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Heart failure rct

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https://www.readbyqxmd.com/read/28338229/response-to-endurance-exercise-training-in-older-adults-with-heart-failure-with-preserved-or-reduced-ejection-fraction
#1
Ambarish Pandey, Dalane W Kitzman, Peter Brubaker, Mark J Haykowsky, Timothy Morgan, J Thomas Becton, Jarett D Berry
OBJECTIVES: To systematically examine the relative magnitude and predictors of responses to exercise training in older adult with heart failure (HF) with reduced ejection fraction (HFrEF), and preserved EF (HFpEF). DESIGN: Secondary analysis of a randomized controlled trial. SETTING: Outpatient cardiac rehabilitation program. PARTICIPANTS: Individuals with HF (24 HFrEF, 24 HFpEF) who underwent supervised exercise training...
March 24, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28337810/electronic-stic-improves-four-dimensional-fetal-echocardiography
#2
F Guasina, F Bellussi, G Morganelli, G Salsi, G Pilu, G Simonazzi
OBJECTIVES: To compare the efficiency of electronic Spatio-Temporal Image Correlation (eSTIC) with conventional STIC to acquire fetal cardiac four-dimensional (4D) volumes of diagnostic quality METHODS: This was a randomized controlled trial of 100 patients at midgestation with normal sonograms. In half of the cases, STIC of the fetal heart were obtained with a conventional mechanical 4D probe, in the remaining eSTIC were obtained with an electronic 4D probe. Examinations were kept within the time frame allotted for a standard examination of fetal anatomy, with a maximum of 2 attempts at obtaining a 4D cardiac volume...
March 24, 2017: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28330835/clinical-effectiveness-of-telemedicine-for-chronic-heart-failure-a-systematic-review-and-meta-analysis
#3
Mao-Huan Lin, Wo-Liang Yuan, Tu-Cheng Huang, Hai-Feng Zhang, Jing-Ting Mai, Jing-Feng Wang
Telemedicine interventions may be associated with reductions in hospital admission rate and mortality in patients with heart failure (HF). The present study is an updated analysis (as of June 30, 2016) of randomized controlled trials, where patients with HF underwent telemedicine care or the usual standard care. Data were extracted from 39 eligible studies for all-cause and HF-related hospital admission rate, length of stay, and mortality. The overall all-cause mortality (pooled OR=0.80, 95% CI 0.71 to 0.91, p<0...
March 22, 2017: Journal of Investigative Medicine: the Official Publication of the American Federation for Clinical Research
https://www.readbyqxmd.com/read/28329380/subclinical-thyroid-dysfunction-and-cardiovascular-diseases-2016-update
#4
Carmen Floriani, Baris Gencer, Tinh-Hai Collet, Nicolas Rodondi
Subclinical thyroid dysfunction comprises subclinical hypothyroidism (SHypo), defined as elevated thyroid-stimulating hormone (TSH) by normal free thyroxine (FT4), and subclinical hyperthyroidism (SHyper) with decreased or undetectable TSH and normal FT4. Up to 10% of the elderly have SHypo, which is usually asymptomatic. Individual participant data (IPD) analyses of prospective cohort studies from the international Thyroid Studies Collaboration show that SHypo is associated with increased coronary heart disease (CHD) mortality [hazard ratio (HR) 1,58 for TSH ≥ 10 mIU/L, 95% CI 1...
February 27, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28316174/-efficacy-and-safety-analysis-of-ivabradine-hydrochloride-treatment-of-chinese-patients-with-chronic-heart-failure-subgroup-analysis-of-chinese-patients-in-the-shift-study
#5
D Y Hu, D J Huang, Z Y Yuan, R P Zhao, X W Yan, M H Wang
Objective: To evaluate the efficacy and safety of ivabradine for the treatment of Chinese patients with chronic heart failure based on the Chinese subgroup data of the systolic heart failure treatment with the I(f) inhibitor ivabradine trial (SHIFT). Method: A total of 6 558 stable outpatients who presented symptoms of heart failure, with a left ventricular ejection fraction (LVEF) ≤35%, sinus rhythms with a heart rate ≥70 bpm participated in the randomized, double-blind, placebo-controlled, international multicenter clinical study...
March 24, 2017: Zhonghua Xin Xue Guan Bing za Zhi
https://www.readbyqxmd.com/read/28316104/implantable-cardioverter-defibrillators-for-primary-prevention-of-mortality-in-patients-with-non-ischemic-cardiomyopathy-a-meta-analysis-of-randomized-controlled-trials
#6
Stavros Stavrakis, Zain Asad, Dwight Reynolds
BACKGROUND: Implantable cardioverter defibrillators (ICDs) improve survival in patients with heart failure due to ischemic cardiomyopathy, but their benefit in non-ischemic cardiomyopathy (NICM) has been recently questioned. We performed a meta-analysis of randomized clinical trials to examine the effect of ICDs on total mortality and arrhythmic death in patients with NICM. We also examined the impact of age and cardiac resynchronization therapy (CRT) on the relative effect of ICD compared to control...
