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Acute heart failure

Ahmad A Abdul-Aziz, Rodney A Hayward, Keith D Aaronson, Scott L Hummel
Importance: US hospitals receive financial penalties for excess risk-standardized 30-day readmissions and mortality in Medicare patients. Under current policy, readmission prevention is incentivized over 10-fold more than mortality reduction. Objective: To determine how penalties for US hospitals would change if policy equally weighted 30-day readmissions and mortality. Design, Setting, and Participants: Publicly available hospital-level data for fiscal year 2014 was obtained, including excess readmission ratio (ERR; risk-standardized predicted over expected 30-day readmissions) and 30-day mortality rates for heart failure, pneumonia, and acute myocardial infarction, as well as readmission penalties (as percent of Medicare Diagnosis Group payments)...
October 26, 2016: JAMA Cardiology
Jeffrey L Ardell, John Andrew Armour
Cardiac control is mediated via a series of reflex control networks involving somata in the (i) intrinsic cardiac ganglia (heart), (ii) intrathoracic extracardiac ganglia (stellate, middle cervical), (iii) superior cervical ganglia, (iv) spinal cord, (v) brainstem, and (vi) higher centers. Each of these processing centers contains afferent, efferent, and local circuit neurons, which interact locally and in an interdependent fashion with the other levels to coordinate regional cardiac electrical and mechanical indices on a beat-to-beat basis...
September 15, 2016: Comprehensive Physiology
Marlon E F Wilsterman, Pauline de Jager, Robert Blokpoel, Inez Frerichs, Sandra K Dijkstra, Marcel J I J Albers, Johannes G M Burgerhof, Dick G Markhorst, Martin C J Kneyber
BACKGROUND: Neuromuscular blockade (NMB) has been shown to improve outcome in acute respiratory distress syndrome (ARDS) in adults, challenging maintaining spontaneous breathing when there is severe lung injury. We tested in a prospective physiological study the hypothesis that continuous administration of NMB agents in mechanically ventilated children with severe acute hypoxemic respiratory failure (AHRF) improves the oxygenation index without a redistribution of tidal volume V T toward non-dependent lung zones...
December 2016: Annals of Intensive Care
Tomohiro Mizuno, Koso Egi, Kenji Sakai, Keiji Oi, Tsuyoshi Hachimaru, Tohru Makita, Kiyotoshi Oishi, Hirokuni Arai
Off-pump coronary artery bypass grafting (OPCAB) in patients with acute myocardial infarction (AMI) is difficult because of circulatory deterioration during displacement of the heart. At our institution, we performed minimally circulatory-assisted on-pump beating coronary artery bypass grafting (MICAB) in these patients. During MICAB, support flow was controlled at a minimal level to maintain a systemic blood pressure of approximately 100 mm Hg and a pulmonary arterial systolic pressure of <30 mm Hg, providing optimal pulsatile circulation for end-organ perfusion and prevention of heart congestion...
October 26, 2016: Artificial Organs
Renato De Vecchis, Marco Di Maio, Giuseppina Di Biase, Carmelina Ariano
Background: Several studies have shown that hyponatremia is associated with increased risk of rehospitalization and death in patients with heart failure. In these studies, chronic heart failure (CHF) patients with persistent hyponatremia were compared only with CHF patients with a normal sodium level at hospital admission. Aims: In the present retrospective study, conducted in a cohort of patients with recent acute decompensated heart failure (ADHF), all with hyponatremia ascertained at the time of hospital admission, we aimed to evaluate the effect of the normalization of serum sodium on the composite endpoint of short-term rehospitalization and mortality...
October 22, 2016: Journal of Clinical Medicine
Yi-Fan Li, Wei-Hong Li, Zhao-Ping Li, Xin-Heng Feng, Wei-Xian Xu, Shao-Min Chen, Wei Gao
BACKGROUND: The left atrial size has been considered as a useful marker of adverse cardiovascular outcomes. However, it is not well known whether left atrial area index (LAAI) has predictive value for prognosis in patients with unstable angina pectoris (UAP). This study was aimed to assess the association between LAAI and outcomes in UAP patients. METHODS: We enrolled a total of 391 in-hospital patients diagnosed as UAP. Clinical and echocardiographic data at baseline were collected...
