2024
Win Ratio Analyses Using a Modified Hierarchical Composite Outcome: Insights from PARAGLIDE-HF
Shoji S, Cyr D, Hernandez A, Velazquez E, Ward J, Williamson K, Sarwat S, Starling R, Desai A, Zieroth S, Solomon S, Mentz R. Win Ratio Analyses Using a Modified Hierarchical Composite Outcome: Insights from PARAGLIDE-HF. American Heart Journal 2024 PMID: 39505123, DOI: 10.1016/j.ahj.2024.10.020.Peer-Reviewed Original ResearchNT-proBNPComposite outcomeRenal outcomesEjection fractionHeart failureN-terminal pro-B-type natriuretic peptidePro-B-type natriuretic peptideNT-proBNP thresholdsNT-proBNP changesClinically significant eventsNatriuretic peptideAssessment of treatment effectsHF hospitalizationCardiovascular deathTreatment effectsTreatment benefitComprehensive assessment of treatment effectsPrimary analysisValsartanHF visitsSecondary analysisPatientsHierarchical outcomesOutcomesA Multimodal Video-Based AI Biomarker for Aortic Stenosis Development and Progression
Oikonomou E, Holste G, Yuan N, Coppi A, McNamara R, Haynes N, Vora A, Velazquez E, Li F, Menon V, Kapadia S, Gill T, Nadkarni G, Krumholz H, Wang Z, Ouyang D, Khera R. A Multimodal Video-Based AI Biomarker for Aortic Stenosis Development and Progression. JAMA Cardiology 2024, 9: 534-544. PMID: 38581644, PMCID: PMC10999005, DOI: 10.1001/jamacardio.2024.0595.Peer-Reviewed Original ResearchCardiac magnetic resonanceAortic valve replacementCardiac magnetic resonance imagingAV VmaxSevere ASAortic stenosisCohort studyPeak aortic valve velocityCohort study of patientsAortic valve velocityCohort of patientsTraditional cardiovascular risk factorsAssociated with faster progressionStudy of patientsCedars-Sinai Medical CenterAssociated with AS developmentCardiovascular risk factorsCardiovascular imaging modalitiesIndependent of ageModerate ASEjection fractionEchocardiographic studiesValve replacementRisk stratificationCardiac structureAssociation of Sacubitril/Valsartan versus Valsartan with Blood Pressure Changes, and Symptomatic Hypotension: The PARAGLIDE-HF Trial
Fudim M, Cyr D, Ward J, Hernandez A, Lepage S, Morrow D, Sharma K, Claggett B, Starling R, Velazquez E, Williamson K, Desai A, Zieroth S, Solomon S, Braunwald E, Mentz R, Investigators P. Association of Sacubitril/Valsartan versus Valsartan with Blood Pressure Changes, and Symptomatic Hypotension: The PARAGLIDE-HF Trial. Journal Of Cardiac Failure 2024 PMID: 38802053, DOI: 10.1016/j.cardfail.2024.04.030.Peer-Reviewed Original ResearchLeft ventricular ejection fractionWorsening heart failureBaseline systolic blood pressureSystolic blood pressureVentricular ejection fractionEjection fractionSymptomatic hypotensionNT-proBNPHeart failureBlood pressureLow baseline systolic blood pressureTime-averaged proportional changeMildly reduced ejection fractionPlasma NT-proBNP levelsAssociated with clinical benefitB-type natriuretic peptideNT-proBNP levelsReduced ejection fractionMedian blood pressureBlood pressure changesSH eventsTime-averaged changePrimary endpointNatriuretic peptideRandomized patientsTorsemide Versus Furosemide After Discharge in Patients Hospitalized With Heart Failure Across the Spectrum of Ejection Fraction: Findings From TRANSFORM-HF
