J G Cleland

..Clinicians should follow the criteria for patient selection in the landmark trials when selecting patients for CRT, should extrapolate with caution from these and should be extremely cautious in the interpretation of observational data...

..We now report the long-term outcome during and subsequent to the randomized trial...

..The lack of a simple, objective test to identify patients with HFPEF at increased risk of cardiovascular events would be valuable...

..For those with the opportunity, engaging with a randomized trial is clinically and scientifically appropriate. The dilemma for such studies is the comparator. Should it be against or in addition to "standard of care" or both?..

..Reversing renal dysfunction and stopping its progression remain important targets for treatment of heart failure...

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..Observational studies suggest that patients having more left ventricular dyssynchrony pre-implantation obtain greater benefit on ventricular function and symptoms with CRT...

..4 months [median 29.6, interquartile range (IQR) 23.6-34.6]. Prior to study closure, an extension phase lasting a further 8 months (allowing time for data analysis and presentation) was declared during which cross-over was discouraged...

..The CArdiac Resynchronisation-Heart Failure study is the only long-term randomized trial of CRT with repeated measures of QoL...

..In the longer-term future, it is possible that the development of less expensive, small, and safe left ventricular assist devices will supplant the role of both CRT and CRT-defibrillator devices...

..The CARE-HF study is a morbidity/mortality trial designed to provide conclusive evidence of the effects of CRT in patients with moderate to severe heart failure...

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..This study was designed to investigate the loss of well-being, in terms of life-years, overall and in patients randomized to metoprolol versus carvedilol in the Carvedilol Or Metoprolol European Trial (COMET)...

..Heart failure is commonly associated with vascular disease and a high rate of athero-thrombotic events, but the risks and benefits of antithrombotic therapy are unknown...

..We sought to identify whether home telemonitoring (HTM) improves outcomes compared with nurse telephone support (NTS) and usual care (UC) for patients with heart failure who are at high risk of hospitalization or death...

..To review the evidence for and against imaging as a means of selecting patients for cardiac resynchronization therapy (CRT)...

..This study was designed to investigate whether selected baseline variables and early response markers predict the effects of cardiac resynchronization therapy (CRT) on long-term mortality...

..It is important to organise care structures to ensure that patients with post-MI heart failure and LVSD are identified and managed appropriately...

..We evaluated its effects on morbidity and mortality...

..No severe, drug-related adverse events occurred. Darbepoetin alfa administered once monthly elevates and maintains the hemoglobin concentration in patients with CHF and anemia...

..Implantable defibrillators confer a small but definite additional survival advantage by treating arrhythmias that have not been prevented...

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..Accordingly, the EuroHeart Failure survey was conducted to ascertain if appropriate tests were being performed with which to confirm or refute a diagnosis of heart failure and how this influenced subsequent management...

..Levosimendan, a novel calcium sensitiser, improves cardiac performance and symptoms without increasing oxygen consumption, and decreases the mortality of patients with low-output heart failure...

..Patients with atrial fibrillation (AF) who also have heart failure have a worse outcome but the diagnosis of heart failure is often missed...

..Cardiac resynchronisation is a promising new intervention for patients with heart failure, left ventricular systolic dysfunction and ventricular dyssynchrony...

..Few substantial randomized controlled trials have been conducted in this population, none has focussed on patients with evidence of diastolic dysfunction and none has shown clear benefit on symptoms, morbidity, or mortality...

..Here, we examine the evidence that cardiac resynchronization is indeed the mechanism by which atrio-biventricular pacing exerts its effects...

..The aim of this study was to assess how primary-care physicians think that heart failure should be managed, how they implement their knowledge, and whether differences exist in practice between countries...

..We report the first study of the cardiac myosin activator, omecamtiv mecarbil, in patients with systolic heart failure...

..To obtain national data on the clinical characteristics, investigation, management and outcome of patients hospitalised with a diagnosis of heart failure...

..For most patients this should be CRT or a combination of CRT and an ICD (CRT-D)...

..If these studies confirm the benefits of levosimendan, then it may become routine therapy for the management of severe heart failure...

