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HFrEF treatment

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https://www.readbyqxmd.com/read/29763816/design-of-a-phase-3-trial-of-intracoronary-administration-of-human-adenovirus-5-encoding-human-adenylyl-cyclase-type-6-rt-100-gene-transfer-in-patients-with-heart-failure-with-reduced-left-ventricular-ejection-fraction-the-flourish-clinical-trial
#1
William F Penny, Timothy D Henry, Matthew W Watkins, Amit N Patel, H Kirk Hammond
The prognosis of patients with HFrEF remains poor despite the use of current medical and device therapies. Preclinical studies of HFrEF using IC delivery of RT-100, a replication deficient, E1/E3-deleted human adenovirus 5 encoding human AC6 was associated with favorable effects on LV function and remodeling. A recent multicenter, double-blind, placebo-controlled, phase 2 study demonstrated the safety of IC delivery of RT-100 in HFrEF patients and potential efficacy at the higher doses. This phase 2 dose finding study, which included doses not expected to be effective, identified a potential reduction in congestive heart failure admissions in the AC6-treated group one year after randomization...
April 6, 2018: American Heart Journal
https://www.readbyqxmd.com/read/29762842/the-role-of-commonly-used-clinical-indicators-in-the-diagnosis-of-acute-heart-failure
#2
X-L Wang, J-M Lei, Y Yuan, L Feng, Y Ning, Y-F Liu
OBJECTIVE: Acute heart failure (AHF) is one of the most commonly seen clinical cases, with a high rate of re-hospitalization and mortality. AHF can be divided into two categories based on the systolic function of the left ventricle, which are heart failure with reduced ejection fraction (HFREF) and heart failure with preserved ejection fraction (HFPEF). Pathogenesis and treatment of the two are quite different. In this article we attempted to explore the value of combined use of clinical and laboratory indicators in the differential diagnosis of AHFREF and AHFPEF...
April 2018: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/29762337/real-life-indications-to-ivabradine-treatment-for-heart-rate-optimization-in-patients-with-chronic-systolic-heart-failure
#3
Lara Tondi, Gabriele Fragasso, Roberto Spoladore, Giuseppe Pinto, Marco Gemma, Massimo Slavich, Cosmo Godino, Anna Salerno, Claudia Montanaro, Alberto Margonato
: Ivabradine is a selective and specific inhibitor of If current. With its pure negative chronotropic action, it is recommended by European Society of Cardiology and American College of Cardiology/American Heart Association guidelines in symptomatic heart failure patients (NYHA ≥ 2) with ejection fraction 35% or less, sinus rhythm and heart rate (HR) at least 70 bpm, despite maximally titrated β-blocker therapy. Data supporting this indication mainly derive from the SHIFT study, in which ivabradine reduced the combined endpoint of mortality and hospitalization, despite the fact that only 26% of patients enrolled were on optimal β-blocker doses...
May 11, 2018: Journal of Cardiovascular Medicine
https://www.readbyqxmd.com/read/29754666/a-genotype-directed-comparative-effectiveness-trial-of-bucindolol-and-metoprolol-succinate-for-prevention-of-symptomatic-atrial-fibrillation-atrial-flutter-in-patients-with-heart-failure-rationale-and-design-of-the-genetic-af-trial
#4
Jonathan P Piccini, Stuart J Connolly, William T Abraham, Jeff S Healey, Benjamin A Steinberg, Hussein R Al-Khalidi, Patricia Dignacco, Dirk J van Veldhuisen, William H Sauer, Michel White, Stephen B Wilton, Inder S Anand, Christopher Dufton, Debra A Marshall, Ryan G Aleong, Gordon W Davis, Richard L Clark, Laura L Emery, Michael R Bristow
BACKGROUND: Few therapies are available for the safe and effective treatment of atrial fibrillation (AF) in patients with heart failure. Bucindolol is a non-selective beta-blocker with mild vasodilator activity previously found to have accentuated antiarrhythmic effects and increased efficacy for preventing heart failure events in patients homozygous for the major allele of the ADRB1 Arg389Gly polymorphism (ADRB1 Arg389Arg genotype). The safety and efficacy of bucindolol for the prevention of AF or atrial flutter (AFL) in these patients has not been proven in randomized trials...
