Exploring the Reno-Cardiac Connection. Protect your kidneys save your heart

Size: px
Start display at page:

Download "Exploring the Reno-Cardiac Connection. Protect your kidneys save your heart"

Transcription

1 Exploring the Reno-Cardiac Connection Protect your kidneys save your heart

2 Heart Failure: a major health care problem ~23 million people with heart failure worldwide Heart failure increases progressively with age Heart failure is associated with high morbidity and mortality While treatment options and clinical outcome have improved for HFrEF, this is not true for HFpEF HFrEF Heart Failure with reduced Ejection Fraction HFpEF Heart Failure with preserved Ejection Fraction

3 HFpEF: A major unmet clinical need Heart Failure with preserved Ejection Fraction Up to 50% of heart failure patients demonstrate HFpEF High mortality: 5 year mortality ~74% Limited therapeutic options for HFpEF patients Pathophysiological mechanisms largely unknown Jessup, Circulation 2014

4 HFpEF: associated with multiple usually interrelated, co-morbidities Aging Female gender Comorbidities: Obesity Diabetes Hypertension Renal dysfunction Male gender Myocardial infarction Genetic myopathies Chronic low-grade inflammation Neurohormonal activation Oxidative stress Chronic pressure overload

5 Chronic Kidney Disease predisposes to HFpEF increased urinary albumin excretion and cystatin C were significantly more associated with the risk for HFpEF, but not for HFrEF In established HFpEF albuminuria and impaired kidney function predict mortality The renal connection Mechanisms David H. Smith et underlying al. Circ Cardiovasc CKD Qual Outcomes. HFpEF 2013;6: relation unknown

6 Role of the microvasculature Renal drivers: Uremic toxins Endocrine Metabolic Ca/P/Vit D FGF23 Salt Comorbidities: Obesity Diabetes Hypertension Renal dysfunction HFpEF HFrEF Adapted from Paulus & Tschope, JACC 2013

7 Central Hypothesis Renal impairment and its systemic consequences adversely impact the coronary microvasculature, thereby modifying pathophysiology, course and prognosis of HFpEF Renal Dysfunction Microvascular Dysfunction Heart Failure with preserved EF Systemic Factors Uremic toxins Endocrine Metabolic Ca/P/VitD FGF23 Salt Inflammation Endothelium Pericytes & Perivascular Fibroblasts IL6 TNFα sst2 Pentr. 3 Chemokines Cytokines Adhesion Molecules ROS Permeability Fibrosis Vascular Stability Inflammatory cell recruitment NO Monocyte activation TGFβ-fibrogenesis cgmp PKG Myofibroblast Interstitial fibrosis Resting tension Hypertrophy Cardiomyocyte ter Maaten et al. Eur J Heart Fail 2016

8 Multicenter Consortium RECONNECT REnal CONNECTion to microvascular disease and heart failure with preserved ejection fraction Amsterdam Groningen Leiden Utrecht Rotterdam

9 Multidisciplinary Consortium RECONNECT Basic Research Clinical Research Epidemiology

10 Aims RECONNECT Aims to: Enhance mechanistic insight in the renal drivers of HFpEF Develop new prognostic tools to define a patient's susceptibility to HFpEF onset and progression Develop customized therapeutic solutions for HFpEF patients

11 Overall Work Plan COHORTS PATIENTS WP1 DISCOVERY WP2 IN-VITRO PATIENTS WP5 PROGNOSIS & THERAPY DESIGN WP4 WP2 MECHANISTIC STUDIES WP3 IN-VIVO ANIMALS

12 WP5 Clinical risk prediction models for onset & prognosis HFpEF in CKD population WP4.2 Clinical strategy design WP1 Exploration, discovery and validation of CKD- HFpEF associated systemic factors COHORTS PATIENTS COHORTS PATIENTS WP5 WP1 PROGNOSIS & THERAPY DESIGN WP4 WP4.1 Preclinical drug-target Evaluation in vivo WP2.1 Functionomic analysis of plasma samples in vitro DISCOVERY IN-VIVO ANIMALS WP2 IN-VITRO PATIENTS Immune response PATIENTS phenotyping in relation to EndoMT & fibrosis WP2 MECHANISTIC STUDIES WP3 Overall Work Plan IN-VITRO WP2.2 Microfluidic and metabolomic analysis of plasma WP3 WP2.3 WP2.4 Transcriptional and epigenetic phenotyping Mechanistic studies in unique rodent and porcine animal models of CKD & HFpEF

13 10 RECONNECT cohorts: >2000 HFpEF patients General population PREVEND 125 HFpEF Screen-detected cases from primary care UHFO-DM 133 HFpEF STRETCH 70 HFpEF TREE 91 HFpEF New-onset or established HFpEF in cardiology outpatient clinic CTMM-CC UCORBIO 296 HFpEF BIOSTAT 430 HFpEF MEDIA 612 HFpEF New-onset or established HFpEF in hospitalized patients CTMM- TRIUMPH 65 HFpEF COACH 204 HFpEF PROTECT 130 HFpEF Different co-morbidities Different stages of cardiac & renal dysfunction

14 Functionomic analysis of plasma samples in vitro (i) Microvasculature in vitro (ii) Microvascular interaction with white blood cells and cardiac fibroblasts (iii) Cardiomyocyte contractility Effect of plasma on: Microfluidic and metabolomic analysis of plasma (i) Endothelial barrier function (ii) White blood cell recruitment (iii) Endothelial mirna profile and Metabolite release Metabolomic analysis of plasma composition Gel channel Perfusion channel

15 Maarten Brandt Renal Dysfunction Microvascular Dysfunction Heart Failure with preserved EF Systemic Factors Uremic toxins Endocrine Metabolic Ca/P/VitD FGF23 Salt Inflammation Endothelium Pericytes & Perivascular Fibroblasts IL6 TNFα sst2 Pentr. 3 Chemokines Cytokines Adhesion Molecules ROS Permeability Fibrosis Vascular Stability Inflammatory cell recruitment NO Monocyte activation TGFβ-fibrogenesis cgmp PKG Myofibroblast Interstitial fibrosis Resting tension Hypertrophy Cardiomyocyte Oana Sorop

