Abstract：
AIMS:Several studies have shown that older patients with heart failure with reduced ejection fraction (HFrEF) are undertreated. The aim of this study was to evaluate the association of up-titration of angiotensin-converting enzyme inhibitors (ACEI), angiotensin receptor blockers (ARB) and beta-blockers on outcome across the age spectrum in HFrEF patients. METHODS AND RESULTS:We analysed HFrEF patients on sub-optimal doses of ACEI/ARB and/or beta-blockers from the BIOSTAT-CHF study stratified by age. Patients underwent a 3-month up-titration period. We used inverse probability weighting to adjust for the likelihood of successful up-titration to determine the association of achieved dose with mortality and/or heart failure hospitalisation, testing for an interaction with age. Over a median follow-up of 21 months in 1720 HFrEF patients (76.5% male, mean age 67 years), the primary outcome occurred in 558 patients. Increased percentage of target dose of ACEI/ARB and beta-blocker achieved at 3 months were both significantly associated with reduced incidence of the primary outcome, [ACEI-ARB: hazard ratio (HR) per 12.5% increase in dose: 0.92, 95% confidence interval (CI) 0.91-0.94, P < 0.001; beta-blocker: HR 0.98, 95% CI 0.95-1.00, P = 0.046], with a significant interaction with age seen for beta-blockers but not ACEI/ARB (P = 0.034 and P = 0.22, respectively). CONCLUSIONS:Achieving higher doses of ACEI/ARB was associated with improved outcome regardless of age. However, achieving higher doses of beta-blockers was only associated with improved outcome in younger, but not in older patients.
journal_name
Eur J Heart Failjournal_title
European journal of heart failureauthors
Mordi IR,Ouwerkerk W,Anker SD,Cleland JG,Dickstein K,Metra M,Ng LL,Samani NJ,van Veldhuisen DJ,Zannad F,Voors AA,Lang CCdoi
10.1002/ejhf.1799subject
Has Abstractpub_date
2020-03-25 00:00:00eissn
1388-9842issn
1879-0844pub_type
杂志文章abstract：BACKGROUND:Nuclear factor kappa B (NF-kappaB) is activated by several factors, which increase the inflammatory response, and this activation, in turn, leads to the expression of several genes such as cytokines, and may play an important role in cardiovascular diseases. AIMS:The aim of the study is to examine the effec...
journal_title：European journal of heart failure
pub_type： 杂志文章
doi：10.1016/j.ejheart.2003.10.007
更新日期：2004-03-01 00:00:00
abstract：BACKGROUND:Bifocal pacing (BFP) has been proposed as a feasible alternative to cardiac resynchronization therapy. AIM:To evaluate BFP in patients with severe heart failure and significant intraventricular conduction delay and to compare it with biventricular pacing (BVP). METHODS:Echocardiographic examination includi...
journal_title：European journal of heart failure
pub_type： 杂志文章
doi：10.1016/j.ejheart.2006.09.003
更新日期：2007-03-01 00:00:00
abstract：AIM:Heart failure with preserved ejection fraction (HFpEF) is associated with increased sympathetic nervous system (SNS) tone. Attenuating the SNS with renal denervation (RDT) might be helpful and there are no data currently in humans with HFpEF. METHODS AND RESULTS:In this single-centre, randomized, open-controlled s...
journal_title：European journal of heart failure
pub_type： 杂志文章,随机对照试验
doi：10.1002/ejhf.502
更新日期：2016-06-01 00:00:00
abstract：:Anti-beta-1-adrenergic receptor antibodies (anti-β1AR Abs) have long been implicated in the pathogenesis of dilated cardiomyopathy (DCM). It is believed that these autoantibodies bind to and constitutively stimulate the β1AR to promote pathological cardiac remodelling and β1AR desensitization and downregulation. The p...
