Valsalva-derived measures and phenylephrine test in patients with heart failure with reduced ejection fraction receiving comprehensive neurohormonal blockade drug therapy: a 5-year event-free survival analysis

2021 ◽  
Author(s):  
Anna Podsiadły ◽  
Bartłomiej Paleczny ◽  
Martyna Olesińska-Mader ◽  
Krzysztof Nowak ◽  
Tymoteusz Okupnik ◽  
...  
Keyword(s):  
Heart Failure ◽  
Survival Analysis ◽  
Drug Therapy ◽  
Ejection Fraction ◽  
Event Free Survival ◽  
Free Survival ◽  
Reduced Ejection Fraction ◽  
Patients With Heart Failure

scholarly journals Head-to-head comparison of clinical, biochemical and functional effects of fosinopril and enalapril in patients with systolic heart failure

2006 ◽  
Vol 59 (1-2) ◽  
pp. 51-56 ◽  
Author(s):  
Petar Otasevic ◽  
Biljana Putnikovic ◽  
Zelimir Vukajlovic ◽  
Bojan Ilisic ◽  
Aleksandar Neskovic
Keyword(s):  
Quality Of Life ◽  
Heart Failure ◽  
Ejection Fraction ◽  
Systolic Heart Failure ◽  
Event Free Survival ◽  
Short Term ◽  
Free Survival ◽  
Significant Difference ◽  
Patients With Heart Failure

Introduction. The aim of this study was to evaluate short-term clinical, bio?chemical and functional effects of fosinopril versus enalapril in patients with heart failure. Material and methods. 59 consecutive patients (mean age 57?8 years, EF 18.9?6.3%, NYHA III or IV class 19/59) -were randomized to receive fosinopril or enalapril for three months. All patients underwent echocardiography, metabolic testing, and a 6-minute walk test and completed the Minnesota questionnaire on inclusion and three months later. Additionally, serum creatinine, BUN, total cholesterol and triglycerides were measured. Kaplan-Meier curve was created to assess event-free survival for cardiac death and hospitalization for heart failure. Results. There was no statistically significant difference in event-free survival between patients on fosinopril and enalapril (86.7% vs. 82.8%, log rank 4.21 p=0.43). However, time to the event was longer in patients on fosinopril (77.0?25.35 vs. 40.2?6.8days, p=0.04). At the end of the study, no difference between fosinopril and enalapril group existed with respect to maximal oxygen consumption (20.90?4.47 vs. 20.89?6.86 ml/kg/mm), ejection fraction (20.5?7.4 vs. 2L4?7.8%), distance during the 6-minute test walk (313?74 vs. 352?129 meters) and quality of life (23.8?15.8 vs. 25.6?20.3 points), but patients on enalapril had higher creatinine (99?13 vs. 113?17 umol/L, p=0.002) and BUN (7.28?1.7vs. 8.89?2.39 mmol/L, p=0.01) levels. Increase in fosinopril dose during the study was higher than increase in enalapril dose (24.1%?23.8% vs. 9.5?24.5%, p=0.04). Conclusions. Fosinopril and enalapril have similar short-term effects on event-free survival, ejection fraction, functional capacity and quality of life in patients with heart failure. Patients on fosinopril presented with longer survival without event and had lower creatinine and BUN at the end of the follow-up. Additionally, fosinopril can be easily titrated to the maximum therapeutic dose. .

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

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