3251
|
Characteristics of patients with survival longer than 20 years following heart transplantation. ACTA ACUST UNITED AC 2013; 66:797-802. [PMID: 24773860 DOI: 10.1016/j.rec.2013.05.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2012] [Accepted: 05/08/2013] [Indexed: 12/14/2022]
Abstract
INTRODUCTION AND OBJECTIVES The number of heart-transplant recipients exceeding 20 years of follow-up is steadily increasing. However, little is known about their functional status, comorbidities, and mortality. Identifying the predictors of prolonged survival could guide the selection of candidates for the low number of available donors. METHODS Functional status, morbidities, and mortality of heart-transplant patients between 1984 and 1992 were analyzed. To identify predictors of 20-year survival, a logistic regression model was constructed using the covariates associated with survival in the univariate analysis. RESULTS A total of 39 patients who survived 20 years (26% of patients transplanted before 1992) were compared to 90 recipients from the same period who died between 1 and 20 years post-transplantation. Major complications were hypertension, renal dysfunction, infections, and cancer. After a mean follow-up of 30 months, 6 survivors had died, yielding a mortality rate of 6% per year (vs 2.5%-3% in years 1-19). Causes of mortality were infection (50%), malignancy (33%), and allograft vasculopathy (17%). Long-term survivors were younger and leaner, and had nonischemic cardiomyopathy and lower ischemic time. Logistic regression identified recipient age <45 years (odds ratio=3.9; 95% confidence interval, 1.6-9.7; P=.002) and idiopathic cardiomyopathy (odds ratio=3; 95% confidence interval, 1.4-7.8; P=.012) as independent predictors for 20-year survival. CONCLUSIONS One fourth of all heart-transplant patients in our series survived >20 years with the same graft, and most enjoy independent lives despite significant comorbidities. Recipient age <45 years and idiopathic cardiomyopathy were associated with survival beyond 2 decades. These data may help decide donor allocation.
Collapse
|
3252
|
Hira RS, Thamwiwat A, Kar B. TandemHeart placement for cardiogenic shock in acute severe mitral regurgitation and right ventricular failure. Catheter Cardiovasc Interv 2013; 83:319-22. [DOI: 10.1002/ccd.25107] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2013] [Revised: 06/10/2013] [Accepted: 06/27/2013] [Indexed: 11/10/2022]
Affiliation(s)
- Ravi S. Hira
- Division of Cardiology; Baylor College of Medicine; Houston Texas
| | - Alisa Thamwiwat
- Division of Cardiology; Baylor College of Medicine; Houston Texas
| | - Biswajit Kar
- Division of Cardiology; Baylor College of Medicine; Houston Texas
- Center for Advanced Heart Failure at Memorial Hermann Heart & Vascular Institute; Texas Medical Center and University of Texas Medical School at Houston; Houston Texas
- Division of Cardiology; Michael E. DeBakey VA Medical Center, Division of Cardiology; Houston Texas
| |
Collapse
|
3253
|
von Knobelsdorff-Brenkenhoff F, Trauzeddel RF, Schulz-Menger J. Cardiovascular magnetic resonance in adults with previous cardiovascular surgery. Eur Heart J Cardiovasc Imaging 2013; 15:235-48. [DOI: 10.1093/ehjci/jet138] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
|
3254
|
Self-care and communication issues at the end of life of recipients of a left-ventricular assist device as destination therapy. Curr Opin Support Palliat Care 2013; 7:29-35. [PMID: 23314013 DOI: 10.1097/spc.0b013e32835d2d50] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
PURPOSE OF REVIEW The purpose of this review is to provide an overview of self- care and communication issues at the end of life of patients with left-ventricular assist devices (LVADs) for destination therapy, based on recent research on end-of-life communication in other diseases. RECENT FINDINGS For many patients with advanced heart failure, LVADs as destination therapy improve survival and quality of life. However, LVADs can be associated with complications, new comorbidities or worsening of previous conditions, resulting in decreased quality of life and limited prognosis, raising the need for planning palliative and end-of-life care. Open communication addressing the consequences of the LVAD implantation for daily life and the future (including advance directives) is advised in different stages of the treatment, involving a multidisciplinary team taking care of these complex patients and their caregivers. SUMMARY Healthcare professionals treating patients before and after LVAD implantation need to take an active role in end-of-life discussions and be able to communicate information regarding expected complications, quality of life and prognosis to the patients and caregivers. Research is needed addressing optimal ways and timing of communication with LVAD patients and families.
Collapse
|
3255
|
Oh J, Kang SM, Hong N, Youn JC, Han S, Jeon ES, Cho MC, Kim JJ, Yoo BS, Chae SC, Oh BH, Choi DJ, Lee MM, Ryu KH. Hemoconcentration is a good prognostic predictor for clinical outcomes in acute heart failure: data from the Korean Heart Failure (KorHF) Registry. Int J Cardiol 2013; 168:4739-43. [PMID: 23958420 DOI: 10.1016/j.ijcard.2013.07.241] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2013] [Revised: 07/17/2013] [Accepted: 07/25/2013] [Indexed: 11/17/2022]
Abstract
BACKGROUND Hemoconcentration is a surrogate marker of effective decongestion and diuresis therapy. Recently, hemoconcentration has been associated with decreased mortality and rehospitalization in heart failure (HF) patients. However, the prognostic power of hemoconcentration in a large sample-sized HF cohort was limited until now. METHODS AND RESULTS We analyzed data from hospitalized patients with acute heart failure (AHF) that were enrolled in the Korean Heart Failure Registry(n=2,357). The primary end point was a composite of all-cause mortality and HF rehospitalization during the follow-up period (median=347, interquartile range=78-744 days).Hemoconcentration, defined as an increased hemoglobin level between admission and discharge, was presented in 1,016 AHF patients (43.1%). In multivariable logistic regression, hemoglobin, total cholesterol, and serum glucose levels at admission, and ischemic HF, were significant determinants for hemoconcentration occurrence. The Kaplan-Meier curve showed that event-free survival was significantly higher in the hemoconcentration group compared to the non-hemoconcentration group (65.1% vs. 58.1%, log rank p<0.001). In multiple Cox proportional hazard analysis, hemoconcentration was an independent predictor of the primary end point after adjusting for other HF risk factors (hazard ratio=0.671, 95% confidence interval=0.564-0.798, p<0.001). CONCLUSIONS Hemoconcentration during hospitalization was a prognostic marker of fewer clinical events in the AHF cohort. Therefore, this novel surrogate marker will help in the risk stratification of AHF patients.
