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Guidelines for HFrEF treatment

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https://www.readbyqxmd.com/read/28530501/palliative-care-for-advanced-heart-failure-in-a-department-of-veterans-affairs-regional-hospice-program-patient-selection-a-treatment-protocol-and-clinical-course
#1
George J Taylor, Dorothy M Lee, Catalin F Baicu, Michael R Zile
BACKGROUND: Palliative care for advanced heart failure (HF) is generally recommended. However, few reports have focused on the particulars of treatment, or the clinical course of HF on a specific treatment regimen. OBJECTIVE: Palliation adequate to allow patients to avoid HF admission and die at home. METHODS: Patients from a veterans administration regional practice with multiple, recent hospital admissions were enrolled in community hospice programs...
May 22, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28496549/phosphodiesterase-5-inhibitors-improve-clinical-outcomes-exercise-capacity-and-pulmonary-hemodynamics-in-patients-with-heart-failure-with-reduced-left-ventricular-ejection-fraction-a-meta-analysis
#2
Renato De Vecchis, Arturo Cesaro, Carmelina Ariano, Anna Giasi, Carmela Cioppa
BACKGROUND: Several studies have compared the use of phosphodiesterase-5 (PDE5) inhibitors sildenafil or udenafil with the placebo in patients suffering from pulmonary hypertension (PH) due to left chronic heart failure (CHF), corresponding to group 2 (PH due to left heart disease) of the PH classification (according to 2015 ESC/ERS guidelines for the diagnosis and treatment of PH). The results of the use of PDE5 inhibitors in the PH due to left heart disease were inconsistent and heterogeneous...
June 2017: Journal of Clinical Medicine Research
https://www.readbyqxmd.com/read/28492561/-sacubitril-valsartan-a-new-and-effective-treatment-for-heart-failure-with-reduced-ejection-fraction
#3
Michele Senni, Bruno Trimarco, Michele Emdin, Luciano De Biase
Despite significant therapeutic advances, patients with chronic heart failure and reduced ejection fraction (HFrEF) remain at high risk for heart failure progression and death. The PARADIGM-HF study, the largest outcome trial in HFrEF, has shown improved cardiovascular outcomes with sacubitril/valsartan (Entresto®, Novartis), previously known as LCZ696, compared with angiotensin-converting enzyme (ACE) inhibitor therapy, possibly leading us to a new era for heart failure treatment. Sacubitril/valsartan represents a first-in-class drug acting through inhibition of angiotensin receptor and neprilysin, thus modulating the renin-angiotensin-aldosterone system and vasoactive substances such as natriuretic peptides...
January 2017: Giornale Italiano di Cardiologia
https://www.readbyqxmd.com/read/28476146/heart-failure-in-patients-with-coronary-heart-disease-prevalence-characteristics-and-guideline-implementation-results-from-the-german-euroaspire-iv-cohort
#4
Caroline Morbach, Martin Wagner, Stefan Güntner, Carolin Malsch, Mehmet Oezkur, David Wood, Kornelia Kotseva, Rainer Leyh, Georg Ertl, Wolfgang Karmann, Peter U Heuschmann, Stefan Störk
BACKGROUND: Adherence to pharmacotherapeutic treatment guidelines in patients with heart failure (HF) is of major prognostic importance, but thorough implementation of guidelines in routine care remains insufficient. Our aim was to investigate prevalence and characteristics of HF in patients with coronary heart disease (CHD), and to assess the adherence to current HF guidelines in patients with HF stage C, thus identifying potential targets for the optimization of guideline implementation...
May 5, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28463464/physicians-guideline-adherence-is-associated-with-better-prognosis-in-outpatients-with-heart-failure-with-reduced-ejection-fraction-the-qualify-international-registry
#5
Michel Komajda, Martin R Cowie, Luigi Tavazzi, Piotr Ponikowski, Stefan D Anker, Gerasimos S Filippatos
AIMS: To evaluate the impact of physicians' adherence to guideline-recommended medications for heart failure with reduced ejection fraction (HFrEF), including ≥50% prescription of recommended doses, on clinical outcomes at 6-month follow-up. METHODS AND RESULTS: In QUALIFY, an international, prospective, observational, longitudinal survey, 6669 outpatients with HFrEF were recruited 1-15 months after heart failure (HF) hospitalization from September 2013 to December 2014 in 36 countries and followed up at 6 months...
