Binkley, P, Desvigne Nickens, P, Drozdz, J, Farsky, P, Feldman, A, Doenst, T, Michler, R, Berman, D, Nicolau, J, Pellikka, P, Wrobel, K, Alotti, N, Asch, F, Favaloro, L, She, L, Velazquez, E, Jones, R, Panza, J, Cherniavsky, A, Marchenko, A, Romanov, A, Wos, S, Deja, M, Golba, K, Malinowski, M, Gradinac, S, Kosevic, D, Vukovic, M, Djokovic, L, Krzeminska Pakula, M, Jaszewski, R, Chrzanowski, L, Rajda, M, Ali, I, Howlett, J, Macfarlane, M, Jain, A, Shah, H, Rakshak, D, Saxena, A, Zembala, M, Przybylski, R, Kukulski, T, Wasilewski, J, Wiechowski, S, Brykczynski, M, Kurowski, M, Mokrzycki, K, Sadowski, J, Kapelak, B, Sobczyk, D, Plicner, C, Piegas, L, Paulista, P, Veiga Kantorowitz, C, Sadowski, Z, Juraszynski, Z, Szwed, H, Dabrowski, R, Rogowski, J, Pawlaczyk, R, Rynkiewicz, A, Betlejewski, P, Siepe, M, Geibel Zehender, A, Cuerten, C, Higgins, R, Crestanello, J, Jones, D, Sun, B, Smith, P, Milano, C, Adams, P, Hill, J, Beaver, T, Leach, D, Airan, B, Das, S, Yii, M, Prior, D, Mack, J, Rao, V, Iwanochko, R, Renton, J, Panchavinnin, P, Phuangkaew, N, Bochenek, A, Krejca, M, Trusz Gluza, M, Wita, K, Ferrazzi, P, Gavazzi, A, Senni, M, Natarajan, S, Padmanabhan, C, Racine, N, Bouchard, D, Ducharme, A, Brown, H, Lupkovics, G, Kumar, S, Agarwal, S, Sinha, N, Rai, H, Andersson, B, Janssen, A, Lamy, A, Demers, C, Rizzo, T, Garbade, J, Thiele, H, Richter, M, Petrie, M, Murday, A, Shaw, M, Raju, K, Mannam, G, Reddy, G, Rao, K, Stolf, N, Vieira, A, Chua, Y, Lim, C, Kwok, B, Gan, Y, Cleland, J, Cale, A, Thackray, S, Lammiman, M, Swayze, R, Grimm, M, Lang, I, Adlbrecht, C, Daly, R, Rodeheffer, R, Nelson, S, Larbalestier, R, Wang, X, Haddad, H, Hendry, P, Donaldson, J, Menicanti, L, Di Donato, M, Castelvecchio, S, Sirvydis, V, Voluckiene, E, Di Benedetto, G, Attisano, T, Favaloro, R, Diez, M, Riccitelli, M, Picone, V, Koslowski, P, Gaito, M, Al mohammad, A, Braidley, P, Steele, H, Nawarawong, W, Woragidpoonpol, S, Kuanprasert, S, Mekara, W, Kon, N, Hammon, J, Wells, G, Tilley, W, Drazner, M, Dimaio, M, Peschka, S, De