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Acute decompensated heart failure

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https://www.readbyqxmd.com/read/29680172/optimal-timing-of-percutaneous-coronary-intervention-in-patients-with-non-st-segment-elevation-myocardial-infarction-complicated-by-acute-decompensated-heart-failure-from-the-korea-acute-myocardial-infarction-registry-national-institutes-of-health-kamir-nih
#1
Min Chul Kim, Myung Ho Jeong, Doo Sun Sim, Young Joon Hong, Ju Han Kim, Youngkeun Ahn, Tae Hoon Ahn, Ki Bae Seung, Dong-Joo Choi, Hyo-Soo Kim, Hyeon Cheol Gwon, In Whan Seong, Kyung Kuk Hwang, Shung Chull Chae, Seung Ho Hur, Kwang Soo Cha, Seok Kyu Oh, Jei Keon Chae
The optimal timing of percutaneous coronary intervention (PCI) in patients with non-ST-segment elevation myocardial infarction (NSTEMI), complicated by acute decompensated heart failure (ADHF), is unclear. A total of 1,027 patients with NSTEMI complicated by ADHF who underwent successful PCI were analyzed using a Korean multicenter registry. All patients were divided into 4 groups by the timing of PCI: group 1 (PCI < 2 hour after admission, n = 149), group 2 (2 to 24 hours, n = 577), group 3 (24 to 72 hours, n = 189), and group 4 (≥72 hours, n = 112)...
March 1, 2018: American Journal of Cardiology
https://www.readbyqxmd.com/read/29678608/clinical-and-hemodynamic-effects-of-intra-aortic-balloon-pump-therapy-in-chronic-heart-failure-patients-with-cardiogenic-shock
#2
Justin A Fried, Abhinav Nair, Koji Takeda, Kevin Clerkin, Veli K Topkara, Amirali Masoumi, Melana Yuzefpolskaya, Hiroo Takayama, Yoshifumi Naka, Daniel Burkhoff, Ajay Kirtane, S M Dimitrios Karmpaliotis, Jeffrey Moses, Paolo C Colombo, A Reshad Garan
BACKGROUND: The role of the intra-aortic balloon pump (IABP) in acute decompensated heart failure (HF) with cardiogenic shock (CS) is largely undefined. In this study we sought to assess the hemodynamic and clinical response to IABP in chronic HF patients with CS and identify predictors of response to this device. METHODS: We retrospectively reviewed all patients undergoing IABP implantation from 2011 to 2016 at our institution to identify chronic HF patients with acute decompensation and CS (cardiac index <2...
March 20, 2018: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/29673559/prognostic-value-of-the-urea-creatinine-ratio-in-decompensated-heart-failure-and-its-relationship-with-acute-kidney-damage
#3
C Josa-Laorden, A Sola, I Giménez-López, J Rubio-Gracia, V Garcés-Horna, J I Pérez-Calvo
BACKGROUND: Worsening renal function is associated with an adverse prognosis for patients with acute heart failure (AHF). Urea-creatinine ratio (U:C ratio) might be useful for measuring renal function and could help stratify patients with AHF. MATERIAL AND METHODS: An observational and prospective study was conducted to analyse the prognostic value of the U:C ratio, measured during the first 24-28 hours of admission, for patients hospitalised for decompensated Heart failure, and its relationship with estimated glomerular filtration rate (eGFR) and acute kidney injury (AKI)...
April 16, 2018: Revista Clínica Española
https://www.readbyqxmd.com/read/29669970/prognostic-relevance-of-liver-stiffness-assessed-by-transient-elastography-in-patients-with-acute-decompensated-heart-failure
#4
Yuki Saito, Mahoto Kato, Koichi Nagashima, Koyuru Monno, Yoshihiro Aizawa, Yasuo Okumura, Naoki Matsumoto, Mitsuhiko Moriyama, Atsushi Hirayama
BACKGROUND: Acute decompensated heart failure (ADHF) is often accompanied by liver congestion through increased right atrial pressure (RAP). Liver stiffness (LS) assessed non-invasively using transient elastography is related to increased RAP and liver congestion in patients with general HF. We investigated the relationship of LS with clinical and echocardiographic variables and outcomes in patients with ADHF.Methods and Results:The subjects were 105 patients with ADHF admitted to hospital between October 2016 and June 2017...
April 17, 2018: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/29657212/mortality-in-the-elderly-with-acute-kidney-injury-in-an-internal-medicine-department-in-abidjan-cote-d-ivoire
#5
Hubert Kouamé Yao, Allah Yves Omer Binan, Serge-Didier Konan, Koffi Justin N'Da, Sery Patrick Diopoh
Acute kidney injury (AKI) in the elderly is characterized by high mortality. The objective of this study is to identify the causes of death in the elderly with AKI. This is a prospective cohort study with a descriptive purpose which was carried out during the period from January 2009 to December 2014 in the Department of Nephrology-Internal Medicine of Treichville University Hospital. The diagnosis of AKI was made on the basis of serum creatinine (SCr) values determined during hospitalization, according to KDIGO classification...