April 30, 2017: European Journal of Heart Failure
https://www.readbyqxmd.com/read/28416525/treatment-of-patients-with-atrial-fibrillation-and-heart-failure-with-reduced-ejection-fraction
#6
REVIEW
Atul Verma, Jonathan M Kalman, David J Callans
Atrial fibrillation (AF) and heart failure with reduced ejection fraction (HFrEF) frequently coexist, and each complicates the course and treatment of the other. Recent population-based studies have demonstrated that the 2 conditions together increase the risk of stroke, heart failure hospitalization, and all-cause mortality, especially soon after the clinical onset of AF. Guideline-directed pharmacological therapy for HFrEF is important; however, although there are various treatment modalities for AF, there is no clear consensus on how best to treat AF with concomitant HFrEF...
April 18, 2017: Circulation
https://www.readbyqxmd.com/read/28398017/differential-effects-of-phosphodiesterase-5-inhibition-in-chronic-cardiac-decompensation-depending-on-the-type-whether-hfref-or-hfpef-of-heart-failure-a-meta-analysis
#7
Renato DE Vecchis, Arturo Cesaro, Carmelina Ariano
INTRODUCTION: According to 2015 ESC/ERS guidelines for the diagnosis and treatment of pulmonary hypertension(PH), no specific drug is currently indicated for PH related to left heart disease( PH-LDH), i.e., the one secondary to left chronic heart failure (CHF), which coincides with the group 2 of the PH classification endorsed by the above-mentioned guidelines. In fact, adoption of therapies that specifically apply for so-called pulmonary arterial hypertension (group 1 of the PH classification) has been regarded as substantially contraindicated in patients with PH- LHD, according to current ESC/ERS guidelines...
April 10, 2017: Minerva Cardioangiologica
https://www.readbyqxmd.com/read/28357714/the-role-for-cardiovascular-remodeling-in-cardiovascular-outcomes
#8
REVIEW
Nishant Krishna Sekaran, Anna Lisa Crowley, Fernanda Rodrigues de Souza, Elmiro Santos Resende, Sunil V Rao
PURPOSE OF REVIEW: Ischemic and non-ischemic injury to the heart causes deleterious changes in ventricular size, shape, and function. This adverse remodeling is mediated by neurohormonal and hemodynamic alterations and is reflected in non-invasive measures of left ventricular ejection fraction (LVEF), left ventricular end-systolic volume (LVESV), and left ventricular end-diastolic volume (LVEDV). These measures are closely linked to cardiovascular outcomes and have become key surrogate endpoints for evaluating the therapeutic efficacy of contemporary treatments for heart failure with reduced ejection fraction (HFrEF)...
May 2017: Current Atherosclerosis Reports
https://www.readbyqxmd.com/read/28329163/determinants-and-clinical-outcome-of-uptitration-of-ace-inhibitors-and-beta-blockers-in-patients-with-heart-failure-a-prospective-european-study
#9
W Ouwerkerk, A A Voors, S D Anker, J G Cleland, K Dickstein, G Filippatos, P van der Harst, H L Hillege, C C Lang, J M Ter Maaten, L L Ng, P Ponikowski, N J Samani, D J van Veldhuisen, F Zannad, M Metra, A H Zwinderman
Introduction: Despite clear guidelines recommendations, most patients with heart failure and reduced ejection-fraction (HFrEF) do not attain guideline-recommended target doses. We aimed to investigate characteristics and for treatment-indication-bias corrected clinical outcome of patients with HFrEF that did not reach recommended treatment doses of ACE-inhibitors/Angiotensin receptor blockers (ARBs) and/or beta-blockers. Methods and results: BIOSTAT-CHF was specifically designed to study uptitration of ACE-inhibitors/ARBs and/or beta-blockers in 2516 heart failure patients from 69 centres in 11 European countries who were selected if they were suboptimally treated while initiation or uptitration was anticipated and encouraged...
March 11, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28290795/-a-breakthrough-in-the-treatment-of-patients-with-heart-failure-with-reduced-ejection-fraction-the-clinical-significance-of-the-paradigm-hf-trial
#10
Zh D Kobalava, S V Villevalde, O I Lukina
The implementation into clinical practice of new therapeutic strategies that could improve the prognosis of patients with heart failure (HF) with reduced ejection fraction (HFrEF) remains relevant. Innovative approach is to restore imbalances of neurohumoral systems by inhibiting angiotensin II receptor and neprilysin. The review presents the role of the natriuretic peptides system in the HFrEF pathophysiology, historical approaches to neurohormonal modulation, clinical pharmacology of the first in the class of angiotensin receptor and neprilysin inhibitor sakubitril/valsartan...
