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Heart failure and elderly

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https://www.readbyqxmd.com/read/28625234/-effect-of-global-end-diastolic-volume-index-guidance-fluid-resuscitation-in-elderly-patients-with-septic-shock
#1
Shuang Ma, Rumin Zhang, Shifu Wang, Meiling Zhao, Lei Wang, Yun Zhang
OBJECTIVE: To evaluate the effect of global end diastolic volume index (GEDVI) on fluid resuscitation in elderly patients with septic shock. METHODS: A prospective randomized controlled trial (RCT) was conducted. Septic shock patients over 65 years admitted to intensive care unit (ICU) of Shandong Province, Zibo Central Hospital from January 2013 to December 2015 were enrolled. The patients were randomly divided into control group and observation group, 20 cases in each group...
June 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28618134/potentially-inappropriate-use-of-furosemide-in-a-very-elderly-population-an-observational-study
#2
Carla Rodriguez-Cillero, Didier Menu, Philippe d'Athis, Sophie Perrin, Mélanie Dipanda, Sanaa Asgassou, Hélène Guepet, Emmanuel Mazen, Patrick Manckoundia, Alain Putot
OBJECTIVE: Little is known about furosemide prescription modalities in elderly people. We describe furosemide prescription in ambulatory elderly patients. METHODS: All patients aged over 80 years, affiliated to Mutualité Sociale Agricole de Bourgogne, a French regional health insurance plan, with a medical prescription delivered in March 2015, were retrospectively included. RESULTS: Among 15 141 patients with a median age of 86 years, comprising 61...
June 15, 2017: International Journal of Clinical Practice
https://www.readbyqxmd.com/read/28606799/patterns-of-readmissions-for-three-common-conditions-among-younger-u-s-adults
#3
Devraj Sukul, Shashank S Sinha, Andrew M Ryan, Michael W Sjoding, Scott L Hummel, Brahmajee K Nallamothu
BACKGROUND: Thirty-day readmissions among elderly Medicare patients are an important hospital quality measure. Although plans for employing 30-day readmission measures are under consideration for younger patients, little is known about readmission in younger patients or the relationship between readmissions in younger and elderly patients at the same hospital. METHODS: Using the 2014 Nationwide Readmissions Database, we examined readmission patterns in younger patients (18- to 64-years-old) using hierarchical models to evaluate associations between hospital 30-day risk-standardized readmission rates (RSRRs) in elderly Medicare patients and readmission risk in younger patients with acute myocardial infarction, heart failure, or pneumonia...
June 9, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/28606649/accuracy-of-lung-ultrasound-in-patients-with-acute-dyspnea-the-influence-of-age-multimorbidity-and-cognitive-and-motor-impairment
#4
Luca Vizioli, Paola Forti, Elena Bartoli, Marco Giovagnoli, Guerino Recinella, Davide Bernucci, Marco Masetti, Elena Martino, Gian Luca Pirazzoli, Marco Zoli, Giampaolo Bianchi
Discriminating between causes of dyspnea may be difficult, particularly in the elderly. The aim of this retrospective study of 83 inpatients with acute dyspnea was to assess the influence of age, multimorbidity and cognitive or motor impairment on the diagnostic accuracy of lung ultrasound (LUS) in discriminating acute heart failure (AHF) from noncardiogenic dyspnea (NCD). Univariate analysis indicates that LUS misdiagnosis was associated with the following parameters: history of stroke (p = 0.037), lower activity of daily living (p = 0...
June 9, 2017: Ultrasound in Medicine & Biology
https://www.readbyqxmd.com/read/28605423/source-3-1-year-outcomes-post-transcatheter-aortic-valve-implantation-using-the-latest-generation-of-the-balloon-expandable-transcatheter-heart-valve
#5
Olaf Wendler, Gerhard Schymik, Hendrik Treede, Helmut Baumgartner, Nicolas Dumonteil, Franz-Josef Neumann, Giuseppe Tarantini, José Luis Zamorano, Alec Vahanian
Aims: Transcatheter aortic valve implantation (TAVI) has developed from a procedure for patients with aortic stenosis inoperable or high risk for surgery, into a treatment option even for intermediate risk elderly patients. This development has been facilitated by the clinical learning curve and constant improvements of transcatheter heart valves used. We present total 1-year results of SOURCE 3, the European post-approval multicentre registry of the latest generation balloon expandable SAPIEN 3TM (Edwards Lifesciences, Irvine, CA, USA)...
