Evidence mapPaperPMID 39098615Full record

ArticleInternational journal of cardiology2024

Impact of guideline directed medical therapy on myocardial function in adults with congenital heart disease.

Carley Bright, Afshan Rizvi, Francis Ezekwueme, Mary Schiff, Jennifer Kliner, Morgan Hindes, Kyla Thorn, Vanessa Kowalski, Patricia Hovanec, Ashley Draxinger and 11 more

Abstract read
In one paragraph

Article in International journal of cardiology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed.

  1. Article
  2. Single Ventricle Fontan: The Basics for General Cardiologists.Methodist DeBakey cardiovascular journal · 2026
    Review
  3. Article
  4. Review
  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

21 authors.

Carley BrightDivision of Cardiology, Department of Pediatrics, Children's Hospital of Pittsburgh, University of Pittsburgh, Pittsburgh, PA 15312, United States of America; Heart Institute, UPMC Children's Hospital of Pittsburgh and UPMC Heart and Vascular Institute, Pittsburgh, PA 15312, United States of America.
Afshan RizviDivision of Cardiology, Department of Pediatrics, Children's Hospital of Pittsburgh, University of Pittsburgh, Pittsburgh, PA 15312, United States of America; Heart Institute, UPMC Children's Hospital of Pittsburgh and UPMC Heart and Vascular Institute, Pittsburgh, PA 15312, United States of America.
Francis EzekwuemeHeart Institute, UPMC Children's Hospital of Pittsburgh and UPMC Heart and Vascular Institute, Pittsburgh, PA 15312, United States of America.
Mary SchiffHeart Institute, UPMC Children's Hospital of Pittsburgh and UPMC Heart and Vascular Institute, Pittsburgh, PA 15312, United States of America.
Jennifer KlinerDivision of Cardiology, Department of Medicine, University of Pittsburgh, Pittsburgh, PA 15213, United States of America.
Morgan HindesHeart Institute, UPMC Children's Hospital of Pittsburgh and UPMC Heart and Vascular Institute, Pittsburgh, PA 15312, United States of America.
Kyla ThornHeart Institute, UPMC Children's Hospital of Pittsburgh and UPMC Heart and Vascular Institute, Pittsburgh, PA 15312, United States of America.
Vanessa KowalskiHeart Institute, UPMC Children's Hospital of Pittsburgh and UPMC Heart and Vascular Institute, Pittsburgh, PA 15312, United States of America.
Patricia HovanecHeart Institute, UPMC Children's Hospital of Pittsburgh and UPMC Heart and Vascular Institute, Pittsburgh, PA 15312, United States of America.
Ashley DraxingerHeart Institute, UPMC Children's Hospital of Pittsburgh and UPMC Heart and Vascular Institute, Pittsburgh, PA 15312, United States of America.
Melissa CostaHeart Institute, UPMC Children's Hospital of Pittsburgh and UPMC Heart and Vascular Institute, Pittsburgh, PA 15312, United States of America.
Natasha WolfeHeart Institute, UPMC Children's Hospital of Pittsburgh and UPMC Heart and Vascular Institute, Pittsburgh, PA 15312, United States of America; Division of Cardiology, Department of Medicine, University of Pittsburgh, Pittsburgh, PA 15213, United States of America.
Tarek AlsaiedDivision of Cardiology, Department of Pediatrics, Children's Hospital of Pittsburgh, University of Pittsburgh, Pittsburgh, PA 15312, United States of America; Heart Institute, UPMC Children's Hospital of Pittsburgh and UPMC Heart and Vascular Institute, Pittsburgh, PA 15312, United States of America.
Adam ChristopherDivision of Cardiology, Department of Pediatrics, Children's Hospital of Pittsburgh, University of Pittsburgh, Pittsburgh, PA 15312, United States of America; Heart Institute, UPMC Children's Hospital of Pittsburgh and UPMC Heart and Vascular Institute, Pittsburgh, PA 15312, United States of America.
Jacqueline KreutzerDivision of Cardiology, Department of Pediatrics, Children's Hospital of Pittsburgh, University of Pittsburgh, Pittsburgh, PA 15312, United States of America; Heart Institute, UPMC Children's Hospital of Pittsburgh and UPMC Heart and Vascular Institute, Pittsburgh, PA 15312, United States of America.
Sunil PatelUPMC Heart and Vascular Institute, Harrisburg, PA 17101, United States of America.
Arvind HoskoppalDivision of Cardiology, Department of Pediatrics, Children's Hospital of Pittsburgh, University of Pittsburgh, Pittsburgh, PA 15312, United States of America; Heart Institute, UPMC Children's Hospital of Pittsburgh and UPMC Heart and Vascular Institute, Pittsburgh, PA 15312, United States of America; Division of Cardiology, Department of Medicine, University of Pittsburgh, Pittsburgh, PA 15213, United States of America.
Samir SabaHeart Institute, UPMC Children's Hospital of Pittsburgh and UPMC Heart and Vascular Institute, Pittsburgh, PA 15312, United States of America.
Laura OlivieriDivision of Cardiology, Department of Pediatrics, Children's Hospital of Pittsburgh, University of Pittsburgh, Pittsburgh, PA 15312, United States of America; Heart Institute, UPMC Children's Hospital of Pittsburgh and UPMC Heart and Vascular Institute, Pittsburgh, PA 15312, United States of America.
Bryan H GoldsteinDivision of Cardiology, Department of Pediatrics, Children's Hospital of Pittsburgh, University of Pittsburgh, Pittsburgh, PA 15312, United States of America; Heart Institute, UPMC Children's Hospital of Pittsburgh and UPMC Heart and Vascular Institute, Pittsburgh, PA 15312, United States of America.
Anita SarafHeart Institute, UPMC Children's Hospital of Pittsburgh and UPMC Heart and Vascular Institute, Pittsburgh, PA 15312, United States of America; Division of Cardiology, Department of Medicine, University of Pittsburgh, Pittsburgh, PA 15213, United States of America. Electronic address: saraf@pitt.edu.

