Abstract:
:Although mineralocorticoid antagonists (MRAs) have been proposed as effective fourth-line blood pressure (BP) lowering agents in resistant hypertension, this effect in heart failure is undetermined. In this synthesis of heart failure randomized controlled trials (RCTs), we evaluated the extent of BP lowering following MRA treatment against placebo. We searched Medline and the Cochrane Collaboration Library databases from 1991 to September 2016 for RCTs, in which MRAs were compared with placebo. The quality of RCTs was assessed with Cochrane risk of bias tool. Outcomes were the extent of systolic and diastolic BP lowering. We included seven studies (13,354 patients, 65.8% males, mean age of 66.3 years, mean follow-up period of 9.4 months, mean baseline BP of 123.5/75.0 mmHg) of MRAs compared with placebo. MRAs were not significantly associated with systolic - 1.8 (95% CI: - 8.0, 4.4) mmHg or diastolic - 0.3 (95% CI: - 3.4, 2.7) mmHg, BP reduction. Although systolic BP was not lowered by spironolactone, diastolic BP was lowered by - 3.0 (95% CI: - 3.4, - 2.6) mmHg. Eplerenone treatment did not significantly lowered systolic [- 0.04 (95% CI: - 4.4, 4.3) mmHg], but it was associated with minimal diastolic BP increase [1.0 (95% CI: 0.5, 1.53) mmHg]. MRAs were not associated with systolic and diastolic BP reduction in heart failure patients. This finding suggests that MRAs should be used according to their indications in heart failure independently of initial BP levels.
journal_name
Heart Fail Revjournal_title
Heart failure reviewsauthors
Bazoukis G,Thomopoulos C,Tse G,Tsioufis Cdoi
10.1007/s10741-018-9689-9subject
Has Abstractpub_date
2018-07-01 00:00:00pages
547-553issue
4eissn
1382-4147issn
1573-7322pii
10.1007/s10741-018-9689-9journal_volume
23pub_type
杂志文章,meta分析,评审abstract::Many factors contribute to the pathophysiology and progression of heart failure (HF), offering the potential for many synergistic therapeutic approaches to its management. For patients, who have systolic HF, prolonged QRS and receiving guideline-indicated pharmacological therapy, cardiac resynchronization therapy (CRT...
journal_title:Heart failure reviews
pub_type: 杂志文章,评审
doi:10.1007/s10741-012-9351-x
更新日期:2012-11-01 00:00:00
abstract::Chronic obstructive pulmonary disease (COPD) is a major health problem worldwide, with co-morbidities contributing to the overall severity and mortality of the disease. The incidence and prevalence of cardiovascular disease among COPD patients are high. Both disorders often co-exist, mainly due to smoking, but they al...
journal_title:Heart failure reviews
pub_type: 杂志文章,评审
doi:10.1007/s10741-017-9646-z
更新日期:2017-11-01 00:00:00
abstract::An important feature of heart failure is the progressive deterioration of left ventricular function that occurs in the absence of clinically apparent intercurrent adverse events. The mechanism or mechanisms responsible for this hemodynamic deterioration are not known. We and others have advanced the hypothesis that th...
journal_title:Heart failure reviews
pub_type: 杂志文章
doi:10.1023/A:1009880720032
更新日期:2000-06-01 00:00:00
abstract::Diabetes mellitus is one of the leading causes of death, and the majority of these deaths are associated with cardiovascular diseases. Development and progression of myocardial infarction leading to heart failure is much more complex and multifactorial in diabetics compared with non-diabetics. Despite significant adva...
journal_title:Heart failure reviews
pub_type: 杂志文章,评审
doi:10.1007/s10741-010-9172-8
更新日期:2010-11-01 00:00:00
abstract::B-Type natriuretic peptide (BNP) is elevated in states of increased ventricular wall stress. BNP is most commonly used to rule out congestive heart failure (CHF) in dyspneic patients. BNP levels are influenced by age, gender and, to a surprisingly large extent, by body mass index (BMI). In addition, it can be elevated...
journal_title:Heart failure reviews
pub_type: 杂志文章,评审
doi:10.1007/s10741-007-9002-9
更新日期:2007-03-01 00:00:00
abstract::Ultrafiltration (UF) has emerged as an alternative therapy for acute decompensated heart failure (ADHF) due to its physiological benefits such as improvement in neurohormonal activation. We performed a systematic review and a meta-analysis to evaluate the efficacy, safety, and the impact on outcomes for UF therapy as ...
journal_title:Heart failure reviews
pub_type: 杂志文章,meta分析,评审
doi:10.1007/s10741-016-9559-2
更新日期:2016-09-01 00:00:00
abstract::Acute heart failure syndromes (AHFS) are associated with the rapid onset of heart failure (HF) signs and symptoms. Hospitalizations for AHFS continue to rise and are associated with significant mortality and morbidity. Several pharmacological agents are currently approved for the treatment of AHFS, but their use is as...
