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Jorge Rubio-Gracia, Biniyam G Demissei, Jozine M Ter Maaten, John G Cleland, Christopher M O'Connor, Marco Metra, Piotr Ponikowski, John R Teerlink, Gad Cotter, Beth A Davison, Michael M Givertz, Daniel M Bloomfield, Howard Dittrich, Kevin Damman, Juan I Pérez-Calvo, Adriaan A Voors
BACKGROUND: Congestion is the main reason for hospital admission for acute decompensated heart failure (ADHF). A better understanding of the clinical course of congestion and factors associated with decongestion are therefore important. We studied the clinical course, predictors and prognostic value of congestion in a cohort of patients admitted for ADHF by including different indirect markers of congestion (residual clinical congestion, brain natriuretic peptides (BNP) trajectories, hemoconcentration or diuretic response)...
May 1, 2018: International Journal of Cardiology
Hiroyuki Takahama, Seiji Takashio, Toshio Nishikimi, Tomohiro Hayashi, Chiaki Nagai-Okatani, Yasuaki Nakagawa, Makoto Amaki, Takahiro Ohara, Takuya Hasegawa, Yasuo Sugano, Hideaki Kanzaki, Satoshi Yasuda, Kenji Kangawa, Naoto Minamino, Toshihisa Anzai
BACKGROUND: A recent study showed that both glycosylation of pro-B-type natriuretic peptide (BNP) and the proBNP/total BNP ratio are decreased in acute decompensated heart failure (ADHF). However, the following points regarding the proBNP/total BNP ratio have not been determined in patients with ADHF: 1) the relationship with the severity of ADHF, 2) the changes in the ratio during treatment, and 3) the relationship with cyclic guanosine monophosphate (cGMP)-generating activity. METHODS: Plasma proBNP and total BNP (proBNP+mature BNP) were measured in patients with ADHF (n=154)...
May 1, 2018: International Journal of Cardiology
Patricia P Chang, Lisa M Wruck, Eyal Shahar, Joseph S Rossi, Laura R Loehr, Stuart D Russell, Sunil K Agarwal, Suma H Konety, Carlos J Rodriguez, Wayne D Rosamond
Background -Community trends of acute decompensated heart failure (ADHF) in diverse populations may differ by race and sex. Methods -The Atherosclerosis Risk in Communities (ARIC) Study sampled heart failure related hospitalizations (age ≥55 years) in four US communities from 2005-2014 using ICD-9-CM codes. ADHF hospitalizations were validated by standardized physician review and computer algorithm, yielding 40,173 events after accounting for sampling design (unweighted n=8746). Results -Of the ADHF hospitalizations, 50% had reduced ejection fraction (HFrEF), 39% had preserved EF (HFpEF)...
March 8, 2018: Circulation
Luke D Plant, David McDonald Taylor, Thomas Worland, Arvind Puri, Antony Ugoni, Sheila K Patel, Douglas F Johnson, Louise M Burrell
BACKGROUND: We aimed to investigate the incidence, precipitants, and outcomes of acute decompensated heart failure (ADHF) that develops during the inpatient stay. METHODS: We undertook a case-control study in the medical, oncology, surgical, and orthopaedic wards of a tertiary referral hospital (February-May, 2016). Patients aged ≥18 years who developed ADHF during their inpatient stay were enrolled as cases. One control patient was matched to each case by age, gender, presenting complaint/surgery performed and co-morbidities...
December 23, 2017: Heart, Lung & Circulation
Darko Vucicevic, Lily Honoris, Federica Raia, Mario Deng
Heart failure (HF) is a complex clinical syndrome that results from structural or functional cardiovascular disorders causing a mismatch between demand and supply of oxygenated blood and consecutive failure of the body's organs. For those patients with stage D HF, advanced therapies, such as mechanical circulatory support (MCS) or heart transplantation (HTx), are potentially life-saving options. The role of risk stratification of patients with stage D HF in a value-based healthcare framework is to predict which subset might benefit from advanced HF (AdHF) therapies, to improve outcomes related to the individual patient including mortality, morbidity and patient experience as well as to optimize health care delivery system outcomes such as cost-effectiveness...
