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HFrEF treatment

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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
#1
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
#2
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
#3
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
#4
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...
July 12, 2017: JACC. Heart Failure
https://www.readbyqxmd.com/read/28705910/fatigability-exercise-intolerance-and-abnormal-skeletal-muscle-energetics-in-heart-failure
#5
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
#6
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)...
July 1, 2017: Vascular Medicine
https://www.readbyqxmd.com/read/28684221/exercise-training-for-prevention-and-treatment-of-heart-failure
#7
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
#8
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
https://www.readbyqxmd.com/read/28676030/heart-failure-with-preserved-ejection-fraction-a-dilemma-in-treatment-options
#9
Taylor Bramblett, Mohamed Teleb, Aymen Albaghdadi, Harsh Agrawal, Debabrata Mukherjee
Heart failure with preserved ejection fraction (HFpEF) makes up half of diagnosed heart failure cases and has similar outcomes compared to heart failure with reduced ejection fraction (HFrEF) but a discrepancy in knowledge and approach to treatment. HFpEF is diagnosed using the following criteria: symptoms, preserved ejection fraction (greater than 50%), and evidence of abnormal left ventricular filling or relaxation, or diastolic distensibility or stiffness. Studies conducted to examine the efficacy of angiotensin receptor blockers (irbesartan and candesartan), thiazide diuretics (chlorthalidone), and angiotensin converting enzyme inhibitors (perindopril) in the treatment of HFpEF, showed moderate efficacy but no clear benefit...
July 3, 2017: Cardiovascular & Hematological Disorders Drug Targets
https://www.readbyqxmd.com/read/28629552/comparative-analysis-of-four-scores-to-stratify-patients-with-heart-failure-and-reduced-ejection-fraction
#10
Pedro Freitas, Carlos Aguiar, António Ferreira, António Tralhão, António Ventosa, Miguel Mendes
There are several prognostic risk scores available for patients with heart failure with reduced ejection fraction (HFrEF) that can aid in the decision of listing candidates for heart transplant (HTx). A direct comparison between these scores has not been performed. Therefore, our objective was to evaluate the calibration and discriminative power of 4 contemporary HF scores. A retrospective analysis of 259 patients with HFrEF who underwent cardiopulmonary exercise test was conducted. The Heart Failure Survival Score (HFSS), Seattle Heart Failure Model (SHFM), Meta-analysis Global Group in Chronic Heart Failure (MAGGIC), and Metabolic Exercise Cardiac Kidney Index (MECKI) were compared...
August 1, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28627045/heart-rate-and-its-reduction-in-chronic-heart-failure-and-beyond
#11
REVIEW
Aleksandra Nikolovska Vukadinović, Davor Vukadinović, Jeffrey Borer, Martin Cowie, Michel Komajda, Mitja Lainscak, Karl Swedberg, Michael Böhm
Heart rate (HR) is associated with cardiovascular outcomes in all the stages of the cardiovascular continuum as well as in patients with pulmonary, cerebrovascular, and renal disease, sepsis, cancer, and erectile dysfunction. In patients with cardiovascular disease, but also in the general population, increased HR represents an important indicator of mortality with each acceleration of HR over 70 b.p.m. increasing the risk. In patients in sinus rhythm with chronic heart failure with reduced ejection fraction (HFrEF), a HR >70 b...
June 19, 2017: European Journal of Heart Failure
https://www.readbyqxmd.com/read/28625374/change-the-management-of-patients-with-heart-failure-rationale-and-design-of-the-champ-hf-registry
#12
MULTICENTER STUDY
Adam D DeVore, Laine Thomas, Nancy M Albert, Javed Butler, Adrian F Hernandez, J Herbert Patterson, John A Spertus, Fredonia B Williams, Stuart J Turner, Wing W Chan, Carol I Duffy, Kevin McCague, Xiaojuan Mi, Gregg C Fonarow
Heart failure (HF) with reduced ejection fraction (HFrEF) is a common and costly condition that diminishes patients' health status and confers a poor prognosis. Despite the availability of multiple guideline-recommended pharmacologic and cardiac device therapies for patients with chronic HFrEF, outcomes remain suboptimal. Currently, there is limited insight into the rationale underlying clinical decisions by health care providers and patient factors that guide the use and intensity of outpatient HF treatments...
