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Heart failure rct

Ling Yu, Lijuan Cao, Jing Sun, Zhongyi Li, Fengzhen Yao, Yabin Zhou
BACKGROUND: Serelaxin, recombinant human relaxin-2, is a hormone with vasodilatory and end-organ protective effects. Recently, it has been licensed to treat acute decompensated heart failure. Here, a systematic review and meta-analysis on randomized controlled trials (RCTs) was performed to assess the effect of serelaxin on mortality and dyspnea improvement in patients with heart failure. METHODS: RCTs comparing serelaxin treatment to other heart failure treatments were searched in PubMed, Embase, Cochrane Library, and ClinicalTrials...
June 2018: Medicine (Baltimore)
Chaudhry M S Sarwar, Muthiah Vaduganathan, Stefan D Anker, Stefano Coiro, Lampros Papadimitriou, Joel Saltz, Elinor R Schoenfeld, Richard L Clark, Wilfried Dinh, Frank Kramer, Mihai Gheorghiade, Gregg C Fonarow, Javed Butler
Cardiovascular disease is the leading cause of mortality and morbidity globally. With widespread and growing use of smart phones and mobile devices, the use of mobile health (mHealth) in transmission of physiologic parameters and patient-referred symptoms to healthcare providers and researchers, as well as reminders and care plan applications from providers to patients, has potential to revolutionize both clinical care and the conduct of clinical trials with improved designs, data capture, and potentially lower costs...
June 12, 2018: International Journal of Cardiology
Parichat Wonggom, Huiyun DU, Robyn A Clark
AIM: The aim of this study is to evaluate the effectiveness of an avatar-based education application for improving knowledge and self-care behavior in patients with heart failure. BACKGROUND: Avatar-based technologies for supporting education are an innovative approach for patients with low literacy, low health literacy and English as a second language. The use of avatar technologies for patient education has shown benefits in improving knowledge, self-care behaviors and quality of life in chronic diseases such as cancer, diabetes and depression...
June 19, 2018: Journal of Advanced Nursing
Gary Tse, Cynthia Chan, Mengqi Gong, Lei Meng, Jian Zhang, Xiao-Ling Su, Sadeq Ali-Hasan-Al-Saegh, Abhishek C Sawant, George Bazoukis, Yun-Long Xia, Ji-Chao Zhao, Alex Pui Wai Lee, Leonardo Roever, Martin Cs Wong, Adrian Baranchuk, Tong Liu
Background: Heart failure is a significant problem leading to repeated hospitalizations. Telemonitoring and hemodynamic monitoring have demonstrated success in reducing hospitalization rates, but not all studies reported significant effects. The aim of this systematic review and meta-analysis is to examine the effectiveness of telemonitoring and wireless hemodynamic monitoring devices in reducing hospitalizations in heart failure. Methods & Results: PubMed and Cochrane Library were searched up to 1st May 2017 for articles that investigated the effects of telemonitoring or hemodynamic monitoring on hospitalization rates in heart failure...
April 2018: Journal of Geriatric Cardiology: JGC
Tomoko Negishi, Paaladinesh Thavendiranathan, Kazuaki Negishi, Thomas H Marwick
OBJECTIVES: This study sought to evaluate the hypothesis that global longitudinal strain (GLS) guidance of cardioprotective therapy would improve cardiac function of at-risk patients undergoing potentially cardiotoxic chemotherapy, compared with usual care. BACKGROUND: The conventional criteria for diagnosis of chemotherapy-related cardiac dysfunction (CTRCD) are dependent on the recognition of heart failure symptoms and/or changes in left ventricular ejection fraction...
June 8, 2018: JACC. Cardiovascular Imaging
Todd C Lee, Rodrigo B Cavalcanti, Emily G McDonald, Louise Pilote, James M Brophy
BACKGROUND: The Systolic Blood Pressure Intervention Trial (SPRINT) was a randomized controlled trial which studied 9361 adults aged 50 and older with systolic blood pressure above 130mmHg and one or more cardiovascular risk factor. Patients were randomized to intensive (≤ 120mmHg) or standard (≤ 140mmHg) systolic targets. In August 2016, a limited dataset was released for secondary analysis. We hypothesized that excessive lowering of diastolic blood pressure could cause harm. Using the data from SPRINT, we sought to determine whether the development of diastolic hypotension during treatment was associated with adverse outcomes...
