Isosorbide mononitrate in heart failure with preserved ejection fraction - New England Journal of Medicine - 2015

Brief Summary:

In patients with HFpEF (LVEF ≥ 50%) and mild-moderate (NYHA II-III) symptoms, the addition of the long-acting nitrate isosorbide mononitrate appears to hinder rather than improve activity level. Patients on nitrate therapy had a borderline significant reduction in total activity units as well as about a 20-minute absolute reduction in activity time per day. There was no effect of nitrate therapy on 6-minute walk distance, quality of life, or clinical biomarkers.