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Heart failure clinical trial

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https://www.readbyqxmd.com/read/28325140/vitamins-in-heart-failure-friend-or-enemy
#1
George Georgiopoulos, Christina Chrysohoou, Georgia Vogiatzi, Nikolaos Magkas, Ippokratis Bournelis, Sofia Bampali, Damien Gruson, Dimitris Tousoulis
BACKGROUND: The failing heart is characterized by a depleted metabolic energy reserve and the up-regulation of several molecular mechanisms leading to cardiac hypertrophy, inflammation, fibrosis, angiogenesis, and apoptosis. Dietary or non-dietary supplementation of vitamins could potentially benefit energy balance. OBJECTIVE: The objective of the present study was to evaluate all available information on vitamins supplementation in patients with chronic HF for possible beneficial effect on metabolic, inotropic, chronotropic and hemodynamic indices...
March 20, 2017: Current Pharmaceutical Design
https://www.readbyqxmd.com/read/28323173/outcomes-of-cardiac-resynchronization-therapy-in-patients-with-intermittent-atrial-fibrillation-or-atrial-flutter-in-the-companion-trial
#2
Matthew M Kalscheur, Leslie A Saxon, Byron K Lee, Jonathan S Steinberg, Chaoqun Mei, Kevin A Buhr, David L DeMets, Michael R Bristow, Steven N Singh
BACKGROUND: Controlled clinical trial data are lacking for cardiac resynchronization therapy (CRT) outcomes in patients with advanced heart failure (HF) from reduced left ventricular ejection fraction (HFrEF) and intermittent atrial fibrillation or flutter (AF/AFL). OBJECTIVE: To describe CRT outcomes in patients with intermittent AF/AFL and advanced HF. METHODS: HF outcomes in patients from the COMPANION trial with NYHA Class III or IV HFrEF, LVEF ≤ 0...
March 17, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/28322590/randomized-clinical-trials-of-gene-transfer-for-heart-failure-with-reduced-ejection-fraction
#3
William F Penny, H Kirk Hammond
Despite improvement in drug and device therapy for heart failure, hospitalization rates and mortality have changed little in the past decade. Randomized clinical trials using gene transfer to improve function of the failing heart are the focus of this review. Four randomized clinical trials of gene transfer in heart failure with reduced ejection fraction (HFrEF) have been published. Each enrolled patients with stable symptomatic HFrEF and used either intracoronary delivery of a virus vector or endocardial injection of a plasmid (1 trial)...
March 21, 2017: Human Gene Therapy
https://www.readbyqxmd.com/read/28322009/prognostic-importance-of-left-ventricular-mechanical-dyssynchrony-in-heart-failure-with-preserved-ejection-fraction
#4
Tor Biering-Sørensen, Sanjiv J Shah, Inder Anand, Nancy Sweitzer, Brian Claggett, Li Liu, Bertram Pitt, Marc A Pfeffer, Scott D Solomon, Amil M Shah
AIMS: Left ventricular mechanical dyssynchrony has been described in heart failure with preserved ejection fraction (HFpEF), but its prognostic significance is not known. METHODS AND RESULTS: Of 3445 patients with HFpEF enrolled in the Treatment of Preserved Cardiac Function Heart Failure with an Aldosterone Antagonist (TOPCAT) trial, dyssynchrony analysis was performed on 424 patients (12%) by multiple speckle tracking echocardiography strain-based criteria. The primary dyssynchrony analysis was the standard deviation of the time to peak longitudinal strain (SD T2P LS)...
March 21, 2017: European Journal of Heart Failure
https://www.readbyqxmd.com/read/28318666/cardiac-sympathetic-denervation-100years-later-jonnesco-would-have-never-believed-it
#5
Peter J Schwartz, Gaetano M De Ferrari, Luigi Pugliese
One hundred years have elapsed since Thomas Jonnesco performed the first left cardiac sympathetic denervation (LCSD) in a patient with unmanageable angina pectoris and ventricular tachyarrhythmias, and the progress in the field has surpassed imagination. Here we will review the historic basis of cardiac sympathectomy for the management of life-threatening arrhythmias and will then discuss the often forgotten critical experimental studies that provided the rationale for the amazing growth of its role in clinical management...
