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Latest & greatest articles for heart failure
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Mineralocorticoid receptor antagonists for heartfailure: a realâ€life observational study Mineralocorticoid receptor antagonists (MRAs) have been demonstrated to improve outcomes in reduced ejection fraction heartfailure (HFrEF) patients. However, MRAs added to conventional treatment may lead to worsening of renal function and hyperkalaemia. We investigated, in a population-based analysis, the long-term effects of MRA treatment in HFrEF patients.We analysed data of 6046 patients included (...) in the Metabolic Exercise Cardiac Kidney Index score dataset. Analysis was performed in patients treated (n = 3163) and not treated (n = 2883) with MRA. The study endpoint was a composite of cardiovascular death, urgent heart transplantation, or left ventricular assist device implantation. Ten years' survival was analysed through Kaplan-Meier, compared by log-rank test and propensity score matching. At 10 years' follow-up, the MRA-untreated group had a significantly lower number of events than the MRA-treated
Catheter Ablation for Atrial Fibrillation with HeartFailure. Mortality and morbidity are higher among patients with atrial fibrillation and heartfailure than among those with heartfailure alone. Catheter ablation for atrial fibrillation has been proposed as a means of improving outcomes among patients with heartfailure who are otherwise receiving appropriate treatment.We randomly assigned patients with symptomatic paroxysmal or persistent atrial fibrillation who did not have a response (...) to antiarrhythmic drugs, had unacceptable side effects, or were unwilling to take these drugs to undergo either catheter ablation (179 patients) or medical therapy (rate or rhythm control) (184 patients) for atrial fibrillation in addition to guidelines-based therapy for heartfailure. All the patients had New York Heart Association class II, III, or IV heartfailure, a left ventricular ejection fraction of 35% or less, and an implanted defibrillator. The primary end point was a composite of death from any
Risk of stroke and bleeding in patients with heartfailure and chronic kidney disease: a nationwide cohort study The aim of this study was to assess the prognostic value of chronic kidney disease (CKD) in relation to ischaemic stroke, intracranial haemorrhage, major bleeding, and all-cause death in heartfailure patients without atrial fibrillation.In this observational cohort study, heartfailure patients without atrial fibrillation were identified using Danish nationwide registries. Risk (...) of stroke, major haemorrhage, and death were calculated after 1 and 5 years to compare patients with and without CKD, ±dialysis [dialysis: CKD with renal replacement therapy (CKD-RRT); no dialysis: CKD-no RRT]. A total of 43 199 heartfailure patients were included, among which 0.8% had CKD-RRT and 5.9% had CKD-no RRT. When compared with heartfailure patients without CKD, both CKD-RRT and CKD-no RRT were associated with a higher 5 year rate of major bleeding (CKD-RRT: adjusted hazard ratio (aHR): 2.91
Subcutaneous implantable cardioverter defibrillator in patients awaiting cardiac transplantation or left ventricular assist device for refractory heartfailure: a feasible alternative to transvenous device? 29377556 2018 12 17 2018 12 17 2055-5822 5 3 2018 06 ESC heartfailure ESC Heart Fail Subcutaneous implantable cardioverter defibrillator in patients awaiting cardiac transplantation or left ventricular assist device for refractory heartfailure: a feasible alternative to transvenous device (...) of Cardiac, Thoracic and Vascular Sciences, University of Padua, Padua, Italy. Gerosa Gino G Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, Padua, Italy. Iliceto Sabino S Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, Padua, Italy. eng Editorial 2018 01 27 England ESC Heart Fail 101669191 2055-5822 IM Defibrillators, Implantable Feasibility Studies HeartFailure surgery Heart Transplantation Heart-Assist Devices Humans Subcutaneous Tissue Waiting
Eligibility of sacubitrilâ€“valsartan in a realâ€world heartfailure population: a communityâ€based singleâ€centre study This study aims to investigate the eligibility of the Prospective Comparison of Angiotensin Receptor-Neprilysin Inhibitor (ARNI) with ACE inhibitor to Determine Impact on Global Mortality and Morbidity in HeartFailure (PARADIGM-HF) study to a real-world heartfailure population.Medical records of all heartfailure patients living within the catchment area of Umeå (...) University Hospital were reviewed. This district consists of around 150 000 people. Out of 2029 patients with a diagnosis of heartfailure, 1924 (95%) had at least one echocardiography performed, and 401 patients had an ejection fraction of ≤35% at their latest examination. The major PARADIGM-HF criteria were applied, and 95 patients fulfilled all enrolment criteria and thus were eligible for sacubitril-valsartan. This corresponds to 5% of the overall heartfailure population and 24% of the population