March 18, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28303555/-iron-deficiency-in-chronic-heart-failure-diagnostic-algorithm-and-present-day-therapeutic-options
#7
Wolfram Doehner, Stefan Blankenberg, Erland Erdmann, Georg Ertl, Gerd Hasenfuß, Ulf Landmesser, Burkert Pieske, Bernhard Schieffer, Heribert Schunkert, Stephan von Haehling, Andreas Zeiher, Stefan D Anker
Iron deficiency (ID) occurs in up to 50% of patients with heart failure (HF). Even without presence of anaemia ID contributes to more severe symptoms, increased hospitalization and mortality. A number of randomized controlled trials demonstrated the clinical benefit of replenishment of iron stores with improvement of symptoms and fewer hospitalizations. Assessment of iron status should therefore become routine assessment in newly diagnosed and in symptomatic patients with HF. ID can be identified with simple and straightforward diagnostic steps...
March 16, 2017: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/28289533/ivabradine-in-the-treatment-of-systolic-heart-failure-a-systematic-review-and-meta-analysis
#8
Mahesh Anantha Narayanan, Yogesh N V Reddy, Janani Baskaran, Abhishek Deshmukh, David G Benditt, Ganesh Raveendran
AIM: To perform a systematic-review and meta-analysis to compare outcomes of ivabradine combined with beta-blocker to beta-blocker alone in heart failure with reduced ejection fraction (HFrEF). METHODS: We searched PubMed, Cochrane, EMBASE, CINAHL and Web of Science for trials comparing ivabradine + beta-blocker to beta-blocker alone in HFrEF. We performed a systematic-review and meta-analysis of published literature. Primary end-point was combined end point of cardiac death and hospitalization for heart failure...
February 26, 2017: World Journal of Cardiology
https://www.readbyqxmd.com/read/28289069/omega-3-polyunsaturated-fatty-acid-fish-oil-supplementation-and-the-prevention-of-clinical-cardiovascular-disease-a-science-advisory-from-the-american-heart-association
#9
REVIEW
David S Siscovick, Thomas A Barringer, Amanda M Fretts, Jason H Y Wu, Alice H Lichtenstein, Rebecca B Costello, Penny M Kris-Etherton, Terry A Jacobson, Mary B Engler, Heather M Alger, Lawrence J Appel, Dariush Mozaffarian
Multiple randomized controlled trials (RCTs) have assessed the effects of supplementation with eicosapentaenoic acid plus docosahexaenoic acid (omega-3 polyunsaturated fatty acids, commonly called fish oils) on the occurrence of clinical cardiovascular diseases. Although the effects of supplementation for the primary prevention of clinical cardiovascular events in the general population have not been examined, RCTs have assessed the role of supplementation in secondary prevention among patients with diabetes mellitus and prediabetes, patients at high risk of cardiovascular disease, and those with prevalent coronary heart disease...
March 13, 2017: Circulation
https://www.readbyqxmd.com/read/28270914/sepsis-induced-cardiac-dysfunction-and-%C3%AE-adrenergic-blockade-therapy-for-sepsis
#10
REVIEW
Takeshi Suzuki, Yuta Suzuki, Jun Okuda, Takuya Kurazumi, Tomohiro Suhara, Tomomi Ueda, Hiromasa Nagata, Hiroshi Morisaki
Despite recent advances in medical care, mortality due to sepsis, defined as life-threatening organ dysfunction caused by a dysregulated host response to infection, remains high. Fluid resuscitation and vasopressors are the first-line treatment for sepsis in order to optimize hemodynamic instability caused by vasodilation and increased vascular permeability. However, these therapies, aimed at maintaining blood pressure and blood flow to vital organs, could have deleterious cardiac effects, as cardiomyocyte damage occurs in the early stages of sepsis...
