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Latest & greatest articles for heart failure
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disease (including coronaryheart disease). For further information, see the CKS topics on , and . Consider if statin therapy is indicated . For further information, see the CKS topic on and . Ensure that any causes, comorbidities, and precipitating factors are optimally managed. For further information, see the CKS topics on , , , , , , and . People with heartfailure due to valve disease should be referred for specialist assessment and advice regarding follow-up. Screen for depression and anxiety (...) to prescribe an antiplatelet drug for people with heartfailure and atherosclerotic arterial disease (including coronaryheart disease) is based on information in the NICE guideline [ ]. Prescribing a statin There is considerable evidence of the value of statin treatment in atherosclerotic disease. Two large placebo-controlled trials (n = 5011 and n = 4574) comparing statin treatment with placebo in people with chronic heartfailure did not demonstrate a significant reduction in cardiovascular death
on . Consider if an antiplatelet drug is indicated. Consider prescribing an antiplatelet to people with atherosclerotic arterial disease (including coronaryheart disease). For further information, see the CKS topics on and . Consider if statin therapy is indicated. For further information, see the CKS topics on and . Ensure that any , comorbidities and precipitating factors are optimally managed. For further information, see the CKS topics on , , , , , , and . People with heartfailure due to valve disease (...) remain symptomatic despite optimal treatment with a diuretic, an ACE-inhibitor (or AIIRA), and a beta-blocker should be referred for specialist assessment and management is based on information in the NICE guideline Chronic heartfailure: national clinical guideline for diagnosis and management in primary and secondary care [ ]. Prescribing an antiplatelet drug The recommendation to prescribe an antiplatelet drug for people with heartfailure and atherosclerotic arterial disease (including coronary
Heartfailure - chronic: Managing diuretics Managing diuretics | Prescribing information | Heartfailure - chronic | CKS | NICE Search CKS… Menu Managing diuretics Heartfailure - chronic: Managing diuretics Last revised in January 2017 Managing diuretics Choice of diuretic Loop diuretics are preferred for the management of oedema due to heartfailure. The loop diuretics available in the UK are furosemide (most widely used), bumetanide, and torasemide. [ ; ] Key drug interactions with loop (...) be exacerbated by hypokalaemia of loop diuretics. Advise the person to be aware of (and report) symptoms of lithium toxicity. Monitor lithium levels carefully and adjust the dosage where necessary. For more information, see the CKS topic on . Muscle relaxants — enhanced hypotensive effect with baclofen or tizanidine. Increased effect of curare-like muscle relaxants. Nitrates — enhanced hypotensive effect. Nonsteroidal anti-inflammatory drugs (NSAIDs) — can exacerbate heartfailure and increase the risk
with advanced heartfailure. Decision Support Document 119. Preview - Sie müssen einen PDF-Viewer auf Ihrem PC installiert haben wie z. B. , oder 839kB Abstract Patients with moderately severe or severe heartfailure often experience cardiac decompensation, which manifests itself in an increase of pulmonary arterial pressure long before the classic symptoms (shortness of breath, water retention, etc.) arise. As a result, hospitalisation and a deterioration in quality of life occur repeatedly. The systematic (...) Implantation of a wireless pulmonary artery pressure sensor in patients with advanced heartfailure. Decision Support Document 119. Implantation of a wireless pulmonary artery pressure sensor in patients with advanced heartfailure - Repository of AIHTA GmbH English | Browse - - - Implantation of a wireless pulmonary artery pressure sensor in patients with advanced heartfailure Winkler, R. and Wild, C. (2020): Implantation of a wireless pulmonary artery pressure sensor in patients
Heartfailure - chronic: Beta-blockers Managing beta-blockers | Prescribing information | Heartfailure - chronic | CKS | NICE Search CKS… Menu Managing beta-blockers Heartfailure - chronic: Beta-blockers Last revised in January 2017 Beta-blockers Contraindications and cautions of beta-blockers Do not prescribe beta-blockers to people with: A history of asthma or bronchospasm. Reversible or severe chronic obstructive pulmonary disease (COPD). Beta-blockers can be used in people with COPD (...) without significant reversible airways obstruction. Known intolerance or hypersensitivity to beta-blockers. Severe or symptomatic bradycardia (heart rate less than 60 beats per minute). Sinoatrial block, second- or third-degree heart block (unless there is a pacemaker in place). Severe or uncontrolled heartfailure. Severe or symptomatic hypotension (systolic blood pressure less than 90 mmHg). Severe peripheral arterial disease (including intermittent claudication) or Raynaud's syndrome. Sick sinus
Effect of a Strategy of Comprehensive Vasodilation vs Usual Care on Mortality and HeartFailure Rehospitalization Among Patients With Acute HeartFailure: The GALACTIC Randomized Clinical Trial. Short-term infusions of single vasodilators, usually given in a fixed dose, have not improved outcomes in patients with acute heartfailure (AHF).To evaluate the effect of a strategy that emphasized early intensive and sustained vasodilation using individualized up-titrated doses of established
L-carnitine supplementation in the recovery of plasma L-carnitine in patients with heartfailure submitted to coronary artery bypass grafting. Coronary artery bypass grafting reduces plasma L-carnitine and may impair the production of myocardial energy. L-carnitine supplementation may elevate plasma L-carnitine and increase cardiac mechanical efficiency. The objective of this study was to verify the recovery of preoperative plasma LC in patients with heartfailure undergoing coronary artery (...) postoperative day, there was a reduction in plasma L-carnitine in groups A (17.4%) and B (14.4%). In the comparison between the groups, plasma L-carnitine was higher in group A than B in 10º (p = 0.024), 30º (p = 0.001), and 60º postoperative day (p = 0.008). Supplementation of L-carnitine at a daily oral dose of 50 mg / kg in patients with heartfailure undergoing coronary artery bypass grafting may recover preoperative plasma L-carnitine within 10 days.
