The online version of this article (doi:10.1186/1471-2261-14-91) contains supplementary material, which is available to authorized users.
Funding for Alberta HEART is provided by Alberta Innovates – Health Solutions (Grant # AHFMR ITG 200801018) awarded in 2009. Additional funding is provided by NCE CECR Centre of Excellence for Prevention of Organ Failure and the Alberta Diabetes Institute. In-kind contributions were received from Capital Health Regional Authority (now Alberta Health Services) and the Alberta HEART investigators. JAE, JRBD, FAM, HJD, GDL, GYO and TJA receive salary awards from AI-HS. GYO receives salary awards from HSFC and CIHR. PEL holds the Charles A. Allard Chair in Diabetes Research. FAM holds the University of Alberta Chair in Cardiovascular Outcomes Research. MF holds the Hornstein Chair in Cardiovascular Imaging. HB holds the Heart & Stroke Foundation Endowed Chair for Cardiovascular Research. TA holds the Merck Frosst Chair in Cardiovascular Research, University of Calgary.
All authors were involved in the conception and design of the research program. TJA, HB, AMC, HJD, JRBD, JAE, MJH, JGH, FAM, GYO, DIP and RBT contributed to the writing of the manuscript. All authors read and approved the final manuscript.
Nationally, symptomatic heart failure affects 1.5-2% of Canadians, incurs $3 billion in hospital costs annually and the global burden is expected to double in the next 1–2 decades. The current one-year mortality rate after diagnosis of heart failure remains high at >25%. Consequently, new therapeutic strategies need to be developed for this debilitating condition.
The objective of the Alberta HEART program (http://albertaheartresearch.ca) is to develop novel diagnostic, therapeutic and prognostic approaches to patients with heart failure with preserved ejection fraction. We hypothesize that novel imaging techniques and biomarkers will aid in describing heart failure with preserved ejection fraction. Furthermore, the development of new diagnostic criteria will allow us to: 1) better define risk factors associated with heart failure with preserved ejection fraction; 2) elucidate clinical, cellular and molecular mechanisms involved with the development and progression of heart failure with preserved ejection fraction; 3) design and test new therapeutic strategies for patients with heart failure with preserved ejection fraction. Additionally, Alberta HEART provides training and education for enhancing translational medicine, knowledge translation and clinical practice in heart failure. This is a prospective observational cohort study of patients with, or at risk for, heart failure. Patients will have sequential testing including quality of life and clinical outcomes over 12 months. After that time, study participants will be passively followed via linkage to external administrative databases. Clinical outcomes of interest include death, hospitalization, emergency department visits, physician resource use and/or heart transplant. Patients will be followed for a total of 5 years.
Alberta HEART has the primary objective to define new diagnostic criteria for patients with heart failure with preserved ejection fraction. New criteria will allow for targeted therapies, diagnostic tests and further understanding of the patients, both at-risk for and with heart failure.
Johansen H, Strauss B, Arnold JMO, Moe G, Liu P: On the rise: The current and projected future burden of congestive heart failure hospitalization in Canada. Can J Cardiol. 2003, 19: 430-435. PubMed
McKelvie RS, Moe GW, Cheung A, Costigan J, Ducharme A, Estrella-Holder E, Ezekowitz JA, Floras J, Giannetti N, Grzeslo A, Harkness K, Heckman GA, Howlett JG, Kouz S, Leblanc K, Mann E, O'Meara E, Rajda M, Rao V, Simon J, Swiggum E, Zieroth S, Arnold JMO, Ashton T, D'Astous M, Dorian P, Haddad H, Isaac DL, Leblanc M-H, Liu P, et al: The 2011 Canadian Cardiovascular Society heart failure management guidelines update: focus on sleep apnea, renal dysfunction, mechanical circulatory support, and palliative care. Can J Cardiol. 2011, 27: 319-338. 10.1016/j.cjca.2011.03.011. CrossRefPubMed
Yancy CW, Jessup M, Bozkurt B, Butler J, Casey DE, Drazner MH, Fonarow GC, Geraci SA, HORWICH T, Januzzi JL, Johnson MR, Kasper EK, Levy WC, Masoudi FA, McBride PE, McMurray JJV, Mitchell JE, Peterson PN, Riegel B, Sam F, Stevenson LW, Tang WHW, Tsai EJ, Wilkoff BL, American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines: 2013 ACCF/AHA guideline for the management of heart failure: a report of the American College of Cardiology Foundation/American Heart Association Task Force on practice guidelines. Circulation. 2013, 128: e240-e327. CrossRefPubMed
Lindenfeld J, Albert NM, Boehmer JP, Collins SP, Ezekowitz JA, Givertz MM, Katz SD, Klapholz M, Moser DK, Rogers JG, Starling RC, Stevenson WG, Tang WHW, Teerlink JR, Walsh MN, Heart Failure Society of America: Comprehensive Heart Failure Practice Guideline. J Card Fail. 2010, 2010: e1-e194.