July 2017: American Heart Journal
https://www.readbyqxmd.com/read/28624483/biomarker-profiles-of-acute%C3%A2-heart%C3%A2-failure%C3%A2-patients-with-a%C3%A2-mid-range-ejection%C3%A2-fraction
#13
Jasper Tromp, Mohsin A F Khan, Robert J Mentz, Christopher M O'Connor, Marco Metra, Howard C Dittrich, Piotr Ponikowski, John R Teerlink, Gad Cotter, Beth Davison, John G F Cleland, Michael M Givertz, Daniel M Bloomfield, Dirk J Van Veldhuisen, Hans L Hillege, Adriaan A Voors, Peter van der Meer
OBJECTIVES: In this study, the authors used biomarker profiles to characterize differences between patients with acute heart failure with a midrange ejection fraction (HFmrEF) and compare them with patients with a reduced (heart failure with a reduced ejection fraction [HFrEF]) and preserved (heart failure with a preserved ejection fraction [HFpEF]) ejection fraction. BACKGROUND: Limited data are available on biomarker profiles in acute HFmrEF. METHODS: A panel of 37 biomarkers from different pathophysiological domains (e...
July 2017: JACC. Heart Failure
https://www.readbyqxmd.com/read/28606099/pulmonary-hemodynamics-and-effects-of-phosphodiesterase-type-5-inhibition-in-heart-failure-a-meta-analysis-of-randomized-trials
#14
In-Chang Hwang, Yong-Jin Kim, Jun-Bean Park, Yeonyee E Yoon, Seung-Pyo Lee, Hyung-Kwan Kim, Goo-Yeong Cho, Dae-Won Sohn
BACKGROUND: Previous studies suggested that phosphodiesterase 5 inhibitors (PDE5i) have a beneficial effect in patients with heart failure (HF), although the results were inconsistent. We performed a meta-analysis to evaluate the effect of PDE5i in HF patients, and investigated the relationship between PDE5i effects and pulmonary hemodynamics. METHOD: We searched PubMed, EMBASE and the Cochrane Library for randomized controlled trials (RCTs) that compared PDE5i with placebo in HF with reduced ejection fraction (HFrEF) or HF with preserved EF (HFpEF)...
June 12, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28602370/the-role-of-positive-inotropic-drugs-in-the-treatment-of-older-adults-with-heart-failure-and-reduced-ejection-fraction
#15
REVIEW
Daniel J Dooley, Phillip H Lam, Ali Ahmed, Wilbert S Aronow
Positive inotropic drugs have long been studied for their potential benefits in patients with heart failure and reduced ejection fraction (HFrEF). Although there has been an extensive amount of research about the clinical effects of these drugs in general, few studies examined their effect in older patients. Therefore, there is little or no evidence to guide the use of positive inotropes in older patients with HFrEF. However, recommendations from national heart failure guidelines may be generalized to older HFrEF patients on an individual basis, taking into consideration the basic geriatric principles of pharmacotherapy: start low and go slow...
July 2017: Heart Failure Clinics
https://www.readbyqxmd.com/read/28602367/heart-failure-with-preserved-ejection-fraction-in-older-adults
#16
REVIEW
Bharathi Upadhya, Dalane W Kitzman
Most elderly patients, particularly women, who have heart failure, have a preserved ejection fraction. Patients with this syndrome have severe symptoms of exercise intolerance, frequent hospitalizations, and increased mortality. Despite the importance of heart failure with preserved ejection fraction (HFpEF), the understanding of its pathophysiology is incomplete, and optimal treatment remains largely undefined. Unlike the management of HFrEF, there is a paucity of large evidence-based trials demonstrating morbidity and mortality benefit for the treatment of HFpEF...
