Publications by authors named "Filippatos G"
Aims: Secondary mitral regurgitation (SMR) and tricuspid regurgitation (TR) are the most common valvular heart diseases in patients with heart failure (HF). Transcatheter edge-to-edge repair (TEER) devices designed for treating MR and TR have been successfully tested in randomized controlled trials, but methodological issues have often challenged their interpretation. This manuscript aimed to provide an overview of TEER registries on SMR and TR in HF, highlighting their key features, describing clinical characteristics and outcomes of patients receiving these devices, and exploring the available data limitations.
View Article and Find Full Text PDF, a common cause of gastroenteritis worldwide, has also been associated with rare extraintestinal infections, including myocarditis. We report a unique case of a 24-year-old male who presented with febrile diarrhea and acute chest pain. Diagnostic investigations revealed elevated cardiac troponin levels, normal electrocardiography findings, and myocardial inflammation on cardiac magnetic resonance imaging, confirming the diagnosis of acute myocarditis.
View Article and Find Full Text PDFA 47-year-old man with congenitally corrected transposition of the great arteries, dextrocardia, heart failure, and pacemaker-dependency presented with nonsustained ventricular tachycardia. He underwent a right-sided transmuscular cardioverter-defibrillator insertion after appropriate testing. One year later, life-saving antiarrhythmic therapy was applied by the subcutaneous defibrillator while the appropriate pacemaker functioning supported heart rhythm.
View Article and Find Full Text PDFAims: Serelaxin is recombinant human relaxin-2, a hormone responsible for haemodynamic adaptations and organ protection in pregnancy. In the RELAX-AHF trial, serelaxin demonstrated reductions in cardiac, renal and hepatic damage. In RELAX-AHF-2, organ damage-related biomarkers were assessed in a biomarker substudy.
View Article and Find Full Text PDFBackground: The prognostic importance of residual congestion after acute heart failure (AHF) hospitalization is still debated.
Objectives: The authors aimed to assess the impact of residual congestion in a large cohort of patients with AHF enrolled in the RELAX-AHF-2 (Relaxin in Acute Heart Failure 2) trial.
Methods: Residual congestion was assessed at day 5 after admission among hospitalized patients using an established composite congestion score (CCS) based on the presence of orthopnea, peripheral edema, and increased jugular venous pressure, ranging from 0 to 8 points.
Background: Outcomes of hospitalized patients with heart failure (HF) and characteristics of advanced HF stage may vary across left ventricular ejection fraction (LVEF) and world regions.
Objectives: This study sought to analyze characteristics of hospitalized advanced HF patients across LVEF spectrum, world regions, and country income.
Methods: Among 18,553 hospitalized patients with acute HF (7,902 new-onset HF and 10,651 decompensated chronic HF) enrolled in the global registry REPORT-HF (International Registry to Assess Medical Practice With Longitudinal Observation for Treatment of Heart Failure), we analyzed characteristics and outcomes of patients with advanced HF, defined as previously diagnosed HF; severe symptoms before current admission (NYHA functional class III/IV); and ≥1 HF-related hospitalization in the preceding 12 months, excluding the current.
Aims: Clinical practice guidelines are commonly written by professional societies in high-income countries (HIC) with limited anticipation of implementation obstacles in other environments. We used heart failure (HF) guidelines as a paradigm to examine this concern, by conducting a survey to understand clinicians' ability to implement HF guidelines and their perceptions of the current HF guideline applicability in low- and middle-income countries (LMIC).
Methods And Results: An online survey of physicians in the database of the Translational Medicine Academy who treat HF patients was offered by email from 5 October to 27 November 2023, inquiring of participants' demographic information, experience, and views of HF guidelines as related to their practice.
Article Synopsis
- SGLT2 inhibitors, like empagliflozin, are shown to improve outcomes for heart failure patients and reduce uric acid levels, with a focus on those having heart failure with preserved ejection fraction (HFpEF).
- In a study of patients receiving empagliflozin, about 49% had elevated uric acid levels, which were linked to worse heart failure severity and higher risk of severe outcomes like hospitalization.
