scholarly journals Long-term Prognosis Analysis of PARACHUTE Device Implantation in Patients with Ischemic Heart Failure: A Single-Center Experience of Chinese patients

2020 ◽  
Author(s):  
Jianghua Li ◽  
Huadong Liu ◽  
Qiyun Liu ◽  
Cheng Liu ◽  
Wei Xiong ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Ejection Fraction ◽  
Left Ventricular ◽  
Chinese Patients ◽  
Device Implantation ◽  
Lv Ejection Fraction ◽  
Long Term Prognosis ◽  
Apical Aneurysm

Abstract Background: Heart failure (HF) is one of the leading causes of mortality and morbidity. The PARACHUTE device is designed to partition for left ventricular (LV) apical aneurysm post extensive anterior myocardial infarction. However, the long-term prognosis of the PARACHUTE device post-implantation is unclear.Methods：From November 2015 to April 2017, six subjects with New York Heart Association Class II, III and IV ischemic HF, LV ejection fraction between 15% and 40%, and LV anterior apical aneurysm were enrolled in our center. The cumulative event rates for myocardial infarction, hospitalization, and mortality were documented respectively. Further assessment of LV ejection fraction, LV end-diastolic diameter, and estimated pulmonary artery pressure were determined by echocardiography core laboratory. For quantitative data comparison, paired t‑test was employed.Results: Device implantation was successful in all six enrolled subjects, and acute device association adverse events were not observed. At 4.6 ± 1.7 years follow-up, MACEs were found in 50% patients, and the survival rate was 86.7%. We found that the LV ejection fraction was significantly elevated after deployment (46.00 ± 6.00% vs. 35.83 ± 1.47%, P=0.009). Besides, the LVEDD elevated after MI (51.17 ± 3.71 vs. 62.83 ± 3.25, P<0.001) was revealed, but the device sustained preserved LVEDD after implantation.Conclusion: The PARACHUTE device is an alternative therapy for patients with severe LV maladaptive remodeling. The procedure of PARACHUTE implantation is safe and has a potential benefit in long-term mortality reduction. However, the device seems to increase the HF ratio.Clinical Trial Registration: NCT02240940, https://clinicaltrials.gov/ct2/ show/NCT02240940

scholarly journals Long-term prognosis analysis of PARACHUTE device implantation in patients with ischemic heart failure: a single-center experience of Chinese patients

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Jianghua Li ◽  
Huadong Liu ◽  
Qiyun Liu ◽  
Cheng Liu ◽  
Wei Xiong ◽  
...  
Keyword(s):  
Heart Failure ◽  
Left Ventricular ◽  
Chinese Patients ◽  
Cardiac Events ◽  
Anterior Myocardial Infarction ◽  
Mortality And Morbidity ◽  
Device Implantation ◽  
Long Term Prognosis ◽  
Apical Aneurysm

Abstract Background Heart failure (HF) is one of the leading causes of mortality and morbidity. The PARACHUTE device is designed to partition for left ventricular (LV) apical aneurysm post extensive anterior myocardial infarction (MI). However, the long-term prognosis of the PARACHUTE device post-implantation is unclear. Methods From November 2015 to April 2017, six subjects with New York Heart Association Classes II, III and IV ischemic HF, LV ejection fraction between (LVEF) 15 and 40%; and LV anterior apical aneurysm were enrolled in our center. The cumulative event rates for MI, hospitalization, and mortality were documented. Further assessment of LVEF, LV end-diastolic diameter (LVEDD), and estimated pulmonary artery pressure were determined by echocardiography core laboratory. For quantitative data comparison, paired t-test was employed. Results Device implantation was successful in all six enrolled subjects, and acute device association adverse events were not observed. At 4.6 ± 1.7 years follow-up, major adverse cardiac events (MACEs) were found in 50% patients, and the survival rate was 86.7%. We observed that the LVEF was significantly elevated after deployment (46.00 ± 6.00% vs. 35.83 ± 1.47%, P = 0.009). Besides, the LVEDD elevated after MI (51.17 ± 3.71 vs. 62.83 ± 3.25, P < 0.001) was revealed, but the device sustained preserved LVEDD after implantation. Conclusion The PARACHUTE device is an alternative therapy for patients with severe LV maladaptive remodeling. However, the device seems to increase the HF ratio. Trial registration NCT02240940

Effects of AT1-receptor blockade on progression of left ventricular dysfunction in dogs with heart failure

1999 ◽  
Vol 276 (4) ◽  
pp. H1385-H1392 ◽  
Author(s):  
Mitsuhiro Tanimura ◽  
Victor G. Sharov ◽  
Hisashi Shimoyama ◽  
Takayuki Mishima ◽  
T. Barry Levine ◽  
...  
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Low Dose ◽  
Left Ventricular ◽  
Term Therapy ◽  
High Dose ◽  
Lv Dysfunction ◽  
Lv Ejection Fraction

