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1

Heart Failure  

MedlinePLUS

... version of this page please turn Javascript on. Heart Failure What is Heart Failure? In heart failure, the heart cannot pump ... the lungs, where it picks up oxygen. The Heart's Pumping Action In normal hearts, blood vessels called ...

2

Heart Failure  

MedlinePLUS

... page from the NHLBI on Twitter. What Is Heart Failure? Heart failure is a condition in which the heart can' ... force. Some people have both problems. The term "heart failure" doesn't mean that your heart has stopped ...

3

Heart Failure  

MedlinePLUS

... Pressure High Blood Pressure Tools & Resources Stroke More Heart Failure Prevention & Treatment of Heart Failure Pause Previous Banner ... you agree to the Terms and Conditions Downloadable Heart Failure Resources What is Heart Failure? (PDF) How Can ...

4

Heart Failure  

MedlinePLUS

Heart failure is a condition in which the heart can't pump enough blood to meet the body's needs. Heart failure does not mean that your heart has stopped ... Tiredness and shortness of breath Common causes of heart failure are coronary artery disease, high blood pressure and ...

5

Heart Failure  

MedlinePLUS

... this? Submit What's this? Submit Button Related CDC Web Sites Heart Disease Stroke High Blood Pressure Salt ... and empower Americans to make heart-healthy choices. Web Sites with More Information About Heart Failure For ...

6

Heart Failure  

MedlinePLUS

... report any unexplained changes to your doctor. Other Organizations ... What is the likely cause of my congestive heart failure? How serious is my condition? How will my life change now that we know I have heart ...

7

Heart Failure  

Microsoft Academic Search

Summary Management 1. When performing the initial evaluation of a patient diagnosed with heart failure (HF), you should assess the following: a. The severity of the symptoms of impaired cardiac function (e.g., dyspnea on exertion, paroxysmal nocturnal dyspnea, orthopnea, fatigue, and leg edema) b. Evidence for risk factors strongly associated with HF: ischemic heart disease, hypertension, diabetes, valvular heart disease

William Lewis; Jim Nuovo

8

Heart Failure Overview  

MedlinePLUS

CHF; Congestive heart failure; Left-sided heart failure; Right-sided heart failure - Cor pulmonale; Cardiomyopathy - heart failure ... Heart failure is often a long-term (chronic) condition, but it may come on suddenly. It can ...

9

Heart Failure Medications  

MedlinePLUS

... Pressure High Blood Pressure Tools & Resources Stroke More Heart Failure Medications Updated:Mar 24,2015 Heart failure patients ... content was last reviewed on 08/20/2012." Heart Failure • Home • About Heart Failure • Warning Signs of Heart ...

10

What Causes Heart Failure?  

MedlinePLUS

... page from the NHLBI on Twitter. What Causes Heart Failure? Conditions that damage or overwork the heart muscle ... and they worsen heart failure. Common Causes of Heart Failure The most common causes of heart failure are ...

11

Heart Failure  

Microsoft Academic Search

Decompensated congestive heart failure (CHF) is a clinical syndrome often characterized by elevated left ventricular fi lling pressures (LVEDP). Therapy for decompensated CHF aims at normalizing fi lling pressures and thereby improves both symptoms and outcomes. However, therapy guided by direct measurements of fi lling pressure is not practical in most patients, focusing attention on non-invasive surrogate measures of LVEDP

Susan Isakson BA; Alan Maisel

12

Heart Failure  

Microsoft Academic Search

In 1997, an estimated $5,501 was spent for every hospital-discharge diagnosis of heart failure, and another $1,742 per month was required to care for each patient after dis- charge. Accordingly, substantial efforts have been made to identify and treat the factors that predict recurrent hospitalization. End points of large randomized trials now include the effect of the studied intervention on

Mariell Jessup; Susan Brozena

2003-01-01

13

Living with Heart Failure  

MedlinePLUS

... page from the NHLBI on Twitter. Living With Heart Failure Currently, heart failure has no cure. You'll ... avoid harmful side effects. Take Steps To Prevent Heart Failure From Getting Worse Certain actions can worsen your ...

14

Types of Heart Failure  

MedlinePLUS

Types of Heart Failure Updated:Sep 9,2014 Left-sided heart failure The heart's pumping action moves oxygen-rich blood as it ... give support. Join now - it's free and easy. Heart Failure Questions to Ask Your Doctor Use these questions ...

15

Classes of Heart Failure  

MedlinePLUS

... Blood Pressure Tools & Resources Stroke More Classes of Heart Failure Updated:Dec 17,2014 Doctors usually classify patients' ... is classified: Functional Capacity IV, Objective Assessment A Heart Failure Questions to Ask Your Doctor Use these questions ...

16

Heart failure - home monitoring  

MedlinePLUS

... body and the symptoms that tell you your heart failure is getting worse will help you stay healthier ... Januzi JL, Mann DL. Clinical assessment of heart failure. In: ... of Cardiovascular Medicine . 10th ed. Philadelphia, PA: Elsevier ...

17

Antithrombotics in heart failure  

PubMed Central

Heart failure is a common clinical condition associated with high morbidity and mortality rate despite significant improvements in pharmacotherapy and implementation of medical procedures. Patients with heart failure are at an increased risk of developing arterial and venous thrombosis, which contribute to the high rate of adverse events and fatal outcomes. Many heart failure patients routinely receive antithrombotic therapy due to the presence of a specific indication for its use, like ischemic heart disease or atrial fibrillation. However, there is no solid evidence to support the routine use of antithrombotic agents in all heart failure patients. This article reviews the evidence for using antithrombotic therapy in heart failure patients. PMID:25559833

Mili?i?, Davor; Samardži?, Jure; Petri?evi?, Mate

2014-01-01

18

Heart failure - palliative care  

MedlinePLUS

Chronic heart failure very often gets worse over time. Many people who have heart failure die of the condition. It can be hard ... whether to continue active or aggressive treatment of heart failure. Then, you may want to discuss the option ...

19

Managing Feelings about Heart Failure  

MedlinePLUS

... About Heart Failure Module 6: Managing Feelings About Heart Failure Download Module Order Hardcopy Heart failure can cause ... professional help for emotional problems. Common Feelings About Heart Failure It is common for people to feel depressed ...

20

Heart failure - tests  

MedlinePLUS

... American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Circulation . Published online June 5, 2013. Mann DL. Management of heart failure patients with reduced ejection fraction. ...

21

Heart failure in women  

Microsoft Academic Search

Increasingly high mortality from cardiovascular disease in women has sparked nationwide campaigns to raise awareness of this\\u000a significant threat to women’s health. Heart failure has the most lethal prognosis of the major cardiovascular diseases, yet\\u000a women demonstrate an apparent survival advantage compared with men. Sex-linked disparities in heart failure risk factors and\\u000a pathophysiology contribute to this divergent clinical outcome. Heart

Denise D. Barnard

2005-01-01

22

Your Heart Failure Healthcare Team  

MedlinePLUS

Your Heart Failure Healthcare Team Updated:Apr 14,2015 Patients with heart failure may work with multiple healthcare professionals. It's ... give support. Join now - it's free and easy. Heart Failure Questions to Ask Your Doctor Use these questions ...

23

How Is Heart Failure Treated?  

MedlinePLUS

... page from the NHLBI on Twitter. How Is Heart Failure Treated? Early diagnosis and treatment can help people ... underway for Heart Failure, visit www.clinicaltrials.gov . Heart Failure in the News April 9, 2014 Drug does ...

24

Warning Signs of Heart Failure  

MedlinePLUS

Warning Signs of Heart Failure Updated:Jan 12,2015 By themselves, any one sign of heart failure may not be cause for alarm. But ... content was last reviewed on 08/20/2012." Heart Failure • Home • About Heart Failure • Warning Signs of Heart ...

25

Troponins in heart failure.  

PubMed

The signs and symptoms of heart failure are frequently unspecific and correlate poorly with objective indices of cardiac function. Objective assessment of cardiac function by echocardiography or other imaging modalities also correlate poorly with symptomatic status and functional capacity. Accordingly, there is a need for circulating biomarkers that can provide incremental diagnostic and prognostic information to the existing armamentarium of tests. The introduction of more sensitive assays that allow determination of very low circulating concentrations of the myofibrillar proteins cardiac troponin I and T has not only resulted in improved diagnostic accuracy in the setting of acute coronary syndromes. The high sensitivity assays have also shown that cardiac troponins are frequently found chronically circulating in a variety of acute and chronic, cardiac and non-cardiac disease conditions, including acute heart failure and chronic symptomatic and asymptomatic left ventricular dysfunction. Cardiac troponin I and T provide may provide clinically useful prognostic information both concerning the future risk of developing heart failure in asymptomatic subjects and the risk of fatal events and hospital admissions in those with already established heart failure This review summarizes current literature on the clinical performance and utility of cardiac troponin measurements as diagnostic and prognostic tools in patients with symptomatic heart failure, as well as in those with asymptomatic left ventricular dysfunction, and clinical phenotypes at high risk for developing heart failure, including stable coronary artery disease, left ventricular hypertrophy, and aortic stenosis. PMID:25151947

Omland, T; Røsjø, H; Giannitsis, E; Agewall, S

2015-03-30

26

Devices in Heart Failure  

PubMed Central

Congestive heart failure has long been one of the most serious medical conditions in the United States; in fact, in the United States alone, heart failure accounts for 6.5 million days of hospitalization each year. One important goal of heart-failure therapy is to inhibit the progression of congestive heart failure through pharmacologic and device-based therapies. Therefore, there have been efforts to develop device-based therapies aimed at improving cardiac reserve and optimizing pump function to meet metabolic requirements. The course of congestive heart failure is often worsened by other conditions, including new-onset arrhythmias, ischemia and infarction, valvulopathy, decompensation, end-organ damage, and therapeutic refractoriness, that have an impact on outcomes. The onset of such conditions is sometimes heralded by subtle pathophysiologic changes, and the timely identification of these changes may promote the use of preventive measures. Consequently, device-based methods could in the future have an important role in the timely identification of the subtle pathophysiologic changes associated with congestive heart failure. PMID:18612451

Munir, Shahzeb M.; Bogaev, Roberta C.; Sobash, Ed; Shankar, K. J.; Gondi, Sreedevi; Stupin, Igor V.; Robertson, Jillian; Brewer, M. Alan; Casscells, S. Ward; Delgado, Reynolds M.; Ahmed, Amany

2008-01-01

27

Heart failure - medicines  

MedlinePLUS

... lower your risk of a stroke or heart attack. Coumadin (Warfarin) is recommended for patients with heart failure who have a higher risk for blood clots. You will need to have extra blood tests to make sure your dose is correct. You ...

28

[Heart failure and anemia].  

PubMed

Chronic heart failure has an age-dependent prevalence of 2% and is therefore one of the most frequent diseases in western societies. A reduced hemoglobin concentration according to the definition of the World Health Organization is a common comorbidity affecting more than half of all heart failure patients. Elderly patients, patients suffering from renal impairment and women are more likely to develop anemia but a definitive etiology of anemia is only identified in the minority of cases. Anemia is associated with a poor clinical status and a greater risk of hospitalization and is a predictive factor for increased mortality. The incidence of anemia appears to increase with a poorer functional class. Intravenous iron therapy improves the exercise capacity in patients with systolic heart failure and iron deficiency and is currently being recommended for patients with persistent symptoms despite optimal medical and device therapy. However, erythropoietin-stimulating agents as a treatment for anemia in chronic heart failure have failed to improve clinical outcome in a large randomized trial. In patients with heart failure but with maintained ejection fraction, anemia is also associated with a poor prognosis. Specific therapeutic recommendations for these patients are still not available. PMID:23900390

Reda, S; Motloch, L J; Hoppe, U C

2013-09-01

29

Chronic heart failure  

Microsoft Academic Search

Opinion statement  \\u000a \\u000a \\u000a \\u000a \\u000a – \\u000a \\u000a Physicians must aggressively treat heart failure in the early stages to prevent disease progression and improve survival.\\u000a Early treatment implies early diagnosis of left ventricular (LV) dysfunction, before the onset of symptoms. Patients with\\u000a risk factors for the development of heart failure, especially coronary disease or hypertension, should undergo echocardiography\\u000a to evaluate LV function. Patients with LV

Elaine Winkel; Maria Rosa Costanzo

1999-01-01

30

Interventions for Heart Failure  

Microsoft Academic Search

The following interventions improve important outcomes in patients with systolic heart failure (all SORs: A, based on meta-analyses): • Angiotensin converting enzyme (ACE) inhibitors reduce mortality, repeat myocardial infarction (MI), and hospitalization rates • Beta-blockers and aldosterone blockers reduce mortality and hospitalization rates • Diuretics reduce mortality and hospitalization rates and improve exercise capacity • Digitalis treatment decreases hospitalization rates

Michael Glickman

2011-01-01

31

If I Had - Heart Failure  

MedlinePLUS

... Injury Risk in Young Athletes If I Had - Heart Failure - Dr. Rebecca Gary, PhD, RN, Emory University In ... School Back to Home Page If I Had - Heart Failure - Dr. Rebecca Gary, PhD, RN, Emory University (Dec ...

32

Oxidative stress and heart failure  

Microsoft Academic Search

Various abnormalities have been implicated in the transition of hypertrophy to heart failure but the exact mechanism is still unknown. Thus heart failure subsequent to hypertrophy remains a major clinical problem. Recently, oxidative stress has been suggested to play a critical role in the pathogenesis of heart failure. Here we describe antioxidant changes as well as their significance during hypertrophy

Neelam Singh; Arvinder K. Dhalla; Charita Seneviratne; Pawan K. Singal

1995-01-01

33

Ejection Fraction Heart Failure Measurement  

MedlinePLUS

Ejection Fraction Heart Failure Measurement Updated:Mar 24,2015 The ejection fraction (EF) is an important measurement in determining how well your ... was last reviewed on 07/09/2013. Downloadable Heart Failure Resources What is Heart Failure? (PDF) How Can ...

34

Primary Prevention of Heart Failure  

PubMed Central

Most heart failure research and quality improvement efforts are targeted at treatment and secondary prevention of patients with manifest heart failure. This is distinct from coronary disease where primary prevention has been a focus for over three decades. Given the current importance and the projected worsening of heart failure epidemiology, a more focused effort on prevention is urgently needed. PMID:22957272

Butler, Javed

2012-01-01

35

Mitochondria in heart failure  

PubMed Central

This review focuses on the evidence accumulated in humans and animal models to the effect that mitochondria are key players in the progression of heart failure (HF). Mitochondria are the primary source of energy in the form of adenosine triphosphate that fuels the contractile apparatus, and are thus essential for the pumping activity of the heart. We evaluate changes in mitochondrial morphology and alterations in the main components of mitochondrial energetics, such as substrate utilization and oxidative phosphorylation coupled with the level of respirasomes, in the context of their contribution to the chronic energy deficit and mechanical dysfunction in HF. PMID:20668004

Rosca, Mariana G.; Hoppel, Charles L.

2010-01-01

36

Congestive Heart Failure  

NSDL National Science Digital Library

This patient education program explains congestive heart failure including heart anatomy, the causes, symptoms, diagnosis, treatment options, and lifestyle changes for managing this condition. This resource is a MedlinePlus Interactive Health Tutorial from the National Library of Medicine, designed and developed by the Patient Education Institute. NOTE: This tutorial requires a special Flash plug-in, version 4 or above. If you do not have Flash, you will be prompted to obtain a free download of the software before you start the tutorial. You will also need an Acrobat Reader, available as a free download, in order to view the Reference Summary.

Patient Education Institute

37

Prevention and management of chronic heart failure in management of asymptomatic patients  

Microsoft Academic Search

Symptomatic heart failure is preceded by a somewhat prolonged asymptomatic stage in many patients. The number of patients with asymptomatic heart dysfunction is about 4-fold greater than the number of patients with clinically overt heart failure. Pharmacologic treatment with angiotensin-converting enzyme inhibitors and ?-blockers (in particular carvedilol) of asymptomatic patients with systolic left ventricular (LV) dysfunction can prevent or delay

Maria Frigerio; Fabrizio Oliva; Fabio M Turazza; Robert O Bonow

2003-01-01

38

Ultrafiltration in heart failure.  

PubMed

Fluid overload is a key pathophysiologic mechanism underlying both the acute decompensation episodes of heart failure and the progression of the syndrome. Moreover, it represents the most important factor responsible for the high readmission rates observed in these patients and is often associated with renal function worsening, which by itself increases mortality risk. In this clinical context, ultrafiltration (UF) has been proposed as an alternative to diuretics to obtain a quicker relief of pulmonary/systemic congestion. This review illustrates technical issues, mechanisms, efficacy, safety, costs, and indications of UF in heart failure. The available evidence does not support the widespread use of UF as a substitute for diuretic therapy. Owing to its operative characteristics, UF cannot be expected to directly influence serum electrolyte levels, azotemia, and acid-base balance, or to remove high-molecular-weight substances (eg, cytokines) in clinically relevant amounts. Ultrafiltration should be used neither as a quicker way to achieve a sort of mechanical diuresis nor as a remedy for an inadequately prescribed and administered diuretic therapy. Instead, it should be reserved to selected patients with advanced heart failure and true diuretic resistance, as part of a more complex strategy aiming at an adequate control of fluid retention. PMID:21392597

Fiaccadori, Enrico; Regolisti, Giuseppe; Maggiore, Umberto; Parenti, Elisabetta; Cremaschi, Elena; Detrenis, Simona; Caiazza, Alberto; Cabassi, Aderville

2011-03-01

39

Electrophysiological Remodeling in Heart Failure  

PubMed Central

Heart failure affects nearly 6 million Americans, with a half-million new cases emerging each year. Whereas up to 50% of heart failure patients die of arrhythmia, the diverse mechanisms underlying heart failure-associated arrhythmia are poorly understood. As a consequence, effectiveness of antiarrhythmic pharmacotherapy remains elusive. Here, we review recent advances in our understanding of heart failure-associated molecular events impacting the electrical function of the myocardium. We approach this from an anatomical standpoint, summarizing recent insights gleaned from pre-clinical models and discussing their relevance to human heart failure. PMID:20096285

Wang, Yanggan; Hill, Joseph A.

2010-01-01

40

Evaluation of the effect of phosphodiesterase inhibitors on mortality in chronic heart failure patients  

Microsoft Academic Search

We examined the influence of phosphodiesterase inhibitors (PDIs) on mortality in patients with overt chronic heart failure. A total of 13 randomised, placebocontrolled trials of PDIs involving 2808 patients were selected.

P. Nony; J.-P. Boissel; M. Lievre; A. Leizorovicz; M. C. Haugh; S. Fareh; B. Breyne

1994-01-01

41

CONGESTIVE HEART FAILURE Congestive Heart Failure: Condition in which the heart muscle can not pump enough  

E-print Network

CONGESTIVE HEART FAILURE Congestive Heart Failure: Condition in which the heart muscle can not pump disease (HTN, Diabetes, Cardiomyopathy, Heart Valve Disease, etc.) ultimately may lead to heart failure down and heart failure symptoms appear. Symptoms of CHF: Shortness of Breath; Dyspnea on Exertion

42

Heart Failure in South America  

PubMed Central

Continued assessment of temporal trends in mortality and epidemiology of specific heart failure in South America is needed to provide a scientific basis for rational allocation of the limited health care resources, and strategies to reduce risk and predict the future burden of heart failure. The epidemiology of heart failure in South America was reviewed. Heart failure is the main cause of hospitalization based on available data from approximately 50% of the South American population. The main etiologies of heart failure are ischemic, idiopathic dilated cardiomyopathy, valvular, hypertensive and chagasic etiologies. In endemic areas, Chagas heart disease may be responsible by 41% of the HF cases. Also, heart failure presents high mortality especially in patients with Chagas etiology. Heart failure and etiologies associated with heart failure may be responsible for 6.3% of causes of deaths. Rheumatic fever is the leading cause of valvular heart disease. However, a tendency to reduction of HF mortality due to Chagas heart disease from 1985 to 2006, and reduction in mortality due to HF from 1999 to 2005 were observed in selected states in Brazil. The findings have important public health implications because the allocation of health care resources, and strategies to reduce risk of heart failure should also consider the control of neglected Chagas disease and rheumatic fever in South American countries. PMID:23597301

Bocchi, Edimar Alcides

2013-01-01

43

Heart failure - fluids and diuretics  

MedlinePLUS

When you have heart failure, your heart does not pump out enough blood. This causes fluids to build up in your body. If you ... the amount of fluids you drink: When your heart failure is not very bad, you may not have ...

44

Heart failure - surgeries and devices  

MedlinePLUS

The most common cause of heart failure is coronary artery disease (CAD), which is a narrowing of the small blood ... that supply blood and oxygen to the heart. CAD may become worse and make it harder to ...

45

Heart failure in women.  

PubMed

Heart failure (HF) is increasing in incidence globally, and approximately half of all HF patients are women. When women and men with HF are compared, there are significant differences in disease etiology, expression, outcomes, and perhaps, response to therapy. Hypertension rather than coronary artery disease is a more important etiology of HF in women, and HF with preserved left ventricular ejection fraction (HFPEF) is more common in women. Regardless of its etiology, women have better survival and less sudden cardiac death, but poorer quality of life with equivalent degrees of left ventricular dysfunction. Animal studies of myocardial response to stressors resulting in heart failure corroborate sex differences in ventricular remodeling, cellular morphology, and function. Despite the fact that women make up nearly 50 % of HF patients, their inclusion in randomized clinical trials has remained at about 20 %, with no trials including women as a prespecified subgroup for statistical analysis. Thus, the evidence base for treatment of HF in women is not robustly supported by sex-specific data. PMID:25633565

Taylor, Anne L

2015-04-01

46

Renal denervation in heart failure.  

PubMed

Heart failure has emerged as one of the most important diseases of the past century. The understanding and treatment of heart failure has evolved significantly over the years. As we move further into the era of device therapy, attention has turned to the idea of sympathetic nervous system modulation through renal denervation to treat heart failure. In this review, we summarize the background research, denervation technique, and current studies on renal denervation for the treatment of heart failure. We also compare and contrast the work on carotid barostimulation. PMID:25754320

Fong, Michael W; Shavelle, David; Weaver, Fred A; Nadim, Mitra K

2015-04-01

47

Heart Failure in North America  

PubMed Central

Heart failure is a major health problem that affects patients and healthcare systems worldwide. Within the continent of North America, differences in economic development, genetic susceptibility, cultural practices, and trends in risk factors and treatment all contribute to both inter-continental and within-continent differences in heart failure. The United States and Canada represent industrialized countries with similar culture, geography, and advanced economies and infrastructure. During the epidemiologic transition from rural to industrial in countries such as the United States and Canada, nutritional deficiencies and infectious diseases made way for degenerative diseases such as cardiovascular diseases, cancer, overweight/obesity, and diabetes. This in turn has resulted in an increase in heart failure incidence in these countries, especially as overall life expectancy increases. Mexico, on the other hand, has a less developed economy and infrastructure, and has a wide distribution in the level of urbanization as it becomes more industrialized. Mexico is under a period of epidemiologic transition and the etiology and incidence of heart failure is rapidly changing. Ethnic differences within the populations of the United States and Canada highlight the changing demographics of each country as well as potential disparities in heart failure care. Heart failure with preserved ejection fraction makes up approximately half of all hospital admissions throughout North America; however, important differences in demographics and etiology exist between countries. Similarly, acute heart failure etiology, severity, and management differ between countries in North America. The overall economic burden of heart failure continues to be large and growing worldwide, with each country managing this burden differently. Understanding the inter-and within-continental differences may help improve understanding of the heart failure epidemic, and may aid healthcare systems in delivering better heart failure prevention and treatment. PMID:23597296

Blair, John E. A; Huffman, Mark; Shah, Sanjiv J

2013-01-01

48

Heart failure in North America.  

PubMed

Heart failure is a major health problem that affects patients and healthcare systems worldwide. Within the continent of North America, differences in economic development, genetic susceptibility, cultural practices, and trends in risk factors and treatment all contribute to both inter-continental and within-continent differences in heart failure. The United States and Canada represent industrialized countries with similar culture, geography, and advanced economies and infrastructure. During the epidemiologic transition from rural to industrial in countries such as the United States and Canada, nutritional deficiencies and infectious diseases made way for degenerative diseases such as cardiovascular diseases, cancer, overweight/obesity, and diabetes. This in turn has resulted in an increase in heart failure incidence in these countries, especially as overall life expectancy increases. Mexico, on the other hand, has a less developed economy and infrastructure, and has a wide distribution in the level of urbanization as it becomes more industrialized. Mexico is under a period of epidemiologic transition and the etiology and incidence of heart failure is rapidly changing. Ethnic differences within the populations of the United States and Canada highlight the changing demographics of each country as well as potential disparities in heart failure care. Heart failure with preserved ejection fraction makes up approximately half of all hospital admissions throughout North America; however, important differences in demographics and etiology exist between countries. Similarly, acute heart failure etiology, severity, and management differ between countries in North America. The overall economic burden of heart failure continues to be large and growing worldwide, with each country managing this burden differently. Understanding the inter-and within-continental differences may help improve understanding of the heart failure epidemic, and may aid healthcare systems in delivering better heart failure prevention and treatment. PMID:23597296

Blair, John E A; Huffman, Mark; Shah, Sanjiv J

2013-05-01

49

Heart Failure Questions to Ask Your Doctor  

MedlinePLUS

... Pressure High Blood Pressure Tools & Resources Stroke More Heart Failure Questions to Ask Your Doctor Updated:Apr 2, ... was last reviewed on 08/20/2012." Downloadable Heart Failure Resources What is Heart Failure? (PDF) How Can ...

50

Heart Failure: Unique to Older Adults  

MedlinePLUS

Heart Failure Unique to Older Adults This section provides information to help older adults and their caregivers ... or maintain quality of life. Urinary Incontinence and Heart Failure If you have heart failure, you may ...

51

Who Is at Risk for Heart Failure?  

MedlinePLUS

... NHLBI on Twitter. Who Is at Risk for Heart Failure? About 5.8 million people in the United ... underway for Heart Failure, visit www.clinicaltrials.gov . Heart Failure in the News April 9, 2014 Drug does ...

52

How Is Heart Failure Diagnosed?  

MedlinePLUS

... done during stress testing. Cardiac MRI Cardiac MRI (magnetic resonance imaging) uses radio waves, magnets, and a ... 9, 2014 Drug does not improve set of cardiovascular outcomes for diastolic heart failure A drug that ...

53

Geriatric conditions in heart failure  

PubMed Central

As the U.S. population ages, the prevalence of geriatric conditions in patients with heart failure is increasing, although they currently fall outside the traditional heart failure disease model. In this review, we describe the co-occurrence of four common geriatric conditions (cognitive impairment, frailty, falls, and incontinence) in older adults with heart failure, their mechanisms of interaction, and their association with outcomes. We propose a new paradigm to meet the needs of the aging heart failure population that includes comprehensive assessment of geriatric conditions and tailoring of therapy and surveillance accordingly. Coordination among relevant disciplines such as cardiology and geriatrics may facilitate this transition. Further research is needed in order to understand how to optimize care for patients with specific impairments in order to improve outcomes. PMID:23997843

Dodson, John A.; Chaudhry, Sarwat I.

2013-01-01

54

Ultrafiltration in decompensated heart failure  

Microsoft Academic Search

Fluid congestion is the hallmark of decompensated heart failure. As heart failure progresses, reduced response to diuretics\\u000a is common. In these patients, ultrafiltration has been found to alleviate excess volume and improve diuretic sensitivity.\\u000a Compared with diuretics, ultrafiltration provides a more predictable and safer way to achieve euvolemia with minimal electrolyte\\u000a abnormalities and neurohormonal activation. The emerging familiarity and ease

Brian E. Jaski; David Miller

2005-01-01

55

Echocardiographic Ratio Indices in Overtly Healthy Boxer Dogs Screened for Heart Disease  

PubMed Central

Background Boxer dogs are routinely screened by echocardiography to exclude congenital and acquired heart disease. Individuals of a given breed may span a large range of body sizes, potentially invalidating linear regression of M-mode measurements against body weight. Echocardiographic ratio indices (ERIs) provide a novel method of characterizing echocardiographic differences between Boxers and other dog breeds. Hypothesis ERIs obtained from overtly healthy Boxer dogs presented for cardiac screening will be different from ERIs established for normal non-Boxer dogs, and those differences will be unrelated to aortic velocity or systolic blood pressure. Animals Eighty-one Boxers with no outward clinical signs of heart disease were studied. Methods All dogs were examined by 2-dimensional, M-mode, and Doppler echocardiography. M-mode measurements were used to perform ERI calculations, and the indices in Boxers were compared between Boxers with varying severity of arrhythmia and those of normal non-Boxer dogs. Results Differences in weight-based ERIs, which reflect increased thickness of the left ventricular free wall (LVW) and interventricular septum (IVS) and smaller aortic size, were found in overtly healthy Boxer dogs compared with normal non-Boxer dogs. ERIs of left atrial and LV cavity size in overtly healthy Boxers were not significantly different from those of non-Boxer dogs. Conclusions and Clinical Importance Boxer dogs may have an increased relative thickness of the LVW and IVS that is independent of aortic size, aortic velocity, or arterial blood pressure, and this morphology should be taken into consideration when screening Boxers by echocardiography. PMID:18537876

Cunningham, S.M.; Rush, J.E.; Freeman, L.M.; Brown, D.J.; Smith, C.E.

2015-01-01

56

Heart Failure in Children and Adolescents  

MedlinePLUS

... like a battery and internal wires. What Is Heart Failure? For a child to grow and develop, the ... a child may not function normally. The term “heart failure” describes a heart that's not functioning properly. It ...

57

Heart failure - what to ask your doctor  

MedlinePLUS

... a pump that moves blood through your body. Heart failure occurs when blood does not move well and ... often, fluid collects in your lungs and legs. Heart failure usually occurs because the muscles of your heart ...

58

Role of Oxidative Stress in Disease Progression in Stage B Heart Failure  

PubMed Central

Oxidative stress represents a persistent imbalance between the production and the compensation of reactive oxygen species. While predominantly found in advanced heart failure, the majority of “at risk” condition has been associated with underlying oxidative stress. It is therefore conceivable that timely detection and early intervention to reduce oxidative stress processes provide an opportunity to prevent disease progression to overt heart failure. This paper reviews our current understanding of the current evidence of oxidative stress involvement in the pathophysiology of human heart failure and its potential therapeutic interventions in patients with Stage A and B heart failure. PMID:22108730

Bhimaraj, Arvind; Wilson Tang, W. H.

2011-01-01

59

Mechanisms of heart failure in obesity.  

PubMed

Heart failure is a leading cause of morbidity and mortality and its prevalence continues to rise. Because obesity has been linked with heart failure, the increasing prevalence of obesity may presage further rise in heart failure in the future. Obesity-related factors are estimated to cause 11% of heart failure cases in men and 14% in women. Obesity may result in heart failure by inducing haemodynamic and myocardial changes that lead to cardiac dysfunction, or due to an increased predisposition to other heart failure risk factors. Direct cardiac lipotoxicity has been described where lipid accumulation in the heart results in cardiac dysfunction inexplicable of other heart failure risk factors. In this overview, we discussed various pathophysiological mechanisms that could lead to heart failure in obesity, including the molecular mechanisms underlying cardiac lipotoxicity. We defined the obesity paradox and enumerated various premises for the paradoxical associations observed in the relationship between obesity and heart failure. PMID:25434909

Ebong, Imo A; Goff, David C; Rodriguez, Carlos J; Chen, Haiying; Bertoni, Alain G

2014-01-01

60

Heart failure and Alzheimer's disease.  

PubMed

It has recently been proposed that heart failure is a risk factor for Alzheimer's disease. Decreased cerebral blood flow and neurohormonal activation due to heart failure may contribute to the dysfunction of the neurovascular unit and cause an energy crisis in neurons. This leads to the impaired clearance of amyloid beta and hyperphosphorylation of tau protein, resulting in the formation of amyloid beta plaques and neurofibrillary tangles. In this article, we will summarize the current understanding of the relationship between heart failure and Alzheimer's disease based on epidemiological studies, brain imaging research, pathological findings and the use of animal models. The importance of atherosclerosis, myocardial infarction, atrial fibrillation, blood pressure and valve disease as well as the effect of relevant medications will be discussed. PMID:25041352

Cermakova, P; Eriksdotter, M; Lund, L H; Winblad, B; Religa, P; Religa, D

2015-04-01

61

Mitochondrial centrality in heart failure  

Microsoft Academic Search

A number of observations have shown that mitochondria are at the center of the pathophysiology of the failing heart and mitochondrial-based\\u000a oxidative stress (OS), myocardial apoptosis, and cardiac bioenergetic dysfunction are implicated in the progression of heart\\u000a failure (HF), as shown by both clinical studies and animal models. In this manuscript, we review the body of evidence that\\u000a multiple defects

José Marín-García; Michael J. Goldenthal

2008-01-01

62

Heart Failure in the Elderly  

Microsoft Academic Search

Heart failure (HF) affects approximately 5 million Americans, and more than 550,000 new cases are reported each year (1,2). In addition, despite recent advances in the diagnosis and treatment of HF, as well as reductions in age-adjusted mortality\\u000a rates from coronary heart disease and hypertensive cardiovascular disease (CVD) (3,4), both the incidence and prevalence of HF are increasing, primarily owing

Michael W. Rich

63

Right side of heart failure  

Microsoft Academic Search

The function of the right ventricle (RV) in heart failure (HF) has been mostly ignored until recently. A 2006 report of the\\u000a National Heart, Lung, and Blood Institute identified a gap between RV research efforts and its clinical importance compared\\u000a with that of the left ventricle. This recent shift in paradigm is fueled by the prognostic value ascribed to RV

Maya Guglin; Sameer Verma

64

Ventricular Reconstruction Surgery for Congestive Heart Failure  

Microsoft Academic Search

The significant increase in the prevalence of heart failure in the United States has made this disease a major health problem. The continued shortage of donor organs has prevented heart transplantation from becoming an effective solution for the treatment of end-stage heart failure, and as a result, surgical treatments for heart failure have been reexamined. Surgical therapies represent the evolution

Richard Lee; Katherine J. Hoercher; Patrick M. McCarthy

2004-01-01

65

Congenital heart disease in adults: management of advanced heart failure  

Microsoft Academic Search

The number of adults living with congenital heart disease grows annually. The sequelae of congenital heart disease surgery may involve the electrical conduction system, cardiac valves, prosthetic materials, the myocardium, vascular beds, and the nervous system. These sequelae may lead to heart failure. Adults with congenital heart disease develop heart failure as a consequence of: (1) chronic cyanosis, volume overload,

Stacy F. Davis; Thomas P. Graham

2003-01-01

66

The Heart Failure Bridge Clinic Quality  

E-print Network

The Heart Failure Bridge Clinic Quality Improvement Project My project involved working with my failure case manager. The heart failure bridge clinic (HFBC), is a standalone clinic that was created for patients, with the primary diagnosis of congestive heart failure (CHF), to be seen in an outpatient setting

von der Heydt, Rüdiger

67

Chronic Heart Failure and Micronutrients  

Microsoft Academic Search

Heart failure (HF) is associated with weight loss, and cachexia is a well-recognized complication. Patients have an increased risk of osteoporosis and lose muscle bulk early in the course of the disease. Basal metabolic rate is increased in HF, but general malnutrition may play a part in the development of cachexia, particularly in an elderly population. There is evidence for

Klaus K. A. Witte; Andrew L. Clark; John G. F. Cleland

2001-01-01

68

Nitrates in congestive heart failure  

Microsoft Academic Search

Nitrates are commonly used in the therapy of congestive heart failure (CHF). They exert beneficial hemodynamic effects by decreasing left ventricular filling pressure and systemic vascular resistance while modestly improving cardiac output. The improvement in left ventricular function caused by nitrates is the result of combined reduction in outflow resistance and mitral regurgitation, while decreased pericardial constraint and subendocardial ischemia

Jocelyn Dupuis

1994-01-01

69

How Can I Live with Heart Failure?  

MedlinePLUS

What medicine might I take? The goal of heart failure treatment is to help you live a longer, better-quality life. Treating the causes of heart failure with medication can lessen tiredness (fatigue), shortness of ...

70

Congestive Heart Failure With Preserved Systolic Function  

E-print Network

Article Congestive Heart Failure With Preserved Systolic Function: Is It a Woman's Disease? Roshni Congestive heart failure with preserved systolic function is increased in prevalence with advancing age (CHF) is a major cause of morbidity and mortality. In recent years, congestive heart failure

71

CLINICAL RESEARCH Heart failure/cardiomyopathy  

E-print Network

RESEARCH Heart failure/cardiomyopathy Preserved left ventricular twist and circumferential deformation, but depressed longitudinal and radial deformation in patients with diastolic heart failure Jianwen Wang, Dirar S and rotation in patients with heart failure, and elucidate the underlying mecha- nisms that account for normal

Duncan, James S.

72

Heart failure in children in tropical regions.  

PubMed

With the ever increasing younger population in tropical countries, the number of children with heart failure is increasing. However, the etiology of heart failure in this region varies considerably from that in the temperate region, with infectious causes leading the list. In this review, we have summarized the important causes of heart failure seen in the pediatric population in tropical regions. PMID:24078337

Rohit, Manojkumar; Gupta, Ankur; Talwar, K K

2013-12-01

73

Vasopressin Antagonism in Heart Failure  

Microsoft Academic Search

Treatment of chronic heart failure (HF) is based on interference with the renin-angiotensin- aldosterone system and the adrenergic nervous system. Diuretics are used in volume-expanded patients. Insights from clinical trials and registries establish the need to consider correcting both cardiac loading conditions and nonload-related biological factors if HF therapy is to be optimized. Arginine vasopressin (AVP) represents a potentially attractive

Steven R. Goldsmith; Mihai Gheorghiade

2005-01-01

74

Androgen Deficiency in Heart Failure  

Microsoft Academic Search

Androgen deficiency is a hormonal disorder that is frequently observed in advanced chronic conditions. A reduction of androgen\\u000a blood levels may be cause or consequence of the disease, or both. Typical symptoms, such as fatigue or muscle weakness, may\\u000a be particularly aggravated in heart failure, and disease severity may be indirectly affected by low levels of androgen. Recently,\\u000a androgen replacement

Gülmisal Güder; Bruno Allolio; Christiane E. Angermann; Stefan Störk

2011-01-01

75

Medication adherence in heart failure  

Microsoft Academic Search

Non-adherence with medical regimens in heart failure is a significant challenge and serves as a major reason that favorable\\u000a outcomes associated with various therapies evaluated in clinical trials have not translated to the so-called real-world setting.\\u000a Non-adherence has complex influences and is clearly associated with poorer outcomes. The approaches that are used or have\\u000a been proposed to improve drug-taking behavior,

Paul J. Hauptman

2008-01-01

76

Heart Failure in South Asia  

PubMed Central

South Asia (SA) is both the most populous and the most densely populated geographical region in the world. The countries in this region are undergoing epidemiological transition and are facing the double burden of infectious and non-communicable diseases. Heart failure (HF) is a major and increasing burden all over the world. In this review, we discuss the epidemiology of HF in SA today and its impact in the health system of the countries in the region. There are no reliable estimates of incidence and prevalence of HF (heart failure) from this region. The prevalence of HF which is predominantly a disease of the elderly is likely to rise in this region due to the growing age of the population. Patients admitted with HF in the SA region are relatively younger than their western counterparts. The etiology of HF in this region is also different from the western world. Untreated congenital heart disease and rheumatic heart disease still contribute significantly to the burden of HF in this region. Due to epidemiological transition, the prevalence of hypertension, diabetes mellitus, obesity and smoking is on the rise in this region. This is likely to escalate the prevalence of HF in South Asia. We also discuss potential developments in the field of HF management likely to occur in the nations in South Asia. Finally, we discuss the interventions for prevention of HF in this region PMID:23597297

Sivadasan Pillai, Harikrishnan; Ganapathi, Sanjay

2013-01-01

77

Acute Heart Failure in the Postoperative Period  

Microsoft Academic Search

In the perioperative period, heart failure is one of the most common conditions requiring evaluation and treatment. Furthermore,\\u000a heart failure is the most frequently encountered postoperative cardiac complication of noncardiac surgery (1, 2). Postoperatively, acute heart failure (AHF), defined as the rapid onset of symptoms and signs secondary to abnormal cardiac\\u000a function, often presents in patients with underlying chronic heart

Todd A. Watson; Lee A. Fleisher

78

Diastolic Heart Failure in the Elderly  

Microsoft Academic Search

It is now clear that diastolic heart failure (DHF) is an important, perhaps even dominant form of heart failure in older Americans. However, our knowledge base regarding the epidemiology, pathophysiology, natural history, and therapy of this relatively recently recognized disorder is limited. A number of normal age related changes in the heart and vascular system may predispose to or lower

Dalane W. Kitzman

2002-01-01

79

Understand Your Risk for Heart Failure  

MedlinePLUS

Understand Your Risk for Heart Failure Updated:Oct 24,2014 All of us lose some blood-pumping ability in our hearts as we age, but ... increases your risk. Conditions that may lead to heart failure Coronary artery disease When cholesterol and fatty ...

80

Prevalence of Stroke in Systolic Heart Failure  

Microsoft Academic Search

BackgroundHeart disease is a major independent risk factor for stroke, ranking third after age and hypertension. Heart failure (HF) patient constitutes an important subgroup of patients with stroke, because of their poor outcome and high rates of mortality and stroke recurrence. We examined the prevalence of stroke in patients with heart failure from 3 different geographic regions.

Kathy Hebert; Mohamed Kaif; Leonard Tamariz; Ilia Gogichaishvili; Nino Nozadze; Maria Carolina Delgado; Lee M. Arcement

2011-01-01

81

Heart failure in the elderly  

PubMed Central

The aging of the population is, currently, a major phenomenon, drawing the attention of a number of investigators. The significant increase of life expectancies over the past few decades, in addition to social and economic consequences, has lead to a major change in the morbidity and mortality profile of elders. Heart failure (HF) is a condition in which the heart can not pump enough blood to meet the body's needs. HF is predominantly a disorder of the elderly with rates increasing exponentially. The prevalence of HF approximately doubles with each decade of life. As people live longer, the occurrence of HF rises, as well as other conditions that complicate its treatment. Impaired heart function implies a reduced duration of survival. Fortunately, many factors that can prevent HF and improve outcome are known and can be applied at any stage. This review emphasizes the importance of factors inherent in aging itself, focusing on heart disease, particularly as a disease of aging, can help critically refine management of this acute and chronic disease, as well as foster preventive strategies to reduce the incidence of this common malady. PMID:22916054

de Freitas, Elizabete Viana; Batlouni, Michel; Gamarsky, Roberto

2012-01-01

82

Device therapy for heart failure.  

PubMed

Although pharmacologic therapy has made impressive advances in the past decade and is the mainstay of therapy for heart failure (HF), there is still a large unmet need, because morbidity and mortality remain unacceptably high. Implanted medical devices are gaining increasing utility in this group of patients and have the potential to revolutionize the treatment of HF. The majority of devices in clinical use or under active investigation in HF can be grouped into 1 of 4 categories: devices to monitor the HF condition, devices to treat rhythm disturbances, devices to improve the mechanical efficiency of the heart, and devices to replace part or all of the heart's function. There are several devices either approved or under development to monitor the HF condition, ranging from interactive weight scales to implantable continuous pressure monitors. The challenge is to demonstrate that this technology can improve patient outcomes. Pacemakers and implantable cardioverter defibrillators (ICDs) are used to treat heart rhythms in a broad range of patients with heart disease, but they now have a special place in HF management with the prophylactic use of ICDs in patients who have advanced systolic dysfunction. The Multicenter Automatic Defibrillator Implantation Trial (MADIT) II study demonstrated a 29% reduction in all-cause mortality with ICDs in patients with a history of a myocardial infarction and a left ventricular (LV) ejection fraction <0.30. LV and multisite pacing are means of improving the mechanical efficiency of the heart. The concept is to create a more coordinated contraction of the ventricles to overcome the inefficiency associated with conduction system delays, which are common in HF. The acute hemodynamic effect can be impressive and is immediate. Several studies of intermediate duration (3 to 6 months) have consistently demonstrated that biventricular pacing improves symptoms and exercise capacity. Mechanical methods of remodeling the heart into a more efficient shape have been under scrutiny for several years. New methods of restraining the heart with prosthetic material are under investigation in humans, with encouraging pilot results. Heart replacement has been evaluated clinically with LV assist devices for several decades. The Randomized Evaluation of Mechanical Assistance Therapy as an Alternative in Congestive Heart Failure (REMATCH) study has demonstrated a proof of concept for the use of mechanical blood pumps to improve survival, functional capacity, and symptoms. Several assist devices with such features as total implantability, improved durability, and smaller size are now under study; these may further improve the outcomes of patients. One year ago, the world witnessed the first clinical use of a totally implantable total artificial heart. Although the long-term outcomes were limited, the device demonstrated an impressive ability to improve organ function and extend survival in the population facing imminent death. Further development in this field is expected. The use of devices in HF now has a strong foothold, and the potential exists for substantially greater use of a broad range of devices in the near future. PMID:12670643

Boehmer, John P

2003-03-20

83

Secondary prevention in heart failure.  

PubMed

Although most recent investigations into sudden cardiac death prevention in heart failure patients have been focused on primary prevention, secondary indications for defibrillators and medical therapy remain vitally important in this complex patient group. Antiarrhythmic therapy is currently used primarily as adjuvant therapy to implantable defibrillators. Secondary prophylaxis defibrillator trials have shown clear benefit in preventing recurrent sudden cardiac death, despite concern over inappropriate shocks and the potential detrimental effects of appropriate shocks. Device programming for secondary prophylaxis can help ameliorate these issues. This article discusses these issues as well as the continued underuse of defibrillators in specific populations. PMID:21439497

Robinson, Melissa R; Epstein, Andrew E; Callans, David J

2011-04-01

84

Tolvaptan, hyponatremia, and heart failure  

PubMed Central

Tolvaptan is the first FDA-approved oral V2 receptor antagonist for the treatment of euvolemic and hypervolemic hyponatremia, in patients with conditions associated with free water excess such as heart failure, cirrhosis, and the syndrome of inappropriate antidiuretic hormone secretion. Tolvaptan inhibits the binding of arginine vasopressin to the V2 receptors on the collecting ducts of the kidneys resulting in aquaresis, the electrolytes sparing excretion of water. This article reviews the accumulated experience with tolvaptan and all the major clinical trials that were conducted to study its safety and efficacy and concludes by summarizing clinicians’ views of its current application in clinical practice. PMID:21694950

Zmily, Hammam D; Daifallah, Suleiman; Ghali, Jalal K

2011-01-01

85

Preceptorships: A practical approach to education in heart failure  

Microsoft Academic Search

Heart failure is increasing in incidence and prevalence and is associated with significant morbidity and mortality (1–3). The heart failure center, although well equipped to handle more complex cases of moderate to severe heart failure, cannot accommodate all heart failure cases. Because the majority of heart failure patients are, and should be, treated at the primary care level, the heart

William T. Abraham

1999-01-01

86

Oxygen free radicals and congestive heart failure  

Microsoft Academic Search

Plasma lipid peroxides (malondialdehyde) and thiols were measured in 45 patients with congestive heart failure and 45 controls. Malondialdehyde concentrations were significantly higher in the patients with congestive heart failure (median 9.0 nmol\\/ml interquartile range (IQR) 7.9-10.2) than in the controls (median 7.7 nmol\\/ml (IQR 6.9-9.2)). Plasma thiols were significantly lower in congestive heart failure (median 420 mumol\\/l (IQR 379-480))

J J Belch; A B Bridges; N Scott; M Chopra

1991-01-01

87

Disease Management Programs for Heart Failure  

Microsoft Academic Search

Opinion statement  The impact of the very significant advances in the management of heart failure over the past several decades had been limited\\u000a by a lack of appropriate infrastructure for heart failure care delivery in the community. The development of disease management\\u000a programs has brought about significant advances in ensuring improved care of the wider heart failure population, allowing\\u000a for effective

Ken McDonald

2010-01-01

88

Genetic causes of human heart failure  

PubMed Central

Factors that render patients with cardiovascular disease at high risk for heart failure remain incompletely defined. Recent insights into molecular genetic causes of myocardial diseases have highlighted the importance of single-gene defects in the pathogenesis of heart failure. Through analyses of the mechanisms by which a mutation selectively perturbs one component of cardiac physiology and triggers cell and molecular responses, studies of human gene mutations provide a window into the complex processes of cardiac remodeling and heart failure. Knowledge gleaned from these studies shows promise for defining novel therapeutic targets for genetic and acquired causes of heart failure. PMID:15765133

Morita, Hiroyuki; Seidman, Jonathan; Seidman, Christine E.