Pasquale, C, Knight, J, Aylward, P, Thomas, C, Gullestad, L, Sorensen, G, Kaul, U, Gupta, R, Schmedtje, Jr, J, Arnold, S, Wilson, V, Grayburn, P, Hamman, B, Hebeler, R, Aston, S, Birjiniuk, V, Harrington, M, Dupree, C, Sheridan, B, Schuler, C, Helou, J, Denis, I, Bigalli, D, Gutierrez, F, Russo, N, Batlle, C, White, H, Alison, P, Stewart, R, Borthwick, L, Philippides, G, Shemin, R, Fitzgerald, C, Dagenais, F, Dussault, G, Kamath, P, Busmann, C, Ferrari, G, Botto, M, Horkay, F, Hartyanszky, I, Bartha, E, Simor, T, Papp, L, Toth, L, Varga Szemes, A, Szekely, L, Keltai, M, Edes, I, Szathmarine, V, Yakub, M, Sarip, S, Maitland, A, Isaac, D, Holland, M, Bogats, G, Csepregi, L, Maia, L, Soares, M, Mouco, O, Souza, A, da Rocha, A, Brito, J, Pitella, F, Camara, A, Horowitz, J, Rose, J, Mcrae, Rj, Geiss, D, Clemson, B, Pierson, M, Kron, I, Kern, J, Bergin, J, Phillips, J, Rich, J, Herre, J, Pine, L, Chin, D, Spyt, T, Logtens, E, Amuchastegui, L, Bracco, D, Ruengsakulrach, P, Pitiguagool, V, Sukhum, P, Srinualta, D, Hayward, C, Herrera, C, Zimmermann, R, Patterson, G, Stephens, W, Dignan, R, French, J, Sequalino, N, Vaishnav, S, Panda, R, Chavan, A, Benetis, R, Jankauskiene, L, Kalil, R, Nesralla, I, Santos, M, Moraes, D, M, Friedrich, I, Buerke, M, Paraforos, A, Konda, S, Leone, C, Murphy, E, Ravichandran, P, Avalos, K, Hetzer, R, Knosalla, C, Hoffmann, K, Landolfo, K, Landolfo, C, Park, M, Chiariello, L, Nardi, P, Stapleton, D, Hoey, K, Hasaniya, N, Wang, N, Bijou, R, Naka, Y, Ascheim, D, Mikati, I, Arnold, M, Mckenzie, N, Smith, J, Gheorghiade, M, Fullerton, D, Roberts, L, Carson, P, Miller, A, Pina, I, Selzman, C, Wertheimer, J, Goldstein, S, Cohn, F, Hlatky, M, Kennedy, K, Rankin, S, Robbins, R, Zaret, B, Rouleau, J, Barfield, T, O'Connor, C, Oh, J, Rankin, G, Sopko, G, Pohost, G, Apte, P, Doyle, M, Forder, J, Ocon, M, Pai, R, Reddy, V, Santos, N, Tripathi, R, Varadarajan, P, Miller, Fj, Lin, G, Borgeson, D, Ommen, S, Casaclang Verzosa, G, Miller, D, Springer, R, Blahnik, F, Manahan, B, Welper, J, Wiste, H, Mark, D, Anstrom, K, Baloch, K, Burnette, A, Cowper, P, Davidson Ray, N, Drew, L, Harding, T, Hunt, V, Knight, D, Patterson, A, Redick, T, Sanderford, B, Bristow, M, Chan, T, Maisel, A, Mann, D, Mcnamara, D, Leonard, S, Helmer, D, Woods, M, Mcnulty, M, Rumsey, M, Bieganski, S, Roberts, B, Handschumacher, M, Mccormick, A, Albright, J, Dandridge, R, Rittenhouse, L, Wagstaff, D, Williams, M, Bailey, D, Glover, D, Parrish, L, Wakeley, N, Jackson, V, Nicholson, B, Mcdaniel, A, Al Khalidi, H, Greene, D, and Moore, V

