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Acute decompensated heart failure

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https://www.readbyqxmd.com/read/29453669/physical-training-and-cardiac-rehabilitation-in-heart-failure-patients
#1
Cesare de Gregorio
Regardless of advances in medical and interventional treatment of cardiovascular disease (CVD), a limited number of patients attend a cardiac rehabilitation (CR) programme on a regular basis. Due to modern therapies more individuals will be surviving an acute cardiovascular event, but the expected burden of chronic heart failure will be increasing worldwide.However, both in high- and low-income countries, secondary prevention after an acute myocardial infarction or stroke has been implemented in less than a half of eligible patients...
February 17, 2018: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/29450742/focused-cardiac-ultrasound-as-a-predictor-of-readmission-in-acute-decompensated-heart-failure
#2
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
https://www.readbyqxmd.com/read/29450594/position-paper-for-the-organization-of-ecmo-programs-for-cardiac-failure-in-adults
#3
Darryl Abrams, A Reshad Garan, Akram Abdelbary, Matthew Bacchetta, Robert H Bartlett, James Beck, Jan Belohlavek, Yih-Sharng Chen, Eddy Fan, Niall D Ferguson, Jo-Anne Fowles, John Fraser, Michelle Gong, Ibrahim F Hassan, Carol Hodgson, Xiaotong Hou, Katarzyna Hryniewicz, Shingo Ichiba, William A Jakobleff, Roberto Lorusso, Graeme MacLaren, Shay McGuinness, Thomas Mueller, Pauline K Park, Giles Peek, Vin Pellegrino, Susanna Price, Erika B Rosenzweig, Tetsuya Sakamoto, Leonardo Salazar, Matthieu Schmidt, Arthur S Slutsky, Christian Spaulding, Hiroo Takayama, Koji Takeda, Alain Vuylsteke, Alain Combes, Daniel Brodie
Extracorporeal membrane oxygenation (ECMO) has been used increasingly for both respiratory and cardiac failure in adult patients. Indications for ECMO use in cardiac failure include severe refractory cardiogenic shock, refractory ventricular arrhythmia, active cardiopulmonary resuscitation for cardiac arrest, and acute or decompensated right heart failure. Evidence is emerging to guide the use of this therapy for some of these indications, but there remains a need for additional evidence to guide best practices...
February 15, 2018: Intensive Care Medicine
https://www.readbyqxmd.com/read/29434126/a-case-of-heart-failure-with-hyperthyroidism-demonstrating-discrepancy-between-the-clinical-course-and-b-type-natriuretic-peptide-levels
#4
Chiaki Kishida, Ryo Naito, Hiroki Kasuya, Tomohiro Kaneko, Kosuke Yabe, Midori Kakihara, Ryosuke Shimai, Hiroyuki Isogai, Dai Ozaki, Yuki Yasuda, Fuminori Odagiri, Tetsuro Miyazaki, Ken Yokoyama, Takashi Tokano, Hajime Koyano, Yuji Nakazato
A 35-year-old Japanese man was emergently admitted to our hospital with chief complaints of palpitation and dyspnea. He has been treated for Basedow's disease. He was diagnosed with acute decompensated heart failure, atrial fibrillation and thyrotoxicosis. We started anti-thyroid agents and a treatment for heart failure with beta blockers and diuretics under anti-coagulation therapy. His B-type natriuretic peptide levels remained high, although the heart failure had been compensated and the heart rate was well controlled while hyperthyroidism still existed...
February 9, 2018: Internal Medicine
https://www.readbyqxmd.com/read/29432453/clinical-findings-and-prognosis-of-patients-hospitalized-for-acute-decompensated-heart-failure-analysis-of-the-influence-of-chagas-etiology-and-ventricular-function
#5
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
https://www.readbyqxmd.com/read/29431103/interaction-of-body-mass-index-on-the-association-between-n-terminal-pro-b-type-natriuretic-peptide-and-morbidity-and-mortality-in-patients-with-acute-heart-failure-findings-from-ascend-hf-acute-study-of-clinical-effectiveness-of-nesiritide-in-decompensated
#6
Ankeet S Bhatt, Lauren B Cooper, Andrew P Ambrosy, Robert M Clare, Adrian Coles, Emer Joyce, Arun Krishnamoorthy, Javed Butler, G Michael Felker, Justin A Ezekowitz, Paul W Armstrong, Adrian F Hernandez, Christopher M O'Connor, Robert J Mentz
BACKGROUND: Higher body mass index (BMI) is associated with lower circulating levels of N-terminal-pro-b-type natriuretic peptide (NT-proBNP). The Interaction between BMI and NT-proBNP with respect to clinical outcomes is not well characterized in patients with acute heart failure. METHODS AND RESULTS: A total of 686 patients from the biomarker substudy of the ASCEND-HF (Acute Study of Clinical Effectiveness of Nesiritide in Decompensated HF ) clinical trial with documented NT-proBNP levels at baseline were included in the present analysis...
