MARGARET REDFIELD

..These trends underscore the importance of this growing public health problem...

..Ejection fraction and diastolic dysfunction are independently related to higher levels of BNP. Heart failure with preserved EF is associated with a high mortality rate, comparable to that of patients with reduced EF...

..Targeting Stage B HF represents one such potential strategy...

..The clinical literature regarding the use of recombinant BNP for the treatment of HF is reviewed, underscoring current gaps in our knowledge regarding the indications for and benefits of this novel agent...

..We postulated that plasma brain natriuretic peptide (BNP) might serve as a biomarker for preclinical ventricular dysfunction (PCVD) but that the discriminatory values for BNP may vary with age and sex...

..This review focuses on the emerging data regarding the prevalence and natural history of diastolic heart failure in the community...

..Yet, the prevalence of diastolic dysfunction and its relation to systolic dysfunction and CHF in the community remain undefined...

..The prevalence of HFnlEF increases strikingly with age, particularly in women. We hypothesized that ventricular-vascular stiffening may occur with age and be more pronounced in women in the general community...

..We wished to examine the effects of age and gender on plasma brain natriuretic peptide (BNP) concentration in a population-based study...

..We hypothesized that a phosphodiesterase-5A inhibitor (sildenafil) alone or in combination with BNP would increase left ventricular diastolic distensibility by phosphorylating titin...

..Some of these receptors also mediate important communication between the heart and intestine, and the kidney to regulate blood volume and Na+ balance...

..The relationship between electrocardiographic unrecognized myocardial infarction (UMI), abnormal functional status, echocardiographic abnormalities, and mortality has not been evaluated...

....

..However, a subset of patients with IPAH is elderly. Our objective was to compare elderly (age >/= 65 years) vs younger persons with unexplained pulmonary hypertension (PH) and a presumptive diagnosis of IPAH...

..Lastly, the NPR-C may also have a role in mediating anti-proliferative actions of BNP in CFs...

..In conclusion, ventricular remodeling, LV diastolic dysfunction, and elevated filling pressures may contribute to the prevalence of heart failure in obese patients...

..DM is associated with a large increase in mortality, particularly among subjects without clinical CAD, underscoring the importance of aggressive management of DM in HF...

..Given the potential benefits of such tests, including more appropriate therapy and more objective monitoring of ventricular function, outcomes in persons with HF may be improved with more consistent use...

..This study was designed to determine whether alternate pro-B-type natriuretic peptide (proBNP) and BNP forms circulate in the general population...

..These findings also demonstrate differential cGMP activating properties of BNP forms and, importantly, that pro-BNP 1-108 and NT-pro-BNP 1-76 have reduced cGMP activity in vitro that may have biological relevance to human heart failure...

..The prevalence of HF stages and their association with mortality are unknown. We sought to estimate HF stage prevalence in the community and to measure the association of HF stages with mortality...

..We determined whether and where AGEs were increased in elderly hypertensive nondiabetic dogs and whether an AGE cross-link breaker (ALT-711) improved vascular or ventricular function...

..These findings implicate Kir6.2 K23 as a risk factor for adverse subclinical myocardial remodeling, and underscore the significance of cardiac K(ATP) channels within the population...

..The present study aimed to compare tissue velocity-derived and strain-derived dyssynchrony indexes in patients with or without systolic dysfunction and left bundle-branch block...

..We hypothesized that brain natriuretic peptide (nesiritide) added to standard HF therapy would preserve renal function and enhance diuretic responsiveness...

....

..The aim of this study was to examine the relationship between individual components of left ventricular (LV) afterload and tissue Doppler echocardiography (TDE) velocities in humans...

..To determine whether survival after cardiac resynchronization therapy (CRT) is related to improvement in clinical or echocardiographic parameters...

..The concordance between these two methods was poorly reflected by comparing the derived alpha and beta but apparent when using EDV(10-30), which provides information regarding the position of the PVR in a single number...

..Despite renal escape, increased left ventricular collagen deposition suggests that the heart but not the kidney failed to escape the tissue effects of DOCA...

