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Reduced ejection fraction

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https://www.readbyqxmd.com/read/28087688/thirty-years-of-evidence-on-the-efficacy-of-drug-treatments-for-chronic-heart-failure-with-reduced-ejection-fraction-a-network-meta-analysis
#1
Heather Burnett, Amy Earley, Adriaan A Voors, Michele Senni, John J V McMurray, Celine Deschaseaux, Shannon Cope
BACKGROUND: Treatments that reduce mortality and morbidity in patients with heart failure with reduced ejection fraction, including angiotensin-converting enzyme inhibitors (ACEI), angiotensin receptor blockers (ARB), β-blockers (BB), mineralocorticoid receptor antagonists (MRA), and angiotensin receptor-neprilysin inhibitors (ARNI), have not been studied in a head-to-head fashion. This network meta-analysis aimed to compare the efficacy of these drugs and their combinations regarding all-cause mortality in patients with heart failure with reduced ejection fraction...
January 2017: Circulation. Heart Failure
https://www.readbyqxmd.com/read/28087687/survival-benefits-of-invasive-versus-conservative-strategies-in-heart-failure-in-patients-with-reduced-ejection-fraction-and-coronary-artery-disease-a-meta-analysis
#2
Georg Wolff, Dimitrios Dimitroulis, Felicita Andreotti, Michalina Kołodziejczak, Christian Jung, Pietro Scicchitano, Fiorella Devito, Annapaola Zito, Michele Occhipinti, Battistina Castiglioni, Giuseppe Calveri, Francesco Maisano, Marco M Ciccone, Stefano De Servi, Eliano P Navarese
BACKGROUND: Heart failure with reduced ejection fraction caused by ischemic heart disease is associated with increased morbidity and mortality. It remains unclear whether revascularization by either coronary artery bypass grafting (CABG) or percutaneous coronary intervention (PCI) carries benefits or risks in this group of stable patients compared with medical treatment. METHODS AND RESULTS: We performed a meta-analysis of available studies comparing different methods of revascularization (PCI or CABG) against each other or medical treatment in patients with coronary artery disease and left ventricular ejection fraction ≤40%...
January 2017: Circulation. Heart Failure
https://www.readbyqxmd.com/read/28086951/sodium-glucose-transporter-2-sglt2-inhibition-with-empagliflozin-improves-cardiac-diastolic-function-in-a-female-rodent-model-of-diabetes
#3
Javad Habibi, Annayya R Aroor, James R Sowers, Guanghong Jia, Melvin R Hayden, Mona Garro, Brady Barron, Eric Mayoux, R Scott Rector, Adam Whaley-Connell, Vincent G DeMarco
Obese and diabetic individuals are at increased risk for impairments in diastolic relaxation and heart failure with preserved ejection fraction. The impairments in diastolic relaxation are especially pronounced in obese and diabetic women and predict future cardiovascular disease (CVD) events in this population. Recent clinical data suggest sodium glucose transporter-2 (SGLT2) inhibition reduces CVD events in diabetic individuals, but the mechanisms of this CVD protection are unknown. To determine whether targeting SGLT2 improves diastolic relaxation, we utilized empagliflozin (EMPA) in female db/db mice...
January 13, 2017: Cardiovascular Diabetology
https://www.readbyqxmd.com/read/28079427/effect-of-functional-electrical-stimulation-on-cardiovascular-outcomes-in-patients-with-chronic-heart-failure
#4
Nikolaos Pe Kadoglou, Christina Mandila, Apostolos Karavidas, Dimitrios Farmakis, Vasiliki Matzaraki, Christos Varounis, Sofia Arapi, Anastasia Perpinia, John Parissis
Background/design Functional electrical stimulation of lower limb muscles is an alternative method of training in patients with chronic heart failure (CHF). Although it improves exercise capacity in CHF, we performed a randomised, placebo-controlled study to investigate its effects on long-term clinical outcomes. Methods We randomly assigned 120 patients, aged 71 ± 8 years, with stable CHF (New York Heart Association (NYHA) class II/III (63%/37%), mean left ventricular ejection fraction 28 ± 5%), to either a 6-week functional electrical stimulation training programme or placebo...
January 1, 2017: European Journal of Preventive Cardiology
https://www.readbyqxmd.com/read/28077531/sodium-bicarbonate-does-not-prevent-postoperative-acute-kidney-injury-after-off-pump-coronary-revascularization-a-double-blinded-randomized-controlled-trial
#5
S Soh, J W Song, J K Shim, J H Kim, Y L Kwak
BACKGROUND: Acute kidney injury (AKI) is a common morbidity after off-pump coronary revascularization. We investigated whether perioperative administration of sodium bicarbonate, which might reduce renal injury by alleviating oxidative stress in renal tubules, prevents postoperative AKI in off-pump coronary revascularization patients having renal risk factors. METHODS: Patients (n=162) having at least one of the following AKI risk factors were enrolled: (i) age >70 yr; (ii) diabetes mellitus; (iii) chronic renal disease; (iv) congestive heart failure or left ventricular ejection fraction <35%; and (v) reoperation or emergency...
