HFpEF: Why Earlier May Be Better | JACC Baran

HFpEF: Why Earlier May Be Better | JACC Baran

Hosts Mitsuaki Sawano, MD, Nobuhiro Ikemura, MD, and Satoshi Shoji, MD welcome Shunichi Doi, MD (St. Marianna University School of Medicine) to discuss his JACC: Heart Failure study, Heart Failure Duration, Cardiac Remodeling, Dysfunction, and Hemodynamic Severity in HFpEF and HFmrEF: Insights From REDUCE LAP-HF II. In this prespecified subanalysis of the REDUCE LAP-HF II trial, 522 patients with HFpEF or HFmrEF were categorized by time since heart failure diagnosis (<1 year, 1–3 years, and >3 years). Longer disease duration was associated with progressive left and right ventricular dysfunction, biatrial remodeling, worsening resting and exercise hemodynamics, and higher rates of heart failure events. In contrast, patients with more recent diagnoses often had normal resting filling pressures with congestion evident only during exercise, suggesting that early HFpEF may be missed by conventional evaluation. The discussion explores whether HFpEF phenotypes represent distinct disease entities or sequential stages of progression, why exercise hemodynamic testing may be critical for early diagnosis, and how identifying HFpEF before advanced remodeling develops may open opportunities for earlier intervention.

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Episoder(82)

The Lancet: OPTIMA-AF, Is 1 Month Enough After PCI? | JACC Baran

The Lancet: OPTIMA-AF, Is 1 Month Enough After PCI? | JACC Baran

Hosts Mitsuaki Sawano, MD, Shun Kohsaka, MD, Nobuhiro Ikemura, MD, and Satoshi Shoji, MD, welcome Yohei Sotomi, MD, PhD (The University of Osaka), and Ken Kozuma, MD, PhD (Teikyo University) for a spe...

25 Aug 47min

Post-PCI Hematoma: What IVUS Tells Us | JACC Baran

Post-PCI Hematoma: What IVUS Tells Us | JACC Baran

Percutaneous coronary intervention (PCI) is safer than ever, yet coronary hematoma remains an underrecognized cause of early ischemic complications. In this episode, Host Mitsuaki Sawano, MD welcome T...

11 Aug 35min

Pediatric Heart Transplantation: When Priority Doesn't Match Urgency | JACC Baran

Pediatric Heart Transplantation: When Priority Doesn't Match Urgency | JACC Baran

Pediatric heart transplantation is one of medicine's scarcest resources, where every allocation decision can mean the difference between life and death. But does the current system truly prioritize th...

4 Aug 35min

PACs: Benign Bystanders or AF in Disguise? | JACC Baran

PACs: Benign Bystanders or AF in Disguise? | JACC Baran

Premature atrial complexes (PACs) are among the most common arrhythmias encountered in daily practice and are often dismissed as benign. But are they truly harmless—or could some represent the earlies...

28 Jul 35min

Cancer VTE + DOAC: Who Will Bleed? | JACC Baran

Cancer VTE + DOAC: Who Will Bleed? | JACC Baran

Patients with active cancer face a difficult balance: preventing recurrent venous thromboembolism while avoiding major bleeding during anticoagulation. But which patients are truly at highest bleeding...

21 Jul 39min

HFpEF Without Obesity: What Coronary Microcirculation Tells Us | JACC Baran

HFpEF Without Obesity: What Coronary Microcirculation Tells Us | JACC Baran

Host Mitsuaki Sawano, MD, welcomes Kai Nogami, MD (Mayo Clinic), to discuss his JACC Brief Report, "Higher Prevalence of Coronary Microvascular Dysfunction in Patients With HFpEF Without Obesity." Why...

14 Jul 37min

What Autopsy Reveals About MINOCA and Sudden Cardiac Death | JACC Baran

What Autopsy Reveals About MINOCA and Sudden Cardiac Death | JACC Baran

Hosts Mitsuaki Sawano, MD, Kentaro Ejiri, MD, Hiroyuki Sato, MD, and Shun Kosaka, MD welcome Dr. Kosuke Nakasuka, MD, PhD to discuss his JACC study, Sudden Cardiac Death Due to Myocardial Infarction W...

7 Jul 45min

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