Acute effects of empagliflozin on left atrial and ventricular filling parameters using echocardiography—a subanalysis of the EMPAG-HF trial

European Heart Journal - Cardiovascular Pharmacotherapy, Journal Year: 2025, Volume and Issue: unknown

Published: March 3, 2025

Sodium-glucose co-transporter 2 (SGLT2) inhibitors improve prognosis in chronic heart failure as part of currently recommended therapeutic strategies. Transthoracic echocardiography (TTE) is frequently used to assess function and dimensions acute lead therapy volume status. Immediate changes, especially left haemodynamic parameters, measured by patients with treated SGLT2 inhibitors, remain unknown. The aim this pre-defined secondary analysis was whether treatment empagliflozin 25 mg/day improves echocardiographic parameters load, ventricular or right function. In the single-centre, prospective, double-blind, placebo-controlled EMPAG-HF trial, decompensated (ADHF) were screened randomized within 12 h following hospital admission receive either placebo addition standard medical over 5 days. Sixty enrolled irrespective ejection fraction diabetes. All received 2D TTE on (tB = at baseline) after completing study (tC time medication) (according design). recorded loops analysed using dedicated software (Image-Arena™ Version 4.6; TomTec Imaging Systems). After days treatment, cohort showed a relevant decrease atrial [LAV: ∆tB-tC 30.9 ± 27.4; 95% confidence interval (CI) 20.1-41.7) compared 10.5 26; CI 0.4-20.5; P <0.001] end-systolic index (LAESVI: 15.7 15.1; 9.8-21.6 vs. 9.7 10.2; 5.7-13.6; 0.016) placebo. LAV recompensation ADHF.

Language: Английский

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Correction: SGLT2-inhibitors in diabetic patients with severe aortic stenosis and cardiac damage undergoing transcatheter aortic valve implantation (TAVI)

Cardiovascular Diabetology, Journal Year: 2025, Volume and Issue: 24(1)

Published: Jan. 13, 2025

Correction: SGLT2-inhibitors in diabetic patients with severe aortic stenosis and cardiac damage undergoing transcatheter valve implantation (TAVI)

Language: Английский

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Aortic valve calcification across stages of dysglycemia in middle-aged individuals from the general population

Cardiovascular Diabetology, Journal Year: 2025, Volume and Issue: 24(1)

Published: March 5, 2025

Aortic valve calcification (AVC) is an underlying pathophysiological mechanism in aortic stenosis, which shares many risk factors with diabetes. However, the association between dysglycemia and early stages of AVC remains unclear. The aim was to examine associations signs among middle-aged individuals from general population. This a cross-sectional study Swedish CArdioPulmonary bioImage Study (SCAPIS) randomly enrolling 30,154 men women six sites Sweden 2013 2018. Glycemic status based on World Health Organization criteria (fasting blood glucose and/or HbA1c) questionnaire-based answers previous diseases categorized as normoglycemia, prediabetes, newly detected diabetes known assessed cardiac computed tomography (CT) defined evident or not. Of 29,331 data glycemic available, mean age 57.5 years normoglycemia present 76%, prediabetes 16%, 3% 5%. prevalence increased progressively across categories, particularly males (8%, 11%, 14% 17%; P < 0.01) compared females (5%, 6%, 8% 9%; 0.01). There already dysglycemia; (OR 1.16, 95% CI 1.02-1.31), (1.34 [1.05-1.71]) (1.61 [1.34-1.93]) after adjusting for age, sex, smoking, site, low density lipoprotein-cholesterol hypertension. In this large, contemporary, selected population individuals, were all associated CT-detected AVC. Further studies are warranted investigate if managing dysglycemia, even its stages, may help slow down progression.

