Unraveling HFpEF - A Systemic Disease

Unraveling HFpEF - A Systemic Disease
Presented by:
Jennifer Ho, MD
Associate Professor, Harvard Medical School and Faculty Member, Advanced Heart Failure and Heart Transplantation, Cardiology Division, Massachusetts General Hospital

[@temesgenteferabekele844]

the best so far I have heard on the topic of HFpEF ... and I am a final year medicine resident ..... thank you for the detailed explanation

[@TheresaGraf]

I have HFpEF. I'm only 5 pounds overweight, don't have high blood pressure or diabetes and my cardiologist has ignored my calls about my feet swelling daily for over two months. I know this kind of heart failure with my circumstances is hard to treat but this is ridiculous. I wish I could find a cardiologist who doesn't harp on salt intake and fluid intake because that is a bunch of BUNK!. Any help with my situation would be greatly appreciated.

[@kaytevanscoy]

Get a different doctor!!

[@skipper55245]

Hello, how are you now?
Have you had COVID infection? it could trigger HFpEF especially if you have family history of HF. What about your kidneys?
Do you go to toilet at night, how many times?
Do you have dyspnea on exertion? palpitations (awareness of heartbeats) at night?
muscle weakness or exercise intolerance?
Did you do ECHO at rest? do you have any structural abnormalities like LV hypertrophy or remodeling?
Discuss Dapagliflozin (Forxiga) treatment with your cardiologist.
To confirm HFpEF with subtle clinical symptoms one should do ECHO on exercise or invasive measurement of PAWP on exercise. Ask your doctor to refer you for those investigations.
There is a new hope for HFpEF patients - this drug halts disease progression and reverses LV hypertrophy and remodeling. But it is in Phase II now.
Your goal is to preserve status quo of your heart health until this will be finally approved and released on the market. I hope this will be the gamechanger in HFpEF treatment. While CDR132L is being investigated I would suggest you to take Forxiga.
clinicaltrials.gov/study/NCT05953831?cond=Heart%20Failure%20With%20Preserved%20Ejection%20Fraction&page=2&rank=16
www.sciencedirect.com/science/article/pii/S2452302X23004229
ua-cam.com/video/mgibfd4Stew/v-deo.html

[@skipper55245]

I suggest you 'officially' confirm the diagnosis by right heart catheterization while exercising. This is required to take part in clinical trials. There are 45 drugs in development for HFpEF by 38 companies/universities/institutes (44 drugs by companies and 1 by universities/institutes). The top development phase for HFpEF is phase 2 with 14 drugs in that stage. Many of them are promising to be disease modifying and even curative. It is not only small molecules but gene therapy, stem cell technologies, mRNA etc.
It is a big hope to find a cure for HFpEF up to 2032. Your goal is to be alive and healthy as much as possible by that time.
Meanwhile, I also suggest you to take Dapagliflozin or Empagliflozin and be involved into the physical exercises as they all slow down the disease progression, reduce fibrosis, and chronic inflammation. Eat plant based food. Get rid of extra pounds and aggressively control and prevent any kind of co-morbidities. That's it at the moment.

[@TheresaGraf]

@@skipper55245 I wouldn't touch anything that is mRNA based, but thank you for the information. I have all my test results. I'll check with my cardiologist and the hospitals as well as local medical schools and see what I can find out. I also wouldn't DARE eat vegies. NOPE. Carnivore all the way. I'm only 5 pounds above normal weight and that's from mild fluid retention.

[@skipper55245]

@@TheresaGraf by mRNA technology I meant inhibiting mRNA
for example there are new effective drugs based on this tech and available today like Inclisiran - small interfering RNA (siRNA) that acts as an inhibitor of a proprotein convertase, specifically, inhibiting translation of the protein PCSK9. It is much more effective than statins.
Olpasiran - in phase 3 - also very promising to treat hypercholesterolemia
When it comes to HFpEF - CDR132L by CARDIOR is an oligonucleotide-based inhibitor directed against miRNA132 (miR-132), designed to halt and reverse the development of detrimental cardiac remodeling. Novo Nordisk bought Cardior and will initiate in the nearest future phase 2 trial for HFpEF. This drug is very very promising to be disease modifying!! So do not be prejudiced regarding mRNA))