Stefan D. Anker

Colorectal cancer is linked to ~6 mL/kg/min lower exercise capacity and reduced LVEF versus controls.

May support pre-treatment cardiovascular evaluation in colorectal cancer; leaves open whether predictors improve outcomes or warrant routine screening.

OCT 2017LamJournal of the American College of Cardiology

Discharge heart rate <70 bpm linked to ~14% lower mortality in hospitalized HFpEF patients.

In hospitalized older patients with HFpEF, a discharge heart rate <70 beats/min is independently associated with a lower risk of long-term all-cause mortality, though it does not significantly reduce hospital readmissions.

Iron Deficiency Predicts Impaired Exercise Capacity in Patients With Systolic Chronic Heart Failure

Background Iron is an indispensable element of hemoglobin, myoglobin, and cytochromes, and, beyond erythropoiesis, is involved in oxidative metabolism and cellular energetics. Hence, iron deficiency (ID) is anticipated to limit exercise capacity. We investigated whether ID predicted exercise intolerance in patients with systolic chronic heart failure (CHF). Methods and results We prospectively studied 443 patients with stable systolic CHF (age 54 ± 10 years, males 90%, ejection fraction 26 ± 7%, New York Heart Association Class I/II/III/IV 49/188/180/26). ID was defined as: serum ferritin <100 μg/L or serum ferritin 100-300 μg/L with serum transferrin saturation <20%. Exercise capacity was expressed as peak oxygen consumption (VO(2)) and ventilatory response to exercise (VE-VCO(2) slope). ID was present in 35 ± 4% (±95% confidence interval) of patients with systolic CHF. Those with ID had reduced peak VO(2) and increased VE-VCO(2) slope as compared to subjects without ID (peak VO(2): 13.3 ± 4.0 versus 15.3 ± 4.5 mL•min•kg, VE-VCO(2) slope: 50.9 ± 15.8 versus 43.1 ± 11.1, respectively, both P < .001, P < .05). In multivariable models, the presence of ID was associated with reduced peak VO(2) (β = -0.14, P < .01 P < .05) and higher VE-VCO(2) slope (β = 0.14, P < .01 P < .05), adjusted for demographics and clinical variables. Analogous associations were found between serum ferritin, and both peak VO(2) and VE-VCO(2) slope (P < .05). Conclusions ID independently predicts exercise intolerance in patients with systolic CHF, but the strength of these associations is relatively weak. Whether iron supplementation would improve exercise capacity in iron-deficient subjects requires further studies.

A high VE-VCO2 slope (>34) in chronic heart failure independently predicted lower 18-month survival compared with a normal slope.

Elevated VE-VCO2 slope signals higher-risk HF; supports prognostic models but leaves open whether it alters management.

Patiromer lowers serum potassium across subgroups, dropping potassium by ~0.28 mEq/L in advanced CKD.

Supports patiromer for potassium management in HFrEF on RAASi across eGFR/K+ levels; extends DIAMOND trial to eGFR <45 and hyperkalemia subgroups.

PA acceleration time <100 ms is linked to ~20% higher all-cause mortality in older adults.

Should not yet guide risk stratification in older adults; leaves open incremental value beyond cardiovascular factors.

Residual moderate secondary MR at 12 months is linked to ~69% higher death or HFH.

Persistent moderate/severe SMR after GDMT optimization identifies higher-risk HF patients; supports serial echo reassessment and trials of intervention in moderate SMR.

AUG 21ArundelENLIGHTEN (Jurnal Bimbingan dan Konseling Islam)

Inpatient target-dose ACE inhibitor initiation is linked to ~9% lower all-cause mortality vs below-target doses.

Target-dose ACE inhibitor initiation was associated with lower mortality in hospitalized HFrEF; leaves open whether randomized trials should confirm this before practice change.

Target-dose vs below-target-dose lisinopril and fosinopril in HFrEF with advanced CKD

AUG 1FerreiraJournal of Cardiac Failure

Empagliflozin slightly increases serum calcium and phosphate levels in patients with heart failure.

Minor increases in calcium and phosphate with empagliflozin warrant no clinical concern; confirms cardiovascular benefits independent of baseline levels in heart failure.

Target-dose ACE inhibitors show no mortality benefit over below-target doses in HFpEF.

Target-dose ACE inhibitors were associated with lower kidney failure risk but no mortality benefit in HFpEF; leaves open optimal dosing pending randomized trials.

MAR 2003AnkerThe Lancet

Weight loss ≥6% in chronic heart failure is linked to ~2.1-fold higher mortality.

Supports weight-loss monitoring for prognosis in chronic HF; leaves open whether preventing ≥6% loss improves survival.

AUG 2022HarringtonEuropean Heart Journal

Putting the puzzle together: SGLT2 inhibitors from prevention to treatment of heart failure

Chronic heart failure is linked to lower levels of specific circulating miRNAs and higher GDF-15.

miRNA/cytokine signatures may flag cardiac cachexia in CHF; leaves open their value as biomarkers for function and remodelling.

Cardiac wasting links to ~46% lower visceral fat index in advanced cancer.

Fat-free mass reduction may flag cardiac wasting in advanced cancer independent of therapy; hypothesis-generating and requires prospective validation before clinical use.

OCT 1ChopraJournal of Cardiac Failure

2026 iCARDIO Alliance Global Implementation Guidelines on Heart Failure

May support equitable HF care in resource-limited settings; leaves open prospective validation of implementation and outcomes.