journal_title:Heart failure reviews
pub_type: 杂志文章,评审
doi:10.1007/s10741-009-9136-z
更新日期:2009-12-01 00:00:00
abstract::Physiologic endurance exercise performance is primarily limited by cardiac function. In patients with heart failure, there is dissociation between cardiac performance and exercise capacity, suggesting a distinct role of abnormal peripheral organ function, including skeletal muscle function. The impact of heart failure...
journal_title:Heart failure reviews
pub_type: 杂志文章,评审
doi:10.1007/s10741-012-9353-8
更新日期:2013-09-01 00:00:00
abstract::It is well established that cardiac remodeling plays a pivotal role in the development of heart failure, a leading cause of death worldwide. Meanwhile, sympathetic hyperactivity is an important factor in inducing cardiac remodeling. Therefore, an in-depth understanding of beta-adrenoceptor signaling pathways would hel...
journal_title:Heart failure reviews
pub_type: 杂志文章,评审
doi:10.1007/s10741-013-9417-4
更新日期:2014-11-01 00:00:00
abstract::Ischemic heart disease (IHD) remains the single most common cause of death worldwide. Ischemic cardiomyopathy is a major sequel of coronary artery disease. The economic health burden of IHD is substantial. In patients with old myocardial infarction (OMI), the extent of viable myocardium (VM) directly affects the short...
journal_title:Heart failure reviews
pub_type: 杂志文章,评审
doi:10.1007/s10741-017-9626-3
更新日期:2017-07-01 00:00:00
abstract::Stem cell therapy is a promising approach to the treatment of ischemic heart disease via replenishing cell loss after myocardial infarction. Both preclinical studies and clinical trials have indicated that cardiac function improved consistently, but very modestly after cell-based therapy. This mainly attributed to low...
journal_title:Heart failure reviews
pub_type: 杂志文章,评审
doi:10.1007/s10741-016-9576-1
更新日期:2016-11-01 00:00:00
abstract::There was a mistake in Prof. Giuseppe Massimo Claudio Rosano's affiliation. ...
journal_title:Heart failure reviews
pub_type: 已发布勘误
doi:10.1007/s10741-020-10000-w
更新日期:2020-09-01 00:00:00
abstract::This review evaluates the hypothesis that the cardiac effects of amiodarone can be explained-at least partly-by the induction of a local 'hypothyroid-like condition' in the heart. Evidence supporting the hypothesis comprises the observation that amiodarone exerts an inhibitory effect on the binding of T3 to thyroid ho...
journal_title:Heart failure reviews
pub_type: 杂志文章,评审
doi:10.1007/s10741-008-9131-9
更新日期:2010-03-01 00:00:00
abstract::Heart failure (HF) is characterized by the elaboration of a portfolio of pro-inflammatory cytokines and inflammatory mediators that are considered to contribute to disease progression by virtue of the deleterious effects that these molecules exert on the heart and circulation. Recent studies have suggested that these ...
journal_title:Heart failure reviews
pub_type: 杂志文章,评审
doi:10.1007/s10741-009-9140-3
更新日期:2010-07-01 00:00:00
abstract::Cardiac fibrosis stems from the changes in the expression of fibrotic genes in cardiac fibroblasts (CFs) in response to the tissue damage induced by various cardiovascular diseases (CVDs) leading to their transformation into active myofibroblasts, which produce high amounts of extracellular matrix (ECM) proteins leadi...
journal_title:Heart failure reviews
pub_type: 杂志文章,评审
doi:10.1007/s10741-019-09854-6
更新日期:2020-09-01 00:00:00
abstract::The development of a diabetic cardiomyopathy is a multifactorial process, and evidence is accumulating that defects in intracellular free calcium concentration [Ca2+]i or its homeostasis are related to impaired mechanical performance of the diabetic heart leading to a reduction in contractile dysfunction. Defects in r...
journal_title:Heart failure reviews
pub_type: 杂志文章,评审
doi:10.1007/s10741-017-9663-y
更新日期:2018-01-01 00:00:00
abstract::Acute heat failure syndromes are a heterogenous group of conditions. Chronic heart failure exacerbations represent the vast majority of cases. Pathophysiologic mechanisms, such as hypotension with peripheral tissue hypoperfusion, renal function impairment and myocardial ischemia and injury, adversely affect patients' ...
journal_title:Heart failure reviews
pub_type: 杂志文章,评审
doi:10.1007/s10741-007-9014-5
更新日期:2007-06-01 00:00:00
abstract::Apelin is an endogenous peptide acting on the APJ receptor. It consists of several isoforms characterized by different numbers of amino acids. The number of amino acids in the active isoforms range from 36 to 12. Apelin-13 and, to a lesser extent, apelin-36 are considered the most active isoforms with the greatest act...
journal_title:Heart failure reviews
pub_type: 杂志文章,评审
doi:10.1007/s10741-015-9475-x
更新日期:2015-07-01 00:00:00
abstract::There is ongoing controversy regarding the association between loop diuretics (LD), especially in high doses, and adverse clinical outcomes in outpatients with heart failure (HF). We performed a systematic review of the evidence for LD in outpatients with HF. We searched MEDLINE, EMBASE, and Cochrane Clinical Trial Co...