August 2016: Journal of Geriatric Cardiology: JGC
Ester Rita Alessandrini, Massimo Stafoggia, Annunziata Faustini, Giovanna Berti, Cristina Canova, Aldo De Togni, Katiuscia Di Biagio, Bianca Gherardi, Simone Giannini, Paolo Lauriola, Paolo Pandolfi, Giorgia Randi, Andrea Ranzi, Lorenzo Simonato, Stefano Zauli Sajani, Ennio Cadum, Francesco Forastiere
We performed a multisite study to evaluate demographic and clinical conditions as potential modifiers of the particulate matter (PM)-mortality association. We selected 228,619 natural deaths of elderly persons (ages ≥65 years) that occurred in 12 Italian cities during the period 2006-2010. Individual data on causes of death, age, sex, location of death, and preexisting chronic and acute conditions from the previous 5 years' hospitalizations were collected. City-specific conditional logistic regression models were applied within the case-crossover "time-stratified" framework, followed by random-effects meta-analysis...
October 25, 2016: American Journal of Epidemiology
Pei-Li Wang, Lei Zhang, Shao-Li Wang, Qiao-Ning Yang, Zhu-Ye Gao, Jian-Peng Du, Da-Wu Zhang, Chang-Geng Fu, Feng Gu, Hao Xu, Li-Zhi Li, Cheng-Long Wang, Da-Zhuo Shi
OBJECTIVE: To evaluate the prognosis effect of Chinese herbal medicines (CHMs) for benefifiting qi and activating blood circulation adjunctive to conventional treatment in patients with acute coronary syndrome (ACS) after percutaneous coronary intervention (PCI). METHODS: A total of 702 patients with ACS who underwent PCI were enrolled and randomly assigned to receive conventional treatment plus CHMs for benefifiting qi and activating blood circulation (treatment group, 351 cases) or conventional treatment alone (control group, 351 cases) for 6 months...
October 24, 2016: Chinese Journal of Integrative Medicine
Masato Matsushita, Akihiro Shirakabe, Noritake Hata, Takuro Shinada, Nobuaki Kobayashi, Kazunori Tomita, Masafumi Tsurumi, Hirotake Okazaki, Yoshiya Yamamoto, Kuniya Asai, Wataru Shimizu
Obesity is known to be associated with the development of heart failure (HF). However, the relationship between the body mass index (BMI) and acute HF (AHF) remains to be elucidated. Eight hundred and eight AHF patients were enrolled in this study. The patients were assigned to four groups according to their BMI values: severely thin (n = 11, BMI <16), normal/underweight (n = 579, 16 ≤ BMI <25), overweight (n = 178, 25 ≤ BMI <30) and obese (n = 40, BMI ≥30). The patients in the severely thin group were more likely to be female, have systolic blood pressure (SBP) <100 mmHg and have valvular disease than normal/underweight patients...
October 24, 2016: Heart and Vessels
Nicola Riccardo Pugliese, Iacopo Fabiani, Salvatore La Carrubba, Lorenzo Conte, Francesco Antonini-Canterin, Paolo Colonna, Pio Caso, Frank Benedetto, Veronica Santini, Scipione Carerj, Maria Francesca Romano, Rodolfo Citro, Vitantonio Di Bello
Patients with asymptomatic heart failure (HF; stage A and B) are characterized by maladaptive left ventricular (LV) remodeling. Classic 4-group classification of remodeling considers only LV mass index and relative wall thickness as variables. Complex remodeling classification (CRC) includes also LV end-diastolic volume index. Main aim was to assess the prognostic impact of CRC in stage A and B HF. A total of 1,750 asymptomatic subjects underwent echocardiographic examination as a screening evaluation in the presence of cardiovascular risk factors...