October 2016: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28077510/mitral-implant-of-the-inovare-transcatheter-heart-valve-in-failed-surgical-bioprostheses-a-novel-alternative-for-valve-in-valve-procedures
#6
Diego Felipe Gaia, Ademir Massarico Braz, Matheus Simonato, Danny Dvir, João Roberto Breda, Gustavo Calado Ribeiro, Carolina Baeta Ferreira, José Augusto Marcondes Souza, Enio Buffolo, José Honório Palma
OBJECTIVES: Reoperative procedure for the treatment of a failed mitral bioprosthesis is associated with considerable risk. In some cases, mortality is high and might contraindicate the benefit of the procedure. The minimally invasive valve-in-valve (ViV) transcatheter mitral valve implant offers an alternative less-invasive approach, reducing morbidity and mortality. The objective of this paper was to evaluate the mitral ViV approach using the Braile Inovare prosthesis. METHODS: The transcatheter balloon-expandable Braile Inovare prosthesis was used in 12 cases...
January 10, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28076830/rosuvastatin-improves-myocardial-and-neurological-outcomes-after-asphyxial-cardiac-arrest-and-cardiopulmonary-resuscitation-in-rats
#7
Yun Qiu, Yichen Wu, Min Meng, Man Luo, Hongmei Zhao, Hong Sun, Sumin Gao
Rosuvastatin, a potent HMG-CoA reductase inhibitor, is cholesterol-lowering drugs and reduce the risk of myocardial infarction and stroke. This study is to explore whether rosuvastatin improves outcomes after cardiac arrest in rats. Male Sprague-Dawley rats were subjected to 8min of cardiac arrest (CA) by asphyxia and randomly assigned to three experimental groups immediately following successful resuscitation: Sham; Control; and Rosuvastatin. The survival, hemodynamics, myocardial function, neurological outcomes and apoptosis were assessed...
January 8, 2017: Biomedicine & Pharmacotherapy, Biomédecine & Pharmacothérapie
https://www.readbyqxmd.com/read/28075105/heart-failure-due-to-reduced-ejection-fraction-medical-management
#8
William E Chavey, Robrt V Hogikyan, R Van Harrison, John M Nicklas
Heart failure is an increasingly common condition resulting in high rates of morbidity and mortality. For patients who have heart failure and reduced ejection fraction, randomized clinical trials demonstrate consistent mortality benefit from angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, direct-acting vasodilators, beta blockers, and aldosterone antagonists. Additionally, some data show benefits from two new classes of drugs: angiotensin receptor blocker/neprilysin inhibitor and sinus node modulator...
January 1, 2017: American Family Physician
https://www.readbyqxmd.com/read/28074340/clinical-significance-of-cathepsin-l-and-cathepsin-b-in-dilated-cardiomyopathy
#9
Siddharth Mehra, Manish Kumar, Mansi Manchanda, Ratnakar Singh, Bhaskar Thakur, Neha Rani, Sudheer Arava, Rajiv Narang, Dharamvir Singh Arya, Shyam S Chauhan
Dysregulated expression of lysosomal cysteine cathepsins is associated with adverse cardiac remodeling, a characteristic of several cardiovascular diseases. However, the information regarding the role of cysteine cathepsin L (CTSL) and cathepsin B (CTSB) in dilated cardiomyopathy (DCM) is limited. The present study was aimed to investigate the expression of CTSL and CTSB in animal model of doxorubicin (doxo)-induced cardiomyopathy as well as in peripheral blood samples of DCM patients. Cardiac tissue sections from doxo-treated and control rats were used to study the expression of CTSL and CTSB by enzyme assay and immunohistochemistry (IHC)...
January 10, 2017: Molecular and Cellular Biochemistry
https://www.readbyqxmd.com/read/28073805/sheet-like-remodeling-of-the-transverse-tubular-system-in-human-heart-failure-impairs-excitation-contraction-coupling-and-functional-recovery-by-mechanical-unloading
#10
Thomas Seidel, Sutip Navankasattusas, Azmi A Ahmad, Nikolaos A Diakos, Weining D Xu, Martin Tristani-Firouzi, Michael Bonios, Iosif Taleb, Dean Y Li, Craig H Selzman, Stavros G Drakos, Frank B Sachse
BACKGROUND: -Cardiac recovery in response to mechanical unloading by left ventricular assist devices (LVADs) has been demonstrated in subgroups of chronic heart failure (HF) patients. Hallmarks of HF are depletion and disorganization of the transverse tubular system (t-system) in cardiomyocytes. Here, we investigated remodeling of the t-system in human end-stage HF and its role in cardiac recovery. METHODS: -Left ventricular biopsies were obtained from 5 donors (CTRL) and 26 chronic HF patients undergoing implantation of LVADs...