of hypertension, and 753 (20%) had a history of myocardial infarction or coronary revascularization. There were 116 TTR V122I carriers (3.1%); 1121 participants (30%) had heartfailure. The case-control study consisted of 2307 individuals of African ancestry and 3663 Hispanic/Latino individuals; the median age was 73 years (interquartile range, 68-80), 2271 (38%) were male, 4709 (79%) had a diagnosis of hypertension, and 1008 (17%) had a history of myocardial infarction or coronary revascularization (...) Association of the V122I Hereditary Transthyretin Amyloidosis Genetic Variant With HeartFailure Among Individuals of African or Hispanic/Latino Ancestry. Hereditary transthyretin (TTR) amyloid cardiomyopathy (hATTR-CM) due to the TTR V122I variant is an autosomal-dominant disorder that causes heartfailure in elderly individuals of African ancestry. The clinical associations of carrying the variant, its effect in other African ancestry populations including Hispanic/Latino individuals
, Beanlands RSB, Mielniczuk LM . N-terminal pro B-type natriuretic peptide and high-sensitivity cardiac troponin T levels are related to the extent of hibernating myocardium in patients with ischemic heartfailure. Can J Cardiol . 2017 ; 33:1478–1488. doi: 10.1016/j.cjca.2017.06.012 AlBadri A, Lai K, Wei J, Landes S, Mehta PK, Li Q, Johnson D, Reis SE, Kelsey SF, Bittner V, et al. . Inflammatory biomarkers as predictors of heartfailure in women without obstructive coronary artery disease: a report from (...) , Wagoner LE, et al. . A polymorphism within a conserved beta(1)-adrenergic receptor motif alters cardiac function and beta-blocker response in human heartfailure. Proc Natl Acad Sci U S A . 2006 ; 103:11288–11293. doi: 10.1073/pnas.0509937103 Cresci S, Kelly RJ, Cappola TP, Diwan A, Dries D, Kardia SL, Dorn GW Clinical and genetic modifiers of long-term survival in heartfailure. J Am Coll Cardiol . 2009 ; 54:432–444. doi: 10.1016/j.jacc.2009.05.009 Liggett SB, Cresci S, Kelly RJ, Syed FM, Matkovich
(95% CI, 1.51–2.28) Similar in men and women … Retrospective cohort of Kaiser Permanente Northwest Database 8231 +DM, 8845 no DM Up to 6 rates (person-years): DM: 30.9/1000 No DM: 12.4/1000 Rate ratio, 2.5 (95% CI, 2.3–2.7) … … CAD indicates coronary artery disease; DM, diabetes mellitus; ellipses (…), not reported; HF, heartfailure; HR, hazard ratio; MESA, Multi-Ethnic Study of Atherosclerosis; NHANES, National Health and Nutrition Examination Survey; and RR, relative risk. The risk of HF (...) via vascular smooth muscle cell proliferation and inflammation ( ). DM is also associated with more atherogenic dyslipidemia, in which low-density lipoprotein cholesterol particles are more atherogenic, and with endothelial dysfunction, which promotes leukocyte and platelet adhesion, thrombosis, inflammation, and coronary plaque ulceration. Figure 1. Pathophysiology of heartfailure in diabetes mellitus. The hyperglycemia, insulin resistance, and hyperinsulinemia that often accompany diabetes
Effect of Once-Weekly Exenatide in Patients With Type 2 Diabetes Mellitus With and Without HeartFailure and HeartFailure-Related Outcomes: Insights From the EXSCEL Trial Once-weekly exenatide (EQW) had a neutral effect on hospitalization for heartfailure (HHF) in the EXSCEL study (Exenatide Study of Cardiovascular Event Lowering), with no differential treatment effect on major adverse cardiac events by baseline heartfailure (HF) status. EQW's effects on secondary end points based on HHF (...) status have not been reported. The objective was to explore the effects of EQW on secondary end points in patients with and without baseline HF and test the effects of EQW on recurrent HHF events.The prespecified analysis of the randomized controlled EXSCEL trial, which enrolled patients with type 2 diabetes mellitus with and without additional cardiovascular disease, analyzed EQW effects on all-cause death, each major adverse cardiac event component, first HHF, and repeat HHF, by baseline HF status
