Dapagliflozin Versus Placebo on Left Ventricular Remodeling in Patients With Diabetes and Heart Failure: The REFORM Trial.

Objective: To determine the effects of dapagliflozin in patients with heart failure (HF) and type 2 diabetes mellitus (T2DM) on left ventricular (LV) remodeling using cardiac MRI.

Research Design And Methods: We randomized 56 patients with T2DM and HF with LV systolic dysfunction to dapagliflozin 10 mg daily or placebo for 1 year, on top of usual therapy. The primary end point was difference in LV end-systolic volume (LVESV) using cardiac MRI.

The APEX trial: Effects of allopurinol on exercise capacity, coronary and peripheral endothelial function, and natriuretic peptides in patients with cardiac syndrome X.

Unlabelled: The role of endothelial dysfunction and oxidative stress in the pathogenesis of cardiac syndrome X has recently been recognized. Allopurinol has previously been shown to improve endothelial dysfunction, reduce oxidative stress burden, and improve myocardial efficiency. In this "proof of concept" study, we investigated the effect of allopurinol on exercise capacity, coronary and peripheral endothelial function, and serum B-type natriuretic peptide (BNP: a marker of cardiac function and myocardial ischemia) in patients with cardiac syndrome X.

Insulin sensitization therapy and the heart: focus on metformin and thiazolidinediones.

Chronic heart failure (CHF) is an insulin-resistant (IR) state and the degree of IR is related to disease severity and poor clinical outcome in CHF. IR may be pathophysiologically linked with CHF. Therefore, IR may represent a new target for treatment in CHF.

Pulmonary hypertension predicts all-cause mortality in patients with heart failure: a retrospective cohort study.

Aims: The presence of pulmonary hypertension (PH) in left ventricular systolic dysfunction (LVSD) and symptomatic heart failure is an ominous sign. There are insufficient data regarding the risk conferred by increasing severity of PH in patients with heart failure.

Methods And Results: We performed a record linkage study in Tayside, Scotland (population ∼400,000) utilizing the Tayside echocardiogram database (>50,000 echocardiograms) maintained by the Health Informatics Centre (HIC).

Compliance to recommended liver function monitoring in patients on statin therapy.

Product information and national guidelines consistently recommend the estimation of serum alanine aminotranferase (ALT) before and after approximately 3 months as part of risk management following initiation of statin therapy. The aim of this study was to determine compliance to the recommendations for monitoring ALT in patients initiated on statin therapy. The prevalence of abnormal serum ALT levels was also evaluated and compared with current data.

Differential effects of carvedilol and atenolol on plasma noradrenaline during exercise in humans.

Aims: Evidence of long-term beneficial effects of beta-blockers on mortality and morbidity in patients with heart failure has been demonstrated in recent randomized trials. However, not all beta-blockers are identical. Carvedilol, a nonselective beta- and alpha-adrenergic blocker, can potentially blunt the release of noradrenaline by blocking presynaptic beta2-adrenergic receptors.