Review
Medicine, General & Internal
Gad Cotter, Beth A. Davison, Alexandre Mebazaa, Koji Takagi, Maria Novosadova, Yonathan Freund, Alain Cohen-Solal
Summary: There are multiple medication options for patients with heart failure and reduced ejection fraction, with RAASbs and BBs being the cornerstone of treatment. ARNis have shown to further reduce adverse effects, while other medications can be considered as adjunct therapies for symptom relief. Comparing the efficacy of these medications and prioritizing certain ones over others is important due to their similar side effects.
JOURNAL OF CLINICAL MEDICINE
(2021)
Article
Cardiac & Cardiovascular Systems
Suzanne V. Arnold, Daniel N. Silverman, Kensey Gosch, Michael E. Nassif, Margaret Infeld, Sheldon Litwin, Markus Meyer, Timothy J. Fendler
Summary: This study examines the association of beta-blockers with heart failure (HF) hospitalization and death in patients with HF and EF >= 40%. The results show that beta-blockers are associated with a higher risk of HF hospitalization as EF increases, with potential benefit in patients with HFmrEF and potential risk in patients with higher EF (particularly >60%).
JACC-HEART FAILURE
(2023)
Article
Medicine, General & Internal
Essraa Bayoumi, Phillip H. Lam, Robert Enders, Cherinne Arundel, Helen M. Sheriff, Vijaywant Brar, Corrine Y. Jurgens, Prakash Deedwania, Charles Faselis, Richard M. Allman, Gregg C. Fonarow, Ali Ahmed
Summary: This study found that the use of beta-blockers in older patients with HFrEF is associated with a lower risk of all-cause mortality, but not with a lower risk of heart failure readmission. This association is similar for patients admitted from nursing homes and those not admitted.
AMERICAN JOURNAL OF MEDICINE
(2022)
Article
Cardiac & Cardiovascular Systems
Fadel Bahouth, Adi Elias, Itai Ghersin, Emad Khoury, Omer Bar, Haitham Sholy, Johad Khoury, Zaher S. Azzam
Summary: This study found that in patients with acute decompensated heart failure (ADHF), the heart rate at discharge has significant prognostic value on 1-year mortality, with patients having a heart rate <90 beats per minute showing significantly lower mortality rates.
Article
Medicine, General & Internal
Makiko Nakamura, Teruhiko Imamura, Koichiro Kinugawa
Summary: This retrospective study evaluated consecutive patients who received vericiguat between September 2021 and December 2022, and the results suggest that vericiguat therapy may be feasible and effective upon quadruple therapy for patients with heart failure, although further investigation is needed to validate these findings.
JOURNAL OF CLINICAL MEDICINE
(2023)
Review
Medicine, General & Internal
Eleni-Evangelia Koufou, Angelos Arfaras-Melainis, Sahil Rawal, Andreas P. Kalogeropoulos
Summary: Most studies suggest that patients with HFmrEF have an intermediate clinical background compared to those with HFrEF and HFpEF. Current evidence shows that HFmrEF patients benefit from medications targeting the neurohormonal axes, similar to HFrEF.
JOURNAL OF CLINICAL MEDICINE
(2021)
Article
Cardiac & Cardiovascular Systems
Sebastian Rosch, Karl-Patrik Kresoja, Christian Besler, Karl Fengler, Anne Rebecca Schoeber, Maximilian von Roeder, Christian Luecke, Matthias Gutberlet, Karin Klingel, Holger Thiele, Karl-Philipp Rommel, Philipp Lurz
Summary: In this study, patients with heart failure with preserved ejection fraction (HFpEF) were stratified based on left ventricular ejection fraction (LVEF), resulting in distinct morphologic and pathophysiologic subphenotypes. Patients with LVEF ranging from 50% to 60% demonstrated reduced contractility, impaired ventriculo-arterial coupling, and higher extracellular volume fraction, while patients with LVEF >60% exhibited a hypercontractile state with excessive left ventricular afterload and diminished preload reserve.
Article
Cardiac & Cardiovascular Systems
Jiayong Li, Zhe Zhen, Peisen Huang, Yu-Gang Dong, Chen Liu, Weihao Liang
Summary: The study found a correlation between overstrict cooking salt intake restriction and worse prognosis in patients with heart failure with preserved ejection fraction (HFpEF), especially in younger and non-white patients. Therefore, clinicians should be cautious when advising salt restriction for HFpEF patients.
