Circulation: Heart Failure

Adenosine-induced vasodilation is impaired and may be a therapeutic target in HFpEF

Contributor: Seyedeh Maryam Hosseini, MD

Heart failure with preserved ejection fraction is characterized by impaired cardiovascular reserve and coronary microvascular dysfunction. Tissue hypoxia activates endogenous adenosine secretion leading to vasodilation of the myocardial microvasculature. By increasing tissue perfusion in working myocardium, adenosine responds to increased metabolic demand. Davila et al. demonstrate that this adenosine vasodilation mechanism is impaired in HFpEF due to up-regulation of the adenosine kinase (ADK) enzyme gene. ADK changes adenosine to its inactive form. Increasing endogenous adenosine by inhibiting the ADK enzyme pharmacologically may have therapeutic potential to improve coronary vasodilation, myocardial perfusion and LV diastolic dysfunction in HFpEF.

By circhf-waveforms|October 25th, 2019|HFpEF, left ventricle, mouse models, Seyedeh Maryam Hosseini|0 Comments

Contributor: Emily Cendrowski

VITALITY-HFPEF is a trial underway which will evaluate the efficacy of vericiguat in HFpEF patients by using the KCCQ-PLS (Kansas City Cardiomyopathy Questionnaire Physical Limitation Score) as a primary endpoint. The choice of this primary endpoint will make it the first HF trial utilizing a quality of life, patient-reported outcome (PRO) as a primary endpoint. There remains a need for medications which improve mortality and functional status for patients with HFpEF. An ongoing area of research involves the cyclic guanosine monophosphate (cGMP) pathway.

By circhf-waveforms|October 25th, 2019|clinical trials, Emily Cendrowski, HFpEF, medication, quality of life, sGC activator|0 Comments

Contributors: Ike Chinyere and Chase Stroud, MD

Effect of Continuous-Flow Left Ventricular Assist Device Support on Coronary Artery Endothelial Function in Ischemic and Nonischemic Cardiomyopathy

Study Link: Effect of Continuous-Flow Left Ventricular Assist Device Support on Coronary Artery Endothelial Function in Ischemic and Nonischemic Cardiomyopathy

By circhf-waveforms|September 12th, 2019|Ike Chinyere, LVAD, mechanical circulatory support, Steven Stroud, Visual Abstract|0 Comments

Contributor: Nicole Smith

Is the opioid system responsible for deteriorating renal function in heart failure?

In a large chronic HF study population, Emmens and colleagues demonstrated higher levels of the opioid surrogate proenkephalin (PENK) are associated with worse HF and deterioration of kidney function. Could PENK be the next renal biomarker in heart failure?

By circhf-waveforms|August 16th, 2019|Biomarkers, HFpEF, HFrEF, Nicole Smith|0 Comments