Publications by authors named "Fozia Ahmed"

Objective: Obesity and insulin resistance in men are linked to decreased testosterone and increased estradiol (E2) levels. Aromatase (ARO) converts testosterone into E2, and this occurs mainly in adipose tissue in men. E2 acts through estrogen receptors ESR1 and ESR2, and they potentially affect development of type 2 diabetes (T2D).

View Article and Find Full Text PDF

Background: Patients with heart failure and iron deficiency have diverse causes for hospitalization and death that might be affected by iron repletion.

Objectives: The purpose of this study was to explore causes of hospitalizations and deaths in a randomized trial (IRONMAN) of heart failure comparing intravenous ferric derisomaltose (FDI) (n = 568) and usual care (n = 569).

Methods: Patients with heart failure, left ventricular ejection fraction ≤45%, and either transferrin saturation <20% or serum ferritin <100 μg/L were enrolled.

View Article and Find Full Text PDF

Background: Remote monitoring (RM) is recommended for the ongoing management of patients with cardiac implantable electronic devices (CIEDs). Despite its benefits, RM adoption has increased the workload for cardiac rhythm management teams. This study used a modified Delphi method to develop a consensus on optimal RM management for adult patients with a CIED in the UK.

View Article and Find Full Text PDF
Article Synopsis
  • The study investigated the effects of spironolactone on blood pressure (BP) during exercise in heart failure (HF) patients, finding that it significantly reduced both pre- and post-exercise BP levels over 9 months.
  • While spironolactone showed a small improvement in the number of completed shuttles during exercise tests, there was no significant difference in overall exercise capacity or quality of life (QoL) between the spironolactone group and the control group.
  • The results suggest that while spironolactone can lower BP in patients at increased risk of HF, it does not enhance their ability to exercise or improve their overall well-being.
View Article and Find Full Text PDF
Article Synopsis
  • * This study examines how semaglutide (2.4 mg) affects cardiac structure and function compared to a placebo, utilizing echocardiography on 491 participants over 52 weeks to measure outcomes like left atrial (LA) volume and other heart parameters.
  • * Results indicated that semaglutide significantly reduced LA remodeling and right ventricular enlargement over the year, suggesting potential benefits in cardiac function for patients with obesity-related HFpEF.
View Article and Find Full Text PDF

Aims: Few randomized trials assessed the changes over time in the chronotropic heart rate (HR) reactivity (CHR), HR recovery (HRR) and exercise endurance (EE) in response to the incremental shuttle walk test (ISWT). We addressed this issue by analysing the open HOMAGE (Heart OMics in Aging) trial.

Methods: In HOMAGE, 527 patients prone to heart failure were randomized to usual treatment with or without spironolactone (25-50 mg/day).

View Article and Find Full Text PDF

Patients with acutely decompensated heart failure (ADHF) are usually admitted to hospital for management. There is growing interest in delivering intravenous (IV) diuretic therapy at home, in the community or at hospital day-care units; the safety and effectiveness of outpatient-based management (OPM) for ADHF has not been established. We conducted a systematic literature review and meta-analysis to investigate the short-term safety and effectiveness of OPM compared with inpatient management (IPM) of ADHF.

View Article and Find Full Text PDF

Background: Implantable cardioverter-defibrillators (ICDs) and cardiac resynchronization therapy defibrillators (CRT-D) are lifesaving treatments for patients at risk for sudden cardiac death. Effective physician-patient communication during the shared decision-making process is essential. Electrophysiologist-patient conversations were targeted to obtain objective data on the interaction, understand the conversation framework, and uncover opportunities for improved communication.

View Article and Find Full Text PDF

Aims: Many European healthcare providers struggle to adopt multidisciplinary, integrated care pathways for people with heart failure (HF) as recommended by the European Society of Cardiology. PRO-HF (Program to Optimize Heart Failure Patient Pathways) was developed to help clinicians identify strengths, gaps, and shortcomings in their HF pathways and support tailored interventions to optimize pathways and enhance patient care. We report initial findings from baseline assessments of HF pathway characteristics and challenges from 10 hospitals in six European countries (France, Ireland, Portugal, Spain, The Netherlands, and United Kingdom).

