Abstract：
:Previous studies have reported superiority of mechanistic target-of-rapamycin (mTOR) antagonists (mTA) over calcineurin inhibitors (CNI) as part of maintenance immunosuppression (IS) in mitigating cardiac allograft vasculopathy (CAV) after heart transplantation (HT). MEDLINE and EMBASE were searched through October 2019 for studies comparing maintenance IS with mTA + antimetabolites (AM), CNI + mTA or CNI + AM post HT. The main outcomes were all-cause mortality, CAV, acute rejection, CMV infections, and change in eGFR. To compare different IS antagonists, a random-effects network meta-analysis was performed. We used p-scores to rank best treatments per outcome. Our search identified fifteen eligible studies (5 studies comparing mTA + AM vs. CNI + AM, 9 comparing CNI + mTA vs. CNI + AM, 1 comparing mTA + AM vs. CNI + mTA, 8 using everolimus and 7 sirolimus as mTA) reporting the selected outcomes. We did not identify any statistical difference in all-cause mortality among the three IS regimens without heterogeneity among studies. CAV rates were significantly lower with CNI + mTA (odds ratio [OR] 0.53, 95% confidence interval [CI] 0.3-0.92). Acute rejection rates were significantly lower with CNI + AM (OR 0.26, 95% CI 0.12-0.56) and with CNI + mTA (OR 0.16, 95% CI 0.07-0.33) compared with mTA + AM without significant heterogeneity (I2 = 43%, p = 0.9). CMV infections were significantly lower with mTA + AM (OR 0.13, 95% CI 0.03-0.46) and with CNI + mTA (OR 0.27, 95% CI 0.2-0.38) compared with CNI + AM without heterogeneity. mTA + AM led to higher eGFR compared with CNI + AM (9.06 ml/min/1.73 m2, 95% CI 3.15-14.97) and CNI + Mta (9.64 ml/min/1.73 m2, 95% CI 0.91-18.36), but the heterogeneity among studies was significant. CNI + mTA ranked better for CAV (p = 0.78), and acute rejection (p = 0.99) while mTA + AM for CMV infection (p = 0.94) and improvement in renal function (p = 0.93) than other regimens. Different IS regimens have similar effects on survival post HT, but CNI + mTA was associated with lower CAV rates, and acute rejection, while mTA + AM with less CMV infection post HT.
journal_name
Heart Fail Revjournal_title
Heart failure reviewsauthors
Ueyama H,Kuno T,Takagi H,Alvarez P,Asleh R,Briasoulis Adoi
10.1007/s10741-020-09967-3subject
Has Abstractpub_date
2020-05-18 00:00:00eissn
1382-4147issn
1573-7322pii
10.1007/s10741-020-09967-3pub_type
杂志文章,评审abstract：:Chronic heart failure (CHF) is a multi-dimensional and complex syndrome. Outcome measures are important for determining both the efficacy and quality of care and capturing the patient's perspective in evaluating the outcomes of health care delivery. Capturing the patient's perspective via patient-reported outcomes is ...
journal_title：Heart failure reviews
pub_type： 杂志文章,评审
doi：10.1007/s10741-012-9369-0
更新日期：2014-03-01 00:00:00
abstract：:Heart failure with preserved ejection fraction (HFpEF) accounts for almost one-half of all heart failure (HF) patients and continues to increase in prevalence. While mortality with heart failure with reduced ejection fraction (HFrEF) has decreased over the past few decades with use of evidence-based HFrEF therapy, mor...
journal_title：Heart failure reviews
pub_type： 杂志文章,评审
doi：10.1007/s10741-020-09958-4
更新日期：2020-05-13 00:00:00
abstract：INTRODUCTION:Heart transplantation has become an acceptable treatment in pediatric patients with end-stage heart disease and complex congenital heart disease. The liberalization of recipient eligibility criteria, mainly age, along with the expansion of the donor pool has resulted in the acceptable transplantation of ol...
