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https://www.readbyqxmd.com/read/28530501/palliative-care-for-advanced-heart-failure-in-a-department-of-veterans-affairs-regional-hospice-program-patient-selection-a-treatment-protocol-and-clinical-course
#1
George J Taylor, Dorothy M Lee, Catalin F Baicu, Michael R Zile
BACKGROUND: Palliative care for advanced heart failure (HF) is generally recommended. However, few reports have focused on the particulars of treatment, or the clinical course of HF on a specific treatment regimen. OBJECTIVE: Palliation adequate to allow patients to avoid HF admission and die at home. METHODS: Patients from a veterans administration regional practice with multiple, recent hospital admissions were enrolled in community hospice programs...
May 22, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28513877/heart-rate-and-outcome-in-heart-failure-with-reduced-ejection-fraction-differences-between-atrial-fibrillation-and-sinus-rhythm-a-cibis-ii-analysis
#2
Bart A Mulder, Kevin Damman, Dirk J Van Veldhuisen, Isabelle C Van Gelder, Michiel Rienstra
BACKGROUND: Heart rate has been associated with prognosis in patients with heart failure with reduced ejection fraction (HFREF) and sinus rhythm; whether this also holds true in patients with atrial fibrillation (AF) is unknown. HYPOTHESIS: To evaluate cardiac rhythm and baseline heart rate and the influence of outcome in patients with HFREF enrolled in the Cardiac Insufficiency Bisoprolol Study II. METHODS: In total, 2539 patients were stratified according to their baseline heart rhythm (AF or sinus rhythm) and into quartiles of heart rate (≤70 bpm, 71-78 bpm, 79-90 bpm, and >90 bpm)...
May 17, 2017: Clinical Cardiology
https://www.readbyqxmd.com/read/28510680/effect-of-oral-iron-repletion-on-exercise-capacity-in-patients-with-heart-failure-with-reduced-ejection-fraction-and-iron-deficiency-the-ironout-hf-randomized-clinical-trial
#3
Gregory D Lewis, Rajeev Malhotra, Adrian F Hernandez, Steven E McNulty, Andrew Smith, G Michael Felker, W H Wilson Tang, Shane J LaRue, Margaret M Redfield, Marc J Semigran, Michael M Givertz, Peter Van Buren, David Whellan, Kevin J Anstrom, Monica R Shah, Patrice Desvigne-Nickens, Javed Butler, Eugene Braunwald
Importance: Iron deficiency is present in approximately 50% of patients with heart failure with reduced left ventricular ejection fraction (HFrEF) and is an independent predictor of reduced functional capacity and mortality. However, the efficacy of inexpensive readily available oral iron supplementation in heart failure is unknown. Objective: To test whether therapy with oral iron improves peak exercise capacity in patients with HFrEF and iron deficiency. Design, Setting, and Participants: Phase 2, double-blind, placebo-controlled randomized clinical trial of patients with HFrEF (<40%) and iron deficiency, defined as a serum ferritin level of 15 to 100 ng/mL or a serum ferritin level of 101 to 299 ng/mL with transferrin saturation of less than 20%...
May 16, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28496549/phosphodiesterase-5-inhibitors-improve-clinical-outcomes-exercise-capacity-and-pulmonary-hemodynamics-in-patients-with-heart-failure-with-reduced-left-ventricular-ejection-fraction-a-meta-analysis
#4
Renato De Vecchis, Arturo Cesaro, Carmelina Ariano, Anna Giasi, Carmela Cioppa
BACKGROUND: Several studies have compared the use of phosphodiesterase-5 (PDE5) inhibitors sildenafil or udenafil with the placebo in patients suffering from pulmonary hypertension (PH) due to left chronic heart failure (CHF), corresponding to group 2 (PH due to left heart disease) of the PH classification (according to 2015 ESC/ERS guidelines for the diagnosis and treatment of PH). The results of the use of PDE5 inhibitors in the PH due to left heart disease were inconsistent and heterogeneous...
June 2017: Journal of Clinical Medicine Research
https://www.readbyqxmd.com/read/28492561/-sacubitril-valsartan-a-new-and-effective-treatment-for-heart-failure-with-reduced-ejection-fraction
#5
Michele Senni, Bruno Trimarco, Michele Emdin, Luciano De Biase
Despite significant therapeutic advances, patients with chronic heart failure and reduced ejection fraction (HFrEF) remain at high risk for heart failure progression and death. The PARADIGM-HF study, the largest outcome trial in HFrEF, has shown improved cardiovascular outcomes with sacubitril/valsartan (Entresto®, Novartis), previously known as LCZ696, compared with angiotensin-converting enzyme (ACE) inhibitor therapy, possibly leading us to a new era for heart failure treatment. Sacubitril/valsartan represents a first-in-class drug acting through inhibition of angiotensin receptor and neprilysin, thus modulating the renin-angiotensin-aldosterone system and vasoactive substances such as natriuretic peptides...