16 Innovation and Translation Unique patient cohorts and biological samples Focus on the microvasculature State-of-the-art technology and beyond - Organ-on-a-Chip Novel (large) animal models of CKD-HFpEF Strong multidisciplinary consortium Renal Dysfunction Microvascular Dysfunction Heart Failure with preserved EF Systemic Factors Uremic toxins Endocrine Metabolic Ca/P/VitD FGF23 Salt Inflammation Endothelium Pericytes & Perivascular Fibroblasts IL6 TNFα sst2 Pentr. 3 Chemokines Cytokines Adhesion Molecules ROS Permeability Fibrosis Vascular Stability Inflammatory cell recruitment NO Monocyte activation TGFβ-fibrogenesis Myofibroblast Interstitial fibrosis Resting tension Hypertrophy cgmp PKG Cardiomyocyte

17 Thank You!

The challenge of treating a stiff heart

The challenge of treating a stiff heart ResearchFeatures.com The challenge of treating a stiff heart Heart failure, when the heart fails to pump blood properly around the body, hospitalises more people in the Western world than any other condition.

More information

Diabetes and the Heart

Diabetes and the Heart Diabetes and the Heart Association of Specialty Professors April 4, 2013 Jorge Plutzky, MD Co-Director, Preventive Cardiology Director, The Lipid Clinic Cardiovascular Division Brigham and Women s Hospital

More information

Risk Stratification in Heart Failure: The Role of Emerging Biomarkers

Risk Stratification in Heart Failure: The Role of Emerging Biomarkers Risk Stratification in Heart Failure: The Role of Emerging Biomarkers David G. Grenache, PhD Associate Professor of Pathology, University of Utah Medical Director, ARUP Laboratories Salt Lake City, UT

More information

Diastolic Heart Failure (HFpEF) Felix J. Rogers, DO, FACOI April 29, 2018

Diastolic Heart Failure (HFpEF) Felix J. Rogers, DO, FACOI April 29, 2018 Diastolic Heart Failure (HFpEF) Felix J. Rogers, DO, FACOI April 29, 2018 Case presentation MSO, an 81 year old woman was admitted to HFWH because of progressive dyspnea and difficult to control hypertension

More information

Heart Failure with Preserved Left Ventricular Ejection Fraction. (HFpEF)

Heart Failure with Preserved Left Ventricular Ejection Fraction. (HFpEF) Thessaloniki, May 27, 2017 Heart Failure with Preserved Left Ventricular Ejection Fraction Filippos Triposkiadis, MD, FESC, FACC Professor of Cardiology Director, Department of Cardiology Larissa University

More information

Doppler ultrasound, see Ultrasonography. Magnetic resonance imaging (MRI), kidney oxygenation assessment 75

Doppler ultrasound, see Ultrasonography. Magnetic resonance imaging (MRI), kidney oxygenation assessment 75 Subject Index Acidemia, cardiorenal syndrome type 3 146 Acute Dialysis Quality Initiative (ADQI) acute kidney injury biomarkers, see Acute kidney injury; specific biomarkers cardiorenal syndrome, see specific

More information

578 Index. Eplerenone, 7, 29, 119, 120, 126, 275, 276,

578 Index. Eplerenone, 7, 29, 119, 120, 126, 275, 276, Index A AC. See Adenylate cyclase (AC) ACEI. See Angiotensin converting enzyme inhibitors (ACEI) Adenosine, 179, 180, 182 184, 191, 196 198 Adenosine A1 receptor, 179 183, 186, 190 198 Adenylate cyclase

More information

Ischemic Heart Failure

Ischemic Heart Failure 15 th Cardiology Congress of Northern Greece Thessaloniki, May 26-28, 2016 Ischemic Heart Failure Filippos Triposkiadis, MD, FESC, FACC Professor of Cardiology Director, Department of Cardiology Larissa

More information

Diagnosis is it really Heart Failure?

Diagnosis is it really Heart Failure? ESC Congress Munich - 25-29 August 2012 Heart Failure with Preserved Ejection Fraction From Bench to Bedside Diagnosis is it really Heart Failure? Prof. Burkert Pieske Department of Cardiology Med.University

More information

Cardiovascular Protection and the RAS

Cardiovascular Protection and the RAS Cardiovascular Protection and the RAS Katalin Kauser, MD, PhD, DSc Senior Associate Director, Boehringer Ingelheim Pharmaceutical Inc. Micardis Product Pipeline Scientific Support Ridgefield, CT, USA Cardiovascular

More information

Heart failure with preserved ejection fraction in women: the Dutch Queen of Hearts program

Heart failure with preserved ejection fraction in women: the Dutch Queen of Hearts program Neth Heart J (2015) 23:89 93 DOI 10.1007/s12471-014-0613-1 REVIEW ARTICLE ICIN Heart failure with preserved ejection fraction in women: the Dutch Queen of Hearts program H. den Ruijter & G. Pasterkamp

More information

Cardiovascular Disease in CKD. Parham Eftekhari, D.O., M.Sc. Assistant Clinical Professor Medicine NSUCOM / Broward General Medical Center

Cardiovascular Disease in CKD. Parham Eftekhari, D.O., M.Sc. Assistant Clinical Professor Medicine NSUCOM / Broward General Medical Center Cardiovascular Disease in CKD Parham Eftekhari, D.O., M.Sc. Assistant Clinical Professor Medicine NSUCOM / Broward General Medical Center Objectives Describe prevalence for cardiovascular disease in CKD

More information

Preserved EF with heart failure (HF pef) 50% 5 year survival. Both have type 2 diabetes Both have hypertension Both have normal ejection fractions

Preserved EF with heart failure (HF pef) 50% 5 year survival. Both have type 2 diabetes Both have hypertension Both have normal ejection fractions Research companies Government / University research Preserved EF with heart failure (HF pef) 50% 5 year survival Both have type 2 diabetes Both have hypertension Both have normal ejection fractions Introduction

More information

Pathophysiology of heart failure with preserved ejection fraction. Extracellular matrix

