A meta‐analysis of the effect of angiotensin‐converting enzyme inhibitors on functional capacity in patients with symptomatic left ventricular systolic dysfunction

Abdulla, Jawdat; Abildstrøm, Steen Zabell; Christensen, Erik; Køber, Lars; Torp‐Pedersen, Christian

doi:10.1016/j.ejheart.2004.02.002

Cited by 28 publications

(18 citation statements)

References 58 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The above functional changes produced by ESA are at least equal to those produced by ACEI [43] and β-blockers [44] in CHF, underlining the possible significance of correction of the anemia by ESA in CHF if these results are verified by larger studies.…”

Section: The Effect Of Correction Of Anemia In Chf Patients Treated Wmentioning

confidence: 68%

The Anemia of Heart Failure

Silverberg¹,

Wexler²,

Palazzuoli³

et al. 2009

Acta Haematol

View full text Add to dashboard Cite

Anemia is common in congestive heart failure (CHF) and is associated with an increased mortality and morbidity. The most likely causes of anemia are chronic kidney disease (CKD) and excessive cytokine production, both of which can cause depression of erythropoietin (EPO) production and bone marrow activity. The cytokines also induce iron deficiency by both reducing gastrointestinal iron absorption and iron release from iron stores located in the macrophages and hepatocytes. Iron deficiency can cause thrombocytosis which might also contribute to cardiovascular complications in both CHF and CKD and is partially reversible with iron treatment. Thus attempts to control this anemia will have to consider both the use of erythropoiesis-stimulating agents (ESA), such as EPO, as well as oral and, probably more importantly, intravenous (IV) iron. The many studies on anemia in CHF patients treated with ESA and oral or IV iron, and even with IV iron without ESA have up to now shown a quite consistent positive effect on hospitalization, fatigue, shortness of breath, quality of life, exercise capacity, and β-natriuretic peptide reduction, in the absence of increased cardiovascular damage related to the therapy. Adequately powered long-term placebo-controlled studies of ESA and/or IV iron are currently being carried out and their results are eagerly awaited.

show abstract

Section: The Effect Of Correction Of Anemia In Chf Patients Treated Wmentioning

confidence: 68%

The Anemia of Heart Failure

Silverberg¹,

Wexler²,

Palazzuoli³

et al. 2009

Acta Haematol

View full text Add to dashboard Cite

show abstract

“…31 Impaired PA may result from chronotropic incompetence, exercise-induced myocardial ischemia, and mitral regurgitation. 39 Treatment with an ACE inhibitor improves exercise duration 40 as well as peak aerobic capacity. 41 There is a direct benefit on cardiac performance through the inhibition of the renin-angiotensin-aldosterone system.…”

Section: Discussionmentioning

confidence: 99%

Physical Activity Measured With Implanted Devices Predicts Patient Outcome in Chronic Heart Failure

Conraads

Spruit

Braunschweig

et al. 2014

Circ: Heart Failure

106

View full text Add to dashboard Cite

Background— Physical activity (PA) predicts cardiovascular mortality in the population at large. Less is known about its prognostic value in patients with chronic heart failure (HF). Methods and Results— Data from 836 patients with implantable cardioverter defibrillator without or with cardiac resynchronization therapy enrolled in the Sensitivity of the InSync Sentry OptiVol feature for the prediction of Heart Failure (SENSE-HF) 1 study and the Diagnostic Outcome Trial in Heart Failure (DOT-HF) were pooled. The devices continuously measured and stored total daily active time (single-axis accelerometer). Early PA (average daily activity over the earliest 30-day study period) was studied as a predictor of time to death or HF-related hospital admission (primary end point). Data from 781 patients were analyzed (65±10 years; 85% men; left ventricular ejection fraction, 26±7%). Older age, shorter height, ischemic cause, peripheral artery disease, atrial fibrillation, diabetes mellitus, rales, peripheral edema, higher New York Heart Association class, lower diastolic blood pressure, and no angiotensin II receptor blocker/angiotensin-converting enzyme inhibitor use were associated with reduced early PA. The primary end point occurred in 135 patients (15±7 months of follow-up). In multivariable analysis including baseline variables, early PA predicted death or HF hospitalization, with a 4% reduction in risk for each 10 minutes per day additional activity (hazard ratio [HR], 0.96; confidence interval [CI], 0.94–0.98; P =0.0002 compared with a model with the same baseline variables but without PA). PA also predicted death (HR, 0.93; CI, 0.90–0.96; P <0.0001) and HF hospitalization (HR, 0.97; CI, 0.95–0.99; P =0.011). Conclusions— Early PA, averaged over a 30-day window early after defibrillator implantation or cardiac resynchronization therapy in patients with chronic HF, predicted death or HF hospitalization, as well as mortality and HF hospitalization separately, accounting for baseline HF severity. Clinical Trial Registration Information— URL: http://www.clinicaltrials.gov . Unique identifiers: NCT00400985, NCT00480077.

show abstract

“…Neurohormonal antagonists slow (but probably rarely prevent) this progression, thereby delaying death and avoiding or postponing hospital admissions [1,2]. The effect of these drugs on patients' symptoms is less well defined and that on functional capacity less convincing [3,4]. Implantable cardioverter defibrillators (ICDs) also reduce the risk of sudden death, which causes a larger proportion of deaths in patients with mild HF, compared to those with severe HF.…”

Section: Introduction: Changing Clinical Characteristics Of Heart Faimentioning

confidence: 99%

Advanced chronic heart failure: A position statement from the Study Group on Advanced Heart Failure of the Heart Failure Association of the European Society of Cardiology

Metra

Ponikowski²,

Dickstein

et al. 2007

European J of Heart Fail

357

242

View full text Add to dashboard Cite

Therapy has improved the survival of heart failure (HF) patients. However, many patients progress to advanced chronic HF (ACHF). We propose a practical clinical definition and describe the characteristics of this condition.Patients that are generally recognised as ACHF often exhibit the following characteristics: 1) severe symptoms (NYHA class III to IV); 2) episodes with clinical signs of fluid retention and/or peripheral hypoperfusion; 3) objective evidence of severe cardiac dysfunction, shown by at least one of the following: left ventricular ejection fraction b 30%, pseudonormal or restrictive mitral inflow pattern at Dopplerechocardiography; high left and/or right ventricular filling pressures; elevated B-type natriuretic peptides; 4) severe impairment of functional capacity demonstrated by either inability to exercise, a 6-minute walk test distance b 300 m or a peak oxygen uptake b 12-14 ml/kg/min; 5) history of N1 HF hospitalisation in the past 6 months; 6) presence of all the previous features despite optimal therapy. This definition identifies a group of patients with compromised quality of life, poor prognosis, and a high risk of clinical events. These patients deserve effective therapeutic options and should be potential targets for future clinical research initiatives.

show abstract

A meta‐analysis of the effect of angiotensin‐converting enzyme inhibitors on functional capacity in patients with symptomatic left ventricular systolic dysfunction

Cited by 28 publications

References 58 publications

The Anemia of Heart Failure

The Anemia of Heart Failure

Physical Activity Measured With Implanted Devices Predicts Patient Outcome in Chronic Heart Failure

Advanced chronic heart failure: A position statement from the Study Group on Advanced Heart Failure of the Heart Failure Association of the European Society of Cardiology

Contact Info

Product

Resources

About