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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
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
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
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
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
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
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
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
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
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
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
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
Sharma Kattel, Takatoshi Kasai, Hiroki Matsumoto, Shoichiro Yatsu, Azusa Murata, Takao Kato, Shoko Suda, Masaru Hiki, Atsutoshi Takagi, Hiroyuki Daida
BACKGROUND: The effect of elevated blood glucose (BG) levels on the long-term prognosis of acute decompensated heart failure (ADHF) patients has not been well defined. The purpose of this study is to evaluate the long-term prognosis of ADHF with elevated BG. METHODS: A cohort of patients consecutively admitted to the cardiac intensive care unit from 2007 to 2011 was studied. Among these, 495 patients who met the criteria were divided into 4 groups based on their BG level and diabetes mellitus (DM) status...
August 20, 2016: Journal of Cardiology
Charbel Abi Khalil, Jassim Al Suwaidi, Rajvir Singh, Nidal Asaad, Galal Abushahba, Unus Kunju, Awad Al-Qahtani, Hajar A AlBinali
BACKGROUND: Beta-blockers reduce mortality in chronic heart failure. OBJECTIVES: To study intra-hospital mortality and adverse cardiovascular (CV) outcomes in relation to beta-blockade therapy in acute decompensated heart failure. METHODS: We retrospectively analyzed a 22-year registry of acute decompensated heart failure (ADHF) in the Middle East. RESULTS: Out of the total 8066 patients admitted for ADHF, 1242(15.4%) were on beta-blockers on admission...
August 22, 2016: Current Vascular Pharmacology
D Stolfo, E Stenner, M Merlo, A G Porto, C Moras, G Barbati, A Aleksova, A Buiatti, G Sinagra
BACKGROUND: The significance of worsening renal function (WRF) in patients admitted for acute decompensated heart failure (ADHF) is still controversial. We hypothesised that changes in brain natriuretic peptide (BNP) might identify patients with optimal diuretic responsiveness resulting in transient WRF, not negatively affecting the prognosis. Our aim was to verify if in-hospital trends of BNP might be helpful in the stratification of patients with WRF after treatment for ADHF. METHODS: 122 consecutive patients admitted for ADHF were enrolled...
July 19, 2016: Heart, Lung & Circulation
Mahoto Kato, Kazuto Tohyama, Toshiyuki Ohya, Takafumi Hiro, Atsushi Hirayama
BACKGROUND: Tolvaptan (TLV) is a useful diuretic for acute decompensated heart failure (ADHF) with fluid overload, but its clinical response varies between patients. The aim of this study is to investigate whether plasma TLV concentrations correlate with the urine volume. METHODS: ADHF inpatients with evidence of fluid overload and total urine volume < 1,500 mL 24 hours after initial intravenous administration of 40 mg furosemide were included in the study. On days 1-7, 7...
August 12, 2016: Cardiology Journal
Abdulla A Damluji, Conrad Macon, Arieh Fox, Grettel Garcia, Mohammed S Al-Damluji, George R Marzouka, Robert J Myerburg, Ian C Gilchrist, Mauricio G Cohen, Mauro Moscucci
INTRODUCTION: The effect of acute changes of hemoglobin during index heart failure admission on long-term outcomes remains unknown. METHODS: We examined 433 patients enrolled in the ESCAPE trial. RESULTS: Of the 433 patients, 324 (75%) had baseline and discharge hemoglobin available for analysis. Of those, 64 (20%) had at least 1g/dL drop of hemoglobin by time of discharge. Compared to patients without hemoglobin changes (g/dL), patients with hemoglobin drop were older (59 vs...
November 1, 2016: International Journal of Cardiology
Marvin Louis Roy Lu, Carlos D Davila, Mahek Shah, David S Wheeler, Mary Rodriguez Ziccardi, Sourin Banerji, Vincent M Figueredo
UNLABELLED: Socioeconomic factors, including social support, may partially explain why African Americans (AA) have the highest prevalence of heart failure and with worse outcomes compared to other races. AA are more likely to be hospitalized and readmitted for heart failure and have higher mortality. The purpose of this study is to determine whether the social factors of marital status and living condition affect readmission rates and all-cause mortality following hospitalization for acute decompensated heart failure (ADHF) in AA patients...
November 1, 2016: International Journal of Cardiology
Aida Hamzić-Mehmedbašić, Senija Rašić, Merima Balavac, Damir Rebić, Marina Delić-Šarac, Azra Durak-Nalbantić
INTRODUCTION: Data regarding prognostic factors of post-discharge mortality and adverse renal function outcome in acute kidney injury (AKI) hospital survivors are scarce and controversial. OBJECTIVES: We aimed to identify predictors of post-discharge mortality and adverse renal function outcome in AKI hospital survivors. PATIENTS AND METHODS: The study group consisted of 84 AKI hospital survivors admitted to the tertiary medical center during 2-year period...
2016: Journal of Renal Injury Prevention
Yoshitaka Okuhara, Shinichi Hirotani, Tomotaka Ando, Koichi Nishimura, Yoshiyuki Orihara, Kazuo Komamura, Yoshiro Naito, Toshiaki Mano, Tohru Masuyama
Hypertonic saline with furosemide has been proposed for a long time as an effective therapeutic option for the treatment of acute decompensated heart failure (ADHF). We previously reported the efficacy of continuous infusion of 1.7 % hypertonic saline plus low-dose furosemide in treatment for ADHF. Although this therapeutic strategy can be a useful option for effective decongestion in treatment for ADHF, there is no study that assesses the effect and safety of saline supplementation compared with standard therapy in Japan...
July 28, 2016: Heart and Vessels
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