January 2018: Annals of Cardiothoracic Surgery
Takumi Kondo, Takahisa Yamada, Shunsuke Tamaki, Takashi Morita, Yoshio Furukawa, Yusuke Iwasaki, Masato Kawasaki, Atsushi Kikuchi, Tatsuhisa Ozaki, Yoshihiro Sato, Masahiro Seo, Iyo Ikeda, Eiji Fukuhara, Makoto Abe, Jun Nakamura, Yasushi Sakata, Masatake Fukunami
BACKGROUND: Although hyponatremia predicts morbidity and mortality in acute decompensated heart failure (ADHF), hypochloremia is also independently associated with poor prognosis in ADHF. Little is known, however, about the prognostic value of serial change in serum chloride during hospitalization in ADHF patients.Methods and Results:We prospectively studied 208 ADHF survivors after discharge and divided them into 4 groups according to serum chloride on admission and at discharge: (1) persistent hypochloremia group (n=12), hypochloremia both on admission and at discharge; (2) progressive hypochloremia group (n=42), development of hypochloremia after admission; (3) improved hypochloremia group (n=14), hypochloremia only on admission; and (4) no hypochloremia group, no hypochloremia during hospitalization (n=140)...
February 22, 2018: Circulation Journal: Official Journal of the Japanese Circulation Society
O Y Narusov, D E Koshkina, V N Protasov, A A Skvortsov, V P Masenko, S N Tereshchenko, Y F Osmolovskaya, T V Kuznetsova
PURPOSE: To assess the suppression of tumorogenicity 2 (ST2) and copeptin significance for risk stratification of patient (pts) with acute decompensated heart failure (ADHF) during long-term follow-up compared with traditional risk factors. METHODS: We included in a prospective study 159 pts with ADHF. Blood samples to determine copeptin, sST2, NT-proBNP and hsTnT concentration were collected at admission and at discharge from the hospital. Serial determination of biomarker concentration was performed at 3, 6 and 12 months of follow-up...
September 2017: Kardiologiia
Y N Belenkov, A A Baranova, S N Botova, I G Pochinka, L G Strongin, A V Razumovsky, M I Dvornikova, K N Yurkova
OBJECTIVE: To assess the impact of type 2 diabetes mellitus (T2DM) on prognosis of patients hospitalized because of acute decompensated heart failure (ADHF). MATERIALS AND METHODS: We analyzed data of the hospital register of ADHF which comprised information on 735 patients (254 [35%] with T2DM) consecutively admitted in 2010-2011. Median follow‑up was 1790 days. RESULTS: The presence of T2DM was associated with increased risk of death: during the index hospitalization due to ADHF (hazard ratio [HR] 1...
September 2017: Kardiologiia
Madeline R Sterling, Monika M Safford, Kathryn Goggins, Sam K Nwosu, Jonathan S Schildcrout, Kenneth A Wallston, Amanda S Mixon, Russell L Rothman, Sunil Kripalani
BACKGROUND: Numeracy, health literacy, and cognition are important for chronic disease management. Prior studies have found them to be associated with poorer selfcare and worse clinical outcomes, but limited data exists in the context of heart failure (HF), a condition that requires patients to monitor their weight, fluid intake, and dietary salt, especially in the posthospitalization period. OBJECTIVE: To examine the relationship between numeracy, health literacy, and cognition with 30-day readmissions among patients hospitalized for acute decompensated HF (ADHF)...
February 12, 2018: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
Luke J Laffin, Amit V Patel, Narayan Saha, Julian Barbat, James K Hall, Matthew Cain, Kishan Parikh, Jay Shah, Kirk T Spencer
Acute decompensated heart failure (ADHF) is a common reason for admission to the hospital, and readmission is frequent. Multiple factors contribute to rehospitalizations, but inadequate assessment of volume status leading to persistent congestion is an important factor. We sought to determine if focused cardiac ultrasound (FCU) of the inferior vena cava (IVC), as a surrogate of volume status, would predict readmission of ADHF patients after index hospitalization. Patients admitted with a primary diagnosis of ADHF were prospectively enrolled...
