Isosorbide Dinitrate and Hydralazine in a Fixed-Dose Combination Produces Further Regression of Left Ventricular Remodeling in a Well-Treated Black Population With Heart Failure: Results From A-HeFT

Jay N. Cohn; S. William Tam; Inder S. Anand; Anne L. Taylor; Michael L. Sabolinski; Manuel Worcel

doi:10.1016/j.cardfail.2007.03.001

Isosorbide Dinitrate and Hydralazine in a Fixed-Dose Combination Produces Further Regression of Left Ventricular Remodeling in a Well-Treated Black Population With Heart Failure: Results From A-HeFT

Jay N. Cohn, S. William Tam, Inder S. Anand, Anne L. Taylor, Michael L. Sabolinski, Manuel Worcel

Medicine - Cardiology Division

Research output: Contribution to journal › Article › peer-review

66 Scopus citations

Abstract

Background: Isosorbide dinitrate combined with hydralazine therapy compared with placebo in patients with heart failure resulted in a sustained increase in left ventricular (LV) ejection fraction (EF) indicative of regression of LV remodeling in the first Vasodilator-Heart Failure Trial (V-HeFT-I) in patients receiving only digoxin and diuretic. In the African-American Heart Failure Trial (A-HeFT) a fixed-dose combination resulted in a 43% reduction in mortality in 1050 black patients with heart failure already treated with recommended neurohormonal inhibiting drugs. Whether the fixed-dose combination produces a further regression of LV remodeling when added to renin-angiotensin and sympathetic inhibitors has not been documented. Methods and Results: Echocardiograms at baseline and 6 months after randomization to placebo or a fixed-dose combination of isosorbide dinitrate/hydralazine (FDC I/H) were analyzed in 678 A-HeFT participants in a core laboratory. LVEF rose by 2.8 EF units in the FDC I/H group versus 0.8% in the control group (P < .01), LV mass index fell by 7.4 g/m² in the FDC I/H group versus an increase of 1.4 g/m² in the placebo group (P < .05), LV diastolic transverse diameter fell by 2.2 mm in FDC I/H and was unchanged in placebo (P < .01), and the LV systolic and diastolic sphericity indices improved in the FDC I/H group but remained unchanged in the placebo group. The mean plasma B-type natriuretic peptide (BNP) also measured in a core laboratory fell in the FDC I/H group by 39 pg/mL compared with 8 pg/mL in the placebo group (P = .05). Conclusions: A fixed-dose combination of I/H produces regression of LV remodeling when added to background therapy with renin-angiotensin and sympathetic inhibitors in black patients with heart failure. This remodeling benefit may explain at least in part the mortality reduction in A-HeFT.

Original language	English (US)
Pages (from-to)	331-339
Number of pages	9
Journal	Journal of cardiac failure
Volume	13
Issue number	5
DOIs	https://doi.org/10.1016/j.cardfail.2007.03.001
State	Published - Jun 2007

Bibliographical note

Funding Information:
A-HeFT was supported by NitroMed. The fixed-dose combination of isosorbide dinitrate and hydralazine was provided as BiDil.

Keywords

Echocardiography
heart failure
mortality
nitric oxide
remodeling

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access

10.1016/j.cardfail.2007.03.001

OpenUrl availability

Full text

Cite this

Cohn, J. N., Tam, S. W., Anand, I. S., Taylor, A. L., Sabolinski, M. L., & Worcel, M. (2007). Isosorbide Dinitrate and Hydralazine in a Fixed-Dose Combination Produces Further Regression of Left Ventricular Remodeling in a Well-Treated Black Population With Heart Failure: Results From A-HeFT. Journal of cardiac failure, 13(5), 331-339. https://doi.org/10.1016/j.cardfail.2007.03.001

Isosorbide Dinitrate and Hydralazine in a Fixed-Dose Combination Produces Further Regression of Left Ventricular Remodeling in a Well-Treated Black Population With Heart Failure: Results From A-HeFT. / Cohn, Jay N.; Tam, S. William; Anand, Inder S. et al.
In: Journal of cardiac failure, Vol. 13, No. 5, 06.2007, p. 331-339.

