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Impact of heart rate changes during hospitalization on outcome in heart failure with preserved ejection fraction.

AIMS: The benefits of lowering heart rate (HR) in heart failure (HF) with preserved ejection fraction (HFpEF) patients are still a matter of … left ventricular ejection fraction, absence of chronic kidney disease, and use of beta-blockers or ivabradine. Independent determinants associated with excessive HR dropping during admission included use of beta-blockers [odds ratio (OR) 1.683, 95% CI 1.558-1.819], lower discharge diastolic blood pressure (OR 0.988, 95% CI 0.985-0.991), no pacemaker (OR 0.5 …

Heart Failure Guidelines on Pharmacotherapy.

Heart Failure (HF) is a serious emerging Public Health issue mainly in the high-income countries. In the USA, more than 6 million adults are affected. Despite the latest advances in device and pharmacological therapeutics, it still carries a huge burden, partially reflected in the annual healthcare cost of approximately $30 billion (2012) and the 5 year mortality rate of 50%. In this article, we review the medications, proven to significantly reduce mortality and morbidity in HF patients with structural myocardial disease and past or current symptoms, based on the latest North American HF guid

Long-Term Preservation of Left Ventricular Systolic Function in Patients With Refractory Angina Pectoris and Inducible Myocardial Ischemia on Optimal Medical Therapy.

Refractory angina pectoris (RAP) represents a clinical condition characterized by frequent episodes of chest pain despite therapy optimization. According to myocardial stunning and myocardial hibernation definitions, RAP should represent the ideal condition for systolic dysfunction development. We aim to investigate the evolution of left ventricular (LV) function in patients with RAP. A retrospective study which encompasses 144 patients with RAP referred to our institution from 1999 to December 2014 was performed. Of them, 88 met the inclusion criteria, and LV function was assessed by echocard

[Heart failure - up to date].

Heart failure is a common disorder associated with high morbidity and mortality as well as increasing socio-economic costs. General practitioners take care of most of the affected patients. Knowledge on pathophysiology and modern treatment concepts are decisive for rational decision making. Patient management focuses on longer survival and higher quality of life. Major goals include reductions in unnecessary hospital admissions as well as appropriate and timely involvement of heart failure specialists.

Natural history of end-stage LV dysfunction: has it improved from the classic Franciosa and Cohn Graph?

The pathophysiology of heart failure is complex, and downstream effects cause decline in multiple systems. Medical therapies intended to slow or reverse disease progression have been shown to improve prognosis in prospective trials. Improvement in prognosis has also been observed in large cohorts across time strata. However, near-term mortality for those with advanced disease remains unacceptably high. Prognosis in advanced heart failure may be assessed with the appropriate use of clinical prediction tools. Optimal timing of evaluation for heart transplantation and/or mechanical circulatory su

Heart failure medication treatment and prognosis: a retrospective cross-sectional study.

OBJECTIVE: Heart failure (HF) is a significant global public health concern and the leading cause of morbidity and mortality worldwide, impo … eline-recommended drugs show good therapeutic effects. And, we found that drugs such as SGLT-2i and ivabradine, despite their low usage rates, also demonstrate good therapeutic effects, providing significant implications for clinical decision-making.

A Randomized Controlled Trial Studying the Effect of Medication Adherence Tools in Patients With Heart Failure.

Background Heart failure significantly contributes to the global increase in morbidity and mortality. In managing such chronic conditions, m … ceptor blockers/angiotensin receptor neprilysin inhibitor, (B) beta-blockers/funny channel blocker (ivabradine), (C) companion drugs (digoxin, hydralazine+isosorbide dinitrate, intravenous iron, statins, oral anticoagulants/antiplatelets, antiarrhythmics, etc.), and (D) diuretics/mineralocorticoid receptor antagonists. The intervention included the ABCD drug …

Посттуральный ортостатический синдром тахикардии и ортостатическое гипотезирование после трансплантации стволовых клеток.