Pathophysiology of heart failure with preserved ejection fraction. Extracellular matrix Pathophysiology of heart failure with preserved ejection fraction Extracellular matrix Javier Díez, MD, PhD. Full Professor of Cardiovascular Medicine and Director Division of Cardiovascular Sciences Centre

More information

Ischemic Heart Failure

Ischemic Heart Failure Kalymnos Days Hellenic Cardiological Society Kalymnos, June 11, 2016 Ischemic Heart Failure Filippos Triposkiadis, MD, FESC, FACC Professor of Cardiology Director, Department of Cardiology Larissa University

More information

Exercise in Adverse Cardiac Remodeling: of Mice and Men

Exercise in Adverse Cardiac Remodeling: of Mice and Men Exercise in Adverse Cardiac Remodeling: of Mice and Men 17-01-2013 Dirk J Duncker Experimental Cardiology, Cardiology, Thoraxcenter Cardiovascular Research Institute COEUR Erasmus MC, University Medical

More information

JOSHUA K. KAYIMA INTERLINKING CARDIOVASCULAR DISEASE, CHRONIC KIDNEY DISEASE, AND OBESITY

JOSHUA K. KAYIMA INTERLINKING CARDIOVASCULAR DISEASE, CHRONIC KIDNEY DISEASE, AND OBESITY INTERLINKING CARDIOVASCULAR DISEASE, CHRONIC KIDNEY DISEASE, AND OBESITY JOSHUA K. KAYIMA ASSOCIATE PROFESSOR DEPT. OF CLINICAL MEDICINE AND THERAPEUTICS UNIVERSITY OF NAIROBI Introduction According to

More information

HFpEF. April 26, 2018

HFpEF. April 26, 2018 HFpEF April 26, 2018 (J Am Coll Cardiol 2017;70:2476 86) HFpEF 50% or more (40-71%) of patients with CHF have preserved LV systolic function. HFpEF is an increasingly frequent hospital discharge. Outcomes

More information

I have no disclosures. Disclosures

I have no disclosures. Disclosures I have no disclosures Disclosures What is Heart Failure? Heart Failure (HF) A complex clinical syndrome where patients present with symptoms (i.e. dyspnea, fatigue, fluid retention) that result from any

More information

Uremic Cardiomyopathy with a focus on the role of α-klotho and FGF23

Uremic Cardiomyopathy with a focus on the role of α-klotho and FGF23 Uremic Cardiomyopathy with a focus on the role of α-klotho and FGF23 Marc G Vervloet, MD, PhD, FERA VU university medical center Amsterdam, The Netherlands Disclosures Scientific support AbbVie, Amgen,

More information

ΒΙΟΔΕΙΚΤΕΣ ΣΤΗΝ ΚΑΡΔΙΑΚΗ ΑΝΕΠΑΡΚΕΙΑ. ΔΗΜΗΤΡΙΟΣ ΤΟΥΣΟΥΛΗΣ Καθηγητής Καρδιολογίας

ΒΙΟΔΕΙΚΤΕΣ ΣΤΗΝ ΚΑΡΔΙΑΚΗ ΑΝΕΠΑΡΚΕΙΑ. ΔΗΜΗΤΡΙΟΣ ΤΟΥΣΟΥΛΗΣ Καθηγητής Καρδιολογίας ΕΘΝΙΚΟ ΚΑΙ ΚΑΠΟΔΙΣΤΡΙΑΚΟ ΠΑΝΕΠΙΣΤΗΜΙΟ ΑΘΗΝΩΝ ΙΑΤΡΙΚΗ ΣΧΟΛΗ Ά ΚΑΡΔΙΟΛΟΓΙΚΗ ΚΛΙΝΙΚΗ Διευθυντής: Καθηγητής Δημήτριος Τούσουλης ΒΙΟΔΕΙΚΤΕΣ ΣΤΗΝ ΚΑΡΔΙΑΚΗ ΑΝΕΠΑΡΚΕΙΑ ΔΗΜΗΤΡΙΟΣ ΤΟΥΣΟΥΛΗΣ Καθηγητής Καρδιολογίας

More information

Therapeutic Targets and Interventions

Therapeutic Targets and Interventions Therapeutic Targets and Interventions Ali Valika, MD, FACC Advanced Heart Failure and Pulmonary Hypertension Advocate Medical Group Midwest Heart Foundation Disclosures: 1. Novartis: Speaker Honorarium

More information

Ejection Fraction in Patients With Chronic Heart Failure. Diastolic Heart Failure or Heart Failure with Preserved Ejection Fraction

Ejection Fraction in Patients With Chronic Heart Failure. Diastolic Heart Failure or Heart Failure with Preserved Ejection Fraction Diastolic Heart Failure or Heart Failure with Preserved Ejection Fraction Keith Miller MD Diastolic Heart Failure Risk Factors Common Risk Factors Aging Female gender Obesity Hypertension Diabetes mellitus

More information

In Vivo Animal Models of Heart Disease. Why Animal Models of Disease? Timothy A Hacker, PhD Department of Medicine University of Wisconsin-Madison

In Vivo Animal Models of Heart Disease. Why Animal Models of Disease? Timothy A Hacker, PhD Department of Medicine University of Wisconsin-Madison In Vivo Animal Models of Heart Disease Timothy A Hacker, PhD Department of Medicine University of Wisconsin-Madison Why Animal Models of Disease? Heart Failure (HF) Leading cause of morbidity and mortality

More information

HFPEF Echo with Strain vs. MRI T1 Mapping

HFPEF Echo with Strain vs. MRI T1 Mapping HFPEF Echo with Strain vs. MRI T1 Mapping Erik Schelbert, MD MS Director, Cardiovascular Magnetic Resonance Assistant Professor of Medicine Heart & Vascular Institute University of Pittsburgh Disclosures

More information

Heart Failure with Preserved Ejection Fraction: Pathologies, Aetiology and Directions for Treatment

Heart Failure with Preserved Ejection Fraction: Pathologies, Aetiology and Directions for Treatment Heart Failure with Preserved Ejection Fraction: Pathologies, Aetiology and Directions for Treatment Dr Will Watson Oxford Centre for Magnetic Resonance Research Will.watson@cardiov.ox.ac.uk Introduction

