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https://www.readbyqxmd.com/read/28062350/discordance-of-patient-reported-and-clinician-ordered-resuscitation-status-in-patients-hospitalized-with-acute-decompensated-heart-failure
#1
Kathleen A Young, Sara E Wordingham, Jacob J Strand, Vėronique L Roger, Shannon M Dunlay
CONTEXT: Accurate documentation of preferences for cardiopulmonary resuscitation at hospital admission is critical to ensure that patients receive resuscitation or not in accordance with their wishes. OBJECTIVES: We sought to identify and characterize inconsistencies in patient-reported and clinician-ordered resuscitation status in patients hospitalized with acute decompensated heart failure (ADHF). METHODS: Southeastern Minnesota residents hospitalized with ADHF were prospectively enrolled into a study that included the administration of face-to-face questionnaires from January 2014 through February 2016...
January 3, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28059841/insights-into-cardiorenal-interactions-in-acute-decompensated-heart-failure
#2
Feras M Bader, Nizar Attallah
PURPOSE OF REVIEW: Acute decompensated heart failure (ADHF) is one of the biggest challenges in the management of chronic heart failure. Despite the advances in medical and device therapy, high readmission and mortality rates continue to be a burden on healthcare systems worldwide. One of the strongest predictors of adverse outcomes in ADHF is renal dysfunction, referred to as cardiorenal syndrome (CRS) type 1. This review discusses some of the recently introduced findings related to the pathophysiology, diagnosis, and management of this disorder...
January 3, 2017: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/28050472/use-of-lung-ultrasound-for-diagnosing-acute-heart-failure-in-emergency-department-of-southern-india
#3
Manav Aggarwal, Mrigakshi Gupta, Vikrant Vijan, Anjith Vupputuri, Sanjeev Chintamani, Bishnukiran Rajendran, Rajesh Thachathodiyal, Rajiv Chandrasekaran
INTRODUCTION: Diagnosing heart failure is often a challenge for the healthcare providers due to it's non-specific and usually subtle physical presentations. The outcomes for treatment are strongly related to the stage of the disease. Considering the importance of early and accurate diagnosis, it is important to have an easy, inexpensive, non-invasive, reliable and reproducible method for diagnosis of heart failure. Recent advancement in radiology and cardiology are supporting the emerging technique of lung ultrasound through B-line evaluation for identifying extravascular lung water...
November 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28008296/point-of-care-ultraportable-echocardiography-predicts-diuretic-response-in-patients-admitted-with-acute-decompensated-heart-failure
#4
Dena K Krishnan, Barbara Pawlaczyk, Peter A McCullough, Susan Enright, Arvind Kunadi, Thomas E Vanhecke
BACKGROUND: Routine management of patients with acute decompensated heart failure (ADHF) requires careful attentiveness to fluid status and diuretic treatment efficacy. New advances in ultrasound have made ultraportable echocardiography (UE) available to physicians for point-of-care use. The purpose of this study is to explore physiologic measures of intravascular fluid volume derived from UE and explore predictors of diuretic response in ADHF. METHODS: Various echocardiography imaging measurements, particularly diameter and collapse of inferior vena cava (IVC), were collected from 77 patients admitted with a primary diagnosis of ADHF...
2016: Clinical Medicine Insights. Cardiology
https://www.readbyqxmd.com/read/28005170/improv-ed-study-outcomes-after-discharge-for-an-episode-of-acute-decompensated-heart-failure-and-comparison-between-patients-discharged-from-the-emergency-department-and-hospital-wards
#5
Òscar Miró, Víctor Gil, Carolina Xipell, Carolina Sánchez, Sira Aguiló, Francisco J Martín-Sánchez, Pablo Herrero, Javier Jacob, Alexandre Mebazaa, Veli-Pekka Harjola, Pere Llorens
OBJECTIVE: To define the short- and mid-term outcomes of patients discharged after an episode of acute-decompensated heart failure (ADHF) and evaluate the differences between patients discharged directly from the emergency department (ED) and those discharged after hospitalization. METHODS: We performed a prospective, multicenter, cohort-designed study, including consecutive patients diagnosed with ADHF in 27 Spanish EDs. Thirty-four variables on epidemiology, comorbidity, baseline status, vital signs, signs of congestion, laboratory tests, and treatment were collected in every patient...
December 22, 2016: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
https://www.readbyqxmd.com/read/27939586/use-of-biomarkers-to-predict-readmission-for-congestive-heart-failure
#6
Sangita Sudharshan, Eric Novak, Karl Hock, Mitchell G Scott, Edward M Geltman
Acute decompensated heart failure (ADHF) is a major reason for repeated hospitalizations. Identifying those patients with ADHF at risk for readmission is critical so that preventive interventions can be implemented. Biomarkers such as B-type natriuretic peptide (BNP), high-sensitivity troponin I, and galectin-3 (Gal-3) assessed at discharge may be useful, although their role in predicting short-term readmission is not well defined in the literature. We enrolled and had follow-up data for 101 participants admitted to our facility from April 2013 to March 2015 with a primary diagnosis of ADHF...
February 1, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/27938912/improvements-of-central-respiratory-events-cheyne-stokes-respiration-and-oxygenation-in-patients-hospitalized-for-acute-decompensated-heart-failure
#7
Kristina Basic, Henrik Fox, Jens Spießhöfer, Thomas Bitter, Dieter Horstkotte, Olaf Oldenburg
BACKGROUND: Sleep-disordered breathing (SDB), and Cheyne-Stokes respiration (CSR) in particular, are associated with reduced survival in patients with acute decompensated heart failure (ADHF). CSR cycle length (CL) has been shown to mirror heart failure severity and therefore may be a predictor of outcome. However, studies characterizing CSR in ADHF are rare and no study has investigated changes in CSR from admission to discharge in ADHF patients. METHODS: Consecutive patients admitted to our Academic Medical Center with ADHF were eligible...
November 2016: Sleep Medicine
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
#8
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
#9
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...
February 1, 2017: 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
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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