Subjects
Settore MED/23 - Chirurgia Cardiaca
Published
2011

15. 234 Allosensitization Associated with Continuous Axial Flow Left Ventricular Assist Device Implantation Does Not Affect Outcomes after Heart Transplantation

Author

Shankar, N., primary, Geske, J., additional, Gandhi, M., additional, Timmons, M., additional, Boilson, B., additional, Schirger, J., additional, Clavell, A., additional, Frantz, R., additional, Rodeheffer, R., additional, Daly, R., additional, Joyce, L., additional, Edwards, B., additional, Kremers, W., additional, Kushwaha, S.K., additional, Park, S., additional, and Pereira, N.L., additional

Published
2012
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16. 522 Donor Specific Anti-HLA Antibodies May Not Play a Major Role in Mediating Allograft Dysfunction after Heart Transplantation

Author

Shankar, N., primary, Gandhi, M., additional, Geske, J., additional, DeGoey, S., additional, Timmons, M., additional, Boilson, B., additional, Schirger, J., additional, Clavell, A., additional, Rodeheffer, R., additional, Wagner, J., additional, Frantz, R., additional, Kushwaha, S., additional, Daly, R., additional, Park, S., additional, Edwards, B., additional, and Pereira, N., additional

Published
2011
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20. Cardiac Safety of Lapatinib Given Concurrently with Paclitaxel and Trastuzumab as Part of Adjuvant Therapy for Patients with HER2+ Breast Cancer: Pilot Data from the Mayo Clinic Cancer Research Consortium Trial RC0639.

Author

Palmieri, F., primary, Dueck, A., additional, Johnson, D., additional, Colon-Otero, G., additional, Diekmann, B., additional, Dakhil, S., additional, Franco, S., additional, Reinholz, M., additional, McCullough, A., additional, Rodeheffer, R., additional, and Perez, E., additional

Published
2009
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23. Congestive heart failure in the community: Trends in incidence and survival in a 10-year period

Author

Senni, M, Tribouilloy, C, Rodeheffer, R, Jacobsen, S, Evans, J, Bailey, K, Redfield, M, Senni M, Tribouilloy CM, Rodeheffer RJ, Jacobsen SJ, Evans JM, Bailey KR, Redfield MM, Senni, M, Tribouilloy, C, Rodeheffer, R, Jacobsen, S, Evans, J, Bailey, K, Redfield, M, Senni M, Tribouilloy CM, Rodeheffer RJ, Jacobsen SJ, Evans JM, Bailey KR, and Redfield MM

Abstract

Objective: To compare the incidence of congestive heart failure and the survival in patients with congestive heart failure in Rochester, Minn, in 1981 with that observed in 1991.Methods: Population-based, descriptive epidemiological study with ecological and individual level comparisons over time. Olmsted County, Minnesota, where the Rochester Epidemiology Project provides passive surveillance of the population for health outcomes. All 248 patients fulfilled the Framingham criteria, 107 patients presenting with the new onset of congestive heart failure in 1981 and 141 patients in 1991. The community inpatient and outpatient medical records of all incident cases were reviewed to evaluate the presenting characteristics of patients at diagnosis.Results: The incidence of congestive heart failure after adjustment for age and sex to the US population was not significantly different in the 1991 cohort compared with that in 1981 (3.0 per 1000 person-years; 95% confidence interval, 2.5-3.5 vs 2.8 per 1000 person-years; 95% confidence interval, 2.2-3.3; P = .55). The survival of patients with new diagnosis of congestive heart failure was similar in the 2 cohorts (P = .53). Survival adjusted for age, sex, and New York Heart Association functional class was not significantly different in patients with congestive heart failure in 1981 and 1991 (relative risk, 0.907; P = .55).Conclusions: These data suggest that recent advances in management of cardiovascular disease, as used in the community, had not yet impacted incidence or survival of patients with congestive heart failure in the community during the 10-year study period. This highlights the need to continue efforts to ensure that advances in diagnosis and therapy are incorporated into the care of patients with congestive heart failure in the community.

Published
1999

24. Use of echocardiography in the management of congestive heart failure in the community

Author

Senni, M, Rodeheffer, R, Tribouilloy, C, Evans, J, Jacobsen, S, Bailey, K, Redfield, M, Senni M, Rodeheffer RJ, Tribouilloy CM, Evans JM, Jacobsen SJ, Bailey KR, Redfield MM, Senni, M, Rodeheffer, R, Tribouilloy, C, Evans, J, Jacobsen, S, Bailey, K, Redfield, M, Senni M, Rodeheffer RJ, Tribouilloy CM, Evans JM, Jacobsen SJ, Bailey KR, and Redfield MM