Research output: Contribution to journal › Article › peer-review

Cohn, JN, Tam, SW, Anand, IS, Taylor, AL, Sabolinski, ML & Worcel, M 2007, 'Isosorbide Dinitrate and Hydralazine in a Fixed-Dose Combination Produces Further Regression of Left Ventricular Remodeling in a Well-Treated Black Population With Heart Failure: Results From A-HeFT', Journal of cardiac failure, vol. 13, no. 5, pp. 331-339. https://doi.org/10.1016/j.cardfail.2007.03.001

@article{f514acfb1d754349be666efe22159e5a,

title = "Isosorbide Dinitrate and Hydralazine in a Fixed-Dose Combination Produces Further Regression of Left Ventricular Remodeling in a Well-Treated Black Population With Heart Failure: Results From A-HeFT",

abstract = "Background: Isosorbide dinitrate combined with hydralazine therapy compared with placebo in patients with heart failure resulted in a sustained increase in left ventricular (LV) ejection fraction (EF) indicative of regression of LV remodeling in the first Vasodilator-Heart Failure Trial (V-HeFT-I) in patients receiving only digoxin and diuretic. In the African-American Heart Failure Trial (A-HeFT) a fixed-dose combination resulted in a 43% reduction in mortality in 1050 black patients with heart failure already treated with recommended neurohormonal inhibiting drugs. Whether the fixed-dose combination produces a further regression of LV remodeling when added to renin-angiotensin and sympathetic inhibitors has not been documented. Methods and Results: Echocardiograms at baseline and 6 months after randomization to placebo or a fixed-dose combination of isosorbide dinitrate/hydralazine (FDC I/H) were analyzed in 678 A-HeFT participants in a core laboratory. LVEF rose by 2.8 EF units in the FDC I/H group versus 0.8% in the control group (P < .01), LV mass index fell by 7.4 g/m2 in the FDC I/H group versus an increase of 1.4 g/m2 in the placebo group (P < .05), LV diastolic transverse diameter fell by 2.2 mm in FDC I/H and was unchanged in placebo (P < .01), and the LV systolic and diastolic sphericity indices improved in the FDC I/H group but remained unchanged in the placebo group. The mean plasma B-type natriuretic peptide (BNP) also measured in a core laboratory fell in the FDC I/H group by 39 pg/mL compared with 8 pg/mL in the placebo group (P = .05). Conclusions: A fixed-dose combination of I/H produces regression of LV remodeling when added to background therapy with renin-angiotensin and sympathetic inhibitors in black patients with heart failure. This remodeling benefit may explain at least in part the mortality reduction in A-HeFT.",

keywords = "Echocardiography, heart failure, mortality, nitric oxide, remodeling",

author = "Cohn, {Jay N.} and Tam, {S. William} and Anand, {Inder S.} and Taylor, {Anne L.} and Sabolinski, {Michael L.} and Manuel Worcel",

note = "Funding Information: A-HeFT was supported by NitroMed. The fixed-dose combination of isosorbide dinitrate and hydralazine was provided as BiDil. ",

year = "2007",

month = jun,

doi = "10.1016/j.cardfail.2007.03.001",

language = "English (US)",

volume = "13",

pages = "331--339",

journal = "Journal of cardiac failure",

issn = "1071-9164",

publisher = "Churchill Livingstone",

number = "5",

}

TY - JOUR

T1 - Isosorbide Dinitrate and Hydralazine in a Fixed-Dose Combination Produces Further Regression of Left Ventricular Remodeling in a Well-Treated Black Population With Heart Failure

T2 - Results From A-HeFT

AU - Cohn, Jay N.

AU - Tam, S. William

AU - Anand, Inder S.

AU - Taylor, Anne L.

AU - Sabolinski, Michael L.

AU - Worcel, Manuel

N1 - Funding Information: A-HeFT was supported by NitroMed. The fixed-dose combination of isosorbide dinitrate and hydralazine was provided as BiDil.