More information

Introduction. Acute sodium overload produces renal tubulointerstitial inflammation in normal rats

Introduction. Acute sodium overload produces renal tubulointerstitial inflammation in normal rats Acute sodium overload produces renal tubulointerstitial inflammation in normal rats MI Roson, et al. Kidney International (2006) Introduction Present by Kanya Bunnan and Wiraporn paebua Tubular sodium

More information

Remodeling the failing heart: : the biology and future treatment options

Remodeling the failing heart: : the biology and future treatment options Remodeling the failing heart: : the biology and future treatment options J-L Balligand (UCL-Brussels, BE) jl.balligand@uclouvain.be Myocardial remodeling: definitions phenotypic plasticity : remodeling

More information

Heart Failure (HF) Treatment

Heart Failure (HF) Treatment Heart Failure (HF) Treatment Heart Failure (HF) Complex, progressive disorder. The heart is unable to pump sufficient blood to meet the needs of the body. Its cardinal symptoms are dyspnea, fatigue, and

More information

Microvascular dysfunction in heart failure with preserved ejection fraction (HFpEF): Evidence from PROMIS-HFpEF

Microvascular dysfunction in heart failure with preserved ejection fraction (HFpEF): Evidence from PROMIS-HFpEF Microvascular dysfunction in heart failure with preserved ejection fraction (HFpEF): Evidence from PROMIS-HFpEF Carolyn S. P. Lam, Sanjiv J. Shah, Sara Svedlund, Antti Saraste, Camilla Hage, Ru San Tan,

More information

An Update in Heart Failure

An Update in Heart Failure An Update in Heart Failure Dr Peter Dias Cardiologist Heartswest AHFCTS Fiona Stanley Hospital Disclosures No financial, industry, pharma disclosures I am not an endocrinologist References Heart disease

More information

ΑΛΛΗΛΕΠΙΔΡΑΗ ΚΑΡΔΙΑ ΚΑΙ ΠΝΕΥΜΟΝΩΝ

ΑΛΛΗΛΕΠΙΔΡΑΗ ΚΑΡΔΙΑ ΚΑΙ ΠΝΕΥΜΟΝΩΝ ΕΜΙΝΑΡΙΟ ΕΠΙΣΗΜΟΝΙΚΩΝ ΕΝΩΕΩΝ ΕΛΛΗΝΙΚΟΤ ΚΟΛΛΕΓΙΟΤ ΚΑΡΔΙΟΛΟΓΙΑ ΑΛΛΗΛΕΠΙΔΡΑΗ ΚΑΡΔΙΑ ΚΑΙ ΠΝΕΥΜΟΝΩΝ Ιωάννησ Αλεξανιάν Καρδιολόγοσ, Επιμελητήσ Β Γενικό Νοςοκομείο Νοςημάτων Θώρακα Αθηνών «Η ωτηρία» Αθήνα 2-4

More information

3D Tissue Models. Simple, Low Cost Fabrication. Simple, Robust Protocols

3D Tissue Models. Simple, Low Cost Fabrication. Simple, Robust Protocols 3D Tissue Models SynVivo is a physiological, cell-based microfluidic platform that provides a morphologically and physiologically realistic microenvironment allowing real-time study of cellular behavior,

More information

In the name of GOD. Animal models of cardiovascular diseases: myocardial infarction & hypertension

In the name of GOD. Animal models of cardiovascular diseases: myocardial infarction & hypertension In the name of GOD Animal models of cardiovascular diseases: myocardial infarction & hypertension 44 Presentation outline: Cardiovascular diseases Acute myocardial infarction Animal models for myocardial

More information

Heart Failure with Preserved Ejection Fraction: Mechanisms and Management

Heart Failure with Preserved Ejection Fraction: Mechanisms and Management Heart Failure with Preserved Ejection Fraction: Mechanisms and Management Jay N. Cohn, M.D. Professor of Medicine Director, Rasmussen Center for Cardiovascular Disease Prevention University of Minnesota

More information

Heart failure (HF) is a complex clinical syndrome that results in the. impairment of the heart s ability to fill or to pump out blood.

Heart failure (HF) is a complex clinical syndrome that results in the. impairment of the heart s ability to fill or to pump out blood. Introduction: Heart failure (HF) is a complex clinical syndrome that results in the impairment of the heart s ability to fill or to pump out blood. As of 2013, an estimated 5.8 million people in the United

More information

The Approach to Patients with Heart Failure and Mid-Range (40-50%) Ejection Fraction (HFmrEF)

The Approach to Patients with Heart Failure and Mid-Range (40-50%) Ejection Fraction (HFmrEF) The Approach to Patients with Heart Failure and Mid-Range (40-50%) Ejection Fraction (HFmrEF) 22 nd Annual Heart Failure 2018 an Update on Therapy April 21, 2018 Los Angeles, CA Barry Greenberg, M.D. Distinguished

More information

Prof. Andrzej Wiecek Department of Nephrology, Endocrinology and Metabolic Diseases Medical University of Silesia Katowice, Poland.

Prof. Andrzej Wiecek Department of Nephrology, Endocrinology and Metabolic Diseases Medical University of Silesia Katowice, Poland. What could be the role of renal denervation in chronic kidney disease? Andrzej Wiecek, Katowice, Poland Chairs: Peter J. Blankestijn, Utrecht, The Netherlands Jonathan Moss, Glasgow, UK Prof. Andrzej Wiecek

More information

Patient Susceptibilities in Preclinical Drug Safety Assessment

Patient Susceptibilities in Preclinical Drug Safety Assessment Patient Susceptibilities in Preclinical Drug Safety Assessment B. R. Berridge GlaxoSmithKline ILAR Roundtable October, 2017 Animal studies represent an apical preclinical modeling system in drug development

More information

Congestive Heart Failure: Outpatient Management

Congestive Heart Failure: Outpatient Management The Chattanooga Heart Institute Cardiovascular Symposium Congestive Heart Failure: Outpatient Management E. Philip Lehman MD, MPP Disclosure No financial disclosures. Objectives Evidence-based therapy