Abstract

Objectives. We evaluated the use and the impact of echocardiography in patients receiving an initial diagnosis of congestive heart failure in Olmsted County, Minnesota, in 1991. Background. The American College of Cardiology/American Heart Association clinical practice guidelines recommend echocardiography in all patients with suspected congestive heart failure. No data are available on use and impact of echocardiography in management of congestive heart failure in a community. Methods. The medical records linkage system of the Rochester Epidemiology Project was used to identify all 216 patients who satisfied the Framingham criteria for congestive heart failure. Of these, 137 (63%) underwent echocardiography within 3 weeks before or after the episode of congestive heart failure (Echo group), and the other 79 patients constitute the No-Echo group. Results. The No-Echo group patients were older (p = 0.022), were more likely to be female (p = 0.072), had milder symptoms (p = 0.001) and were less often hospitalized at diagnosis (p = 0.001). Fewer patients in the No-Echo group were treated with angiotensin- converting enzyme inhibitors (p = 0.001). Advanced age (≥80 years), lower New York Heart Association functional class, absence of a fourth heart sound on examination, absence of cardiomegaly or signs of congestive heart failure on chest radiography and absence of known valve disease were independently related to the decision not to obtain an echocardiogram. Survival after adjustment for age, functional class and gender was lower in the No-Echo group than the Echo group (risk ratio = 0.607, p = 0.017). Conclusions. The underuse of echocardiography appears to be associated with poorer survival and underuse of angiotensin-converting enzyme inhibitor therapy.

Published
1999

28. Incidence and survival in the community: trends over a decade

Author

Senni, M, Triboulloy, C, Rodeheffer, R, Evans, J, Jacobsen, S, Bailey, K, Redfield, M, Senni M, Triboulloy CM, Rodeheffer RR, Evans JM, Jacobsen SJ, Bailey KR, Redfield MM, Senni, M, Triboulloy, C, Rodeheffer, R, Evans, J, Jacobsen, S, Bailey, K, Redfield, M, Senni M, Triboulloy CM, Rodeheffer RR, Evans JM, Jacobsen SJ, Bailey KR, and Redfield MM

Published
1998

29. Congestive heart failure in the community: A study of all incident cases in Olmsted county, Minnesota, in 1991

Author

Senni, M, Tribouilloy, C, Rodeheffer, R, Jacobsen, S, Evans, J, Bailey, K, Redfield, M, Senni M, Tribouilloy CM, Rodeheffer RJ, Jacobsen SJ, Evans JM, Bailey KR, Redfield MM, Senni, M, Tribouilloy, C, Rodeheffer, R, Jacobsen, S, Evans, J, Bailey, K, Redfield, M, Senni M, Tribouilloy CM, Rodeheffer RJ, Jacobsen SJ, Evans JM, Bailey KR, and Redfield MM

Abstract

Background - Data are limited regarding the classification and prognosis of patients with congestive heart failure (CHF) in the community. Methods and Results - Using the resources of the Rochester Epidemiology Project, we evaluated all patients receiving a first diagnosis of CHF in Olmsted County, Minnesota, in 1991 (n=216). Among these patients, 88% were ≥65 years and 49% were ≥80 years of age. The prognosis of patients with a new diagnosis of CHF was poor; survival was 86±2% at 3 months, 76±3% at 1 year, and 35±3% at 5 years. Of the 216 patients, 137 (63%) had an assessment of ejection fraction. In these patients, systolic function was preserved (ejection fraction ≥50%) in 59 (43%) and reduced (ejection fraction <50%)in 78 (57%). Survival adjusted for age, sex, NYHA class, and coronary artery disease was not significantly different between patients with preserved and those with reduced systolic function (relative risk, 0.80; P=0.369). ACE inhibitors were used in only 44% of the total population with CHF. Conclusions - The present study reports the clinical characteristics and natural history of CHF as it presents in the community in the vasodilator era. CHF is a disease of the 'very elderly,' frequently occurs in the setting of normal ejection fraction, and has a poor prognosis, regardless of the level of systolic function. Diagnostic and therapeutic methods are underused in the community.