March 8, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28318353/gender-differences-in-sexual-interest-or-activity-among-adults-with-symptomatic-heart-failure
#6
Stacy Fischer, David Bekelman
CONTEXT: Problems with sexual function can have a detrimental effect on quality of life. Symptomatic heart failure has been associated with problems with sexual function, although the majority of reports are focused on men and erectile dysfunction. Understanding women's perception of and gender differences in problems with sexual function in heart failure could yield new insights. OBJECTIVES: To determine the gender differences in reporting and bothersomeness of problems with sexual function, defined as sexual interest or activity...
March 20, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28316980/clinical-and-prognostic-significance-of-positive-hepatojugular-reflux-on-discharge-in-acute-heart-failure-insights-from-the-escape-trial
#7
Hesham R Omar, Maya Guglin
Background. There has been a decline in emphasis of the value of physical examination in heart failure (HF) with increased reliance on cardiac imaging. We aim to study the clinical and prognostic significance of positive hepatojugular reflux (HJR) on discharge in patients hospitalized with HF. Methods. Using the ESCAPE trial data, patients were compared according to the presence or absence of a positive HJR on discharge. The primary study endpoints were all-cause mortality and a composite endpoint of death, rehospitalization, and cardiac transplant during the first 6 months after discharge...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28316174/-efficacy-and-safety-analysis-of-ivabradine-hydrochloride-treatment-of-chinese-patients-with-chronic-heart-failure-subgroup-analysis-of-chinese-patients-in-the-shift-study
#8
D Y Hu, D J Huang, Z Y Yuan, R P Zhao, X W Yan, M H Wang
Objective: To evaluate the efficacy and safety of ivabradine for the treatment of Chinese patients with chronic heart failure based on the Chinese subgroup data of the systolic heart failure treatment with the I(f) inhibitor ivabradine trial (SHIFT). Method: A total of 6 558 stable outpatients who presented symptoms of heart failure, with a left ventricular ejection fraction (LVEF) ≤35%, sinus rhythms with a heart rate ≥70 bpm participated in the randomized, double-blind, placebo-controlled, international multicenter clinical study...
March 24, 2017: Zhonghua Xin Xue Guan Bing za Zhi
https://www.readbyqxmd.com/read/28316104/implantable-cardioverter-defibrillators-for-primary-prevention-of-mortality-in-patients-with-non-ischemic-cardiomyopathy-a-meta-analysis-of-randomized-controlled-trials
#9
Stavros Stavrakis, Zain Asad, Dwight Reynolds
BACKGROUND: Implantable cardioverter defibrillators (ICDs) improve survival in patients with heart failure due to ischemic cardiomyopathy, but their benefit in non-ischemic cardiomyopathy (NICM) has been recently questioned. We performed a meta-analysis of randomized clinical trials to examine the effect of ICDs on total mortality and arrhythmic death in patients with NICM. We also examined the impact of age and cardiac resynchronization therapy (CRT) on the relative effect of ICD compared to control...
March 18, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28315072/direct-myosin-activation-by-omecamtiv-mecarbil-for-heart-failure-with-reduced-ejection-fraction
#10
Mitchell A Psotka, John R Teerlink
Myosin is the indispensable molecular motor that utilizes chemical energy to produce force for contraction within the cardiac myocyte. Myosin activity is gated by intracellular calcium levels which are regulated by multiple upstream signaling cascades that can be altered for clinical utility using inotropic medications. In contrast to clinically available cardiac inotropes, omecamtiv mecarbil is a novel direct myosin activator developed to augment left ventricular systolic function without the undesirable secondary effects of altered calcium homeostasis...
March 18, 2017: Handbook of Experimental Pharmacology
https://www.readbyqxmd.com/read/28306749/cigarette-smoking-and-cardio-renal-events-in-patients-with-atherosclerotic-renal-artery-stenosis
#11
Christopher A Drummond, Pamela S Brewster, Wencan He, Kaili Ren, Yanmei Xie, Katherine R Tuttle, Steven T Haller, Kenneth Jamerson, Lance D Dworkin, Donald E Cutlip, Timothy P Murphy, Ralph B D'Agostino, William L Henrich, Jiang Tian, Joseph I Shapiro, Christopher J Cooper
Cigarette smoking causes cardiovascular disease and is associated with poor kidney function in individuals with diabetes mellitus and primary kidney diseases. However, the association of smoking on patients with atherosclerotic renal artery stenosis has not been studied. The current study utilized data from the Cardiovascular Outcomes in Renal Atherosclerotic Lesions (CORAL, NCT00081731) clinical trial to evaluate the effects of smoking on the risk of cardio-renal events and kidney function in this population...
