Abstract:
AIMS:Exercise oscillatory breathing (EOB) is a ventilatory abnormality that occurs in ∼20% of heart failure (HF) patients and carries a very unfavourable prognosis. Pulmonary vasoconstriction has been suggested to be involved in this disorder. We hypothesized that modulation of pulmonary vascular hypertone by oversignalling of the nitric oxide pathway with phosphodiesterase 5 (PDE5) inhibition might be beneficial. Accordingly, we performed a 1-year pilot trial with sildenafil in patients with HF and EOB. METHODS AND RESULTS:Among 122 HF cases, 32 presented with EOB during cardiopulmonary exercise testing (CPX) and were randomized to receive placebo (n = 16) or sildenafil (n = 16) at the dose of 50 mg three times a day, in addition to their current antifailure treatment. CPX-derived variables and pulmonary haemodynamics were assessed at 6 and 12 months. Sildenafil reversed EOB in 87% of patients at 6 months and 93% at 1 year, respectively (P < 0.01). This effect was accompanied by an improvement in functional performance (peak VO(2); from 9.6 to 12.4 and 13.2 mL/min/kg; P < 0.01) and exercise ventilation efficiency (ventilation to CO(2) production slope; from 41.1 to 32.7 and 31.5; P < 0.01). Chronic treatment with PDE5 inhibition significantly decreased pulmonary capillary wedge pressure (from 21 to 14 and 14 mmHg), mean pulmonary artery pressure (PAP; from 34.8 to 23 and 24 mmHg), and pulmonary vascular resistance (PVR; from 360 to 270 and 266 dyne/s/cm(5)) compared with placebo (P < 0.01 for each comparison). On exploratory analysis, there was a correlation between PAP and PVR and the decrease in EOB in the treatment group. Placebo did not alter any of the aforementioned variables. CONCLUSIONS:PDE5 inhibition in HF patients with EOB offers the dual advantage of improving functional capacity and modulating the EOB pattern. PAP and PVR reduction seem to underlie the correction of the breathing disorder. Whether reversal of this unfavourable prognostic signal can affect survival remains unconfirmed at the moment.
journal_name
Eur J Heart Failjournal_title
European journal of heart failureauthors
Guazzi M,Vicenzi M,Arena Rdoi
10.1093/eurjhf/hfr147subject
Has Abstractpub_date
2012-01-01 00:00:00pages
82-90issue
1eissn
1388-9842issn
1879-0844pii
hfr147journal_volume
14pub_type
杂志文章,随机对照试验abstract::BNP is a marker of systolic left ventricular dysfunction (LVSD) and heart failure. To assess BNP for the detection of diastolic dysfunction in the general population, we examined 1678 subjects within an age- and sex-stratified survey (MONICA Augsburg). BNP was measured using a commercially available RIA (Shionogi). BN...
journal_title:European journal of heart failure
pub_type: 杂志文章
doi:10.1016/j.ejheart.2004.12.010
更新日期:2005-06-01 00:00:00
abstract:AIMS:To determine the effects of a nurse-led intervention designed to improve self-management of patients with heart failure in a primary health care setting regarding health-related quality of life and depression. METHODS:Patients at eight primary health care centres were screened by the Diagnosis Related Groups regi...
journal_title:European journal of heart failure
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1016/j.ejheart.2004.01.016
更新日期:2005-03-16 00:00:00
abstract:AIMS:We evaluated the applicability and prognostic importance of oral glucose tolerance testing (OGTT) among outpatients with systolic heart failure (SHF). METHODS AND RESULTS:Consecutive patients with SHF and left ventricular ejection fraction (LVEF) ≤ 45% referred to a heart failure clinic (n= 413) were included in ...
journal_title:European journal of heart failure
pub_type: 杂志文章
doi:10.1093/eurjhf/hfq216
更新日期:2011-03-01 00:00:00
abstract:AIMS:Congestive heart failure (CHF) is associated with impaired renal function. Previously, we have demonstrated that rats with decompensated CHF exhibited exaggerated sensitivity to the adverse renal effects of increased increased intra-abdominal pressure (IAP) as compared with normal controls. This study tested wheth...