Published
1998

34. Frequency of familial dilated cardiomyopathy

Author

Goerss, J. B., primary, Michels, V. V., additional, Burnett, J., additional, Driscoll, D. J., additional, Miller, F., additional, Rodeheffer, R., additional, Tajik, A. J., additional, and Schaid, D., additional

Published
1995
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35. Endothelin in human congestive heart failure.

Author

Wei, C M, primary, Lerman, A, additional, Rodeheffer, R J, additional, McGregor, C G, additional, Brandt, R R, additional, Wright, S, additional, Heublein, D M, additional, Kao, P C, additional, Edwards, W D, additional, and Burnett, J C, additional

Published
1994
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37. Natriuretic peptide system in human heart failure.

Author

Wei, C M, primary, Heublein, D M, additional, Perrella, M A, additional, Lerman, A, additional, Rodeheffer, R J, additional, McGregor, C G, additional, Edwards, W D, additional, Schaff, H V, additional, and Burnett, J C, additional

Published
1993
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39. The clinical course of idiopathic dilated cardiomyopathy. A population-based study.

Author

Sugrue, D D, Rodeheffer, R J, Codd, M B, Ballard, D J, Fuster, V, and Gersh, B J

Subjects
*COMPARATIVE studies, *LONGITUDINAL method, *RESEARCH methodology, *MEDICAL cooperation, *MEDICAL referrals, *PROGNOSIS, *RESEARCH, *RESEARCH funding, *SURVIVAL, *EVALUATION research, *DILATED cardiomyopathy
Abstract

Objective: To describe the prognosis of individuals with idiopathic dilated cardiomyopathy in a population-based sample and to compare this with the prognosis of patients in a previous referral center case series of idiopathic dilated cardiomyopathy.Design: Cohort study.Setting: Population-based in Olmsted County, Minnesota.Patients: Forty residents of Olmsted County, Minnesota with idiopathic dilated cardiomyopathy initially diagnosed between 1975 and 1984 who were followed through 1 July 1989 and 104 patients from a Mayo Clinic referral case series from 1960 to 1973.Measurements: Survival for the population-based cohort at 1 year and 5 years.Results: Survival at 1 year differed dramatically between the population-based cohort and the referral case series at 1 year (95% compared with 69%, respectively) and at 5 years (80% compared with 36%, respectively) (P less than 0.001). Long-term survival for the population-based cohort was nonetheless impaired when compared with an age- and sex-matched cohort, that is, the 1980 Minnesota white population (8-year survival: observed, 58% compared with expected, 83%; P less than 0.001). Among community patients, older age (adjusted Cox model hazard ratio for 10-year increase in age, 1.59; 95% CI, 1.08 to 2.35) and lower left ventricular ejection fraction (adjusted hazard ratio for 10% decrease, 1.90; CI, 1.04 to 3.50) were independently associated with impaired survival.Conclusions: These population-based data challenge the clinical perception of the clinical course of idiopathic dilated cardiomyopathy based on referral practice prognostic studies and suggest that the clinical course of this condition may be more favorable than previously recognized. [ABSTRACT FROM AUTHOR]

Published
1992
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44. Pro-B-type natriuretic peptide(1-108) circulates in the general community: plasma determinants and detection of left ventricular dysfunction.

Author

Macheret F, Boerrigter G, McKie P, Costello-Boerrigter L, Lahr B, Heublein D, Sandberg S, Ikeda Y, Cataliotti A, Bailey K, Rodeheffer R, Burnett JC Jr, Macheret, Fima, Boerrigter, Guido, McKie, Paul, Costello-Boerrigter, Lisa, Lahr, Brian, Heublein, Denise, Sandberg, Sharon, and Ikeda, Yasuhiro