2005-01-01

89

Heart Failure - Multiple Languages: MedlinePlus  

MedlinePLUS

... Failure - Multiple Languages Amharic (amarunya) Arabic (???????) Bosnian (Bosanski) Chinese - Simplified (????) Chinese - Traditional (????) French (français) ... ????? - ??????? Bilingual PDF Health Information Translations Bosnian (Bosanski) Heart Failure Zatajenje srca - Bosanski (Bosnian) Bilingual PDF ...

90

Randomized, controlled trial of integrated heart failure management. The Auckland Heart Failure Management Study  

Microsoft Academic Search

Aims To determine the effect of an integrated heart failure management programme, involving patient and family, primary and secondary care, on quality of life and death or hospital readmissions in patients with chronic heart failure. Methods and Results This trial was a cluster randomized, controlled trial of integrated primary\\/secondary care com- pared with usual care for patients with heart failure.

R. N. Doughty; S. P. Wright; A. Pearl; H. J. Walsh; S. Muncaster; G. A. Whalley; G. Gamble; N. Sharpe

2002-01-01

91

Diuretic therapy in chronic heart failure: Implications for heart failure nurse specialists  

Microsoft Academic Search

Chronic heart failure (CHF) is a syndrome precipitated by inadequate cardiac output and neurohormonal activation, leading to sodium and water retention. With increasing prevalence of CHF, heart failure nurse specialists (HFNS) are becoming involved in collaborative models of care in community and outpatient settings.Diuretic therapy in both acute and chronic heart failure is effective in relieving symptoms of congestion and

Patricia Davidson; Peter Macdonald; Glenn Paull; David Rees; Laurence Howes; Jill Cockburn; Mark Brown

2003-01-01

92

Heart failure: Novel therapeutic approaches.  

PubMed

Heart failure (HF) is a complex clinical syndrome that can result from any structural or functional cardiac disorders that impairs the ability of the ventricle to fill with or eject blood. Despite effective medical interventions, mortality and morbidity remain substantial. There have been significant advances in the therapy of HF in recent decades, such as the introduction of beta-blockers and antagonists of the renin-angiotensin system but still there is a major unmet need for better therapies for HF. In the present era, pathophysiology of HF has been explored. Various novel pathways, molecular sites have been identified, which contribute to the progression of the disease. By targeting these sites, newer pharmacological agents have been developed, which can play a promising role in the treatment of HF. This article focuses on recent advancements in pharmacotherapy of HF, which include agents targeting myocardial contractility, cytokines and inflammation, fibrosis and remodeling, myocardial metabolism, oxidative stress, and other newly defined pathways. PMID:25766342

Patel, C; Deoghare, S

2015-01-01

93

Mitochondrial dysfunction in heart failure  

PubMed Central

Heart failure (HF) is a complex chronic clinical syndrome. Energy deficit is considered to be a key contributor to the development of both cardiac and skeletal myopathy. In HF several components of cardiac and skeletal muscle bioenergetics are altered, such as oxygen availability, substrate oxidation, mitochondrial ATP production, and ATP transfer to the contractile apparatus via the creatine kinase shuttle. This review focuses on alterations in mitochondrial biogenesis and respirasome organization, substrate oxidation coupled with ATP synthesis in the context of their contribution to the chronic energy deficit, and mechanical dysfunction of the cardiac and skeletal muscle in HF. We conclude that HF is associated with decreased mitochondrial biogenesis and function in both heart and skeletal muscle, supporting the concept of a systemic mitochondrial cytopathy. The sites of mitochondrial defects are located within the electron transport and phosphorylation apparatus, and differ with the etiology and progression of HF in the two mitochondrial populations (subsarcolemmal and interfibrillar) of cardiac and skeletal muscle. The roles of adrenergic stimulation, the renin-angiotensin system, and cytokines are evaluated as factors responsible for the systemic energy deficit. We propose a cylic AMP-mediated mechanism by which increased adrenergic stimulation contributes to the mitochondrial dysfunction. PMID:22948484

Rosca, Mariana G.; Hoppel, Charles L.

2013-01-01

94

in heart failure due to myocardial infarction  

Microsoft Academic Search

Objective: Patients surviving large transmural myocardial infarction (MI) are at risk for congestive heart failure with attendant alteration of ventricular geometry and scar remodeling. Altered G and G protein expression may be involved in cardiac remodeling i-2a sa associated with heart failure, however their expression in scar tissue remains unclear. Methods: MI was produced in Sprague-Dawley rats by ligation of

David J. Peterson; Haisong Ju; Jianming Hao; Marcello Panagia; Donald C. Chapman; Ian M. C. Dixon

95

Carvedilol: a countermeasure to heart failure.  

PubMed

Initially used primarily as an antihypertensive, the beta-blocker carvedilol is now being used to alleviate heart failure, significantly reducing hospitalizations and mortality. In this article, we discuss the pathophysiology of heart failure; carvedilol's action, long-term benefits, and administration; and potential short-term adverse effects. PMID:22076514

Barkman, A; Pooler, C

2001-01-01

96

Nursing care and education in heart failure  

Microsoft Academic Search

Summary The number of patients with heart failure has steadily increased during recent decades and the cost of frequent hospitalizations has had a strong economic impact on health care services. The compliance and education in heart failure patients are poor, and only a small proportion of the patients are on optimal therapy. Therefore, it is justified to build up specific

U. Dahlström

1999-01-01

97

Management of Heart Failure in the Elderly  

Microsoft Academic Search

The management of chronic heart failure in elderly patients is often complicated by the presence of multiple comorbid conditions, polypharmacy, psychosocial and financial concerns, and difficulties with adherence to complex medication and dietary regimens. In addition, few patients over 80 years of age have been enrolled in clinical trials, so that the efficacy of current heart failure therapies remains uncertain

Michael W. Rich

2002-01-01

98

Explanatory Models of Heart Failure Etiology  

PubMed Central

Chronic health failure is a leading cause of hospital readmissions and is reaching epidemic proportions in the United States. Explanatory models of illness can provide insight about how people with heart failure perceive their etiology of heart failure. Six themes were found in this descriptive, qualitative study to explore the perceived origin of heart failure in 50 participants. Forty percent of the people were unaware of why they had the diagnosis. Misconceptions and misinformation were common, including confusion about whether the symptoms themselves caused the disease. PMID:22156813

Clark, Angela P.; McDougall, Graham J.; Joiner-Rogers, Glenda; Innerarity, Sheri; Delville, Carol; Meraviglia, Marty; Davila, Ashley

2014-01-01

99

Profile for Estimating Risk of Heart Failure  

Microsoft Academic Search

Methods: The routinely measured risk factors used in constructing the heart failure profile include age, elec- trocardiographic left ventricular hypertrophy, cardio- megaly on chest x-ray film, heart rate, systolic blood pres- sure, vital capacity, diabetes mellitus, evidence of myocardial infarction, and valvular disease or hyperten- sion. Based on 486 heart failure cases during 38 years of follow-up, 4-year probabilities of

William B. Kannel; Ralph B. D'Agostino; Halit Silbershatz; Albert J. Belanger; Peter W. F. Wilson; Daniel Levy

1999-01-01

100

New surgical treatments for heart failure  

Microsoft Academic Search

Medical therapy for heart failure is quickly advancing, but long-term survival unfortunately remains poor. New surgical techniques\\u000a seek to halt and reverse the progression of heart failure. Positron emission tomography has refined patient selection techniques\\u000a for coronary artery bypass grafting in the failing heart. Left ventricular (LV) remodeling surgery and new devices change\\u000a the shape of the LV and decrease

Mauricio J. Garrido; Mehmet C. Oz

2002-01-01

101

Hyponatremia in patients with heart failure  

PubMed Central

The present review analyses the mechanisms relating heart failure and hyponatremia, describes the association of hyponatremia with the progress of disease and morbidity/mortality in heart failure patients and presents treatment options focusing on the role of arginine vasopressin (AVP)-receptor antagonists. Hyponatremia is the most common electrolyte disorder in the clinical setting and in hospitalized patients. Patients with hyponatremia may have neurologic symptoms since low sodium concentration produces brain edema, but the rapid correction of hyponatremia is also associated with major neurologic complications. Patients with heart failure often develop hyponatremia owing to the activation of many neurohormonal systems leading to decrease of sodium levels. A large number of clinical studies have associated hyponatremia with increased morbidity and mortality in patients hospitalized for heart failure or outpatients with chronic heart failure. Treatment options for hyponatremia in heart failure, such as water restriction or the use of hypertonic saline with loop diuretics, have limited efficacy. AVP-receptor antagonists increase sodium levels effectively and their use seems promising in patients with hyponatremia. However, the effects of AVP-receptor antagonists on hard outcomes in patients with heart failure and hyponatremia have not been thoroughly examined. PMID:24109495

Filippatos, Theodosios D; Elisaf, Moses S

2013-01-01

102

Community management of heart failure.  

PubMed Central

OBJECTIVE: To review therapies for treating patients with heart failure (HF). QUALITY OF EVIDENCE: Recommendations in this paper are mainly based on the results of randomized controlled trials. To a lesser extent, data from smaller, more physiologic studies are included. Where appropriate, recommendations are based on the results of a consensus conference. MAIN MESSAGE: Although pharmacologic therapy is the main strategy for treating HF patients, general measures, such as counseling and advice about regular physical activity, are an important component of management. Use of angiotensin-converting enzyme inhibitors (ACE-I) is central to treating HF patients, because these agents decrease mortality and morbidity significantly. Digoxin does not reduce mortality but does reduce morbidity. Angiotensin II antagonists, although found to provide clinical benefit equal to ACE-I, have not been found as yet to have similar effects on mortality and morbidity. Diuretics and nitrates are useful for treating these patients' symptoms. Calcium channel blockers should generally be avoided. CONCLUSIONS: Angiotensin-converting enzyme inhibitors are the therapy of choice for HF patients and should be used in all cases unless there are contraindications or clear evidence of intolerance. All other therapies are used mainly for symptom relief. PMID:9870122

McKelvie, R. S.

1998-01-01

103

Mortality in heart failure patients.  

PubMed

Heart failure (HF) is a clinical syndrome, which is becoming a major public health problem in recent decades, due to its increasing prevalence, especially in the developed countries, mostly due to prolonged lifespan of the general population as well as the increased of HF patients. The HF treatment, particularly, new pharmacological and non-pharmacological agents, has markedly improved clinical outcomes of patients with HF including increased life expectancy and improved quality of life. However, despite the facts that mortality in HF patients has decreased, it still remains unacceptably high. This review of summarizes the evidence to date about the mortality of HF patients. Despite the impressive achievements in the pharmacological and non-pharmacological treatment of HF patients which has undeniably improved the survival of these patients, the mortality still remains high particularly among elderly, male and African-American patients. Patients with HF and reduced ejection fraction have higher mortality rates, most commonly due to cardiovascular causes, compared with patients HF and preserved ejection fraction. PMID:25550250

Bytyçi, Ibadete; Bajraktari, Gani

2015-01-01

104

Heart failure and galectin 3  

PubMed Central

Innovations in medical diagnosis and treatment have led to prolongation of life of patients. Increasing the life expectancy of cardiac patients and thereby increasing the prevalence of heart failure (HF). Currently more than one million hospital admissions per year are due to HF and it has been estimated that the cost is approximately $39 billion annually in the U.S. There are two pathophysiologic myocardial mechanisms that cause HF: systolic dysfunction and diastolic dysfunction. Normal cardiac aging is characterized by morphological and structural changes that increase cardiomyocyte size, increased number of apoptosis with decreased number in myocytes, increased collagen deposition, and functional changes at cellular level. All these factors contribute to fibrotic remodeling that leads to LV diastolic stiffness, which ultimately leads to impaired diastolic function. At the same time it has been shown that galectin-3, a soluble ?-galactoside-binding protein secreted by activated macrophages, promotes cardiac fibroblast proliferation, collagen deposition, and ventricular dysfunction. In this paper we review the prognostic value of galectin-3 as an independent predictor of mortality in patients with moderate to advanced chronic HF (CHF). PMID:25405161

Suarez, Gabriela

2014-01-01

105

Diabetes-related heart failure.  

PubMed

As the link between heart failure (HF) and diabetes mellitus (DM) becomes unignorable, so the need is further increasing for pathological comprehension: What is "diabetic cardiomyopathy (DMC)?" In response to current concern, the most updated guidelines stated by the ACCF/AHA and by the ESC/EASD take one step further, including the definition of DMC, although it is a matter yet to be completed. For more than 40 years, coronary artery disease and hypertension have been considered as the main causes of diabetes-related cardiac dysfunction. HF was originally considered as a result of reduced left ventricular ejection fraction (HF-REF); however, it has been recognized that HF symptoms are often observed in patients with preserved EF (HF-PEF). DMC includes HF with both reduced and preserved entities independent of coronary stenosis and hypertension. Cardiologists are thus facing a sort of chaos without clear guidelines for the "deadly intersection" of DM and HF. Today, the increasing interest and concern have caused DMC to be revisited and the first step in controlling the chaos around DMC is to organize and analyze all of the available evidence from preclinical and clinical studies. This review aims to illustrate the current concepts of DMC by shedding light on the new molecular mechanisms.??(Circ J?2014; 78: 576-583). PMID:24500073

Bando, Yasuko K; Murohara, Toyoaki

2014-01-01

106

[Hemofiltration in chronic heart failure].  

PubMed

30 patients with severe congestive heart failure (NYHA IV) unresponsive to medical management were treated by continuous hemofiltration (CHF). 57% of patients received arteriovenous CHF and 43% of patients venovenous, machine assisted CHF over 95 +/- 31 hours. A reduction of body edemas was achieved. The removal of body fluid by CHF between 2 and 40 kg led to a reduction of body edemas and short-term clinical improvement. Furthermore CHF treatment induced hemodynamic improvement with a reduction of central venous pressure (18 +/- 6 cm H2O pre CHF vs 8 +/- 4 cm H2O post CHF p less than 0.01) and a reduction of left ventricular filling pressure (22 +/- 6 mm Hg vs 14 +/- 5 mm Hg, p less than 0.01), while the left ventricular ejection fraction remained unchanged. Patients with low serum sodium levels (less than 132 mval/l) benefited most. While 28/30 of patients has short-term clinical improvement between 2 and 8 weeks, 38% of patients had long-term benefits. PMID:4090936

Glogar, D H; Stummvoll, H K; Wittels, P; Silberbauer, K; Sochor, H; Wolf, C; Kaindl, F

1985-01-01

107

Heart failure in patients with human immunodeficiency virus: a review of the literature.  

PubMed

Coronary artery disease represents the leading cause of death for HIV patients treated with highly active antiretroviral treatment. Besides this, an extensive amount of data related to the risk of overt heart failure and consequently of atrial fibrillation and sudden cardiac death (SCD) in this population has been reported. It seems that persistent deregulation of immunity in HIV-infected patients is a common pathway related to both of these adverse clinical outcomes. Despite the fact that atrial fibrillation and heart failure are relatively common in HIV, few data are reported about screening, diagnosis, and potential treatment of these conditions. PMID:25058690

Cannillo, Margherita; D'Ascenzo, Fabrizio; Grosso Marra, Walter; Cerrato, Enrico; Calcagno, Andrea; Omedè, Pierluigi; Bonora, Stefano; Mancone, Massimo; Vizza, Dario; DiNicolantonio, James J; Pianelli, Martina; Barbero, Umberto; Gili, Sebastiano; Annone, Umberto; Raviola, Alessio; Salera, Davide; Mistretta, Elisa; Vilardi, Ilaria; Colaci, Chiara; Abbate, Antonio; Zoccai, Giuseppe Biondi; Moretti, Claudio; Gaita, Fiorenzo

2015-05-01

108

Ca2+ Cycling in Heart Failure  

PubMed Central

Ca2+ plays a crucial role in connecting membrane excitability with contraction in myocardium. The hallmark features of heart failure are mechanical dysfunction and arrhythmias; defective intracellular Ca2+ homeostasis is a central cause of contractile dysfunction and arrhythmias in failing myocardium. Defective Ca2+ homeostasis in heart failure can result from pathological alteration in the expression and activity of an increasingly understood collection of Ca2+ homeostatic binding proteins, ion channels and enzymes. This review focuses on the molecular mechanisms of defective Ca2+ cycling in heart failure and consider how fundamental understanding of these pathways may translate into novel and innovative therapies. PMID:23989713

Luo, Min; Anderson, Mark E.

2013-01-01

109

Soluble guanylate cyclase modulators in heart failure.  

PubMed

This review summarizes the role of soluble guanylate cyclase (sGC)-cyclic guanosine 3', 5'-monophosphate pathways in heart failure and several new drugs that modify guanylate cyclase. The sGC activators and stimulators as modulators of sGC are promising drugs in the therapy for decompensated heart failure and pulmonary hypertension. Cinaciguat is a nitric oxide (NO)-independent direct activator of sGC, which also may be effective under oxidative stress conditions resulting in oxidized or heme-free sGC refractory to organic nitrates. Riociguat is an NO-independent direct stimulator of sGC with beneficial effects in patients with decompensated heart failure and pulmonary hypertension. The sGC modulators play an important role in patients with heart failure and pulmonary hypertension. PMID:21207207

Mitrovic, Veselin; Jovanovic, Ana; Lehinant, Stefan

2011-03-01

110

Fried Foods and Heart Failure Risk  

MedlinePLUS Videos and Cool Tools

... lower right-hand corner of the player. Fried Foods and Heart Failure Risk HealthDay March 4, 2015 ... than 15,000 male physicians who filled out food surveys during a 3- year period, including questions ...

111

Telerehabilitation for patients with heart failure  

PubMed Central

Heart failure is a chronic and progressive condition that is associated with high morbidity and mortality rates. Even though cardiac rehabilitation (CR) has been shown to be beneficial to heart failure patients, only a very small proportion of them will actually be referred and eventually participate. The low participation rate is due in part to accessibility and travel difficulties. Telerehabilitation is a new approach in the rehabilitation field that allows patients to receive a complete rehabilitation program at home in a safe manner and under adequate supervision. We believe that by increasing accessibility to CR, telerehabilitation programs will significantly improve heart failure patients’ functional capacity and quality of life. However, it is crucial to provide policy makers with evidence-based data on cardiac telerehabilitation if we want to see its successful implementation in heart failure patients. PMID:25774353

Tousignant, Michel

2015-01-01

112

Significance of hyponatremia in heart failure  

Microsoft Academic Search

Heart failure is one of the most common, costly, disabling and growing diseases (McMurray and Pfeffer in Lancet 365(9474):1877–1889,\\u000a 2005). Hyponatremia, conventionally defined as a serum-sodium concentration equal or less than 135 mmol\\/l (American Heart\\u000a Association in Heart disease and stroke statistics—2007 update. American Heart Association, Dallas, 2007; Stewart et al. in\\u000a Eur J Heart Fail 4:361–371, 2002), is a common

Luca Bettari; Mona Fiuzat; Gary M. Felker; Christopher M. O’Connor

113

Soluble Guanylate Cyclase Modulators in Heart Failure  

Microsoft Academic Search

This review summarizes the role of soluble guanylate cyclase (sGC)-cyclic guanosine 3?, 5?-monophosphate pathways in heart\\u000a failure and several new drugs that modify guanylate cyclase. The sGC activators and stimulators as modulators of sGC are promising\\u000a drugs in the therapy for decompensated heart failure and pulmonary hypertension. Cinaciguat is a nitric oxide (NO)–independent\\u000a direct activator of sGC, which also may

Veselin Mitrovic; Ana Jovanovic; Stefan Lehinant

2011-01-01

114

Heart failure with normal ejection fraction  

Microsoft Academic Search

Opinion statement  Heart failure with normal ejection fraction, also known as diastolic heart failure, is a major problem for patients and health-care\\u000a providers and is a substantial expense to society. The main pathophysiologic processes involved are increased left ventricular\\u000a stiffness and abnormal relaxation, with resulting impaired left ventricular filling. These processes typically displace the\\u000a pressure-volume relationship in an upward direction, resulting

Mauro Ortiz; Gregory L. Freeman

2001-01-01

115

Overview of the Treatment of Heart Failure  

Microsoft Academic Search

Short-term goals of heart failure management are directed toward relieving symptoms such as shortness of breath, decreased exercise tolerance, and lower-extremity edema and improving functional capacity and quality of life. Long-term goals include decreasing mortality and slowing or reversing the underlying cardiac structural abnormalities of heart failure. Improvement in symptomatic endpoints (e.g., exercise tolerance) does not necessarily correlate with endpoints

Jay N Cohn

1997-01-01

116

Educating nurses and patients to manage heart failure  

Microsoft Academic Search

Patient education is an important component in the management of patients with heart failure and nurses are increasingly involved in this area. This paper reviews the literature on education to patients with heart failure and the education and training for heart failure nurses. Patients with heart failure need education in order to adapt to their chronic syndrome and perform self-care.

Anna Strömberg

2002-01-01

117

What Are the Signs and Symptoms of Heart Failure?  

MedlinePLUS

... Twitter. What Are the Signs and Symptoms of Heart Failure? The most common signs and symptoms of heart ... in your lungs. The condition requires emergency treatment. Heart Failure Signs and Symptoms The image shows the major ...

118

Self-Care Guide for the Heart Failure Patient  

MedlinePLUS

... Cardiology Patient Page Self-Care Guide for the Heart Failure Patient Maria Fe White , MSN, NP ; Joan Kirschner , ... influenza are recommended. Previous Section Next Section Additional Heart Failure Treatments Your heart condition may remain stable long ...

119

Ethnic differences in patient perceptions of heart failure and treatment: the West Birmingham heart failure project  

Microsoft Academic Search

Objective: To investigate further the hypothesis that ethnic groups would have different levels of knowledge and perceptions of congestive heart failure (CHF) and treatments for this condition, a cross sectional survey was conducted of patients who were attending the heart failure clinics in two teaching hospitals of Birmingham, UK, that serve a multiethnic population.Methods: 103 patients with CHF (66 men,

G Y H Lip; H Khan; A Bhatnagar; N Brahmabhatt; P Crook; M K Davies

2004-01-01

120

Hemoconcentration-guided diuresis in heart failure.  

PubMed

One quarter of patients hospitalized for heart failure are readmitted within 30 days, perhaps related to ineffective decongestion. Limited data exist guiding the extent and duration of diuresis in patients hospitalized for heart failure. The objective of this review was to determine the prognostic value of hemoconcentration, or the relative increase in the cellular elements in blood, in patients hospitalized for heart failure and to clarify its role in guiding inpatient diuretic practices. Six post hoc retrospective studies from 2010 to 2013 were available for review. Hemoconcentration was consistently associated with markers of aggressive fluid removal, including higher diuretic dosing and reduced body weight, but increased risk of in-hospital worsening renal function. Despite this, hemoconcentration was associated with improved short-term mortality and rehospitalization. Hemoconcentration is a practical, readily available, noninvasive, economically feasible strategy to help guide diuresis and monitor congestion relief in patients hospitalized for worsening heart failure. Clinicians should strongly consider using changes in hemoglobin and hematocrit as an adjunct to other available measures of decongestion and clinical acumen in inpatient heart failure care. PMID:24937157

Vaduganathan, Muthiah; Greene, Stephen J; Fonarow, Gregg C; Voors, Adriaan A; Butler, Javed; Gheorghiade, Mihai

2014-12-01

121

Heart failure with preserved ejection fraction  

PubMed Central

Abstract Heart failure with preserved ejection fraction (HFpEF) has recently emerged as a major cause of cardiovascular morbidity and mortality. Contrary to initial beliefs, HFpEF is now known to be as common as heart failure with reduced ejection fraction (HFrEF) and carries an unacceptably high mortality rate. With a prevalence that has been steadily rising over the past two decades, it is very likely that HFpEF will represent the dominant heart failure phenotype over the coming few years. The scarcity of trials in this semi-discrete form of heart failure and lack of unified enrolment criteria in the studies conducted to date might have contributed to the current absence of specific therapies. Understanding the epidemiological, pathophysiological and molecular differences (and similarities) between these two forms of heart failure is cornerstone to the development of targeted therapies. Carefully designed studies that adhere to unified diagnostic criteria with the recruitment of appropriate controls and adoption of practical end-points are urgently needed to help identify effective treatment strategies. PMID:25610841

ElGuindy, Ahmed; Yacoub, Magdi H

2012-01-01

122

Heart failure and weight gain monitoring.  

PubMed

Heart failure is one of the most common diagnoses of the elderly in the United States. The nursing literature has demonstrated that nursing interventions aimed at effective discharge planning and appropriate self-care activities can improve outcomes for patients hospitalized with heart failure. The purpose of this research was to identify, through retrospective medical record review, the discharge instruction related to self-weight monitoring provided to a sample of heart failure patients. The patients in the sample were 65 years and older with an ICD-9 diagnostic code of heart failure upon discharge from an acute care hospital in the Midwest. Results demonstrated the lack of nursing attentiveness to teaching self-monitoring weight gain to heart failure patients while hospitalized and the need for more comprehensive planning for appropriate discharge referrals. Suggestions are made for expanding documentation tools to improve nursing discharge planning and case management to ensure that the patient or caregiver is able to carry out self-care activities at home. PMID:16317329

Lesperance, Mary Ellen; Bell, Sue Ellen; Ervin, Naomi E

2005-01-01

123

When the heart kills the liver: acute liver failure in congestive heart failure  

PubMed Central

Congestive heart failure as a cause of acute liver failure is rarely documented with only a few cases. Although the pathophysiology is poorly understood, there is rising evidence, that low cardiac output with consecutive reduction in hepatic blood flow is a main causing factor, rather than hypotension. In the setting of acute liver failure due to congestive heart failure, clinical signs of the latter can be absent, which requires an appropriate diagnostic approach. As a reference center for acute liver failure and liver transplantation we recorded from May 2003 to December 2007 202 admissions with the primary diagnoses acute liver failure. 13/202 was due to congestive heart failure, which was associated with a mortality rate of 54%. Leading cause of death was the underlying heart failure. Asparagine transaminase (AST), bilirubin, and international normalized ratio (INR) did not differ significantly in surviving and deceased patients at admission. Despite both groups had signs of cardiogenic shock, the cardiac index (CI) was significantly higher in the survival group on admission as compared with non-survivors (2.1 L/min/m2 vs. 1.6 L/min/m2, p = 0.04). Central venous - and pulmonary wedge pressure did not differ significantly. Remarkable improvement of liver function was recorded in the group, who recovered from cardiogenic shock. In conclusion, patients with acute liver failure require an appropriate diagnostic approach. Congestive heart failure should always be considered as a possible cause of acute liver failure. PMID:20149988

2009-01-01

124

Heart transplantation: Assessment of heart failure mortality risk  

Microsoft Academic Search

Heart failure (HF) presents with a wide spectrum of disease severity and with a broad risk of associated morbidity and mortality.\\u000a Identification of individuals at high risk for HF death is important for assessment of candidacy for heart transplantation\\u000a and mechanical circulatory assistance and, more broadly, for guiding pharmaceutical, surgical, or palliative interventions.\\u000a In this article, we review and compare

Jennifer Cowger Matthews; Todd F. Dardas; Keith D. Aaronson

2007-01-01

125

Management of acute decompensated heart failure.  

PubMed

Heart failure, a debilitating complex clinical syndrome, affects nearly 5 million people in the United States and presents a heavy socioeconomic burden. Neurohormonal abnormalities contribute to the pathophysiology of heart failure. Acute decompensated heart failure (ADHF) has emerged as a major health problem associated with poor prognosis, increased costs related to care, reduced quality of life, and frequent readmissions. Symptoms of ADHF are primarily related to congestion and/or low perfusion states. The use of biomakers such as B-natriuretic peptides is useful in distinguishing between cardiac and noncardiac causes of symptoms. Treatment for ADHF begins with identification and treatment of precipitating factors for acute decompensation. Initial goal of therapy is focused on symptom management followed by interventions that delay disease progression, reduce readmission, and prolong survival. PMID:17356351

Varughese, Sheeba

2007-01-01

126

Device based treatment of heart failure  

PubMed Central

As the population ages and survival from ischaemic heart disease improves, the incidence and prevalence of congestive cardiac failure has increased dramatically. Medical treatments including ACE inhibitors, ß blockers, and aldosterone antagonists have improved the outlook for most patients. However, despite optimal medical treatment there is a significant group of patients who continue to suffer poor morbidity and mortality. Device based treatment consisting of implantable cardioverter defibrillators (ICD) and cardiac resynchronisation therapy (CRT) devices offer new modes of treatment to patients with symptomatic heart failure despite optimal medical therapy. ICDs have been shown to reduce mortality in patients with severe heart failure while CRT leads to an improvement in functional class, quality of life scores, physiological measures such as peak VO2, and reduce hospitalisations. Combination devices, which provide both ICD and CRT functions, have now been seen to provide synergistic benefits in selected patients. PMID:15879039

Patwala, A; Wright, D

2005-01-01

127

Spontaneous Subclinical Hypothyroidism in Patients Older than 55 Years: An Analysis of Natural Course and Risk Factors for the Development of Overt Thyroid Failure  

Microsoft Academic Search

We aimed to analyze the natural course of subclinical hypo- thyroidism, quantify the incidence rate of overt hypothyroid- ism, and evaluate the risk factors for the development of de- finitive thyroid failure in elderly patients. One hundred seven patients (93 women and 14 men) over age 55 yr with subclin- ical hypothyroidism and no previous history of thyroid dis- ease

JUAN J. DIEZ; PEDRO IGLESIAS

128

Antithrombotic Therapy in Heart Failure and Cardiomyopathy  

Microsoft Academic Search

\\u000a Patients with heart failure and cardiomyopathy often present with risk factors that may warrant anti-thrombotic therapy, such\\u000a as atrial fibrillation, left ventricular thrombus, and the presence of a hypercoagulable state. Decades of clinical studies\\u000a have provided a wealth of information and speculations, but the current role of prophylactic antiplatelet and anticoagulant\\u000a therapies remained controversial. Post hoc analyses from large heart

Zuheir Abrahams; George Sokos; W. H. Wilson Tang

129

Management of heart failure with pulmonary hypertension  

Microsoft Academic Search

Heart failure (HF) and pulmonary hypertension (PH) coexist frequently and contribute to each other. Because PH often is an\\u000a insidious disease, the cornerstone of management is the early identification and treatment of its underlying causes, such\\u000a as left-sided heart disease, left to right shunts, and pulmonary disorders. A practical clinical classification has been proposed\\u000a by the Third World Symposium on

Mohammed Najeeb Osman; Mark E. Dunlap

2005-01-01

130

Antisynthetases syndrome associated with right heart failure  

Microsoft Academic Search

Cardiac involvement is a complication of end stage polymyositis with left heart insufficiency reported to be the most frequent manifestation. We here describe an unusual clinical presentation of antisynthetases syndrome, beginning with right-sided cardiomyopathy associated with right heart failure. A 26 year-old Caucasian male experienced a 6-month clinical course of polyarthritis, fever, sweats, and myalgia. Laboratory studies showed elevated C

Latifa Tahiri; Sandra Guignard; Patricia Pinto; Muriel Duclos; Maxime Dougados

2009-01-01

131

Recognizing Advanced Heart Failure and Knowing Your Options  

MedlinePLUS

Recognizing Advanced Heart Failure and Knowing Your Options Updated:Mar 24,2015 Understanding the Medical Situation Having advanced heart failure does not ... need in the future. Treatment Options for Advanced Heart Failure Major Interventions Open-heart surgery: For patients with ...

132

Tackling heart failure in the twenty-first century  

Microsoft Academic Search

Heart failure, or congestive heart failure, is a condition in which the heart cannot supply the body's tissues with enough blood. The result is a cascade of changes that lead to severe fatigue, breathlessness and, ultimately, death. In the past quarter century, much progress has been made in understanding the molecular and cellular processes that contribute to heart failure, leading

James O. Mudd; David A. Kass

2008-01-01

133

Developing a Program for Tracking Heart Failure William Long1  

E-print Network

Developing a Program for Tracking Heart Failure William Long1 , Hamish Fraser1 , Shapur Naimi2 failure in patients at home using data available to the patient. Introduction. Heart failure is a chronic from 22 patients participating in a prospective trial of SPAN-CHF (our heart failure management program

Long, William J.

134

Multiscale Complexity Analysis of Heart Rate Dynamics in Heart Failure: Preliminary Findings from the MUSIC Study  

E-print Network

Multiscale Complexity Analysis of Heart Rate Dynamics in Heart Failure: Preliminary Findings from with congestive heart failure (CHF) enrolled in the MUSIC study. Our hypothe- sis is that the heart rate time of CHF. 1. Introduction The development of new markers of mortality risk in congestive heart failure (CHF

135

Drugs acting on the heart: heart failure and coronary insufficiency  

Microsoft Academic Search

Heart failure (HF) and coronary insufficiency are common among intensive care patients or those undergoing surgery. Both conditions can present as an acute decompensated state with high mortality or with a more stable, chronic course. Although similar drugs can be used to treat both conditions, an understanding of the respective pathological processes enables better targeting of treatment. Several drugs have

Alcira Serrano-Gomez; Jonathan Thompson

2009-01-01

136

Echocardiography and heart failure: a glimpse of the right heart.  

PubMed

The catastrophic consequences for patients in the settings of certain clinical conditions such as acute right ventricular infarction or massive pulmonary embolism with right heart failure illustrate the essential role that the right ventricle plays in sustaining life. With the development of more sophisticated diagnostic imaging technologies at the end of the last century and the dawn of this century, the importance of the right ventricle has been clearly demonstrated. The continued and evolving nature of our understanding of the right ventricle was emphasized in 2006, when the National Heart, Blood, and Lung Institute formed a working group focused on developing a better understanding of the right ventricle in both healthy and disease states. The objective of this review paper is to examine the right ventricle structure and function and describe the role of echocardiography in the evaluation of the right ventricle and right heart failure. Special focus will be on echocardiographic images and major society guidelines. PMID:25234293

Pleister, Adam; Kahwash, Rami; Haas, Garrie; Ghio, Stefano; Cittadini, Antonio; Baliga, Ragavendra R

2015-01-01

137

Combination stem cell therapy for heart failure  

Microsoft Academic Search

Patients with congestive heart failure (CHF) that are not eligible for transplantation have limited therapeutic options. Stem cell therapy such as autologous bone marrow, mobilized peripheral blood, or purified cells thereof has been used clinically since 2001. To date over 1000 patients have received cellular therapy as part of randomized trials, with the general consensus being that a moderate but

Thomas E Ichim; Fabio Solano; Fabian Lara; Jorge Paz Rodriguez; Octav Cristea; Boris Minev; Famela Ramos; Erik J Woods; Michael P Murphy; Doru T Alexandrescu; Amit N Patel; Neil H Riordan

2010-01-01

138

Load Dependent Diastolic Dysfunction in Heart Failure  

Microsoft Academic Search

Congestive heart failure may result from cardiovascular overload, from systolic or from diastolic dysfunction. Diastolic left ventricular dysfunction may result from structural resistance to filling such as induced by pericardial constraint, right ventricular compression, increased chamber stiffness (hypertrophy) and increased myocardial stiffness (fibrosis). A distinct and functional etiology of diastolic dysfunction is slow and incomplete myocardial relaxation. Relaxation may be

Thierry C. Gillebert; Adelino F. Leite-Moreira; Stefan G. De Hert

2000-01-01

139

Heart Failure: The Hidden Problem of Pain  

Microsoft Academic Search

Although dyspnea and fatigue are hallmark symptoms of heart failure (HF), the burden of pain may be underrecognized. This study assessed pain in HF and identified contributing factors. As part of a multicenter study, 96 veterans with HF (96% male, 67±11 years) completed measures of symptoms, pain (Brief Pain Inventory [BPI]), functional status (Functional Morbidity Index), and psychological state (Patient

Joy R. Goebel; Lynn V. Doering; Lisa R. Shugarman; Steve M. Asch; Cathy D. Sherbourne; Andy B. Lanto; Lorraine S. Evangelista; Adeline M. Nyamathi; Sally L. Maliski; Karl A. Lorenz

2009-01-01

140

Death in Heart Failure A Community Perspective  

Microsoft Academic Search

Background—Mortality in patients with heart failure (HF) remains high, but causes of death are incompletely defined. As HF is a heterogeneous syndrome categorized according to the ejection fraction (EF), the association between EF and causes of death is important, yet elusive. Methods and Results—Community subjects with HF were classified according to the preserved (50%) and the reduced EF (50%). Deaths

Danielle M. Henkel; Margaret M. Redfield; Susan A. Weston; Yariv Gerber; Veronique L. Roger

141

Nurses's knowledge of heart failure education principles  

Microsoft Academic Search

Objective: The goal of this study was to determine nurses' knowledge of heart failure (HF) self-management education principles. Design: The study was exploratory and descriptive and included a convenience sample. Setting: Research took place in a large midwestern health care system that included a university-based hospital, community hospitals, and home or palliative care. Subjects: Subjects included 300 nurses who provide

Nancy M. Albert; Susan Collier; Veronica Sumodi; Sandra Wilkinson; Jeffrey P. Hammel; Linda Vopat; Cindy Willis; Barb Bittel

2002-01-01

142

Biventricular pacemakers in patients with heart failure.  

PubMed

Patients with heart failure may benefit from implantation of a biventricular pacemaker. This article discusses the indications for biventricular pacemaker implantation and the assessment of patients with biventricular pacemakers. Biventricular pacemakers require more assessments than do traditional single- or dual-chamber pacemakers. PMID:25834005

Cooper, Karen Leslie

2015-04-01

143

Combination stem cell therapy for heart failure.  

PubMed

Patients with congestive heart failure (CHF) that are not eligible for transplantation have limited therapeutic options. Stem cell therapy such as autologous bone marrow, mobilized peripheral blood, or purified cells thereof has been used clinically since 2001. To date over 1000 patients have received cellular therapy as part of randomized trials, with the general consensus being that a moderate but statistically significant benefit occurs. Therefore, one of the important next steps in the field is optimization. In this paper we discuss three ways to approach this issue: a) increasing stem cell migration to the heart; b) augmenting stem cell activity; and c) combining existing stem cell therapies to recapitulate a "therapeutic niche". We conclude by describing a case report of a heart failure patient treated with a combination stem cell protocol in an attempt to augment beneficial aspects of cord blood CD34 cells and mesenchymal-like stem cells. PMID:20398245

Ichim, Thomas E; Solano, Fabio; Lara, Fabian; Rodriguez, Jorge Paz; Cristea, Octav; Minev, Boris; Ramos, Famela; Woods, Erik J; Murphy, Michael P; Alexandrescu, Doru T; Patel, Amit N; Riordan, Neil H

2010-01-01

144

Combination stem cell therapy for heart failure  

PubMed Central

Patients with congestive heart failure (CHF) that are not eligible for transplantation have limited therapeutic options. Stem cell therapy such as autologous bone marrow, mobilized peripheral blood, or purified cells thereof has been used clinically since 2001. To date over 1000 patients have received cellular therapy as part of randomized trials, with the general consensus being that a moderate but statistically significant benefit occurs. Therefore, one of the important next steps in the field is optimization. In this paper we discuss three ways to approach this issue: a) increasing stem cell migration to the heart; b) augmenting stem cell activity; and c) combining existing stem cell therapies to recapitulate a "therapeutic niche". We conclude by describing a case report of a heart failure patient treated with a combination stem cell protocol in an attempt to augment beneficial aspects of cord blood CD34 cells and mesenchymal-like stem cells. PMID:20398245

2010-01-01

145

Remote Monitoring of Heart Failure Patients  

PubMed Central

“The Teledactyl (Tele, far; Dactyl, finger — from the Greek) is a future instrument by which it will be possible for us to ‘feel at a distance.’ This idea is not at all impossible, for the instrument can be built today with means available right now. It is simply the well known telautograph, translated into radio terms, with additional refinements. The doctor of the future, by means of this instrument, will be able to feel his patient, as it were, at a distance…The doctor manipulates his controls, which are then manipulated at the patient’s room in exactly the same manner. The doctor sees what is going on in the patient’s room by means of a television screen.” —Hugo Gernsback, Science and Invention Magazine, February 1925 Heart failure continues to be a major burden on our health care system. As the number of patients with heart failure increases, the cost of hospitalization alone is contributing significantly to the overall cost of this disease. Readmission rate and hospital length of stay are emerging as quality markers of heart failure care along with reimbursement policies that force hospitals to optimize these outcomes. Apart from maintaining quality assurance, the disease process of heart failure per-se requires demanding and close attention to vitals, diet, and medication compliance to prevent acute decompensation episodes. Remote patient monitoring is morphing into a key disease management strategy to optimize care for heart failure. Innovative implantable technologies to monitor intracardiac hemodynamics also are evolving, which potentially could offer better and substantial parameters to monitor. PMID:23519115

Bhimaraj, Arvind

2013-01-01

146

Insulin Resistance in Chronic Heart Failure: Relation to Severity and Etiology of Heart Failure  

Microsoft Academic Search

Objectives. We attempted to assess insulin sensitivity in patients with chronic heart failure (CHF) and its relation to disease severity.Background. Peripheral muscular changes influence the progression of heart failure. This effect may be due to chronic disturbances of insulin and glucose metabolism that affect the energy status of skeletal and myocardial muscle.Methods. We investigated insulin sensitivity in 79 men—38 patients

Jonathan W Swan; Stefan D Anker; Christopher Walton; Ian F Godsland; Andrew L Clark; Francisco Leyva; John C Stevenson; Andrew J. S Coats

1997-01-01

147

Are Too Many Heart Failure Patients Getting IV Fluids?  

MedlinePLUS

... please enable JavaScript. Are Too Many Heart Failure Patients Getting IV Fluids? Since treatment usually aims at ... IV) fluids are being given to too many patients with severe heart failure, a new study suggests. ...

148

Serum myostatin levels in chronic heart failure.  

PubMed

Muscle wasting is common in advanced heart failure. Myostatin is an important modulator of muscle catabolism. We measured serum levels of myostatin and its propeptide in patients with chronic heart failure and analyzed their relationships with clinical parameters and prognosis. The study included 70 patients: 30 in New York Heart Association (NYHA) functional class I-II and 40 in class III-IV. Their mean ejection fraction was 32%+/-12%. The mean follow-up time was 17.9+/-1.3 months. Thirteen patients (18.6%) died. No correlation was found between myostatin and myostatin propeptide levels. Nor was the myostatin or myostatin propeptide level correlated with age, sex, left ventricular ejection fraction, symptom duration, or the level of N-terminal probrain natriuretic peptide (NT-proBNP) or tumor necrosis factor-alpha receptor type-2 (TNFalpha R2). Moreover, no relationship was observed between the myostatin or myostatin propeptide level and NYHA functional class or mortality, in contrast to the relationships found with NT-proBNP (P< .001 and P< .001, respectively) and TNFalpha R2 (P=.001 and P=.005, respectively) levels. In conclusion, there was no relationship between the myostatin or myostatin propeptide level and any parameter of disease severity or prognosis in patients with chronic heart failure. PMID:20738945

Zamora, Elisabet; Simó, Rafael; Lupón, Josep; Galán, Amparo; Urrutia, Agustín; González, Beatriz; Mas, Dolores; Valle, Vicente

2010-08-01

149

Nurse-led heart failure clinics in Sweden  

Microsoft Academic Search

Objectie: The aim of this study was to describe the nurse-led heart failure care in Sweden. Methods: A postal questionnaire was sent to all 86 hospitals in Sweden treating heart failure patients. All hospitals completed the questionnaire, which contained 20 questions about heart failure nurses, patient education, heart failure clinics, co-operation with primary . healthcare and care programmes. Results: Sixty-nine

Anna Stromberg; Bengt Fridlundb

150

What do patients know about their heart failure?  

Microsoft Academic Search

Positive health outcomes for heart failure (HF) patients depend on patient participation in the selection and use of appropriately focused heart failure self-care. To produce a system of heart failure self-care, patients must have an adequately developed fund of highly specialized antecedent knowledge. This research found that knowledge needed to produce heart failure self-care was deficient in a diverse sample

Nancy T. Artinian; Morris Magnan; Willecia Christian; M. Patricia Lange

2002-01-01

151

End-of-life care in heart failure  

Microsoft Academic Search

The clinical syndrome of heart failure is increasing in prevalence, as is the number of elderly persons with heart failure.\\u000a Increasing frailty and progression of heart failure in large numbers of patients means clinicians are increasingly challenged\\u000a to provide end-of-life care for heart failure patients. End-of-life care has been little studied, but management can be understood\\u000a from early clinical trials

Sarah J. Goodlin

2009-01-01

152

Mathematical Approaches to Predictive Health Monitoring for Heart Failure Patients  

E-print Network

Mathematical Approaches to Predictive Health Monitoring for Heart Failure Patients Yi­Ju Chao 127 and the theoretical approaches to explore pa­ rameters, which can be used to predict the health of heart failure patients and to classify heart failure patients. From the statistical point of view, the comparison

153

Altered Cardiac Myocyte Ca Regulation In Heart Failure  

NSDL National Science Digital Library

The article explores Myocyte Ca regulation in heart failure. The article suggests that there are alterations in how myocyte Ca is regulated which causes characteristics found during heart failure. There is a lot known about this topic and this review could help further the investigation into the cause of heart failure.

