Publications by authors named "Robert Mentz"
Aims: This post hoc analysis aimed to assess the efficacy and safety of the non-steroidal mineralocorticoid receptor antagonist finerenone by baseline diuretic use in FIDELITY, a pre-specified pooled analysis of the phase III trials FIDELIO-DKD and FIGARO-DKD.
Methods And Results: Eligible patients with type 2 diabetes (T2D) and chronic kidney disease (CKD; urine albumin-to-creatinine ratio [UACR] ≥30-<300 mg/g and estimated glomerular filtration rate [eGFR] ≥25-≤90 ml/min/1.73 m, or UACR ≥300-≤5000 mg/g and eGFR ≥25 ml/min/1.
Background: Hyperkalemia, generally defined as serum potassium levels greater than 5.0 mEq/L, poses significant clinical risks, including cardiac toxicity and muscle weakness. Its prevalence and severity increase in patients with chronic kidney disease (CKD), diabetes mellitus, and heart failure (HF), particularly when compounded by medications like Angiotensin converting inhibitors, Angiotensin receptor blockers, and potassium sparing diuretics.
View Article and Find Full Text PDFAims: Whether prior treatment with angiotensin-converting enzyme inhibitors (ACEi) or angiotensin receptor blockers (ARBs) modifies efficacy and safety of sacubitril/valsartan (Sac/Val) in patients with heart failure (HF) and ejection fraction (EF) >40% is unclear, thus Sac/Val according to ACEi/ARB status at baseline was assessed.
Methods And Results: This was a pre-specified analysis of Prospective comparison of ARNI with ARB Given following stabiLization In DEcompensated HFpEF (PARAGLIDE-HF), a double-blind, randomized controlled trial of Sac/Val versus valsartan, categorizing patients according to baseline ACEi/ARB status. The primary endpoint was time-averaged proportional change in N-terminal pro-B-type natriuretic peptide (NT-proBNP) from baseline through weeks 4 and 8.
Several trials have evaluated diuretic-based strategies to improve symptoms and outcomes in patients with acute heart failure (AHF). The authors sought to summarize the effect of different combination strategies on symptoms, physical signs, physiological variables, and outcomes in patients with AHF. Twelve trials were identified that assessed the addition of thiazide diuretics, sodium-glucose cotransporter 2 inhibitors, mineralocorticoid receptor antagonists, vasopressin receptor antagonists, carbonic anhydrase inhibitors, or loop diuretic intensification to conventional therapy for AHF.
View Article and Find Full Text PDFObjective: To assess the extent to which the concomitant presence of subclinical myocardial injury or stress and diabetes affects the risk of heart failure (HF) subtypes.
Research Design And Methods: The Jackson Heart Study included Black adults, categorized based on diabetes status, high-sensitivity cardiac troponin I (hs-cTnI), and brain natriuretic peptide (BNP) levels. Subclinical myocardial injury was defined as hs-cTnI ≥4 ng/L in women and ≥6 ng/L in men, and subclinical myocardial stress as BNP ≥35 pg/mL.
BAY 2413555 is a novel selective and reversible positive allosteric modulator of the type 2 muscarinic acetylcholine (M2) receptor, aimed at enhancing parasympathetic signaling and restoring cardiac autonomic balance for the treatment of heart failure (HF). This study tested the safety, tolerability and pharmacokinetics of this novel therapeutic option. REMOTE-HF was a multicenter, double-blind, randomized, placebo-controlled, phase Ib dose-titration study with two active arms.
View Article and Find Full Text PDFBackground: Cigarette smoking has been associated with incident heart failure (HF). However, the association between cigarette smoking and smoking cessation with HF subtypes has not been well elucidated, particularly among Black people.
Methods And Results: We investigated 4189 (never smoker n=2934, former smoker n=761, current smoker n=464) Black participants (mean age 54 years, 64% women) without a history of HF or coronary heart disease at baseline in the Jackson Heart Study.
Background: Black adults show heightened cardiovascular risk compared with other groups despite comparable or lower coronary artery calcium (CAC) scores, indicating potential cardiovascular risk underestimation by CAC. Abdominal aortic calcification (AAC), preceding CAC, may predict cardiovascular events better in Black adults who are prone to early atherosclerotic cardiovascular disease and excess events at low CAC scores.
Methods: We included 2551 participants from the JHS (Jackson Heart Study) visit 2 examination (2005-2008) without cardiovascular disease, followed through 2016.
Background: The win ratio (WR) is an emerging alternative for reporting composite outcomes, prioritizing clinically significant events such as mortality while incorporating surrogate measures. However, its benefits should be weighed against limitations, particularly the influence of lower hierarchical outcomes. This secondary analysis of the PARAGLIDE-HF trial performed a WR sensitivity analysis using a modified hierarchical composite outcome to assess the utility of WR sensitivity analysis and the efficacy of sacubitril/valsartan versus valsartan.