Language: Английский

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Impact of Echocardiographic Cardiac Damage Staging on Mortality and Heart Failure Hospitalizations in Aortic Stenosis Patients Undergoing Transcatheter Aortic Valve Replacement

Journal of Clinical Medicine, Journal Year: 2025, Volume and Issue: 14(2), P. 408 - 408

Published: Jan. 10, 2025

Background: A significant proportion of elderly patients referred to transcatheter aortic valve replacement (TAVR) do not experience an improvement their symptoms. New tools are needed better select candidates and avoid futile procedures. The objective this study was evaluate the impact a new echocardiographic classification which assesses consequences chronic elevation afterload on mortality hospitalizations for heart failure (HF) in with severe AS undergoing TAVR. Methods: This included 130 high-risk, who underwent TAVR between January 2018 December 2019. were classified into three groups according anatomical functional features based transthoracic echocardiography (TTE). combined end point death from all causes HF admissions. Results: Echocardiographic staging significantly associated increased rates hospitalizations. After multivariate adjustment, cardiac damage exhibited increase all-cause (HR 4.79; 95% CI 2.00-11.05; p = 0.000), whereas moderate group did 1.84; 0.88-3.84; 0.104). Conclusions: could be useful tool predicting after elderly, high-risk patients. Evaluating score may promising strategy improve outcomes following

Language: Английский

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Rapid Improvement in Cardiac Damage Predicts Better Prognosis After Transcatheter Aortic Valve Replacement

Journal of Cardiovascular Development and Disease, Journal Year: 2025, Volume and Issue: 12(1), P. 29 - 29

Published: Jan. 16, 2025

Background: A staging system based on cardiac damage for severe aortic stenosis (AS) has been validated prognosis prediction following transcatheter valve replacement (TAVR). Our study aims to investigate whether TAVR can lead changes in shortly after the procedure and how these impact prognosis. Method: Patients this retrospective cohort were classified into five stages (0–4) before echocardiographic findings of damage. The closest echocardiogram was used restaging primary composite outcome all-cause mortality or hospitalization due heart failure (HF). Results: total 64 patients enrolled (53.1% male, mean age 81.7 ± 7.7 years). Within a interval 4 days (interquartile range = 3 7 days) TAVR, improved 25.0% patients, while it worsened 20.3%. During median follow-up 2.5 1.9 years, 34.4% met endpoint, which included 16 deaths 6 HF hospitalizations. Cox regression analysis revealed that improvement correlated with lower risk death (HR: 0.095; 95% CI: 0.014–0.627; p 0.015). Conclusions: over short period AS, rapid is associated better

Language: Английский

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Longitudinal Outcomes of Patients with Aortic Stenosis Stratified by Sex: An Asian Perspective

Journal of Cardiovascular Development and Disease, Journal Year: 2025, Volume and Issue: 12(1), P. 32 - 32

Published: Jan. 19, 2025

Background: Severe aortic stenosis (AS) stratified by sex has been increasingly studied in the European population. Sex-specific outcomes Asian patients with AS remain poorly defined. Hence, we aimed to study clinical characteristics and impact of moderate-to-severe AS, undergoing both invasive conservative interventions an cohort over 10 years. Methods: Consecutive data echocardiographic diagnoses were according gender a tertiary academic center between 2011 2021. Demographics, comorbidities, compared. Results: Seven hundred three (703) included (56%, n = 397 female). Calcific was dominant etiology genders. Females had higher incidences anemia (p < 0.001) chronic kidney disease 0.026); although, females lower cardiovascular complications coronary artery (CAD) 0.002) prior acute myocardial infarction (AMI) 0.015). Echocardiographically, smaller left ventricular outflow tract diameter (LVOTd) 0.001), LV mass ventricle end diastolic volume (LVEDV) 0.001). Conversely, atrial (LA) area index (LAVI) larger females. average E/e’ 0.010) ratios compared males. The mean follow-up duration genders 4.1 ± 3.3 Upon univariate analysis, greater proportion female encountered (CV) hospitalization during (female: 27.5%, 109 vs. male: 18.3%, 56; p 0.005) male patients, but there no significant differences for heart failure 0.612), stroke 0.664), all-cause mortality 0.827). Fewer underwent valve (AV) intervention males (21.2% 27.8%, 0.042), albeit longer AV (3.6 years 2.4 2.6 2.3, 0.016). In severe cohort, remained independent predictor subsequent (aHR 2.89, 95% CI 1.01–8.29, 0.048) CV 20.0, 1.19–335, 0.037) after adjustments age, ethnicity, body (BMI), ejection fraction (LVEF), intervention. Conclusions: There difference failure, stroke, AS. However, more hospitalizations, fewer our cohort.