Kapelios C, Greene S, Mentz R, Ikeaba U, Wojdyla D, Anstrom K, Eisenstein E, Pitt B, Velazquez E, Fang J, Investigators T. Torsemide Versus Furosemide After Discharge in Patients Hospitalized With Heart Failure Across the Spectrum of Ejection Fraction: Findings From TRANSFORM-HF. Circulation Heart Failure 2024, 17: e011246. PMID: 38436075, PMCID: PMC10950535, DOI: 10.1161/circheartfailure.123.011246.Peer-Reviewed Original ResearchConceptsLeft ventricular ejection fractionLVEF groupsKansas City Cardiomyopathy Questionnaire Clinical Summary ScoreMildly reduced left ventricular ejection fractionBaseline left ventricular ejection fractionReduced left ventricular ejection fractionClinical summary scoreHeart failureNo significant differenceEjection fractionClinical outcomesLVEF spectrumSignificant differenceLeft ventricular ejection fraction dataEnd pointsSpectrum of ejection fractionEffect of torsemideRisk of clinical outcomesVentricular ejection fractionStudy end pointBaseline patient characteristicsClinical end pointsSummary scoreAll-cause mortalityPrevalence of comorbiditiesSacubitril/Valsartan in Patients Hospitalized With Decompensated Heart Failure
Morrow D, Velazquez E, Desai A, DeVore A, Lepage S, Park J, Sharma K, Solomon S, Starling R, Ward J, Williamson K, Zieroth S, Hernandez A, Mentz R, Braunwald E. Sacubitril/Valsartan in Patients Hospitalized With Decompensated Heart Failure. Journal Of The American College Of Cardiology 2024, 83: 1123-1132. PMID: 38508844, DOI: 10.1016/j.jacc.2024.01.027.Peer-Reviewed Original ResearchConceptsWorsening heart failureHeart failureEjection fractionNT-proBNPSpectrum of EFPIONEER-HFSpectrum of left ventricular ejection fractionRandomized trialsTime-averaged proportional changeN-terminal pro-B-type natriuretic peptidePro-B-type natriuretic peptideLeft ventricular ejection fractionWorsening heart failure eventDecompensated heart failureVentricular ejection fractionPlasma NT-proBNPPIONEER-HF trialDouble-blindMedian ageMedian EFSNatriuretic peptideSymptomatic hypotensionBaseline characteristicsClinical outcomesPooled analysisFactors associated with reporting left ventricular ejection fraction with 3D echocardiography in real‐world practice
Faridi K, Zhu Z, Shah N, Crandall I, McNamara R, Flueckiger P, Bachand K, Lombo B, Hur D, Agarwal V, Reinhardt S, Velazquez E, Sugeng L. Factors associated with reporting left ventricular ejection fraction with 3D echocardiography in real‐world practice. Echocardiography 2024, 41: e15774. PMID: 38329886, DOI: 10.1111/echo.15774.Peer-Reviewed Original ResearchConceptsTransthoracic echocardiogramVentricular ejection fractionOutpatient transthoracic echocardiogramsReal-world practiceEjection fractionLeft ventricular ejection fractionAssess left ventricular ejection fractionInpatient transthoracic echocardiogramsMultivariate logistic regressionLVEFHospitalized patientsMedical CenterSonographersClinical settingLogistic regressionUltrasound machineChemotherapyContrast enhancement agentsPortable studiesNegative associationTorsemide vs Furosemide Among Patients With New-Onset vs Worsening Chronic Heart Failure
Krim S, Anand S, Greene S, Chen A, Wojdyla D, Vilaro J, Haught H, Herre J, Eisenstein E, Anstrom K, Pitt B, Velazquez E, Mentz R. Torsemide vs Furosemide Among Patients With New-Onset vs Worsening Chronic Heart Failure. JAMA Cardiology 2024, 9: 182-188. PMID: 37955908, PMCID: PMC10644243, DOI: 10.1001/jamacardio.2023.4776.Peer-Reviewed Original ResearchDe novo heart failureNovo heart failureChronic heart failureHeart failurePatient-reported outcomesCause mortalityHF typeKansas City Cardiomyopathy Questionnaire clinical summary scoreHigher glomerular filtration rateSignificant differencesHeart Failure TrialGlomerular filtration rateClinical summary scoreDiuretic strategyFirst rehospitalizationCause hospitalizationNew onsetTotal hospitalizationsClinical characteristicsClinical profileEjection fractionLoop diureticsFailure TrialHospitalization outcomesNatriuretic peptide
