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Heart Failure

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926 papers 100 to 500 followers
By Elvis Amao Internal Medicine , Cardiology and infectious diseases
https://www.readbyqxmd.com/read/28602367/heart-failure-with-preserved-ejection-fraction-in-older-adults
#1
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/28602368/use-of-diuretics-in-the-treatment-of-heart-failure-in-older-adults
#2
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/28602373/cardiac-resynchronization-therapy-in-older-adults-with%C3%A2-heart-failure
#3
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/28602374/treatment-of-ventricular-arrhythmias-and-use-of-implantable-cardioverter-defibrillators-to-improve-survival-in-older-adult-patients-with-cardiac-disease
#4
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/28602369/heart-failure-complicating-acute-mtyocardial-infarction
#5
REVIEW
Wilbert S Aronow
Factors predisposing the older person with acute myocardial infarction (MI) to develop heart failure (HF) include an increased prevalence of MI, multivessel coronary artery disease, decreased left ventricular (LV) contractile reserve, impairment of LV diastolic relaxation, increased hypertension, LV hypertrophy, diabetes mellitus, valvular heart disease, and renal insufficiency. HF associated with acute MI should be treated with a loop diuretic. The use of nitrates, angiotensin-converting enzyme inhibitors, angiotensin II receptor blockers, aldosterone antagonists, beta-blockers, digoxin, and positive inotropic drugs; treatment of arrhythmias and mechanical complications; and indications for use of implantable cardioverter-defibrillators and cardiac resynchronization is discussed...
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
#6
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/28597798/ultrafiltration-versus-intravenous-loop-diuretics-in-patients-with-acute-decompensated-heart-failure-a-meta-analysis-of-clinical-trials
#7
Mohamad Kabach, Hassan Alkhawam, Sachil Shah, Georges Joseph, Elie M Donath, Noah Moss, Robert S Rosenstein, Robert Chait
Background Intravenous loop diuretics are the first-line therapy for acute decompensated heart failure (ADHF) but many patients are discharged with unresolved congestion resulting in higher re-hospitalization and mortality rates. Ultrafiltration (UF) is a promising intervention for ADHF. However, studies comparing UF to diuretics have been inconsistent in their clinical outcomes. Methods A comprehensive literature search was performed. Trials were included if they met the following criteria: (1) randomization with a control group, (2) comparison of UF with a loop diuretic, and (3) a diagnosis of ADHF...
April 2017: Acta Cardiologica
https://www.readbyqxmd.com/read/28597803/prognostic-value-of-galectin-3-on-admission-in-chinese-patients-with-heart-failure-a-prospective-observational-study
#8
Hua Wang, Qingyong Chen, Yingying Li, Xianchao Jing, Tianya Liang, Jiefu Yang
Objective We performed a prospective observational study to explore the prognostic value of plasma galectin-3, a biomarker for fibrosis and inflammation, in Chinese patients with heart failure (HF). Methods and results Galectin-3, N-terminal pro B-type natriuretic peptide (NT-proBNP) and other clinically related variables were measured in consecutive HF patients in Beijing Hospital. Specifically, galectin-3 was detected by an enzyme-linked immunosorbent assay. The primary end point was major adverse cardiac events (MACE), including all-cause mortality or readmission at the end of follow-up...
April 2017: Acta Cardiologica
https://www.readbyqxmd.com/read/28562571/hemodynamic-instability-after-pulmonary-veins-isolation-in-a-patient-with-dual-chamber-pacemaker-the-phantom-injury-of-the-ventricular-lead
#9
Márcio Galindo Kiuchi, Guilherme Miglioli Lobato, Shaojie Chen
INTRODUCTION: The standard treatment of sinus node dysfunction (SND) is the pacemaker implantation, and the ideal methodology for the management of atrial fibrillation (AF) is rhythm control, but this is sometimes very hard to accomplish. For such actions, complete isolation of all pulmonary veins (PVI) is currently widely accepted as the best endpoint. CASE PRESENTATION: In this case, we report a female patient, 81 years old, with controlled hypertension, without coronary artery disease, bearer of bilateral knee replacement, and dual chamber pacemaker implanted 1...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28570258/novel-method-for-exchange-of-impella-circulatory-assist-catheter-the-trojan-horse-technique
#10
Colin T Phillips, Hector Tamez, Thomas M Tu, Robert W Yeh, Duane S Pinto
Patients with an indwelling Impella may require escalation of hemodynamic support or exchange to another circulatory assistance platform. As such, preservation of vascular access is preferable in cases where anticoagulation cannot be discontinued or to facilitate exchange to an alternative catheter or closure device. Challenges exist in avoiding bleeding and loss of wire access in these situations. We describe a single-access "Trojan Horse" technique that minimizes bleeding while maintaining arterial access for rapid exchange of this percutaneous ventricular assist device...