View Article and Find Full Text PDFAims: In the VICTORIA (Vericiguat Global Study in Subjects with Heart Failure with Reduced Ejection Fraction) trial, the soluble guanylate cyclase stimulator vericiguat reduced the risk of hospitalization for heart failure (HHF) or cardiovascular death in patients with heart failure (HF) and reduced ejection fraction (HFrEF) with recent worsening HF. The effect of vericiguat in patients with HFrEF without recent worsening HF remains unknown. The VICTOR (Vericiguat Global Study in Participants with Chronic Heart Failure) trial was designed to assess the efficacy and safety of vericiguat in patients with ejection fraction ≤40% without recent worsening HF on a background of current foundational HFrEF therapy.
View Article and Find Full Text PDFArticle Synopsis
- The study analyzed Global Burden of Disease (GBD) data from 1990 to 2019 to understand how Chagas Cardiomyopathy (CCM) prevalence has changed globally and regionally over time.
- Findings showed an increase in the total number of CCM cases from 220,166 in 1990 to 283,236 in 2019, but a decrease in the age-standardized prevalence rate per 100,000 people during the same period.
- The highest prevalence rates occurred in Latin America, particularly among individuals over 70 and males, while rates in high-income North American and Western European regions were much lower, indicating possible improvements in healthcare or lifestyle factors contributing to the declining global prevalence.
Aims: The VICTORIA trial demonstrated a significant reduction in the primary composite outcome of heart failure (HF) hospitalization or cardiovascular death with vericiguat relative to placebo in high-risk HF. This study aimed to contextualize treatment effects of vericiguat in populations with varying risk profiles simulated from the PARADIGM-HF and DAPA-HF trials.
Methods: Subgroups of VICTORIA participants (n = 5050) were generated to simulate PARADIGM-HF and DAPA-HF trial populations.
Article Synopsis
- The study investigates how SGLT2 inhibitors, particularly dapagliflozin, affect metabolism in patients with heart failure (HF) differing by ejection fraction (EF), focusing on ketone and fatty acid changes.
- It analyzed data from two trials involving 527 participants, using metabolomic profiling to identify the effects of dapagliflozin on various metabolites over 12 weeks.
- The findings revealed that dapagliflozin increased certain metabolites associated with ketosis and acylcarnitines but had less effect on amino acids, showing varying impacts depending on the patient's left ventricular ejection fraction.
Background: Given the increasing interest in dietary interventions to improve cardiovascular health, this trial assessed the impact of fortified eggs (FE) versus nonegg supplemented diet and time-restricted eating (TRE) versus usual care diet on cardiovascular biomarkers.
Methods: The study was a unblinded, 2-by-2 factorial design, which randomized patients, with either a prior cardiovascular event or 2 cardiovascular risk factors, to FE or a nonegg supplemented diet and TRE or usual care diet. Patients randomized to FE were instructed to consume at least 12 FE/week (with eggs provided); those on a nonegg supplemented diet restricted egg consumption to <2 eggs/week.
Aims: Glucagon-like peptide-1 receptor agonists reduce major adverse cardiovascular events (MACE) and cardiovascular mortality in people with type 2 diabetes (T2D). However, previous studies suggest the effects on heart failure outcomes vary according to left ventricular ejection fraction (LVEF). We aimed to evaluate the effects of exenatide on cardiovascular events according to LVEF in people with T2D.
View Article and Find Full Text PDFAims: The TRANSFORM-HF trial found no difference in clinical outcomes between torsemide versus furosemide after hospitalization for heart failure. This analysis aimed to assess the impact of diuretic dosing on the primary and secondary clinical outcomes.
Methods And Results: This post-hoc analysis of TRANSFORM-HF categorized patients into three groups by discharge diuretic dose: (1) ≤40 mg, (2) >40-80 mg, and (3) >80 mg of furosemide equivalents.
Background: Glucagon-like peptide-1 receptor agonists are a viable option for the prevention of Alzheimer's disease (AD) but the mechanisms of this potential disease modifying action are unclear. We investigated the effects of once-weekly exenatide (EQW) on AD associated proteomic clusters.
Methods: The Exenatide Study of Cardiovascular Event Lowering study compared the cardiovascular effects of EQW 2 mg with placebo in 13,752 people with type 2 diabetes mellitus.
Article Synopsis
- Women are under-represented in academic cardiology publishing, and implementing double-blind peer reviews is thought to help reduce gender bias in authorship.
- The Journal of Cardiac Failure switched to double-blind reviews in July 2021 and studied changes in author demographics over three time periods from 2021 to 2023.
- The analysis revealed a rise in female first authors from 24% to 39%, indicating that double-blind reviews might enhance gender diversity in authorship, while senior authorship by women remained consistent.
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.