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https://www.readbyqxmd.com/read/27894126/brain-type-natriuretic-peptide-and-amino-terminal-pro-brain-type-natriuretic-peptide-discharge-thresholds-for-acute-decompensated-heart-failure-a-systematic-review
#1
Casey N McQuade, Marisa Mizus, Joyce W Wald, Lee Goldberg, Mariell Jessup, Craig A Umscheid
Background: Acute decompensated heart failure (ADHF) requiring hospitalization is associated with high postdischarge mortality and readmission rates. Purpose: To examine the association between achieving predischarge natriuretic peptide (NP) thresholds and mortality and readmission rates in adults hospitalized for ADHF. Data Sources: Multiple databases from 1947 to October 2016 (English-language studies only). Study Selection: Trials and observational studies that compared mortality and readmission outcomes between patients with ADHF achieving a specific predischarge NP goal and those not achieving the goal...
November 29, 2016: Annals of Internal Medicine
https://www.readbyqxmd.com/read/27863352/ultrafiltration-for-acute-decompensated-cardiac-failure-a-systematic-review-and-meta-analysis
#2
Chun Shing Kwok, Chun Wai Wong, Claire A Rushton, Fozia Ahmed, Colin Cunnington, Simon J Davies, Ashish Patwala, Mamas A Mamas, Duwarakan Satchithananda
BACKGROUND: Ultrafiltration is a method used to achieve diuresis in acute decompensated heart failure (ADHF) when there is diuretic resistance, but its efficacy in other settings is unclear. We therefore conducted a systematic review and meta-analysis to evaluate the use of ultrafiltration in ADHF. METHODS: We searched MEDLINE and EMBASE for studies that evaluated outcomes following filtration compared to diuretic therapy in ADHF. The outcomes of interest were body weight change, change in renal function, length of stay, frequency of rehospitalization, mortality and dependence on dialysis...
November 9, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27834898/an-admission-to-discharge-bnp-increase-is-a-predictor-of-six-month-all-cause-death-in-adhf-patients-inferences-from-multivariate-analysis-including-admission-bnp-and-various-clinical-measures-of-congestion
#3
Renato De Vecchis, Carmelina Ariano, Cesare Baldi
BACKGROUND: According to some authors, a single isolated measurement of serum B-type natriuretic peptide (BNP) executed on hospital admission would not be a sufficiently accurate method to predict the outcome of patients with acute decompensated heart failure (ADHF). AIMS: To verify this assumption, a retrospective study was conducted on patients hospitalized for ADHF. Our main objective was to ascertain whether there was any difference in midterm mortality among patients with increasing BNP at discharge as compared with those with decreasing BNP at discharge...
November 10, 2016: Journal of Clinical Medicine
https://www.readbyqxmd.com/read/27829716/association-of-hyponatremia-with-in-hospital-outcomes-in-infective-endocarditis-a-5-year-review-from-an-indian-intensive-care-unit
#4
Saraschandra Vallabhajosyula, Muralidhar D Varma, Shashaank Vallabhajosyula, Saarwaani Vallabhajosyula
Hyponatremia is commonly noted with cardiovascular disorders, but its role in infective endocarditis (IE) is limited to being a marker of increased morbidity in IE patients with intravenous drug use. This was a 5-year retrospective review from an Indian Intensive Care Unit (ICU). Patients >18 years with IE and available serum sodium levels were included in the study. Pediatric and pregnant patients were excluded from the study. Hyponatremia was defined as admission sodium <135 mmol/L. Detailed data were abstracted from the medical records...
October 2016: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/27824904/circulating-omega-6-but-not-omega-3-polyunsaturated-fatty-acids-are-associated-with-clinical-outcomes-in-patients-with-acute-decompensated-heart-failure
#5
Toshiyuki Nagai, Yasuyuki Honda, Yasuo Sugano, Kunihiro Nishimura, Michikazu Nakai, Satoshi Honda, Naotsugu Iwakami, Atsushi Okada, Yasuhide Asaumi, Takeshi Aiba, Teruo Noguchi, Kengo Kusano, Hisao Ogawa, Satoshi Yasuda, Toshihisa Anzai
BACKGROUND: Circulating polyunsaturated fatty acid (PUFA) levels are associated with clinical outcomes in cardiovascular diseases including coronary artery disease and chronic heart failure (HF). However, their clinical implications in acute decompensated HF (ADHF) remain unclear. The aim of this study was to investigate the clinical roles of circulating PUFAs in patients with ADHF. METHODS: Circulating levels of PUFAs, eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA), arachidonic acid (AA) and dihomo-gamma linoleic acid (DGLA), were measured on admission in 685 consecutive ADHF patients...