PhD Donald M. Bers (Stritch School of Medicine - Loyola University Chicago Physiology)

2006-12-01

154

Mathematical Approaches to Predictive Health Monitoring for Heart Failure Patients  

E-print Network

Mathematical Approaches to Predictive Health Monitoring for Heart Failure Patients Yi-Ju Chao 127 and the theoretical approaches to explore pa- rameters, which can be used to predict the health of heart failure patients and to classify heart failure patients. From the statistical point of view, the comparison

155

Adrenal GRK2 upregulation mediates sympathetic overdrive in heart failure  

E-print Network

Adrenal GRK2 upregulation mediates sympathetic overdrive in heart failure Anastasios Lymperopoulos1 by the sympathetic nervous system (SNS) is a salient characteristic of heart failure, reflected by elevated circulating levels of catecholamines. The success of b-adrenergic receptor (bAR) antagonists in heart failure

Cai, Long

156

MODELING CARDIOVASCULAR AND RESPIRATORY DYNAMICS IN CONGESTIVE HEART FAILURE  

E-print Network

MODELING CARDIOVASCULAR AND RESPIRATORY DYNAMICS IN CONGESTIVE HEART FAILURE LAURA M. ELLWEIN1 heart failure. The model is a lumped parameter model giving rise to a system of ordinary differential physiologically reasonable for a patient with congestive heart failure. 1. Introduction. The strong

Olufsen, Mette Sofie

157

Living with heart failure; patient and carer perspectives  

Microsoft Academic Search

Patients with heart failure have multiple readmissions to hospital, a poor prognosis and varying quality of life. This paper explores how patients with heart failure and their family carers cope with daily life. 36 patients and 20 family caregivers were interviewed in five centres in the UK. Analysis showed that living with heart failure can be frightening, restrictive and distressing

J. F. Pattenden; H. Roberts; R. J. P. Lewin

2007-01-01

158

Predictors of depressive symptoms in older veterans with heart failure  

Microsoft Academic Search

Objectives: This study collected data on demographic factors, heart failure physical limitations, perception of heart failure intrusiveness, coping mechanisms, locus of control, self-efficacy and social support for 104 older veterans with heart failure (HF) to determine the factors’ relative importance in predicting depressive symptoms.Method: Participants were veterans at least 60 years of age with HF who were screened for depression

Amber Lynn Paukert; Ashley LeMaire; Jeffrey A. Cully

2009-01-01

159

Empowering Family Members for Supporting a Person with Heart Failure  

Microsoft Academic Search

Family involvement in chronic care regimen has been explored in multiple studies. Chronic illness and full time caregiving place a new stress on the family but this partnership shows positive outcomes. Family members of 60 elderly patients with chronic heart failure filled out the questionnaire prepared in accordance with the educational modules on heart failure of the Heart Failure Society

L Jankauskiene; V Lesauskaite

160

Self care in patients with chronic heart failure  

Microsoft Academic Search

'Heart failure self care' refers to the practices in which patients engage to maintain their own health, and to the decisions that they make about managing signs or symptoms. In this article, we base our discussion of self care in chronic heart failure on the classification of patients as being 'expert', inconsistent', or 'novice' in heart failure self-care behaviors. The

Christopher S. Lee; Victoria Vaughan Dickson; Barbara Riegel

2011-01-01

161

Illness representation of patients with systolic heart failure.  

PubMed

Studies have shown that individuals influence their health outcomes, both positively and negatively, through their illness representation. To date, no studies describe the illness representation of persons with systolic heart failure, a significant contributor of morbidity and mortality in older adults. The purpose of this study was to describe illness representation in heart failure. Twenty-two subjects with New York Heart Association class II or III systolic heart failure were recruited at a university-based heart failure clinic. Illness representation was measured using the revised Illness Perception Questionnaire. The means on each of the 9 subscales were found to be significantly different from the neutral point of 3. The results suggest that participants believed that their heart failure was a chronic, cyclic disease with serious consequences that they could control through treatment. In addition, participants believed that they understood their heart failure and did not have a negative affective response to their heart failure. PMID:17170594

Cherrington, Candace C; Lawson, Thomas N; Clark, Karen B

2006-01-01

162

Heart failure in the diabetic population – pathophysiology, diagnosis and management  

PubMed Central

Evidence from clinical trials repeatedly confirms the association of diabetes with heart failure, independent of hypertension, atherosclerosis, coronary artery disease and valvular heart disease. However, the importance of coexistence of diabetes and heart failure is not universally recognized, despite the fact that it may significantly contribute to morbidity and mortality of the diabetic population. It seems that prevention of heart failure, early diagnosis, and appropriate management could improve the outcome. Unfortunately, the etiology of heart failure in diabetic patients is still to be elucidated. It is multifactorial in nature and several cellular, molecular and metabolic factors are implicated. Additionally, there are still no definite guidelines on either the diagnosis and treatment of heart failure in diabetic patients or on the therapy of diabetes in subjects with heart failure. This review focuses on the pathophysiology, diagnosis, and prevention of heart failure in the diabetic population as well as management of both comorbidities. PMID:25097587

Drzewoski, Jozef

2014-01-01

163

Diastolic heart failure: The forgotten manifestation of hypertensive heart disease  

Microsoft Academic Search

Heart failure (HF) is a progressively debilitating disorder characterized by frequent hospital admissions and high annual\\u000a mortality rates. Coronary artery disease (CAD), hypertension, and aging are major risk factors for the development\\/ progression\\u000a of HF. For years, most of the attention has been focused on HF caused by reduced left ventricular (LV) systolic function,\\u000a largely attributable to CAD. It is

Rigobert Lapu-Bula; Elizabeth Ofili

2004-01-01

164

Coenzyme Q10 supplementation and heart failure.  

PubMed

Cardiovascular disease (CVD) is the leading cause of morbidity and mortality in the Western world. Oxidative stress appears to play a pivotal role in atherosclerosis. Coenzyme Q10 (CoQ10), one of the most important antioxidants, is synthesized de novo by every cell in the body. Its biosynthesis decreases with age and its deficit in tissues is associated with degenerative changes of aging, thus implicating a possible therapeutic role of CoQl0 in human diseases. There is evidence to support the therapeutic value of CoQ10 as an adjunct to standard medical therapy in congestive heart failure. However, much further research is required, especially in the use of state-of-the-art techniques to assess functional outcomes in patients with congestive heart failure. PMID:17605305

Singh, Uma; Devaraj, Sridevi; Jialal, Ishwarlal

2007-06-01

165

[Acute heart failure - a unique challenge].  

PubMed

Acute heart failure (AHF) is frequent, often life threatening and followed by emergency hospitalization. Leading symptoms are dyspnea, edema and fatigue. A broad spectrum of risk factors, cardiac diseases and comorbidities predisposes to AHF. Typical triggers (e.?g. arrhythmias) modulate the individual clinical picture. Their misinterpretation may delay the diagnosis, which always needs to be ascertained by cardiac imaging (echocardiography). Rescue therapy aims at amelioration of symptoms and stabilization of vital parameters. In contrast to chronic heart failure evidence of the efficacy of available treatments is limited and in the past innovations have been sparse in this area. The clinical course is characterized by high short- and long-term mortality and repeat cardiac decompensations, but seamless multidisciplinary care and better knowledge and self-supervision on the patients' side might improve prognosis. Today, too little attention is paid to the palliative needs of patients with AHF. PMID:25774728

Angermann, Christiane E; Ertl, Georg

2015-03-01

166

Heart failure patients utilizing an electric home monitor: What effects does heart failure have on their quality of life?  

Microsoft Academic Search

Heart Failure continues to be a major public health problem associated with high mortality and morbidity. Heart Failure is the leading cause of hospitalization for persons older than 65 years, has a poor prognosis and is associated with poor quality of life. More than 5.3 million American adults are living with heart failure. Despite maximum medical therapy and frequent hospitalizations

Gloria J. Simuel

2010-01-01

167

Cardiovascular Magnetic Resonance in Heart Failure  

Microsoft Academic Search

Imaging has a central role in the evaluation of patients with heart failure (HF). Cardiovascular magnetic resonance (CMR)\\u000a is rapidly evolving as a versatile imaging modality that often provides additional information to echocardiography in patients\\u000a with suspected or known HF. CMR is the only imaging modality that has the ability to assess, without exposure to ionizing\\u000a radiation, cardiac function, structure

Theodoros D. Karamitsos; Stefan Neubauer

2011-01-01

168

Psychosocial factors and congestive heart failure  

Microsoft Academic Search

The incidence and prevalence of congestive heart failure (CHF) are increasing, even after adjustment for an aging population.\\u000a Because coverage of psychosocial factors in CHF has been insufficient, we reviewed the literature in this area. Four major\\u000a themes emerged in our review as we examined relations between psychosocial factors and CHF: psychiatric comorbidity, psychosocial\\u000a precipitation and exacerbation of CHF, psychosocial

Judi Profant; Joel E. Dimsdale

2000-01-01

169

Cell sheet technology for heart failure.  

PubMed

Heart failure is a life threatening disorder in worldwide and many papers reported about myocardial regeneration through surgical method induced by LVAD, cellular cardiomyoplasty (cell injection), tissue cardiomyoplasty (bioengineered cardiac graft implantation), in situ engineering (scaffold implantation), and LV restrictive devices. Some of these innovated technologies have been introduced to clinical settings. This review article provides summary about recent basical and clinical advances about myocardial regeneration induced by bioengineered cardiac tissue. PMID:23437937

Sawa, Yoshiki; Miyagawa, Shigeru

2013-01-01

170

Genomics, heart failure and sudden cardiac death  

Microsoft Academic Search

Sudden cardiac death (SCD) is among the most common causes of death in developed countries throughout the world. Despite decreased\\u000a overall cardiac mortality, SCD rates appear to be increasing in concert with escalating global prevalence of coronary disease\\u000a and heart failure, the two major conditions predisposing to SCD. This unfavorable trend is a consequence of our inability\\u000a to identify those

Dawood Darbar

2010-01-01

171

Epidemiology and risk profile of heart failure  

Microsoft Academic Search

Heart failure (HF) is a major public health issue, with a prevalence of over 5.8 million in the USA, and over 23 million worldwide, and rising. The lifetime risk of developing HF is one in five. Although promising evidence shows that the age-adjusted incidence of HF may have plateaued, HF still carries substantial morbidity and mortality, with 5-year mortality that

Anh L. Bui; Tamara B. Horwich; Gregg C. Fonarow

2010-01-01

172

Mitochondrion: Key Factors in Acute Heart Failure  

Microsoft Academic Search

Mitochondria are largely abundant in the myocardium, not only because they provide the large part of energy in an organ that\\u000a consumes a lot of adenosine triphosphate (ATP) for its mechanical activity and its cellular processes, but also because mitochondria\\u000a play a potent role in cardiac homeostasis. Acute heart failure (AHF), defined as a reversible incapacity of the myocardium\\u000a to

Christophe Rabuel

173

Pharmacological treatment of chronic heart failure  

Microsoft Academic Search

Heart failure (HF) is associated with a high morbidity and mortality in the Western World. Our knowledge of the epidemiology,\\u000a pathophysiology, and therapy has improved dramatically during the last 20 years. Pharmacological treatment, as it stands today,\\u000a is a combination of preventive and symptomatic strategies. The mainstay life-saving drugs are angiotensin-converting enzyme\\u000a inhibitors and ?-blockers. Additional benefits are obtained when

Rachele Adorisio; Leonardo De Luca; Joseph Rossi; Mihai Gheorghiade

2006-01-01

174

Targeting heart failure therapeutics: a historical perspective.  

PubMed

This article reviews information on the role of genetic variability in the development, progression, and treatment of heart failure. It focuses primarily on genetic variation in neurohormonal systems, where adrenergic receptors and the renin-angiotensin-aldosterone system are the two most explored areas. The article also reviews the endothelin system and natriuretic peptides. Clinical trial design issues are examined, and suggestions for pharmacogenomic clinical trials are presented. Finally, lessons from the oncology field and the changing regulatory landscape are discussed. PMID:19945056

Murphy, Guinevere A; Fiuzat, Mona; Bristow, Michael R

2010-01-01

175

Acute Heart Failure and Systemic Diseases  

Microsoft Academic Search

Acute heart failure in systemic lupus erythematosus (SLE) may result from myocarditis, endocarditis, systemic hypertension,\\u000a coronary artery disease, and left ventricular dysfunction secondary to drug toxicity. Pericarditis is an early and common\\u000a cardiac manifestation of active lupus. Moderate to severe pericardial disease is infrequent (1), and constrictive pericarditis is rare. Pericardial fluid is usually exudative (1), and may contain anti-DNA

Iris Cohen; Nadia Benyounes-Iglesias; Nadia Belmatoug; Ariel A. Cohen

176

The cardiorenal connection in heart failure  

Microsoft Academic Search

Heart failure (HF) and renal dysfunction frequently coexist; this combination is commonly referred to as the “cardiorenal\\u000a syndrome.” The intersection of cardiac and renal dysfunction has important therapeutic and prognostic implications in patients\\u000a with HF. Approximately 60% to 80% of patients hospitalized for HF have at least stage III renal dysfunction; this comorbid\\u000a renal insufficiency (RI) is associated with significantly

Anjay Rastogi; Gregg C. Fonarow

2008-01-01

177

Cardiac resynchronisation therapy for heart failure.  

PubMed

Heart failure (HF) is increasingly common and, despite advances in pharmacotherapeutic management, often progresses. Progression is marked by structural and electrical changes-remodelling. In approximately one-third of patients, ventricular dilatation is accompanied by intraventricular conduction delays, most commonly the left bundle branch block (LBBB). The presence of LBBB is associated with mechanical dyssynchrony of the heart. Cardiac resynchronisation therapy (CRT), the use of special pacemakers with or without implantable cardioverter defibrillators, aims to resynchronise the failing heart, improving myocardial contraction without increased energetics. Several, large, randomised clinical trials have now established the benefit of CRT in a select group of HF patients, providing functional and, recently shown, mortality benefits. However, a substantial proportion of patients are considered non-responders to CRT, and studies are now underway to identify the patients most likely to respond to CRT. PMID:16472265

Mariani, J A; Gould, P A; Broughton, A; Kaye, D M

2006-02-01

178

Chronic Heart Failure: Contemporary Diagnosis and Management  

PubMed Central

Chronic heart failure (CHF) remains the only cardiovascular disease with an increasing hospitalization burden and an ongoing drain on health care expenditures. The prevalence of CHF increases with advancing life span, with diastolic heart failure predominating in the elderly population. Primary prevention of coronary artery disease and risk factor management via aggressive blood pressure control are central in preventing new occurrences of left ventricular dysfunction. Optimal therapy for CHF involves identification and correction of potentially reversible precipitants, target-dose titration of medical therapy, and management of hospitalizations for decompensation. The etiological phenotype, absolute decrease in left ventricular ejection fraction and a widening of QRS duration on electrocardiography, is commonly used to identify patients at increased risk of progression of heart failure and sudden death who may benefit from prophylactic implantable cardioverter-defibrillator placement with or without cardiac resynchronization therapy. Patients who transition to advanced stages of disease despite optimal traditional medical and device therapy may be candidates for hemodynamically directed approaches such as a left ventricular assist device; in selected cases, listing for cardiac transplant may be warranted. PMID:20118395

Ramani, Gautam V.; Uber, Patricia A.; Mehra, Mandeep R.

2010-01-01

179

Heart Failure Associated Hospitalizations in the United States  

PubMed Central

Objective We sought to characterize temporal trends in hospitalizations with heart failure as a primary or secondary diagnosis. Background Heart failure patients are frequently admitted for both heart failure and other causes. Methods Using the Nationwide Inpatient Sample (NIS), we evaluated trends in heart failure hospitalizations between 2001 and 2009. Hospitalizations were categorized as either primary or secondary heart failure hospitalizations based the location of heart failure in the discharge diagnosis. National estimates were calculated using the sampling weights of the NIS. Age- and gender-standardized hospitalization rates were determined by dividing the number of hospitalizations by the United States population in a given year and using direct standardization. Results The number of primary heart failure hospitalizations in the United States decreased from 1,137,944 in 2001 to 1,086,685 in 2009, while secondary heart failure hospitalizations increased from 2,753,793 to 3,158,179 over the same period. Age- and gender-adjusted rates of primary heart failure hospitalizations decreased steadily over 2001–2009, from 566 to 468 per 100,000 people. Rates of secondary heart failure hospitalizations initially increased, from 1370 to 1476 per 100,000 from 2001–2006, then decreased to 1359 per 100,000 in 2009. Common primary diagnoses for secondary heart failure hospitalizations included pulmonary disease, renal failure, and infections. Conclusions Although primary heart failure hospitalizations declined, rates of hospitalizations with a secondary diagnosis of heart failure were stable in the past decade. Strategies to reduce the high burden of hospitalizations of heart failure patients should include consideration of both cardiac disease and non-cardiac conditions. PMID:23500328

Blecker, Saul; Paul, Margaret; Taksler, Glen; Ogedegbe, Gbenga; Katz, Stuart

2013-01-01

180

Incretin-related drug therapy in heart failure.  

PubMed

The new pharmacological classes of GLP-1 agonists and DPP-4 inhibitors are now widely used in diabetes and have been postulated as beneficial in heart failure. These proposed benefits arise from the inter-related pathophysiologies of diabetes and heart failure (diabetes increases the risk of heart failure, and heart failure can induce insulin resistance) and also in light of the dysfunctional myocardial energetics seen in heart failure. The normal heart utilizes predominantly fatty acids for energy production, but there is some evidence to suggest that increased myocardial glucose uptake may be beneficial for the failing heart. Thus, GLP-1 agonists, which stimulate glucose-dependent insulin release and enhance myocardial glucose uptake, have become a focus of investigation in both animal models and humans with heart failure. Limited pilot data for GLP-1 agonists shows potential improvements in systolic function, hemodynamics, and quality of life, forming the basis for current phase II trials. PMID:25323108

Vest, Amanda R

2015-02-01

181

New diagnostic and therapeutic possibilities for diastolic heart failure  

PubMed Central

Despite the fact that up to half of all heart failure occurs in patients without evidence of systolic cardiac dysfunction, there are no universally accepted diagnostic markers and no approved therapies for heart failure with preserved ejection fraction (HFpEF). HFpEF, otherwise known as diastolic heart failure, has nearly the same grim prognosis as systolic heart failure, and diastolic heart failure is increasing in incidence and prevalence. Major trials have shown that many of the treatments that are salutary in systolic heart failure have no beneficial effects in diastolic heart failure, suggesting different underlying mechanisms for these two disorders. Even criteria for diagnosis of HFpEF are still debated, and there is still no gold standard marker to detect diastolic dysfunction. Here, we will review some promising new insights into the pathogenesis of diastolic dysfunction that may lead to new diagnostic and therapeutic tools. PMID:24494212

Jeong, Euy-Myoung; Dudley, Samuel C.

2014-01-01

182

Right ventricular failure in congenital heart disease  

PubMed Central

Despite developments in surgical techniques and other interventions, right ventricular (RV) failure remains an important clinical problem in several congenital heart diseases (CHD). RV function is one of the most important predictors of mortality and morbidity in patients with CHD. RV failure is a progressive disorder that begins with myocardial injury or stress, neurohormonal activation, cytokine activation, altered gene expression, and ventricular remodeling. Pressure-overload RV failure caused by RV outflow tract obstruction after total correction of tetralogy of Fallot, pulmonary stenosis, atrial switch operation for transposition of the great arteries, congenitally corrected transposition of the great arteries, and systemic RV failure after the Fontan operation. Volume-overload RV failure may be caused by atrial septal defect, pulmonary regurgitation, or tricuspid regurgitation. Although the measurement of RV function is difficult because of many reasons, the right ventricle can be evaluated using both imaging and functional modalities. In clinical practice, echocardiography is the primary mode for the evaluation of RV structure and function. Cardiac magnetic resonance imaging is increasingly used for evaluating RV structure and function. A comprehensive evaluation of RV function may lead to early and optimal management of RV failure in patients with CHD. PMID:23559970

Ma, Jae Sook

2013-01-01

183

Dilemmas in end-stage heart failure  

PubMed Central

Heart failure (HF), a complex clinical syndrome due to structural or functional disorder of the heart, is a major global health issue, with a prevalence of over 5.8 million in the USA alone, and over 23 million worldwide. As a leading cause of hospitalizations among patients aged 65 years or older, HF is a major consumer of healthcare resources, creating a substantial strain on the healthcare system. This paper discusses the epidemiology of HF, financial impact, and multifaceted predicaments in end-stage HF care. A search was conducted on the U.S. National Library of Medicine website (www.pubmed.gov) using keywords such as end-stage heart failure, palliative care, ethical dilemmas. Despite the poor prognosis of HF (worse than that for many cancers), many HF patients, caregivers, and clinicians are unaware of the poor prognosis. In addition, the unpredictable clinical trajectory of HF complicates the planning of end-of-life care, such as palliative care and hospice, leading to underutilization of such resources. In conclusion, ethical dilemmas in end-stage HF are numerous, embroiling not only the patient, but also the caregiver, healthcare team, and society. PMID:25678905

Chen-Scarabelli, Carol; Saravolatz, Louis; Hirsh, Benjamin; Agrawal, Pratik; Scarabelli, Tiziano M.

2015-01-01

184

The effects of simvastatin on the incidence of heart failure in patients with coronary heart disease  

Microsoft Academic Search

Background: Although treatment of myocardial overload effectively reduces death from progression of heart failure, it is not known whether the retardation of progressive coronary artery disease obtained with lipid lowering treatment will prevent the onset and consequences of heart failure in patients without previous symptoms of heart failure.Methods and Results: In the Scandinavian Simvastatin Survival Study, 4444 patients with coronary

John Kjekshus; Terje R. Pedersen; Anders G. Olsson; Ole Færgeman; Kalevi Pyörälä

1997-01-01

185

Ventricular-Vascular Interaction in Heart Failure  

PubMed Central

Synopsis Nearly half of all patients with heart failure have preserved ejection fraction (HFpEF). HFpEF patients tend to be older, female, and hypertensive, and characteristically display increased ventricular and arterial stiffening. In this review, we discuss the pathophysiology of abnormal ventriculoarterial stiffening and how the latter affects ventricular function, cardiovascular hemodynamics, reserve capacity, and symptoms. We conclude by exploring how novel treatment strategies targeting abnormal ventricular-arterial interaction might prove useful in the treatment of patients with HFpEF. PMID:18313622

Borlaug, Barry A.; Kass, David A.

2008-01-01

186

Iron deficiency anemia in heart failure.  

PubMed

Anemia and iron deficiency are quite prevalent in patients with heart failure (HF) and may overlap. Both anemia and iron deficiency are associated with worse symptoms and adverse clinical outcomes. In the past few years, there has been an enormous interest in the subject of iron deficiency and its management in patients with HF. In this review, the etiology and relevance of iron deficiency, iron metabolism in the setting of HF, studies on iron supplementation in patients with HF and potential cardiovascular effects of subclinical iron overload are discussed. PMID:22948485

Arora, Natasha P; Ghali, Jalal K

2013-07-01

187

[Telemedicine and wireless devices in heart failure].  

PubMed

Telemedicine has the potential to constitute the central element of the future primary care and become an effective means of prevention and early warning of acute exacerbation of chronic diseases. Up to now, the application of telemedicine has found a variety of difficulties, regarding the types and methods of acquisition and transmission of biological signals, the acceptance and cooperation of the patient, etc. The latest technological developments involve the combined use of wireless technologies and smartphones, for the collection and the transmission of data, and specific softwares for their automatic analysis. This paper examines some of the critical aspects in the application of new technologies for heart failure remote management. PMID:24873944

Billeci, Lucia; Guerriero, Lorenzo; L'Abbate, Antonio; Pioggia, Giovanni; Tartarisco, Gennaro; Trivella, Maria Giovanna

2014-05-01

188

Technology-assisted congestive heart failure care.  

PubMed

The interface between eHealth technologies and disease management in chronic conditions such as chronic heart failure (CHF) has advanced beyond the research domain. The substantial morbidity, mortality, health resource utilization and costs imposed by chronic disease, accompanied by increasing prevalence, complex comorbidities and changing client and health staff demographics, have pushed the boundaries of eHealth to alleviate costs whilst maintaining services. Whilst the intentions are laudable and the technology is appealing, this nonetheless requires careful scrutiny. This review aims to describe this technology and explore the current evidence and measures to enhance its implementation. PMID:25586005

Iyngkaran, P; Toukhsati, S R; Biddagardi, N; Zimmet, H; J Atherton, J; Hare, D L

2015-04-01

189

A roadmap to inpatient heart failure management.  

PubMed

Heart failure (HF) accounts for over 1 million primary hospitalizations in the USA each year and carries a tremendous burden on costs and patient outcomes. The clinical syndrome of HF is not a single disease, but represents the complex interplay between various cardiac and non-cardiac processes, each of which need to be individually addressed. This review provides an updated, contemporary roadmap for inpatient worsening chronic HF management with a focus on identifying and addressing initiating mechanisms, amplifying factors, and cardiac structural abnormalities. Inpatient risk stratification should guide patient education, team structuring, disposition, and post-discharge monitoring. PMID:25238886

Vaduganathan, Muthiah; Gheorghiade, Mihai

2015-01-01

190

Positive airway pressure therapy for heart failure  

PubMed Central

Heart failure (HF) is a life-threatening disease and is a growing public health concern. Despite recent advances in pharmacological management for HF, the morbidity and mortality from HF remain high. Therefore, non-pharmacological approaches for HF are being developed. However, most non-pharmacological approaches are invasive, have limited indication and are considered only for advanced HF. Accordingly, the development of less invasive, non-pharmacological approaches that improve outcomes for patients with HF is important. One such approach may include positive airway pressure (PAP) therapy. In this review, the role of PAP therapy applied through mask interfaces in the wide spectrum of HF care is discussed. PMID:25429330

Kato, Takao; Suda, Shoko; Kasai, Takatoshi

2014-01-01

191

Acute Heart Failure: Patient Characteristics and Pathophysiology  

PubMed Central

The number of hospitalizations for acute heart failure (HF) continues to increase and it remains the most common discharge diagnosis among Medicare beneficiaries. Prognosis after hospitalization for HF is poor, with high in-hospital mortality and even higher post-discharge mortality and rehospitalization rates. It is a complex clinical syndrome that varies widely with respect to clinical presentation and underlying pathophysiology. This paper reviews what is documented in the literature regarding the known pathophysiologic mechanisms reported in patients hospitalized for HF. PMID:23918642

Marti, Catherine N.; Georgiopoulou, Vasiliki V.; Kalogeropoulos, Andreas P.

2013-01-01

192

Left Ventricular Wall Movement in Heart Failure  

PubMed Central

Of 34 patients admitted to hospital with left ventricular failure seven died before echocardiograms could be repeated after treatment and in three no echocardiograms could be obtained owing to chronic obstructive lung disease. In the remaining 24 patients echocardiograms were taken soon after admission and compared with echocardiograms taken later, after clinical improvement. The results show that in most patients both anterior and posterior motion of the posterior left ventricular wall increased. The rate of backward diastolic motion was appreciably less before and after treatment of heart failure compared with that in a small group of normal younger healthy men. This technique is a quick and apparently reliable way to assess ventricular function. The rate of diastolic motion is probably a reflection of left ventricular wall compliance. Imagesp78-a PMID:5097424

Carson, Peter; Kanter, Lawrence

1971-01-01

193

Consensus The Heart Failure Clinic: A Consensus Statement of the Heart Failure Society of America  

Microsoft Academic Search

Background: Outpatient care accounts for a significant proportion of total heart failure (HF) expendi- tures. This observation, plus an expanding list of treatment options, has led to the development of the dis- ease-specific HF clinic. Methods and Results: The goals of the HF clinic are to reduce mortality and rehospitalization rates and improve quality of life for patients with HF

PAUL J. HAUPTMAN; MICHAEL W. RICH; PAUL A. HEIDENREICH; JOHN CHIN; NANCY CUMMINGS; MARK E. DUNLAP; MICHELLE L. EDWARDS; DOUGLAS GREGORY; CHRISTOPHER M. O'CONNOR; STEPHEN M. PEZZELLA; EDWARD PHILBIN

194

Treatment of Congestive Heart Failure Guidelines for the Primary Care Physician and the Heart Failure Specialist  

Microsoft Academic Search

uring the past 10 years, the philosophy of heart failure treatment has evolved from symptom control to a combined prevention and symptom-management strategy. Re- cent clinical trials have proved that early detection can delay progression. Treatment of asymptomatic left ventricular dysfunction is as important as treatment of symp- tomatic disease. The purpose of this review is to simplify recent guidelines

Mardi Gomberg-Maitland; David A. Baran; Valentin Fuster

2001-01-01

195

Statins in heart failure: do we need another trial?  

PubMed Central

Statins lower serum cholesterol and are employed for primary and secondary prevention of cardiovascular events. Clinical evidence from observational studies, retrospective data, and post hoc analyses of data from large statin trials in various cardiovascular conditions, as well as small scale randomized trials, suggest survival and other outcome benefits for heart failure. Two recent large randomized controlled trials, however, appear to suggest statins do not have beneficial effects in heart failure. In addition to lowering cholesterol, statins are believed to have many pleotropic effects which could possibly influence the pathophysiology of heart failure. Following the two large trials, evidence from recent studies appears to support the use of statins in heart failure. This review discusses the role of statins in the pathophysiology of heart failure, current evidence for statin use in heart failure, and suggests directions for future research. PMID:23807852

Bonsu, Kwadwo Osei; Kadirvelu, Amudha; Reidpath, Daniel Diamond

2013-01-01

196

Rehospitalization for heart failure: problems and perspectives.  

PubMed

With a prevalence of 5.8 million in the United States alone, heart failure (HF) is associated with high morbidity, mortality, and healthcare expenditures. Close to 1 million hospitalizations for heart failure (HHF) occur annually, accounting for over 6.5 million hospital days and a substantial portion of the estimated $37.2 billion that is spent each year on HF in the United States. Although some progress has been made in reducing mortality in patients hospitalized with HF, rates of rehospitalization continue to rise, and approach 30% within 60 to 90 days of discharge. Approximately half of HHF patients have preserved or relatively preserved ejection fraction (EF). Their post-discharge event rate is similar to those with reduced EF. HF readmission is increasingly being used as a quality metric, a basis for hospital reimbursement, and an outcome measure in HF clinical trials. In order to effectively prevent HF readmissions and improve overall outcomes, it is important to have a complete and longitudinal characterization of HHF patients. This paper highlights management strategies that when properly implemented may help reduce HF rehospitalizations and include adopting a mechanistic approach to cardiac abnormalities, treating noncardiac comorbidities, increasing utilization of evidence-based therapies, and improving care transitions, monitoring, and disease management. PMID:23219302

Gheorghiade, Mihai; Vaduganathan, Muthiah; Fonarow, Gregg C; Bonow, Robert O

2013-01-29

197

Metabolic and structural impairment of skeletal muscle in heart failure  

PubMed Central

Physiologic endurance exercise performance is primarily limited by cardiac function. In patients with heart failure, there is dissociation between cardiac performance and exercise capacity, suggesting a distinct role of abnormal peripheral organ function, including skeletal muscle function. The impact of heart failure upon skeletal muscle and exercise performance will be discussed with a focus on molecular, structural, and functional derangements in skeletal muscle of patients with heart failure. PMID:23065040

Zizola, Cynthia; Schulze, P. Christian

2013-01-01

198

Heart failure in pregnant women: is it peripartum cardiomyopathy?  

PubMed

Peripartum cardiomyopathy is a rare but important cause of maternal morbidity and mortality. Women with peripartum cardiomyopathy often present with symptoms and signs of heart failure. The diagnosis of peripartum cardiomyopathy is made after all other causes of heart failure are excluded. Emphasis is on the immediate recognition of an unwell pregnant or recently pregnant woman, early diagnosis with the use of echocardiography, and the correct treatment of heart failure. PMID:25695578

Dennis, Alicia Therese

2015-03-01

199

Financial aspects of heart failure programs of care  

Microsoft Academic Search

As suggested by studies that have examined the economic burden imposed by heart failure and, more specifically where the greatest expenditure occurs, the key to cost-effectively minimising the impact of a sustained heart failure epidemic is to minimise recurrent hospital use—even at the expense of increasing levels of community-based care and prescribed pharmacotherapy (Mark DB. Economics of treating heart failure.

Simon Stewart

2005-01-01

200

Cost effective management programme for heart failure reduces hospitalisation  

Microsoft Academic Search

ObjectiveTo study the effects of a management programme on hospitalisation and health care costs one year after admission for heart failure.DesignProspective, randomised trial.SettingUniversity hospital with a primary catchment area of 250 000 inhabitants.Patients190 patients (aged 65–84 years, 52.3% men) hospitalised because of heart failure.InterventionTwo types of patient management were compared. The intervention group received education on heart failure and self

C M J Cline; B Y A Israelsson; R B Willenheimer; K Broms; L R Erhardt

1998-01-01

201

Sleep-disordered breathing in patients with decompensated heart failure  

Microsoft Academic Search

Sleep-disordered breathing (SDB) has a higher prevalence in patients with heart failure than in the general middle-aged population.\\u000a Obstructive sleep apnea (OSA), one of the forms of SBD, promotes poorly controlled hypertension, coronary events, and atrial\\u000a fibrillation events that can lead to acutely decompensated heart failure (ADHF), and evidence suggests that untreated OSA\\u000a increases mortality in patients with heart failure.

Martin A. Valdivia-Arenas; Michael Powers; Rami N. Khayat

2009-01-01

202

Hyperkalemia in patients with heart failure: Incidence, prevalence, and management  

Microsoft Academic Search

Multilevel inhibition of neurohormonal activation using angiotensin-converting enzyme inhibitors, ?-blockers, angiotensin\\u000a receptor blockers, and aldosterone antagonists is the cornerstone of modern heart failure treatment. Use of these agents in\\u000a optimal doses is associated with significant improvements in heart failure-associated morbidity and mortality but also may\\u000a increase serum potassium. Because potassium excretion already is impaired in many heart failure patients because

Akshay S. Desai

2009-01-01

203

Who should pay for home monitoring of heart failure?  

Microsoft Academic Search

Despite the recent advancement in medical therapy for heart failure, morbidity associated with heart failure continues to\\u000a be excessive, with rising hospitalization rates and costs. Disease management models have been instituted successfully for\\u000a several chronic disease states, and observational trials have shown different models to be beneficial. A multidisciplinary\\u000a approach to management of heart failure improves outcomes. Multiple recent trials

Monica Colvin Adams; Syed Sohail Ali

2006-01-01

204

Palliative care for end-stage heart failure  

Microsoft Academic Search

Heart failure is growing in prevalence. Despite an array of treatments targeting a complicated pathophysiology, heart failure\\u000a ultimately leads to death, and thus there is a clear need to provide palliative care to persons with end-stage heart failure.\\u000a Palliative care, or education and support of the patient and family and management of distressing symptoms, should be provided\\u000a throughout the course

Sarah J. Goodlin

2005-01-01

205

The role of ultrafiltration in the management of heart failure  

Microsoft Academic Search

Opinion statement  In the United States, 90% of one million annual hospitalizations for heart failure are due to symptoms of volume overload.\\u000a Hypervolemia contributes to heart failure progression and mortality. Treatment guidelines recommend that therapy for patients\\u000a with heart failure be aimed at achieving euvolemia. Intravenous loop diuretics induce a rapid diuresis that reduces lung congestion\\u000a and dyspnea. However, loop diuretics’

Maria Rosa Costanzo

2006-01-01

206

Carvedilol versus other beta-blockers in heart failure.  

PubMed

Carvedilol is a beta-blocker with ancillary properties. Pilot clinical studies with carvedilol, added to the standard therapy of digoxin, diuretics and ACE inhibitors, showed beneficial effects in mild, moderate and severe heart failure. Patients consistently showed improvement in LV ejection fraction and NYHA functional class. Subsequently large clinical trials showed decreased morbidity and mortality with carvedilol in mild and moderate and more recently, severe heart failure. However, there is little or no improvement in exercise tolerance with carvedilol. The beneficial effects of carvedilol in heart failure are associated with cardiac remodelling. Metoprolol and bisoprolol are selective beta(1)-blockers without ancillary properties. Early studies showed benefits with metoprolol and bisoprolol in heart failure. Large clinical trials established that metoprolol and bisoprolol decreased mortality and morbidity in heart failure. In contrast no benefit has been shown with celiprolol, a selective beta(1)-blocker and beta(2)-stimulant in heart failure. There is a debate as to whether the ancillary properties of carvedilol contribute to its beneficial effect in heart failure, making it a better drug to use than metoprolol. Short-term studies suggested that carvedilol and metoprolol were equivalent in heart failure but short-term is probably not an appropriate way to compare the drugs. A recent long-term study and study in poor responders to metoprolol, suggest that carvedilol may be better than metoprolol in heart failure. PMID:11322870

Doggrell, S A

2001-05-01

207

Maximizing therapy in the advanced heart failure patient.  

PubMed

Heart failure is a common clinical syndrome in which left ventricular dysfunction results in vasoconstriction, volume overload, activity intolerance, reduced quality of life, and high mortality. Recognition of the role of neurohormonal activation in the progression of heart failure has led to more effective treatment. Integral to optimal treatment of heart failure is maximization of both pharmacologic and nonpharmacologic therapy. This article presents information important to maximizing both types of therapy in the advanced heart failure patient. The importance of effective patient and family education is emphasized. PMID:8656236

Moser, D K

1996-01-01

208

Sleep-disordered breathing in patients with decompensated heart failure  

PubMed Central

Sleep-disordered breathing (SDB) has a higher prevalence in patients with heart failure than in the general middle-aged population. Obstructive sleep apnea (OSA), one of the forms of SBD, promotes poorly controlled hypertension, coronary events, and atrial fibrillation events that can lead to acutely decompensated heart failure (ADHF), and evidence suggests that untreated OSA increases mortality in patients with heart failure. Cheyne–Stokes respiration and central sleep apnea (CSA) have long been associated with heart failure and, in many patients, can coexist with OSA. In this article, we propose a systematic approach to diagnose and treat OSA in patients with ADHF based on current evidence. PMID:18758944

Valdivia-Arenas, Martin A.; Powers, Michael

2009-01-01

209

Metformin in Diabetic Patients with Heart Failure: Safe and Effective?  

PubMed Central

Management of diabetic patients with heart failure is a complex endeavor. The initial reluctance to use metformin in these patients has given way to a broader acceptance after clinical trials and meta-analyses have revealed that some of the insulin-sensitizing agents lead to adverse cardiovascular events. We have proposed that an increase of substrate uptake by the insulin-resistant heart is detrimental because the heart is already flooded with fuel. In light of this evidence, metformin offers a unique safety profile in the patient with diabetes and heart failure. Our article expands on the use of metformin in patients with heart failure. We propose that the drug targets both the source as well as the destination (in this case the heart) of excess fuel. We consider treatment of diabetic heart failure patients with metformin both safe and effective. PMID:24466358

Ekeruo, Ijeoma Ananaba; Solhpour, Amirreza; Taegtmeyer, Heinrich

2013-01-01

210

Targeting interleukin-1 in heart failure and inflammatory heart disease.  

PubMed

Heart failure (HF) is a clinical syndrome characterized by dyspnea, fatigue, and poor exercise capacity due to insufficient cardiac function. HF represents the leading cause of hospitalization among adult patients over 65 years of age. Neurohormonal blockade has improved clinical outcomes; however, HF incidence continues to rise, suggesting an urgent need to develop novel drugs that target a different pathophysiological paradigm. Inflammation plays a central role in many cardiovascular diseases. Interleukin-1 (IL-1), a prototypical proinflammatory cytokine, is upregulated in HF and associated with worse prognosis. Preclinical models suggest a beneficial effect of IL-1 blockade, and pilot clinical trials are currently underway to evaluate the role of IL-1 blockade to reduce inflammation, ameliorate ventricular remodeling, and improve exercise capacity in patients with HF. PMID:25315037

Van Tassell, Benjamin W; Raleigh, Juan M Valle; Abbate, Antonio

2015-02-01

211

Remote patient monitoring in chronic heart failure.  

PubMed

Heart failure (HF) poses a significant economic burden on our health-care resources with very high readmission rates. Remote monitoring has a substantial potential to improve the management and outcome of patients with HF. Readmission for decompensated HF is often preceded by a stage of subclinical hemodynamic decompensation, where therapeutic interventions would prevent subsequent clinical decompensation and hospitalization. Various methods of remote patient monitoring include structured telephone support, advanced telemonitoring technologies, remote monitoring of patients with implanted cardiac devices such as pacemakers and defibrillators, and implantable hemodynamic monitors. Current data examining the efficacy of remote monitoring technologies in improving outcomes have shown inconsistent results. Various medicolegal and financial issues need to be addressed before widespread implementation of this exciting technology can take place. PMID:23018667

Palaniswamy, Chandrasekar; Mishkin, Aaron; Aronow, Wilbert S; Kalra, Ankur; Frishman, William H

2013-01-01

212

Advanced heart failure due to cancer therapy.  

PubMed

Certain chemotherapeutic agents and mediastinal irradiation can be cardiotoxic and place cancer survivors at risk for developing advanced heart failure (HF). Anthracyclines are the prototypical agents associated with left ventricular (LV) dysfunction. Newer agents including trastuzumab and certain tyrosine kinase inhibitors such as sunitinib can also cause cardiomyopathy. Cancer survivors with advanced HF refractory to standard medical management should be considered for advanced therapies, including mechanical circulatory support (MCS) and transplantation. While overall outcomes after MCS and transplantation are similar in cancer survivors compared to other etiologies of HF, patients with radiation-induced restrictive cardiomyopathy have a significantly worse prognosis after transplantation. The increased need for right ventricular (RV) support after MCS in cancer survivors necessitates a careful evaluation for pre-operative RV dysfunction. Special consideration must also be given to the risk for recurrent malignancy, neurocognitive dysfunction, and increased psychological needs in this patient population. PMID:25687365

Shah, Sachin; Nohria, Anju

2015-04-01

213

Cognitive impairment in heart failure patients  

PubMed Central

Cognitive damage in heart failure (HF) involves different domains thus interfering with the ability for single patient to self-care and to cope with treatment regimens, modifying symptoms and health behaviours. Many cerebral and functional changes were detected in brain imaging, involving areas of both grey and white matter deputed to cognition. Although various instruments are available to explore cognition, no consensus was obtained on better tools to be used in HF population. Reduction in cerebral blood flow, decreased cardiac output, alterations of cerebrovascular reactivity and modification of blood pressure levels are the main features involved in the etiopathogenetic mechanisms of cognitive deficit. Several cardiac variables, laboratory parameters, demographic and clinical elements were studied for their possible relation with cognition and should be properly evaluated to define patients at increased risk of impairment. The present review gathers available data pointing out assured information and discussing possible areas of research development. PMID:25593581

Leto, Laura; Feola, Mauro

2014-01-01

214

The Alberta Heart Failure Etiology and Analysis Research Team (HEART) study  

PubMed Central

Background Nationally, symptomatic heart failure affects 1.5-2% of Canadians, incurs $3 billion in hospital costs annually and the global burden is expected to double in the next 1–2 decades. The current one-year mortality rate after diagnosis of heart failure remains high at >25%. Consequently, new therapeutic strategies need to be developed for this debilitating condition. Methods/Design The objective of the Alberta HEART program (http://albertaheartresearch.ca) is to develop novel diagnostic, therapeutic and prognostic approaches to patients with heart failure with preserved ejection fraction. We hypothesize that novel imaging techniques and biomarkers will aid in describing heart failure with preserved ejection fraction. Furthermore, the development of new diagnostic criteria will allow us to: 1) better define risk factors associated with heart failure with preserved ejection fraction; 2) elucidate clinical, cellular and molecular mechanisms involved with the development and progression of heart failure with preserved ejection fraction; 3) design and test new therapeutic strategies for patients with heart failure with preserved ejection fraction. Additionally, Alberta HEART provides training and education for enhancing translational medicine, knowledge translation and clinical practice in heart failure. This is a prospective observational cohort study of patients with, or at risk for, heart failure. Patients will have sequential testing including quality of life and clinical outcomes over 12 months. After that time, study participants will be passively followed via linkage to external administrative databases. Clinical outcomes of interest include death, hospitalization, emergency department visits, physician resource use and/or heart transplant. Patients will be followed for a total of 5 years. Discussion Alberta HEART has the primary objective to define new diagnostic criteria for patients with heart failure with preserved ejection fraction. New criteria will allow for targeted therapies, diagnostic tests and further understanding of the patients, both at-risk for and with heart failure. Trial registration ClinicalTrials.gov NCT02052804. PMID:25063541

2014-01-01

215

Comprehensive rehabilitation in chronic heart failure.  

PubMed

Chronic heart failure (CHF) is a complex disease process connected with cardiovascular system as well as other organs and skeletal muscles. In connection with the above, cardiac rehabilitation, consisting of exercise training and diet supplementation, aims at recovery of physical, social and psychic function and removing risk factors influencing the occurrence of circulatory system diseases. Evidence has shown that exercise training in CHF patients, both aerobic and resistance, can increase peak oxygen consumption and exercise capacity, improve NYHA (New York Heart Association) functional class, reduce mortality and improve the quality of life. Evidence suggests that most improvement is due to the effects of training on the peripheral circulation and skeletal muscle, rather than on the heart itself. Exercise training can improve skeletal muscle metabolism, increase blood flow within the active skeletal muscles, increase capillary density, promote the synthesis and release of nitric oxide, improve angiogenesis, and decrease oxidative stress. Physical effort reduces sympathetic arousal and increases parasympathetic arousal, thus reducing cardiac dysrythmia and ischemia. Mitochondria start working harder, as the demand for energy is higher and electron flow provides energy in the form of ATP. Studies have consistently demonstrated that exercise training is safe and has no deleterious effect on central haemodynamics, left ventricular remodeling, systolic or diastolic function, or myocardial metabolism. Taking several supplements that have documented roles in medical therapy, including vitamins B, C and E, coenzyme Q10, alpha-lipoic acid, chromium, omega-3 polyunsaturated fatty acids, L-carnitine, and quercetin, has beneficiary effect on many diseases, including CHF. In our experience, 19 patients with CHF who undertook resistance (weight) training and food supplementation, returned to their normal activities after 4 months, without any complaints. PMID:24069873

G?siorowski, Adam; Dutkiewicz, Jacek

2013-01-01

216

Practical guide on home health in heart failure patients  

PubMed Central

Introduction Chronic heart failure is a common condition affecting up to 15 million people in the extended Europe. Heart failure is burdensome and costly for patients in terms of decreased quality of life and poor prognosis, and it is also costly for society. Better integrated care is warranted in this population and specialised heart failure care can save costs and improve the quality of care. However, only a few European countries have implemented specialised home care and offered this to a larger number of patients with heart failure. Method We developed a guide on Home Health in Heart Failure patients from a literature review, a survey of heart failure management programs, the opinion of researchers and practitioners, data from clinical trials and a reflection of an international expert meeting. Results In integrated home care for heart failure patients, it is advised to consider the following components: integrated multidisciplinary care, patient and partner participation, care plans with clear goals of care, patient education, self-care management, appropriate access to care and optimised treatment. Discussion We summarised the state of the art of home-based care for heart failure patients in Europe, described the typical content of such care to provide a guide for health care providers. PMID:24250283

Jaarsma, Tiny; Larsen, Torben; Strömberg, Anna

2013-01-01

217

Increased Oxidative Stress in Patients With Congestive Heart Failure  

Microsoft Academic Search

Objectives. We sought to study the markers of lipid peroxida- tion and defenses against oxidative stress in patients with varying degrees of heart failure. Background. Despite advances in other areas of cardiovascular disease, the morbidity and mortality from congestive heart failure (CHF) are increasing. Data mainly from animal models suggest that free radical injury may promote myocardial decompensation. However, there

MARY KEITH; AMIR GERANMAYEGAN; MICHAEL J. SOLE; REGINA KURIAN; ANDREW ROBINSON; AHMAD S. OMRAN; KHURSHEED N. JEEJEEBHOY

218

Excess Weight May Help Heart Failure Patients, Study Contends  

MedlinePLUS

... page, please enable JavaScript. Excess Weight May Help Heart Failure Patients, Study Contends 'Paradoxical' finding suggests fat is ... December 22, 2014 Related MedlinePlus Pages Body Weight Heart Failure Obesity MONDAY, Dec. 22, 2014 (HealthDay News) -- Obese ...