May 2018: American Heart Journal
https://www.readbyqxmd.com/read/29744528/device-therapy-in-heart-failure-with-reduced-ejection-fraction-cardiac-resynchronization-therapy-and-more
#5
D Duncker, C Veltmann
In patients with heart failure with reduced ejection fraction (HFrEF), optimal medical treatment includes beta-blockers, ACE inhibitors/angiotensinreceptor-neprilysin inhibitors (ARNI), mineralocorticoid receptor antagonists, and ivabradine when indicated. In device therapy of HFrEF, implantable cardioverter-defibrillators and cardiac resynchronization therapy (CRT) have been established for many years. CRT is the therapy of choice (class I indication) in symptomatic patients with HFrEF and a broad QRS complex with a left bundle branch block (LBBB) morphology...
May 9, 2018: Herz
https://www.readbyqxmd.com/read/29731121/sudden-death-after-hospitalization-for-heart-failure-with-reduced-ejection-fraction-from-the-everest-trial
#6
Muthiah Vaduganathan, Ravi B Patel, Robert J Mentz, Haris Subacius, Neal A Chatterjee, Stephen J Greene, Andrew P Ambrosy, Aldo P Maggioni, James E Udelson, Karl Swedberg, Marvin A Konstam, Christopher M O'Connor, Javed Butler, Mihai Gheorghiade, Faiez Zannad
Patients with chronic heart failure with reduced ejection fraction (HFrEF) benefit from medical and device therapies targeting sudden cardiac death (SCD). Contemporary estimates of SCD risk after hospitalization for heart failure are limited. We describe the incidence, timing, and clinical predictors of SCD after hospitalization for HFrEF (≤40%) in the EVEREST (Efficacy of Vasopressin Antagonism in Heart Failure Outcome Study with Tolvaptan) trial. Multiple logistic regression analyses tested >30 baseline covariates (including treatment randomization, demographics, comorbid conditions, natriuretic peptides, ejection fraction, and medical and device therapies) to identify predictors of 1-year SCD...
April 11, 2018: American Journal of Cardiology
https://www.readbyqxmd.com/read/29731118/post-traumatic-stress-disorder-and-heart-failure-in-men-within-the-veteran-affairs-health-system
#7
Marat Fudim, Lukasz P Cerbin, Srikant Devaraj, Tarek Ajam, Sunil V Rao, Masoor Kamalesh
Patients with post-traumatic stress disorder (PTSD) are at risk of multiple co-morbidities and are more likely to develop incident heart failure with reduced ejection fraction (HFrEF). The relation of PTSD with clinical outcomes in HFrEF is not established. US veterans diagnosed with HFrEF from January 2007 to January 2015 and treated nationwide in the Veterans Affairs (VA) Health System were included in the study. Patients with HFrEF were identified through International Classification of Diseases, Ninth Revision (ICD-9) codes...
April 11, 2018: American Journal of Cardiology
https://www.readbyqxmd.com/read/29705650/baroreflex-activation-therapy-for-the-treatment-of-heart-failure-with-reduced-ejection-fraction-in-patients-with-and-without-coronary-artery-disease
#8
Marcel Halbach, William T Abraham, Christian Butter, Anique Ducharme, Didier Klug, William C Little, Hannes Reuter, Jill E Schafer, Michele Senni, Vijay Swarup, Rolf Wachter, Fred A Weaver, Seth J Wilks, Michael R Zile, Jochen Müller-Ehmsen
BACKGROUND: In a randomized trial, baroreflex activation therapy (BAT) improved exercise capacity, quality of life and NT-proBNP in patients with heart failure with reduced ejection fraction (HFrEF). In view of different mechanisms underlying HFrEF, we performed a post-hoc subgroup analysis of efficacy and safety of BAT in patients with and without coronary artery disease (CAD). METHODS AND RESULTS: Patients with left ventricular ejection fraction <35% and NYHA Class III were randomized 1:1 to guideline-directed medical and device therapy alone or plus BAT...
April 21, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29685696/does-natriuretic-peptide-monitoring-improve-outcomes-in-heart-failure-patients-a-systematic-review-and-meta-analysis
#9
Muhammad Shahzeb Khan, Tariq Jamal Siddiqi, Muhammad Shariq Usman, Jayakumar Sreenivasan, Setri Fugar, Haris Riaz, M H Murad, Farouk Mookadam, Vincent M Figueredo
BACKGROUND: Current guidelines do not support the use of serial natriuretic peptide (NP) monitoring for heart failure with preserved (HFpEF) or reduced ejection fraction (HFrEF) treatment, despite some studies showing benefit. We conducted an updated meta-analysis to address whether medical therapy in HFpEF or HFrEF should be titrated according to NP levels. METHODS: MEDLINE, Scopus and Cochrane CENTRAL databases were searched for randomized controlled trials (RCTs) comparing NP versus guideline directed titration in HF patients through December 2017...
