Reduction in pulmonary artery pressures with use of sacubitril/valsartan

Publication date: Available online 23 August 2019Source: Journal of Cardiology CasesAuthor(s): Vincenzo De Simone, Paola Guarise, Gabriele Zanotto, Giorgio MorandoAbstractPulmonary hypertension due to left heart disease (PH-LHD) frequently complicates heart failure with reduced ejection fraction (HFrEF). Specific therapies for PH have not offered an advantage in patients with PH-LHD. The combined angiotensin receptor blocker–neprilysin inhibitor (ARNI), sacubitril/valsartan, is a novel therapy that can increase levels of natriuretic peptides (NPs). The resulting action on natriuresis and vasodilation may play an important role in the reduction of pulmonary pressures. Here, we report how the use of ARNI in two patients with HFrEF has resulted in an improvement in PH and, consequently, in clinical status and prognosis.
Source: Journal of Cardiology Cases - Category: Cardiology Source Type: research

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Pulmonary hypertension, defined as a resting mean pulmonary artery pressure greater than or equal to 25 mmHg, results from a myriad of conditions. The Fifth World Symposium on Pulmonary Hypertension proposed a classification system that organizes pulmonary hypertension into five groups based on common hemodynamic, pathophysiologic, and therapeutic parameters.1 This review focuses on pulmonary arterial hypertension (Group 1 pulmonary hypertension), a disease in which progressive pulmonary vascular obstruction, remodeling, and destruction lead to increased right ventricular afterload and hypertrophy, right heart failure, and...
Source: Anesthesiology - Category: Anesthesiology Source Type: research
Publication date: Available online 11 September 2019Source: JACC: Heart FailureAuthor(s): Karen Sliwa, Lucia Baris, Christoph Sinning, Elvin Zengin-Sahm, Lina Gumbiene, Israa F. Yaseen, Ghada Youssef, Mark Johnson, Hasan Al-Farhan, Malgorzata Lelonek, Roger Hall, Jolien Roos-HesselinkAbstractBackgroundGlobally, congenital heart disease (CHD) is an important cause of maternal morbidity and mortality in women reaching reproductive stage. There is lack of data from larger cohorts of women with uncorrected CHD.ObjectivesTo study maternal and fetal outcome of women with uncorrected CHD.MethodsAn analysis of 10-year data from th...
Source: JACC: Heart Failure - Category: Cardiology Source Type: research
Authors: Jany B, Bals R, Dreher M, Held M, Jany L, Rembert Koczulla A, Pfeifer M, Randerath W, Watz H, Wilkens H, Steinkamp G Abstract When caring for patients with respiratory diseases, always think of the heart! This is especially important for COPD patients, but also for a variety of other disorders of the respiratory system. At the workshop "Luftschlösser", held once more at Wiesbaden, Germany in February 2019 the many and important interactions of the lungs and the heart as well as the therapeutic implications were discussed. Based on pathophysiology, the psycho-social consequences of dyspnea, t...
Source: Pneumologie - Category: Respiratory Medicine Tags: Pneumologie Source Type: research
Authors: Yokokawa T, Sugimoto K, Yoshihisa A, Goto T, Misaka T, Oikawa M, Kobayashi A, Yamaki T, Kunii H, Nakazato K, Ishida T, Takeishi Y Abstract Heart failure causes increased venous pressure, leading to liver dysfunction. The fibrosis-4 index is a simple index for liver fibrosis and has been reported to be useful for predicting prognosis in heart failure; however, its impact on patients with pulmonary hypertension due to left heart disease (PH-LHD) has not yet been fully elucidated.We enrolled consecutive 230 hospitalized patients who had been diagnosed as having PH-LHD. The fibrosis-4 index was calculated as f...
Source: International Heart Journal - Category: Cardiology Tags: Int Heart J Source Type: research
Pulmonary hypertension (PH) in the setting of left heart disease (PH-LHD) is the most common cause of PH in the general population, with a prevalence of up to 80% and is associated with high morbidity and mortality. We have previously demonstrated the utility of right ventricular outflow tract (RVOT) Doppler notching as a composite marker of pulmonary vascular disease (PVD) in patients with PH-associated with heart failure with preserved ejection fraction (HFpEF). Our study examines the ability of RVOT Doppler notching to predict survival in patients with PH-HFpEF.
Source: Journal of Cardiac Failure - Category: Cardiology Authors: Tags: 171 Source Type: research
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Source: Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy - Category: Drugs & Pharmacology Authors: Tags: Review of Therapeutics Source Type: research
This article reviews the clinical application of stress echocardiography, including dobutamine, semisupine bicycle, treadmill, and leg-positive pressure for VHD patient management, and focuses on the current consensus regarding the use of stress echocardiography in VHD. Stress echocardiography is safe and should be encouraged, especially in heart valve clinics, to understand the complex mechanism in asymptomatic patients.
Source: Journal of Medical Ultrasonics - Category: Radiology Source Type: research
Publication date: Available online 5 June 2019Source: Heart &LungAuthor(s): Barak Zafrir, Shemy Carasso, Sorel Goland, Liaz Zilberman, Robert Klempfner, Nir Shlomo, Evgeny Radzishevsky, Tal Hasin, Avraham Shotan, Alicia Vazan, Jean Marc Weinstein, Wadi Kinany, Robert Dragu, Elad Maor, Liza Grosman-Rimon, Offer AmirAbstractBackgroundThe most common cause of pulmonary hypertension (PH) in developed countries is left heart disease (LHD, group 2 PH). The development of PH in heart failure (HF) patients is indicative of worse outcomes.ObjectiveThe aim of this study was to evaluate the long term outcomes of HF patients with ...
Source: Heart and Lung: The Journal of Acute and Critical Care - Category: Respiratory Medicine Source Type: research
AbstractPurpose of ReviewPulmonary hypertension (PH) frequently complicates heart failure and portends a worse prognosis. This review will summarize and discuss recent updates in the classification and management of patients with PH due to left heart disease.Recent FindingsCareful hemodynamic assessment is critical to the classification of patients with PH and heart failure. Two hemodynamic subgroups of PH in heart failure patients have been described: isolated post-capillary pulmonary hypertension and combined post- and precapillary pulmonary hypertension. The cornerstone in management of PH due to left heart disease is t...
Source: Current Cardiology Reports - Category: Cardiology Source Type: research
Authors: Zolty R Abstract INTRODUCTION: Pulmonary hypertension (PH) secondary to left-sided heart disease (Group 2 PH) is a frequent complication of heart failure (HF) and is a heterogeneous phenotypic disorder that worsens exercise capacity, increases risk for hospitalization and survival independent of left ventricular ejection fraction (LVEF) or stage of HF. Areas covered: In this review, an update of the current knowledge and some potential challenges about the pathophysiology and treatments of group 2 PH in patients with HF of either preserved or reduced ejection fraction are provided. Also, this review discus...
Source: Expert Review of Cardiovascular Therapy - Category: Cardiology Tags: Expert Rev Cardiovasc Ther Source Type: research
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