February 3, 2018: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29428497/pleural-effusions-in-acute-decompensated-heart-failure-prevalence-and-prognostic-implications
#7
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
https://www.readbyqxmd.com/read/29423950/guideline-directed-medical-therapy-and-survival-following-hospitalization-in-patients-with-heart-failure
#8
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
https://www.readbyqxmd.com/read/29417223/relationship-between-blood-urea-nitrogen-to-creatinine-ratio-at-hospital-admission-and-long-term-mortality-in-patients-with-acute-decompensated-heart-failure
#9
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
https://www.readbyqxmd.com/read/29408802/analysis-of-volatile-organic-compounds-an-innovative-approach-to-heart-failure-characterization-in-older-patients
#10
P Finamore, C Pedone, D Lelli, L Costanzo, I Rossi Bartoli, A De Vincentis, S Grasso, F Romana Parente, G Pennazza, M Santonico, R Antonelli Incalzi
BACKGROUND: Analysis of exhaled volatile organic compounds (VOCs) may be applied for diagnostic purposes in some chronic diseases, but there are no data on their role for discriminating people with congestive heart failure (CHF), particularly in older patients where natriuretic peptides have lower accuracy. We evaluated whether VOCs analysis can discriminate patients with or without CHF, stratify CHF severity and predict the response to therapy of decompensated CHF. METHODS AND RESULTS: We recruited 89 subjects admitted to an acute care ward with acutely decompensated CHF, 117 healthy controls and 103 chronic obstructive pulmonary disease (COPD) controls...
February 6, 2018: Journal of Breath Research
https://www.readbyqxmd.com/read/29402506/unidimensional-longitudinal-strain-a-simple-approach-for-the-assessment-of-longitudinal-myocardial-deformation-by-echocardiography
#11
Matthias Aurich, Patrick Fuchs, Matthias Müller-Hennessen, Lorenz Uhlmann, Matthias Niemers, Sebastian Greiner, Tobias Täger, Kristof Hirschberg, Philipp Ehlermann, Benjamin Meder, Lutz Frankenstein, Evangelos Giannitsis, Hugo A Katus, Derliz Mereles
BACKGROUND: Impaired left ventricular (LV) longitudinal function (LF) is a known predictor of cardiac events in patients with heart failure, but two-dimensional strain imaging, the reference method to measure myocardial deformation, is not always feasible or available. Therefore, reliable and reproducible alternatives are needed. The aim of the present study was to evaluate unidimensional longitudinal strain (ULS) as a simple echocardiographic parameter for the assessment of LV LF. METHODS: Two hundred two patients with dilated cardiomyopathy who had their first presentation in the authors' cardiology department, as well as the same number of age- and gender-matched control subjects, were prospectively included in this study...
February 2, 2018: Journal of the American Society of Echocardiography
https://www.readbyqxmd.com/read/29375117/tolvaptan-improves-prognosis-in-responders-with-acute-decompensated-heart-failure-by-reducing-the-dose-of-loop-diuretics
#12
COMPARATIVE STUDY
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
https://www.readbyqxmd.com/read/29369003/clinical-characteristics-and-prognosis-in-patients-with-a-first-acute-heart-failure-hospitalization-according-to-admission-hyponatremia
#13
Francesc Formiga, David Chivite, Ariadna Brasé, Irene Petit, Rafael Moreno-Gonzalez, Jose Carlos Arévalo-Lorido, Xavier Corbella
Objective Admission hyponatremia is related to poor outcomes in patients with heart failure (HF). Few studies have examined the influence of hyponatremia in the prognosis of HF patients without previous admissions. Our aim is to determine whether baseline hyponatremia predicts worse outcomes in a cohort of real-world HF patients admitted because of a first episode of acute HF. Methods We reviewed the medical records of 985 patients >50 years of age admitted within a two-year period for a first episode of decompensation of HF...
