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Artikel ; Online: [Titelangabe fehlt]

Weinstein, Jordan / Girard, Louis-Philippe / Lepage, Serge / McKelvie, Robert S / Tennankore, Karthik

CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne

2022 Band 194, Heft 10, Seite(n) E391–E397

Titelübersetzung	Prévention et traitement de l’hyperkaliémie chez les patients sous inhibiteurs du système rénine–angiotensine–aldostérone.
Sprache	Französisch
Erscheinungsdatum	2022-03-12
Erscheinungsland	Canada
Dokumenttyp	Journal Article ; Review
ZDB-ID	215506-0
ISSN	1488-2329 ; 0008-4409 ; 0820-3946
ISSN (online)	1488-2329
ISSN	0008-4409 ; 0820-3946
DOI	10.1503/cmaj.210831-f
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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Artikel ; Online: Acute decompensated heart failure.

Lepage, Serge

The Canadian journal of cardiology

2008 Band 24 Suppl B, Seite(n) 6B–8B

Abstract: Acute decompensated heart failure is the most common cause of hospitalization for patients older than 65 years of age. Although treatment of this condition has improved over the past two decades, the specific approach to patients in the acute setting has ...

Abstract	Acute decompensated heart failure is the most common cause of hospitalization for patients older than 65 years of age. Although treatment of this condition has improved over the past two decades, the specific approach to patients in the acute setting has not evolved in the same way. A patient facing acute decompensation is experiencing a serious medical condition that is associated with a poor prognosis. In addition, acute decompensated heart failure results in significant costs to the health care system. Significant morbidity and mortality are associated with patients who are readmitted within a year of the first hospitalization. Because of this important problem, further research on improving the prognosis for this condition is warranted. The present article will focus on the risk factors associated with acute decompensation and the importance of this condition, both on prognosis and economics.
Mesh-Begriff(e)	Acute Disease ; Age Distribution ; Aged ; Aged, 80 and over ; Canada/epidemiology ; Cardiotonic Agents/therapeutic use ; Diuretics/therapeutic use ; Drug Therapy, Combination ; Female ; Heart Failure/diagnosis ; Heart Failure/drug therapy ; Heart Failure/epidemiology ; Hospital Costs ; Hospitalization/economics ; Hospitalization/statistics & numerical data ; Humans ; Incidence ; Male ; Natriuretic Peptide, Brain/therapeutic use ; Patient Readmission/economics ; Patient Readmission/statistics & numerical data ; Risk Assessment ; Severity of Illness Index ; Sex Distribution ; Survival Analysis
Chemische Substanzen	Cardiotonic Agents ; Diuretics ; Natriuretic Peptide, Brain (114471-18-0)
Sprache	Englisch
Erscheinungsdatum	2008-07-16
Erscheinungsland	England
Dokumenttyp	Journal Article ; Review
ZDB-ID	632813-1
ISSN	1916-7075 ; 0828-282X
ISSN (online)	1916-7075
ISSN	0828-282X
DOI	10.1016/s0828-282x(08)71022-5
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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Artikel ; Online: Prevention and management of hyperkalemia in patients treated with renin-angiotensin-aldosterone system inhibitors.

Weinstein, Jordan / Girard, Louis-Philippe / Lepage, Serge / McKelvie, Robert S / Tennankore, Karthik

CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne

2021 Band 193, Heft 48, Seite(n) E1836–E1841

Mesh-Begriff(e)	Angiotensin II Type 1 Receptor Blockers/adverse effects ; Angiotensin-Converting Enzyme Inhibitors/adverse effects ; Humans ; Hyperkalemia/prevention & control ; Kidney Diseases/drug therapy ; Kidney Diseases/metabolism ; Mineralocorticoid Receptor Antagonists/adverse effects ; Potassium/metabolism ; Renin-Angiotensin System/drug effects ; Risk Factors
Chemische Substanzen	Angiotensin II Type 1 Receptor Blockers ; Angiotensin-Converting Enzyme Inhibitors ; Mineralocorticoid Receptor Antagonists ; Potassium (RWP5GA015D)
Sprache	Englisch
Erscheinungsdatum	2021-11-21
Erscheinungsland	Canada
Dokumenttyp	Journal Article ; Research Support, Non-U.S. Gov't ; Review
ZDB-ID	215506-0
ISSN	1488-2329 ; 0008-4409 ; 0820-3946
ISSN (online)	1488-2329
ISSN	0008-4409 ; 0820-3946
DOI	10.1503/cmaj.210831
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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Artikel: A Heart Stopping Case of the Bezold-Jarisch Reflex.

