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HFrEF treatment

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https://www.readbyqxmd.com/read/29350254/sacubitril-valsartan-for-heart-failure-with-reduced-left-ventricular-ejection-fraction-a%C3%A2-retrospective-cohort-study
#1
R De Vecchis, C Ariano, G Di Biase, M Noutsias
BACKGROUND: The combination drug sacubitril/valsartan was reported to be superior to enalapril in reducing all-cause death, cardiovascular mortality, and heart failure (HF) hospitalizations in patients with cardiac insufficiency and reduced left ventricular ejection fraction (HFREF) with NYHA class II-IV. METHODS: Our retrospective cohort study aimed to assess the effects of sacubitril/valsartan in addition to a beta-blocker and mineral receptor antagonist (MRA) in a group of HFREF patients with NYHA class II-III HF vs...
January 19, 2018: Herz
https://www.readbyqxmd.com/read/29343997/hospitalisation-in-patients-with-heart-failure-with-preserved-ejection-fraction
#2
REVIEW
Shane Nanayakkara, Hitesh C Patel, David M Kaye
Heart failure is highly prevalent with more than 50% of cases being patients with a preserved ejection fraction (HFPEF), a figure that is projected to increase due to the changing risk factor landscape, in particular the ageing population. Overall mortality is similar to patients with heart failure with reduced ejection fraction (HFREF), as are the rates of hospitalisation. Patients with HFPEF have more comorbid conditions with fewer therapeutic options available. In this review, we explore the epidemiology of hospitalisation of HFPEF, the impact of current treatment modalities, and the potential of future therapies...
2018: Clinical Medicine Insights. Cardiology
https://www.readbyqxmd.com/read/29333094/left-ventricular-diastolic-and-systolic-dyssynchrony-and-dysfunction-in-heart-failure-with-preserved-ejection-fraction-and-a-narrow-qrs-complex
#3
Shuang Liu, Zhengyu Guan, Xuanyi Jin, Pingping Meng, Yonghuai Wang, Xianfeng Zheng, Dalin Jia, Chunyan Ma, Jun Yang
Aims: Mechanical dyssynchrony has been reported in heart failure with preserved ejection fraction (HFpEF), with a majority of patients having a narrow QRS complex; however, whether any benefit is observed with restoration of dyssynchrony remains unclear. We sought to assess left ventricular (LV) dyssynchrony and function in HFpEF and elucidate the underlying mechanisms that may account for HFpEF. Methods: Seventy-eighty patients with a narrow QRS complex including 47 with HFpEF, 31 with heart failure with reduced ejection fraction (HFrEF) patients, and 29 with asymptomatic left ventricular diastolic dysfunction (LVDD) were recruited...
2018: International Journal of Medical Sciences
https://www.readbyqxmd.com/read/29318651/effect-of-the-angiotensin-receptor-neprilysin-inhibitor-sacubitril-valsartan-on-pharmacokinetics-and-pharmacodynamics-of-a-single-dose-of-furosemide
#4
Surya Ayalasomayajula, Uwe Schuehly, Parasar Pal, Fabian Chen, Wei Zhou, Gangadhar Sunkara, Thomas H Langenickel
AIMS: Sacubitril/valsartan is indicated for the treatment of heart failure and reduced ejection fraction (HFrEF). Furosemide, a loop diuretic commonly used for the treatment of HFrEF, may be co-administrated with sacubitril/valsartan in clinical practice. The effect of sacubitril/valsartan on pharmacokinetics and pharmacodynamics of furosemide was evaluated in this open label, two- period, single-sequence study in healthy subjects (N=28). METHODS: All subjects received 40 mg oral single dose furosemide during period 1 followed by washout of 2 days...