Collapse
Affiliation(s)
- Jaewon Oh
- Division of Cardiology, Severance Cardiovascular Hospital and Cardiovascular Research Institute, Seoul, Korea
| | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
3256
|
Zachariah D, Olechowski B, Kalra PR. Clinical utility of biomarkers in chronic kidney disease and chronic heart failure. J Ren Care 2013; 39:128-39. [PMID: 23902278 DOI: 10.1111/j.1755-6686.2013.12025.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Biomarkers have an increasingly important clinical role in managing patients with heart failure as well as those with kidney disease, both common conditions with generally poor prognostic outcomes and huge impacts on healthcare economics. For patients with chronic heart failure, biomarkers have become centre place in streamlining diagnostic pathways as well as identifying those with worse prognosis. There is much interest in the role for biomarkers in identifying patients at risk of acute kidney injury, although a number of these currently remain as research tools or are in the early stages of evaluation in clinical practice. Patients with cardiorenal syndrome represent a particular challenge to the clinician, and recent studies have suggested a valuable clinical role for certain biomarkers in this setting, either on their own or in combination. This paper will focus on biomarkers with a current clinical role in patients with cardiorenal disease (natriuretic peptides and neutrophil gelatinase-associated lipocalin), although brief reference will be made to other biomarkers with potential future application.
Collapse
Affiliation(s)
- Donah Zachariah
- Department of Cardiology, Queen Alexandra Hospital, Portsmouth Hospitals NHS Trust, Portsmouth, Hampshire, UK.
| | | | | |
Collapse
|
3257
|
|
3258
|
Fiuzat M, O’Connor CM, Gueyffier F, Mascette AM, Geller NL, Mebazaa A, Voors AA, Adams KF, Piña IL, Neyses L, Muntendam P, Felker GM, Pitt B, Zannad F, Bristow MR. Biomarker-Guided Therapies in Heart Failure: A Forum for Unified Strategies. J Card Fail 2013; 19:592-9. [DOI: 10.1016/j.cardfail.2013.05.012] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2013] [Revised: 05/16/2013] [Accepted: 05/20/2013] [Indexed: 12/17/2022]
|
3259
|
Affiliation(s)
- Eberhard Standl
- Munich Diabetes Research Group e.V. at Helmholtz Centre, Munich, Germany.
| | | | | |
Collapse
|
3260
|
Kajimoto K, Sato N, Sakata Y, Takano T. Relationship between systolic blood pressure and preserved or reduced ejection fraction at admission in patients hospitalized for acute heart failure syndromes. Int J Cardiol 2013; 168:4790-5. [PMID: 23962780 DOI: 10.1016/j.ijcard.2013.07.226] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2012] [Revised: 07/18/2013] [Accepted: 07/25/2013] [Indexed: 10/26/2022]
Abstract
BACKGROUND Among patients with acute heart failure syndromes (AHFS), it has been reported that those with a reduced left ventricular ejection fraction (LVEF) tend to be hypotensive or normotensive, whereas those with a preserved LVEF tend to be hypertensive. However, it is unclear whether the systolic blood pressure (SBP) is actually associated with the LVEF in AHFS patients. Therefore, we evaluated the relationship between the SBP at admission and LVEF in patients hospitalized for AHFS. METHODS Data from the Acute Decompensated Heart Failure Syndromes (ATTEND) registry were analyzed to investigate the relationship between the admission SBP and a preserved or reduced LEF in AHFS patients. Of the 4,842 patients enrolled in this registry, 4,831 patients (99.8%) were evaluated. They were divided into SBP quartiles (SBP <120, 120 to <140, 140 to <160, and ≥160 mmHg), and LVEF was compared among the quartiles. RESULTS Patients with an admission SBP <120 mmHg were more likely to have a reduced LVEF than a preserved LVEF. In contrast, patients with an admission SBP ≥120 mmHg were equally likely to have a preserved or reduced LVEF, indicating that there was no relation between a higher admission SBP and the LVEF. CONCLUSIONS Our data indicated that an elevated SBP at admission may not be useful to distinguish between a preserved or reduced LVEF in the urgent phase of AHFS. However, taking geographical differences of AHFS into consideration, further investigations are needed to clarify the relationship between admission SBP and LVEF in patients hospitalized for AHFS.
