Pacing and Clinical Electrophysiology,
Год журнала:
2024,
Номер
47(6), С. 714 - 770
Опубликована: Апрель 30, 2024
Abstract
Atrial
fibrillation
(AF)
is
the
most
common
sustained
cardiac
arrhythmia,
significantly
impacting
patients'
quality
of
life
and
increasing
risk
death,
stroke,
heart
failure,
dementia.
Over
past
two
decades,
there
have
been
significant
breakthroughs
in
AF
prediction
screening,
stroke
prevention,
rhythm
control,
catheter
ablation,
integrated
management.
During
this
period,
scale,
quality,
experience
management
China
greatly
improved,
providing
a
solid
foundation
for
development
guidelines
diagnosis
AF.
To
further
promote
standardized
management,
apply
new
technologies
concepts
to
clinical
practice
timely
fully,
Chinese
Society
Cardiology
Medical
Association
Heart
Rhythm
Committee
Biomedical
Engineering
jointly
developed
Guidelines
Diagnosis
Management
Fibrillation
.
The
comprehensively
elaborated
on
various
aspects
proposed
CHA
2
DS
‑VASc‑60
score
based
characteristics
Asian
population.
also
reevaluated
application
emphasized
significance
early
highlighted
central
role
ablation
control.
New England Journal of Medicine,
Год журнала:
2023,
Номер
389(12), С. 1069 - 1084
Опубликована: Авг. 25, 2023
BackgroundHeart
failure
with
preserved
ejection
fraction
is
increasing
in
prevalence
and
associated
a
high
symptom
burden
functional
impairment,
especially
persons
obesity.
No
therapies
have
been
approved
to
target
obesity-related
heart
fraction.MethodsWe
randomly
assigned
529
patients
who
had
body-mass
index
(the
weight
kilograms
divided
by
the
square
of
height
meters)
30
or
higher
receive
once-weekly
semaglutide
(2.4
mg)
placebo
for
52
weeks.
The
dual
primary
end
points
were
change
from
baseline
Kansas
City
Cardiomyopathy
Questionnaire
clinical
summary
score
(KCCQ-CSS;
scores
range
0
100,
indicating
fewer
symptoms
physical
limitations)
body
weight.
Confirmatory
secondary
included
6-minute
walk
distance;
hierarchical
composite
point
that
death,
events,
differences
KCCQ-CSS
C-reactive
protein
(CRP)
level.Download
PDF
Research
Summary.ResultsThe
mean
was
16.6
8.7
(estimated
difference,
7.8
points;
95%
confidence
interval
[CI],
4.8
10.9;
P<0.001),
percentage
−13.3%
−2.6%
−10.7
CI,
−11.9
−9.4;
P<0.001).
distance
21.5
m
1.2
20.3
m;
8.6
32.1;
In
analysis
point,
produced
more
wins
than
(win
ratio,
1.72;
1.37
2.15;
CRP
level
–43.5%
–7.3%
treatment
0.61;
0.51
0.72;
Serious
adverse
events
reported
35
participants
(13.3%)
group
71
(26.7%)
group.ConclusionsIn
obesity,
led
larger
reductions
limitations,
greater
improvements
exercise
function,
loss
placebo.
(Funded
Novo
Nordisk;
STEP-HFpEF
ClinicalTrials.gov
number,
NCT04788511.)
Quick
Take
Semaglutide
Heart
Failure
Obesity
2m
5s
New England Journal of Medicine,
Год журнала:
2024,
Номер
390(15), С. 1394 - 1407
Опубликована: Март 28, 2024
Obesity
and
type
2
diabetes
are
prevalent
in
patients
with
heart
failure
preserved
ejection
fraction
characterized
by
a
high
symptom
burden.
No
approved
therapies
specifically
target
obesity-related
persons
diabetes.
Nature Medicine,
Год журнала:
2023,
Номер
29(9), С. 2358 - 2365
Опубликована: Авг. 27, 2023
In
the
STEP-HFpEF
trial,
semaglutide
improved
symptoms,
physical
limitations
and
exercise
function
reduced
body
weight
in
patients
with
obesity
phenotype
of
heart
failure
preserved
ejection
fraction
(HFpEF).