March 2018: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/29650706/pro-inflammatory-biomarkers-in-stable-versus-acutely-decompensated-heart-failure-with-preserved-ejection-fraction
#6
Abraham Abernethy, Sadi Raza, Jie-Lena Sun, Kevin J Anstrom, Russell Tracy, Johannes Steiner, Peter VanBuren, Martin M LeWinter
BACKGROUND: Underlying inflammation has been increasingly recognized in heart failure with a preserved ejection fraction (HFpEF). In this study we tested the hypothesis that pro-inflammatory biomarkers are elevated in patients with acutely decompensated HFpEF (AD-HFpEF) compared with patients with stable HFpEF (S-HFpEF). METHODS AND RESULTS: Using a post hoc analysis the serum biomarkers tumor necrosis factor-alpha, high-sensitivity C-reactive protein interleukin 6 and pentraxin 3 (PTX3) and clinical, demographic, echocardiographic-Doppler and clinical outcomes data were analyzed in HFpEF patients enrolled in NHLBI Heart Failure Research Network clinical trials which enrolled patients with either AD-HFpEF or S-HFpEF...
April 12, 2018: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29619917/emergency-department-ultrasound-for-the-detection-of-b-lines-in-the-early-diagnosis-of-acute-decompensated-heart-failure-a-systematic-review-and-meta-analysis
#7
Kyle McGivery, Paul Atkinson, David Lewis, Luke Taylor, Tim Harris, Kathleen Gadd, Jacqueline Fraser, George Stoica
CLINICIAN'S CAPSULE What is known about the topic? Current diagnostic tools for heart failure in the emergency department (ED) have limited accuracy and often lead to delays in management. What did this study ask? What is the accuracy of early bedside lung ultrasound in the diagnosis of acute decompensated heart failure? What did this study find? This meta-analysis found that the sensitivity and specificity of bedside lung US in ADHF is 82.5% and 83.6%, respectively. Why does this study matter to clinicians? The implementation of early bedside lung US in the ED may lead to more accurate and timely diagnoses of ADHF...
April 5, 2018: CJEM
https://www.readbyqxmd.com/read/29619581/approach-to-undifferentiated-dyspnea-in-emergency-department-aids-in-rapid-clinical-decision-making
#8
Siva Nageswara Rao Guttikonda, Kiran Vadapalli
BACKGROUND: Diagnosis and management of patients presenting with acute dyspnea is one of the major challenges for physicians in emergency department (ED). A correct diagnosis is frequently delayed and difficult to ascertain, and clinical uncertainty is common, explaining the need for rapid diagnosis and a management plan. The primary aim of our study is to assess a diagnostic strategy using multiorgan point of care ultrasonography (USG) to differentiate patients presenting with acute dyspnea to ED into different diagnostic categories for timely management in a resource-limited setting...
April 4, 2018: International Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29611010/expanded-algorithm-for-managing-patients-with-acute-decompensated-heart-failure
#9
REVIEW
Joyce N Njoroge, Baljash Cheema, Andrew P Ambrosy, Stephen J Greene, Sean P Collins, Muthiah Vaduganathan, Alexandre Mebazaa, Ovidiu Chioncel, Javed Butler, Mihai Gheorghiade
Heart failure is a complex disease process, the manifestation of various cardiac and noncardiac abnormalities. General treatment approaches for heart failure have remained the same over the past decades despite the advent of novel therapies and monitoring modalities. In the same vein, the readmission rates for heart failure patients remain high and portend a poor prognosis for morbidity and mortality. In this context, development and implementation of improved algorithms for assessing and treating HF patients during hospitalization remains an unmet need...
April 3, 2018: Heart Failure Reviews
https://www.readbyqxmd.com/read/29597247/home-hospitalization-for-acute-decompensated-heart-failure-opportunities-and-strategies-for-improved-health-outcomes
#10
REVIEW
Konstantinos V Voudris, Marc A Silver
IMPORTANCE: Heart failure (HF) is the leading cause of hospitalization among patients over the age of 65 in the United States and developed countries, posing a significant economic burden to the health care systems. More than half of the patients with HF will be readmitted to the hospital within 6 months from discharge, leading not only to increased health care related expenses but also functional decline, iatrogenic injuries and in-hospital infections. With the increasing prevalence of HF, there is a substantial need for innovative delivery care models that can provide hospital level of care at a patient's home...