More information

Review of Cardiac Imaging Modalities in the Renal Patient. George Youssef

Review of Cardiac Imaging Modalities in the Renal Patient. George Youssef Review of Cardiac Imaging Modalities in the Renal Patient George Youssef ECHO Left ventricular hypertrophy (LVH) assessment Diastolic dysfunction Stress ECHO Cardiac CT angiography Echocardiography - positives

More information

Alterations in cardiomyocyte function during diastolic heart failure

Alterations in cardiomyocyte function during diastolic heart failure Alterations in cardiomyocyte function during diastolic heart failure Attila Borbély VUmc UDMHSC, Division of Clinical Physiology, Institute of Cardiology, Debrecen, Hungary Laboratory for Physiology, ICaR-VU

More information

What to do for the Patient with Heart Failure and Preserved Ejection Fraction: HFpEF

What to do for the Patient with Heart Failure and Preserved Ejection Fraction: HFpEF What to do for the Patient with Heart Failure and Preserved Ejection Fraction: HFpEF Mariell Jessup MD, FAHA, FACC, FESC Professor of Medicine University of Pennsylvania Philadelphia, Pennsylvania Disclosure:

More information

renoprotection therapy goals 208, 209

renoprotection therapy goals 208, 209 Subject Index Aldosterone, plasminogen activator inhibitor-1 induction 163, 164, 168 Aminopeptidases angiotensin II processing 64 66, 214 diabetic expression 214, 215 Angiotensin I intrarenal compartmentalization

More information

Uncovering the mechanisms of wound healing and fibrosis

Uncovering the mechanisms of wound healing and fibrosis Any Questions??? Ask now or contact support support@sabiosciences.com 1-888-503-3187 International customers: SABio@Qiagen.com Uncovering the mechanisms of wound healing and fibrosis Webinar related questions:

More information

Extracellular matrix Basic and translational science: Highlights of the congress

Extracellular matrix Basic and translational science: Highlights of the congress Extracellular matrix Basic and translational science: Highlights of the congress Stephane Heymans, Maastricht University Medical Centre, CARIM, Netherlands Speaker The extracellular matrix modulates cardiac

More information

Index. cardiology.theclinics.com. Note: Page numbers of article titles are in boldface type.

Index. cardiology.theclinics.com. Note: Page numbers of article titles are in boldface type. Note: Page numbers of article titles are in boldface type. A Acute myocardial infarction contemporary DES platforms in patients with, 290 AF. See Atrial fibrillation (AF) African Americans dietary factors

More information

HFpEF, Mito or Realidad?

HFpEF, Mito or Realidad? HFpEF, Mito or Realidad? Ileana L. Piña, MD, MPH Professor of Medicine and Epidemiology/Population Health Associate Chief for Academic Affairs -- Cardiology Montefiore-Einstein Medical Center Bronx, NY

More information

AN INNOVATIVE APPROCH TOWARDS IDENTIFICAION OF NOVEL THERAPEUTIC DRUG TARGETS TO IMPROVE THE MANAGEMENT OF HEART FAILURE

AN INNOVATIVE APPROCH TOWARDS IDENTIFICAION OF NOVEL THERAPEUTIC DRUG TARGETS TO IMPROVE THE MANAGEMENT OF HEART FAILURE AN INNOVATIVE APPROCH TOWARDS IDENTIFICAION OF NOVEL THERAPEUTIC DRUG TARGETS TO IMPROVE THE MANAGEMENT OF HEART FAILURE Cardiology, New solutions for drug development, Cutting-edge technologies, Multi-disciplinary

More information

Cardiovascular Complications Of Chronic Kidney Disease. Dr Atir Khan Consultant Physician Diabetes & Endocrinology West Wales Hospital, Carmarthen

Cardiovascular Complications Of Chronic Kidney Disease. Dr Atir Khan Consultant Physician Diabetes & Endocrinology West Wales Hospital, Carmarthen Cardiovascular Complications Of Chronic Kidney Disease Dr Atir Khan Consultant Physician Diabetes & Endocrinology West Wales Hospital, Carmarthen Markers of kidney dysfunction Raised Albumin / Creatinine

More information

Renal Denervation. Henry Krum MBBS PhD FRACP. Centre of Cardiovascular Research & Monash University/Alfred Hospital;

Renal Denervation. Henry Krum MBBS PhD FRACP. Centre of Cardiovascular Research & Monash University/Alfred Hospital; Renal Denervation Henry Krum MBBS PhD FRACP Centre of Cardiovascular Research & Education in Therapeutics, Monash University/Alfred Hospital; Alfred Heart Centre, The Alfred Hospital, Melbourne Australia

More information

Effects of Kidney Disease on Cardiovascular Morbidity and Mortality

Effects of Kidney Disease on Cardiovascular Morbidity and Mortality Effects of Kidney Disease on Cardiovascular Morbidity and Mortality Joachim H. Ix, MD, MAS Assistant Professor in Residence Division of Nephrology University of California San Diego, and Veterans Affairs

More information

Biomarkers in cardiovascular disease. Felix J. Rogers, DO, FACOI April 29, 2018

Biomarkers in cardiovascular disease. Felix J. Rogers, DO, FACOI April 29, 2018 Biomarkers in cardiovascular disease Felix J. Rogers, DO, FACOI April 29, 2018 Biomarkers NIH: A biomarker is a characteristic that is objectively measured and evaluated as an indicator of normal biological

More information

Atrial Fibrillation and Heart Failure: A Cause or a Consequence

Atrial Fibrillation and Heart Failure: A Cause or a Consequence Atrial Fibrillation and Heart Failure: A Cause or a Consequence Rajat Deo, MD, MTR Assistant Professor of Medicine Division of Cardiology, Electrophysiology Section University of Pennsylvania November

More information

Hypertension, Remodelling and Novel Biomarkers in African Subjects

Hypertension, Remodelling and Novel Biomarkers in African Subjects Hypertension, Remodelling and Novel Biomarkers in African Subjects Dike Ojji MBBS, PhD, FWACP, FACP, FESC Senior Lecturer, Department of Medicine, Faculty of Health Sciences, University of Abuja & Honorary