September 29, 2016: American Journal of Cardiology
Bin Wang, Suijun Liu, Ling Li, Qiuming Yao, Ronghua Song, Xiaoqing Shao, Qian Li, Xiaohong Shi, Jin-An Zhang
BACKGROUND: Non-thyroidal illness syndrome (NTIS) is characterized by decreased serum triiodothyronine level without increased thyroid-stimulating hormone level during critical illness. The summary data on the prevalence of NTIS in cardiovascular patients are lacking, and its prognostic role in cardiovascular patients is also unclear. METHODS: We performed a systematic review and meta-analysis to comprehensively determine the prevalence and the prognostic role of NTIS in cardiovascular patients...
October 18, 2016: International Journal of Cardiology
G-X Hu, J Zhang, Y-G Tian, Y-H Li, L Mou, L-J Qiao
OBJECTIVE: We discussed the diagnostic value of joint detection of homocysteine (HCY) and red blood cell volume distribution width variable coefficient on acute myocardial infarction (AMI). PATIENTS AND METHODS: We collected 300 coronary heart disease cases, among which there were 121 cases of stenocardia, 65 cases of ischemic heart failure, and 114 cases of AMI at the Department of Cardiology of our hospital during the period from January 2012 to June 2013. At the same time, we took 100 normal physical examinees as the control group, used the full-automatic cell-analyzer and the immunization to measure HCY and red blood cell distribution width (RDW) CV respectively and analyze their value in diagnosing AMI...
October 2016: European Review for Medical and Pharmacological Sciences
Cunlin Wang, Robert Kane, Mark Levenson, Jeffrey Kelman, Michael Wernecke, Joo-Yeon Lee, Steven Kozlowski, Carmen Dekmezian, Zhiwei Zhang, Aliza Thompson, Kimberly Smith, Yu-Te Wu, Yuqin Wei, Yoganand Chillarige, Qin Ryan, Chris Worrall, Thomas E MaCurdy, David J Graham
Importance: In 2011, the US Centers for Medicare & Medicaid Services (CMS) changed its reimbursement policy for hemodialysis to a bundled comprehensive payment system that included the cost of erythrocyte-stimulating agents (ESAs). Also in 2011, the US Food and Drug Administration revised the drug label for ESAs, recommending more conservative dosing in patients with chronic kidney disease. In response to concerns that these measures could have adverse effects on patient care and outcomes, the CMS and the FDA initiated a collaboration to assess the effect...
October 24, 2016: JAMA Internal Medicine
Cüneyt Toprak, Gökhan Kahveci, Alev Kılıçgedik, Cevat Kırma, Selçuk Pala, Mustafa Bulut, Cihangir Kaymaz, Nihal Özdemir, İbrahim Akın İzgi, Mehmet İnanır, Anıl Avcı, Ali Metin Esen
OBJECTIVE: Mitral valve regurgitation (MR) is the second most common heart valve disease in Europe. Without intervention, prognosis of severe symptomatic MR is poor. Percutaneous edge-to-edge mitral valve repair with MitraClip is a promising mitral regurgitation treatment technique in select, high-surgical-risk patients. The present objective was to describe the experience of a single center with MitraClip use in a high-risk series in Turkey. METHODS: Between May 2013 and September 2014, 28 high-surgical-risk patients with MR of at least grade 3+ and mean EuroSCORE of 26% underwent MitraClip implantation at our institution...
October 2016: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
Anna J Meredith, Darlene L Y Dai, Virginia Chen, Zsuzsanna Hollander, Raymond Ng, Annemarie Kaan, Scott Tebbutt, Krishnan Ramanathan, Anson Cheung, Bruce M McManus
BACKGROUND: Severe inotrope-dependent acute heart failure (AHF) is associated with poor clinical outcomes. There are currently no well-defined blood biomarkers of response to treatment that can guide management or identify recovery in this patient population. In the present study, we characterized the levels of novel and emerging circulating biomarkers of heart failure in patients with AHF over the first 30 days of medical management or mechanical circulatory support (MCS). We hypothesized a shared a plasma proteomic treatment response would be identifiable in both patient groups, representing reversal of the AHF phenotype...