2016: PloS One
https://www.readbyqxmd.com/read/27818781/subclinical-hypothyroidism-is-an-independent-predictor-of-adverse-cardiovascular-outcomes-in-patients-with-acute-decompensated-heart-failure
#6
Tomohiro Hayashi, Takuya Hasegawa, Hideaki Kanzaki, Akira Funada, Makoto Amaki, Hiroyuki Takahama, Takahiro Ohara, Yasuo Sugano, Satoshi Yasuda, Hisao Ogawa, Toshihisa Anzai
AIMS: Altered thyroid hormone metabolism characterized by a low triiodothyronine (T3), so-called low-T3 syndrome, is a common finding in patients with severe systemic diseases. Additionally, subclinical thyroid dysfunction, defined as abnormal thyroid stimulating hormone (TSH) and normal thyroxine (T4), causes left ventricular dysfunction. Our objective was to identify the prevalence and prognostic impact of low-T3 syndrome and subclinical thyroid dysfunction in patients with acute decompensated heart failure (ADHF)...
September 2016: ESC Heart Failure
https://www.readbyqxmd.com/read/27788392/changes-in-natriuretic-peptides-after-acute-hospital-presentation-for-heart-failure-with-preserved-ejection-fraction-a-feasible-surrogate-trial-endpoint-a-report-from-the-prospective-karen-study
#7
Gianluigi Savarese, Erwan Donal, Camilla Hage, Emmanuel Oger, Hans Persson, Jean-Claude Daubert, Cecilia Linde, Lars H Lund
BACKGROUND: In acute decompensated heart failure (ADHF) with preserved ejection fraction (HFpEF) there are no surrogate endpoints for early phase trials. The aim of the current study was to evaluate whether a reduction in natriuretic peptides (NP) between acute hospital presentation to stable follow-up is associated with improved mortality and morbidity. METHODS: Patients presenting acutely to the hospital for ADHF with HFpEF enrolled in the Karolinska Rennes (KaRen) study and reporting N-terminal pro-B-type NP or B-type NP assessment at baseline hospital presentation and at 4-8weeks follow-up were prospectively studied...
October 17, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27782093/effects-of-hyponatremia-normalization-on-the-short-term-mortality-and-rehospitalizations-in-patients-with-recent-acute-decompensated-heart-failure-a-retrospective-study
#8
Renato De Vecchis, Marco Di Maio, Giuseppina Di Biase, Carmelina Ariano
Background: Several studies have shown that hyponatremia is associated with increased risk of rehospitalization and death in patients with heart failure. In these studies, chronic heart failure (CHF) patients with persistent hyponatremia were compared only with CHF patients with a normal sodium level at hospital admission. Aims: In the present retrospective study, conducted in a cohort of patients with recent acute decompensated heart failure (ADHF), all with hyponatremia ascertained at the time of hospital admission, we aimed to evaluate the effect of the normalization of serum sodium on the composite endpoint of short-term rehospitalization and mortality...
October 22, 2016: Journal of Clinical Medicine
https://www.readbyqxmd.com/read/27769970/evolving-therapies-for-the-management-of-chronic-and-acute-decompensated-heart-failure
#9
Jennifer C Cook, Richard H Tran, J Herbert Patterson, Jo E Rodgers
PURPOSE: The pharmacology, clinical efficacy, and safety profiles of evolving therapies for the management of chronic heart failure (HF) and acute decompensated heart failure (ADHF) are described. SUMMARY: HF confers a significant financial burden despite the widespread use of traditional guideline-directed medical therapies such as angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, β-blockers, and aldosterone receptor antagonists, and the rates of HF-related mortality and hospitalization have remained unacceptably high...
November 1, 2016: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/27682424/the-usefulness-of-the-delta-neutrophil-index-for-predicting-superimposed-pneumonia-in-patients-with-acute-decompensated-heart-failure-in-the-emergency-department
#10
Yong Sung Cha, Kang Hyun Lee, Jong Wook Lee, Woocheol Kwon, Seok Jeong Lee, Kyung Sik Kang, Hyung Il Kim, Oh Hyun Kim, Kyoung-Chul Cha, Hyun Kim, Sung Oh Hwang
BACKGROUND: Although respiratory infections, such as pneumonia, have long been recognized as precipitators of exacerbation in patients with acute decompensated heart failure (ADHF), identifying signs of concomitant pneumonia in ADHF is a clinical diagnostic challenge. We evaluated the predictive value of the delta neutrophil index (DNI), a new indicator for immature granulocytes, for diagnosing superimposed pneumonia in patients presenting with ADHF in the emergency department (ED). METHODS: This was a retrospective and observational study of consecutive patients (>18 years old) diagnosed with an ADHF in the ED over a 7-month period...
