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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
Kotaro Nochioka, Yasuhiko Sakata, Hiroaki Shimokawa
Renin-angiotensin-aldosterone system (RAAS) and sympathetic nervous system play crucial roles in heart failure with reduced ejection fraction (HFrEF). Clinical trials provide strong evidence of prognostic benefits for combination therapy with angiotensin-converting enzyme inhibitor (ACEI) and β-blocker in the treatment of HFrEF. Angiotensin receptor blocker (ARB) is not superior to ACEI in improving mortality and an alternative for patients who are intolerant to ACEI. Prognostic evidence for triple therapy which combined angiotensin receptor blocker (ARB) and ACEI in addition to β-blocker therapy, is still controversial in HFrEF...
March 15, 2018: Advances in Experimental Medicine and Biology
Jeehoon Kang, Jin Joo Park, Young-Jin Cho, Il-Young Oh, Hyun-Ah Park, Sang Eun Lee, Min-Seok Kim, Hyun-Jai Cho, Hae-Young Lee, Jin Oh Choi, Kyung-Kuk Hwang, Kye Hun Kim, Byung-Su Yoo, Seok-Min Kang, Sang Hong Baek, Eun-Seok Jeon, Jae-Joong Kim, Myeong-Chan Cho, Shung Chull Chae, Byung-Hee Oh, Dong-Ju Choi
BACKGROUND: Worsening renal function (WRF) is associated with adverse outcomes in patients with heart failure. We investigated the predictors and prognostic value of WRF during admission, in patients with preserved ejection fraction (HFpEF) versus those with reduced ejection fraction (HFrEF). METHODS AND RESULTS: A total of 5625 patients were enrolled in the KorAHF (Korean Acute Heart Failure) registry. WRF was defined as an absolute increase in creatinine of ≥0...
March 13, 2018: Journal of the American Heart Association
L Li, Q Mo, T Mo, Y Liu, J L Tian, Z Wan
Objective: To investigate the clinical characteristics and pharmaceutical therapy of elderly patients with chronic heart failure (CHF). Methods: Using the multi-center retrospective cross-sectional survey, we analyzed 1 799 hospitalized patients with CHF as the main cause and NYHA heart function classification Ⅱ-Ⅳ from nine tertiary hospitals of Tianjin during March 2014 to February 2016. According to age, we divided them into non- elderly group(age<65 years), normal elderly group (age ≥65-79 years), and the old elderly group(age≥80 years)...
March 6, 2018: Zhonghua Yi Xue za Zhi [Chinese medical journal]
Raza M Alvi, Noor Tariq, Atul Malhotra, Magid Awadalla, Virginia Triant, Markella V Zanni, Tomas G Neilan
Background: Sleep apnea (SA) is common and has prognostic significance among broad groups of patients with heart failure (HF). Among persons living with HIV (PLHIV), both SA and HF are reported. However, there are no data characterizing the presence, associations and prognostic significance of SA among PLHIV with HF. Methods: We conducted a single center study of PLHIV admitted with HFrEF (LVEF of <50%) and analyzed the relationship of SA with 30-day HF hospital readmission rate, cardiovascular (CV) and all-cause mortality...
March 9, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Peter H Khalil, Ghazal Kabbach, Debabrata Mukherjee, Sarmad Said
Heart Failure (HF) is one of the main health care burdens in the United States and in the world. Many drugs are approved and used in practice for management of this condition; including beta blockers, diuretics, aldosterone antagonists, angiotensin converting enzyme inhibitors (ACEI's), and angiotensin receptor blockers (ARBs). Recently, the Food and Drug Administration (FDA) approved a drug with brand name Entresto (Sacubitril/Valsartan or LCZ696), an angiotensin receptor neprilysin inhibitor for the use in Heart Failure with Reduced Ejection Fraction (HFrEF) patients instead of ACEI's and ARBs...
