Studies of left ventricular dysfunction

Francis GS, Benedict C, Johnstone DE, Kirlin PC, Nicklas J, Liang CS, Kubo SH, Rudin-Toretsky E, Yusuf S (1990) Comparison of neuroendocrine activation in patients with left ventricular dysfunction with and without congestive heart failure a substudy of the studies of left ventricular dysfunction (SOLVD). Circulation 82 1724-1729... 

The more recent use of aggressive medical therapy with beta blockers, ACE-inhibitors, aspirin, and HMG Co A reductase inhibitors has had a profound benefit on those with coronary artery disease and reduced LVEF. To that end, revascularization still plays an important role in mortality reduction. In the Studies of Left Ventricular Dysfunction (SOLVD) database, CABG does improve survival compared to more modern use of medical therapy, with a 25% mortality risk reduction as well as an intriguing 46% risk reduction of sudden death [91]. This benefit improved as LVEF decreased, thus providing evidence that revascularization may stabilize heart function, reduce abnormal remodeling, and thus reduce the propensity to arrhythmogenicity. 

Vermes E et al Enalapril reduces the incidence of diabetes in patients with chronic heart failure Insight from the Studies Of Left Ventricular Dysfunction (SOLVD). Circulation 2003 107 1291. [PMID 12628950]... 

Abbreviations. AIRE, acute Infarction ramipril efficacy CONSENSUS, cooperative north Scandinavian enalapril sur/f/a study HF, heart failure LVEF, left ventricular ejection fraction NYHA. New York Heart Association SAVE, survival and ventricular enlargement SMILE, survival of myocardial infarction long-term evaluation SOLVD. studies of left ventricular dysfunction TRACE, trandolapril cardiac evaluation study group. 

Konstam MA, Kronenberg MW, Rousseau Mp et al, Effects of the angiotensin converting enzyme inhibitor enalapril on the long-term progression of left ventricular dilatation in patients with asymptomatic systolic dysfunction, SOLVD (Studies of Left Ventricular Dysfunction) Investigators, Circulation 1993 88 2277-2283. 

Vermes E, Tardif JC, Bourassa MG, Racine N, Levesque S, White M, Guerra PG, Ducharme A. Enalapril decreases the incidence of atrial fibrillation in patients with left ventricular dysfunction insight from the studies of left ventricular dysfunction (SOLVD) trials. Circulation 2003 107 2926-2931. 

SOLVD = Studies of Left Ventricular Dysfunction. The SOLVD Investigators 1991 Effect of enalapril on survival in patients with reduced left ventricular ejection fractions and congestive heart failure. New England Journal of Medicine 325 293-302. 

In the studies of left ventricular dysfunction (SOLVD), adverse effects related to the long-term use of enalapril have been thoroughly investigated (10). 

Kostis JB, Shelton B, Gosselin G, Goulet C, Hood WB Jr, Kohn RM, Kubo SH, Schron E, Weiss MB, Willis PW 3rd, Young JB, Probstfield J. Adverse effects of enalapril in the Studies of Left Ventricular Dysfunction (SOLVD). SOLVD Investigators. Am Heart J 1996 131(2) 350-5. 

Gorkin L, Norvell NK, Rosen R, et al. Assessment of quality of life as observed from the baseline data of the Studies of Left Ventricular Dysfunction (SOLVD) trial quality-of-life substudy. Am J Cardiol 1993 71 1069-73. 

The beneficial effect of ACE inhibitors on mortality has been documented conclusively, with numerous trials showing a 20% to 30% relative reduction in mortality with ACE inhibitor therapy compared with placebo. A long-term (12-year) follow-up of the Studies of Left Ventricular Dysfunction (SOLVD) prevention and treatment trials demonstrated sustained survival benefits in patients treated with enalapril. In addition to improving survival, ACE inhibitors also reduce the combined risk of death or hospitalization, slow the progression of heart failure, and reduce the rates of reinfarction.The benefits of ACE inhibitor therapy are independent of the etiology of heart failure (ischemic versus nonischemic) and are observed in patients with mild, moderate, or severe symptoms. ACE inhibitors clearly are superior to vasodilator therapy with hydralazine-isosorbide dinitrate. ... 

