Topic
Ventricular Ejection Fraction
About: Ventricular Ejection Fraction is a research topic. Over the lifetime, 311 publications have been published within this topic receiving 10746 citations.
Papers published on a yearly basis
Papers
TL;DR: Nebivolol, a beta-blocker with vasodilating properties, is an effective and well-tolerated treatment for heart failure in the elderly.
Abstract: Aims Large randomized trials have shown that beta-blockers reduce mortality and hospital admissions in patients with heart failure. The effects of beta-blockers in elderly patients with a broad range of left ventricular ejection fraction are uncertain. The SENIORS study was performed to assess effects of the beta-blocker, nebivolol, in patients ≥70 years, regardless of ejection fraction.
Methods and results We randomly assigned 2128 patients aged ≥70 years with a history of heart failure (hospital admission for heart failure within the previous year or known ejection fraction ≤35%), 1067 to nebivolol (titrated from 1.25 mg once daily to 10 mg once daily), and 1061 to placebo. The primary outcome was a composite of all cause mortality or cardiovascular hospital admission (time to first event). Analysis was by intention to treat. Mean duration of follow-up was 21 months. Mean age was 76 years (SD 4.7), 37% were female, mean ejection fraction was 36% (with 35% having ejection fraction >35%), and 68% had a prior history of coronary heart disease. The mean maintenance dose of nebivolol was 7.7 mg and of placebo 8.5 mg. The primary outcome occurred in 332 patients (31.1%) on nebivolol compared with 375 (35.3%) on placebo [hazard ratio (HR) 0.86, 95% CI 0.74–0.99; P =0.039]. There was no significant influence of age, gender, or ejection fraction on the effect of nebivolol on the primary outcome. Death (all causes) occurred in 169 (15.8%) on nebivolol and 192 (18.1%) on placebo (HR 0.88, 95% CI 0.71–1.08; P =0.21).
Conclusion Nebivolol, a beta-blocker with vasodilating properties, is an effective and well-tolerated treatment for heart failure in the elderly.
1,528 citations
TL;DR: Left ventricular hypertrophy or concentric remodeling, LA enlargement, and diastolic dysfunction were present in the majority of patients with HFPEF, and left ventricular mass and LA size were independently associated with an increased risk of morbidity and mortality.
Abstract: Background—The purpose of this study was to examine the prevalence of abnormalities in cardiac structure and function present in patients with heart failure and a preserved ejection fraction (HFPEF) and to determine whether these alterations in structure and function were associated with cardiovascular morbidity and mortality. Methods and Results—The Irbesartan in HFPEF trial (I-PRESERVE) enrolled 4128 patients; echocardiographic determination of left ventricular (LV) volume, mass, left atrial (LA) size, systolic function, and diastolic function were made at baseline in 745 patients. The primary end point was death or protocol-specific cardiovascular hospitalization. A secondary end point was the composite of heart failure death or heart failure hospitalization. Associations between baseline structure and function and patient outcomes were examined using univariate and multivariable Cox proportional hazard analyses. In this substudy, LV hypertrophy or concentric remodeling was present in 59%, LA enlargeme...
503 citations
Brigham and Women's Hospital1, Imperial College London2, Baylor University Medical Center3, United States Department of Veterans Affairs4, Medical University of South Carolina5, University of Gothenburg6, Montreal Heart Institute7, Karolinska University Hospital8, Copenhagen University Hospital9, University of Minnesota10, University of Arizona11, Semmelweis University12, Carol Davila University of Medicine and Pharmacy13, National Yang-Ming University14, Novartis15, British Heart Foundation16
TL;DR: The therapeutic effects of sacubitril/valsartan, compared with a renin-angiotensin-aldosterone–system inhibitor alone, vary by LVEF with treatment benefits, particularly for heart failure hospitalization, that appear to extend to patients with heart failure and mildly reduced ejection fraction.
Abstract: Background: While disease-modifying therapies exist for heart failure (HF) with reduced left ventricular ejection fraction (LVEF), few options are available for patients in the higher range of LVEF...