Parent, Marc-Etienne / Lepage, Serge

Case reports in cardiology

2015 Band 2015, Seite(n) 359401

Abstract: The Bezold-Jarisch reflex is a parasympathetic reflex induced by intense mechanical stimulation of the ventricular myocytes. Exceptionally, cases have been described in patients receiving dobutamine infusion during a stress echocardiography. All were ... ...

Abstract	The Bezold-Jarisch reflex is a parasympathetic reflex induced by intense mechanical stimulation of the ventricular myocytes. Exceptionally, cases have been described in patients receiving dobutamine infusion during a stress echocardiography. All were healthy middle-aged women and recovered without sequelae. A healthy 60-year-old woman suffered two 5.9-second episodes of asystole during her 20 mcg/kg/min infusion of dobutamine. Recovery was quick and without sequelae. Echocardiography and coronary angiography were both normal. In conclusion, this is the fourth documented case of a severe Bezold-Jarisch reflex causing asystole during dobutamine infusion. Diagnosis can only be made after excluding all other possible diagnoses, most importantly ischemia. This serves as a reminder of the importance of close monitoring during dobutamine infusion.
Sprache	Englisch
Erscheinungsdatum	2015-12-01
Erscheinungsland	United States
Dokumenttyp	Journal Article
ZDB-ID	2627627-6
ISSN	2090-6412 ; 2090-6404
ISSN (online)	2090-6412
ISSN	2090-6404
DOI	10.1155/2015/359401
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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Artikel ; Online: Sacubitril/Valsartan in Patients Hospitalized With Decompensated Heart Failure.

Morrow, David A / Velazquez, Eric J / Desai, Akshay S / DeVore, Adam D / Lepage, Serge / Park, Jeong-Gun / Sharma, Kavita / Solomon, Scott D / Starling, Randall C / Ward, Jonathan H / Williamson, Kristin M / Zieroth, Shelley / Hernandez, Adrian F / Mentz, Robert J / Braunwald, Eugene

Journal of the American College of Cardiology

2024 Band 83, Heft 12, Seite(n) 1123–1132

Abstract: Background: The efficacy and safety of sacubitril/valsartan in patients hospitalized with heart failure (HF) across the spectrum of left ventricular ejection fraction (EF) has not been described.: Objectives: Data from randomized trials of sacubitril/ ...

