Beta-blockers and inhibitors of the renin-angiotensin aldosterone system for chronic heart failure with preserved ejection fraction

Martin, Nicole; Manoharan, Karthick; Davies, Ceri; Lumbers, R Thomas

doi:10.1002/14651858.cd012721.pub3

Cited by 30 publications

(26 citation statements)

References 422 publications

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“…Some large-scale clinical trials abroad have also confirmed this result [ 30 , 31 ]. Some studies found that for patients who were routinely followed up at the hospital every quarter, inappropriate discharge events in ICD occur 64 days earlier than the next follow-up and remote monitoring could detect these inappropriate discharge events in time, which provided sufficient reaction time for doctors [ 32 ].…”

Section: Discussionmentioning

confidence: 99%

Effect of ICD/CRT-D Implantation on Adverse Events and Readmission Rate in Patients with Chronic Heart Failure (CHF)

Liu

Xing

2022

Computational and Mathematical Methods in Medicine

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Objective. To explore the effect of implantable cardioverter defibrillator/cardiac resynchronization therapy defibrillator (ICD/CRT-D) implantation on adverse events and the readmission rate in patients with chronic heart failure (CHF). Methods. Sixty patients with CHF treated in our hospital from April 2019 to July 2021 were enrolled. The patients were randomly assigned into the control group and study group. The control group received routine intervention, and the study group received remote management with ICD/CRT-D implantation. Results. First of all, we compared the general data of the two groups. There was no significant difference in LVEF, NYHA grade, concomitant disease, and history of arrhythmia ( P > 0.05 ). Secondly, we compared the end-point events. In the study group, 5 cases of heart failure were readmitted, 0 cases died, and 4 cases were admitted to hospital with arrhythmia and ICD events, with a total incidence of 30.0%, while in the control group, 12 cases were rehospitalized with heart failure, 3 cases died, 25 cases were admitted with arrhythmia and ICD events, and the total incidence rate was 56.67% ( P < 0.05 ). In terms of the readmission rate of patients with heart failure in grade NYHAII and grade III, among the patients with grade NYHAII, the number of patients with heart failure less than once in the study group was higher compared to that in the control group and the number of patients with heart failure ≥ once in the study group was lower compared to that in the control group ( P < 0.05 ). Among the patients with grade NYHAIII, the number of patients with heart failure less than once in the study group was higher compared to that in the control group and the number of patients with heart failure ≥ once in the study group was lower compared to that in the control group. There exhibited no significant difference in the data ( P > 0.05 ). Considering the occurrence of VT and VF events, the study team reported that 14 patients recorded a total of 276 ventricular arrhythmias: 261 ventricular tachycardia and 15 ventricular fibrillations. Among them, 24 VT (9.2%) and 4 VF (26.7%) were determined to be misrecognition of the equipment. A total of 178 ventricular arrhythmias were recorded in 13 patients in the control group, including 152 ventricular tachycardia and 26 ventricular fibrillations. Among them, 10 VT (6.6%) and 8 VF (30.8%) were determined as misrecognition of the device. In regard to the treatment results of the two groups, after admission to the hospital for radio frequency, ablation, and adjustment of drug treatment to reprogram control, the patients did not reappear to have CRT-D misidentification and misdischarged. Finally, we compared the diagnosis time of VT/VE events. The time from VT/VE events to diagnosis in 14 patients in the study group was 2.55 ± 1.41 days, and that in 13 patients in the control group was 37.32 ± 15.31 days. The discovery of ICD events in the study group was significantly earlier compared to that in the routine follow-up group ( P < 0.05 ). This gives doctors enough time to assess the patient’s condition and determine a further diagnosis and treatment plan. Conclusion. Using ICD/CRT-D implantation to remotely monitor patients with CHF, through remote monitoring of the 24-hour average heart rate and the heart rate at rest and patient activity and other parameters and early intervention, the readmission rate caused by the deterioration of heart failure can be reduced. Compared with routine follow-up, remote monitoring significantly reduced the diagnosis time of VT/VE events.