..These observations provide insight into the mechanisms whereby arterial remodeling and acute and chronic VA coupling in both systole and diastole may predispose to and interact with increases in load to cause HFnlEF...

....

..However, adjusting for these secular trends in patient characteristics, mortality after HF admission is improving. These data enhance our understanding of the changing natural history of HF...

....

..There are very few data describing the association of electrocardiogram-based unrecognized myocardial infarction (ECG-UMI) with nonanginal cardiopulmonary symptoms, echocardiographic abnormalities, and mortality in the community...

..Triphasic mitral inflow with middiastolic flow is related to elevated filling pressure, delayed myocardial relaxation, and slow heart rate, indicating advanced diastolic dysfunction...

..Here we review available population-based studies assessing the predictive characteristics of BNP for the detection of pre-clinical structural heart disease (Stage B Heart Failure)...

..CONCLUSIONS: All newer Doppler diastolic function parameters showed a variable but significant correlation with age. Age-specific reference values will aid in the interpretation of diastolic function parameters...

..This suggests that improved survival after MI is unlikely to be a major contributor to the heart failure epidemic...

..These findings support the use of AT(1) receptor blockade for human CHF requiring acute diuretics to improve renal hemodynamic and tubular function and to suppress aldosterone...

..Further, we find that in the community, left atrial enlargement is common and reflects the burden of cardiovascular disease...

..Myocardial bioenergetic deficits are a conserved feature of dysfunctional atrial and ventricular myocardium in CHF and may constitute a component of the substrate for AF in CHF...

..CONCLUSION: This population-based study provides a comprehensive clinical profile, current management, prognosis, and predictors of outcome of patients with new onset CHF who had normal ejection fraction...

..Synergistic effects on humoral and probably endothelial vasodilatory factors appear to be important in mediating the unique hemodynamic profile of vasopeptidase inhibition in this form of experimental hypertension...

..Given that clinical assessment of CHF is subjective, plasma BNP is a useful objective biomarker in monitoring human CHF in the outpatient setting...

..The epidemic of heart failure has yet to be fully investigated, and data on incidence, survival, and sex-specific temporal trends in community-based populations are limited...

..CONCLUSION: Among patients with advanced CHF, hemodynamically significant MR is common. The severity of MR did not provide independent prognostic information in this group recognized to have uniformly high mortality...

..76) after adjustment for age, sex, and comorbid conditions. CONCLUSIONS: These results provide some reassurance that participation bias in this study may have little influence on its overall findings, although this cannot be conclusive...

..This study sought to characterize factors influencing amino-terminal pro-B-type natriuretic peptide (NT-proBNP) and to evaluate the ability of NT-proBNP to detect left ventricular (LV) dysfunction in a large community sample...

..Thus therapy with omapatrilat demonstrates the benefit in protecting phosphotransfer enzyme activities and in preventing impairment of atrial and ventricular bioenergetics in heart failure...

..The similar prognosis after UMI and RMI cannot be explained by comparable degrees of ventricular damage...

..Congestive heart failure (CHF) results in decreased cardiac sympathetic innervation...

..Ablation of the gly96/IEX-1 gene results in hypertension and cardiac hypertrophy, suggesting a novel role for this gene in cardiovascular physiology...

....

..We also hypothesized that chronic NEPI during progressive CHF (PCHF) would improve the natriuretic response to acute volume expansion...

....

..This model mimics many of the structural and functional characteristics described in the limited studies of human DHF and provides insight into the pathogenesis of DHF...

....

....

..11 +/- 4% four weeks after device, p < 0.05) CONCLUSIONS: Percutaneous mitral annuloplasty results in acute and chronic reduction of functional MR in experimental HF...

..05), and Tau decreased (31 +/- 2 to 27 +/- 1 ms, P < 0.05). The effects on hemodynamics, LV function, and second messenger generation suggest synthetic DNP may have a role as a cardiac unloading and lusitropic peptide...

..Specific Aim 4. Establish a Clinical HF Research Skills Development Core The objective is to train future investigators in clinical HF research facilitating their ability to attain independent status. (End of Abstract) ..

....

..abstract_text> ..

....