PY - 2007/6

Y1 - 2007/6

N2 - Background: Isosorbide dinitrate combined with hydralazine therapy compared with placebo in patients with heart failure resulted in a sustained increase in left ventricular (LV) ejection fraction (EF) indicative of regression of LV remodeling in the first Vasodilator-Heart Failure Trial (V-HeFT-I) in patients receiving only digoxin and diuretic. In the African-American Heart Failure Trial (A-HeFT) a fixed-dose combination resulted in a 43% reduction in mortality in 1050 black patients with heart failure already treated with recommended neurohormonal inhibiting drugs. Whether the fixed-dose combination produces a further regression of LV remodeling when added to renin-angiotensin and sympathetic inhibitors has not been documented. Methods and Results: Echocardiograms at baseline and 6 months after randomization to placebo or a fixed-dose combination of isosorbide dinitrate/hydralazine (FDC I/H) were analyzed in 678 A-HeFT participants in a core laboratory. LVEF rose by 2.8 EF units in the FDC I/H group versus 0.8% in the control group (P < .01), LV mass index fell by 7.4 g/m2 in the FDC I/H group versus an increase of 1.4 g/m2 in the placebo group (P < .05), LV diastolic transverse diameter fell by 2.2 mm in FDC I/H and was unchanged in placebo (P < .01), and the LV systolic and diastolic sphericity indices improved in the FDC I/H group but remained unchanged in the placebo group. The mean plasma B-type natriuretic peptide (BNP) also measured in a core laboratory fell in the FDC I/H group by 39 pg/mL compared with 8 pg/mL in the placebo group (P = .05). Conclusions: A fixed-dose combination of I/H produces regression of LV remodeling when added to background therapy with renin-angiotensin and sympathetic inhibitors in black patients with heart failure. This remodeling benefit may explain at least in part the mortality reduction in A-HeFT.

AB - Background: Isosorbide dinitrate combined with hydralazine therapy compared with placebo in patients with heart failure resulted in a sustained increase in left ventricular (LV) ejection fraction (EF) indicative of regression of LV remodeling in the first Vasodilator-Heart Failure Trial (V-HeFT-I) in patients receiving only digoxin and diuretic. In the African-American Heart Failure Trial (A-HeFT) a fixed-dose combination resulted in a 43% reduction in mortality in 1050 black patients with heart failure already treated with recommended neurohormonal inhibiting drugs. Whether the fixed-dose combination produces a further regression of LV remodeling when added to renin-angiotensin and sympathetic inhibitors has not been documented. Methods and Results: Echocardiograms at baseline and 6 months after randomization to placebo or a fixed-dose combination of isosorbide dinitrate/hydralazine (FDC I/H) were analyzed in 678 A-HeFT participants in a core laboratory. LVEF rose by 2.8 EF units in the FDC I/H group versus 0.8% in the control group (P < .01), LV mass index fell by 7.4 g/m2 in the FDC I/H group versus an increase of 1.4 g/m2 in the placebo group (P < .05), LV diastolic transverse diameter fell by 2.2 mm in FDC I/H and was unchanged in placebo (P < .01), and the LV systolic and diastolic sphericity indices improved in the FDC I/H group but remained unchanged in the placebo group. The mean plasma B-type natriuretic peptide (BNP) also measured in a core laboratory fell in the FDC I/H group by 39 pg/mL compared with 8 pg/mL in the placebo group (P = .05). Conclusions: A fixed-dose combination of I/H produces regression of LV remodeling when added to background therapy with renin-angiotensin and sympathetic inhibitors in black patients with heart failure. This remodeling benefit may explain at least in part the mortality reduction in A-HeFT.

KW - Echocardiography

KW - heart failure

KW - mortality

KW - nitric oxide

KW - remodeling

UR - http://www.scopus.com/inward/record.url?scp=34250793851&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=34250793851&partnerID=8YFLogxK

U2 - 10.1016/j.cardfail.2007.03.001

DO - 10.1016/j.cardfail.2007.03.001

M3 - Article

C2 - 17602978

AN - SCOPUS:34250793851

SN - 1071-9164

VL - 13

SP - 331

EP - 339

JO - Journal of cardiac failure

JF - Journal of cardiac failure

IS - 5

ER -

Isosorbide Dinitrate and Hydralazine in a Fixed-Dose Combination Produces Further Regression of Left Ventricular Remodeling in a Well-Treated Black Population With Heart Failure: Results From A-HeFT

Abstract

Bibliographical note

Keywords

UN SDGs

Access

OpenUrl availability

Other files and links

Fingerprint

Cite this