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Section: Discussionmentioning

confidence: 99%

Effect of ICD/CRT-D Implantation on Adverse Events and Readmission Rate in Patients with Chronic Heart Failure (CHF)

Liu

Xing

2022

Computational and Mathematical Methods in Medicine

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“…Thus, the use of ACEI or ARB for direct treatment of HFpEF is not supported by evidence. A recent meta-analysis which included 10 trials investigating beta-blockers showed that, beta-blockers might reduce cardiovascular mortality in HFpEF patients, but the evidence certainty was low ( 42 ). Till now, there is no large prospective trials focusing on calcium channel blockers in HFpEF.…”

Section: Does Treatment For Arterial Stiffness Benefit In Hfpef?mentioning

confidence: 99%

Association Between Arterial Stiffness and Heart Failure With Preserved Ejection Fraction

Chen

Liu

2021

Front. Cardiovasc. Med.

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Cardiovascular diseases are the leading cause of mortality in the world. Heart failure with preserved ejection fraction (HFpEF) accounts for about half of all heart failure. Unfortunately, the mechanisms of HFpEF are still unclear, leading to little progress of effective treatment of HFpEF. Arterial stiffness is the decrement of arterial compliance. The media of large arteries degenerate in both physiological and pathological conditions. Many studies have proven that arterial stiffness is an independent risk factor for cardiovascular disorders including diastolic dysfunction. In this perspective, we discussed if arterial stiffness is related to HFpEF, and how does arterial stiffness contribute to HFpEF. Finally, we briefly summarized current treatment strategies on arterial stiffness and HFpEF. Though some new drugs were developed, the safety and effectiveness were not adequately assessed. New pharmacologic treatment for arterial stiffness and HFpEF are urgently needed.

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“…[16] The same applies to a blockade of the sympathetic adrenergic system using beta blockers. [17,18] Because of this, it was also surprising that there was already veri able reverse remodeling in our small HFpEF cohort. The absence of signi cant changes in HFmrEF maybe due to the small sample size.…”

Section: Discussionmentioning

confidence: 92%

Myocardial Deformation Parameters Assessed By CMR Feature Tracking In Chronic Heart Failure: The Influence of An Optimal Medical Therapy On Myocardial Remodeling

Kersten

Hackenbroch

Gann³

et al. 2021

Preprint

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Background: Myocardial deformation parameters have been shown to yield early detection of pathological changes in chronic heart failure (CHF). Aim of our study was to evaluate myocardial deformation changes under optimal medical therapy (OMT) in CHF patients.Methods: CHF patients were examined longitudinally with two cardiac magnetic resonance imaging (CMR) examinations at a median time interval of 140 days. Left and right ventricular volumes were quantified, and deformation analysis was performed using feature tracking, respectively.Results: 57 patients were included into the study. There was a high rate of OMT with a prescription of beta blockers in 98.2% and ACE-inhibitors/Angiotensin receptor blockers in 93.0%. In the total cohort, there were indications of positive remodeling with a significant improvement in left ventricular (LV) ejection fraction (38.9% ± 11.6 vs. 43.0% ± 12.7, p=0.009), LV enddiastolic volume indexed (92.1ml/m2 ± 23.5 vs. 87.2ml/m2 ± 21.2, p=0.007), LV mass (140.3g ± 35.7 vs. 128.0g ± 34.4, p=0.001) and right ventricular global longitudinal strain (RV GLS) (-18.1% ± 5.1 vs. -20.3% ± 4.5, p<0.001) during follow-up. Discussion: Patients with CHF and OMT show positive reverse remodeling with improvement of LV volumes and function and RV GLS. This has a potential impact on the surveillance of this patient group, which should be further investigated in larger prospective studies.

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Beta-blockers and inhibitors of the renin-angiotensin aldosterone system for chronic heart failure with preserved ejection fraction

Abstract: Beta-blockers and inhibitors of the renin-angiotensin aldosterone system for chronic heart failure with preserved ejection fraction.

Cited by 30 publications

References 422 publications

Effect of ICD/CRT-D Implantation on Adverse Events and Readmission Rate in Patients with Chronic Heart Failure (CHF)

Effect of ICD/CRT-D Implantation on Adverse Events and Readmission Rate in Patients with Chronic Heart Failure (CHF)

Association Between Arterial Stiffness and Heart Failure With Preserved Ejection Fraction

Myocardial Deformation Parameters Assessed By CMR Feature Tracking In Chronic Heart Failure: The Influence of An Optimal Medical Therapy On Myocardial Remodeling

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