Latest & greatest articles for heart failure

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Top results for heart failure

41. Hand-held ultrasound devices for cardiac assessment and diagnosis of heart failure, in the community or primary care setting

Hand-held ultrasound devices for cardiac assessment and diagnosis of heart failure, in the community or primary care setting Hand-held ultrasound devices - Health Technology Wales > Hand-held ultrasound devices Hand-held ultrasound devices Topic Status Complete Hand-held ultrasound devices for cardiac assessment and diagnosis of heart failure, in the community or primary care setting. Outcome of the appraisal Hand-held ultrasound devices (HUDs) show promise in the diagnosis of heart failure (...) was this topic appraised? Heart failure is a common and serious condition that is exerting an increasing burden on cardiology and heart imaging services in Wales. The diagnosis of heart failure can be suspected from clinical assessment and biochemical testing but the use of cardiac ultrasound (echocardiography) is pivotal to either confirming or excluding the diagnosis. Echocardiography is usually done in a hospital setting, but the use of hand-held ultrasound devices means that it can be offered as a quick

2019 Health Technology Wales

42. Rivaroxaban With or Without Aspirin in Patients With Heart Failure and Chronic Coronary or Peripheral Artery Disease Full Text available with Trip Pro

Rivaroxaban With or Without Aspirin in Patients With Heart Failure and Chronic Coronary or Peripheral Artery Disease Patients with chronic coronary artery disease or peripheral artery disease and history of heart failure (HF) are at high risk for major adverse cardiovascular events. We explored the effects of rivaroxaban with or without aspirin in these patients.The COMPASS trial (Cardiovascular Outcomes for People Using Anticoagulation Strategies) randomized 27 395 participants with chronic (...) coronary artery disease or peripheral artery disease to rivaroxaban 2.5 mg twice daily plus aspirin 100 mg daily, rivaroxaban 5 mg twice daily alone, or aspirin 100 mg alone. Patients with New York Heart Association functional class III or IV HF or left ventricular ejection fraction (EF) <30% were excluded. The primary major adverse cardiovascular events outcome comprised cardiovascular death, stroke, or myocardial infarction, and the primary safety outcome was major bleeding using modified

2019 EvidenceUpdates

43. Use of sodium glucose cotransporter 2 inhibitors and risk of major cardiovascular events and heart failure: Scandinavian register based cohort study. Full Text available with Trip Pro

Use of sodium glucose cotransporter 2 inhibitors and risk of major cardiovascular events and heart failure: Scandinavian register based cohort study. To investigate the cardiovascular effectiveness of sodium glucose cotransporter 2 (SGLT2) inhibitors in routine clinical practice.Cohort study using data from nationwide registers and an active-comparator new-user design.Denmark, Norway, and Sweden, from April 2013 to December 2016.20 983 new users of SGLT2 inhibitors and 20 983 new users (...) of dipeptidyl peptidase 4 (DPP4) inhibitors, aged 35-84, matched by age, sex, history of major cardiovascular disease, and propensity score.Primary outcomes were major cardiovascular events (composite of myocardial infarction, stroke, and cardiovascular death) and heart failure (hospital admission for heart failure or death due to heart failure). Secondary outcomes were the individual components of the cardiovascular composite and any cause death. In the primary analyses, patients were defined as exposed

2019 BMJ

44. Effects of Serelaxin in Patients with Acute Heart Failure. Full Text available with Trip Pro

Effects of Serelaxin in Patients with Acute Heart Failure. Serelaxin is a recombinant form of human relaxin-2, a vasodilator hormone that contributes to cardiovascular and renal adaptations during pregnancy. Previous studies have suggested that treatment with serelaxin may result in relief of symptoms and in better outcomes in patients with acute heart failure.In this multicenter, double-blind, placebo-controlled, event-driven trial, we enrolled patients who were hospitalized for acute heart (...) and worsening heart failure at 5 days.A total of 6545 patients were included in the intention-to-treat analysis. At day 180, death from cardiovascular causes had occurred in 285 of the 3274 patients (8.7%) in the serelaxin group and in 290 of the 3271 patients (8.9%) in the placebo group (hazard ratio, 0.98; 95% confidence interval [CI], 0.83 to 1.15; P = 0.77). At day 5, worsening heart failure had occurred in 227 patients (6.9%) in the serelaxin group and in 252 (7.7%) in the placebo group (hazard ratio