Abstract	Background: The efficacy and safety of sacubitril/valsartan in patients hospitalized with heart failure (HF) across the spectrum of left ventricular ejection fraction (EF) has not been described. Objectives: Data from randomized trials of sacubitril/valsartan in HF patients with EF ≤40% (PIONEER-HF [Comparison of Sacubitril/Valsartan Versus Enalapril on Effect of NT-proBNP in Patients Stabilized From an Acute Heart Failure Episode] trial) and >40% (PARAGLIDE-HF [Prospective comparison of ARNI with ARB Given following stabiLization In DEcompensated HFpEF] trial) following recent worsening heart failure (WHF) were pooled to examine treatment effect across the EF spectrum. Methods: The PIONEER-HF and PARAGLIDE-HF trials were double-blind, randomized trials of sacubitril/valsartan vs control therapy (enalapril or valsartan, respectively). All participants in the PIONEER-HF trial and 69.5% in the PARAGLIDE-HF trial were enrolled during hospitalization for HF after stabilization. The remainder in the PARAGLIDE-HF trial were enrolled ≤30 days after a WHF event. The primary endpoint of both trials was time-averaged proportional change in N-terminal pro-B-type natriuretic peptide (NT-proBNP) from baseline through weeks 4 and 8. Adjudicated clinical endpoints were analyzed through the end of follow-up, adjusting for trial. Results: The pooled analysis included 1,347 patients (881 from PIONEER-HF, 466 from PARAGLIDE-HF). Baseline characteristics included median age 66 years, 36% women, 31% Black, 34% de novo HF, and median EF 30%. The reduction in NT-proBNP was 24% greater with sacubitril/valsartan vs control therapy (n = 1,130; ratio of change = 0.76; 95% CI: 0.69-0.83; P < 0.0001). Cardiovascular death or hospitalization for HF was reduced by 30% with sacubitril/valsartan vs control therapy (HR: 0.70; 95% CI: 0.54-0.91; P = 0.0077). This effect was consistent across the spectrum of EF ≤60%. Sacubitril/valsartan increased symptomatic hypotension (risk ratio: 1.35; 95% CI: 1.05-1.72). Conclusions: In patients stabilized after WHF, sacubitril/valsartan led to a greater reduction in plasma NT-proBNP and improved clinical outcome compared with control therapy, in particular across the spectrum of EF ≤60%. (Comparison of Sacubitril/Valsartan Versus Enalapril on Effect of NT-proBNP in Patients Stabilized From an Acute Heart Failure Episode [PIONEER-HF]; NCT02554890; Changes in NT-proBNP, Safety, and Tolerability in HFpEF Patients With a WHF Event [HFpEF Decompensation] Who Have Been Stabilized and Initiated at the Time of or Within 30 Days Post-decompensation [PARAGLIDE-HF]; NCT03988634).
Mesh-Begriff(e)	Aged ; Female ; Humans ; Male ; Aminobutyrates ; Angiotensin Receptor Antagonists ; Angiotensin-Converting Enzyme Inhibitors/therapeutic use ; Angiotensin-Converting Enzyme Inhibitors/pharmacology ; Biphenyl Compounds/therapeutic use ; Drug Combinations ; Enalapril/therapeutic use ; Heart Failure ; Stroke Volume ; Tetrazoles ; Valsartan/therapeutic use ; Ventricular Function, Left ; Double-Blind Method
Chemische Substanzen	Aminobutyrates ; Angiotensin Receptor Antagonists ; Angiotensin-Converting Enzyme Inhibitors ; Biphenyl Compounds ; Drug Combinations ; Enalapril (69PN84IO1A) ; sacubitril (17ERJ0MKGI) ; Tetrazoles ; Valsartan (80M03YXJ7I)
Sprache	Englisch
Erscheinungsdatum	2024-03-20
Erscheinungsland	United States
Dokumenttyp	Randomized Controlled Trial ; Journal Article
ZDB-ID	605507-2
ISSN	1558-3597 ; 0735-1097
ISSN (online)	1558-3597
ISSN	0735-1097
DOI	10.1016/j.jacc.2024.01.027
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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Artikel ; Online: Rationale, Design and Baseline Characteristics of the PARAGLIDE-HF Trial: Sacubitril/Valsartan vs Valsartan in HFmrEF and HFpEF With a Worsening Heart Failure Event.

Mentz, Robert J / Ward, Jonathan H / Hernandez, Adrian F / Lepage, Serge / Morrow, David A / Sarwat, Samiha / Sharma, Kavita / Solomon, Scott D / Starling, Randall C / Velazquez, Eric J / Williamson, Kristin / Zieroth, Shelley / Braunwald, Eugene

Journal of cardiac failure

2023 Band 29, Heft 6, Seite(n) 922–930

Abstract: Background: The PARAGON-HF trial studied the effect of sacubitril/valsartan (Sac/Val) compared with valsartan (Val) on clinical outcomes in patients with chronic heart failure with preserved ejection fraction (HFpEF) or mildly reduced EF (HFmrEF). ... ...

