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Latest & greatest articles for heart failure
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A meta-analysis of antithrombotics for heartfailure from randomized controlled trials Print | PDF PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. The registrant confirms that the information supplied for this submission is accurate and complete. CRD bears no responsibility or liability for the content of this registration record, any associated files or external websites
A systematic review and meta-analysis, including dose-response relationships, between the pharmacological treatment of heartfailure with reduced ejection fraction (stage C HFrEF) and the risks and consequences of hypotension Print | PDF PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. The registrant confirms that the information supplied for this submission is accurate
Catheter Ablation of Atrial Fibrillation in Patients With HeartFailure: A Meta-analysis of Randomized Controlled Trials. Atrial fibrillation (AF) and heartfailure (HF) frequently coexist and are associated with increased morbidity and mortality risk.To compare benefits and harms between catheter ablation and drug therapy in adult patients with AF and HF.ClinicalTrials.gov, PubMed, Web of Science (Clarivate Analytics), EBSCO Information Services, Cochrane Central Register of Controlled Trials (...) %; risk ratio [RR], 0.52 [95% CI, 0.33 to 0.81) and HF hospitalizations (16.4% vs. 27.6%; RR, 0.60 [CI, 0.39 to 0.93]). Ablation improved left ventricular ejection fraction (LVEF) (mean difference, 6.95% [CI, 3.0% to 10.9%]), 6-minute walk test distance (mean difference, 20.93 m [CI, 5.91 to 35.95 m]), peak oxygen consumption (Vo2max) (mean difference, 3.17 mL/kg per minute [CI, 1.26 to 5.07 mL/kg per minute]), and quality of life (mean difference in Minnesota Living with HeartFailure Questionnaire
Association of the Hospital Readmissions Reduction Program With Mortality Among Medicare Beneficiaries Hospitalized for HeartFailure, Acute Myocardial Infarction, and Pneumonia. The Hospital Readmissions Reduction Program (HRRP) has been associated with a reduction in readmission rates for heartfailure (HF), acute myocardial infarction (AMI), and pneumonia. It is unclear whether the HRRP has been associated with change in patient mortality.To determine whether the HRRP was associated
Specialist nurses can manage heartfailure drug dosing successfully Specialist nurses can manage heartfailure drug dosing successfully Discover Portal Discover Portal Specialist nurses can manage heartfailure drug dosing successfully Published on 9 February 2016 doi: Use of specialist nurses to optimise drug dosages using protocols in people with heartfailure was more effective than dose monitoring by other health professionals. These nurses had advanced practice certification. This finding (...) came from a review of seven trials with more than 1600 patients. International guidelines recommend two or three first-line medications for people with heartfailure. These drugs (beta-adrenergic blocking agents, angiotensin converting enzyme inhibitors and angiotensin receptor blockers) can improve survival and are usually started at low doses by cardiologists and then gradually increased over time, a process managed between cardiologists and GPs. This can be a prolonged process because outpatient
Telehealth can help people with heartfailure avoid hospital admission Telehealth can help people with heartfailure avoid hospital admission Discover Portal Discover Portal Telehealth can help people with heartfailure avoid hospital admission Published on 18 January 2016 doi: Home telephone or telemonitoring support can bring some aspects of specialised care and monitoring into the homes of people with heartfailure. This updated Cochrane review confirmed that people with heartfailure who (...) received home telehealth support were less likely to die or go into hospital for problems relating to their heartfailure than those getting usual care. Usual care involved visiting a GP surgery or hospital for care and monitoring, which may be difficult for frail people with limited mobility. The review included seventeen new trials since the last review was published five years ago. More evidence is needed on which people would gain most benefit, particularly considering that people with heart
Association of Renin-Angiotensin Inhibitor Treatment With Mortality and HeartFailure Readmission in Patients With Transcatheter Aortic Valve Replacement. Data are lacking on the effect of a renin-angiotensin system (RAS) inhibitor prescribed after transcatheter aortic valve replacement (TAVR). Treatment with a RAS inhibitor may reverse left ventricular remodeling and improve function.To investigate the association of prescription of a RAS inhibitor and outcomes after TAVR.Retrospective cohort (...) outcomes were all-cause death and readmission due to heartfailure at 1 year after discharge, which were considered separately. The secondary outcome was health status assessed by the Kansas City Cardiomyopathy Questionnaire (KCCQ; score range: 0-100, with a higher score indicating less symptom burden and better quality of life; a small effect size was defined as 5 points) at 1 year.Among 21 312 patients who underwent TAVR at 417 US sites, 8468 patients (39.7%) were prescribed a RAS inhibitor