June 2016: ESC Heart Failure
Heli Tolppanen, Krista Siirila-Waris, Veli-Pekka Harjola, David Marono, Jiri Parenica, Philipp Kreutzinger, Tuomo Nieminen, Marie Pavlusova, Tuukka Tarvasmaki, Raphael Twerenbold, Jukka Tolonen, Roman Miklik, Markku S Nieminen, Jindrich Spinar, Christian Mueller, Johan Lassus
AIMS: Data on the prognostic role of left and right bundle branch blocks (LBBB and RBBB), and nonspecific intraventricular conduction delay (IVCD; QRS ≥ 110 ms, no BBB) in acute heart failure (AHF) are controversial. Our aim was to investigate electrocardiographic predictors of long-term survival in patients with de novo AHF and acutely decompensated chronic heart failure (ADCHF). METHODS AND RESULTS: We analysed the admission electrocardiogram of 982 patients from a multicenter European cohort of AHF with 3...
March 2016: ESC Heart Failure
Arash Haghikia, Philipp Röntgen, Jens Vogel-Claussen, Johannes Schwab, Ralf Westenfeld, Philipp Ehlermann, Dominik Berliner, Edith Podewski, Denise Hilfiker-Kleiner, Johann Bauersachs
AIMS: Peripartum cardiomyopathy (PPCM) is a major cause of acute heart failure in the peripartum period and considered potentially life threatening. While many aspects of its clinical profiles have been frequently reported, functional analysis, in particular of the right ventricle, and tissue characterization by cardiovascular magnetic resonance (CMR) imaging have been only sporadically described. The aim of the present study was to analyse pathological alterations and their prognostic relevance found in CMR imaging of patients newly diagnosed with PPCM...
December 2015: ESC Heart Failure
Joerg C Schefold, Mitja Lainscak, Lea Majc Hodoscek, Stefan Blöchlinger, Wolfram Doehner, Stephan von Haehling
BACKGROUND: Acute heart failure (AHF) is a leading cause of death in critically ill patients and is often accompanied by significant renal dysfunction. Few data exist on the predictive value of measures of renal dysfunction in large cohorts of patients hospitalized for AHF. METHODS: Six hundred and eighteen patients hospitalized for AHF (300 male, aged 73.3 ± 10.3 years, 73% New York Heart Association Class 4, mean hospital length of stay 12.9 ± 7.7 days, 97% non-ischaemic AHF) were included in a retrospective single-centre data analysis...
December 2015: ESC Heart Failure
Alexander J Sweidan, Navneet K Singh, Natasha Dang, Vinh Lam, Jyoti Datta
INTRODUCTION: Amiodarone is often used in the suppression of tachyarrhythmias. One of the more serious adverse effects includes amiodarone pulmonary toxicity (APT). Several pulmonary diseases can manifest including interstitial pneumonitis, organizing pneumonia, acute respiratory distress syndrome, diffuse alveolar hemorrhage, pulmonary nodules or masses, and pleural effusion. Incidence of APT varies from 5-15% and is correlated to dosage, age of the patient, and preexisting lung disease...
2016: Clinical Medicine Insights. Case Reports
Mohamed M Al-Daydamony, El-Sayed M Farag
AIM: To examine the value of CRUSADE bleeding score in predicting bleeding events in our local patients with acute coronary syndrome (ACS) in Zagazig University Hospitals. METHODS: Our study included 240 patients with ACS. They underwent history and clinical examination; 12-lead electrocardiography; echocardiography; troponin I, hematocrit value; estimated glomerular filtration rate (eGFR); application of CRUSADE score; and follow-up of the hospital stay and documentations of events...
September 2016: Indian Heart Journal
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