Phosphodiesterase inhibitor for heart failure with preserved ejection fraction: A systematic review and meta-analysis

Chen, Zhu; Zhao, Kaihui; Xiao, Changhu; He, Ziyu; Li, Sha; Wu, Xuemei; Shi, Shuting; Guo, Yuan

doi:10.1016/j.jsps.2022.05.012

Cited by 3 publications

(1 citation statement)

References 30 publications

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“…However, to date, there is no convincing evidence that PDE5 inhibition would have a significant impact on the quality of life, exercise capacity, or pulmonary pressure in patients with HFpEF. 4 Of note, downregulated NO signaling leading to significantly lower cGMP levels would also necessarily significantly dampen the therapeutic efficacy of PDE5 inhibitors while a negative cGMP-PDE5 feedback loop would additionally affect the therapeutic effect by increasing PDE5 activity at higher cGMP levels. [5][6][7] Finally, targeted metabolomic profiling in patients with HFpEF revealed that PDE5 inhibition with sildenafil had adverse effects on mitochondrial function while inducing endoplasmic stress, which may have contributed to the neutral results of the PhosphdiesteRasE-5 Inhibition to Improve CLinical Status and EXercise Capacity in Diastolic Heart Failure (RELAX) trial.…”

Section: Introductionmentioning

confidence: 99%

Clinical and Hemodynamic Improvement in Pulmonary Hypertension After Switching to Sacubitril/Valsartan in Patients With Heart Failure With Preserved Ejection Fraction

Brockmöller,

Ivanoski,

Hundack

et al. 2023

Journal of Cardiovascular Pharmacology

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Patients with heart failure with preserved ejection fraction (HFpEF) and pulmonary hypertension have poor survival, and established medical therapies for both conditions are not available. In this retrospective study of 69 patients with HFpEF and either isolated postcapillary pulmonary hypertension (IpcPH, n = 53) or combined postcapillary and precapillary pulmonary hypertension (CpcPH, n = 16), we investigated the effects of sacubitril/valsartan on pulmonary hypertension measured using right heart catheterization (RHC) at baseline (i.e., pre-sacubitril/valsartan) and 99 (94 - 123) days after switching to sacubitril/valsartan. After switching to sacubitril/valsartan, RHC showed significantly lower pulmonary artery pressures (systolic/diastolic/mean) in both patient groups compared to pre-sacubitril/valsartan (IpcPH:44 [38 - 52]/15 [12 - 19]/28 [22 - 33] mm Hg versus 47 [40 - 55]/18 [15 - 23]/31 [26 - 35] mm Hg, p < 0. 01; CpcPH: 54 [43 - 57]/18 [12 - 23]/34 [30 - 36] mm Hg versus 61 [50 - 79]/24 [19 - 30]/40 [31 - 53] mm Hg, p < 0.05). The median sacubitril/valsartan dose at follow-up was 24/26 (24/26 - 49/51) mg BID in both IpcPH and CpcPH patients. Clinically, the New York Heart Association functional class improved by at least one class in 32 of 69 patients (p < 0.01). In conclusion, sacubitril/valsartan therapy improves pulmonary hypertension in patients with HFpEF and either IpcPH or CpcPH. Further prospective randomized trials are needed for confirmation of our results.

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Section: Introductionmentioning

confidence: 99%

Clinical and Hemodynamic Improvement in Pulmonary Hypertension After Switching to Sacubitril/Valsartan in Patients With Heart Failure With Preserved Ejection Fraction

Brockmöller,

Ivanoski,

Hundack

et al. 2023

Journal of Cardiovascular Pharmacology

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Exploring PKG signaling as a therapeutic avenue for pressure overload, ischemia, and HFpEF

Zhazykbayeva,

Budde,

Kaçmaz

et al. 2024

Expert Opinion on Therapeutic Targets

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A Review of Contemporary and Future Pharmacotherapy for Chronic Heart Failure in Children

Das

2024

Children

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This review delves into the most recent therapeutic approaches for pediatric chronic heart failure (HF) as proposed by the International Society for Heart and Lung Transplantation (ISHLT), which are not yet publicly available. The guideline proposes an exhaustive overview of the evolving pharmacological strategies that are transforming the management of HF in the pediatric population. The ISHLT guidelines recognize the scarcity of randomized clinical trials in children, leading to a predominance of consensus-based recommendations, designated as Level C evidence. This review article aims to shed light on the significant paradigm shifts in the proposed 2024 ISHLT guidelines for pediatric HF and their clinical ramifications for pediatric cardiology practitioners. Noteworthy advancements in the updated proposed guidelines include the endorsement of angiotensin receptor-neprilysin inhibitors (ARNIs), sodium-glucose cotransporter 2 inhibitors (SGLT2is), and soluble guanylate cyclase (sGC) stimulators for treating chronic HF with reduced ejection fraction (HFrEF) in children. These cutting-edge treatments show potential for enhancing outcomes in pediatric HFrEF. Nonetheless, the challenge persists in validating the efficacy of therapies proven in adult HFrEF for the pediatric cohort. Furthermore, the proposed ISHLT guidelines address the pharmacological management of chronic HF with preserved ejection fraction (HFpEF) in children, marking a significant step forward in pediatric HF care. This review also discusses the future HF drugs in the pipeline, their mechanism of actions, potential uses, and side effects.

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Phosphodiesterase inhibitor for heart failure with preserved ejection fraction: A systematic review and meta-analysis

Cited by 3 publications

References 30 publications

Clinical and Hemodynamic Improvement in Pulmonary Hypertension After Switching to Sacubitril/Valsartan in Patients With Heart Failure With Preserved Ejection Fraction

Clinical and Hemodynamic Improvement in Pulmonary Hypertension After Switching to Sacubitril/Valsartan in Patients With Heart Failure With Preserved Ejection Fraction

Exploring PKG signaling as a therapeutic avenue for pressure overload, ischemia, and HFpEF

A Review of Contemporary and Future Pharmacotherapy for Chronic Heart Failure in Children

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