June 12, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28602374/treatment-of-ventricular-arrhythmias-and-use-of-implantable-cardioverter-defibrillators-to-improve-survival-in-older-adult-patients-with-cardiac-disease
#6
REVIEW
Jason T Jacobson, Sei Iwai, Wilbert S Aronow
Ventricular arrhythmia (VA) and sudden cardiac death (SCD) are well-recognized problems in the overall heart failure population, but treatment decisions can be more complex and nuanced in older patients. Sustained VA does not always lead to SCD, but identifies a higher risk population and may cause significant symptoms. Antiarrhythmic drugs (AAD) and catheter ablation are the mainstays for prevention of VA, but have not been shown to improve mortality. The value of implantable cardiac defibrillators (ICDs) may be influenced by patient age...
July 2017: Heart Failure Clinics
https://www.readbyqxmd.com/read/28602373/cardiac-resynchronization-therapy-in-older-adults-with%C3%A2-heart-failure
#7
REVIEW
Phillip H Lam, George E Taffet, Ali Ahmed, Steve Singh
Heart failure is a disease of poor prognosis marked by frequent hospitalizations, premature death, and impaired quality of life. Despite advances in medical therapy for patients with heart failure and reduced ejection fraction, mortality and hospitalizations with advanced disease are still increased and the quality of life continues to be poor in this population. The advent of cardiac resynchronization therapy has led to a significant improvement in both survival and symptom management in patients with heart failure and reduced ejection fraction...
July 2017: Heart Failure Clinics
https://www.readbyqxmd.com/read/28602368/use-of-diuretics-in-the-treatment-of-heart-failure-in-older-adults
#8
REVIEW
Domenic A Sica, Todd W B Gehr, William H Frishman
Diuretics are the most commonly prescribed class of drugs in patients with heart failure, and in the short term they remain the most effective treatment for relief from fluid congestion. This article reviews the mode of action of the various diuretic classes and the physiologic adaptations that follow and sets up the basis for their use in the treatment of volume-retaining states, particularly as applies to the elderly. In addition, the article reviews the common side effects related to diuretics.
July 2017: Heart Failure Clinics
https://www.readbyqxmd.com/read/28602367/heart-failure-with-preserved-ejection-fraction-in-older-adults
#9
REVIEW
Bharathi Upadhya, Dalane W Kitzman
Most elderly patients, particularly women, who have heart failure, have a preserved ejection fraction. Patients with this syndrome have severe symptoms of exercise intolerance, frequent hospitalizations, and increased mortality. Despite the importance of heart failure with preserved ejection fraction (HFpEF), the understanding of its pathophysiology is incomplete, and optimal treatment remains largely undefined. Unlike the management of HFrEF, there is a paucity of large evidence-based trials demonstrating morbidity and mortality benefit for the treatment of HFpEF...
July 2017: Heart Failure Clinics
https://www.readbyqxmd.com/read/28602365/role-of-echocardiography-in-the-diagnostic-assessment-and-etiology-of-heart-failure-in-older-adults-opacify-quantify-and-rectify
#10
REVIEW
Vedant A Gupta, Navin C Nanda, Vincent L Sorrell
Echocardiography allows the assessment of systolic and diastolic function and identifies many of the common causes of heart failure (HF). Patients with minimally symptomatic or unsuspected left ventricular systolic dysfunction may be identified and receive the benefits of angiotensin-converting enzyme inhibitor therapy. Echocardiography is also for assessing prognosis and can be used serially to evaluate treatment. Ventricular filling pressures, pulmonary artery pressures, and cardiac output can be sequentially determined...
July 2017: Heart Failure Clinics
https://www.readbyqxmd.com/read/28599947/an-elderly-man-with-pancreatic-neuroendocrine-tumor-and-a-cavitary-right-upper-lobe-lung-mass
#11
Palla DeSilva, Adarsha Selvachandra, Jennifer Kanaan, Debapriya Datta
An elderly man presented to the ED from a nursing care facility after transient loss of consciousness. Three weeks previously, the patient had been diagnosed with a high-grade pancreatic neuroendocrine tumor (NET) with metastases to the liver after being hospitalized for weakness. A chest radiograph at that time had revealed a right upper lobe mass that was presumed to represent a metastatic lesion (Fig 1); CT of the chest demonstrated similar findings (Fig 2). The patient had recovered consciousness on arrival to the ED and was diagnosed clinically as having had a syncopal episode from dehydration due to poor intake...