journal_title：European journal of heart failure
pub_type： 杂志文章,评审
doi：10.1093/eurjhf/hft065
更新日期：2013-07-01 00:00:00
abstract：AIMS:To assess adherence to medical treatment in patients with heart failure (HF) using a specific questionnaire and measurement of the serum concentration of digoxin. METHODS AND RESULTS:Forty patients with symptomatic HF and a clinical indication for digoxin were included in this pilot study. The assessment of adher...
journal_title：European journal of heart failure
pub_type： 临床试验,杂志文章,多中心研究
doi：10.1093/eurjhf/hfq015
更新日期：2010-04-01 00:00:00
abstract：BACKGROUND:Renal failure in heart failure is related to decreased cardiac output. However, little is known about its association with venous congestion. AIMS:To investigate the relationship between venous congestion and glomerular filtration rate (GFR) in patients with cardiac dysfunction. METHODS AND RESULTS:Right a...
journal_title：European journal of heart failure
pub_type： 临床试验,杂志文章
doi：10.1016/j.ejheart.2007.05.010
更新日期：2007-09-01 00:00:00
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 oversigna...
journal_title：European journal of heart failure
pub_type： 杂志文章,随机对照试验
doi：10.1093/eurjhf/hfr147
更新日期：2012-01-01 00:00:00
abstract：BACKGROUND:Plasma concentrations of atrial natriuretic peptides are correlated with atrial pressures, as are left ventricular ejection fraction and left ventricular filling abnormalities. AIMS:This study investigated the relation of atrial natriuretic peptides to both left ventricular systolic and diastolic function i...
journal_title：European journal of heart failure
pub_type： 杂志文章
doi：10.1016/s1388-9842(98)00005-1
更新日期：1999-03-01 00:00:00
abstract：AIMS:Psychopathologies may occur in heart failure (HF) and can be associated with adverse outcomes. Amongst neuropeptide S receptor gene functional sequence variants, the T-allele [asparagine(107)isoleucine, NPSR1 rs324981] has been identified as a risk factor for increased anxiety/overinterpretation of bodily symptoms...
journal_title：European journal of heart failure
pub_type： 杂志文章
doi：10.1002/ejhf.706
更新日期：2017-03-01 00:00:00
abstract：AIMS:Modulation of vagal tone using electrical vagal nerve stimulation or pharmacological acetylcholinesterase inhibition by donepezil exerts beneficial effects in an animal model of chronic heart failure (CHF). Considering different treatment mechanisms underlying renin-angiotensin system (RAS) suppression and parasym...
journal_title：European journal of heart failure
pub_type： 杂志文章
doi：10.1002/ejhf.164
更新日期：2014-10-01 00:00:00
abstract：AIMS:To determine whether a strategy of intensive blood pressure control reduces the risk of heart failure (HF) events consistently across the spectrum of kidney function and albuminuria. METHODS AND RESULTS:SPRINT was a randomized clinical trial in which 9361 individuals ≥50 years, at high risk for or with cardiovasc...
journal_title：European journal of heart failure
pub_type： 杂志文章
doi：10.1002/ejhf.1971
更新日期：2020-07-21 00:00:00
abstract：AIMS:With improvement in survival of chronic heart failure (HF), the clinical importance of co-morbidity is increasing. The aim of this study was to assess the incidence and risk of cancer and all-cause mortality in a large Danish HF cohort. METHODS AND RESULTS:A total of 9307 outpatients with verified HF without a pr...
journal_title：European journal of heart failure
pub_type： 杂志文章
doi：10.1002/ejhf.472
更新日期：2016-03-01 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：:Galectins are a family of soluble beta-galactoside-binding lectins that play many important regulatory roles in inflammation, immunity, and cancer. Recently, a role for galectin-3 in the pathophysiology of heart failure (HF) has been suggested. Numerous studies have demonstrated the up-regulation of galectin-3 in hype...
journal_title：European journal of heart failure
pub_type： 杂志文章,评审
doi：10.1093/eurjhf/hfp097
更新日期：2009-09-01 00:00:00
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 card...
