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Heart rate reactivity, recovery, and endurance of the incremental shuttle walk test in patients prone to heart failure (2024)
Journal Article
Wei, F. F., Mariottoni, B., An, D. W., Pellicori, P., Yu, Y. L., Verdonschot, J. A., Liu, C., Ahmed, F. Z., Petutschnigg, J., Rossignol, P., Heymans, S., Cuthbert, J., Girerd, N., Li, Y., Clark, A. L., Nawrot, T. S., Ferreira, J. P., Zannad, F., Cleland, J. G., Staessen, J. A., & the HOMAGE investigators. (online). Heart rate reactivity, recovery, and endurance of the incremental shuttle walk test in patients prone to heart failure. ESC Heart Failure, https://doi.org/10.1002/ehf2.15000

Aims: Few randomized trials assessed the changes over time in the chronotropic heart rate (HR) reactivity (CHR), HR recovery (HRR) and exercise endurance (EE) in response to the incremental shuttle walk test (ISWT). We addressed this issue by analysi... Read More about Heart rate reactivity, recovery, and endurance of the incremental shuttle walk test in patients prone to heart failure.

Disease progression in chronic heart failure is linear: Insights from multistate modelling (2024)
Journal Article
Kazmi, S., Kambhampati, C., Rigby, A. S., Cleland, J. G. F., Kazmi, K. S., Cuthbert, J., Pellicori, P., & Clark, A. L. (online). Disease progression in chronic heart failure is linear: Insights from multistate modelling. European journal of heart failure, https://doi.org/10.1002/ejhf.3400

Aims: Understanding the pattern of disease progression in chronic heart failure (HF) may inform patient care and healthcare system design. We used a four-state Markov model to describe the disease trajectory of patients with HF. Methods and results:... Read More about Disease progression in chronic heart failure is linear: Insights from multistate modelling.

Urinary proteomic signature of mineralocorticoid receptor antagonism by spironolactone: evidence from the HOMAGE trial (2024)
Journal Article
Yu, Y. L., Siwy, J., An, D. W., González, A., Hansen, T. W., Latosinska, A., …Collier, T. (in press). Urinary proteomic signature of mineralocorticoid receptor antagonism by spironolactone: evidence from the HOMAGE trial. Heart, https://doi.org/10.1136/heartjnl-2023-323796

Objective Heart failure (HF) is characterised by collagen deposition. Urinary proteomic profiling (UPP) followed by peptide sequencing identifies parental proteins, for over 70% derived from collagens. This study aimed to refine understanding of the... Read More about Urinary proteomic signature of mineralocorticoid receptor antagonism by spironolactone: evidence from the HOMAGE trial.

Outcomes in patients treated with loop diuretics without a diagnosis of heart failure: a retrospective cohort study (2024)
Journal Article
Cuthbert, J. J., Soyiri, I., Lomax, S. J., Turgoose, J., Fuat, A., Cohen, J., & Clark, A. L. (2024). Outcomes in patients treated with loop diuretics without a diagnosis of heart failure: a retrospective cohort study. Heart, 110(12), 854-862. https://doi.org/10.1136/heartjnl-2023-323577

Background Loop diuretics are commonly prescribed in the community, not always to patients with a recorded diagnosis of heart failure (HF). The rate of HF events in patients prescribed loop diuretics without a diagnosis of HF is unknown. Methods This... Read More about Outcomes in patients treated with loop diuretics without a diagnosis of heart failure: a retrospective cohort study.

Hospital admissions in the last year of life of patients with heart failure (2024)
Journal Article
AI Abel, A., Samuel, N. A., Cuthbert, J. J., Brown, O. I., Pellicori, P., Kazmi, S., GF Cleland, J., Johnson, M., & Clark, A. L. (2024). Hospital admissions in the last year of life of patients with heart failure. European Heart Journal - Quality of Care and Clinical Outcomes, 10(2), 168-175. https://doi.org/10.1093/ehjqcco/qcad047

Aim To explore the frequency, causes, and pattern of hospitalisation for patients with chronic heart failure (HF) in the 12 months preceding death. We also investigated cause of death. Methods Patients referred to a secondary care HF clinic were rout... Read More about Hospital admissions in the last year of life of patients with heart failure.