Collapse
|
3261
|
Left bundle-branch block: the relationship between electrocardiogram electrical activation and echocardiography mechanical contraction. Am Heart J 2013; 166:340-8. [PMID: 23895818 DOI: 10.1016/j.ahj.2013.04.005] [Citation(s) in RCA: 69] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2012] [Accepted: 04/13/2013] [Indexed: 11/22/2022]
Abstract
BACKGROUND The relationship between myocardial electrical activation by electrocardiogram (ECG) and mechanical contraction by echocardiography in left bundle-branch block (LBBB) has never been clearly demonstrated. New strict criteria for LBBB based on a fundamental understanding of physiology have recently been independently published for both ECG and echocardiography. The relationship between the 2 modalities and the relation to cardiac resynchronization therapy (CRT) response was investigated. METHODS Sixty-six patients with LBBB by conventional criteria had a standard 12-lead ECG and 2-dimensional strain echocardiography performed before CRT implantation. Criteria for LBBB by echocardiography included early termination of contraction in one wall and prestretch and late contraction in opposing wall(s). New strict criteria by ECG included QRS duration ≥140 ms (men) or 130 ms (women), QS or rS in leads V1 and V2, and mid-QRS notching or slurring in ≥2 of leads V1, V2, V5, V6, I, and aVL. Response was defined as >15% decrease in left ventricular end-systolic volume after 6 months. RESULTS In 64 of 66 patients, ECG analysis was possible. Echo and ECG readings for LBBB presence were concordant in 54 (84%) of 64. Thirty-seven (82%) of 45 patients with LBBB by strict ECG criteria responded to CRT, whereas only 4 (21%) of the 19 patients without LBBB responded (sensitivity 90% and specificity 65%). Thirty-six (95%) of 38 patients with concordance for the presence of LBBB responded to CRT. In patients with concordance for the absence of LBBB, 15 (94%) of 16 did not respond. CONCLUSION For the first time, a close relation has been demonstrated between electrical activation by ECG and mechanical contraction by echocardiography. These findings may help identify CRT candidates.
Collapse
|
3262
|
Comparison of clinical guidelines for the diagnosis and treatment of chronic heart failure of ČKS and ESC 2012. COR ET VASA 2013. [DOI: 10.1016/j.crvasa.2013.03.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
|
3263
|
Abstract
CLINICAL ISSUE Cardiomyopathies and myocarditis are frequently challenging in clinical practice regarding differentiation, risk stratification and treatment strategy. There are various disease entities which often affect young or middle-aged adults and the course is variable from asymptomatic and irrelevant for prognosis to sudden cardiac death or severe heart failure even at an early age. Making the right diagnosis is therefore fundamental to correctly identify affected patients and to initiate treatment steps in time. STANDARD TREATMENT Whereas causal treatment options exist for some forms of cardiomyopathy, the majority of patients receives standard heart failure and device therapy but others require lifelong careful monitoring. DIAGNOSTIC WORK-UP The diagnosis of cardiomyopathy is mainly based on the cardiac phenotype; therefore, non-invasive imaging is very important. Cardiovascular magnetic resonance has become the gold standard to assess cardiomyopathy as it combines functional information (e.g. wall motion) with myocardial tissue analysis (e.g. fibrosis and edema) and in some cases it can replace invasive endomyocardial biopsies. PERFORMANCE The importance of cardiovascular magnetic resonance to assess cardiomyopathy is based on several aspects: accurate analysis of cardiac dimensions and function, non-invasive tissue analysis to make the diagnosis (e.g. myocarditis), estimation of prognosis by non-invasive tissue analysis, high reproducibility for accurate follow-up examinations, potential for technical improvements (e.g. quantification of extracellular volume fraction by T1 mapping). ACHIEVEMENTS In all types of cardiomyopathy, cardiovascular magnetic resonance has a major impact on the differential diagnosis, risk stratification and treatment. In some entities the appropriate clinical use is already confirmed by evidence (e.g. myocarditis) and in others there are first encouraging results that indicate the future potential (e.g. risk stratification in hypertrophic cardiomyopathy). PRACTICAL RECOMMENDATIONS Cardiovascular magnetic resonance has evolved as the gold standard to assess cardiomyopathy as it provides both functional and morphological information. It is recommended to use this technique in a comprehensive approach to achieve complete work-up of affected patients.
Collapse
|
3264
|
|
3265
|
[Utility of B-type natriuretic peptide measurement in outpatients with heart failure with preserved ejection fraction]. Rev Port Cardiol 2013; 32:647-52. [PMID: 23910641 DOI: 10.1016/j.repc.2012.10.019] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2012] [Revised: 09/14/2012] [Accepted: 10/11/2012] [Indexed: 11/20/2022] Open
Abstract
INTRODUCTION Heart failure with preserved ejection fraction (HFPEF) is a highly prevalent syndrome that is difficult to diagnose in outpatients. The measurement of B-type natriuretic peptide (BNP) may be useful in the diagnosis of HFPEF, but with a different cutoff from that used in the emergency room. The aim of this study was to identify the BNP cutoff for a diagnosis of HFPEF in outpatients. METHODS AND RESULTS This prospective, observational study enrolled 161 outpatients (aged 68.1±11.5 years, 72% female) with suspected HFPEF. Patients underwent ECG, tissue Doppler imaging, and plasma BNP measurement, and were classified in accordance with algorithms for the diagnosis of HFPEF. HFPEF was confirmed in 49 patients, who presented higher BNP values (mean 144.4pg/ml, median 113pg/ml, vs. mean 27.6pg/ml, median 16.7pg/ml, p<0.0001). The results showed a significant correlation between BNP levels and left atrial volume index (r=0.554, p<0.0001), age (r=0.452; p<0.0001) and E/E' ratio (r=0.345, p<0.0001). The area under the ROC curve for BNP to detect HFPEF was 0.92 (95% confidence interval: 0.87-0.96; p<0.001), and 51pg/ml was identified as the best cutoff to detect HFPEF, with sensitivity of 86%, specificity of 86% and accuracy of 86%. CONCLUSIONS BNP levels in outpatients with HFPEF are significantly higher than in those without. A cutoff value of 51pg/ml had the best diagnostic accuracy in outpatients.
Collapse
|
3266
|
Abstract
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.