March 13, 2018: Cardiovascular & Hematological Agents in Medicinal Chemistry
Alberto Palazzuoli, Gaetano Ruocco, Matteo Beltrami, Ranuccio Nuti, John G Cleland
BACKGROUND: Lung ultrasound (LUS) can be used to assess pulmonary congestion by imaging B-lines ('comets') for patients with acute heart failure (AHF). OBJECTIVES: Investigate relationship of B-lines, plasma concentrations of B-type natriuretic peptide (BNP), and echocardiographic left ventricular (LV) function measured at admission and discharge and their relationship to prognosis for AHF with preserved (HFpEF) or reduced (HFrEF) LV ejection fraction. METHODS: Patients with AHF had the above tests done at admission and discharge...
March 12, 2018: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
Cole S Bailey, Luke T Wooster, Mary Buswell, Sarvagna Patel, Paul P Pappagianopoulos, Kristian Bakken, Casey White, Melissa Tanguay, Jasmine B Blodgett, Aaron L Baggish, Rajeev Malhotra, Gregory D Lewis
OBJECTIVES: This study sought to characterize the functional and prognostic significance of oxygen uptake (VO2 ) kinetics following peak exercise in individuals with heart failure (HF). BACKGROUND: It is unknown to what extent patterns of VO2 recovery following exercise reflect circulatory response during exercise in HF with preserved ejection fraction (HFpEF) and HF with reduced ejection fraction (HFrEF). METHODS: We investigated patients (30 HFpEF, 20 HFrEF, and 22 control subjects) who underwent cardiopulmonary exercise testing with invasive hemodynamic monitoring and a second distinct HF cohort (n = 106) who underwent noninvasive cardiopulmonary exercise testing with assessment of long-term outcomes...
March 1, 2018: JACC. Heart Failure
Özcan Örsçelik, Buğra Özkan, Ayça Arslan, Emre Ertan Şahin, Ozan Sakarya, Orçun Ali Sürmeli, Şenay Balcı Fidancı, Ahmet Çelik, Burak Yavuz Çimen, İsmail Türkay Özcan
OBJECTIVE: Heart failure (HF) is a clinical syndrome resulting from structural or functional damages. Although clinical trials have shown that the plasma renin-angiotensin system (RAS) activation decreases HF functional status and increases hospitalization for HF patients, the effect of intrarenal RAS activity is still unknown. In this study, we investigated the relationship between the New York Heart Association (NYHA) class, duration, and number of hospitalizations in the previous year and urinary angiotensinogen (UAGT) in patients with HF with reduced ejection fraction (HFrEF)...
March 2018: Anatolian Journal of Cardiology
Petar M Seferović, Mark C Petrie, Gerasimos S Filippatos, Stefan D Anker, Giuseppe Rosano, Johann Bauersachs, Walter J Paulus, Michel Komajda, Francesco Cosentino, Rudolf A de Boer, Dimitrios Farmakis, Wolfram Doehner, Ekaterini Lambrinou, Yuri Lopatin, Massimo F Piepoli, Michael J Theodorakis, Henrik Wiggers, John Lekakis, Alexandre Mebazaa, Mamas A Mamas, Carsten Tschöpe, Arno W Hoes, Jelena P Seferović, Jennifer Logue, Theresa McDonagh, Jillian P Riley, Ivan Milinković, Marija Polovina, Dirk J van Veldhuisen, Mitja Lainscak, Aldo P Maggioni, Frank Ruschitzka, John J V McMurray
The coexistence of type 2 diabetes mellitus (T2DM) and heart failure (HF), either with reduced (HFrEF) or preserved ejection fraction (HFpEF), is frequent (30-40% of patients) and associated with a higher risk of HF hospitalization, all-cause and cardiovascular (CV) mortality. The most important causes of HF in T2DM are coronary artery disease, arterial hypertension and a direct detrimental effect of T2DM on the myocardium. T2DM is often unrecognized in HF patients, and vice versa, which emphasizes the importance of an active search for both disorders in the clinical practice...
