scholarly journals Who ′Nose′, is it the ARNi?: A Case Series of Persistent Nasal Pruritus in Heart Failure Patients receiving Sacubitril/Valsartan

Author(s):  
Jaclyn Gan ◽  
Haunnah Rheault ◽  
Yee Weng Wong

Abstract Background Sacubitril/valsartan is approved for the treatment of chronic heart failure with reduced left ventricular ejection fraction (HFrEF) of less than or equal to 40% to decrease mortality and morbidity. Nasal pruritus is not a recognised adverse effect in the product information. In this case series, we encountered three patients presented with nasal pruritus that improved after discontinuation of sacubitril/valsartan. Case Summary Three patients aged 58-73 years-old presented with pruritus at the nasal septum post-initiation of sacubitril/valsartan. The pruritus did not subside despite the use of anti-histamines. Within 3-6 months, all individuals discontinued sacubitril/valsartan with complete resolution of their nasal pruritus. Discussion Many physicians may not aware of this unusual but reversible adverse effect of sacubitril/valsartan. Despite the positive prognostic value of sacubitril/valsartan, the constant nasal pruritus had impacted the quality of life of our patients, leading them to discontinue sacubitril/valsartan permanently.

Kardiologiia ◽  
2021 ◽  
Vol 61 (4) ◽  
pp. 73-78
Author(s):  
Yu. V. Mareev ◽  
S. R. Gilarevsky ◽  
Yu. L. Begrambekova ◽  
Yu. M. Lopatin ◽  
A. A. Garganeeva ◽  
...  

In recent years there has been significant interest in treating iron deficiency (ID) in patients with heart failure (HF) due to its high prevalence and detrimental effects in this population. As stated in the 2020 Russain HF guidelines, Intravenous ferric carboxymaltose remains the only proven therapy for ID.This document was prompted by the results from the recent AFFIRM-AHF trial which demonstrates that treatment of ID after acute HF decompensation reduces the risk of future decompensations. Experts have concluded that in HF patients with acute decompensation, a left ventricular ejection fraction of < 50% and ID, Intravenous ferric carboxymaltose reduces future HF hospitalisations. Patients with stable HF may also benefit from treatment of ID to improve quality of life and alleviate symptoms.  It is, therefore, reasonable to screen for and treat ID in patients with HF.


2020 ◽  
Vol 35 (2) ◽  
pp. 157-162
Author(s):  
I. A. Ryabov ◽  
I. N. Mamchur ◽  
T. Yu. Chichkova ◽  
S. E. Mamchur ◽  
I. N. Sizova ◽  
...  

The article provides a clinical case of a 58-year-old man with the fi rst clinical manifestation of chronic heart failure in the presence of a signifi cant decrease in the left ventricular ejection fraction. Left ventricular non-compaction cardiomyopathy was diagnosed by echocardiography. After 12 months, a cardiac contractility modulation device was implanted to the patient in the presence of disease progression despite optimal medical therapy. We assessed the course of disease, quality of life, exercise tolerance, and myocardial contractility of the patient before and six months after surgery. The methods of assessment were collection of patient complaints, physical examination, electrocardiography (ECG), fi lling out the Minnesota Living with Heart Failure Questionnaire (MLHFQ), sixminute walk test, spiroergometry, and echocardiography.


2013 ◽  
Vol 2013 ◽  
pp. 1-15 ◽  
Author(s):  
Jing Luo ◽  
Hao Xu ◽  
Keji Chen

Objective. This paper systematically evaluated the efficacy and safety of compound Danshen dropping pill (CDDP) in patients with acute myocardial infarction (AMI).Methods. Randomized controlled trials (RCTs), comparing CDDP with no intervention, placebo, or conventional western medicine, were retrieved. Data extraction and analyses were conducted in accordance with the Cochrane standards. We assessed risk of bias for each included study and evaluated the strength of evidence on prespecified outcomes.Results. Seven RCTs enrolling 1215 patients were included. CDDP was associated with statistically significant reductions in the risk of cardiac death and heart failure compared with no intervention based on conventional therapy for AMI. In addition, CDDP was associated with improvement of quality of life and impaired left ventricular ejection fraction. Nevertheless, the safety of CDDP was unproven for the limited data. The quality of evidence for each outcome in the main comparison (CDDP versus no intervention) was “low” or “moderate.”Conclusion. CDDP showed some potential benefits for AMI patients, such as the reductions of cardiac death and heart failure. However, the overall quality of evidence was poor, and the safety of CDDP for AMI patients was not confirmed. More evidence from high quality RCTs is warranted to support the use of CDDP for AMI patients.


