Lifestyle Intervention Improves Parasympathetic Activity in Hypertrophic Cardiomyopathy.

Unlabelled: Background A limited number of studies have investigated the effects of lifestyle interventions in hypertrophic cardiomyopathy (HCM). This study evaluated the effect of a novel lifestyle intervention incorporating physical activity (PA) and dietary nitrate supplementation on heart rate variability (HRV) and haemodynamic measures in HCM.

Methods: Twenty-eight individuals with HCM were randomised into either the intervention or control group.

Impact of age and sex on heart rate variability and cardiometabolic function in healthy adults.

Heart rate variability (HRV) is a non-invasive measure of cardiac autonomic function. A clearer understanding as to whether resting autonomic function represented by HRV could be associated with changes in peak exercise cardiac function remains unanswered. This study evaluated the effect of age and sex on HRV, cardiometabolic function, and determined the correlation between HRV and cardiac function in healthy individuals.

SIGNET: protocol for a multicentre, single-blind prospective, group sequential, randomised controlled trial to evaluate the benefits of a single dose of simvastatin given to potential organ donors declared dead by neurological criteria on outcomes in organ recipients.

Introduction: Successful organ transplantation in patients with end-stage organ failure improves long-term survival, improves quality of life and reduces costs to the NHS. Despite an increase in the number of deceased organ donors over the last decade, there remains a considerable shortfall of suitable organs available for transplantation. Over half of UK donors are certified dead by neurological criteria following brain stem compression, which leads to severe physiological stress in the donor, combined with a hyperinflammatory state.

Effect of CMV Mismatch on Heart Transplant Outcomes Using a Surveillance and Preemptive Strategy.

Purpose: The aim of the study was to determine outcomes after heart transplantation for cytomegalovirus (CMV) mismatched patients (D/R) who underwent a surveillance and preemptive therapy protocol, compared to nonmismatch patients.

Methods: A review of patient records from January 2010 to December 2020 with follow-up to October 2023 was done. The protocol consisted weekly surveillance with CMV PCR starting 4 weeks after transplant continuing up until the patient seroconverts or up to 3 months posttransplant if the patient does not seroconvert.

Sacubitril/valsartan for the treatment of non-obstructive hypertrophic cardiomyopathy: An open label randomized controlled trial (SILICOFCM).

Aim: Sacubitril/valsartan treatment reduces mortality and hospitalizations in heart failure with reduced ejection fraction but has limited application in hypertrophic cardiomyopathy (HCM). The aim of this study was to evaluate the effect of sacubitril/valsartan on peak oxygen consumption (VO) in patients with non-obstructive HCM.

Methods And Results: This is a phase II, randomized, open-label multicentre study that enrolled adult patients with symptomatic non-obstructive HCM (New York Heart Association class I-III) who were randomly assigned (2:1) to receive sacubitril/valsartan (target dose 97/103 mg) or control for 16 weeks.

Physical Activity, Inactivity and Sleep in Individuals with Hypertrophic Cardiomyopathy.

Physical activity presents an important cornerstone in the management and care of individuals with hypertrophic cardiomyopathy (HCM). Twenty-one individuals with HCM (age: 52±15 years old, body mass index (BMI): 30±7 kg/m) completed 7-day monitoring using wrist-worn triaxial accelerometers (GENEActiv, ActivInsights Ltd, UK) and were compared to age and sex-matched healthy controls (age: 51±14 years old, BMI: 25±4 kg/m). For individuals with HCM, clinical parameters (left atrial diameter and volume, peak oxygen consumption, NTproBNP and Minnesota Living with Heart Failure (MLHF)) were correlated with accelerometry.

Application of non-invasive bioreactance to assess hemodynamic function in patients with hypertrophic cardiomyopathy.

Non-invasive technologies have become popular for the clinical evaluation of cardiac function. The present study evaluated hemodynamic response to cardiopulmonary exercise stress testing using bioreactance technology in patients with hypertrophic cardiomyopathy. The study included 29 patients with HCM (age 55 ± 15 years; 28% female) and 12 age (55 ± 14 years), and gender matched (25% female) healthy controls.

Heart rate variability and haemodynamic function in individuals with hypertrophic cardiomyopathy.

Objectives: Heart rate variability (HRV) is a measure of cardiac autonomic function. This study: (1) evaluated the differences in HRV and haemodynamic function between individuals with hypertrophic cardiomyopathy (HCM) and healthy controls, and (2) determined the relationship between HRV and haemodynamic variables in individuals with HCM.

Methods: Twenty-eight individuals with HCM (n = 7, females; age 54 ± 15 years; body mass index: 29 ± 5 kg/m ) and 28 matched healthy individuals (n = 7 females; age 54 ± 16 years; body mass index: 29 ± 5 kg/m ) completed 5-min HRV and haemodynamic measurements under resting (supine) conditions using bioimpedance technology.

Haemodynamic determinants of quality of life in chronic heart failure.

Background: Heart failure patients demonstrate reduced functional capacity, hemodynamic function, and quality of life (QOL) which are associated with high mortality and morbidity rate. The aim of the present study was to assess the relationship between functional capacity, hemodynamic response to exercise and QOL in chronic heart failure.

Methods: A single-centre prospective study recruited 42 chronic heart failure patients (11 females, mean age 60 ± 10 years) with reduced left ventricular ejection fraction (LVEF = 23 ± 7%).