journal_title：Heart failure reviews
pub_type： 杂志文章
doi：10.1023/a:1011406022657
更新日期：2001-09-01 00:00:00
abstract：:The diagnosis and management of heart failure remains challenging despite considerable clinical advances in recent decades. With greater understanding of the pathophysiology of this complex syndrome, a large number of candidate biomarkers have emerged and duly received scientific and clinical attention. These are freq...
journal_title：Heart failure reviews
pub_type： 杂志文章,评审
doi：10.1007/s10741-008-9123-9
更新日期：2010-07-01 00:00:00
abstract：:It is over 4 years since the Prospective Comparison of angiotensin receptor/neprilysin inhibitor (ARNI) with ACEI to Determine Impact on Global Mortality and Morbidity in Heart Failure (PARADIGM-HF) trial was published in New England Journal of Medicine. The PARADIGM-HF trial was the one that contributed to the offici...
journal_title：Heart failure reviews
pub_type： 杂志文章,评审
doi：10.1007/s10741-019-09879-x
更新日期：2020-05-01 00:00:00
abstract：:Congestive heart failure is most often caused by scar from coronary occlusion. The transition from occluded vessel to scar to dilation results in a remodeled ventricle that changes shape from ellipse to sphere. This shape change following an index event is called remodeling and a surgical approach for restoration (bri...
journal_title：Heart failure reviews
pub_type： 杂志文章,评审
doi：10.1007/s10741-005-6801-8
更新日期：2004-10-01 00:00:00
abstract：:The prognosis for patients with congestive heart failure (CHF) has been improved as a result of the use of angiotensin converting enzyme inhibitors and beta-adrenergic receptor blockers. The success of these therapies underscores the pathogenic role of neurohormonal activation in CHF. Clinical and experimental evidenc...
journal_title：Heart failure reviews
pub_type： 杂志文章,评审
doi：10.1023/a:1011405926588
更新日期：2001-03-01 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：: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
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：: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：:Pulmonary arterial hypertension (PAH) is a subcategory of pulmonary hypertension (PH) that comprises a group of disorders with similar pulmonary vascular pathology. Though PH is common, the estimated incidence of IPAH is 1-3 cases per million, making it a rare disease. The hemodynamic definition of PAH is a mean pulmo...
journal_title：Heart failure reviews
pub_type： 杂志文章,评审
doi：10.1007/s10741-015-9510-y
更新日期：2016-05-01 00:00:00
abstract：:There is little doubt that the discovery of ischemic preconditioning (PC) has been one of the fundamental milestones in the field of ischemic biology in the past 20 years. The purpose of this article is to review the pathophysiology and molecular basis of the late phase of myocardial PC. The exploitation of late PC fo...
journal_title：Heart failure reviews
pub_type： 杂志文章,评审
doi：10.1007/s10741-007-9031-4
更新日期：2007-12-01 00:00:00
abstract：:Despite therapeutic advances, patients with worsening heart failure (HF) requiring hospitalization have unacceptably high post-discharge mortality and re-admission rates soon after discharge. Evidence suggests a hypercoagulable state is present in patients with HF. Although thromboembolism as a direct consequence of H...
journal_title：Heart failure reviews
pub_type： 杂志文章,评审
doi：10.1007/s10741-012-9343-x
更新日期：2013-11-01 00:00:00
abstract：:Diabetes mellitus is a chronic disease requiring lifelong control with hypoglycemic agents that must demonstrate excellent efficacy and safety profiles. In patients taking glucose-lowering drugs, hypoglycemia is a common cause of death associated with arrhythmias, increased thrombus formation, and specific effects of ...
journal_title：Heart failure reviews
pub_type： 杂志文章,评审
doi：10.1007/s10741-017-9647-y
更新日期：2018-05-01 00:00:00
abstract：:Anemia is common in Congestive Heart Failure (CHF) and is associated with an increased mortality, morbidity and progressive renal failure. The most common causes of the anemia in CHF are (1) the associated Chronic Kidney Disease (CKD), which causes depression of erythropoietin (EPO) production in the kidney, and (2) e...
