New drugs for the treatment of chronic heart failure with a reduced ejection fraction: What the future may hold

Sciatti, Edoardo; Dallapellegrina, Lucia; Metra, Marco; Lombardi, Carlo

doi:10.2459/jcm.0000000000000850

Cited by 11 publications

(5 citation statements)

References 101 publications

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“…It is not recommended in patients with concomitant use of phosphodiesterase-5 inhibitors (sildenafil and vardenafil) due to increased risk of hypotension. 17 Prescribers are advised to avoid use if the patient is taking avanafil or tadalafil. Prescribers are advised to monitor and modify treatment as needed with concomitant use of cilostazol, dipyridamole, epoprostenol, iloprost, isosorbide dinitrate, isosorbide mononitrate, milrinone, NO, nitrite, nitroglycerin, nitroprusside, sacubitril, and treprostinil.…”

Section: Drug Interactionsmentioning

confidence: 99%

Vericiguat: A Novel Soluble Guanylate Cyclase Stimulator for Use in Patients With Heart Failure

Gupta

Lin

Maitz

et al. 2022

Cardiology in Review

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Heart failure (HF) affects 6.2 million Americans and is increasing annually in its frequency. Treatment of HF has been at the forefront of medical advancements due to the financial burden on our health care system. As such, changes to the guidelines regarding standard of care have been evolving over the last decade with the recent additions of sacubitril-valsartan and sodium glucose co-transporter-2 inhibitors to standard of care in the treatment of HF. Despite the aforementioned expansions in treatment options, HF continues to have a significant impact on the American health care system. Most recently, a novel drug vericiguat that targets an unprecedented pathway for the treatment of HF was Food and Drug Administration approved for the management of patients with HF with a reduced ejection fraction with a recent hospitalization or need for outpatient intravenous diuretics. In clinical trials, vericiguat was associated with a reduction in death from cardiovascular causes and first hospitalization in comparison to placebo. The aim of this review is to provide a comprehensive literature analysis of the various trials surrounding the approval of vericiguat and to both inform and synthesize the data surrounding the clinical use of vericiguat. The introduction of Vericiguat should be considered as a treatment option in patients to decrease the mortality/morbidity of HF with reduced ejection fraction and to increase the quality of life.

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Section: Drug Interactionsmentioning

confidence: 99%

Vericiguat: A Novel Soluble Guanylate Cyclase Stimulator for Use in Patients With Heart Failure

Gupta

Lin

Maitz

et al. 2022

Cardiology in Review

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“…According to their characteristics, ZS-9 could be a useful drug in the acute hyperkalemia setting, while patiromer could be used in the chronic context. Such drugs could therefore represent an additional weapon for cardiologists in the management of patients with HF in order to avoid underdosing or withdrawal of essential drugs, with potential consequent benefit in terms of prognosis (Desai et al, 2020;Kovesdy et al, 2020;Sciatti et al, 2019).…”

Section: Prospectives For Use Of New Drugsmentioning

confidence: 99%

Hyperkalemia in heart failure: current treatment and new therapeutic perspectives

Minà

Ajello

Gesaro

et al. 2020

Rev. Cardiovasc. Med.

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Hyperkalemia in heart failure is a condition that can occur with relative frequency because it is related to pathophysiological aspects of the disease, and favored by drugs that form the basis of chronic cardiac failure therapy. Often, associated comorbidities, such as kidney failure or diabetes mellitus can further adversely affect potassium levels. Hyperkalemia can result in acute and even severe clinical manifestations that put patients at risk. On the other hand, the finding of hyperkalemia in a chronic context can lead to a reduction in dosages or to suspension of drugs such as angiotensin-converting enzymes inhibitor, angiotensin receptor blocker, angiotensin receptor neprilysin inhibitor, and mineralcorticoid receptor antagonist, first line in the treatment of the disease, with negative effects in prognostic terms. Therapies for the correction of hyperkalemia have so far mainly concerned the treatment of acute clinical pictures. Newly developed molecules, such as patiromer or sodium zirconium cyclosilicate, now open new prospectives in the long-term management of hyperkalemia, and allow us to glimpse the possibility of a better titration of the cardinal drugs for heart failure, with consequent positive effects on patient prognosis. The aim of this review is to focus on the problem of hyperkalemia in the setting of heart failure, with particular regard to its incidence, its prognostic role, and the underlining pathophysiological mechanisms. The review also provides an overview of therapeutic strategies for correcting hyperkalemia in acute and chronic conditions, with a focus on the new potassium binders that promise to improve management of heart failure.