The objective of the present study was to determine the effects of early long-term monotherapy with the angiotensin II AT1-receptor antagonist valsartan on the progression of left ventricular (LV) dysfunction and remodeling in dogs with moderate heart failure (HF). Studies were performed in 30 dogs with moderate HF produced by multiple sequential intracoronary microembolizations. Embolizations were discontinued when LV ejection fraction was 30–40%. Two weeks after the last embolization, dogs were randomized to 3 mo of oral therapy with low-dose valsartan (400 mg twice daily, n = 10), to high-dose valsartan (800 mg twice daily, n = 10), or to no treatment at all (control, n = 10). Treatment with valsartan significantly reduced mean aortic pressure and LV end-diastolic pressure compared with control. In untreated dogs, LV ejection fraction decreased (37 ± 1 vs. 29 ± 1%, P = 0.001) and end-systolic volume (ESV) and end-diastolic volume (EDV) increased (81 ± 5 vs. 92 ± 5 ml, P < 0.001; 51 ± 3 vs. 65 ± 3 ml, P = 0.001, respectively) after 3 mo of follow-up compared with those levels before follow-up. In dogs treated for 3 mo with low-dose valsartan, ejection fraction was preserved (37 ± 1 vs. 38 ± 2%, pretreatment vs. posttreatment) as was ESV but not EDV. In dogs treated for 3 mo with high-dose valsartan, ejection fraction decreased (35 ± 1 vs. 31 ± 2%, P = 0.02) and ESV and EDV increased in a manner comparable to those levels in controls. Valsartan had no significant effects on cardiomyocyte hypertrophy or on the extent of interstitial fibrosis. We conclude that, for dogs with moderate HF, early long-term therapy with the AT1-receptor blocker valsartan decreases preload and afterload but has only limited benefits in attenuating the progression of LV dysfunction and chamber remodeling.

scholarly journals Clinical features and long-term prognosis of patients with congestive heart failure taking tolvaptan: a comparison of patients with preserved and reduced left ventricular ejection fraction

2021 ◽  
Author(s):  
Toshiki Seki ◽  
Yoshiaki Kubota ◽  
Junya Matsuda ◽  
Yukichi Tokita ◽  
Yu-ki Iwasaki ◽  
...  
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Univariate Analysis ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction ◽  
Reduced Ejection Fraction ◽  
All Cause Mortality ◽  
Long Term Prognosis

AbstractFew studies have investigated the clinical benefit of the long-term use of tolvaptan (TLV) for heart failure (HF). This study evaluated the long-term prognosis of patients administered TLV for > 1 year among patients who had HF with preserved ejection fraction (HFpEF) and those who had HF with reduced ejection fraction (HFrEF). Overall, 591 consecutive patients were admitted to our hospital and administered TLV for HF between 2011 and 2018. We retrospectively enrolled 147 patients who were administered TLV for > 1 year. We divided them into the HFpEF group (n = 77, 52.4%) and the HFrEF group (n = 70; 47.6%). Their clinical backgrounds and long-term prognosis were examined. Compared with the patients in the HFrEF group, the patients in the HFpEF group were significantly older and included more women. Moreover, the HFpEF group showed significantly lower all-cause mortality (38.6% vs. 24.7%; log-rank, P = 0.014) and cardiovascular mortality during the average 2.7-year follow-up. Univariate analysis revealed that all-cause mortality was correlated with male sex, HFpEF, and changes in serum creatinine levels from baseline. Multivariate analysis revealed that HFpEF was an independent influencing factor for all-cause mortality (hazard ratio, 0.44; 95% confidence interval, 0.23–0.86; P = 0.017). Long-term administration of TLV may be more beneficial for HFpEF than for HFrEF.

scholarly journals Clinical features and long-term prognosis of patients with congestive heart failure taking tolvaptan: a comparison between preserved and reduced left ventricular ejection fraction

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
T Seki ◽  
Y Kubota ◽  
J Matsuda ◽  
Y Tokita ◽  
Y Iwasaki ◽  
...  
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Univariate Analysis ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction ◽  
All Cause Mortality ◽  
Long Term Prognosis ◽  
Stratified Analysis

Abstract Background There were few reports which investigated the clinical benefit of long-term use of tolvaptan (TLV) for heart failure (HF). The purpose of this study was to evaluate the long-term prognosis of patients administrated TLV for more than 1 year in the HF patients with preserved ejection fraction (HFpEF) and reduced ejection fraction (HFrEF). Method In a total of 591 consecutive patients who were admitted to our hospital and administered TLV for HF between 2011 and 2018, we retrospectively enrolled 147 patients who were administered TLV for more than 1 year. The patients were classified into 2 groups, the HFpEF group (n=77, 52.4%) and the HFrEF group (n=70, 47.6%), and clinical backgrounds and long-term prognosis were examined. Furthermore, we performed stratified analysis based on the response to TLV defined by urine osmolality (The responder group n=40, the non-responder group n=52). Results The HFpEF group was significantly older (77.7±9.2 vs. 71.3±11.5 years, P&lt;0.01) and included more female (41.6 vs. 21.4%, P&lt;0.01) compared with the HFrEF group. Other baseline characteristics were not different between the two groups. During the average 2.7 years follow up, the HFpEF group showed significantly lower all-cause mortality and cardiovascular mortality compared to the HFrEF group (24.7 vs. 38.6%, Log-Rank P=0.014, 13.0 vs. 25.7%, Log-Rank P=0.007, respectively). Univariate analysis revealed that male, HFpEF, serum creatinine changes from baseline (ΔCre) were the factors correlated with all-cause mortality (HR 2.12, 95% CI 1.02 – 4.40, P=0.045, HR 0.48, 95% CI 0.26 - 0.87, P=0.016 and HR 1.50, 95% CI 1.00 - 2.24, P=0.049, respectively). According to multivariate analysis, HFpEF was the independent influencing factor of all-cause mortality (HR 0.44, 95% CI 0.23 - 0.86, P=0.017). Stratified analysis revealed that in the non-responder group all-cause mortality was significantly lower in the HFpEF group than in the HFrEF group (24.2% vs 48.3%, P=0.049). Conclusion Long-term administration of TLV maybe more beneficial for HFpEF compared with HFrEF. This tendency was remarkable at non-responder group. FUNDunding Acknowledgement Type of funding sources: None.

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