journal_title:European journal of heart failure
pub_type: 杂志文章
doi:10.1093/eurjhf/hfs102
更新日期:2012-10-01 00:00:00
abstract:AIMS:The identification of valuable markers of sudden cardiac death (SCD) in patients with established HF remains a challenge. We sought to assess the value of clinical, echocardiographic and biochemical variables to predict SCD in a consecutive cohort of patients with heart failure (HF) due to systolic dysfunction. M...
journal_title:European journal of heart failure
pub_type: 杂志文章,多中心研究
doi:10.1016/j.ejheart.2007.05.001
更新日期:2007-08-01 00:00:00
abstract:AIMS:Reliable detectors of worsening renal function (WRF) in Emergency Department (ED) patients with acute heart failure (AHF) are limited. We hypothesized that initial urinary neutrophil gelatinase-associated lipocalcin (NGAL) levels, and changes in urinary NGAL levels after initial ED AHF therapy, would be associated...
journal_title:European journal of heart failure
pub_type: 杂志文章
doi:10.1093/eurjhf/hfs087
更新日期:2012-09-01 00:00:00
abstract:AIMS:The purpose of this study was to determine that the administration of an angiotensin converting enzyme (ACE) inhibitor enalapril would confer protection against doxorubicin-induced experimental heart failure, and attenuate the development of left ventricular dysfunction. METHODS:Seventeen dogs were chronically in...
journal_title:European journal of heart failure
pub_type: 杂志文章
doi:10.1016/s1388-9842(02)00091-0
更新日期:2002-10-01 00:00:00
abstract:BACKGROUND:Serial measurements of N-terminal pro brain natriuretic peptide (NT-proBNP) have been suggested for the management of outpatients with chronic heart failure (CHF). The relationship between NT-proBNP plasma levels and central haemodynamic parameters in this setting is not known. METHODS:In 19 outpatients wit...
journal_title:European journal of heart failure
pub_type: 杂志文章
doi:10.1016/j.ejheart.2006.03.002
更新日期:2006-12-01 00:00:00
abstract::Transthyretin amyloidosis (ATTR) is a rare, yet underdiagnosed disease characterized by progressive impairment of neurologic and cardiac function due to deposition of misfolded transthyretin. Despite great efforts, such as the introduction of orthotopic liver transplant, the devastating prognosis for both variant and ...
journal_title:European journal of heart failure
pub_type: 杂志文章,评审
doi:10.1002/ejhf.1695
更新日期:2020-01-01 00:00:00
abstract:AIMS:Women with heart failure (HF) are under-represented in individual randomized clinical trials (RCTs). Little is known about sex-specific treatment effects in HF medications. We evaluated sex differences in the response to mineralocorticoid receptor antagonists (MRAs) in major HF MRA trials, including a broad spectr...
journal_title:European journal of heart failure
pub_type: 杂志文章
doi:10.1002/ejhf.1740
更新日期:2020-05-01 00:00:00
abstract:OBJECTIVES:To compare the efficacy of the homeopathic Crataegus preparation Cralonin for non-inferiority to standard treatment for mild cardiac insufficiency. METHODS:Multicentre non-randomised cohort study in patients aged 50-75 years in New York Heart Association class II. Patients received Cralonin (n=110) or ACE i...
journal_title:European journal of heart failure
pub_type: 杂志文章,多中心研究
doi:10.1016/s1388-9842(02)00237-4
更新日期:2003-06-01 00:00:00
abstract:AIMS:To investigate the prognostic value of autonomic variables in patients with symptomatic chronic heart failure (HF) treated according to current recommendations. METHODS AND RESULTS:We analysed 24 h time-domain [standard deviation of all normal-to-normal RR intervals (SDNN)], frequency-domain [very low frequency a...
journal_title:European journal of heart failure
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1093/eurjhf/hfs126
更新日期:2012-12-01 00:00:00
abstract:AIMS:Although pulse pressure (PP) is a recognized risk factor for various cardiovascular diseases, its association with cardiovascular outcomes in patients with heart failure with preserved ejection fraction (HFpEF) is uncertain. METHODS AND RESULTS:We enrolled 512 of 951 consecutive HFpEF patients admitted to the Kum...