Collapse
Affiliation(s)
- S Reda
- Klinik II für Innere Medizin, Paracelsus Medizinische Privatuniversität, Müllner Hauptstr. 48, A-5020, Salzburg, Österreich,
| | | | | |
Collapse
|
3267
|
The direct factor Xa inhibitor Rivaroxaban reduces platelet activation in congestive heart failure. Pharmacol Res 2013; 74:49-55. [DOI: 10.1016/j.phrs.2013.05.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2013] [Revised: 05/03/2013] [Accepted: 05/16/2013] [Indexed: 11/22/2022]
|
3268
|
Schroten NF, Ruifrok WPT, Kleijn L, Dokter MM, Silljé HH, Lambers Heerspink HJ, Bakker SJL, Kema IP, van Gilst WH, van Veldhuisen DJ, Hillege HL, de Boer RA. Short-term vitamin D3 supplementation lowers plasma renin activity in patients with stable chronic heart failure: an open-label, blinded end point, randomized prospective trial (VitD-CHF trial). Am Heart J 2013; 166:357-364.e2. [PMID: 23895820 DOI: 10.1016/j.ahj.2013.05.009] [Citation(s) in RCA: 84] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2012] [Accepted: 05/02/2013] [Indexed: 01/21/2023]
Abstract
BACKGROUND Many chronic heart failure (CHF) patients have low vitamin D (VitD) and high plasma renin activity (PRA), which are both associated with poor prognosis. Vitamin D may inhibit renin transcription and lower PRA. We investigated whether vitamin D3 (VitD3) supplementation lowers PRA in CHF patients. METHODS AND RESULTS We conducted a single-center, open-label, blinded end point trial in 101 stable CHF patients with reduced left ventricular ejection fraction. Patients were randomized to 6 weeks of 2,000 IU oral VitD3 daily or control. At baseline, mean age was 64 ± 10 years, 93% male, left ventricular ejection fraction 35% ± 8%, and 56% had VitD deficiency. The geometric mean (95% CI) of 25-hydroxyvitamin D3 increased from 48 nmol/L (43-54) at baseline to 80 nmol/L (75-87) after 6 weeks in the VitD3 treatment group and decreased from 47 nmol/L (42-53) to 44 nmol/L (39-49) in the control group (P < .001). The primary outcome PRA decreased from 6.5 ng/mL per hour (3.8-11.2) to 5.2 ng/mL per hour (2.9-9.5) in the VitD3 treatment group and increased from 4.9 ng/mL per hour (2.9-8.5) to 7.3 ng/mL per hour (4.5-11.8) in the control group (P = .002). This was paralleled by a larger decrease in plasma renin concentration in the VitD3 treatment group compared to control (P = .020). No significant changes were observed in secondary outcome parameters, including N-terminal pro-B-type natriuretic peptide natriuretic peptide and fibrosis markers. CONCLUSIONS Most CHF patients had VitD deficiency and high PRA levels. Six weeks of supplementation with 2,000 IU VitD3 increased 25-hydroxyvitamin D3 levels and decreased PRA and plasma renin concentration.
Collapse
Affiliation(s)
- Nicolas F Schroten
- Department of Cardiology, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
3269
|
|
3270
|
Inflammatory cardiomyopathy: Still many questions await answers. COR ET VASA 2013. [DOI: 10.1016/j.crvasa.2013.03.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
|
3271
|
Goncalvesová E. Durable left ventricular assist devices - the minimum for referring cardiologists. COR ET VASA 2013. [DOI: 10.1016/j.crvasa.2013.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
|
3272
|
Roubille F, Lattuca B, Busseuil D, Leclercq F, Davy JM, Rhéaume E, Tardif JC. Is ivabradine suitable to control undesirable tachycardia induced by dobutamine in cardiogenic shock treatment? Med Hypotheses 2013; 81:202-6. [DOI: 10.1016/j.mehy.2013.05.002] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2013] [Accepted: 05/02/2013] [Indexed: 12/26/2022]
|
3273
|
Effect of If-channel inhibition on hemodynamic status and exercise tolerance in heart failure with preserved ejection fraction: a randomized trial. J Am Coll Cardiol 2013; 62:1330-8. [PMID: 23916925 DOI: 10.1016/j.jacc.2013.06.043] [Citation(s) in RCA: 156] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2013] [Revised: 05/22/2013] [Accepted: 06/13/2013] [Indexed: 12/22/2022]
Abstract
OBJECTIVES The aim of this study was to test the effects of treatment with ivabradine on exercise capacity and left ventricular filling in patients with heart failure with preserved ejection fraction (HFpEF). BACKGROUND Because symptoms of HFpEF are typically exertional, optimization of diastolic filling time by controlling heart rate may delay the onset of symptoms. METHODS Sixty-one patients with HFpEF were randomly assigned to ivabradine 5 mg twice daily (n = 30) or placebo (n = 31) for 7 days in this double-blind trial. Cardiopulmonary exercise testing with echocardiographic assessment of myocardial function and left ventricular filling were undertaken at rest and after exercise. RESULTS The ivabradine group demonstrated significant improvement between baseline and follow-up exercise capacity (4.2 ± 1.8 METs vs. 5.7 ± 1.9 METs, p = 0.001) and peak oxygen uptake (14.0 ± 6.1 ml/min/kg vs. 17.0 ± 3.3 ml/min/kg, p = 0.001), with simultaneous reduction in exercise-induced increase in the ratio of peak early diastolic mitral flow velocity to peak early diastolic mitral annular velocity (3.1 ± 2.7 vs. 1.3 ± 2.0, p = 0.004). Work load-corrected chronotropic response (the difference in heart rate at the same exercise time at the baseline and follow-up tests) showed a slower increase in heart rate during exercise than in the placebo-treated group. Therapy with ivabradine (β = 0.34, p = 0.04) and change with treatment in exertional increase in the ratio of peak early diastolic mitral flow velocity to peak early diastolic mitral annular velocity (β = -0.30, p = 0.02) were independent correlates of increase in exercise capacity, and therapy with ivabradine (β = 0.32, p = 0.007) was independently correlated with increase in peak oxygen uptake. CONCLUSIONS In patients with HFpEF, short-term treatment with ivabradine increased exercise capacity, with a contribution from improved left ventricular filling pressure response to exercise as reflected by the ratio of peak early diastolic mitral flow velocity to peak early diastolic mitral annular velocity. Because this patient population is symptomatic on exertion, therapeutic treatments targeting abnormal exercise hemodynamic status may prove useful. (Use of Exercise and Medical Therapies to Improve Cardiac Function Among Patients With Exertional Shortness of Breath Due to Lung Congestion; ACTRN12610001087044).