This
prespecified
analysis
examined
effects
on
dual
primary
endpoints
(change
Kansas
City
Cardiomyopathy
Questionnaire-Clinical
Summary
Score
(KCCQ-CSS)
weight)
confirmatory
secondary
6-minute
walk
distance
(6MWD),
hierarchical
composite
(death,
HF
events,
change
KCCQ-CSS
6MWD)
C-reactive
protein
(CRP))
across
classes
I-III
(body
mass
index
(BMI)
30.0-34.9
kg
m
JACC Heart Failure,
Год журнала:
2023,
Номер
11(8), С. 1000 - 1010
Опубликована: Май 21, 2023
The
majority
of
patients
with
heart
failure
preserved
ejection
fraction
(HFpEF)
have
the
obesity
phenotype,
but
no
therapies
specifically
targeting
in
HFpEF
exist.The
aim
this
study
was
to
describe
design
and
baseline
characteristics
2
trials
semaglutide,
a
glucagon-like
peptide-1
receptor
agonist,
phenotype:
STEP-HFpEF
(Semaglutide
Treatment
Effect
People
HFpEF;
NCT04788511)
DM
type
diabetes;
NCT04916470).Both
are
international
multicenter,
double-blind,
placebo-controlled
that
randomized
adults
body
mass
index
≥30
kg/m2
once-weekly
semaglutide
at
dose
2.4
mg
or
placebo.
Participants
were
eligible
if
they
had
left
ventricular
(LVEF)
≥45%;
NYHA
functional
class
II
IV;
Kansas
City
Cardiomyopathy
Questionnaire
(KCCQ)-Clinical
Summary
Score
(CSS)
<90
points;
≥1
following:
elevated
filling
pressures,
natriuretic
peptides
plus
structural
echocardiographic
abnormalities,
recent
hospitalization
ongoing
diuretic
use,
and/or
abnormalities.
dual
primary
endpoints
52-week
change
KCCQ-CSS
weight.In
(N
=
529
N
617,
respectively),
nearly
half
women,
most
severe
(median
37
kg/m2)
typical
features
LVEF
57%,
frequent
comorbidities,
peptides).
Most
participants
received
agents
renin-angiotensin
blockers
baseline,
approximately
one-third
on
mineralocorticoid
antagonists.
Sodium-glucose
cotransporter-2
inhibitor
use
rare
not
STEP
(32%).
Patients
both
marked
symptomatic
impairments
(KCCQ-CSS
∼59
points,
6-minute
walking
distance
∼300
m).In
total,
program
1,146
phenotype
will
determine
whether
improves
symptoms,
physical
limitations,
exercise
function
addition
weight
loss
vulnerable
group.
The Lancet,
Год журнала:
2024,
Номер
404(10454), С. 773 - 786
Опубликована: Авг. 1, 2024
Semaglutide,
a
GLP-1
receptor
agonist,
reduces
the
risk
of
major
adverse
cardiovascular
events
(MACE)
in
people
with
overweight
or
obesity,
but
effects
this
drug
on
outcomes
patients
atherosclerotic
disease
and
heart
failure
are
unknown.
We
report
prespecified
analysis
effect
once-weekly
subcutaneous
semaglutide
2·4
mg
ischaemic
outcomes.
aimed
to
investigate
if
was
beneficial
history
compared
placebo;
there
difference
outcome
designated
as
having
preserved
ejection
fraction
reduced
fraction;
efficacy
safety
related
baseline
characteristics
subtype
failure.
Circulation,
Год журнала:
2023,
Номер
149(3), С. 204 - 216
Опубликована: Ноя. 12, 2023
Patients
with
heart
failure
(HF)
preserved
ejection
fraction
(HFpEF)
and
obesity
experience
a
high
burden
of
symptoms
functional
impairment,
poor
quality
life.
In
the
STEP-HFpEF
trial
(Research
Study
to
Investigate
How
Well
Semaglutide
Works
in
People
Living
With
Heart
Failure
Obesity),
once-weekly
semaglutide
2.4
mg
improved
symptoms,
physical
limitations,
exercise
function,
reduced
inflammation
body
weight.
This
prespecified
analysis
investigated
effects
on
primary
confirmatory
secondary
end
points
across
range
Kansas
City
Cardiomyopathy
Questionnaire
(KCCQ)
scores
at
baseline
all
key
summary
individual
KCCQ
domains.
npj Digital Medicine,
Год журнала:
2024,
Номер
7(1)
Опубликована: Янв. 6, 2024
Abstract
Assessment
of
left
ventricular
diastolic
function
plays
a
major
role
in
the
diagnosis
and
prognosis
cardiac
diseases,
including
heart
failure
with
preserved
ejection
fraction.