May 15, 2017: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/28571618/repetitive-use-of-levosimendan-in-advanced-heart-failure-need-for-stronger-evidence-in-a-field-in-dire-need-of-a-useful-therapy
#11
Gerhard Pölzl, Johann Altenberger, Loant Baholli, Paola Beltrán, Attila Borbély, Josep Comin-Colet, Juan F Delgado, Francesco Fedele, Antonella Fontana, Friedrich Fruhwald, Gregory Giamouzis, George Giannakoulas, Martín J Garcia-González, Finn Gustafsson, Kari Kaikkonen, Matti Kivikko, Jacek Kubica, Dirk von Lewinski, Ida Löfman, Gabriella Malfatto, Nicolás Manito, Martin Martínez-Sellés, Josep Masip, Bela Merkely, Fabrizio Morandi, Henning Mølgaard, Fabrizio Oliva, Emil Pantev, Zoltán Papp, Gian Piero Perna, Roman Pfister, Vito Piazza, Ramón Bover, Diego Rangel-Sousa, Alejandro Recio-Mayoral, Alexander Reinecke, Andreas Rieth, Toni Sarapohja, Gunter Schmidt, Mirko Seidel, Stefan Störk, Bojan Vrtovec, Gerhard Wikström, Patrik Yerly, Piero Pollesello
Patients in the latest stages of heart failure are severely compromised, with poor quality of life and frequent hospitalizations. Heart transplantation and left ventricular assist device implantation are viable options only for a minority, and intermittent or continuous infusions of positive inotropes may be needed as a bridge therapy or as a symptomatic approach. In these settings, levosimendan has potential advantages over conventional inotropes (catecholamines and phosphodiesterase inhibitors), such as sustained effects after initial infusion, synergy with beta-blockers, and no increase in oxygen consumption...
May 23, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28558929/agreement-between-heart-failure-patients-and-providers-in-assessing-new-york-heart-association-functional-class
#12
Brent A Williams, Sanjay Doddamani, Melissa A Troup, Alison L Mowery, Cynthia M Kline, Janine A Gerringer, Robert T Faillace
BACKGROUND: Uncertainty persists regarding whether patient assessment of New York Heart Association (NYHA) functional classification should be preferred over provider assessment among patients with heart failure (HF). OBJECTIVES: To compare patient against provider NYHA assessments, and both to distance walked on a 6-minute walk test (6MWT) among patients with HF. METHODS: In this prospective study, we enrolled 101 HF patients who self-assessed NYHA classification...
May 27, 2017: Heart & Lung: the Journal of Critical Care
https://www.readbyqxmd.com/read/28555959/design-of-the-magnetic-resonance-imaging-evaluation-of-mineralocorticoid-receptor-antagonism-in-diabetic-atherosclerosis-magma-trial
#13
Sanjay Rajagopalan, M Amer Alaiti, Kylene Broadwater, Aditya Goud, Juan Gaztanaga, Kim Connelly, Anas Fares, Shayan Shirazian, Catherine Kreatsoulas, Michael Farkouh, Mirela Dobre, Jeffrey C Fink, Matthew R Weir
Mineralocorticoid receptor (MR) activation plays an essential role in promoting inflammation, fibrosis, and target organ damage. Currently, no studies are investigating MR antagonism in patients with type 2 diabetes mellitus (T2DM) with chronic kidney disease, at high risk for cardiovascular complications, who are otherwise not candidates for MR antagonism by virtue of heart failure. Further, there is limited information on candidate therapies that may demonstrate differential benefit from this therapy. We hypothesized that MR antagonism may provide additional protection from atherosclerosis progression in higher-risk patients who otherwise may not be candidates for such a therapeutic approach...