January 10, 2017: Circulation
https://www.readbyqxmd.com/read/28073804/hemodynamic-support-with-a-micro-axial-percutaneous-left-ventricular-assist-device-impella%C3%A2-protects-against-acute-kidney-injury-in-patients-undergoing-high-risk-percutaneous-coronary-intervention
#11
Michael P Flaherty, Sadip Pant, Samir V Patel, Tyler Kilgore, Sujith Dassanayaka, John Loughran, Wasiq Rawasia, Buddhadeb Dawn, Allen Cheng, Carlo R Bartoli
RATIONALE: Acute kidney injury (AKI) is common during high-risk percutaneous coronary intervention (PCI) particularly in those with severely reduced left ventricular (LV) ejection fraction (EF). The impact of partial hemodynamic support with a micro-axial percutaneous LV assist device (pLVAD) on renal function following high-risk PCI remains unknown. OBJECTIVE: We tested the hypothesis that partial hemodynamic support with the Impella 2.5 micro-axial pLVAD during high-risk PCI protected against AKI...
January 10, 2017: Circulation Research
https://www.readbyqxmd.com/read/28069008/accuracy-of-echocardiographic-area-length-method-in-chronic-myocardial-infarction-comparison-with-cardiac-ct-in-pigs
#12
Haitham Ballo, Miikka Tarkia, Matti Haavisto, Christoffer Stark, Marjatta Strandberg, Tommi Vähäsilta, Virva Saunavaara, Tuula Tolvanen, Mika Teräs, Ville-Veikko Hynninen, Timo Savunen, Anne Roivainen, Juhani Knuuti, Antti Saraste
BACKGROUND: We evaluated echocardiographic area-length methods to measure left ventricle (LV) volumes and ejection fraction (EF) in parasternal short axis views in comparison with cardiac computed tomography (CT) in pigs with chronic myocardial infarction (MI). METHODS: Male farm pigs with surgical occlusion of the left anterior descending coronary artery (n = 9) or sham operation (n = 5) had transthoracic echocardiography and cardiac-CT 3 months after surgery...
January 9, 2017: Cardiovascular Ultrasound
https://www.readbyqxmd.com/read/28068900/galectin-3-and-fibulin-1-in-systolic-heart-failure-relation-to-glucose-metabolism-and-left-ventricular-contractile-reserve
#13
Pernille Holmager, Michael Egstrup, Ida Gustafsson, Morten Schou, Jordi S Dahl, Lars Melholt Rasmussen, Jacob E Møller, Christian Tuxen, Jens Faber, Caroline Kistorp
BACKGROUND: Heart failure (HF) patients with diabetes (DM) have an adverse prognosis and reduced functional capacity, which could be associated with cardiac fibrosis, increased chamber stiffness and reduced left ventricular (LV) contractile reserve. Galectin-3 (Gal-3) and fibulin-1 are circulating biomarkers potentially reflecting cardiac fibrosis. We hypothesize that plasma levels of Gal-3 and fibulin-1 are elevated in HF patients with DM and are associated with reduced LV contractile reserve in these patients...
January 10, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28065654/challenging-cardiac-function-post-spinal-cord-injury-with-dobutamine
#14
Kathryn M DeVeau, Emily K Martin, Nicholas T King, Alice Shum-Siu, Bradley B Keller, Christopher R West, David S K Magnuson
There is general consensus that spinal cord injuries (SCI) above T6 result in altered sympathetic control of the heart, which negatively influences cardiac structure and function. To by-pass disrupted circuitry and investigate cardiac responses under enhanced sympathetic activity we utilized dobutamine (DOB) stress echocardiography. Animals were divided into a T2, 25g-cm contusive SCI (SCI) or an uninjured control (CON) group. Echocardiography was performed pre-SCI and at 1, 2 and 6weeks post-SCI. Increasing doses of DOB (5, 10 & 20μg/min/kg) were infused intravenously pre-SCI and at 1 and 6weeks post-SCI...
