scholarly journals Sympathetic activation in heart failure with reduced and mildly reduced ejection fraction: the role of aetiology

2021 ◽  
Author(s):  
Réka Urbancsek ◽  
Zoltán Csanádi ◽  
Ildikó Noémi Forgács ◽  
Tímea Bianka Papp ◽  
Judit Boczán ◽  
...  
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Sympathetic Activation ◽  
Reduced Ejection Fraction

Prognostic role of myocardial work in patients with heart failure and reduced ejection fraction treated by sacubitril/valsartan

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
E Galli ◽  
Y Bouali ◽  
C Laurin ◽  
A Gallard ◽  
A Hubert ◽  
...  
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Rank Test ◽  
Reduced Ejection Fraction ◽  
Non Invasive ◽  
Patients With Heart Failure ◽  
Increase Risk ◽  
Echocardiographic Examination ◽  
Constructive Work

Abstract Background The non-invasive assessment of myocardial work (MW) by pressure-strain loops analysis (PSL) is a relative new tool for the evaluation of myocardial performance. Sacubitril/Valsartan is a treatment for heart failure with reduced ejection fraction (HFrEF) which has a spectacular effect on the reduction of cardiovascular events (MACEs). Purposes of this study were to evaluate 1) the short and medium term effect of Sacubitril/Valsartan treatment on MW parameters; 2) the prognostic value of MW in this specific group of patients. Methods 79 patients with HFrEF (mean age: 66±12 years; LV ejection fraction: 28±9%) were prospectively included in the study and treated with Sacubitril/Valsartan. Echocardiographic examination was performed at baseline, and after 6- and 12-month of therapy with Sacubitril/Valsartan. Results Sacubitril/Valsartan significantly increased global myocardial constructive work (CW) (1023±449 vs 1424±484 mmHg%, p<0.0001) and myocardial work efficiency (WE) [87 (78–90) vs 90 (86–95), p<0.0001]. During FU (2.6±0.9 years), MACEs occurred in 13 (16%) patients. After correction for LV size, LVEF and WE, CW was the only predictor of MACEs (Table 1). A CW<910 mmHg (AUC=0.81, p<0.0001, Figure 1A) identified patients at particularly increase risk of MACEs [HR 11.09 (1.45–98.94), p=0.002, log-rank test p<0.0001] (Figure 1 B). Conclusions In patients with HFrEF who receive a comprehensive background beta-blocker and mineral-corticoid receptor antagonist therapy, Sacubitril/Valsartan induces a significant improvement of myocardial CW and WE. In this population, the estimation of CW before the initiation of Sacubitril/Valsartan therapy allows the prediction of MACEs. Funding Acknowledgement Type of funding source: None

scholarly journals Refining the Role of Left Atrial Strain in Heart Failure with Reduced Ejection Fraction

2021 ◽  
Author(s):  
Alessandro Malagoli ◽  
Luca Rossi ◽  
Alessia Zanni ◽  
Concetta Sticozzi ◽  
Massimo Francesco Piepoli ◽  
...  
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Left Atrial ◽  
Left Atrial Strain ◽  
Reduced Ejection Fraction ◽  
Atrial Strain

scholarly journals Clinical Utility of Exercise Training in Heart Failure with Reduced and Preserved Ejection Fraction

2015 ◽  
Vol 9 ◽  
pp. CMC.S21372 ◽  
Author(s):  
Muhammad Asrar Ul Haq ◽  
Cheng Yee Goh ◽  
Itamar Levinger ◽  
Chiew Wong ◽  
David L. Hare
Keyword(s):  
Heart Failure ◽  
Exercise Training ◽  
Ejection Fraction ◽  
Exercise Tolerance ◽  
Exercise Intolerance ◽  
Sufficient Evidence ◽  
Preserved Ejection Fraction ◽  
Reduced Ejection Fraction ◽  
Patients With Heart Failure

Reduced exercise tolerance is an independent predictor of hospital readmission and mortality in patients with heart failure (HF). Exercise training for HF patients is well established as an adjunct therapy, and there is sufficient evidence to support the favorable role of exercise training programs for HF patients over and above the optimal medical therapy. Some of the documented benefits include improved functional capacity, quality of life (QoL), fatigue, and dyspnea. Major trials to assess exercise training in HF have, however, focused on heart failure with reduced ejection fraction (HFREF). At least half of the patients presenting with HF have heart failure with preserved ejection fraction (HFPEF) and experience similar symptoms of exercise intolerance, dyspnea, and early fatigue, and similar mortality risk and rehospitalization rates. The role of exercise training in the management of HFPEF remains less clear. This article provides a brief overview of pathophysiology of reduced exercise tolerance in HFREF and heart failure with preserved ejection fraction (HFPEF), and summarizes the evidence and mechanisms by which exercise training can improve symptoms and HF. Clinical and practical aspects of exercise training prescription are also discussed.

Prognostic role of transthoracic echocardiography in patients affected by heart failure and reduced ejection fraction

2014 ◽  
Vol 20 (3) ◽  
pp. 305-316 ◽  
Author(s):  
Maria Prastaro ◽  
Carmen D’Amore ◽  
Stefania Paolillo ◽  
Mariangela Losi ◽  
Caterina Marciano ◽  
...  
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Transthoracic Echocardiography ◽  
Prognostic Role ◽  
Reduced Ejection Fraction

scholarly journals Breakthrough in Heart Failure therapy: LCZ696 combining ACE-Neprilysin inhibition

2017 ◽  
Vol 8 (1) ◽  
pp. 1-4
Author(s):  
Sandeep Lahiry ◽  
Rajasree Sinha ◽  
Shouvik Choudhury ◽  
Ayan Mukherjee
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Troponin T ◽  
Controlled Trial ◽  
Convincing Evidence ◽  
Trial Data ◽  
Bibliographic Databases ◽  
Reduced Ejection Fraction ◽  
Neprilysin Inhibitor

Background: Current Heart failure (HF) pharmacotherapy has been unsatisfactory in halting disease progression completely.Aims and Objective: To evaluate the role of LCZ696, a recent FDA-approved ACE -Neprilysin inhibitor (ARNi) in the management of HF from available trial data.Materials and Methods: Trial data on ‘LCZ696’ was assessed using PubMed search. Methodological filters were applied to limit retrieval to ‘Randomized Controlled Trial’ (RCT). Bibliographic databases with ‘Human’ data were selected. Trial data comparing ‘LCZ696’ to other drugs or placebo were accessed in full-text. CONSORT guidelines were used for quality assessment. Incomplete methodology, results in abstract form, duplicate publications were excluded. Data extraction forms were piloted and used to obtain uniform quality of data.Results: Multi-centric trial data (n=2) revealed noticeable benefits with ‘LCZ696’ in patients with HF with reduced ejection fraction (HFrEF), reducing cardiovascular death or hospitalization for HF by 20%; cardiovascular deaths by 20%; hospitalization for HF by 21% ; all cause mortality reduction by 20% as compared to ACE inhibitors (ACEi) (PARADIGM-HF; n=8442). Angioedema was notably absent. Decrease in high sensitivity Troponin-T, improvement in N-terminal-pro-BNP and left atrial dimensions suggested reduction of myocardial injury in HF with preserved ejection fraction (HFpEF) (PARAMOUNT trial; n=301).Conclusion: There is convincing evidence of the role of novel ARNi (Angiotensin receptor – Neprilysin Inhibitors) in HF pharmacotherapy. Its role in other cardiovascular conditions merits assessment.Asian Journal of Medical Sciences Vol.8(1) 2017 1-4

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