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Heart failure management women

Renate B Schnabel, Ladislav Pecen, Daniel Engler, Markus Lucerna, Jean Marc Sellal, Francisco M Ojeda, Raffaele De Caterina, Paulus Kirchhof
OBJECTIVES: Determinants of atrial fibrillation (AF) patterns and of progression of earlier forms to permanent AF, and their relationship with outcome are still poorly understood. METHODS: We examined AF patterns (paroxysmal, persistent and permanent), rate and predictors of AF progression, and outcomes in the PREFER (PREvention oF thromboembolic events-European Registry) in AF. The primary analysis was performed in the PREFER in AF prolongation dataset (n=3223 patients with AF with a complete 1-year follow-up, mean age 72±9 years, 40% women)...
March 17, 2018: Heart: Official Journal of the British Cardiac Society
Evann Eisenberg, Katherine E Di Palo, Ileana L Piña
Heart failure (HF) numbers continue to grow in the United States and approximately 50% of patients living with HF are women. For the provider, it is critical to understand the role that gender plays in recognition, diagnosis, and management. The purpose of this literature review is to highlight the prevalence of heart failure in women and discuss gender variations in epidemiology, symptoms, pharmacology, and treatment as well as examine the representation of women in clinical trials.
February 27, 2018: Clinical Cardiology
Richard Lee, David Carr
Cardiac emergencies in pregnancy and the postpartum period are rare but often life-threatening. An emergency physician's differential diagnosis for chest pain in the peripartum patient often includes serious etiologies such as pulmonary embolism or myocardial infarction (MI). A lesser-known but important consideration on the differential for MI is that of a spontaneous coronary artery dissection (SCAD). SCAD is defined as an intramural hematoma within the coronary artery that compresses the true lumen. Expansion by increased pressures may lead to subsequent myocardial ischemia and infarction...
February 22, 2018: CJEM
Calvin Tong, Marla Kiess, Marc William Deyell, Michael Qiu, Merav Orgad, Valerie Rychel, Ariel Claman, Emma Hardwick, Beverly McCarthy, Candice K Silversides, Jasmine Grewal
OBJECTIVES: To determine cardiac and fetal/neonatal event rates among pregnant women with premature ventricular contractions (PVCs) and compare with control groups. METHODS: Prospective case-control cohort study: 53 consecutive pregnancies in 49 women referred to the St. Paul's Hospital between 2010 and 2016 with PVC burden >1% in women without underlying cardiac disease. Maternal cardiac and fetal/neonatal outcomes were compared with two pregnant control groups: (1) supraventricular tachycardia (SVT) group of 53 women referred for a history of SVT/SVT in the current pregnancy and (2) low-risk group of 53 women with no cardiac disease...
February 20, 2018: Heart: Official Journal of the British Cardiac Society
Lusine Abrahamyan, Yeva Sahakyan, Harindra C Wijeysundera, Murray Krahn, Valeria E Rac
BACKGROUND: Although heart failure (HF) prevalence is equally high among men and women, observed differences in the provision of care are still not fully understood. We sought to evaluate gender differences in patient profiles, diagnostic testing, medication prescription, and referrals in specialized multidisciplinary ambulatory HF clinics in Ontario. MATERIALS AND METHODS: Medical chart abstraction was conducted first by randomly selecting 9 (out of 34) HF clinics in Ontario, and then by randomly selecting 100 patient records in each clinic...
January 10, 2018: Journal of Women's Health
Domenico Scrutinio, Pietro Guida, Andrea Passantino, Rocco Lagioia, Rosa Raimondo, Mario Venezia, Enrico Ammirati, Fabrizio Oliva, Miriam Stucchi, Maria Frigerio
BACKGROUND: Still there is conflicting evidence about gender-related differences in prognosis among patients with heart failure. This prognostic uncertainty may have implications for risk stratification and planning management strategy. The aim of the present study was to explore the association between gender and one-year mortality in patients admitted with acute decompensated heart failure (ADHF). METHODS: We studied 1513 patients. The Cumulative Incidence Function (CIF) method was used to estimate the absolute rate of mortality, heart transplantation (HT)/ventricular assist device (VAD) implantation, and survival free of HT/VAD implantation at 1year...
January 6, 2018: European Journal of Internal Medicine
Nabil Naser, Mehmed Kulic, Mirza Dilic, Alen Dzubur, Azra Durak, Esad Pepic, Elnur Smajic, Zumreta Kusljugic
Introduction: Atrial fibrillation represents the most common cardiac arrhythmia in clinical practice. By year 2030, 14-17 million AF patients are anticipated in the European Union. Atrial fibrillation remains one of the major causes of stroke, heart failure, sudden death all over the world. Research Objectives: The objective of our study is to determine the cardiac and cerebrovascular events (myocardial infarction, heart failure, stroke, sudden cardiac death) and their cumulative incidence during 11 years follow up period...