455 citations
1 Jan 1991
TL;DR: In this paper, the authors identify indexes of left ventricular function predictive ofsymptomatic and functional deterioration during the long-term course of AS patients, and study 104 AS patients with chronic severe aortic regurgitation and normalleft ventricular ejection fraction atrest.
Abstract: Background. Manyasymptomatic patients withaortic regurgitation andnormalleft ventricularsystolic function remainclinically stable formany years,butothers ultimately develop symptoms or left ventricular dysfunction andrequire operation. Toidentify indexes ofleft ventricular function predictive ofsymptomatic andfunctional deterioration duringthe long-term courseofasymptomatic patients, we studied 104asymptomatic patients withchronic severeaortic regurgitation andnormalleft ventricular ejection fraction atrest. Methods andResults. Serial echocardiographic (average, 7.8perpatient) andradionuclide angiographic (average, 5.0perpatient) studies wereobtained overa mean follow-up period of 8years(range, 2-16years). ByKaplan-Meier life table analysis, 58±9%oofpatients remained asymptomatic withnormalejection fraction at11years,an averageattrition rateofless than 5% per year;twopatients diedsuddenly, fourdeveloped asymptomatic leftventricular dysfunction, and19underwent operation because symptomsdeveloped. Byunivariate Cox regression analysis, many variables on initial study were associated withdeath, ventricular dysfunction, or symptoms, including age,left ventricular end-systolic dimension andenddiastolic dimension, fractional shortening, andbothrestandexercise ejection fraction (all p<0.001). Theaverageratesofchangeofrestejection fraction, fractional shortening, and end-systolic dimension werealsoassociated withdeath orsymptomsbyunivariate Coxanalysis (allp<0.01). However, whenallvariables wereincluded inamultivariate Coxanalysis, only age (p<0.05), initial end-systolic dimension (p<0.001), andrateofchangeinend-systolic dimension andrestejection fraction during serial studies (both p<0.05) predicted outcome. Conclusions. Thus,inaddition toindexes ofleft ventricular function determined on initial evaluation, serial long-term changes insystolic function identify patients likely todevelop symptoms andrequire operation. Patients havea higher riskofsymptomatic deterioration if thereisprogressive change inend-systolic dimension orresting ejection fraction during the courseofserial studies. (Circulation 1991;84:1625-1635)
377 citations
Medical University of South Carolina1, Lahey Hospital & Medical Center2, Wake Forest University3, University of Florida4, Autonomous University of Madrid5, University of California, San Francisco6, Université de Montréal7, University of Glasgow8, University of Paris9, McMaster University10, Bristol-Myers Squibb11, University of Wisconsin-Madison12, Georgetown University13
TL;DR: Sixty percent of the deaths in patients with HFPEF were cardiovascular, with sudden death and heart failure death being the most common and treatment with irbesartan did not affect overall mortality or the distribution of mode-specific mortality rates.
Abstract: Background— The mode of death has been well characterized in patients with heart failure and a reduced ejection fraction; however, less is known about the mode of death in patients with heart failure and a preserved ejection fraction (HFPEF). The purpose of this study was to examine the mode of death in patients with HFPEF enrolled in the Irbesartan in Heart Failure With Preserved Ejection Fraction Study (I-Preserve) trial and to determine whether irbesartan altered the distribution of mode of death in HFPEF. Methods and Results— All deaths were reviewed by a clinical end-point committee, and the mode of death was assigned by consensus of the members. The annual mortality rate was 5.2% in the I-Preserve trial. There were no significant differences in mortality rate between the placebo and irbesartan groups. The mode of death was cardiovascular in 60% (including 26% sudden, 14% heart failure, 5% myocardial infarction, and 9% stroke), noncardiovascular in 30%, and unknown in 10%. There were no differences i...
334 citations
Related Topics (5)
Performance Metrics
| Year | Papers |
|---|---|
| 2021 | 7 |
| 2020 | 7 |
| 2019 | 11 |
| 2018 | 14 |
| 2017 | 11 |
| 2016 | 10 |