Abstract	Background: The PARAGON-HF trial studied the effect of sacubitril/valsartan (Sac/Val) compared with valsartan (Val) on clinical outcomes in patients with chronic heart failure with preserved ejection fraction (HFpEF) or mildly reduced EF (HFmrEF). Further data are needed regarding the use of Sac/Val in these groups with EF and with recent worsening heart failure (WHF) events and in key populations not broadly represented in the PARAGON-HF trial, including those with de novo HF, the severely obese and Black patients. Methods: The PARAGLIDE-HF trial is a multicenter, double-blind, randomized, controlled trial of Sac/Val vs Val that enrolled patients at 100 sites. Medically stable patients ≥ 18 years old with EF > 40%, amino terminal-pro B-type natriuretic peptide (NT-proBNP) levels ≥ 500 pg/mL and within 30 days of a WHF event were eligible for participation. Patients were randomly assigned 1:1 to Sac/Val vs Val. The primary efficacy endpoint is time-averaged proportional change in NT-proBNP from baseline through Weeks 4 and 8. Secondary endpoints include clinical outcomes during follow-up and additional biomarker assessments. Safety endpoints include symptomatic hypotension, worsening renal function and hyperkalemia. Results: The trial enrolled 467 participants from June 2019 through October 2022 (52% women, 22% Black, age 70 ± 12 years, median (IQR) BMI 33 (27-40) kg/m Conclusions: The PARAGLIDE-HF trial enrolled a broad and diverse range of patients with heart failure with mildly reduced or preserved ejection fraction and will inform clinical practice by providing evidence about the safety, tolerability and efficacy of Sac/Val vs Val in those with a recent WHF event.
Mesh-Begriff(e)	Humans ; Female ; Middle Aged ; Aged ; Aged, 80 and over ; Adolescent ; Male ; Heart Failure/diagnosis ; Heart Failure/drug therapy ; Heart Failure/chemically induced ; Stroke Volume ; Tetrazoles/therapeutic use ; Angiotensin Receptor Antagonists/therapeutic use ; Valsartan ; Aminobutyrates/therapeutic use ; Biphenyl Compounds ; Drug Combinations
Chemische Substanzen	sacubitril (17ERJ0MKGI) ; Tetrazoles ; Angiotensin Receptor Antagonists ; Valsartan (80M03YXJ7I) ; Aminobutyrates ; Biphenyl Compounds ; Drug Combinations
Sprache	Englisch
Erscheinungsdatum	2023-02-14
Erscheinungsland	United States
Dokumenttyp	Randomized Controlled Trial ; Multicenter Study ; Journal Article
ZDB-ID	1281194-4
ISSN	1532-8414 ; 1071-9164
ISSN (online)	1532-8414
ISSN	1071-9164
DOI	10.1016/j.cardfail.2023.02.001
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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Artikel ; Online: Heart Failure, Iron Deficiency, and Supplementation: Where Do We Stand?

O'Meara, Eileen / de Denus, Simon / Lepage, Serge

The Canadian journal of cardiology

2016 Band 32, Heft 2, Seite(n) 148–150

Mesh-Begriff(e)	Anemia, Iron-Deficiency/drug therapy ; Heart Failure/complications ; Humans ; Iron Compounds/administration & dosage ; Nutritional Support/methods
Chemische Substanzen	Iron Compounds
Sprache	Englisch
Erscheinungsdatum	2016-02
Erscheinungsland	England
Dokumenttyp	Comment ; Editorial ; Research Support, Non-U.S. Gov't
ZDB-ID	632813-1
ISSN	1916-7075 ; 0828-282X
ISSN (online)	1916-7075
ISSN	0828-282X
DOI	10.1016/j.cjca.2015.07.725
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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Artikel: Very late transcatheter heart valve thrombosis.

Couture, Etienne L / Lepage, Serge / Masson, Jean-Bernard / Daneault, Benoit

World journal of cardiology

2017 Band 9, Heft 2, Seite(n) 196–199

Abstract: We describe a case of very late transcatheter heart valve (THV) thrombosis of a first-generation SAPIEN prosthesis (Edwards Lifesciences, Irvine, CA) implanted in a 64-year-old woman with severe symptomatic aortic stenosis. More than 54 mo after ... ...

