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https://www.readbyqxmd.com/read/28329163/determinants-and-clinical-outcome-of-uptitration-of-ace-inhibitors-and-beta-blockers-in-patients-with-heart-failure-a-prospective-european-study
#1
W Ouwerkerk, A A Voors, S D Anker, J G Cleland, K Dickstein, G Filippatos, P van der Harst, H L Hillege, C C Lang, J M Ter Maaten, L L Ng, P Ponikowski, N J Samani, D J van Veldhuisen, F Zannad, M Metra, A H Zwinderman
Introduction: Despite clear guidelines recommendations, most patients with heart failure and reduced ejection-fraction (HFrEF) do not attain guideline-recommended target doses. We aimed to investigate characteristics and for treatment-indication-bias corrected clinical outcome of patients with HFrEF that did not reach recommended treatment doses of ACE-inhibitors/Angiotensin receptor blockers (ARBs) and/or beta-blockers. Methods and results: BIOSTAT-CHF was specifically designed to study uptitration of ACE-inhibitors/ARBs and/or beta-blockers in 2516 heart failure patients from 69 centres in 11 European countries who were selected if they were suboptimally treated while initiation or uptitration was anticipated and encouraged...
March 11, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28323173/outcomes-of-cardiac-resynchronization-therapy-in-patients-with-intermittent-atrial-fibrillation-or-atrial-flutter-in-the-companion-trial
#2
Matthew M Kalscheur, Leslie A Saxon, Byron K Lee, Jonathan S Steinberg, Chaoqun Mei, Kevin A Buhr, David L DeMets, Michael R Bristow, Steven N Singh
BACKGROUND: Controlled clinical trial data are lacking for cardiac resynchronization therapy (CRT) outcomes in patients with advanced heart failure (HF) from reduced left ventricular ejection fraction (HFrEF) and intermittent atrial fibrillation or flutter (AF/AFL). OBJECTIVE: To describe CRT outcomes in patients with intermittent AF/AFL and advanced HF. METHODS: HF outcomes in patients from the COMPANION trial with NYHA Class III or IV HFrEF, LVEF ≤ 0...
March 17, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/28322590/randomized-clinical-trials-of-gene-transfer-for-heart-failure-with-reduced-ejection-fraction
#3
William F Penny, H Kirk Hammond
Despite improvement in drug and device therapy for heart failure, hospitalization rates and mortality have changed little in the past decade. Randomized clinical trials using gene transfer to improve function of the failing heart are the focus of this review. Four randomized clinical trials of gene transfer in heart failure with reduced ejection fraction (HFrEF) have been published. Each enrolled patients with stable symptomatic HFrEF and used either intracoronary delivery of a virus vector or endocardial injection of a plasmid (1 trial)...
March 21, 2017: Human Gene Therapy
https://www.readbyqxmd.com/read/28321682/recent-advances-and-clinical-applications-of-pet-cardiac-autonomic-nervous-system-imaging
#4
REVIEW
Nabil E Boutagy, Albert J Sinusas
PURPOSE OF REVIEW: The purpose of this review was to summarize current advances in positron emission tomography (PET) cardiac autonomic nervous system (ANS) imaging, with a specific focus on clinical applications of novel and established tracers. RECENT FINDINGS: [(11)C]-Meta-hydroxyephedrine (HED) has provided useful information in evaluation of normal and pathological cardiovascular function. Recently, [(11)C]-HED PET imaging was able to predict lethal arrhythmias, sudden cardiac death (SCD), and all-cause mortality in heart failure patients with reduced ejection fraction (HFrEF)...
April 2017: Current Cardiology Reports
https://www.readbyqxmd.com/read/28321027/effects-of-long-acting-loop-diuretics-in-heart-failure-with-reduced-ejection-fraction-patients-with-cardiac-resynchronization-therapy
#5
Masahiko Asami, Jiro Aoki, Shuzou Tanimoto, Yu Horiuchi, Mika Watanabe, Koichi Furui, Kentaro Yasuhara, Tatsuyuki Sato, Kengo Tanabe, Kazuhiro Hara
There have been no reports evaluating the impact of long-acting loop diuretics (LLD) on the outcome of heart failure (HF) and arrhythmia treatment in HF with reduced ejection fraction (HFrEF) patients implanted with a cardiac resynchronization therapy (CRT) device.This was a prospective, single-blind, randomized crossover study. We allocated 21 consecutive CRT implanted patients into 2 groups. The furosemide group received furosemide as a first treatment and azosemide as a second treatment. The azosemide group received this treatment in the reverse order...
