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https://www.readbyqxmd.com/read/28611787/lack-of-diuretic-efficiency-but-not-low-diuresis-early-in-an-acutely-decompensated-heart-failure-episode-is-associated-with-increased-180-day-mortality
#1
João Pedro Ferreira, Nicolas Girerd, Pedro Bettencourt Medeiros, Miguel Bento Ricardo, Tiago Almeida, Alexandre Rola, Faiez Zannad, Patrick Rossignol, Irene Aragão
INTRODUCTION: The assessment of the amount of urine produced by the dose of administered diuretic has been proposed as the main signal of interest in diuretic responsiveness - diuretic efficiency (DE). The main aim of our study is to determine if a low DE is associated with 180-day all-cause mortality (ACM). METHODS: During a 3-year period, we retrospectively studied patients with acutely decompensated heart failure (ADHF) and respiratory insufficiency admitted to the emergency room of a tertiary university hospital in Porto, Portugal...
February 2017: Cardiorenal Medicine
https://www.readbyqxmd.com/read/28597798/ultrafiltration-versus-intravenous-loop-diuretics-in-patients-with-acute-decompensated-heart-failure-a-meta-analysis-of-clinical-trials
#2
Mohamad Kabach, Hassan Alkhawam, Sachil Shah, Georges Joseph, Elie M Donath, Noah Moss, Robert S Rosenstein, Robert Chait
Background Intravenous loop diuretics are the first-line therapy for acute decompensated heart failure (ADHF) but many patients are discharged with unresolved congestion resulting in higher re-hospitalization and mortality rates. Ultrafiltration (UF) is a promising intervention for ADHF. However, studies comparing UF to diuretics have been inconsistent in their clinical outcomes. Methods A comprehensive literature search was performed. Trials were included if they met the following criteria: (1) randomization with a control group, (2) comparison of UF with a loop diuretic, and (3) a diagnosis of ADHF...
April 2017: Acta Cardiologica
https://www.readbyqxmd.com/read/28552064/management-of-blood-pressure-and-heart-rate-in-acute-decompensated-heart-failure-with-volume-overload
#3
Duygu Kocyigit, Kadri Murat Gurses, Muhammed Ulvi Yalcin, Lale Tokgozoglu
BACKGROUND Heart failure (HF) is a global health problem. Like most chronic diseases, HF also courses with acute exacerbations, which have been found to be associated with significant morbidity and mortality. A substantial proportion of acute decompensated heart failure (ADHF) patients clinically present with volume overload. METHODS The goal of this work was to review the current literature and recent guidelines of European Society of Cardiology and American Heart Association/ American College of Cardiology regarding the management strategies in patients with ADHF and volume overload...
May 25, 2017: Current Pharmaceutical Design
https://www.readbyqxmd.com/read/28506551/early-in-hospital-variation-of-red-blood-cell-distribution-width-predicts-mortality-in-patients-with-acute-heart-failure
#4
Gianni Turcato, Elisabetta Zorzi, Daniele Prati, Giorgio Ricci, Antonio Bonora, Massimo Zannoni, Antonio Maccagnani, Gian Luca Salvagno, Fabian Sanchis-Gomar, Gianfranco Cervellin, Giuseppe Lippi
BACKGROUND: Some studies showed that the value of red blood cell distribution width (RDW) at admission may predict clinical outcomes in patients with acutely decompensated heart failure (ADHF). Therefore, this study was planned to investigate whether in-hospital variations of RDW may also predict mortality in this condition. METHODS: The final study population consisted of 588 patients admitted to the local Emergency Department (ED), who were hospitalized for ADHF...
May 6, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28499978/salt-taste-recognition-in-a-heart-failure-cohort
#5
Laura P Cohen, Scott L Hummel, Mathew S Maurer, Sara López-Pintado, Jeffrey D Wessler
BACKGROUND: Heart failure (HF) disproportionately affects older adults. Dietary sodium indiscretion is frequently implicated in HF decompensation. The affinity for and ability to taste salt in this process is unexplored. We sought to evaluate differences in salt taste by age and HF diagnosis and to map changes after hospitalization for acute decompensated heart failure (ADHF). METHODS: Seventy-two subjects underwent initial salt-taste testing during hospitalization for ADHF...
May 10, 2017: Journal of Cardiac Failure
https://www.readbyqxmd.com/read/28475215/effect-of-inpatient-dobutamine-vs-milrinone-on-out-of-hospital-mortality-in-patients-with-acute-decompensated-heart-failure
#6
Jordan B King, Rashmee U Shah, Amy Sainski-Nguyen, Joseph Biskupiak, Mark A Munger, Adam P Bress
STUDY OBJECTIVE: To determine the effect of dobutamine versus milrinone on out-of-hospital mortality in treatment of patients with acute decompensated heart failure (ADHF). DESIGN: Propensity score weighted, retrospective cohort study with mortality as primary outcome. SETTING: An academic health-care system. PATIENTS: 500 adult patients with a prior history of heart failure, who survived a hospitalization for ADHF that included treatment with dobutamine or milrinone between January 1, 2006 and April 30, 2014...