February 15, 2018: International Journal of Cardiovascular Imaging
Caíque Bueno Terhoch, Henry Fukuda Moreira, Silvia Moreira Ayub-Ferreira, Germano Emilio Conceição-Souza, Vera Maria Cury Salemi, Paulo Roberto Chizzola, Mucio Tavares Oliveira, Silvia Helena Gelas Lage, Edimar Alcides Bocchi, Victor Sarli Issa
AIMS: Explore the association between clinical findings and prognosis in patients with acute decompensated heart failure (ADHF) and analyze the influence of etiology on clinical presentation and prognosis. METHODS AND RESULTS: Prospective cohort of 500 patients admitted with ADHF from Aug/2013-Feb/2016; patients were predominantly male (61.8%), median age was 58 (IQ25-75% 47-66 years); etiology was dilated cardiomyopathy in 141 (28.2%), ischemic heart disease in 137 (27...
February 2018: PLoS Neglected Tropical Diseases
José Luis Morales-Rull, Silvia Bielsa, Alicia Conde-Martel, Oscar Aramburu-Bodas, Pau Llàcer, Miguel Angel Quesada, Iván Suárez-Pedreira, Luis Manzano, Manuel Montero-Pérez Barquero, José M Porcel
BACKGROUND: The incidence of pleural effusions (PEs) in acute decompensated heart failure (ADHF) is not well established. We aimed to determine their prevalence, clinical characteristics and prognostic implications. METHODS: Retrospective review of 3245 consecutive patients with ADHF from the Spanish RICA Registry. The clinical characteristics of those with or without PEs on chest radiographs were compared and a predictive PE model was generated. RESULTS: Patient's median age was 80 years and 60% had a left ventricular ejection fraction (LVEF) >50%...
February 7, 2018: European Journal of Internal Medicine
Richard H Tran, Ahmed Aldemerdash, Patricia Chang, Carla A Sueta, Brystana Kaufman, Josephine Asafu-Adjei, Orly Vardeny, Eliza Daubert, Khalid A Alburikan, Anna M Kucharska-Newton, Sally C Stearns, Jo E Rodgers
BACKGROUND: Modification of guideline-directed medical therapy (GDMT) in hospitalized patients with heart failure (HF) has not been extensively evaluated. METHODS: The community surveillance arm of the Atherosclerosis Risk in Communities Study identified 6959 HF hospitalizations from 2005 to 2011. Predictors of GDMT modification and survival were assessed using multivariable logistic regression and Cox proportional hazards models. RESULTS: For 5091 hospitalizations, patient mean age was 75 years old, 53% were female, 69% were Caucasian, and 81% had acute decompensated HF (ADHF)...
February 9, 2018: Pharmacotherapy
Azusa Murata, Takatoshi Kasai, Yuya Matsue, Hiroki Matsumoto, Shoichiro Yatsu, Takao Kato, Shoko Suda, Masaru Hiki, Atsutoshi Takagi, Hiroyuki Daida
Although elevated blood urea nitrogen (BUN)-to-creatinine (BUN/Cr) ratio at hospital admission has been reported to be associated with poor short-term prognosis, its association to long-term mortality in patients with acute decompensated heart failure (ADHF) remains to be elucidated. Moreover, an additive prognostic value to preexisting renal markers including creatinine and BUN has not been well described. A cohort of 557 consecutive ADHF patients admitted to the cardiac intensive care unit was studied. All cohorts were divided into high and low BUN/Cr ratios according to the median value of BUN/Cr ratio at admission...
February 7, 2018: Heart and Vessels
Makiko Nakamura, Osahiko Sunagawa, Koichiro Kinugawa
It is unknown whether a response to tolvaptan (TLV) is related to prognosis in patients with acute decompensated heart failure (ADHF). We selected 25 patients as responders by their urinary response to TLV and by reduction of loop diuretics from 37 consecutive ADHF patients treated with TLV. As a control group, we selected 25 patients from 100 consecutive ADHF patients who were not treated with TLV by propensity score matching for age, serum sodium level, serum creatinine level, plasma B-type natriuretic peptide (BNP) level, systolic blood pressure, heart rate, and dose of loop diuretics...
