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failure heart

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
Jarrod D Frizzell, Li Liang, Phillip J Schulte, Clyde W Yancy, Paul A Heidenreich, Adrian F Hernandez, Deepak L Bhatt, Gregg C Fonarow, Warren K Laskey
Importance: Several attempts have been made at developing models to predict 30-day readmissions in patients with heart failure, but none have sufficient discriminatory capacity for clinical use. Machine-learning (ML) algorithms represent a novel approach and may have potential advantages over traditional statistical modeling. Objective: To develop models using a ML approach to predict all-cause readmissions 30 days after discharge from a heart failure hospitalization and to compare ML model performance with models developed using "conventional" statistically based methods...
October 26, 2016: JAMA Cardiology
Aakash Garg, Deepti Virmani, Sahil Agrawal, Chirag Agarwal, Abhishek Sharma, Giulio Stefanini, John B Kostis
Heart failure with a preserved ejection fraction (HFpEF) is increasingly prevalent and a leading cause of morbidity and mortality worldwide. HFpEF has a complex pathophysiology, with recent evidence suggesting that an interaction of cardiovascular and noncardiovascular comorbidities (e.g. obesity, hypertension, diabetes, coronary artery disease, and chronic kidney disease) induces an inflammatory state that eventually leads to myocardial structural and functional alterations. Current ACCF/AHA guidelines suggest incorporation of biomarkers along with clinical and imaging tools to establish the diagnosis and disease severity in heart failure (HF)...
October 27, 2016: Cardiology
Sainan Cheng, Hongyue Wang, Minjie Lu, Chen Cui, Lu Li, Gang Yin, Shihua Zhao
No abstract text is available yet for this article.
October 18, 2016: International Journal of Cardiology
Lauren B Cooper, Xiaojuan Mi, Robert J Mentz, Jennifer B Green, Kevin J Anstrom, Adrian F Hernandez, Lesley H Curtis
BACKGROUND: Several diabetes mellitus (DM) therapies are associated with worse heart failure (HF) outcomes, yet limited data exist characterizing routine DM management based on HF status. HYPOTHESIS: DM medications prescribed for patients with HF will differ in meaningful ways from patients without HF, and co-morbidities will impact the choice of medications prescribed. METHODS: Using Medicare fee-for-service claims data, we identified patients with newly treated DM between 2008 and 2011 and used multivariable logistic regression to assess associations between baseline HF status and DM medication use...
October 26, 2016: Clinical 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
(no author information available yet)
[This corrects the article doi: 10.1590/0034-7167.2016690312i].
September 2016: Revista Brasileira de Enfermagem
Wei Qin, Feng Liu, Chen Wan
BACKGROUND AND AIMS: The role of Body Mass Index (BMI) for the prognosis of heart failure (HF) patients remains to be a great interest for a long time. However, the precise effect of dose-response for BMI and mortality risk in HF patients is still unclear. We conducted a dose-response meta-analysis to quantitatively assess the effect of BMI on all-cause mortality in subjects with HF. METHODS: Fourteen prospective cohort studies included 13508 death cases identified among 46794 HF patients...
October 26, 2016: Cardiovascular Therapeutics
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
D L Misner, M A Kauss, J Singh, H Uppal, A Bruening-Wright, B M Liederer, T Lin, B McCray, N La, T Nguyen, D Sampath, P S Dragovich, T O'Brien, T S Zabka
Nicotinamide phosphoribosyltransferase (NAMPT) is a pleiotropic protein that functions as an enzyme, cytokine, growth factor and hormone. As a target for oncology, NAMPT is particularly attractive, because it catalyzes the rate-limiting step in the salvage pathway to generate nicotinamide adenine dinucleotide (NAD), a universal energy- and signal-carrying molecule involved in cellular energy metabolism and many homeostatic functions. Inhibition of NAMPT generally results in NAD depletion, followed by ATP reduction and loss of cell viability...
October 25, 2016: Cardiovascular Toxicology
Jochen Springer, Markus S Anker, Stefan D Anker
No abstract text is available yet for this article.