More information

Chapter 4: Cardiovascular Disease in Patients With CKD

Chapter 4: Cardiovascular Disease in Patients With CKD Chapter 4: Cardiovascular Disease in Patients With CKD The prevalence of cardiovascular disease is 68.8% among patients aged 66 and older who have CKD, compared to 34.1% among those who do not have CKD

More information

Pathophysiology and Diagnosis of Heart Failure

Pathophysiology and Diagnosis of Heart Failure Pathophysiology and Diagnosis of Heart Failure Francesco Paneni, MD, PhD, FESC Cardiology Unit Karolinska University Hospital Stockholm, Sweden Cardiology University Hospital Zurich Switzerland francesco.paneni@gmail.com

More information

Μαρία Μπόνου Διευθύντρια ΕΣΥ, ΓΝΑ Λαϊκό

Μαρία Μπόνου Διευθύντρια ΕΣΥ, ΓΝΑ Λαϊκό Μαρία Μπόνου Διευθύντρια ΕΣΥ, ΓΝΑ Λαϊκό Diastolic HF DD: Diastolic Dysfunction DHF: Diastolic HF HFpEF: HF with preserved EF DD Pathophysiologic condition: impaired relaxation, LV compliance, LV filling

More information

Heart Failure. GP Update Refresher 18 th January 2018

Heart Failure. GP Update Refresher 18 th January 2018 GP Update Refresher 18 th January 2018 Heart Failure Dr. Alexander Lyon Senior Lecturer and Consultant Cardiologist Clinical Lead in Cardio-Oncology Royal Brompton Hospital, London UK President of British

More information

Βασιλική Κατσή. Καρδιολόγος ΓNA Ιπποκράτειο

Βασιλική Κατσή. Καρδιολόγος ΓNA Ιπποκράτειο Βασιλική Κατσή Καρδιολόγος ΓNA Ιπποκράτειο 40 διαφάνειες ίσως Και πρέπει και δικαιούνται ΣΥΧΝΟΤΕΡΑ 76-96% 3343 men and 4199 women followed for 25 years, no HF at baseline BP (mm Hg)

More information

Atrial fibrillation and stroke. Isabelle C Van Gelder University Medical Center Groningen The Netherlands

Atrial fibrillation and stroke. Isabelle C Van Gelder University Medical Center Groningen The Netherlands Atrial fibrillation and stroke Isabelle C Van Gelder University Medical Center Groningen The Netherlands ESC stroke council Prague January 2018 Content Stroke what is the problem for patients with AF?

More information

Mechanisms of Action for Arsenic in Cardiovascular Toxicity and Implications for Risk Assessment

Mechanisms of Action for Arsenic in Cardiovascular Toxicity and Implications for Risk Assessment Mechanisms of Action for Arsenic in Cardiovascular Toxicity and Implications for Risk Assessment Mandeep Sidhu, MD, MBA, FACC Assistant Professor of Medicine Division of Cardiology Albany Medical College

More information

Objectives. Systolic Heart Failure: Definitions. Heart Failure: Historical Perspective 2/7/2009

Objectives. Systolic Heart Failure: Definitions. Heart Failure: Historical Perspective 2/7/2009 Objectives Diastolic Heart Failure and Indications for Echocardiography in the Asian Population Damon M. Kwan, MD UCSF Asian Heart & Vascular Symposium 02.07.09 Define diastolic heart failure and differentiate

More information

Peripheral Contributions to HFpEF

Peripheral Contributions to HFpEF Peripheral Contributions to HFpEF Greg Lewis MD Heart Failure Section Head MGH Cardiology Division and Pulmonary Critical Care Unit Harvard Medical School March 12, 2018 Pathophysiology of HFpEF vs. HFrEF

More information

Beta-blockers in Patients with Mid-range Left Ventricular Ejection Fraction after AMI Improved Clinical Outcomes

Beta-blockers in Patients with Mid-range Left Ventricular Ejection Fraction after AMI Improved Clinical Outcomes Beta-blockers in Patients with Mid-range Left Ventricular Ejection Fraction after AMI Improved Clinical Outcomes Seung-Jae Joo and other KAMIR-NIH investigators Department of Cardiology, Jeju National

More information

Advanced Care for Decompensated Heart Failure

Advanced Care for Decompensated Heart Failure Advanced Care for Decompensated Heart Failure Sara Kalantari MD Assistant Professor of Medicine, University of Chicago Advanced Heart Failure, Mechanical Circulatory Support and Cardiac Transplantation

More information

Women s Heart Health: Holistic Approaches Throughout the Lifetime - Key Differences in Heart Failure in Women

Women s Heart Health: Holistic Approaches Throughout the Lifetime - Key Differences in Heart Failure in Women Women s Heart Health: Holistic Approaches Throughout the Lifetime - Key Differences in Heart Failure in Women C. Noel Bairey Merz MD Medical Director and Barbra Streisand Women s Heart Center Preventive

More information

Advanced Heart Failure and Transplant Cardiology

Advanced Heart Failure and Transplant Cardiology Advanced Heart Failure and Transplant Cardiology Certification Examination Blueprint Purpose of the exam The exam is designed to evaluate the knowledge, diagnostic reasoning, and clinical judgment skills

More information

Management of Heart Failure in Adult with Congenital Heart Disease

Management of Heart Failure in Adult with Congenital Heart Disease Management of Heart Failure in Adult with Congenital Heart Disease Ahmed Krimly Interventional and ACHD consultant King Faisal Cardiac Center National Guard Jeddah Background 0.4% of adults have some form

More information

Vitamin D & Cardiovascular Disease

Vitamin D & Cardiovascular Disease Vitamin D & Cardiovascular Disease Disclosures None Vitamin D Objectives: Discuss the basics of vitamin D metabolism Discuss the role of vitamin D deficiency in the development of coronary disease Review

More information

Heart Failure Guidelines For your Daily Practice

Heart Failure Guidelines For your Daily Practice Heart Failure Guidelines For your Daily Practice Juan M. Aranda, Jr., MD, FACC, FHFSA Professor of Medicine Director of Heart Failure and Cardiac Transplantation University of Florida College of Medicine

More information

Antialdosterone treatment in heart failure

Antialdosterone treatment in heart failure Update on the Treatment of Chronic Heart Failure 2012 Antialdosterone treatment in heart failure 전남의대윤현주 Chronic Heart Failure Prognosis of Heart failure Cecil, Text book of Internal Medicine, 22 th edition

More information

DISCLAIMER: ECHO Nevada emphasizes patient privacy and asks participants to not share ANY Protected Health Information during ECHO clinics.

