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HFrEF treatment

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https://www.readbyqxmd.com/read/28915854/medical-therapy-following-hospitalization-for-heart-failure-with-reduced-ejection-fraction-and-association-with-discharge-to-long-term-care-a-cross-sectional-analysis-of-the-reasons-for-geographic-and-racial-differences-in-stroke-regards-population
#1
Emily B Levitan, Melissa K Van Dyke, Ligong Chen, Raegan W Durant, Todd M Brown, J David Rhodes, Olusola Olubowale, Oluwole Muyiwa Adegbala, Meredith L Kilgore, Justin Blackburn, Karen C Albright, Monika M Safford
BACKGROUND: Less intensive treatment for heart failure with reduced ejection fraction (HFrEF) may be appropriate for patients in long-term care settings because of limited life expectancy, frailty, comorbidities, and emphasis on quality of life. METHODS: We compared treatment patterns between REasons for Geographic And Racial Differences in Stroke (REGARDS) study participants discharged to long-term care versus home following HFrEF hospitalizations. We examined medical records and Medicare pharmacy claims for 147 HFrEF hospitalizations among 80 participants to obtain information about discharge disposition and medication prescriptions and fills...
September 16, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28901848/pulmonary-hypertension-secondary-to-left-heart-disease
#2
Ghazal Kabbach, Debabrata Mukherjee
Pulmonary hypertension (PH) related to left heart disease (LHD) is the most common form of PH, accounting for more than two third of all PH cases. The hemodynamic abnormalities seen in PH-LHD are complex, and there are currently minimal evidence-based recommendations for the management of PH-LHD. While it is accepted that PH in the context of left heart disease is a marker of worse prognosis, it remains unclear whether its primary treatment is beneficial or harmful. In this article, we discuss the prevalence and significance of PH in patients with heart failure (HF) with reduced ejection fraction (HFrEF) as well as HF with preserved ejection fraction (HFpEF), and those with valvular heart disease and provide insights into the complex pathophysiology of cardiopulmonary interrelationship in individuals with PH due to left heart disease...
September 12, 2017: Current Vascular Pharmacology
https://www.readbyqxmd.com/read/28883863/the-evolution-of-natriuretic-peptide-augmentation-in-management-of-heart-failure-and-the-role-of-sacubitril-valsartan
#3
Srikanth Yandrapalli, Wilbert S Aronow, Pratik Mondal, David R Chabbott
Heart failure (HF) is one of the leading causes of morbidity, mortality, and health care expenditures in the US and worldwide. For three decades, the pillars of treatment of HF with reduced ejection fraction (HFrEF) were medications that targeted the sympathetic nervous system (SNS) and the renin-angiotensin-aldosterone system (RAAS). Prior attempts to augment the natriuretic peptide system (NPS) for the management of HF failed either due to lack of significant clinical benefit or due to the unacceptable side effect profile...
August 2017: Archives of Medical Science: AMS
https://www.readbyqxmd.com/read/28875746/plasma-renin-activity-in-patients-with-heart-failure-and-reduced-ejection-fraction-on-optimal-medical-therapy
#4
Petra Nijst, Frederik H Verbrugge, Pieter Martens, Philippe B Bertrand, Matthias Dupont, Gary S Francis, Wh Wilson Tang, Wilfried Mullens
BACKGROUND: Renin-angiotensin-aldosterone system (RAAS) activation in heart failure with reduced ejection fraction (HFREF) is detrimental through promotion of ventricular remodeling and salt and water retention. AIMS: The aims of this article are to describe RAAS activity in distinct HFREF populations and to assess its prognostic impact. METHODS: Venous blood samples were prospectively obtained in 76 healthy volunteers, 72 patients hospitalized for acute decompensated HFREF, and 78 ambulatory chronic HFREF patients without clinical signs of congestion...
July 2017: Journal of the Renin-angiotensin-aldosterone System: JRAAS
https://www.readbyqxmd.com/read/28873219/treatment-effectiveness-in-heart-failure-with-comorbidity-lung-disease-and-kidney-disease
#5
Jerry H Gurwitz, David J Magid, David H Smith, Grace H Tabada, Sue Hee Sung, Larry A Allen, David D McManus, Robert J Goldberg, Mayra Tisminetzky, Alan S Go
OBJECTIVES: To assess the clinical effectiveness of beta-blocker therapy in individuals with heart failure (HF) and chronic lung disease and of angiotensin-converting enzyme inhibitors (ACE-Is) and angiotensin II receptor blockers (ARBs) in individuals with HF and chronic kidney disease. DESIGN: Retrospective cohort study. SETTING: Community. PARTICIPANTS: Individuals with HF with reduced ejection fraction (HFrEF) or HF with preserved ejection fraction (HFpEF)...