2023
Predicting aortic stenosis progression using a video-based deep learning model of aortic stenosis built for single-view two-dimensional echocardiography
Oikonomou E, Holste G, Mcnamara R, Velazquez E, Nadkarni G, Ouyang D, Krumholz H, Wang Z, Khera R. Predicting aortic stenosis progression using a video-based deep learning model of aortic stenosis built for single-view two-dimensional echocardiography. European Heart Journal 2023, 44: ehad655.040. DOI: 10.1093/eurheartj/ehad655.040.Peer-Reviewed Original ResearchLeft ventricular ejection fractionSevere aortic stenosisAortic stenosisAS progressionAV VmaxTransthoracic echocardiographyYale New Haven Health SystemBaseline left ventricular ejection fractionAortic stenosis progressionModerate aortic stenosisRetrospective cohort studyVentricular ejection fractionTwo-dimensional echocardiographyMean rateModerate ASAS severityCohort studyEjection fractionPatient sexStenosis progressionTTE studiesEligible participantsSerial monitoringSpecialized centersTimely diagnosisThe Impact of Ejection Fraction on Major Adverse Limb Events after Lower Extremity Revascularization
Jamil Y, Huttler J, Alameddine D, Wu Z, Zhuo H, Mena-Hurtado C, Velazquez E, Guzman R, Ochoa Chaar C. The Impact of Ejection Fraction on Major Adverse Limb Events after Lower Extremity Revascularization. Annals Of Vascular Surgery 2023, 98: 210-219. PMID: 37802138, DOI: 10.1016/j.avsg.2023.08.009.Peer-Reviewed Original ResearchMajor adverse limb eventsReduced ejection fractionLower extremity revascularizationPeripheral arterial diseaseMALE-free survivalAdverse limb eventsCoronary artery diseaseEjection fractionExtremity revascularizationArtery diseaseLimb eventsChronic limb-threatening ischemiaLimb-threatening ischemiaTricuspid valve regurgitationKaplan-Meier curvesElectronic medical recordsMajor amputationSevere mitralDiastolic dysfunctionEchocardiographic findingsTransthoracic echocardiogramHeart failureValve regurgitationArterial diseaseSingle centerElectronic health record alerts for management of heart failure with reduced ejection fraction in hospitalized patients: the PROMPT-AHF trial
Ghazi L, Yamamoto Y, Fuery M, O'Connor K, Sen S, Samsky M, Riello R, Dhar R, Huang J, Olufade T, McDermott J, Inzucchi S, Velazquez E, Wilson F, Desai N, Ahmad T. Electronic health record alerts for management of heart failure with reduced ejection fraction in hospitalized patients: the PROMPT-AHF trial. European Heart Journal 2023, 44: 4233-4242. PMID: 37650264, DOI: 10.1093/eurheartj/ehad512.Peer-Reviewed Original ResearchGuideline-directed medical therapyAcute heart failureMineralocorticoid receptor antagonistsHeart failureElectronic health recordsGDMT prescriptionPrimary outcomeEnzyme inhibitors/angiotensin receptor blockers/angiotensin receptor-neprilysin inhibitorsSodium-glucose cotransporter 2 inhibitorsAngiotensin receptor neprilysin inhibitorElectronic health record alertsEvidence-based regimenProviders of patientsReduced ejection fractionCotransporter 2 inhibitorsRelevant patient characteristicsTime of dischargePre-specified criteriaAHF hospitalizationEligible patientsInpatient initiationPatient characteristicsEjection fractionHospitalized patientsMedian ageDetection of Left Ventricular Systolic Dysfunction From Electrocardiographic Images