DISCLAIMER: ECHO Nevada emphasizes patient privacy and asks participants to not share ANY Protected Health Information during ECHO clinics. DISCLAIMER: Video will be taken at this clinic and potentially used in Project ECHO promotional materials. By attending this clinic, you consent to have your photo taken and allow Project ECHO to use this

More information

Inhaled sodium nitrite in pulmonary hypertension associated with heart failure with preserved ejection fraction

Inhaled sodium nitrite in pulmonary hypertension associated with heart failure with preserved ejection fraction Inhaled sodium nitrite in pulmonary hypertension associated with heart failure with preserved ejection fraction 4th Annual Pulmonary Hypertension Drug Discovery and Development Symposium July -, 7 Berlin,

More information

Diastolic Dysfunction: Hypertension to Hypertrophy to Heart Failure

Diastolic Dysfunction: Hypertension to Hypertrophy to Heart Failure Diastolic Dysfunction: Hypertension to Hypertrophy to Heart Failure Dr. Shelley Zieroth FRCPC Assistant Professor, Cardiology, University of Manitoba Director of Cardiac Transplant and Heart Failure Clinics

More information

UPDATES IN MANAGEMENT OF HF

UPDATES IN MANAGEMENT OF HF UPDATES IN MANAGEMENT OF HF Jennifer R Brown MD, MS Heart Failure Specialist Medstar Cardiology Associates DC ACP Meeting Fall 2017 Disclosures: speaker bureau for novartis speaker bureau for actelion

More information

Pathophysiology of Coronary Microvascular Dysfunction

Pathophysiology of Coronary Microvascular Dysfunction Pathophysiology of Coronary Microvascular Dysfunction Cheol Woong Yu, MD, PhD Cardiology Department Division of Internal Medicine Korea University Anam Hospital. Etiologies of Chest Pain without obstructive

More information

FOCUS ON CARDIOVASCULAR DISEASE

FOCUS ON CARDIOVASCULAR DISEASE The Consequences of Vitamin D Deficiency: FOCUS ON CARDIOVASCULAR DISEASE Vitamin D deficiency is a global health problem. With all the medical advances of the century, vitamin D deficiency is still epidemic.

More information

Entresto Development of sacubitril/valsartan (LCZ696) for the treatment of heart failure with reduced ejection fraction

Entresto Development of sacubitril/valsartan (LCZ696) for the treatment of heart failure with reduced ejection fraction Cardio-Metabolic Franchise Entresto Development of sacubitril/valsartan (LCZ696) for the treatment of heart failure with reduced ejection fraction Randy L Webb, PhD Rutgers Workshop October 21, 2016 Heart

More information

Hans Strijdom SA Heart Meeting November 2017

Hans Strijdom SA Heart Meeting November 2017 Hans Strijdom SA Heart Meeting November 2017 HIV-infection and ART, but not high sensitivity CRP, are associated with markers of vascular function: Results from the Western Cape cohort of the EndoAfrica

More information

Hormonal Alterations in Heart Failure: Anabolic Impairment in Chronic Heart Failure Diagnostic, Prognostic and Therapeutic Issues

Hormonal Alterations in Heart Failure: Anabolic Impairment in Chronic Heart Failure Diagnostic, Prognostic and Therapeutic Issues Hormonal Alterations in Heart Failure: Anabolic Impairment in Chronic Heart Failure Diagnostic, Prognostic and Therapeutic Issues Michele Arcopinto Antonio Cittadini Department of Translational Medical

More information

Cardiac Gene Therapy: Beyond the Mouse. David M Kaye Heart Failure Research Group Baker IDI, Melbourne, AUSTRALIA

Cardiac Gene Therapy: Beyond the Mouse. David M Kaye Heart Failure Research Group Baker IDI, Melbourne, AUSTRALIA Cardiac Gene Therapy: Beyond the Mouse David M Kaye Heart Failure Research Group Baker IDI, Melbourne, AUSTRALIA Presenter Disclosure Information FINANCIAL DISCLOSURE: Equity: Osprey Medical Grants/Research

More information

Disclosures. Speaker s bureau: Research grant: Advisory Board: Servier International, Bayer, Merck Serono, Novartis, Boehringer Ingelheim, Lupin

Disclosures. Speaker s bureau: Research grant: Advisory Board: Servier International, Bayer, Merck Serono, Novartis, Boehringer Ingelheim, Lupin Disclosures Speaker s bureau: Research grant: Advisory Board: Servier International, Bayer, Merck Serono, Novartis, Boehringer Ingelheim, Lupin Servier International, Boehringer Ingelheim Servier International,

More information

REVIEW ARTICLE NEWER BIOMARKERS IN EARLY DIABETIC NEPHROPATHY

REVIEW ARTICLE NEWER BIOMARKERS IN EARLY DIABETIC NEPHROPATHY JCD REVIEW ARTICLE NEWER BIOMARKERS IN EARLY DIABETIC NEPHROPATHY SAPTARSHI MUKHOPADHYAY* *FACULTY (DEPARTMENT OF MEDICINE), B R SINGH HOSPITAL (EASTERN RAILWAY), KOLKATA. INTRODUCTION renal disease. It

More information

HEART FAILURE IN WOMEN. Marian Limacher, MD Division of Cardiovascular Medicine University of Florida

HEART FAILURE IN WOMEN. Marian Limacher, MD Division of Cardiovascular Medicine University of Florida HEART FAILURE IN WOMEN Marian Limacher, MD Division of Cardiovascular Medicine University of Florida Outline Epidemiology Clinical Overview Why HF is such a challenge State of the Field Heart Failure Adjudication

More information

Correlation of novel cardiac marker

Correlation of novel cardiac marker Correlation of novel cardiac marker and mortality in EGAT population. Soluble ST2 hscrp Poh Chanyavanich, MD SukitYamwong, MD Piyamitr Sritara, MD Ramathibodi hospital Background hscrp - the most widely

More information

How toxic is uric acid? Elisabetta Toso, MD Città della Salute e della Scienza di Torino Cardiology Division, University of Turin

How toxic is uric acid? Elisabetta Toso, MD Città della Salute e della Scienza di Torino Cardiology Division, University of Turin How toxic is uric acid? Elisabetta Toso, MD Città della Salute e della Scienza di Torino Cardiology Division, University of Turin Uric acid is a heterocyclic compound of carbon, nitrogen, oxygen and hydrogen.