March 8, 2018: European Journal of Heart Failure
Wally Omar, Ambarish Pandey, Mark J Haykowsky, Jarett D Berry, Carl J Lavie
PURPOSE OF REVIEW: This paper highlights the dynamic relationship between cardiorespiratory fitness (CRF) and heart failure (HF). As heart failure with preserved ejection fraction (HFpEF) surpasses heart failure with reduced ejection fraction (HFrEF) in prevalence, our void in understanding how to treat this syndrome becomes less justifiable. As such, significant attention has been given to the role that obesity and physical inactivity play, as both risk factors for heart failure, and therapeutic targets for its treatment...
March 8, 2018: Current Heart Failure Reports
R De Vecchis, C Ariano, G Di Biase, M Noutsias
INTRODUCTION: In heart failure with reduced left ventricular ejection fraction (HFREF) patients, the dosage of sacubitril/valsartan is modulated according to a gradual increase regimen. Nevertheless, if patients exhibit tolerability problems, a provisional reduction of the dose of sacubitril/valsartan or even its interruption are recommended. MATERIAL AND METHODS: This study provides estimates of respective proportions of patients receiving minimum or intermediate doses of sacubitril/valsartan...
March 8, 2018: Herz
Patricia P Chang, Lisa M Wruck, Eyal Shahar, Joseph S Rossi, Laura R Loehr, Stuart D Russell, Sunil K Agarwal, Suma H Konety, Carlos J Rodriguez, Wayne D Rosamond
Background -Community trends of acute decompensated heart failure (ADHF) in diverse populations may differ by race and sex. Methods -The Atherosclerosis Risk in Communities (ARIC) Study sampled heart failure related hospitalizations (age ≥55 years) in four US communities from 2005-2014 using ICD-9-CM codes. ADHF hospitalizations were validated by standardized physician review and computer algorithm, yielding 40,173 events after accounting for sampling design (unweighted n=8746). Results -Of the ADHF hospitalizations, 50% had reduced ejection fraction (HFrEF), 39% had preserved EF (HFpEF)...
March 8, 2018: Circulation
Yasuhiko Sakata, Kanako Tsuji, Kotaro Nochioka, Hiroaki Shimokawa
Along with a worldwide epidemiological transition and dramatic increase in the elderly population, both the incidence and prevalence of heart failure (HF) are increasing worldwide. This epidemic of HF is characterized by an increase of HF with preserved left ventricular ejection fraction (LVEF) (HFpEF) and a decrease of HF with reduced LVEF (HFrEF). Of note, transition between HFpEF and HFrEF has been recently highlighted, since it significantly relates with prognosis. Our recent studies indicated that temporary changes in LVEF are common and associated with prognosis in patients with HF...
March 8, 2018: Advances in Experimental Medicine and Biology
Ki Hong Choi, Ga Yeon Lee, Jin-Oh Choi, Eun-Seok Jeon, Hae-Young Lee, Hyun-Jai Cho, Sang Eun Lee, Min-Seok Kim, Jae-Joong Kim, Kyung-Kuk Hwang, Shung Chull Chae, Sang Hong Baek, Seok-Min Kang, Dong-Ju Choi, Byung-Su Yoo, Kye Hun Kim, Hyun-Young Park, Myeong-Chan Cho, Byung-Hee Oh
BACKGROUND: After introduction of up-titration strategy, there are limited data on comparison between the effects of angiotensin converting enzyme inhibitors (ACEI) and angiotensin receptor blocker (ARB) in patients with heart failure with reduced ejection fraction (HFrEF). The study sought to investigate the association between treatment with ARB at discharge and clinical outcomes in patients with HFrEF compared with treatment with ACEI or no renin angiotensin system blocker (RASB). METHODS: The KorAHF registry is a prospective multicenter cohort and included patients who were hospitalized for acute heart failure (AHF)...