Sangha V, Nargesi A, Dhingra L, Khunte A, Mortazavi B, Ribeiro A, Banina E, Adeola O, Garg N, Brandt C, Miller E, Ribeiro A, Velazquez E, Giatti L, Barreto S, Foppa M, Yuan N, Ouyang D, Krumholz H, Khera R. Detection of Left Ventricular Systolic Dysfunction From Electrocardiographic Images. Circulation 2023, 148: 765-777. PMID: 37489538, PMCID: PMC10982757, DOI: 10.1161/circulationaha.122.062646.Peer-Reviewed Original ResearchConceptsLV systolic dysfunctionYale-New Haven HospitalVentricular systolic dysfunctionSystolic dysfunctionLV ejection fractionBrazilian Longitudinal StudyNew Haven HospitalEjection fractionCardiology clinicRegional hospitalLeft ventricular systolic dysfunctionCedars-Sinai Medical CenterAdult Health (ELSA-Brasil) cohortAngiotensin-Neprilysin Inhibition in Patients With Mildly Reduced or Preserved Ejection Fraction and Worsening Heart Failure
Mentz R, Ward J, Hernandez A, Lepage S, Morrow D, Sarwat S, Sharma K, Starling R, Velazquez E, Williamson K, Desai A, Zieroth S, Solomon S, Braunwald E, Investigators P. Angiotensin-Neprilysin Inhibition in Patients With Mildly Reduced or Preserved Ejection Fraction and Worsening Heart Failure. Journal Of The American College Of Cardiology 2023, 82: 1-12. PMID: 37212758, DOI: 10.1016/j.jacc.2023.04.019.Peer-Reviewed Original ResearchConceptsSacubitril/valsartanEjection fractionWHF eventNT-proBNPSymptomatic hypotensionHeart failureAmino-terminal pro-B-type natriuretic peptideTerminal pro-B-type natriuretic peptidePro-B-type natriuretic peptidePlasma NT-proBNP levelsAngiotensin-Neprilysin InhibitionNT-proBNP changesNT-proBNP levelsUrgent HF visitsChronic heart failureHeart failure eventsLarge treatment effectsHF hospitalizationHF visitsCardiovascular deathPrimary endpointRenal functionClinical benefitNatriuretic peptideWeek 4Sacubitril/valsartan in heart failure with mildly reduced or preserved ejection fraction: a pre-specified participant-level pooled analysis of PARAGLIDE-HF and PARAGON-HF
Vaduganathan M, Mentz R, Claggett B, Miao Z, Kulac I, Ward J, Hernandez A, Morrow D, Starling R, Velazquez E, Williamson K, Desai A, Zieroth S, Lefkowitz M, McMurray J, Braunwald E, Solomon S. Sacubitril/valsartan in heart failure with mildly reduced or preserved ejection fraction: a pre-specified participant-level pooled analysis of PARAGLIDE-HF and PARAGON-HF. European Heart Journal 2023, 44: 2982-2993. PMID: 37210743, PMCID: PMC10424880, DOI: 10.1093/eurheartj/ehad344.Peer-Reviewed Original ResearchConceptsSacubitril/valsartanRenal composite endpointPARAGON-HFHeart failureEjection fractionPooled analysisHF eventsRenal eventsCardiovascular deathComposite endpointLeft ventricular ejection fractionVentricular ejection fractionActive-controlled trialParticipant-level dataPrimary endpointSecondary endpointsClinical outcomesNatriuretic peptideLike patientsTreatment benefitCare settingsPatientsPrimary analysisLVEFValsartanRationale, Design and Baseline Characteristics of the PARAGLIDE-HF Trial: Sacubitril/Valsartan vs Valsartan in HFmrEF and HFpEF With a Worsening Heart Failure Event
Mentz R, Ward J, Hernandez A, Lepage S, Morrow D, Sarwat S, Sharma K, Solomon S, Starling R, Velazquez E, Williamson K, Zieroth S, Braunwald E. Rationale, Design and Baseline Characteristics of the PARAGLIDE-HF Trial: Sacubitril/Valsartan vs Valsartan in HFmrEF and HFpEF With a Worsening Heart Failure Event. Journal Of Cardiac Failure 2023, 29: 922-930. PMID: 36796671, DOI: 10.1016/j.cardfail.2023.02.001.Peer-Reviewed Original ResearchConceptsSac/ValSacubitril/valsartanHeart failure eventsPARAGON-HF trialWHF eventNT-proBNPEjection fractionHeart failureClinical outcomesAmino-terminal pro-B-type natriuretic peptide levelsTerminal pro-B-type natriuretic peptide levelsB-type natriuretic peptide levelsDe novo HFChronic heart failureNatriuretic peptide levelsPrimary efficacy endpointPg/mLEfficacy endpointSafety endpointSecondary endpointsSymptomatic hypotensionBaseline characteristicsRenal functionStable patientsBlack patientsEffect of Torsemide vs Furosemide After Discharge on All-Cause Mortality in Patients Hospitalized With Heart Failure