Funding

Molecular and Functional Evaluation of NOTCH1 Deficient iPSC Derived Cardiomyocytes in Hypoplastic Left Heart SyndromeK08HL161440 · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · 2025 to 2025
$161k
NHLBI NIH HHS K08 HL161440
6 · The paper itself

Abstract

backgroundGuideline-directed heart failure therapy with angiotensin receptor blocker/neprilysin inhibitor (ARNi) and sodium-glucose transporter inhibitors (SGLT2i) has been incrementally beneficial in improving outcomes in heart failure patients.

objectiveEvaluate the feasibility and efficacy of guideline-directed medical therapy (GDMT) in adults congenital heart disease (ACHD) patients.

methodsIn a retrospective cohort study, ACHD patients with either New York Heart Association (NYHA) Class II symptoms or systemic ejection fraction (EF) <45%, optimized on a combination of beta-blocker (BB), ARNi, mineralocorticoid receptor antagonist (MRA) and SGLT2i were evaluated.

resultsForty-six patients with a mean age 42.6 ± 12.1 years prescribed GDMT were identified. Twenty-eight (61%) were male, 20 (43%) had a systemic right ventricle (RV) and 9 (20%) had single-ventricle physiology. Over the optimization period, 20 (43%) were sustained on ARNi and 42 (91%) on SGLT2i in addition to treatment with BB and MRA. Over a period of 45 weeks, echocardiography parameters for left ventricle (LV) ejection fraction (EF) (+7.5%, p = 0.006), systemic ventricle (SV) velocity time integral (VTI) (+1.9 cm, p = 0.012) and LV global longitudinal strain (GLS) (-2.5%, p = 0.005) improved when 3-4 medications were used versus 1-2 medications alone. The use of either ARNi or SGLT2i (+8.1%, p = 0.017) or in combination (+7.0%, p = 0.043) increased LVEF compared to the use of neither medication.

conclusionCombination GDMT is beneficial in improving myocardial characteristics in ACHD patients with systemic RV and LV.

Indexed as

Heart Defects, CongenitalAdultAngiotensin Receptor AntagonistsCohort StudiesFemaleHeart FailureHumansMaleMiddle AgedNeprilysinPractice Guidelines as TopicRetrospective StudiesSodium-Glucose Transporter 2 InhibitorsStroke VolumeTreatment OutcomeAngiotensin Receptor AntagonistsNeprilysinSodium-Glucose Transporter 2 InhibitorsAdult congenital heart diseaseGuideline-directed medical therapyHeart failureSingle ventricleSystemic right ventricle

Identifiers

PMID39098615
PMCPMC11816014

What Socratic holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.