February 2017: Kardiologiia
https://www.readbyqxmd.com/read/28244205/what-proportion-of-patients-with-chronic-heart-failure-are-eligible-for-sacubitril-valsartan
#11
Pierpaolo Pellicori, Alessia Urbinati, Parin Shah, Alexandra MacNamara, Syed Kazmi, Riet Dierckx, Jufen Zhang, John G F Cleland, Andrew L Clark
AIMS: The PARADIGM-HF trial showed that sacubitril-valsartan, an ARB-neprilysin inhibitor, is more effective than enalapril for some patients with heart failure (HF). It is uncertain what proportion of patients with HF would be eligible for sacubitril-valsartan in clinical practice. METHODS AND RESULTS: Between 2001 and 2014, 6131 patients consecutively referred to a community HF clinic with suspected HF were assessed. The criteria required to enter the randomized phase of PARADIGM-HF, including symptoms, NT-proBNP, and current treatment with or without target doses of ACE inhibitors or ARBs, were applied to identify the proportion of patients eligible for sacubitril-valsartan...
February 27, 2017: European Journal of Heart Failure
https://www.readbyqxmd.com/read/28154958/combination-of-high-sensitivity-troponin-i-and-n-terminal-pro-b-type-natriuretic-peptide-predicts-future-hospital-admission-for-heart-failure-in-high-risk-hypertensive-patients-with-preserved-left-ventricular-ejection-fraction
#12
Ryunosuke Okuyama, Junnichi Ishii, Hiroshi Takahashi, Hideki Kawai, Takashi Muramatsu, Masahide Harada, Akira Yamada, Sadako Motoyama, Shigeru Matsui, Hiroyuki Naruse, Masayoshi Sarai, Midori Hasegawa, Eiichi Watanabe, Atsushi Suzuki, Mutsuharu Hayashi, Hideo Izawa, Yukio Yuzawa, Yukio Ozaki
Additional risk stratification may provide more aggressive and focalized preventive treatment to high-risk hypertensive patients according to the Japanese hypertension guidelines. We prospectively investigated the predictive value of high-sensitivity troponin I (hsTnI), both independently and in combination with N-terminal pro-B-type natriuretic peptide (NT-proBNP), for incident heart failure (HF) in high-risk hypertensive patients with preserved left ventricular ejection fraction (LVEF). Baseline hsTnI and NT-proBNP levels and echocardiography data were obtained for 493 Japanese hypertensive outpatients (mean age, 68...
February 2, 2017: Heart and Vessels
https://www.readbyqxmd.com/read/28004291/sacubitril-valsartan-lcz696-in-heart-failure
#13
Yasser Khder, Victor Shi, John J V McMurray, Martin P Lefkowitz
It has been known since the 1990s that long-term morbidity and mortality is improved in patients with heart failure with reduced ejection fraction (HFrEF) by treatments that target the renin-angiotensin-aldosterone system (RAAS). It has also long been thought that enhancement of the activity of natriuretic peptides (NPs) could potentially benefit patients with HFrEF, but multiple attempts to realize this benefit had failed over the years - until 2014, when a large, phase III, randomized, controlled clinical trial (PARADIGM-HF) was completed comparing sacubitril/valsartan with enalapril, a well-established treatment for HFrEF...
December 22, 2016: Handbook of Experimental Pharmacology
https://www.readbyqxmd.com/read/27867524/varying-effects-of-recommended-treatments-for-heart-failure-with-reduced-ejection-fraction-meta-analysis-of-randomized-controlled-trials-in-the-esc-and-accf-aha-guidelines
#14
REVIEW
Marius Mark Thomsen, Christian Lewinter, Lars Køber
The aim of this paper is to evaluate the treatment effects of recommended drugs and devices on key clinical outcomes for patients with heart failure with reduced ejection fraction (HFREF). Randomized controlled trials (RCTs) listed in the 2012 HF guideline from the European Society of Cardiology as well as the 2013 HF guideline from the American College of Cardiology Foundation and American Heart Association were evaluated for use in the meta-analysis. RCTs written in English evaluating recommended drugs and devices for the treatment of patients with HFREF were included...