May 5, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/28460776/pathophysiology-of-the-cardio-renal-syndromes-types-1-5-an-uptodate
#7
REVIEW
L Di Lullo, A Bellasi, V Barbera, D Russo, L Russo, B Di Iorio, M Cozzolino, C Ronco
According to the recent definition proposed by the Consensus conference on Acute Dialysis Quality Initiative Group, the term cardio-renal syndrome (CRS) has been used to define different clinical conditions in which heart and kidney dysfunction overlap. Type 1 CRS (acute cardio- renal syndrome) is characterized by acute worsening of cardiac function leading to AKI (5, 6) in the setting of active cardiac disease such as ADHF, while type - 2 CRS occurs in a setting of chronic heart disease. Type 3 CRS is closely link to acute kidney injury (AKI), while type 4 represent cardiovascular involvement in chronic kidney disese (CKD) patients...
March 2017: Indian Heart Journal
https://www.readbyqxmd.com/read/28456315/usefulness-of-the-direct-and-or-total-bilirubin-to-predict-adverse-outcomes-in-patients-with-acute-decompensated-heart-failure
#8
Atsushi Okada, Yasuo Sugano, Toshiyuki Nagai, Yasuyuki Honda, Naotsugu Iwakami, Hiroki Nakano, Seiji Takashio, Satoshi Honda, Yasuhide Asaumi, Takeshi Aiba, Teruo Noguchi, Kengo Kusano, Satoshi Yasuda, Toshihisa Anzai
Abnormal liver function test results are often observed in acute decompensated heart failure (ADHF). However, the prognostic value of bilirubin fractionation has not been elucidated. The prognostic value of direct bilirubin (DB), in comparison with total bilirubin (TB), was examined in 556 consecutive patients with ADHF. Patients with elevated DB showed mostly similar patient characteristics including signs of elevated right-sided pressure (frequent hepatomegaly, jugular venous distention, dilated inferior vena cava, and elevated gamma-glutamyltransferase) and decreased cardiac output (cold extremities, decreased pulse pressure, and lower blood pressure) and other parameters of heart failure (HF) severity (increased plasma renin activity, decreased sodium, total cholesterol, and ejection fraction) to elevated TB; however, only patients with elevated DB showed a significant difference in the frequency of HF history and alkaline phosphatase value...
March 29, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28438307/usefulness-of-the-combination-of-in-hospital-poor-diuretic-response-and-systemic-congestion-to-predict-future-cardiac-events-in-patients-with-acute-decompensated-heart-failure
#9
Soichiro Aoki, Takahiro Okumura, Akinori Sawamura, Katsuhide Kitagawa, Ryota Morimoto, Masaki Sakakibara, Toyoaki Murohara
We aimed to (1) investigate the relation between diuretic response (DR) with or without systemic congestion and prognosis and (2) explore the potential predictors of poor DR for risk stratification in patients with acute decompensated heart failure (ADHF). We enrolled 186 consecutive patients hospitalized for ADHF. The DR was defined as (body weight at discharge - body weight at admission)/40 mg furosemide or equivalent loop diuretic dose. Systemic congestion on admission was simply evaluated by the presence of leg edema or jugular venous distention...
March 29, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28395889/identification-of-acute-decompensated-heart-failure-hospitalizations-using-administrative-data
#10
Hans Huang, Matthew Turner, Srihari Raju, Jon Reich, Sarah Leatherman, Katherine Armstrong, Patricia Woods, Ryan E Ferguson, Louis D Fiore, Frank A Lederle
Hospitalization for acute decompensated heart failure (ADHF) is an important outcome in clinical trials and heart failure registries; however, the optimal strategy to identify these hospitalizations using International Classification of Diseases, Ninth Revision (ICD-9) codes is uncertain. We sought to identify diagnostic codes that improve ascertainment of ADHF hospitalizations. Heart failure-related ICD-9 principal discharge codes were used to identify 2,202 hospitalizations within the Minneapolis Veterans Affairs Medical Center from 2009 to 2014...