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“…Heart failure (HF) patients with reduced LVEF (HFrEF) are associated with persistent symptoms and significant functional limitations (Sénior et al, 2016), high mortality and rehospitalization rates, poor quality of life, and high health care costs (Crespo-Leiro et al, 2016;Ponikowski et al, 2016;Sciatti et al, 2019). According to the 2012 European Society of Cardiology (ESC) Guidelines, cardiac resynchronization therapy (CRT) should be considered in patients in New York Heart Association (NYHA) functional class III or ambulatory class IV with QRS duration ≥120 ms and ejection fraction (EF) ≤35% (McMurray et al, 2012).…”

Section: Introductionmentioning

confidence: 99%

Effects of renal denervation therapy on cardiac function and malignant arrhythmia in patients with reduced left ventricular ejection fraction and narrow QRS complexes treated with implantable cardioverter defibrillator

Yang

Gao

et al. 2022

Front. Physiol.

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Objective: The purpose of this study was to explore the effects of renal denervation (RDN) on cardiac function and malignant arrhythmia in patients with reduced left ventricular ejection fraction (HFrEF) and narrow QRS treated with an implantable cardioverter defibrillator (ICD).Methods: A total of 20 eligible HFrEF patients [left ventricular ejection fraction (LVEF) <40%] and narrow QRS complexes (QRS duration <120 ms) were randomized into either the ICD plus RDN group or the ICD only group during 17 April 2014 to 22 November 2016. Clinical data, including clinical characteristics, blood biochemistry, B-type natriuretic peptide, echocardiographic indexes, 6-min walk distance (6MWD), New York Heart Association (NYHA) classification, and count of ICD discharge events before and after the operation were analyzed. Patients were followed up for up to 3 years post ICD or ICD plus RDN.Results: Baseline clinical data were comparable between the two groups. Higher LVEF (%) (mixed model repeated measure, p = 0.0306) (39.50% ± 9.63% vs. 31.20% ± 4.52% at 1 year; 41.57% ± 9.62% vs. 31.40% ± 8.14% at 3 years), systolic blood pressure (p = 0.0356), and longer 6MWD (p < 0.0001) as well as reduction of NYHA classification (p < 0.0001) were evidenced in the ICD plus RDN group compared to ICD only group during follow-up. Patients in the ICD plus RDN group experienced fewer ICD discharge events (2 vs. 40) and decreased diuretic use; rehospitalization rate (30% vs. 100%, p = 0.0031) and cardiogenic mortality rate (0% vs. 50%, p = 0.0325) were also significantly lower in the ICD plus RDN group than in the ICD only group during follow-up.Conclusion: ICD implantation plus RDN could significantly improve cardiac function and cardiac outcome as well as increase exercise capacity compared to ICD only for HFrEF patients with narrow QRS complexes.

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New drugs for the treatment of chronic heart failure with a reduced ejection fraction: What the future may hold

Cited by 11 publications

References 101 publications

Vericiguat: A Novel Soluble Guanylate Cyclase Stimulator for Use in Patients With Heart Failure

Vericiguat: A Novel Soluble Guanylate Cyclase Stimulator for Use in Patients With Heart Failure

Hyperkalemia in heart failure: current treatment and new therapeutic perspectives

Effects of renal denervation therapy on cardiac function and malignant arrhythmia in patients with reduced left ventricular ejection fraction and narrow QRS complexes treated with implantable cardioverter defibrillator

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