December 2016: ESC Heart Failure
https://www.readbyqxmd.com/read/27858115/-the-new-esc-guidelines-for-acute-and-chronic-heart-failure-2016
#15
C U Oeing, C Tschöpe, B Pieske
The new guidelines for the diagnosis and treatment of acute and chronic heart failure (HF) were presented in May 2016 during the congress of the Heart Failure Association (HFA) of the European Society of Cardiology (ESC) in Florence. An important amendment affects the classification of HF which now differentiates between HF with preserved ejection fraction (HFpEF) and left ventricular EF (LVEF) > 50%, HF with reduced ejection fraction (HFrEF, LVEF < 40%) and the new entity HF with mid-range ejection fraction (HFmrEF, LVEF 40-49%)...
December 2016: Herz
https://www.readbyqxmd.com/read/27824422/-sacubitril-valsartan-in-patients-with-diabetes-and-heart-failure
#16
REVIEW
Vincent Matthias Brandenburg, Hans-Peter Brunner-La Rocca, Nikolaus Marx
Sacubitril / Valsartan proofed to be an effective treatment compared to enalapril in reducing heart failure hospitalisations and mortality in patients with severe "Heart failure with reduced ejection fraction" (HFREF). Recent European cardiology guidelines attributed a class IB recommendation for Sacubitril / Valsartan in HFREF patients who remain symptomatic despite optimal treatment with ACE-I, a beta-blocker, and a mineralocorticoid receptor antagonist. There is a significant overlap between diabetic and HFREF patients and thus, efficacy assessment of Sacubitril / Valsartan is a clinically meaningful issue in the large subgroup of HFREF patients with diabetes...
October 2016: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/27747488/angiotensin-neprilysin-inhibition-as-a-paradigm-for-all
#17
REVIEW
Muthiah Vaduganathan, Akshay S Desai
Composite angiotensin receptor-neprilysin inhibition (ARNi) represents a novel pharmacologic strategy for treatment of heart failure with reduced ejection fraction (HFrEF). In the PARADIGM-HF (Prospective comparison of ARNi with ACEi to Determine Impact on Global Mortality and Morbidity in Heart Failure) trial of 8399 subjects with HFrEF, treatment with the ARNi LCZ696 (sacubitril/valsartan) was associated with statistically important reductions in cardiovascular death, all-cause mortality, and the composite of cardiovascular death or heart failure hospitalization in comparison with enalapril...
November 2016: Current Cardiology Reports
https://www.readbyqxmd.com/read/27630137/could-modification-of-titin-contribute-to-an-answer-for-heart-failure-with-preserved-ejection-fraction
#18
EDITORIAL
Martin M LeWinter, Michael R Zile
No abstract text is available yet for this article.
October 11, 2016: Circulation
https://www.readbyqxmd.com/read/27620301/should-mras-be-at-the-front-row-in-heart-failure-a-plea-for-the-early-use-of-mineralocorticoid-receptor-antagonists-in-medical-therapy-for-heart-failure-based-on-clinical-experience
#19
REVIEW
Ward A Heggermont, Marc Goethals, Riet Dierckx, Sofie Verstreken, Jozef Bartunek, Marc Vanderheyden
The brand new 2016 ESC guidelines for the treatment of acute and chronic heart failure continue to give a prominent place to mineralocorticoid receptor antagonists in the treatment of chronic heart failure with reduced ejection fraction (HFrEF). In the prevention of HF hospitalization and death, a class I, level of recommendation A, is given to MRAs for patients with HFrEF, who remain symptomatic despite treatment with an ACE-inhibitor and a beta-blocker and have an LVEF below 35 %. This recommendation is primarily based on two landmark trials, the RALES trial (for spironolactone) and the EMPHASIS-HF trial (for eplerenone)...
November 2016: Heart Failure Reviews
https://www.readbyqxmd.com/read/27573608/practical-considerations-on-the-introduction-of-sacubitril-valsartan-in-clinical-practice-current-evidence-and-early-experience
#20
EDITORIAL
Dimitrios Farmakis, Vassiliki Bistola, Apostolos Karavidas, John Parissis
The combination of neprilysin inhibitor sacubitril with the angiotensin II receptor 1 blocker valsartan is the first agent from the angiotensin receptor neprilysin inhibitors (ARNI) class authorized for clinical use in heart failure (HF) patients with reduced ejection fraction (HFrEF). Sacubitril/valsartan resulted in 20% reduction in the incidence rate of death or HF hospitalization compared to enalapril in symptomatic HFrEF patients in the seminal PARADIGM-HF trial. As a result, the recently updated European and American HF guidelines granted this agent a class IB indication for the treatment of ambulatory/chronic symptomatic HFrEF patients...
November 15, 2016: International Journal of Cardiology
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