ESC heart failure
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Heart rate reduction therapy using ivabradine, a selective inhibitor of the funny current of the sinoatrial node, is widely used in the systolic heart failure cohort. However, the optimal target of heart rate remains controversial. The association between heart rate and 'overlap' between E-wave and A-wave in the pulse wave transmitral flow Doppler echocardiography might be a key to find the ideal heart rate in each individual. ⋯ We proposed a novel formula using deceleration time to estimate ideal heart rate that achieves a zero overlap between E-wave and A-wave in patients with systolic heart failure. Prognostic impact of the formula-guided heart rate optimization should be studied.
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Soluble suppression of tumourigenicity 2 (sST2) and catestatin (CST) reflect myocardial fibrosis and sympathetic overactivity during the acute worsening of heart failure (AWHF). We aimed to determine serum levels and associations of sST2 and CST with in-hospital death as well as the association between sST2 and CST among AWHF patients. ⋯ Elevated sST2 and CST levels, reflecting two distinct pathophysiological pathways in heart failure, might indicate impending clinical deterioration among AWHF patients during hospitalization and facilitate prognosis beyond traditional biomarkers regarding the risk of in-hospital death (CATSTAT-HF ClinicalTrials.gov Number NCT03389386).