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Heart failure clinical trial

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https://www.readbyqxmd.com/read/28526186/cardiovascular-protection-in-the-treatment-of-type-2-diabetes-a-review-of-clinical-trial-results-across-drug-classes
#1
Francesco Paneni, Thomas F Lüscher
Patients with type 2 diabetes (T2DM) have a significantly higher risk of developing cardiovascular disease (CVD)-namely myocardial infarction, heart failure, and stroke. Despite clear advances in the prevention and treatment of CVD, the impact of T2DM on CVD outcome remains high and continues to escalate. Available evidence indicates that the risk of macrovascular complications increases with the severity of hyperglycemia, thus suggesting that the relation between metabolic disturbances and vascular damage is approximately linear...
May 15, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/28525585/the-effects-of-gender-on-electrical-therapies-for-the-heart-physiology-epidemiology-and-access-to-therapies-a-report-from-the-xii-congress-of-the-italian-association-on-arrhythmology-and-cardiostimulation-aiac
#2
Giuseppe Boriani, Stefano Lorenzetti, Elisabetta Cerbai, Giuseppe Oreto, Gabriele Bronzetti, Vincenzo Livio Malavasi, Alessandro Biffi, Luigi Padeletti, Gianluca Botto, Igor Diemberger
The difference between men and women is clear even just by looking at an electrocardiogram: females present higher resting heart rate, a shorter QRS complex length and greater corrected QT interval. The development of these differences from pubertal age onward suggests that sexual hormones play a key role, although their effect is far from being completely understood. Different incidences between sexes have been reported for many arrhythmias, both ventricular and supraventricular, and also for sudden cardiac death...
May 19, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28524025/-effect-of-esmolol-on-hemodynamics-and-clinical-outcomes-in-patients-with-septic-shock
#3
Shupeng Wang, Min Li, Jun Duan, Li Yi, Xu Huang, Desheng Chen, Gang Li
OBJECTIVE: To evaluate the effect of heart rate control with esmolol on hemodynamics, inflammatory cytokines and clinical outcomes in patients with septic shock. METHODS: A prospective randomized controlled trial was conducted. The patients with septic shock admitted to Department of Critical Care Medicine of China-Japan Friendship Hospital from August 2014 to October 2016 were enrolled. After 24 hours of resuscitation and other therapy, they were randomly divided into two groups by sealed envelope...
May 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28523932/repeated-recall-as-an-intervention-to-improve-memory-performance-in-heart-failure-patients
#4
Jennifer Viveiros, Kristen Sethares, Amy Shapiro
BACKGROUND: Up to 50% of heart failure patients demonstrate aspects of cognitive impairment, including memory deficit. Novel interventions are needed to address memory deficit among heart failure patients. AIM: The goal of this study was to evaluate the testing effect as an intervention to improve memory performance in heart failure patients. METHODS: This was a randomized controlled clinical trial ( N=84) comparing the memory performance of heart failure patients with and without mild cognitive impairment after a repeated testing intervention...
May 1, 2017: European Journal of Cardiovascular Nursing
https://www.readbyqxmd.com/read/28522450/lower-risk-of-heart-failure-and-death-in-patients-initiated-on-sglt-2-inhibitors-versus-other-glucose-lowering-drugs-the-cvd-real-study
#5
Mikhail Kosiborod, Matthew A Cavender, Alex Z Fu, John P Wilding, Kamlesh Khunti, Reinhard W Holl, Anna Norhammar, Kåre I Birkeland, Marit Jørgensen, Marcus Thuresson, Niki Arya, Johan Bodegård, Niklas Hammar, Peter Fenici
Background -Reduction in cardiovascular death and hospitalization for heart failure (HHF) was recently reported with the sodium-glucose co-transporter-2 inhibitor (SGLT-2i) empagliflozin in type 2 diabetes patients with atherosclerotic cardiovascular disease. We compared HHF and death in patients newly initiated on any SGLT-2i versus other glucose lowering drugs (oGLDs) in six countries to determine if these benefits are seen in real-world practice, and across SGLT-2i class. Methods -Data were collected via medical claims, primary care/hospital records and national registries from the US, Norway, Denmark, Sweden, Germany and the UK...
May 18, 2017: Circulation
https://www.readbyqxmd.com/read/28521892/achieving-a-maximally-tolerated-%C3%AE-blocker-dose-in-heart-failure-patients-is-there-room%C3%A2-for%C3%A2-improvement
#6
REVIEW
Ankeet S Bhatt, Adam D DeVore, Tracy A DeWald, Karl Swedberg, Robert J Mentz
Heart failure (HF) is associated with significant morbidity and mortality. Although initially thought to be harmful in HF, beta-adrenergic blockers (β-blockers) have consistently been shown to reduce mortality and HF hospitalization in chronic HF with reduced ejection fraction. Proposed mechanisms include neurohormonal blockade and heart rate reduction. A new therapeutic agent now exists to target further heart rate lowering in patients who have been stable on a "maximally tolerated β-blocker dose," but this definition and how to achieve it are incompletely understood...
