The Effect of Sacubitril-Valsartan in Heart Failure Patients With Mid-Range and Preserved Ejection Fraction: A Meta-Analysis

Nie, Dan; Xiong, Bin; Qian, Jun; Shu, Rong; Yao, Yuanqing; Jing, Huang

doi:10.1016/j.hlc.2020.10.012

Cited by 24 publications

(31 citation statements)

References 22 publications

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“…The observed rate ratio in the below-median subgroup (0.78; 95%CI 0.64–0.95) was similar to that observed in the HFrEF-focused PARADIGM-HF (HR 0.80; 95%CI 0.73–0.87) [ 31 ]. In a recent meta-analysis of six studies with over 5500 patients, compared with ACEIs and ARBs, sacubitril-valsartan reduced hospitalizations for HF (risk ratio 0.84; 95%CI 0.77–0.91; p < 0.001) and improved NYHA class (risk ratio 1.25; 95%CI 1.10–1.43; p = 0.001) in HFmrEF and HFpEF patients [ 32 ].…”

Section: Established Therapiesmentioning

confidence: 99%

Treatment of Heart Failure with Mid-Range Ejection Fraction: What Is the Evidence

Koufou

Arfaras-Melainis

Rawal

et al. 2021

JCM

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In this review, we briefly outline our current knowledge on the epidemiology, outcomes, and pathophysiology of heart failure (HF) with mid-range ejection fraction (HFmrEF), and discuss in more depth the evidence on current treatment options for this group of patients. In most studies, the clinical background of patients with HFmrEF is intermediate between that of patients with HF and reduced ejection fraction (HFrEF) and patients with HF and preserved ejection fraction (HFpEF) in terms of demographics and comorbid conditions. However, the current evidence, stemming from observational studies and post hoc analyses of randomized controlled trials, suggests that patients with HFmrEF benefit from medications that target the neurohormonal axes, a pathophysiological behavior that resembles that of HFrEF. Use of β-blockers, angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, mineralocorticoid receptor antagonists, and sacubitril/valsartan is reasonable in patients with HFmrEF, whereas evidence is currently scarce for other therapies. In clinical practice, patients with HFmrEF are treated more like HFrEF patients, potentially because of history of systolic dysfunction that has partially recovered. Assessment of left ventricular systolic function with contemporary noninvasive modalities, e.g., echocardiographic strain imaging, is promising for the selection of patients with HFmrEF who will benefit from neurohormonal antagonists and other HFrEF-targeted therapies.

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Section: Established Therapiesmentioning

confidence: 99%

Treatment of Heart Failure with Mid-Range Ejection Fraction: What Is the Evidence

Koufou

Arfaras-Melainis

Rawal

et al. 2021

JCM

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“…However, ANRIs significantly reduced HF hospitalization and improved physical capacity in patients with HFmrEF or HFpEF. This suggested that ARNIs may reduce HF hospitalization and improve clinical symptoms in patients with HFmrEF or HFpEF ( 59 ).…”

Section: Therapymentioning

confidence: 99%

Heart Failure With Mid-range Ejection Fraction: A Distinctive Subtype or a Transitional Stage?

Zhou

Zhao

et al. 2021

Front. Cardiovasc. Med.

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Heart failure with mid-range ejection fraction (HFmrEF) was first proposed by Lam and Solomon in 2014, and was listed as a new subtype of heart failure (HF) in 2016 European Society of Cardiology guidelines. Since then, HFmrEF has attracted an increasing amount of attention, and the number of related studies on this topic has grown rapidly. The diagnostic criteria on the basis of left ventricular ejection fraction (LVEF) are straightforward; however, LVEF is not a static parameter, and it changes dynamically during the course of HF. Thus, HFmrEF may not be an independent disease with a uniform pathophysiological process, but rather a collection of patients with different characteristics. HFmrEF is often associated with various cardiovascular and non-cardiovascular diseases. Thus, the pathophysiological mechanisms of HFmrEF are particularly complex, and its clinical phenotypes are diverse. The complexity and heterogeneity of HFmrEF may be one reason for inconsistent results between clinical studies. In fact, whether HFmrEF is a distinctive subtype or a transitional stage between HF with reduced ejection fraction (HFrEF) and HF with preserved ejection fraction (HFpEF) is controversial. In this review, we discuss the clinical characteristics, treatment and prognosis of patients with HFmrEF, as well as the differences among HFmrEF, HFrEF, and HFpEF.

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“…1.). Он включает в себя выделение симптомов СН, проведение эхокардиографии (ЭХО-КГ) в покое и при нагрузке, определение натриуретического пептида (НУП), а также инвазивную оценку гемодинамики и определение этиологии СН [60]. Насколько данный алгоритм может быть применен к пациентам ХСНпФВ, пока не известно.…”

Section: диагностика хсн с промежуточной фракцией выброса (40-49 %) лunclassified

Position of Patients with Mid-Range Ejection Fraction in the General Chronic Heart Failure Population

Ватутин

Шевелёк

Венжега

2021

Arhivʺ vnutrennej mediciny

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The European society of cardiology guideline for the diagnosis and treatment of acute and chronic heart failure (CHF) in 2016 identified a new group of patients with mid-range left ventricular ejection fraction (LVEF) with reference interval in the range of 40-49 %. This review highlights the issues of epidemiology and etiology of CHF, outlines the echocardiographic portrait, biomarker profile and patients` dynamic phenotypes, considers the guidelines of their managements and the prognosis of the disease determiner’s factors. Special attention is paid to the peculiarities of the formation of this heterogeneous cohort of patients and the feasibility of expanding the existing CHF classification by introducing two transitional phenotypes.

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The Effect of Sacubitril-Valsartan in Heart Failure Patients With Mid-Range and Preserved Ejection Fraction: A Meta-Analysis

Cited by 24 publications

References 22 publications

Treatment of Heart Failure with Mid-Range Ejection Fraction: What Is the Evidence

Treatment of Heart Failure with Mid-Range Ejection Fraction: What Is the Evidence

Heart Failure With Mid-range Ejection Fraction: A Distinctive Subtype or a Transitional Stage?

Position of Patients with Mid-Range Ejection Fraction in the General Chronic Heart Failure Population

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