January 9, 2018: British Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/29305104/heart-failure-with-mid-range-ejection-fraction-in-patients-admitted-to-internal-medicine-departments-findings-from-the-rica-registry
#5
María Esther Guisado-Espartero, Prado Salamanca-Bautista, Óscar Aramburu-Bodas, Alicia Conde-Martel, José Luis Arias-Jiménez, Pau Llàcer-Iborra, Melitón Francisco Dávila-Ramos, Yolanda Cabanes-Hernández, Luis Manzano, Manuel Montero-Pérez-Barquero
AIM: To improve the knowledge on characteristics, treatment and prognosis in patients with heart failure (HF) and mid-range ejection fraction discharged after an acute HF episode. METHODS: We prospectively included and followed 2753 patients admitted with HF to Internal Medicine units. Patients were classified according to ejection fraction (EF) into three strata: reduced, EF <40% (HFrEF); mid-range EF 40-49% (HFmrEF); and preserved EF ≥50% (HFpEF). Clinical, echocardiographic, laboratory data and treatment at discharge were recorded and the groups were compared...
January 2, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29305071/effectiveness-of-guideline-consistent-heart-failure-drug-prescriptions-at-hospital-discharge-on-1-year-mortality-results-from-the-epical2-cohort-study
#6
Amandine Busson, Nathalie Thilly, Hervé Laborde-Castérot, François Alla, Ziyad Messikh, Isabelle Clerc-Urmes, Alexandre Mebazaa, Marc Soudant, Nelly Agrinier
BACKGROUND: We aimed to assess the effectiveness of recommended drug prescriptions at hospital discharge on 1-year mortality in patients with heart failure (HF) and reduced ejection fraction (HFREF). MATERIALS AND METHODS: We used data from the EPICAL2 cohort study. HF patients ≥18years old with left ventricular ejection fraction (LVEF) <40% and alive at discharge were included and followed up for mortality. Socio-demographic, clinical and therapeutic data were collected at admission...
January 2, 2018: European Journal of Internal Medicine
https://www.readbyqxmd.com/read/29297194/red-cell-distribution-width-and-its-relationship-with-global-longitudinal-strain-in-patients-with-heart-failure-with-reduced-ejection-fraction-a-study-using-two-dimensional-speckle-tracking-echocardiography
#7
Elif Eroglu, Alev Kilicgedik, Gokhan Kahveci, Ruken Bengi Bakal, Cevat Kirma
BACKGROUND: Red cell distribution width (RDW) is a measurement of size variability of the red blood cells and has been shown to be a powerful predictor of prognosis in heart failure (HF). Recently, global longitudinal strain (GLS) emerged as a more accurate marker of left ventricular (LV) systolic function. AIM: We aimed to assess the relationship between RDW and standard echocardiographic parameters and left ventricular global strain measured by two-dimensional (2D) speckle tracking echocardiography in patients with HF with reduced EF (HFrEF)...
January 3, 2018: Kardiologia Polska
https://www.readbyqxmd.com/read/29283405/the-impact-of-bronchodilator-therapy-on-systolic-heart-failure-with-concomitant-mild-to-moderate-copd
#8
Mahoto Kato, Kazuo Komamura, Masafumi Kitakaze, Atsushi Hirayama
In older adults, chronic obstructive pulmonary disease (COPD) is commonly associated with heart failure with reduced ejection fraction (HFrEF), and the high prevalence of this combination suggests that customized treatment is highly necessary in patients with COPD and HFrEF. To investigate whether the treatment of COPD with tiotropium, an anticholinergic bronchodilator, reduces the severity of heart failure in patients with HFrEF complicated by mild to moderate COPD, forty consecutive participants were randomly divided into two groups and enrolled in a crossover design study...