September 5, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28859754/evolution-of-functional-mitral-regurgitation-and-prognosis-in-medically%C3%A2-managed-heart-failure-patients%C3%A2-with-reduced-ejection-fraction
#6
Riwa Nasser, Lauranne Van Assche, Anne Vorlat, Tom Vermeulen, Emeline Van Craenenbroeck, Viviane Conraads, Vicky Van der Meiren, Bharati Shivalkar, Paul Van Herck, Marc J Claeys
OBJECTIVES: The purpose of this study was to assess whether medical management may alter the severity of functional mitral regurgitation (FMR) and its prognosis in patients who have heart failure with reduced ejection fraction (HFrEF). BACKGROUND: FMR in patients who have HFrEF is associated with a worse prognosis. It is uncertain to what extent medical management may alter the severity of FMR and its prognosis. METHODS: The extent of FMR was assessed at baseline and after a median follow-up period of 50 months in 163 consecutive HFrEF patients (left ventricular ejection fraction <40%)...
September 2017: JACC. Heart Failure
https://www.readbyqxmd.com/read/28844335/sacubitril-valsartan-an-important-piece-in-the-therapeutic-puzzle-of-heart-failure
#7
REVIEW
Pedro Marques da Silva, Carlos Aguiar
Sacubitril/valsartan (LCZ696), a supramolecular sodium salt complex of the neprilysin inhibitor prodrug sacubitril and the angiotensin receptor blocker (ARB) valsartan, was recently approved in the EU and the USA for the treatment of chronic heart failure (HF) with reduced ejection fraction (HFrEF) (NYHA class II-IV). Inhibition of chronically activated neurohormonal pathways (the renin-angiotensin-aldosterone system [RAAS] and sympathetic nervous system [SNS]) is central to the treatment of chronic HFrEF. Furthermore, enhancement of the natriuretic peptide (NP) system, with favorable cardiovascular (CV) and renal effects in HF, is a desirable therapeutic goal to complement RAAS and SNS blockade...
August 23, 2017: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
https://www.readbyqxmd.com/read/28840572/pharmacologic-management-for-heart-failure-and-emerging-therapies
#8
REVIEW
Diana H Kim, Feng-Ju Chien, Howard J Eisen
PURPOSE OF REVIEW: This review aims to summarize the growing body of literature of HF with reduced ejection fraction (HFrEF) and preserved ejection fraction (HFpEF) with a focus on recent pharmacologics. RECENT FINDINGS: HFrEF continues to be more widely investigated than HFpEF. Ivabradine and combinatorial treatment with sacubitril and valsartan are promising newly approved therapies. Other experimental therapies have emerged, which include Serelaxin, Empagliflozin, Neuregulin, and Omecamtive mecarbil, among others...
August 24, 2017: Current Cardiology Reports
https://www.readbyqxmd.com/read/28835976/-medicinal-treatment-of-tricuspid-valve-regurgitation
#9
REVIEW
M Lankeit, K Keller, C Tschöpe, B Pieske
The vast majority of tricuspid valve regurgitations are of low degree without prognostic relevance in healthy individuals; however, morbidity and mortality increase with the degree of regurgitation, which can be secondary to either primary (structural) or secondary (functional) alterations of the valve. Due to the frequent lack of symptoms, echocardiographic examinations should be annually performed in patients with higher degree (at least moderate) tricuspid valve regurgitation, in particular in the presence of risk factors...
August 23, 2017: Herz
https://www.readbyqxmd.com/read/28832572/mediterranean-diet-and-prognosis-of-first-diagnosed-acute-coronary-syndrome-patients-according-to-heart-failure-phenotype-hellenic-heart-failure-study
#10
M Kouvari, C Chrysohoou, P Aggelopoulos, E Tsiamis, K Tsioufis, C Pitsavos, D Tousoulis
BACKGROUND/OBJECTIVES: Nutrition in secondary prevention of Acute Coronary Syndrome (ACS) is inadequately investigated. We sought to evaluate the role of Mediterranean diet in prognosis of first-diagnosed ACS patients, according to heart failure type. SUBJECTS/METHODS: in 2006-2009, 1000 consecutive patients hospitalized at First Cardiology Clinic of Athens with ACS diagnosis were enrolled in the study. In 2016, 10-year follow-up was performed (75% participation rate)...