April 15, 2018: International Journal of Cardiology
Kristin H Dwyer, Allison A Merz, Eldrin Lewis, Brian Claggett, Daniela R Crousillat, Emily S Lau, Montane B Silverman, Julie Peck, Jose Rivero, Susan Cheng, Elke Platz
BACKGROUND: Although pulmonary congestion can be quantified by lung ultrasonography (LUS) in heart failure (HF), little is known about LUS findings (B-lines) in different HF phenotypes. This prospective cohort study investigated the prevalence, clinical and echocardiographic correlates of B-lines in ambulatory HF patients with preserved (HFpEF) or reduced ejection fraction (HFrEF) compared with hypertensive patients. We related LUS findings to 12-month HF hospitalizations and all-cause mortality...
February 27, 2018: Journal of Cardiac Failure
Adriana Mihaela Ilieșiu, Andreea Simona Hodorogea
Heart failure with preserved ejection fraction (HFpEF) is a growing epidemiologic problem affecting more than half of the patients with heart failure (HF). HFpEF has a significant morbidity and mortality and so far no treatment has been clearly demonstrated to improve the outcomes in HFpEF, in contrast to the efficacy of treatment in heart failure with reduced ejection fraction (HFrEF).The failure of proven beneficial drugs in HFrEF to influence the outcome of patients with HFpEF could be related to the heterogeneity of the disease, its various phenotypes and multifactorial pathophysiology, incompletely elucidated yet...
March 2, 2018: Advances in Experimental Medicine and Biology
Jonathan K Ehrman, Clinton A Brawner, Ali Shafiq, David E Lanfear, Matthew Saval, Steven J Keteyian
BACKGROUND: This study evaluated if different prognostic characteristics exist for peak VO2 , percent predicted peak VO2 (ppVO2 ), and the VE -VCO2 slope between men and women with heart failure and reduced ejection fraction (HFrEF). METHODS: Analysis of the FIT-CPX database (n=1,085; 33% women, 55% black) of individuals with HFrEF who completed a physician-referred CPX between 1997 and 2010. Primary outcome was a composite of all-cause death, left ventricular assist device (LVAD) placement, and orthotopic heart transplant (OHT)...
February 26, 2018: Journal of Cardiac Failure
Á Hernáez, J F Delgado, J Cinca, F Fernández-Avilés, J Marrugat
BACKGROUND AND OBJECTIVES: Hyperkalaemia (K+ levels≥5.5mmol/L) is a severe ion imbalance that occurs in patients who have heart failure (HF) with reduced ejection fraction (HFrEF) and increases the risk of ventricular fibrillation. Given that there are no estimates on the number of patients with this complication, the aim of this study was to estimate the prevalence and incidence of hyperkalaemia in patients with HFrEF in Spain. MATERIAL AND METHODS: Based on a systematic literature search and through a meta-analysis, we calculated an HFrEF prevalence of ≤40% in the European and U...
February 26, 2018: Revista Clínica Española
Azmil H Abdul-Rahim, Li Shen, Christopher J Rush, Pardeep S Jhund, Kennedy R Lees, John J V McMurray
AIMS: To evaluate the effects of digoxin in patients with the newly described phenotype of heart failure (HF) and mid-range ejection fraction (HFmrEF), attributed to mild left ventricular systolic dysfunction. METHODS AND RESULTS: We carried out a retrospective analysis of the Digitalis Investigation Group (DIG) trial which had 7788 patients available for analysis with a left ventricular ejection fraction (LVEF) ranging between 3% and 85%. We compared the effect of digoxin to placebo in three mutually exclusive groups of patients defined by LVEF category: <40% (HF with reduced LVEF, HFrEF, n = 5874), 40-49% (HFmrEF, n = 1195) and ≥50% (HF with preserved LVEF, HFpEF, n = 719)...
March 1, 2018: European Journal of Heart Failure
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