G Michael Felker, Robert J Mentz, Robert T Cole, Kirkwood F Adams, Gregory F Egnaczyk, Mona Fiuzat, Chetan B Patel, Melvin Echols, Michel G Khouri, James M Tauras, Divya Gupta, Pamela Monds, Rhonda Roberts, Christopher M O'Connor
BACKGROUND: The oral vasopressin-2 receptor antagonist tolvaptan causes aquaresis in patients with volume overload, potentially facilitating decongestion and improving the clinical course of patients with acute heart failure (AHF). OBJECTIVES: The TACTICS-HF (Targeting Acute Congestion with Tolvaptan in Congestive Heart Failure) study was conducted to address the acute use of tolvaptan to improve congestion in AHF. METHODS: The TACTICS-HF study randomized patients (n = 257) within 24 h of AHF presentation in a prospective, double blind, placebo-controlled trial...
March 21, 2017: Journal of the American College of Cardiology
Xi-Min He, Lin Chen, Jiang-Bin Luo, Xu-Xia Feng, Yun-Bo Zhang, Qi-Jing Chen, Xiao-Li Ji, Tian-Song Wang
OBJECTIVE: To investigate the effects of exogenous recombinant human brain natriuretic peptide (rhBNP) after primary percutaneous coronary intervention (PCI) on non-invasive hemodynamic in acute myocardial infarction patients with left ventricular failure. METHODS: A number of 96 acute myocardial infarction patients accompanied with heart failure after PCI hospitalized in the People's Hospital of Sanya during February 2012 to October 2015 were selected. They were randomly divided into the therapy group (n = 50) and control group (n = 46)...
August 2016: Asian Pacific Journal of Tropical Medicine
Robert L Page, Cindy L O'Bryant, Davy Cheng, Tristan J Dow, Bonnie Ky, C Michael Stein, Anne P Spencer, Robin J Trupp, JoAnn Lindenfeld
Heart failure is a common, costly, and debilitating syndrome that is associated with a highly complex drug regimen, a large number of comorbidities, and a large and often disparate number of healthcare providers. All of these factors conspire to increase the risk of heart failure exacerbation by direct myocardial toxicity, drug-drug interactions, or both. This scientific statement is designed to serve as a comprehensive and accessible source of drugs that may cause or exacerbate heart failure to assist healthcare providers in improving the quality of care for these patients...
August 9, 2016: Circulation
Piotr Ponikowski, Adriaan A Voors, Stefan D Anker, Héctor Bueno, John G F Cleland, Andrew J S Coats, Volkmar Falk, José Ramón González-Juanatey, Veli-Pekka Harjola, Ewa A Jankowska, Mariell Jessup, Cecilia Linde, Petros Nihoyannopoulos, John T Parissis, Burkert Pieske, Jillian P Riley, Giuseppe M C Rosano, Luis M Ruilope, Frank Ruschitzka, Frans H Rutten, Peter van der Meer
No abstract text is available yet for this article.
July 14, 2016: European Heart Journal
Salvatore Paterna, Francesca Di Gaudio, Vincenzo La Rocca, Fabio Balistreri, Massimiliano Greco, Daniele Torres, Umberto Lupo, Giuseppina Rizzo, Pietro di Pasquale, Sergio Indelicato, Francesco Cuttitta, Javed Butler, Gaspare Parrinello
INTRODUCTION: Diuretic responsiveness in patients with chronic heart failure (CHF) is better assessed by urine production per unit diuretic dose than by the absolute urine output or diuretic dose. Diuretic resistance arises over time when the plateau rate of sodium and water excretion is reached prior to optimal fluid elimination and may be overcome when hypertonic saline solution (HSS) is added to high doses of furosemide. METHODS: Forty-two consecutively hospitalized patients with refractory CHF were randomized in a 1:1:1 ratio to furosemide doses (125 mg, 250 mg, 500 mg) so that all patients received intravenous furosemide diluted in 150 ml of normal saline (0...
October 2015: Advances in Therapy
Shane Nanayakkara, David M Kaye
PURPOSE: The purpose of this article was to review the clinical management of patients with heart failure with preserved ejection fraction (HFPEF). METHODS: For this critical review, electronic databases (MEDLINE, EMBASE, PubMed) were searched for relevant basic research studies and randomized clinical trials recently published or presented at major meetings. Details of in-progress or planned studies were obtained from the website. The range of publication dates was the year 2000 to 2015...