March 28, 2018: Healthcare (Basel, Switzerland)
https://www.readbyqxmd.com/read/29594372/short-term-outcomes-of-heart-failure-patients-with-reduced-and-preserved-ejection-fraction-after-acute-decompensation-according-to-the-final-destination-after-emergency-department-care
#11
Òscar Miró, V Íctor Gil, Francisco Javier Martín-Sánchez, Javier Jacob, Pablo Herrero, Aitor Alquézar, Lluís Llauger, Sira Aguiló, Gemma Martínez, José Ríos, Alberto Domínguez-Rodríguez, Veli-Pekka Harjola, Christian Müller, John Parissis, W Frank Peacock, Pere Llorens
AIMS: To compare short-term outcomes after an episode of acute heart failure (AHF) in patients with reduced and preserved ejection fractions (HFrEF, < 40%; and HFpEF, > 49%; respectively) according to their destinations after emergency department (ED) care. METHODS AND RESULTS: This secondary analysis of the EAHFE Registry (consecutive AHF patients diagnosed in 41 Spanish EDs) investigated 30-day all-cause mortality, in-hospital all-cause mortality, prolonged hospitalisation (> 7 days), and 30-day post-discharge ED revisit due to AHF, all-cause death, and combined endpoint (ED revisit/death) in 5829 patients with echocardiographically documented HFrEF and HfpEF (HFrEF/HFpEF: 1,442/4,387)...
March 28, 2018: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
https://www.readbyqxmd.com/read/29582318/clinical-mimics-an-emergency-medicine-focused-review-of-pneumonia-mimics
#12
REVIEW
Drew Alan Long, Brit Long, Alex Koyfman
Pneumonia is a common cause of morbidity and mortality in adults in the United States. While pneumonia classically presents with a fever, cough, and shortness of breath, the presentation can vary widely in adults. This review evaluates history and physical examination findings of pneumonia and several conditions that mimic pneumonia. Pneumonia is a potentially deadly disease. History and examination findings are variable in pneumonia, and many conditions mimic pneumonia. These conditions include pulmonary embolism, diffuse interstitial lung disease, endocarditis, vasculitis, diffuse alveolar hemorrhage, acute decompensated heart failure, tuberculosis, lung cancer, and acute respiratory distress syndrome...
March 26, 2018: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/29581599/new-medications-in-the-treatment-of-acute-decompensated-heart-failure
#13
Ryan Dahn, Scot Walker
Acute decompensated heart failure is a sudden worsening of heart failure symptoms, typically resulting in peripheral edema and dyspnea as a result of pulmonary congestion. Acute decompensated heart failure is responsible for over 1 million hospitalizations every year. Current pharmacologic therapy is limited in its options. Despite an improved survival rate, statistic still suggests that about 50% of patients die within 5 years of diagnosis. New pharmacologic agents aim to improve efficacy by targeting previously unexplored physiological pathways...
April 2018: Hospital Pharmacy
https://www.readbyqxmd.com/read/29573742/systemic-inflammation-in-dogs-with-advanced-stage-heart-failure
#14
Aleksandra Domanjko Petrič, Tajda Lukman, Barbara Verk, Alenka Nemec Svete
BACKGROUND: Although human studies have shown that inflammation plays a role in the development of congestive heart failure, scarce information exists on white blood cell count (WBC) and differential cell counts in various stages of heart failure in man and dogs. A few studies demonstrated increased concentrations of C-reactive protein (CRP), a major acute-phase protein, in cardiac diseases in dogs. Our research aimed to investigate whether CRP concentration, WBC and neutrophil count (NEUT), as markers of systemic inflammation, are elevated in canine cardiovascular patients...
March 24, 2018: Acta Veterinaria Scandinavica
https://www.readbyqxmd.com/read/29572367/myocarditis-secondary-to-smallpox-vaccination
#15
Kyle Keinath, Tyler Church, Benjamin Kurth, Edward Hulten
The development of vaccines ushered in the most profound advancement in 20th century medicine, and have widely been regarded as the one of the most important scientific discovery in the history of mankind. However, vaccines are not without risk; reactions can range from injection site reactions to life-threatening anaphylaxis. Among the more serious vaccine-related sequela is myocarditis. Although myocarditis has been reported following many different vaccines, the smallpox vaccine has the strongest association...