2019 NEJM Controlled trial quality: predicted high

45. Planning to reduce 30-day adverse events after discharge of frail elderly patients with acute heart failure: design and rationale for the DEED FRAIL-AHF trial. (Abstract)

Planning to reduce 30-day adverse events after discharge of frail elderly patients with acute heart failure: design and rationale for the DEED FRAIL-AHF trial. To demonstrate the efficacy of a system for comprehensive care transfer (Multilevel Guided Discharge Plan [MGDP]) for frail older patients diagnosed with acute heart failure (AHF) and to validate the results of MGDP implementation under real clinical conditions. The MGDP seeks to reduce the number of adverse outcomes within 30 days

2019 Emergencias : revista de la Sociedad Espanola de Medicina de Emergencias Controlled trial quality: uncertain

46. Trends in Kidney Function Outcomes Following RAAS Inhibition in Patients With Heart Failure With Reduced Ejection Fraction Full Text available with Trip Pro

Trends in Kidney Function Outcomes Following RAAS Inhibition in Patients With Heart Failure With Reduced Ejection Fraction Angiotensin-converting enzyme (ACE) inhibitors are beneficial in heart failure with reduced ejection fraction (HFrEF). We sought to describe longitudinal trends in estimated glomerular filtration rate (eGFR) in HFrEF and how ACE-inhibitor therapy influences these changes.Post hoc analysis of trial data.Symptomatic (Treatment Trial, n=2,423) and asymptomatic (Prevention

2019 EvidenceUpdates

47. Cardiac contractility modulation device implantation for heart failure

Cardiac contractility modulation device implantation for heart failure Cardiac contr Cardiac contractility modulation de actility modulation device vice implantation for heart failure implantation for heart failure Interventional procedures guidance Published: 26 June 2019 www.nice.org.uk/guidance/ipg655 Y Y our responsibility our responsibility This guidance represents the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement (...) tissues. It can lead to oedema in the lungs (causing breathlessness) and swelling of the legs. Other symptoms include reduced ability to exercise, fatigue and malaise. Heart failure can be caused by structural or functional abnormalities of the heart. Current treatments 2.2 NICE's guideline describes the diagnosis and management of chronic heart failure in adults. Treatments for heart failure include drugs to improve heart function, cardiac rehabilitation, cardiac resynchronisation therapy and cardiac

2019 National Institute for Health and Clinical Excellence - Interventional Procedures

48. Analysis of How Emergency Physicians' Decisions to Hospitalize or Discharge Patients With Acute Heart Failure Match the Clinical Risk Categories of the MEESSI-AHF Scale (Abstract)

Analysis of How Emergency Physicians' Decisions to Hospitalize or Discharge Patients With Acute Heart Failure Match the Clinical Risk Categories of the MEESSI-AHF Scale The Multiple Estimation of Risk Based on the Emergency Department Spanish Score in Patients With Acute Heart Failure (MEESSI-AHF) is a validated clinical decision tool that characterizes risk of mortality in emergency department (ED) acute heart failure patients. The objective of this study is to compare the distribution of risk (...) categories between hospitalized and discharged ED patients with acute heart failure.We included consecutive acute heart failure patients from 34 Spanish EDs. Patients were retrospectively classified according to MEESSI-AHF risk categories. We calculated the odds of hospitalization (versus direct discharge from the ED) across MEESSI-AHF risk categories. Next, we assessed the following 30-day postdischarge outcomes: ED revisit, hospitalization, death, and their combination. We used Cox hazards models

2019 EvidenceUpdates

49. Usefulness of Right Ventricular to Pulmonary Circulation Coupling as an Indicator of Risk for Recurrent Admissions in Heart Failure With Preserved Ejection Fraction (Abstract)