Chronic HeartFailure and Exercise Rehabilitation: A Systematic Review and Meta-Analysis The aim of this systematic review was to identify the effect of specific exercise parameters on physical function and quality of life (QOL) in people with chronic heartfailure living in the community.A total of 5 electronic databases were searched for relevant studies published after 1994.The screening process was completed by 2 independent researchers, with a third independent reviewer for conflict (...) -regression, including 27 randomized control trials and 13 cohort studies. Exercise was shown to have a positive effect on QOL outcomes (standardized mean difference 1.16; 95% confidence interval [CI], 0.76-1.56) with the most commonly used measure, the Minnesota Living with HeartFailure Questionnaire, showing a clinically significant change of 8.5 points. Physical function was improved postexercise intervention in the 23 included studies (standardized mean difference 0.89; 95% CI, 0.40-1.38
Home oxygen therapy prescribed for 15 hours a day did not reduce breathlessness at six months and is hard to take for people with severe chronic heartfailure Home oxygen therapy prescribed for 15 hours a day did not reduce breathlessness at six months and is hard to take for people with severe chronic heartfailure Discover Portal Discover Portal Home oxygen therapy prescribed for 15 hours a day did not reduce breathlessness at six months and is hard to take for people with severe chronic (...) heartfailure Published on 7 January 2016 doi: This NIHR-funded trial found no evidence that long-term home oxygen therapy improves symptoms or quality of life for people with severe chronic heartfailure. There were encouraging signs after three months but these were not sustained at six months by which time there was no difference between the oxygen therapy group, who continued to receive best medical care, and the control group. The trial was stopped early due to poor adherence to the therapy
Angiotensin-Neprilysin Inhibition in Acute Decompensated HeartFailure. Acute decompensated heartfailure accounts for more than 1 million hospitalizations in the United States annually. Whether the initiation of sacubitril-valsartan therapy is safe and effective among patients who are hospitalized for acute decompensated heartfailure is unknown.We enrolled patients with heartfailure with reduced ejection fraction who were hospitalized for acute decompensated heartfailure at 129 sites (...) . -25.3%; ratio of change with sacubitril-valsartan vs. enalapril, 0.71; 95% confidence interval [CI], 0.63 to 0.81; P<0.001). The greater reduction in the NT-proBNP concentration with sacubitril-valsartan than with enalapril was evident as early as week 1 (ratio of change, 0.76; 95% CI, 0.69 to 0.85). The rates of worsening renal function, hyperkalemia, symptomatic hypotension, and angioedema did not differ significantly between the two groups.Among patients with heartfailure with reduced ejection
Withdrawal of pharmacological treatment for heartfailure in patients with recovered dilated cardiomyopathy (TRED-HF): an open-label, pilot, randomised trial. Patients with dilated cardiomyopathy whose symptoms and cardiac function have recovered often ask whether their medications can be stopped. The safety of withdrawing treatment in this situation is unknown.We did an open-label, pilot, randomised trial to examine the effect of phased withdrawal of heartfailure medications in patients (...) ) to phased withdrawal or continuation of treatment. After 6 months, patients in the continued treatment group had treatment withdrawn by the same method. The primary endpoint was a relapse of dilated cardiomyopathy within 6 months, defined by a reduction in LVEF of more than 10% and to less than 50%, an increase in LVEDV by more than 10% and to higher than the normal range, a two-fold rise in NT-pro-BNP concentration and to more than 400 ng/L, or clinical evidence of heartfailure, at which point
Effect of Inorganic Nitrite vs Placebo on Exercise Capacity Among Patients With HeartFailure With Preserved Ejection Fraction: The INDIE-HFpEF Randomized Clinical Trial. There are few effective treatments for heartfailure with preserved ejection fraction (HFpEF). Short-term administration of inorganic nitrite or nitrate preparations has been shown to enhance nitric oxide signaling, which may improve aerobic capacity in HFpEF.To determine the effect of 4 weeks' administration of inhaled (...) /mL; difference, 11 [95% CI, -53 to 75]; P = .74). Worsening heartfailure occurred in 3 participants (2.9%) during the nitrite phase and 8 (7.6%) during the placebo phase.Among patients with HFpEF, administration of inhaled inorganic nitrite for 4 weeks, compared with placebo, did not result in significant improvement in exercise capacity.ClinicalTrials.gov Identifier: NCT02742129.