More information

Diastolic Heart Failure. Edwin Tulloch-Reid MBBS FACC Consultant Cardiologist Heart Institute of the Caribbean December 2012

Diastolic Heart Failure. Edwin Tulloch-Reid MBBS FACC Consultant Cardiologist Heart Institute of the Caribbean December 2012 Diastolic Heart Failure Edwin Tulloch-Reid MBBS FACC Consultant Cardiologist Heart Institute of the Caribbean December 2012 Disclosures Have spoken for Merck, Sharpe and Dohme Sat on a physician advisory

More information

What s new in 2016 Guidelines of the European Society of Cardiology? HEART FAILURE. Marc Ferrini (Lyon Fr)

What s new in 2016 Guidelines of the European Society of Cardiology? HEART FAILURE. Marc Ferrini (Lyon Fr) What s new in 2016 Guidelines of the European Society of Cardiology? HEART FAILURE Marc Ferrini (Lyon Fr) Palermo (I) 1 04 2017 Consulting Fees, Honoraria: BAYER PHARMA BOEHRINGER INGELHEIM BRISTOL MEYERS

More information

HEART FAILURE: PHARMACOTHERAPY UPDATE

HEART FAILURE: PHARMACOTHERAPY UPDATE HEART FAILURE: PHARMACOTHERAPY UPDATE 3 HEART FAILURE REVIEW 1 5.1 million x1.25 = 6.375 million 40 years old = MICHAEL F. AKERS, PHARM.D. CLINICAL PHARMACIST CENTRACARE HEALTH, ST. CLOUD HOSPITAL HF Diagnosis

More information

Structural abnormalities of the heart and vascular system in CKD & Dialysis - Thick but weak

Structural abnormalities of the heart and vascular system in CKD & Dialysis - Thick but weak Structural abnormalities of the heart and vascular system in CKD & Dialysis - Thick but weak Kerstin Amann Nephropathology, Dept. of Pathology, University of Erlangen-Nürnberg Krankenhausstr. 8-10 91054

More information

Role of Inflammatory and Progenitor Cells in Pulmonary Vascular Remodeling: Potential Role for Targeted Therapies. Traditional Hypothesis Stress

Role of Inflammatory and Progenitor Cells in Pulmonary Vascular Remodeling: Potential Role for Targeted Therapies. Traditional Hypothesis Stress 3/1/212 Role of Inflammatory and Progenitor Cells in Pulmonary Vascular Remodeling: Potential Role for Targeted Therapies K.R. Stenmark University of Colorado Denver, CO 845 Prominent Fibroproliferative

More information

Selected age-associated changes in the cardiovascular system

Selected age-associated changes in the cardiovascular system Selected age-associated changes in the cardiovascular system Tamara Harris, M.D., M.S. Chief, Interdisciplinary Studies of Aging Acting Co-Chief, Laboratory of Epidemiology and Population Sciences Intramural

More information

Heart Failure. Disclosures. Objectives: 8/28/2017. This is not a virus. It doesn t go away. none

Heart Failure. Disclosures. Objectives: 8/28/2017. This is not a virus. It doesn t go away. none Heart Failure This is not a virus. It doesn t go away Shelley Wojtaszczyk, FNP-C, CHFN Heart Failure Program Coordinator Mercy Hospital of Buffalo none Disclosures Objectives: Defining and identifying

More information

Heart Failure in Women: Dr Goh Ping Ping Cardiologist Asian Heart & Vascular Centre

Heart Failure in Women: Dr Goh Ping Ping Cardiologist Asian Heart & Vascular Centre Heart Failure in Women: More than EF? Dr Goh Ping Ping Cardiologist Asian Heart & Vascular Centre Overview Review pathophysiology as it relates to diagnosis and management Rational approach to workup:

More information

Heart Failure. Guillaume Jondeau Hôpital Bichat, Paris, France

Heart Failure. Guillaume Jondeau Hôpital Bichat, Paris, France Heart Failure Guillaume Jondeau Hôpital Bichat, Paris, France Epidemiology Importance of PEF Europe I-PREFER study. Abstract: 2835 Prevalence of HF Preserved LV systolic Function older (65 vs 62 y, p

More information

Role of spironolactone in the treatment of heart failure with preserved ejection fraction

Role of spironolactone in the treatment of heart failure with preserved ejection fraction Review Article Page 1 of 5 Role of spironolactone in the treatment of heart failure with preserved ejection fraction Constantine E. Kosmas 1, Delia Silverio 2, Andreas Sourlas 3, Peter D. Montan 2, Eliscer

More information

Preliminary Programme

Preliminary Programme Preliminary Programme The scientific programme comprises various styles of presentations and sessions, each offering a unique opportunity to amass new and important scientific information. Optimal management

More information

Mayo Clinic Proceedings September 2018 Issue Summary

Mayo Clinic Proceedings September 2018 Issue Summary Greetings, I am Dr Karl Nath, the Editor-in-Chief of Mayo Clinic Proceedings, and I am pleased to welcome you to the multimedia summary for the journal s September 2018 issue. There are 4 articles this

More information

Checklist for Treating Heart Failure. Alan M. Kaneshige MD, FACC, FASE Oklahoma Heart Institute

Checklist for Treating Heart Failure. Alan M. Kaneshige MD, FACC, FASE Oklahoma Heart Institute Checklist for Treating Heart Failure Alan M. Kaneshige MD, FACC, FASE Oklahoma Heart Institute Novartis Disclosure Heart Failure (HF) a complex clinical syndrome that arises secondary to abnormalities

More information