Usefulness of Right Ventricular to Pulmonary Circulation Coupling as an Indicator of Risk for Recurrent Admissions in Heart Failure With Preserved Ejection Fraction In recent years, the study of right ventricular (RV) to pulmonary circulation (PC) coupling in heart failure with preserved ejection fraction (HFpEF) has been a matter of special interest. Tricuspid annular plane systolic excursion (TAPSE) to pulmonary artery systolic pressure (PASP) ratio has emerged as a reliable noninvasive index

2019 EvidenceUpdates

50. The OPTIMIZER smart system for managing heart failure

The OPTIMIZER smart system for managing heart failure The OPTIMIZER smart system for managing The OPTIMIZER smart system for managing heart failure heart failure Medtech innovation briefing Published: 27 June 2019 www.nice.org.uk/guidance/mib186 pathways Summary Summary The technology technology described in this briefing is the OPTIMIZER smart system. It is a programmable cardiac stimulation device for people with chronic heart failure. The system is for people who still have symptoms after (...) was unblinded. Also, none of the studies were done in the NHS. The cost cost of the OPTIMIZER smart system is £17,000 per unit (excluding VAT). The resource resource impact impact would be greater than standard care. © NICE 2019. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 1 of 11NICE's interventional procedures guidance on cardiac contractility modulation device implantation for heart failure recommends that this technique appears

2019 National Institute for Health and Clinical Excellence - Advice

51. Hand-held ultrasound devices for cardiac assessment and diagnosis of heart failure

Hand-held ultrasound devices for cardiac assessment and diagnosis of heart failure Hand-held ultrasound devices - Health Technology Wales > Hand-held ultrasound devices Hand-held ultrasound devices Topic Status Complete Hand-held ultrasound devices for cardiac assessment and diagnosis of heart failure, in the community or primary care setting. Outcome of the appraisal Hand-held ultrasound devices (HUDs) show promise in the diagnosis of heart failure in a primary care or community setting (...) and serious condition that is exerting an increasing burden on cardiology and heart imaging services in Wales. The diagnosis of heart failure can be suspected from clinical assessment and biochemical testing but the use of cardiac ultrasound (echocardiography) is pivotal to either confirming or excluding the diagnosis. Echocardiography is usually done in a hospital setting, but the use of hand-held ultrasound devices means that it can be offered as a quick and portable test to people in a primary care

2019 Health Technology Wales

52. Effect of Neladenoson Bialanate on Exercise Capacity Among Patients With Heart Failure With Preserved Ejection Fraction: A Randomized Clinical Trial. Full Text available with Trip Pro

Effect of Neladenoson Bialanate on Exercise Capacity Among Patients With Heart Failure With Preserved Ejection Fraction: A Randomized Clinical Trial. Heart failure with preserved ejection fraction (HFpEF) lacks effective treatments. Based on preclinical studies, neladenoson bialanate, a first-in-class partial adenosine A1 receptor agonist, has the potential to improve several heart failure-related cardiac and noncardiac abnormalities but has not been evaluated to treat HFpEF.To determine (...) whether neladenoson improves exercise capacity, physical activity, cardiac biomarkers, and quality of life in patients with HFpEF and to find the optimal dose.Phase 2b randomized clinical trial conducted at 76 centers in the United States, Europe, and Japan. Patients (N = 305) with New York Heart Association class II or III HFpEF with elevated natriuretic peptide levels were enrolled between May 10, 2017, and December 7, 2017 (date of final follow-up: June 20, 2018).Participants were randomized (1:2:2