June 2017: Chest
https://www.readbyqxmd.com/read/28595859/left-atrial-appendage-occlusion-in-patients-with-atrial-fibrillation-and-previous-major-gastrointestinal-bleeding-from-the-amplatzer-cardiac-plug-multicenter-registry
#12
Mathieu Lempereur, Adel Aminian, Xavier Freixa, Sameer Gafoor, Samera Shakir, Heyder Omran, Sergio Berti, Gennaro Santoro, Joelle Kefer, Ulf Landmesser, Jens Erik Nielsen-Kudsk, Ignacio Cruz-Gonzalez, Prapa Kanagaratnam, Fabian Nietlispach, Reda Ibrahim, Horst Sievert, Wolfgang Schillinger, Jai-Wun Park, Steffen Gloekler, Apostolos Tzikas
History of major gastrointestinal (GI) bleeding may represent a frequent clinical indication for left atrial appendage occlusion (LAAO) in patients with non-valvular atrial fibrillation (AF). This study aims to investigate the procedural safety and long-term outcome of patients with previous major GI bleeding (MGIB) who underwent LAAO. Data from the Amplatzer Cardiac Plug multicenter registry on 1,047 patients were analyzed. Patients with previous MGIB as indication for LAAO were compared with patients without previous MGIB...
May 12, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28593038/comprehensive-healthcare-resource-use-among-newly-diagnosed-congestive-heart-failure
#13
Lori D Bash, Dahlia Weitzman, Robert O Blaustein, Ofer Sharon, Varda Shalev, Gabriel Chodick
BACKGROUND: Congestive heart failure (CHF) is among the most common causes of hospital admissions and readmissions in the Western world. However, the burden of ambulatory care has not been as well investigated. The objective of this study was to assess the relative burden and direct medical costs of CHF including inpatient and outpatient care. METHODS: We used longitudinal clinical data from a two-million member health organization in Israel (Maccabi Healthcare Services) to identify adults with newly diagnosed CHF between January 2006 and December 2012, either in the in- or outpatient setting...
2017: Israel Journal of Health Policy Research
https://www.readbyqxmd.com/read/28590261/orthostatic-hypotension-and-association-of-arterial-compliance-in-elderly-patients-with-hypertension-a-pilot-study
#14
Ayumi Toba, Joji Ishikawa, Kazumasa Harada
BACKGROUNDS: Orthostatic hypotension (OH) is associated with cardiovascular diseases, heart failure, and increased mortality. We evaluated whether OH was affected by cardiac structure and function or autonomic function in elderly hypertensive outpatients. PATIENTS AND METHODS: In 64 hypertension patients (mean age 74.2±1.7 years old), we evaluated changes in blood pressure (BP) and heart rate variability before and after standing up using the MemCalc system. In addition, we retrospectively reviewed their medical records and echocardiographic data...
June 5, 2017: Blood Pressure Monitoring
https://www.readbyqxmd.com/read/28579091/characteristics-and-outcomes-of-heart-failure-hospitalization-before-implementation-of-a-heart-failure-clinic-the-precic-study
#15
Irene Marques, Sara Abreu, Manuela V Bertão, Betânia Ferreira, Raquel Lopes Ramos, Juliana Lopes, Sandra Nunes, Denisa Mendonça, Laetitia Teixeira
OBJECTIVE: This study aims to characterize patients hospitalized for acute heart failure (HF) in an internal medicine department and their one-year mortality and rate of rehospitalization for decompensated HF. METHODS: This retrospective observational study enrolled all patients discharged in 2012 after hospitalization for acute HF. Discharge summaries, clinical records and telephone interviews were analysed. The data reports to the year before implementation of a heart failure clinic...