July 2017: Heart Failure Clinics
https://www.readbyqxmd.com/read/28601914/left-ventricular-ejection-fraction-as-therapeutic-target-is-it-the-ideal-marker
#17
REVIEW
V Katsi, G Georgiopoulos, A Laina, E Koutli, J Parissis, C Tsioufis, P Nihoyannopoulos, D Tousoulis
Heart failure (HF) consists the fastest growing clinical cardiac disease. HF patients are categorized on the basis of underlying left ventricular ejection fraction (LVEF) into HF with preserved EF (HFpEF), reduced LVEF (HFrEF), and mid-range LVEF (HFmrEF). While LVEF is the most commonly used surrogate marker of left ventricular (LV) systolic function, the implementation of two-dimensional echocardiography in estimating this parameter imposes certain caveats on current HF classification. Most importantly, LVEF could fluctuate in repeated measurements or even recover after treatment, thus blunting the borders between proposed categories of HF and enabling upward classification of patients...
June 10, 2017: Heart Failure Reviews
https://www.readbyqxmd.com/read/28599060/evaluation-of-pharmacokinetic-and-pharmacodynamic-drug-drug-interaction-of-sacubitril-valsartan-lcz696-and-sildenafil-in-patients-with-mild-to-moderate-hypertension
#18
Hsiu-Ling Hsiao, Thomas H Langenickel, Jesika Petruck, Kiran Kode, Surya Ayalasomayajula, Uwe Schuehly, Michael Greeley, Parasar Pal, Wei Zhou, Margaret F Prescott, Gangadhar Sunkara, Iris Rajman
Sacubitril/valsartan (LCZ696) is indicated for the treatment of patients with heart failure and reduced ejection fraction (HFrEF). Since patients with HFrEF may receive sacubitril/valsartan and sildenafil, both increasing cGMP, the present study evaluated the pharmacokinetic and pharmacodynamic drug interaction potential between sacubitril/valsartan and sildenafil. In this open-label, 3-period, single sequence study, patients with mild-to-moderate hypertension (153.8±8.2 mm Hg mean SBP) received a single dose of sildenafil 50 mg, sacubitril/valsartan 400 mg once daily for 5 days, and sacubitril/valsartan and sildenafil co-administration...
June 9, 2017: Clinical Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/28579160/complex-energy-metabolic-changes-in-heart-failure-with-preserved-ejection-fraction-and-heart-failure-with-reduced-ejection-fraction
#19
REVIEW
Kirstie A De Jong, Gary D Lopaschuk
Alterations in cardiac energy metabolism contribute to the severity of heart failure. However, the energy metabolic changes that occur in heart failure are complex, and are dependent not only on the severity and type of heart failure present, but also on the coexistence of common comorbidities such as obesity and type 2 diabetes. In this article we review the cardiac energy metabolic changes that occur in heart failure. An emphasis is made on distinguishing the differences in cardiac energy metabolism between heart failure with preserved ejection fraction (HFpEF) and heart failure with reduced ejection fraction (HFrEF) and in clarifying the common misconceptions surrounding the fate of fatty acids and glucose in the failing heart...
July 2017: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/28567353/differential-efficacy-profile-of-aldosterone-receptor-antagonists-depending-on-the-type-of-chronic-heart-failure-whether-with-reduced-or-preserved-left-ventricular-ejection-fraction-results-of-a-meta-analysis-of-randomized-controlled-trials
#20
Renato De Vecchis, Carmelina Ariano
BACKGROUND: Because of renin-angiotensin-aldosterone system (RAAS) activation, the patients with chronic heart failure (CHF) manifest increased ventricular stress, with impaired left ventricular function, and a slowing down in systemic venous drainage. More importantly, a reduction of the patient's life expectancy has been proven in the case of RAAS overstimulation. For these reasons, huge efforts have been made to obtain molecules able to efficaciously antagonize the RAAS overstimulation, such as aldosterone receptor antagonists (ARAs)...
June 2017: Cardiovascular Diagnosis and Therapy
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