January 2017: Giornale Italiano di Cardiologia
https://www.readbyqxmd.com/read/28492288/epidemiology-of-heart-failure-with-preserved-ejection-fraction
#6
REVIEW
Shannon M Dunlay, Véronique L Roger, Margaret M Redfield
Heart failure (HF) with preserved ejection fraction (HFpEF) is a clinical syndrome associated with poor quality of life, substantial health-care resource utilization, and premature mortality. We summarize the current knowledge regarding the epidemiology of HFpEF with a focus on community-based studies relevant to quantifying the population burden of HFpEF. Current data regarding the prevalence and incidence of HFpEF in the community as well as associated conditions and risk factors, risk of morbidity and mortality after diagnosis, and quality of life are presented...
May 11, 2017: Nature Reviews. Cardiology
https://www.readbyqxmd.com/read/28489317/pharmacogenomics-of-angiotensin-receptor-neprilysin-inhibitor-and-its-long-term-side-effects
#7
REVIEW
Chayakrit Krittanawong, Takeshi Kitai
The development of the promising agent sacubitril/valsartan, known as an angiotensin receptor blocker-neprilysin inhibitor (ARNI), to improve heart failure (HF) management, may benefit morbidity, mortality, and readmission rates in patients with HF. The PARADIGM-HF trial demonstrated that the ARNI can reduce morbidity and mortality in patients with heart failure with reduced ejection fraction (HFrEF), while ongoing PARAMOUNT and PARAGON-HF trials determined whether the ARNI has morbidity and mortality benefits in patients with heart failure with preserved ejection fraction (HFpEF)...
May 10, 2017: Cardiovascular Therapeutics
https://www.readbyqxmd.com/read/28484123/adaptive-servo-ventilation-treatment-increases-stroke-volume-in-stable-systolic-heart-failure-patients-with-low-tricuspid-annular-plane-systolic-excursion
#8
Toshihiro Iwasaku, Tomotaka Ando, Akiyo Eguchi, Yoshitaka Okuhara, Yoshiro Naito, Toshiaki Mano, Tohru Masuyama, Shinichi Hirotani
We hypothesized that the effects of adaptive servo-ventilation (ASV) therapy were influenced by right-sided heart performance. This study aimed to clarify the interaction between the effects of ASV and right-sided heart performance in patients with stable heart failure (HF) with reduced ejection fraction (HFrEF).Twenty-six stable HF inpatients (left ventricular ejection fraction < 0.45, without moderate to severe mitral regurgitation (MR) were analyzed. Echocardiography was performed before and after 30 minutes of ASV...
May 8, 2017: International Heart Journal
https://www.readbyqxmd.com/read/28476146/heart-failure-in-patients-with-coronary-heart-disease-prevalence-characteristics-and-guideline-implementation-results-from-the-german-euroaspire-iv-cohort
#9
Caroline Morbach, Martin Wagner, Stefan Güntner, Carolin Malsch, Mehmet Oezkur, David Wood, Kornelia Kotseva, Rainer Leyh, Georg Ertl, Wolfgang Karmann, Peter U Heuschmann, Stefan Störk
BACKGROUND: Adherence to pharmacotherapeutic treatment guidelines in patients with heart failure (HF) is of major prognostic importance, but thorough implementation of guidelines in routine care remains insufficient. Our aim was to investigate prevalence and characteristics of HF in patients with coronary heart disease (CHD), and to assess the adherence to current HF guidelines in patients with HF stage C, thus identifying potential targets for the optimization of guideline implementation...
May 5, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28475676/comparative-effectiveness-of-enalapril-lisinopril-and-ramipril-in-the-treatment-of-patients-with-chronic-heart-failure-a-propensity-score-matched-cohort-study
#10
Hanna Fröhlich, Felix Henning, Tobias Täger, Dieter Schellberg, Morten Grundtvig, Kevin Goode, Anna Corletto, Syed Kazmi, Torstein Hole, Hugo A Katus, Dan Atar, John G F Cleland, Stefan Agewall, Lutz Frankenstein, Andrew L Clark
Background: Angiotensin converting enzyme inhibitors (ACEIs) are recommended as first-line therapy in patients with heart failure with reduced ejection fraction (HFrEF). The comparative effectiveness of different ACEIs is not known. Methods and results: 4,723 out-patients with stable HFrEF prescribed either enalapril, lisinopril, or ramipril were identified from three registries in Norway, England, and Germany. In three separate matching procedures, patients were individually matched with respect to both dose equivalents and their respective propensity scores for ACEI treatment...
