scholarly journals A Systematic Review Concerning the Relation between the Sympathetic Nervous System and Heart Failure with Preserved Left Ventricular Ejection Fraction

PLoS ONE ◽  
2015 ◽  
Vol 10 (2) ◽  
pp. e0117332 ◽  
Author(s):  
Willemien L. Verloop ◽  
Martine M. A. Beeftink ◽  
Bernadet T. Santema ◽  
Michiel L. Bots ◽  
Peter J. Blankestijn ◽  
...  
Keyword(s):  
Heart Failure ◽  
Systematic Review ◽  
Nervous System ◽  
Left Ventricular Ejection Fraction ◽  
Sympathetic Nervous System ◽  
Ejection Fraction ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction ◽  
Sympathetic Nervous

Reclassification of Heart Failure With Preserved Ejection Fraction Following Cardiac Sympathetic Nervous System Activation: a New Cutoff Value of 58%

2021 ◽  
Author(s):  
Toshihiko Goto ◽  
Takafumi Nakayama ◽  
Junki Yamamoto ◽  
Kento Mori ◽  
Yasuhiro Shintani ◽  
...  
Keyword(s):  
Heart Failure ◽  
Nervous System ◽  
Sympathetic Nervous System ◽  
Ejection Fraction ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction ◽  
All Cause Mortality ◽  
Sympathetic Nervous

Abstract A left ventricular ejection fraction (LVEF) of 50% as the cutoff for heart failure (HF) with preserved LVEF is controversial. We previously reported that patients with an LVEF of ≥58% have good prognoses. In this study, 123I-metaiodobenzylguanidine scintigraphy was performed to evaluate cardiac sympathetic nervous system (SNS) activity in 63 HF patients (78.4±9.6 years; males, 49.2%). During the follow-up period (median, 3.0 years), 18 all-cause deaths occurred. The delayed heart/mediastinum (H/M) ratio was significantly higher in the LVEF ≥58% group (n=15) than the LVEF <58% group (n=48) (2.1±0.3 vs. 1.7±0.4, p=0.004), and the all-cause mortality was significantly lower in patients in the former than those in the latter group (log-rank, p=0.04). When these patients were divided into LVEF ≥50% (n=22) and LVEF <50% (n=41) groups; no significant differences were found in the delayed H/M ratio, and the all-cause mortality did not differ between the groups (log-rank, p=0.09).In conclusion, cardiac SNS activity was more elevated in patients with an LVEF of <58% than in those with an LVEF of ≥58%. Furthermore, an LVEF of <58% was significantly associated with all-cause mortality. Thus, an LVEF of 58% is a good candidate for reclassifying HF patients according to cardiac SNS activity.

Systematic Review of Glucagon Like Peptide One Receptor Agonist liraglutide for Subjects with Heart Failure with Reduced Left Ventricular Ejection Fraction

2020 ◽  
Vol 16 ◽  
Author(s):  
Farah Hamad ◽  
Asim Ahmed Elnour ◽  
Abdelgadir Elamin ◽  
Sasha Mohamed ◽  
Isra Yousif ◽  
...  
Keyword(s):  
Heart Failure ◽  
Systematic Review ◽  
Left Ventricular Ejection Fraction ◽  
Ejection Fraction ◽  
Receptor Agonist ◽  
Primary Outcome ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction ◽  
Glucagon Like Peptide

Background: The major cardiovascular outcome trials on glucagon-like peptide one receptor agonist has examined its effect on hospitalization of subjects with heart failure, however, very limited trials has been conducted on subjects with reduced ejection fraction as primary outcome. Objective: We have conducted a systematic review on two major (FIGHT and LIVE) placebo-controlled trials of liraglutide and its clinical effect on ejection fraction of subjects with heart failure Method: Medline was retrieved for trials involving liraglutide from 2012 to 2020. The inclusion criteria for trials were: subjects with or without T2DM, subjects with heart failure with reduced left ventricular ejection fraction (rLVEF), major trials (phase II or III) on liraglutide, trials included liraglutide with defined efficacy primary outcome of patients with heart failure with rLVEF. The search was limited to the English language, whereby two trials [FIGHT and LIVE] have been included and have excluded two trials due to different primary outcomes. Participants (541) have been randomized for either liraglutide or placebo for 24 weeks. Results: In the FIGHT trial the primary intention-to-treat, sensitivity, and diabetes subgroup analyses have showed no significant between-group difference in the global rank scores (mean rank of 146 in the liraglutide group versus 156 in the placebo group; Wilcoxon rank-sum P=.31), in number of deaths, re-hospitalizations for heart failure, or the composite of death or in change in NT-pro BNP level (P= .94). In the LIVE trial, the change in LVEF from baseline to week 24 was not significantly different between treatment groups. The overall discontinuation rate of liraglutide was high in the FIGHT trial (29%, [86]) as compared to the LIVE trial (11.6%, [28]). Conclusion: The two trials FIGHT and LIVE have demonstrated that liraglutide use in subjects with heart failure and rLVEF was implicated with an increased adverse risk of heart failure-related outcomes.

scholarly journals Cardiac sympathetic dysfunction in pulmonary arterial hypertension: lesson from left-sided heart failure

2019 ◽  
Vol 9 (3) ◽  
pp. 204589401986862 ◽  
Author(s):  
Valentina Mercurio ◽  
Teresa Pellegrino ◽  
Giorgio Bosso ◽  
Giacomo Campi ◽  
Paolo Parrella ◽  
...  
Keyword(s):  
Heart Failure ◽  
Nervous System ◽  
Pulmonary Arterial Hypertension ◽  
Left Ventricular Ejection Fraction ◽  
Arterial Hypertension ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction ◽  
Pulmonary Arterial ◽  
Sympathetic Nervous