Cardiology ◽  
2017 ◽  
Vol 138 (Suppl. 1) ◽  
pp. 11-12 ◽  
Author(s):  
Gerardo Riccio

Obesity is one of the commonest comorbidities in patients with heart failure, and it is associated with increased mortality risk. However, obese patients are often underrepresented in clinical trials and therefore evidence on their management remains scant. In order to expand knowledge on the management of these patients, anecdotal reports may be considered. In the present case report, we discuss the successful management of an obese patient who received sacubitril/valsartan therapy. This treatment was initiated after a 12-month period of losartan therapy, which did not provide any benefit in terms of heart function. Importantly, during this period the patient required frequent hospitalizations, with a marked decrease in quality of life. After the switch to sacubitril/valsartan, a 10% increase in left ventricular ejection fraction was observed (from 30 to 40%) over a 12-month period. Moreover, no hospitalizations were required, and the patient was able to carry on at least some of his daily activities.


2020 ◽  
Author(s):  
Kai Zhang ◽  
Min Wu ◽  
Xianyu Qin ◽  
Xianwu Zhou ◽  
Jianrong Zhou ◽  
...  

Abstract Background: Heart failure (HF), the leading cause of adult mortality and morbidity worldwide, is the end-stage of various diseases, especially ischemic cardiomyopathy (ICM) and dilated cardiomyopathy (DCM). This study aimed to investigate the common molecular mechanism of ICM and DCM.Methods: Four gene expression datasets, GSE1869, GSE5406, GSE57338, and GSE79962, were obtained from the Gene Expression Omnibus (GEO) database. The differentially expressed genes (DEGs) of ICM or DCM samples compared with those of nonfailing samples were identified. Gene ontology (GO) annotation, Kyoto encyclopedia of gene and genome (KEGG) pathway analysis, and the protein-protein network (PPI) of the coregulated DEGs in at least three datasets were performed using the online tools of DAVID, the KOBAS database, and the STRING database, respectively. Hub genes of HF were analyzed for their correlation with left ventricular ejection fraction (LVEF) in dataset GSE19303. The expression levels of notable DEGs were further validated in our tissue microarray (TMA).Results: Fifty-nine coregulated ICM and sixty-eight coregulated DCM relevant DEGs were identified (in at least three datasets). Moreover, 38 common DEGs between ICM and DCM relevant DEGs were obtained that were mainly involved in inflammatory/stress processes, proliferation, and some lipid metabolism pathways. Among the ten hub genes with top degrees, four genes showed a correlation with LVEF, and ASPN had the most significant correlation. Finally, the expression of ASPN protein was validated in our TMA and was significantly increased in ICM and DCM left ventricular samples.Conclusion: The present study revealed some common molecular mechanisms of HF with different causes. Furthermore, ASPN may be a potential promising biomarker for HF.


2015 ◽  
Vol 8 (3) ◽  
pp. 49 ◽  
Author(s):  
Mohannad Eid AbuRuz ◽  
Fawwaz Alaloul ◽  
Ahmed Saifan ◽  
Rami Masa'deh ◽  
Said Abusalem

<p><strong>INTRODUCTION:</strong> Heart failure is a major public health issue and a growing concern in developing countries, including Saudi Arabia. Most related research was conducted in Western cultures and may have limited applicability for individuals in Saudi Arabia. Thus, this study assesses the quality of life of Saudi patients with heart failure.</p> <p><strong>MATERIALS &amp; METHODS:</strong><em> </em>A cross-sectional correlational design was used on a convenient sample of 103 patients with heart failure. Data were collected using the Short Form-36 and the Medical Outcomes Study-Social Support Survey.</p> <p><strong>RESULTS:</strong> Overall, the patients’ scores were low for all domains of Quality of Life. The Physical Component Summary and Mental Component Summary mean scores and SDs were (36.7±12.4, 48.8±6.5) respectively, indicating poor Quality of Life. Left ventricular ejection fraction was the strongest predictor of both physical and mental summaries.</p> <p><strong>CONCLUSION:</strong> Identifying factors that impact quality of life for Saudi heart failure patients is important in identifying and meeting their physical and psychosocial needs.</p>


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