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Impact of vericiguat on heart failure with reduced ejection fraction:a review

Global Health Journal 2023年第3期7卷 123-129页

作者： Manisha Vohra Mohammad Amir Ian Osoro Amit Sharma Ranjeet Kumar Department of Pharmacy Practice ISF College of PharmacyMogaPunjab 142001India

Introduction:heart failure is a major public health issue with a prevalence of about 26 million people *** nitric oxide availability,lower soluble guanylate cyclase(sGC)activity,and decreased cyclic guanosine monophosphate(cGMP)production are the causes of HF's *** prescribed under the brand name Verquvo was approved by *** and Drug Administration(FDA)in January *** is a novel agent and the first sGC stimulator which helps to treat patients suffering from heart failure with reduced ejection fraction(HFrEF).Objective:The mechanism of action(cGMP pathway)of vericiguat,its clinical trials,its use in the treatment of heart failure,and its possible future aspects in therapeutic recommendations are all covered in this *** will also raise awareness amongst healthcare professionals about the pharmacokinetic and pharmacodynamic parameters,dosing,administration,and drug-related problems of this new ***:Various databases for drug review were used in this review like PubMed,Medline,Google scholar,Drug bank,***,Medscape,and European society of cardiology guidelines.A total of 58 articles were screened out of which 39 articles were included in this ***:This review discusses vericiguat's mechanism of action(cGMP pathway),clinical studies,application in the treatment of heart failure,and potential future considerations in therapeutic *** will also educate healthcare professionals about the new drug's pharmacokinetics and pharmacodynamics,dose,administration,and drug-related ***:After hospitalization for HFrEF,the 5-year survival rate is just 25%,and disease morbidity and death are stil *** adjunctive therapy for individuals with heart failure and a low ejection fraction,vericiguat has a moderate level of ***'s efficacy as an adjunct therapy to different drugs used to cure HF has to be further ***'s safety and dosage in patients w

关键词： Vericiguat heart failure with reduced ejection fraction Soluble guanylate cyclase stimulator Nitric oxide Cyclicguanosinemonophosphate

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Dapagliﬂozin in heart failure with reduced ejection fraction:A Real-World Study

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Cardiovascular Innovations and Applications 2022年第2期6卷 219-223页

作者： Zhengyang Hao Yanzhou Zhang Department of Cardiology The First Affi liated Hospital of Zhengzhou UniversityZhengzhou 450052China

Aims:We aimed to observe the improvements in cardiac function indexes and the occurrence of adverse events in patients with heart failure with reduced ejection fraction(HFrEF)after dapagliﬂozin administration in a real-world ***:We retrospectively included 201 patients with HFrEF who were treated at a tertiary hospital in Zhengzhou and started to take dapagliﬂozin(10 mg/d)from March 2020 to June *** New York heart Association(NYHA)functional class,cardiac ultrasound indexes,laboratory indexes,and vital signs between baseline and the last follow-up visit were compared,and their adverse events during the follow-up period were ***:The follow-up period was 173(67–210)*** cardiac function indexes of patients at follow-up,com-pared with baseline,indicated signiﬁcant improvement(proportion of NYHA functional class I and II:40.8%vs.56.2%;left ventricular ejection fraction:28.4±5.3%vs.34.7±5.9%;left ventricular end-diastolic diameter:70.1±6.4 mm vs.64.7±5.6 mm;N-terminal pro-B-type natriuretic peptide:5421.9±2864.4 pg/mL vs.2842.8±1703.4 pg/mL at baseline *** follow-up;all P<0.05).The rates of hypotension,deterioration of renal function,and genital infection during the follow-up period were 6.5%,4.0%,and 3.5%,***:We believe that dapagliﬂozin is safe and effective in patients with HFrEF in the real world.