CardioMEMS for HeartFailure Monitoring Health Evidence Review Commission (HERC) Coverage Guidance: CardioMEMS™ for HeartFailure Monitoring Approved 10/4/2018 HERC Coverage Guidance CardioMEMS™ is not recommended for coverage for heartfailure monitoring (weak recommendation). Note: Definitions for strength of recommendation are in Appendix A. GRADE Table Element Descriptions. Rationales for each recommendation appear below in the GRADE table. 2 ¦ CardioMEMS™ for HeartFailure Monitoring (...) Approved 10/4/2018 Table of Contents Coverage Guidance: CardioMEMS™ for HeartFailure Monitoring 1 Table of Contents 2 Rationale for development of coverage guidances and multisector intervention reports 3 GRADE Table 3 GRADE Table 5 Should CardioMEMS™ be recommended for coverage for heartfailure monitoring? 5 Background 8 Indications 8 Technology Description 8 Evidence Review 9 Abraham et al., 2011 9 Adamson et al., 2014 11 Adamson et al., 2016 12 Abraham et al., 2016 13 Givertz et al., 2017 15
Reduced Salt Intake for HeartFailure: A Systematic Review Recent estimates suggest that more than 26 million people worldwide have heartfailure. The syndrome is associated with major symptoms, significantly increased mortality, and extensive use of health care. Evidence-based treatments influence all these outcomes in a proportion of patients with heartfailure. Current management also often includes advice to reduce dietary salt intake, although the benefits are uncertain.To systematically (...) review randomized clinical trials of reduced dietary salt in adult inpatients or outpatients with heart failure.Several bibliographic databases were systematically searched, including the Cochrane Central Register of Controlled Trials, MEDLINE, Embase, and CINAHL. The methodologic quality of the studies was evaluated, and data associated with primary outcomes of interest (cardiovascular-associated mortality, all-cause mortality, and adverse events, such as stroke and myocardial infarction
Suspected New-Onset and Nonacute HeartFailure New 2018 ACR Appropriateness Criteria ® 1 Suspected New-Onset and Known Nonacute HeartFailure American College of Radiology ACR Appropriateness Criteria ® Suspected New-Onset and Known Nonacute HeartFailure Variant 1: Suspected new-onset nonacute heartfailure, not previously diagnosed. Initial imaging. Procedure Appropriateness Category Relative Radiation Level US echocardiography transthoracic resting Usually Appropriate O Radiography chest (...) and inotropic stress without IV contrast Usually Not Appropriate O MRI heart with function and vasodilator stress perfusion without and with IV contrast Usually Not Appropriate O Rb-82 PET/CT heart stress Usually Not Appropriate ? ? ?? Tc-99m SPECT/CT MPI rest and stress Usually Not Appropriate ???? Tc-99m ventriculography Usually Not Appropriate ??? US echocardiography transthoracic stress Usually Not Appropriate O ACR Appropriateness Criteria ® 2 Suspected New-Onset and Known Nonacute HeartFailure
Acute exacerbation of congestive heartfailure Acute exacerbation of congestive heartfailure - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search Acute exacerbation of congestive heartfailure Last reviewed: February 2019 Last updated: October 2018 Summary Clinical syndrome of reduced cardiac output, tissue hypoperfusion, increased pulmonary pressure, and tissue congestion. Presents with dyspnoea, decreased exercise (...) tolerance, swelling of the legs, fatigue, and generalised weakness. Clinical diagnosis is supported by ancillary tests such as ECG, chest x-ray, B-type natriuretic peptide, and echocardiogram. In cases where echocardiographic images are suboptimal or when an unusual cause of heartfailure is suspected, and for diagnosis of specific cardiomyopathies, other tests (e.g., cardiac catheterisation with haemodynamic measurements, computed tomography, and cardiac magnetic resonance imaging) are used. Diuretics
HeartFailure After Ischemic Stroke or TIA in Insulin-Resistant Patients Without Diabetes Treated with Pioglitazone The IRIS trial (Insulin Resistance Intervention After Stroke) demonstrated that pioglitazone reduced the risk for both cardiovascular events and diabetes mellitus in insulin-resistant patients. However, concern remains that pioglitazone may increase the risk for heartfailure (HF) in susceptible individuals.In IRIS, patients with insulin resistance but without diabetes mellitus
The Metabolic Syndrome, Cardiovascular Fitness and Survival in Patients With Advanced Systolic HeartFailure The metabolic syndrome (MetS), which incorporates insulin resistance, visceral adiposity, and dyslipidemia, is an independent risk factor for incident heartfailure (HF), but the impact on survival is uncertain. We sought to determine the relation between the metabolic syndrome and survival in ambulatory systolic HF patients and the impact of MetS on cardiopulmonary exercise test (CPET
Parity and HeartFailure in Postmenopausal Women "Parity and HeartFailure in Postmenopausal Women" by Erin Dingman < > > > > > Title Author Date of Graduation Summer 8-11-2018 Degree Type Capstone Project Degree Name Master of Science in Physician Assistant Studies Rights . Abstract Background: Previous research has identified physiologic changes post-menopause with cardiovascular disease, but little research has been conducted investigating a link with heartfailure or the influence of parity (...) for risk stratification. Methods: An exhaustive search of available medical literature was performed. MEDLINE OVID, CINAHL, and Web of Science databases were searched using the keywords nulliparity, postmenopause, and heartfailure. The articles were evaluated using GRADE. Results: The search resulted in 2 studies evaluating the incidence of heartfailure in a postmenopausal population and accounting for gravidity. Conclusion: There is an association between nulliparity, grand multiparity, and increase