January 25, 2018: Acta Clinica Belgica
https://www.readbyqxmd.com/read/29365353/can-available-mathematical-models-predict-serum-digoxin-levels-in-thai-patients
#14
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
https://www.readbyqxmd.com/read/29365092/the-influence-of-advanced-age-on-venous-arterial-extracorporeal-membrane-oxygenation-outcomes
#15
Michael Salna, Koji Takeda, Paul Kurlansky, Hirohisa Ikegami, Liqiong Fan, Jiho Han, Samantha Stein, Veli Topkara, Melana Yuzefpolskaya, Paolo C Colombo, Dimitrios Karmpaliotis, Yoshifumi Naka, Ajay J Kirtane, Arthur R Garan, Hiroo Takayama
OBJECTIVES: Ethical and health care economic concerns surround the use of venous-arterial extracorporeal membrane oxygenation (VA-ECMO) in elderly patients. Patients requiring VA-ECMO are often in critical condition and the decision to cannulate is time-sensitive. We investigated the relationship between age and VA-ECMO outcomes to better inform this decision. METHODS: This is a retrospective study of 355 patients placed on VA-ECMO between March 2007 and August 2016 at our institution...
January 22, 2018: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29361704/usefulness-of-a-telemedicine-program-in-refractory-older-congestive-heart-failure-patients
#16
Emanuela Burdese, Marzia Testa, Pasquale Raucci, Cinzia Ferreri, Gabriele Giovannini, Enrico Lombardo, Enrico Avogadri, Mauro Feola
BACKGROUND: Home telemonitoring is a modern and effective disease management model that is able to improve medical care, quality of life, and prognosis of chronically ill patients, and to reduce expenditure. The objective of this study was to evaluate the efficacy, costs, and patients' and caregivers' acceptance of our model of telemedicine in a high-risk chronic heart failure (CHF) older population. METHODS: Patients with high risk/refractory CHF were included...
January 20, 2018: Diseases (Basel)
https://www.readbyqxmd.com/read/29355381/detection-of-microembolic-signals-in-the-common-carotid-artery-using-doppler-sonography-in-the-porcine-model-of-acute-heart-failure-treated-by-veno-arterial-extracorporeal-membrane-oxygenation
#17
D Janák, P Hála, M Mlček, M Popková, S Lacko, J Kudlička, O Kittnar
Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) is a method used for the treatment most severe cases of decompensated heart failure. The purpose of this study was to evaluate the risk of the formation of microembolisms during VA-ECMO-based therapy. Heart failure was induced with simultaneous detection of microembolisms and the measurement of blood flow rate in the common carotid artery (CCA) without VA-ECMO (0 l/min) and at the VA-ECMO blood flow rate of 1, 2, 3 and 4 l/min. If embolisms for VA-ECMO 0 l/min and the individual regimes for VA-ECMO 1, 2, 3, 4 l/min are compared, a higher VA-ECMO flow rate is accompanied by a higher number of microembolisms...
December 30, 2017: Physiological Research
https://www.readbyqxmd.com/read/29346407/relaxin-reverses-inflammatory-and-immune-signals-in-aged-hearts
#18
Brian Martin, Beth Ann Gabris-Weber, Rajiv Reddy, Guillermo Romero, Ansuman Chattopadhyay, Guy Salama
BACKGROUND: 'Healthy' aging drives structural and functional changes in the heart including maladaptive electrical remodeling, fibrosis and inflammation, which lower the threshold for cardiovascular diseases such as heart failure (HF) and atrial fibrillation (AF). Despite mixed results in recent clinical trials, Relaxin-therapy for 2-days could reduce mortality by 37% at 180-days post-treatment, in patients with acute decompensated HF. Relaxin's short life-span (hours) but long-lasting protective actions led us to test the hypothesis that relaxin acts at a genomic level to reverse maladaptive remodeling in aging and HF...
2018: PloS One
https://www.readbyqxmd.com/read/29345431/the-effect-of-diuresis-on-extravascular-lung-water-and-pulmonary-function-in-acute-decompensated-heart-failure
#19
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
https://www.readbyqxmd.com/read/29345426/single-dose-intravenous-iron-in-southeast-asian-heart-failure-patients-a-pilot-randomized-placebo-controlled-study-practice-asia-hf
#20
Tee Joo Yeo, Poh Shuan Daniel Yeo, Farid Abdul Hadi, Timothy Cushway, Kim Yee Lee, Fang Fang Yin, Anne Ching, Ruili Li, Seet Yoong Loh, Shir Lynn Lim, Raymond Ching-Chiew Wong, Bee Choo Tai, Arthur Mark Richards, Carolyn S P Lam
AIMS: Iron deficiency is highly prevalent in Southeast Asians with heart failure (HF) and associated with worse outcomes. This trial aimed to assess the effect of intravenous iron in Southeast Asians hospitalized with decompensated HF. METHODS AND RESULTS: Fifty patients hospitalized for acute decompensated HF, regardless of ejection fraction, with iron deficiency (defined as serum ferritin <300 ng/mL if transferrin saturation is <20%) were randomized to receive either one dose of intravenous ferric carboxymaltose (FCM) 1000 mg or placebo (0...
January 18, 2018: ESC Heart Failure
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