Gender differences in the assessment, decision-making and outcomes for ventricular assist devices and heart transplantation: An analysis from a UK transplant center.

Purpose: There are marked gender differences in all etiologies of advanced heart failure. We sought to determine whether there is evidence of gender-specific decision making for transplant assessments, and how gender effects outcomes.

Methods: Retrospective analysis of adult heart transplant assessments at a single UK center between April 2015 and March 2020.

Peak atrio-ventricular mechanics predicts exercise tolerance in heart failure patients.

Purpose: Exercise intolerance is a cardinal symptom of patients with heart failure (HF). We hypothesized that patients with HF with preserved ejection fraction (HFpEF) in comparison with those with reduced ejection fraction (HFrEF) have disproportionate exercise-induced impairment of left atrial (LA) function that may explain the effort intolerance.

Methods: Total 40 HFpEF patients, 40 HFrEF patients, and 20 matched healthy controls underwent resting and exercise stress transthoracic echocardiography using modified Bruce protocol with speckle-tracking derived assessments of peak atrial longitudinal strain (PALS) and left ventricular global longitudinal strain (LVGLS).

Gender Related Differences in the Clinical Presentation of Hypertrophic Cardiomyopathy-An Analysis from the SILICOFCM Database.

: Hypertrophic cardiomyopathy (HCM) is the most common inherited cardiac disease that affects approximately 1 in 500 people. Due to an incomplete disease penetrance associated with numerous factors, HCM is not manifested in all carriers of genetic mutation. Although about two-thirds of patients are male, it seems that female gender is associated with more severe disease phenotype and worse prognosis.

Does infection predispose to thrombosis during long-term ventricular assist device support?

Background: Infections and thrombotic events remain life-threatening complications in patients with ventricular assist devices (VAD).

Methods: We describe the relationship between both events in our cohort of patients (n = 220) supported with the HeartWare VAD (HVAD). This is a retrospective analysis of patients undergoing HVAD implantation between July 2009 and March 2019 at the Freeman Hospital, Newcastle upon Tyne, United Kingdom.

Disease Progression of Hypertrophic Cardiomyopathy: Modeling Using Machine Learning.

Background: Cardiovascular disorders in general are responsible for 30% of deaths worldwide. Among them, hypertrophic cardiomyopathy (HCM) is a genetic cardiac disease that is present in about 1 of 500 young adults and can cause sudden cardiac death (SCD).

Objective: Although the current state-of-the-art methods model the risk of SCD for patients, to the best of our knowledge, no methods are available for modeling the patient's clinical status up to 10 years ahead.

Feasibility of the cardiac output response to stress test in suspected heart failure patients.

Background: Diagnostic tools available to support general practitioners diagnose heart failure (HF) are limited.

Objectives: (i) Determine the feasibility of the novel cardiac output response to stress (CORS) test in suspected HF patients, and (ii) Identify differences in the CORS results between (a) confirmed HF patients from non-HF patients, and (b) HF reduced (HFrEF) vs HF preserved (HFpEF) ejection fraction.

Methods: Single centre, prospective, observational, feasibility study.

Prognostic Value of Peak Oxygen Uptake in Patients Supported With Left Ventricular Assist Devices (PRO-VAD).

Objectives: The purpose of this study was to examine whether peak oxygen uptake (pVO) and other cardiopulmonary exercise test (CPET)-derived variables could predict intermediate-term mortality in stable continuous flow LVAD recipients.

Background: pVO is a cornerstone in the selection of patients for heart transplantation, but the prognostic power of pVO obtained in patients treated with a left ventricular assist device (LVAD) is unknown.

Methods: We collected data for pVO and outcomes in adult LVAD recipients in a retrospective, multicenter study and evaluated cutoff values for pVO including: 1) values above or below medians; 2) grouping patients in tertiles; and 3) pVO ≤14 ml/kg/min if the patient was not treated with beta-blockers (BB) or pVO ≤12 ml/kg/min if the patient was taking BB therapy.

A machine learning-based risk stratification model for ventricular tachycardia and heart failure in hypertrophic cardiomyopathy.

Background: Machine learning (ML) and artificial intelligence are emerging as important components of precision medicine that enhance diagnosis and risk stratification. Risk stratification tools for hypertrophic cardiomyopathy (HCM) exist, but they are based on traditional statistical methods. The aim was to develop a novel machine learning risk stratification tool for the prediction of 5-year risk in HCM.

The effect of age on mechanisms of exercise tolerance: Reduced arteriovenous oxygen difference causes lower oxygen consumption in older people.

Objective: To assess the effect of age on mechanisms of exercise tolerance.

Methods: Prospective observational study recruited 71 healthy individuals divided into two groups according to their age i.e.

Using existing technology better: Improving outcomes with the HeartWare left ventricular assist device.

Background: The HeartWare left ventricular assist device has been in use for over 12 years. We sought to determine how outcomes at our centre have improved over time.

Methods: Review of electronic hospital records at the Freeman Hospital, Newcastle upon Tyne, United Kingdom.

Genetic determinants of clinical phenotype in hypertrophic cardiomyopathy.

Background: Hypertrophic cardiomyopathy (HCM) is the most common inherited cardiovascular disease that affects approximately one in 500 people. HCM is a recognized genetic disorder most often caused by mutations involving myosin-binding protein C (MYBPC3) and β-myosin heavy chain (MYH7) which are responsible for approximately three-quarters of the identified mutations.

Methods: As a part of the international multidisciplinary SILICOFCM project ( www.