August 23, 2017: European Journal of Clinical Nutrition
https://www.readbyqxmd.com/read/28829876/effect-of-natriuretic-peptide-guided-therapy-on-hospitalization-or-cardiovascular-mortality-in-high-risk-patients-with-heart-failure-and-reduced-ejection-fraction-a-randomized-clinical-trial
#11
RANDOMIZED CONTROLLED TRIAL
G Michael Felker, Kevin J Anstrom, Kirkwood F Adams, Justin A Ezekowitz, Mona Fiuzat, Nancy Houston-Miller, James L Januzzi, Daniel B Mark, Ileana L Piña, Gayle Passmore, David J Whellan, Hongqiu Yang, Lawton S Cooper, Eric S Leifer, Patrice Desvigne-Nickens, Christopher M O'Connor
Importance: The natriuretic peptides are biochemical markers of heart failure (HF) severity and predictors of adverse outcomes. Smaller studies have evaluated adjusting HF therapy based on natriuretic peptide levels ("guided therapy") with inconsistent results. Objective: To determine whether an amino-terminal pro-B-type natriuretic peptide (NT-proBNP)-guided treatment strategy improves clinical outcomes vs usual care in high-risk patients with HF and reduced ejection fraction (HFrEF)...
August 22, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28819094/atrioventricular-conduction-delay-predicts-impaired-exercise-capacity-in-patients-with-heart-failure-with-reduced-ejection-fraction
#12
Jakub Stępniewski, Grzegorz Kopeć, Wojciech Magoń, Piotr Podolec
BACKGROUND Atrioventricular conduction delay (AVCD) impairs left ventricular (LV) filling and consequently leads to a reduction of cardiac output. We hypothesized that in patients with severely depressed LV function and coexisting intraventricular conduction disturbances (IVCD), AVCD can affect exercise performance. Therefore, we evaluated the association of AVCD and exercise capacity in patients with heart failure (HFREF) and coexisting IVCD. MATERIAL AND METHODS We included patients with stable, chronic HFREF, LVEF <35%, sinus rhythm, and QRS ≥120 ms...
August 18, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/28795299/adherence-to-optimal-heart-rate-control-in-heart-failure-with-reduced-ejection-fraction-insight-from-a-survey-of-heart-rate-in-heart-failure-in-sweden-hr-hf-study
#13
M Fu, U Ahrenmark, S Berglund, C J Lindholm, A Lehto, A Månsson Broberg, G Tasevska-Dinevska, G Wikstrom, A Ågard, B Andersson
INTRODUCTION: Despite that heart rate (HR) control is one of the guideline-recommended treatment goals for heart failure (HF) patients, implementation has been painstakingly slow. Therefore, it would be important to identify patients who have not yet achieved their target heart rates and assess possible underlying reasons as to why the target rates are not met. MATERIALS AND METHODS: The survey of HR in patients with HF in Sweden (HR-HF survey) is an investigator-initiated, prospective, multicenter, observational longitudinal study designed to investigate the state of the art in the control of HR in HF and to explore potential underlying mechanisms for suboptimal HR control with focus on awareness of and adherence to guidelines for HR control among physicians who focus on the contributing role of beta-blockers (BBs)...
August 9, 2017: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
https://www.readbyqxmd.com/read/28774374/effectiveness-and-cost-effectiveness-of-serum-b-type-natriuretic-peptide-testing-and-monitoring-in-patients-with-heart-failure-in-primary-and-secondary-care-an-evidence-synthesis-cohort-study-and-cost-effectiveness-model
#14
Maria Pufulete, Rachel Maishman, Lucy Dabner, Syed Mohiuddin, William Hollingworth, Chris A Rogers, Julian Higgins, Mark Dayer, John Macleod, Sarah Purdy, Theresa McDonagh, Angus Nightingale, Rachael Williams, Barnaby C Reeves
BACKGROUND: Heart failure (HF) affects around 500,000 people in the UK. HF medications are frequently underprescribed and B-type natriuretic peptide (BNP)-guided therapy may help to optimise treatment. OBJECTIVE: To evaluate the clinical effectiveness and cost-effectiveness of BNP-guided therapy compared with symptom-guided therapy in HF patients. DESIGN: Systematic review, cohort study and cost-effectiveness model. SETTING: A literature review and usual care in the NHS...
August 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/28714796/effect-of-bariatric-surgery-on-heart-failure
#15
Marcela Rodriguez Flores, Carlos Aguilar Salinas, Marie-Eve Piché, Audrey Auclair, Paul Poirier
Obesity increases the risk of heart failure (HF), which continues to be a significant proportion of all cardiovascular diseases and affects increasingly younger populations. The cross-talk between adipose and the heart involves insulin resistance, adipokine signaling and inflammation, with the capacity of adipose tissue to mediate hemodynamic signals, promoting progressive cardiomyopathy. Areas covered: From a therapeutic perspective, there is not yet a single obesity-related pathway that when addressed, can ameliorate cardiomyopathy in obese patients and this is a matter of ongoing research...