June 12, 2018: American Journal of Medicine
Giacomo Emmi, Maria Letizia Urban, Massimo Imazio, Marco Gattorno, Silvia Maestroni, Giuseppe Lopalco, Luca Cantarini, Domenico Prisco, Antonio Brucato
PURPOSE OF REVIEW: This review aims to summarize the role of the interleukin-1 (IL-1) blocking agents in cardiovascular diseases, briefly describing the pathogenetic rationale and the most relevant clinical studies. RECENT FINDINGS: IL-1 is a pivotal cytokine of the innate immune system. Anti-IL-1 agents are currently used for the treatment of several autoimmune and autoinflammatory conditions. Recently, the role of IL-1 has also emerged in cardiovascular diseases...
June 14, 2018: Current Cardiology Reports
Manal M Alem, Abdullah M Alshehri, Peter Mb Cahusac, Matthew R Walters
Background: The xanthine oxidase inhibitor allopurinol improves endothelial function in different populations, including patients with chronic heart failure (CHF). Its effect on arterial stiffness parameters is less clear. We investigated the effect of short-term low-dose allopurinol therapy on arterial stiffness in Saudi patients with stable mild-moderate CHF. Methods: A prospective, randomized, double-blind, placebo-controlled study was performed on 73 patients with mild-moderate CHF...
2018: Clinical Medicine Insights. Cardiology
John S Harrington, Edward J Schenck, Clara Oromendia, Augustine M K Choi, Ilias I Siempos
PURPOSE: We examined whether patients with acute respiratory distress syndrome (ARDS) lacking risk factors are enrolled in therapeutic trials and assessed their clinical characteristics and outcomes. METHODS: We performed a secondary analysis of patient-level data pooled from the ARMA, ALVEOLI, FACTT, ALTA and EDEN ARDSNet randomized controlled trials obtained from the Biologic Specimen and Data Repository Information Coordinating Center of the National Heart, Lung and Blood Institute...
June 2, 2018: Journal of Critical Care
Przemyslaw J Kotyla
Treatment with anti-TNF-α (tumor necrosis factor), one of the pivotal cytokines, was introduced to clinical practice at the end of last century and revolutionized the treatment of rheumatoid arthritis (RA) as well as many other inflammatory conditions. Such a treatment may however bring many safety issues regarding infections, tuberculosis, as well as cardiovascular diseases, including heart failure. Given the central role of proinflammatory cytokines in RA, atherosclerosis, and congestive heart failure (CHF), such a treatment might result in better control of the RA process on the one side and improvement of heart function on the other...
June 12, 2018: International Journal of Molecular Sciences
Lin Zhang, JinKui Yang, LanTing Li, DongDong Liu, XiaoPing Xie, Peng Dong, Yong Lin
AIM: Reducing the fluctuation of blood pressure has recently been recognized as a potential target for improving management of hypertension to prevent cardiovascular events, particularly for strokes. Some randomized controlled trials demonstrated that amlodipine can effectively reduce blood pressure as a well-established, long-acting calcium channel blocker (CCB). However, few data are available for amlodipine on blood pressure variability (BPV) in China in a real-world setting. This study aimed to assess the effect of amlodipine versus other CCB antihypertensive agents on BPV...
June 11, 2018: Journal of Comparative Effectiveness Research
Mohammad Y Salmasi, Amer Harky, Mohammed F Chowdhury, Ali Abdelnour, Anastasia Benjafield, Farah Suker, Stephanie Hubbard, Hunaid A Vohra
BACKGROUND: Ischemic mitral regurgitation (IMR) is associated with increased mortality and recurrent congestive heart failure following coronary artery bypass graft (CABG) surgery. While mitral surgery should be undertaken for severe MR during CABG, the treatment of moderate IMR remains controversial. We conducted a meta-analysis to determine the outcomes of CABG alone and combine with mitral valve repair (MVr) in moderate IMR. METHODS: A literature search was conducted by Pubmed, Ovid, and Embase, which included 643 articles...
June 10, 2018: Journal of Cardiac Surgery
Gian Francesco Mureddu
The concept that 'the lower the blood pressure (BP) achieved the better the outcome' rests on the demonstration of a direct relationship between BP and incident outcomes, down to levels of 115 mmHg of systolic BP (sBP) and 75 mmHg of diastolic BP (dBP) carried out in 1 million individuals from 61 cohorts recruited between 1950 and 1990 and followed for about 14 years. The alternative to the 'lower the better' concept is the hypothesis of a J-shaped relationship, according to which the benefits of reducing sBP or dBP to low values may be dangerous leading even to an increase in total mortality and/or in CV outcomes...
