scholarly journals The role of insulin resistance in patients with heart failure with preserved systolic function of the left ventricle

2014 ◽  
Vol 18 (4) ◽  
pp. 16-22
Author(s):  
A. V. Bolotskykh ◽  
Yu. S. Rudyk ◽  
S. M. Pyvovar
Keyword(s):  
Heart Failure ◽  
Insulin Resistance ◽  
Left Ventricle ◽  
Systolic Function ◽  
Patients With Heart Failure

scholarly journals Effective influence of sacubutril/valsartan on systolic function of left ventricle in patients with heart failure and a reduced ejеction fraction

2021 ◽  
Vol 2 (4/S) ◽  
pp. 746-752
Author(s):  
Ikbol Adilova ◽  
Gulnoza Akbarova
Keyword(s):  
Heart Failure ◽  
Left Ventricle ◽  
Ejection Fraction ◽  
Systolic Function ◽  
Clinical Status ◽  
Volume Index ◽  
Left Ventricle Mass ◽  
End Diastolic Volume ◽  
Study Results ◽  
Patients With Heart Failure

Aim: We evaluated the influence of sacubitril/valsartan on the left ventricle function and clinical status of patients with heart failure and a reduced ejection fraction. Materials and methods: From 2018 to 2020, patients cured with 50-200 mg sacubitril/valsartan after coronary bypass grafting or coronary stenting for ischemic heart disease and HFrEF (aged 54-70 years) were enrolled in this prospective study. Results: There was no death case. There was a female prevalence with female to male ratio of 1,7:1. the value of ejection fraction high significantly increased (p=0,035), whereas the indices of left ventricle end-diastolic volume (p=0,015) and end-diastolic volume index (p=0,022) as well as left ventricle mass index were high significantly decreased (p=0,001) that indicate the amelioration of left ventricle systolic function. Correspondingly, the clinical status of all patients improved according to New York Heart Association Class (p=0,001). Conclusion: The post-CABG or PCI patients with HFrEF should be cured with sacubitril/valsartan basing on its implementation instruction. Nevertheless, future studies should focus on a larger cohort of post-CABG or PCI patients to compare the effectiveness and safety of sacubitril/valsartan usage raising from its adverse event in comparison to conventional therapy.  

scholarly journals Myocardial phenotypes and dysfunction in HFpEF and HFrEF assessed by echocardiography and cardiac magnetic resonance

2019 ◽  
Vol 25 (1) ◽  
pp. 75-84 ◽  
Author(s):  
Bostjan Berlot ◽  
Chiara Bucciarelli-Ducci ◽  
Alberto Palazzuoli ◽  
Paolo Marino
Keyword(s):  
Heart Failure ◽  
Cardiac Magnetic Resonance ◽  
Magnetic Resonance ◽  
Systolic Function ◽  
Diagnostic Algorithm ◽  
Integrated Approach ◽  
Preserved Ejection Fraction ◽  
Patients With Heart Failure ◽  
Systolic And Diastolic Function

AbstractHeart failure (HF) with either reduced or preserved ejection fraction is an increasingly prevalent condition. Cardiac imaging plays a central role in trying to identify the underlying cause of the underlying systolic and diastolic dysfunction, as the imaging findings have implications for patient’s management and individualised treatment. The imaging modalities used more frequently in patients with heart failure in clinical routine are echocardiography and cardiac magnetic resonance. Both techniques keep some strengths and weakness due to their spatial and temporal resolution. Notably, several features in the diagnostic algorithm of heart failure with preserved systolic function (HFpEF) may be improved by an integrated approach. This review focuses on the role of each modality in characterising cardiac anatomy, systolic and diastolic function as well as myocardial tissue characterisation in the most common phenotypes of dilated and hypertrophied hearts.

scholarly journals Heart failure with preserved ejection fraction – onset

2021 ◽  
Vol 27 (2) ◽  
pp. 17-36
Author(s):  
Branimir Kanazirev
Keyword(s):  
Heart Failure ◽  
Left Ventricle ◽  
Ejection Fraction ◽  
Diastolic Dysfunction ◽  
Systolic Function ◽  
Diastolic Heart Failure ◽  
Preserved Ejection Fraction ◽  
Reduced Ejection Fraction ◽  
Rich Variety ◽  
Patients With Heart Failure

During these more than 20 years of evolution in understandings of the mechanisms of heart failure (HF) with preserved fractional ejection, there has been a rich variety of terminology, including „diastolic heart failure“, „heart failure with preserved systolic function“ and „heart failure with preserved fraction“. By defi nition, the latter term “ejection fraction-induced heart failure” proved to be the most appropriate and was accepted as the most correct, as the presence of diastolic dysfunction is not unique only to this group and exists in these patients, albeit subclinically and discrete disturbance in the longitudinal systolic function of the left ventricle against the background of the preserved ejection fraction. The problem, however, is not in the value of the ejection fraction or in the paradox of the combination of a well-functioning left ventricle and classic symptoms of heart failure, but in the non-infl uence of the prognosis of these patients in the way it is in patients with suppressed EF. Unlike patients with heart failure with a reduced ejection fraction, the prognosis and results in patients with HF with preserved EF do not mark the expected results and so far there are not enough effective and promising therapies.