journal_title:Heart failure reviews
pub_type: 杂志文章,评审
doi:10.1007/s10741-020-09995-z
更新日期:2020-06-21 00:00:00
abstract::The prevalence of heart failure (HF) is increasing. A distinction is made between diastolic HF (preserved left ventricular ejection fraction (LVEF)) and systolic HF (reduced LVEF). Advanced glycation end-products (AGEs) are crystallized proteins that accumulate during ageing, but are particularly increased in patients...
journal_title:Heart failure reviews
pub_type: 杂志文章,评审
doi:10.1007/s10741-010-9225-z
更新日期:2012-03-01 00:00:00
abstract::Evidence-based management has improved long-term survival in patients with heart failure (HF). However, an unintended consequence of increased longevity is that patients with HF are exposed to a greater symptom burden over time. In addition to classic symptoms such as dyspnea and edema, patients with HF frequently suf...
journal_title:Heart failure reviews
pub_type: 杂志文章,评审
doi:10.1007/s10741-016-9581-4
更新日期:2017-01-01 00:00:00
abstract::The underlying mechanism for clinical and biochemical manifestations of chronic heart failure (HF) may be due in part to neurohumoral adaptations, such as activation of the renin-angiotensin-aldosterone and sympathetic nervous systems in the periphery and the brain. Internet search and discussion with colleagues are t...
journal_title:Heart failure reviews
pub_type: 杂志文章,评审
doi:10.1007/s10741-018-9747-3
更新日期:2019-03-01 00:00:00
abstract::Patients diagnosed with CHF have disproportionately high rates of depression. Research has demonstrated significant consequences of depression in patients with CHF including poor quality of life, worse medical adherence and increased health complications, health care utilization, and medical costs. Despite these conse...
journal_title:Heart failure reviews
pub_type: 杂志文章,评审
doi:10.1007/s10741-008-9081-2
更新日期:2009-03-01 00:00:00
abstract:BACKGROUND:Transient left ventricular apical ballooning syndrome also called Tako-Tsubo cardiomyopathy is defined as a syndrome consisting of stress induced apical ballooning of the left ventricle and normal coronary arteries. The majority of the published reports are case reports or case series with a small number of ...
journal_title:Heart failure reviews
pub_type: 杂志文章,meta分析
doi:10.1007/s10741-005-8555-8
更新日期:2005-12-01 00:00:00
abstract::Uric acid, the metabolic mediator of gout and urate renal stones, is associated with increased cardiovascular risk burden. Hyperuricemia is an old emerging metabolic disorder, and interaction among uric acid and cardiovascular diseases has been clearly described. Several illness including hypertension, myocardial infa...
journal_title:Heart failure reviews
pub_type: 杂志文章,评审
doi:10.1007/s10741-019-09869-z
更新日期:2020-01-01 00:00:00
abstract::Heart failure is a complex clinical syndrome associated with a significant morbidity and mortality burden. Reductions in left ventricular (LV) function trigger adaptive mechanisms, leading to structural changes within the LV and the potential development of dyssynchronous ventricular activation. This is the substrate ...
journal_title:Heart failure reviews
pub_type: 杂志文章,评审
doi:10.1007/s10741-018-9734-8
更新日期:2019-01-01 00:00:00
abstract::Heart failure (HF) is a common complication in patients with type 2 diabetes and it is closely associated with high morbidity and mortality rate. The incidence of cardiovascular events in patients with diabetes is related to high levels of glycemia, expressed by increase of HbA1c levels. However, there is little evide...
journal_title:Heart failure reviews
pub_type: 杂志文章,评审
doi:10.1007/s10741-018-9669-0
更新日期:2018-05-01 00:00:00
abstract::Heart failure with preserved ejection fraction (HFpEF) is a common disorder generating high mortality and important morbidity prevalence, with a very limited medical treatment available. Studies have shown that the pathophysiological hallmark of this condition is an elevated left intra-atrial pressure (LAP), exertiona...
journal_title:Heart failure reviews
pub_type: 杂志文章,评审
doi:10.1007/s10741-019-09787-0
更新日期:2019-09-01 00:00:00
abstract::Pulmonary hypertension that develops in the setting of underlying lung diseases such as COPD or idiopathic pulmonary fibrosis (IPF) is associated with decreased functional status, worsening hypoxemia and quality of life, and increased mortality. This complication of lung disease is complex in its origin and carries a ...
journal_title:Heart failure reviews
pub_type: 杂志文章,评审
doi:10.1007/s10741-016-9551-x
更新日期:2016-05-01 00:00:00
abstract::Despite remarkable progress in the therapeutic approach of patients with chronic heart failure (CHF), exercise intolerance remains one of the hallmarks of the disease. During the past two decades, evidence has accumulated to underscore the key role of both endothelial dysfunction and skeletal muscle wasting in the pro...
journal_title:Heart failure reviews
pub_type: 杂志文章,评审
doi:10.1007/s10741-012-9324-0
更新日期:2013-01-01 00:00:00