Abstract:
:Current pharmacological therapies for heart failure with reduced ejection fraction are largely either repurposed anti-hypertensives that blunt overactivation of the neurohormonal system or diuretics that decrease congestion. However, they do not address the symptoms of heart failure that result from reductions in cardiac output and reserve. Over the last few decades, numerous attempts have been made to develop and test positive cardiac inotropes that improve cardiac haemodynamics. However, definitive clinical trials have failed to show a survival benefit. As a result, no positive inotrope is currently approved for long-term use in heart failure. The focus of this state-of-the-art review is to revisit prior clinical trials and to understand the causes for their findings. Using the learnings from those experiences, we propose a framework for future trials of such agents that maximizes their potential for success. This includes enriching the trials with patients who are most likely to derive benefit, using biomarkers and imaging in trial design and execution, evaluating efficacy based on a wider range of intermediate phenotypes, and collecting detailed data on functional status and quality of life. With a rapidly growing population of patients with advanced heart failure, the epidemiologic insignificance of heart transplantation as a therapeutic intervention, and both the cost and morbidity associated with ventricular assist devices, there is an enormous potential for positive inotropic therapies to impact the outcomes that matter most to patients.
journal_name
Eur J Heart Failjournal_title
European journal of heart failureauthors
Ahmad T,Miller PE,McCullough M,Desai NR,Riello R,Psotka M,Böhm M,Allen LA,Teerlink JR,Rosano GMC,Lindenfeld Jdoi
10.1002/ejhf.1557subject
Has Abstractpub_date
2019-09-01 00:00:00pages
1064-1078issue
9eissn
1388-9842issn
1879-0844journal_volume
21pub_type
杂志文章,评审abstract:AIMS:The MITRA-FR trial showed that among symptomatic patients with severe secondary mitral regurgitation, percutaneous repair did not reduce the risk of death or hospitalization for heart failure at 12 months compared with guideline-directed medical treatment alone. We report the 24-month outcome from this trial. MET...
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:10.1002/ejhf.1616
更新日期:2019-12-01 00:00:00
abstract:AIMS:The aim of this study was to investigate the clinical picture and outcome of cardiogenic shock and to develop a risk prediction score for short-term mortality. METHODS AND RESULTS:The CardShock study was a multicentre, prospective, observational study conducted between 2010 and 2012. Patients with either acute co...
journal_title:European journal of heart failure
pub_type: 杂志文章,多中心研究
doi:10.1002/ejhf.260
更新日期:2015-05-01 00:00:00
abstract:AIMS:Patients with intestinal malabsorption may develop cardiac dysfunction the origin of which is often unclear. We sought to investigate the pathogenesis of dilated cardiomyopathy in human malabsorption. METHODS AND RESULTS:Eighteen patients with intestinal bypass as treatment for severe obesity and cardiomyopathy u...
journal_title:European journal of heart failure
pub_type: 杂志文章
doi:10.1093/eurjhf/hfr167
更新日期:2012-02-01 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:The goal of the study was to examine the prognostic impact, haemodynamic and clinical features associated with lung congestion in patients with chronic heart failure (HF). METHODS AND RESULTS:HF patients (n = 186) and HF-free controls (n = 21) underwent right heart catheterization, echocardiography, pulmonary fun...
journal_title:European journal of heart failure
pub_type: 杂志文章
doi:10.1002/ejhf.417
更新日期:2015-11-01 00:00:00
abstract::Nitric oxide (NO) appears to play a role in modulating cardiac function in both health and disease. Early studies in isolated rodent cardiac myocytes demonstrated a depressant effect of NO supplied by NO donors (exogenous) as well as NO generated within myocytes (endogenous). There is increasing evidence for a functio...
journal_title:European journal of heart failure
pub_type: 杂志文章,评审
doi:10.1016/s1388-9842(01)00163-5
更新日期:2001-10-01 00:00:00
abstract:AIMS:Recent studies have shown that microRNAs (miRNAs), besides being potent regulators of gene expression, can additionally serve as circulating biomarkers of disease. The aim of this study is to determine if plasma miRNAs can be used as indicators of disease progression or therapeutic efficacy in hypertension-induced...
journal_title:European journal of heart failure
pub_type: 杂志文章
doi:10.1093/eurjhf/hft018
更新日期:2013-06-01 00:00:00
abstract:AIMS:Knowledge of patient preferences is vital for delivering optimal healthcare. This study uses utility measurement to assess the preferences of heart failure (HF) patients regarding quality of life or longevity. The utility approach represents the perspective of a patient; facilitates the combination of mortality, m...
journal_title:European journal of heart failure
pub_type: 杂志文章
doi:10.1093/eurjhf/hft071
更新日期:2013-10-01 00:00:00
abstract::Alternations in gut microbial composition (i.e. loss of microbial diversity or 'gut dysbiosis') have been associated with heart failure with reduced ejection fraction (HFrEF). It has also been suggested that increased chronic low-level inflammation and immune system dysregulation seen in patients with HFrEF could be r...