2017: PloS One
https://www.readbyqxmd.com/read/28306670/innovations-in-cardiac-transplantation
#12
Reema Hasan, Ashraf Abou El Ela, Daniel Goldstein
PURPOSE OF REVIEW: As the number of people living with heart failure continues to grow, future treatments will focus on efficient donor organ donation and ensuring safe and durable outcomes. This review will focus on organ procurement, graft surveillance and emerging therapies. RECENT FINDINGS: Preliminary studies into donation after cardiac death have indicated that this may be an effective means to increase the donor pool. Novel preservation techniques that include ex-vivo perfusion to improve donor metabolic stabilization prior to implantation may also expand the donor pool...
March 16, 2017: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/28303624/effect-of-eplerenone-in-patients-with-heart-failure-and-reduced-ejection-fraction-potential-effect-modification-by-abdominal-obesity-insight-from-the-emphasis-hf-trial
#13
Arnaud Olivier, Bertram Pitt, Nicolas Girerd, Zohra Lamiral, Jean-Loup Machu, John J V McMurray, Karl Swedberg, Dirk J van Veldhuisen, Timothy J Collier, Stuart J Pocock, Patrick Rossignol, Faiez Zannad, Anne Pizard
AIMS: An excessive production of aldosterone influences outcome in patients with heart failure (HF) and in obese patients. Findings from laboratory studies suggest that chronic aldosterone blockade maybe more beneficial in abdominally obese HF-prone rats. In the current study, we investigated if the clinical response to a mineralocorticoid receptor antagonist in mildly symptomatic HF patients varied by abdominal obesity. METHODS AND RESULTS: A total of 2587 NYHA class II, reduced ejection fraction HF (HFrEF) patients enrolled in the EMPHASIS-HF trial were randomly assigned to eplerenone and placebo...
March 16, 2017: European Journal of Heart Failure
https://www.readbyqxmd.com/read/28303555/-iron-deficiency-in-chronic-heart-failure-diagnostic-algorithm-and-present-day-therapeutic-options
#14
Wolfram Doehner, Stefan Blankenberg, Erland Erdmann, Georg Ertl, Gerd Hasenfuß, Ulf Landmesser, Burkert Pieske, Bernhard Schieffer, Heribert Schunkert, Stephan von Haehling, Andreas Zeiher, Stefan D Anker
Iron deficiency (ID) occurs in up to 50% of patients with heart failure (HF). Even without presence of anaemia ID contributes to more severe symptoms, increased hospitalization and mortality. A number of randomized controlled trials demonstrated the clinical benefit of replenishment of iron stores with improvement of symptoms and fewer hospitalizations. Assessment of iron status should therefore become routine assessment in newly diagnosed and in symptomatic patients with HF. ID can be identified with simple and straightforward diagnostic steps...
March 16, 2017: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/28302916/advances-in-heart-failure-a-review-of-biomarkers-emerging-pharmacological-therapies-durable-mechanical-support-and-telemonitoring
#15
REVIEW
Yasbanoo Moayedi, Heather J Ross
The purpose of this review is to provide an overview of diagnosis, prognosis and management of heart failure (HF) with reduced ejection fraction (HFrEF). Specifically, this review is divided into three sections. The first section will address biomarkers. The discovery of biomarkers has allowed further understanding of the pathophysiology of HF and provides insight into potential therapeutic targets. This review will focus on novel applications of natriuretic peptides (NPs) in clinical trials. Next, emerging biomarkers of HF, such as ST2, galectin-3 and copeptin, will be discussed...
