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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/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
#2
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/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
#3
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
#4
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/28484123/adaptive-servo-ventilation-treatment-increases-stroke-volume-in-stable-systolic-heart-failure-patients-with-low-tricuspid-annular-plane-systolic-excursion
#5
Toshihiro Iwasaku, Tomotaka Ando, Akiyo Eguchi, Yoshitaka Okuhara, Yoshiro Naito, Toshiaki Mano, Tohru Masuyama, Shinichi Hirotani
We hypothesized that the effects of adaptive servo-ventilation (ASV) therapy were influenced by right-sided heart performance. This study aimed to clarify the interaction between the effects of ASV and right-sided heart performance in patients with stable heart failure (HF) with reduced ejection fraction (HFrEF).Twenty-six stable HF inpatients (left ventricular ejection fraction < 0.45, without moderate to severe mitral regurgitation (MR) were analyzed. Echocardiography was performed before and after 30 minutes of ASV...
May 8, 2017: International Heart Journal
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
#6
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/28475676/comparative-effectiveness-of-enalapril-lisinopril-and-ramipril-in-the-treatment-of-patients-with-chronic-heart-failure-a-propensity-score-matched-cohort-study
#7
Hanna Fröhlich, Felix Henning, Tobias Täger, Dieter Schellberg, Morten Grundtvig, Kevin Goode, Anna Corletto, Syed Kazmi, Torstein Hole, Hugo A Katus, Dan Atar, John G F Cleland, Stefan Agewall, Lutz Frankenstein, Andrew L Clark
Background: Angiotensin converting enzyme inhibitors (ACEIs) are recommended as first-line therapy in patients with heart failure with reduced ejection fraction (HFrEF). The comparative effectiveness of different ACEIs is not known. Methods and results: 4,723 out-patients with stable HFrEF prescribed either enalapril, lisinopril, or ramipril were identified from three registries in Norway, England, and Germany. In three separate matching procedures, patients were individually matched with respect to both dose equivalents and their respective propensity scores for ACEI treatment...
May 5, 2017: European Heart Journal. Cardiovascular Pharmacotherapy
https://www.readbyqxmd.com/read/28467883/heart-rate-heart-rhythm-and-prognostic-benefits-of-beta-blockers-in-heart-failure-individual-patient-data-meta-analysis
#8
Dipak Kotecha, Marcus D Flather, Douglas G Altman, Jane Holmes, Giuseppe Rosano, John Wikstrand, Milton Packer, Andrew J S Coats, Luis Manzano, Michael Böhm, Dirk J van Veldhuisen, Bert Andersson, Hans Wedel, Thomas G von Lueder, Alan S Rigby, Åke Hjalmarson, John Kjekshus, John G F Cleland
BACKGROUND: The relationship between mortality and heart rate remains unclear for patients with heart failure and reduced ejection fraction (HFrEF) in either sinus rhythm or atrial fibrillation (AF). OBJECTIVE: To investigate the prognostic importance of heart rate in HFrEF in randomized controlled trials (RCTs) comparing beta-blockers and placebo. METHODS: The Beta-blockers in Heart Failure Collaborative Group performed a meta-analysis of harmonized individual-patient data from eleven double-blind RCTs...
April 5, 2017: Journal of the American College of Cardiology
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
#9
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/28450040/comparison-of-predictors-of-heart-failure-with-preserved-versus-reduced-ejection-fraction-in-a-multiracial-cohort-of-preclinical-left-ventricular-diastolic-dysfunction
#10
Lili Zhang, Jared J Liebelt, Nidhi Madan, Jian Shan, Cynthia C Taub
Preclinical diastolic dysfunction (PDD) is a well-known but poorly understood risk factor for heart failure. We aimed to investigate risk factors contributing to progression of PDD to heart failure with preserved ejection fraction (HFpEF) and heart failure with reduced ejection fraction (HFrEF). Patients with echocardiogram from 2003 to 2008 with left ventricular ejection fraction ≥50%, grade I diastolic dysfunction, and free of clinical heart failure were included. The end point was incident HFpEF or HFrEF...
June 1, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28416525/treatment-of-patients-with-atrial-fibrillation-and-heart-failure-with-reduced-ejection-fraction
#11
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
#12
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/28384660/association-between-hiv-infection-and-the-risk-of-heart-failure-with-reduced-ejection-fraction-and-preserved-ejection-fraction-in-the-antiretroviral-therapy-era-results-from-the-veterans-aging-cohort-study
#13
Matthew S Freiberg, Chung-Chou H Chang, Melissa Skanderson, Olga V Patterson, Scott L DuVall, Cynthia A Brandt, Kaku A So-Armah, Ramachandran S Vasan, Kris Ann Oursler, John Gottdiener, Stephen Gottlieb, David Leaf, Maria Rodriguez-Barradas, Russell P Tracy, Cynthia L Gibert, David Rimland, Roger J Bedimo, Sheldon T Brown, Matthew Bidwell Goetz, Alberta Warner, Kristina Crothers, Hilary A Tindle, Charles Alcorn, Justin M Bachmann, Amy C Justice, Adeel A Butt
Importance: With improved survival, heart failure (HF) has become a major complication for individuals with human immunodeficiency virus (HIV) infection. It is unclear if this risk extends to different types of HF in the antiretroviral therapy (ART) era. Determining whether HIV infection is associated with HF with reduced ejection fraction (HFrEF), HF with preserved ejection fraction (HFpEF), or both is critical because HF types differ with respect to underlying mechanism, treatment, and prognosis...