СПРАВОЧНИК: Посттуральная ортопедическая тахикардия (POTS) и ортостатическая гипотензия (OH), как правило, происходят после трансплантации стволовых клеток (HSCT). ЦЕЛИ: Данное исследование было направлено на определение распространенности ПОТС и ОЖ до ХОСТ и числа новых случаев после ХОСТ. МЕТОДЫ: В этом одном центре перспективного исследования была проведена оценка пациентов. 30 за несколько дней до 30 и 100 Через несколько дней после HSCT. Кровяное давление, сердечный ритм и уровень плазменного норепинефрина измерялись в суперном положении и после 10-minute испытание активного стенда для оц

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… Ivabradine, a sinoatrial node inhibitor, may also be a suitable treatment for patients with POTS after HSCT. … Accordingly, inhibition of the tachycardia response with ivabradine may disrupt this feedback loop and blunt symptoms of sympathetic activation. …

Heart failure treatment: Keeping up with best practices.

This article briefly reviews the diagnosis and initial evaluation of the patient with suspected heart failure and then describes how newer treatments fit within heart failure management priorities and strategies.

The Effectiveness of Trimetazidine Treatment in Patients with Stable Angina Pectoris of Various Durations: Results from the CHOICE-2 Study.

INTRODUCTION: Trimetazidine (TMZ) has been shown to reduce angina symptoms and to increase exercise capacity in randomized clinical trials, but more extensive data would be useful to assess its effects in real-world clinical practice and in patients with different durations of disease. METHODS: CHOICE-2 was a Russian, multicenter, 6-month, open-label, prospective observational study that assessed the effect of adding TMZ modified release 35 mg bid to antianginal treatment in a real-world setting. The present analysis of CHOICE-2 results explored the effects of adding TMZ to background antiang

Heart Failure in Older Patients: An Update.

Heart failure (HF) is a clinical syndrome with high incidence and prevalence and high morbidity and death rate, even in the short term, representing a serious public health issue, mainly in older people. It is a growing cause for hospital admission in this age group, being frequently associated with several comorbidities, further aggravating the disease's course. Moreover, older HF patients are usually affected by clinical conditions, like frailty, malnutrition, and cachexia, which significantly impact the overall management of HF and need to be properly identified and treated. Diagnosing and

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… Ivabradine Ivabradine decreases heart rate, inhibiting I f channels in the sinus node [ 22 ]. … There is limited scientific evidence regarding the role of ivabradine in older HF patients. …

Heart Failure.

Heart failure affects more than 6 million people in the United States and incurs a heavy toll in morbidity, mortality, and health care costs. It frequently coexists with other important disorders, including hypertension, coronary artery disease, diabetes, and obesity. Decades of clinical trials have shown that several medications and interventions are effective for improving outcomes; however, mortality and hospitalization rates remain high. More recently, additional medications and devices have shown promise in reducing the health burden of heart failure.

Electroacupuncture inhibits PDK1/Akt/HCN4 pathway to improve neurogenic urinary retention in rats.

OBJECTIVES: To observe the therapeutic effect of electroacupuncture (EA) on neurogenic urinary retention rats, so as to explore the underlyi … n of OSU-03012 (20 mg/kg), and rats of the HCN4 blocker group received intraperitoneal injection of ivabradine (10 mg/kg), both once every other day for 10 days. The urodynamic indexes of rats were detected by multi-channel physiological recorder；muscle strip test was used to detect detrusor excitability；the morphological changes of bladder were observed by …

Ion channels and neuronal hyperexcitability in chemotherapy-induced peripheral neuropathy; cause and effect?

AbstractCancer is the second leading cause of death worldwide and is a major global health burden. Significant improvements in survival have been achieved, due in part to advances in adjuvant antineoplastic chemotherapy. The most commonly used antineoplastics belong to the taxane, platinum, and vinca alkaloid families. While beneficial, these agents are frequently accompanied by severe side effects, including chemotherapy-induced peripheral neuropathy (CPIN). While CPIN affects both motor and sensory systems, the majority of symptoms are sensory, with pain, tingling, and numbness being the pre

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… ivabradine, gabapentin, and vehicle-treated animals. … ivabradine, gabapentin, and vehicle-treated animals. …

Issues Related to the Frequency of Exploratory Analyses by Evidence Review Groups in the NICE Single Technology Appraisal Process.

