Naslov
Reply: Different Phenotype Characterization in PARAGON-HF: An Unresolved Puzzle in Patients With HFpEF

Autori
Shah, Amil M. ; Čikeš, Maja ; Zile, Michael R. ; McMurray, John J. V. ; Solomon, Scott D.

Izvornik
Journal of the American College of Cardiology (0735-1097) 75 (2020), 12; 1501-1502

Vrsta, podvrsta i kategorija rada
Radovi u časopisima, pismo, znanstveni

Ključne riječi
PRESERVED EJECTION FRACTION, HEART-FAILURE, CARDIAC STRUCTURE

Sažetak
We agree that appreciable heterogeneity in cardiac structure exists among patients in the echocardiographic substudies of PARAGON-HF, TOPCAT (Treatment of Preserved Cardiac Function Heart Failure With an Aldosterone Antagonist), and I- PRESERVE (Irbesartan in Heart Failure With Preserved Ejection Fraction). Specifically, left ventricular (LV) mass was similar between PARAGON- HF and I-PRESERVE but appreciably lower than in TOPCAT (Americas region), whereas left atrial (LA) size was similar between PARAGON-HF and I-PRESERVE but appreciably higher than TOPCAT (Americas region). Indeed, LA enlargement was observed in >80% of PARAGON-HF patients in the echocardiographic study. Although one interpretation of this variability may be to question the certainty of the HFpEF diagnosis among these studies, 96% of patients in the PARAGON-HF echocardiography substudy met the 2016 European Society of Cardiology heart failure guideline echocardiographic criteria for HFpEF, and >75% met the diagnostic criteria for HFpEF recently proposed by the European Society of Cardiology Heart Failure Association. More importantly, E/e′, estimated pulmonary arterial pressure, and incidence of HF-specific clinical events were similarly elevated in all 3 studies, strongly suggesting that these morphological differences instead reflect the inherent heterogeneity of this syndrome.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

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