219

Fried Foods Tied to Raised Heart Failure Risk  

MedlinePLUS

... please enable JavaScript. Fried Foods Tied to Raised Heart Failure Risk Eaten regularly, they might boost chances as ... Tuesday, March 3, 2015 Related MedlinePlus Pages Diets Heart Failure TUESDAY, March 3, 2015 (HealthDay News) -- The more ...

220

A systematicreview of telemonitoring for the management of heart failure  

Microsoft Academic Search

Background: Telemonitoring allows a clinician to monitor, on a daily basis, physiological variables measured by patients at home. This provides a means to keep patients with heart failure under close supervision, which could reduce the rate of admission to hospital and accelerate discharge. Objective: To review the literature on the application of telemedicine in the management of heart failure. Methods:

Amala A. Louis; Tracy Turner; Marcia Gretton; Angela Baksh; John G. F. Cleland

221

The crucial role of patient education in heart failure  

Microsoft Academic Search

Background: Deterioration of heart failure causes and complicates many hospital admissions in people aged over 65 years. Frequent readmissions cause an immense burden on the individual, the family and the health care system. Heart failure management programmes, in which patient education is an important component, have been shown to be effective in improving self-care and reducing readmissions. Aim: This paper

Anna Strfmberg

2005-01-01

222

Randomised controlled trial of specialist nurse intervention in heart failure  

Microsoft Academic Search

Objectives To determine whether specialist nurse intervention improves outcome in patients with chronic heart failure. Design Randomised controlled trial. Setting Acute medical admissions unit in a teaching hospital. Participants 165 patients admitted with heart failure due to left ventricular systolic dysfunction. The intervention started before discharge and continued thereafter with home visits for up to 1 year. Main outcome measures

Lynda Blue; Elanor Lang; J. J V McMurray; A. P Davie; T. A McDonagh; D. R Murdoch; M. C Petrie; E. Connolly; J. Norrie; C. E Round; I. Ford; C. E Morrison

2001-01-01

223

Heart failure patient learning needs after hospital discharge  

Microsoft Academic Search

This descriptive-correlational study examined the perceived learning needs of heart failure patients in postdischarge settings, as well as the influence of demographic variables on these learning needs. The Outpatient Heart Failure Learning Needs Inventory was used to rate subjects’ perceptions of the importance of educational topics on a five-point Likert scale. Findings indicated that subjects perceived signs and symptoms and

Judith C. Clark; Virginia M. Lan

2004-01-01

224

Clinical Benefit and Approach of Ultrafiltration in Acute Heart Failure  

Microsoft Academic Search

Because of the increasing incidence of acute heart failure admissions to critical care units, nephrologists have been asked to become more involved in the management of these patients. Renal dysfunction is a major element in impeding clinical recovery. In acute heart failure, renal function is often abnormal. The judicious application of ultrafiltration techniques may represent an efficacious adjunct to present

Amit Sharma; Denise D. Hermann; Ravindra L. Mehta

2001-01-01

225

The prognostic importance of anemia in patients with heart failure  

Microsoft Academic Search

PurposePhysiologic studies have suggested that anemia could adversely affect the cardiovascular condition of patients with heart failure. Yet, the prognostic importance of this treatable condition is not well established by epidemiologic studies. We sought to determine the prognostic value of hematocrit level in a cohort of elderly patients hospitalized with heart failure.

Mikhail Kosiborod; Grace L Smith; Martha J Radford; JoAnne M Foody; Harlan M Krumholz

2003-01-01

226

Evaluation of depression in patients with heart failure  

Microsoft Academic Search

Background: Despite advances in medical therapy heart failure consists a prevalent debilitating disease of poor prognosis, strongly associated with high mortality and morbidity rates. On the same time, depression rates are higher in patients with heart failure than in the general population. Depression may be underdiagnosed and consequently undertreated in the patients, as symptoms can often be similar in the

Maria Polikandrioti; Apostolos Christou; Zoi Morou; Gregory Kotronoulas; Helen Evagelou; Helen Kyritsi

2010-01-01

227

Office management of heart failure in the elderly  

Microsoft Academic Search

Heart failure is one of the most common conditions affecting older patients seen by clinicians in routine office practice. This article reviews the clinical features, diagnosis, and management of heart failure in elderly patients evaluated in the ambulatory care setting, and provides concise, practical information relevant to all major aspects of care. Specific topics include the role of diagnostic testing,

Michael W. Rich

2005-01-01

228

Pharmacotherapy for Heart Failure in Patients with Renal Insufficiency  

Microsoft Academic Search

benefits in patients with more advanced renal dysfunction. -Blockers improve survival in patients with heart failure, and their beneficial effect is unlikely to differ according to renal func- tion. Spironolactone improves outcomes in patients with advanced heart failure, but renal insufficiency appears to increase risk for hyperkalemia and limits the use of the drug in patients with severe renal insufficiency.

Michael G. Shlipak

2003-01-01

229

Scientists Spot Mutation Behind Genetic Form of Heart Failure  

MedlinePLUS

... 2015) Wednesday, January 14, 2015 Related MedlinePlus Pages Genes and Gene Therapy Heart Failure WEDNESDAY, Jan. 14, 2015 (HealthDay News) -- ... HealthDay . All rights reserved. More Health News on: Genes and Gene Therapy Heart Failure Recent Health News Page last updated ...

230

Circadian rhythm and sudden death in heart failure  

Microsoft Academic Search

OBJECTIVEThe purpose of this study was to address the timing of sudden death in advanced heart failure patients.BACKGROUNDSudden death is a catastrophic event in cardiovascular disease. It has a circadian pattern prominent in the early am, which has been thought to be due to a surge of sympathetic stimulation. We postulated that the distribution of events in advanced heart failure,

Peter A Carson; Christopher M O’Connor; Alan B Miller; Susan Anderson; Robert Belkin; Gerald W Neuberg; John H Wertheimer; David Frid; Anne Cropp; Milton Packer

2000-01-01

231

Anemia associated with chronic heart failure: current concepts  

PubMed Central

Anemia is a frequent comorbidity of heart failure and is associated with poor outcomes. Anemia in heart failure is considered to develop due to a complex interaction of iron deficiency, kidney disease, and cytokine production, although micronutrient insufficiency and blood loss may contribute. Currently, treatment of anemia of heart failure lacks clear targets and specific therapy is not defined. Intravenous iron use has been shown to benefit anemic as well as nonanemic patients with heart failure. Treatment with erythropoietin-stimulating agents has been considered alone or in combination with iron, but robust evidence to dictate clear guidelines is not currently available. Available and emerging new agents in the treatment of anemia of heart failure will need to be tested in randomized, controlled studies. PMID:23403618

Shah, Ravish; Agarwal, Anil K

2013-01-01

232

Recall of lifestyle advice in patients recently hospitalised with heart failure: A EuroHeart Failure Survey analysis  

Microsoft Academic Search

Background: There are limited data on recall and implementation of lifestyle advice in patients with heart failure (HF). Aim: To investigate what advice patients with HF recall being given, and whether they report following the advice they remember. Methods and results: 3261 patients with suspected HF participating in the EuroHeart Failure Survey were interviewed by a health professional 12 weeks

Mitja Lainš?ak; John G. F. Cleland; Mattie J. Lenzen; Samantha Nabb; Irena Keber; Ferenc Follath; Michel Komajda

2007-01-01

233

Racial differences in response to therapy for heart failure: Analysis of the vasodilator-heart failure trials  

Microsoft Academic Search

Background: Heart failure in blacks has been associated with a poorer prognosis than in whites. In such diseases as hypertension, blacks show pathophysiological differences and respond differently to some therapies than whites. The aim of this study is to evaluate the clinical characteristics and response to therapy of black compared with white patients with heart failure.Methods and Results: In the

Peter Carson; Susan Ziesche; Gary Johnson; Jay N. Cohn

1999-01-01

234

Acute heart failure: epidemiology, risk factors, and prevention.  

PubMed

Acute heart failure represents the first cause of hospitalization in elderly persons and is the main determinant of the huge healthcare expenditure related to heart failure. Despite therapeutic advances, the prognosis of acute heart failure is poor, with in-hospital mortality ranging from 4% to 7%, 60- to 90-day mortality ranging from 7% to 11%, and 60- to 90-day rehospitalization from 25% to 30%. Several factors including cardiovascular and noncardiovascular conditions as well as patient-related and iatrogenic factors may precipitate the rapid development or deterioration of signs and symptoms of heart failure, thus leading to an acute heart failure episode that usually requires patient hospitalization. The primary prevention of acute heart failure mainly concerns the prevention, early diagnosis, and treatment of cardiovascular risk factors and heart disease, including coronary artery disease, while the secondary prevention of a new episode of decompensation requires the optimization of heart failure therapy, patient education, and the development of an effective transition and follow-up plan. PMID:25659507

Farmakis, Dimitrios; Parissis, John; Lekakis, John; Filippatos, Gerasimos

2015-03-01

235

Diminished heart beat non-stationarities in congestive heart failure  

PubMed Central

Studies on heart rate variability (HRV) have become popular and the possibility of diagnosis based on non-invasive techniques compels us to overcome the difficulties originated on the environmental changes that can affect the signal. We perform a non-parametric segmentation which consists of locating the points where the signal can be split into stationary segments. By finding stationary segments we are able to analyze the size of these segments and evaluate how the signal changes from one segment to another, looking at the statistical moments given in each patch, for example, mean and variance. We analyze HRV data for 15 patients with congestive heart failure (CHF; 11 males, 4 females, age 56±11 years), 18 elderly healthy subjects (EH; 11 males, 7 females, age 50±7 years), and 15 young healthy subjects (YH; 11 females, 4 males, age 31±6 years). Our results confirm higher variance for YH, and EH, while CHF displays diminished variance with p-values <0.01, when compared to the healthy groups, presenting higher HRV in healthy subjects. Moreover, it is possible to distinguish between YH and EH with p < 0.05 through the segmentation outcomes. We found high correlations between the results of segmentation and standard measures of HRV analysis and a connection to results of detrended fluctuation analysis (DFA). The segmentation applied to HRV studies detects aging and pathological conditions effects on the non-stationary behavior of the analyzed groups, promising to contribute in complexity analysis and providing risk stratification measures. PMID:23720631

Camargo, Sabrina; Riedl, Maik; Anteneodo, Celia; Kurths, Jürgen; Wessel, Niels

2013-01-01

236

Broken hearts and the heart broken: living with, and dying from, heart failure in Scotland   

E-print Network

Heart failure is a common and serious chronic condition, which can be as ‘malignant’ as most forms of cancer (Stewart, MacIntyre, Hole, Capewell, & McMurray, 2001). Recent estimates are that around 40,000 men and 45,000 ...

Pratt, Rebekah Janet

2012-11-30

237

The war against heart failure: the Lancet lecture.  

PubMed

Heart failure is a global problem with an estimated prevalence of 38 million patients worldwide, a number that is increasing with the ageing of the population. It is the most common diagnosis in patients aged 65 years or older admitted to hospital and in high-income nations. Despite some progress, the prognosis of heart failure is worse than that of most cancers. Because of the seriousness of the condition, a declaration of war on five fronts has been proposed for heart failure. Efforts are underway to treat heart failure by enhancing myofilament sensitivity to Ca(2+); transfer of the gene for SERCA2a, the protein that pumps calcium into the sarcoplasmic reticulum of the cardiomyocyte, seems promising in a phase 2 trial. Several other abnormal calcium-handling proteins in the failing heart are candidates for gene therapy; many short, non-coding RNAs--ie, microRNAs (miRNAs)--block gene expression and protein translation. These molecules are crucial to calcium cycling and ventricular hypertrophy. The actions of miRNAs can be blocked by a new class of drugs, antagomirs, some of which have been shown to improve cardiac function in animal models of heart failure; cell therapy, with autologous bone marrow derived mononuclear cells, or autogenous mesenchymal cells, which can be administered as cryopreserved off the shelf products, seem to be promising in both preclinical and early clinical heart failure trials; and long-term ventricular assistance devices are now used increasingly as a destination therapy in patients with advanced heart failure. In selected patients, left ventricular assistance can lead to myocardial recovery and explantation of the device. The approaches to the treatment of heart failure described, when used alone or in combination, could become important weapons in the war against heart failure. PMID:25467564

Braunwald, Eugene

2015-02-28

238

Procedure May Beat Drug in Patients with Heart Failure, Irregular Heartbeat  

MedlinePLUS

... please enable JavaScript. Procedure May Beat Drug in Patients With Heart Failure, Irregular Heartbeat Catheter ablation appears ... Heart Failure MONDAY, March 16, 2015 (HealthDay News) -- Patients with heart failure can sometimes also develop the ...

239

Nutrient Intake in Heart Failure Patients  

PubMed Central

Background and Research Objective Approximately 50% of heart failure (HF) patients are thought to be malnourished, and macronutrient and micronutrient deficiencies may potentially aggravate HF symptoms. Thus, concerns have been raised about the overall nutrient composition of diets in HF populations. The purpose of this study was to examine the macronutrient and micronutrient intake by caloric adequacy among community-dwelling adults with HF. Participants and Methods A secondary analysis of baseline data of participants in an HF lifestyle intervention study was conducted. Participants (n = 45) were predominantly male (55.6%), white, and non-Hispanic (64.4%); had a mean age of 61 years (SD, 11 years) and mean body mass index of 31.2 kg/m2 (SD, 7.3 kg/m2); were of New York Heart Association functional classes II and III (77.8%); and had a mean ejection fraction of 31.9% (SD,13.2%); and 69% had a college or higher level of education. The Block Food Habits Questionnaire was used to assess the intake of macronutrients and micronutrients. Analysis included descriptive statistics and Mann-Whitney U tests. Results and Conclusions Individuals reporting inadequate daily caloric intake reported a lower intake of macronutrients and micronutrients as well as other differences in dietary patterns compared with individuals reporting adequate daily caloric intake. More than half of the individuals reporting adequate caloric intake did not meet the recommended dietary allowance for magnesium and vitamin E. Interventions aimed at increasing overall intake and nutrient density are suggested. Further research is needed to better understand the relationship between dietary factors and outcomes in HF. PMID:18596500

Grossniklaus, Daurice A.; O’Brien, Marian C.; Clark, Patricia C.; Dunbar, Sandra B.

2009-01-01

240

Heart failure patients utilizing an electric home monitor: What effects does heart failure have on their quality of life?  

NASA Astrophysics Data System (ADS)

Heart Failure continues to be a major public health problem associated with high mortality and morbidity. Heart Failure is the leading cause of hospitalization for persons older than 65 years, has a poor prognosis and is associated with poor quality of life. More than 5.3 million American adults are living with heart failure. Despite maximum medical therapy and frequent hospitalizations to stabilize their condition, one in five heart failure patients die within the first year of diagnosis. Several disease-management programs have been proposed and tested to improve the quality of heart failure care. Studies have shown that hospital admissions and emergency room visits decrease with increased nursing interventions in the home and community setting. An alternative strategy for promoting self-management of heart failure is the use of electronic home monitoring. The purpose of this study was to examine what effects heart failure has on patient's quality of life that had been monitoring on an electronic home monitor longer than 2 months. Twenty-one questionnaires were given to patients utilizing an electronic home monitor by their home health agency nurse. Eleven patients completed the questionnaire. The findings showed that there is some deterioration in quality of life with more association with the physical aspects of life than with the emotional aspects of life, which probably was due to the small sample size. There was no significant difference in readmission rates in patients utilizing an electronic home monitor. Further research is needed with a larger population of patients with chronic heart failure and other chronic diseases which may provide more data, and address issues such as patient compliance with self-care, impact of heart failure on patient's quality of life, functional capacity, and heart failure patient's utilization of the emergency rooms and hospital. Telemonitoring holds promise for improving the self-care abilities of persons with HF.

Simuel, Gloria J.

241

Employing Time-Domain Methods and Poincaré Plot of Heart Rate Variability Signals to Detect Congestive Heart Failure  

Microsoft Academic Search

Congestive heart failure (CHF) is a common and serious medical condition where the heart is not able to pump enough blood to meet the body's energy demands. Heart failure typically develops slowly after injury to the heart, such as a heart attack, too much strain on the heart due to years of untreated high blood pressure or diseased cardiac valves.

Alia S. Khaled; Mohamed I. Owis; Abdalla S. A. Mohamed

2006-01-01

242

Atrial natriuretic factor binding sites in experimental congestive heart failure  

SciTech Connect

A quantitative in vitro autoradiographic study was performed on the aorta, renal glomeruli, and adrenal cortex of cardiomyopathic hamsters in various stages of heart failure and correlated, in some instances, with in vivo autoradiography. The results indicate virtually no correlation between the degree of congestive heart failure and the density of 125I-labeled atrial natriuretic factor ((Ser99, Tyr126)ANF) binding sites (Bmax) in the tissues examined. Whereas the Bmax was increased in the thoracic aorta in moderate and severe heart failure, there were no significant changes in the zona glomerulosa. The renal glomeruli Bmax was lower in mild and moderate heart failure compared with control and severe heart failure. The proportion of ANF B- and C-receptors was also evaluated in sections of the aorta, adrenal, and kidney of control and cardiomyopathic hamsters with severe heart failure. (Arg102, Cys121)ANF (des-(Gln113, Ser114, Gly115, Leu116, Gly117) NH2) (C-ANF) at 10(-6) M displaced approximately 505 of (Ser99, Tyr126)125I-ANF bound in the aorta and renal glomeruli and approximately 20% in the adrenal zona glomerulosa in both series of animals. These results suggest that ANF may exert a buffering effect on the vasoconstriction of heart failure and to a certain extent may inhibit aldosterone secretion. The impairment of renal sodium excretion does not appear to be related to glomerular ANF binding sites at any stage of the disease.

Bianchi, C.; Thibault, G.; Wrobel-Konrad, E.; De Lean, A.; Genest, J.; Cantin, M. (Clinical Research Institute of Montreal, Quebec (Canada))

1989-10-01

243

Exercise training in chronic heart failure  

PubMed Central

The syndrome of heart failure (HF) is a growing epidemic that causes a significant socio-economic burden. Despite considerable progress in the management of patients with HF, mortality and morbidity remain a major healthcare concern and frequent hospital admissions jeopardize daily life and social activities. Exercise training is an important adjunct nonpharmacological treatment modality for patients with HF that has proven positive effects on mortality, morbidity, exercise capacity and quality of life. Different training modalities are available to target the problems with which HF patients are faced. It is essential to tailor the prescribed exercise regimen, so that both efficiency and safety are guaranteed. Electrical implanted devices and mechanical support should not exclude patients from exercise training; however, particular precautions and a specialized approach are advised. At least 50% of patients with HF, older than 65 years of age, present with HF with preserved ejection fraction (HFPEF). Although the study populations included in studies evaluating the effect of exercise training in this population are small, the results are promising and seem to support the idea that exercise training is beneficial for HFPEF patients. Both the short- and especially long-term adherence to exercise training remain a major challenge that can only be tackled by a multidisciplinary approach. Efforts should be directed towards closing the gap between recommendations and the actual implementation of training programmes. PMID:23634278

Beckers, Paul; Vrints, Christiaan J.; Conraads, Viviane M.

2013-01-01

244

Blood flow dynamics in heart failure  

NASA Technical Reports Server (NTRS)

BACKGROUND: Exercise intolerance in heart failure (HF) may be due to inadequate vasodilation, augmented vasoconstriction, and/or altered muscle metabolic responses that lead to fatigue. METHODS AND RESULTS: Vascular and metabolic responses to rhythmic forearm exercise were tested in 9 HF patients and 9 control subjects (CTL) during 2 protocols designed to examine the effect of HF on the time course of oxygen delivery versus uptake (protocol 1) and on vasoconstriction during exercise with 50 mm Hg pressure about the forearm to evoke a metaboreflex (protocol 2). In protocol 1, venous lactate and H+ were greater at 4 minutes of exercise in HF versus CTL (P<0.05) despite similar blood flow and oxygen uptake responses. In protocol 2, mean arterial pressure increased similarly in each group during ischemic exercise. In CTL, forearm blood flow and vascular conductance were similar at the end of ischemic and ambient exercise. In HF, forearm blood flow and vascular conductance were reduced during ischemic exercise compared with the ambient trial. CONCLUSIONS: Intrinsic differences in skeletal muscle metabolism, not vasodilatory dynamics, must account for the augmented glycolytic metabolic responses to moderate-intensity exercise in class II and III HF. The inability to increase forearm vascular conductance during ischemic handgrip exercise, despite a normal pressor response, suggests that enhanced vasoconstriction of strenuously exercising skeletal muscle contributes to exertional fatigue in HF.

Shoemaker, J. K.; Naylor, H. L.; Hogeman, C. S.; Sinoway, L. I.

1999-01-01

245

MODELS OF INSULIN RESISTANCE AND HEART FAILURE  

PubMed Central

The incidence of heart failure (HF) and diabetes mellitus is rapidly increasing and is associated with poor prognosis. In spite of the advances in therapy, HF remains a major health problem with high morbidity and mortality. When HF and diabetes coexist, clinical outcomes are significantly worse. The relationship between these two conditions has been studied in various experimental models. However, the mechanisms for this interrelationship are complex, incompletely understood, and have become a matter of considerable clinical and research interest. There are only few animal models that manifest both HF and diabetes. However, the translation of results from these models to human disease is limited and new models are needed to expand our current understanding of this clinical interaction. In this review, we discuss mechanisms of insulin signaling and insulin resistance, the clinical association between insulin resistance and HF and its proposed pathophysiologic mechanisms. Finally, we discuss available animal models of insulin resistance and HF and propose requirements for future new models. PMID:23456447

Velez, Mauricio; Kohli, Smita; Sabbah, Hani N.

2013-01-01

246

Heart failure among Indigenous Australians: a systematic review  

PubMed Central

Background Cardiovascular diseases contribute substantially to the poor health and reduced life expectancy of Indigenous Australians. Heart failure is a common, disabling, progressive and costly complication of these disorders. The epidemiology of heart failure and the adequacy of relevant health service provision in Indigenous Australians are not well delineated. Methods A systematic search of the electronic databases PubMed, Embase, Web of Science, Cinahl Plus, Informit and Google Scholar was undertaken in April 2012 for peer-reviewed journal articles relevant to the topic of heart failure in Indigenous Australians. Additionally, a website search was done to identify other pertinent publications, particularly government reports. Results There was a paucity of relevant peer-reviewed research, and government reports dominated the results. Ten journal articles, 1 published conference abstract and 10 reports were eligible for inclusion. Indigenous Australians reportedly have higher morbidity and mortality from heart failure than their non-Indigenous counterparts (age-standardised prevalence ratio 1.7; age-standardised hospital separation ratio ?3; crude per capita hospital expenditure ratio 1.58; age-adjusted mortality ratio >2). Despite the evident disproportionate burden of heart failure in Indigenous Australians, the accuracy of estimation from administrative data is limited by poor indigenous identification, inadequate case ascertainment and exclusion of younger subjects from mortality statistics. A recent journal article specifically documented a high prevalence of heart failure in Central Australian Aboriginal adults (5.3%), noting frequent undiagnosed disease. One study examined barriers to health service provision for Indigenous Australians in the context of heart failure. Conclusions Despite the shortcomings of available published data, it is clear that Indigenous Australians have an excess burden of heart failure. Emerging data suggest that undiagnosed cases may be common in this population. In order to optimise management and to inform policy, high quality research on heart failure in Indigenous Australians is required to delineate accurate epidemiological indicators and to appraise health service provision. PMID:23116367

2012-01-01

247

Heart failure in congenital heart disease: the role of genes and hemodynamics.  

PubMed

Heart failure can be a consequence of insufficient palliation of structural malformations in patients with congenital heart disease (CHD) or genetic perturbations resulting in cardiomyopathies. Although CHD is traditionally considered a pediatric clinical problem, there is a rapidly increasing population of patients surviving into adulthood with CHD and a corresponding increase in the rate of hospital admissions for adult CHD patients with heart failure. Therefore, there is recognition of the clinical importance in translating conventional heart failure pharmacotherapies to patients with CHD, improving management of heart failure in the context of structural consequences of CHD, and understanding the underlying genetic abnormalities which impact myocardial performance. Heart failure in CHD typically involves complex interactions between primary structural defects, the consequences of interventions (i.e., residual lesions), and the heart's response to enhanced myocardial mechanical stress which depends on many other genetic factors (i.e., gene modifiers). In this review, we will examine how altered genes and hemodynamic loading contribute to heart failure seen in congenital heart patients. Understanding mechanisms of myocardial response and remodeling within the congenital population can provide insight into physiological principles and improve our understanding of heart failure. PMID:24488006

Vanderlaan, Rachel D; Caldarone, Christopher A; Backx, Peter H

2014-06-01

248

Prospective Study of Heart Rate Variability and Mortality in Chronic Heart Failure Results of the United Kingdom Heart Failure Evaluation and Assessment of Risk Trial (UK-Heart)  

Microsoft Academic Search

Background—Patients with chronic heart failure (CHF) have a continuing high mortality. Autonomic dysfunction may play an important role in the pathophysiology of cardiac death in CHF. UK-HEART examined the value of heart rate variability (HRV) measures as independent predictors of death in CHF. Methods and Results—In a prospective study powered for mortality, we recruited 433 outpatients 62 69.6 years old

James Nolan; Phillip D. Batin; Richard Andrews; Steven J. Lindsay; Paul Brooksby; Michael Mullen; Wazir Baig; Andrew D. Flapan; Alan Cowley; Robin J. Prescott; James M. M. Neilson; Keith A. A. Fox

249

'Hearts and minds': association, causation and implication of cognitive impairment in heart failure.  

PubMed

The clinical syndrome of heart failure is one of the leading causes of hospitalisation and mortality in older adults. An association between cognitive impairment and heart failure is well described but our understanding of the relationship between the two conditions remains limited. In this review we provide a synthesis of available evidence, focussing on epidemiology, the potential pathogenesis, and treatment implications of cognitive decline in heart failure. Most evidence available relates to heart failure with reduced ejection fraction and the syndromes of chronic cognitive decline or dementia. These conditions are only part of a complex heart failure-cognition paradigm. Associations between cognition and heart failure with preserved ejection fraction and between acute delirium and heart failure also seem evident and where data are available we will discuss these syndromes. Many questions remain unanswered regarding heart failure and cognition. Much of the observational evidence on the association is confounded by study design, comorbidity and insensitive cognitive assessment tools. If a causal link exists, there are several potential pathophysiological explanations. Plausible underlying mechanisms relating to cerebral hypoperfusion or occult cerebrovascular disease have been described and it seems likely that these may coexist and exert synergistic effects. Despite the prevalence of the two conditions, when cognitive impairment coexists with heart failure there is no specific guidance on treatment. Institution of evidence-based heart failure therapies that reduce mortality and hospitalisations seems intuitive and there is no signal that these interventions have an adverse effect on cognition. However, cognitive impairment will present a further barrier to the often complex medication self-management that is required in contemporary heart failure treatment. PMID:25722749

Cannon, Jane A; McMurray, John Jv; Quinn, Terry J

2015-01-01

250

Incorporating Common Biomarkers into the Clinical Management of Heart Failure  

PubMed Central

Heart failure is a prevalent and costly disease, and its management with polypharmacy is complex. Commonly available biomarkers primarily help to 1) establish or refute the diagnosis of heart failure; 2) help to determine the disease severity; and 3) identify adverse consequences of treatment. Although several of them are commonly ordered (such as electrolytes, renal and liver function), their use is primarily based on broad clinical experience rather than established evidence. The availability of cardiac-specific natriuretic peptide testing has provided an evidence-based breakthrough in our abilities to establish the diagnosis and severity of heart failure, yet the appropriate boundaries to guide management are still in refinement. PMID:24085636

Halkar, Meghana

2013-01-01

251

Gene Therapy in the Treatment of Heart Failure  

NSDL National Science Digital Library

Heart failure is a major cause of morbidity and mortality in contemporary societies. Although progress in conventional treatment modalities is making steady and incremental gains to reduce this disease burden, there remains a need to explore new and potentially therapeutic approaches. Gene therapy, for example, was initially envisioned as a treatment strategy for inherited monogenic disorders. It is now apparent that gene therapy has broader potential that also includes acquired polygenic diseases, such as heart failure. Advances in the understanding of the molecular basis of conditions such as these, together with the evolution of increasingly efficient gene transfer technology, has placed congestive heart failure within reach of gene-based therapy.

2007-04-01

252

Cardiac Metabolism in Heart Failure - Implications beyond ATP production  

PubMed Central

The heart has a high rate of ATP production and turnover which is required to maintain its continuous mechanical work. Perturbations in ATP generating processes may therefore affect contractile function directly. Characterizing cardiac metabolism in heart failure revealed several metabolic alterations termed metabolic remodeling, ranging from changes in substrate utilization to mitochondrial dysfunction, ultimately resulting in ATP deficiency and impaired contractility. However, ATP depletion is not the only relevant consequence of metabolic remodeling during heart failure. By providing cellular building blocks and signaling molecules, metabolic pathways control essential processes such as cell growth and regeneration. Thus, alterations in cardiac metabolism may also affect the progression to heart failure by mechanisms beyond ATP supply. Our aim is therefore to highlight that metabolic remodeling in heart failure not only results in impaired cardiac energetics, but also induces other processes implicated in the development of heart failure such as structural remodeling and oxidative stress. Accordingly, modulating cardiac metabolism in heart failure may have significant therapeutic relevance that goes beyond the energetic aspect. PMID:23989714

Doenst, Torsten; Nguyen, T. Dung; Abel, E. Dale

2013-01-01

253

Present and future pharmacotherapy for heart failure.  

PubMed

The pharmacotherapy currently recommended by the American College of Cardiology and the American Heart Association for heart failure (HF) is a diuretic, an angiotensin-converting enzyme inhibitor (ACEI), a beta-adrenoceptor antagonist and (usually) digitalis. This current treatment of HF may be improved by optimising the dose of ACEI used, as increasing the dose of lisinopril increases its benefits in HF. Selective angiotensin receptor-1 (AT(1)) antagonists are effective alternatives for those who cannot tolerate ACEIs. AT(1) antagonists may also be used in combination with ACEIs, as some studies have shown cumulative benefits for the combination. In addition to being used in Stage IV HF patients, in whom it has a marked benefit, spironolactone should be studied in less severe HF and in the presence of beta-blockers. The use of carvedilol, extended-release metoprolol and bisoprolol should be extended to severe HF patients as these agents have been shown to decrease mortality in this group. The ancillary properties of carvedilol, particularly antagonism at prejunctional beta -adrenoceptors, may give it additional benefits to selective beta(1)-adrenoceptor antagonists. Celiprolol and bucindolol are not the beta-blockers of choice in HF, as they do not decrease mortality. Although digitalis does not reduce mortality, it remains the only option for a long-term positive inotropic effect, as the long-term use of the phosphodiesterase inhibitors is associated with increased mortality. The calcium sensitising drug levosimendan may be useful in the hospital treatment of decompensated HF to increase cardiac output and improve dyspnoea and fatigue. The antiarrhythmic drug amiodarone should probably be used in patients at high risk of arrhythmic or sudden death, although this treatment may soon be superseded by the more expensive implanted cardioverter defibrillators, which are probably more effective and have fewer side effects. The natriuretic peptide nesiritide has recently been introduced for the hospital treatment of decompensated HF. Novel drugs that may be beneficial in the treatment of HF include the vasopeptidase inhibitors and the selective endothelin-A receptor antagonists but these require much more investigation. However, disappointing results have been obtained in a large clinical trial of the tumour necrosis factor alpha antagonist etanercept, where no likelihood of a difference between placebo and etanercept was observed. Small clinical trials with recombinant growth hormone to thicken ventricles in dilated cardiomyopathy have given variable results. PMID:12083991

Doggrell, Sheila A; Brown, Lindsay

2002-07-01

254

Heart rate variability and its relation to ventricular arrhythmias in congestive heart failure.  

PubMed Central

BACKGROUND--It has been shown that heart rate variability is decreased in patients with congestive heart failure and that depressed heart rate variability is associated with a propensity to ventricular arrhythmias. Little is known, however, about heart rate variability in patients with both congestive heart failure and ventricular arrhythmias. METHODS--Spectral heart rate variability was analysed from 24 hour ambulatory electrocardiograms in 15 controls, 15 patients with non-sustained ventricular tachycardia associated with clinically normal hearts (NHVT group), and 40 patients with congestive heart failure (CHF group) secondary to either ischaemic heart disease (n = 15) or idiopathic dilated cardiomyopathy (n = 25). Of the 40 patients with congestive heart failure 15 had no appreciable ventricular arrhythmias (ventricular extrasystoles < 10 beats/h and no salvos) and formed the CHF-VA- group. Another 15 patients with congestive heart failure and non-sustained ventricular tachycardia formed the CHF-NSVT group. RESULTS--Heart rate variability was significantly lower in the CHF group than in controls (mean (SD) total frequency 23 (12) v 43 (13) ms; low frequency 12 (8) v 28 (9) ms; high frequency 8 (5) v 14 (7) ms; p < 0.001). The differences in heart rate variability between controls and the NHVT group, between ischaemic heart disease and dilated cardiomyopathy, and between the CHF-VA- and CHF-NSVT groups were not significant. In the CHF group heart rate variability was significantly related to left ventricular ejection fraction but not associated with ventricular arrhythmias. The frequency of ventricular extrasystoles was significantly related to the high frequency component of heart rate variability (r = 0.54, p < 0.05) in the NHVT group. Stepwise multiple regression analysis showed that in the CHF group, heart rate variability was predominantly related to left ventricular ejection fraction (p < 0.05). There was no significant difference in heart rate variability between survivors (n = 34) and those who died suddenly (n = 6) at one year of follow up in the CHF group. CONCLUSION--In patients with congestive heart failure, heart rate variability is significantly decreased. The depressed heart rate variability is principally related to the degree of left ventricular impairment and is independent of aetiology and the presence of ventricular arrhythmias. The data suggest that analysis of heart rate variability does not help the identification of patients with congestive heart failure at increased risk of sudden death. PMID:8198881

Fei, L.; Keeling, P. J.; Gill, J. S.; Bashir, Y.; Statters, D. J.; Poloniecki, J.; McKenna, W. J.; Camm, A. J.

1994-01-01

255

[Epidemiology and prognosis of heart failure].  

PubMed

Heart failure (HF) is a major and growing health problem in western communities. Recent data indicate that more than 50% of patients with the clinical syndrome of HF have a preserved left ventricular ejection fraction (HF with preserved ejection fraction, HFpEF). In contrast to the calculated expectations, the observed incidence of HF is rising. Despite the fact that the relative proportion of patients with preserved left ventricular function is also increasing, other factors, such as ageing of the population and the concomitant change of compound risk factors may also contribute to the actual rise in the incidence of HF. Patients with HF suffer from reduced exercise capacity, impaired quality of life and also from recurrent hospitalization due to HF. Over the past decades, an increase of recurrent HF events has been documented. In contrast to earlier reports in which HFpEF was considered to be more benign than HF with reduced ejection fraction (HFrEF), recent data suggest that once hospitalized for HF, patients with HFpEF and those with HFrEF have a comparable prognosis in terms of morbidity and mortality. Despite increasing clinical and economic relevance, no treatment has yet been shown to convincingly reduce mortality in HFpEF. In contrast, strategies for improving survival have now been established for HFrEF. The problem of HF will continue to be major challenge for the healthcare systems in western communities; therefore, consolidated clinical research is necessary to further improve therapeutic strategies for HFrEF and to generally establish treatment options for HFpEF. PMID:25822419

Edelmann, F

2015-04-01

256

Inflammatory cytokines as biomarkers in heart failure.  

PubMed

Inflammation has been implicated in the pathogenesis of heart failure (HF). In addition to their direct involvement as mediators in the pathogenesis of HF, inflammatory cytokines and related mediators could also be suitable markers for risk stratification and prognostication in HF patients. Many reports have suggested that inflammatory cytokines may predict adverse outcome in these patients. However, most studies have been limited in sample size and lacking full adjustment with the most recent and strongest biochemical predictor such as NT-proBNP and high sensitivity troponins. Furthermore, a number of pre-analytical and analytical aspects of cytokine measurements may limit their use as biomarkers. This review focuses on technical, informative and practical considerations concerning the clinical use of inflammatory cytokines as prognostic biomarkers in HF. We focus on the predictive value of tumor necrosis factor (TNF) ?, the TNF family receptors sTNFR1 and osteoprotegerin, interleukin (IL)-6 and its receptor gp130, the chemokines MCP-1, IL-8, CXCL16 and CCL21 and the pentraxin PTX-3 in larger prospective fully adjusted studies. No single inflammatory cytokine provides sufficient discrimination to justify the transition to everyday clinical use as a prognosticator in HF. However, while subjecting potential new HF markers to rigorous comparisons with "gold-standard" markers, such as NT-proBNP, using receiver operating characteristics (ROCs) and HF risk models, makes sense from a clinical standpoint, it may pose a threat to a broadening of mechanistic insight if the new markers are dismissed solely on account of lower statistical power. PMID:25199849

Ueland, Thor; Gullestad, Lars; Nymo, Ståle H; Yndestad, Arne; Aukrust, Pål; Askevold, Erik T

2015-03-30

257

Genomics, heart failure and sudden cardiac death  

PubMed Central

Sudden cardiac death (SCD) is among the most common causes of death in developed countries throughout the world. Despite decreased overall cardiac mortality, SCD vrates appear to be increasing in concert with escalating global prevalence of coronary disease and heart failure, the two major conditions predisposing to SCD. This unfavorable trend is a consequence of our inability to identify those who will die suddenly from lethal ventricular arrhythmias and to develop effective therapies for all populations at risk. The known risk factors for SCD lack the predictive power needed to generate preventive strategies for the large number of fatal arrhythmic events that occur among lower-risk subsets of the population. Even among recognized high-risk subsets, prediction of SCD remains challenging. With the exception of the implantable cardioverter defibrillator (ICD) there are few effective strategies for the prevention and treatment of SCD. This article discusses the prospect of genomic science as an approach to the identification of patients at high-risk for SCD. While the final common pathway for SCD is malignant ventricular arrhythmias, there are many potential contributors, pathways, and mechanisms by which common genetic variants (polymorphisms) could affect initiation and propagation of life-threatening cardiac arrhythmias. Recent advances in genomic medicine now provide us with novel approaches to both identify candidate genes/pathways and relatively common polymorphisms which may predispose patients to increased risk for SCD. Improved understanding of the relationship between common polymorphisms and SCD will not only improve risk stratification such that ICDs can be targeted to those patients most likely to benefit from them but also provide new insight into the pathophysiology of SCD. PMID:18437561

Darbar, Dawood

2008-01-01

258

Heart Failure: The Hidden Problem of Pain  

PubMed Central

Although dyspnea and fatigue are hallmark symptoms of heart failure (HF), the burden of pain may be underrecognized. This study assessed pain in HF and identified contributing factors. As part of a multicenter study, 96 veterans with HF (96% male, 67 ± 11 years) completed measures of symptoms, pain (Brief Pain Inventory [BPI]), functional status (Functional Morbidity Index), and psychological state (Patient Health Questionnaire-2 and Generalized Anxiety Disorder-2). Single items from the BPI interference and the quality of life-end of life measured social and spiritual well-being. Demographic and clinical variables were obtained by chart audit. Correlation and linear regression models evaluated physical, emotional, social, and spiritual factors associated with pain. Fifty-three (55.2%) HF patients reported pain, with a majority (36 [37.5%]) rating their pain as moderate to severe (pain ? 4/10). The presence of pain was reported more frequently than dyspnea (67 [71.3%] vs. 58 [61.7%]). Age (P = 0.02), psychological (depression: P = 0.002; anxiety: P = 0.001), social (P < 0.001), spiritual (P = 0.010), and physical (health status: P = 0.001; symptom frequency: P = 0.000; functional status: P = 0.002) well-being were correlated with pain severity. In the resulting model, 38% of the variance in pain severity was explained (P < 0.001); interference with relations (P < 0.001) and symptom number (P = 0.007) contributed to pain severity. The association of physical, psychological, social, and spiritual domains with pain suggests that multidisciplinary interventions are needed to address the complex nature of pain in HF. PMID:19733032

Goebel, Joy R.; Doering, Lynn V.; Shugarman, Lisa R.; Asch, Steve M.; Sherbourne, Cathy D.; Lanto, Andy B.; Evangelista, Lorraine S.; Nyamathi, Adeline M.; Maliski, Sally L.; Lorenz, Karl A.

2010-01-01

259

Heart failure: the hidden problem of pain.  

PubMed

Although dyspnea and fatigue are hallmark symptoms of heart failure (HF), the burden of pain may be underrecognized. This study assessed pain in HF and identified contributing factors. As part of a multicenter study, 96 veterans with HF (96% male, 67+/-11 years) completed measures of symptoms, pain (Brief Pain Inventory [BPI]), functional status (Functional Morbidity Index), and psychological state (Patient Health Questionnaire-2 and Generalized Anxiety Disorder-2). Single items from the BPI interference and the quality of life-end of life measured social and spiritual well-being. Demographic and clinical variables were obtained by chart audit. Correlation and linear regression models evaluated physical, emotional, social, and spiritual factors associated with pain. Fifty-three (55.2%) HF patients reported pain, with a majority (36 [37.5%]) rating their pain as moderate to severe (pain>or=4/10). The presence of pain was reported more frequently than dyspnea (67 [71.3%] vs. 58 [61.7%]). Age (P=0.02), psychological (depression: P=0.002; anxiety: P=0.001), social (P<0.001), spiritual (P=0.010), and physical (health status: P=0.001; symptom frequency: P=0.000; functional status: P=0.002) well-being were correlated with pain severity. In the resulting model, 38% of the variance in pain severity was explained (P<0.001); interference with relations (P<0.001) and symptom number (P=0.007) contributed to pain severity. The association of physical, psychological, social, and spiritual domains with pain suggests that multidisciplinary interventions are needed to address the complex nature of pain in HF. PMID:19733032

Goebel, Joy R; Doering, Lynn V; Shugarman, Lisa R; Asch, Steve M; Sherbourne, Cathy D; Lanto, Andy B; Evangelista, Lorraine S; Nyamathi, Adeline M; Maliski, Sally L; Lorenz, Karl A

2009-11-01

260

Heart Failure in Acute Ischemic Stroke  

PubMed Central

Heart failure (HF) is a complex clinical syndrome that can result from any structural or functional cardiac disorder that impairs the ability of the ventricle to fill with or eject blood. Due to the aging of the population it has become a growing public health problem in recent decades. Diagnosis of HF is clinical and there is no diagnostic test, although some basic complementary testing should be performed in all patients. Depending on the ejection fraction (EF), the syndrome is classified as HF with low EF or HF with normal EF (HFNEF). Although prognosis in HF is poor, HFNEF seems to be more benign. HF and ischemic stroke (IS) share vascular risk factors such as age, hypertension, diabetes mellitus, coronary artery disease and atrial fibrillation. Persons with HF have higher incidence of IS, varying from 1.7% to 10.4% per year across various cohort studies. The stroke rate increases with length of follow-up. Reduced EF, independent of severity, is associated with higher risk of stroke. Left ventricular mass and geometry are also related with stroke incidence, with concentric hypertrophy carrying the greatest risk. In HF with low EF, the stroke mechanism may be embolism, cerebral hypoperfusion or both, whereas in HFNEF the mechanism is more typically associated with chronic endothelial damage of the small vessels. Stroke in patients with HF is more severe and is associated with a higher rate of recurrence, dependency, and short term and long term mortality. Cardiac morbidity and mortality is also high in these patients. Acute stroke treatment in HF includes all the current therapeutic options to more carefully control blood pressure. For secondary prevention, optimal control of all vascular risk factors is essential. Antithrombotic therapy is mandatory, although the choice of a platelet inhibitor or anticoagulant drug depends on the cardiac disease. Trials are ongoing to evaluate anticoagulant therapy for prevention of embolism in patients with low EF who are at sinus rhythm. PMID:21804779

Cuadrado-Godia, Elisa; Ois, Angel; Roquer, Jaume

2010-01-01

261

CONGESTIVE HEART FAILURE: WHERE HOMEOSTASIS BEGETS DYSHOMEOSTASIS  

PubMed Central

Despite today’s standard of care, aimed at containing homeostatic neurohormonal activation, 1 in every 5 patients recently hospitalized with congestive heart failure (CHF) will be readmitted within 30 days of discharge because of a recurrence of their symptoms and signs. In light of recent pathophysiologic insights, it is now propitious to revisit CHF with a view toward complementary and evolving management strategies. CHF is a progressive systemic illness. Its features include: oxidative stress in diverse tissues; an immunostimulatory state with circulating proinflammatory cytokines; a wasting of soft tissues; and a resorption of bone. Its origins are rooted in homeostatic mechanisms gone awry to beget dyshomeostasis. For example, marked excretory losses of Ca2+ and Mg2+ accompany renin-angiotensin-aldosterone system (RAAS) activation, causing ionized hypocalcemia and hypomagnesemia that lead to secondary hyperparathyroidism (SHPT) with consequent bone resorption and a propensity to atraumatic fractures. Parathyroid hormone (PTH) accounts for paradoxical intracellular Ca2+ overloading in diverse tissues and consequent systemic induction of oxidative stress. In cardiac myocytes and mitochondria these events orchestrate opening of the mitochondrial membrane permeability transition pore (mPTP) with an ensuing osmotic-based destruction of these organelles and resultant cardiomyocyte necrosis with myocardial scarring. Contemporaneous with Ca2+ and Mg2+ dyshomeostasis is hypozincemia and hyposelenemia, which compromise metalloenzyme-based antioxidant defenses while hypovitaminosis D threatens Ca2+ stores needed to prevent SHPT. An intrinsically coupled dyshomeostasis of intracellular Ca2+ and Zn2+, representing prooxidant and antioxidant, respectively, is integral to regulating mitochondrial redox state; it can be uncoupled by a Zn2+ supplement in favor of antioxidant defenses. Hence, the complementary use of nutriceuticals to nullify dyshomeostatic responses involving macro- and micronutrients should be considered. Evolving strategies with mitochondria-targeted interventions interfering with their uptake of Ca2+ or serving as selective antioxidant or mPTP inhibitor may also prove efficacious in the overall management of CHF. PMID:20588190

Kamalov, German; Bhattacharya, Syamal K.; Weber, Karl T.

