William T Abraham

..In addition, the results of recently completed clinical trials, as well as the status of ongoing clinical trials, are reviewed...

..The effects of cardiac resynchronization therapy (CRT) in patients with mildly symptomatic heart failure have not been fully elucidated...

..Ongoing and future clinical trials should help to further validate the role of cardiac resynchronization in the treatment of patients with systolic HF...

..2) The ACE DD genotype is associated with preserved right ventricular function in PPH patients, supporting a compensatory myocardial or inotropic role for Ang II in the pressure overloaded right ventricle...

..The optimal selection and use of adrenergic-blocking agents in the cardiovascular continuum will assist in providing improved management while minimizing safety and tolerability concerns...

..Cardiac resynchronization therapy has been shown to significantly improve LV structure and function, New York Heart Association functional class, exercise tolerance, quality of life, and morbidity and mortality...

..Thus, cardiac resynchronization therapy should be routinely considered in eligible NYHA class III and IV heart failure patients with ventricular dyssynchrony...

..Thus, the clinical and hemodynamic benefits and safety of nesiritide are preserved in decompensated congestive heart failure patients receiving chronic beta blockade...

..The purpose of this study was to examine the renal effects of a V2 receptor arginine vasopressin (AVP) antagonist in heart failure...

..We sought to compare the in-hospital mortality of patients with acute decompensated heart failure (ADHF) who were receiving parenteral treatment with one of four intravenous vasoactive medications...

..In the first 60 to 90 days after hospital discharge, little up-titration in beta-blocker dosing occurs. Further efforts are needed to help understand and overcome this beta-blocker titration gap...

..We sought to evaluate the characteristics, treatments, and outcomes of patients with preserved and reduced systolic function heart failure (HF)...

..This study evaluated the association between precipitating factors identified at the time of HF hospital admission and subsequent clinical outcomes...

..Community patients with heart failure (HF) are older, less often treated by HF specialists, and have more comorbidity than those in randomized clinical trials. These differences might affect beta-blocker prescribing in HF...

..The Prospective Evaluation of Elastic Restraint to LESSen the effects of Heart Failure (PEERLESS-HF) trial was designed to further evaluate the safety and efficacy of one such device, the HeartNet (Paracor Medical, Sunnyvale, CA)...

..This study ascertains the relationship between continuation or withdrawal of beta-blocker therapy and clinical outcomes in patients hospitalized with systolic heart failure (HF)...

..9% vs 7.5%, hazard ratio 1.2 vs 1.0, P=.276). Thus carvedilol was similarly effective in blacks and whites with HF in the community setting, consistent with carvedilol clinical trials...

..The objective of this study was to prospectively evaluate beta-blocker use at hospital discharge as an indicator of quality of care and outcomes in patients with heart failure (HF)...

..Lower hemoglobin is associated with higher morbidity and mortality in hospitalized patients with HF...

..The aim of this study was to develop a clinical model predictive of in-hospital mortality in a broad hospitalized heart failure (HF) patient population...

..Long-term continuous HRV can be measured from an implantable device, but the clinical value of these measurements is unknown...

..We sought to evaluate the effect of a national hospital-based initiative on quality of care in patients hospitalized with HF...

..This study examined the relationship between the day of the week patients are hospitalized for HF and death rate, length of stay (LOS), and rehospitalization rate...

..The aim of this study was to assess the feasibility, safety, and preliminary efficacy of a novel percutaneous left ventricular partitioning device (VPD) in patients with chronic heart failure (HF) and a prior anterior myocardial infarction...

..This study aimed to ascertain the relationship between smoking and clinical outcomes in patients hospitalized with heart failure (HF)...

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..v.) inotropic support. Chronic parenteral inotropic therapy in UA-HF is costly and requires an indwelling catheter. An effective and safe oral inotrope would have value...

..Results of previous studies support the hypothesis that implantable haemodynamic monitoring systems might reduce rates of hospitalisation in patients with heart failure. We undertook a single-blind trial to assess this approach...

..We conducted a double-blind trial to evaluate this therapeutic approach...

..5%) experienced a 16.7-events/h mean reduction in AHI. Thus, the Clear Path system appears to be a useful device to monitor response to SDB-directed treatment for apnea in patients with heart failure...