August 2017: Expert Review of Cardiovascular Therapy
https://www.readbyqxmd.com/read/28711446/clinical-effectiveness-of-hydralazine-isosorbide-dinitrate-in-african-american-patients-with-heart%C3%A2-failure
#16
Boback Ziaeian, Gregg C Fonarow, Paul A Heidenreich
OBJECTIVES: This study sought to evaluate the effectiveness of hydralazine-isosorbide dinitrate (H-ISDN) in African Americans with heart failure (HF) with reduced ejection fraction (HFrEF). BACKGROUND: Among African-American patients with HFrEF, H-ISDN was found to improve quality of life and lower HF-related hospitalization and mortality rates in the A-HEFT (African-American Heart Failure Trial). Few studies have evaluated the effectiveness of this therapy in clinical practice...
September 2017: JACC. Heart Failure
https://www.readbyqxmd.com/read/28705910/fatigability-exercise-intolerance-and-abnormal-skeletal-muscle-energetics-in-heart-failure
#17
Kilian Weiss, Michael Schär, Gurusher S Panjrath, Yi Zhang, Kavita Sharma, Paul A Bottomley, Asieh Golozar, Angela Steinberg, Gary Gerstenblith, Stuart D Russell, Robert G Weiss
BACKGROUND: Among central and peripheral factors contributing to exercise intolerance (EI) in heart failure (HF), the extent to which skeletal muscle (SM) energy metabolic abnormalities occur and contribute to EI and increased fatigability in HF patients with reduced or preserved ejection fraction (HFrEF and HFpEF, respectively) are not known. An energetic plantar flexion exercise fatigability test and magnetic resonance spectroscopy were used to probe the mechanistic in vivo relationships among SM high-energy phosphate concentrations, mitochondrial function, and EI in HFrEF and HFpEF patients and in healthy controls...
July 2017: Circulation. Heart Failure
https://www.readbyqxmd.com/read/28693409/long-term-outcomes-in-patients-with-critical-limb-ischemia-and-heart-failure-with-preserved-or-reduced-ejection-fraction
#18
Kavita B Khaira, Ellen Brinza, Gagan D Singh, Ezra A Amsterdam, Stephen W Waldo, Kathleen Tong, Kruti Pandya, John R Laird, Ehrin J Armstrong
The impact of heart failure (HF) on long-term survival in patients with critical limb ischemia (CLI) has not been well described. Outcomes stratified by left ventricular ejection fraction (EF) are also unknown. A single center retrospective chart review was performed for patients who underwent treatment for CLI from 2006 to 2013. Baseline demographics, procedural data and outcomes were analyzed. HF diagnosis was based on appropriate signs and symptoms as well as results of non-invasive testing. Among 381 CLI patients, 120 (31%) had a history of HF and 261 (69%) had no history of heart failure (no-HF)...
August 2017: Vascular Medicine
https://www.readbyqxmd.com/read/28684221/exercise-training-for-prevention-and-treatment-of-heart-failure
#19
REVIEW
Nitin Kondamudi, Mark Haykowsky, Daniel E Forman, Jarett D Berry, Ambarish Pandey
Heart failure (HF) results in high healthcare costs and burdens for the United States in respects to hospitalizations, therapies, and associated disability. The relative proportion of HF with preserved ejection fraction (HFpEF) compared with HF with reduced ejection fraction (HFrEF) is on the rise; HFpEF has already become the dominant form of HF and it continues to increase. The serious implications of these trends are compounded by a dearth of effective HFpEF therapies. While low physical activity, low cardiorespiratory fitness (CRF), and obesity, are risk factors for HF in general, they particularly predispose to HFpEF...
June 2017: Progress in Cardiovascular Diseases
https://www.readbyqxmd.com/read/28677877/a-phase-2a-dose-escalation-study-of-the-safety-tolerability-pharmacokinetics-and-haemodynamic-effects-of-bms-986231-in-hospitalized-patients-with-heart-failure-with-reduced-ejection-fraction
#20
Cristina Tita, Edward M Gilbert, Adrian B Van Bakel, Jacek Grzybowski, Garrie J Haas, Mohammad Jarrah, Stephanie H Dunlap, Stephen S Gottlieb, Marc Klapholz, Parag C Patel, Roman Pfister, Tim Seidler, Keyur B Shah, Tomasz Zieliński, Robert P Venuti, Douglas Cowart, Shi Yin Foo, Alexander Vishnevsky, Veselin Mitrovic
AIMS: This study was designed to evaluate the safety, tolerability and haemodynamic effects of BMS-986231, a novel second-generation nitroxyl donor with potential inotropic, lusitropic and vasodilatory effects in patients hospitalized with decompensated heart failure and reduced ejection fraction (HFrEF). METHODS AND RESULTS: Forty-six patients hospitalized with decompensated HFrEF were enrolled into four sequential dose-escalation cohorts in this double-blind, randomized, placebo-controlled Phase 2a study...
July 5, 2017: European Journal of Heart Failure
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