journal_title：European journal of heart failure
pub_type： 杂志文章,评审
doi：10.1002/ejhf.1557
更新日期：2019-09-01 00:00:00
abstract：AIMS:Galectin-3 is a prognostic heart failure (HF) biomarker that may mediate cardiac fibrosis. We examined the value of serial galectin-3 measurement for prognosis and response to therapy in chronic HF. METHODS AND RESULTS:A total of 151 subjects with LV systolic dysfunction (LVSD) were followed through 908 visits ov...
journal_title：European journal of heart failure
pub_type： 杂志文章
doi：10.1093/eurjhf/hft075
更新日期：2013-10-01 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 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:Ventricular septal rupture (VSR) became a rare mechanical complication of myocardial infarction in the era of percutaneous coronary interventions but is associated with extreme mortality in patients who present with cardiogenic shock (CS). Promising outcomes have been reported with the use of circulatory support a...
journal_title：European journal of heart failure
pub_type： 杂志文章
doi：10.1002/ejhf.852
更新日期：2017-05-01 00:00:00
abstract：:Cardiac contractility modulating (CCM) signals delivered by the OPTIMIZER System are being investigated as a treatment for medically refractory heart failure. Previous chronic studies of CCM have excluded patients with prolonged QRS and a cardiac resynchronization therapy (CRT) device. However, symptoms persist in mor...
journal_title：European journal of heart failure
pub_type： 杂志文章
doi：10.1016/j.ejheart.2007.05.012
更新日期：2007-09-01 00:00:00
abstract：AIMS:A restrictive transmitral filling (RF) pattern predicts increased mortality in heart failure (HF) with reduced left ventricular (LV) systolic function. We performed a combined evaluation of LV function and RF for prognosis in patients with HF with and without systolic dysfunction. METHODS AND RESULTS:Doppler echo...
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：10.1016/j.ejheart.2008.05.007
更新日期：2008-07-01 00:00:00
abstract：BACKGROUND:Mortality in patients with mild to moderate chronic heart failure remains high. At present there is no easy way of identifying patients within this population at increased risk of death in the medium to long term. AIMS:To develop a prognostic index to identify outpatients with mild to moderate chronic heart...
journal_title：European journal of heart failure
pub_type： 杂志文章
doi：10.1016/s1388-9842(03)00053-9
更新日期：2003-08-01 00:00:00
abstract：BACKGROUND:Beneficial effects of left ventricular (LV)-based pacing on acute hemodynamic parameters were reported in several series, but only a few studies examined the long-term effects of this new pacing procedure. AIMS:To assess long-term effects of permanent LV-based pacing on LV function and mitral regurgitation ...
journal_title：European journal of heart failure
pub_type： 杂志文章
doi：10.1016/s1388-9842(01)00145-3
更新日期：2001-08-01 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: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 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:The aim of this study was to investigate the prognostic impact of right ventricular (RV) size in patients with chronic heart failure. METHODS AND RESULTS:Normal volunteers (n = 80) and patients (n = 380) with left ventricular (LV) ejection fraction <45% on echocardiography and on optimal treatment for heart failu...
journal_title：European journal of heart failure
pub_type： 杂志文章
doi：10.1093/eurjhf/hfq161
更新日期：2011-01-01 00:00:00
abstract：:Heart failure and sleep apnoea are major health problems with an increasingly recognized association; evidence suggests that sleep apnoea may play a role in the progression of heart failure. However, confounding factors such as obesity, hypertension and coronary heart disease make this relationship uncertain and an in...
journal_title：European journal of heart failure
pub_type： 杂志文章,评审
doi：10.1016/j.ejheart.2005.07.013
更新日期：2006-05-01 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：AIM:Evaluation of N-terminal pro-brain natriuretic peptide (NT-proBNP) to confirm or disprove heart failure in community patients complaining of dyspnoea. METHODS AND RESULTS:General practitioners referred 345 consecutive patients complaining of dyspnoea to our hospital-based clinic, where a diagnosis was established ...
journal_title：European journal of heart failure
pub_type： 杂志文章
doi：10.1016/j.ejheart.2003.10.003
更新日期：2004-01-01 00:00:00