May 1, 2017: JAMA Cardiology
https://www.readbyqxmd.com/read/28378286/resetting-the-neurohormonal-balance-in-heart-failure-hf-the-relevance-of-the-natriuretic-peptide-np-system-to-the-clinical-management-of-patients-with-hf
#14
REVIEW
Speranza Rubattu, Filippos Triposkiadis
The natriuretic peptide (NP) system, which includes atrial natriuretic peptide, B-type natriuretic peptide, and C-type natriuretic peptide, has an important role in cardiovascular homeostasis, promoting a number of physiological effects including diuresis, vasodilation, and inhibition of the renin-angiotensin-aldosterone system. Heart failure (HF) is associated with defects in NP processing and synthesis, and there is a strong relationship between NP levels and disease state. NPs are useful biomarkers in HF, and their use in diagnosis and evaluation of prognosis is well established, particularly in patients with HF with reduced ejection fraction (HFrEF)...
April 5, 2017: Heart Failure Reviews
https://www.readbyqxmd.com/read/28371247/ivabradine-current-and-future-treatment-of-heart-failure
#15
REVIEW
Lene Thorup, Ulf Simonsen, Daniela Grimm, Elise R Hedegaard
In heart failure (HF), the heart cannot pump blood efficiently and is therefore unable to meet the body's demands of oxygen, and/or there is increased end-diastolic pressure. Current treatments for HF with reduced ejection fraction (HFrEF) include angiotensin-converting enzyme (ACE) inhibitors, angiotension receptor type 1 (AT1 ) antagonists, β-adrenoceptor antagonists, aldosterone receptor antagonists, diuretics, digoxin and a combination drug with AT1 receptor antagonist and neprilysin inhibitor. In HF, the risk of readmission for hospital and mortality is markedly higher with a heart rate (HR) above 70 bpm...
April 2, 2017: Basic & Clinical Pharmacology & Toxicology
https://www.readbyqxmd.com/read/28357714/the-role-for-cardiovascular-remodeling-in-cardiovascular-outcomes
#16
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/28336474/the-evolution-of-heart-failure-with-reduced-ejection-fraction-pharmacotherapy-what-do-we-have-and-where-are-we-going
#17
REVIEW
Ahmed Selim, Ronald Zolty, Yiannis S Chatzizisis
Cardiovascular diseases represent a leading cause of mortality and increased healthcare expenditure worldwide. Heart failure, which simply describes an inability of the heart to meet the body's needs, is the end point for many other cardiovascular conditions. The last three decades have witnessed significant efforts aiming at the discovery of treatments to improve the survival and quality of life of patients with heart failure; many were successful, while others failed. Given that most of the successes in treating heart failure were achieved in patients with reduced left ventricular ejection fraction (HFrEF), we constructed this review to look at the recent evolution of HFrEF pharmacotherapy...
March 21, 2017: Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/28330649/effect-of-sacubitril-valsartan-versus-enalapril-on-glycaemic-control-in-patients-with-heart-failure-and-diabetes-a-post-hoc-analysis-from-the-paradigm-hf-trial
#18
Jelena P Seferovic, Brian Claggett, Sara B Seidelmann, Ellen W Seely, Milton Packer, Michael R Zile, Jean L Rouleau, Karl Swedberg, Martin Lefkowitz, Victor C Shi, Akshay S Desai, John J V McMurray, Scott D Solomon
BACKGROUND: Diabetes is an independent risk factor for heart failure progression. Sacubitril/valsartan, a combination angiotensin receptor-neprilysin inhibitor, improves morbidity and mortality in patients with heart failure with reduced ejection fraction (HFrEF), compared with the angiotensin-converting enzyme inhibitor enalapril, and improves peripheral insulin sensitivity in obese hypertensive patients. We aimed to investigate the effect of sacubitril/valsartan versus enalapril on HbA1c and time to first-time initiation of insulin or oral antihyperglycaemic drugs in patients with diabetes and HFrEF...
May 2017: Lancet Diabetes & Endocrinology
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
#19
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/28321027/effects-of-long-acting-loop-diuretics-in-heart-failure-with-reduced-ejection-fraction-patients-with-cardiac-resynchronization-therapy
#20
RANDOMIZED CONTROLLED TRIAL
Masahiko Asami, Jiro Aoki, Shuzou Tanimoto, Yu Horiuchi, Mika Watanabe, Koichi Furui, Kentaro Yasuhara, Tatsuyuki Sato, Kengo Tanabe, Kazuhiro Hara
There have been no reports evaluating the impact of long-acting loop diuretics (LLD) on the outcome of heart failure (HF) and arrhythmia treatment in HF with reduced ejection fraction (HFrEF) patients implanted with a cardiac resynchronization therapy (CRT) device.This was a prospective, single-blind, randomized crossover study. We allocated 21 consecutive CRT implanted patients into 2 groups. The furosemide group received furosemide as a first treatment and azosemide as a second treatment. The azosemide group received this treatment in the reverse order...
April 6, 2017: International Heart Journal
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