April 1, 2017: Clinical Science (1979-)
https://www.readbyqxmd.com/read/28302292/short-term-effects-of-tolvaptan-in-patients%C3%A2-with-acute-heart-failure-and%C3%A2-volume-overload
#16
Marvin A Konstam, Michael Kiernan, Arthur Chandler, Ravi Dhingra, Freny Vaghaiwalla Mody, Howard Eisen, W Herbert Haught, Lynne Wagoner, Divya Gupta, Richard Patten, Paul Gordon, Kenneth Korr, Russell Fileccia, Susan J Pressler, Douglas Gregory, Patricia Wedge, Douglas Dowling, Matthew Romeling, Jeremy M Konstam, Joseph M Massaro, James E Udelson
BACKGROUND: In patients with acute heart failure (AHF), dyspnea relief is the most immediate goal. Renal dysfunction, diuretic resistance, and hyponatremia represent treatment impediments. OBJECTIVES: It was hypothesized that the addition of tolvaptan to a background diuretic improved dyspnea early in patients selected for an enhanced vasopressin antagonism response. METHODS: In a double-blind trial, patients were randomized to tolvaptan 30 mg/day or placebo...
March 21, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28299615/remote-monitoring-in-heart-failure-the-current-state
#17
REVIEW
Rajeev C Mohan, J Thomas Heywood, Roy S Small
The treatment of congestive heart failure is an expensive undertaking with much of this cost occurring as a result of hospitalization. It is not surprising that many remote monitoring strategies have been developed to help patients maintain clinical stability by avoiding congestion. Most of these have failed. It seems very unlikely that these failures were the result of any one underlying false assumption but rather from the fact that heart failure is a progressive, deadly disease and that human behavior is hard to modify...
March 2017: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28297727/new-knowledge-about-old-drugs-the-anti-inflammatory-properties-of-cardiac-glycosides
#18
Robert Fürst, Ilse Zündorf, Theo Dingermann
In the 19th century, cardio-active steroid glycosides, shortly cardiac glycosides, were scientifically established as drugs against heart failure. Their in vivo, cellular, and molecular actions as well as their predominant target, Na(+)-K(+)-ATPase, have been comprehensively investigated in the 20th century and the discovery of endogenous cardiac glycosides has fostered this research field. In the last years, however, results from clinical trials and meta-analyses have questioned their therapeutic value due to efficacy and safety issues...
March 15, 2017: Planta Medica
https://www.readbyqxmd.com/read/28296005/ischemic-postconditioning-during-primary-percutaneous-coronary-intervention
#19
Amgad Mentias, Ahmed N Mahmoud, Islam Y Elgendy, Akram Y Elgendy, Amr F Barakat, A Sami Abuzaid, Marwan Saad, Samir R Kapadia
BACKGROUND: Although some studies have shown potential benefit for ischemic postconditioning (IPoC) during primary percutaneous coronary intervention (PCI) in improving surrogate markers of reperfusion and infarction size, the benefit of this approach on clinical outcomes remains unknown. METHODS AND RESULTS: Electronic databases were searched for randomized clinical trials that compared IPoC versus conventional treatment during primary PCI. Random effects DerSimonian-Laird risk ratios (RR) were calculated for different clinical and surrogate outcomes...
March 15, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28295985/heart-failure-with-mid-range-ejection-fraction-a-distinct-clinical-entity-insights-from-the-trial-of-intensified-versus-standard-medical-therapy-in-elderly-patients-with-congestive-heart-failure-time-chf
#20
Peter Rickenbacher, Beat A Kaufmann, Micha T Maeder, Alain Bernheim, Kaatje Goetschalckx, Otmar Pfister, Matthias Pfisterer, Hans-Peter Brunner-La Rocca
AIMS: While the conditions of heart failure (HF) with reduced (HFrEF, LVEF < 40%) and preserved (HFpEF, LVEF ≥ 50%) left ventricular ejection fraction (LVEF) are well characterized, it is unknown whether patients with HF and mid-range LVEF (HFmrEF, LVEF 40-49%) have to be regarded as a separate clinical entity. The aim of this study was to characterize these three populations and to compare outcome and response to therapy. METHODS AND RESULTS: The analysis was based on the Trial of Intensified versus standard Medical therapy in Elderly patients with Congestive Heart Failure (TIME-CHF) comprising a population with established HF including the whole spectrum of LVEF...
March 15, 2017: European Journal of Heart Failure
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