..The role of various investigations in risk stratification of sudden death has also been discussed...

..These surveys will provide information on the nature of cardiovascular disease and its management. This manuscript describes a survey into the nature and management of heart failure...

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..The RENAISSANCE and RECOVER outcome studies of etanercept, a tumour necrosis factor (TNF) receptor analogue that blocks the effect of TNF, were stopped because of lack of evidence of benefit shortly after the ACC...

..In summary, the annual congress of the ESC provided important new information for clinical practice and, to date, was, by far, the most important cardiology congress in the world this year...

..The ACTIVE W study of warfarin versus aspirin plus clopidogrel in atrial fibrillation has been stopped due to superiority of warfarin...

..This is predominantly due to AF coinciding with or preceding the development of HF. The annual risk of persistent AF developing can be estimated from clinical variables...

..The aim of the present study was to establish whether the kinetics of O2 are influenced by the work rate...

..To assess the prevalence of heart failure and asymptomatic left ventricular systolic dysfunction in the chronically paced population...

..The ICELAND MI study showed that CMR imaging was more sensitive than ECG or clinical criteria for detecting myocardial infarction...

..Rimonabant was shown to be safe and effective in treating the combined cardiovascular risk factors of smoking and obesity. An overview of new developments in cardiac resynchronisation therapy (CRT) in heart failure is also reported...

..Analysis of data from SCD-HeFT supports the cost-effectiveness of ICDs in heart failure, although overall cost implications may be prohibitive...

..We hypothesized that plasma levels of NT-proBNP, measured after optimization of pharmacotherapy in patients with CHF, may provide independent prognostic information when compared with baseline values and conventional prognostic markers...

..T-wave alternans is an interesting experimental technique that may be useful in selecting which patients need an implantable defibrillator, although the technology needs testing in an appropriate patient population...

..As symptoms worsen, the influence of spirometric variables on peak exercise capacity diminishes, and there is no such relation in the NYHA class III-IV patients...

..Most patients suspected of having heart failure (HF) will get a 12-lead electrocardiogram (ECG) but its utility for excluding HF or assisting in its management has rarely been investigated...

..Only once the outcomes to these and other planned trials are known can the medical community know how best to treat their patients...

..05). R at 5 Hz correlated with pV(O(2)) (0.46; P = .0025) and V(E)/V(CO(2)) slope (0.43; P < .05). CONCLUSION: CHF patients have elevated airway resistance and reduced reactance measured with IOS compared with control subjects...

..The primary outcome measure is death or hospitalisation for any reason...

..A large study of BNP provided additional information on its ability to distinguish cardiac and pulmonary breathlessness. The importance of dietary intervention in post-MI patients was highlighted by the findings of THIS-diet study...

..The aim of this study was to describe the effects of long-term beta-blocker therapy on metabolic gas exchange variables and ventilation during exercise in CHF patients...

..To identify factors associated with short term mortality in hospitalised patients with heart failure...

..Summaries of the following clinical studies are included: WARIS-II, ESCAMI, PAFAC, RITZ-I and TIME...

..The combination of aspirin and angiotensin-converting enzyme inhibitors is warranted during this period, after which discontinuation or substitution of aspirin with another agent should be considered...

..Three trials of stem cell therapy in post-MI patients gave conflicting results...

..This study examined the relative merits of digoxin, carvedilol, and their combination for the management of patients with atrial fibrillation (AF) and heart failure (HF)...

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..In conclusion, in outpatients with chronic HF, anemia and RD are common and co-exist but confer independent prognostic information. A deficiency of conventional hematinic factors may cause about 1/3 of anemia in this clinical setting...

..NT-proBNP is elevated in MSHD and heart failure (HF). AF, a common finding in HF and MSHD, is also associated with raised plasma NT-proBNP. As a result, the utility of NT-proBNP for predicting MSHD may be reduced...

..Beta-blockers are effective for the treatment of heart failure, but their mechanism of action is unresolved. Heart rate reduction may be a central mechanism or a troublesome side effect...