2019 JAMA Controlled trial quality: predicted high

53. Effect of Dapagliflozin on Heart Failure and Mortality in Type 2 Diabetes Mellitus Full Text available with Trip Pro

Effect of Dapagliflozin on Heart Failure and Mortality in Type 2 Diabetes Mellitus In DECLARE-TIMI 58 (Dapagliflozin Effect on Cardiovascular Events-Thrombolysis in Myocardial Infarction 58), the sodium-glucose cotransporter 2 inhibitor dapagliflozin reduced the composite end point of cardiovascular death/hospitalization for heart failure (HHF) in a broad population of patients with type 2 diabetes mellitus. However, the impact of baseline left ventricular ejection fraction (EF) on the clinical (...) benefit of sodium-glucose cotransporter 2 inhibition is unknown.In the DECLARE-TIMI 58 trial, baseline heart failure (HF) status was collected from all patients, and EF was collected when available. HF with reduced EF (HFrEF) was defined as EF <45%. Outcomes of interest were the composite of cardiovascular death/HHF, its components, and all-cause mortality.Of 17 160 patients, 671 (3.9%) had HFrEF, 1316 (7.7%) had HF without known reduced EF, and 15 173 (88.4%) had no history of HF at baseline

2019 EvidenceUpdates

54. Iron Supplementation Improves Cardiovascular Outcomes in Patients with Heart Failure (Abstract)

; 95% CI, -6.12 to -3.17, respectively).Our meta-analysis suggests that iron therapy can reduce heart failure hospitalization, increase cardiac function, improve quality of life, and decrease serum levels of NT-proBNP and CRP in patients with heart failure.Copyright © 2019 Elsevier Inc. All rights reserved. (...) Iron Supplementation Improves Cardiovascular Outcomes in Patients with Heart Failure Iron deficiency is prevalent in patients with heart failure. This meta-analysis was performed to evaluate the therapeutic effects of iron in patients with systolic heart failure and iron deficiency.We searched PubMed, Embase, and Cochrane databases through March 2018 and included 10 randomized controlled trials involving 1404 heart failure patients who underwent iron or placebo treatment. Odds ratio

2019 EvidenceUpdates

55. Association between mortality and implantable cardioverter-defibrillators by aetiology of heart failure: a propensity-matched analysis of the WARCEF trial. Full Text available with Trip Pro

Association between mortality and implantable cardioverter-defibrillators by aetiology of heart failure: a propensity-matched analysis of the WARCEF trial. There is debate on whether the beneficial effect of implantable cardioverter-defibrillators (ICDs) is attenuated in patients with non-ischaemic cardiomyopathy (NICM). We assess whether any ICD benefit differs between patients with NICM and those with ischaemic cardiomyopathy (ICM), using data from the Warfarin versus Aspirin in Reduced (...) proportional hazards model to assess the effect of ICD status on mortality for patients with ICM and those with NICM and tested the interaction between ICD status and aetiology of heart failure. During mean follow-up of 3.5 ± 1.8 years, 527 patients died. The presence of ICD was associated with a lower risk of all-cause death among those with ICM (hazard ratio: 0.640; 95% confidence interval: 0.448 to 0.915; P = 0.015) but not among those with NICM (hazard ratio: 0.984; 95% confidence interval: 0.641

2019 ESC heart failure Controlled trial quality: uncertain

56. Health Status After Transcatheter Mitral-Valve Repair in Heart Failure and Secondary Mitral Regurgitation: COAPT Trial (Abstract)

Health Status After Transcatheter Mitral-Valve Repair in Heart Failure and Secondary Mitral Regurgitation: COAPT Trial In the COAPT (Cardiovascular Outcomes Assessment of the MitraClip Percutaneous Therapy for Heart Failure Patients with Functional Mitral Regurgitation) trial, transcatheter mitral valve repair (TMVr) led to reduced heart failure (HF) hospitalizations and improved survival in patients with symptomatic HF and 3+ to 4+ secondary mitral regurgitation (MR) on maximally-tolerated (...) timepoint (24-month mean difference in SF-36 summary scores: physical 3.6 points; 95% CI: 1.4 to 5.8 points; mental 3.6 points; 95% CI: 0.8 to 6.4 points).Among patients with symptomatic HF and 3+ to 4+ secondary MR receiving maximally-tolerated medical therapy, edge-to-edge TMVr resulted in substantial early and sustained health status improvement compared with medical therapy alone. (Cardiovascular Outcomes Assessment of the MitraClip Percutaneous Therapy for Heart Failure Patients With Functional