May 23, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28521683/impact-of-red-wine-consumption-on-cardiovascular-health
#7
Luca Liberale, Aldo Bonaventura, Fabrizio Montecucco, Franco Dallegri, Federico Carbone
The devastating effects of heavy alcohol drinking have been long time recognized. In the last decades, potential benefits of modest red wine drinking were suggested. In European countries in which red wide intake is not negligible (such as France), the association between cholesterol and cardiovascular (CV) risk was less evident, suggesting the action of some protective molecules in red wine or other foods and drinks. Epidemiological and mechanistic evidence of a J-shaped relationship between red wine intake and CV risk further supported the "French paradox"...
May 17, 2017: Current Medicinal Chemistry
https://www.readbyqxmd.com/read/28517367/rationale-and-design-of-a-randomized-trial-to-assess-the-safety-and-efficacy-of-multipoint-pacing-mpp-in-cardiac-resynchronization-therapy-the-mpp-trial
#8
Gery Tomassoni, James Baker, Raffaele Corbisiero, Charles Love, David Martin, Robert Sheppard, Seth J Worley, Kwangdeok Lee, Imran Niazi
BACKGROUND: Although the majority of Class III congestive heart failure (HF) patients treated with cardiac resynchronization therapy (CRT) show a clinical benefit, up to 40% of patients do not respond to CRT. This paper reports the design of the MultiPoint Pacing (MPP) trial, a prospective, randomized, double-blind, controlled study to evaluate the safety and efficacy of CRT using MPP compared to standard biventricular (Bi-V) pacing. METHODS: A maximum of 506 patients with a standard CRT-D indication will be enrolled at up to 50 US centers...
May 18, 2017: Annals of Noninvasive Electrocardiology
https://www.readbyqxmd.com/read/28516519/exercise-training-in-diastolic-heart-failure-ex-dhf-rationale-and-design-of-a-multicentre-prospective-randomized-controlled-parallel-group-trial
#9
Frank Edelmann, Anna Bobenko, Götz Gelbrich, Gerd Hasenfuss, Christoph Herrmann-Lingen, André Duvinage, Silja Schwarz, Meinhard Mende, Christiane Prettin, Tobias Trippel, Ruhdja Lindhorst, Daniel Morris, Elisabeth Pieske-Kraigher, Kathleen Nolte, Hans-Dirk Düngen, Rolf Wachter, Martin Halle, Burkert Pieske
Heart failure with preserved ejection fraction (HFpEF) is a common disease with high incidence and increasing prevalence. Patients suffer from functional limitation, poor health-related quality of life, and reduced prognosis. A pilot study in a smaller group of HFpEF patients showed that structured, supervised exercise training (ET) improves maximal exercise capacity, diastolic function, and physical quality of life. However, the long-term effects of ET on patient-related outcomes remain unclear in HFpEF. The primary objective of the Exercise training in Diastolic Heart Failure (Ex-DHF) trial is to investigate whether a 12 month supervised ET can improve a clinically meaningful composite outcome score in HFpEF patients...
May 17, 2017: European Journal of Heart Failure
https://www.readbyqxmd.com/read/28512184/effect-of-intensive-blood-pressure-lowering-on-left-ventricular-hypertrophy-in-patients-with-hypertension-the-systolic-blood-pressure-intervention-sprint-trial
#10
Elsayed Z Soliman, Walter T Ambrosius, William C Cushman, Zhu-Ming Zhang, Jeffrey T Bates, Javier A Neyra, Thaddeus Y Carson, Leonardo Tamariz, Lama Ghazi, Monique E Cho, Brian P Shapiro, Jiang He, Lawrence J Fine, Cora E Lewis
Background -It is currently unknown whether intensive blood pressure (BP) lowering beyond that recommended would lead to more lowering of the risk of Left ventricular hypertrophy (LVH) in patients with hypertension, and whether reducing the risk of LVH explains the reported cardiovascular disease (CVD) benefits of intensive BP lowering in this population. Methods -This analysis included 8,164 participants (mean age 67.9 years, 35.3% women, 31.2% blacks) with hypertension but no diabetes from the Systolic Blood Pressure Intervention (SPRINT) Trial; 4,086 randomly assigned to intensive BP lowering (target systolic BP<120mmHg) and 4,078 assigned to standard BP lowering (target systolic BP <140mmHg)...
