Renal Function and the Effects of Vericiguat in Patients with Worsening Heart Failure with Reduced Ejection Fraction: Insights from VICTORIA ( VerICiguaT Global Study in Subjects with HFrEF ) Trial

Abstract Background Acute heart failure is a life-threatening clinical condition. Levosimendan is an effective inotropic agent used to maintain cardiac output, but its usage is limited by the lack of evidence in patients with severely abnormal renal function. Therefore, we analyzed data of patients with acute heart failure with and without abnormal renal function to examine the effects of levosimendan. Methods We performed this retrospective cohort study using data from the Chang Gung Research Database (CGRD) of Chang Gung Memorial Hospital (CGMH). Patients admitted for heart failure with LVEF ≤ 40% between January 2013 and December 2018 who received levosimendan or dobutamine in the critical cardiac care units (CCU) were identified. Patients with extracorporeal membrane oxygenation (ECMO) were excluded. Outcomes of interest were mortality at 30, 90, and 180 days after the cohort entry date. Results There were no significant differences in mortality rate at 30, 90, and 180 days after the cohort entry date between the levosimendan and dobutamine groups, or between subgroups of patients with an estimated glomerular filtration rate (eGFR) ≥ 30 mL/min/1.73 m2 and eGFR < 30 mL/min/1.73 m2 or on dialysis. The results were consistent before and after propensity score matching. Conclusions Levosimendan did not increase short- or long-term mortality rates in critical patients with acute heart failure and reduced ejection fraction compared to dobutamine, regardless of their renal function. An eGFR less than 30 mL/min/1.73 m2 was not necessarily considered a contraindication for levosimendan in these patients.

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Elevated plasma soluble (pro)renin receptor levels are associated with left ventricular remodeling and renal function in chronic heart failure patients with reduced ejection fraction

Peptides ◽

10.1016/j.peptides.2018.04.010 ◽

2019 ◽

Vol 111 ◽

pp. 152-157 ◽

Cited By ~ 6

Author(s):

Linghui Gong ◽

Shenglin Zhang ◽

Linrui Li ◽

Xin Gao ◽

Dongxia Wang ◽

...

Keyword(s):

Heart Failure ◽

Renal Function ◽

Chronic Heart Failure ◽

Ejection Fraction ◽

Ventricular Remodeling ◽

Left Ventricular Remodeling ◽

Left Ventricular ◽

Elevated Plasma ◽

Reduced Ejection Fraction ◽

Heart Failure Patients

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Effect Of Empagliflozin On Major Heart Failure Outcomes, Renal Function And Quality Of Life In Patients With Heart Failure With A Reduced Ejection Fraction, With And Without Sacubitril/valsartan

Journal of Cardiac Failure ◽

10.1016/j.cardfail.2020.11.019 ◽

2020 ◽

Vol 26 (12) ◽

pp. 1109

Author(s):

Milton Packer

Keyword(s):

Quality Of Life ◽

Heart Failure ◽

Renal Function ◽

Ejection Fraction ◽

Reduced Ejection Fraction ◽

Patients With Heart Failure

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412 Sacubitril/valsartan promotes cardiac reverse remodeling and preserves renal function in a real-world heart failure and reduced ejection fraction (HFrEF) population

European Heart Journal - Cardiovascular Imaging ◽

10.1093/ehjci/jez319.1183 ◽

2020 ◽

Vol 21 (Supplement_1) ◽

Author(s):

M V Polito ◽

A Rispoli ◽

V Vitulano ◽

F D"auria ◽

A Silverio ◽

...

Keyword(s):

Heart Failure ◽

Renal Function ◽

Ejection Fraction ◽

Real World ◽

Cardiac Death ◽

Nyha Class ◽

P Value ◽

Composite Outcome ◽

Reduced Ejection Fraction ◽

Echocardiographic Parameters

Abstract Funding Acknowledgements none Aims. To evaluate the effects of Sacubitril/Valsartan (S/V) on clinical, laboratory and echocardiographic parameters and outcomes in a real-world population with heart failure with reduced ejection fraction (HFrEF). Methods and results. Prospective study enrolling consecutive patients with HFrEF treated with S/V.The primary outcome was HF rehospitalization;secondary outcomes were all-cause death, cardiac death and the composite of cardiac death and HF rehospitalization at 12 months follow up.The clinical outcome was compared with a retrospective cohort of 90 HFrEF patients treated with standard medical therapy by using propensity score weighting. At 6 months follow-up, changes in symptoms, echocardiographic parameters, eGFR and furosemide dose were also evaluated. The study population consisted of 90 patients (66.1 ± 11.7 years). At 6 months FU, a significant improvement in NYHA class, LVEF (from 31.0% to 34.0%; p = 0.001), LVESV (from 115.0 to 101.0 mL; p = 0.033) and sPAP (from 31.0 to 25.0 mmHg; p = 0.024) was observed. Moreover, S/V did not affect negatively eGFR and was associated with a significantly lower dose of furosemide prescribed. The propensity score weighting adjusted regression analysis showed a significantly lower risk for HF rehospitalization (HR, 0.131; 95% CI, 0.034-0.503; p = 0.003) and the composite outcome (HR, 0.162; 95% CI, 0.053-0.492; p = 0.001) among patients treated with S/V as compared to the standard therapy group. Conclusions In this real-world HFrEF population, S/V reduced HF rehospitalization and cardiac death at 1 year. Moreover, S/V improved significantly NYHA class, LVEF, LVESV and sPAP at 6 months, preserving renal function and reducing the need of furosemide. Table Study outcomes Unadjusted model HR 95% CI p-value HF rehospitalization 0.273 0.101-0.740 0.011 Cardiac death 0.443 0.137-1.440 0.176 Composite outcome 0.331 0.155-0.710 0.005 All-cause death 0.666 0.272-1.628 0.372 Adjusted model HR 95% CI p-value HF rehospitalization 0.131 0.034-0.503 0.003 Cardiac death 0.259 0.047-1.415 0.119 Composite outcome 0.162 0.053-0.492 0.001 All-cause death 0.713 0.201-2.529 0.601 Adjusted and unadjusted HR for the study outcomes. Abstract 412 Figure.

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