April 12, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29668577/the-use-of-a-novel-non-steroidal-mineralocorticoid-receptor-antagonist-finerenone-for-the-treatment-of-chronic-heart-failure-a-systematic-review-and-meta-analysis
#10
Hui Pei, Wei Wang, Di Zhao, Lei Wang, Guo-Hai Su, Zhuo Zhao
BACKGROUND: The non-steroidal mineralocorticoid receptor antagonist finerenone (BAY 94-8862) has been used to treat chronic heart failure (CHF) with reduced ejection fraction (HFrEF). However, conflicting results were reported for its efficacy and safety. The study aimed to compare the efficacy and safety of finerenone versus spironolactone or eplerenone in patients with chronic heart failure. METHODS: Electronic databases including MEDLINE, EMBASE, and CENTRAL were searched from inception to December 2017 for randomized controlled trials assessing finerenone treatment in patients with chronic heart failure...
April 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29667019/what-is-new-in-heart-failure-management-in-2017-update-on-acc-aha-heart-failure-guidelines
#11
REVIEW
Biykem Bozkurt
PURPOSE OF REVIEW: The goal of this paper is to provide a summary of the new recommendations in the most recent 2017 ACC/AHA/HFSA Focused Update of the 2013 ACCF/AHA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Failure Society of America. The intent is to provide the background and the supporting evidence for the recommendations and to provide practical guidance for management strategies in treatment of heart failure patients...
April 17, 2018: Current Cardiology Reports
https://www.readbyqxmd.com/read/29651826/new-percutaneous-interventions-in-heart-failure
#12
Elisabetta Moscarella, Salvatore Brugaletta, Manel Sabaté
Chronic heart failure (HF) is one of the main causes of mortality and morbidity worldwide and represents a growing challenge in interventional cardiology. Its prevalence is recently increasing due to the improvements in cardiac care with subsequent significant reduction in the HF acute mortality. HF may occur with either a reduced left ventricular ejection fraction (LVEF) (LVEF<40%, HFrEF) or a preserved EF (typically LVEF≥50%, HFpEF) indicative of diastolic dysfunction. Despite recent advances in drug therapies as well as in nonpharmacological strategies, including defibrillators, cardiac resynchronization therapy, LV assist devices (LVAD), mortality in HF remains high...
April 12, 2018: Minerva Cardioangiologica
https://www.readbyqxmd.com/read/29625952/effects-of-dietary-inorganic-nitrate-supplementation-on-exercise-performance-in-patients-with-heart-failure-protocol-for-a-randomized-placebo-controlled-cross-over-trial
#13
Mary N Woessner, Itamar Levinger, Christopher Neil, Cassandra Smith, Jason D Allen
BACKGROUND: Chronic heart failure is characterized by an inability of the heart to pump enough blood to meet the demands of the body, resulting in the hallmark symptom of exercise intolerance. Chronic underperfusion of the peripheral tissues and impaired nitric oxide bioavailability have been implicated as contributors to the decrease in exercise capacity in these patients. nitric oxide bioavailability has been identified as an important mediator of exercise tolerance in healthy individuals, but there are limited studies examining the effects in patients with chronic heart failure...
April 6, 2018: JMIR Research Protocols
https://www.readbyqxmd.com/read/29621054/the-importance-of-heart-rate-in-heart-failure-and-reduced-ejection-fraction
#14
Marilyn A Prasun, Nancy M Albert
BACKGROUND: Heart failure with reduced ejection fraction (HFrEF) is a progressive, chronic, and burdensome cardiovascular condition. It is associated with limiting symptoms, such as dyspnea and fatigue; a decline in functional capacity; and premature mortality and hospitalization. In heart failure (HF) management, heart rate is commonly assessed yet frequently overlooked as a modifiable risk factor and a predictor of mortality. An elevated heart rate increases myocardial demand and decreases diastolic filling time...
April 4, 2018: Journal of Cardiovascular Nursing
https://www.readbyqxmd.com/read/29608504/inter-atrial-shunting-a-novel-device-based-therapy-for-patients-with-heart-failure
#15
Brian Kw Yum, William H Frishman
Heart failure patients with either reduced ejection fraction (HFrEF) or preserved ejection fraction (HFpEF) experience a high mortality rate. The most recent pharmacologic advance for treating patients with HFrEF has been with sacubitril/valsartan. Along with pharmaceutical research, there has been interest in device-based therapies as another treatment approach. One novel interventional device therapy that has shown promise in early tests and trials is the inter-atrial shunt device developed by Corvia Medical Inc...
