Clinical trials update from the Heart Failure Society of America: EMOTE, HERB‐CHF, BEST genetic sub‐study and RHYTHM‐ICD

Lalukota, Krishna; Cleland, John G.F.; Ingle, Lee; Clark, Andrew L.; Coletta, A

doi:10.1016/j.ejheart.2004.10.003

Cited by 13 publications

(9 citation statements)

References 14 publications

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“…It is reported to have positive inotropic, vasodilator, anti‐ischaemic, anti‐arrhythmic and anti‐oxidant properties. A previous small randomised controlled trial showed no evidence of a beneficial effect of crataegus extract over placebo [13].…”

Section: Survival and Prognosis: Investigation Of Crataegus Extract Wmentioning

confidence: 87%

Clinical trials update from the American College of Cardiology 2007: ALPHA, EVEREST, FUSION II, VALIDD, PARR‐2, REMODEL, SPICE, COURAGE, COACH, REMADHE, pro‐BNP for the evaluation of dyspnoea and THIS‐diet

Cleland

Coletta

Clark

2007

European J of Heart Fail

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This article provides information and a commentary on trials relevant to the pathophysiology, prevention and treatment of heart failure, presented at the American College of Cardiology meeting in March 2007. Unpublished reports should be considered as preliminary data, as analyses may change in the final publication.The ALPHA study suggested that patients with heart failure (HF) due to idiopathic dilated cardiomyopathy who have a negative T-wave alternans test have a good prognosis and are unlikely to benefit from ICD therapy. EVEREST provides some evidence of short-term symptom benefit of tolvaptan in patients with acute decompensated HF but no clinically important long-term benefit. FUSION II failed to show a benefit of nesiritide in patients with chronic decompensated HF. Reducing blood pressure in hypertensive patients improved diastolic dysfunction in VALIDD. Eplerenone did not improve left ventricular remodelling in mild to moderate chronic HF. Selecting HF patients for revascularisation using FDG-PET imaging did not significantly improve outcome. Crataegus extract added to standard HF therapy did not reduce morbidity or mortality in SPICE. The COURAGE study, conducted in patients without HF or major cardiac dysfunction, showed that PCI did not reduce cardiac morbidity or mortality and can be safely deferred in patients with stable coronary disease on optimal medical therapy. The COACH study failed to show that HF nurse-intervention could reduce hospitalisations but did show trends to lower mortality, especially amongst patients with reduced ejection fraction; however, the smaller REMADHE study suggested striking benefits on morbidity and mortality. A large study of BNP provided additional information on its ability to distinguish cardiac and pulmonary breathlessness. The importance of dietary intervention in post-MI patients was highlighted by the findings of THIS-diet study.

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Section: Survival and Prognosis: Investigation Of Crataegus Extract Wmentioning

confidence: 87%

Clinical trials update from the American College of Cardiology 2007: ALPHA, EVEREST, FUSION II, VALIDD, PARR‐2, REMODEL, SPICE, COURAGE, COACH, REMADHE, pro‐BNP for the evaluation of dyspnoea and THIS‐diet

Cleland

Coletta

Clark

2007

European J of Heart Fail

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“…The 30-day time point was selected to allow sufficient time for clinical stabilization and restoration of cardiopulmonary homoeostasis, as reported previously [40]. Similar time points were selected in clinical trials such as EMOTE (EnoxiMone in intravenous inOTropE) investigating the effect of enoximone on the success of weaning chronic inotropic support in patients with advanced heart failure [40]. At 30-days post-therapy, all patients exhibited marked improvement in cardiac function, as evidenced by the improvement from NYHA class IV pre-admission to NYHA class II-III post-treatment and by the 6-min walk test.…”

Section: Discussionmentioning

confidence: 99%

Increased systemic inflammation and oxidative stress in patients with worsening congestive heart failure: improvement after short-term inotropic support

et al. 2006

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In the present study, we evaluated circulating pro-inflammatory mediators and markers of oxidative stress in patients with decompensated CHF (congestive heart failure) and assessed whether clinical recompensation by short-term inotropic therapy influences these parameters. Patients with worsening CHF (n=29, aged 61.9+/-2.7 years), NYHA (New York Heart Association) class III-IV, and left ventricular ejection fraction of 23.7+/-1.8% were studied. Controls comprised age-matched healthy volunteers (n=15; 54.1+/-3.2 years). Plasma levels of cytokines [IL (interleukin)-6 and IL-18], chemokines [MCP-1 (monocyte chemotactic protein-1)], adhesion molecules [sICAM (soluble intercellular adhesion molecule), sE-selectin (soluble E-selectin)], systemic markers of oxidation [TBARS (thiobarbituric acid-reactive substances), 8-isoprostaglandin F(2alpha) and nitrotyrosine] and hs-CRP (high-sensitivity C-reactive protein) were measured by ELISA and colorimetric assays at admission and 30 days following 72-h milrinone (n=15) or dobutamine (n=14) infusion. Plasma IL-6, IL-18, sICAM, E-selectin, hs-CRP and oxidative markers were significantly higher in patients on admission before inotropic treatment compared with controls (P<0.05). Short-term inotropic support improved clinical status as assessed by NYHA classification and by the 6-min walk test and significantly decreased plasma levels of IL-6, IL-18, sICAM, hs-CRP and markers of oxidation (P<0.05) at 30 days. The effects of milrinone and dobutamine were similar. In conclusion, our results demonstrate that patients with decompensated CHF have marked systemic inflammation and increased production of oxygen free radicals. Short-term inotropic support improves functional status and reduces indices of inflammation and oxidative stress in patients with decompensated CHF.

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“…The more recent advances in CHF therapy have underlined the importance of the peripheral and autonomic adjustments developed in the syndrome. Intervention that ameliorates only the cardiac function may be harmful if not accompanied by improvements in the compensatory mechanisms, such as neurohormonal activation and ventilatory changes 11 …”

Section: Introductionmentioning

confidence: 99%

Time Course of Effects of Cardiac Resynchronization Therapy in Chronic Heart Failure: Benefits in Patients with Preserved Exercise Capacity

Piepoli

Villani

Corrà

et al. 2008

Pacing Clinical Electrophis

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Clinical trials update from the Heart Failure Society of America: EMOTE, HERB‐CHF, BEST genetic sub‐study and RHYTHM‐ICD

Cited by 13 publications

References 14 publications

Clinical trials update from the American College of Cardiology 2007: ALPHA, EVEREST, FUSION II, VALIDD, PARR‐2, REMODEL, SPICE, COURAGE, COACH, REMADHE, pro‐BNP for the evaluation of dyspnoea and THIS‐diet

Clinical trials update from the American College of Cardiology 2007: ALPHA, EVEREST, FUSION II, VALIDD, PARR‐2, REMODEL, SPICE, COURAGE, COACH, REMADHE, pro‐BNP for the evaluation of dyspnoea and THIS‐diet

Increased systemic inflammation and oxidative stress in patients with worsening congestive heart failure: improvement after short-term inotropic support

Time Course of Effects of Cardiac Resynchronization Therapy in Chronic Heart Failure: Benefits in Patients with Preserved Exercise Capacity

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