Collapse
|
3274
|
|
3275
|
Khan MA, Ahmed F, Neyses L, Mamas MA. Atrial fibrillation in heart failure: The sword of Damocles revisited. World J Cardiol 2013; 5:215-227. [PMID: 23888191 PMCID: PMC3722419 DOI: 10.4330/wjc.v5.i7.215] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2013] [Revised: 06/06/2013] [Accepted: 06/20/2013] [Indexed: 02/06/2023] Open
Abstract
Heart failure (HF) and atrial fibrillation (AF) frequently coexist and have emerged as major cardiovascular epidemics. There is growing evidence that AF is an independent prognostic marker in HF and affects patients with both reduced as well as preserved LV systolic function. There has been a general move in clinical practice from a rhythm control to a rate control strategy in HF patients with AF, although recent data suggests that rhythm control strategies may provide better outcomes in selected subgroups of HF patients. Furthermore, various therapeutic modalities including pace and ablate strategies with cardiac resynchronisation or radiofrequency ablation have become increasingly adopted, although their role in the management of AF in patients with HF remains uncertain. This article presents an overview of the multidimensional impact of AF in patients with HF. Relevant literature is highlighted and the effect of various therapeutic modalities on prognosis is discussed. Finally, while novel anticoagulants usher in a new era in thromboprophylaxis, research continues in a variety of new pathways including selective atrial anti-arrhythmic agents and genomic polymorphisms in AF with HF.
Collapse
|
3276
|
Tavazzi L, Maggioni AP, Borer JS. Should we revise our approach to 'optimal medical therapy'? The case of chronic heart failure. Eur Heart J 2013; 34:2792-4. [DOI: 10.1093/eurheartj/eht279] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
3277
|
|
3278
|
Lessons from Lisbon on AHF drug treatment: is it really true that all-old-failed-all-new-will-succeed? Int J Cardiol 2013; 168:4798-9. [PMID: 23886529 DOI: 10.1016/j.ijcard.2013.07.042] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2013] [Accepted: 07/01/2013] [Indexed: 11/21/2022]
|
3279
|
Abstract
The family of polyunsaturated fatty acids (PUFAs), which can be found in most lipid classes, includes n-3 PUFAs essential for mammals and whose deficiency is associated with multiple diseases. Because of their multiple physiological actions, n-3 PUFAs play a crucial role in normal human metabolism as well as maintenance of a healthy status, with clinical effects that are not limited to the cardiovascular system but also include maternal and offspring health, growth and development, immune system disorders, cancer, cognitive function and psychological status. Multiple health organisations and scientific societies recommend increasing food-derived n-3 PUFA intake and also suggest that patients with documented coronary heart disease receive a minimum of 1000 mg/day of eicosapentaenoic acid and docosahexaenoic acid. The preventive and therapeutic effects of n-3 PUFAs appear to be largely dependent on the dosages employed and the characteristics of selected patients. So, in the era of personalised medicine, the time has come to move from generic advice to increase n-3 PUFA intake to a more evidence-based approach characterised by tailored indications to n-3 PUFA dietary or supplement consumption. This approach will require evaluation on a case-to-case basis the potential usefulness of n-3 PUFAs, taking into consideration their 'pleiotropic effects', the optimal dose for any given indication in relation to international guidelines, potential interactions with background therapy, possible side effects, differences in genetics and dietary response to supplementation, and the cost:benefit ratio, which is likely to vary as a function of differences in the range of fish intake in the diet.
Collapse
|
3280
|
Stockburger M, de Teresa E, Lamas G, Desaga M, Koenig C, Habedank D, Cobo E, Navarro X, Wiegand U. Exercise capacity and N-terminal pro-brain natriuretic peptide levels with biventricular vs. right ventricular pacing for atrioventricular block: results from the PREVENT-HF German Substudy. Europace 2013; 16:63-70. [PMID: 23861381 DOI: 10.1093/europace/eut217] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
AIMS Previous studies showed unfavourable effects of right ventricular (RV) pacing. Ventricular pacing (VP), however, is required in many patients with atrioventricular (AV) block. The PREVENT-HF study explored left ventricular (LV) remodelling during RV vs. biventricular (BIV) pacing in AV block without advanced heart failure. The pre-specified PREVENT-HF German Substudy examined exercise capacity and N-terminal pro-brain natriuretic peptide (NT-proBNP). METHODS AND RESULTS Patients with expected VP ≥80% were randomized to RV or BIV pacing. Endpoints were peak oxygen uptake (pVO2), oxygen uptake at the anaerobic threshold (VO2AT), ventilatory efficiency (VE/VCO2), and logNT-proBNP. Considering crossover, intention to treat (ITT), and on-treatment (OT) analyses of covariance (ANCOVA) were performed. For exercise testing 44 (RV: 25, BIV: 19), and for NT-proBNP 53 patients (RV: 29, BIV: 24) were included. The ITT analysis revealed significant differences in pVO2 [ANCOVA effect 2.83 mL/kg/min, confidence interval (CI) 0.83-4.91, P = 0.007], VO2AT (ANCOVA effect 2.14 mL/min/k, CI 0.14-4.15, P = 0.03), and VE/VCO2 (ANCOVA effect -5.46, CI -10.79 to -0.13, P = 0.04) favouring BIV randomization. The significant advantage in pVO2 persisted in OT analysis, while VO2AT and VE/VCO2 showed trends favouring BIV pacing. LogNT-proBNP did not differ between groups. (ITT: ANCOVA effect 0.008, CI -0.40 to +0.41, P = 0.97; OT: ANCOVA effect -0.03, CI -0.44 to 0.30, P = 0.90). CONCLUSION Our study suggests that BIV pacing produces better exercise capacity over 1 year compared with RV pacing in patients without advanced heart failure and AV block. In contrast, we observed no significant changes of NT-proBNP. Larger trials will allow appraising the clinical usefulness of BIV pacing in AV block. ClinicalTrials.gov Identifier: NCT00170326.
