Akers, Scott

Beraun, Melissa

Chirinos, Julio A

Chittams, Jesse

Haines, Philip G

Koppula, Maheswara R

Rawat, Deepa

Segers, Patrick

Soto-Calderon, Haideliza

Townsend, Raymond R

Varakantam, Swapna

Witschey, Walter R

Zamani, Payman

English

Ghent University Academic Bibliography

     1.Abstract 14963:  Isosorbide Dinitrate, With or Without Hydrazine, Does Not ReduceWave Reflections, LV Hypertrophy or Fibrosis in HFpEF.Zamani, Payman;  Akers, Scott;  Soto-Calderon, Haideliza;  Beraun, Melissa;Koppula, Maheswara R;  Varakantam, Swapna;  Rawat, Deepa;  Haines, Philip G;Chittams, Jesse;  Townsend, Raymond R;  Witschey, Walter R;  Segers, Patrick;Chirinos, Julio ACirculation.    134(Suppl_1) Supplement 1:A14963, November 11, 2016.[Heart Failure and Cardiomyopathies:  ABSTRACT Only]AN: 00003017-201611111-01147.Arterial wave reflections, which are increased in heart failure with preserved ejectionfraction (HFpEF), impair diastolic function and promote pathologic myocardialremodeling. Organic nitrates reduce wave reflections acutely, but whether this issustained chronically or affected by hydralazine is unknown. We randomized 44subjects with HFpEF in a double-blinded fashion to isosorbide dinitrate (ISDN),ISDN+hydralazine (ISDN+Hydral), or placebo for 24 weeks. The primary endpointwas the change in reflection magnitude (RM, assessed with arterial tonometry andDoppler echocardiography). Secondary endpoints included the change in LV massand fibrosis on cardiac MRI and six-minute walk (6MW) distance. ISDN reducedaortic characteristic impedance (Median baseline: 0.13 [IQR 0.12,0.17]; 3-month:0.10 [0.06,0.17]; final: 0.09 [0.08,0.15] mmHg/mL/s, P=0.003) and forward waveamplitude (Pf, median baseline: 48.7 [IQR 42.5,63.1], 3-month: 38.0 [25.8,49.0]; final:40.4 [23.6,52.0] mmHg, P=0.04), but had no effects on RM (P=0.64). ISDN+Hydralincreased RM (Median baseline: 0.37 [IQR 0.31,0.43]; 3-month: 0.35 [0.27,0.37];final: 0.45 [0.41,0.58], P=0.03), reduced 6MW distance (Median baseline: 398.7 [IQR297.0,432.7]; final: 300.0 [122.0,370.7] meters, P=0.022), and increased nativemyocardial T1 (Median baseline: 1002 [IQR 974,1006]; final: 1060 [1034.5,1121.5],P=0.021), suggesting increased fibrosis. A higher proportion of subjects experiencedadverse events with active therapy (ISDN=61.5%, ISDN+Hydral=60%;Placebo=12.5%; P=0.007). Long-term administration of IDSN, with or withouthydralazine, does not exert beneficial effects on RM, LV remodeling, or submaximalexercise and is poorly tolerated. The combination of ISDN+Hydral has deleteriouseffects on RM, interstitial remodeling, and submaximal exercise. Our findings do notsupport the routine use of these vasodilators in HFpEF.(C) 2016  by the American College of Cardiology Foundation and the American HeartAssociation, Inc.Institution(1)Medicine, Univ of Pennsylvania, Philadelphia, PA, (2)Medicine, VA Med Cntr,Philadelphia, PA, (3)Cardiovascular Medicine, Hosp of the Univ of Pennsylvania,Philadelphia, PA, (4)Medicine, Hosp of the Univ of Pennsylvania; Rhode Island Hosp,Warren Alpert Med Sch of Brown Univ, Providence, RI, (5)Sch of Nursing, Univ ofPennsylvania, Philadelphia, PA, (6)Medicine, Div of Nephrology/Hypertension, Univof Pennsylvania, Philadelphia, PA, (7)Radiology, Univ of Pennsylvania, Philadelphia,PA, (8)Biofluid, Tissue, and Solid Mechanics for Med Applications, IBiTech, iMindsMed IT, Ghent Univ, Gent, BelgiumLanguageEnglish.Journal SubsetClinical Medicine.ISSN0009-7322NLM Journal Codedaw, 0147763  Link to the Ovid Full Text or citation:Click here for full text options  Link to the External Link Resolver:SFX   

Isosorbide Dinitrate, With or Without Hydrazine, Does Not Reduce Wave Reflections, LV Hypertrophy or Fibrosis in HFpEF

https://biblio.ugent.be/publication/8521252/file/8521285.pdf

Isosorbide Dinitrate, With or Without Hydrazine, Does Not Reduce Wave Reflections, LV Hypertrophy or Fibrosis in HFpEF

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