Effects of intravenous home dobutamine in palliative endâ€stage heartfailure on quality of life, heartfailure hospitalization, and cost expenditure In patients with palliative end-stage heartfailure, interventions that could provide symptomatic relief and prevent hospital admissions are important. Ambulatory continuous intravenous inotropes have been advocated by guidelines for such a purpose. We sought to determine the effect of intravenous dobutamine on symptomatic status, hospital stay (...) , mortality, and cost expenditure.All consecutive end-stage heartfailure patients not amenable for advanced therapies and discharged with continuous intravenous home dobutamine from a single tertiary centre between April 2011 and January 2017 were retrospectively analysed. Dobutamine (fixed dose) was infused through a single-lumen central venous catheter with a small pump that was refilled by a nurse on a daily basis. Symptomatic status was longitudinally assessed as the change in New York Heart
Automating Quality Measures for HeartFailure Using Natural Language Processing: A Descriptive Study in the Department of Veterans Affairs We developed an accurate, stakeholder-informed, automated, natural language processing (NLP) system to measure the quality of heartfailure (HF) inpatient care, and explored the potential for adoption of this system within an integrated health care system.To accurately automate a United States Department of Veterans Affairs (VA) quality measure (...) for inpatients with HF.We automated the HF quality measure Congestive HeartFailure Inpatient Measure 19 (CHI19) that identifies whether a given patient has left ventricular ejection fraction (LVEF) <40%, and if so, whether an angiotensin-converting enzyme inhibitor or angiotensin-receptor blocker was prescribed at discharge if there were no contraindications. We used documents from 1083 unique inpatients from eight VA medical centers to develop a reference standard (RS) to train (n=314) and test (n=769
. Strong FOR Low Invasive coronary angiography should be considered in patients with heartfailure associated with refractory angina, resuscitated cardiac arrest, sustained ventricular arrhythmias, or with evidence of ischaemic heart disease on other investigations, or an intermediate-to-high pretest probability for coronary artery disease, to determine the need for coronary revascularisation. Strong FOR Low Either computed tomography (CT) coronary angiography or cardiac magnetic resonance imaging (CMR (...) receptor neprilysin inhibitor; AV, atrioventricular; BNP, B-type natriuretic peptide; BP, blood pressure; bpm, beats per minute; CABG, coronary artery bypass graft; CMR, cardiac magnetic resonance imaging; CRT, cardiac resynchronisation therapy; CT, computed tomography; ECG, electrocardiogram; DCM, dilated cardiomyopathy; GRADE, Grading of Recommendations Assessment, Development and Evaluation; HFrEF, heartfailure with reduced ejection fraction; ICD, implantable cardioverter defibrillator; LGE, late
National Heart Foundation of Australia and Cardiac Society of Australia and New Zealand: Australian clinical guidelines for the management of heartfailure 2018 National Heart Foundation of Australia and Cardiac Society of Australia and New Zealand: Australian clinical guidelines for the management of heartfailure 2018 | The Medical Journal of Australia mja-search search Use the for more specific terms. Title contains Body contains Date range from Date range to Article type Author's surname (...) Volume First page doi: 10.5694/mja__.______ Search Reset close Individual Login Purchase options Connect person_outline Login keyboard_arrow_down Individual Login Purchase options menu search Advertisement close National Heart Foundation of Australia and Cardiac Society of Australia and New Zealand: Australian clinical guidelines for the management of heartfailure 2018 John J Atherton, Andrew Sindone, Carmine G De Pasquale, Andrea Driscoll, Peter S MacDonald, Ingrid Hopper, Peter Kistler, Tom G
Patients’ Experiences with Cardiac Monitors for Stroke, Atrial Fibrillation, and HeartFailure: A Rapid Qualitative Review Patients’ Experiences with Cardiac Monitors for Stroke, Atrial Fibrillation, and HeartFailure: A Rapid Qualitative Review | CADTH.ca Find the information you need Patients’ Experiences with Cardiac Monitors for Stroke, Atrial Fibrillation, and HeartFailure: A Rapid Qualitative Review Patients’ Experiences with Cardiac Monitors for Stroke, Atrial Fibrillation, and Heart (...) Failure: A Rapid Qualitative Review Last updated: September 17, 2018 Project Number: RC1019-000 Product Line: Research Type: Devices and Systems Report Type: Summary with Critical Appraisal Result type: Report Question How do patients experience, make decisions around, and live with outpatient cardiac monitors for the diagnosis of stroke, atrial fibrillation, and/or heartfailure? Key Message The onset of cardiac monitor use accompanies many life changes and new personal responsibilities. For some
One-Year Safety and Clinical Outcomes of a Transcatheter Interatrial Shunt Device for the Treatment of HeartFailure With Preserved Ejection Fraction in the Reduce Elevated Left Atrial Pressure in Patients With HeartFailure (REDUCE LAP-HF I) Trial: A Ran In patients with heartfailure (HF) and left ventricular ejection fraction (LVEF) equal to or greater than 40%, a transcatheter interatrial shunt device (IASD; Corvia Medical) reduces exercise pulmonary capillary wedge pressure (PCWP (...) centers in the United States, Europe, and Australia on patients with New York Heart Association (NYHA) class III or ambulatory class IV HF, LVEF equal to or greater than 40%, exercise PCWP equal to or greater than 25 mm Hg, and PCWP-right atrial pressure gradient equal to or greater than 5 mm Hg.Safety was assessed by major adverse cardiac, cerebrovascular, or renal events (MACCRE). Exploratory outcomes evaluated at 1 year were hospitalizations for HF, NYHA class, quality of life, a 6-minute walk test