View Article and Find Full Text PDF

Objective: Heart failure (HF) is characterised by collagen deposition. Urinary proteomic profiling (UPP) followed by peptide sequencing identifies parental proteins, for over 70% derived from collagens. This study aimed to refine understanding of the antifibrotic action of spironolactone.

View Article and Find Full Text PDF

Aims: Clinical pathways have been shown to improve outcomes in patients with heart failure (HF). Although patients with HF often have a cardiac implantable electronic device, few studies have reported the utility of device-derived risk scores to augment and organize care. TriageHF Plus is a device-based HF clinical pathway (DHFP) that uses remote monitoring alerts to trigger structured telephone assessment for HF stability and optimization.

View Article and Find Full Text PDF

Aims: This study aimed to examine the diagnostic pathways and outcomes of patients with heart failure (HF), stratified by left ventricular ejection fraction (EF), and to highlight deficiencies in real-world HF diagnosis and management.

Methods And Results: We conducted a retrospective cohort study in Salford, United Kingdom, utilizing linked primary and secondary care data for HF patients diagnosed between January 2010 and November 2019. We evaluated characteristics, diagnostic patterns, healthcare resource utilization, and outcomes.

View Article and Find Full Text PDF
Article Synopsis
  • The STEP-HFpEF and STEP-HFpEF DM trials investigated the effects of the GLP-1 receptor agonist semaglutide on individuals with obesity-related heart failure, showing improvements in symptoms, physical limitations, body weight, and exercise function.
  • A pooled analysis was conducted to assess the effects of semaglutide across various outcomes and determine consistency among different patient subgroups, utilizing data from randomized, double-blind, placebo-controlled trials.
  • Participants were assigned to receive either semaglutide or a placebo for 52 weeks, with primary endpoints focusing on changes in heart failure-related symptoms and body weight, and secondary endpoints assessing physical activity and inflammation markers.
View Article and Find Full Text PDF
Article Synopsis
  • Obesity and type 2 diabetes are common in patients with heart failure with preserved ejection fraction, leading to significant symptoms, and there's a lack of approved treatments targeting this condition.
  • A study assigned 616 patients with heart failure, obesity, and type 2 diabetes to receive either once-weekly semaglutide or a placebo for one year, measuring improvements in symptoms and weight.
  • Results showed that those on semaglutide had significantly better improvements in symptom scores (KCCQ-CSS) and lost more body weight compared to the placebo group, along with other beneficial outcomes in physical activity and inflammation markers.
View Article and Find Full Text PDF
Article Synopsis
  • Catecholamine-stimulated lipolysis decreases with age, leading to increased fat accumulation and insulin resistance, linked to the function of OCT3, a transporter inhibited by estradiol (E2).
  • The study involved analyzing subcutaneous adipose tissue (SAT) from women of varying ages and diabetes statuses to measure OCT3 mRNA levels and their correlation to insulin resistance.
  • Results showed that OCT3 mRNA and protein levels rise with age and postmenopause, but decrease with E2 treatment, suggesting that higher OCT3 levels may impair lipolysis and contribute to insulin resistance in older women.
View Article and Find Full Text PDF

Background: In some countries, intravenous ferric derisomaltose (FDI) is only licensed for treating iron deficiency with anemia. Accordingly, we investigated the effects of intravenous FDI in a subgroup of patients with anemia in the IRONMAN (Effectiveness of Intravenous (IV) Iron Treatment Versus Standard Care in Patients With Heart Failure and Iron Deficiency) trial.

Method And Results: IRONMAN enrolled patients with heart failure, a left ventricular ejection fraction of ≤45%, and iron deficiency (ferritin <100 µg/L or transferrin saturation of <20%), 771 (68%) of whom had anemia (hemoglobin <12 g/dL for women and <13 g/dL for men).

View Article and Find Full Text PDF

Purpose: To evaluate the dopaminergic signaling in human adipose tissue in the context of obesity and type 2 diabetes (T2D) and potential direct implications in adipose tissue metabolism.

Methods: mRNA and protein expression of dopamine receptors D1 and D2 (DRD1 and DRD2) were determined in subcutaneous adipose tissue from subjects without or with T2D and with different body weight, and correlated with markers of obesity, hyperglycemia, and insulin resistance. Glucose uptake and lipolysis were measured in adipocytes ex vivo following short-term exposure to dopamine, DRD1 receptor agonist (SKF81297), or DRD2 receptor agonist (bromocriptine).

