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HFrEF treatment

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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
#1
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/28132957/risk-of-heart-failure-with-preserved-ejection-fraction-in-older-women-after-contemporary-radiotherapy-for-breast-cancer
#2
Hirofumi Saiki, Ivy A Petersen, Christopher G Scott, Kent R Bailey, Shannon M Dunlay, Randi R Finley, Kathryn J Ruddy, Elizabeth Yan, Margaret M Redfield
BACKGROUND: -Cardiomyocytes are resistant to radiation. However, cardiac radiation exposure causes coronary microvascular endothelial inflammation, a perturbation implicated in the pathogenesis of heart failure (HF) and particularly, HF with preserved ejection fraction (HFpEF). Radiotherapy for breast cancer results in variable cardiac radiation exposure and may increase the risk of HF. METHODS: -We conducted a population-based case-control study of incident HF in 170 female residents of Olmsted County, Minnesota (59 cases and 111 controls) who underwent contemporary (1998-2013) radiotherapy for breast cancer utilizing computed tomography-assisted radiotherapy planning...
January 29, 2017: Circulation
https://www.readbyqxmd.com/read/28097518/beneficial-effects-of-ozone-therapy-on-oxidative-stress-cardiac-functions-and-clinical-findings-in-patients-with-heart-failure-reduced-ejection-fraction
#3
Mutlu Buyuklu, Fatih Mehmet Kandemir, Turan Set, Eftal Murat Bakırcı, Husnu Degirmenci, Hikmet Hamur, Ergun Topal, Sefa Kucukler, Kultigin Turkmen
The aim of study was to determine the effects of ozone therapy on the oxidative stress, cardiac functions and clinical findings in patients with heart failure reduced ejection fraction (HFrEF). A total of 40 patients with New York Heart Association 2 and 3 HF with left ventricular ejection fraction (LVEF) <35%, and 40 subjects without HF as control group were included in the study. Patients with HFrEF were given additional ozone therapy of major and minor administrations along with conventional HF treatment for 5 weeks...
January 17, 2017: Cardiovascular Toxicology
https://www.readbyqxmd.com/read/28090229/the-impact-exerted-on-clinical-outcomes-of-patients-with-chronic-heart-failure-by-aldosterone-receptor-antagonists-a-meta-analysis-of-randomized-controlled-trials
#4
Renato De Vecchis, Claudio Cantatrione, Damiana Mazzei, Augusto Barone, Nicola Maurea
BACKGROUND: Aldosterone receptor antagonists (ARAs) have been associated with improved clinical outcomes in patients with heart failure with reduced left ventricular ejection fraction (HFREF), but not in those with heart failure with preserved left ventricular ejection fraction (HFpEF). With the aim to study this topic more deeply, we carried out a meta-analysis of selective and non-selective ARAs in HFREF and HFpEF. METHODS: We searched PubMed and Scopus databases...
February 2017: Journal of Clinical Medicine Research
https://www.readbyqxmd.com/read/28089316/decreased-mortality-with-beta-blockers-in%C3%A2-patients-with-heart-failure-and-coexisting-atrial-fibrillation-an-af-chf-substudy
#5
Julia Cadrin-Tourigny, Azadeh Shohoudi, Denis Roy, Mario Talajic, Rafik Tadros, Blandine Mondésert, Katia Dyrda, Léna Rivard, Jason G Andrade, Laurent Macle, Peter G Guerra, Bernard Thibault, Marc Dubuc, Paul Khairy
OBJECTIVES: The impact of beta-blockers on mortality and hospitalizations was assessed in the largest randomized trial of patients with both atrial fibrillation (AF) and heart failure with a reduced ejection fraction (HFrEF): the Atrial Fibrillation-Congestive Heart Failure trial. BACKGROUND: Although beta-blockers are the cornerstone of therapy for HFrEF, a recent patient-level meta-analysis cast doubt on their efficacy in patients with coexisting AF. METHODS: From a total of 1,376 subjects randomized in the AF-CHF trial, those without beta-blockers at baseline were propensity matched to a maximum of 2 exposed patients...
February 2017: JACC. Heart Failure
https://www.readbyqxmd.com/read/28052978/the-diabetic-hfpef-phenotype-is-it-real-and-is-it-worth-targeting-therapeutically
#6
Brian R Lindman
For investigators, physicians, and patients, the inability to identify therapies to improve clinical outcomes, particularly mortality, in patients with heart failure with preserved ejection fraction (HFpEF) has been particularly vexing and stands in stark contrast to the progress made in the treatment of patients with heart failure with reduced ejection fraction (HFrEF). This has prompted a return to the proverbial drawing board, forcing a reconsideration of long-held assumptions and paradigms. Despite different underlying etiologies, patients with HFrEF are generally responsive to several classes of medications that target the neurohormonal axis...