June 1, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28379962/persistent-increase-in-cardiac-troponin-t-at-hospital-discharge-predicts-repeat-hospitalization-in-patients-with-acute-decompensated-heart-failure
#11
Seiji Takashio, Toshiyuki Nagai, Yasuo Sugano, Satoshi Honda, Atsushi Okada, Yasuhide Asaumi, Takeshi Aiba, Teruo Noguchi, Kengo F Kusano, Hisao Ogawa, Satoshi Yasuda, Toshihisa Anzai
BACKGROUND: High-sensitive cardiac troponin T (hsTnT) is a sensitive biomarker of myocardial damage and predictor of acute decompensated heart failure (ADHF). However, there is little information on changes over time in hsTnT level during ADHF management. The aim of this prospective study was to evaluate changes in hsTnT levels between admission and at discharge in patients with ADHF, and identify factors that determine such levels and their prognostic significance. METHODS AND RESULTS: We evaluated 404 ADHF patients with abnormal hsTnT levels (≥0...
2017: PloS One
https://www.readbyqxmd.com/read/28376504/discontinuation-dose-reduction-of-angiotensin-converting-enzyme-inhibitors-angiotensin-receptor-blockers-during-acute-decompensated-heart-failure-in-african-american-patients-with-reduced-left-ventricular-ejection-fraction
#12
Jesse A Kane, Joseph K Kim, Syed Abbas Haidry, Louis Salciccioli, Jason Lazar
OBJECTIVES: Patients with heart failure (HF) and reduced left-ventricular ejection fraction (LVEF) benefit from angiotensin-converting enzyme inhibitors (ACEI) and angiotensin receptor blocker (ARB) therapy. While dose reduction/discontinuation (r/d) of β-blockers (BB) and furosemide in acute decompensated HF (ADHF) worsen outcomes, data on ACEI/ARB are lacking. METHODS: To determine the frequency and reasons for ACEI/ARB therapy r/d in ADHF patients, we studied 174 patients with LVEF <40% on ACEI/ARB and BB therapy upon admission over 1 year...
2017: Cardiology
https://www.readbyqxmd.com/read/28374342/the-effect-of-intravenous-isosorbide-dinitrate-in-acute-decompensated-heart-failure-in-hospital
#13
Jérémy Chambord, David Attivi, Véronique Thuus, Claire Zeghmouli, Stéphane Gibaud
Background According to new recommendations for the management of acute decompensated heart failure (ADHF) in 2015, intravenous vasodilator therapy might be given as an early therapy when systolic blood pressure is normal to high (≥110 mmHg). Only 29% of patients with ADHF are treated with vasodilators without medical contraindication. Objective To evaluate the effect of the systematic use of ISDN on ADHF without contraindication especially on rehospitalization rate. Settings The 600-bed hospital (Centre Hospitalier de l'Ouest Vosgien, Neufchâteau, France)...
April 3, 2017: International Journal of Clinical Pharmacy
https://www.readbyqxmd.com/read/28364091/effect-of-intensive-blood-pressure-treatment-on-heart-failure-events-in-the-systolic-blood-pressure-reduction-intervention-trial
#14
RANDOMIZED CONTROLLED TRIAL
Bharathi Upadhya, Michael Rocco, Cora E Lewis, Suzanne Oparil, Laura C Lovato, William C Cushman, Jeffrey T Bates, Natalie A Bello, Gerard Aurigemma, Lawrence J Fine, Karen C Johnson, Carlos J Rodriguez, Dominic S Raj, Anjay Rastogi, Leonardo Tamariz, Alan Wiggers, Dalane W Kitzman
BACKGROUND: Acute decompensated heart failure (ADHF) was a frequent common outcome in SPRINT (Systolic Blood Pressure Intervention Trial). We examined whether there was differential reduction in ADHF events from intensive blood pressure [BP] treatment among the 6 key, prespecified subgroups in SPRINT: age ≥75 years, prior cardiovascular disease, chronic kidney disease, women, black race, and 3 levels of baseline systolic BP (≤132 versus >132 to <145 versus ≥145 mm Hg). METHODS AND RESULTS: ADHF was defined as hospitalization for ADHF, confirmed and formally adjudicated by a blinded events committee using standardized protocols...
April 2017: Circulation. Heart Failure
https://www.readbyqxmd.com/read/28357890/pneumonia-and-inflammation-in-acute-decompensated-heart-failure-a-registry-based-analysis-of-1939-patients
#15
Alexander Jobs, Ronja Simon, Suzanne de Waha, Kyrill Rogacev, Alexander Katalinic, Valentin Babaev, Holger Thiele
BACKGROUND: The prognostic impact of pneumonia and signs of systemic inflammation in patients with acute decompensated heart failure (ADHF) has not been fully elucidated yet. The aim of the present study was thus to investigate the association of pneumonia and the inflammation surrogate C-reactive protein with all-cause mortality in patients admitted for ADHF. METHODS: We analysed data of 1939 patients admitted for ADHF. Patients were dichotomised according to the presence or absence of pneumonia...