The Results of the Use of Angiotensin Receptor Inhibitors and Neprilisin in Secondary Functional Mitral Regurgitation in Outpatient Practice

2020 ◽  
Vol 75 (5) ◽  
pp. 514-522
Author(s):  
Alexey S. Ryazanov ◽  
Konstantin I. Kapitonov ◽  
Mariya V. Makarovskaya ◽  
Alexey A. Kudryavtsev
Keyword(s):  
Heart Failure ◽  
Left Ventricle ◽  
Mitral Regurgitation ◽  
Effective Area ◽  
Left Ventricular ◽  
Functional Mitral Regurgitation ◽  
Angiotensin Receptor ◽  
Optimal Drug ◽  
Patients With Heart Failure ◽  
Valsartan Group

Background. Morbidity and mortality in patients with functional mitral regurgitation (FMR) remains high, however, no pharmacological therapy has been proven to be effective.Aimsto study the effect of sacubitrile/valsartan and valsartan on functional mitral regurgitation in chronic heart failure.Methods.This double-blind study randomly assigned sacubitrile/valsartan or valsartan in addition to standard drug therapy for heart failure among 100 patients with heart failure with chronic FMR (secondary to left ventricular (LV) dysfunction). The primary endpoint was a change in the effective area of the regurgitation hole during the 12-month follow-up. Secondary endpoints included changes in the volume of regurgitation, the final systolic volume of the left ventricle, the final diastolic volume of the left ventricle, and the area of incomplete closure of the mitral valves.Results.The decrease in the effective area of the regurgitation hole was significantly more pronounced in the sacubitrile/valsartan group than in the valsartan group (0.070.066against0.030.058sm2; p=0.018)in the treatment efficacy analysis, which included 100patients (100%). The regurgitation volume also significantly decreased in the sacubitrile/valsartan group compared to the valsartan group (mean difference:8.4ml; 95%CI, from 13.2 until 1.9;р=0.21). There were no significant differences between the groups regarding changes in the area ofincomplete closure of the mitral valves and LV volumes, with the exception of the index of the final LV diastolic volume (p=0.07).Conclusion.Among patients with secondary FMR, sacubitril/valsartan reduced MR more than valsartan. Thus, angiotensin receptor inhibitors and neprilysin can be considered for optimal drug treatment of patients with heart failure and FMR.

Prognostic role of myocardial work in patients with heart failure and reduced ejection fraction treated by sacubitril/valsartan

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
E Galli ◽  
Y Bouali ◽  
C Laurin ◽  
A Gallard ◽  
A Hubert ◽  
...  
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Rank Test ◽  
Reduced Ejection Fraction ◽  
Non Invasive ◽  
Patients With Heart Failure ◽  
Increase Risk ◽  
Echocardiographic Examination ◽  
Constructive Work

Abstract Background The non-invasive assessment of myocardial work (MW) by pressure-strain loops analysis (PSL) is a relative new tool for the evaluation of myocardial performance. Sacubitril/Valsartan is a treatment for heart failure with reduced ejection fraction (HFrEF) which has a spectacular effect on the reduction of cardiovascular events (MACEs). Purposes of this study were to evaluate 1) the short and medium term effect of Sacubitril/Valsartan treatment on MW parameters; 2) the prognostic value of MW in this specific group of patients. Methods 79 patients with HFrEF (mean age: 66±12 years; LV ejection fraction: 28±9%) were prospectively included in the study and treated with Sacubitril/Valsartan. Echocardiographic examination was performed at baseline, and after 6- and 12-month of therapy with Sacubitril/Valsartan. Results Sacubitril/Valsartan significantly increased global myocardial constructive work (CW) (1023±449 vs 1424±484 mmHg%, p<0.0001) and myocardial work efficiency (WE) [87 (78–90) vs 90 (86–95), p<0.0001]. During FU (2.6±0.9 years), MACEs occurred in 13 (16%) patients. After correction for LV size, LVEF and WE, CW was the only predictor of MACEs (Table 1). A CW<910 mmHg (AUC=0.81, p<0.0001, Figure 1A) identified patients at particularly increase risk of MACEs [HR 11.09 (1.45–98.94), p=0.002, log-rank test p<0.0001] (Figure 1 B). Conclusions In patients with HFrEF who receive a comprehensive background beta-blocker and mineral-corticoid receptor antagonist therapy, Sacubitril/Valsartan induces a significant improvement of myocardial CW and WE. In this population, the estimation of CW before the initiation of Sacubitril/Valsartan therapy allows the prediction of MACEs. Funding Acknowledgement Type of funding source: None

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