journal_title：Heart failure reviews
pub_type： 杂志文章,评审
doi：10.1007/s10741-010-9194-2
更新日期：2011-11-01 00:00:00
abstract：:Cardiopulmonary exercise testing (CPET) is a procedure widely used in daily clinical activity to investigate cardiac and pulmonary disorders. Peak oxygen consumption (VO2 peak) is the most validated and clinically accepted parameter used to report aerobic capacity in healthy individuals and in different clinical setti...
journal_title：Heart failure reviews
pub_type： 杂志文章,评审
doi：10.1007/s10741-013-9403-x
更新日期：2014-09-01 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：: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：:Treatment of patients with heart failure with reduced ejection fraction (HFrEF) with currently available therapies reduces morbidity and mortality. However, implementation of these therapies is a problem with only few patients achieving guideline-recommended maximal doses of therapy. In an effort to improve guideline ...
journal_title：Heart failure reviews
pub_type： 杂志文章,评审
doi：10.1007/s10741-020-10004-6
更新日期：2021-01-01 00:00:00
abstract：:Brief ischemia to the myocardium initiates a cascade of biochemical events in cardiac myocytes that protects the heart muscle during subsequent ischemic insults. This phenomenon is called ischemic preconditioning. If an acute myocardial infarction is preceded by preinfarction angina, it results in smaller infarction s...
journal_title：Heart failure reviews
pub_type： 杂志文章,评审
doi：10.1007/s10741-007-9037-y
更新日期：2007-12-01 00:00:00
abstract：:Objective and validated measures of depression/distress (anxiety and anger) are available and readily usable at the bedside or in clinic. Foremost among these is the Patient's Health Questionnaire--an adaptation of DSM IV criteria for Major Depressive Disorder that permits administration and scoring by nursing or phys...
journal_title：Heart failure reviews
pub_type： 杂志文章,评审
doi：10.1007/s10741-007-9046-x
更新日期：2009-03-01 00:00:00
abstract：:There are multiple intrinsic mechanisms for diastolic dysfunction ranging from molecular to structural derangements in ventricular myocardium. The molecular mechanisms regulating the progression from normal diastolic function to severe dysfunction still remain poorly understood. Recent studies suggest a potentially im...
journal_title：Heart failure reviews
pub_type： 杂志文章,评审
doi：10.1007/s10741-016-9569-0
更新日期：2016-11-01 00:00:00
abstract：:Accumulation of macrophages within the artery wall is an eminent feature of atherosclerotic plaques. Macrophages are influenced by various plaque microenvironmental stimuli, such as oxidized lipids, cytokines, and senescent erythrocytes, and thereby polarize into two main phenotypes called proinflammatory M1 and anti-...
journal_title：Heart failure reviews
pub_type： 杂志文章,评审
doi：10.1007/s10741-018-09764-z
更新日期：2019-05-01 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：:Right ventricular (RV) diastolic dysfunction was first reported as an indicator for the assessment of ventricular dysfunction in heart failure a little over two decades ago. However, the underlying mechanisms and precise role of RV diastolic dysfunction in heart failure remain poorly described. Complexities in the str...
journal_title：Heart failure reviews
pub_type： 杂志文章,评审
doi：10.1007/s10741-015-9472-0
更新日期：2015-05-01 00:00:00
abstract：:Coronavirus disease 2019 (COVID-19) is due to severe acute respiratory syndrome coronavirus (SARS-CoV)-2 which binds and enters the host cells through the angiotensin-converting enzyme (ACE)2. While the potential for benefit with the use of renin-angiotensin-aldosterone system inhibitors (RAASi) and the risks from sto...
journal_title：Heart failure reviews
pub_type： 杂志文章,评审
doi：10.1007/s10741-020-10022-4
更新日期：2020-09-01 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：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：: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