Collapse
Affiliation(s)
- Martin Stockburger
- Charité - Universitaetsmedizin Berlin, Experimental and Clinical Research Center (ECRC), Lindenberger Weg 80, 13125 Berlin, Germany
| | | | | | | | | | | | | | | | | |
Collapse
|
3281
|
Abstract
PURPOSE OF REVIEW Imaging plays a central role in the diagnosis, assessment of cause and guiding treatment in heart failure. Several modalities are available that are of relevance in patients with heart failure, although echocardiography continues to be the method of choice due to widespread availability, good safety profile and low cost. RECENT FINDINGS Echocardiography is appropriate in diagnosis of heart failure when placed in clinical context and supported by measurement of biomarkers. New methods of diagnosis of heart failure with preserved ejection fraction are emerging. The role of cardiovascular magnetic resonance (CMR) continues to expand in assessing cause of heart failure, with simpler methods for assessment of myocardial deformation and extracellular fibrosis. These progressively supplant the use of cardiac catheterization, although the value of myocardial viability assessment is now questionable. As utilization of cardiac resynchronization therapy continues to grow, the role of dyssynchrony beyond the ECG is being re-evaluated. SUMMARY Echocardiography remains at the forefront in heart failure, although CMR is complementary and the role of invasive cardiac catheterization may be diminishing.
Collapse
|
3282
|
|
3283
|
|
3284
|
Diuretic Use in Heart Failure and Outcomes. Clin Pharmacol Ther 2013; 94:490-8. [DOI: 10.1038/clpt.2013.140] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2013] [Accepted: 07/08/2013] [Indexed: 01/08/2023]
|
3285
|
Bartos JA, Francis GS. The High-Risk Patient With Heart Failure With Reduced Ejection Fraction: Treatment Options and Challenges. Clin Pharmacol Ther 2013; 94:509-18. [DOI: 10.1038/clpt.2013.137] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2013] [Accepted: 07/08/2013] [Indexed: 12/17/2022]
|
3286
|
Gillebert TC, Brooks N, Fontes-Carvalho R, Fras Z, Gueret P, Lopez-Sendon J, Salvador MJ, van den Brink RBA, Smiseth OA, Griebenow R, Kearney P, Vahanian A, Bauersachs J, Bax J, Burri H, Caforio ALP, Calvo F, Charron P, Ertl G, Flachskampf F, Giannuzzi P, Gibbs S, Goncalves L, Gonzalez-Juanatey JR, Hall J, Herpin D, Iaccarino G, Iung B, Kitsiou A, Lancellotti P, McDonough T, Monsuez JJ, Nunez IJ, Plein S, Porta-Sanchez A, Priori S, Price S, Regitz-Zagrosek V, Reiner Z, Ruilope LM, Schmid JP, Sirnes PA, Sousa-Ouva M, Stepinska J, Szymanski C, Taggart D, Tendera M, Tokgozoglu L, Trindade P, Zeppenfeld K, Joubert L, Carrera C. ESC Core Curriculum for the General Cardiologist (2013). Eur Heart J 2013; 34:2381-411. [DOI: 10.1093/eurheartj/eht234] [Citation(s) in RCA: 61] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
|
3287
|
Ersbøll M, Valeur N, Andersen MJ, Mogensen UM, Vinther M, Svendsen JH, Møller JE, Kisslo J, Velazquez EJ, Hassager C, Søgaard P, Køber L. Early echocardiographic deformation analysis for the prediction of sudden cardiac death and life-threatening arrhythmias after myocardial infarction. JACC Cardiovasc Imaging 2013; 6:851-60. [PMID: 23850252 DOI: 10.1016/j.jcmg.2013.05.009] [Citation(s) in RCA: 80] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2013] [Revised: 05/24/2013] [Accepted: 05/30/2013] [Indexed: 11/16/2022]
Abstract
OBJECTIVES This study sought to hypothesize that global longitudinal strain (GLS) as a measure of infarct size, and mechanical dispersion (MD) as a measure of myocardial deformation heterogeneity, would be of incremental importance for the prediction of sudden cardiac death (SCD) or malignant ventricular arrhythmias (VA) after acute myocardial infarction (MI). BACKGROUND SCD after acute MI is a rare but potentially preventable late complication predominantly caused by malignant VA. Novel echocardiographic parameters such as GLS and MD have previously been shown to identify patients with chronic ischemic heart failure at increased risk for arrhythmic events. Risk prediction during admission for acute MI is important because a majority of SCD events occur in the early period after hospital discharge. METHODS We prospectively included patients with acute MI and performed echocardiography, with measurements of GLS and MD defined as the standard deviation of time to peak negative strain in all myocardial segments. The primary composite endpoint (SCD, admission with VA, or appropriate therapy from a primary prophylactic implantable cardioverter-defibrillator [ICD]) was analyzed with Cox models. RESULTS A total of 988 patients (mean age: 62.6 ± 12.1 years; 72% male) were included, of whom 34 (3.4%) experienced the primary composite outcome (median follow-up: 29.7 months). GLS (hazard ratio [HR]: 1.38; 95% confidence interval [CI]: 1.25 to 1.53; p < 0.0001) and MD (HR/10 ms: 1.38; 95% CI: 1.24 to 1.55; p < 0.0001) were significantly related to the primary endpoint. GLS (HR 1.24; 95% CI: 1.10 to 1.40; p = 0.0004) and MD (HR/10 ms: 1.15; 95% CI: 1.01 to 1.31; p = 0.0320) remained independently prognostic after multivariate adjustment. Integrated diagnostic improvement (IDI) and net reclassification index (NRI) were significant for the addition of GLS (IDI: 4.4% [p < 0.05]; NRI: 29.6% [p < 0.05]), whereas MD did not improve risk reclassification when GLS was known. CONCLUSIONS Both GLS and MD were significantly and independently related to SCD/VA in these patients with acute MI and, in particular, GLS improved risk stratification above and beyond existing risk factors.