2019 EvidenceUpdates

57. Intramyocardial Injection of Mesenchymal Precursor Cells and Successful Temporary Weaning From Left Ventricular Assist Device Support in Patients With Advanced Heart Failure: A Randomized Clinical Trial. Full Text available with Trip Pro

Intramyocardial Injection of Mesenchymal Precursor Cells and Successful Temporary Weaning From Left Ventricular Assist Device Support in Patients With Advanced Heart Failure: A Randomized Clinical Trial. Left ventricular assist device (LVAD) therapy improves myocardial function, but few patients recover sufficiently for explant, which has focused attention on stem cells to augment cardiac recovery.To assess efficacy and adverse effects of intramyocardial injections of mesenchymal precursor (...) cells (MPCs) during LVAD implant.A randomized phase 2 clinical trial involving patients with advanced heart failure, undergoing LVAD implant, at 19 North American centers (July 2015-August 2017). The 1-year follow-up ended August 2018.Intramyocardial injections of 150 million allogeneic MPCs or cryoprotective medium as a sham treatment in a 2:1 ratio (n = 106 vs n = 53).The primary efficacy end point was the proportion of successful temporary weans (of 3 planned assessments) from LVAD support within

2019 JAMA Controlled trial quality: predicted high

58. Heart failure drug treatment. (Abstract)

Heart failure drug treatment. Heart failure is the most common cardiovascular reason for hospital admission for people older than 60 years of age. Few areas in medicine have progressed as remarkably as heart failure treatment over the past three decades. However, progress has been consistent only for chronic heart failure with reduced ejection fraction. In acutely decompensated heart failure and heart failure with preserved ejection fraction, none of the treatments tested to date have been (...) definitively proven to improve survival. Delaying or preventing heart failure has become increasingly important in patients who are prone to heart failure. The prevention of worsening chronic heart failure and hospitalisations for acute decompensation is also of great importance. The objective of this Series paper is to provide a concise and practical summary of the available drug treatments for heart failure. We support the implementation of the international guidelines. We offer views on the basis of our

2019 Lancet

59. Beyond pharmacological treatment: an insight into therapies that target specific aspects of heart failure pathophysiology. (Abstract)

in heart failure management, in which the treatment specifically targets the underlying pathophysiological mechanisms responsible for the symptoms. These treatments include treatment of electromechanical dyssynchrony and dysrhythmia by cardiac resynchronisation and implantable cardioverter-defibrillators; neurohumoral modification by baroreflex and vagal stimulation; prevention of adverse cardiac remodelling by interatrial shunts; and finally targeting the myocardium directly by cell therapy (...) Beyond pharmacological treatment: an insight into therapies that target specific aspects of heart failure pathophysiology. Heart failure is a common syndrome associated with substantial morbidity and mortality. The management of symptoms and the strategies for improving prognosis have largely been based on pharmacological treatments. The pathophysiology of heart failure is complex because of the multiple causes responsible for this syndrome. This Series paper presents some examples of advances

2019 Lancet

60. Multimodality imaging in ischaemic heart failure. (Abstract)

Multimodality imaging in ischaemic heart failure. In heart failure, extensive evaluation with modern non-invasive imaging modalities is needed to assess causes, pathophysiology, and haemodynamics, to determine prognosis and consider therapeutic options. This systematic evaluation includes a stepwise assessment of left ventricular size and function, the presence and severity of coronary artery disease, mitral regurgitation, pulmonary hypertension, right ventricular dilation and dysfunction (...) , and tricuspid regurgitation. Based on this imaging-derived information, the need for specific therapies besides optimised medical therapy can be determined. The need for revascularisation, implantation of an implantable cardiac defibrillator, and mitral or tricuspid valve repair or replacement, can be (partially) guided by non-invasive imaging. Importantly, randomised controlled trials on the use of non-inasive imaging to guide therapy are scarce in this field and most non-pharmacological therapies

2019 Lancet