Ezekowitz JA, Lee DS, Tu JV, Newman AM, McAlister FA: Comparison of One-Year Outcome (Death and Rehospitalization) in Hospitalized Heart Failure Patients With Left Ventricular Ejection Fraction >50% Versus Those With Ejection Fraction. Am J Cardiol. 2008, 102: 79-83. 10.1016/j.amjcard.2008.02.102. CrossRefPubMed
McMurray JJV, Adamopoulos S, Anker SD, Auricchio A, Böhm M, Dickstein K, Falk V, Filippatos G, Fonseca C, Sanchez MAG, Jaarsma T, Køber L, Lip GYH, Maggioni AP, Parkhomenko A, Pieske BM, Popescu BA, Rønnevik PK, Rutten FH, Schwitter J, Seferovic P, Stepinska J, Trindade PT, Voors AA, Zannad F, Zeiher A, Bax JJ, Baumgartner H, Authors/Task Force Members, et al: ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure 2012: The Task Force for the Diagnosis and Treatment of Acute and Chronic Heart Failure 2012 of the European Society of Cardiology. Developed in collaboration with the Heart Failure Association (HFA) of the ESC. Eur Heart J. 2012, 33: 1787-1847. CrossRefPubMed
McKelvie RS, Moe GW, Ezekowitz JA, Heckman GA, Costigan J, Ducharme A, Estrella-Holder E, Giannetti N, Grzeslo A, Harkness K, Howlett JG, Kouz S, Leblanc K, Mann E, Nigam A, O'Meara E, Rajda M, Steinhart B, Swiggum E, Le VV, Zieroth S, Arnold JMO, Ashton T, D'Astous M, DORIAN P, Haddad H, Isaac DL, Leblanc MH, Liu P, Rao V, et al: The 2012 Canadian Cardiovascular Society Heart Failure Management Guidelines Update: Focus on Acute and Chronic Heart Failure. CJCA. 2012, 1-14.
Paulus WJ, Tschöpe C, Sanderson JE, Rusconi C, Flachskampf FA, Rademakers FE, Marino P, Smiseth OA, De Keulenaer G, Leite-Moreira AF, Borbély A, Edes I, Handoko ML, Heymans S, Pezzali N, Pieske B, Dickstein K, Fraser AG, Brutsaert DL: How to diagnose diastolic heart failure: a consensus statement on the diagnosis of heart failure with normal left ventricular ejection fraction by the Heart Failure and Echocardiography Associations of the European Society of Cardiology. Eur Heart J. 2007, 28: 2539-2550. 10.1093/eurheartj/ehm037. CrossRefPubMed
Zile MR, Gaasch WH, Carroll JD, Feldman MD, Aurigemma GP, Schaer GL, Ghali JK, Liebson PR: Heart Failure With a Normal Ejection Fraction: Is Measurement of Diastolic Function Necessary to Make the Diagnosis of Diastolic Heart Failure?. Circulation. 2001, 104: 779-782. 10.1161/hc3201.094226. CrossRefPubMed
Massie BM, Carson PE, McMurray JJ, Komajda M, McKelvie R, Zile MR, Anderson S, Donovan M, Iverson E, Staiger C, Ptaszynska A, I-PRESERVE Investigators: Irbesartan in patients with heart failure and preserved ejection fraction. N Engl J Med. 2008, 359: 2456-2467. 10.1056/NEJMoa0805450. CrossRefPubMed
