Diastolic heart failure

Nicoara, Alina; Jones-Haywood, Mandisa Maia

doi:10.1097/aco.0000000000000276

Cited by 19 publications

(4 citation statements)

References 34 publications

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“…[2] Patients with an LVEF in the range of 40 to 49% now are defined as HF with mid-range ejection fraction (HFmrEF). [2,3] Over the next decade, HFmrEF and HFpEF are expected to become a dominant cause of HF worldwide, which result in high morbidity and mortality due to the lack of effective proven therapies, making it a provocative and important health problem. [4]…”

Section: Introductionmentioning

confidence: 99%

Efficacy and safety of spironolactone in the heart failure with mid-range ejection fraction and heart failure with preserved ejection fraction

Xiang

Shi

et al. 2019

Medicine

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Background: Recent studies have shown the efficacy for using spironolactone to treat heart failure with reduced ejection fraction (HFrEF), but the efficacy of spironolactone for heart failure with mid-range ejection fraction (HFmrEF) and heart failure with preserved ejection fraction (HFpEF) is unclear. This meta-analysis investigated the efficacy and safety of spironolactone in patients with HFmrEF and HFpEF. Methods and results: We searched several databases including PubMed and the Cochrane Collaboration, for randomized controlled trials (RCTs) that assessed spironolactone treatment in HFmrEF and HFpEF. Eleven RCTs including 4539 patients were included. Spironolactone reduced hospitalizations (odds ratio [OR], 0.84; 95% confidence interval [CI], 0.73–0.95; P = .006), improved New York Heart Association functional classifications (NYHA-FC) (OR, 0.35; 95% CI, 0.19–0.66; P = .001), decreased the levels of brain natriuretic peptide (BNP) (mean difference [MD], − 44.80 pg/mL; 95% CI, −73.44–−16.17; P = .002), procollagen type I C-terminal propeptide (PICP) (MD, −27.04 ng/mL; 95% CI, −40.77–−13.32, P < .001) in HFmrEF and HFpEF. Besides, it improved 6-minute walking distances (6-MWD) (standard weighted mean difference [SMD], 0.45 m; 95% CI, 0.27–0.64; P < .001), decreased amino-terminal peptide of procollagen type-III (PIIINP) (SMD, −0.37 μg/L; 95% CI, −0.59–−0.15; P = .001) in HFpEF only. The risks of hyperkalemia ( P <.001) and gynecomastia ( P <.001) were increased. Conclusion: Patients with HFmrEF and HFpEF could benefit from spironolactone treatment, with reduced hospitalizations, BNP levels, improved NYHA-FC, alleviated myocardial fibrosis by decreasing serum PICP in HFmrEF and HFpEF, decreased PIIINP levels and increased 6-MWD only in HFpEF. The risks of hyperkalemia and gynecomastia were significantly increased with the spironolactone treatment.

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Section: Introductionmentioning

confidence: 99%

Efficacy and safety of spironolactone in the heart failure with mid-range ejection fraction and heart failure with preserved ejection fraction

Xiang

Shi

et al. 2019

Medicine

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“…Diastolic dysfunction is characterized by slow or incomplete relaxation of the ventricles during diastole, which is a key pathogenic feature of HFPEF [14]. Calcium mishandling is a hallmark of HFPEF [11].…”

Section: Discussionmentioning

confidence: 99%

Effect of Valsartan on Sarcoplasmic Reticulum Ca2+-ATPase Pump of the Left Ventricular Myocardium in Rats with Heart Failure with Preserved Ejection Fraction

et al. 2016

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Objectives: The aim was to investigate the effects of valsartan on the sarcoplasmic reticulum Ca²⁺-ATPase pump (SERCA) and L-type Ca²⁺ channel current (I_CaL) of the left ventricular myocardium in rats with heart failure with preserved ejection fraction. Methods: The 30-week-old male spontaneously hypertensive rats (SHRs) are randomly divided into the non-Valsartan and Valsartan groups, and the 30-week-old male Wistar-Kyoto rats served as control rats. The expression of SERCA is measured by Western blot. The I_CaL is measured by whole-cell patch clamp. The left ventricular end-diastolic pressure and left ventricular relaxation time constant quantity are measured at the same time. Results: The left ventricular end-diastolic pressure is much higher in SHRs compared with that in control rats (p < 0.01). The left ventricular relaxation time constant quantity is markedly extended in SHRs compared with control rats (p < 0.01). Valsartan cannot increase the expression of SERCA nor decrease the density of I_CaL compared with the non-Valsartan group (p > 0.05). Conclusions: Valsartan has no effect on SERCA and I_CaL of the left ventricular myocardium in rats with heart failure with preserved ejection fraction.

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“…Advances in echocardiography, its noninvasive, safe, and easy use, have allowed Doppler echocardiography to become a cornerstone for diagnosing diastolic dysfunction in clinical practice 12 . In the ICU‐real life, the diagnosis of diastolic dysfunction and increased filling pressures is nevertheless complex and the clinical application of current guidelines algorithms are challenging and even not feasible 6,13–15 …”

Section: Introductionmentioning

confidence: 99%

“…[9][10][11] Advances in echocardiography, its noninvasive, safe, and easy use, have allowed Doppler echocardiography to become a cornerstone for diagnosing diastolic dysfunction in clinical practice. 12 In the ICU-real life, the diagnosis of diastolic dysfunction and increased filling pressures is nevertheless complex and the clinical application of current guidelines algorithms are challenging and even not feasible. 6,[13][14][15] An echo-dynamic approach may help assess different stages of diastolic dysfunction and identify patients at risk of acute HF, ultimately allowing to improve patient management.…”

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confidence: 99%

The value of a dynamic echocardiographic approach to diastolic dysfunction in intensive care medicine

Catena,

Volontè,

Rizzuto

et al. 2023

J of Clinical Ultrasound

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Diastolic dysfunction is an underestimated feature in the context of the critically ill setting and perioperative medicine. Advances in echocardiography, its noninvasive, safe and easy use, have allowed Doppler echocardiography to become a cornerstone for diagnosing diastolic dysfunction in clinical practice. The diagnosis of diastolic dysfunction and increased filling pressures is nevertheless complex. Using an echocardiographic assessment and the routine application of preload stress maneuvers during echocardiographic examination can help identify early stages of diastolic dysfunction leading to better management of patients at risk of acute heart decompensation in the perioperative period or during ICU stay.

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Diastolic heart failure

Abstract: The understanding of the phenotypic heterogeneity and multifactorial pathophysiology of DHF may lead to novel therapeutic targets in the future. Currently, the key to the treatment of DHF is aggressive management of contributing factors.

Cited by 19 publications

References 34 publications

Efficacy and safety of spironolactone in the heart failure with mid-range ejection fraction and heart failure with preserved ejection fraction

Efficacy and safety of spironolactone in the heart failure with mid-range ejection fraction and heart failure with preserved ejection fraction

Effect of Valsartan on Sarcoplasmic Reticulum Ca2+-ATPase Pump of the Left Ventricular Myocardium in Rats with Heart Failure with Preserved Ejection Fraction

The value of a dynamic echocardiographic approach to diastolic dysfunction in intensive care medicine

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