May 26, 2017: Clinical Cardiology
https://www.readbyqxmd.com/read/28556898/hemoglobin-concentration-influences-n-terminal-pro-b-type-natriuretic-peptide-levels-in-hospitalized-older-adults-with-and-without-heart-failure
#14
Diana Lelli, Raffaele Antonelli Incalzi, Claudio Pedone
OBJECTIVES: To investigate the relationship between hemoglobin and N-terminal pro B-type natriuretic peptide (NT-proBNP) concentration in hospitalized older adults with or without a diagnosis of heart failure (HF). DESIGN: Cross-sectional study based on retrospective hospital records review. SETTING: Geriatric acute care ward. PARTICIPANTS: Individuals aged 65 and older (N = 226; mean age 81.1), with (n = 104) and without (n = 122) a diagnosis of HF...
May 29, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28558086/acute-heart-failure-registry-risk-assessment-model-in-decompensated-heart-failure
#15
Anne Delgado, Bruno Rodrigues, Sara Nunes, Rui Baptista, Bruno Marmelo, Davide Moreira, Pedro Gama, Luís Nunes, Oliveira Santos, Costa Cabral
BACKGROUND: Heart failure (HF) is a highly prevalent syndrome. Although the long-term prognostic factors have been identified in chronic HF, this information is scarcer with respect to patients with acute HF. despite available data in the literature on long-term prognostic factors in chronic HF, data on acute HF patients are more scarce. OBJECTIVES: To develop a predictor of unfavorable prognostic events in patients hospitalized for acute HF syndromes, and to characterize a group at higher risk regarding their clinical characteristics, treatment and outcomes...
December 2016: Arquivos Brasileiros de Cardiologia
https://www.readbyqxmd.com/read/28536222/giant-cell-myocarditis-presenting-with-acute-heart-failure
#16
Ioannis Kasouridis, Joaquim Majo, Guy MacGowan, Andrew L Clark
Idiopathic giant cell myocarditis (GCM) is a rare and rapidly progressing form of myocarditis predominantly affecting younger people. We report a case of a 23-year-old athletic patient who presented with features of acute heart failure due to GCM and discuss his management that included a left ventricular assist device as a bridge to transplant. He died immediately following the transplant.We also review the literature on this rare disease, highlighting the advances in the management of the disease including immunosuppressive therapy, ventricular assist devices and heart transplantation...
May 22, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28540276/plasmatic-levels-of-n-terminal-pro-bnp-in-elderly-patients-with-atrial-fibrillation-and-heart-failure-with-preserved-ejection-fraction
#17
Vasile Mircea Zăgreanu, Dana Pop, Mihnea Zdrenghea, Adela Sitar-Taut, Bogdan Caloian, Dumitru Tudor Zdrenghea
No abstract text is available yet for this article.
April 2017: Iranian Journal of Public Health
https://www.readbyqxmd.com/read/28544166/clinical-features-of-extremely-elderly-patients-with-heart-failure
#18
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
https://www.readbyqxmd.com/read/28539565/successful-treatment-of-congestive-heart-failure-due-to-severe-aortic-valve-stenosis-with-low-dose-tolvaptan-in-elderly-patients
#19
Kiyoshi Takasu, Tetsuro Miyazaki, Kanako Negoro, Shoichiro Yatsu, Megumi Shimizu, Azusa Murata, Takao Kato, Shoko Suda, Masaru Hiki, Takatoshi Kasai, Katsumi Miyauchi, Hiroyuki Daida
Medical therapy for severe aortic valve stenosis (AS) is necessary for inoperable patients due to comorbid conditions. Tolvaptan (TLV), unlike other diuretics, resulted in modest changes in filling pressures associated with an increase in urine output, suggesting that TLV improves congestive heart failure (CHF) due to severe AS without hemodynamic instability.We retrospectively investigated 14 consecutive patients ≥ 80 years of age admitted due to decompensated CHF with severe AS at Juntendo University Hospital from April 2014 to November 2015...
May 23, 2017: International Heart Journal
https://www.readbyqxmd.com/read/28545624/drug-development-for-heart-failure-with-preserved-ejection-fraction-what-pieces-are-missing-from-the-puzzle
#20
REVIEW
Michele Senni, Stephen J Greene, Javed Butler, Gregg C Fonarow, Mihai Gheorghiade
Despite the growing number of patients with heart failure with preserved ejection fraction (HFpEF) and event rates comparable with many cancers, there remain no pharmacologic agents definitively proven to improve patient outcomes. Although phase II trials have intermittently yielded encouraging results, none have translated into successful achievement of a phase III primary end point. Thus, because of the urgent need to discover proven therapies, it is prudent to reevaluate our current approach to HFpEF drug development...
June 2017: Canadian Journal of Cardiology
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