Collapse
Affiliation(s)
- Mads Ersbøll
- The Heart Centre, Department of Cardiology, Rigshospitalet, Copenhagen University, Copenhagen, Denmark.
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
3288
|
Boyne JJJ, Van Asselt ADI, Gorgels APM, Steuten LMG, De Weerd G, Kragten J, Vrijhoef HJM. Cost-effectiveness analysis of telemonitoring versus usual care in patients with heart failure: the TEHAF-study. J Telemed Telecare 2013; 19:242-8. [PMID: 24163233 DOI: 10.1177/1357633x13495478] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
We examined the incremental cost-effectiveness of telemonitoring (TM) versus usual care (UC) in patients with congestive heart failure (CHF). In one university and two general hospitals, 382 patients were randomised to usual care or telemonitoring and followed for 1 year. Hospital-related and home costs were estimated, based on resource use multiplied by the appropriate unit prices. Effectiveness was expressed as QALYs gained. Information was gathered, using 3 monthly costs diaries and questionnaires. The mean age of the patients was 71 years (range 32-93), 59% were male and 64% lived with a partner. Health related quality of life improved by 0.07 points for the usual care and 0.1 points for the telemonitoring group, but the difference between groups was not significant. There were no significant differences in annual costs per patient between groups. At a threshold of €50,000 the probability of telemonitoring being cost-effective was 48%. The cost effectiveness analysis showed a high level of decision uncertainty, probably caused by the divergence between the participating institutions. It is therefore premature to draw an unambiguous conclusion regarding cost-effectiveness for the whole group.
Collapse
Affiliation(s)
- Josiane J J Boyne
- Department of Patient and Care, Maastricht University Medical Centre, Maastricht, The Netherlands
| | | | | | | | | | | | | |
Collapse
|
3289
|
Relaxin for Treatment of Acute Heart Failure: Making the Case for Treating Targeted Patient Profiles. Curr Heart Fail Rep 2013; 10:198-203. [DOI: 10.1007/s11897-013-0148-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
|
3290
|
Giavarini A, Chedid A, Bobrie G, Plouin PF, Hagège A, Amar L. Acute catecholamine cardiomyopathy in patients with phaeochromocytoma or functional paraganglioma. Heart 2013; 99:1438-44. [PMID: 23837998 DOI: 10.1136/heartjnl-2013-304073] [Citation(s) in RCA: 86] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVE Phaeochromocytomas and paragangliomas (PPGL) can cause acute catecholamine cardiomyopathy (ACC). We assessed the prevalence of ACC and compared the presentation of cases with and without ACC in a large series of PPGL. DESIGN Single centre retrospective study. SETTING Hypertension Unit, University Hospital, Paris. PATIENTS 140 consecutive patients with PPGL, referred from January 2003 to September 2012. MAIN OUTCOME MEASURES Left ventricular ejection fraction (LVEF), perioperative mortality. RESULTS Fifteen patients (11%) had suffered an ACC, occurring in 14 cases before the diagnosis of PPGL. Precipitating factors were identified in 11 cases. Twelve patients presented with acute pulmonary oedema, including 10 with cardiogenic shock, requiring life support in eight cases. Seven patients (five with pulmonary oedema) presented with acute chest pain and cardiac dysfunction. Electrocardiographic abnormalities were present in 14 cases: ST segment elevation or pathological Q waves, ST segment depression, and/or diffuse T wave inversion. Six patients displayed classical (apical ballooning) or inverted (basal/mid ventricular stunning) takotsubo-like cardiomyopathy. Coronary arteries were always normal on angiography. In patients with ACC, median LVEF rose from 30% (IQR 23-33%) during ACC to 71% (50-72%) before surgery (n=11, p<0.001). Median LVEF before PPGL surgery was 65% (51-72%) and 65% (60-70%) in patients with and without a history of ACC, respectively (not significant). CONCLUSIONS PPGL may present as ACC in 11% of cases, excluding patients dying from undiagnosed tumours. Left ventricular dysfunction is usually reversible before surgery. PPGL should be suspected in patients with acute heart failure without evidence of valvular or coronary artery disease.
Collapse
Affiliation(s)
- Alessandra Giavarini
- Hypertension Unit, Université Paris-Descartes, Sorbonne Paris Cité, Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Paris cedex 15, France
| | | | | | | | | | | |
Collapse
|
3291
|
Affiliation(s)
- François Roubille
- Montreal Heart Institute, 5000 Belanger St, Montreal, PQ H1T 1C8, QC, Canada
| | | |
Collapse
|
3292
|
Hawkins NM, Virani S, Ceconi C. Heart failure and chronic obstructive pulmonary disease: the challenges facing physicians and health services. Eur Heart J 2013; 34:2795-803. [PMID: 23832490 DOI: 10.1093/eurheartj/eht192] [Citation(s) in RCA: 140] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Pulmonary disease is common in patients with heart failure, through shared risk factors and pathophysiological mechanisms. Adverse pulmonary vascular remodelling and chronic systemic inflammation characterize both diseases. Concurrent chronic obstructive pulmonary disease presents diagnostic and therapeutic challenges, and is associated with increased morbidity and mortality. The cornerstones of therapy are beta-blockers and beta-agonists, whose pharmacological properties are diametrically opposed. Each disease is implicated in exacerbations of the other condition, greatly increasing hospitalizations and associated health care costs. Such multimorbidity is a key challenge for health-care systems oriented towards the treatment of individual diseases. Early identification and treatment of cardiopulmonary disease may alleviate this burden. However, diagnostic and therapeutic strategies require further validation in patients with both conditions.