March 30, 2018: Cardiology in Review
https://www.readbyqxmd.com/read/29601093/cost-effectiveness-analysis-of-sacubitril-valsartan-for-the-treatment-of-heart-failure-with-reduced-ejection-fraction-in-the-united-states
#16
Patrick M Zueger, Varun M Kumar, Rachel L Harrington, Gianna C Rigoni, Alicia Atwood, Robert J DiDomenico, Daniel R Touchette
OBJECTIVE: Sacubitril/valsartan (SAC/VAL) has been shown to reduce mortality and hospitalization in patients with heart failure with reduced ejection fraction (HFrEF) compared with enalapril but at a substantially higher cost. This study evaluates the cost-effectiveness of SAC/VAL versus enalapril in patients with HFrEF over a 5-year time horizon from the U.S. payer perspective. METHODS: A cohort-based Markov model was developed to compare costs and quality-adjusted life years (QALYs) between SAC/VAL and enalapril in patients with HFrEF over a 5-year time horizon...
March 30, 2018: Pharmacotherapy
https://www.readbyqxmd.com/read/29578280/factors-associated-with-underuse-of-mineralocorticoid-receptor-antagonists-in-heart-failure-with-reduced-ejection-fraction-an-analysis-of-11-215-patients-from-the-swedish-heart-failure-registry
#17
Gianluigi Savarese, Juan-Jesus Carrero, Bertram Pitt, Stefan D Anker, Giuseppe M C Rosano, Ulf Dahlström, Lars H Lund
AIM: Mineralocorticoid receptor antagonists (MRAs) improve outcomes in heart failure with reduced ejection fraction (HFrEF), but are underutilized. Hyperkalaemia may be one reason, but the underlying reasons for underuse are unknown. The aim of this study was to investigate the independent predictors of MRA underuse in a large and unselected HFrEF cohort. METHODS AND RESULTS: We included patients with HFrEF (ejection fraction <40%), New York Heart Association (NYHA) class II-IV and heart failure (HF) duration ≥6 months from the Swedish HF Registry...
March 26, 2018: European Journal of Heart Failure
https://www.readbyqxmd.com/read/29566300/are-the-effects-of-drugs-to-prevent-and-to-treat-heart-failure-always-concordant-the-statin-paradox-and-its-implications-for-understanding-the-actions-of-antidiabetic-medications
#18
REVIEW
Milton Packer
Most treatments for chronic heart failure are effective both in preventing its onset and reducing its progression. However, statins prevent the development of heart failure, but they do not decrease morbidity and mortality in those with established heart failure. This apparent discordance cannot be explained by an effect to prevent interval myocardial infarctions. Instead, it seems that the disease that statins were preventing in trials of patients with a metabolic disorder was different from the disease that they were treating in trials of chronic heart failure...
March 22, 2018: European Journal of Heart Failure
https://www.readbyqxmd.com/read/29557071/current-management-and-future-directions-of-heart-failure-with-preserved-ejection-fraction-a-contemporary-review
#19
REVIEW
Chayakrit Krittanawong, Marrick L Kukin
Heart failure with preserved ejection fraction (HFpEF), a complex and debilitating syndrome, is commonly seen in elderly populations. Exacerbation of HFpEF is among the most common reasons for hospital admission in the USA. The high rate of morbidity and mortality from this condition underscores the fact that HFpEF is heterogeneous, complex, and poorly characterized. Randomized, controlled trials have been very successful at identifying treatments for HF with reduced ejection fraction (HFrEF), but effective treatment options for HFpEF are lacking...
March 20, 2018: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/29549927/assessing-guideline-directed-medication-therapy-for-heart-failure-in-end-stage-renal-disease
#20
B Tate Cutshall, Benjamin T Duhart, Jagannath Saikumar, Michael Samarin, Lydia Hutchison, Joanna Q Hudson
BACKGROUND: Treatment of heart failure with reduced ejection fraction (HFrEF) requires guideline-directed medication therapy (GDMT) consisting of either an angiotensin-converting enzyme inhibitor or an angiotensin receptor blocker in combination with an indicated beta-blocker. There is concern that end-stage renal disease (ESRD) patients are not being prescribed GDMT. The study aim was to determine whether outcomes differ for patients with HFrEF and ESRD receiving GDMT compared to those not receiving GDMT...
March 2018: American Journal of the Medical Sciences
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