May 16, 2017: Circulation
https://www.readbyqxmd.com/read/28512159/employing-extracellular-volume-cardiovascular-magnetic-resonance-measures-of-myocardial-fibrosis-to-foster-novel-therapeutics
#11
Erik B Schelbert, Hani N Sabbah, Javed Butler, Mihai Gheorghiade
Quantifying myocardial fibrosis (MF) with myocardial extracellular volume measures acquired during cardiovascular magnetic resonance promises to transform clinical care by advancing pathophysiologic understanding and fostering novel therapeutics. Extracellular volume quantifies MF by measuring the extracellular compartment depicted by the myocardial uptake of contrast relative to plasma. MF is a key domain of dysfunctional but viable myocardium among others (eg, microvascular dysfunction and cardiomyocyte/mitochondrial dysfunction)...
June 2017: Circulation. Cardiovascular Imaging
https://www.readbyqxmd.com/read/28510680/effect-of-oral-iron-repletion-on-exercise-capacity-in-patients-with-heart-failure-with-reduced-ejection-fraction-and-iron-deficiency-the-ironout-hf-randomized-clinical-trial
#12
Gregory D Lewis, Rajeev Malhotra, Adrian F Hernandez, Steven E McNulty, Andrew Smith, G Michael Felker, W H Wilson Tang, Shane J LaRue, Margaret M Redfield, Marc J Semigran, Michael M Givertz, Peter Van Buren, David Whellan, Kevin J Anstrom, Monica R Shah, Patrice Desvigne-Nickens, Javed Butler, Eugene Braunwald
Importance: Iron deficiency is present in approximately 50% of patients with heart failure with reduced left ventricular ejection fraction (HFrEF) and is an independent predictor of reduced functional capacity and mortality. However, the efficacy of inexpensive readily available oral iron supplementation in heart failure is unknown. Objective: To test whether therapy with oral iron improves peak exercise capacity in patients with HFrEF and iron deficiency. Design, Setting, and Participants: Phase 2, double-blind, placebo-controlled randomized clinical trial of patients with HFrEF (<40%) and iron deficiency, defined as a serum ferritin level of 15 to 100 ng/mL or a serum ferritin level of 101 to 299 ng/mL with transferrin saturation of less than 20%...
May 16, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28509761/dabigatran-in-nonvalvular-atrial-fibrillation-from-clinical-trials-to-real-life-experience
#13
Nicola Mumoli, Daniela Mastroiacovo, Eleonora Tamborini-Permunian, Josè Vitale, Matteo Giorgi-Pierfranceschi, Marco Cei, Francesco Dentali
: Atrial fibrillation is the most common arrhythmia in over-midlife patients. In addition to systolic heart failure, cerebral thromboembolism represents the most dramatic complication of this rhythm disorder, contributing to morbidity and mortality. Traditionally, anticoagulation has been considered the main strategy in preventing stroke and systemic embolism in atrial fibrillation patients and vitamin K-dependent antagonists have been widely used in clinical practice. Recently, the development of direct oral anticoagulants has certainly improved the management of this disease, providing, for the first time, the opportunity to go beyond vitamin K-dependent antagonists limits...
July 2017: Journal of Cardiovascular Medicine
https://www.readbyqxmd.com/read/28507431/targeted-drugs-for-pulmonary-arterial-hypertension-a-network-meta-analysis-of-32-randomized-clinical-trials
#14
Xiao-Fei Gao, Jun-Jie Zhang, Xiao-Min Jiang, Zhen Ge, Zhi-Mei Wang, Bing Li, Wen-Xing Mao, Shao-Liang Chen
BACKGROUND: Pulmonary arterial hypertension (PAH) is a devastating disease and ultimately leads to right heart failure and premature death. A total of four classical targeted drugs, prostanoids, endothelin receptor antagonists (ERAs), phosphodiesterase 5 inhibitors (PDE-5Is), and soluble guanylate cyclase stimulator (sGCS), have been proved to improve exercise capacity and hemodynamics compared to placebo; however, direct head-to-head comparisons of these drugs are lacking. This network meta-analysis was conducted to comprehensively compare the efficacy of these targeted drugs for PAH...
2017: Patient Preference and Adherence
https://www.readbyqxmd.com/read/28505464/treatment-of-the-cardiac-hypertrophic-response-and-heart-failure-with-ginseng-ginsenosides-and-ginseng-related-products
#15
Morris Karmazyn, Tracey Gan
Heart failure is a major medical as well as economic burden throughout the world. Although various treatment options are available to treat heart failure, death rates in both men and women remain high. Potential adjunctive therapies may lie with use of herbal medications many of which possess potent pharmacological properties. Among the most widely studied is ginseng, a member of the genus Panax which is grown in many parts of the world and which has been used as a medical treatment for a variety of conditions for thousands of years, particularly in Asian societies...