January 4, 2017: Circulation
https://www.readbyqxmd.com/read/28043438/surgical-experience-and-long-term-results-of-baroreflex-activation-therapy-for-heart-failure-with-reduced-ejection-fraction
#7
Fred A Weaver, William T Abraham, William C Little, Christian Butter, Anique Ducharme, Marcel Halbach, Didier Klug, Eric G Lovett, Navid Madershahian, Jochen Müller-Ehmsen, Jill E Schafer, Michele Senni, Vijay Swarup, Rolf Wachter, Michael R Zile
The purpose of this publication is to describe the intraoperative experience along with long-term safety and efficacy of the second-generation baroreflex activation therapy (BAT) system in patients with heart failure (HF) and reduced ejection fraction HF (HFrEF). In a randomized trial of New York Heart Association Class III HFrEF, 140 patients were assigned 1:1 to receive BAT plus medical therapy or medical therapy alone. Procedural information along with safety and efficacy data were collected and analyzed over 12 months...
July 2016: Seminars in Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28030609/impact-of-exhaled-breath-acetone-in-the-prognosis-of-patients-with-heart-failure-with-reduced-ejection-fraction-hfref-one-year-of-clinical-follow-up
#8
Fabiana G Marcondes-Braga, Guilherme L Batista, Ivano G R Gutz, Paulo H N Saldiva, Sandrigo Mangini, Victor S Issa, Silvia M Ayub-Ferreira, Edimar A Bocchi, Alexandre Costa Pereira, Fernando Bacal
BACKGROUND: The identification of new biomarkers of heart failure (HF) could help in its treatment. Previously, our group studied 89 patients with HF and showed that exhaled breath acetone (EBA) is a new noninvasive biomarker of HF diagnosis. However, there is no data about the relevance of EBA as a biomarker of prognosis. OBJECTIVES: To evaluate whether EBA could give prognostic information in patients with heart failure with reduced ejection fraction (HFrEF). METHODS: After breath collection and analysis by gas chromatography-mass spectrometry and by spectrophotometry, the 89 patients referred before were followed by one year...
2016: PloS One
https://www.readbyqxmd.com/read/28024961/efficacy-and-safety-of-sacubitril-valsartan-lcz696-in-japanese-patients-with-chronic-heart-failure-and-reduced-ejection-fraction-rationale-for-and-design-of-the-randomized-double-blind-parallel-hf-study
#9
Hiroyuki Tsutsui, Shinichi Momomura, Yoshihiko Saito, Hiroshi Ito, Kazuhiro Yamamoto, Tomomi Ohishi, Naoko Okino, Weinong Guo
BACKGROUND: The prognosis of heart failure patients with reduced ejection fraction (HFrEF) in Japan remains poor, although there is growing evidence for increasing use of evidence-based pharmacotherapies in Japanese real-world HF registries. Sacubitril/valsartan (LCZ696) is a first-in-class angiotensin receptor neprilysin inhibitor shown to reduce mortality and morbidity in the recently completed largest outcome trial in patients with HFrEF (PARADIGM-HF trial). The prospectively designed phase III PARALLEL-HF (Prospective comparison of ARNI with ACE inhibitor to determine the noveL beneficiaL trEatment vaLue in Japanese Heart Failure patients) study aims to assess the clinical efficacy and safety of LCZ696 in Japanese HFrEF patients, and show similar improvements in clinical outcomes as the PARADIGM-HF study enabling the registration of LCZ696 in Japan...
December 23, 2016: Journal of Cardiology
https://www.readbyqxmd.com/read/28004291/sacubitril-valsartan-lcz696-in-heart-failure
#10
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/27999929/acute-heart-failure-with-mid-range-left-ventricular-ejection-fraction-clinical-profile-in-hospital-management-and-short-term-outcome
#11
Dimitrios Farmakis, Panagiotis Simitsis, Vasiliki Bistola, Filippos Triposkiadis, Ignatios Ikonomidis, Spyridon Katsanos, George Bakosis, Erifili Hatziagelaki, John Lekakis, Alexandre Mebazaa, John Parissis
BACKGROUND: Heart failure with mid-range left ventricular ejection fraction (HFmrEF) is a poorly characterized population as it has been studied either in the context of HF with reduced (HFrEF) or preserved (HFpEF) left ventricular ejection fraction (LVEF) depending on applied LVEF cutoffs. We sought to investigate the clinical profile, in-hospital management, and short-term outcome of HFmrEF patients in comparison with those with HFrEF or HFpEF in a large acute HF cohort. METHODS AND RESULTS: The Acute Heart Failure Global Registry of Standard Treatment (ALARM-HF) included 4953 patients hospitalized for HF in nine countries in Europe, Latin America, and Australia...
December 20, 2016: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
https://www.readbyqxmd.com/read/27984253/does-heart-rate-really-matter-to-patients-with-heart-failure
#12
Robert J H Miller, Jonathan G Howlett
PURPOSE OF REVIEW: Measurement of heart rate (HR) and rhythm is used to identify patients at increased risk of disease progression, guide selection of treatments and gauge response to therapy. RECENT FINDINGS: Lowering HR with a pure HR lowering agent (ivabradine) in heart failure with reduced ejection fraction (HFrEF) and sinus rate more than 70 beats/min despite beta blockade has been shown to improve outcomes. Additionally, coadministration of ivabradine and beta blockade may enhance symptoms and HR control...