- Empagliflozin significantly lowered uric acid levels early on and reduced related clinical events by 38%, with its effectiveness in improving heart failure outcomes not impacted by initial uric acid levels.
Hypokalaemia in patients with type 2 diabetes and chronic kidney disease: the effect of finerenone - a FIDELITY analysis.
Eur Heart J Cardiovasc Pharmacother
October 2024
Article Synopsis
- Hypokalaemia, or low potassium levels, increases the risk of heart-related issues and death in patients with chronic kidney disease (CKD) and type 2 diabetes (T2D).
- An analysis from the FIDELITY study showed that a significant percentage of patients experienced treatment-emergent hypokalaemia while on finerenone or placebo, with lower potassium levels correlating to higher cardiovascular risks.
- Finerenone was effective in lowering the incidence of hypokalaemia and also reduced the overall risk of cardiovascular events and arrhythmias, regardless of the initial potassium levels in patients.
Article Synopsis
- Cardiogenic shock (CS) poses significant health risks, necessitating effective interventions to maintain blood pressure and tissue perfusion, while current treatments, like inotropes, can lead to serious side effects.
- The SEISMiC study aims to evaluate the safety and effectiveness of istaroxime, a new drug that may improve blood flow without overstimulating adrenergic receptors, in patients at risk for CS.
- This multinational, double-blind study involves patients with severe heart failure and aims to measure the drug's impact on blood pressure and other cardiac metrics over a 60-hour period, aiming to clarify istaroxime's potential benefits in managing pre-CS conditions.
Article Synopsis
- A study looked at how steroids, like prednisone, help reduce congestion in patients with acute heart failure (AHF).
- Patients taking prednisone showed more improvement in their congestion levels compared to those receiving regular care.
- The results suggest that steroids can help with symptoms related to congestion, but more research is needed to confirm these findings.
Article Synopsis
- Study investigates the use of patiromer, a potassium binder, to improve the effectiveness of RAAS inhibitors in patients with heart failure and hyperkalemia.
- In a trial with over 1,000 patients, those with hyperkalemia were able to optimize their medication while on patiromer, showing a slight reduction in serum potassium levels compared to placebo.
- Results suggest patiromer helps patients with current hyperkalemia maintain optimal doses of medication more effectively than those with a history of hyperkalemia, enhancing treatment outcomes for heart failure management.
Article Synopsis
- Hyperkalemia (HK) impacts the effectiveness of renin-angiotensin system (RAS) inhibitors and mineralocorticoid receptor antagonists (MRAs) in patients with heart failure with reduced ejection fraction (HFrEF).
- The study analyzed patients with HFrEF and either HK or a history of HK during a run-in phase designed to optimize their RAS inhibitor and MRA doses using patiromer.
- Results showed significant increases in the use of RAS inhibitors and MRAs among patients meeting the optimization criteria, indicating that patiromer helped enhance treatment for those with HK or a history of HK.
Article Synopsis
- An interatrial shunt is being studied as a potential treatment for heart failure, aimed at lowering left atrial pressure and improving symptoms and outcomes for patients.
- In a clinical trial involving 508 patients, participants were randomly assigned to receive either the shunt or a placebo, with their progress tracked over a maximum of two years.
- Results showed that while the shunt had no major safety issues, it did not significantly improve overall effectiveness compared to the placebo, although it appeared to reduce adverse cardiovascular events in patients with reduced left ventricular ejection fraction.
Heart failure (HF) is an important comorbidity for patients with ischemic stroke, present in 11 %-18 % of patients, and may also independently increase the risk of first-ever and recurrent ischemic stroke. HF is categorized based on ejection fraction (EF) into HF with reduced (HFrEF), mildly-reduced (HFmrEG) and preserved ejection fraction (HFpEF), with the efficacy of HF therapies differing between the three subcategories. Despite this classification, the incidence, recurrence rates and outcomes of ischemic stroke do not appear to differ significantly between the three subtypes, even when considering the concurrent presence of atrial fibrillation.