October 2017: Medical Archives
Giulio Cavalli, Alessandro Tomelleri, Davide Di Napoli, Elena Baldissera, Lorenzo Dagna
OBJECTIVES: Takayasu arteritis (TA), a systemic vasculitis typically occurring in female patients aged ≤40, can affect coronary arteries and cause ischemic heart disease (IHD). In this study, we investigated the prevalence of TA in young women presenting with IHD in the Emergency Department. METHODS: We evaluated hospital records of 158,860 consecutive female patients aged <40, who accessed the Emergency Department of our institution over 8 consecutive years (2007-2015)...
February 1, 2018: International Journal of Cardiology
Dana R Sax, Dustin G Mark, Renee Y Hsia, Thida C Tan, Grace H Tabada, Alan S Go
BACKGROUND: Although 80% of patients with heart failure seen in the emergency department (ED) are admitted, less is known about short-term outcomes and demand for services among discharged patients. METHODS AND RESULTS: We examined adult members of a large integrated delivery system who visited an ED for acute heart failure and were discharged from January 1, 2013, through September 30, 2014. The primary outcome was a composite of repeat ED visit, hospital admission, or death within 7 days of discharge...
December 2017: Circulation. Heart Failure
Ping Guo, Richard Harding, Irene J Higginson
PURPOSE OF REVIEW: Recognizing the rising prevalence of heart failure in China, patients with heart failure have substantial palliative needs. This review highlights recent evidence on the epidemic of heart failure, identifies needs and potential benefit of palliative care in heart failure, and sets future strategic policy and research directions in China. RECENT FINDINGS: Epidemiological studies demonstrate the prevalence of heart failure among women is higher than men in China and increases substantially with age...
March 2018: Current Opinion in Supportive and Palliative Care
Laura C van Vark, Ivonne Lesman-Leegte, Sara J Baart, Douwe Postmus, Yigal M Pinto, Rudolf A de Boer, Folkert W Asselbergs, Elly M C J Wajon, Joke G Orsel, Eric Boersma, Hans L Hillege, K Martijn Akkerhuis
BACKGROUND: Several clinical studies have evaluated the association between galectin-3 levels and outcome in patients with heart failure (HF). However, little is known about the predictive value of repeated galectin-3 measurements. This study evaluates the prognostic value of repeated time-dependent galectin-3 measurements in acute HF patients. METHODS AND RESULTS: In the TRIUMPH (Translational Initiative on Unique and Novel Strategies for Management of Patients with Heart Failure) clinical cohort study, 496 acute HF patients were enrolled in 14 hospitals in The Netherlands, between 2009 and 2014...
November 29, 2017: Journal of the American Heart Association
Lidia Castagneto Gissey, Germano Mariano, Layla Musleh, Pasquale Lepiane, Marco Colasanti, Roberto L Meniconi, Federico Ranocchi, Francesco Musumeci, Mario Antonini, Giuseppe M Ettorre
BACKGROUND: Uterine leiomyomas represent the gynecological neoplasm with the highest prevalence worldwide. This apparently benign pathological entity may permeate into the venous system causing the so-called intravenous leiomyomatosis of the uterus (IVL). IVL may seldom extend to large caliber veins and reach the right cardiac chambers or pulmonary arteries and cause signs of right sided congestive heart failure and sudden death. Due to its low incidence, however, IVL with intracardiac extension is often misdiagnosed resulting in deferred treatment...
November 29, 2017: BMC Surgery
Aliah Ali Khesroh, Faisal Al-Roumi, Ibrahim Al-Zakwani, Sreeja Attur, Wafa Rashed, Mohammad Zubaid
Background: There is controversy regarding the relationship between gender and acute coronary syndrome (ACS). Objective: To study the impact of gender on presentation, management, and mortality among patients with ACS in the Middle East. Methodology: From January 2012 to January 2013, 4057 patients with ACS were enrolled from four Arabian Gulf countries (Kuwait, Oman, United Arab Emirates, and Qatar), representing more than 85% of the general hospitals in each of the participating countries...
July 2017: Heart Views: the Official Journal of the Gulf Heart Association
Barbara Wizner, Małgorzata Fedyk-Łukasik, Grzegorz Opolski, Tomasz Zdrojewski, Adam Windak, Marcin Czech, Jacek S Dubiel, Michał Marchel, Krzysztof Rewiuk, Tomasz Rywik, Jerzy Korewicki, Tomasz Grodzicki
BACKGROUND: Organizational and educational activities in primary care in Poland have been introduced to improve the chronic heart failure (CHF) management. OBJECTIVES: To assess the use of diagnostic procedures, pharmacotherapy and referrals of CHF in primary care in Poland. METHODS: The cross-sectional survey was conducted in 2013, involving 390 primary care centres randomly selected from a national database. Trained nurses contacted primary care physicians who retrospectively filled out the study questionnaires on the previous year's CHF management in the last five patients who had recently visited their office...