2018: International Heart Journal
J Jiratham-Opas, R Kanjanavanit, W Wongcharoen, B Punyawudho, P Arunmanakul, A Amaritakomol, P Topaiboon, S Gunaparn, A Phrommintikul
WHAT IS KNOWN AND OBJECTIVE: Digoxin is commonly prescribed for heart failure patients with reduced ejection fraction (HFrEF) and patients with atrial fibrillation (AF). Due to digoxin's narrow therapeutic range, monitoring the serum digoxin concentration (SDC) is important. However, the SDC measurement is not widely available. Equations using clinical parameters can be employed to estimate the SDC but have never been studied in the Thai population. Therefore, we conducted this study to evaluate the correlation between the measured SDC and predicted digoxin level using 2 commonly used equations: the Konishi equation and the Koup and Jusko equation...
January 24, 2018: Journal of Clinical Pharmacy and Therapeutics
Steven C Chase, Caitlin C Fermoyle, Courtney M Wheatley, Jacob J Schaefer, Lyle J Olson, Bruce D Johnson
AIMS: The effect of extravascular lung water (EVLW) and relationship to functional status as a result of acute decompensated heart failure (ADHF) are not well understood. We sought to quantify changes in clinical variables, EVLW, airway anatomy, spirometry, and diffusing capacity for carbon monoxide before and after treatment for ADHF. METHODS AND RESULTS: Fifteen patients were recruited within 24 h of hospital admission. Spirometry, diffusing capacity for carbon monoxide, and surrogates of EVLW by computed tomography were measured and were then repeated within 24 h of discharge...
January 18, 2018: ESC Heart Failure
Kenneth C Bilchick, Nathaniel Chishinga, Alex M Parker, David X Zhuo, Mitchell H Rosner, LaVone A Smith, Hunter Mwansa, Jacob N Blackwell, Peter A McCullough, Sula Mazimba
Background: Plasma volume (PV) is contracted in stable patients with heart failure (HF) due to decongestion strategies. On the other hand, increased PV can adversely affect the trajectory of HF. We therefore examined the effects of increased percentage change in PV (%ΔPV), blood urea nitrogen (BUN), and %ΔPV stratified by BUN and glomerular filtration rate (GFR) on survival after discharge in patients hospitalized for acute decompensated HF (ADHF). Methods: We used the Strauss-Davis-Rosenbaum formula to calculate the %ΔPV between baseline and hospital discharge in a cohort from the Evaluation Study of Congestive Heart Failure and Pulmonary Artery Catheterization Effectiveness trial (ESCAPE)...
December 2017: Cardiorenal Medicine
Keiichi Tsuchida, Yuki Fujihara, Jiro Hiroki, Takahiro Hakamata, Ryohei Sakai, Kota Nishida, Koji Sudo, Komei Tanaka, Yukio Hosaka, Kazuyoshi Takahashi, Hirotaka Oda
In patients with chronic heart failure (HF), the clinical importance of sarcopenia has been recognized in relation to disease severity, reduced exercise capacity, and adverse clinical outcome. Nevertheless, its impact on acute decompensated heart failure (ADHF) is still poorly understood. Dual-energy X-ray absorptiometry (DXA) is a technique for quantitatively analyzing muscle mass and the degree of sarcopenia. Fat-free mass index (FFMI) is a noninvasive and easily applicable marker of muscle mass.This was a prospective observational cohort study comprising 38 consecutive patients hospitalized for ADHF...
January 15, 2018: International Heart Journal
Min Joo Ahn, Min Chul Kim, Youngkeun Ahn, Doo Sun Sim, Young Joon Hong, Ju Han Kim, Myung Ho Jeong, Jeong Gwan Cho, Jong Chun Park
It remains unclear whether complete revascularization (CR) reduces the incidences of acute decompensated heart failure (ADHF) and adverse cardiac outcomes in patients with ST-segment elevation myocardial infarction (STEMI) and multivessel coronary artery disease (MVD). A total of 453 hemodynamically stable patients with STEMI and MVD were retrospectively evaluated; the patients were divided into 2 groups according to interventional strategy: CR (n = 240) and incomplete revascularization (IR) (n = 213)...
March 1, 2018: American Journal of Cardiology
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