2016: PloS One
https://www.readbyqxmd.com/read/27669547/role-of-isolated-ultrafiltration-in-the-management-of-chronic-refractory-and-acute-decompensated-heart-failure
#11
Mayank K Mittal, Natraj Katta, Martin A Alpert
Chronic congestive heart failure (CHF) and acute decompensated heart failure (ADHF) refractory to medical therapy represent therapeutic challenges. In such patients, attempts to reduce pulmonary and systemic congestion frequently produce deterioration of renal function. In studies of patients with chronic severe CHF refractory to medical therapy (including loop diuretics), isolated ultrafiltration was frequently able to relieve congestive symptoms by precise removal of extracellular water and sodium, and in some cases was able to restore responsiveness to loop diuretics...
October 2016: Hemodialysis International
https://www.readbyqxmd.com/read/27638544/acute-decompensated-heart-failure
#12
Drayton A Hammond, Melanie N Smith, Kristen C Lee, Danielle Honein, April Miller Quidley
Heart failure (HF) is a societal burden due to its high prevalence, frequent admissions for acute decompensated heart failure (ADHF), and the economic impact of direct and indirect costs associated with HF and ADHF. Common etiologies of ADHF include medication and diet noncompliance, arrhythmias, deterioration in renal function, poorly controlled hypertension, myocardial infarction, and infections. Appropriate medical management of ADHF in patients is guided by the identification of signs and symptoms of fluid overload or low cardiac output and utilization of evidence-based practices...
September 16, 2016: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/27635179/change-of-serum-bnp-between-admission-and-discharge-after-acute-decompensated-heart-failure-is-a-better-predictor-of-6-month-all-cause-mortality-than-the-single-bnp-value-determined-at-admission
#13
Renato De Vecchis, Carmelina Ariano, Giuseppe Giandomenico, Marco Di Maio, Cesare Baldi
BACKGROUND: B-type natriuretic peptide (BNP) is regarded as a reliable predictor of outcome in patients with acute decompensated heart failure (ADHF). However, according to some scholars, a single isolated measurement of serum BNP at the time of hospital admission would not be sufficient to provide reliable prognostic information. METHODS: A retrospective study was carried out on patients hospitalized for ADHF, who had then undergone follow-up of at least 6 months, in order to see if there was any difference in midterm mortality among patients with rising BNP at discharge as compared to those with decreasing BNP at discharge...
October 2016: Journal of Clinical Medicine Research
https://www.readbyqxmd.com/read/27634557/insufficient-reduction-in-heart-rate-during-hospitalization-despite-beta-blocker-treatment-in-acute-decompensated-heart-failure-insights-from-the-ascend-hf-trial
#14
Takeshi Kitai, Justin L Grodin, Robert J Mentz, Adrian F Hernandez, Javed Butler, Marco Metra, John J McMurray, Paul W Armstrong, Randall C Starling, Christopher M O'Connor, Karl Swedberg, W H Wilson Tang
AIMS: Heart failure (HF) can be associated with a higher resting heart rate (HR), and an elevated HR is associated with adverse long-term events. However, the mechanistic and causal role of HR in HF is unclear. This study aimed to investigate changes in HR during hospitalization, and the association between discharge HR and clinical outcomes as well as an interaction with beta-blocker therapy in patients with acute decompensated HF (ADHF). METHODS AND RESULTS: We studied 2906 patients with an LVEF ≤35%, without AF, who were enrolled in the ASCEND-HF trial...
September 16, 2016: European Journal of Heart Failure
https://www.readbyqxmd.com/read/27631119/patient-activation-in-acute-decompensated-heart-failure
#15
Shannon M Dunlay, Joan M Griffin, Margaret M Redfield, Véronique L Roger
BACKGROUND: Recent data suggest that patient activation, or having the knowledge, skills, and confidence to engage and manage one's own health, favorably impacts patient behaviors and health outcomes. However, the role of activation in patients with heart failure is unknown. OBJECTIVES: The aims of this study are to measure the level of activation of patients hospitalized with acute decompensated heart failure (ADHF) and to determine whether activation is associated with in-hospital and early postdischarge outcomes...
