ORLANDO, Fla. — Heart failure patients with preserved ejection fraction (HFpEF) — where the heart becomes stiff and cannot relax or fill properly — did not have increased exercise tolerance after taking isosorbide mononitrate, compared to a placebo, according to a study presented today at the American Heart Association’s Scientific Sessions 2015. The findings come from the National Heart, Lung, and Blood Institute’s Heart Failure Clinical Research Network and are also published in the New England Journal of Medicine.
Importantly, the HFpEF patients’ daily activity level was assessed with accelerometers, devices patients wore to measure movement throughout the study. Daily activity progressively and significantly decreased as the dose of the nitrate increased, says Margaret Redfield, M.D., first author and cardiologist at Mayo Clinic’s Rochester, Minnesota, campus.
“It is important to relieve symptoms in heart failure, so patients can be more active. Inactivity perpetuates deconditioning and frailty in heart failure,” Dr. Redfield says. “While nitrates are commonly prescribed for symptom relief in HFpEF, the effects of nitrates in patients with HFpEF have not been studied.”
In a multicenter, randomized, double-blind, two-period, 12-week crossover study called the Nitrate’s Effect on Activity Tolerance in Heart Failure with Preserved Ejection Fraction (NEAT-HFpEF) Trial, 110 patients with HFpEF at 20 sites were studied. Patients were randomized into one of two treatment groups:
Six weeks of placebo first, followed by six weeks of isosorbide mononitrate
Six weeks of isosorbide mononitrate, followed by six weeks of placebo
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Journalists: Sound bites with Dr. Redfield are available in the downloads.