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Therapeutic interventions for heart failure with preserved ejection fraction:A summary of current evidence 被引量:7
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作者 Muhammad Asrar ul Haq Chiew Wong +4 位作者 Vivek Mutha Nagesh Anavekar Kwang lim Peter Barlis david l hare 《World Journal of Cardiology》 CAS 2014年第2期67-76,共10页
Heart failure with preserved ejection fraction(HFPEF)is common and represents a major challenge in cardiovascular medicine.Most of the current treatment of HFPEF is based on morbidity benefits and symptom reduction.Va... Heart failure with preserved ejection fraction(HFPEF)is common and represents a major challenge in cardiovascular medicine.Most of the current treatment of HFPEF is based on morbidity benefits and symptom reduction.Various pharmacological interventions available for heart failure with reduced ejection fraction have not been supported by clinical studies for HFPEF.Addressing the specific aetiology and aggressive risk factor modification remain the mainstay in the treatment of HFPEF.We present a brief overview of the currently recommended therapeutic options with available evidence. 展开更多
关键词 HEART FAILURE DIASTOLIC dysfunction HEART FAILURE with PRESERVED EJECTION FRACTION HEART FAILURE with normal EJECTION FRACTION
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Shortness of breath in clinical practice: A case for left atrial function and exercise stress testing for a comprehensive diastolic heart failure workup 被引量:6
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作者 Pupalan Iyngkaran Nagesh S Anavekar +2 位作者 Christopher Neil liza Thomas david l hare 《World Journal of Methodology》 2017年第4期117-128,共12页
The symptom cluster of shortness of breath(SOB) contributes significantly to the outpatient workload of cardiology services. The workup of these patients includes blood chemistry and biomarkers, imaging and functional... The symptom cluster of shortness of breath(SOB) contributes significantly to the outpatient workload of cardiology services. The workup of these patients includes blood chemistry and biomarkers, imaging and functional testing of the heart and lungs. A diagnosis of diastolic heart failure is inferred through the exclusion of systolic abnormalities, a normal pulmonary function test and normal hemoglobin, coupled with diastolic abnormalities on echocardiography. Differentiating confounders such as obesity or deconditioning in a patient with diastolic abnormalities is difficult. While the most recent guidelines provide more avenues for diagnosis, such as incorporating the left atrial size, little emphasis is given to understanding left atrial function, which contributes to at least 25% of diastolic left ventricular filling; additionally, exercise stress testing to elicit symptoms and test the dynamics of diastolic parameters, especially when access to the "gold standard" invasive tests is lacking, presents clinical translational gaps. It is thus important in diastolic heart failure work up to understand left atrial mechanics and the role of exercise testing to build a comprehensive argument for the diagnosis of diastolic heart failure in a patient presenting with SOB. 展开更多
关键词 Diastolic heart failure Exercise stress test Left atrium Shortness of breath Work-up
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Risk stratification for coronary artery disease in multi-ethnic populations:Are there broader considerations for cost efficiency?
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作者 Pupalan Iyngkaran William Chan +5 位作者 Danny liew Jalal Zamani John D Horowitz Michael Jelinek david l hare James A Shaw 《World Journal of Methodology》 2019年第1期1-19,共19页
Coronary artery disease(CAD) screening and diagnosis are core cardiac specialty services.From symptoms,autopsy correlations supported reductions in coronary blood flow and dynamic epicardial and microcirculatory coron... Coronary artery disease(CAD) screening and diagnosis are core cardiac specialty services.From symptoms,autopsy correlations supported reductions in coronary blood flow and dynamic epicardial and microcirculatory coronaries artery disease as etiologies.While angina remains a clinical diagnosis,most cases require correlation with a diagnostic modality.At the onset of the evidence building process much research,now factored into guidelines were conducted among population and demographics that were homogenous and often prior to newer technologies being available.Today we see a more diverse multi-ethnic population whose characteristics and risks may not consistently match the populations from which guideline evidence is derived.While it would seem veryunlikely that for the majority,scientific arguments against guidelines would differ,however from a translational perspective,there will be populations who differ and importantly there are cost-efficacy questions,e.g.,the most suitable first-line tests or what parameters equate to an adequate test.This article reviews non-invasive diagnosis of CAD within the context of multi-ethnic patient populations. 展开更多
关键词 Cost efficacy CORONARY artery DISEASE CORONARY heart DISEASE ETHNICITY Outcomes Risk STRATIFICATION
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