journal_title:European journal of heart failure
pub_type: 杂志文章,评审
doi:10.1002/ejhf.1792
更新日期:2020-04-01 00:00:00
abstract:AIMS:Impaired tissue perfusion is often observed in patients with acute heart failure. We tested whether low-dose nitroglycerin (NTG) improves microcirculatory perfusion in patients admitted for acute heart failure. METHODS AND RESULTS:In 20 acute heart failure patients, NTG was given as intravenous infusion at a fixe...
journal_title:European journal of heart failure
pub_type: 杂志文章
doi:10.1093/eurjhf/hfp021
更新日期:2009-04-01 00:00:00
abstract::Myocardial fibrosis is the result of excessive fibrillar collagen synthesis and deposition without reciprocally balanced degradation. It causes cardiac dysfunction, arrhythmias, and ischaemia, and thereby determines the clinical course and outcome of cardiac patients even when adequately treated. Therefore, further re...
journal_title:European journal of heart failure
pub_type: 杂志文章,评审
doi:10.1002/ejhf.312
更新日期:2015-08-01 00:00:00
abstract:AIMS:Heart failure (HF) is common in geriatric patients. Clinicians face diagnostic challenges primarily due to comorbidity and limited access to echocardiography. The purpose of this study was to identify independent determinants of the presence of HF in geriatric outpatients and to determine the optimal diagnostic st...
journal_title:European journal of heart failure
pub_type: 杂志文章
doi:10.1093/eurjhf/hfr021
更新日期:2011-05-01 00:00:00
abstract::The published version of this paper contained an error. The part C of the figure only has the header "multiple organs", whereas it must read: “HF does not affect multiple organs”. ...
journal_title:European journal of heart failure
pub_type: 已发布勘误
doi:10.1002/ejhf.499
更新日期:2016-02-01 00:00:00
abstract::This article updates the Heart Failure Association of the European Society of Cardiology (ESC) 2007 classification of advanced heart failure and describes new diagnostic and treatment options for these patients. Recognizing the patient with advanced heart failure is critical to facilitate timely referral to advanced h...
journal_title:European journal of heart failure
pub_type: 杂志文章,评审
doi:10.1002/ejhf.1236
更新日期:2018-11-01 00:00:00
abstract::The ELITE-II, BEST and CHAMP Trials were reported for the first time at the American Heart Association in November 1999. These trials provide valuable new information to guide clinical practice in the management of heart failure and of myocardial infarction, although none mandate a major change from current clinical p...
journal_title:European journal of heart failure
pub_type: 杂志文章
doi:10.1016/s1388-9842(00)00053-2
更新日期:2000-03-01 00:00:00
abstract:BACKGROUND:Recent advances in pharmacological and pacemaker-based treatments for heart failure (HF) have brought about significant improvements in left ventricular function. AIMS:To identify the proportion of treated systolic HF patients in whom left ventricular systolic function improves and/or returns to normal. ME...
journal_title:European journal of heart failure
pub_type: 杂志文章
doi:10.1016/j.ejheart.2007.10.001
更新日期:2007-12-01 00:00:00
abstract:BACKGROUND:Several studies have shown that cardiac-resynchronization therapy (CRT) improves haemodynamic function, cardiac symptoms, and heart rate variability (HRV) and reduces the risk of mortality and sudden death in subjects with chronic heart failure (CHF). In subjects with CHF, power spectral values for the low-f...
journal_title:European journal of heart failure
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.ejheart.2006.01.008
更新日期:2006-11-01 00:00:00
abstract:AIMS:Endothelial dysfunction has been shown to correlate with severity of congestive heart failure (CHF) and recent data suggest morphological changes of peripheral vasculature to be associated with the syndrome. We therefore investigated the hypothesis that vascular remodeling is associated with functional changes in ...
journal_title:European journal of heart failure
pub_type: 杂志文章
doi:10.1016/j.ejheart.2004.04.008
更新日期:2005-01-01 00:00:00
abstract:BACKGROUND:Biventricular (BiV) pacing has been found to improve systolic function and exercise tolerance in patients with severe congestive heart failure and bundle branch block. The mechanisms behind this beneficial effect is still not sufficiently clarified. AIM:To evaluate the regional myocardial perfusion (MP) dur...
journal_title:European journal of heart failure
pub_type: 杂志文章,多中心研究
doi:10.1016/s1388-9842(02)00245-3
更新日期:2003-03-01 00:00:00
abstract:AIMS:Previous evaluations of natriuretic peptide (NP) levels in patients with acute dyspnoea presenting to the emergency department (ED) have selected only a minority of patients for echocardiography. We aimed to evaluate the association between NPs and more subtle echocardiographic findings and to assess the potential...