June 7, 2018: Monaldi Archives for Chest Disease, Archivio Monaldi Per le Malattie del Torace
Rui Zheng, Guihua Tian, Qin Zhang, Lin Wu, Yanwei Xing, Hongcai Shang
Objectives: To evaluate possible adverse effects and efficacy of Wenxin keli (WXKL)-amiodarone combination on heart failure complicated by ventricular arrhythmia. Methods: Nine electronic literature databases (the Cochrane Library, PubMed, EMBASE, IPA, AMED, CBM, CNKI, VIP, and WanFang) were searched up to February 2018. Two authors extracted data and assessed risk of bias of the included studies independently. Randomized controlled trials (RCTs) and quasi-RCTs about WXKL-amiodarone combination and amiodarone alone were eligible for comparison...
2018: Frontiers in Physiology
V Y Mareev, M Y Drobizhev, Y L Begrambekova
AIM: To reveal the probability and duration of the onset of remission of anxiety-depressive symptoms in patients with CHF III-IV receiving optimal medicine treatment (OMT) or (OMT), supplemented with the education program and active outpatient monitoring (OMT + A). MATERIALS AND METHODS: A secondary analysis of the results of RCT CHANCE, which studied the impact of the training program and active outpatient control (further additional exposure (DV) plus optimal medication (OMT) on mortality and cardiovascular hospitalization in patients with CHF III-IV FC...
May 2018: Kardiologiia
Vinit Sawhney, Giulia Domenichini, James Gamble, Guy Furniss, Dimitrios Panagopoulos, Pier Lambiase, Kim Rajappan, Anthony Chow, Martin Lowe, Simon Sporton, Mark J Earley, Mehul Dhinoja, Niall Campbell, Ross J Hunter, Guy Haywood, Tim R Betts, Richard J Schilling
Aims: Endocardial left ventricular (LV) pacing is a viable alternative in patients with failed coronary sinus (CS) lead implantation. However, long-term thrombo-embolic risk remains unknown. Much of the data have come from a small number of centres. We examined the safety and efficacy of endocardial LV pacing to determine the long-term thrombo-embolic risk. Methods and results: Registries from four UK centres were combined to include 68 patients with endocardial leads with a mean follow-up of 20 months...
June 1, 2018: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Clotilde Chatre, François Roubille, Hélène Vernhet, Christian Jorgensen, Yves-Marie Pers
INTRODUCTION: Chloroquine and hydroxychloroquine are widely used in the long-term treatment of connective tissue disease and usually considered safe. However, chloroquine- or hydroxychloroquine-related cardiac disorder is a rare but severe adverse event, which can lead to death. This systematic review investigates cardiac complications attributed to chloroquine and hydroxychloroquine. METHODS: PubMED, EMBASE, and Cochrane database searches were conducted using keywords derived from MeSH terms...
June 1, 2018: Drug Safety: An International Journal of Medical Toxicology and Drug Experience
Satish M Mahajan, Amey S Mahajan, Sahand Negahban
Many researchers are working toward the goal of data-driven care by predicting the risk of 30-day readmissions for patients with heart failure. Most published predictive models have used only patient level data from either single-center studies or secondary data analysis of randomized control trials. This study describes a hierarchical model that captures regional differences in addition to patient-level data from 1778 unique patients across 31 geographically distributed hospitals from one health system. The model was developed using Bayesian techniques operating on a large set of predictors...
2018: Studies in Health Technology and Informatics
Ulrich Laufs, Nina Griese-Mammen, Katrin Krueger, Angelika Wachter, Stefan D Anker, Friedrich Koehler, Volker Rettig-Ewen, Lea Botermann, Dorothea Strauch, Dietmar Trenk, Michael Böhm, Martin Schulz
We report the rationale and design of a community PHARMacy-based prospective randomized controlled interdisciplinary study for ambulatory patients with Chronic Heart Failure (PHARM-CHF) and results of its pilot study. The pilot study randomized 50 patients to a pharmacy-based intervention or usual care for 12 months. It demonstrated the feasibility of the design and showed reduced systolic blood pressure in the intervention group as indicator for improved medication adherence. The main study will randomize patients ≥60 years on stable pharmacotherapy including at least one diuretic and a history of heart failure hospitalization within 12 months...
May 30, 2018: European Journal of Heart Failure
Iben Rix, Julie Steen Pedersen, Heidi Storgaard, Lise Lotte Gluud
PURPOSE: Non-alcoholic fatty liver disease (NAFLD) affects about 25% of the population worldwide. NAFLD may be viewed as the hepatological manifestation of metabolic syndrome. Patients with metabolic syndrome due to diabetes or obesity have an increased risk of cardiovascular disease. This narrative review describes cardiometabolic effects of antidiabetic drugs in NAFLD. METHODS: We conducted a systematic search in PubMed and manually scanned bibliographies in trial databases and reference lists in relevant articles...
May 29, 2018: Clinical Physiology and Functional Imaging
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