May 31, 2017: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
https://www.readbyqxmd.com/read/28576781/electrocardiographic-preexcitation-and-risk-of-cardiovascular-morbidity-and-mortality-results-from-the-copenhagen-ecg-study
#16
Morten W Skov, Peter V Rasmussen, Jonas Ghouse, Steen M Hansen, Claus Graff, Morten S Olesen, Adrian Pietersen, Christian Torp-Pedersen, Stig Haunsø, Lars Køber, Jesper H Svendsen, Anders G Holst, Jonas B Nielsen
BACKGROUND: The majority of available data on the clinical course of patients with ventricular preexcitation in the ECG originates from tertiary centers. We aimed to investigate long-term outcomes in individuals from a primary care population with electrocardiographic preexcitation. METHODS AND RESULTS: Digital ECGs from 328 638 primary care patients were collected during 2001 to 2011. We identified 310 individuals with preexcitation (age range, 8-85 years). Data on medication, comorbidity, and outcomes were collected from Danish nationwide registries...
June 2017: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/28570246/a-retrospective-study-of-the-impact-of-pressure-ulcers-on-survival-in-elderly-persons-with-chronic-diseases
#17
Efraim Jaul, Joshua P Rosenzweig
Medical advancements are extending the lives of persons with chronic diseases, increasing their risk for pressure ulcer (PU) development. A retrospective chart review of 192 patients (49.48% male, mean age 9.7 ± 10.9 years) admitted to a skilled nursing department between 2008 and 2013 was performed to determine whether PUs and comorbidities, singly and combined, affect patient survival. Characteristics abstracted and assessed included sociodemographic factors (age, gender), diseases/comorbidities (eg, chronic renal failure, dementia, Parkinson's disease [PD], ischemic heart disease, and diabetes mellitus), persistent vegetative state (PVS), type and quantity of PUs (excluding Stage I and PUs that developed during the study), body mass index (BMI) <22, and laboratory data (serum albumin, total protein level, and hemoglobin [Hg] <10)...
May 2017: Ostomy/wound Management
https://www.readbyqxmd.com/read/28562342/association-between-obesity-and-trastuzumab-related-cardiac-toxicity-in-elderly-patients-with-breast-cancer
#18
Hai-Yan Wang, Bei-Bei Yin, Dan-Yan Jia, Ying-Long Hou
PURPOSE: Trastuzumab can improve the prognosis for patients with breast cancer, but its related cardiac toxicity is concerning. This study aimed to identify the risk factors associated with trastuzumab-related cardiac toxicity in elderly patients with HER2-positive breast cancer. PATIENTS AND METHODS: A total of 133 elderly (≥ 65 years) patients who were diagnosed with breast cancer between June 1, 2007, and January 31, 2016, and received trastuzumab treatment were retrospectively reviewed...
May 11, 2017: Oncotarget
https://www.readbyqxmd.com/read/28553792/adherence-to-guidelines-for-screening-and-medication-use
#19
Arseniy P Yashkin, Frank Sloan
OBJECTIVE: The objective of this study is to investigate relationships between adherence to recommended screening and medication use and severe macrovascular complications and all-cause mortality among persons aged above 68 years with diabetes mellitus (DM). METHOD: Data came from a 5% Medicare claims sample of beneficiaries initially diagnosed with DM during 2006-2008; follow-up was up to 7 years. RESULTS: Adherence to screening guidelines led to reduced mortality-hazard ratio (HR) = 0...
December 1, 2016: Journal of Aging and Health
https://www.readbyqxmd.com/read/28544166/clinical-features-of-extremely-elderly-patients-with-heart-failure
#20
Tetsuro Yokokawa, Akiomi Yoshihisa, Yuki Kanno, Takamasa Sato, Satoshi Suzuki, Tomofumi Misaka, Masayoshi Oikawa, Atsushi Kobayashi, Takayoshi Yamaki, Hiroyuki Kunii, Kazuhiko Nakazato, Hitoshi Suzuki, Shu-Ichi Saitoh, Yasuchika Takeishi
AIM: To investigate the clinical features of heart failure in extremely elderly patients. METHODS: We analyzed 1163 consecutive hospitalized heart failure patients. The patients were divided into an extremely elderly group (≥85 years-of-age, n = 88) and a non-extremely elderly group (<85 years-of-age, n = 1075). RESULTS: The extremely elderly group had higher rates of hypertension, chronic kidney disease, anemia, higher systolic blood pressure and lower body mass index, and lower use of β-blockers and anticoagulants compared with the non-extremely elderly group...
May 21, 2017: Geriatrics & Gerontology International
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