2010-01-01

262

Insulin Resistance and Incident Heart Failure  

PubMed Central

Objectives This study was designed to assess the relationship between insulin resistance and incident heart failure (HF) in a community-based cohort. Background Diabetes mellitus increases the risk for HF, but the association between insulin resistance and HF in individuals without diabetes is unclear. Methods We prospectively analyzed 12,606 participants without diabetes mellitus, prevalent HF, or history of myocardial infarction at baseline (1987 to 1989) from the ARIC (Atherosclerosis Risk in Communities) study. We assessed the relationship between insulin resistance and incident HF using the homeostatic model assessment of insulin resistance (HOMA-IR) equation, adjusting for age, sex, race, body mass index, smoking, hypertension, center, and interim myocardial infarction. We tested for interactions by age, sex, obesity, and race. Results Participants with insulin resistance, defined as HOMA-IR ?2.5 (n = 4,810, 39%), were older, more likely female, African American, hypertensive, and had a higher body mass index as compared with those without insulin resistance. There were 1,455 incident HF cases during a median of 20.6 years of follow-up. Insulin resistance defined by this threshold was not significantly associated with an increased risk for incident HF after adjustment (hazard ratio: 1.08, 95% confidence interval: 0.95 to 1.23). However, when analyzed continuously, this relationship was nonlinear, which indicated that risk increased, and was significantly associated with incident HF between HOMA-IR of 1.0 to 2.0, adjusting for baseline covariates; however, values over 2.5 were not associated with additional increased risk in adjusted models. Conclusions In a community cohort, insulin resistance, defined by lower levels of HOMA-IR than previously considered, was associated with an increased risk for HF. PMID:24455475

Vardeny, Orly; Gupta, Deepak K.; Claggett, Brian; Burke, Stuart; Shah, Amil; Loehr, Laura; Rasmussen-Torvik, Laura; Selvin, Elizabeth; Chang, Patricia P.; Aguilar, David; Solomon, Scott D.

2014-01-01

263

[Epidemiology and treatment of chronic heart failure; use of bisoprolol].  

PubMed

The prevalence of chronic heart failure in Hungary is 1.6% in the adult population, but it occurs in 15-20% of subjects over 80 years of age. The base of treatment of heart failure is the blockade of the neuro-hormonal system, which includes the use of angiotensin converting enzyme inhibitors (angiotensin receptor blockers in case of angiotensin converting enzyme inhibitors intolerance), beta receptor blockers and mineralocorticoid receptor antagonists. Because of their negative inotropic effect, beta blockers were neglected for a long time from the treatment of heart failure. However, during the past decades several studies have demonstrated that beta blockers decrease mortality in patients with heart failure. The effectiveness of bisoprolol in reducing mortality has also also been documented in a number of studies. PMID:24161596

Nagy, Viktor

2013-11-01

264

[Surgical treatment options in end-stage heart failure].  

PubMed

Despite significant improvements in pharmacological therapy heart failure is still one of the leading causes for death in the Western World. The gold standard treatment of end-stage heart failure remains cardiac transplantation, but there is a great excess of eligible candidates compared with the low number of suitable donor organs. The variety of surgical organ preserving treatment strategies has significantly increased during the last 20 years, intenting either to delay or even to prevent the need for cardiac transplantation. An individually tailored surgical concept should be considered as an alternative in any heart failure patient who has reached the limits of pharmacologic therapy. This article gives an overview about current and potential future therapeutic options in end-stage heart failure. PMID:21271540

Grapow, Martin T R; Carrel, Thierry P; Eckstein, Friedrich S

2011-02-01

265

Using beta-blockers to treat heart failure.  

PubMed

Bisoprolol, carvedilol, metoprolol, and nebivolol are beta-blocker drugs used to improve survival in patients with systolic heart failure. This article reviews these drugs and how practitioners can initiate and titrate them for maximum patient benefit. PMID:25417667

Nguyen, Timothy; Shaheed, Ahmed; Venigalla, Srikanth; Mullokandov, Emanuel

2014-12-01

266

Post-Exercise Heart Rate Recovery Independently Predicts Mortality Risk in Patients With Chronic Heart Failure  

Microsoft Academic Search

BackgroundPost-exercise heart rate recovery (HRR) is an index of parasympathetic function associated with clinical outcomes in populations with and without documented coronary heart disease. Decreased parasympathetic activity is thought to be associated with disease progression in chronic heart failure (HF), but an independent association between post-exercise HRR and clinical outcomes among such patients has not been established.

Yi-Da Tang; Thomas A. Dewland; Detlef Wencker; Stuart D. Katz

2009-01-01

267

Pathogenesis and clinical presentation of acute heart failure.  

PubMed

Acute heart failure constitutes a heterogeneous clinical syndrome, whose pathophysiology is complex and not completely understood. Given the diversity of clinical presentations, several different pathophysiological mechanisms along with factors triggering circulatory decompensation are involved. This article discusses the available evidence on the pathophysiological phenomena attributed or/and associated with episodes of acute heart failure and describes different clinical profiles, which, from a clinical perspective, constitute a key element for therapeutic decision-making. PMID:25743769

Ponikowski, Piotr; Jankowska, Ewa A

2015-04-01

268

ESRD and Death after Heart Failure in CKD.  

PubMed

CKD is a risk factor for heart failure, but there is no data on the risk of ESRD and death after recurrent hospitalizations for heart failure. We sought to determine how interim heart failure hospitalizations modify the subsequent risk of ESRD or death before ESRD in patients with CKD. We retrospectively identified 2887 patients with a GFR between 15 and 60 ml/min per 1.73 m(2) referred between January of 2001 and December of 2008 to a nephrology clinic in Toronto, Canada. We ascertained interim first, second, and third heart failure hospitalizations as well as ESRD and death before ESRD outcomes from administrative data. Over a median follow-up time of 3.01 (interquartile range=1.56-4.99) years, interim heart failure hospitalizations occurred in 359 (12%) patients, whereas 234 (8%) patients developed ESRD, and 499 (17%) patients died before ESRD. Compared with no heart failure hospitalizations, one, two, or three or more heart failure hospitalizations increased the adjusted hazard ratio of ESRD from 4.89 (95% confidence interval [95% CI], 3.21 to 7.44) to 10.27 (95% CI, 5.54 to 19.04) to 14.16 (95% CI, 8.07 to 24.83), respectively, and the adjusted hazard ratio death before ESRD from 3.30 (95% CI, 2.55 to 4.27) to 4.20 (95% CI, 2.82 to 6.25) to 6.87 (95% CI, 4.96 to 9.51), respectively. We conclude that recurrent interim heart failure is associated with a stepwise increase in the risk of ESRD and death before ESRD in patients with CKD. PMID:25190730

Sud, Maneesh; Tangri, Navdeep; Pintilie, Melania; Levey, Andrew S; Naimark, David M J

2015-03-01

269

Heart failure and the risk of stroke: the Rotterdam Study.  

PubMed

Patients with heart failure used to have an increased risk of stroke, but this may have changed with current treatment regimens. We assessed the association between heart failure and the risk of stroke in a population-based cohort that was followed since 1990. The study uses the cohort of the Rotterdam Study and is based on 7,546 participants who at baseline (1990–1993) were aged 55 years or over and free from stroke. The associations between heart failure and risk of stroke were assessed using time-dependent Cox proportional hazards models, adjusted for cardiovascular risk factors (smoking, diabetes mellitus, BMI, ankle brachial index, blood pressure, atrial fibrillation, myocardial infarction and relevant medication). At baseline, 233 participants had heart failure. During an average follow-up time of 9.7 years, 1,014 persons developed heart failure, and 827 strokes (470 ischemic, 75 hemorrhagic, 282 unclassified) occurred. The risk of ischemic stroke was more than five-fold increased in the first month after diagnosis of heart failure (age and sex adjusted HR 5.79, 95% CI 2.15–15.62), but attenuated over time (age and sex adjusted HR 3.50 [95% CI 1.96–6.25] after 1–6 months and 0.83 [95% CI 0.53–1.29] after 0.5–6 years). Additional adjustment for cardiovascular risk factors only marginally attenuated these risks. In conclusion, the risk of ischemic stroke is strongly increased shortly after the diagnosis of heart failure but returns to normal within 6 months after onset of heart failure. PMID:21061046

Alberts, V P; Bos, M J; Koudstaal, P J; Hofman, A; Witteman, J C M; Stricker, B H C; Breteler, M M B

2010-11-01

270

Renal dysfunction in acute heart failure: epidemiology, mechanisms and assessment  

Microsoft Academic Search

Renal dysfunction is often present and\\/or worsens in patients with heart failure and this is associated with increased costs\\u000a of care, complications and mortality. The cardiorenal syndrome can be defined as the presence or development of renal dysfunction\\u000a in patients with heart failure. Its mechanisms are likely related to low cardiac output, increased venous congestion and renal\\u000a venous pressure, neurohormonal

Valentina Carubelli; Marco Metra; Carlo Lombardi; Luca Bettari; Silvia Bugatti; Valentina Lazzarini; Livio Dei Cas

271

Device monitoring strategies in acute heart failure syndromes  

Microsoft Academic Search

Acute heart failure syndromes (AHFS) represent the most common discharge diagnoses in adults over age 65 and translate into\\u000a dramatically increased heart failure–associated morbidity and mortality. Conventional approaches to the early detection of\\u000a pulmonary and systemic congestion have been shown to be of limited sensitivity. Despite their proven efficacy, disease management\\u000a and structured telephone support programs have failed to achieve

Michael A. Samara; W. H. Wilson Tang

2011-01-01

272

Hyponatremia in acute heart failure syndromes: A potential therapeutic target  

Microsoft Academic Search

Mild hyponatremia is common in patients hospitalized for worsening heart failure, and it is a major predictor of post-discharge\\u000a mortality and morbidity irrespective of left ventricular ejection fraction. Recent data also suggest that standard therapy\\u000a for heart failure does not improve or normalize serum sodium concentration during hospitalization. There are conclusive data\\u000a that vasopressin antagonists improve or normalize serum sodium

Filippo Brandimarte; Francesco Fedele; Leonardo De Luca; Gregg C. Fonarow; Mihai Gheorghiade

2007-01-01

273

Who cares for the patient with heart failure?  

Microsoft Academic Search

Heart failure is a progressive and often fatal clinical syndrome caused by cardiac dysfunction. Therapeutic advances in both\\u000a acute and chronic heart failure care have resulted in the ability to partially or completely reverse cardiac dysfunction,\\u000a with accompanying reductions in attributable morbidity, mortality, and cost. In order to examine who is best suited to provide\\u000a care for the patient with

Denise D. Barnard

2006-01-01

274

Observation Units in the Management of Acute Heart Failure Syndromes  

Microsoft Academic Search

Observation units (OUs) for acute heart failure syndromes (AHFS) have proven to be effective in reducing heart failure admissions\\u000a and may reduce costs. Goals for risk-stratifying patients with AHFS in OUs include determining patients suitable for OU management\\u000a and determining end points of treatment. Although many provider models and settings exist, management algorithms common to\\u000a most OUs include monitoring\\/nursing care,

Gregory J. Fermann; Sean P. Collins

2010-01-01

275

Impact of Systemic Venous Congestion in Heart Failure  

Microsoft Academic Search

Systemic venous congestion is one of the hallmarks of the syndrome of heart failure that results from activation of different\\u000a deleterious neurohormonal pathways. Apart from contributing to patients’ symptoms and hospital admissions, growing evidence\\u000a suggests that congestion itself drives further heart failure progression. In addition, systemic venous congestion exerts detrimental\\u000a effects on other organs (such as kidneys and liver) due

Matthias Dupont; Wilfried Mullens; W. H. Wilson Tang

276

Femoral bone mineral density in patients with heart failure  

Microsoft Academic Search

Introduction  Heart failure and osteoporosis are common conditions in older, frail individuals. It is important to investigate interactions of the common problems in the aging population to devise relevant interventions. Methods  Sixty individuals (43 men, mean age 77±9 years, and 17 women, mean age 78±12 years) with heart failure (HF) and 23 age- and gender-matched non-HF controls (15 men, eight women; mean age 77±9 years)

A. M. Kenny; R. Boxer; S. Walsh; W. D. Hager; L. G. Raisz

2006-01-01

277

End of Life Care in Advanced Heart Failure  

Microsoft Academic Search

Opinion Statement  I individualize my approach to each patient based upon their understanding of their disease process, acuity of their progression\\u000a to Stage D heart failure, clinical setting (hospitalized vs outpatient), and family needs. My first goal is to prove intolerance\\u000a of traditional therapies for heart failure by challenging patients with various medication combinations, including staggered\\u000a dosing regimens and alternatives to

Eldrin F. Lewis

2011-01-01

278

Statins in the prevention of heart failure after myocardial infarction  

Microsoft Academic Search

Statin therapy has demonstrated clear reductions in the risk of death and recurrent cardiac events in patients with acute\\u000a coronary syndrome (ACS) and coronary artery disease. Heart failure after myocardial infarction (MI) is associated with increased\\u000a in-hospital mortality and worse long-term prognosis. Some controversy exists about the effects of statin therapy on heart\\u000a failure, although the favorable effects of statin

Helene Glassberg

2009-01-01

279

Diastology 2010: clinical approach to diastolic heart failure  

Microsoft Academic Search

The role of echocardiography in the evaluation of left ventricular diastolic function is increasingly important in both systolic\\u000a and diastolic heart failure. In routine clinical practice, the diastolic dysfunction associated with diastolic heart failure\\u000a can mainly be evaluated by Doppler echocardiography. In order to use echocardiographic techniques for this purpose, one should\\u000a recognize the definition, terminology, epidemiology, and pathophysiology of

Hirotsugu Yamada; Allan L. Klein

2010-01-01

280

Mitral regurgitation in chronic heart failure: More questions than answers?  

Microsoft Academic Search

The presence, implications, and approach to mitral valvular disease in the setting of a cardiomyopathy has recently become\\u000a a focal issue for discussion. Although recent evidence suggests that mitral regurgitation confers a poor prognosis in heart\\u000a failure, the true prevalence of mitral regurgitation as well as its pathogenic contribution to prognosis in heart failure\\u000a remains uncertain. Whereas angiotensin-converting enzyme inhibitors

Mandeep R. Mehra; Mihai Gheorghiade; Robert O. Bonow

2004-01-01

281

Therapeutics in Congestive Heart Failure: From Hemodynamics to Neurohormones  

Microsoft Academic Search

\\u000a Congestive heart failure has traditionally been thought of as a hemodynamic problem wherein impaired left ventricular function\\u000a leads to decreased peripheral perfusion, sodium retention, increased ventricular afterload, and progressively deteriorating\\u000a left ventricular pumping capacity. In new or decompensated heart failure, this hemodynamic paradigm predicts acute clinical\\u000a improvement. Chronically, however, treatment based fundamentally on inotropic support or vasodilation has proved either

Steven R. Goldsmith; Lorrie A. Kirshenbaum; Naranjan S. Dhalla

282

Frontiers of therapy for patients with heart failure.  

PubMed

This review broadly covers advances in heart failure, which is responsible for significant morbidity, mortality, and cost in the United States. It is a heterogeneous condition, and accurate classification helps ensure appropriate application of evidence-based therapies. Hemodynamics are important in acute heart failure syndromes and may help tailor therapy. Neurohormonal modulation forms the cornerstone of chronic systolic heart failure treatment but does not affect outcomes in diastolic heart failure where management goals emphasize optimization of central volume, blood pressure, and atrial rhythm, as well as the treatment of comorbidities. Frontiers of heart failure therapy range from advances in pharmacology (novel inotropic agents and neurohormonal modulators), to cell biology (nucleic acid-based drugs and cell therapy) to biomedical engineering (devices such as ultrafiltration, biventricular pacemakers, implantable cardiac defibrillators, remote monitoring systems, and left ventricular assist devices), and to health systems (risk stratification and integrated care of comorbidities). The ultimate frontier will be to integrate these data effectively to ensure that patients with heart failure consistently receive the best evidenced-based care possible. PMID:23260502

Liu, Stanley S; Monti, Jennifer; Kargbo, Hamid M; Athar, Muhammad W; Parakh, Kapil

2013-01-01

283

Heart Failure Management: The Present and the Future  

PubMed Central

Abstract Clinical heart failure has been defined for a long time as a clinical syndrome with symptoms and signs including shortness of breath, cyanosis, ascites, and edema. However, in recent years, with the thought of promoting early diagnosis and heart-failure prevention, the concept of heart failure has often been defined simply as a subject with severe LV dysfunction and a dilated left ventricle, or by some, defined by evidence of increased circulating levels of molecular markers of cardiac dysfunction, such as ANP and BNP. Heart failure has been considered an irreversible clinical end point. Current medical management for heart failure only relieves symptoms, slows deterioration, and prolongs life modestly. However, in the recent years, rejuvenation of the failing myocardium began to seem possible as the accumulating preclinical studies demonstrated that rejuvenating the myocardium at the molecular and cellular level can be achieved by gene therapy or stem cell transplantation. Here, we review selected novel modalities that have been shown in preclinical studies to exert beneficial effects in animal models of severe LV dysfunction and seem to have the potential to make an impact in the clinical practice of heart-failure management. Antioxid. Redox Signal. 11, 1989–2010. PMID:19203220

Jameel, Mohammad N.

2009-01-01

284

Angiotensin II, sympathetic nerve activity and chronic heart failure.  

PubMed

Sympathetic nerve activity has been reported to be increased in both humans and animals with chronic heart failure. One of the mechanisms believed to be responsible for this phenomenon is increased systemic and cerebral angiotensin II signaling. Plasma angiotensin II is increased in humans and animals with chronic heart failure. The increase in angiotensin II signaling enhances sympathetic nerve activity through actions on both central and peripheral sites during chronic heart failure. Angiotensin II signaling is enhanced in different brain sites such as the paraventricular nucleus, the rostral ventrolateral medulla and the area postrema. Blocking angiotensin II type 1 receptors decreases sympathetic nerve activity and cardiac sympathetic afferent reflex when therapy is administered to the paraventricular nucleus. Injection of an angiotensin receptor blocker into the area postrema activates the sympathoinhibitory baroreflex. In peripheral regions, angiotensin II elevates both norepinephrine release and synthesis and inhibits norepinephrine uptake at nerve endings, which may contribute to the increase in sympathetic nerve activity seen in chronic heart failure. Increased circulating angiotensin II during chronic heart failure may enhance the sympathoexcitatory chemoreflex and inhibit the sympathoinhibitory baroreflex. In addition, increased circulating angiotensin II can directly act on the central nervous system via the subfornical organ and the area postrema to increase sympathetic outflow. Inhibition of angiotensin II formation and its type 1 receptor has been shown to have beneficial effects in chronic heart failure patients. PMID:23225134

Wang, Yutang; Seto, Sai-Wang; Golledge, Jonathan

2014-03-01

285

Grading the severity of congestive heart failure in infants  

Microsoft Academic Search

To determine which variables most accurately define congestive heart failure (CHF) in infants, 41 patients (median age 2.5 months) were graded by four pediatric cardiologists for the presence and severity of CHF based on the following variables: amount of formula consumed per feeding, feeding time, history of diaphoresis or tachypnea, growth parameters, respiratory and heart rates, respiratory pattern, perfusion, presence

Robert D. Ross; Robert O. Bollinger; William W. Pinsky

1992-01-01

286

Reverse remodeling in heart failure—mechanisms and therapeutic opportunities  

Microsoft Academic Search

Heart failure (HF) involves changes in cardiac structure, myocardial composition, myocyte deformation, and multiple biochemical and molecular alterations that impact heart function and reserve capacity. Collectively, these changes have been referred to as 'cardiac remodeling'. Understanding the components of this process with the goal of stopping or reversing its progression has become a major objective. This concept is often termed

Norimichi Koitabashi; David A. Kass

2011-01-01

287

Spouse Distress Predicts Health Outcomes in Patients with Heart Failure  

Microsoft Academic Search

Psychological distress reported by the spouses of 60 heart failure patients predicted changes in the patients' physical health over the next six months independent of baseline illness severity and the patient's own distress. Negative spouse emotion also had a marginally significant effect on patient survival. Background Chronic heart disease is a potential source of psychological distress for both patients and

Audrey Cleary; Michael J. Rohrbaugh; Varda Shoham; Emily A. Butler

288

[Diagnosis and treatment of heart failure in primary health care. Low correlation between Pro-ANF and heart failure].  

PubMed

Three eastern Swedish primary care clinics serving a predominantly rural clientele monitored for 13 months all patients under 80 years of age with a diagnosis based on clinical signs alone of heart failure (n = 56) or suspected incipient heart failure (n = 62). Echocardiography was performed on all patients. For 64% of the former group, the putative diagnosis matched echocardiography findings. Results showed a purely diastolic disorder in one-fifth of all 118 patients, and a hemodynamically significant, hitherto unknown heart defect in about as many. Pro-ANF assays correlated poorly with manifest heart failure. Pharmacological treatments were registered, and at 6-month follow-up, 82% of patients with systolic failure were receiving ACE-inhibition. PMID:10687345

Blomqvist, K; Ortoft, K; Johansson, A; Ascione, S; Nylander, E; Akerlind, I

2000-01-19

289

Pediatric Heart Failure: Current State and Future Possibilities  

PubMed Central

Heart failure is a complex pathophysiological syndrome that can occur in children from a variety of diseases, including cardiomyopathies, myocarditis, and congenital heart disease. The condition is associated with a high rate of morbidity and mortality and places a significant burden on families of affected children and to society as a whole. Current medical therapy is taken largely from the management of heart failure in adults, though clear survival benefit of these medications are lacking. Ventricular assist devices (VADs) have taken an increasingly important role in the management of advanced heart failure in children. The predominant role of these devices has been as a bridge to heart transplantation, and excellent results are currently achieved for most children with cardiomyopathies. There is an ongoing investigation to improve outcomes in high-risk populations, such as small infants and those with complex congenital heart disease, including patients with functionally univentricular hearts. Additionally, there is an active investigation and interest in expansion of VADs beyond the predominant utilization as a bridge to a heart transplant into ventricular recovery, device explant without a heart transplantation (bridge to recovery), and placement of devices without the expectation of recovery or transplantation (destination therapy). PMID:25653697

Jang, Gi Young

2015-01-01

290

How to diagnose diastolic heart failure: a consensus statement on the diagnosis of heart failure with normal left ventricular ejection fraction by the Heart Failure and Echocardiography Associations of the European Society of Cardiology  

Microsoft Academic Search

Diastolic heart failure (DHF) currently accounts for more than 50\\\\% of\\u000a all heart failure patients. DHF is also referred to as heart failure\\u000a with normal Left ventricular (W) ejection fraction (HFNEF) to indicate\\u000a that HFNEF could be a precursor of heart failure with reduced LVEF\\u000a Because of improved cardiac imaging and because of widespread clinical\\u000a use of plasma levels of

Walter J. Paulus; Carsten Tschope; John E. Sanderson; Cesare Rusconi; Frank A. Flachskampf; Frank E. Rademakers; Paolo Marino; Otto A. Smiseth; Gilles De Keulenaer; Adelino F. Leite-Moreira; Attila Borbely; Istvan Edes; Martin Louis Handoko; Stephane Heymans; Natalia Pezzali; Burkert Pieske; Kenneth Dickstein; Alan G. Fraser; Dirk L. Brutsaert

2007-01-01

291

Reduction in Heart Failure Events by the Addition of a Clinical Pharmacist to the Heart Failure Management Team: Results of the Pharmacist in Heart Failure Assessment Recommendation and Monitoring (PHARM) Study  

Microsoft Academic Search

Background: The multidisciplinary approach to man- aging heart failure has been shown to improve out- comes. The role of a clinical pharmacist in treating heart failure has not been evaluated. Methods: One hundred eighty-one patients with heart failure and left ventricular dysfunction (ejection frac- tion ,45) undergoing evaluation in clinic were random- ized to an intervention or a control group.

Wendy A. Gattis; Vic Hasselblad; David J. Whellan; Christopher M. O'Connor

1999-01-01

292

Heart Failure Symposium: Promoting Knowledge and Self-Care: The Keys to  

E-print Network

Heart Failure Symposium: Promoting Knowledge and Self-Care: The Keys to a Woman's Healthy Heart This is the Fourth Annual UConn Health Center Heart Failure Symposium. This year we will focus on women and heart); complications related to patients with heart failure, and medication reconciliation challenges. This conference

Kim, Duck O.

293

Capillary filtration is reduced in lungs adapted to chronic heart failure: morphological and haemodynamic correlates  

Microsoft Academic Search

Objective: To determine pulmonary capillary filtration in experimental chronic heart failure and to investigate some morphological and haemodynamic mechanisms that could account for reduced filtration in lungs adapted to chronic heart failure. Methods: We studied pulmonary capillary filtration, vascular resistances and morphology in lungs from guinea-pigs adapted to chronic heart failure. Heart failure was induced by banding of the ascending

Wenxin Huang; Martyn P. Kingsbury; Mark A. Turner; J. Leo Donnelly; Nicholas A. Flores; Desmond J. Sheridan

294

Large animal models for diastolic dysfunction and diastolic heart failure—a review of the literature  

Microsoft Academic Search

Diastolic heart failure (DHF) or heart failure with preserved systolic left ventricular function is estimated to account for approximately 40% of heart failure cases. Medical treatment of patients with DHF is limited and mainly empirical. Device-based therapy has an increasing role in the treatment of systolic heart failure and may have a future role in the treatment of DHF patients.

Shay Dubi; Yaron Arbel

2010-01-01

295

Heart failure with normal ejection fraction (HFNEF): is it worth considering?  

Microsoft Academic Search

Summary A significant proportion of patients with heart failure happen to have a normal ventricular ejection fraction at echocardiography during examination. Previously called diastolic heart failure, it is nowadays referred to as heart failure with normal ejection fraction (HFNEF) or HF with preserved ejection fraction. The European Society of Cardiology, recognizing the importance of this type of heart failure, recently

Coralie Blanche; Thierry Fumeaux; Ralf Polikar

2009-01-01

296

The Role of the Dietitian in an Outpatient Heart Failure Center  

Microsoft Academic Search

LEARNING OUTCOME: To identify a model for the role of a dietitian in an outpatient heart failure center and to identify outcome indicators appropriate for use with congestive heart failure outpatients.The establishment of outpatient heart failure centers is recognized as an essential step in decreasing the staggering cost of caring for the patient with congestive heart failure (CHF). These outpatient

T. Kuehneman; D. Saulsbury; P. L. Splett

1997-01-01

297

Demonstrating the Impact of Nutrition Intervention in a Heart Failure Program  

Microsoft Academic Search

Outpatient heart failure centers using a multidisciplinary approach to management of heart failure are recognized as essential to decreasing costs of treating heart failure. These centers do not typically employ registered dietitians. With hospital foundation funding, our objective was to develop the role of the dietitian and to evaluate the impact of nutrition intervention in a multidisciplinary heart failure program.

TONI KUEHNEMAN; DEBORAH SAULSBURY; PATRICIA SPLETT; DOUGLAS B CHAPMAN

2002-01-01

298

Improvement in refractory heart failure by nephrectomy for renal tumour  

PubMed Central

Hypoalbuminaemia and anaemia are conditions known to aggravate congestive cardiac failure (CCF). Renal cell carcinoma is often associated with hypoalbuminaemia and anaemia. The authors report an interesting case of a patient with severe refractory CCF who incidentally was found to have a massive renal cell tumour. Clinically, his heart failure was being aggravated by hypoalbuminaemia and anaemia. Despite aggressive diuretic therapy and multiple blood and albumin transfusions, there was no clinical improvement. He subsequently underwent nephrectomy of the renal tumour, with subsequent dramatic clinical improvement in his heart failure. His symptoms resolved completely and he did not require any further diuretic therapy. PMID:22665397

Shahzad, Adeel; Powell, Christopher; Etherington, Robert; Somauroo, John

2012-01-01

299

The effect of a tailored message intervention on heart failure readmission rates, quality of life, and benefit and barrier beliefs in persons with heart failure  

Microsoft Academic Search

ObjectiveThe purpose of this study was to determine the effect of a tailored message intervention on heart failure readmission rates, quality of life, and health beliefs in persons with heart failure (HF).

Kristen A Sethares; Kathleen Elliott

2004-01-01

300

Effectiveness of self-management interventions on mortality, hospital readmissions, chronic heart failure hospitalization rate and quality of life in patients with chronic heart failure: A systematic review  

Microsoft Academic Search

ObjectiveThis review examined the effectiveness of self-management interventions compared to usual care on mortality, all-cause hospital readmissions, chronic heart failure hospitalization rate and quality of life in patients with chronic heart failure.

Joanne B. Ditewig; Helene Blok; Jeroen Havers; Haske van Veenendaal

2010-01-01

301

Healing the orphaned heart: heart failure in a patient with glucose-6-phosphate dehydrogenase deficiency.  

PubMed

Patients with glucose-6-phosphate dehydrogenase (G6PD) deficiency are not represented in clinical trials for heart failure. Moreover, many of the recommended medications can cause haemolysis in this group of patients. We present the case of a 71-year-old woman with G6PD deficiency admitted for acute non-ischemic heart failure with reduced ejection fraction. Our experience showed that a combination of ethacrynic acid and spironolactone is safe and effective for relief of volume overload in this group of patients. Studies are needed to determine whether the morbidity and mortality benefits of established heart failure regimens extend to patients with G6PD deficiency. PMID:25743872

Balderia, Percy Guanzon; Wongrakpanich, Supakanya; Patel, Monil; Stanek, Marjorie

2015-01-01

302

Iron deficiency: an emerging therapeutic target in heart failure.  

PubMed

In patients with heart failure, iron deficiency is frequent but overlooked, with a prevalence of 30%-50%. Since it contributes to cardiac and peripheral muscle dysfunction, iron deficiency is associated with poorer clinical outcomes and a greater risk of death, independent of haemoglobin level. Therefore, iron deficiency emerges as a new comorbidity and a therapeutic target of chronic heart failure in addition to chronic renal insufficiency, anaemia and diabetes. In a series of placebo-controlled, randomised studies in patients with heart failure and iron deficiency, intravenous iron had a favourable effect on exercise capacity, functional class, LVEF, renal function and quality of life. These clinical studies were performed in the context of a renewed interest in iron metabolism. During the past 10 years, knowledge about the transport, storage and homeostasis of iron has improved dramatically, and new molecules involved in iron metabolism have been described (eg, hepcidin, ferroportin, divalent metal transporter 1). Recent European guidelines recommend the monitoring of iron parameters (ie, serum ferritin, transferrin saturation) for all patients with heart failure. Ongoing clinical trials will explore the benefits of iron deficiency correction on various heart failure parameters. PMID:24957529

Cohen-Solal, Alain; Leclercq, Christophe; Deray, Gilbert; Lasocki, Sigismond; Zambrowski, Jean-Jacques; Mebazaa, Alexandre; de Groote, Pascal; Damy, Thibaud; Galinier, Michel

2014-09-15

303

Cardiorenal Syndrome Caused by Heart Failure with Preserved Ejection Fraction  

PubMed Central

Since cardiorenal dysfunction is usually secondary to multiple factors acting in concert (and not only reduced cardiac output) in the present paper we are going to focus on the interrelationship between heart failure with normal ejection fraction and the development of cardiorenal syndrome. The coexistence of renal impairment in heart failure with preserved ejection fraction (CRS type 2 and 4) is common especially in older females with hypertension and/or diabetes. It can be hypothesized that the incidence of this disease association is growing, while clinical trials enrolling these patients are still lacking. The main mechanisms thought to be involved in the pathophysiology of this condition are represented by the increase of intra-abdominal and central venous pressure and the activation of the renin-angiotensin system. Differently from CRS in heart failure with reduced ejection fraction, the involvement of the kidney may be under-diagnosed in patients with heart failure and preserved ejection fraction and the optimal therapeutic strategy in this condition, though challenging, is far to be completely elucidated. Further studies are needed to assess the best therapeutic regimen in patients with renal dysfunction (and worsening) and heart failure and preserved ejection fraction. PMID:21331316

Lazzeri, Chiara; Valente, Serafina; Tarquini, Roberto; Gensini, Gian Franco

2011-01-01

304

Percutaneous mechanical devices in the management of decompensated heart failure.  

PubMed

Heart failure is the only cardiovascular disease diagnosis increasing in prevalence in the United States. A number of drugs have been shown to reduce morbidity and mortality in patients with chronic heart failure. Despite these advances, the frequency of hospitalization for heart failure has continued to increase, and clinical trial data are lacking in demonstrable benefit of drug therapy for patients hospitalized with acute, decompensated heart failure. A number of percutaneous devices have been developed and are in various stages of investigation and use to improve symptoms and clinical outcomes in patients hospitalized with heart failure. These include "add-on" devices, such as continuous aortic flow augmentation and ultrafiltration devices, and "rescue" devices to be used in patients who are rapidly deteriorating despite medical therapy. In addition to the intra-aortic balloon pump, newer approaches include percutaneous ventricular assist devices that are available for short-term use to stabilize patients until recovery can occur or as "bridges" to longer-term assist or cardiac transplantation. In the coming years, expanded clinical investigation is likely to explore the potential for devices to normalize underlying cardiac function and thereby improve long-term clinical outcomes. PMID:17386185

Mather, Paul J; Konstam, Marvin A

2007-03-01

305

Modelli integrati tra ospedale e territorio per l'assistenza al paziente con scompenso cardiaco Heart Failure Programs and Comprehensive Management in Heart Failure  

Microsoft Academic Search

Heart Failure Programs and Comprehensive Management in Heart Failure. A. Di Lenarda, G. Sabbadini, G. Sinagra. Chronic heart failure is a major health problem, which is growing parallel to the increasing proportion of el- derly in the population. Recurrent hospitalizations occur in about half of the subjects within 6 months after the initial admission. Several co-morbidities usually coexist in these

A. Di Lenard; G. Sabbadini; G. Sinagra

306

Palliative care in heart failure: a position statement from the palliative care workshop of the Heart Failure Association of the European Society of Cardiology  

Microsoft Academic Search

Heart failure is a serious condition and equivalent to malignant disease in terms of symptom burden and mortality. At this moment only a comparatively small number of heart failure patients receive specialist palliative care. Heart failure patients may have generic palliative care needs, such as refractory multifaceted symptoms, communication and decision making issues and the requirement for family support. The

Tiny Jaarsma; James M. Beattie; Mary Ryder; Frans H. Rutten; Theresa McDonagh; Paul Mohacsi; Scott A. Murray; Thomas Grodzicki; Ingrid Bergh; Marco Metra; Inger Ekman; Marcia Leventhal; Antonis Pitsis; Stefan D. Anker; Antonello Gavazzi; Piotr Ponikowski; Kenneth Dickstein; Etienne Delacretaz; Florian Strasser; John McMurray

307

Ivabradine, coronary artery disease, and heart failure: beyond rhythm control.  

PubMed

Elevated heart rate could negatively influence cardiovascular risk in the general population. It can induce and promote the atherosclerotic process by means of several mechanisms involving endothelial shear stress and biochemical activities. Furthermore, elevated heart rate can directly increase heart ischemic conditions because of its skill in unbalancing demand/supply of oxygen and decreasing the diastolic period. Thus, many pharmacological treatments have been proposed in order to reduce heart rate and ameliorate the cardiovascular risk profile of individuals, especially those suffering from coronary artery diseases (CAD) and chronic heart failure (CHF). Ivabradine is the first pure heart rate reductive drug approved and currently used in humans, created in order to selectively reduce sinus node function and to overcome the many side effects of similar pharmacological tools (ie, ?-blockers or calcium channel antagonists). The aim of our review is to evaluate the role and the safety of this molecule on CAD and CHF therapeutic strategies. PMID:24940047

Scicchitano, Pietro; Cortese, Francesca; Ricci, Gabriella; Carbonara, Santa; Moncelli, Michele; Iacoviello, Massimo; Cecere, Annagrazia; Gesualdo, Michele; Zito, Annapaola; Caldarola, Pasquale; Scrutinio, Domenico; Lagioia, Rocco; Riccioni, Graziano; Ciccone, Marco Matteo

2014-01-01

308

Ivabradine, coronary artery disease, and heart failure: beyond rhythm control  

PubMed Central

Elevated heart rate could negatively influence cardiovascular risk in the general population. It can induce and promote the atherosclerotic process by means of several mechanisms involving endothelial shear stress and biochemical activities. Furthermore, elevated heart rate can directly increase heart ischemic conditions because of its skill in unbalancing demand/supply of oxygen and decreasing the diastolic period. Thus, many pharmacological treatments have been proposed in order to reduce heart rate and ameliorate the cardiovascular risk profile of individuals, especially those suffering from coronary artery diseases (CAD) and chronic heart failure (CHF). Ivabradine is the first pure heart rate reductive drug approved and currently used in humans, created in order to selectively reduce sinus node function and to overcome the many side effects of similar pharmacological tools (ie, ?-blockers or calcium channel antagonists). The aim of our review is to evaluate the role and the safety of this molecule on CAD and CHF therapeutic strategies. PMID:24940047

Scicchitano, Pietro; Cortese, Francesca; Ricci, Gabriella; Carbonara, Santa; Moncelli, Michele; Iacoviello, Massimo; Cecere, Annagrazia; Gesualdo, Michele; Zito, Annapaola; Caldarola, Pasquale; Scrutinio, Domenico; Lagioia, Rocco; Riccioni, Graziano; Ciccone, Marco Matteo

2014-01-01

309

Diesel Exhaust Inhalation Increases Cardiac Output, Bradyarrhythmias, and Parasympathetic Tone in Aged Heart Failure–Prone Rats  

PubMed Central

Acute air pollutant inhalation is linked to adverse cardiac events and death, and hospitalizations for heart failure. Diesel engine exhaust (DE) is a major air pollutant suspected to exacerbate preexisting cardiac conditions, in part, through autonomic and electrophysiologic disturbance of normal cardiac function. To explore this putative mechanism, we examined cardiophysiologic responses to DE inhalation in a model of aged heart failure–prone rats without signs or symptoms of overt heart failure. We hypothesized that acute DE exposure would alter heart rhythm, cardiac electrophysiology, and ventricular performance and dimensions consistent with autonomic imbalance while increasing biochemical markers of toxicity. Spontaneously hypertensive heart failure rats (16 months) were exposed once to whole DE (4h, target PM2.5 concentration: 500 µg/m3) or filtered air. DE increased multiple heart rate variability (HRV) parameters during exposure. In the 4h after exposure, DE increased cardiac output, left ventricular volume (end diastolic and systolic), stroke volume, HRV, and atrioventricular block arrhythmias while increasing electrocardiographic measures of ventricular repolarization (i.e., ST and T amplitudes, ST area, T-peak to T-end duration). DE did not affect heart rate relative to air. Changes in HRV positively correlated with postexposure changes in bradyarrhythmia frequency, repolarization, and echocardiographic parameters. At 24h postexposure, DE-exposed rats had increased serum C-reactive protein and pulmonary eosinophils. This study demonstrates that cardiac effects of DE inhalation are likely to occur through changes in autonomic balance associated with modulation of cardiac electrophysiology and mechanical function and may offer insights into the adverse health effects of traffic-related air pollutants. PMID:23047911

Farraj, Aimen K.

2013-01-01

310

Heart failure and the emergency department: epidemiology, characteristics, and outcomes.  

PubMed

It is widely recognized that the impact of heart failure on society is enormous. The research community has responded, resulting in an ongoing period of rapid advancement across a wide range of fields. The pace of progress is perhaps most apparent in the barrage of new and revised terminology appearing in the heart failure literature. Although sometimes confusing, the complexity of nomenclature directly reflects a growing appreciation that the symptom complex previously labeled "heart failure" is actually a spectrum of complex multisystem pathologies. Accordingly, clinicians must adopt a more sophisticated and more effective approach to evaluation and treatment that is increasingly based on objective measurement of outcome-linked physiologic parameters rather than the subjectively described symptom constellations relied on previously. PMID:19026380

Green, Gary B

2009-01-01

311

Ventricular resynchronization: a promising therapy for heart failure.  

PubMed

Primarily a disease of the elderly, heart failure continues to be an ever-increasing health care problem given the growth in the number of individuals over age 65. Although there have been many advances in the pharmacologic management of heart failure, there continues to be a significant number of patients with persistent symptoms despite maximal therapy and it is likely that this group of patients will only continue to increase in number. Given this, significant research has gone into exploring new modalities, such as device therapies, to treat heart failure. Of these, ventricular resynchronization has emerged as one of the most promising. This review will examine the most important aspects of ventricular resynchronization therapy including: the significance of ventricular dyssynchrony, the role of traditional pacemakers, the effects on contractile function and reverse remodeling, and the currently accepted indications for resynchronization devices. Additionally, various aspects of completed and ongoing trials will be discussed. PMID:12502915

Kumar, Uday N; Saxon, Leslie A

2003-01-01

312

Subclinical Myocardial Disease in Heart Failure Detected by CMR  

PubMed Central

Noninvasive cardiac imaging plays a central role in the assessment of patients with heart failure at all stages of disease. Moreover, this role can be even more important for individuals with asymptomatic cardiac functional or structural abnormalities—subclinical myocardial disease — because they could have benefits from early interventions before the onset of clinical heart failure. In this sense, cardiac magnetic resonance offers not only precise global cardiac function and cardiac structure, but also more detailed regional function and tissue characterization by recent developing methods. In this section, some of the main methods available for subclinical myocardial disease detection are reviewed in terms of what they can provide and how they can improve heart failure assessment. PMID:25132911

Ohyama, Yoshiaki; Volpe, Gustavo J.

2014-01-01

313

A New Approach to Detect Congestive Heart Failure Using Short-Term Heart Rate Variability Measures  

PubMed Central

Heart rate variability (HRV) analysis has quantified the functioning of the autonomic regulation of the heart and heart's ability to respond. However, majority of studies on HRV report several differences between patients with congestive heart failure (CHF) and healthy subjects, such as time-domain, frequency domain and nonlinear HRV measures. In the paper, we mainly presented a new approach to detect congestive heart failure (CHF) based on combination support vector machine (SVM) and three nonstandard heart rate variability (HRV) measures (e.g. SUM_TD, SUM_FD and SUM_IE). The CHF classification model was presented by using SVM classifier with the combination SUM_TD and SUM_FD. In the analysis performed, we found that the CHF classification algorithm could obtain the best performance with the CHF classification accuracy, sensitivity and specificity of 100%, 100%, 100%, respectively. PMID:24747432

Wang, Qian; Zhou, GuangMin; Wang, Ying; Jiang, Qing

2014-01-01

314

What Causes a Broken Heart—Molecular Insights into Heart Failure  

Microsoft Academic Search

Our understanding of the molecular processes which regulate cardiac function has grown immeasurably in recent years. Even with the advent of ?-blockers, angiotensin inhibitors and calcium modulating agents, heart failure (HF) still remains a seriously debilitating and life-threatening condition. Here, we review the molecular changes which occur in the heart in response to increased load and the pathways which control

Seán P. Barry; Paul A. Townsend

2010-01-01

315

Mechanical support in acute and chronic heart failure  

Microsoft Academic Search

Heart failure (HF) is the leading cause of hospital admissions in the United States in people over the age of 65 years. Major\\u000a advancements in the medical therapy of HF, combined with automatic implantable cardioverterdefibrillators and cardiac resynchronization\\u000a therapy, have substantially reduced the mortality and morbidity of chronic HF, but mortality remains high, and the availability\\u000a of donor hearts for

Andreas Brieke; Joseph Cleveland Jr; JoAnn Lindenfeld

2008-01-01

316

Electrical modalities beyond pacing for the treatment of heart failure.  

PubMed

In this review, we report on electrical modalities, which do not fit the definition of pacemaker, but increase cardiac performance either by direct application to the heart (e.g., post-extrasystolic potentiation or non-excitatory stimulation) or indirectly through activation of the nervous system (e.g., vagal or sympathetic activation). The physiological background of the possible mechanisms of these electrical modalities and their potential application to treat heart failure are discussed. PMID:21104313

Cornelussen, Richard N; Splett, Vincent; Klepfer, Ruth Nicholson; Stegemann, Berthold; Kornet, Lilian; Prinzen, Frits W

2011-05-01

317

[Endotoxinemia and systemic inflammation in pathogenesis of chronic heart failure].  

PubMed

Large intestine microbiocenosis, levels of endotoxinemia, tumor necrosis factor alpha, C-reactive protein, sE-selectin, matrix metalloproteinase-9 (MMP) and tissue inhibitor of metalloproteinases-4 (TIMP) in chronic heart failure (CHF) patients was studied. Association of dysbiosis and endotoxinemia levels increase, systemic inflammation activation and an imbalance of MMP-TIMP system with progression of CHF has been shown. It can be a reason of a myocardium extracellular matrix structure disturbance and heart remodeling at CHF. PMID:22359933

Egorova, E N; Kalinkin, M N; Mazur, E S

2011-01-01

318

Mechanisms of Carvedilol Action in Human Congestive Heart Failure  

Microsoft Academic Search

The precise mechanism by which b-adrenoceptor blockers exert their beneficial actions in patients with heart failure remains unclear. Several possibilities have been proposed, including heart rate reduction, b2-adrenoceptor- mediated modulation of catecholamine release, antagonism of the receptor-mediated toxic actions of norepinephrine on the myocardium, and favorable effects on myocardial energetics. In the present study we evaluated the effect of 3

David M. Kaye; Leonie Johnston; Gautam Vaddadi; Hanspeter Brunner-LaRocca; Garry L. Jennings; Murray D. Esler

2010-01-01

319

Management of heart failure patients using telemedicine communication systems  

Microsoft Academic Search

Heart failure (HF) continues to place significant demands on health care resources because of the large number of hospital\\u000a admissions for HF, the growth of the elderly population with HF, and the improved survival of patients with chronic heart\\u000a disease who develop HF that requires continuous care. Because HF is best managed using a disease management approach, frequent\\u000a communication is

Abul Kashem; Robert C. Cross; William P. Santamore; Alfred A. Bove

2006-01-01

320

Low circulating androgens and mortality risk in heart failure  

Microsoft Academic Search

ObjectiveDeficiency of anabolic sex steroids is common in heart failure (HF). The pathophysiological implications of this phenomenon, however, have not been fully elucidated. This clinical study investigated the significance of low serum androgen levels in HF.DesignProspective cohort study.Patients and MethodsIn 191 consecutively recruited men with HF (mean age 64 years; New York Heart Association (NYHA) class I–IV 24%\\/35%\\/35%\\/6%) and reduced

G Güder; S Frantz; J Bauersachs; B Allolio; G Ertl; C E Angermann; S Störk

2009-01-01

321

UTA Urea Transporter Protein in Heart Increased Abundance During Uremia, Hypertension, and Heart Failure  

Microsoft Academic Search

Urea transporters have been cloned from kidney medulla (UT-A) and erythrocytes (UT-B). We determined whether UT-A proteins could be detected in heart and whether their abundance was altered by uremia or hypertension or in human heart failure. In normal rat heart, bands were detected at 56, 51, and 39 kDa. In uremic rats, the abundance of the 56-kDa protein increased

Rafael Duchesne; Janet D. Klein; Jeffrey B. Velotta; John J. Doran; Patricia Rouillard; Brian R. Roberts; Alicia A. McDonough; Jeff M. Sands

2010-01-01

322

Factors contributing to rehospitalization of elderly patients with heart failure.  