View Article and Find Full Text PDFArticle Synopsis
- - Anemia is a common issue among heart failure patients, affecting their treatment outcomes, and this study aimed to examine how anemia prevalence changes and its relationship with clinical results in heart failure patients from the STRONG-HF study.
- - In the study of 1077 patients, anemia rates rose from 27.2% at enrollment to 32.1% at 90 days, with a slightly higher primary composite outcome observed in anemic patients, but the difference wasn't statistically significant.
- - Patients with baseline anemia showed less improvement in health-related quality of life, while the incidence of anemia was higher in those receiving high-intensity care compared to usual care; factors like male sex and non-European regions were linked to a higher
Aims: We analysed baseline characteristics and guideline-directed medical therapy (GDMT) use and decisions in the European Society of Cardiology (ESC) Heart Failure (HF) III Registry.
Methods And Results: Between 1 November 2018 and 31 December 2020, 10 162 patients with acute HF (AHF, 39%, age 70 [62-79], 36% women) or outpatient visit for HF (61%, age 66 [58-75], 33% women), with HF with reduced (HFrEF, 57%), mildly reduced (HFmrEF, 17%) or preserved (HFpEF, 26%) ejection fraction were enrolled from 220 centres in 41 European or ESC-affiliated countries. With AHF, 97% were hospitalized, 2.
Aims: Acute heart failure (AHF) is a major cause of hospitalizations and death in the elderly. However, elderly patients are often underrepresented in randomized clinical trials. We analysed the impact of age on clinical outcomes and response to treatment in patients enrolled in Relaxin in Acute Heart Failure (RELAX-AHF-2), a study that included older patients than in previous AHF trials.
View Article and Find Full Text PDFArticle Synopsis
- Left ventricular hypertrophy (LVH) is linked to higher risks of cardiovascular disease and mortality, particularly in patients with chronic kidney disease (CKD) and type 2 diabetes (T2D) who commonly experience hypertension and LVH.
- This pooled analysis from the FIDELITY studies aimed to investigate the effects of the drug finerenone, a nonsteroidal mineralocorticoid receptor antagonist, on cardiovascular and kidney health in CKD and T2D patients, those with and without baseline LVH.
- Results indicated that while finerenone significantly reduced the risk of heart failure hospitalization in patients with LVH compared to those without, its overall impact on cardiovascular and kidney outcomes was not significantly different based on baseline LV
Article Synopsis
- Steroidal mineralocorticoid receptor antagonists help patients with heart failure and reduced ejection fraction, but their effectiveness in those with mildly reduced or preserved ejection fraction is unclear, indicating a need for further research on finerenone.
- In a double-blind study, patients with heart failure (ejection fraction 40% or greater) were assigned to receive either finerenone or a placebo to assess its impact on heart failure events and cardiovascular death.
- Results showed that finerenone led to fewer worsening heart failure events and a lower overall rate of primary outcome events compared to placebo, although it also carried a higher risk of hyperkalemia.
Article Synopsis
- Cardiovascular-kidney-metabolic syndrome links heart disease, chronic kidney disease, and diabetes, with finerenone being a key treatment studied in three clinical trials: FIDELIO-DKD, FIGARO-DKD, and FINEARTS-HF.
- A pooled analysis of these trials involved nearly 19,000 participants and looked at outcomes over an average follow-up of 2.9 years, showing finerenone reduced overall mortality and hospitalization for heart failure.
- Although the reduction in cardiovascular death wasn't statistically significant, finerenone effectively lower the risk of deaths from any cause, cardiovascular events, and adverse kidney outcomes.
Article Synopsis
- - This study analyzes the effects of mitral transcatheter edge-to-edge repair (M-TEER) on hospitalization rates for patients with functional mitral regurgitation (FMR) and symptomatic heart failure (HF), aiming to clarify conflicting results from previous research.
- - The results indicate that patients who underwent M-TEER experienced significantly lower rates of recurrent heart failure hospitalizations and cardiovascular (CV) deaths over a 24-month period, as well as an improved quality of life compared to those in the control group.
- - Specifically, patients in the M-TEER group spent fewer days in the hospital due to HF or CV issues, with a statistically significant reduction in total days lost due to these health complications.