Abstract

Objectives: The purpose of this study was to investigate circulating pro-B-type natriuretic peptide (proBNP(1-108)) in the general community and evaluate its ability to detect left ventricular (LV) dysfunction.Background: The current concept for cardiac endocrine function is that, in response to cardiac stress, the heart secretes B-type natriuretic peptide (BNP(1-32)) and amino-terminal pro-B-type natriuretic peptide (NT-proBNP(1-76)) after intracardiac cleavage of their molecular precursor, proBNP(1-108). We hypothesized that proBNP(1-108) circulates in normal human subjects and that it is a useful biomarker for LV dysfunction.Methods: Our population-based study included a cohort of 1,939 adults (age ≥45 years) from Olmsted County, Minnesota, with 672 participants defined as healthy. Subjects underwent in-depth clinical characterization, detailed echocardiography, and measurement of proBNP(1-108). Independent factors associated with proBNP(1-108) and test characteristics for the detection of LV dysfunction were determined.Results: ProBNP(1-108) in normal humans was strongly influenced by sex, age, heart rate, and body mass index. The median concentration was 20 ng/l with a mean proBNP(1-108) to NT-proBNP(1-76) ratio of 0.366, which decreased with heart failure stage. ProBNP(1-108) was a sensitive (78.8%) and specific (86.1%) biomarker for detecting LV systolic dysfunction, which was comparable to BNP(1-32), but less than NT-proBNP(1-76), in several subsets of the population.Conclusions: ProBNP(1-108) circulates in the majority of healthy humans in the general population and is a sensitive and specific biomarker for the detection of systolic dysfunction. The proBNP(1-108) to NT-proBNP(1-76) ratio may provide insights into altered proBNP(1-108) processing during heart failure progression. Thus, this highly specific assay for proBNP(1-108) provides important new insights into the biology of the BNP system. [ABSTRACT FROM AUTHOR]

Published
2011
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45. Congestive heart failure despite normal left ventricular systolic function in a population-based sample: the Strong Heart Study.

Author

Devereux, Richard B., Roman, Mary J., Devereux, R B, Roman, M J, Liu, J E, Welty, T K, Lee, E T, Rodeheffer, R, Fabsitz, R R, and Howard, B V

Subjects
*CONGESTIVE heart failure, *CARDIAC contraction
Abstract

In selected clinical series, > or = 50% of adults with congestive heart failure (CHF) do not have left ventricular (LV) systolic dysfunction. Little is known of the prevalence of this phenomenon in population samples. Therefore, clinical examination and echocardiography were used in the second examination of the Strong Heart Study (3,184 men and women, 47 to 81 years old) to identify 95 participants with CHF, 50 of whom had normal LV ejection fraction (EF) (> 54%), 19 of whom had mildly reduced EF (40% to 54%), and 26 of whom had EF < or = 40%. Compared with those with no CHF, participants with CHF and no, mild, or severe decrease in EF had higher creatinine levels (2.34 to 2.85 vs 1.01 mg/dl, p < 0.001) and higher prevalences of diabetes (60% to 70% vs 50%) and hypertension (75% to 96% vs 46%, p < 0.05). Compared with those with no CHF, participants with CHF and normal EF had prolonged deceleration time (233 vs 204 ms, p < 0.05) and a reduced E/A, whereas those with CHF and EF < or = 40% had short deceleration time (158 ms, p < 0.05) and high E/A (1.70, p < 0.001); patients with CHF and normal EF had higher LV mass (98 vs 84 g/m2, p < 0.001) and relative wall thickness (0.37 vs 0.35, p < 0.05) than those without CHF. Patients with CHF with normal EF were, compared with those without CHF or with CHF and EF < or = 40%, disproportionately women (mean 84% vs 63% and 42%, p < 0.001), older (mean 64 vs 60 years and 63 years, respectively, p < 0.01), had higher body mass index (mean 33.1 vs 31.0 and 27.7 kg/m2, p < 0.05), and higher systolic blood pressure (mean 137 vs 130 and 128 mm Hg, both p < 0.05). Thus, in a population-based sample, patients with CHF and normal LV EF were older and overweight, more often women, had renal dysfunction, impaired early diastolic LV relaxation, and concentric LV geometry, whereas patients with CHF and severe LV dysfunction were more often men, had lower body mass index, a restrictive pattern of LV filling, and eccentric LV hypertrophy. [ABSTRACT FROM AUTHOR]

