Treatment Approaches to Congestion Relief in Acute Decompensated HF: Insights After DOSE-AHF and CARRESS-HF.

Most patients admitted to the hospital with ADHF do not achieve adequate relief of signs and symptoms of congestion. Patients with inadequate decongestion are known to be at higher risk of readmission for heart failure and mortality, although it is uncertain whether this is a cause or simply a marker of increased risk. Nonetheless, adequate decongestion is critical for improving quality of life.

Carvedilol for the treatment of benign prostatic hypertrophy in patients with heart failure?

Heart failure (HF) and benign prostatic hypertrophy (BPH) are two conditions that commonly coexist in men 60 years and older. Carvedilol is the only β-adrenergic blocker approved for HF that also has additional α1-adrenergic blockade. As α1-adrenergic blockers are used in the treatment of BPH, it is intuitive that carvediolol could improve BPH symptoms.

Left ventricular assist device as bridge to transplantation does not adversely affect one-year heart transplantation survival.

Objective: Left ventricular assist devices are increasingly used as a bridge to transplantation. It remains unclear whether the use of pretransplant left ventricular assist devices adversely affects short-term survival after cardiac transplantation.

Methods: A retrospective review of 317 consecutive patients undergoing cardiac transplantation at an academic center between 1986 and 2006 was undertaken.

Assist devices fail to reverse patterns of fetal gene expression despite beta-blockers.

Background: Heart failure is associated with reversal to a fetal gene expression pattern of contractile and metabolic genes. Substantial recovery of ventricular function with assist devices is rare. Our goal was to evaluate the effects of assist devices on fetal gene expression and hypoxia inducible factor-1 alpha (HIF-1 alpha), a transcriptional factor in hypoxic signaling.

Quality of life and prognosis in heart failure: results of the Beta-Blocker Evaluation of Survival Trial (BEST).

Background: Quality of life (QOL) was a prespecified secondary end point in the Beta-Blocker Evaluation of Survival Trial. The Beta-Blocker Evaluation of Survival Trial used four QOL questionnaires to evaluate patient health status over time in response to treatment with placebo or bucindolol. The goal of the current study was to determine the relationship between the different questionnaires, assess the effect of treatment on health status, and evaluate the association between changes in health status and prognosis.

Low-dose oral enoximone enhances the ability to wean patients with ultra-advanced heart failure from intravenous inotropic support: results of the oral enoximone in intravenous inotrope-dependent subjects trial.

Background: We determined whether low-dose oral enoximone could wean patients with ultra-advanced heart failure (UA-HF) from intravenous (i.v.) inotropic support.

Rationale and design of the enoximone clinical trials program.

Background: Chronic heart failure is a disease syndrome characterized in its advanced stages by a poor quality of life, frequent hospitalizations, and a high risk of mortality. In advanced and ultra-advanced chronic heart failure, many treatment options, such as cardiac transplantation and mechanical devices, are severely limited by availability and cost. Short-term Phase II clinical trials suggest that low-dose oral inotropic therapy with enoximone may improve hemodynamics and exercise capacity, without adversely affecting mortality, in selected subjects with advanced chronic heart failure.

Peak oxygen consumption and outcome in heart failure patients chronically treated with beta-blockers.

Background: Peak oxygen consumption (VO(2)) is an important criterion for listing patients for cardiac transplantation. Beta-blockers improve survival without affecting peak VO(2). We questioned the value of peak VO(2) in predicting outcome in patients treated with beta-blockers.