Abstract	We describe a case of very late transcatheter heart valve (THV) thrombosis of a first-generation SAPIEN prosthesis (Edwards Lifesciences, Irvine, CA) implanted in a 64-year-old woman with severe symptomatic aortic stenosis. More than 54 mo after implantation, she presented with severe symptomatic prosthesis dysfunction (stenosis) which was successfully treated with oral anticoagulation. To our knowledge, this is the tardiest case of THV thrombosis ever reported. This case should increase clinical awareness for THV thrombosis even beyond the first two-year period following implantation.
Sprache	Englisch
Erscheinungsdatum	2017-02-06
Erscheinungsland	United States
Dokumenttyp	Case Reports
ZDB-ID	2573665-6
ISSN	1949-8462
ISSN	1949-8462
DOI	10.4330/wjc.v9.i2.196
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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Artikel ; Online: Angiotensin-Neprilysin Inhibition in Patients With Mildly Reduced or Preserved Ejection Fraction and Worsening Heart Failure.

Mentz, Robert J / Ward, Jonathan H / Hernandez, Adrian F / Lepage, Serge / Morrow, David A / Sarwat, Samiha / Sharma, Kavita / Starling, Randall C / Velazquez, Eric J / Williamson, Kristin M / Desai, Akshay S / Zieroth, Shelley / Solomon, Scott D / Braunwald, Eugene

Journal of the American College of Cardiology

2023 Band 82, Heft 1, Seite(n) 1–12

Abstract: Background: U.S. guidelines recommend consideration of sacubitril/valsartan in chronic heart failure (HF) and mildly reduced or preserved ejection fraction (EF). Whether initiation is safe and effective in EF >40% after a worsening heart failure (WHF) ... ...

Abstract	Background: U.S. guidelines recommend consideration of sacubitril/valsartan in chronic heart failure (HF) and mildly reduced or preserved ejection fraction (EF). Whether initiation is safe and effective in EF >40% after a worsening heart failure (WHF) event is unknown. Objectives: PARAGLIDE-HF (Prospective comparison of ARNI with ARB Given following stabiLization In DEcompensated HFpEF) assessed sacubitril/valsartan vs valsartan in EF >40% following a recent WHF event. Methods: PARAGLIDE-HF is a double-blind, randomized controlled trial of sacubitril/valsartan vs valsartan in patients with EF >40% enrolled within 30 days of a WHF event. The primary endpoint was time-averaged proportional change in amino terminal pro-B-type natriuretic peptide (NT-proBNP) from baseline through Weeks 4 and 8. A secondary hierarchical outcome (win ratio) consisted of: 1) cardiovascular death; 2) HF hospitalizations; 3) urgent HF visits; and 4) change in NT-proBNP. Results: In 466 patients (233 sacubitril/valsartan; 233 valsartan), time-averaged reduction in the NT-proBNP was greater with sacubitril/valsartan (ratio of change: 0.85; 95% CI: 0.73-0.999; P = 0.049). The hierarchical outcome favored sacubitril/valsartan but was not significant (unmatched win ratio: 1.19; 95% CI: 0.93-1.52; P = 0.16). Sacubitril/valsartan reduced worsening renal function (OR: 0.61; 95% CI: 0.40-0.93) but increased symptomatic hypotension (OR: 1.73; 95% CI: 1.09-2.76). There was evidence of a larger treatment effect in the subgroup with EF ≤60% for NT-proBNP change (0.78; 95% CI: 0.61-0.98) and the hierarchical outcome (win ratio: 1.46; 95% CI: 1.09-1.95). Conclusions: Among patients with EF >40% stabilized after WHF, sacubitril/valsartan led to greater reduction in plasma NT-proBNP levels and was associated with clinical benefit compared with valsartan alone, despite more symptomatic hypotension. (Prospective comparison of ARNI with ARB Given following stabiLization In DEcompensated HFpEF; NCT03988634).
Mesh-Begriff(e)	Humans ; Heart Failure ; Neprilysin/therapeutic use ; Angiotensins/pharmacology ; Angiotensins/therapeutic use ; Angiotensin Receptor Antagonists/therapeutic use ; Angiotensin Receptor Antagonists/pharmacology ; Stroke Volume ; Tetrazoles/therapeutic use ; Tetrazoles/pharmacology ; Angiotensin-Converting Enzyme Inhibitors/therapeutic use ; Valsartan/therapeutic use ; Aminobutyrates/therapeutic use ; Aminobutyrates/pharmacology ; Biphenyl Compounds/therapeutic use ; Hypotension/chemically induced ; Hypotension/drug therapy ; Drug Combinations
Chemische Substanzen	sacubitril (17ERJ0MKGI) ; Neprilysin (EC 3.4.24.11) ; Angiotensins ; Angiotensin Receptor Antagonists ; Tetrazoles ; Angiotensin-Converting Enzyme Inhibitors ; Valsartan (80M03YXJ7I) ; Aminobutyrates ; Biphenyl Compounds ; Drug Combinations
Sprache	Englisch
Erscheinungsdatum	2023-05-21
Erscheinungsland	United States
Dokumenttyp	Randomized Controlled Trial ; Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	605507-2
ISSN	1558-3597 ; 0735-1097
ISSN (online)	1558-3597
ISSN	0735-1097
DOI	10.1016/j.jacc.2023.04.019
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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Artikel ; Online: Canadian Cardiovascular Society-Canadian Heart Failure Society Focused Clinical Practice Update of Patients With Differing Heart Failure Phenotypes.