Published
2000
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47. Use of echocardiography in the management of congestive heart failure in the community

Author

Steven J. Jacobsen, Margaret M. Redfield, Christophe Tribouilloy, Jonathan M. Evans, Michele Senni, Richard J. Rodeheffer, Kent R. Bailey, Senni, M, Rodeheffer, R, Tribouilloy, C, Evans, J, Jacobsen, S, Bailey, K, and Redfield, M

Subjects
Adult, Male, medicine.medical_specialty, Fourth heart sound, Heart disease, Minnesota, Angiotensin-Converting Enzyme Inhibitors, Rochester Epidemiology Project, Retrospective Studie, Internal medicine, Ambulatory Care, Humans, Medicine, Survival rate, Aged, Retrospective Studies, Heart Failure, Congestive, Heart Failure, Framingham Risk Score, business.industry, Angiotensin-Converting Enzyme Inhibitor, Retrospective cohort study, Middle Aged, medicine.disease, Survival Rate, Treatment Outcome, Echocardiography, Heart failure, Relative risk, Cardiology, Female, medicine.symptom, Cardiology and Cardiovascular Medicine, business, Human
Abstract

Objectives. We evaluated the use and the impact of echocardiography in patients receiving an initial diagnosis of congestive heart failure in Olmsted County, Minnesota, in 1991. Background. The American College of Cardiology/American Heart Association clinical practice guidelines recommend echocardiography in all patients with suspected congestive heart failure. No data are available on use and impact of echocardiography in management of congestive heart failure in a community. Methods. The medical records linkage system of the Rochester Epidemiology Project was used to identify all 216 patients who satisfied the Framingham criteria for congestive heart failure. Of these, 137 (63%) underwent echocardiography within 3 weeks before or after the episode of congestive heart failure (Echo group), and the other 79 patients constitute the No-Echo group. Results. The No-Echo group patients were older (p = 0.022), were more likely to be female (p = 0.072), had milder symptoms (p = 0.001) and were less often hospitalized at diagnosis (p = 0.001). Fewer patients in the No-Echo group were treated with angiotensin-converting enzyme inhibitors (p = 0.001). Advanced age (≥80 years), lower New York Heart Association functional class, absence of a fourth heart sound on examination, absence of cardiomegaly or signs of congestive heart failure on chest radiography and absence of known valve disease were independently related to the decision not to obtain an echocardiogram. Survival after adjustment for age, functional class and gender was lower in the No-Echo group than the Echo group (risk ratio = 0.607, p = 0.017). Conclusions. The underuse of echocardiography appears to be associated with poorer survival and underuse of angiotensin-converting enzyme inhibitor therapy.

Published
1999

48. Congestive heart failure in the community: trends in incidence and survival in a 10-year period

Author

Steven J. Jacobsen, Kent R. Bailey, Richard J. Rodeheffer, Christophe Tribouilloy, Jonathan M. Evans, Margaret M. Redfield, Michele Senni, Senni, M, Tribouilloy, C, Rodeheffer, R, Jacobsen, S, Evans, J, Bailey, K, and Redfield, M

Subjects
Male, medicine.medical_specialty, Heart disease, Minnesota, Population, Community Health Planning, Medical Records, Rochester Epidemiology Project, Age Distribution, Retrospective Studie, Internal Medicine, Medicine, Humans, Sex Distribution, Intensive care medicine, education, Multivariate Analysi, Aged, Retrospective Studies, Heart Failure, Congestive, Heart Failure, education.field_of_study, Framingham Risk Score, business.industry, Incidence (epidemiology), Incidence, Retrospective cohort study, Confounding Factors, Epidemiologic, Health Survey, Middle Aged, medicine.disease, Confounding Factors (Epidemiology), Health Surveys, Survival Rate, Heart failure, Cohort, Emergency medicine, Multivariate Analysis, Medical Record, Female, business, Sentinel Surveillance, Needs Assessment, Human
Abstract