journal_title:European journal of heart failure
pub_type: 杂志文章
doi:10.1002/ejhf.559
更新日期:2016-11-01 00:00:00
abstract:BACKGROUND:The development of heart failure after acute myocardial infarction (AMI) has been shown to be associated with inflammation, which is positively and negatively regulated by T helper (Th) 1 and Th2 lymphocytes, respectively. Several studies have indicated that statins can improve heart function after AMI. AIM...
journal_title:European journal of heart failure
pub_type: 杂志文章
doi:10.1016/j.ejheart.2005.01.020
更新日期:2005-12-01 00:00:00
abstract::Many patients with Congestive Heart Failure (CHF) are anaemic. This anaemia is associated with more severe CHF and a higher incidence of mortality, hospitalisation and morbidity. The only way to prove that the anaemia is causing this worsening of CHF is to correct it. We review here some of the published papers about ...
journal_title:European journal of heart failure
pub_type: 杂志文章,评审
doi:10.1016/j.ejheart.2008.06.015
更新日期:2008-09-01 00:00:00
abstract:AIMS:We aimed to determine the relation between baseline systolic blood pressure (SBP), change in SBP, and worsening renal function (WRF) in acute heart failure (AHF) patients enrolled in the Pre-RELAX-AHF trial. METHODS AND RESULTS:The Pre-RELAX-AHF study enrolled 234 patients within 16 h of admission (median 7 h) fo...
journal_title:European journal of heart failure
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1093/eurjhf/hfr060
更新日期:2011-09-01 00:00:00
abstract:AIMS:The primary objective of this systematic review was to estimate the prevalence and temporal changes in chronic comorbid conditions reported in heart failure (HF) clinical trials. METHODS AND RESULTS:We searched MEDLINE for HF trials enrolling more than 400 patients published between 2001 and 2016.Trials were divi...
journal_title:European journal of heart failure
pub_type: 杂志文章
doi:10.1002/ejhf.1818
更新日期:2020-06-01 00:00:00
abstract:AIMS:A recent study suggested that no single echocardiographic index of cardiac dyssynchrony can reliably identify candidates for cardiac resynchronization therapy (CRT). We examined the value of three simple echocardiographic indices for predicting the 6-month clinical and echocardiographic responses to CRT. METHODS ...
journal_title:European journal of heart failure
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1093/eurjhf/hfq058
更新日期:2010-06-01 00:00:00
abstract:AIMS:We sought to describe the frequency, type and timing of clinical events, and delineate patterns in their transitions, after a first episode of heart failure (HF). METHODS AND RESULTS:In 1036 Framingham participants with new-onset HF (mean age 79 years; 53% women), we used mixture models to estimate probabilities ...
journal_title:European journal of heart failure
pub_type: 杂志文章
doi:10.1002/ejhf.1918
更新日期:2020-10-01 00:00:00
abstract:BACKGROUND:Patients presenting to the emergency department (ED) with acute heart failure (AHF) are at an increased risk of morbidity and mortality. The electrocardiogram (ECG) is a routine investigation in patients with AHF used to identify potential causes and/or complications. It is unclear whether 12-lead ECG charac...
journal_title:European journal of heart failure
pub_type: 杂志文章
doi:10.1002/ejhf.561
更新日期:2016-08-01 00:00:00
abstract::The use of Left Ventricular Assist Devices (LVADs) has increased over the last decade because of the lack of healthy donor hearts. In this report we describe for the first time a patient with an LVAD Heart Mate II (HM II) implanted 6 months before admission, who initially suffered from severe anaemia and later on unde...
journal_title:European journal of heart failure
pub_type: 杂志文章
doi:10.1093/eurjhf/hfp090
更新日期:2009-08-01 00:00:00
abstract:AIMS:Drug-induced changes in QT dispersion may be a way of detecting harmful repolarisation abnormalities for patients receiving antiarrhythmic drugs affecting ventricular repolarisation. METHODS AND RESULTS:In 463 congestive heart failure (CHF) patients enrolled in the Danish Investigations Of Arrhythmia and Mortalit...