May 15, 2017: Canadian Journal of Physiology and Pharmacology
https://www.readbyqxmd.com/read/28503301/is-there-a-role-for-ischaemic-conditioning-in-cardiac-surgery
#16
REVIEW
Luciano Candilio, Derek Hausenloy
Coronary artery disease (CAD) is a major cause of morbidity and mortality worldwide. Coronary artery bypass graft (CABG) surgery is the revascularisation strategy of choice in patients with diabetes mellitus and complex CAD. Owing to a number of factors, including the ageing population, the increased complexity of CAD being treated, concomitant valve and aortic surgery, and multiple comorbidities, higher-risk patients are being operated on, the result of which is an increased risk of sustaining perioperative myocardial injury (PMI) and poorer clinical outcomes...
2017: F1000Research
https://www.readbyqxmd.com/read/28501522/long-term-effects-of-flosequinan-on-the-morbidity-and-mortality-of-patients-with-severe-chronic-heart-failure-primary-results-of-the-profile-trial-after-24-years
#17
Milton Packer, Bertram Pitt, Jean-Lucien Rouleau, Karl Swedberg, David L DeMets, Lloyd Fisher
OBJECTIVES: The objective of this clinical trial was to evaluate the long-term effects of flosequinan on the morbidity and mortality of patients with severe chronic heart failure. BACKGROUND: Flosequinan was the first oral vasodilator to be used in the clinic to augment the effects of digitalis, diuretics, and angiotensin-converting enzyme inhibitors in heart failure. However, the drug activated neurohormonal systems and exerted both positive inotropic and chronotropic effects, raising concerns about its safety during long-term use...
May 2, 2017: JACC. Heart Failure
https://www.readbyqxmd.com/read/28501352/effects-of-glucagon-like-peptide-1-receptor-agonists-on-mortality-and-cardiovascular-events-a-comprehensive-meta-analysis-of-randomized-controlled-trials
#18
Matteo Monami, Stefania Zannoni, Laura Pala, Antonio Silverii, Francesco Andreozzi, Giorgio Sesti, Edoardo Mannucci
INTRODUCTION: The publication of the results of LEADER and SUSTAIN-6 trials suggested a possible beneficial effect of the class of GLP-1 receptor agonists on cardiovascular morbidity and mortality. The aim of the present meta-analysis is to collect and synthetize all available evidence on the effect of GLP-1 receptor agonists on cardiovascular events and mortality. METHODS: A Medline search for GLP-1 receptor agonists (exenatide, liraglutide, lixisenatide, albiglutide, dulaglutide, or semaglutide) was performed, collecting all randomized clinical trials with a duration >11weeks, enrolling patients with type 2 diabetes, and comparing a GLP-1 receptor agonist with placebo or any other non-GLP-1 receptor agonist drug...
May 5, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28499979/inspiratory-muscle-training-improves-intercostal-and-forearm-muscle-oxygenation-in-patients-with-chronic-heart-failure-evidence-of-the-origin-of-the-respiratory-metaboreflex
#19
Adalgiza M Moreno, Alessandra C Toledo-Arruda, Jéssica S Lima, Carolina S Duarte, Humberto Vilacortta-Junior, Antonio C L Nóbrega
BACKGROUND: The impact of inspiratory muscle training (IMT) on respiratory and peripheral muscle oxygenation and perfusion during inspiratory muscle fatigue in patients with chronic heart failure has not been established. METHODS AND RESULTS: Twenty-six patients with chronic heart failure were randomly assigned to either 8 weeks of IMT or to a control group. Inspiratory fatigue was induced by a progressive inspiratory resistive loading protocol until there was an inability to sustain inspiratory pressure, when the inspiratory muscle metaboreflex should be activated...
May 9, 2017: Journal of Cardiac Failure
https://www.readbyqxmd.com/read/28498942/effect-of-vitamin-d-on-all-cause-mortality-in-heart-failure-evita-a-3-year-randomized-clinical-trial-with-4000%C3%A2-iu-vitamin-d-daily
#20
Armin Zittermann, Jana B Ernst, Sylvana Prokop, Uwe Fuchs, Jens Dreier, Joachim Kuhn, Cornelius Knabbe, Ingvild Birschmann, Uwe Schulz, Heiner K Berthold, Stefan Pilz, Ioanna Gouni-Berthold, Jan F Gummert, Marcus Dittrich, Jochen Börgermann
Aims: Circulating 25-hydroxyvitamin D (25OHD) levels <75 nmol/L are associated with a nonlinear increase in mortality risk. Such 25OHD levels are common in heart failure (HF). We therefore examined whether oral vitamin D supplementation reduces mortality in patients with advanced HF. Methods and results: Four hundred HF patients with 25OHD levels <75 nmol/L were randomized to receive 4000 IU vitamin D daily or matching placebo for 3 years. Primary endpoint was all-cause mortality...
May 12, 2017: European Heart Journal
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