European journal of heart failure
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Eur. J. Heart Fail. · Mar 2015
Randomized Controlled Trial Multicenter StudyThe impact of intravenous ferric carboxymaltose on renal function: an analysis of the FAIR-HF study.
Anaemia and iron deficiency are constituents of the cardio-renal syndrome in chronic heart failure (CHF). We investigated the effects of i.v. iron in iron-deficient CHF patients on renal function, and the efficacy and safety of this therapy in patients with renal dysfunction. ⋯ Treatment of iron deficiency in CHF patients with i.v. FCM was associated with an improvement in renal function. FCM therapy was effective and safe in CHF patients with renal dysfunction.
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Eur. J. Heart Fail. · Mar 2015
Randomized Controlled Trial Multicenter StudyLoop diuretic dose adjustments after a hospitalization for heart failure: insights from ASCEND-HF.
Loop diuretics are a cornerstone of heart failure (HF) treatment, but data regarding diuretic dose adjustments after a HF hospitalization and the association with subsequent outcomes are limited. This study was therefore conducted to determine these factors. ⋯ In a large multinational clinical trial, 56% of patients hospitalized with HF were either initiated on a daily loop diuretic at discharge or discharged on higher doses compared with admission. In patients established on diuretics prior to hospitalization, we found no association between changes to chronic doses at discharge and improved outcomes, whereas initiation of loop diuretic therapy was associated with better outcomes compared with no dose change.
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Eur. J. Heart Fail. · Mar 2015
ReviewNeprilysin inhibition to treat heart failure: a tale of science, serendipity, and second chances.
This review describes the role of neprilysin (also known as neutral endopeptidase or enkephalinase) in the degradation of natriuretic and other vasoactive peptides, including bradykinin and adrenomedullin. The initial development of neprilysin inhibitors, then angiotensin converting enzyme-neprilysin inhibitors and, most recently, the angiotensin receptor neprilysin inhibitor (ARNI) LCZ696 (sacubitril valsartan) as an extension of the nurohumoral basis for the treatment of heart failure is also summarised. Finally, the implications of the compelling benefits of LCZ696 compared with enalapril in the Prospective comparison of ARNI with ACEI to Determine Impact on Global Mortality and morbidity in Heart Failure trial (PARADIGM-HF) is discussed.
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Eur. J. Heart Fail. · Mar 2015
Pulmonary vascular response to exercise in symptomatic heart failure with reduced ejection fraction and pulmonary hypertension.
To study pulmonary vascular response patterns to exercise in heart failure with reduced ejection fraction (HFrEF) and pulmonary hypertension (PH). ⋯ Even after thorough decongestion and under continuous afterload reduction, PH secondary to HFrEF is completely reversible in only a minority of patients. Others demonstrate an exercise-induced PVR increase, associated with impaired right ventricular stroke work, which might be ameliorated by nitric oxide donor support.