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Acute Heart Failure

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7 papers 0 to 25 followers
Behnood Bikdeli, Kelly M Strait, Kumar Dharmarajan, Shu-Xia Li, Purav Mody, Chohreh Partovian, Steven G Coca, Nancy Kim, Leora I Horwitz, Jeffrey M Testani, Harlan M Krumholz
OBJECTIVES: This study sought to determine the use of intravenous fluids in the early care of patients with acute decompensated heart failure (HF) who are treated with loop diuretics. BACKGROUND: Intravenous fluids are routinely provided to many hospitalized patients. METHODS: We conducted a retrospective cohort study of patients admitted with HF to 346 hospitals from 2009 to 2010. We assessed the use of intravenous fluids during the first 2 days of hospitalization...
February 2015: JACC. Heart Failure
Julio Núñez, Gema Miñana, Enrique Santas, Vicente Bertomeu-González
Cardiorenal syndrome has been defined as the simultaneous dysfunction of both the heart and the kidney. Worsening renal function that occurs in patients with acute heart failure has been classified as cardiorenal syndrome type 1. In this setting, worsening renal function is a common finding and is due to complex, multifactorial, and not fully understood processes involving hemodynamic (renal arterial hypoperfusion and renal venous congestion) and nonhemodynamic factors. Traditionally, worsening renal function has been associated with worse outcomes, but recent findings have revealed mixed and heterogeneous results, perhaps suggesting that the same phenotype represents a diversity of pathophysiological and clinical situations...
May 2015: Revista Española de Cardiología
Arman Kilic, Robert S D Higgins, Bryan A Whitson, Ahmet Kilic
BACKGROUND: This study evaluated whether minority orthotopic heart transplant (OHT) recipients tend to be transplanted at worse performing centers. METHODS AND RESULTS: OHT recipients between 2000 and 2010 were identified in the United Network for Organ Sharing database and stratified by race. Center performance was evaluated using observed-to-expected mortality ratios that were calculated using validated indexes for recipient and donor risk in OHT. The primary outcome was 1-year post-OHT mortality...
March 10, 2015: Circulation
Jozef L Van Herck, Marc J Claeys, Rudi De Paep, Paul L Van Herck, Christiaan J Vrints, Philippe G Jorens
Cardiogenic shock complicates approximately 5-10% of cases with acute myocardial infarction and carries a poor prognosis. Early revascularization remains the cornerstone treatment of cardiogenic shock complicating myocardial infarction. Inotropic and/or vasopressor agents can be used for haemodynamic stabilization, although this comes at the expense of increased myocardial oxygen consumption and extended myocardial ischaemia. In recent years, the use of mechanical circulatory support has significantly increased...
June 2015: European Heart Journal. Acute Cardiovascular Care
John R Teerlink, Gad Cotter, Beth A Davison, G Michael Felker, Gerasimos Filippatos, Barry H Greenberg, Piotr Ponikowski, Elaine Unemori, Adriaan A Voors, Kirkwood F Adams, Maria I Dorobantu, Liliana R Grinfeld, Guillaume Jondeau, Alon Marmor, Josep Masip, Peter S Pang, Karl Werdan, Sam L Teichman, Angelo Trapani, Christopher A Bush, Rajnish Saini, Christoph Schumacher, Thomas M Severin, Marco Metra
BACKGROUND: Serelaxin, recombinant human relaxin-2, is a vasoactive peptide hormone with many biological and haemodynamic effects. In a pilot study, serelaxin was safe and well tolerated with positive clinical outcome signals in patients with acute heart failure. The RELAX-AHF trial tested the hypothesis that serelaxin-treated patients would have greater dyspnoea relief compared with patients treated with standard care and placebo. METHODS: RELAX-AHF was an international, double-blind, placebo-controlled trial, enrolling patients admitted to hospital for acute heart failure who were randomly assigned (1:1) via a central randomisation scheme blocked by study centre to standard care plus 48-h intravenous infusions of placebo or serelaxin (30 μg/kg per day) within 16 h from presentation...
January 5, 2013: Lancet
L T Cooper, C ElAmm
Giant cell myocarditis (GCM) usually presents as acute dilated cardiomyopathy that does not improve with guideline-based treatments. Ventricular tachycardia and heart block occur in a substantial number of patients. Diagnosis by endomyocardial biopsy can allow for the addition of immunosuppressive therapy and timely use of mechanical circulatory support when indicated. Recent studies suggest that the ventricular arrhythmias in GCM may be mediated by a cytokine-induced change in desmosomal protein expression...
September 2012: Herz
G Michael Felker, Kerry L Lee, David A Bull, Margaret M Redfield, Lynne W Stevenson, Steven R Goldsmith, Martin M LeWinter, Anita Deswal, Jean L Rouleau, Elizabeth O Ofili, Kevin J Anstrom, Adrian F Hernandez, Steven E McNulty, Eric J Velazquez, Abdallah G Kfoury, Horng H Chen, Michael M Givertz, Marc J Semigran, Bradley A Bart, Alice M Mascette, Eugene Braunwald, Christopher M O'Connor
BACKGROUND: Loop diuretics are an essential component of therapy for patients with acute decompensated heart failure, but there are few prospective data to guide their use. METHODS: In a prospective, double-blind, randomized trial, we assigned 308 patients with acute decompensated heart failure to receive furosemide administered intravenously by means of either a bolus every 12 hours or continuous infusion and at either a low dose (equivalent to the patient's previous oral dose) or a high dose (2...
March 3, 2011: New England Journal of Medicine
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