March 1, 2017: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/28295429/urinary-timp-2-%C3%A2-%C3%A3-%C3%A2-igfbp7-for-risk-prediction-of-acute-kidney-injury-in-decompensated-heart-failure
#16
Moritz Schanz, Jing Shi, Christoph Wasser, Mark Dominik Alscher, Martin Kimmel
BACKGROUND: In acute decompensated heart failure (ADHF) the risk of acute kidney injury (AKI) is high. Early detection of patients at risk for AKI is important. We tested urinary [TIMP-2] × [IGFBP7], a new US Food and Drug Administration-cleared test to assess AKI risk, in a cohort of hospitalized ADHF patients. HYPOTHESIS: In patients with ADHF, urinary [TIMP-2] × [IGFBP7] is associated with moderate to severe AKI and related to increased mortality. METHODS: We enrolled 400 patients in the emergency department at Robert-Bosch Hospital, Stuttgart, Germany...
March 10, 2017: Clinical Cardiology
https://www.readbyqxmd.com/read/28290833/-soluble-suppression-of-tumorogenicity-2-increases-opportunities-for-risk-stratification-after-acute-heart-failure-decompensation
#17
A A Skvortsov, V N Protasov, O Yu Narusov, D E Koshkina, S N Nasonova, V P Masenko, S N Tereschenko
PURPOSE: to evaluate the significance of soluble ST2-receptor (sST2) concentrations in patient (pts) risk stratification in with acute decompensated heart failure (ADHF) during long-term follow-up period. METHODS: In the prospective single-center study were included 159 pts with ADHF III-IV FC NYHA. Blood samples to determine NT-proBNP, sST2, hsTnT concentration were collected at the admission and at discharge from the hospital, and after 3, 6 and 12 months of follow-up...
January 2017: Kardiologiia
https://www.readbyqxmd.com/read/28290803/-assessment-of-impact-of-acute-kidney-injury-on-prognosis-of-a-hospitalized-patients-with-acute-decompensated-heart-failure
#18
D S Polyakov, I V Fomin, A R Vaisberg, F Yu Valigulova, Nabil Kraiem Nabil Kraiem
OBJECTIVE: to assess prevalence of acute kidney injury (AKI) among patients with acute decompensated heart failure (ADHF) and its impact on prognosis in a hospitalized patient. MATERIAL AND METHODS: a sample of patients hospitalized with signs of ADHF. RESULTS: Prevalence of AKI in this sample was 23.1%. There was no significant difference between patients with and without AKI by age, gender, and hemodynamic parameters. Portion of subjects with systolic blood pressure below 125 mm Hg among patients with AKI did not exceed one third...
December 2016: Kardiologiia
https://www.readbyqxmd.com/read/28285867/a-modified-lung-and-cardiac-ultrasound-protocol-saves-time-and-rules-in-the-diagnosis-of-acute-heart-failure
#19
Frances M Russell, Robert R Ehrman
BACKGROUND: Multiorgan ultrasound (US), which includes evaluation of the lungs and heart, is an accurate method that outperforms clinical gestalt for diagnosing acutely decompensated heart failure (ADHF). A known barrier to ultrasound use is the time needed to perform these examinations. OBJECTIVE: The primary goal of this study was to determine the test characteristics of a modified lung and cardiac US (LuCUS) protocol for the accurate diagnosis of ADHF. METHODS: This was a secondary analysis of a prospective observational study that enrolled adult patients presenting to the emergency department with undifferentiated dyspnea...
March 9, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28285121/a-novel-rehabilitation-intervention-for%C3%A2-older-patients-with-acute%C3%A2-decompensated%C3%A2-heart-failure-the-rehab-hf-pilot-study
#20
Gordon R Reeves, David J Whellan, Christopher M O'Connor, Pamela Duncan, Joel D Eggebeen, Timothy M Morgan, Leigh Ann Hewston, Amy Pastva, Mahesh J Patel, Dalane W Kitzman
OBJECTIVES: This study sought to assess a novel physical rehabilitation intervention in older patients hospitalized for acute decompensated heart failure (ADHF). BACKGROUND: After ADHF, older patients, who are frequently frail with multiple comorbidities, have prolonged and incomplete recovery of physical function and remain at high risk for poor outcomes. METHODS: The REHAB-HF (Rehabilitation Therapy in Older Acute Heart Failure Patients) pilot study was a 3-site, randomized, attention-controlled pilot study of a tailored, progressive, multidomain physical rehabilitation intervention beginning in the hospital and continuing for 12 weeks post-discharge in patients ≥60 years hospitalized with ADHF...
May 2017: JACC. Heart Failure
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