View Article and Find Full Text PDF
Article Synopsis
  • The STEP-HFpEF trial found that semaglutide significantly improved symptoms, physical limitations, exercise function, and reduced body weight in patients with heart failure and preserved ejection fraction (HFpEF) who also have obesity.
  • The analysis highlighted that greater reductions in body weight led to better improvements in clinical outcomes like the Kansas City Cardiomyopathy Questionnaire-Clinical Summary Score (KCCQ-CSS) and the 6-minute walk distance (6MWD).
  • Overall, the study suggests that weight loss through semaglutide is an effective treatment strategy for patients with the obesity phenotype of HFpEF, benefiting all obesity classes examined.
View Article and Find Full Text PDF
Article Synopsis
  • Heart failure with preserved ejection fraction (HFpEF) is more common in individuals with obesity and currently lacks approved treatments targeting this specific condition.
  • A study involving 529 obese patients with HFpEF tested the weekly administration of semaglutide against a placebo over a 52-week period, measuring changes in symptoms, body weight, and physical activity.
  • Results showed that semaglutide significantly improved symptoms (KCCQ-CSS score increase of 16.6 vs. 8.7 for placebo), reduced body weight (-13.3% vs. -2.6%), and enhanced walking distance (21.5 m vs. 1.2 m), with additional benefits noted in inflammation levels. *
View Article and Find Full Text PDF

Background: Ventricular arrhythmia is an important cause of mortality in patients with ischemic left ventricular dysfunction. Revascularization with coronary artery bypass graft or percutaneous coronary intervention is often recommended for these patients before implantation of a cardiac defibrillator because it is assumed that this may reduce the incidence of fatal and potentially fatal ventricular arrhythmias, although this premise has not been evaluated in a randomized trial to date.

Methods: Patients with severe left ventricular dysfunction, extensive coronary disease, and viable myocardium were randomly assigned to receive either percutaneous coronary intervention (PCI) plus optimal medical and device therapy (OMT) or OMT alone.

View Article and Find Full Text PDF

Research examining the utility of cardiac device data to manage patients with heart failure (HF) is rapidly evolving. COVID-19 has reignited interest in remote monitoring, with manufacturers each developing and testing new ways to detect acute HF episodes, risk stratify patients and support self-care. As standalone diagnostic tools, individual physiological metrics and algorithm-based systems have demonstrated utility in predicting future events, but the integration of remote monitoring data with existing clinical care pathways for device HF patients is not well described.

View Article and Find Full Text PDF

Background Prolonged activation of angiotensin II is the main mediator that contributes to the development of heart diseases, so converting angiotensin II into angiotensin 1-7 has emerged as a new strategy to attenuate detrimental effects of angiotensin II. Prolylcarboxypeptidase is a lysosomal pro-X carboxypeptidase that is able to cleave angiotensin II at a preferential acidic pH optimum. However, insufficient attention has been given to the cardioprotective functions of prolylcarboxylpeptidase.

View Article and Find Full Text PDF

Infective endocarditis (IE) remains a difficult condition to diagnose and treat and is an infection of high consequence for patients, causing long hospital stays, life-changing complications and high mortality. A new multidisciplinary, multiprofessional, British Society for Antimicrobial Chemotherapy (BSAC)-ledWorking Party was convened to undertake a focused systematical review of the literature and to update the previous BSAC guidelines relating delivery of services for patients with IE. A scoping exercise identified new questions concerning optimal delivery of care, and the systematic review identified 16 231 papers of which 20 met the inclusion criteria.

View Article and Find Full Text PDF

Background: Heart failure (HF) is a global problem responsible for significant morbidity and mortality.

Methods: This review describes the patient pathways and missed opportunities related to treatment for patients with HF.

Results: The contemporary management strategies in HF, including medical therapies, device therapy, transplant, and palliative care.

View Article and Find Full Text PDF

Second-generation antipsychotics (SGAs), used as the cornerstone treatment for schizophrenia and other mental disorders, can cause adverse metabolic effects (e.g. obesity and type 2 diabetes).

View Article and Find Full Text PDF