Mentz R, Anstrom K, Eisenstein E, Sapp S, Greene S, Morgan S, Testani J, Harrington A, Sachdev V, Ketema F, Kim D, Desvigne-Nickens P, Pitt B, Velazquez E, Adams K, Bhatt K, DeWald T, Axsom K, Murthy S, Rich J, Testani J, Smith B, Vader J, McCulloch M, Skopicki H, Psotka M, Heroux A, Lala-Trindade A, Stevens G, Tang W, Lev Y, William P, Eberly A, Gottleib S, Haught W, Grafton G, Larned J, Tejwani L, Mody F, Krim S, Robinson M, Fang J, Adler A, Bell A, Banerjee D, Ruiz Duque E, Mizyed A, Rommel J, Arhinful J, Goyal P, Hall M, Hummel S, Shetty S, Haas D, Vilaro J, Alexy T, Herre J, Clark J, Ambrosy A, Gaglianello N, Ramasubbu K, Meadows J, Tabtabai S, Sherwood M, Hasni S, D'Urso M, Muneer B, Dunlap S, Davis W, Friedman D, Guglin M, Ferguson A, Abbate A, Smart F. Effect of Torsemide vs Furosemide After Discharge on All-Cause Mortality in Patients Hospitalized With Heart Failure. JAMA 2023, 329: 214-223. PMID: 36648467, PMCID: PMC9857435, DOI: 10.1001/jama.2022.23924.Peer-Reviewed Original ResearchConceptsCause mortalityHeart failureTorsemide groupFurosemide groupTotal hospitalizationsCause hospitalizationEffects of torsemideDiuretic strategyPrespecified subgroupsSecondary outcomesEjection fractionMedian agePrimary outcomeHospitalizationMAIN OUTCOMEPatientsFurosemideMortalityMonthsTorsemidePrimary hypothesisSignificant differencesFinal dateOutcomesTrials
2022
Pragmatic trial of messaging to providers about treatment of acute heart failure: The PROMPT-AHF trial
Ghazi L, O'Connor K, Yamamoto Y, Fuery M, Sen S, Samsky M, Riello R, Huang J, Olufade T, McDermott J, Inzucchi S, Velazquez E, Wilson F, Desai N, Ahmad T. Pragmatic trial of messaging to providers about treatment of acute heart failure: The PROMPT-AHF trial. American Heart Journal 2022, 257: 111-119. PMID: 36493842, DOI: 10.1016/j.ahj.2022.12.002.Peer-Reviewed Original ResearchConceptsGuideline-directed medical therapyAcute heart failureHeart failurePragmatic trialElectronic health recordsSubstantial health care costsBest practice advisoryReduced ejection fractionUsual care armHealth recordsTime of dischargeEvidence-based careHealth care costsClinical decision support systemAHF patientsCare armEligible patientsHF hospitalizationInpatient initiationCardiovascular deathMedication classesEjection fractionMedical therapyPrimary outcomePractice advisory
2021
Optimal medical therapy with or without surgical revascularization and long-term outcomes in ischemic cardiomyopathy
Farsky PS, White J, Al-Khalidi HR, Sueta CA, Rouleau J, Panza J, Velazquez E, O'Connor C, Investigators W, Dabrowski R, Djokovic L, Drazner M, Haddad H, Ali I, Keltai M, Naik A, Sopko G, Golba K, Andersson B, Carson P, Kukulski T. Optimal medical therapy with or without surgical revascularization and long-term outcomes in ischemic cardiomyopathy. Journal Of Thoracic And Cardiovascular Surgery 2021, 164: 1890-1899.e4. PMID: 33610365, PMCID: PMC8260609, DOI: 10.1016/j.jtcvs.2020.12.094.Peer-Reviewed Original ResearchConceptsOptimal medical therapyCoronary artery bypassMedical therapyArtery bypassIschemic cardiomyopathyCause mortalityIschemic Heart Failure (STICH) trialVentricular ejection fraction 35Improved long-term survivalEjection fraction 35Angiotensin receptor blockersHeart Failure TrialLower cardiovascular mortalityMultivariable Cox modelOutcomes of patientsVentricular ejection fractionCoronary artery diseaseLong-term outcomesLong-term survivalSurgical revascularizationReceptor blockersCardiovascular mortalityAntiplatelet drugsArtery diseaseEjection fraction