We
aimed
to
develop
an
artificial
intelligence
(AI)-enabled
electrocardiogram
(ECG)
model
identify
echocardiographically
determined
dysfunction
increased
filling
pressure.
trained,
validated,
tested
AI-enabled
ECG
98,736,
21,963,
98,763
patients,
respectively,
who
had
echocardiographic
assessment
within
14
days
no
exclusion
criteria.
It
was
also
55,248
patients
indeterminate
by
echocardiography.
The
evaluated
using
area
under
curve
(AUC)
receiver
operating
characteristic
curve,
its
prognostic
performance
compared
AUC
for
detecting
pressure
0.911.
AUCs
grades
≥1,
≥2,
3
were
0.847,
0.911,
0.943,
respectively.
During
median
follow-up
5.9
years,
20,223
(20.5%)
died.
Patients
predicted
AI-ECG
higher
mortality
than
those
normal
pressure,
after
adjusting
age,
sex,
comorbidities
test
group
(hazard
ratio
(HR)
1.7,
95%
CI
1.645–1.757)
similar
echocardiography
(HR
1.34,
1.298–1.383).
An
identifies
good
value
is
simple
promising
tool
enhance
detection
diseases
associated
The Lancet,
Год журнала:
2024,
Номер
404(10458), С. 1119 - 1131
Опубликована: Сен. 1, 2024
SummaryBackgroundMineralocorticoid
receptor
antagonists
(MRAs)
reduce
hospitalisations
and
death
in
patients
with
heart
failure
reduced
ejection
fraction
(HFrEF),
but
the
benefit
mildly
(HFmrEF)
or
preserved
(HFpEF)
is
unclear.
We
evaluated
effect
of
MRAs
four
trials
that
enrolled
across
range
fraction.MethodsThis
a
prespecified,
individual
patient
level
meta-analysis
RALES
(spironolactone)
EMPHASIS-HF
(eplerenone)
trials,
which
HFrEF,
TOPCAT
FINEARTS-HF
(finerenone)
HFmrEF
HFpEF.
The
primary
outcome
this
was
composite
time
to
first
hospitalisation
for
cardiovascular
death.
also
estimated
on
components
composite,
total
(first
repeat)
(with
without
deaths),
all-cause
Safety
outcomes
were
assessed,
including
serum
creatinine,
glomerular
filtration
rate,
potassium,
systolic
blood
pressure.
An
interaction
between
treatment
tested
examine
heterogeneity
these
populations.
This
study
registered
PROSPERO,
CRD42024541487.Findings13
846
included
trials.
risk
(hazard
ratio
0·77
[95%
CI
0·72–0·83]).
There
statistically
significant
by
(p
interaction=0·0012)
due
greater
efficacy
HFrEF
(0·66
[0·59–0·73])
compared
HFpEF
(0·87
[0·79–0·95]).
observed
reductions
(0·63
[0·55–0·72])
(0·82
[0·74–0·91]).
same
pattern
Cardiovascular
(0·72
[0·63–0·82])
not
(0·92
[0·80–1·05]).
All-cause
(0·73
[0·65–0·83])
(0·94
[0·85–1·03]).
With
an
MRA,
hyperkalaemia
doubled
placebo
(odds
2·27
2·02–2·56]),
incidence
serious
(serum
potassium
>6·0
mmol/L)
low
(2·9%
vs
1·4%);
hypokalaemia
(potassium
<3·5
halved
(0·51
[0·45–0·57];
7%
14%).InterpretationSteroidal
non-steroidal
HFpEF.FundingNone.
Diabetes Care,
Год журнала:
2024,
Номер
48(Supplement_1), С. S207 - S238
Опубликована: Дек. 9, 2024
The
American
Diabetes
Association
(ADA)
"Standards
of
Care
in
Diabetes"
includes
the
ADA's
current
clinical
practice
recommendations
and
is
intended
to
provide
components
diabetes
care,
general
treatment
goals
guidelines,
tools
evaluate
quality
care.
Members
ADA
Professional
Practice
Committee,
an
interprofessional
expert
committee,
are
responsible
for
updating
Standards
annually,
or
more
frequently
as
warranted.
For
a
detailed
description
standards,
statements,
reports,
well
evidence-grading
system
full
list
Committee
members,
please
refer
Introduction
Methodology.
Readers
who
wish
comment
on
invited
do
so
at
professional.diabetes.org/SOC.