September 13, 2016: Journal of Cardiovascular Nursing
https://www.readbyqxmd.com/read/27622896/emergency-heart-failure-mortality-risk-grade-score-performance-for-7-day-mortality-prediction-in-patients-with-heart-failure-attended-at-the-emergency-department-validation-in-a-spanish-cohort
#16
Víctor Gil, Òscar Miró, Michael J Schull, Pere Llorens, Pablo Herrero, Javier Jacob, José Ríos, Douglas S Lee, Francisco J Martín-Sánchez
OBJECTIVE: The Emergency Heart Failure Mortality Risk Grade (EHMRG) scale, derived in 86 Canadian emergency departments (EDs), stratifies patients with acute-decompensated heart failure (ADHF) according to their 7-day mortality risk. We evaluated its external validity in a Spanish cohort. PATIENTS AND METHODS: We applied the EHMRG scale to ADHF patients consecutively included in the Epidemiology of Acute Heart Failure in Emergency departments (EAHFE) registry (29 Spanish EDs) and measured its performance...
September 10, 2016: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/27620387/superior-performance-of-n-terminal-pro-brain-natriuretic-peptide-for-diagnosis-of-acute-decompensated-heart-failure-in-an-asian-compared-with-a-western-setting
#17
Irwani Ibrahim, Win Sen Kuan, Chris Frampton, Richard Troughton, Oi Wah Liew, Jenny Pek Ching Chong, Siew Pang Chan, Li Ling Tan, Wei Qin Lin, Chris J Pemberton, Shirley Beng Suat Ooi, A Mark Richards
AIMS: This study was conducted to test the diagnostic performance of NT-proBNP for discrimination of acute decompensated heart failure (ADHF) among breathless patients presenting in an Asian compared with a Western centre. METHODS AND RESULTS: Patients with breathlessness were prospectively and contemporaneously recruited in Emergency Departments in Singapore and New Zealand (NZ). The diagnosis of ADHF was adjudicated by two clinician specialists. A total of 606 patients were recruited in Singapore and 500 in NZ...
September 13, 2016: European Journal of Heart Failure
https://www.readbyqxmd.com/read/27613439/the-utilization-and-prognostic-impact-of-b-type-natriuretic-peptide-in-hospitalized-acute-decompensated-heart-failure-in-an-asian-population
#18
Li Juen Chen, Chung-Lieh Hung, Hung-I Yeh, Mei-Jy Jeng, Cheng-Huang Su, Te-Yu Wu, Shou-Chuan Shih, Cheng-Ho Tsai
BACKGROUND: B-type natriuretic peptide (BNP) levels during admission have been shown to have prognostic value in the diagnosis of heart failure and further predict the in-hospital mortality of acute decompensated heart failure (ADHF). This study describes the characteristics of BNP among hospitalized ADHF and elucidates its prognostic value of in-hospital mortality in an Asian population. METHODS: We consecutively studied patients aged 20+ who were discharged with a diagnosis of ADHF from March 2013 to March 2014 in a tertiary hospital of northern Taiwan by reviewing medical records...
2016: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/27592046/acute-decompensated-heart-failure-adhf-a-comprehensive-contemporary-review-on-preventing-early-readmissions-and-postdischarge-death
#19
Bruno M L Rocha, Luiz Menezes Falcão
Heart failure (HF) is an increasingly prevalent syndrome and a leading cause of both first hospitalization and readmissions. Strikingly, up to 25% of the patients are readmitted within 30 to 60-days, accounting for HF as the primary cause for readmission in the adult population. Given its poor prognosis, one could describe it as a "malignant condition". Acute decompensation is intrinsically related to increased right heart tele-diastolic pressures and often related to congestive symptoms. In-hospital strategies to adequately compensate and timely discharge patients are limited...
November 15, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27590414/the-beneficial-prognostic-value-of-hemoconcentration-is-negatively-affected-by-hyponatremia-in-acute-decompensated-heart-failure-data-from-the-korean-heart-failure-korhf-registry
#20
Jaewon Oh, Seok-Min Kang, In-Cheol Kim, Seongwoo Han, Byung-Su Yoo, Dong-Ju Choi, Jae-Joong Kim, Eun-Seok Jeon, Myeong-Chan Cho, Byung-Hee Oh, Shung Chull Chae, Myung-Mook Lee, Kyu-Hyung Ryu
BACKGROUND: Hemoconcentration (HC) is associated with reduced mortality, whereas hyponatremia (HN) has been associated with an increased risk of adverse outcomes in patients with acute decompensated heart failure (ADHF). We sought to determine if the presence of HN influences the beneficial prognostic value of HC in ADHF patients. METHODS: We analyzed 2046 ADHF patients from the Korean Heart Failure Registry. We defined HC as an increased hemoglobin level from admission to discharge, and HN as sodium <135mmol/L at admission...
August 30, 2016: Journal of Cardiology
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