March 17, 2017: International Heart Journal
https://www.readbyqxmd.com/read/28318662/mid-range-left-ventricular-ejection-fraction-clinical-profile-and-cause-of-death-in-ambulatory-patients-with-chronic-heart-failure
#6
Domingo A Pascual-Figal, Andreu Ferrero-Gregori, Ines Gomez-Otero, Rafael Vazquez, Juan Delgado-Jimenez, Jesus Alvarez-Garcia, Juan R Gimeno-Blanes, Fernando Worner-Diz, Alfredo Bardají, Luis Alonso-Pulpon, Jose Ramon Gonzalez-Juanatey, Juan Cinca
BACKGROUND: The intermediate group of patients with heart failure (HF) and mid-range left ventricular ejection fraction (HFmrEF) may constitute a specific phenotype, but a direct evidence is lacking. This study aimed to know whether this HF category is accompanied by a particular clinical phenotype and prognosis. METHODS AND RESULTS: This study includes 3446 ambulatory patients with chronic HF from two national registries. According to EF at enrollment, patients were classified as reduced (HFrEF, <40%), mid-range (HFmrEF, 40-49%) or preserved (HFpEF, ≥50%)...
March 9, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28318656/clinical-characteristics-and-prognosis-of-patients-admitted-for-heart-failure-a-5-year-retrospective-study-of-african-patients
#7
Kwadwo Osei Bonsu, Isaac Kofi Owusu, Kwame Ohene Buabeng, Daniel D Reidpath, Amudha Kadirvelu
BACKGROUND: Mortality associated with heart failure (HF) remains high. There are limited clinical data on mortality among HF patients from African populations. We examined the clinical characteristics, long-term outcomes, and prognostic factors of African HF patients with preserved, mid-range or reduced left ventricular ejection fraction (LVEF). METHODS AND RESULTS: We conducted a retrospective longitudinal cohort study of individuals aged ≥18years discharged from first HF admission between January 1, 2009 and December 31, 2013 from the Cardiac Clinic, Directorate of Medicine of the Komfo Anokye Teaching Hospital, Ghana...
March 6, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28316006/management-of-heart-failure-with-preserved-ejection-fraction-current-challenges-and-future-directions
#8
REVIEW
Bharathi Upadhya, Dalane W Kitzman
Heart failure (HF) with preserved ejection fraction (HFpEF) is the most common form of HF in patients older than 65 years. Among elderly women living in the community, HFpEF comprises nearly 90% of incident HF cases. The health and economic impact of HFpEF is at least as great as that of HF with reduced ejection fraction (HFrEF), with similar severity of acute hospitalization rates and substantial mortality. Despite the importance of HFpEF, our understanding of its pathophysiology is incomplete, and optimal treatment remains largely undefined...
March 18, 2017: American Journal of Cardiovascular Drugs: Drugs, Devices, and Other Interventions
https://www.readbyqxmd.com/read/28315072/direct-myosin-activation-by-omecamtiv-mecarbil-for-heart-failure-with-reduced-ejection-fraction
#9
Mitchell A Psotka, John R Teerlink
Myosin is the indispensable molecular motor that utilizes chemical energy to produce force for contraction within the cardiac myocyte. Myosin activity is gated by intracellular calcium levels which are regulated by multiple upstream signaling cascades that can be altered for clinical utility using inotropic medications. In contrast to clinically available cardiac inotropes, omecamtiv mecarbil is a novel direct myosin activator developed to augment left ventricular systolic function without the undesirable secondary effects of altered calcium homeostasis...
March 18, 2017: Handbook of Experimental Pharmacology
https://www.readbyqxmd.com/read/28303624/effect-of-eplerenone-in-patients-with-heart-failure-and-reduced-ejection-fraction-potential-effect-modification-by-abdominal-obesity-insight-from-the-emphasis-hf-trial
#10
Arnaud Olivier, Bertram Pitt, Nicolas Girerd, Zohra Lamiral, Jean-Loup Machu, John J V McMurray, Karl Swedberg, Dirk J van Veldhuisen, Timothy J Collier, Stuart J Pocock, Patrick Rossignol, Faiez Zannad, Anne Pizard
AIMS: An excessive production of aldosterone influences outcome in patients with heart failure (HF) and in obese patients. Findings from laboratory studies suggest that chronic aldosterone blockade maybe more beneficial in abdominally obese HF-prone rats. In the current study, we investigated if the clinical response to a mineralocorticoid receptor antagonist in mildly symptomatic HF patients varied by abdominal obesity. METHODS AND RESULTS: A total of 2587 NYHA class II, reduced ejection fraction HF (HFrEF) patients enrolled in the EMPHASIS-HF trial were randomly assigned to eplerenone and placebo...