December 28, 2017: Diseases (Basel)
https://www.readbyqxmd.com/read/29251818/acutely-decompensated-heart-failure-with-preserved-and-reduced-ejection-fraction-present-with-comparable-haemodynamic-congestion
#9
Lucas N L Van Aelst, Mattia Arrigo, Rui Placido, Eiichi Akiyama, Nicolas Girerd, Faiez Zannad, Philippe Manivet, Patrick Rossignol, Marc Badoz, Malha Sadoune, Jean-Marie Launay, Etienne Gayat, Carolyn S P Lam, Alain Cohen-Solal, Alexandre Mebazaa, Marie-France Seronde
AIMS: Congestion is a central feature of acute heart failure (HF) and its assessment is important for clinical decisions (e.g. tailoring decongestive treatments). It remains uncertain whether patients with acute HF with preserved ejection fraction (HFpEF) are comparably congested as in acute HF with reduced EF (HFrEF). This study assessed congestion, right ventricular (RV) and renal dysfunction in acute HFpEF, HFrEF and non-cardiac dyspnoea. METHODS AND RESULTS: We compared echocardiographic and circulating biomarkers of congestion in 146 patients from the MEDIA-DHF study: 101 with acute HF (38 HFpEF, 41 HFrEF, 22 HF with mid-range ejection fraction) and 45 with non-cardiac dyspnoea...
December 18, 2017: European Journal of Heart Failure
https://www.readbyqxmd.com/read/29232274/from-theory-to-practice-the-diuretic-potential-of-sacubitril-valsartan-a-tale-of-2-patients
#10
Sabrina M Hormann, Lindsay E Davis, Elizabeth K Pogge
BACKGROUND: Heart failure prevalence continues to rise in the United States causing significant morbidity and mortality and costing billions in healthcare expenditures. Consensus guidelines updated in 2016 recommend an angiotensin receptor-neprilysin inhibitor (ARNi) as a therapeutic option in lieu of an angiotensin-converting enzyme inhibitor or angiotensin receptor blocker for the management of stage C heart failure with reduced ejection fraction (HFrEF). For chronic HFrEF patients with New York Heart Association class II or III symptoms tolerating an angiotensin-converting enzyme inhibitor/angiotensin receptor blocker, a change in therapy to an ARNi is recommended to further reduce morbidity and mortality...
December 11, 2017: Journal of Cardiovascular Nursing
https://www.readbyqxmd.com/read/29193563/sacubitril-valsartan-reduces-serum-uric-acid-concentration-an-independent-predictor-of-adverse-outcomes-in-paradigm-hf
#11
Ulrik M Mogensen, Lars Køber, Pardeep S Jhund, Akshay S Desai, Michele Senni, Søren L Kristensen, Andrej Dukát, Chen-Huan Chen, Felix Ramires, Martin P Lefkowitz, Margaret F Prescott, Victor C Shi, Jean L Rouleau, Scott D Solomon, Karl Swedberg, Milton Packer, John J V McMurray
AIMS: Elevated serum uric acid concentration (SUA) has been associated with an increased risk of cardiovascular disease, but this may be due to unmeasured confounders. We examined the association between SUA and outcomes as well as the effect of sacubitril/valsartan on SUA in patients with heart failure with reduced ejection fraction (HFrEF) in PARADIGM-HF. METHODS AND RESULTS: The association between SUA and the primary composite outcome of cardiovascular death or heart failure (HF) hospitalization, its components, and all-cause mortality was examined using Cox regression analyses among 8213 patients using quintiles (Q1-Q5) of SUA adjusted for baseline prognostic variables including estimated glomerular filtration rate (eGFR), diuretic dose, and log N-terminal pro-brain natriuretic peptide...
November 30, 2017: European Journal of Heart Failure
https://www.readbyqxmd.com/read/29192956/initial-clinical-experience-with-the-first-drug-sacubitril-valsartan-in-a-new-class-arnis-in-patients-with-heart-failure-with-reduced-left-ventricular-ejection-fraction-in-poland
#12
Marta Kałużna-Oleksy, Jolanta Kolasa, Jacek Migaj, Agnieszka Pawlak, Małgorzata Lelonek, Jadwiga Nessler, Ewa Straburzyńska-Migaj
Sacubitril/valsartan is the first drug from a new class of angiotensin receptor neprilisin inhibitors (ARNIs) recommended in the new European Society of Cardiology's guidelines instead of ACEIs, or ARBs (angiotensin receptor antagonists) used if ACEIs are not tolerated, for further reduction in the risk of hospitalisation or death in outpatients with HFrEF if symptoms continue despite optimal treatment with ACEIs/ARBs, betablockers and MRAs (mineralocorticoid antagonists). The aim of this paper is to present the initial experience with regard to the effectiveness, tolerance and safety of sacubitril/valsartan in the outpatient cardiology practice in Poland...