March 2017: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/27958695/aldosterone-receptor-antagonists-decrease-mortality-and-cardiovascular-hospitalizations-in-chronic-heart-failure-chf-with-reduced-left-ventricular-ejection-fraction-lvef-but-not-in-chf-with-preserved-lvef-a-meta-analysis-of-randomized-controlled-trials
#13
Renato DE Vecchis, Carmelina Ariano
INTRODUCTION: Aldosterone receptor antagonists (ARAs) were introduced in the treatment of chronic heart failure (CHF), as a result of the demonstration of their protective effect on the failing heart. However, important questions remain unanswered regarding the clinical efficacy of the ARAs on the clinical and echocardiographic phenotype of heart failure, called heart failure with preserved left ventricular ejection fraction( HFpEF). EVIDENCE ACQUISITION: The aim of the present meta-analysis was to verify the impact of the ARAs on some hard endpoints, such as all - cause death and hospitalizations from cardiovascular cause, making a comparative evaluation of these outcomes in CHF patients with reduced left ventricular ejection fraction (HFREF) and in those with HFpEF, respectively...
December 13, 2016: Minerva Cardioangiologica
https://www.readbyqxmd.com/read/27900610/novel-sgc-stimulators-and-sgc-activators-for-the-treatment-of-heart-failure
#14
Stefanie Breitenstein, Lothar Roessig, Peter Sandner, Kelly S Lewis
The burden of heart failure (HF) increases worldwide with an aging population, and there is a high unmet medical need in both, heart failure with reduced ejection fraction (HFrEF) and with preserved ejection fraction (HFpEF). The nitric oxide (NO) pathway is a key regulator in the cardiovascular system and modulates vascular tone and myocardial performance. Disruption of the NO-cyclic guanosine monophosphate (cGMP) signaling axis and impaired cGMP formation by endothelial dysfunction could lead to vasotone dysregulation, vascular and ventricular stiffening, fibrosis, and hypertrophy resulting in a decline of heart as well as kidney function...
November 30, 2016: Handbook of Experimental Pharmacology
https://www.readbyqxmd.com/read/27868321/dementia-related-adverse-events-in-paradigm-hf-and-other-trials-in-heart-failure-with-reduced-ejection-fraction
#15
Jane A Cannon, Li Shen, Pardeep S Jhund, Søren L Kristensen, Lars Køber, Fabian Chen, Jianjian Gong, Martin P Lefkowitz, Jean L Rouleau, Victor C Shi, Karl Swedberg, Michael R Zile, Scott D Solomon, Milton Packer, John J V McMurray
AIMS: Inhibition of neprilysin, an enzyme degrading natriuretic and other vasoactive peptides, is beneficial in heart failure with reduced ejection fraction (HFrEF), as shown in PARADIGM-HF which compared the angiotensin receptor-neprilysin inhibitor (ARNI) sacubitril/valsartan with enalapril. As neprilysin is also one of many enzymes clearing amyloid-β peptides from the brain, there is a theoretical concern about the long-term effects of sacubitril/valsartan on cognition. Therefore, we have examined dementia-related adverse effects (AEs) in PARADIGM-HF and placed these findings in the context of other recently conducted HFrEF trials...
January 2017: European Journal of Heart Failure
https://www.readbyqxmd.com/read/27867532/left-ventricular-ejection-fraction-recovery-in-patients-with-heart-failure-treated-with-intravenous-iron-a-pilot-study
#16
Julio Núñez, José Vicente Monmeneu, Anna Mollar, Eduardo Núñez, Vicent Bodí, Gema Miñana, Sergio García-Blas, Enrique Santas, Jaume Agüero, Francisco J Chorro, Juan Sanchis, Maria Pilar López-Lereu
AIMS: In patients with heart failure with reduced ejection fraction (HFrEF) and iron deficiency, treatment with intravenous iron has shown a clinical improvement regardless of anaemic status. Cardiac magnetic resonance (CMR) T2* sequence has shown a potential utility for evaluating myocardial iron deficiency. We aimed to evaluate whether T2* sequence significantly changes after ferric carboximaltose (FCM) administration, and if such changes correlate with changes in left ventricle ejection fraction (LVEF)...
December 2016: ESC Heart Failure
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
#17
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/27858191/focus-on-the-novel-cardiovascular-drug-lzc696-from-evidence-to-clinical-consideration
#18
L M Lin, Y Wu, M F Wu, J X Lin
LCZ696, a first-in-class angiotensin receptor neprilysin inhibitor (ARNI), is comprised of the angiotensin receptor blocker valsartan and the neprilysin inhibitor pro-drug sacubitril (AHU377). After oral administration, AHU377 is rapidly metabolized to the active neprilysin inhibitor LBQ657. LCZ696 exerts its effects of diuresis, natriuresis, vasodilation and aldosterone secretion inhibition through simultaneous renin-angiotensin-aldosterone system (RAAS) blockade and natriuretic peptides system (NPS) enhancement...
December 2016: Cardiovascular Drugs and Therapy
https://www.readbyqxmd.com/read/27858115/-the-new-esc-guidelines-for-acute-and-chronic-heart-failure-2016
#19
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
#20
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
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