Diuretic Treatment in Patients with Heart Failure: Current Evidence and Future Directions-Part II: Combination Therapy (2024)
Journal Article
Cuthbert, J., Clark, A., & Cleland, J. (2024). Diuretic Treatment in Patients with Heart Failure: Current Evidence and Future Directions-Part II: Combination Therapy. Current Heart Failure Reports, https://doi.org/10.1007/s11897-024-00644-2

Purpose of Review Fluid retention or congestion is a major cause of symptoms, poor quality of life, and adverse outcome in patients with heart failure (HF). Despite advances in disease-modifying therapy, the mainstay of treatment for congestion loop... Read More about Diuretic Treatment in Patients with Heart Failure: Current Evidence and Future Directions-Part II: Combination Therapy.

Diuretic Treatment in Patients with Heart Failure: Current Evidence and Future Directions – Part I: Loop Diuretics (2024)
Journal Article
Cuthbert, J. J., & Clark, A. L. (2024). Diuretic Treatment in Patients with Heart Failure: Current Evidence and Future Directions – Part I: Loop Diuretics. Current Heart Failure Reports, 21(2), 101-114. https://doi.org/10.1007/s11897-024-00643-3

Purpose of Review: Fluid retention or congestion is a major cause of symptoms, poor quality of life, and adverse outcome in patients with heart failure (HF). Despite advances in disease-modifying therapy, the mainstay of treatment for congestion—loop... Read More about Diuretic Treatment in Patients with Heart Failure: Current Evidence and Future Directions – Part I: Loop Diuretics.

Medicines optimization prior to discharge in patients admitted to hospital with heart failure (2024)
Journal Article
Cuthbert, J. J., Brown, O. I., Pellicori, P., Dobbs, K., Bulemfu, J., Kazmi, S., …Clark, A. L. (2024). Medicines optimization prior to discharge in patients admitted to hospital with heart failure. ESC Heart Failure, 11(2), 950-961. https://doi.org/10.1002/ehf2.14638

Aims: Approximately half of patients with heart failure and a reduced ejection fraction (HeFREF) are discharged from hospital on triple therapy [angiotensin-converting enzyme inhibitors (ACE-Is) or angiotensin receptor blockers (ARBs), beta-blockers... Read More about Medicines optimization prior to discharge in patients admitted to hospital with heart failure.

Effects of spironolactone on exercise blood pressure in patients at increased risk of developing heart failure: report from the HOMAGE trial (2024)
Journal Article
Wei, F. F., Pellicori, P., Ferreira, J. P., González, A., Mariottoni, B., An, D. W., Verdonschot, J. A., Liu, C., Ahmed, F. Z., Petutschnigg, J., Rossignol, P., Heymans, S., Cuthbert, J., Girerd, N., Clark, A. L., Li, Y., Nawrot, T. S., Díez, J., Zannad, F., Cleland, J. G., …Asayama, K. (2024). Effects of spironolactone on exercise blood pressure in patients at increased risk of developing heart failure: report from the HOMAGE trial. Hypertension Research, https://doi.org/10.1038/s41440-024-01843-z

None of the spironolactone trials in heart failure (HF) assessed the blood pressure (BP) responses to exercise, while conflicting results were reported for exercise capacity. In the HOMAGE trial, 527 patients at increased HF risk were randomized to u... Read More about Effects of spironolactone on exercise blood pressure in patients at increased risk of developing heart failure: report from the HOMAGE trial.

Phenotyping patients with ischaemic heart disease at risk of developing heart failure: an analysis of the HOMAGE trial (2023)
Journal Article
Santos-Ferreira, D., Diaz, S. O., Ferreira, J. P., Girerd, N., Pellicori, P., Mariottoni, B., …Zannad, F. (2024). Phenotyping patients with ischaemic heart disease at risk of developing heart failure: an analysis of the HOMAGE trial. ESC Heart Failure, 11(1), 209-218. https://doi.org/10.1002/ehf2.14465

Aims: We aim to characterize the clinical and proteomic profiles of patients at risk of developing heart failure (HF), with and without coronary artery disease (CAD) or prior myocardial infarction (MI). Methods and results: HOMAGE evaluated the effec... Read More about Phenotyping patients with ischaemic heart disease at risk of developing heart failure: an analysis of the HOMAGE trial.