October 1, 2015: Clinical Therapeutics
Ahmed Hassaan Qavi, Rida Kamal, Robert W Schrier
Diuretics play significant role in pharmacology and treatment options in medicine. This paper aims to review and evaluate the clinical use of diuretics in conditions that lead to fluid overload in the body such as cardiac failure, cirrhosis, and nephrotic syndrome. To know the principles of treatment it is essential to understand the underlying pathophysiological mechanisms that cause the need of diuresis in the human body. Various classes of diuretics exist, each having a unique mode of action. A systemic approach for management is recommended based on the current guidelines, starting from thiazides and proceeding to loop diuretics...
2015: International Journal of Nephrology
Dalane W Kitzman, Bharathi Upadhya, Sujethra Vasu
No abstract text is available yet for this article.
February 10, 2015: Circulation
Pierre V Ennezat, Merrill Stewart, Rohan Samson, Nadia Bouabdallaoui, Sylvestre Maréchaux, Carlo Banfi, Hélène Bouvaist, Thierry H Le Jemtel
Recent therapeutic trials regarding the management of acute heart failure (AHF) failed to demonstrate the efficacy of newer therapeutic modalities and agents. Low- versus high-dose and continuous administration of furosemide were shown not to matter. Ultrafiltration was not found to be more efficacious than sophisticated diuretic therapy including dose-adjusted intravenous furosemide and metolazone. Dopamine and nesiritide were not shown to be superior to current therapy. Tezosentan and tovalptan had no effect on mortality...
February 2016: European Heart Journal. Acute Cardiovascular Care
H Thomas Robertson
An elevated physiological dead space, calculated from measurements of arterial CO2 and mixed expired CO2, has proven to be a useful clinical marker of prognosis both for patients with acute respiratory distress syndrome and for patients with severe heart failure. Although a frequently cited explanation for an elevated dead space measurement has been the development of alveolar regions receiving no perfusion, evidence for this mechanism is lacking in both of these disease settings. For the range of physiological abnormalities associated with an increased physiological dead space measurement, increased alveolar ventilation/perfusion ratio (V'A/Q') heterogeneity has been the most important pathophysiological mechanism...
June 2015: European Respiratory Journal
Adrian F Hernandez, Xiaojuan Mi, Bradley G Hammill, Stephen C Hammill, Paul A Heidenreich, Frederick A Masoudi, Laura G Qualls, Eric D Peterson, Gregg C Fonarow, Lesley H Curtis
CONTEXT: Aldosterone antagonist therapy for heart failure and reduced ejection fraction has been highly efficacious in randomized trials. However, questions remain regarding the effectiveness and safety of the therapy in clinical practice. OBJECTIVE: To examine the clinical effectiveness of newly initiated aldosterone antagonist therapy among older patients hospitalized with heart failure and reduced ejection fraction. DESIGN, SETTING, AND PARTICIPANTS: Using clinical registry data linked to Medicare claims from 2005 through 2010, we examined outcomes of eligible patients hospitalized with heart failure and reduced ejection fraction...
November 28, 2012: JAMA
Ali Vazir, Brian Claggett, Pardeep Jhund, Davide Castagno, Hicham Skali, Salim Yusuf, Karl Swedberg, Christopher B Granger, John J V McMurray, Marc A Pfeffer, Scott D Solomon
BACKGROUND: Resting heart rate (HR) is a predictor of adverse outcome in patients with heart failure (HF). Whether changes in HR over time in patients with chronic HF are also associated with adverse outcome is unknown. We explored the relationship between changes in HR from a preceding visit, time-updated HR (i.e. most recent available HR value from a clinic visit) and subsequent outcomes in patients with chronic HF. METHODS AND RESULTS: We studied 7599 patients enrolled in the candesartan in heart failure: assessment of reduction in mortality and morbidity program...
March 14, 2015: European Heart Journal
Ana C Alba, Thomas Agoritsas, Milosz Jankowski, Delphine Courvoisier, Stephen D Walter, Gordon H Guyatt, Heather J Ross
BACKGROUND: Optimal management of heart failure requires accurate assessment of prognosis. Many prognostic models are available. Our objective was to identify studies that evaluate the use of risk prediction models for mortality in ambulatory patients with heart failure and describe their performance and clinical applicability. METHODS AND RESULTS: We searched for studies in Medline, Embase, and CINAHL in May 2012. Two reviewers selected citations including patients with heart failure and reporting on model performance in derivation or validation cohorts...