Collapse
Affiliation(s)
- Nathaniel M Hawkins
- Institute of Cardiovascular Medicine and Science, Liverpool Heart and Chest Hospital, Thomas Drive, Liverpool L14 3PE, UK
| | | | | |
Collapse
|
3293
|
Bauersachs J. The ARTS of third-generation mineralocorticoid receptor antagonists: achieving cardiovascular benefit with minimized renal side effects? Eur Heart J 2013; 34:2426-8. [PMID: 23824829 DOI: 10.1093/eurheartj/eht235] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
|
3294
|
Wang NC, Piccini JP, Fonarow GC, Knight BP, Harinstein ME, Butler J, Lahiri MK, Metra M, Vaduganathan M, Gheorghiade M. The potential role of nonpharmacologic electrophysiology-based interventions in improving outcomes in patients hospitalized for heart failure. Heart Fail Clin 2013; 9:331-43, vi-vii. [PMID: 23809419 DOI: 10.1016/j.hfc.2013.04.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Hospitalization for heart failure (HHF) is commonly associated with symptomatic improvement in response to standard medical therapy, yet there remains a substantial risk of rehospitalization and death. Clinically stable outpatients and decompensated inpatients represent two types of patients with chronic heart failure. In the former, treatment of common heart rhythm disorders with nonpharmacologic electrophysiology-based interventions is of substantial benefit in select patients. The potential benefits of these interventions in the hospitalized setting are not well studied. In this review, current knowledge is discussed and future research directions are suggested with nonpharmacologic electrophysiology-based interventions to reduce the morbidity and mortality associated with patients with HHF.
Collapse
Affiliation(s)
- Norman C Wang
- Heart and Vascular Institute, University of Pittsburgh Medical Center, 200 Lothrop Street, Pittsburgh, PA 15213, USA
| | | | | | | | | | | | | | | | | | | |
Collapse
|
3295
|
Caforio ALP, Pankuweit S, Arbustini E, Basso C, Gimeno-Blanes J, Felix SB, Fu M, Heliö T, Heymans S, Jahns R, Klingel K, Linhart A, Maisch B, McKenna W, Mogensen J, Pinto YM, Ristic A, Schultheiss HP, Seggewiss H, Tavazzi L, Thiene G, Yilmaz A, Charron P, Elliott PM. Current state of knowledge on aetiology, diagnosis, management, and therapy of myocarditis: a position statement of the European Society of Cardiology Working Group on Myocardial and Pericardial Diseases. Eur Heart J 2013; 34:2636-48, 2648a-2648d. [PMID: 23824828 DOI: 10.1093/eurheartj/eht210] [Citation(s) in RCA: 2083] [Impact Index Per Article: 189.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
In this position statement of the ESC Working Group on Myocardial and Pericardial Diseases an expert consensus group reviews the current knowledge on clinical presentation, diagnosis and treatment of myocarditis, and proposes new diagnostic criteria for clinically suspected myocarditis and its distinct biopsy-proven pathogenetic forms. The aims are to bridge the gap between clinical and tissue-based diagnosis, to improve management and provide a common reference point for future registries and multicentre randomised controlled trials of aetiology-driven treatment in inflammatory heart muscle disease.
Collapse
Affiliation(s)
- Alida L P Caforio
- Division of Cardiology, Department of Cardiological Thoracic and Vascular Sciences, University of Padua, Padova, Italy.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
3296
|
Jondeau G, Arnoult F, Caligiuri G, Phan G, Charles J, Morgant C, Aumont MC. Practical management of heart failure with preserved ejection fraction. A modest proposal. Arch Cardiovasc Dis 2013; 106:345-8. [PMID: 23810131 DOI: 10.1016/j.acvd.2013.04.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2013] [Accepted: 04/04/2013] [Indexed: 11/16/2022]
|
3297
|
Verbrugge FH, Verhaert D, Grieten L, Dupont M, Rivero-Ayerza M, De Vusser P, Van Herendael H, Reyskens R, Vandervoort P, Tang WHW, Mullens W. Revisiting diastolic filling time as mechanistic insight for response to cardiac resynchronization therapy. ACTA ACUST UNITED AC 2013; 15:1747-56. [DOI: 10.1093/europace/eut130] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
|
3298
|
B-type natriuretic peptide levels are decreased by reducing dietary salt intake in patients with permanent atrial fibrillation. Int J Cardiol 2013; 167:294-6. [DOI: 10.1016/j.ijcard.2012.09.201] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2012] [Accepted: 09/26/2012] [Indexed: 11/16/2022]
|
3299
|
Psotka MA, Teerlink JR. Strategies to Prevent Postdischarge Adverse Events Among Hospitalized Patients with Heart Failure. Heart Fail Clin 2013; 9:303-20, vi. [DOI: 10.1016/j.hfc.2013.04.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
|
3300
|
Escudero C, Khairy P, Sanatani S. Electrophysiologic Considerations in Congenital Heart Disease and Their Relationship to Heart Failure. Can J Cardiol 2013; 29:821-9. [DOI: 10.1016/j.cjca.2013.02.016] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2012] [Revised: 02/14/2013] [Accepted: 02/20/2013] [Indexed: 10/26/2022] Open
|