关键词： Dapagliﬂozin heart failure with reduced ejection fraction Real world

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The role of device therapy in heart failure with reduced ejection fraction(HFrEF) : a narrative review

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South China Journal of Cardiology 2022年第3期23卷 215-228页

作者： FU Bing-qi WANG Qi TAN Tong WEI Xue-biao YU Dan-qing Division of Cardiology Guangdong Cardiovascular InstituteGuangdong Provincial Key Laboratory of Coronary Heart Disease PreventionGuangdong Provincial People's HospitalGuangdong Academy of Medical SciencesGuangzhou 510080China

heart failure has gained increasing notice due to its high prevalence and mortality rate. The management for heart failure has been emphasized on the role of device therapy. Implantable cardioverter defibrillator(ICD) and cardiac resynchronization therapy(CRT) were given strong recommendation for heart failure with reduced ejection fraction(HFrEF), considering their effectiveness on preventing sudden cardiac death(SCD), improving cardiac function and benefiting survival. In this review, we explained the underlying mechanisms of disease initiation and progression in HFrEF, in order to build the connection between the pathological basis of HFrEF and the rationality of ICD and CRT on terminating ventricular arrhythmia, improving cardiac function, decreasing the rate of adverse clinical outcomes and benefiting survival. In addition, we discussed the high-quality researches with significant values on the discovery of device therapy clinical benefits, and compared the class I recommendations for device therapy in HFr EF, suggested by American heart Association and European Society of Cardiology.

关键词： heart failure with reduced ejection fraction systolic heart failure Implantable cardioverter defibrillator Cardiac resynchronization therapy Cardiac resynchronization therapy-defibrillator Device therapy

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Heterogeneity in cardiorenal protection by Sodium glucose cotransporter 2 inhibitors in heart failure across the ejection fraction strata:Systematic review and meta-analysis

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World Journal of Nephrology 2023年第5期12卷 182-200页

作者： Saeed Taheri Department of Medicine New Lahijan Scientific FoundationLahijan ***Iran

BACKGROUND Gliflozins or Sodium glucose cotransporter 2 inhibitors(SGLT2i)are relatively novel antidiabetic medications that have recently been shown to represent favorable effects on patients’cardiorenal ***,there is shortage of data on potential disparities in this therapeutic effect across different patient *** To investigate differential effects of SGLT2i on the cardiorenal outcomes of heart failure patients across left ventricular ejection fraction(LVEF)*** Literature was searched systematically for the large randomized double-blind controlled trials with long enough follow up periods reporting cardiovascular and renal outcomes in their patients regarding heart failure status and LVEF *** were then meta-analyzed after stratification of the pooled data across the LVEF strata and New York heart Associations(NYHA)classifications for heart failure using Stata software version *** The literature search returned 13 Large clinical trials and 13 post hoc analysis ***-analysis of the effects of gliflozins on the primary composite outcome showed no significant difference in efficacy across the heart failure subtypes,but higher efficacy were detected in patient groups at lower NYHA classifications(I2=46%,P=0.02).Meta-analyses across the LVEF stratums revealed that a baseline LVEF lower than 30%was associated with enhanced improvement in the primary composite outcome compared to patients with higher LVEF levels at the borderline statistical significance(HR:0.70,95%CI:0.60 to 0.79 vs 0.81,95%CI:0.75 to 0.87;respectively,P=0.06).Composite renal outcome was improved significantly higher in patients with no heart failure than in heart failure patients with preserved ejection fraction(HFpEF)(HR:0.60,95%CI:0.49 to 0.72 vs 0.94,95%CI:0.74 to 1.13;P=0.04).Acute renal injury occurred significantly less frequently in heart failure patients with reduced ejection fraction who received gliflozins than in HFpEF(HR:0.67,95%

关键词： Sodium glucose cotransporter 2 inhibitors Cardiovascular Renal outcome efficacy heart failure with preserved ejection fraction heart failure with reduced ejection fraction

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Association of frailty with in-hospital outcomes in elderly patients with heart failure

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World Journal of Clinical Cases 2021年第36期9卷 11208-11219页

作者： Yun-Peng Kang Li-Ying Chen Jia-Jia Zhu Wen-Xian Liu Chang-Sheng Ma Department of Cardiology Beijing Anzhen HospitalCapital Medical UniversityNational Clinical Research Center for Cardiovascular DiseasesBeijing 100029China