December 2016: Journal of Cardiovascular Medicine
Mitja Lainscak, Cristiana Vitale
No abstract text is available yet for this article.
December 2016: Journal of Cardiovascular Medicine
A Sporková, Z Husková, P Škaroupková, N R Reddy, J R Falck, J Sadowski, L Červenka
Pathophysiological mechanisms underlying the development of renal dysfunction and progression of congestive heart failure (CHF) remain poorly understood. Recent studies have revealed striking differences in the role of epoxyeicosatrienoic acids (EETs), active products of cytochrome P-450-dependent epoxygenase pathway of arachidonic acid, in the progression of aorto-caval fistula (ACF)-induced CHF between hypertensive Ren-2 renin transgenic rats (TGR) and transgene-negative normotensive Hannover Sprague-Dawley (HanSD) controls...
October 26, 2016: Physiological Research
Michael Melin, Andreas Montelius, Lars Rydén, Adrian Gonon, Inger Hagerman, Eric Rullman
Enhanced external counterpulsation (EECP) is a non-invasive treatment in which leg cuff compressions increase diastolic aortic pressure and coronary perfusion. EECP is offered to patients with refractory angina pectoris and increases physical capacity. Benefits in heart failure patients have been noted, but EECP is still considered to be experimental and its effects must be confirmed. The mechanism of action is still unclear. The aim of this study was to evaluate the effect of EECP on skeletal muscle gene expression and physical performance in patients with severe heart failure...
October 26, 2016: Clinical Physiology and Functional Imaging
Aditya J Ullal, Daniel W Kaiser, Jun Fan, Susan Schmitt, Claire T Than, Wolfgang C Winkelmayer, Paul A Heidenreich, Jonathon P Piccini, Marco V Perez, Paul J Wang, Mintu P Turakhia
INTRODUCTION: Data regarding catheter ablation of atrial fibrillation (AF) in patients with chronic kidney disease (CKD) is limited. We therefore assessed the association of CKD with common safety and clinical outcomes in a nationwide sample of ablation recipients. METHODS: Using MarketScan(®) Commercial Claims and Medicare Supplemental Databases, we evaluated 30-day safety and 1-year clinical outcomes in patients who underwent a first AF ablation procedure between 2007-2011...
October 26, 2016: Journal of Cardiovascular Electrophysiology
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
Saurabh Kumar, Akira Fujii, Sunil Kapur, Jorge Romero, Nishaki K Mehta, Shinichi Tanigawa, Laurence M Epstein, Bruce A Koplan, Gregory F Michaud, Roy M John, William G Stevenson, Usha B Tedrow
AIMS: Catheter ablation can be lifesaving in ventricular tachycardia (VT) storm, but the underlying substrate in patients with storm is not well characterized. We sought to compare the clinical factors, substrate and outcomes differences in patients with sustained monomorphic VT who present for catheter ablation with VT storm versus those with a non-storm presentation. METHODS: Consecutive ischemic (ICM; n = 554) or non-ischemic cardiomyopathy patients (NICM; n = 369) with a storm vs...
October 26, 2016: Journal of Cardiovascular Electrophysiology
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
Dhavalkumar B Patel, Rachit M Shah, Deepak L Bhatt, Li Liang, Phillip J Schulte, Adam D DeVore, Adrian F Hernandez, Paul A Heidenreich, Clyde W Yancy, Gregg C Fonarow
BACKGROUND: Despite increasing awareness regarding evidence-based guidelines, considerable gaps exist for heart failure (HF) quality of care at teaching hospitals (TH) and nonteaching hospitals (NTH). We analyzed data from Get With The Guidelines (GWTG)-HF to compare the rates and trends of guideline-recommended care at TH and NTH for patients with HF. METHOD AND RESULTS: Baseline patient characteristics, performance measures, and in-hospital outcomes were compared between 197 187 HF patients admitted to TH and 106 924 patients admitted to NTH between 2005 and 2014...
October 25, 2016: Circulation. Cardiovascular Quality and Outcomes
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