Insufficient reduction in heart rate during hospitalization despite beta‐blocker treatment in acute decompensated heart failure: insights from the <scp>ASCEND‐HF</scp> trial

Kitai, Takeshi; Grodin, Justin L.; Mentz, Robert J.; Hernandez, Adrian F.; Butler, Javed; Metra, Marco; McMurray, John J.V.; Armstrong, Paul W.; Starling, Randall C.; O’Connor, Christopher M.; Swedberg, Karl; Tang, W.H. Wilson

doi:10.1002/ejhf.629

Cited by 19 publications

(14 citation statements)

References 29 publications

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“…In an analysis of 2906 patients with AHF enrolled in ASCEND‐HF, Kitai et al show that a heart rate ≥70 bpm at discharge is associated with reduced survival. The association of tachycardia with increased mortality was independent of other baseline variables related to outcomes, including beta‐blocker therapy . Similar results have been shown by two previous studies and confirm that tachycardia may be target of treatment also in the patients recently hospitalized for AHF …”

Section: Acute Heart Failuresupporting

confidence: 88%

February 2017 at a glance: fibrosis, acute heart failure and neurologic abnormalities

Metra

2017

European J of Heart Fail

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Section: Acute Heart Failuresupporting

confidence: 88%

February 2017 at a glance: fibrosis, acute heart failure and neurologic abnormalities

Metra

2017

European J of Heart Fail

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“…The severity of cardiac pathological remodeling frequently predicts treatment outcome and patient response [98]. In light of the current findings, such remodeling can be reversed and result in improved of cardiac function and, consequently, better patient prognosis and survival [99][100][101]. Reverse remodeling (RR) can be defined by any functional, structural, cellular, and/or molecular changes, resulting in improved heart function following pathological remodeling [99].…”

Section: Pathological Reverse Remodelingmentioning

confidence: 96%

Non-Coding RNAs as Blood-Based Biomarkers in Cardiovascular Disease

Videira

Martins

Falcão-Pires

2020

IJMS

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In 2020, cardiovascular diseases (CVDs) remain a leading cause of mortality and morbidity, contributing to the burden of the already overloaded health system. Late or incorrect diagnosis of patients with CVDs compromises treatment efficiency and patient’s outcome. Diagnosis of CVDs could be facilitated by detection of blood-based biomarkers that reliably reflect the current condition of the heart. In the last decade, non-coding RNAs (ncRNAs) present on human biofluids including serum, plasma, and blood have been reported as potential biomarkers for CVDs. This paper reviews recent studies that focus on the use of ncRNAs as biomarkers of CVDs.

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“…4, 17 Poorer outcome are associated with a lower systolic blood pressure and higher heart rate and their decrease or lack of decrease, respectively, during follow-up. [18][19][20] The role of comorbidities is outlined in the next chapters.…”

Section: Clinical Signsmentioning

confidence: 99%

“…233 Heart rate has prognostic value also in acute HF with tachycardia and a lack of decrease in heart rate before discharge associated with poorer outcomes. 18 In addition to clinical signs, imaging techniques are used to detect the severity of the haemodynamic impairment and relief from congestion. 225 Echocardiography allows an estimate of LV filling pressure and pulmonary artery pressure.…”

Section: Acute Heart Failurementioning

confidence: 99%

Highlights in heart failure

et al. 2019

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Heart failure (HF) remains a major cause of mortality, morbidity, and poor quality of life. It is an area of active research. This article is aimed to give an update on recent advances in all aspects of this syndrome. Major changes occurred in drug treatment of HF with reduced ejection fraction (HFrEF). Sacubitril/valsartan is indicated as a substitute to ACEi/ARBs after PARADIGM-HF (hazard ratio [HR], 0.80; 95% confidence interval [CI], 0.73 to 0.87 for sacubitril/valsartan vs. enalapril for the primary endpoint and Wei, Lin and Weissfeld HR 0.79, 95% CI 0.71-0.89 for recurrent events). Its initiation was then shown as safe and potentially useful in studies in patients hospitalized for acute HF. More recently, DAPA-HF trial showed the beneficial effects of the sodium-glucose transporter type 2 (SGLT2) inhibitor dapaglifozin vs. placebo, added to optimal standard therapy [HR, 0.74; 95% CI, 0.65 to 0.85;0.74; 95% CI, 0.65 to 0.85 for the primary endpoint]. Trials with other SGLT 2 inhibitors and in other patients, such as those with HF with preserved ejection fraction (HFpEF) or with recent decompensation, are ongoing. Multiple studies showed the unfavourable prognostic significance of abnormalities in serum potassium levels. Potassium lowering agents may allow initiation and titration of mineralocorticoid antagonists in a larger proportion of patients. Meta-analyses suggest better outcomes with ferric carboxymaltose in patients with iron deficiency. Drugs effective in HFrEF may be useful also in HF with mid-range ejection fraction. Better diagnosis and phenotype characterization seem warranted in HF with preserved ejection fraction. These and other burning aspects of HFpEF research are summarized and reviewed in this article.A multiparametric approach is often proposed for risk stratification of HF patients. The prognostic accuracy of the metabolic exercise test data combined with cardiac and kidney indexes risk score was found as superior to the HF Survival Score and Seattle HF model risk scores in a cohort of 6112 1106 D. Tomasoni et al.

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Insufficient reduction in heart rate during hospitalization despite beta‐blocker treatment in acute decompensated heart failure: insights from the ASCEND‐HF trial

Abstract: Despite current beta-blocker therapy, many patients with hospitalized ADHF with reduced LVEF have relatively high discharge HR, and discharge HR is associated with higher mortality. Further studies are warranted to determine the optimal strategy for HR control to improve outcomes.

Cited by 19 publications

References 29 publications

February 2017 at a glance: fibrosis, acute heart failure and neurologic abnormalities

February 2017 at a glance: fibrosis, acute heart failure and neurologic abnormalities

Non-Coding RNAs as Blood-Based Biomarkers in Cardiovascular Disease

Highlights in heart failure

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