The perindopril in elderly people with chronic heart failure (PEP-CHF) study

Cleland, John G.F.; Tendera, Michał; Adamus, J; Freemantle, Nick; Poloński, Lech; Taylor, Jacqueline

doi:10.1093/eurheartj/ehl250

Cited by 1,343 publications

(767 citation statements)

References 29 publications

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“…Lowering neurohormonal activation has unexpectedly failed to improve clinical outcome in large, placebo‐controlled, randomized HFpEF trials 20, 21, 22, 23, 24. Diagnostic uncertainties may partially account for the lack of therapeutic benefit 29, 76, 77.…”

Section: Aging Phenotypementioning

confidence: 99%

“…The large, all‐inclusive, randomized, placebo‐controlled therapeutic trials approach that led to great therapeutic progress in HFrEF has not worked so far in HFpEF 20, 21, 22, 23, 24, 25, 26, 27. Such discrepancy is, in part, attributable to overt differences in the pathogenesis and progression of HFpEF and HFrEF.…”

Section: Future Directionsmentioning

confidence: 99%

“…However, little therapeutic progress was made 20, 21, 22, 23, 24, 25, 26, 27. Among the issues that may account for the modest therapeutic progress, one appears to be overwhelming: HFpEF is not a well‐defined clinical entity: It is an amalgam of cardiovascular, metabolic, renal, and geriatric conditions 28, 29.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Clinical Phenotypes in Heart Failure With Preserved Ejection Fraction

Samson

Jaiswal

Ennezat

et al. 2016

JAHA

110

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Section: Aging Phenotypementioning

confidence: 99%

Section: Future Directionsmentioning

confidence: 99%

See 1 more Smart Citation

Clinical Phenotypes in Heart Failure With Preserved Ejection Fraction

Samson

Jaiswal

Ennezat

et al. 2016

JAHA

110

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“…The Perindopril for Elderly People with Chronic Heart Failure trial prospectively included n = 850 elderly patients with HF, preserved LVEF (LVEF > 40%), and echocardiographic evidence of diastolic dysfunction 11. After the mean follow‐up of 26.2 months, no significant reduction in all‐cause mortality or HF hospitalization (primary composite endpoint) was observed in the perindopril group (Table 1).…”

Section: Beta‐blockers and Calcium‐channel Blockersmentioning

confidence: 99%

Facts and numbers on epidemiology and pharmacological treatment of heart failure with preserved ejection fraction

Edelmann

2015

ESC Heart Failure

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Heart failure with preserved ejection fraction (HFpEF) is a major and growing public health problem. Epidemiologic studies demonstrated that heart failure (HF) can be clinically diagnosed in patients with normal or preserved left ventricular ejection fraction. These patients are therefore termed as having HFpEF. In the past, this was often called diastolic HF. Because of the permanent increase of the prevalence of HFpEF during the past decades, HFpEF now accounts for more than 50% of the total HF population. There are uncertainties and debates regarding the definition, diagnosis, and pathophysiology with the consequence that all outcome trials performed so far used criteria for inclusion and exclusion that were not consistent. These trials also failed to document improved prognosis. Recent smaller proof‐of‐concept or Phase II clinical trials investigating different pathophysiological approaches with substances such as the neprilysin inhibitor–angiotensin receptor blocker− combination (LCZ 696), ranolazine, or ivabradine were successful to improve biomarkers, haemodynamics, or functional capacity. Future trials will need to document whether also prognosis can be improved.

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“…The prevalence of HF with preserved ejection fraction (HFpEF) is high and increasing, making HFpEF a continuously growing public health problem 1, 2. Morbidity and mortality in HFpEF are quite similar to HF with reduced ejection fraction (HFrEF), but no effective pharmacological treatment has been identified so far3, 4, 5, 6 and a successful management of the disease remains elusive 2. Therefore, an intensified search for prevention and treatment strategies in HFpEF is of global interest.…”

Section: Introductionmentioning

confidence: 99%

Amount or intensity? Potential targets of exercise interventions in patients with heart failure with preserved ejection fraction

et al. 2017

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AimsHeart failure with preserved ejection fraction (HFpEF) remains a common condition with no pharmacological treatment. Physical activity (PA) improves symptoms and quality of life (QoL), but no clear recommendations exist on PA in HFpEF patients. We investigated the association of PA (amount/intensity) on clinical phenotype in HFpEF.Methods and resultsThe Aldosterone in Diastolic Heart Failure trial investigated spironolactone vs. placebo in stable HFpEF patients. At baseline, all patients underwent detailed phenotypization including echocardiography, cardiopulmonary exercise testing, 6 minute walking test (6MWT), and QoL assessment (36‐item Short‐Form questionnaire). PA was assessed by a self‐report questionnaire, classified in metabolic equivalents of task (MET) and analysed with regard to exercise capacity, diastolic function, and QoL. Four hundred twenty‐two patients (52% women, age 67 ± 8 years, New York Heart Association II and III) were classified by weekly MET hours into a low (<70), middle (70–140), or high (>140) level of PA. Total PA correlated positively with 6MWT distance (r = 0.17; P = 0.002) and physical function of QoL (r = 0.10; P = 0.05), but not with peak oxygen uptake (peakVO2). In contrast, both 6MWT distance and peakVO2 were significantly higher in patients who performed high‐intensity PA for >8 h/week (P < 0.001, P = 0.02, respectively). Time of high‐intensity PA was related to higher 6MWT distance (r = 0.21, P < 0.001), peakVO2, and better physical function of QoL (both r = 0.13, P = 0.01), whereas low‐intensity PA did not show significant associations. Interestingly, PA was not related to any measure of diastolic function.ConclusionsA higher amount of PA is related to higher submaximal exercise capacity and physical function of QoL. Regarding maximal exercise capacity, only high‐intensity PA showed significant association in HFpEF patients.

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The perindopril in elderly people with chronic heart failure (PEP-CHF) study

Cited by 1,343 publications

References 29 publications

Clinical Phenotypes in Heart Failure With Preserved Ejection Fraction

Clinical Phenotypes in Heart Failure With Preserved Ejection Fraction

Facts and numbers on epidemiology and pharmacological treatment of heart failure with preserved ejection fraction

Amount or intensity? Potential targets of exercise interventions in patients with heart failure with preserved ejection fraction

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