Bossuyt PM, Reitsma JB, Bruns DE, Gatsonis CA, Glasziou PP, Irwig LM, Lijmer JG, Moher D, Rennie D, de Vet HCW, Standards for Reporting of Diagnostic Accuracy: Towards complete and accurate reporting of studies of diagnostic accuracy: the STARD initiative. BMJ. 2003, 326: 41-44. 10.1136/bmj.326.7379.41. CrossRefPubMedPubMedCentral
Whiting PF, Rutjes AWS, Westwood ME, Mallett S, Deeks JJ, Reitsma JB, Leeflang MMG, Sterne JAC, Bossuyt PMM: QUADAS-2 Group: QUADAS-2: a revised tool for the quality assessment of diagnostic accuracy studies. Ann Intern Med. 2011, 155: 529-536. 10.7326/0003-4819-155-8-201110180-00009. CrossRefPubMed
Westermann D, Kasner M, Steendijk P, Spillmann F, Riad A, Weitmann K, Hoffmann W, Poller W, Pauschinger M, Schultheiss H-P, Tschöpe C: Role of left ventricular stiffness in heart failure with normal ejection fraction. Circulation. 2008, 117: 2051-2060. 10.1161/CIRCULATIONAHA.107.716886. CrossRefPubMed
Agostoni P, Cattadori G, Apostolo A, Contini M, Palermo P, Marenzi G, Wasserman K: Noninvasive Measurement of Cardiac Output During Exercise by Inert Gas Rebreathing Technique: A New Tool for Heart Failure Evaluation. J Am Coll Cardiol. 2005, 46: 1779-1781. 10.1016/j.jacc.2005.08.005. CrossRefPubMed
Haykowsky MJ, Brubaker PH, Morgan TM, Kritchevsky S, Eggebeen J, Kitzman DW: Impaired Aerobic Capacity and Physical Functional Performance in Older Heart Failure Patients With Preserved Ejection Fraction: Role of Lean Body Mass. J Gerontol A: Biol Med Sci. 2013, 68: 968-975. 10.1093/gerona/glt011. CrossRef
Kitzman DW, Brubaker PH, Herrington DM, Morgan TM, Stewart KP, Hundley WG, Abdelhamed A, Haykowsky MJ: Effect of Endurance Exercise Training on Endothelial Function and Arterial Stiffness in Older Patients With Heart Failure and Preserved Ejection Fraction: A Randomized, Controlled, Single-Blind Trial. J Am Chem Soc. 2013, 62: 584-592.
Akiyama E, Sugiyama S, Matsuzawa Y, Konishi M, Suzuki H, Nozaki T, Ohba K, Matsubara J, Maeda H, Horibata Y, Sakamoto K, Sugamura K, Yamamuro M, Sumida H, Kaikita K, Iwashita S, Matsui K, Kimura K, Umemura S, Ogawa H: Incremental Prognostic Significance of Peripheral Endothelial Dysfunction in Patients With Heart Failure With Normal Left Ventricular Ejection Fraction. J Am Chem Soc. 2012, 60: 1778-1786.
Ezekowitz JA, van Walraven C, McAlister FA: Impact of specialist follow-up in outpatients with congestive heart failure. Can Med Assoc J. 2005, 172: 189-194. 10.1503/cmaj.1032017. CrossRef
- The Alberta Heart Failure Etiology and Analysis Research Team (HEART) study
Justin A Ezekowitz
Alexander M Clark
Henry J Duff
Matthias G Friedrich
Mark J Haykowsky
Jonathan G Howlett
Daniel H Kim
Merril L Knudtson
Peter E Light
Gary D Lopaschuk
Finlay A McAlister
Michelle L Noga
Gavin Y Oudit
D Ian Paterson
Richard B Thompson
Sarah G Weeks
Todd J Anderson
Jason RB Dyck
- BioMed Central
Neu im Fachgebiet Kardiologie
Mail Icon II