Are non-invasive estimations of plasma volume an accurate measure of congestion in patients with chronic heart failure? (2023)
Journal Article
Cuthbert, J. J., Pellicori, P., Rigby, A. S., Abel, A. A., Kalvickbacka-Bennet, A., Shah, P., Kearsley, J. W., Kazmi, S., Cleland, J. G., & Clark, A. L. (2023). Are non-invasive estimations of plasma volume an accurate measure of congestion in patients with chronic heart failure?. European Heart Journal - Quality of Care and Clinical Outcomes, 9(3), 281-292. https://doi.org/10.1093/ehjqcco/qcac035

Aims: We report associations between different formulae for estimating plasma volume status (PVS) and clinical and ultrasound markers of congestion in patients with chronic heart failure (CHF) enrolled in the Hull Lifelab registry. Methods and result... Read More about Are non-invasive estimations of plasma volume an accurate measure of congestion in patients with chronic heart failure?.

Inferior vena cava diameter is associated with prognosis in patients with chronic heart failure independent of tricuspid regurgitation velocity (2023)
Journal Article
Iaconelli, A., Cuthbert, J., Kazmi, S., Maffia, P., Clark, A. L., Cleland, J. G., & Pellicori, P. (2023). Inferior vena cava diameter is associated with prognosis in patients with chronic heart failure independent of tricuspid regurgitation velocity. Clinical Research in Cardiology, 112(8), 1077-1086. https://doi.org/10.1007/s00392-023-02178-4

Aims: A high, Doppler-derived, tricuspid regurgitation velocity (TRV) indicates pulmonary hypertension, which may contribute to right ventricular dysfunction and worsening tricuspid regurgitation leading to systemic venous congestion, reflected by an... Read More about Inferior vena cava diameter is associated with prognosis in patients with chronic heart failure independent of tricuspid regurgitation velocity.

Dynamic risk stratification using Markov chain modelling in patients with chronic heart failure (2022)
Journal Article
Kazmi, S., Kambhampati, C., Cleland, J., Cuthbert, J., Kazmi, K. S., Pellicori, P., …Clark, A. L. (2022). Dynamic risk stratification using Markov chain modelling in patients with chronic heart failure. ESC Heart Failure, https://doi.org/10.1002/ehf2.14028

Aims: Risk changes with the progression of disease and the impact of treatment. We developed a dynamic risk stratification Markov chain model using artificial intelligence in patients with chronic heart failure (CHF). Methods and results: We describe... Read More about Dynamic risk stratification using Markov chain modelling in patients with chronic heart failure.

Biomarker-based assessment of collagen cross-linking identifies patients at risk of heart failure more likely to benefit from spironolactone effects on left atrial remodelling. Insights from the HOMAGE clinical trial (2021)
Journal Article
Ravassa, S., López, B., Ferreira, J. P., Girerd, N., Bozec, E., Pellicori, P., Mariottoni, B., Cosmi, F., Hazebroek, M., Verdonschot, J. A., Cuthbert, J., Petutschnigg, J., Moreno, M. U., Heymans, S., Staessen, J. A., Pieske, B., Edelmann, F., Clark, A. L., Cleland, J. G., Zannad, F., …HOMAGE Trial Committees and Investigators. (2022). Biomarker-based assessment of collagen cross-linking identifies patients at risk of heart failure more likely to benefit from spironolactone effects on left atrial remodelling. Insights from the HOMAGE clinical trial. European journal of heart failure, 24(2), 321-331. https://doi.org/10.1002/ejhf.2394

Aims: The HOMAGE randomized trial found that spironolactone reduced left atrial volume index (LAVI), E:A ratio, and a marker of collagen type I synthesis (procollagen type I C-terminal propeptide) in patients at risk of heart failure (HF). Previous t... Read More about Biomarker-based assessment of collagen cross-linking identifies patients at risk of heart failure more likely to benefit from spironolactone effects on left atrial remodelling. Insights from the HOMAGE clinical trial.