..This randomized, double-blind, controlled study evaluated whether optimizing the interventricular stimulating interval (V-V) to sequentially activate the ventricles is clinically better than simultaneous V-V stimulation during CRT...

..The goal of this study was to determine the effect of chronic carvedilol treatment in patients with cardiac sympathetic nerve dysfunction of varying severity...

..In this unselected community population, these historical factors were better predictors of risk than the left ventricular ejection fraction...

..In the present analysis, we sought to identify if there was a subgroup of patients who showed a response to CCM...

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..Future studies should take these clinical factors into account when determining the influence of genetic factors and novel therapies on ventricular remodeling in chronic heart failure...

..Sleep-disordered breathing (SDB) is present in more than 50% of ambulatory patients with chronic heart failure. The prevalence and type of SDB in hospitalized patients with acutely decompensated heart failure (ADHF) are not known...

..This study used relevant data from all RCTs of nesiritide in ADHF completed as of June 2006 to independently estimate the effect of nesiritide on 30- and 180-day mortality...

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..7%). In addition, it took less time for the acoustic cardiogram to collect sufficient information to make a recommendation, and it was found that the acoustic cardiogram data trend is easier to interpret...

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..We conclude that beta(1)AR-389 variation alters signaling in multiple models and affects the beta-blocker therapeutic response in HF and, thus, might be used to individualize treatment of the syndrome...

..This article discusses recently approved drugs and devices and clinical trials that may affect the management of this challenging disease...

..The ultimate aim of this program is to improve the standard of HF care in the hospital and outpatient settings and increase the use of evidence-based therapeutic strategies to save lives...

..The present study examined whether an improvement in ventricular performance from resynchronization therapy changes the autonomic control of heart rate...

..In this article, we review CRT's effects on reverse remodeling in an expanding patient population and as a novel pacing mechanism, its cardiac contractility modulation, and its benefits in patients with heart failure...

..Given this reality and until further information is available about the most ideal utilization of these medications, diuretics will continue to represent a double-edged sword for physicians treating this disease process...

..In this review, we summarize current insights into beta-adrenergic signal-transduction pathways, the best-described beta-AR polymorphisms, and therapies that target the beta-AR pathway in HF...

..Overall, nesiritide represents an effective and safe therapeutic option for the treatment of decompensated CHF...

..IHM systems may extend such monitoring capabilities. Both emerging approaches for monitoring patients with heart failure may alert clinicians (and possibly patients) to impending decompensation before symptoms appear...

..The goal of this investigation was to evaluate the safety and technical performance of a novel wireless pulmonary artery pressure monitoring system in 17 patients with symptomatic HF...

..BALANCE seeks to address unmet questions regarding the use of vasopressin antagonists including their effects on cognitive function and clinical outcomes in patients with hyponatremia and worsening heart failure...

..This review illustrates the impact of these therapies on post-MI LVD patients using evidence from multiple clinical trials. In addition, current and emerging treatments for acute decompensated HF will be outlined...

..The purpose of this study was to use echocardiographic and implantable hemodynamic monitor data to examine the pathophysiology of chronic compensated and acute decompensated HF in SHF versus DHF patients...

..Baseline characteristics for patients randomized in this trial are also presented...

..In conclusion, device-derived HF diagnostic criteria evaluated 7 days after discharge identified patients at significantly greater risk of a HF event within 30 days after discharge...

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..We review the recent evidence regarding the efficacy and safety profile of nesiritide, and discuss upcoming trials designed to address concerns regarding safety and the comparative efficacy of nesiritide...

..The device was judged by 80% of patients to be easy or very easy to use, and 74% of patients expressed a preference for the in-home system. Therefore, this system represents a reasonable home testing device in these patients...

..Forty-two percent of patients with stable heart failure presenting to a heart failure clinic screened positive for SDB, despite receiving optimal standard of care...

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..The methods for overcoming this resistance are varied and require a focused approach with emphasis on relieving the congestive symptoms related to HF while attempting to preserve renal function and minimize any untoward systemic effects...

..With the exponential rise in implants, new issues have emerged, such as optimal device programming, identifying appropriate candidates, and accounting for cases without clinical benefit from CRT...

..The intermediate-term effect of bilevel PAP on left ventricular ejection fraction (LVEF) in patients with stable heart failure and OSA has not been compared to the effect of CPAP...