March 22, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29571428/sex-differences-in-left-ventricular-cavity-dilation-and-outcomes-in-acute-heart-failure-patients-with-left-ventricular-systolic-dysfunction
#16
Katsuya Kajimoto, Yuichiro Minami, Shigeru Otsubo, Naoki Sato
BACKGROUND: In this study we evaluated the influence of sex on the left ventricular end-diastolic dimension (LVEDD) and adverse outcomes in patients hospitalized for acute decompensated heart failure (HF) with a reduced ejection fraction (EF). METHODS: Among the 4842 patients enrolled in the Acute Decompensated Heart Failure Syndromes (ATTEND) registry, 2367 patients (1607 men and 760 women) discharged alive after hospitalization for acute decompensated HF with a reduced EF (defined as a left ventricular EF < 50%) were investigated to assess the association of sex and LVEDD with the primary end point (all-cause death and readmission for HF after discharge)...
April 2018: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/29569033/decreased-blood-glucose-at-admission-has-a-prognostic-impact-in-patients-with-severely-decompensated-acute-heart-failure-complicated-with-diabetes-mellitus
#17
Akihiro Shirakabe, Noritake Hata, Nobuaki Kobayashi, Hirotake Okazaki, Masato Matsushita, Yusaku Shibata, Suguru Nishigoori, Saori Uchiyama, Kazutaka Kiuchi, Fumitaka Okajima, Toshiaki Otsuka, Kuniya Asai, Wataru Shimizu
The prognostic impact of a decreased blood glucose level in acute heart failure (AHF) has not been sufficiently clarified. The data from 1234 AHF patients were examined in the present study. The blood glucose (BG) levels were evaluated at admission. The patients were divided into groups based on the following: with or without diabetes mellitus (DM), and BG level ≥ 200 mg/dl (elevated BG) or < 200 mg/dl (decreased BG). The elevated and decreased BG patients were further divided into another three groups: 200 mg/ml ≤ BG < 300 mg/dl (mild-elevated), 300 mg/ml ≤ BG < 400 mg/dl (moderate-elevated) and BG ≥ 400 mg/ml (severe-elevated); and 150 mg/ml ≤ BG < 200 mg/dl (mild-decreased), 100 mg/ml ≤ BG < 150 mg/dl (moderate-decreased) and BG < 100 mg/ml (severe-decreased), respectively...
March 22, 2018: Heart and Vessels
https://www.readbyqxmd.com/read/29566934/comparison-of-two-dosing-methods-for-immediate-administration-of-tolvaptan-in-acute-decompensated-heart-failure
#18
Mitsutoshi Oguri, Hideki Ishii, Shiou Ohguchi, Kunihiko Takahara, Yoshihiro Kawamura, Yuki Yokoi, Kazuhiro Izumi, Hiroshi Takahashi, Haruo Kamiya, Toyoaki Murohara
BACKGROUND: The clinical dosing method for tolvaptan in patients with acute heart failure (HF) is still unclear. We aimed to compare the differences in clinical effect between two dosing regimens: once-daily 7.5mg and twice-daily 3.75mg. METHODS: In this randomized trial, tolvaptan was administered within 12h from hospital admission. The primary outcome was the serial change in congestion scores measured every day from enrollment until dosing day 7. Outcomes including safety parameters were also evaluated...
March 19, 2018: Journal of Cardiology
https://www.readbyqxmd.com/read/29564979/levosimendan-for-perioperative-cardioprotection-myth-or-reality
#19
Elpidio Santillo, Monica Migale, Carlo Massini, Raffaele Antonelli Incalzi
BACKGROUND: Levosimendan is a calcium sensitizer drug causing increased contractility in the myocardium and vasodilation in the vascular system. It is mainly used for the therapy of acute decompensated heart failure. Several studies on animals and humans provided evidence of the cardioprotective properties of levosimendan including preconditioning and anti-apoptotic. In view of these favorable effects, levosimendan has been tested in patients undergoing cardiac surgery for the prevention or treatment of low cardiac output syndrome...
March 21, 2018: Current Cardiology Reviews
https://www.readbyqxmd.com/read/29562736/pre-discharge-anemia-as-a-predictor-of-adverse-clinical-outcomes-in-patients-with-acute-decompensated-heart-failure
#20
Min Chul Kim, Kye Hun Kim, Jae Yeong Cho, Ki Hong Lee, Doo Sun Sim, Hyun Ju Yoon, Nam Sik Yoon, Young Joon Hong, Hyung Wook Park, Ju Han Kim, Youngkeun Ahn, Myung Ho Jeong, Jeong Gwan Cho, Jong Chun Park
Background/Aims: The impact of the timing of anemia during hospitalization on future clinical outcomes after surviving discharge from an index heart failure (HF) has been poorly studied in patients with acute decompensated heart failure (ADHF). Methods: A total of 384 surviving patients with acute ADHF were divided into two groups: an anemia group (n = 270, 199 anemia at admission and 71 pre-discharge anemia) and a no anemia group (n = 114). All-cause mortality and HF re-hospitalization were compared between groups...
March 23, 2018: Korean Journal of Internal Medicine
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