September 1, 2013: Circulation. Heart Failure
Faiez Zannad, John J V McMurray, Henry Krum, Dirk J van Veldhuisen, Karl Swedberg, Harry Shi, John Vincent, Stuart J Pocock, Bertram Pitt
BACKGROUND: Mineralocorticoid antagonists improve survival among patients with chronic, severe systolic heart failure and heart failure after myocardial infarction. We evaluated the effects of eplerenone in patients with chronic systolic heart failure and mild symptoms. METHODS: In this randomized, double-blind trial, we randomly assigned 2737 patients with New York Heart Association class II heart failure and an ejection fraction of no more than 35% to receive eplerenone (up to 50 mg daily) or placebo, in addition to recommended therapy...
January 6, 2011: New England Journal of Medicine
Gerhard Hindricks, Milos Taborsky, Michael Glikson, Ullus Heinrich, Burghard Schumacher, Amos Katz, Johannes Brachmann, Thorsten Lewalter, Andreas Goette, Michael Block, Josef Kautzner, Stefan Sack, Daniela Husser, Christopher Piorkowski, Peter Søgaard
BACKGROUND: An increasing number of patients with heart failure receive implantable cardioverter-defibrillators (ICDs) or cardiac resynchronisation defibrillators (CRT-Ds) with telemonitoring function. Early detection of worsening heart failure, or upstream factors predisposing to worsening heart failure, by implant-based telemonitoring might enable pre-emptive intervention and improve outcomes, but the evidence is weak. We investigated this possibility in IN-TIME, a clinical trial. METHODS: We did this randomised, controlled trial at 36 tertiary clinical centres and hospitals in Australia, Europe, and Israel...
August 16, 2014: Lancet
Martin H Ruwald, Scott D Solomon, Elyse Foster, Valentina Kutyifa, Anne-Christine Ruwald, Saadia Sherazi, Scott McNitt, Christian Jons, Arthur J Moss, Wojciech Zareba
BACKGROUND: Appropriate guideline criteria for use of implantable cardioverter-defibrillators (ICDs) do not take into account potential recovery of left ventricular ejection fraction (LVEF) in patients treated with CRT-defibrillator. METHODS AND RESULTS: Patients randomized to CRT-defibrillator from the Multicenter Automatic Defibrillator Implantation Trial With Cardiac Resynchronization Therapy (MADIT-CRT) trial who survived and had paired echocardiograms at enrollment and at 12 months (n=752) were included...
December 23, 2014: Circulation
Lars H Lund, Lina Benson, Ulf Dahlström, Magnus Edner
CONTEXT: Heart failure with preserved ejection fraction (HFPEF) may be as common and as lethal as heart failure with reduced ejection fraction (HFREF). Three randomized trials of angiotensin-converting enzyme inhibitors or angiotensin receptor blockers (ie, renin-angiotensin system [RAS] antagonists) did not reach primary end points but may have had selection bias or been underpowered. OBJECTIVE: To test the hypothesis that use of RAS antagonists is associated with reduced all-cause mortality in an unselected population with HFPEF...
November 28, 2012: JAMA
Vincent M van Deursen, Adrian F Hernandez, Amanda Stebbins, Vic Hasselblad, Justin A Ezekowitz, Robert M Califf, Stephen S Gottlieb, Christopher M O'Connor, Randall C Starling, W H Wilson Tang, John J McMurray, Kenneth Dickstein, Adriaan A Voors
BACKGROUND: Contradictory results have been reported on the effects of nesiritide on renal function in patients with acute decompensated heart failure. We studied the effects of nesiritide on renal function during hospitalization for acute decompensated heart failure and associated outcomes. METHODS AND RESULTS: A total of 7141 patients were randomized to receive either nesiritide or placebo and creatinine was recorded in 5702 patients at baseline, after infusion, discharge, peak/nadir levels until day 30...
September 16, 2014: Circulation
Chana A Sacks, John A Jarcho, Gregory D Curfman
New England Journal of Medicine, Volume 0, Issue 0, Ahead of Print.
September 11, 2014: New England Journal of Medicine
2014-09-16 11:51:35
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