2020
Initiation of Angiotensin-Neprilysin Inhibition After Acute Decompensated Heart Failure
DeVore AD, Braunwald E, Morrow DA, Duffy CI, Ambrosy AP, Chakraborty H, McCague K, Rocha R, Velazquez EJ. Initiation of Angiotensin-Neprilysin Inhibition After Acute Decompensated Heart Failure. JAMA Cardiology 2020, 5: 202-207. PMID: 31825471, PMCID: PMC6990764, DOI: 10.1001/jamacardio.2019.4665.Peer-Reviewed Original ResearchMeSH KeywordsAcute DiseaseAgedAminobutyratesAngiotensin Receptor AntagonistsAngiotensin-Converting Enzyme InhibitorsBiphenyl CompoundsDrug CombinationsEnalaprilFemaleHeart FailureHospitalizationHumansMaleMiddle AgedNatriuretic Peptide, BrainNeprilysinPatient DischargePeptide FragmentsTetrazolesValsartanConceptsAcute decompensated heart failureSacubitril/valsartanNT-proBNP levelsDecompensated heart failureOpen-label studyReduced ejection fractionHospital initiationHeart failurePIONEER-HFEjection fractionWeek 8N-terminal pro-B-type natriuretic peptide levelsPro-B-type natriuretic peptide levelsOpen-label extension phaseAngiotensin-Neprilysin InhibitionHeart failure rehospitalizationPIONEER-HF trialWeek 8 visitNatriuretic peptide levelsActive-controlled trialCardiovascular deathComposite outcomeHemodynamic stabilityRecent hospitalizationClinical outcomes
2019
Association between systolic ejection time and outcomes in heart failure by ejection fraction
Patel PA, Ambrosy AP, Phelan M, Alenezi F, Chiswell K, Van Dyke MK, Tomfohr J, Honarpour N, Velazquez EJ. Association between systolic ejection time and outcomes in heart failure by ejection fraction. European Journal Of Heart Failure 2019, 22: 1174-1182. PMID: 31863532, PMCID: PMC7493053, DOI: 10.1002/ejhf.1659.Peer-Reviewed Original ResearchConceptsSystolic ejection timeEjection fractionHeart failureClinical outcomesVentricular systolic ejection timeOutpatient transthoracic echocardiogramReduced ejection fractionTertiary referral centerMultivariable logistic regressionHFrEF patientsHF patientsReferral centerTransthoracic echocardiogramAmbulatory patientsHF populationEjection timeEligibility criteriaLogistic regressionPatientsOutcomesAssociationHFpEFEchocardiogramBiomarker Profile of Left Atrial Myopathy in Heart Failure With Preserved Ejection Fraction: Insights From the RELAX Trial
Patel RB, Alenezi F, Sun JL, Alhanti B, Vaduganathan M, Oh JK, Redfield MM, Butler J, Hernandez AF, Velazquez EJ, Shah SJ. Biomarker Profile of Left Atrial Myopathy in Heart Failure With Preserved Ejection Fraction: Insights From the RELAX Trial. Journal Of Cardiac Failure 2019, 26: 270-275. PMID: 31857197, PMCID: PMC7078046, DOI: 10.1016/j.cardfail.2019.12.001.Peer-Reviewed Original ResearchConceptsLA reservoir strainLA myopathyHeart failureNT-proBNPEjection fractionLA reservoirReservoir strainLA strainN-terminal pro-B-type natriuretic peptidePro-B-type natriuretic peptideAtrial mechanical dysfunctionEjection Fraction trialLA contractile strainLower LA reservoirJugular venous pressurePoor clinical outcomePhosphodiesterase-5 inhibitionAssociation of LAAtrial myopathyBaseline echocardiogramRELAX trialNeurohormonal activationExercise capacityVenous pressureClinical outcomes