BACKGROUND Frailty is prevalent in elderly patients with cardiovascular ***,the association between frailty and in-hospital outcomes for elderly patients with heart failure and reduced ejection(HFrEF)remains *** To evaluate the predictive efficacy of frailty,compared with pre-frailty,for adverse events in these *** Elderly patients(≥60 years)with HFrEF were *** was evaluated with the Fried phenotype criteria,and physical performance was evaluated based on handgrip strength and the short physical performance battery(SPPB).The composite incidence of adverse events,including all-cause death,multiple organ failure,cardiac shock,and malignant arrhythmia,during hospitalization was *** Overall,252 elderly individuals with HFrEF[mean age:69.4±6.7 years,male:169(67.0%)]were *** hundred and thirty-five(53.6%)patients were frail and 93(36.9%)were *** patients were older,more likely to be female,to have a lower blood pressure,and to present with left ventricular thrombosis(P all<0.05).Frail patients with HFrEF had a higher incidence of in-hospital mortality(11.9%vs 4.3%,P=0.048).Multivariate analyses showed that female gender(OR=0.422),aging(OR=1.090),poor cardiac functional class(OR=2.167),frailty(OR=2.379),and lower handgrip strength(OR=1.106)were independent predictors of in-hospital adverse events(P all<0.05).CONCLUSION Frailty may be associated with poor in-hospital outcomes for elderly patients with *** influence of frailty on long-term prognosis in these patients deserves further investigation.

关键词： heart failure with reduced ejection fraction Frailty Elderly Adverse events

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Kill two birds with one stone:Hapatologist’s approach to metabolic dysfunction-associated steatotic liver disease and heart failure

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World Journal of Cardiology 2024年第11期16卷 660-664页

作者： Yusuke Hirao Clarke Morihara Tomoki Sempokuya Department of Medicine John A Burns School of MedicineUniversity of Hawaii at ManoaHonoluluHI 96813United States Division of Gastroenterology and Hepatology Department of MedicineJohn A Burns School of MedicineUniversity of Hawaii at ManoaHonoluluHI 96813United States

heart failure(HF)is a major global public health concern,and one of the less commonly known risk factors for HF development is metabolic dysfunction-associated steatotic liver disease(MASLD),as they share a similar pathophysio-logical *** this article,we evaluated a recently published review article by Arriola-Montenegro et *** article briefly summarizes the common pathophysiology of HF and MASLD development and evaluates the available therapeutic options to treat both *** practice guidelines highlight the importance of initiating and titrating guideline-directed medication therapy(GDMT)for patients with HF with reduced ejection *** is comprised of the four pillars currently proposed in most clinical practice guidelines,namely angiotensin-converting enzyme inhibitors(ACEIs),angiotensin receptor blockers(ARBs),angiotensin receptor-neprilysin inhibitors,beta-blockers,mineralocor-ticoid receptor antagonists,and sodium-glucose co-transporter 2 inhibitors(SGLT-2i).Given the similarity of pathophysiology and risk factors,recent studies for GDMT regarding ACEIs,ARBs,mineralocorticoid receptor antagonists,and SGLT-2i have shown beneficial effects on ***,other medications for both conditions and novel therapies require more robust data and well-designed clinical studies to demonstrate their efficacies in both conditions.

关键词： Metabolic dysfunction-associated steatotic liver disease heart failure heart failure with reduced ejection fraction Non-pharmacological Pharmacological Surgical intervention

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A Brief Review of a Common Clinical Question: Intravenous Diltiazem or Metoprolol for Atrial Fibrillation with Rapid Ventricular Response?

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World Journal of Cardiovascular Diseases 2023年第9期13卷 550-555页

作者： Zachary Visinoni Neeladri Misra Daniel Jurewitz Department of Graduate Medical Education Internal Medicine Residency Sutter Roseville Medical Center Roseville USA Sutter Medical Group Roseville USA Sutter Medical Group Cardiology Roseville USA

Two classes of rate controlling medications—beta blockers (BBs) and non- dihydropyridine calcium channel blockers (CCBs)—are given to patients who present with atrial fibrillation (AF) with rapid ventricular response (RVR). Both are Class I recommendations from the American heart Association (AHA), American College of Cardiology (ACC), and heart Rhythm Society (HRS) for the management of AF with RVR. Multiple studies support the view that diltiazem is more effective than metoprolol, even though data from the AFFIRM trial suggests BBs are more frequently used. CCBs are generally avoided in AF with RVR patients who have concomitant heart failure with reduced ejection fraction (HFrEF) for concern of triggering decompensation. However, some recent studies indicate this idea may be unfounded. The aim of this article is to compare the efficacy of diltiazem and metoprolol for rate control in AF with RVR and examine the use of diltiazem in patients with both AF with RVR and HFrEF.

关键词： Atrial Fibrillation Rapid Ventricular Response Diltiazem Metoprolol heart failure with reduced ejection fraction

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