December 1, 2017: Kardiologia Polska
https://www.readbyqxmd.com/read/29185253/cost-effectiveness-of-sacubitril-valsartan-in-chronic-heart-failure-patients-with-reduced-ejection-fraction
#13
Zanfina Ademi, Alena M Pfeil, Elizabeth Hancock, David Trueman, Rola Haroun Haroun, Celine Deschaseaux, Matthias Schwenkglenks
AIMS: We aimed to assess the cost effectiveness of sacubitril/valsartan compared to angiotensin-converting enzyme inhibitors (ACEIs) for the treatment of individuals with chronic heart failure and reduced-ejection fraction (HFrEF) from the perspective of the Swiss health care system. METHODS: The cost-effectiveness analysis was implemented as a lifelong regression-based cohort model. We compared sacubitril/valsartan with enalapril in chronic heart failure patients with HFrEF and New York-Heart Association Functional Classification II-IV symptoms...
November 29, 2017: Swiss Medical Weekly
https://www.readbyqxmd.com/read/29183646/a-risk-score-to-predict-the-absence-of-left-ventricular-reverse-remodeling-implications-for-the-timing-of-icd-implantation-in-primary-prevention
#14
Jordi Pérez-Rodon, Enrique Galve, Carmen Pérez-Bocanegra, Teresa Soriano-Sánchez, Jesús Recio-Iglesias, Eva Domingo-Baldrich, Mila Alzola-Guevara, Ignacio Ferreira-González, Josep Ramon Marsal, Aida Ribera-Solé, Laura Gutierrez García-Moreno, Luz María Cruz-Carlos, Nuria Rivas-Gandara, Ivo Roca-Luque, Jaume Francisco-Pascual, Artur Evangelista-Masip, Àngel Moya-Mitjans, David García-Dorado
BACKGROUND: A prophylactic implantable cardioverter defibrillator (ICD) in patients with heart failure and reduced left ventricular ejection fraction (HFrEF) is only indicated when left ventricular ejection fraction (LVEF) reassessment remains ≤35% after 3-6 months on optimal pharmacological therapy. However, LVEF may not improve during this period and the patient may be exposed to an unnecessary risk of sudden cardiac death. This study aimed to determine the incidence and predictors of the absence of left ventricular reverse remodeling (LVRR) after pharmacological treatment optimization in patients with HFrEF to design a risk score of absence of LVRR...
November 25, 2017: Journal of Cardiology
https://www.readbyqxmd.com/read/29181610/barriers-to-beta-blocker-use-and-up-titration-among-patients-with-heart-failure-with-reduced-ejection-fraction
#15
Emily B Levitan, Melissa K Van Dyke, Matthew Shane Loop, Ronan O'Beirne, Monika M Safford
PURPOSE: For patients with heart failure with reduced ejection fraction (HFrEF), guidelines recommend use of beta-blockers with gradual up-titration. However, many patients with HFrEF do not use beta-blockers and up-titration is rare. Our purpose was to identify and rank barriers to beta-blocker use and up-titration from the perspective of primary care physicians. METHODS: We conducted 4 moderated, structured group discussions among 19 primary care physicians using the nominal group technique; 16 participants also completed a survey...