Ducharme, Anique / Zieroth, Shelley / Ahooja, Vineeta / Anderson, Kim / Andrade, Jason / Boivin-Proulx, Laurie-Anne / Ezekowitz, Justin / Howlett, Jonathan / Lepage, Serge / Leong, Derek / McDonald, Michael A / O'Meara, Eileen / Poon, Stephanie / Swiggum, Elizabeth / Virani, Sean

The Canadian journal of cardiology

2023 Band 39, Heft 8, Seite(n) 1030–1040

Abstract: A number of societies produce heart failure (HF) management guidelines, comprising official recommendations on the basis of recent research discoveries, but their applicability to specific situations encountered in daily practice might be difficult. In ... ...

Abstract	A number of societies produce heart failure (HF) management guidelines, comprising official recommendations on the basis of recent research discoveries, but their applicability to specific situations encountered in daily practice might be difficult. In this clinical practice update we aim to provide responses to fundamental questions that face health care providers, like appropriate timing for the introduction and optimization of different classes of medication according to specific patient phenotypes, when second-line therapies and valvular interventions should be considered, and management of difficult clinical scenarios such as cardiorenal syndrome and frailty. A consensus-based methodology was used. Approaches to 5 different phenotypes are presented: (1) The wet HF phenotype is the easiest to manage, decongestion being performed alongside introduction of guideline-directed medical therapy (GDMT); (2) The de novo HF phenotype requires the introduction of the 4 pillars of GDMT, personalizing the order on the basis of the individuals' biological and physiological characteristics; (3) The worsening HF phenotype is a marker of poor prognosis, and therefore should motivate optimization of GDMT, start second-line therapies, and/or reevaluate goals of care/advanced HF therapies; (4) The cardiorenal phenotypes require correct volume assessment, because renal function usually improves with decongestion; and (5) The frail HF phenotype require special attention, careful drug titration, and consideration of cardiac rehabilitation programs. In conclusion, specific common HF phenotypes call for a personalized approach to improve adoption of the HF guidelines into clinical practice.
Mesh-Begriff(e)	Humans ; Canada ; Heart Failure ; Cardiovascular System ; Societies, Medical ; Phenotype ; Stroke Volume
Sprache	Englisch
Erscheinungsdatum	2023-05-09
Erscheinungsland	England
Dokumenttyp	Practice Guideline ; Journal Article
ZDB-ID	632813-1
ISSN	1916-7075 ; 0828-282X
ISSN (online)	1916-7075
ISSN	0828-282X
DOI	10.1016/j.cjca.2023.04.022
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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