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Volume 17, Supplement 1 - 2016

Volume 17, Supplement 1 - 2016

Table of Contents

Heart Failure University 2015: Presentation Summaries
[Rev Cardiovasc Med. 2016;17(suppl 1):S1-S8 doi:10.3909/ricm17S1S0001] © 2016 MedReviews®, LLC
Acute and Chronic Cardiovascular Effects of Hyperkalemia: New Insights Into Prevention and Clinical Management
Hyperkalemia is a common electrolyte disorder associated with life-threatening cardiac arrhythmias and increased mortality. Patients at greatest risk for hyperkalemia include those with diabetes and those with impaired renal function in whom a defect in the excretion of renal potassium may already exist. Hyperkalemia is likely to become more common clinically because angiotensin receptor blockers and angiotensin-converting enzyme inhibitors are increasingly being used in higher doses and are thought to confer cardiovascular and renal protection. Until recently, options for treating hyperkalemia were limited to the use of thiazide and loop diuretics and sodium polystyrene sulfonate. Newer options such as sodium zirconium cyclosilicate will allow for the safe and effective treatment of hyperkalemia while maintaining patients on prescribed renin-angiotensin-aldosterone system inhibitors. [Rev Cardiovasc Med. 2016;17(suppl 1):S9-S21 doi: 10.3909/ ricm17S1S0002] © 2016 MedReviews®, LLC
A Treatment Approach for Patients With Chronic Systolic Heart Failure
The treatment of heart failure with reduced ejection (HFrEF) is changing rapidly. Advances over the past several decades have focused on blocking the adverse effects of neurohormonal activation. This approach has resulted in marked improvement in outcomes in the HFrEF population. Despite these advances, however, mortality and morbidity remain high and HFrEF patients have poor quality of life. New approaches to therapy now offer additional benefits. Combined neprilysin inhibition and angiotensin receptor blockade using sacubitril-valsartan (LCZ696) has been shown to be superior to an angiotensin-converting enzyme inhibitor in HFrEF patients. Compared with enalapril, treatment with LCZ696 was associated with significant reductions in the composite of cardiovascular mortality and heart failure hospitalization, both components of this composite endpoint and all-cause mortality. Another approach that has been shown to be effective is the use of ivabradine, an agent that blocks If channels in the sinus node to reduce heart rate. When added to standard therapy (that included a b-blocker in 89% of patients) in symptomatic HFrEF patients who were in sinus rhythm, ivabradine significantly reduced combined cardiovascular mortality and heart failure hospitalizations. Death from heart failure, all-cause hospitalization, and heart failure hospitalization were also significantly reduced when ivabradine was added to the medical regimen. Thus, both LCZ696 and ivabradine represent significant advances in the therapy of HFrEF. Utilization of these drugs in the growing HFrEF population will benefit millions of patients around the world. [Rev Cardiovasc Med. 2016;17(suppl 1):S22-S29 doi:10.3909/ricm17S1S0003] © 2016 MedReviews®, LLC
Nutritional Deficiencies and Sarcopenia in Heart Failure: A Therapeutic Opportunity to Reduce Hospitalization and Death
There is an expanding prevalence pool of heart failure (HF) due to the increasing prevalence of survivors of myocardial infarction, diabetes, hypertension, chronic kidney disease, and obesity. There is increasing interest in the role of nutrition in all forms of HF, given observations concerning micro- and macronutrient deficiencies, loss of lean body mass or sarcopenia, and their relationships with hospitalization and death. This review examines the relationships among loss of lean body mass, macro- and micronutrient intake, and the natural history of HF, particularly in the elderly, in whom the risks for all-cause rehospitalization, infection, falls, and mortality are increased. These risks are potentially modifiable through strategies that improve nutrition in this vulnerable population. [Rev Cardiovasc Med. 2016;17(suppl 1): S30-S39 doi: 10.3909/ricm17S1S004] © 2016 MedReviews®, LLC