November 27, 2017: Cardiovascular Drugs and Therapy
https://www.readbyqxmd.com/read/29164797/impact-of-systolic-blood-pressure-on-the-safety-and-tolerability-of-initiating-and-up-titrating-sacubitril-valsartan-in-patients-with-heart-failure-and-reduced-ejection-fraction-insights-from-the-titration-study
#16
Michele Senni, John J V McMurray, Rolf Wachter, Hugh F McIntyre, Inder S Anand, Vincenzo Duino, Arnab Sarkar, Victor Shi, Alan Charney
AIMS: The TITRATION trial investigated two strategies to initiate and up-titrate sacubitril/valsartan (LCZ696) to the same target dose, over a condensed (3-week) or conservative (6-week) period, in patients with heart failure with reduced ejection fraction (HFrEF) and systolic blood pressure (SBP) of ≥100 mmHg. This post hoc analysis examined the relationship between baseline SBP at screening and achievement of the target dose of sacubitril/valsartan of 97 mg/103 mg (also termed 'LCZ696 200 mg') twice per day during the study...
November 22, 2017: European Journal of Heart Failure
https://www.readbyqxmd.com/read/29150163/the-management-of-diagnosed-heart-failure-in-older-people-in-primary-care
#17
REVIEW
Nicholas R Jones, F D Richard Hobbs, Clare J Taylor
Heart failure (HF) is a common condition affecting predominantly older people. Symptoms include breathlessness and fatigue, and can significantly reduce quality of life. HF rarely occurs in isolation, with most patients having several co-existing diseases requiring multiple medications. There is a large evidence base for treatment of HF with reduced ejection fraction, or HFrEF; however, many of the trials did not include older people with multimorbidity so their findings should be applied to this group with some caution...
December 2017: Maturitas
https://www.readbyqxmd.com/read/29141781/heart-failure-with-preserved-borderline-and-reduced-ejection-fraction-5-year-outcomes
#18
Kevin S Shah, Haolin Xu, Roland A Matsouaka, Deepak L Bhatt, Paul A Heidenreich, Adrian F Hernandez, Adam D Devore, Clyde W Yancy, Gregg C Fonarow
BACKGROUND: Patients with heart failure (HF) have a poor prognosis and are categorized by ejection fraction (EF). OBJECTIVES: This study sought to characterize differences in outcomes in patients hospitalized with heart failure with preserved ejection fraction (HFpEF) (EF ≥50%), heart failure with borderline ejection fraction (HFbEF) (EF 41% to 49%), and heart failure with reduced ejection fraction (HFrEF) (EF ≤40%). METHODS: Data from GWTG-HF (Get With The Guidelines-Heart Failure) were linked to Medicare data for longitudinal follow-up...
October 31, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/29138270/low-and-high-renin-heart-failure-phenotypes-with-clinical-implications
#19
Noemi Pavo, Georg Goliasch, Raphael Wurm, Johannes Novak, Guido Strunk, Mariann Gyöngyösi, Marko Poglitsch, Marcus D Säemann, Martin Hülsmann
BACKGROUND: Blockade of the renin-angiotensin system (RAS) represents a main strategy in the therapy of heart failure with reduced ejection fraction (HFrEF), but the role of active renin concentration (ARC) for guiding therapy in the presence of an RAS blockade remains to be established. This study assessed angiotensin profiles of HFrEF patients with distinct RAS activations as reflected by ARC. METHODS: Two cohorts of stable chronic HFrEF patients on optimal medical treatment (OMT) were enrolled...
November 14, 2017: Clinical Chemistry
https://www.readbyqxmd.com/read/29124734/evolution-of-a-geriatric-syndrome-pathophysiology-and-treatment-of-heart-failure-with-preserved-ejection-fraction
#20
REVIEW
Bharathi Upadhya, Barbara Pisani, Dalane W Kitzman
The majority of older adults who develop heart failure (HF), particularly older women, have a preserved left ventricular ejection fraction (HFpEF). The prevalence of this syndrome is increasing, and the prognosis is not improving, unlike that of HF with reduced ejection fraction (HFrEF). Individuals with HFpEF have severe symptoms of effort intolerance, poor quality of life, frequent hospitalizations, and greater likelihood of death. Despite the importance of HFpEF, there are numerous major gaps in our understanding of its pathophysiology and management...
November 2017: Journal of the American Geriatrics Society
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