May 5, 2017: European Heart Journal. Cardiovascular Pharmacotherapy
https://www.readbyqxmd.com/read/28473403/performance-of-ahead-score-in-an-asian-cohort-of-acute-heart-failure-with-either-preserved-or-reduced-left-ventricular-systolic-function
#11
Yu-Jen Chen, Shih-Hsien Sung, Hao-Min Cheng, Wei-Ming Huang, Chung-Li Wu, Chi-Jung Huang, Pai-Feng Hsu, Jong-Shiuan Yeh, Chao-Yu Guo, Wen-Chung Yu, Chen-Huan Chen
BACKGROUND: AHEAD (A: atrial fibrillation; H: hemoglobin; E: elderly; A: abnormal renal parameters; D: diabetes mellitus) score has been related to clinical outcomes of acute heart failure. However, the prognostic value of the AHEAD score in acute heart failure patients with either reduced or preserved left ventricular ejection fraction (HFrEF and HFpEF) remain to be elucidated. METHODS AND RESULTS: The study population consisted of 2143 patients (age 77±12 years, 68% men, 38% HFrEF) hospitalized primarily for acute heart failure with a median follow-up of 23...
May 4, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28467883/heart-rate-heart-rhythm-and-prognostic-benefits-of-beta-blockers-in-heart-failure-individual-patient-data-meta-analysis
#12
Dipak Kotecha, Marcus D Flather, Douglas G Altman, Jane Holmes, Giuseppe Rosano, John Wikstrand, Milton Packer, Andrew J S Coats, Luis Manzano, Michael Böhm, Dirk J van Veldhuisen, Bert Andersson, Hans Wedel, Thomas G von Lueder, Alan S Rigby, Åke Hjalmarson, John Kjekshus, John G F Cleland
BACKGROUND: The relationship between mortality and heart rate remains unclear for patients with heart failure and reduced ejection fraction (HFrEF) in either sinus rhythm or atrial fibrillation (AF). OBJECTIVE: To investigate the prognostic importance of heart rate in HFrEF in randomized controlled trials (RCTs) comparing beta-blockers and placebo. METHODS: The Beta-blockers in Heart Failure Collaborative Group performed a meta-analysis of harmonized individual-patient data from eleven double-blind RCTs...
April 5, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28463464/physicians-guideline-adherence-is-associated-with-better-prognosis-in-outpatients-with-heart-failure-with-reduced-ejection-fraction-the-qualify-international-registry
#13
Michel Komajda, Martin R Cowie, Luigi Tavazzi, Piotr Ponikowski, Stefan D Anker, Gerasimos S Filippatos
AIMS: To evaluate the impact of physicians' adherence to guideline-recommended medications for heart failure with reduced ejection fraction (HFrEF), including ≥50% prescription of recommended doses, on clinical outcomes at 6-month follow-up. METHODS AND RESULTS: In QUALIFY, an international, prospective, observational, longitudinal survey, 6669 outpatients with HFrEF were recruited 1-15 months after heart failure (HF) hospitalization from September 2013 to December 2014 in 36 countries and followed up at 6 months...
April 30, 2017: European Journal of Heart Failure
https://www.readbyqxmd.com/read/28455131/echocardiographic-pulmonary-artery-pressure-estimation-and-heart-failure-rehospitalization-burden-in-patients-with-acute-heart-failure
#14
Enrique Santas, Rafael de la Espriella-Juan, Anna Mollar, Ernesto Valero, Gema Miñana, Juan Sanchis, Francisco Javier Chorro, Julio Núñez
Pulmonary hypertension (PH) is a strong predictor of mortality in patients with heart failure (HF). However, the relationship between PH, through echocardiographic pulmonary artery pressure (PASP) estimation, and the risk of HF rehospitalizations remains unclear. METHODS: We prospectively included 2343 consecutive patients discharged for acute heart failure (AHF). PH was estimated by echocardiography through PASP determination during the index admission. Patients were categorized as follows across PASP: non-measurable, normal (≤35mmHg), mild (36-45mmHg), moderate (46-60mmHg), or severe PH (>60mmHg)...
April 21, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28451445/who-are-patients-classified-within-the-new-terminology-of-heart-failure-from-the-2016-esc-guidelines
#15
Benoit Delepaul, Guillaume Robin, Clément Delmas, Thomas Moine, Adrien Blanc, Pauline Fournier, Aénora Roger-Rollé, Guillaume Domain, Clémence Delon, Charles Uzan, Rabah Boudjellil, Didier Carrié, Jérôme Roncalli, Michel Galinier, Olivier Lairez
AIMS: The main terminology used to describe heart failure (HF) is based on measurement of the left ventricular ejection fraction (LVEF). LVEF in the range of 40-49% was recently defined as HF with mid-range EF (HFmrEF) by the 2016 European Society of Cardiology guidelines. The purpose of our study was to assess the clinical profile and prognosis of patients with HF according to this new classification. METHODS AND RESULTS: A total of 482 patients referred for HF were retrospectively included over a period of 1 year...