PubMed

This article describes factors contributing to rehospitalizations of elderly patients with heart failure. Advanced practice nurses' logs, study questionnaires, and medical record summaries from a recent clinical trial provided rich, descriptive information about a variety of social and behavioral factors surrounding rehospitalization in these medically fragile older people. Medication and dietary nonadherence were factors affecting symptom appearance and rehospitalization. Social and behavioral factors, such as the absence of strong social support or motivation, contributed to nonadherence. These results suggest that social and behavioral factors must be identified and addressed in an individualized manner to prevent recurrent hospitalizations for elderly patients with heart failure. PMID:9200021

Happ, M B; Naylor, M D; Roe-Prior, P

1997-07-01

323

Heart failure in which coronary spasms played an important role.  

PubMed

A 69-year-old woman was admitted for further examinations and treatment of chest pain. Emergency cardiac catheterization showed no significant stenosis on coronary angiograms; however, diffuse wall hypokinesis was observed on a left ventriculogram. After treating the patient's heart failure, cardiac catheterization was performed again. A spasm provocation test showed coronary spasms of the right and left coronary arteries. A right ventricular endomyocardial biopsy revealed denaturation and fibrosis of the myocardium under the endocardium, thus suggesting the presence of myocardial ischemia. This case highlights coronary spasms as a cause of heart failure. PMID:24492691

Oda, Shinsuke; Fujii, Yuichi; Takemoto, Hiroaki; Nomura, Shuichi; Nakayama, Hirofumi; Toyota, Yasushi; Nakamura, Hiroshi; Teragawa, Hiroki

2014-01-01

324

Why it Pays for Hospitals to Initiate a Heart Failure Disease Management Program  

Microsoft Academic Search

Heart failure is a clinical syndrome usually caused by structural changes in the heart. These changes result in varying degrees of symptomatic functional limitation, typically shortness of breath and fatigue. Heart failure is common, with a lifetime risk for its occurrence in a healthy 40-year-old of 20%. In the US, the cost of heart failure care is now estimated at

Mauricio Velez; Bethany Westerfeldt; Peter S. Rahko

2008-01-01

325

Pattern of arrhythmias among Nigerians with congestive heart failure  

PubMed Central

Background In patients with heart failure, death is often sudden due to life-threatening arrhythmias. This work was carried out to evaluate the pattern of arrhythmias in Nigerians with heart failure. Materials and methods Thirty subjects with congestive heart failure (CHF), 30 subjects with hypertensive heart disease, and 15 normal subjects with no obvious features of heart disease were evaluated with resting and 24-hour electrocardiographic monitoring and transthoracic echocardiography. Data were analyzed with one-way analysis of variance with post hoc Duncan’s analysis, Fisher’s exact test, and linear regression analysis using SPSS version 16. Results CHF subjects had more instances of supraventricular tachycardia (P=0.005), ventricular extrasystoles (P<0.001), bigeminy (P<0.001), trigeminy (P<0.001), couplets (P<0.001), triplets (P<0.001), and nonsustained ventricular tachycardia (VT) (P=0.003) than the other two control groups. They also showed a significantly longer VT duration (4.6±5.6 seconds) compared with the other groups (P<0.001). Linear regression analysis showed a significant direct relationship between VT and the maximum number of ventricular extrasystoles per hour (P=0.001). Conclusion Cardiac arrhythmias are common in subjects with CHF and are more frequent when compared with patients with hypertensive heart disease and normal subjects. PMID:25870514

Ajayi, Olufemi E; Abiodun, Olugbenga O; Akintomide, Anthony O; Adebayo, Rasaaq A; Ogunyemi, Suraj A; Balogun, Michael O; Bamikole, Olaniyi J; Ajibare, Adeola O; Ajayi, Adesuyi A

2015-01-01

326

Nitric Oxide Synthases in Heart Failure  

PubMed Central

Abstract Significance: The regulation of myocardial function by constitutive nitric oxide synthases (NOS) is important for the maintenance of myocardial Ca2+ homeostasis, relaxation and distensibility, and protection from arrhythmia and abnormal stress stimuli. However, sustained insults such as diabetes, hypertension, hemodynamic overload, and atrial fibrillation lead to dysfunctional NOS activity with superoxide produced instead of NO and worse pathophysiology. Recent Advances: Major strides in understanding the role of normal and abnormal constitutive NOS in the heart have revealed molecular targets by which NO modulates myocyte function and morphology, the role and nature of post-translational modifications of NOS, and factors controlling nitroso-redox balance. Localized and differential signaling from NOS1 (neuronal) versus NOS3 (endothelial) isoforms are being identified, as are methods to restore NOS function in heart disease. Critical Issues: Abnormal NOS signaling plays a key role in many cardiac disorders, while targeted modulation may potentially reverse this pathogenic source of oxidative stress. Future Directions: Improvements in the clinical translation of potent modulators of NOS function/dysfunction may ultimately provide a powerful new treatment for many hearts diseases that are fueled by nitroso-redox imbalance. Antioxid. Redox Signal. 18, 1078–1099. PMID:22871241

Carnicer, Ricardo; Crabtree, Mark J.; Sivakumaran, Vidhya

2013-01-01

327

Population Monitoring of Quality of Life for Congestive Heart Failure  

Microsoft Academic Search

Abstract The healthcare system has traditionally focused on treating disease at point of failure, such as life-saving surgery or intensive medical therapy. As demographics,shifts more to an aging population, management of health-relate d quality of life and life-restricting disease becomes,more necessary. Prominent,among,such diseases is congestive heart failure (CHF), which must be addressed as a major chronic health condition with its

Richard B. Berlin; Bruce R. Schatz

328

Mortality by Heart Failure and Ischemic Heart Disease in Brazil from 1996 to 2011  

PubMed Central

Background Circulatory system diseases are the first cause of death in Brazil. Objective To analyze the evolution of mortality caused by heart failure, by ischemic heart diseases and by ill-defined causes, as well as their possible relations, in Brazil and in the geoeconomic regions of the country (North, Northeast, Center-West, South and Southeast), from 1996 to 2011. Methods Data were obtained from DATASUS and death declaration records with codes I20 and I24 for acute ischemic diseases, I25 for chronic ischemic diseases, and I50 for heart failure, and codes in chapter XIII for ill-defined causes, according to geoeconomic regions of Brazil, from 1996 to 2011. Results Mortality rates due to heart failure declined in Brazil and its regions, except for the North and the Northeast. Mortality rates due to acute ischemic heart diseases increased in the North and Northeast regions, especially from 2005 on; they remained stable in the Center-West region; and decreased in the South and in the Southeast. Mortality due to chronic ischemic heart diseases decreased in Brazil and in the Center-West, South and Southeast regions, and had little variation in the North and in the Northeast. The highest mortality rates due to ill-defined causes occurred in the Northeast until 2005. Conclusions Mortality due to heart failure is decreasing in Brazil and in all of its geoeconomic regions. The temporal evolution of mortality caused by ischemic heart diseases was similar to that of heart failure. The decreasing number of deaths due to ill-defined causes may represent the improvement in the quality of information about mortality in Brazil. The evolution of acute ischemic heart diseases ranged according to regions, being possibly confused with the differential evolution of ill-defined causes. PMID:25004417

Gaui, Eduardo Nagib; de Oliveira, Gláucia Maria Moraes; Klein, Carlos Henrique

2014-01-01

329

Catheter ablation of atrial fibrillation in heart failure.  

PubMed

Atrial fibrillation in the presence of heart failure is an independent predictor of mortality and is associated with increased hospitalizations and worsening New York Heart Association functional class. Despite these associations, large-scale trials have not shown a benefit in rhythm restoration. However, further analysis of these trials showed that patients who remained in sinus rhythm did have improved survival rates. Studies to examine the efficacy of catheter ablation of atrial fibrillation were therefore conducted and reported efficacy rates ranging from 50% to 92% at maintaining sinus rhythm with associated improvements in left ventricular ejection fraction, quality of life, and New York Heart Association functional class. PMID:24054483

Kirubakaran, Senthil; O'Neill, Mark D

2013-10-01

330

Increased walking variability in elderly persons with congestive heart failure  

NASA Technical Reports Server (NTRS)

OBJECTIVES: To determine the effects of congestive heart failure on a person's ability to walk at a steady pace while ambulating at a self-determined rate. SETTING: Beth Israel Hospital, Boston, a primary and tertiary teaching hospital, and a social activity center for elderly adults living in the community. PARTICIPANTS: Eleven elderly subjects (aged 70-93 years) with well compensated congestive heart failure (NY Heart Association class I or II), seven elderly subjects (aged 70-79 years) without congestive heart failure, and 10 healthy young adult subjects (aged 20-30 years). MEASUREMENTS: Subjects walked for 8 minutes on level ground at their own selected walking rate. Footswitches were used to measure the time between steps. Step rate (steps/minute) and step rate variability were calculated for the entire walking period, for 30 seconds during the first minute of the walk, for 30 seconds during the last minute of the walk, and for the 30-second period when each subject's step rate variability was minimal. Group means and 5% and 95% confidence intervals were computed. MAIN RESULTS: All measures of walking variability were significantly increased in the elderly subjects with congestive heart failure, intermediate in the elderly controls, and lowest in the young subjects. There was no overlap between the three groups using the minimal 30-second variability (elderly CHF vs elderly controls: P < 0.001, elderly controls vs young: P < 0.001), and no overlap between elderly subjects with and without congestive heart failure when using the overall variability. For all four measures, there was no overlap in any of the confidence intervals, and all group means were significantly different (P < 0.05).

Hausdorff, J. M.; Forman, D. E.; Ladin, Z.; Goldberger, A. L.; Rigney, D. R.; Wei, J. Y.

1994-01-01

331

Similarities and Differences between the Pathogenesis and Pathophysiology of Diastolic and Systolic Heart Failure  

PubMed Central

Pathophysiology of heart failure has been considered to be a damaged state of systolic function of the heart followed by a state of low cardiac output that is, systolic heart failure. Even if systolic function is preserved, left ventricular filling in diastole can be impeded and resulted in elevation of filling pressure and symptoms of heart failure. This kind of heart failure is called diastolic heart failure. Nowadays, diastolic heart failure is referred to as heart failure with preserved ejection fraction (HFpEF), whereas systolic heart failure is referred to as heart failure with reduced ejection fraction (HFrEF). In this paper, the similarities and differences between the pathogenesis and pathophysiology of diastolic and systolic heart failure were reviewed. Although diastolic heart failure is a common condition of heart failure worldwide, its pathophysiology has not been sufficiently elucidated. This is thought to be the most significant reason for a lack of established treatment methods for diastolic heart failure. We hope to proceed with future studies on this topic. PMID:24459600

2013-01-01

332

Peritoneal ultrafiltration in patients with advanced decompensated heart failure.  

PubMed

The aim of the Best Practice guidelines on peritoneal ultrafiltration (UF) in patients with treatment-resistant advanced decompensated heart failure (TR-AHDF) is to achieve a common approach to the management of decompensated heart failure in those situations in which all conventional treatment options have been unsuccessful, and to stimulate a closer cooperation between nephrologists and cardiologists. The standardization of the case series of different centers would allow a better definition of the results published in the literature, without which they are nothing more than anecdotes. TR-AHDF is characterized by the persistence of severe symptoms even when all possible pharmacological and surgical options have been exhausted. These patients are often treated with methods that allow extracorporeal UF - slow continuous ultrafiltration (SCUF) and continuous renal replacement therapy (CRRT) - which have to be performed in hospital facilities. Peritoneal ultrafiltration (PUF) can be considered a treatment option in patients with TR-AHDF when, despite the fact that all treatment options have been used, patients meet the following criteria: • stage D decompensated heart failure (ACC/AHA classification); • INTERMACS level 4 decompensated heart failure; • INTERMACS frequent flyer profile; • chronic renal failure (estimated glomerular filtration rate <50 ml/min per 1.73 m2: KDOQI classification stage 3 chronic kidney disease); • no obvious contraindications to peritoneal UF. PUF treatment modes are derived from the treatment regimens proposed by various authors to obtain systemic UF in patients with severe decompensated heart failure, using manual and automated incremental peritoneal dialysis involving various glucose concentrations in addition to the single icodextrin exchange. These guidelines also identify a minimum set of tests and procedures for the follow-up phase, to be supplemented, according to the center's resources and policy, with other tests that are less routine or more complex also from a logistic/organizational standpoint, emphasizing the need for the patient's clinical and treatment program to involve both the nephrologist and the cardiologist. The pathophysiological aspects of a deterioration in kidney function in patients with decompensated heart failure are also considered, and the results of PUF in patients with decompensated heart failure reported in the various case series are reviewed. PMID:24307445

Iadarola, Gian Maria; Lusardi, Paola; La Milia, Vincenzo; Amici, Gianpaolo; Santarelli, Stefano; Virga, Giovambattista; Basile, Carlo; Bertoli, Silvio; Bonofiglio, Renzo; Del Rosso, Goffredo; Feriani, Mariano; Galli, Emilio; Gallieni, Maurizio; Gambaro, Giovanni; Sandrini, Massimo; Sisca, Sergio; Cancarini, Giovanni

2013-01-01

333

Novel Strategies for the Treatment of Heart Failure  

PubMed Central

Heart failure is a leading cause of morbidity and mortality with a prevalence that is rising throughout the world. Currently the pharmaceutical therapy of heart failure is mainly based on inhibition of the neurohumoral pathways that are activated secondary to the deterioration of cardiac function, and diuretics to alleviate the salt and water overload. With our increasing understanding of the pathophysiology of heart failure, it is now clear that the macroscopic and functional changes in the failing heart result from remodeling at the cellular, interstitial, and molecular levels. Therefore, emerging therapies propose to intervene directly in the remodeling process at the cellular and the molecular levels. Here, several experimental strategies that aim to correct the abnormalities in receptor and post-receptor-function, calcium handling, excitation and contraction coupling, signaling, and changes in the extra-cellular matrix in the failing heart will be discussed. These novel approaches, aiming to reverse the remodeling process at multiple levels, may appear on the clinical arena in the coming years. PMID:23908835

Kehat, Izhak

2012-01-01

334

Non-transplant surgical therapy options of heart failure.  

PubMed

Congestive heart failure (CHF) results from damage to the myocardium and has a broad etiology ranging from ischemic to non--ischemic etiology. It is one of the leading causes of cardiovascular morbidity and mortality and carries a 5--year mortality of 50%, estimated by WHO to represent 30% of deaths in the United States. Costs related to the care of patients with CHF have increased substantially over the past 2 decades partly owing to increased frequency of hospitalization, implantation of costly novel devices and, as the disease progresses, consideration for heart transplantation, mechanical circulatory support, and end--of--life care. CHF progression is accompanied by changes within the myocardium, collectively referred to as left ventricular remodeling, which can be categorized into changes in the cardiomyocytes and changes that occur in the volume and composition of the extracellular matrix. Since remodeling in heart failure is progressive and detrimental, the majority of treatment strategies are aimed at stopping or possibly reversing this process. Some successful methods include medical management, long--term or destination mechanical circulatory support, cardiac resychronization therapy, and biventricular pacemakers. During the last few decades, the management of heart failure has evolved tremendously with the introduction of new therapies and assist devices. Advances in mechanical support, left ventricular assist devices (LVADs), and total artificial heart have significantly reduced mortality in patients awaiting transplantation. This manuscript is an overview of non--transplant surgical options in the management of CHF. PMID:25283167

Neragi-Miandoab, S

2014-10-01

335

Non-transplant surgical therapy options of heart failure.  

PubMed

Congestive heart failure (CHF) results from damage to the myocardium and has a broad etiology ranging from ischemic to non-ischemic etiology. It is one of the leading causes of cardiovascular morbidity and mortality and carries a 5-year mortality of 50%, estimated by WHO to represent 30% of deaths in the United States. Costs related to the care of patients with CHF have increased substantially over the past 2 decades partly owing to increased frequency of hospitalization, implantation of costly novel devices and, as the disease progresses, consideration for heart transplantation, mechanical circulatory support, and end-of-life care. CHF progression is accompanied by changes within the myocardium, collectively referred to as left ventricular remodeling, which can be categorized into changes in the cardiomyocytes and changes that occur in the volume and composition of the extracellular matrix. Since remodeling in heart failure is progressive and detrimental, the majority of treatment strategies are aimed at stopping or possibly reversing this process. Some successful methods include medical management, long-term or destination mechanical circulatory support, cardiac resychronization therapy, and biventricular pacemakers. During the last few decades, the management of heart failure has evolved tremendously with the introduction of new therapies and assist devices. Advances in mechanical support, left ventricular assist devices (LVADs), and total artificial heart have significantly reduced mortality in patients awaiting transplantation. This manuscript is an overview of non-transplant surgical options in the management of CHF. PMID:25420501

Neragi-Miandoab, S

2014-12-01

336

Palliative care services for patients with heart failure  

Microsoft Academic Search

As the broader needs of patients with heart failure become more widely recog- nised (see Chapter 1), so further challenges arise - how best to provide the supportive and palliative care that is so clearly needed, and how should the specialist palliative care (SPC) services be involved? This chapter will discuss some of the barriers to SPC involvement, and offers

Miriam Johnson

337

Depression in hospitalized older patients with congestive heart failure  

Microsoft Academic Search

The objectives of this study were to evamine the prevalence of depression in hospitalized, medically ill, older patients with and without congestive heart failure (CHF), and examine correlates, course, predictors of outcome, and treatment of depression in patients with CHF. A consecutive sample of 542 patients age 60 or over admitted to inpatient services of Duke University Medical Center were

Horold G. Koenig

1998-01-01

338

Noncompliance with congestive heart failure therapy in the elderly  

Microsoft Academic Search

BACKGROUND: Noncompliance with long-term medication regimens, such as those employed in the treatment of congestive heart failure (CHF), has been found to be approximately 50%. However, no evaluation has been performed on a population-based cohort of elderly patients beginning the use of digoxin and followed up longitudinally for an extended observation period. METHODS: To study patterns of medication compliance, we

Mark Monane; Rhonda L. Bohn; Jerry H. Gurwitz; Robert J. Glynn; Jerry Avorn

1994-01-01

339

QRS duration and mortality in patients with congestive heart failure  

Microsoft Academic Search

Background and Objectives It has been suggested that prolongation of the QRS duration (>120 ms) is an independent risk factor for mortality in patients with cardiomyopathy. The purpose of this study was to examine the association between QRS duration and survival in patients with heart failure. Methods We performed a retrospective analysis to examine the association between QRS prolongation (?120

Stephen Iuliano; Susan G. Fisher; Pamela E. Karasik; Ross D. Fletcher; Steven N. Singh

2002-01-01

340

Teaching Congestive Heart Failure to Doctor of Pharmacy Students.  

ERIC Educational Resources Information Center

This paper summarizes a lecture given to pharmacy students that emphasizes the pathophysiologic mechanisms causing congestive heart failure and the effects of drugs on these mechanisms. The approach shows the importance of drug therapy in this disorder and how this knowledge can improve patient care. An appendix provides a case study. (GLR)

Parker, Robert B.

1992-01-01

341

Family caregiving and congestive heart failure. Review and analysis  

Microsoft Academic Search

Background: There is increasing evidence that discharge planning and post-discharge support for CHF patients can contribute greatly to the medical management of heart failure (CHF) in the community and that the quality of the CHF patient's close personal relationships can influence outcome in CHF. However, there has been little research on the impact of CHF on the family or the

Gerard J. Molloy; Derek W. Johnston; Miles D. Witham

342

Body Fluid Distribution in Elderly Subjects with Congestive Heart Failure  

Microsoft Academic Search

The aims of this study were to investigate body fluid changes in elderly patients suffering from congestive heart failure (CHF) and to identify the fluid measurement that best characterizes fluid overload states in CHF patients by comparison with normal hydration in the elderly. In a case-controlled experimental design, 72 elderly subjects (65-98 yr), 38 healthy and 34 with CHF, were

Giuseppe Sergi; Lucia Lupoli; Stefania Volpato; Roberta Bertani; Alessandra Coin; Egle Perissinotto; Irene Calliari; Emine Meral Inelmen; Luca Busetto; Giuliano Enzi

343

Heart Failure in Diabetes mellitus: Clinical Features and Prognostic Implications  

Microsoft Academic Search

We defined the prevalence and impact on survival of clinical bedside variables in 385 patients with symptomatic congestive heart failure (CHF), of whom there were 176 with and 209 without diabetes mellitus. Patients were consecutively hospitalized and admitted for various acute conditions. Following discharge all-cause mortality was recorded. Prevalence and association of various variables with mortality were statistically analyzed. Prevailing

Oleg Gorelik; Dorit Almoznino-Sarafian; Irena Alon; Miriam Shteinshnaider; Shulamit Chachashvily; Irma Tzur; David Modai; Natan Cohen

2005-01-01

344

[A mobile team caring for patients with heart failure].  

PubMed

The prevalence of heart failure in the population is increasing. The frequency of re-hospitalisation as well as mortality remains high. Early medical care combining modern treatments and therapeutic education can help to improve the patient's prognosis and comfort. A transversal mobile team, coordinated by a specialist nurse, contributes to this improvement. PMID:23697061

Charles, Jacques

2013-04-01

345

A Novel Telemedicine System for Monitoring Congestive Heart Failure Patients  

Microsoft Academic Search

Summary form only given. The aim of this project was to build a portable system designed to monitor on a daily basis the severity of pulmonary edema in chronic heart failure (CHF) patients. As for today, the current methods for monitoring pulmonary edema severity in these patients are inaccurate (weighing), or involve ionizing radiation (CT imaging). The proposed system is

M. M. Radai; H. Krief; T. Engelman; S. Abboud

2006-01-01

346

Chronic heart failure consumer information: an exploratory study.  

PubMed

The purpose of this project was to explore how persons with chronic heart failure (CHF) obtain and use health information about their condition and how health literacy might have an impact. We interviewed 28 patients with CHF regarding their quality of life, chronic illness care, literacy level, and knowledge about self-management care for CHF. PMID:18998896

Boren, Suzanne Austin; Wakefield, Bonnie J; Dohrmann, Mary

2008-01-01

347

Gender and risk of adverse outcomes in heart failure  

Microsoft Academic Search

Congestive heart failure (CHF) is the leading cause of hospitalization in the elderly, and these patients are at high risk for subsequent hospitalization. Whether gender affects the risk of rehospitalization in patients who have CHF is less well understood. We studied a random sample of 1,700 adults who had been hospitalized with CHF (from July 1, 1999 to June 30,

Wendy Y. Lee; Angela M. Capra; Nancy G. Jensvold; Jerry H. Gurwitz; Alan S. Go

2004-01-01

348

Atrial fibrillation in heart failure: the chicken or the egg?  

Microsoft Academic Search

Atrial fibrillation (AF) and heart failure (HF) are the emerging epidemics of cardiovascular disease in the new millennium. Both are responsible for considerable morbidity and mortality and health budget expenditure. The advent of catheter ablation for patients with AF has provided important new insights into the relative contribution of AF to left ventricular dysfunction. The aim of this review is

R Balasubramaniam; P M Kistler

2009-01-01

349

Outcomes in heart failure patients with preserved ejection fraction  

Microsoft Academic Search

ObjectivesWe evaluated the six-month clinical trajectory of patients hospitalized for heart failure (HF) with preserved ejection fraction (EF), as the natural history of this condition has not been well established. We compared mortality, hospital readmission, and changes in functional status in patients with preserved versus depressed EF.

Grace L Smith; Frederick A Masoudi; Viola Vaccarino; Martha J Radford; Harlan M Krumholz

2003-01-01

350

Gene Therapy Targets in Heart Failure: The Path to Translation  

Microsoft Academic Search

Heart failure (HF) is the common end point of cardiac diseases. Despite the optimization of therapeutic strategies and the consequent overall reduction in HF-related mortality, the key underlying intracellular signal transduction abnormalities have not been addressed directly. In this regard, the gaps in modern HF therapy include derangement of ?-adrenergic receptor (?-AR) signaling, Ca2+ disbalances, cardiac myocyte death, diastolic dysfunction,

P W J Raake; H Tscheschner; J Reinkober; J Ritterhoff; H A Katus; W J Koch; P Most

2011-01-01

351

Irbesartan in patients with heart failure and preserved ejection fraction  

Microsoft Academic Search

Introduction: About 50% of patients have symptomatic heart failure (HF) with normal to near-normal ejection fraction (EF), a condition often referred to as HF with preserved EF (HFPEF). Prevalence of HFPEF increases with age, particularly among older women. Trial data on optimal treatment strategies for HFPEF are limited. Basic science studies have demonstrated that plasma renin activity is enhanced in

Daniel Forman; J. Michael Gaziano

2009-01-01

352

ST2 and Multimarker Testing in Acute Decompensated Heart Failure.  

PubMed

Most data on heart failure biomarkers have been derived from patient cohorts with chronic disease. However, risk prediction in patients admitted with acute decompensated heart failure (ADHF) remains a challenge. ADHF is not a single disease: it presents in various manners, and different causes may underlie ADHF, which may be reflected by different biomarkers. Soluble suppression of tumorigenicity 2 (ST2) has been shown to be a strong independent predictor of short-, mid-, and long-term outcome in ADHF. Furthermore, combining biomarkers may help further improve the prognostic power of ST2. The ProBNP Investigation of Dyspnea in the Emergency Department study showed that elevated plasma levels of ST2 together with elevated levels of 4 other biomarkers have clear incremental values to predict outcome in ADHF. The Multinational Observational Cohort on Acute Heart Failure study is an international collaborative network that recruited 5,306 patients hospitalized for ADHF that demonstrated that ST2 and midregional pro-adrenomedulin had independently strong value to predict 30-day and 1-year outcome in patients with ADHF. The Multinational Observational Cohort on Acute Heart Failure study also showed that C-reactive protein plus ST2 better classified risk in patients with ADHFs than ST2 alone. Combining biomarkers for risk prediction or risk stratification might have clinical and more importantly pathophysiological meaning. PMID:25697917

Mebazaa, Alexandre; Di Somma, Salvatore; Maisel, Alan S; Bayes-Genis, Antoni

2015-04-01

353

Diuretic resistance predicts mortality in patients with advanced heart failure  

Microsoft Academic Search

Background In patients with chronic heart failure (CHF), diuretic requirements increase as the disease progresses. Because diuretic resistance can be overcome with escalating doses, the evaluation of CHF severity and prognosis may be incomplete without considering the intensity of therapy. Methods The prognostic importance of diuretic resistance (as evidenced by a high-dose requirement) was retrospectively evaluated in 1153 patients with

Gerald W. Neuberg; Alan B. Miller; Chris M. O'Connor; Robert N. Belkin; Peter E. Carson; Anne B. Cropp; David J. Frid; Regina G. Nye; Milton L. Pressler; John H. Wertheimer; Milton Packer

2002-01-01

354

Inotropes do not increase mortality in advanced heart failure  

PubMed Central

Inotrope use is one of the most controversial topics in the management of heart failure. While the heart failure community utilizes them and recognizes the state of inotrope dependency, retrospective analyses and registry data have overwhelmingly suggested high mortality, which is logically to be expected given the advanced disease states of those requiring their use. Currently, there is a relative paucity of randomized control trials due to the ethical dilemma of creating control groups by withholding inotropes from patients who require them. Nonetheless, results of such trials have been mixed. Many were also performed with agents no longer in use, on patients without an indication for inotropes, or at a time before automatic cardio-defibrillators were recommended for primary prevention. Thus, their results may not be generalizable to current clinical practice. In this review, we discuss current indications for inotrope use, specifically dobutamine and milrinone, depicting their mechanisms of action, delineating their patterns of use in clinical practice, defining the state of inotrope dependency, and ultimately examining the literature to ascertain whether evidence is sufficient to support the current view that these agents increase mortality in patients with heart failure. Our conclusion is that the evidence is insufficient to link inotropes and increased mortality in low output heart failure. PMID:24899821

Guglin, Maya; Kaufman, Marc

2014-01-01

355

Statins stimulate atherosclerosis and heart failure: pharmacological mechanisms.  

PubMed

In contrast to the current belief that cholesterol reduction with statins decreases atherosclerosis, we present a perspective that statins may be causative in coronary artery calcification and can function as mitochondrial toxins that impair muscle function in the heart and blood vessels through the depletion of coenzyme Q10 and 'heme A', and thereby ATP generation. Statins inhibit the synthesis of vitamin K2, the cofactor for matrix Gla-protein activation, which in turn protects arteries from calcification. Statins inhibit the biosynthesis of selenium containing proteins, one of which is glutathione peroxidase serving to suppress peroxidative stress. An impairment of selenoprotein biosynthesis may be a factor in congestive heart failure, reminiscent of the dilated cardiomyopathies seen with selenium deficiency. Thus, the epidemic of heart failure and atherosclerosis that plagues the modern world may paradoxically be aggravated by the pervasive use of statin drugs. We propose that current statin treatment guidelines be critically reevaluated. PMID:25655639

Okuyama, Harumi; Langsjoen, Peter H; Hamazaki, Tomohito; Ogushi, Yoichi; Hama, Rokuro; Kobayashi, Tetsuyuki; Uchino, Hajime

2015-03-01

356

The duality of chemokines in heart failure.  

PubMed

The failing human heart is a bustling network of intra- and inter-cellular signals and related processes attempting to coordinate a repair mechanism for the injured or diseased myocardium. While our understanding of signaling by mode of cytokines is well understood on a systemic level, we are only now coming to elucidate the role of cytokines in cardiac self-regulation. An increasing number of studies are showing now that cardiomyocytes themselves have not only the ability but also the mandate to produce signals, and play direct roles in how these signals are interpreted. One of the families of cytokines employed by distressed cardiac tissue are chemokines. By regulating the movement of pro-inflammatory cell types to sites of injury, we see now how the myocardium responds to stress. Herein we review the participation of these inflammatory mediators and explore the delicate balance between their protective roles and damaging functions. PMID:25764001

Jarrah, Andrew A; Tarzami, Sima T

2015-04-01

357

Physician-Determined Worsening Heart Failure: A Novel Definition for Early Worsening Heart Failure in Patients Hospitalized for Acute Heart Failure – Association with Signs and Symptoms, Hospitalization Duration, and 60Day Outcomes  

Microsoft Academic Search

Objectives: To evaluate physician-determined worsening heart failure (PD-WHF) in patients admitted with acute heart failure (AHF). Methods: The PROTECT pilot study evaluated rolofylline, an adenosine A1 receptor antagonist, versus placebo in patients with AHF and renal impairment. Signs and symptoms of heart failure (HF) and diuretic administration were prospectively recorded daily for 7 days and patients were followed for 60

Gad Cotter; Marco Metra; Beth Davison Weatherley; Howard C. Dittrich; Barry M. Massie; Piotr Ponikowski; Daniel M. Bloomfield; Christopher M. O’Connor

2010-01-01

358

Angiopoietin-2 in Adults with Congenital Heart Disease and Heart Failure  

PubMed Central

Background Chronic heart failure is an important cause for morbidity and mortality in adults with congenital heart disease (ACHD). While NT-proBNP is an established biomarker for heart failure of non-congenital origin, its application in ACHD has limitations. The angiogenic factors Angiopoietin-1 and -2 (Ang-1, Ang-2), vascular endothelial growth factor (VEGF), and soluble receptor tyrosine kinase of the Tie family (sTie2) correlate with disease severity in heart failure of non-congenital origin. Their role in ACHD has not been studied. Methods In 91 patients Ang-2 and NT-proBNP were measured and related to New York Heart Association class, systemic ventricular function and parameters of cardiopulmonary exercise testing. Ang-1, VEGF, and sTie2 were also measured. Results Ang-2 correlates with NYHA class and ventricular dysfunction comparable to NT-proBNP. Further, Ang-2 showed a good correlation with parameters of cardiopulmonary exercise testing. Both, Ang-2 and NT-proBNP identified patients with severely limited cardiopulmonary exercise capacity. Additionally, Ang-2 is elevated in patients with a single ventricle physiology in contrast to NT-proBNP. VEGF, Ang-1, and sTie2 were not correlated with any clinical parameter. Conclusion The performance of Ang-2 as a biomarker for heart failure in ACHD is comparable to NT-proBNP. Its significant elevation in patients with single ventricle physiology indicates potential in this patient group and warrants further studies. PMID:23826161

Kümpers, Philipp; Denecke, Agnieszka; Westhoff-Bleck, Mechthild; Schieffer, Bernhard; Bauersachs, Johann; Kielstein, Jan T.; Tutarel, Oktay

2013-01-01

359

Drug Does Not Improve Set of Cardiovascular Outcomes for Diastolic Heart Failure  

MedlinePLUS

... not improve set of cardiovascular outcomes for diastolic heart failure NIH-supported study finds drug does appear to reduce hospitalizations for diastolic heart failure A drug that blocks the action of a ...

360

Quality of Life After Bypass Surgery in Patients with Chest Pain and Heart Failure  

MedlinePLUS

... Bypass Surgery in Patients With Chest Pain and Heart Failure The full report is titled “Quality-of-Life ... in patients who have coronary artery disease plus heart failure, which can cause additional symptoms, such as shortness ...

361

Following Your Heart Failure Treatment Plan and Dealing with Your Symptoms  

MedlinePLUS

... it in a convenient spot. Emergency Symptoms of Heart Failure Call 911 for emergency help, if you have: ... breath. Fainted or passed out. Urgent Symptoms of Heart Failure Call your doctor immediately, if you have any ...

362

Heart Failure Patients Who Struggle with Daily Tasks At Greatest Risk  

MedlinePLUS

... on this page, please enable JavaScript. Heart Failure Patients Who Struggle With Daily Tasks at Greatest Risk ... WEDNESDAY, Feb. 25, 2015 (HealthDay News) -- Heart failure patients who struggle to perform daily tasks are at ...

363

High Blood Sugar in Heart Failure Patients May Point to Risk of Early Death  

MedlinePLUS

... enable JavaScript. High Blood Sugar in Heart Failure Patients May Point to Risk of Early Death Even ... Checking the blood sugar levels of emergency department patients with heart failure can identify those at risk ...

364

ST2 and Patient Prognosis in Chronic Heart Failure.  

PubMed

Biomarkers of cardiovascular diseases are indispensable tools for diagnosis and prognosis, and the use of several biomarkers is now considered the standard of care. New markers continue to be developed, but few prove to be substantially better than established markers. Suppression of tumorigenicity 2 (ST2) is a marker of cardiomyocyte stress and fibrosis that provides incremental value to natriuretic peptides for risk stratification of patients with a wide spectrum of cardiovascular diseases. On the basis of all available data, the 2013 American College of Cardiology and American Heart Association guidelines now recommend measurement of ST2 for additive risk stratification in patients with acute or chronic ambulatory heart failure (HF). This report provides an up-to-date overview of the clinical studies that led to the endorsement of ST2 as a cardiovascular prognostic marker in chronic HF. The presented data suggest that the addition of ST2 to a model that includes established mortality risk factors, including natriuretic peptides, substantially improves the risk stratification for death and HF hospitalization in patients with HF. ST2's prognostic value remains strong even in the subset of patients with renal insufficiency and is superior to other remodeling-fibrosis biomarkers currently being evaluated. In conclusion, these results have been repeatedly validated; thus, ST2 could be rapidly incorporated into clinical practice for risk prediction. Indeed, the body of evidence supporting the use of ST2 in chronic HF stratification continues to grow, with consistent data from cohorts around the world in single-center (Barcelona, Brussels, and San Diego cohorts) and multicenter (Penn Heart Failure Study [PHFS] and Muerte Subita en Insuficiencia Cardiac [MUSIC]) studies and in post hoc studies from clinical trials (Prospective Randomized Amlodipine Survival Evaluation 2 [PRAISE-2], Heart Failure: A Controlled Trial Investigating Outcomes of Exercise Training [HF-ACTION], and Controlled Rosuvastatin Multinational Trial in Heart Failure [CORONA]). PMID:25665758

Bayes-Genis, Antoni; Zhang, Yuhui; Ky, Bonnie

2015-04-01

365

Electronically monitored medication adherence predicts hospitalization in heart failure patients  

PubMed Central

Background Hospitalization contributes enormously to health care costs associated with heart failure. Many investigators have attempted to predict hospitalization in these patients. None of these models has been highly effective in prediction, suggesting that important risk factors remain unidentified. Purpose To assess prospectively collected medication adherence, objectively measured by the Medication Event Monitoring System, as a predictor of hospitalization in heart failure patients. Materials and methods We used recently developed adaptive modeling methods to describe patterns of medication adherence in a sample of heart failure patients, and tested the hypothesis that poor medication adherence as determined by adaptive methods was a significant predictor of hospitalization within 6 months. Results Medication adherence was the best predictor of hospitalization. Besides two dimensions of poor adherence (adherence pattern type and low percentage of prescribed doses taken), four other single factors predicted hospitalization: low hemoglobin, depressed ejection fraction, New York Heart Association class IV, and 12 or more medications taken daily. Seven interactions increased the predictive capability of the model: 1) pattern of poor adherence type and lower score on the Letter–Number Sequencing test, a measure of short-term memory; 2) higher number of comorbid conditions and higher number of daily medications; 3) higher blood urea nitrogen and lower percentage of prescribed doses taken; 4) lower hemoglobin and much worse perceived health compared to last year; 5) older age and lower score on the Telephone Interview of Cognitive Status; 6) higher body mass index and lower hemoglobin; and 7) lower ejection fraction and higher fatigue. Patients with none of these seven interactions had a hospitalization rate of 9.7%. For those with five of these interaction risk factors, 100% were hospitalized. The C-index (the area under the receiver-operating characteristics [ROC] curve) for the model based on the seven interactions was 0.83, indicating excellent discrimination. Conclusion Medication adherence adds important new information to the list of variables previously shown to predict hospitalization in adults with heart failure. PMID:24353407

Riegel, Barbara; Knafl, George J

2014-01-01

366

Bio-Artificial Heart as Ultimate Treatment of End-Stage Heart Failure  

PubMed Central

End-stage heart failure is a major health problem, but implementation of guidelines and optimizing medical therapy for this devastating disease should decrease mortality. If optimal conservative therapy is no longer sufficient, a mechanical support system may be required as final destination therapy or as bridge-to-transplant. Since the first heart transplantation in 1967, this therapy has become the criterion standard for end-stage heart failure, but is limited due to organ shortage. Tissue engineering could help overcome this limitation and provide regeneration, remodeling, and growth potential. This so-called bio-artificial heart would be available, created by a decellularized extracellular matrix and seeded with in vitro proliferated autologous cardiovascular cells. Results of the first experimental studies have been promising, but numerous challenges must be met before this procedure will be available. PMID:25321347

Smit, Francis E.; Dohmen, Pascal M.

2014-01-01

367

Bio-artificial heart as ultimate treatment of end-stage heart failure.  

PubMed

End-stage heart failure is a major health problem, but implementation of guidelines and optimizing medical therapy for this devastating disease should decrease mortality. If optimal conservative therapy is no longer sufficient, a mechanical support system may be required as final destination therapy or as bridge-to-transplant. Since the first heart transplantation in 1967, this therapy has become the criterion standard for end-stage heart failure, but is limited due to organ shortage. Tissue engineering could help overcome this limitation and provide regeneration, remodeling, and growth potential. This so-called bio-artificial heart would be available, created by a decellularized extracellular matrix and seeded with in vitro proliferated autologous cardiovascular cells. Results of the first experimental studies have been promising, but numerous challenges must be met before this procedure will be available. PMID:25321347

Smit, Francis E; Dohmen, Pascal M

2014-01-01

368

Mechanisms of bioprosthetic heart valve failure: Fatigue causes collagen denaturation and glycosaminoglycan loss  

E-print Network

Mechanisms of bioprosthetic heart valve failure: Fatigue causes collagen denaturation heart valve (BPHV) degeneration, characterized by extracellular matrix deterioration, remod- eling; FTIR spectroscopy; in vitro ac- celerated fatigue; bioprosthetic heart valve degeneration

Zand, Robert

369

Discrimination power of long-term heart rate variability measures for chronic heart failure detection  

Microsoft Academic Search

The aim of this study was to investigate the discrimination power of standard long-term heart rate variability (HRV) measures\\u000a for the diagnosis of chronic heart failure (CHF). The authors performed a retrospective analysis on four public Holter databases,\\u000a analyzing the data of 72 normal subjects and 44 patients suffering from CHF. To assess the discrimination power of HRV measures,\\u000a an

Paolo Melillo; Roberta Fusco; Mario Sansone; Marcello Bracale; Leandro Pecchia

2011-01-01

370

Effect of behavioral management on quality of life in mild heart failure: a randomized controlled trial  

Microsoft Academic Search

There has been a lack of research regarding nonpharmacologic interventions in heart failure. The objective was to determine the effect of behavioral management on health related quality of life (HRQL) in patients with heart failure. Participants (N = 116) were randomly assigned to one of two groups: usual care for heart failure (n = 58) and the 15-week behavioral management

Martha Shively; Mary Kodiath; Tom L. Smith; Ann Kelly; Patricia Bone; Lizz Fetterly; Nancy Gardetto; Ralph Shabetai; Samuel Bozzette; Kathleen Dracup

2005-01-01

371

Telehealth for patients with heart failure: A comparison between telehealth systems  

E-print Network

Telehealth for patients with heart failure: A comparison between telehealth systems C. Varon1,2 , J by the patients. Here, patients suffering from heart failure were studied, and two telehealth platforms were evaluated, namely Docobo and Philips. Introduction Heart failure (HF) is considered one of the most common

372

Myocardial Structure and Function Differ in Systolic and Diastolic Heart Failure  

E-print Network

Myocardial Structure and Function Differ in Systolic and Diastolic Heart Failure Loek van Heerebeek, MD, PhD Background--To support the clinical distinction between systolic heart failure (SHF) and diastolic heart failure (DHF), left ventricular (LV) myocardial structure and function were compared in LV

Linke, Wolfgang A.

373

Appl Physiol Nutr Metab. Author manuscript Exercise training, energy metabolism, and heart failure  

E-print Network

, and heart failure Ventura-Clapier Ren eé * Signalisation et physiopathologie cardiaque INSERM : U769, IFR141 in many pathophysiological processes among which heart failure. Because endurance training improves recognized as a beneficial practice for heart failure patients. The mechanisms involved in the beneficial

Paris-Sud XI, Université de

374

Induction of high STAT1 expression in transgenic mice with LQTS and heart failure  

E-print Network

Induction of high STAT1 expression in transgenic mice with LQTS and heart failure Ling Wu a and heart failure. Ó 2007 Elsevier Inc. All rights reserved. Keywords: Cardiac sodium channel gene SCN5A cardiomyopathy and heart failure; STAT1 The long QT syndrome (LQTS) is characterized by pro- longation of the QT

375

Lifestyle modification with diet and exercise in obese patients with heart failure - A pilot study  

Technology Transfer Automated Retrieval System (TEKTRAN)

There is a paucity of data regarding intentional weight loss in obese heart failure patients. This study sought to ascertain the safety and effectiveness of a lifestyle modification program in patients with systolic heart failure and metabolic syndrome. Patients (n=20) with systolic heart failure (e...

376

Decreased T-Cell Responses to Influenza Vaccination in Patients with Heart Failure  

E-print Network

Decreased T-Cell Responses to Influenza Vaccination in Patients with Heart Failure Orly Vardeny vaccination in patients with chronic heart failure (CHF) are less vigorous than the responses of healthy strategies for influenza vaccination. Key Words: chronic heart failure, CHF, influenza vaccination, immune

Wisconsin at Madison, University of

377

Web-Based Visualisations Supporting Rehabilitation of Heart Failure Patients by Promoting Behavioural Change  

E-print Network

Web-Based Visualisations Supporting Rehabilitation of Heart Failure Patients by Promoting.cameron@auckland.ac.nz, emor029@aucklanduni.ac.nz, l.jago@auckland.ac.nz Abstract Heart failure is a major cause of death the responses of M¯aori individuals with heart failure and their wh¯anau to a patient education intervention

Sun, Jing

378

Evidence for endothelin-1-mediated vasoconstriction in severe chronic heart failure  

Microsoft Academic Search

SummaryHeart failure is commonly associated with high plasma concentrations of endothelin-1, a powerful vasoconstrictor produced by endothelium. The role of endogenously released endothelin-1 in the maintenance of vascular tone in chronic heart failure was assessed by acute administration of an endothelin receptor antagonist, bosentan. 24 patients with chronic heart failure received randomly and double blind two intravenous infusions of either

W Kiowski; J Kim; E Oechslin; G Sütsch; P Hunziker; P Müller; O Bertel; R Schmitt; R Jones

1995-01-01

379

Predicting Outcomes of Hospitalization for Heart Failure Using Logistic Regression and Knowledge Discovery Methods  

E-print Network

Predicting Outcomes of Hospitalization for Heart Failure Using Logistic Regression and Knowledge The purpose of this study is to determine the best prediction of heart failure outcomes, resulting from two with supervised learning/data mining. Heart failure was chosen for this study as it exhibits higher prevalence

Street, Nick

380

Blood Signature of Pre-Heart Failure: A Microarrays Fatima Smih1  

E-print Network

Blood Signature of Pre-Heart Failure: A Microarrays Study Fatima Smih1 *, Franck Desmoulin1, Cardiology Department, Toulouse, France Abstract Background: The preclinical stage of systolic heart failure, Harmancey R, et al. (2011) Blood Signature of Pre-Heart Failure: A Microarrays Study. PLoS ONE 6(6): e20414

Boyer, Edmond

381

Original article Increased late sodium current in myocytes from a canine heart failure  

E-print Network

Original article Increased late sodium current in myocytes from a canine heart failure model December 2004 Abstract Electrophysiological remodeling of ion channels in heart failure causes action-regulation of potassium currents is well-known, but a role for Na current (INa) in heart failure is less well established

Kamp, Tim

382

Soluble Epoxide Hydrolase Inhibitors and Heart Failure Jun-Yan Liu,3  

E-print Network

REVIEW Soluble Epoxide Hydrolase Inhibitors and Heart Failure Hong Qiu,1 Ning Li,1 Jun-Yan Liu,3; Epoxyeicosatrienoic acids (EETs); Heart failure; Soluble epoxide hydrolase inhibitors. Correspondence Nipavan of death in the West- ern societies. Heart failure (HF) is due primarily to progressive myocardial dys

Hammock, Bruce D.