March 16, 2017: European Journal of Heart Failure
https://www.readbyqxmd.com/read/28302916/advances-in-heart-failure-a-review-of-biomarkers-emerging-pharmacological-therapies-durable-mechanical-support-and-telemonitoring
#11
REVIEW
Yasbanoo Moayedi, Heather J Ross
The purpose of this review is to provide an overview of diagnosis, prognosis and management of heart failure (HF) with reduced ejection fraction (HFrEF). Specifically, this review is divided into three sections. The first section will address biomarkers. The discovery of biomarkers has allowed further understanding of the pathophysiology of HF and provides insight into potential therapeutic targets. This review will focus on novel applications of natriuretic peptides (NPs) in clinical trials. Next, emerging biomarkers of HF, such as ST2, galectin-3 and copeptin, will be discussed...
April 1, 2017: Clinical Science (1979-)
https://www.readbyqxmd.com/read/28302709/acute-impact-of-conventional-and-eccentric-cycling-on-platelet-and-vascular-function-in-patients-with-chronic-heart-failure
#12
Andrew Haynes, Matthew D Linden, Lauren C Chasland, Kazunori Nosaka, Andrew J Maiorana, Ellen Adele Dawson, Lawrence Dembo, Louise H Naylor, Daniel J Green
Evidence-based guidelines recommend exercise therapy for patients with chronic heart failure (CHF). Such patients have increased atherothrombotic risk. Exercise can transiently increase platelet activation and reactivity and decrease vascular function in healthy participants, although data in CHF is scant. Eccentric (ECC) cycling is a novel exercise modality which may be particularly suited to patients with CHF, but the acute impacts of ECC on platelet and vascular function are currently unknown. Our null hypothesis was that ECC and concentric (CON) cycling, performed at matched external workloads, would not induce changes in platelet or vascular function in patients with CHF...
March 16, 2017: Journal of Applied Physiology
https://www.readbyqxmd.com/read/28295985/heart-failure-with-mid-range-ejection-fraction-a-distinct-clinical-entity-insights-from-the-trial-of-intensified-versus-standard-medical-therapy-in-elderly-patients-with-congestive-heart-failure-time-chf
#13
Peter Rickenbacher, Beat A Kaufmann, Micha T Maeder, Alain Bernheim, Kaatje Goetschalckx, Otmar Pfister, Matthias Pfisterer, Hans-Peter Brunner-La Rocca
AIMS: While the conditions of heart failure (HF) with reduced (HFrEF, LVEF < 40%) and preserved (HFpEF, LVEF ≥ 50%) left ventricular ejection fraction (LVEF) are well characterized, it is unknown whether patients with HF and mid-range LVEF (HFmrEF, LVEF 40-49%) have to be regarded as a separate clinical entity. The aim of this study was to characterize these three populations and to compare outcome and response to therapy. METHODS AND RESULTS: The analysis was based on the Trial of Intensified versus standard Medical therapy in Elderly patients with Congestive Heart Failure (TIME-CHF) comprising a population with established HF including the whole spectrum of LVEF...
March 15, 2017: European Journal of Heart Failure
https://www.readbyqxmd.com/read/28290795/-a-breakthrough-in-the-treatment-of-patients-with-heart-failure-with-reduced-ejection-fraction-the-clinical-significance-of-the-paradigm-hf-trial
#14
Zh D Kobalava, S V Villevalde, O I Lukina
The implementation into clinical practice of new therapeutic strategies that could improve the prognosis of patients with heart failure (HF) with reduced ejection fraction (HFrEF) remains relevant. Innovative approach is to restore imbalances of neurohumoral systems by inhibiting angiotensin II receptor and neprilysin. The review presents the role of the natriuretic peptides system in the HFrEF pathophysiology, historical approaches to neurohormonal modulation, clinical pharmacology of the first in the class of angiotensin receptor and neprilysin inhibitor sakubitril/valsartan...