December 23, 2016: Autonomic Neuroscience: Basic & Clinical
https://www.readbyqxmd.com/read/28065583/left-ventricular-contraction-pattern-in-chronic-aortic-regurgitation-and-preserved-ejection-fraction-simultaneous-stress-strain-analysis-by-three-dimensional-echocardiography
#15
Kaspar Broch, Stefano F de Marchi, Richard Massey, Jonny Hisdal, Svend Aakhus, Lars Gullestad, Stig Urheim
BACKGROUND: The role of speckle-tracking echocardiography in the assessment of chronic aortic regurgitation (AR) is not established. Load dependency may encumber the interpretation of strain measurements in the chronically overloaded left ventricle. The aim of this study was to investigate the mechanisms of left ventricular (LV) contraction patterns in asymptomatic patients with moderate to severe AR and preserved ejection fractions. METHODS: In this prospective, cross-sectional study, 31 patients with moderate to severe AR, 15 elite endurance athletes, and 17 healthy control subjects were examined using three-dimensional speckle-tracking echocardiography...
January 5, 2017: Journal of the American Society of Echocardiography
https://www.readbyqxmd.com/read/28062623/a-novel-lipid-biomarker-panel-for-the-detection-of-heart-failure-with-reduced-ejection-fraction
#16
Matthias Mueller-Hennessen, Hans-Dirk Düngen, Matthias Lutz, Tobias Daniel Trippel, Michael Kreuter, Johanna Sigl, Oliver J Müller, Elvis Tahirovic, Henning Witt, Philipp Ternes, Susan Carvalho, Erik Peter, Dietrich Rein, Philipp Schatz, Felix Herth, Evangelos Giannitsis, Tanja Weis, Norbert Frey, Hugo A Katus
OBJECTIVES: In this study we aimed to identify novel metabolomic biomarkers suitable for improved diagnosis of heart failure with reduced ejection fraction (HFrEF). METHODS: We prospectively recruited 887 individuals consisting of HFrEF patients with either ischemic (ICMP, n = 257) or nonischemic cardiomyopathy (NICMP, n = 269), healthy controls (n = 327), and patients with pulmonary diseases (n = 34). A single-center identification (n = 238) was followed by a multicenter confirmation study (n = 649)...
January 2017: Clinical Chemistry
https://www.readbyqxmd.com/read/28062617/growth-differentiation-factor-15-as-a-biomarker-in-cardiovascular-disease
#17
REVIEW
Kai C Wollert, Tibor Kempf, Lars Wallentin
BACKGROUND: Growth differentiation factor 15 (GDF-15) is expressed and secreted in response to inflammation, oxidative stress, hypoxia, telomere erosion, and oncogene activation. Cardiovascular (CV) disease is a major driver of GDF-15 production. GDF-15 has favorable preanalytic characteristics and can be measured in serum and plasma by immunoassay. CONTENT: In community-dwelling individuals higher concentrations of GDF-15 are associated with increased risks of developing CV disease, chronic kidney disease, and cancer, independent of traditional CV risk factors, renal function, and other biomarkers (C-reactive protein, B-type natriuretic peptide, cardiac troponin)...
January 2017: Clinical Chemistry
https://www.readbyqxmd.com/read/28062537/effects-of-coping-skills-training-on-quality-of-life-disease-biomarkers-and-clinical-outcomes-in-patients-with-heart-failure-a-randomized-clinical-trial
#18
Andrew Sherwood, James A Blumenthal, Gary G Koch, Benson M Hoffman, Lana L Watkins, Patrick J Smith, Christopher M O'Connor, Kirkwood F Adams, Joseph G Rogers, Carla Sueta, Patricia P Chang, Kristy S Johnson, Jeanne Schwartz, Alan L Hinderliter
BACKGROUND: Heart failure (HF) is a chronic disease that compromises patients' quality of life (QoL). Interventions designed to reduce distress and improve disease self-management are needed. We evaluated the efficacy of a telephone-based coping skills training (CST) intervention. METHODS AND RESULTS: This randomized clinical trial involved 180 HF outpatients with reduced ejection fraction. Participants ranged in age from 29 to 87 years (mean=58 years); 27% were women, and 47% were nonwhite...
January 2017: Circulation. Heart Failure
https://www.readbyqxmd.com/read/28060547/the-safety-of-sacubitril-valsartan-for-the-treatment-of-chronic-heart-failure
#19
Jeffrey M Tyler, John R Teerlink
Sacubitril-valsartan is a combination drug that contains the neprilysin inhibitor sacubitril and angiotensin II receptor blocker valsartan. In 2015, the US Food and Drug Administration approved sacubitril-valsartan for treatment of heart failure patients with reduced ejection fraction and New York Heart Association class II-IV symptoms following a large, Phase III clinical trial (PARADIGM-HF) that demonstrated a 20% reduction in the combined primary end-point of death from cardiovascular cause or hospitalization for heart failure compared to enalapril...
January 6, 2017: Expert Opinion on Drug Safety
https://www.readbyqxmd.com/read/28052978/the-diabetic-hfpef-phenotype-is-it-real-and-is-it-worth-targeting-therapeutically
#20
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
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