2017: Journal of Intensive Care
https://www.readbyqxmd.com/read/28255812/is-there-any-benefit-using-low-intensity-inspiratory-and-peripheral-muscle-training-in-heart-failure-a-randomized-clinical-trial
#11
Tatiana Satie Kawauchi, Iracema Ioco Kikuchi Umeda, Lays Magalhães Braga, Antonio de Pádua Mansur, João Manoel Rossi-Neto, Amanda Guerra de Moraes Rego Sousa, Mário Hiroyuki Hirata, Lawrence P Cahalin, Naomi Kondo Nakagawa
BACKGROUND: Inspiratory and peripheral muscle training improves muscle strength, exercise tolerance, and quality of life in patients with chronic heart failure (HF). However, studies investigating different workloads for these exercise modalities are still lacking. OBJECTIVE: To examine the effects of low and moderate intensities on muscle strength, functional capacity, and quality of life. DESIGN: A randomized controlled trial. METHODS: Thirty-five patients with stable HF (aged >18 years, NYHA II/III, LVEF <40%) were randomized to: non-exercise control group (n = 9), low-intensity training group (LIPRT, n = 13, 15% maximal inspiratory workload, and 0...
March 2, 2017: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
https://www.readbyqxmd.com/read/28249585/incretin-based-agents-in-type-2-diabetic-patients-at-cardiovascular-risk-compare-the-effect-of-glp-1-agonists-and-dpp-4-inhibitors-on-cardiovascular-and-pancreatic-outcomes
#12
Zeqing Zhang, Xi Chen, Puhan Lu, Jianhua Zhang, Yongping Xu, Wentao He, Mengni Li, Shujun Zhang, Jing Jia, Shiying Shao, Junhui Xie, Yan Yang, Xuefeng Yu
BACKGROUND: Incretin-based agents, including dipeptidyl peptidase-4 inhibitors (DPP-4Is) and glucagon-like peptide-1 agonists (GLP-1As), work via GLP-1 receptor for hyperglycemic control directly or indirectly, but have different effect on cardiovascular (CV) outcomes. The present study is to evaluate and compare effects of incretin-based agents on CV and pancreatic outcomes in patients with type 2 diabetes mellitus (T2DM) and high CV risk. METHODS: Six prospective randomized controlled trials (EXMAINE, SAVOR-TIMI53, TECOS, ELIXA, LEADER and SUSTAIN-6), which included three trials for DPP-4Is and three trials for GLP-1As, with 55,248 participants were selected to assess the effect of different categories of incretin-based agents on death, CV outcomes (CV mortality, major adverse CV events, nonfatal myocardial infarction, nonfatal stroke, heart failure hospitalization), pancreatic events (acute pancreatitis and pancreatic cancer) as well as on hypoglycemia...
March 1, 2017: Cardiovascular Diabetology
https://www.readbyqxmd.com/read/28248887/the-optimal-exhaled-concentration-of-sevoflurane-for-intubation-without-neuromuscular-blockade-using-clinical-bolus-doses-of-remifentanil-a-randomized-controlled-trial
#13
RANDOMIZED CONTROLLED TRIAL
Eui-Kyoung Goo, Jong Seok Lee, Jae Chul Koh
BACKGROUND: The aim of this study was to investigate the optimal exhaled sevoflurane concentration that produces adequate endotracheal intubation conditions when sevoflurane is combined with the different bolus doses of remifentanil used in clinical practice. METHODS: The patients were randomized to 3 groups (groups 1.0, 1.5, and 2.0), receiving remifentanil bolus doses of 1.0, 1.5, and 2.0 μg/kg, respectively. For each group, the concentration of sevoflurane used for each consecutive patient was increased or decreased using the "up-and-down" method based on the success or failure to achieve adequate conditions for intubation in the previous patient...
March 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28247180/registry-based-pragmatic-trials-in-heart-failure-current-experience-and-future-directions
#14
REVIEW
Lars H Lund, Jonas Oldgren, Stefan James
PURPOSE OF REVIEW: Randomized controlled trials (RCTs) in heart failure (HF) are becoming increasingly complex and expensive to conduct and if positive deliver expensive therapy tested only in selected populations. RECENT FINDINGS: Electronic health records and clinical cardiovascular quality registries are providing opportunities for pragmatic and registry-based prospective randomized clinical trials (RRCTs). Simplified regulatory, ethics, and consent procedures; recruitment integrated into real-world care; and simplified or automated baseline and outcome collection allow assessment of study power and feasibility, fast and efficient recruitment, delivery of generalizable findings at low cost, and potentially evidence-based and novel use of generic drugs with low costs to society...
April 2017: Current Heart Failure Reports
https://www.readbyqxmd.com/read/28245786/management-of-hypertension-in-patients-with-aortic-valvular-stenosis
#15
Kanishk Agnihotri, Vikas Singh, Sidakpal S Panaich, Nileshkumar J Patel, Nilay Patel, Shilpkumar Arora, Dhaval Pau, Abhishek Deshmukh, Apurva O Badheka
Aortic stenosis (AS) has an increasing prevalence with age and is commonly associated with hypertension. While it has been established that hypertension is associated with increased mortality in patients with AS, further randomized control trials addressing the use of anti-hypertensives specifically in patients with AS are needed. The management of hypertension in patients with AS needs a cautious approach due to complex hemodynamic and structural changes involved. Comorbidities like coronary artery disease, heart failure and arrhythmias further dictate management of hypertension in patients with AS ...