Objective To compare the incidence of congestive heart failure and the survival in patients with congestive heart failure in Rochester, Minn, in 1981 with that observed in 1991. Methods Population-based, descriptive epidemiological study with ecological and individual level comparisons over time. Olmsted County, Minnesota, where the Rochester Epidemiology Project provides passive surveillance of the population for health outcomes. All 248 patients fulfilled the Framingham criteria, 107 patients presenting with the new onset of congestive heart failure in 1981 and 141 patients in 1991. The community inpatient and outpatient medical records of all incident cases were reviewed to evaluate the presenting characteristics of patients at diagnosis. Results The incidence of congestive heart failure after adjustment for age and sex to the US population was not significantly different in the 1991 cohort compared with that in 1981 (3.0 per 1000 person-years; 95% confidence interval, 2.5-3.5 vs 2.8 per 1000 person-years; 95% confidence interval, 2.2-3.3; P =.55). The survival of patients with new diagnosis of congestive heart failure was similar in the 2 cohorts ( P = .53). Survival adjusted for age, sex, and New York Heart Association functional class was not significantly different in patients with congestive heart failure in 1981 and 1991 (relative risk, 0.907; P = .55). Conclusions These data suggest that recent advances in management of cardiovascular disease, as used in the community, had not yet impacted incidence or survival of patients with congestive heart failure in the community during the 10-year study period. This highlights the need to continue efforts to ensure that advances in diagnosis and therapy are incorporated into the care of patients with congestive heart failure in the community.

Published
1999

49. Congestive heart failure in the community: a study of all incident cases in Olmsted County, Minnesota, in 1991

Author

Jonathan M. Evans, Kent R. Bailey, Margaret M. Redfield, Michele Senni, Steven J. Jacobsen, Richard J. Rodeheffer, Christophe Tribouilloy, Senni, M, Tribouilloy, C, Rodeheffer, R, Jacobsen, S, Evans, J, Bailey, K, and Redfield, M

Subjects
Gerontology, Male, medicine.medical_specialty, Heart disease, Epidemiology, Prognosi, Minnesota, Coronary artery disease, Cohort Studies, Rochester Epidemiology Project, Age Distribution, Physiology (medical), Internal medicine, medicine, Humans, Community Health Services, Survival rate, Aged, Retrospective Studies, Aged, 80 and over, Heart Failure, Ejection fraction, business.industry, Incidence, Stroke Volume, medicine.disease, Prognosis, Hospitalization, Survival Rate, Relative risk, Heart failure, Cardiology, Female, Cardiology and Cardiovascular Medicine, business, Cohort study
Abstract

Background —Data are limited regarding the classification and prognosis of patients with congestive heart failure (CHF) in the community. Methods and Results —Using the resources of the Rochester Epidemiology Project, we evaluated all patients receiving a first diagnosis of CHF in Olmsted County, Minnesota, in 1991 (n=216). Among these patients, 88% were ≥65 years and 49% were ≥80 years of age. The prognosis of patients with a new diagnosis of CHF was poor; survival was 86±2% at 3 months, 76±3% at 1 year, and 35±3% at 5 years. Of the 216 patients, 137 (63%) had an assessment of ejection fraction. In these patients, systolic function was preserved (ejection fraction ≥50%) in 59 (43%) and reduced (ejection fraction P =0.369). ACE inhibitors were used in only 44% of the total population with CHF. Conclusions —The present study reports the clinical characteristics and natural history of CHF as it presents in the community in the vasodilator era. CHF is a disease of the “very elderly,” frequently occurs in the setting of normal ejection fraction, and has a poor prognosis, regardless of the level of systolic function. Diagnostic and therapeutic methods are underused in the community.

Published
1998

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