Sympathetic nervous system hyperactivity has a well-recognized role in the pathophysiology of heart failure with reduced left ventricular ejection fraction. Alterations in sympathetic nervous system have been related to the pathophysiology of pulmonary arterial hypertension, but it is unclear whether cardiac sympathetic nervous system is impaired and how sympathetic dysfunction correlates with hemodynamics and clinical status in pulmonary arterial hypertension patients. The aim of this study was to evaluate the cardiac sympathetic nervous system activity by means of123Iodine-metaiodobenzylguanidine nuclear imaging in pulmonary arterial hypertension patients and to explore its possible correlation with markers of disease severity. Twelve consecutive pulmonary arterial hypertension patients (nine women, median age 56.5 (17.8), eight idiopathic and four connective tissue-associated pulmonary arterial hypertension) underwent cardiac123Iodine-metaiodobenzylguanidine scintigraphy. The results were compared with those of 12 subjects with a negative history of cardiovascular or pulmonary disease who underwent the same nuclear imaging test because of a suspected paraganglioma or pheochromocytoma, with a negative result (controls), and 12 patients with heart failure with reduced left ventricular ejection fraction. Hemodynamics, echocardiography, six-minute walking distance, cardiopulmonary exercise testing, and N-terminal pro brain natriuretic peptide were collected in pulmonary arterial hypertension patients within one week from123Iodine-metaiodobenzylguanidine scintigraphy. Cardiac123Iodine-metaiodobenzylguanidine uptake, assessed as early and late heart-to-mediastinum ratio, was significantly lower in pulmonary arterial hypertension compared to controls (p = 0.001), but similar to heart failure with reduced left ventricular ejection fraction. Myocardial123Iodine-metaiodobenzylguanidine turnover, expressed as washout rate, was similar in pulmonary arterial hypertension and heart failure with reduced left ventricular ejection fraction and significantly higher compared to controls (p = 0.016). In the pulmonary arterial hypertension group, both early and late heart-to-mediastinum ratios and washout rate correlated with parameters of pulmonary arterial hypertension severity including pulmonary vascular resistance, right atrial pressure, tricuspid annular plane systolic excursion, N-terminal pro brain natriuretic peptide, and peak VO2. Although we evaluated a small number of subjects, our study showed a significant impairment in cardiac sympathetic nervous system in pulmonary arterial hypertension, similarly to that observed in heart failure with reduced left ventricular ejection fraction. This impairment correlated with indices of pulmonary arterial hypertension severity. Cardiac sympathetic dysfunction may be a contributing factor to the development of right-sided heart failure in pulmonary arterial hypertension.

ACCESSMENT OF RIGHT VENTRICULAR SYSTOLIC FUNCTION USING TAPSE

2011 ◽  
pp. 62-70
Author(s):  
Lien Nhut Nguyen ◽  
Anh Vu Nguyen
Keyword(s):  
Heart Failure ◽  
Left Ventricular Ejection Fraction ◽  
Ejection Fraction ◽  
Right Ventricular ◽  
Systolic Function ◽  
Systolic Heart Failure ◽  
Left Ventricular ◽  
Ventricular Ejection ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction

Background: The prognostic importance of right ventricular (RV) dysfunction has been suggested in patients with systolic heart failure (due to primary or secondary dilated cardiomyopathy - DCM). Tricuspid annular plane systolic excursion (TAPSE) is a simple, feasible, reality, non-invasive measurement by transthoracic echocardiography for evaluating RV systolic function. Objectives: To evaluate TAPSE in patients with primary or secondary DCM who have left ventricular ejection fraction ≤ 40% and to find the relation between TAPSE and LVEF, LVDd, RVDd, RVDd/LVDd, RA size, severity of TR and PAPs. Materials and Methods: 61 patients (36 males, 59%) mean age 58.6 ± 14.4 years old with clinical signs and symtomps of chronic heart failure which caused by primary or secondary DCM and LVEF ≤ 40% and 30 healthy subject (15 males, 50%) mean age 57.1 ± 16.8 were included in this study. All patients and controls were underwent echocardiographic examination by M-mode, two dimentional, convensional Dopler and TAPSE. Results: TAPSE is significant low in patients compare with the controls (13.93±2.78 mm vs 23.57± 1.60mm, p<0.001). TAPSE is linearly positive correlate with echocardiographic left ventricular ejection fraction (r= 0,43; p<0,001) and linearly negative correlate with RVDd (r= -0.39; p<0.01), RVDd/LVDd (r=-0.33; p<0.01), RA size (r=-0.35; p<0.01), TR (r=-0.26; p<0.05); however, no correlation was found with LVDd and PAPs. Conclusions: 1. Decreased RV systolic function as estimated by TAPSE in patients with systolic heart failure primary and secondary DCM) compare with controls. 2. TAPSE is linearly positive correlate with LVEF (r= 0.43; p<0.001) and linearly negative correlate with RVDd (r= -0.39; p<0.01), RVDd/LVDd (r=-0.33; p<0.01), RA size (r=-0.35; p<0.01), TR (r=-0.26; p<0.05); however, no correlation is found with LVDd and PAPs. 3. TAPSE should be used routinely as a simple, feasible, reality method of estimating RV function in the patients systolic heart failure DCM (primary and secondary).

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