May 2017: ESC Heart Failure
https://www.readbyqxmd.com/read/28450040/comparison-of-predictors-of-heart-failure-with-preserved-versus-reduced-ejection-fraction-in-a-multiracial-cohort-of-preclinical-left-ventricular-diastolic-dysfunction
#16
Lili Zhang, Jared J Liebelt, Nidhi Madan, Jian Shan, Cynthia C Taub
Preclinical diastolic dysfunction (PDD) is a well-known but poorly understood risk factor for heart failure. We aimed to investigate risk factors contributing to progression of PDD to heart failure with preserved ejection fraction (HFpEF) and heart failure with reduced ejection fraction (HFrEF). Patients with echocardiogram from 2003 to 2008 with left ventricular ejection fraction ≥50%, grade I diastolic dysfunction, and free of clinical heart failure were included. The end point was incident HFpEF or HFrEF...
June 1, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28446199/different-determinants-of-exercise-capacity-in-hfpef-compared-to-hfref
#17
Arlind Batalli, Pranvera Ibrahimi, Ibadete Bytyçi, Artan Ahmeti, Edmond Haliti, Shpend Elezi, Michael Y Henein, Gani Bajraktari
BACKGROUND: Quality of life is as important as survival in heart failure (HF) patients. Controversies exist with regards to echocardiographic determinants of exercise capacity in HF, particularly in patients with preserved ejection fraction (HFpEF). The aim of this study was to prospectively examine echocardiographic parameters that correlate and predict functional exercise capacity assessed by 6 min walk test (6-MWT) in patients with HFpEF. METHODS: In 111 HF patients (mean age 63 ± 10 years, 47% female), an echo-Doppler study and a 6-MWT were performed in the same day...
April 26, 2017: Cardiovascular Ultrasound
https://www.readbyqxmd.com/read/28438373/geriatric-nutritional-risk-index-as-a-nutritional-and-survival-risk-assessment-tool-in-stable-outpatients-with-systolic-heart-failure
#18
L Sargento, A Vicente Simões, J Rodrigues, S Longo, N Lousada, R Palma Dos Reis
BACKGROUND AND AIMS: Malnutrition is frequent in heart failure (HF). However, the best tool for evaluating malnutrition in geriatric patients with HF with reduced ejection fraction (HFrEF) is unknown. This study aimed to evaluate the incremental prognostic value of the geriatric nutritional risk index (GNRI) in stable geriatric outpatients with HFrEF compared with a clinical/laboratory prognostic model. METHODS AND RESULTS: A total of 143 outpatients with HFrEF, aged >65 years, a LVEF <40%, and who were stable and on optimal therapy were studied...
May 2017: Nutrition, Metabolism, and Cardiovascular Diseases: NMCD
https://www.readbyqxmd.com/read/28424575/contribution-of-autonomic-reflexes-to-the-hyperadrenergic-state-in-heart-failure
#19
REVIEW
Edgar Toschi-Dias, Maria Urbana P B Rondon, Chiara Cogliati, Nazareno Paolocci, Eleonora Tobaldini, Nicola Montano
Heart failure (HF) is a complex syndrome representing the clinical endpoint of many cardiovascular diseases of different etiology. Given its prevalence, incidence and social impact, a better understanding of HF pathophysiology is paramount to implement more effective anti-HF therapies. Based on left ventricle (LV) performance, HF is currently classified as follows: (1) with reduced ejection fraction (HFrEF); (2) with mid-range EF (HFmrEF); and (3) with preserved EF (HFpEF). A central tenet of HFrEF pathophysiology is adrenergic hyperactivity, featuring increased sympathetic nerve discharge and a progressive loss of rhythmical sympathetic oscillations...
2017: Frontiers in Neuroscience
https://www.readbyqxmd.com/read/28416525/treatment-of-patients-with-atrial-fibrillation-and-heart-failure-with-reduced-ejection-fraction
#20
REVIEW
Atul Verma, Jonathan M Kalman, David J Callans
Atrial fibrillation (AF) and heart failure with reduced ejection fraction (HFrEF) frequently coexist, and each complicates the course and treatment of the other. Recent population-based studies have demonstrated that the 2 conditions together increase the risk of stroke, heart failure hospitalization, and all-cause mortality, especially soon after the clinical onset of AF. Guideline-directed pharmacological therapy for HFrEF is important; however, although there are various treatment modalities for AF, there is no clear consensus on how best to treat AF with concomitant HFrEF...
April 18, 2017: Circulation
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