Randomized Evaluation of Heart Failure with Preserved Ejection Fraction Patients with Acute Heart Failure and Dopamine (Ropa-Dop) Trial

Sharma, Kavita; Vaishnav, Joban; Kalathiya, Rohan; Miller, John P.; Shah, Nishant; Hill, Terence E.; Sharp, Michelle; Tsao, Allison L.; Alexander, Kevin M.; Gupta, Richa; Montemayor, Kristina; Kovell, Lara C.; Ndumele, Chiadi E; Hu, Ruifeng; Chasler, Jessica; Lee, Joon; Grams, Morgan E.; Fine, Derek M.; Kass, David A.; Weiss, Robert G.; Thiemann, David R.; Schulman, Steven P.; Russell, Stuart D.

doi:10.1016/j.cardfail.2017.10.006

Cited by 15 publications

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“…3 In our practice, HF patients have been placed in our observation units under aggressive diuresis protocols with most patients being discharged within 24 h. However, a significant number of HFpEF patients with chronic renal insufficiency will need extended inpatient treatment due to their WRF after diuresis. 4 Such findings support more cautious discharges of HFpEF patients with WRF.…”

mentioning

confidence: 76%

Worsening renal function after diuresis among heart failure patients with preserved ejection fraction: a dilemma to heart failure management. Letter regarding the article ‘Association of left ventricular ejection fraction with worsening renal function in patients with acute heart failure: insights from the RELAX‐AHF‐2 study’

Starwalt

Wang

2020

European J of Heart Fail

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confidence: 76%

Worsening renal function after diuresis among heart failure patients with preserved ejection fraction: a dilemma to heart failure management. Letter regarding the article ‘Association of left ventricular ejection fraction with worsening renal function in patients with acute heart failure: insights from the RELAX‐AHF‐2 study’

Starwalt

Wang

2020

European J of Heart Fail

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“…Greater than 90% of the patients had hypertension. These conditions are associated with increased arterial and left ventricular wall stiffness and reduced venous capacitance that is thought to lead to interstitial fluid expansion and a greater dependence on preload to maintain cardiac output [10, 11]. Maldistribution of fluid therefore results in a reduced GFR in HFpEF, while in HFrEF, WRF is more likely related to left ventricular systolic dysfunction [12].…”

Section: Discussionmentioning

confidence: 99%

Worsening Renal Function during Index Hospitalization Does Not Predict Prognosis in Heart Failure with Preserved Ejection Fraction Patients

et al. 2021

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Introduction: Worsening renal function (WRF) predicts poor prognosis in patients with left ventricular systolic dysfunction. The effect of WRF in heart failure with preserved ejection fraction (HFpEF) is unclear. Objective: The objective of this study was to determine whether WRF during index hospitalization for HFpEF is associated with increased death or readmission for heart failure. Methods: National Veterans Affairs electronic medical data recorded between January 1, 2002, and December 31, 2014, were screened to identify index hospitalizations for HFpEF using an iterative algorithm. Patients were divided into 3 groups based on changes in serum Cr (sCr) during this admission. WRF was defined as a rise in sCr ≥0.3 mg/dL. Group 1 had no evidence of WRF, group 2 had transient WRF, and group 3 had persistent WRF at the time of discharge. Results: A total of 10,902 patients with index hospitalizations for HFpEF were identified (mean age 72, 97% male). Twenty-nine percent had WRF during this hospital admission, with 48% showing recovery of sCr and 52% with no recovery at discharge. The mortality rate over a mean follow-up duration of 3.26 years was 72%. Compared to group 1, groups 2 and 3 showed no significant difference in risk of death from any cause (hazard ratio [HR] = 0.95 [95% confidence interval [CI]: 0.87, 1.03] and 1.02 [95% CI: 0.93, 1.11], respectively), days hospitalized for any cause (incidence density ratio [IDR] = 1.01 [95% CI: 0.92, 1.11] and 1.01 [95% CI: 0.93, 1.11], respectively), or days hospitalized for heart failure (IDR = 0.94 [95% CI: 0.80, 1.10] and 0.94 [95% CI: 0.81, 1.09], respectively) in analyses adjusted for covariates affecting renal function and outcomes. Conclusions: While there is a high incidence of WRF during index hospitalizations for HFpEF, WRF is not associated with an increased risk of death or hospitalization. This suggests that WRF alone should not influence decisions regarding heart failure management.

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“…(в среднем 27 мг) АМКР спиронолактона пациентам с тяжелой ХСН OOO-OV ФК в дополнение к оптимальной терапии, включавшей иАПФ и у 10 % пациентов БАБ, позволяло достоверно снижать риск смерти на 27 %, причем как внезапной, так и связанной с обострением декомпенсации [422] [440,449] . Однако контролируемые клинические исследования либо не выявили преимуществ длительного применения фуросемида [450], либо показали увеличичение риска развития нарушения функции почек [451] .…”

Section: антагонисты минералокортикоидных рецепторов (амкр)unclassified

Russian Heart Failure Society, Russian Society of Cardiology. Russian Scientific Medical Society of Internal Medicine Guidelines for Heart failure: chronic (CHF) and acute decompensated (ADHF). Diagnosis, prevention and treatment

Mareev

Фомин

Агеев

et al. 2018

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Клинические рекомендации ОССН -РКО -РНМОТ . Сердечная недостаточность: хроническая (ХСН) и острая декомпенсированная (ОДСН) . Диагностика, профилактика и лечение Мареев В . Ю . 1 (сопредседатель рабочей группы), Фомин И . В . 2 (сопредседатель рабочей группы), Агеев Ф .

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Randomized Evaluation of Heart Failure with Preserved Ejection Fraction Patients with Acute Heart Failure and Dopamine (Ropa-Dop) Trial

Cited by 15 publications

References 0 publications

Worsening Renal Function during Index Hospitalization Does Not Predict Prognosis in Heart Failure with Preserved Ejection Fraction Patients

Russian Heart Failure Society, Russian Society of Cardiology. Russian Scientific Medical Society of Internal Medicine Guidelines for Heart failure: chronic (CHF) and acute decompensated (ADHF). Diagnosis, prevention and treatment

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