Shindler D.M., Kostis J.B., Yusuf S., Quinones M.A., Pitt B., Stewart D., Pinkett T., Ghali J.K., Wilson A.C. Diabetes mellitus, a predictor of morbidity and mortality in the Studies of Left Ventricular Dysfunction (SOLVD) Trials and Registry. Am. J. Cardiol. 77 (1996) 1017-1020. 

Rogers, W.J., et al.. Quality of life among 5,025 patients with left ventricular dysfunction randomized between placebo and enalapril the Studies of Left Ventricular Dysfunction. The SOLVD Investigators. J Am Coll Cardiol, 1994. 23(2) p. 393 100. 

The development of a bedside assay for plasma BNP has focused considerable attention on the use of BNP as an aid in the diagnosis of suspected heart failure. Plasma BNP concentration is positively correlated with the degree of left ventricular dysfunction and heart failure, and this assay is now used frequently in acute care settings to assist in the differential diagnosis of dyspnea [heart failure versus asthma, chronic obstructive pulmonary disease (COPD), or infection]. Recent studies found that an elevated BNP concentration is an independent predictor of heart failure as the cause of dyspnea and that in patients with decompensated heart failure, an elevated pre-hospital discharge BNP concentration is associated with an increased risk of death or readmission. Additional research is ongoing to better characterize the role of BNP measurement in the diagnosis and treatment of heart failure. 

Chymostatin-sensitive Il-generating enzyme Carvedilol Post-Infarct Survival Control in Left Ventricular Dysfunction Trial Collaborative Study Captopril Trial ( The Effect of Angiotensin-Converting Enzyme Inhibition on Diabetic Nephropathy ) calcium channel blocking agents Candesartan in Heart Failure Assessment of Reduction in Morbidity and Mortality Trial congestive heart failure, but the latest recommendations use HF for heart failure chronic kidney disease cardiac output... 

Nishimura RA, Hayes DL, Holmes DR, Jr., Tajik AJ. Mechanism of hemodynamic improvement by dualchamber pacing for severe left ventricular dysfunction an acute Doppler and catheterization hemodynamic study. J. Am. Coll. Cardiol. 1995 25 281-8. 

Moller M, Torp-Pedersen C, Kober L. Dofetilide in patients with congestive heart failure and left ventricular dysfunction safety aspects and effect on atrial fibrillation. The Danish Investigators of Arrhythmia and Mortality on Dofetilide (DIAMOND) Study Group. Congest Heart Fail 2001 7(3) 146-50. 

Di Lenarda A, Sabbadini G, Salvatore L. Long-term effects of carvedilol in idiopathic dilated cardiomyopathy with persistent left ventricular dysfunction despite chronic metoprolol. The Heart-Muscle Disease Study Group. J Am Coll Cardiol 1999 33 1926-1934. 

The-RESOLVD-Investigators. Effects of metoprolol CR in patients with ischemic and dilated cardiomyopathy. The randomized evaluation of strategies for left ventricular dysfunction pilot study. Circulation 2000 101 378-384. 

McKelvie RS, Yusuf S, Pericak D, Avezum A, Burns RJ, Probstfield J, Tsuyuki RT, White M, Rouleau J, Latini R, Maggioni A, Young J, Pogue J. Comparison of candesartan, enalapril, and their combination in congestive heart failure randomized evaluation of strategies for left ventricular dysfunction (RESOLVD) pilot study. The RESOLVD Pilot Study Investigators. Circulation 1999 100(10) 1056-64. 

In the Eplerenone Post-Acute Myocardial Infarction Heart Failure Efficacy and Survival Study (EPHESUS), in 6632 patients with an acute myocardial infarction complicated by left ventricular dysfunction and heart failure, the addition of eplerenone 25-50 mg/day to optimal medical therapy significantly reduced all-cause mortality by 15% and cardiovascular mortality by 17% over a mean follow-up period of 16 months hospitalization rates were also reduced (29). 

Danish Investigations of Arrhythmia and Mortality ON Dofetilide. Dofetilide in patients with left ventricular dysfunction and either heart failure or acute myocardial infarction rationale, design, and patient characteristics of the DIAMOND studies. Clin Cardiol 1997 20(8) 704-10. 

The Encainide-Ventricular Tachycardia Study Group. Treatment of life-threatening ventricular tachycardia with encainide hydrochloride in patients with left ventricular dysfunction. Am J Cardiol 1988 62(9) 571-5. 

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