383

Edinburgh Research Explorer Global association of air pollution and heart failure  

E-print Network

Edinburgh Research Explorer Global association of air pollution and heart failure Citation & Mills, NL 2013, 'Global association of air pollution and heart failure: a systematic review and meta-6736(13)60898-3 1 Global association of air pollution and heart failure: a systematic review and meta-analysis Anoop

Edinburgh, University of

384

B-Type Natriuretic Peptide: Spectrum of Application. Nesiritide (Recombinant BNP) for Heart Failure  

Microsoft Academic Search

The therapeutic goals for patients hospitalized with acutely decompensated heart failure are to reverse acute hemodynamic abnormalities, relieve symptoms, and to initiate heart failure therapies which will decrease disease progression and improve long-term survival. Nesiritide (recombinant B-type natriuretic peptide) is the first in a new class of therapeutic agents for the treatment of heart failure and has been demonstrated to

Gregg C. Fonarow

2003-01-01

385

Endothelium-ameliorating effects of statin therapy and coenzyme Q 10 reductions in chronic heart failure  

Microsoft Academic Search

Although not currently indicated for chronic heart failure (CHF), statins have been associated with improved outcome in retrospective analysis. However, statin therapy reduces plasma levels of coenzyme Q10 (ubiquinone), which may have adverse effects on heart failure states. We hypothesized that atorvastatin treatment improves endothelial function in patients with chronic heart failure independent of LDL-cholesterol alterations. Furthermore, we assessed how

Christopher H. Strey; Joanna M. Young; Sarah L. Molyneux; Peter M. George; Christopher M. Florkowski; Russell S. Scott; Christopher M. Frampton

2005-01-01

386

Randomised trial of telephone intervention in chronic heart failure: DIAL trial  

Microsoft Academic Search

Objective To determine whether a centralised telephone intervention reduces the incidence of death or admissions for worsening heart failure in outpatients with chronic heart failure. Design Multicentre randomised controlled trial. Setting 51 centres in Argentina (public and private hospitals and ambulatory settings). Participants 1518 outpatients with stable chronic heart failure and optimal drug treatment randomised, stratified by attending cardiologist, to

H Grancelli

2005-01-01

387

Reverse remodeling of the extracellular matrix in heart failure after left ventricular mechanical support  

Microsoft Academic Search

This thesis describes a study of the changes in the extracellular matrix (ECM) of the myocardium, in patients with end stage heart failure and during mechanical support (Left Ventricular Assist Device support, LVAD) of the left ventricle. The changes during LVAD support may lead to recovery of the heart. Chapter 1 is a general introduction about heart failure, heart transplantation,

A. H. Bruggink

2008-01-01

388

Palliative care in heart failure: a position statement from the palliative care workshop of the Heart Failure Association of the European Society of Cardiology  

Microsoft Academic Search

Heart failure is a serious condition and equivalent to malignant disease in terms of symptom burden and mortality. At this moment only a\\u000acomparatively small number of heart failure patients receive specialist palliative care. Heart failure patients may have generic palliative care\\u000aneeds, such as refractory multifaceted symptoms, communication and decision making issues and the requirement for family support. The

T. Jaarsma; J. M. Beattie; M. Ryder; F. H. Rutten; T. McDonagh; P. Mohasci; S. A. Murray; T. Grodzicki; I. Bergh; M. Metra; I. Ekman; C. E. Angermann; M. Leventhal; A. Pitsis; S. D. Anker; A. Gavazzi; P. Ponikowski; K. Dickstein; E. Delacretaz; L. Blue; F. Strasser; J. J. McMurray

2009-01-01

389

Management of Chronic Heart Failure in Primary Care: What Evidence do we have for Heart Failure with Preserved Systolic Function?  

PubMed

Chronic Heart Failure (CHF) is a debilitating illness commonly encountered in primary care. Its prevalence in developing countries is rising as a result of an ageing population, and an escalating epidemic of hypertension, type 2 diabetes and coronary heart disease. CHF can be specifically diagnosed as Heart Failure with Reduced Systolic Function (HF-RSF) or Heart Failure with Preserved Systolic Function (HF-PSF). This paper illustrates a common presentation of HF-PSF in primary care; and critically appraises the evidence in support of its diagnosis, prognosis and management. Regardless of the specific diagnosis, long term management of CHF is intricate as it involves a complex interplay between medical, psychosocial, and behavioural factors. Hence, there is a pressing need for a multidisciplinary team management of CHF in primary care, and this usually takes place within the broader context of an integrated chronic disease management programme. Primary care physicians are ideally suited to lead multidisciplinary teams to ensure better co-ordination, continuity and quality of care is delivered for patients with chronic conditions across time and settings. Given the rising epidemic of cardiovascular risk factors in the Malaysian population, preventive strategies at the primary care level are likely to offer the greatest promise for reducing the growing burden of CHF. PMID:25606191

Ramli, As; Jackson, B; Toh, Ct; Ambigga, D; Piterman, L

2010-01-01

390

Ultrafiltration in the management of refractory congestive heart failure.  

PubMed

Ultrafiltration was performed in nine patients with congestive cardiac failure that was refractory to conventional medical treatment. A mean of 12 X 7 litres of fluid was removed, and there was a sustained symptomatic improvement in all patients. Weight loss continued after ultrafiltration and a sustained increase in serum sodium concentration was also noted. A transient fall in right atrial pressure was seen only at four hours after ultrafiltration. No adverse haemodynamic effects were seen four and eighteen hours after fluid removal. Intracardiac dimensions measured by echocardiography remained unchanged. Ultrafiltration can be used to relieve symptoms in patients with refractory congestive heart failure and gross oedema. PMID:3964500

Simpson, I A; Rae, A P; Simpson, K; Gribben, J; Boulton Jones, J M; Allison, M E; Hutton, I

1986-04-01

391

Relation of heart rate and blood pressure turbulence following premature ventricular complexes to baroreflex sensitivity in chronic congestive heart failure  

Microsoft Academic Search

Reduced heart rate variability (HRV) and attenuated baroreflex sensitivity (BS) after myocardial infarction and in patients with chronic congestive heart failure (CHF) are associated with poor prognosis. Recent studies have shown that a large proportion of the prognostic power from HRV measurements is localized in heart rate turbulence immediately after ventricular premature complexes. The mechanism of heart rate turbulence remains

L. Ceri Davies; Darrel P Francis; Piotr Ponikowski; Massimo F Piepoli; Andrew J. S Coats

2001-01-01

392

Cardiohepatic interactions in heart failure: an overview and clinical implications.  

PubMed

Heart failure (HF) is a major public health problem leading to frequent hospitalizations, impaired quality of life, and shortened life expectancy. Heart failure leads to a chronic inability to meet metabolic requirements of end organs or skeletal muscle. Current literature lacks comprehensive descriptions of HF effects on hepatic function. In this review paper, we summarize the literature that is available in hopes of highlighting the key differences in clinical presentation, histological findings, and biochemical profiles of patients who present with both acute and chronic liver injury secondary to HF. We further discuss the use of liver function tests as prognostic markers in patients with HF, as well as the implications of liver injury on drug metabolism in this patient population. Finally, we provide recommendations regarding the management of both types of liver injury in HF patients. PMID:23603231

Samsky, Marc D; Patel, Chetan B; DeWald, Tracy A; Smith, Alastair D; Felker, G Michael; Rogers, Joseph G; Hernandez, Adrian F

2013-06-18

393

Novelties in the early management of acute heart failure syndromes.  

PubMed

The recent European Society of Cardiology (ESC) guidelines delineate the diagnosis and management of distinct categories of acute heart failure syndromes. However, physicians dealing with these patients may need guidance in choosing therapeutic alternatives as soon as the dyspneic patient arrives at the emergency department, until distinct categories of the ESC guidelines are identified. Hence, this manuscript summarizes practical recommendations for the very early management of patients with acute heart failure syndromes. The recommendations are based on a clinical classification system considering the initial systolic blood pressure and other symptoms. Early initiation of diagnostic and goal-directed treatment strategies are key factors in improving patient outcomes. Early and frequent reassessment is also imperative so that adjustments to the initial therapeutic approach can be made, as clinically indicated. PMID:20407961

Salem, Reda; Sibellas, Franck; Socrates, Thenral; Arenja, Nisha; Yilmaz, Mehmet Birhan; Mueller, Christian; Mebazaa, Alexandre

2010-01-01

394

Pharmacologic management of the cardiorenal syndrome in heart failure.  

PubMed

Cardiorenal syndrome describes the impairment of renal function and associated diuretic resistance in patients with heart failure and clinically manifest volume overload. The pathophysiology of this syndrome is poorly understood, but appears to be caused by impairment of tubuloglomerular feedback, neurohormonal activation, and other factors and therapies used in the management of heart failure. Early diagnosis of the cardiorenal syndrome by way of markers of renal injury and function is critical for timely interventions that may attenuate progression. Many novel therapies have been evaluated in the cardiorenal syndrome setting, including agents that block key local factors (eg, adenosine A(I) receptor antagonists), improve diuresis, aquaresis, and natriuresis, and augment natural vasodilator mechanisms to improve renal perfusion. Furthermore, device-based approaches such as ultrafiltration may also play an important therapeutic role. PMID:19486594

Krum, Henry; Iyngkaran, Pupalan; Lekawanvijit, Suree

2009-06-01

395

Vasopressin receptor antagonists, heart failure, and polycystic kidney disease.  

PubMed

The synthesis of nonpeptide orally bioavailable vasopressin antagonists devoid of agonistic activity (vaptans) has made possible the selective blockade of vasopressin receptor subtypes for therapeutic purposes. Vaptans acting on the vasopressin V2 receptors (aquaretics) have attracted attention as a possible therapy for heart failure and polycystic kidney disease. Despite a solid rationale and encouraging preclinical testing, aquaretics have not improved clinical outcomes in randomized clinical trials for heart failure. Additional clinical trials with select population targets, more flexible dosing schedules, and possibly a different drug type or combination (balanced V1a/V2 receptor antagonism) may be warranted. Aquaretics are promising for the treatment of autosomal dominant polycystic kidney disease and have been approved in Japan for this indication. More studies are needed to better define their long-term safety and efficacy and optimize their utilization. PMID:25493947

Torres, Vicente E

2015-01-01

396

The benefits of revascularization in chronic heart failure.  

PubMed

Recent efforts have reduced the mortality from coronary artery disease (CAD), with the consequent increase in heart failure with reduced left ventricular function, referred to as ischaemic cardiomyopathy (ICM). As ischemic left ventricular (LV) dysfunction may be partially or completely reversible by revascularization in the presence of viable myocardium, the assessment of myocardial viability is central to the management of ICM. Decades of observational analyses have provided positive evidence for the role of revascularization in hibernating myocardium in improving survival. However, recently the Surgical Treatment for Ischaemic Heart Failure (STICH) trial has challenged this notion, highlighting the noninferiority of optimal medical therapy (OMT) over revascularization and OMT. In this review, we discuss noninvasive imaging modalities to assess myocardial viability and the impact of myocardial viability on revascularization. We critically appraise the STICH trial and suggest an algorithm for viability testing before revascularization in patients with ICM and significant LV dysfunction. PMID:25500783

Gurunathan, Sothinathan; Ahmed, Asrar; Senior, Roxy

2015-04-01

397

The Biologic Syndrome of Frailty in Heart Failure  

PubMed Central

As we continue to care for an older and sicker end-stage heart failure population, it has become challenging to evaluate patients based on current risk scores that mainly focus on subjective symptoms and patient disability. For generations, geriatricians have sought to identify the body’s underlying vulnerabilities that characterize frailty. More recently, cardiologists have begun to recognize this entity in their own practice. Several studies have suggested rates of frailty as high as 50% in patients with cardiovascular disease. However, despite recognizing frailty, it remains difficult to define. Like heart failure, frailty is a biologic syndrome that affects multiple organ systems. Measures of frailty are shown to strongly correlate with adverse outcomes in the health care system. PMID:25861225

Jermyn, Rita; Patel, Snehal

2014-01-01

398

Nitrosative stress and pharmacological modulation of heart failure  

PubMed Central

Dysregulation of nitric oxide (NO) and increased oxidative and nitrosative stress are implicated in the pathogenesis of heart failure. Peroxynitrite is a reactive oxidant that is produced from the reaction of nitric oxide with superoxide anion and impairs cardiovascular function through multiple mechanisms, including activation of matrix metalloproteinases (MMPs) and nuclear enzyme poly(ADP-ribose) polymerase (PARP). Recent studies suggest that the neutralization of peroxynitrite or pharmacological inhibition of MMPs and PARP are promising new approaches in the experimental therapy of various forms of myocardial injury. In this article, the role of nitrosative stress and downstream mechanisms, including activation of MMPs and PARP, in various forms of heart failure are discussed and novel emerging therapeutic strategies offered by neutralization of peroxynitrite and inhibition of MMPs and PARP in these pathophysiological conditions are reviewed. PMID:15925705

Pacher, Pal; Schulz, Richard; Liaudet, Lucas; Szabó, Csaba

2008-01-01

399

Heart Failure with Preserved Ejection Fraction: Emerging Drug Strategies  

PubMed Central

Approximately half of heart failure patients have a normal ejection fraction, a condition designated as heart failure with preserved ejection fraction (HFpEF). This heart failure subtype disproportionately affects women and the elderly and is commonly associated with other cardiovascular comorbidities, such as hypertension and diabetes. HFpEF is increasing at a steady rate and is predicted to become the leading cause of heart failure within a decade. HFpEF is characterized by impaired diastolic function, thought to be due to concentric remodeling of the heart along with increased stiffness of both the extracellular matrix and myofilaments. In addition, oxidative stress and inflammation are thought to have a role in HFpEF progression, along with endothelial dysfunction and impaired nitric oxide-cyclic guanosine monophosphate (cGMP)-protein kinase G (PKG) signaling. Surprisingly a number of clinical studies have failed to demonstrate any benefit of drugs effective in heart failure with systolic dysfunction in HFpEF patients. Thus, HFpEF is one of the largest unmet needs in cardiovascular medicine and there is a substantial need for new therapeutic approaches and strategies that target mechanisms specific for HFpEF. This conclusion is underscored by the recently reported disappointing results of the RELAX trial, which assessed the use of phosphodiesterase-5 inhibitor sildenafil for treating HFpEF. In animal models, endothelial nitric oxide synthase (eNOS) activators and If current inhibitors have shown benefit in improving diastolic function and there is a rationale for assessing matrix metalloproteinase-9 (MMP-9) inhibitors and nitroxyl donors. LCZ696, a combination drug of angiotensin II receptor blocker and neprilysin inhibitor, and the aldosterone receptor antagonist spironolactone are currently in clinical trial for treating HFpEF. Here we present an overview of the etiology and diagnosis of HFpEF that segues into a discussion of new therapeutic approaches emerging from basic research, as well as drugs currently in clinical trial, that primarily target diastolic dysfunction or imbalanced ventricular-arterial coupling. PMID:23714774

Zouein, Fouad A.; de Castro Brás, Lisandra E.; da Costa, Danielle V.; Lindsey, Merry L.; Kurdi, Mazen; Booz, George W.

2013-01-01

400

Cellular cardiomyoplasty for a patient with heart failure  

SciTech Connect

Background: A 73-year-old man with a history of myocardial infarction and hypertension for 5 years suffered heart failure (NYHA III-IV). Methods: 2D echo indicated hypokinesia at septal, left ventricular anterior wall and apical regions. Coronary angiograms demonstrated 60% stenosis in distal left main and 99% stenosis in proximal and distal left anterior descending coronary arteries (LAD). Both proximal artery and middle left circumflex coronary artery (LC) had 90% stenosis, and diffuse stenosis of right coronary artery (RC) was found. Myocardial perfusion imaging using {sup 99m}Tc-MIBI indicated defective perfusion of left ventricular apex, anterior wall and septal region and severe reduced perfusion of posterior inferior wall. Myocardial metabolic activities ({sup 18}F-deoxyglucose) also showed comparable reductions. After exposing the heart, LAD, LC, and RC were all completely occluded and bypass procedure could not be completed. Autologous satellite cells were implanted without any complication and the patient had an uneventful recovery. Results: During the first 2 months, he remained in heart failure, and by the third month, he gradually improved and reached NYHA II. At fifth month after the procedure, significant increased ejection fraction (37.1-48.6%) and wall movement with modest reduction of left ventricular systolic diameter (48-45 mm) were observed. Imaging with {sup 18}F-deoxyglucose showed dramatic improvement in myocardial metabolic activity with similar improvement in myocardial perfusion ({sup 99m}Tc-MIBI). Conclusion: This is the first successful case of cellular cardiomyoplasty without any conjunctional procedure for patient with severe coronary heart disease and heart failure.

Zhang Fumin; Chen Yijiang; Yang Zhijian; Gao Xiang; Ma Wenzhu; Li Chuanfu; Kao, Race L

2003-03-01

401

High Fat Feeding in Mice Is Insufficient to Induce Cardiac Dysfunction and Does Not Exacerbate Heart Failure  

PubMed Central

Preclinical studies of animals with risk factors, and how those risk factors contribute to the development of cardiovascular disease and cardiac dysfunction, are clearly needed. One such approach is to feed mice a diet rich in fat (i.e. 60%). Here, we determined whether a high fat diet was sufficient to induce cardiac dysfunction in mice. We subjected mice to two different high fat diets (lard or milk as fat source) and followed them for over six months and found no significant decrement in cardiac function (via echocardiography), despite robust adiposity and impaired glucose disposal. We next determined whether antecedent and concomitant exposure to high fat diet (lard) altered the murine heart’s response to infarct-induced heart failure; high fat feeding during, or before and during, heart failure did not significantly exacerbate cardiac dysfunction. Given the lack of a robust effect on cardiac dysfunction with high fat feeding, we then examined a commonly used mouse model of overt diabetes, hyperglycemia, and obesity (db/db mice). db/db mice (or STZ treated wild-type mice) subjected to pressure overload exhibited no significant exacerbation of cardiac dysfunction; however, ischemia-reperfusion injury significantly depressed cardiac function in db/db mice compared to their non-diabetic littermates. Thus, we were able to document a negative influence of a risk factor in a relevant cardiovascular disease model; however, this did not involve exposure to a high fat diet. High fat diet, obesity, or hyperglycemia does not necessarily induce cardiac dysfunction in mice. Although many investigators use such diabetes/obesity models to understand cardiac defects related to risk factors, this study, along with those from several other groups, serves as a cautionary note regarding the use of murine models of diabetes and obesity in the context of heart failure. PMID:24367585

Brainard, Robert E.; Watson, Lewis J.; DeMartino, Angelica M.; Brittian, Kenneth R.; Readnower, Ryan D.; Boakye, Adjoa Agyemang; Zhang, Deqing; Hoetker, Joseph David; Bhatnagar, Aruni; Baba, Shahid Pervez; Jones, Steven P.

2013-01-01

402

Pharmacologic modulation of parasympathetic activity in heart failure  

Microsoft Academic Search

In the congestive heart failure state, autonomic dysregulation involves an increase in sympathetic tone and decrease in parasympathetic\\u000a tone and is associated with increased mortality. It is possible that augmentation of the parasympathetic nervous system (PNS)\\u000a with pharmacologic therapy may lead to improved symptoms and\\/or clinical outcomes. There are several new and established pharmacologic\\u000a interventions that have been studied for

Monali Y. Desai; Mari A. Watanabe; Abhay A. Laddu; Paul J. Hauptman

2011-01-01

403

Role of guanylate cyclase modulators in decompensated heart failure  

Microsoft Academic Search

In this review we investigate the role of particulate and soluble guanylate cyclase (pGC and sGC, respectively) pathways in\\u000a heart failure, and several novel drugs that modify guanylate cyclase. Nesiritide and ularitide\\/urodilatin are natriuretic\\u000a peptides with vasodilating, natriuretic and diuretic effects, acting on pGC, whilst cinaciguat (BAY 58-2667) is a novel sGC\\u000a activator. Cinaciguat has a promising and novel mode

Veselin Mitrovic; Adrian F. Hernandez; Markus Meyer; Mihai Gheorghiade

2009-01-01

404

Common Atrium: A Rare Cause of Acute Decompensated Heart Failure  

PubMed Central

We report a rare case of common atrium and acute decompensated heart failure most likely precipitated by acute bacterial pericarditis leading to premature death, in a 25-year-old male footballer. The silent course of the disease for decades as well as the diagnostic and management pitfalls of this case illustrates the importance of early detection by echocardiography and urgent appropriate treatment in intensive care settings to limit the poor prognosis of the condition. PMID:25763071

Karaye, K. M.; Balarabe, S. A.; Yakasai, M. M.; Suleiman, I. M.; Saidu, H.; Bonny, Aimé

2015-01-01

405

?-Adrenergic Signaling in Chronic Heart Failure—Friend or Foe?  

Microsoft Academic Search

\\u000a In chronic heart failure, a number of compensatory mechanisms are activated in order to maintain circulation and thus supply\\u000a of the body with blood and oxygen. One important mechanism is the activation of the sympathetic nervous system, resulting\\u000a in increased ?-adrenergic signaling. This leads to both adaptive and pathological processes within the cell, including a desensitization\\u000a of the ?-adrenergic signal

Christoph Maack; Michael Böhm

406

Predictors of excess heart failure readmissions: implications for nursing practice.  

PubMed

In this study of California, Massachusetts, and New York hospitals, 6 factors predicted 27.6% of readmissions for patients with heart failure (HF). We found that higher admissions per bed, teaching hospitals, and poor nurse-patient communication increased HF readmissions. Conversely, the HF readmissions were lower when nurse staffing was greater, more patients reported receiving discharge information, and among hospitals in California. The implications for nursing practice in the delivery of care to patients with HF are discussed. PMID:24378355

Stamp, Kelly D; Flanagan, Jane; Gregas, Matt; Shindul-Rothschild, Judith

2014-01-01

407

[Immune mechanisms in pathogenesis of chronic heart failure].  

PubMed

In the review the new information about a participation of immune mechanisms in a pathogenesis of a chronic heart failure (CHF) is presented. Significance of a bacterial endotoxin, as inductor of activation of immune system at CHF, and factors of a system inflammation in a pathogenesis of the disease, breaking balance of matrix metalloproteinases and tissue inhibitors of metalloproteinases system, leading to change of structure of an extracellular matrix of a myocardium, are discussed. PMID:22708411

Egorova, E N; Kalinkin, M N; Mazur, E S

2012-01-01

408

Associations between Endothelin1 and Adiponectin in Chronic Heart Failure  

Microsoft Academic Search

Objectives: Endothelin-1 (ET-1) induces cardiac hypertrophy, whereas adiponectin may elicit protective effects in the vasculature and myocardium. We therefore evaluated the relationship between plasma ET-1 and adiponectin levels in heart failure (HF) patients, and the association between adiponectin expression and ET-1-induced hypertrophy of human cardiomyocytes (HCM) in vitro. Methods: One hundred seventeen patients with chronic HF were enrolled into this

Wei-Hsian Yin; Yung-Hsiang Chen; Jeng Wei; Hsu-Lung Jen; Wen-Ping Huang; Mason Shing Young; Der-Cherng Chen; Po-Len Liu

2011-01-01

409

Prognostic Importance of Defibrillator Shocks in Patients with Heart Failure  

PubMed Central

BACKGROUND Patients with heart failure who receive an implantable cardioverter–defibrillator (ICD) for primary prevention (i.e., prevention of a first life-threatening arrhythmic event) may later receive therapeutic shocks from the ICD. Information about long-term prognosis after ICD therapy in such patients is limited. METHODS Of 829 patients with heart failure who were randomly assigned to ICD therapy, we implanted the ICD in 811. ICD shocks that followed the onset of ventricular tachycardia or ventricular fibrillation were considered to be appropriate. All other ICD shocks were considered to be inappropriate. RESULTS Over a median follow-up period of 45.5 months, 269 patients (33.2%) received at least one ICD shock, with 128 patients receiving only appropriate shocks, 87 receiving only inappropriate shocks, and 54 receiving both types of shock. In a Cox proportional-hazards model adjusted for baseline prognostic factors, an appropriate ICD shock, as compared with no appropriate shock, was associated with a significant increase in the subsequent risk of death from all causes (hazard ratio, 5.68; 95% confidence interval [CI], 3.97 to 8.12; P<0.001). An inappropriate ICD shock, as compared with no inappropriate shock, was also associated with a significant increase in the risk of death (hazard ratio, 1.98; 95% CI, 1.29 to 3.05; P = 0.002). For patients who survived longer than 24 hours after an appropriate ICD shock, the risk of death remained elevated (hazard ratio, 2.99; 95% CI, 2.04 to 4.37; P<0.001). The most common cause of death among patients who received any ICD shock was progressive heart failure. CONCLUSIONS Among patients with heart failure in whom an ICD is implanted for primary prevention, those who receive shocks for any arrhythmia have a substantially higher risk of death than similar patients who do not receive such shocks. PMID:18768944

Poole, Jeanne E.; Johnson, George W.; Hellkamp, Anne S.; Anderson, Jill; Callans, David J.; Raitt, Merritt H.; Reddy, Ramakota K.; Marchlinski, Francis E.; Yee, Raymond; Guarnieri, Thomas; Talajic, Mario; Wilber, David J.; Fishbein, Daniel P.; Packer, Douglas L.; Mark, Daniel B.; Lee, Kerry L.; Bardy, Gust H.

2010-01-01

410

Understanding and Promoting Effective Self-Care During Heart Failure  

Microsoft Academic Search

Opinion statement  Heart failure (HF) self-care relates to the decisions made outside clinical settings by the individual with HF to maintain\\u000a life, healthy functioning, and well-being. The people who help patients most (ie, caregivers\\/family members) should be involved\\u000a in care, and general principles of health behavior change should be used to guide support. Medicines should be prescribed\\u000a with once-daily dosing, with

Alexander M. Clark; Patricia Davidson; Kay Currie; Mehri Karimi; Amanda S. Duncan; David R. Thompson

2010-01-01

411

The management of conditioned nutritional requirements in heart failure  

Microsoft Academic Search

Patients suffering from congestive heart failure exhibit impaired myocardial energy production, myocyte calcium overload and\\u000a increased oxidative stress. Nutritional factors known to be important for myocardial energy production, calcium homeostasis\\u000a and the reduction of oxidative stress, such as thiamine, riboflavin, pyridoxine, L-carnitine, coenzyme Q10, creatine and taurine\\u000a are reduced in this patient population. Furthermore, deficiencies of taurine, carnitine, and thiamine

Marc L. Allard; Khursheed N. Jeejeebhoy; Michael J. Sole

2006-01-01

412

Do statins prevent heart failure in patients after myocardial infarction?  

Microsoft Academic Search

3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors, or statins, reduce morbidity and mortality in patients with coronary\\u000a artery disease (CAD). Because CAD is the major cause of heart failure (HF) in developed countries, prevention of CAD may result\\u000a in reduced HF. Evidence from randomized trials on lipid reduction (Cholesterol and Recurrent Events and the Scandinavian Simvastatin\\u000a Survival Study) has shown statins to

Anique Ducharme; Jean Lucien Rouleau

2004-01-01

413

Hydrogen sulfide mitigates transition from compensatory hypertrophy to heart failure.  

PubMed

We reported previously that although there is disruption of coordinated cardiac hypertrophy and angiogenesis in transition to heart failure, matrix metalloproteinase (MMP)-9 induced antiangiogenic factors play a vital role in this process. Previous studies have shown the cardioprotective role of hydrogen sulfide (H?S) in various cardiac diseases, but its role during transition from compensatory hypertrophy to heart failure is yet to be unveiled. We hypothesize that H?S induces MMP-2 activation and inhibits MMP-9 activation, thus promoting angiogenesis, and mitigates transition from compensatory cardiac hypertrophy to heart failure. To verify this, aortic banding (AB) was created to mimic pressure overload in wild-type (WT) mice, which were treated with sodium hydrosulfide (NaHS, H?S donor) in drinking water and compared with untreated control mice. Mice were studied at 3 and 8 wk. In the NaHS-treated AB 8 wk group, the expression of MMP-2, CD31, and VEGF was increased while the expression of MMP-9, endostatin, angiostatin, and tissue inhibitor of matrix metalloproteinase (TIMP)-3 was decreased compared with untreated control mice. There was significant reduction in fibrosis in NaHS-treated groups. Echocardiograph and pressure-volume data revealed improvement of cardiac function in NaHS-treated groups over untreated controls. These results show that H?S by inducing MMP-2 promotes VEGF synthesis and angiogenesis while it suppresses MMP-9 and TIMP-3 levels, inhibits antiangiogenic factors, reduces intracardiac fibrosis, and mitigates transition from compensatory hypertrophy to heart failure. PMID:21233344

Givvimani, Srikanth; Munjal, Charu; Gargoum, Riyad; Sen, Utpal; Tyagi, Neetu; Vacek, Jonathan C; Tyagi, Suresh C

2011-04-01

414

Role of Automated External Defibrillators in Acute Heart Failure Patients  

Microsoft Academic Search

A lethal complication associated with acute heart failure syndrome (AHFS) is out-of-hospital cardiac arrest due to a sudden\\u000a ventricular arrhythmia, either ventricular fibrillation (VF) or ventricular tachycardia (VT) deteriorating into VF (1–6). However, the unique morbidity of AHFS makes management more of a challenge. One potential intervention that should be considered\\u000a is evolving technology for automated external defibrillation, the main

Jane G. Wiggington; Paul E. Pepe; Thomas R. Aversano

415

Endothelial Dysfunction in Congestive Heart Failure: Effects of Carvedilol  

Microsoft Academic Search

In this review, we have examined the role of oxidative stress and apoptosis in the continuum of molecular changes that accompanies congestive heart failure. Cytokine activation and tumor necrosis factor-a, in particular, may play a role in this continuum, favouring both oxidative stress and apoptosis. Carvedilol, a non selective ß- and a-blocker, exerts an anti-apoptotic effect on both the myocytes

R. Ferrari; L. Agnoletti; C. Ceconi; S. Curello; F. Nesta; R. Manfredini

1999-01-01

416

Treatment of Heart Failure With Normal Ejection Fraction  

Microsoft Academic Search

Opinion Statement  Heart failure (HF) is a major cause of mortality and morbidity and one of the most frequent reasons for hospital admission\\u000a in the United States and Europe. Currently, more than 50% of HF patients have a normal (N) left ventricular (LV) ejection\\u000a fraction (EF) (LVEF >50%). The main pathophysiologic processes involved in HFNEF are increased LV stiffness and abnormal

Nazha Hamdani; Walter J. Paulus

2011-01-01

417

Diastolic dysfunction and diastolic heart failure: Mechanisms and epidemiology  

Microsoft Academic Search

Studies have demonstrated that diastolic dysfunction is frequently present in asymptomatic community-based individuals, especially\\u000a in the elderly with hypertension, coronary artery disease, and diabetes. The presence of diastolic dysfunction is a predictor\\u000a for the development of heart failure (HF) and confers a higher risk of mortality. These findings have raised the question\\u000a of whether treating preclinical diastolic dysfunction will be

Anita Deswal

2005-01-01

418

Evidence-based Treatment of Chronic Heart Failure  

Microsoft Academic Search

The past two decades have seen a knowledge explosion in the field of cardiovascular diseases, in general, and in the understanding\\u000a of chronic heart failure (HF) as a complex neurohumoral syndrome in particular. A new staging system for chronic HF has been\\u000a developed within the last decade to facilitate the evidence-based prescription of medications and medical devices for each\\u000a of

David Rosen; Matthew V. Decaro; Mark G. Graham

2007-01-01

419

Future Pharmacologic Agents for Treatment of Heart Failure in Children  

Microsoft Academic Search

The addition of new agents to the armamentarium of treatment options for heart failure in pediatric patients is exciting and\\u000a challenging. Administration of these therapies to pediatric patients will require careful scrutiny of the data and skilled\\u000a application. Developmental changes in drug metabolism, excretion, and distribution are concerning in pediatric patients, and\\u000a inappropriate evaluation of these parameters can have disastrous

Brady S. Moffett; Anthony C. Chang

2006-01-01

420

Treatment of Heart Failure with Normal Left Ventricular Ejection Fraction  

Microsoft Academic Search

Underlying causes and precipitating causes of heart failure (HF) should be treated when possible. Persons with HF and normal\\u000a left ventricular ejection fraction (LVEF) should have maintenance of sinus rhythm, treatment of hypertension, myocardial ischemia,\\u000a dyslipidemia, and anemia, slowing of the ventricular rate below 90 bpm, and reduction of salt overload. First-line drug treatment\\u000a in the management of these persons is

Wilbert S. Aronow

2007-01-01

421

Emerging therapies for heart failure: renal mechanisms and effects  

Microsoft Academic Search

Improved understanding of the pathophysiology of salt and water homeostasis has provided a foundation for explaining the renal\\u000a mechanisms of emerging therapies for heart failure, as well as why renal function might potentially be improved or harmed.\\u000a These aspects are reviewed in this article for a number of newer therapies including adenosine, endothelin, and vasopressin\\u000a receptor antagonists, as well as

Amir KazoryEdward; Edward A. Ross

422

Reversible Right-Sided Heart Failure Secondary to Carcinoid Crisis  

PubMed Central

Carcinoid crisis is an infrequent and little-described complication of neuroendocrine tumors that can be life threatening. It may develop during induction of anesthesia, intraoperatively, during tumor manipulation and arterial embolization, or even spontaneously. The massive release of neuroendocrine substances can lead to potentially fatal complications. Somatostatin analogs inhibit the release of these substances and are the mainstay of treatment. The following case report describes a patient with reversible acute right-sided heart failure posterior to hepatic artery embolization. PMID:24804121

Soto Herrera, Mariana; Restrepo, José A.; Díaz, Jesús H.; Ramos, Andrés; Felipe Buitrago, Andrés; Gómez Mejía, Mabel

2013-01-01

423

[Recent and future innovations in the treatment of heart failure].  

PubMed

Heart failure is still an important public health problem despite important advances regarding its treatment. Several new treatment strategies are being investigated in order to contend with this disease. Strategies proved to be safe and effective in clinical trials are being adapted to clinical practice. In this review, we will first focus on most recent treatment strategies that are recommended to be used in clinical practice and then try to mention novel strategies which are still being explored in preclinical studies. PMID:23395710

Kepez, Alper; Mutlu, Bülent

2013-05-01

424

Effectiveness of visits from community pharmacists for patients with heart failure: HeartMed randomised controlled trial  

Microsoft Academic Search

Objective To test whether a drug review and symptom self management and lifestyle advice intervention by community pharmacists could reduce hospital admissions or mortality in heart failure patients.Design Randomised controlled trial.Setting Home based intervention in heart failure patients.Participants 293 patients diagnosed with heart failure were included (149 intervention, 144 control) after an emergency admission.Intervention Two home visits by one of

Richard Holland; Iain Brooksby; Elizabeth Lenaghan; Kate Ashton; Laura Hay; Richard Smith; Lee Shepstone; Alistair Lipp; Clare Daly; Amanda Howe; Roger Hall; Ian Harvey

2007-01-01

425

Predictive value of dobutamine echocardiography and positron emission tomography in identifying hibernating myocardium in patients with postischaemic heart failure  

PubMed Central

Objective—To compare the predictive value of dobutamine echocardiography (DE) and positron emission tomography (PET) in identifying reversible chronic left ventricular (LV) dysfunction (hibernating myocardium) in patients with coronary artery disease (CAD) and overt heart failure.?Patients—30 patients (four women) with CAD and heart failure undergoing coronary artery bypass grafting (CABG).?Methods—Myocardial viability was assessed with DE (5 and 10 µg/kg/min) and PET with [18F] 2-fluoro-2-deoxy-D-glucose (FDG) under hyperinsulinaemic euglycaemic clamp. Regional (echo) and global LV function (MUGA) were assessed at baseline and six months after CABG.?Results—192 of the 336 (57%) dysfunctional LV segments improved function following CABG (hibernating) and the LV ejection fraction (EF) increased from 23(7) to 32(9)% (p < 0.0001) (in 17 patients > 5%). DE and PET had similar positive predictive values (68% and 66%) in the identification of hibernating myocardium, but DE had a significantly lower negative predictive value than PET (54% v 96%; p < 0.0001). A significant linear correlation was found between the number of PET viable segments and the changes in EF following CABG (r = 0.65; p = 0.0001). Stepwise logistic regression identified the number of PET viable segments as an independent predictor of improvement in EF > 5%, whereas the number of DE viable segments, the baseline LVEF, and wall motion were not.?Conclusions—DE has a higher false negative rate than PET in identifying recoverable LV dysfunction in patients with severe postischaemic heart failure. The amount of PET viable myocardium correlates with the functional outcome following CABG.?? Keywords: dobutamine echocardiography;  positron emission tomography;  coronary artery disease;  heart failure;  hibernating myocardium PMID:9602663

Pagano, D; Bonser, R; Townend, J; Ordoubadi, F; Lorenzoni, R; Camici, P

1998-01-01

426

Patient Selection for Advanced Heart Failure Therapy Referral  

PubMed Central

Despite advances in medical therapy for chronic heart failure (HF), advanced HF carries a dismal prognosis. Options such as transplantation and durable mechanical circulatory support have greatly improved outcomes for these patients, but their introduction has introduced signifcant complexity to patient management. Although much of this management occurs at specialized heart transplant centers, it is the responsibility of the primary cardiologist of the patient with advanced HF to refer patients at the appropriate time and to help them navigate the difficult decisions related to the pursuit of advanced therapies. We present a unique pathway that incorporates guidelines, recent data, and expert opinion to help general cardiologists determine which patients should be referred for transplantation or durable mechanical circulatory support, and when they should be referred. Decision making on referral to the heart transplant center is also summarized. PMID:24526143

Fanaroff, Alexander C.; DeVore, Adam D.; Mentz, Robert J.; Daneshmand, Mani A.; Patel, Chetan B.

2014-01-01

427

Iron Deficiency in Heart Failure: A Practical Guide  

PubMed Central

Iron is an element necessary for cells due to its capacity of transporting oxygen and electrons. One of the important co-morbidities in heart failure is iron deficiency. Iron has relevant biological functions, for example, the formation of haemoglobin, myoglobin and numerous enzymatic groups. The prevalence of iron deficiency increases with the severity of heart failure. For a long time, the influence of iron deficiency was underestimated especially in terms of worsening of cardiovascular diseases and of developing anaemia. In recent years, studies with intravenous iron agents in patients with iron deficiency and cardiovascular diseases indicated new insights in the improvement of therapy. Experimental studies support the understanding of iron metabolism. Many physicians remain doubtful of the use of intravenous iron due to reports of side effects. The aim of this review is to describe iron metabolism in humans, to highlight the influence of iron deficiency on the course and symptoms of heart failure, discuss diagnostic tools of iron deficiency and provide guidance on the use of intravenous iron. PMID:24064572

Ebner, Nicole; von Haehling, Stephan

2013-01-01

428

Advanced therapies for end-stage heart failure.  

PubMed

Management of the advanced heart failure patient can be complex. Therapies include cardiac transplantation and mechanical circulatory support, as well inotropic agents for the short-term. Despite a growing armamentarium of resources, the clinician must carefully weigh the risks and benefits of each therapy to develop an optimal treatment strategy. While cardiac transplantation remains the only true "cure" for end-stage disease, this resource is limited and the demand continues to far outpace the supply. For patients who are transplant-ineligible or likely to succumb to their illness prior to transplant, ventricular assist device therapy has now become a viable option for improving morbidity and mortality. Particularly for the non-operative patient, intravenous inotropes can be utilized for symptom control. Regardless of the treatments considered, care of the heart failure patient requires thoughtful dialogue, multidisciplinary collaboration, and individualized care. While survival is important, most patients covet quality of life above all outcomes. An often overlooked component is the patient's control over the dying process. It is vital that clinicians make goals-of-care discussions a priority when seeing patients with advanced heart failure. The use of palliative care consultation is well-validated and facilitates these difficult conversations to ensure that all patient needs are ultimately met. PMID:24251460

Katz, Jason N; Waters, Sarah B; Hollis, Ian B; Chang, Patricia P

2015-01-01

429

[Congestive heart failure in patients with chronic kidney disease].  

PubMed

Cardiovascular disorders are the most frequent cause of death (46-60%) among patients with advanced chronic renal failure (CRF), and on dialysis treatment. Uremic cardiomyopathy is the basic pathophysiologic substrate, whereas ischemic heart disease (IHD) and anemia are the most important contributing factors. Associated with well-know risk factors and specific disorders for terminal kidney failure and dialysis, the aforementioned factors instigate congestive heart failure (CHF). Suspected CHF is based on the anamnesis, clinical examination and ECG, while it is confirmed and defined more precisely on the basis of echocardiography and radiology examination. Biohumoral data (BNP, NT-proBNP) are not sufficiently reliable because of specific volemic fluctuation and reduced natural clearance. Therapy approach is similar to the one for the general population: ACEI, ARBs, ?-blockers, inotropic drugs and diuretics. Hypervolemia and most of the related symptoms can be kept under control effectively by the isolated or ultrafiltation, in conjunction with dialysis, during the standard bicarbonate hemodialysis or hemodiafiltration. In the same respect peritoneal dialysis is efficient for the control of hypervolemia symptoms, mainly during the first years of its application and in case of the lower NYHA class (II°/III°). In general, heart support therapy, surgical interventions of the myocardium and valve replacement are rarely used in patients on dialysis, whereas revascularization procedures are beneficial for associated IHD. In selected cases the application of cardiac resynchronization and/or implantation of a cardioverter defibrillator are advisable. PMID:25731010

Poskurica, Mileta; Petrovi?, Dejan

2014-01-01

430

The Adrenergic Nervous System in Heart Failure: Pathophysiology and Therapy  

PubMed Central

Heart failure (HF), the leading cause of death in the western world, develops when a cardiac injury or insult impairs the ability of the heart to pump blood and maintain tissue perfusion. It is characterized by a complex interplay of several neurohormonal mechanisms that get activated in the syndrome in order to try and sustain cardiac output in the face of decompensating function. Perhaps the most prominent among these neurohormonal mechanisms is the adrenergic (or sympathetic) nervous system (ANS), whose activity and outflow are enormously elevated in HF. Acutely, and if the heart works properly, this activation of the ANS will promptly restore cardiac function. However, if the cardiac insult persists over time, chances are the ANS will not be able to maintain cardiac function, the heart will progress into a state of chronic decompensated HF, and the hyperactive ANS will continue to “push” the heart to work at a level much higher than the cardiac muscle can handle. From that point on, ANS hyperactivity becomes a major problem in HF, conferring significant toxicity to the failing heart and markedly increasing its morbidity and mortality. The present review discusses the role of the ANS in cardiac physiology and in HF pathophysiology, the mechanisms of regulation of ANS activity and how they go awry in chronic HF, methods of measuring ANS activity in HF, the molecular alterations in heart physiology that occur in HF along with their pharmacological and therapeutic implications, and, finally, drugs and other therapeutic modalities used in HF treatment that target or affect the ANS and its effects on the failing heart. PMID:23989716

Lymperopoulos, Anastasios; Rengo, Giuseppe; Koch, Walter J.

2013-01-01

431

Telomere attrition and Chk2 activation in human heart failure  

PubMed Central

The “postmitotic” phenotype in adult cardiac muscle exhibits similarities to replicative senescence more generally and constitutes a barrier to effective restorative growth in heart disease. Telomere dysfunction is implicated in senescence and apoptotic signaling but its potential role in heart disorders is unknown. Here, we report that cardiac apoptosis in human heart failure is associated specifically with defective expression of the telomere repeat- binding factor TRF2, telomere shortening, and activation of the DNA damage checkpoint kinase, Chk2. In cultured cardiomyocytes, interference with either TRF2 function or expression triggered telomere erosion and apoptosis, indicating that cell death can occur via this pathway even in postmitotic, noncycling cells; conversely, exogenous TRF2 conferred protection from oxidative stress. In vivo, mechanical stress was sufficient to down-regulate TRF2, shorten telomeres, and activate Chk2 in mouse myocardium, and transgenic expression of telomerase reverse transcriptase conferred protection from all three responses. Together, these data suggest that apoptosis in chronic heart failure is mediated in part by telomere dysfunction and suggest an essential role for TRF2 even in postmitotic cells. PMID:12702777

Oh, Hidemasa; Wang, Sam C.; Prahash, Arun; Sano, Motoaki; Moravec, Christine S.; Taffet, George E.; Michael, Lloyd H.; Youker, Keith A.; Entman, Mark L.; Schneider, Michael D.

2003-01-01

432

Systolic Heart Failure: Knowledge Gaps, Misconceptions, and Future Directions  

PubMed Central

Background Systolic heart failure is the final manifestation of several cardiovascular conditions. The 2001 American College of Cardiology/American Heart Association guidelines depicting the progression of heart failure (HF) from stage A through stage D are aimed at the early treatment of risk factors. However, treatment is often delayed until stage C, and as a result HF continues to impose a major burden on our healthcare industry. Methods We conducted an extensive literature review of the MEDLINE/PubMed database with the purpose of elucidating knowledge gaps and misconceptions regarding systolic HF. Results Long-term beta adrenergic blocking is the only pharmacologic intervention that reverses left ventricular remodeling. Whether beta adrenergic blocking prevents or delays left ventricular remodeling in patients at risk of HF is presently unknown. A knowledge gap also exists regarding the phenotype of patients that derives a mortality benefit from implantable cardioverter defibrillator therapy. Acute decompensated HF is a misnomer because patients with chronic HF are known to be deteriorating in the weeks preceding hospitalization. Functional class and ejection fraction are not closely correlated. Advanced HF therapies such as heart transplantation and mechanical circulatory support are available to an extremely small fraction of patients with systolic HF. Conclusion Concentrating efforts on the early stages of the disease process with optimal management of risk factors for HF is critical to having a significant impact on this ongoing pandemic. PMID:25598722

Samson, Rohan; Ramachandran, Rohit; Le Jemtel, Thierry H.

2014-01-01

433

Liguzinediol improved the heart function and inhibited myocardial cell apoptosis in rats with heart failure  

PubMed Central

Aim: Liguzinediol is a novel derivative of ligustrazine isolated from the traditional Chinese medicine Chuanxiong (Ligusticum wallichii Franch), and produces significant positive inotropic effect in isolated rat hearts. In this study we investigated the effects of liguzinediol on a rat model of heart failure. Methods: To induce heart failure, male SD rats were injected with doxorubicin (DOX, 2 mg/kg, ip) once a week for 4 weeks. Then the rats were administered with liguzinediol (5, 10, 20 mg·kg?1·d?1, po) for 2 weeks. Hemodynamic examination was conducted to evaluate heart function. Myocardial cell apoptosis was examined morphologically. The expression of related genes and proteins were analyzed using immunohistochemical staining and Western blot assays, respectively. Results: Oral administration of liguzinediol dose-dependently improved the heart function in DOX-treated rats. Electron microscopy revealed that liguzinediol (10 mg·kg?1·d?1) markedly attenuated DOX-induced injury of cardiomyocytes, and decreased the number of apoptotic bodies in cardiomyocytes. Furthermore, liguzinediol significantly decreased Bax protein level, and increased Bcl-2 protein level in cardiomyocytes of DOX-treated rats, led to an increase in the ratio of Bcl-2/Bax. Moreover, liguzinediol significantly decreased the expression of both cleaved caspase-3 and NF-?B in cardiomyocytes of DOX-treated rats. Administration of digitalis (0.0225 mg·kg?1·d?1) also markedly improved the heart function and the morphology of cardiomyocytes in DOX-treated rats. Conclusion: Liguzinediol improves the heart function and inhibits myocardial cell apoptosis in the rat model of heart failure, which is associated with regulating Bcl-2, Bax, caspase-3 and NF-?B expression. PMID:25220638

Li, Yu; Song, Ping; Zhu, Qing; Yin, Qiu-yi; Ji, Jia-wen; Li, Wei; Bian, Hui-min

2014-01-01

434

Aging-associated cardiovascular changes and their relationship to heart failure  

PubMed Central

Synopsis Aging represents a convergence of declining cardioprotective systems and increasing disease processes that is fertile ground for the development of heart failure. With 50% of all heart failure diagnoses and 90% of all heart failure deaths occurring in the segment of the population over age 70, heart failure is largely a disease of the elderly. This review discusses the microscopic and macroscopic changes in cardiovascular structure, function, protective systems, and disease associated with aging. In addition to outlining important clinical considerations and conditions in older persons, the link between normal aging and the elevated risk for development of stage B heart failure is explained and potential therapeutic pathways highlighted. PMID:22108734

Strait, James B.; Lakatta, Edward G.