journal_title:European journal of heart failure
pub_type: 杂志文章,多中心研究
doi:10.1093/eurjhf/hfp075
更新日期:2009-07-01 00:00:00
abstract:AIMS:Incident heart failure (HF) continues to pose a common and serious problem. We sought to examine the value of echocardiographic predictors of new HF in a community-based elderly population at risk for HF, independent of and incremental to clinical evaluation. METHODS AND RESULTS:Asymptomatic patients ≥65 years ol...
journal_title:European journal of heart failure
pub_type: 杂志文章
doi:10.1002/ejhf.643
更新日期:2016-11-01 00:00:00
abstract::This article provides information and a commentary on trials presented at the American Heart Association meeting held in November 2005, relevant to the pathophysiology, prevention and treatment of heart failure. All reports should be considered as preliminary data, as analyses may change in the final publication. In R...
journal_title:European journal of heart failure
pub_type: 杂志文章,评审
doi:10.1016/j.ejheart.2005.12.003
更新日期:2006-01-01 00:00:00
abstract:AIMS:To evaluate right-ventricular (RV) function during stress echocardiography (SE) and to assess its relationship with exercise capacity in heart failure (HF) patients. METHODS AND RESULTS:We included 88 patients aged 60.9 +/- 11.2 years with a mean LVEF of 27.2 +/- 9.5%. The following RV parameters were measured at...
journal_title:European journal of heart failure
pub_type: 杂志文章
doi:10.1093/eurjhf/hfp200
更新日期:2010-03-01 00:00:00
abstract:BACKGROUND:Platelet-endothelial interactions modulated by adhesion molecules, may play an important role in the pathogenesis of congestive heart failure (CHF). Soluble levels of these molecules and platelet-derived substances are reportedly elevated in patients with CHF. However, no data are available on the plasma lev...
journal_title:European journal of heart failure
pub_type: 杂志文章
doi:10.1016/s1388-9842(99)00029-x
更新日期:1999-08-01 00:00:00
abstract:AIMS:To determine the association between obesity and outcomes in post-acute myocardial infarction (AMI) patients with systolic heart failure (HF). METHODS AND RESULTS:Of the 6632 Eplerenone Post-Acute Myocardial Infarction Heart Failure Efficacy and Survival Study (EPHESUS) participants, 6611 had data on baseline bod...
journal_title:European journal of heart failure
pub_type: 杂志文章,随机对照试验
doi:10.1093/eurjhf/hfq043
更新日期:2010-06-01 00:00:00
abstract::We have documented a pre-junctional beta-2 adrenoceptor mediated reduction in cardiac norepinephrine spillover (CNES) in heart failure patients receiving chronic beta-blockade. Our present objective was to ascertain the consequence of this decrease for vagal heart rate (HR) regulation by determining CNES, arterial bar...
journal_title:European journal of heart failure
pub_type: 杂志文章
doi:10.1016/j.ejheart.2004.10.012
更新日期:2005-08-01 00:00:00
abstract:AIMS:To characterise the prevalence, in-hospital complications, management, and long-term outcome of patients with congestive heart failure but preserved left ventricular systolic function after acute myocardial infarction. METHODS:3166 consecutive patients screened for entry in the Bucindolol Evaluation in Acute Myoc...
journal_title:European journal of heart failure
pub_type: 杂志文章
doi:10.1016/s1388-9842(03)00159-4
更新日期:2003-12-01 00:00:00
abstract:AIMS:Current guidelines for the diagnosis of heart failure with normal or preserved ejection fraction (HFpEF) are based on measurements at rest. However, in HFpEF ventricular dysfunction is more apparent on exercise. We hypothesized that Mitral annular plane systolic excursion (MAPSE) which is easy to acquire on exerci...
journal_title:European journal of heart failure
pub_type: 杂志文章
doi:10.1093/eurjhf/hfr081
更新日期:2011-09-01 00:00:00
abstract:BACKGROUND:The use of oral anticoagulation in patients with heart failure in sinus rhythm remains controversial as previous large randomized controlled trials (RCTs) have not shown a survival benefit. However, heterogeneity exists among heart failure patients and it is possible that high-risk subgroups may benefit from...
journal_title:European journal of heart failure
pub_type: 杂志文章
doi:10.1002/ejhf.199
更新日期:2015-01-01 00:00:00
abstract::Self-care is essential in the long-term management of chronic heart failure. Heart failure guidelines stress the importance of patient education on treatment adherence, lifestyle changes, symptom monitoring and adequate response to possible deterioration. Self-care is related to medical and person-centred outcomes in ...
journal_title:European journal of heart failure
pub_type: 杂志文章
doi:10.1002/ejhf.2008
更新日期:2020-09-18 00:00:00