Article
Cardiac & Cardiovascular Systems
Phillip H. Lam, Kalliopi Keramida, Gerasimos S. Filippatos, Neha Gupta, Charles Faselis, Prakash Deedwania, Brandon George, Ami Iskandrian, John G. Cleland, Gaurav Choudhary, Wen-Chih Wu, Charity J. Morgan, Gregg C. Fonarow, Ali Ahmed
Summary: A low right ventricular ejection fraction (RVEF) is a marker of poor outcomes in patients with heart failure with reduced ejection fraction (HFrEF). The effect of beta-blockers on outcomes in HFrEF may be modified by RVEF, but further research is needed to confirm these findings.
JOURNAL OF CARDIAC FAILURE
(2022)
Article
Cardiac & Cardiovascular Systems
Michael R. Zile, Maria Rosa R. Costanzo, Ekaterina M. Ippolito, Yan Zhang, Russell Stapleton, Ashish Sadhu, Javier Jimenez, Joe Hobbs, Vinod Sharma, Eduardo N. Warman, Lindsay Streeter, Javed Butler
Summary: The study aimed to determine the feasibility of implementing a heart failure management strategy using a device-based risk stratification model and standardized ambulatory medication intervention. The results support the testing of an ambulatory medication intervention strategy in a large randomized clinical trial based on individualized device risk stratification, physician-directed, and CHFN-implemented.
Review
Cardiac & Cardiovascular Systems
Daniele Masarone, Maria Luigia Martucci, Vittoria Errigo, Giuseppe Pacileo
Summary: Beta-blockers are underused in managing heart failure with reduced ejection fraction due to misconceptions about their potential side effects and contraindications, despite their proven benefits in reversing neurohumoral effects. This article reviews the clinical pharmacology of beta-blockers, evidence of their beneficial effects, and guidelines for proper use in the presence of comorbidities, aiming to promote their increased use, titration, and tailored approach for HFrEF patients.
JOURNAL OF CARDIOVASCULAR DEVELOPMENT AND DISEASE
(2021)
Letter
Medicine, General & Internal
Debdatta Bhattacharyya, Ayan Kar, Saurabh Dhumale, Filippos K. Triposkiadis, Andrew Xanthopoulos, Efstathios K. Iliodromitis, James Amato, Hiddo J. L. Heerspink, Lesley Inker, Tom Greene, Stefan D. Anker, Javed Butler, Milton Packer
Summary: In patients with heart failure and preserved ejection fraction, Empagliflozin reduced the incidence of primary outcome events compared to other drugs, but had higher rates of cardiovascular death, death from any cause, and hospitalization for heart failure compared to spironolactone.
NEW ENGLAND JOURNAL OF MEDICINE
(2022)
Letter
Medicine, General & Internal
Elric Zweck, Ralf Westenfeld, Bjorn Redfors, Elmir Omerovic, Robin A. P. Weir, Domenico Gabrielli, Fabrizio Oliva, Giuseppe Zuccala, Scott D. Solomon, Muthiah Vaduganathan, John J. V. McMurray
Summary: Solomon et al. report on the DELIVER trial, which showed that dapagliflozin reduced risks of heart failure-related outcomes in patients with a mildly reduced or preserved left ventricular ejection fraction. These findings are expected to influence guidelines and clinical practice. The trial also confirmed dapagliflozin's efficacy in patients with a left ventricular ejection fraction of 60% or above.
NEW ENGLAND JOURNAL OF MEDICINE
(2023)
Article
Cardiac & Cardiovascular Systems
Mario Mekhael, Botao Shan, Charbel Noujaim, Nour Chouman, Alaa Assaf, Hadi Younes, Abdel Hadi El Hajjar, Lilas Dagher, Han Feng, Hua He, Cong Zhao, Omar Kreidieh, Chan Ho Lim, Chao Huang, Tarek Ayoub, Eugene Kholmovski, Mihail Chelu, Nassir Marrouche, Eoin Donnellan
Summary: The goal of this study was to assess the differences in post-ablation AF recurrence, burden, and LVEF changes in different CHF subcategories of the DECAAF-II population. The results showed no significant differences in AF recurrence and burden between CHF and non-CHF patients, as well as different CHF subcategories. Patients with HFrEF experienced the greatest improvement in LVEF after CA. Moreover, the improvement in ventricular function seemed to be independent of atrial fibrosis stages.
Article
Physiology
Rubens P. Homme, Yuting Zheng, Irina Smolenkova, Mahavir Singh, Suresh C. Tyagi
Summary: Remote ischemic conditioning has beneficial effects during acute heart failure, and its effectiveness in chronic congestive, cardiopulmonary heart failure remains unclear. Research has shown that the transition from HFpEF to HFrEF is related to factors like reduced angiogenesis, and ischemic conditioning can increase musclin content in muscles. Multi-omics analysis revealed that the CHF phenotype causes dysfunction in cardiac metabolism, contraction, and relaxation, which can be mitigated by ischemic conditioning.
FRONTIERS IN PHYSIOLOGY
(2021)