The effect of spironolactone on cardiovascular function and markers of fibrosis in people at increased risk of developing heart failure: the heart 'OMics' in AGEing (HOMAGE) randomized clinical trial (2020)
Journal Article
Cleland, J. G. F., Ferreira, J. P., Mariottoni, B., Pellicori, P., Cuthbert, J., Verdonschot, J. A. J., Petutschnigg, J., Ahmed, F. Z., Cosmi, F., Brunner La Rocca, H. P., Mamas, M. A., Clark, A. L., Edelmann, F., Pieske, B., Khan, J., McDonald, K., Rouet, P., Staessen, J. A., Mujaj, B., González, A., …the HOMAGE Trial Committees and Investigators. (2021). The effect of spironolactone on cardiovascular function and markers of fibrosis in people at increased risk of developing heart failure: the heart 'OMics' in AGEing (HOMAGE) randomized clinical trial. European Heart Journal, 42(6), 684-696. https://doi.org/10.1093/eurheartj/ehaa758

Aims: To investigate the effects of spironolactone on fibrosis and cardiac function in people at increased risk of developing heart failure. Methods and results: Randomized, open-label, blinded-endpoint trial comparing spironolactone (50 mg/day) or c... Read More about The effect of spironolactone on cardiovascular function and markers of fibrosis in people at increased risk of developing heart failure: the heart 'OMics' in AGEing (HOMAGE) randomized clinical trial.

Relation Between Thyroid Function and Mortality in Patients With Chronic Heart Failure (2020)
Journal Article
Samuel, N. A., Cuthbert, J. J., Brown, O. I., Kazmi, S., Cleland, J. G., Rigby, A. S., & Clark, A. L. (2021). Relation Between Thyroid Function and Mortality in Patients With Chronic Heart Failure. The American journal of cardiology, 139, 57-63. https://doi.org/10.1016/j.amjcard.2020.10.034

Thyroid dysfunction is common in patients with chronic heart failure (CHF), but there is conflicting evidence regarding its prognostic significance. We investigated the relation between thyroid function and prognosis in a large, well characterized co... Read More about Relation Between Thyroid Function and Mortality in Patients With Chronic Heart Failure.

Hypochloraemia in Patients with Heart Failure: Causes and Consequences (2020)
Journal Article
Cuthbert, J. J., Bhandari, S., & Clark, A. L. (2020). Hypochloraemia in Patients with Heart Failure: Causes and Consequences. Cardiology and Therapy, 9, 333-347. https://doi.org/10.1007/s40119-020-00194-3

Hypochloraemia is a common electrolyte abnormality in patients with heart failure (HF). It has a strong association with adverse outcome regardless of HF phenotype and independent of other prognostic markers. How hypochloraemia develops in a patient... Read More about Hypochloraemia in Patients with Heart Failure: Causes and Consequences.

Routine exercise-based cardiac rehabilitation does not increase aerobic fitness: A CARE CR study (2020)
Journal Article
Nichols, S., Taylor, C., Goodman, T., Page, R., Kallvikbacka-Bennett, A., Nation, F., Clark, A. L., Birkett, S. T., Carroll, S., & Ingle, L. (2020). Routine exercise-based cardiac rehabilitation does not increase aerobic fitness: A CARE CR study. International journal of cardiology, 305, 25-34. https://doi.org/10.1016/j.ijcard.2020.01.044

© 2020 The Authors Background: Recent evidence suggests that routine exercise-based cardiac rehabilitation (CR) may not lead to a substantial increase in estimated peak oxygen uptake (V̇O2peak). This could reduce the potential benefits of CR and expl... Read More about Routine exercise-based cardiac rehabilitation does not increase aerobic fitness: A CARE CR study.

Cardiovascular Outcomes with Sacubitril-Valsartan in Heart Failure: Emerging Clinical Data (2020)
Journal Article
Cuthbert, J. J., Pellicori, P., & Clark, A. L. (2020). Cardiovascular Outcomes with Sacubitril-Valsartan in Heart Failure: Emerging Clinical Data. Therapeutics and Clinical Risk Management, 16, 715-726. https://doi.org/10.2147/tcrm.s234772

One of the defining features of heart failure (HF) is neurohormonal activation. The renin-angiotensin-aldosterone-system (RAAS) and sympathetic nervous system (SNS) cause vasoconstriction and fluid retention and, in response, the secretion of natriur... Read More about Cardiovascular Outcomes with Sacubitril-Valsartan in Heart Failure: Emerging Clinical Data.