BackgroundEvidence Review Groups (ERGs) critically appraise company submissions as part of the National Institute for Health and Care Excellence (NICE) Single Technology Appraisal (STA) process. As part of their critique of the evidence submitted by companies, the ERGs undertake exploratory analyses to explore uncertainties in the company's model. The aim of this study was to explore pre-defined factors that might influence or predict the extent of ERG exploratory analyses.ObjectiveThe aim of this study was to explore predefined factors that might influence or predict the extent of ERG explora

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… of recurrent deep vein thrombosis and pulmonary embolism TA263 | Bevacizumab in combination with capecitabine for the first-line treatment of metastatic breast cancer TA264 | Alteplase for treating acute ischaemic stroke TA266 | Mannitol dry powder for inhalation for treating cystic fibrosis TA267 | Ivabradine … Ivabradine for treating chronic heart failure. NICE technology appraisal guidance TA267. 2012. https://www.nice.org.uk/guidance/ta267 . Accessed 2 May 2015. 14. …

Contemporary Drug Treatment of Chronic Heart Failure With Reduced Ejection Fraction: The CHECK-HF Registry.

OBJECTIVES: This study investigated adherence to drug therapy guidelines in heart failure (HF) with reduced left-ventricular ejection fraction (LVEF) of <40% (heart failure with reduced ejection fraction [HFrEF]), in which evidence-based treatment has been established. BACKGROUND: Despite previous surveys of HF, important uncertainties remain regarding guideline adherence in a representative real-world population. METHODS: A cross-sectional registry in 34 Dutch HF outpatient clinics that included 10,910 patients with the diagnosis of HF was examined. Of that number, 8,360 patients had LVEF <

Heart Failure Update: Outpatient Management.

Outpatient management of heart failure (HF) is aimed at treating symptoms and preventing hospitalizations and readmissions. Management is initiated in a stepwise approach. Blockade of the renin-angiotensin system is a cornerstone of therapy and should be started, along with beta blockers, as soon as the diagnosis of HF is made. Other drugs, including diuretics, aldosterone antagonists, hydralazine, and nitrates, may be added based on symptoms and American College of Cardiology/American Heart Association stage. Despite a great interest in and theoretical benefit of naturoceutical products in th

Prognosis After Withdrawal of Cardioprotective Therapy in Patients With Improved Cancer Therapeutics-Related Cardiac Dysfunction.

BackgroundThe long-term prognosis after the discontinuation of cardioprotective therapy (CPT) in patients with cancer therapeutics-related cardiac dysfunction (CTRCD) that has shown improvement remains unclear.ObjectivesThis study aims to assess the prognosis after CPT withdrawal in patients exhibiting improved CTRCD.MethodsIn this retrospective analysis of a single-center prospective cohort study, patients with improved CTRCD, defined as an increase in left ventricular ejection fraction (LVEF) ≥10 percentage points from the time of CTRCD diagnosis, were included. We analyzed their clinical ou

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… 40.9) | 0.45 Diabetes mellitus | 19 (21.1) | 16 (36.4) | 0.059 Dyslipidemia | 38 (42.2) | 13 (29.5) | 0.16 Smoking | 9 (10.0) | 6 (13.6) | 0.57 CPT | | | ACEI/ARB | 63 (70.0) | 33 (75.0) | 0.55 ARNI | 18 (20.0) | 7 (15.9) | 0.57 BB | 77 (85.6) | 36 (81.8) | 0.58 MRA | 36 (40.0) | 13 (29.5) | 0.24 Ivabradine … Diabetes mellitus | 1.31 (1.12-2.24) | 0.019 | 1.26 (1.05-2.08) | 0.016 Smoking | 1.06 (0.66-2.37) | 0.51 | | CPT | | | | ACEI/ARB | 1.02 (0.36-2.88) | 0.97 | | ARNI | 0.78 (0.26-2.36) | 0.65 | | BB | 0.71 (0.42-0.97) | 0.021 | 0.76 (0.54-0.98) | 0.013 MRA | 0.80 (0.31-2.07) | 0.62 | | Ivabradine …