Heart failure (HF) with preserved ejection fraction (HFpEF) is a chronic cardiac condition whose prevalence continues to rise, with high social and economic burden, but with no specific approved treatment. Patients diagnosed with HFpEF have a high prevalence of comorbidities and exhibit a high misdiagnosis rate. True HFpEF is likely to have multiple pathophysiological causes - with these causes being clinically ill-defined due to limitations of current measurement techniques. Myocyte, interstitium, microvascular, and metabolic abnormalities have been regarded as key components of the pathophysiology and potential therapeutic targets. Cardiac magnetic resonance (CMR) has the capability to look deeper with a number of tissue characterization techniques which are closer to the underlying specific abnormalities and which could be linked to personalized medicine for HFpEF. This review aims to discuss the potential role of CMR to better define HFpEF phenotypes and to infer measurable therapeutic targets.
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http://dx.doi.org/10.1002/ejhf.1961 | DOI Listing |
Nature
January 2025
German Centre for Cardiovascular Research (DZHK), Partner Site Lower Saxony, Göttingen, Germany.
Cardiomyocytes can be implanted to remuscularize the failing heart. Challenges include sufficient cardiomyocyte retention for a sustainable therapeutic impact without intolerable side effects, such as arrhythmia and tumour growth. We investigated the hypothesis that epicardial engineered heart muscle (EHM) allografts from induced pluripotent stem cell-derived cardiomyocytes and stromal cells structurally and functionally remuscularize the chronically failing heart without limiting side effects in rhesus macaques.
View Article and Find Full Text PDFBMJ Case Rep
January 2025
ARHC/Stroke Service, Naas General Hospital, Naas, Kildare, Ireland.
A woman in her early 60s presented with multiple transient neurological symptoms over the course of 20 months, including transient loss of power to her right lower limb. Initial workup with CT brain scan, carotid dopplers and ECG revealed no abnormality; however, MRI of the brain suggested recent ischaemic events in separate cortical territories. Subsequent transoesophageal echocardiogram revealed a large mobile mass histologically confirmed to be an atrial myxoma.
View Article and Find Full Text PDFBMJ Open
January 2025
Department of Cardiovascular Sciences, University of Leicester and the National Institute for Health Research Leicester Biomedical Research Centre, Glenfield Hospital, Leicester LE3 9QP, UK
Introduction: Heart failure with preserved ejection fraction (HFpEF) is characterised by severe exercise intolerance, particularly in those living with obesity. Low-energy meal-replacement plans (MRPs) have shown significant weight loss and potential cardiac remodelling benefits. This pragmatic randomised trial aims to evaluate the efficacy of MRP-directed weight loss on exercise intolerance, symptoms, quality of life and cardiovascular remodelling in a multiethnic cohort with obesity and HFpEF.
View Article and Find Full Text PDFR I Med J (2013)
February 2025
Department of Medicine, Division of Cardiology, Alpert Medical School of Brown University, Providence RI.
Cardiac amyloidosis (CA) is an infiltrative disease that results from the deposition of amyloid fibrils in the myocardium, resulting in restrictive cardiomyopathy. The amyloid fibrils are predominantly derived from two parent proteins, immunoglobulin light chain (AL) and transthyretin (ATTR), and ATTR is further classified into hereditary (ATTRv) and wild-type (ATTRwt) based on the presence or absence, respectively, of a mutation in the transthyretin gene. Once thought to be a rare entity, CA is increasingly recognized as a significant cause of heart failure due to improved clinical awareness and better diagnostic imaging.
View Article and Find Full Text PDFR I Med J (2013)
February 2025
Brown University Health Cardiovascular Institute; Rhode Island, the Miriam and Newport Hospitals; Warren Alpert Medical School, Brown University.
Cardiac magnetic resonance imaging (CMR) is an exciting noninvasive imaging modality with increasing utilization in the field of cardiovascular medicine. In conjunction with echocardiogram, computed tomography, and invasive therapies, CMR has provided exceptional capability to further evaluate complex clinical cardiac conditions. CMR provides both anatomical and physiological information of a variety of tissue types, without the need for ionizing radiation.
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