Language: Английский

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Multiparametric Outcome Assessment After Transcatheter Aortic Valve Implantation—A Systematic Review

Journal of Clinical Medicine, Journal Year: 2025, Volume and Issue: 14(5), P. 1426 - 1426

Published: Feb. 20, 2025

Backround/Objectives: Aortic stenosis (AS) is the most commonly acquired valvular disorder. Patient risk stratification and development of an accurate reliable tool are crucial in identifying suitable candidates for TAVI. The present review summarized current state knowledge on influence selected factors outcomes course patients with AS undergoing transcatheter aortic valve implantation (TAVI). Methods: inclusion criteria systematic were as follows: (1) studies indexed medical databases PubMed, MEDLINE, EMBASE, CINAHL, Web Science, Scopus; (2) full-text articles available English; (3) papers published between 2013 2023; (4) addressing topic assessing impact This used PRISMA 2020 reporting guidelines reviews meta-analyses. Results: One hundred thirty-two eligible this review. showed association psychosocial socioeconomic factors, parameters, comorbidities, clinical treatment-related biomarkers, treatment methods Conclusions: Given conflicting results obtained regarding right ventricular dysfunction, paravalvular leaks, method mortality implantation, further research these areas needed. In view researchers’ differing views some affecting patient after TAVI, analysis needed to develop a new predictive patients. study registered at PROSPERO (CRD42024612752).

Language: Английский

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Retrospective chart review of Euglycemic Diabetic Ketoacidosis rates and outcomes post implementation of Sodium Glucose Cotransporter 2 Inhibitor use stoppage 5 days prior to open heart surgery.

Journal of Cardiothoracic and Vascular Anesthesia, Journal Year: 2025, Volume and Issue: unknown

Published: Feb. 1, 2025

Language: Английский

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Aortic Valve Replacement with Rapid-Deployment Bioprostheses: Long-Term Single-Center Results After 1000 Consecutive Implantations

Journal of Clinical Medicine, Journal Year: 2025, Volume and Issue: 14(5), P. 1552 - 1552

Published: Feb. 26, 2025

Introduction: This study aimed to analyze long-term survival and valve-related adverse events after 1000 consecutive rapid-deployment surgical aortic valve replacements (RD-SAVRs) in a single center. Methods: A total of patients following RD-SAVR at our institution were included prospective database. Median follow-up was 68 months (IQR: 37–91). Preoperative operative parameters, assessed. Results: Mean age 73 ± 7 years (45% female). EuroSCORE II 2.7% 1.4–5.5). Concomitant procedures performed 50% patients. In the case isolated SAVR, minimally invasive access conducted 415 (83%). New early pacemaker implantation required 9.1%. Perioperative stroke observed 1.6%, cumulative incidence thromboembolic major bleeding 10 8.1% (95% CI: 6.2–10.4%). The 5- 10-year incidences severe structural degeneration 0.8% 0.3–2.1%) 9.2% 4.5–15.9%). Overall re-intervention or re-operation with explantation occurred 38 cases, 7.7% 5.0–11.2%). 30-day mortality 0.3% (n = 3) 1, 5 FU 95% 93–96%), 81% 78–84%) 58% 51–64%). Age, diabetes, COPD creatinine, concomitant acute indication independent predictive factors mortality. Conclusions: Rapid-deployment valves appear support can be potentially used low real-world collective. Favorable durability acceptable event rates follow-up.

Language: Английский

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Association of cardiac damage and computed tomography-derived extracellular volume in patients undergoing transcatheter aortic valve implantation

Canadian Journal of Cardiology, Journal Year: 2025, Volume and Issue: unknown

Published: Feb. 1, 2025

Language: Английский

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