..A variety of nonpharmacologic approaches compliment drug therapy of heart failure, and many have been shown to improve patient quality of life and functional capacity, while reducing morbidity and mortality...

..Whether treating anemia will improve outcomes in patients with heart failure has yet to be determined, however. The decision to use an agent to treat anemia in heart failure should be made on a case-by-case basis...

..Given these findings, cardiac resynchronization therapy should be routinely considered in eligible NYHA Class III and IV heart failure patients with ventricular dyssynchrony...

..Management of heart failure has thus entered a new era of more effective pharmacotherapy, often delivered within the primary care setting...

..The purpose of this study is to investigate the relationship of reverse anatomical remodeling to ventricular arrhythmias in CRT patients...

..These trials established that it is feasible to design and execute heart failure studies of sufficient scale to assess improvement in rates of mortality and morbidity...

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..9% sensitivity. Intrathoracic impedance monitoring is not intended to replace careful frequent clinical evaluation of the heart failure patient, but instead aims to complement traditional heart failure management practices...

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..To evaluate whether patients with LVEF >35% might benefit from CRT, we performed a retrospective analysis of the predictors of response to CRT (PROSPECT) database...

..Together, they contribute to the clinical efficacy of carvedilol in a broad spectrum of patient types and may also confer a range of cardioprotective benefits...

..This curriculum outlines a new approach to training interventional HF cardiologists and internal medicine HF specialists to meet the growing demands for specially trained health care providers...

..The purpose of the present study was to determine whether improvements in left ventricular (LV) size and function were associated with CRT...

..A lower cut-point (BNP > or = 54 pg/mL) should be used in severely obese patients to preserve sensitivity. A higher cut-point in lean patients (BNP > or = 170 pg/mL) could be used to increase specificity...

..The purpose of this analysis is to identify predictors and characterize the timing of response to CRT in patients with advanced heart failure...

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..Adenosine may adversely affect renal function via its effects on renal arterioles and tubuloglomerular feedback, but effects of adenosine blockade in humans receiving furosemide and ACE inhibitors is unknown...

..This study examines B-type natriuretic peptide (BNP) levels in patients with systolic versus non-systolic dysfunction presenting with shortness of breath...

..In conclusion, assessment of quality of life before device implantation is necessary in order to select those individuals who are most likely to benefit from cardiac resynchronization therapy...

..The effects of CRT on HF outcomes in patients with asymptomatic left ventricular dysfunction (ALVD) or mild HF remain to be determined...

..CONCLUSIONS: In idiopathic dilated cardiomyopathy, functional improvement related to treatment with beta-blockers is associated with changes in myocardial gene expression...

..The InSync III study evaluated sequential cardiac resynchronization therapy (CRT) in patients with moderate-to-severe heart failure and prolonged QRS...

..B-type natriuretic peptide is released from the cardiac ventricles in response to increased wall tension...

..The purpose of this study was to evaluate the safety of implanting a cardiac resynchronization therapy (CRT) system...

..The Study of Anemia in Heart Failure Trial (STAMINA-HeFT) is the largest multicenter, randomized, double-blind, placebo-controlled trial to date evaluating the effect of treating anemia in HF...

..We hypothesized that CRT would improve glomerular filtration rate as estimated by the abbreviated Modification of Diet in Renal Disease equation (eGFR)...

..Among systolic HF patients, the presence of a low hemoglobin concentration is not a factor in the interpretation of BNP results...

..myocardial constraint device...

..In conclusion, without a control group, the effect of carvedilol on outcomes is not conclusive and trials of carvedilol in patients with HF and preserved EF should be undertaken...

..beta-Blockers reduce morbidity and mortality rates in heart failure (HF) clinical trials, but it is unknown whether these findings persist in the community setting...

..We determined the effect of diabetes on B-type natriuretic peptide (BNP) concentrations in patients presenting to the emergency department with dyspnea...

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..001). Characteristics of women and the elderly with HF in the community suggest increased risk, but both populations respond well after initiating carvedilol...

..The trial will take place over 5 years with an initial 6 months for planning, training, and implementation; 3 years of enrollment; 1 year of follow-up; and 6 months for close out, analysis, and presentation. ..