December 2018: European Journal of General Practice
Lisa Adams, Michel Noutsias, Boris Bigalke, Marcus R Makowski
Coronary artery disease (CAD) is a major risk factor for the incidence and progression of heart failure (HF). HF is characterized by a substantial morbidity and mortality and its lifetime risk is estimated at approximately 20% for men and women. As patients are in most cases identified only after developing overt clinical symptoms, detecting early stages of CAD and HF is of paramount importance. Due to its non-invasiveness, excellent soft-tissue contrast, high spatial resolution, and multiparametric nature, cardiovascular magnetic resonance (CMR) imaging has emerged as a promising radiation-free technique to assess a wide range of cardiovascular diseases such as CAD or HF, enabling a comprehensive evaluation of myocardial anatomy, regional and global function, and viability with the additional benefit of in vivo tissue characterization...
November 21, 2017: ESC Heart Failure
Kangmin Yang, Han-Bing Deng, Andy W C Man, Erfei Song, Jialiang Zhang, Cuiting Luo, Bernard M Y Cheung, Kwok-Yung Yuen, Pia Søndergaard Jensen, Akhmadjon Irmukhamedov, Atlanta G I M Elie, Paul M Vanhoutte, Aimin Xu, Jo G R De Mey, Yu Wang
AIMS: Lipocalin-2 is a pro-inflammatory molecule characterized by a highly diversified pattern of expression and structure-functional relationships. In vivo, this molecule exists as multiple variants due to post-translational modifications and/or protein-protein interactions. Lipocalin-2 is modified by polyamination, which enhances the clearance of this protein from the circulation and prevents its excessive accumulation in tissues. On the other hand, animal studies suggest that non-polyaminated lipocalin-2 (npLcn2) plays a causal role in the pathogenesis of obesity-associated medical complications...
November 2017: ESC Heart Failure
D Chassard, E Verspyck
Between 2010 and 2012, 29 maternal deaths were caused by cardiovascular disease, i.e. an overall maternal mortality ratio of 1.2 per 100,000 live births. Deaths occurred in pre-existing heart disease (n=19), peripartum cardiomyopathy (n=5), or arterial rupture (n=5). Care was considered non-optimal in three of five patients with congenital heart disease and due to delayed management by specialized teams. Pregnant patients with heart disease should be considered to be at high risk of mortality or severe cardiovascular complications and therefore reoriented as soon as possible to a perinatal center with the expertise of these pathologies...
December 2017: Gynecologie, Obstetrique, Fertilite & Senologie
Bharathi Upadhya, Barbara Pisani, Dalane W Kitzman
The majority of older adults who develop heart failure (HF), particularly older women, have a preserved left ventricular ejection fraction (HFpEF). The prevalence of this syndrome is increasing, and the prognosis is not improving, unlike that of HF with reduced ejection fraction (HFrEF). Individuals with HFpEF have severe symptoms of effort intolerance, poor quality of life, frequent hospitalizations, and greater likelihood of death. Despite the importance of HFpEF, there are numerous major gaps in our understanding of its pathophysiology and management...
November 2017: Journal of the American Geriatrics Society
Maaike Giezeman, Mats Arne, Kersti Theander
OBJECTIVE: To describe adherence to international guidelines for chronic heart failure (CHF) management concerning diagnostics, pharmacological treatment and self-care behaviour in primary health care. DESIGN: A cross-sectional descriptive study of patients with CHF, using data obtained from medical records and a postal questionnaire. SETTING: Three primary health care centres in Sweden. SUBJECTS: Patients with a CHF diagnosis registered in their medical record...
December 2017: Scandinavian Journal of Primary Health Care
Laura C van Vark, Ivonne Lesman-Leegte, Sara J Baart, Douwe Postmus, Yigal M Pinto, Joke G Orsel, B Daan Westenbrink, Hans P Brunner-la Rocca, Addy J M van Miltenburg, Eric Boersma, Hans L Hillege, K Martijn Akkerhuis
BACKGROUND: Several clinical studies have evaluated the association between ST2 and outcome in patients with heart failure (HF). However, little is known about the predictive value of frequently measured ST2 levels in patients with acute HF. OBJECTIVES: This study sought to describe the prognostic value of baseline and repeated ST2 measurements in patients with acute HF. METHODS: In the TRIUMPH (Translational Initiative on Unique and novel strategies for Management of Patients with Heart failure) clinical cohort study, 496 patients with acute HF were enrolled in 14 hospitals in the Netherlands between 2009 and 2014...
November 7, 2017: Journal of the American College of Cardiology
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