2011-01-01

435

Nitrendipine binding in congestive heart failure due to myocardial infarction  

SciTech Connect

Depressed cardiac pump function is the hallmark of congestive heart failure, and it is suspected that decreased influx of Ca2+ into the cardiac cell is responsible for depressed contractile function. Since Ca2+ channels in the sarcolemmal membrane are considered to be an important route for the entry of Ca2+, we examined the status of Ca2+ receptors/channels in failing rat hearts after myocardial infarction of the left ventricular free wall. For this purpose, the left coronary artery was ligated and hearts were examined 4, 8, and 16 weeks later; sham-operated animals served as controls. Hemodynamic assessment revealed decreased total mechanical energy (left ventricular systolic pressure x heart rate), increased left ventricular diastolic pressure, and decreased positive and negative dP/dt in experimental animals at 4, 8, and 16 weeks. Although accumulation of ascites in the abdominal cavity was evident at 4 weeks, other clinical signs of congestive heart failure in experimental rats were evident from the presence of lung congestion and cardiac dilatation at 8 and 16 weeks after induction of myocardial infarction. The density of Ca2+ receptors/channels in crude membranes, as assessed by (3H)nitrendipine binding assay, was found to be decreased in the uninfarcted experimental left ventricle at 8 and 16 weeks; however, no change in the affinity of nitrendipine was evident. A similar depression in the specific binding of another dihydropyridine compound, (3H)PN200-110, was also evident in failing hearts. Brain and skeletal muscle crude membrane preparations, unlike those of the right ventricle and liver, revealed a decrease in Ca2+ receptors/channels density in experimental animals at 16 weeks.

Dixon, I.M.; Lee, S.L.; Dhalla, N.S. (St. Boniface General Hospital Research Centre, Winnipeg, Manitoba (Canada))

1990-03-01

436

Differential clinical characteristics and prognosis of intraventricular conduction defects in patients with chronic heart failure  

PubMed Central

Aims Intraventricular conduction defects (IVCDs) can impair prognosis of heart failure (HF), but their specific impact is not well established. This study aimed to analyse the clinical profile and outcomes of HF patients with LBBB, right bundle branch block (RBBB), left anterior fascicular block (LAFB), and no IVCDs. Methods and results Clinical variables and outcomes after a median follow-up of 21 months were analysed in 1762 patients with chronic HF and LBBB (n = 532), RBBB (n = 134), LAFB (n = 154), and no IVCDs (n = 942). LBBB was associated with more marked LV dilation, depressed LVEF, and mitral valve regurgitation. Patients with RBBB presented overt signs of congestive HF and depressed right ventricular motion. The LAFB group presented intermediate clinical characteristics, and patients with no IVCDs were more often women with less enlarged left ventricles and less depressed LVEF. Death occurred in 332 patients (interannual mortality = 10.8%): cardiovascular in 257, extravascular in 61, and of unknown origin in 14 patients. Cardiac death occurred in 230 (pump failure in 171 and sudden death in 59). An adjusted Cox model showed higher risk of cardiac death and pump failure death in the LBBB and RBBB than in the LAFB and the no IVCD groups. Conclusion LBBB and RBBB are associated with different clinical profiles and both are independent predictors of increased risk of cardiac death in patients with HF. A more favourable prognosis was observed in patients with LAFB and in those free of IVCDs. Further research in HF patients with RBBB is warranted. PMID:23512097

Cinca, Juan; Mendez, Ana; Puig, Teresa; Ferrero, Andreu; Roig, Eulalia; Vazquez, Rafael; Gonzalez-Juanatey, Jose R.; Alonso-Pulpon, Luis; Delgado, Juan; Brugada, Josep; Pascual-Figal, Domingo; Brugada, J.; Batlle, M.; Berruezo, A.; Hevia, S.; Mont, L.; Pérez-Villa, F.; Cinca, J.; Roig, E.; Bayés de Luna, A.; Borrás, X.; Carreras, F.; Ferrero, A.; Guerra, J.M.; Hove-Madsen, L.; Jorge, E.; Martínez, R.; Padró, J.; Puig, T.; Ribas, N.; Viñolas, X.; Alvarez-Garcia, J.; González-Juanatey, J.R.; Bandín, M.; Eiras, S.; Fernández-Hernández, L.; García-Acuña, J.; Gómez-Otero, I.; Grigorian-Shamagian, L.; Lago, F.; Manzón, P.; Moure, M.; Otero-Raviña, F.; Otero-Santiago, F.; Rodino Janeiro, B.K.; Rubio, J.; Salgado, A.; Seoane, A.; Varela, A.; Lear, P.V.; Fernández-Cruz, A.; Alvarez de Arcaya Vicente, A.; Avila, M.; Bordiu, E.; Calle, L.; Fernández-Pinilla, C.; Gómez-Garre, D.; González-Rubio, L.; Marco, J.; Martell, N.; Muñoz-Pacheco, P.; Ortega, A.; Patiño, R.; Pedrajas, J.; Reinares, L.; Pérez-Villacastín, J.; Bover, R.; Cobos, M.; García-Quintanilla, J.; Moreno, J.; Pérez-Castellano, N.; Pérez-Serrano, M.; Vila, I.; Delgado, J.F.; Arribas, F.; Escribano, P.; Flox, A.; Jiménez López-Guarch, C.; Paradina, M.; Ruiz-Cano, J.; Sáenz de la Calzada, C.; Salguero, R.; Sánchez-Sánchez, V.; Tello de Meneses, R.; Vicente-Hernández, M.; Alonso-Pulpón, L.; Fernández -Lozano, I.; García-Pavía, P.; García-Touchard, A.; Gómez-Bueno, M.; Márquez, J.; Segovia, J.; Silva, L.; Vázquez-Mosquera, M.; Valdés, M.; García-Alberola, A.; Garrido, I.; Pascual-Figal, D. A.; Pastor-Pérez, F.J.; Sánchez-Más, J.; Tornel, P.; Rivera, M.; Almenar, L.; Cortés, R.; Martínez-Dolz, L.; Montero, J.; Portolés, M.; Roselló-Lleti, E.; Salvador, A.; Vila, V.; Vázquez, R.; Cubero, J.; Fernández-Palacín, A.; García-Medina, D.; García-Rey, S.; Laguna, E.; Leal del Ojo, J.; Miñano, F.; Pastor-Torres, L.; Pavón, R.; Pérez-Navarro, A.; Villagómez, D.; Vázquez, R.; Arana, R.; Bartolomé, D.; Cabeza, P.; Calle-Pérez, G.; Camacho, F.; Cano, L.; Carrillo, A.; Díaz-Retamino, E.; Escolar, V.; Fernández-Rivero, R.; Gamaza, S.; Giráldes, A.; Hernández-Vicente, N.; Lagares, M.; López-Benítez, J.; Marante, M.; Otero, E.; Pedregal, J.; Sancho-Jaldón, M.; Sevillano, R.; Zayas, R.; Verdú, J.M.; Aguilar, S.; Aizpurúa, M.; Alguacil, F.; Casacuberta, J.; Cerain, J.; Domingo, M.; García-Lareo, M.; Herrero-Melechón, J.; López-Pareja, N.; Mena, A.; Pérez-Orcero, A.; Rodríguez- Cristóbal, J.; Rozas, M.; Sorribes, J.; Torán, P.; Worner, F.; Barta, L.; Bravo, C.; Cabau, J.; Casanova, J.; Daga, B.; De la Puerta, I.; Hernández-Martín, I.; Piñol, E.; Pueo, E.; Torres, G.; Troncoso, A.; Viles, D.; Bardají, A.; Mercè, J.; Sanz-Girgas, E.; Valdovinos, P.; Aramburu, O.; Arias, J.; García-González, C.; Alonso, M.; Bischofberger, C.; Domínguez-De Pablos, G.; Jiménez-Cervantes, D.; Ureña, I.; Grau-Sepúlveda, A.; Fiol, C.; Pericas, P.; Villalonga, M.; Orosa, P.; Agüero, J.; Planas-Aymá, F.; Grau-Amoros, J.; Planas-Comes, F.; San Vicente, L.

2013-01-01

437

Cardiomyocyte Transplantation into the Failing Heart—New Therapeutic Approach for Heart Failure?  

Microsoft Academic Search

Heart failure, frequently the consequence of irreversible myocardial damage with subsequent formation of akinetic scar tissue, is a highly prevalent disease, and in its advanced stages associated with high mortality. The transplantation of exogenous cells with the inherent ability to contract has been put forward as one potential treatment strategy to increase contractility and cardiac performance. Besides skeletal myoblasts or

Thorsten Reffelmann; Jonathan Leor; Jochen Müller-Ehmsen; Larry Kedes; Robert A. Kloner

2003-01-01

438

Lesson 1, Volume 13—Understanding and Managing the Patient With Acute and Chronic Heart Failure  

E-print Network

2. Know the epidemiology of heart failure in the United States. 3. Recognize the multiple etiologies of heart failure in the United States. 4. Understand the appropriate diagnostic evaluation for patients with heart failure. 5. Know the appropriate therapeutic strategy for patients with heart failure. Key words congestive heart failure; diagnosis; epidemiology; left-ventricular systolic dysfunction; prognosis; therapy Abbreviations ACE=angiotensin-converting enzyme Heart failure is one of the most common problems seen in the practices of physicians who care for adults. In hospitalized Medicare patients, heart failure is the most frequently cited diagnosis-related group. Heart failure prevalence increases with age; it ranges from 3 to 20 persons per 1,000 when all ages are considered, but when only persons>65 years of age are considered, the prevalence of heart failure lies between 30 and 130 per 1,000. 1 The crude incidence for heart failure, unadjusted for age, ranges from 1 to 5 cases per 1,000 population per year with a steep increase associated with advancing age. The incidence rate for persons>75 years of age is approximately 40 per 1,000 population per year. Etiology Hypertension was formerly the most common etiology for heart failure. Coronary artery disease has recently moved into the first

S. Alpert

439

Complexity of program and clinical outcomes of heart failure disease management incorporating specialist nurse-led heart failure clinics  

Microsoft Academic Search

Abstract Objectives: To determine whether,a hierarchy of effectiveness exists with respect to complexity of published protocols of heart failure (HF) disease management,(DM) incorporating specialist nurse-led HF clinics. Data sources and study selection: We searched MEDLINE (1966–November 2004), the Cochrane Library, article bibliographies, and contacted experts. Inclusion criteria were random allocation of at least 100 patients, specialist HF nurses, HF clinics,

Christopher O. Phillips; Ramesh M. Singasupbs; Haya R. Rubin; Tiny Jaarsma

440

Monoamine oxidases (MAO) in the pathogenesis of heart failure and ischemia/reperfusion injury  

PubMed Central

Recent evidence highlights monoamine oxidases (MAO) as another prominent source of oxidative stress. MAO are a class of enzymes located in the outer mitochondrial membrane, deputed to the oxidative breakdown of key neurotransmitters such as norepinephrine, epinephrine and dopamine, and in the process generate H2O2. All these monoamines are endowed with potent modulatory effects on myocardial function. Thus, when the heart is subjected to chronic neuro-hormonal and/or peripheral hemodynamic stress, the abundance of circulating/tissue monoamines can make MAO-derived H2O2 production particularly prominent. This is the case of acute cardiac damage due to ischemia/reperfusion injury or, on a more chronic stand, of the transition from compensated hypertrophy to overt ventricular dilation/pump failure. Here, we will first briefly discuss mitochondrial status and contribution to acute and chronic cardiac disorders. We will illustrate possible mechanisms by which MAO activity affects cardiac biology and function, along with a discussion as to their role as a prominent source of reactive oxygen species. Finally, we will speculate on why MAO inhibition might have therapeutic value for treating cardiac affections of ischemic and non-ischemic origin. PMID:20869994

Kaludercic, Nina; Carpi, Andrea; Menabò, Roberta; Lisa, Fabio Di; Paolocci, Nazareno

2010-01-01

441

Decrease of cardiac chaos in congestive heart failure  

NASA Astrophysics Data System (ADS)

The electrical properties of the mammalian heart undergo many complex transitions in normal and diseased states. It has been proposed that the normal heartbeat may display complex nonlinear dynamics, including deterministic chaos,, and that such cardiac chaos may be a useful physiological marker for the diagnosis and management, of certain heart trouble. However, it is not clear whether the heartbeat series of healthy and diseased hearts are chaotic or stochastic, or whether cardiac chaos represents normal or abnormal behaviour. Here we have used a highly sensitive technique, which is robust to random noise, to detect chaos. We analysed the electrocardiograms from a group of healthy subjects and those with severe congestive heart failure (CHF), a clinical condition associated with a high risk of sudden death. The short-term variations of beat-to-beat interval exhibited strongly and consistently chaotic behaviour in all healthy subjects, but were frequently interrupted by periods of seemingly non-chaotic fluctuations in patients with CHF. Chaotic dynamics in the CHF data, even when discernible, exhibited a high degree of random variability over time, suggesting a weaker form of chaos. These findings suggest that cardiac chaos is prevalent in healthy heart, and a decrease in such chaos may be indicative of CHF.

Poon, Chi-Sang; Merrill, Christopher K.

1997-10-01

442

Intermittent Outpatient Nesiritide Infusion Reduces Hospital Admissions in Patients With Advanced Heart Failure  

Microsoft Academic Search

Recombinant B-type natriuretic peptide (BNP) is a therapeutic modality in patients with decompensated congestive heart failure. Retrospectively tested are the effects of intermittent outpatient nesiritide infusion on symptoms, hospital readmission rates, endogenous BNP, and renal function in patients with advanced heart failure. Twenty-four patients in heart failure in New York Heart Association (NYHA) classes III-IV received a 6- to 8-hour

Ernst R. Schwarz; Sabeen Najam; Rami Akel; Nasir Sulimanjee; Susan Bionat; Salvatore Rosanio

2007-01-01

443

Sustained Sympathoinhibitory Effects of Cardiac Resynchronization Therapy in Severe Heart Failure  

Microsoft Academic Search

Evidence is available that in heart failure, cardiac resynchronization therapy by biventricular pacing improves myocardial function and exercise capacity. Whether this is accompanied by a sustained inhibition of heart failure- dependent sympathoexcitation is uncertain. In 11 heart failure patients (meanSEM age, 68.41.5 years) in New York Heart Association (NYHA) class III and IV under medical treatment with an intraventricular conduction

Guido Grassi; Antonio Vincenti; Roberta Brambilla; Raffaella Dell' Oro; Antonio Ciro; Giuseppe Trocino; Antonella Vincenzi; Giuseppe Mancia

2009-01-01

444

Influence of heart failure on nucleolar organization and protein expression in human hearts  

SciTech Connect

Highlights: Black-Right-Pointing-Pointer Heart failure alters nucleolar morphology and organization. Black-Right-Pointing-Pointer Nucleolin expression is significant increased in ischemic and dilated cardiomyopathy. Black-Right-Pointing-Pointer Ventricular function of heart failure patients was related with nucleolin levels. -- Abstract: We investigate for the first time the influence of heart failure (HF) on nucleolar organization and proteins in patients with ischemic (ICM) or dilated cardiomyopathy (DCM). A total of 71 human hearts from ICM (n = 38) and DCM (n = 27) patients, undergoing heart transplantation and control donors (n = 6), were analysed by western-blotting, RT-PCR and cell biology methods. When we compared protein levels according to HF etiology, nucleolin was increased in both ICM (117%, p < 0.05) and DCM (141%, p < 0.01). Moreover, mRNA expression were also upregulated in ICM (1.46-fold, p < 0.05) and DCM (1.70-fold, p < 0.05. Immunofluorescence studies showed that the highest intensity of nucleolin was into nucleolus (p < 0.0001), and it was increased in pathological hearts (p < 0.0001). Ultrastructure analysis by electron microscopy showed an increase in the nucleus and nucleolus size in ICM (17%, p < 0.05 and 131%, p < 0.001) and DCM (56%, p < 0.01 and 69%, p < 0.01). Nucleolar organization was influenced by HF irrespective of etiology, increasing fibrillar centers (p < 0.001), perinucleolar chromatin (p < 0.01) and dense fibrillar components (p < 0.01). Finally, left ventricular function parameters were related with nucleolin levels in ischemic hearts (p < 0.0001). The present study demonstrates that HF influences on morphology and organization of nucleolar components, revealing changes in the expression and in the levels of nucleolin protein.

Rosello-Lleti, Esther; Rivera, Miguel; Cortes, Raquel [Cardiocirculatory Unit, Research Center, Hospital Universitario La Fe, Valencia (Spain)] [Cardiocirculatory Unit, Research Center, Hospital Universitario La Fe, Valencia (Spain); Azorin, Inmaculada [Experimental Neurology, Research Center, Hospital Universitario La Fe, Valencia (Spain)] [Experimental Neurology, Research Center, Hospital Universitario La Fe, Valencia (Spain); Sirera, Rafael [Biotechnology Department, Universidad Politecnica, Valencia (Spain)] [Biotechnology Department, Universidad Politecnica, Valencia (Spain); Martinez-Dolz, Luis [Cardiology Unit, Hospital Universitario La Fe, Valencia (Spain)] [Cardiology Unit, Hospital Universitario La Fe, Valencia (Spain); Hove, Leif; Cinca, Juan [Cardiology Unit, Hospital San Pau, Barcelona (Spain)] [Cardiology Unit, Hospital San Pau, Barcelona (Spain); Lago, Francisca; Gonzalez-Juanatey, Jose R. [Cardiology Unit, Institute of Biomedical Research, Hospital Clinicode Santiagode Compostela (Spain)] [Cardiology Unit, Institute of Biomedical Research, Hospital Clinicode Santiagode Compostela (Spain); Salvador, Antonio [Experimental Neurology, Research Center, Hospital Universitario La Fe, Valencia (Spain)] [Experimental Neurology, Research Center, Hospital Universitario La Fe, Valencia (Spain); Portoles, Manuel, E-mail: portoles_man@gva.es [Cell Biology and Pathology Unit, Research Center, Hospital Universitario La Fe, Valencia (Spain)] [Cell Biology and Pathology Unit, Research Center, Hospital Universitario La Fe, Valencia (Spain)

2012-02-10

445

Heart rate and cardiac rhythm relationships with bisoprolol benefit in chronic heart failure in CIBIS II trial  

Microsoft Academic Search

Background— b-Blockade-induced benefit in heart failure (HF) could be related to baseline heart rate and treatment- induced heart rate reduction, but no such relationships have been demonstrated. Methods and Results—In CIBIS II, we studied the relationships between baseline heart rate (BHR), heart rate changes at 2 months (HRC), nature of cardiac rhythm (sinus rhythm or atrial fibrillation), and outcomes (mortality

Philippe Lechat; Jean-Sébastien Hulot; A Mallet

2001-01-01

446

RESICARD: East Paris network for the management of heart failure: Absence of effect on mortality and rehospitalization in patients with severe heart failure admitted following severe decompensation  

Microsoft Academic Search

Summary Background. — Heart failure presents a major public health problem due to its high prevalence and the increasing number of hospital admissions for this condition. A coordinated healthcare network involving general practitioners and cardiologists was set up in the east of Paris in an effort to improve the management and outcomes of patients with severe heart failure.

Patrick Assyag; Thomas Renaud; Alain Cohen-Solal; Magali Viaud; Henry Krys; Aleksandra Bundalo; Pierre-Louis Michel; Robert Boukobza; Yann Bourgueil; Ariel Cohen

2009-01-01

447

A Simple New Visualization of Exercise Data Discloses Pathophysiology and Severity of Heart Failure  

PubMed Central

Background The complexity of cardiopulmonary exercise testing data and their displays tends to make assessment of patients, including those with heart failure, time consuming. Methods and Results We postulated that a new single display that uses concurrent values of oxygen uptake / ventilation versus carbon dioxide output / ventilation ratios (–versus–), plotted on equal X–Y axes, would better quantify normality and heart failure severity and would clarify pathophysiology. Consecutive –versus– values from rest to recovery were displayed on X–Y axes for patients with Class II and IV heart failure and for healthy subjects without heart failure. The displays revealed distinctive patterns for each group, reflecting sequential changes in cardiac output, arterial and mixed venous O2 and CO2 content differences, and ventilation (). On the basis of exercise tests of 417 healthy subjects, reference formulas for highest and , which normally occur during moderate exercise, are presented. Absolute and percent predicted values of highest and were recorded for 10 individuals from each group: Those of healthy subjects were significantly higher than those of patients with Class II heart failure, and those of patients with Class II heart failure were higher than those of patients with Class IV heart failure. These values differentiated heart failure severity better than peak , anaerobic threshold, peak oxygen pulse, and slopes. Resting –versus– values were strikingly low for patients with Class IV heart failure, and with exercise, increased minimally or even decreased. With regard to the pathophysiology of heart failure, high values during milder exercise, previously attributed to ventilatory inefficiency, seem to be caused primarily by reduced cardiac output rather than increased . Conclusion –versus– measurements and displays, extractable from future or existing exercise data, separate the 3 groups (healthy subjects, patients with Class II heart failure, and patients with Class IV heart failure) well and confirm the dominant role of low cardiac output rather than excessive in heart failure pathophysiology. (J Am Heart Assoc. 2012;1:e001883 doi: 10.1161/JAHA.112.001883.) PMID:23130146

Hansen, James E.; Sun, Xing-Guo; Stringer, William W.

2012-01-01

448

[New therapy concepts for heart failure with preserved ejection fraction].  

PubMed

The management of patients with heart failure and preserved ejection fraction (HFpEF) remains challenging and requires an accurate diagnosis. Although currently no convincing therapy that can prolong survival in patients with HFpEF has been established, treatment of fluid retention, heart rate and control of comorbidities are important cornerstones to improve the quality of life and symptoms. In recent years many new therapy targets have been tested for development of successful interventional strategies for HFpEF. Insights into new mechanisms of HFpEF have shown that heart failure is associated with dysregulation of the nitric oxide-cyclic guanosine monophosphate-protein kinase (NO-cGMP-PK) pathway. Two new drugs are currently under investigation to test whether this pathway can be significantly improved by either the neprilysin inhibitor LCZ 696 due to an increase in natriuretic peptides or by the soluble guanylate cyclase stimulator vericiguat, which is also able to increase cGMP. In addition, several preclinical or early phase studies which are currently investigating new mechanisms for matrix, intracellular calcium and energy regulation including the role of microRNAs and new devices are presented and discussed. PMID:25737289

Tschöpe, C; Pieske, B

2015-04-01

449

Pattern of heart failure in a Nigerian teaching hospital  

PubMed Central

Background Congestive cardiac failure (CCF) has emerged as a major public health problem worldwide and imposes an escalating burden on the health care system. Objective To determine the causes and mortality rate of CCF in the University of Port Harcourt Teaching Hospital (UPTH), south Nigeria, over a five-year period from January 2001 to December 2005. Methods A retrospective study of CCF cases were identified from the admission and discharge register of the medical wards of UPTH and the case notes were retrieved from the medical records department and analyzed. Results There were 423 patients: 242 males and 181 females. Their ages ranged from 18 to 100 years with a mean of 54.4 ± 17.3. The commonest causes of CCF were hypertension (56.3%) and cardiomyopathy (12.3%). Chronic renal failure, rheumatic heart disease, and ischemic heart disease accounted for 7.8%, 4.3%, and 0.2% of CCF, respectively. Peripartum heart disease was rare despite being commonly reported in northern Nigerian females. Eighteen patients died from various complications with a mortality rate of 4.3%. Conclusion The burden of CCF in the Niger Delta is mainly attributed to hypertension. Efforts should be geared towards hypertension awareness, detection, treatment, and prevention in the region. PMID:19774215

Onwuchekwa, Arthur C; Asekomeh, Godspower E

2009-01-01

450

Glycoproteins identified from heart failure and treatment models.  

PubMed

Conduction abnormalities can lead to dyssynchronous contraction, which significantly worsens morbidity and mortality of heart failure. Cardiac resynchronization therapy (CRT) can reverse ventricular remodeling and improve cardiac function. Although the underlying molecular changes are unknown, the use of a canine model of dyssynchronous heart failure (DHF) and CRT has shown that there are global changes across the cardiac proteome. This study determines changes in serum glycoprotein concentration from DHF and CRT compared to normal. We hypothesize that CRT invokes protective or advantageous pathways that can be reflected in the circulating proteome. Two prong discovery approaches were carried out on pooled normal, DHF, and CRT samples composed of individual canine serum to determine the overall protein concentration and the N-linked glycosites of circulating glycoproteins. The level of the glycoproteins was altered in DHF and CRT compared to control sera, with 63 glycopeptides substantially increased in DHF and/or CRT. Among the 32 elevated glycosite-containing peptides in DHF, 13 glycopeptides were reverted to normal level after CRT therapy. We further verify the changes of glycopeptides using label-free LC-MS from individual canine serum. Circulating glycoproteins such as alpha-fetoprotein, alpha-2-macroglobulin, galectin-3-binding protein, and collectin-10 show association to failing heart and CRT treatment model. PMID:25141849

Yang, Shuang; Chen, Lijun; Sun, Shisheng; Shah, Punit; Yang, Weiming; Zhang, Bai; Zhang, Zhen; Chan, Daniel W; Kass, David A; van Eyk, Jennifer E; Zhang, Hui

2015-01-01

451

Air Travel Considerations for the Patients With Heart Failure  

PubMed Central

Context: Prevalence of patients with heart failure (HF) is increasing in worldwide, and also the number of people with HF traveling long distances is increasing. These patients are more prone to experience problems contributed air travel and needs more attention during flight. However, observational studies about problems of HF patients during flight and appropriated considerations for them are limited. Evidence Acquisition: We evaluated the conditions that may be encountered in a HF patient and provide the recommendations to prevent the exacerbation of cardiac failure during air travel. For this review article, a comprehensive search was undertaken for the studies that evaluated the complications and considerations of HF patients during flight. Data bases searched were: MEDLINE, EMBASE, Science Direct, and Google Scholar. Results: HF patients are more prone to experience respiratory distress, anxiety, stress, cardiac decompensation, and venous thromboembolism (VTE) during air travel. Although stable HF patients can tolerate air travel, but those with acute heart failure syndrome should not fly until complete improvement is achieved. Conclusions: Thus, identifying the HF patients before the flight and providing them proper education about the events that may occur during flight is necessary. PMID:25068047

Izadi, Morteza; Alemzadeh-Ansari, Mohammad Javad; Kazemisaleh, Davood; Moshkani-Farahani, Maryam

2014-01-01

452

Dystrophic heart failure blocked by membrane sealant poloxamer  

NASA Astrophysics Data System (ADS)

Dystrophin deficiency causes Duchenne muscular dystrophy (DMD) in humans, an inherited and progressive disease of striated muscle deterioration that frequently involves pronounced cardiomyopathy. Heart failure is the second leading cause of fatalities in DMD. Progress towards defining the molecular basis of disease in DMD has mostly come from studies on skeletal muscle, with comparatively little attention directed to cardiac muscle. The pathophysiological mechanisms involved in cardiac myocytes may differ significantly from skeletal myofibres; this is underscored by the presence of significant cardiac disease in patients with truncated or reduced levels of dystrophin but without skeletal muscle disease. Here we show that intact, isolated dystrophin-deficient cardiac myocytes have reduced compliance and increased susceptibility to stretch-mediated calcium overload, leading to cell contracture and death, and that application of the membrane sealant poloxamer 188 corrects these defects in vitro. In vivo administration of poloxamer 188 to dystrophic mice instantly improved ventricular geometry and blocked the development of acute cardiac failure during a dobutamine-mediated stress protocol. Once issues relating to optimal dosing and long-term effects of poloxamer 188 in humans have been resolved, chemical-based membrane sealants could represent a new therapeutic approach for preventing or reversing the progression of cardiomyopathy and heart failure in muscular dystrophy.

Yasuda, Soichiro; Townsend, Dewayne; Michele, Daniel E.; Favre, Elizabeth G.; Day, Sharlene M.; Metzger, Joseph M.

2005-08-01

453

Emerging hemodynamic signatures of the right heart (Third International Right Heart Failure Summit, part 2)  

PubMed Central

Abstract Despite the importance of preserved right ventricular structure and function with respect to outcome across the spectrum of lung, cardiac, and pulmonary vascular diseases, only recently have organized efforts developed to consider the pulmonary vascular–right ventricular apparatus as a specific unit within the larger context of cardiopulmonary pathophysiology. The Third International Right Heart Failure Summit (Boston, MA) was a multidisciplinary event dedicated to promoting a dialogue about the scientific and clinical basis of right heart disease. The current review provides a synopsis of key discussions presented during the section of the summit titled “Emerging Hemodynamic Signatures of the Right Heart.” Specifically, topics emphasized in this element of the symposium included (1) the effects of pulmonary vascular dysfunction at rest or provoked by exercise on the right ventricular pressure-volume relationship, (2) the role of pressure-volume loop analysis as a method to characterize right ventricular inefficiency and predict right heart failure, and (3) the importance of a systems biology approach to identifying novel factors that contribute to pathophenotypes associated with pulmonary arterial hypertension and/or right ventricular dysfunction. Collectively, these concepts frame a forward-thinking paradigm shift in the approach to right heart disease by emphasizing factors that regulate the transition from adaptive to maladaptive right ventricular–pulmonary vascular (patho)physiology. PMID:25610606

2014-01-01

454

Modeling congestive heart failure: a control system model with state delay  

E-print Network

Modeling congestive heart failure: a control system model with state delay Jerry Batzel 1 , Susanne cardiovascular-respiratory control system is presented and applied to modeling congestive heart failure to minimize de- viations of certain state variables. The model will consider the congestive heart condition

Batzel, Jerry

455

Serum uric acid as an index of impaired oxidative metabolism in chronic heart failure  

Microsoft Academic Search

Background Elevated serum uric acid concentrations have been observed in clinical conditions associated with hypoxia. Since chronic heart failure is a state of impaired oxidative metabolism, we sought to determine whether serum uric acid concentrations correlate with measures of functional capacity and disease severity. Methods Fifty nine patients with a diagnosis of chronic heart failure due to coronary heart disease

F. Leyva; S. Anker; J. W. Swan; T.-P. Chua; J. C. Stevensonf; A. J. S. Coats

456

Healthy Living in Middle Age Keeps Heart Failure At Bay Decades Later  

MedlinePLUS

... enable JavaScript. Healthy Living in Middle Age Keeps Heart Failure at Bay Decades Later Avoid obesity, hypertension, diabetes ... 2015 Related MedlinePlus Pages Diabetes Heart Diseases--Prevention Heart Failure THURSDAY, March 5, 2015 (HealthDay News) -- Are you ...

457

Cardiovascular Effects of Continuous Positive Airway Pressure in Patients with Heart Failure and Obstructive Sleep Apnea  

Microsoft Academic Search

background Obstructive sleep apnea subjects the failing heart to adverse hemodynamic and adre- nergic loads and may thereby contribute to the progression of heart failure. We hypoth- esized that treatment of obstructive sleep apnea by continuous positive airway pressure in patients with heart failure would improve left ventricular systolic function. methods Twenty-four patients with a depressed left ventricular ejection fraction

Yasuyuki Kaneko; John S. Floras; Kengo Usui; Julie Plante; Ruzena Tkacova; Toshihiko Kubo; Shin-ichi Ando; T. Douglas Bradley

2003-01-01

458

Cardiac-Resynchronization Therapy with or without an Implantable Defibrillator in Advanced Chronic Heart Failure  

Microsoft Academic Search

background We tested the hypothesis that prophylactic cardiac-resynchronization therapy in the form of biventricular stimulation with a pacemaker with or without a defibrillator would reduce the risk of death and hospitalization among patients with advanced chronic heart failure and intraventricular conduction delays. methods A total of 1520 patients who had advanced heart failure (New York Heart Association class III or

Michael R. Bristow; Leslie A. Saxon; John Boehmer; Steven Krueger; David A. Kass; Teresa De Marco; Peter Carson; Lorenzo DiCarlo; David DeMets; Bill G. White; Dale W. DeVries; Arthur M. Feldman

2010-01-01

459

The Role of Anemia in Congestive Heart Failure and Chronic Kidney Insufficiency  

Microsoft Academic Search

Anemia is a major problem in patients with chronic kidney insuffi- ciency.The development of recombinant human erythropoietin has enabled physicians to correct this anemia. Although anemia has not been considered to be a common or important contributor to congestive heart failure, anemia of any cause can lead to car- diac damage and eventually congestive heart failure. Our joint renal-cardiac heart

Donald S. Silverberg; Dov Wexler; Adrian Iaina

2004-01-01

460

Felodipine in patients with chronic heart failure: discrepant haemodynamic and clinical effects  

Microsoft Academic Search

Previous open studies have suggested that felodipine, a selective calcium antagonist and vasodilator, may be useful in the treatment of heart failure. A double blind placebo controlled crossover trial was therefore conducted to investigate the clinical and haemodynamic effects of felodipine in 15 patients with chronic ischaemic heart failure in New York Heart Association symptom class III. Felodipine significantly increased

L B Tan; R G Murray; W A Littler

1987-01-01

461

Combination of Isosorbide Dinitrate and Hydralazine in Blacks with Heart Failure  

Microsoft Academic Search

background We examined whether a fixed dose of both isosorbide dinitrate and hydralazine pro- vides additional benefit in blacks with advanced heart failure, a subgroup previously noted to have a favorable response to this therapy. methods A total of 1050 black patients who had New York Heart Association class III or IV heart failure with dilated ventricles were randomly assigned

Anne L. Taylor; Susan Ziesche; Clyde Yancy; Peter Carson; Ralph D'Agostino; Keith Ferdinand; Malcolm Taylor; Kirkwood Adams; Michael Sabolinski; Manuel Worcel; Jay N. Cohn

2010-01-01

462

Oxidative Stress and Heart Failure in Altered Thyroid States  

PubMed Central

Increased or reduced action of thyroid hormone on certain molecular pathways in the heart and vasculature causes relevant cardiovascular derangements. It is well established that hyperthyroidism induces a hyperdynamic cardiovascular state, which is associated with a faster heart rate, enhanced left ventricular systolic and diastolic function whereas hypothyroidism is characterized by the opposite changes. Hyperthyroidism and hypothyroidism represent opposite clinical conditions, albeit not mirror images. Recent experimental and clinical studies have suggested the involvement of ROS tissue damage under altered thyroid status. Altered-thyroid state-linked changes in heart modify their susceptibility to oxidants and the extent of the oxidative damage they suffer following oxidative challenge. Chronic increase in the cellular levels of ROS can lead to a catastrophic cycle of DNA damage, mitochondrial dysfunction, further ROS generation and cellular injury. Thus, these cellular events might play an important role in the development and progression of myocardial remodeling and heart failure in altered thyroid states (hypo- and hyper-thyroidism). The present review aims at elucidating the various signaling pathways mediated via ROS and their modulation under altered thyroid state and the possibility of antioxidant therapy. PMID:22649319

Mishra, Pallavi; Samanta, Luna

2012-01-01

463

Remodeling of Calcium Handling in Human Heart Failure  

PubMed Central

Heart failure (HF) is an increasing public health problem accelerated by a rapidly aging global population. Despite considerable progress in managing the disease, the development of new therapies for effective treatment of HF remains a challenge. To identify targets for early diagnosis and therapeutic intervention, it is essential to understand the molecular and cellular basis of calcium handling and the signaling pathways governing the functional remodeling associated with HF in humans. Calcium (Ca2+) cycling is an essential mediator of cardiac contractile function, and remodeling of calcium handling is thought to be one of the major factors contributing to the mechanical and electrical dysfunction observed in HF. Active research in this field aims to bridge the gap between basic research and effective clinical treatments of HF. This chapter reviews the most relevant studies of calcium remodeling in failing human hearts and discusses their connections to current and emerging clinical therapies for HF patients. PMID:22453987

Lou, Qing; Janardhan, Ajit; Efimov, Igor R.

2013-01-01

464

Metastatic Carcinoid Tumor Presenting As Right Sided Heart Failure  

PubMed Central

Carcinoid tumor is a slow-growing type of neuroendocrine tumor, originating in the enterochromaffin cells and secreting mainly serotonin. The diagnosis is based on clinical symptoms, hormone levels, radiological and nuclear imaging, and histological confirmation. The clinical symptoms are characterized by flushing, diarrhea, abdominal pain, telangiectasia and/or bronchoconstriction. However, most patients have metastatic disease at diagnosis because the clinic goes unnoticed or are ascribed to other abdominal conditions. We report the clinical symptoms, hormone levels, radiological and nuclear imaging, histological diagnosis, treatment and evaluation of a 44-year-old female patient with congestive heart failure secondary to carcinoid heart disease in the context of liver metastases of an ileum carcinoid tumor. PMID:23825984

Martinez-Quintana, Efren; Avila-Gonzalez, Maria Del Mar; Suarez-Castellano, Laura; Rodriguez-Gonzalez, Fayna

2013-01-01

465

Treatment of chronic heart failure with pirbuterol: acute haemodynamic responses.  

PubMed Central

Fifty-nine patients with severe chronic heart failure were given pirbuterol, a beta agonist with vasodilator and positive inotropic properties. The acute haemodynamic responses to both single (20 patients) and incremental doses (39 patients) were measured. Pirbuterol increased cardiac index and reduced left ventricular filling pressure and systemic vascular resistance with only small changes in heart rate and blood pressure. Maximal effects were observed at an average of 170 minutes after a single oral dose of pirbuterol. In the incremental dose studies the plasma pirbuterol concentration was found to increase with increasing doses and was related to the magnitude of the haemodynamic response. Pirbuterol was well tolerated, and no drug-related side effects were recorded. Oral pirbuterol clearly improved pump performance in these patients, the haemodynamic changes being consistent with vasodilatation as the dominant mechanism rather than a direct inotropic effect. PMID:6112039

Dawson, J R; Canepa-Anson, R; Kuan, P; Whitaker, N H; Carnie, J; Warnes, C; Reuben, S R; Poole-Wilson, P A; Sutton, G C

1981-01-01

466

Impact of Heart Failure on Hip Fracture Outcomes: A Population-Based Study  

PubMed Central

Background Hip fracture and heart failure are becoming more prevalent conditions in hospitalized patients. Despite differences in postoperative outcomes from other intermediate risk procedures, guidelines classify hip fracture repair as an intermediate risk operation. Objective This population-based study sought to examine the prevalence and incidence of heart failure in hip fracture patients. Design, Setting, and Patients We conducted a population-based historical cohort study of 1,116 Olmsted County, MN residents undergoing 1,212 hip surgeries from 1988 through 2002. Data were obtained through medical record review. Heart failure was defined by Framingham criteria. Results The prevalence of preoperative heart failure in our study population was 27% (327 of 1,212 cases). Those with preoperative heart failure demonstrated longer lengths of stay, were more often discharged to a skilled facility, and had higher inpatient mortality rates. Rates of postoperative heart failure were 6.7% at seven days and 21.3% at one year. Postoperative heart failure was more common among those with preoperative heart failure (HR 3.0), and those with preoperative heart failure demonstrated higher postoperative mortality rates. Men had a higher risk of postoperative mortality compared to women. Overall survival was lowest among those with both preoperative and postoperative heart failure. Conclusions Heart failure represents a common and serious perioperative condition in hip fracture patients. Hip fracture patients with and without heart failure carry higher postoperative risk than guidelines may suggest. Future work must focus on the perioperative management of hip fracture patients with and without heart failure to mitigate postoperative morbidity. PMID:22042721

Cullen, Michael W.; Gullerud, Rachel E.; Larson, Dirk R.; Melton, L. Joseph; Huddleston, Jeanne M.

2011-01-01

467

Multimarker Testing With ST2 in Chronic Heart Failure.  

PubMed

Despite important progress in recent decades, mortality remains high for patients with chronic heart failure. Risk stratification may be refined by the use of biomarkers for different pathophysiological processes that established mortality risk factors do not directly reflect. Biomarkers that are currently available can provide information about at least 7 pathobiological processes operative in HF, help to identify the specific processes involved in individual patients, and aid in constructing management plans. However, the additional prognostic information gained by any biomarker over a clinical risk model plus other biomarkers needs to be determined with adequate statistical tools. A major problem in selecting a biomarker profile is the proportional increase in economic burden; thus, the addition of any biomarker to a profile should be justified by adequate discrimination, calibration, reclassification, and likelihood analyses. Three studies that implemented such rigorous analyses have assessed a multimarker panel in chronic heart failure that incorporated the biomarker ST2: the Penn HF Study, the Barcelona Study, and the ProBNP Outpatient Tailored Chronic Heart Failure (PROTECT) biomarker substudy. In all 3 studies, a multimarker panel appeared to provide significant information over conventional risk stratification. The latter 2 reports proposed that ST2 might be superior to natriuretic peptides. The Barcelona Bio-HF calculator (www.bcnbiohfcalculator.cat) is a novel risk calculator that considers clinical variables, treatment, and biomarkers (i.e., N terminal pro-brain natriuretic peptide [NT-proBNP], ST2, and high sensitivity troponin T [hsTnT]). The optimal panel of markers, the change in these markers over time, and how these changes might help guide therapeutic interventions remain to be defined. PMID:25697916

Bayes-Genis, Antoni; Richards, A Mark; Maisel, Alan S; Mueller, Christian; Ky, Bonnie

2015-04-01

468

Mineralocorticoid receptor antagonists as diuretics: Can congestive heart failure learn from liver failure?  

PubMed

Despite significant improvements in diagnosis, understanding the pathophysiology and management of the patients with acute decompensated heart failure (ADHF), diuretic resistance, yet to be clearly defined, is a major hurdle. Secondary hyperaldosteronism is a pivotal factor in pathogenesis of sodium retention, refractory congestion in heart failure (HF) as well as diuretic resistance. In patients with decompensated cirrhosis who suffer from ascites, similar pathophysiological complications have been recognized. Administration of natriuretic doses of mineralocorticoid receptor antagonists (MRAs) has been well established in management of cirrhotic patients. However, this strategy in patients with ADHF has not been well studied. This article will discuss the potential use of natriuretic doses of MRAs to overcome the secondary hyperaldosteronism as an alternative diuretic regimen in patients with HF. PMID:25447845

Masoumi, Amirali; Ortiz, Fernando; Radhakrishnan, Jai; Schrier, Robert W; Colombo, Paolo C

2015-05-01

469

Sodium pump isoform expression in heart failure: implication for treatment.  

PubMed

In the human heart several isoforms of the sodium pump (Na,K-ATPase, the cardiac glycoside receptor) are expressed (alpha1beta1, alpha2beta1, and alpha3beta1). Their expression is regulated in a highly specific manner, so that there are region specific differences in the expression pattern. The isoform expression pattern is also known to be organ specific in many cases (e.g., kidney, skeletal muscle), suggesting isoform specific functions. In human heart, we have demonstrated that the isoform composition of the left ventricle is altered during heart failure in man and postulate a role of Na,K-ATPase isoforms in the compensatory mechanisms of this disease. When Na,K-ATPase isoforms were expressed separately in yeast cells, we found that the affinities of K and ouabain were lower for alpha2beta1 than for alpha1beta1 or alpha3beta1. In addition, alpha3beta1 had a lower turnover rate than alpha1beta1. Similar results were found in a study, where Na,K-ATPase isoforms were expressed in Xenopus oocytes. Thus, there is evidence for specific biochemical properties of the Na,K-ATPase isoforms. In heterozygous knock-out mice, in which either alpha1 or alpha2 isoforms were selectively reduced, only the lower expression and activity of alpha2 led to a hypercontractile response as seen with cardiac glycosides. Therefore in mice, the effect of cardiac glycosides seems to be mediated specifically by alpha2. In summary, there is a tissue-specific regulation of Na,K-ATPase isoform expression in humans, as well as a highly specific regulation of the isoforms during disease, e.g., heart failure. There is also evidence for specific biochemical properties of different isoforms of the human Na,K-ATPase as well as for a specific functional impact on cardiac contractility in mice. Therefore, the isoforms of human Na,K-ATPase are not exchangeable and targeting specific isoforms by drugs or gene therapy may promise therapeutic benefit in diseases like heart failure or atrial fibrillation. PMID:12479230

Müller-Ehmsen, Jochen; McDonough, Alicia A; Farley, Robert A; Schwinger, Robert H G

2002-01-01

470

Heart failure with preserved ejection fraction - unwinding the diagnosis mystique  

PubMed Central

A precise diagnosis of diastolic dysfunction is often difficult and requires invasive techniques to determine left ventricular volume, relaxation, and compliance properties. At this current point of time there is no single non-invasive index available to adequately reflect diastolic function, perhaps because of the numerous factors that can alter diastolic function. In most clinical settings, diastolic function is estimated using Doppler echocardiography. Cardiac magnetic resonance imaging (CMRI) is yet another emerging modality for diastolic function analysis. Here we present a comprehensive review of the various parameters used to assess diastolic function as part of diagnosis of clinical syndrome “Heart failure with preserved ejection fraction (HFPEF)”. PMID:25360388

Asrar ul Haq, Muhammad; Mutha, Vivek; Rudd, Nima; Hare, David L; Wong, Chiew

2014-01-01

471

Unexpected triggers for pheochromocytoma-induced recurrent heart failure.  

PubMed

Pheochromocytoma crisis typically presents as paroxysmal episodes of headache, tachycardia, diaphoresis or hypertension. We describe an uncommon case of recurrent non-hypertensive heart failure with systolic dysfunction in a young female due to pheochromocytoma compression. It presented as acute pulmonary oedema while straining during pregnancy and later on as cardiogenic shock after a recreational body massage. Such crisis occurring during pregnancy is rare. Moreover, of the few reported cases of pheochromocytoma-induced cardiogenic shock, recreational body massage has not yet been reported as a trigger for this condition. PMID:24987459

Pereira-da-Silva, Tiago; Abreu, João; Ramos, Ruben; Galrinho, Ana; Fortuna, Philip; Tavares, Nuno Jalles; Ferreira, Rui Cruz

2014-01-01

472

Unexpected triggers for pheochromocytoma-induced recurrent heart failure  

PubMed Central

Pheochromocytoma crisis typically presents as paroxysmal episodes of headache, tachycardia, diaphoresis or hypertension. We describe an uncommon case of recurrent non-hypertensive heart failure with systolic dysfunction in a young female due to pheochromocytoma compression. It presented as acute pulmonary oedema while straining during pregnancy and later on as cardiogenic shock after a recreational body massage. Such crisis occurring during pregnancy is rare. Moreover, of the few reported cases of pheochromocytoma-induced cardiogenic shock, recreational body massage has not yet been reported as a trigger for this condition. PMID:24987459