journal_title:European journal of heart failure
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/s1388-9842(01)00235-5
更新日期:2002-03-01 00:00:00
abstract::The Elecsys NT-proBNP assay is based on two polyclonal antibodies directed at residues 1-21 and 39-50 of the NT-proBNP molecule. Analytical performance was assessed using NCCLS protocol EP-5A using three serum pools in a preliminary study then as part of a multicentre evaluation (16 instruments in 8 hospitals). Using ...
journal_title:European journal of heart failure
pub_type: 杂志文章
doi:10.1016/j.ejheart.2004.01.011
更新日期:2004-03-15 00:00:00
abstract:AIMS:Urine proteome analysis (UPA) has already provided accurate discriminatory patterns of urinary peptides for renal disease, coronary artery disease, and asymptomatic LV diastolic dysfunction. UPA has now been used to characterize a discriminatory peptide biomarker pattern and establish a diagnostic classifier for h...
journal_title:European journal of heart failure
pub_type: 杂志文章
doi:10.1002/ejhf.544
更新日期:2016-07-01 00:00:00
abstract:BACKGROUND:The epidemiology of heart failure in Arabia, with a population different from the West in cultural and ethnic origin, has not been studied before. AIMS:To determine the prevalence and aetiologies of symptomatic heart failure in an indigenous Arab population over a 3-year period. METHODS:All patients with h...
journal_title:European journal of heart failure
pub_type: 杂志文章
doi:10.1016/s1388-9842(00)00149-5
更新日期:2001-06-01 00:00:00
abstract:BACKGROUND:Coronary artery disease (CAD) is frequent among patients hospitalized with acute heart failure syndromes (AHFS). AIMS:To describe the influence of coronary revascularization status on survival in patients with AHFS. METHODS AND RESULTS:OPTIMIZE-HF enrolled 48,612 patients with AHFS from 259 U.S. hospitals....
journal_title:European journal of heart failure
pub_type: 杂志文章
doi:10.1016/j.ejheart.2008.09.009
更新日期:2008-12-01 00:00:00
abstract::Carvedilol has been shown to be beneficial for patients with heart failure, but it is not clear how it should be initiated in routine clinical practice, particularly in the elderly. This study is a retrospective review of 19 patients of age 80+/-4 years with heart failure, who had Carvedilol treatment initiated in a r...
journal_title:European journal of heart failure
pub_type: 杂志文章
doi:10.1016/s1388-9842(00)00092-1
更新日期:2000-09-01 00:00:00
abstract:AIMS:Advances in diagnostic imaging have increased the recognition of coexisting transthyretin cardiac amyloidosis (ATTR-CA) and severe aortic stenosis (AS), with a reported prevalence between 8-16%. In this prospective study, we aimed to evaluate the implications of ATTR-CA on outcomes after transcatheter aortic valve...
journal_title:European journal of heart failure
pub_type: 杂志文章
doi:10.1002/ejhf.1974
更新日期:2020-07-30 00:00:00
abstract:BACKGROUND:Myocardial contractility can be altered using voltage clamp techniques by modulating amplitude and duration of the action potential resulting in enhanced calcium entry in the cell of isolated muscle strips (Non-Excitatory Currents; NEC). Extracellular electrical stimuli delivered during the absolute refracto...
journal_title:European journal of heart failure
pub_type: 杂志文章
doi:10.1016/j.ejheart.2005.05.011
更新日期:2006-01-01 00:00:00
abstract:AIMS:To investigate the relationship between decongestion, central venous pressure, and risk of worsening renal function (WRF) in patients with acute decompensated heart failure (ADHF). METHODS AND RESULTS:We studied 475 patients with ADHF, of whom 238 underwent right heart catheterization. Right atrial pressure (RAP)...
journal_title:European journal of heart failure
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1093/eurjhf/hft036
更新日期:2013-06-01 00:00:00