..Adequately powered multicentre, randomised controlled trials are required to further evaluate the potential benefits and cost-effectiveness of this intervention...

..Assessment of N-terminal brain natriuretic peptide (NT-BNP) as a screening tool for heart failure in patients with a permanent pacemaker...

..LV dyssynchrony is conventionally measured at rest but the symptoms of heart failure occur predominantly on exercise. Induction or exacerbation of dyssynchrony during stress might identify additional patients who could benefit from CRT...

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..This is reinforced by the salutary benefits of carvedilol for the reduction in the morbidity and mortality of HF itself...

..To review systematically the use of intravenous (IV) inotropic agents acting through the adrenergic signalling pathway, compared with placebo or an active agent, in patients with heart failure...

..Appropriate screening strategies are needed to cost effectively identify patients with undiagnosed and untreated left ventricular systolic dysfunction (LVSD)...

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..We explored the relation between hematinic levels and hemoglobin (Hb) levels and exercise tolerance in a group of patients with CHF...

..Signal-HF randomized elderly heart failure patients to treatment guided by NT-proBNP levels or usual care, and showed no effect of NT-proBNP-guided treatment on outcomes...

..If these results can be confirmed it would render it unique among intravenous inotropic agents...

..The prognostic usefulness of submaximal exercise testing is not clear. The aim of the present study was to assess the prognostic value of the V(E)/V(CO(2)) slope when derived from data acquired from submaximal exercise...

..1% and +12.0%, respectively). Revised mortality data for the CASINO study and a meta-analysis of the effects of cardiac resynchronisation therapy on mortality in the light of the recently published COMPANION study are reported...

..We aimed to investigate the relationship between hsCRP and prognosis in patients with CHF and left ventricular systolic dysfunction (LVSD)...

..Different methods exist for measuring left ventricular function echocardiographically; each may be error prone due to the abnormal pattern of ventricular activation during pacing...

..The result of COMET is entirely consistent with the results of previous placebo-controlled trials of beta-1-selective blockers and carvedilol...

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..In a combined analysis of two studies (n=186), the adenosine A(1) receptor antagonist KW-3902 showed diuretic properties and appeared to enhance response to loop diuretics in heart failure patients hospitalised with fluid overload...

..Patient-rated NYHA (Pa-NYHA) and physician-rated NYHA (Dr-NYHA) class have never been compared directly, and it is unknown whether they carry similar prognostic significance...

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..Approximately one third of patients with chronic heart failure have left bundle branch block (LBBB) on their 12-lead ECG...

..The purpose of this report is to describe in greater detail the heterogeneity of this population at baseline with particular reference to the impact of symptomatic severity, age and gender on patient characteristics...

..This study was designed to assess left ventricular (LV) morphology, global and longitudinal function in healthy older men and women using cardiac magnetic resonance (CMR)...

..In the HOME-HF study, telemonitoring support failed to reduce the time to first re-hospitalisation or death, or days alive and out of hospital, compared with usual care...

..The selective myosin activator CK-1827452 produced a concentration dependent increase in systolic ejection time, stroke volume and fractional shortening in patients with heart failure compared to placebo...

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..Patients volunteering to take part in a study might be unrepresentative of the potential treatment population or the trial itself may confer benefit by offering closer supervision...

..ix) A secondary analysis from ATHENA showed a reduction in cardiovascular hospitalizations and strokes for patients with atrial fibrillation receiving dronedarone compared with placebo...

..The ESTEEM study showed that the oral thrombin inhibitor ximelagatran plus aspirin was more effective than aspirin alone in the prophylaxis of major cardiovascular events following MI...

..The aim of this study was to obtain normal values for atrioventricular annular and regional myocardial velocities using this method...

..The SHAPE survey of heart failure awareness in Europe identified a need for further heart failure education amongst the public, patients, their carers and primary care physicians...

..Abnormalities of longitudinal left ventricular (LV) contraction and relaxation may be early markers of cardiac disease. This study was designed to assess the relationship between long-axis LV function and age in healthy subjects...