February 28, 2017: Current Hypertension Reviews
https://www.readbyqxmd.com/read/28219580/use-of-anti-thymocyte-globulin-for-induction-therapy-in-cardiac-transplantation-a-review
#16
V Ruan, L S C Czer, M Awad, M Kittleson, J Patel, F Arabia, F Esmailian, D Ramzy, J Chung, M De Robertis, A Trento, J A Kobashigawa
The most common causes of death after heart transplantation (HTx) include acute rejection and multi-organ failure in the early period and malignancy and cardiac allograft vasculopathy (CAV) in the late period. Polyclonal antibody preparations such as rabbit anti-thymocyte globulin (ATG) may reduce early acute rejection and the later occurrence of CAV after HTx. ATG therapy depletes T cells, modulates adhesion and cell-signaling molecules, interferes with dendritic cell function, and induces B-cell apoptosis and regulatory and natural killer T-cell expansion...
March 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28214615/the-effect-on-patient-outcomes-of-a-nursing-care-and-follow-up-program-for-patients-with-heart-failure-a-randomized-controlled-trial
#17
Dilek Sezgin, Hatice Mert, Ebru Özpelit, Bahri Akdeniz
BACKGROUND: Heart failure is associated with exacerbated symptoms such as dyspnea and edema and results in frequent hospitalization and a poor quality of life. With the adoption of a comprehensive nursing care and follow-up program, patients with heart failure may exhibit improvements in their self-care capabilities and their hospitalizations may be reduced. OBJECTIVE: The purpose of this study was to examine the effect of a nursing care and follow-up program for patients with heart failure on self-care, quality of life, and rehospitalization...
February 14, 2017: International Journal of Nursing Studies
https://www.readbyqxmd.com/read/28213711/implantable-cardioverter-defibrillators-for-primary-prevention-in-dilated-cardiomyopathy-post-danish-an-updated-meta-analysis-and-systematic-review-of-randomized-controlled-trials
#18
Georg Wolff, Yingfeng Lin, Athanasios Karathanos, Maximilian Brockmeyer, Susanne Wolters, Bernd Nowak, Alexander Fürnkranz, Hisaki Makimoto, Malte Kelm, Volker Schulze
BACKGROUND: Sudden cardiac death (SCD) is frequent in patients with heart failure due to dilated cardiomyopathy (DCM). Implantable cardioverter/defibrillator (ICD) device therapy is currently used for primary prevention. However, publication of the DANISH trial has recently given reason for doubt, showing no significant improvement in all-cause mortality in comparison to contemporary medical therapy. METHODS: We performed a meta-analysis of all randomized controlled trials comparing ICD therapy to medical therapy (MT) for primary prevention in DCM...
February 17, 2017: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
https://www.readbyqxmd.com/read/28211952/long-term-experience-with-first-generation-implantable-neurostimulation-device-in-central-sleep-apnea-treatment
#19
Henrik Fox, Thomas Bitter, Dieter Horstkotte, Olaf Oldenburg, Klaus-Jürgen Gutleben
BACKGROUND: Sleep-disordered breathing (SDB) and Cheyne-Stokes respiration (CSR) are associated with shorter survival in patients with heart failure (HF). A novel treatment method for this patient group is unilateral phrenic nerve stimulation by the remedē® system, a transvenously implantable neurostimulation device, which has recently been studied in a large randomized, controlled trial. Previous literature has shown efficacy and safety of the treatment with this first-generation device, but hardly any data is available on long-term clinical parameters, the remedē® device's battery lifetime, device exchangeability, lead position stability, surgical accessibility and manageability...
February 17, 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/28205056/analyzing-health-related-quality-of-life-data-to-estimate-parameters-for-cost-effectiveness-models-an-example-using-longitudinal-eq-5d-data-from-the-shift-randomized-controlled-trial
#20
Alison Griffiths, Noman Paracha, Andrew Davies, Neil Branscombe, Martin R Cowie, Mark Sculpher
INTRODUCTION: The aim of this article is to discuss methods used to analyze health-related quality of life (HRQoL) data from randomized controlled trials (RCTs) for decision analytic models. The analysis presented in this paper was used to provide HRQoL data for the ivabradine health technology assessment (HTA) submission in chronic heart failure. METHODS: We have used a large, longitudinal EuroQol five-dimension questionnaire (EQ-5D) dataset from the Systolic Heart Failure Treatment with the I f Inhibitor Ivabradine Trial (SHIFT) (clinicaltrials...
February 15, 2017: Advances in Therapy
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