February 2017: Kardiologiia
https://www.readbyqxmd.com/read/28289533/ivabradine-in-the-treatment-of-systolic-heart-failure-a-systematic-review-and-meta-analysis
#15
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/28284756/feasibility-and-association-of-neurohumoral-blocker-uptitration-following-cardiac-resynchronization-therapy
#16
Pieter Martens, Frederik H Verbrugge, Petra Nijst, Philippe Pb Bertrand, Matthias Dupont, Wilson Wh Tang, Wilfried Mullens
BACKGROUND Cardiac resynchronization therapy (CRT) improves mortality and morbidity on top of optimal medical therapy in heart failure with reduced ejection fraction (HFrEF). This study aims to elucidate the association between neurohumoral blocker uptitration following CRT-implantation and clinical outcome. METHODS & RESULTS Doses of angiotensin-converting enzyme inhibitors (ACE-I), angiotensin receptor blockers (ARB) and beta-blockers were retrospectively evaluated in 650 consecutive CRT patients implanted between October 2008 and August 2015 and followed in a tertiary multi-disciplinary CRT clinic...
March 8, 2017: Journal of Cardiac Failure
https://www.readbyqxmd.com/read/28282705/study-of-serum-uric-acid-levels-in-myocardial-infarction-and-its-association-with-killip-class
#17
Maryam Mehrpooya, Farnoosh Larti, Younes Nozari, Roya Sattarzadeh-Badkoobeh, Amir Farhang Zand Parsa, Jayran Zebardast, Anahita Tavoosi, Fatemeh Shahbazi
The present study aimed to compare the serum level of uric acid in patients with and without heart failure and also to determine the association between uric acid level and clinical status by Killip class in patients with STEMI. This case-control study was conducted on 50 consecutives as control group and 50 patients with acute heart failure, (20 patients had acute STEMI), who documented by both clinical conditions and echocardiography assessment. The mean plasma level of uric acid in the case group was 7.6±1...
February 2017: Acta Medica Iranica
https://www.readbyqxmd.com/read/28269196/characterization-of-patient-specific-biventricular-mechanics-in-heart-failure-with-preserved-ejection-fraction-hyperelastic-warping
#18
Hua Zou, Xiaodan Zhao, Xi Ce, Lik Chuan Lee, Martin Genet, Yi Su, Rusan Tan, Liang Zhong
Heart failure with preserved ejection fraction (HFPEF) is considered as a major public health problem. Traditionally, HFPEF is diagnosed based on a "normal" EF, but the studies have explored the potential role of left ventricular mechanics. Furthermore, right ventricular mechanics and bi-ventricular interaction in HFPEF is currently not well understood. In this study, we aim to develop a framework using a hyperelastic warping approach to quantify bi-ventricular and septum strains from cardiac magnetic resonance (CMR) images...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28260318/-clinical-value-of-bendopnea-in-chronic-heart-failure-patients-with-reduced-left-ventricular-ejection-fraction
#19
F Niu, Q Ma, N R Liu, J H Chen, J Ren
Objective: To explore the clinical value of bendopnea in chronic heart failure patients with reduced ejection fraction (HFrEF). Methods: According to the existence of bendopnea or not, a total of 192 consecutive chronic heart failure patients with HFrEF admitted to our department from January 2014 to January 2016 were divided into the bendopnea group and non-bendopnea group. Subgroup analysis was performed in the subgroups with various bendopnea symptoms appearance time (0-10 s, 11-20 s and 21-30 s). The relationship between bendopnea and left ventricular ejection fraction (LVEF), 6-minute walking distance (6-MWD), NT-proBNP and NYHA classification were analyzed...
February 24, 2017: Zhonghua Xin Xue Guan Bing za Zhi
https://www.readbyqxmd.com/read/28259550/current-use-of-guideline-based-medical-therapy-in-elderly-patients-admitted-with-acute-heart-failure-with-reduced-ejection-fraction-and-its-impact-on-event-free-survival
#20
Keitaro Akita, Takashi Kohno, Shun Kohsaka, Yasuyuki Shiraishi, Yuji Nagatomo, Yuki Izumi, Ayumi Goda, Atsushi Mizuno, Mitsuaki Sawano, Taku Inohara, Keiichi Fukuda, Tsutomu Yoshikawa
BACKGROUND: Acute heart failure (HF) is a frequently encountered cardiac condition. Its prevalence increases exponentially with age. In spite of this, elderly patients are underrepresented in clinical trials and the implementation of guideline-based medical therapy (GBMT) in them is not well established. We investigated the current use of GBMT and its effects on mortality and HF rehospitalization among elderly patients with acute HF with reduced ejection fraction (HFrEF) using data obtained from a contemporary multi-center registry...
February 24, 2017: International Journal of Cardiology
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