-ventricular ejection fraction MCS Mental Health Composite Scale MLHFQ Minnesota Living with HeartFailure Questionnaire NYHA New York Heart Association OR odds ratio PCS Physical Composite Scale RCT randomized controlled trial SAE serious adverse event SF-36 Short Form (36) Health Survey SGB Sozialgesetzbuch (Social Code Book) TM telemedicine VAS visual analogue scale Extract of rapid report N19-01 Version 1.0 Telemonitoring in advanced cardiacfailure 27 September 2019 Institute for Quality (...) of the heart to supply the organism with sufficient oxygen to ensure metabolism under both resting and exercise conditions . It is a common disease in the older population  and is one of the most common causes of death in Germany . Severity of cardiacfailure is usually classified according to the New York Heart Association criteria (NYHA) . However, the NYHA stage is not stable, i.e. it can change in one and the same person  and also relies heavily on the physician’s subjective assessment
Optimizer Smart Implantable Pulse Generator (IPG) – Cardiac Contractility Modulation (CCM) therapy for patients with Chronic HeartFailure 1 Public Summary Document Application No. 1387.2 – Optimizer® Smart Implantable Pulse Generator (IPG) – Cardiac Contractility Modulation (CCM) therapy for patients with Chronic HeartFailure Applicant: Impulse Dynamics and Life Systems Date of MSAC consideration: MSAC 75 th Meeting, 28-29 March 2019 Context for decision: MSAC makes its advice in accordance (...) with its Terms of Reference, visit the MSAC website 1. Purpose of application An application for the resubmission of an implantable pulse generator (IPG) delivering Cardiac Contractility Modulation (CCM) therapy for patients with chronic heartfailure was received from Impulse Dynamics Australia Pty Ltd by the Department of Health. 2. MSAC’s advice to the Minister After considering the strength of the available evidence in relation to comparative safety, clinical effectiveness and cost-effectiveness
Improving Communication in HeartFailure Patient Care Although implantable cardioverter-defibrillators (ICDs) reduce sudden death, these patients die of heartfailure (HF) or other diseases. To prevent shocks at the end of life, clinicians should discuss deactivating the defibrillation function.The purpose of this study was to determine if a clinician-centered teaching intervention and automatic reminders increased ICD deactivation discussions and increased device deactivation.In this 6-center (...) , single-blinded, cluster-randomized, controlled trial, primary outcomes were proportion of patients: 1) having ICD deactivation discussions; and 2) having the shocking function deactivated. Secondary outcomes included goals of care conversations and advance directive completion.A total of 525 subjects were included with advanced HF who had an ICD: 301 intervention and 224 control. At baseline, 52% (n = 272) were not candidates for advanced therapies (i.e., cardiac transplant or mechanical circulatory
Incidence of heartfailure after pacemaker implantation: a nationwide Danish Registry-based follow-up study The objective of the current study is to investigate the risk of heartfailure (HF) after implantation of a pacemaker (PM) with a right ventricular pacing (RVP) lead in comparison to a matched cohort without a PM and factors associated with this risk.All patients without a known history of HF who had a PM implanted with an RVP lead between 2000 and 2014 (n = 27 704) were identified using
Natriuretic peptide-guided treatment for the prevention of cardiovascular events in patients without heartfailure. Cardiovascular disease (CVD) is the leading cause of morbidity and mortality globally. Early intervention for those with high cardiovascular risk is crucial in improving patient outcomes. Traditional prevention strategies for CVD have focused on conventional risk factors, such as overweight, dyslipidaemia, diabetes, and hypertension, which may reflect the potential (...) for cardiovascular insult. Natriuretic peptides (NPs), including B-type natriuretic peptide (BNP) and N-terminal pro B-type natriuretic peptide (NT-proBNP), are well-established biomarkers for the detection and diagnostic evaluation of heartfailure. They are of interest for CVD prevention because they are secreted by the heart as a protective response to cardiovascular stress, strain, and damage. Therefore, measuring NP levels in patients without heartfailure may be valuable for risk stratification
Identifying optimal doses of heartfailure medications in men compared with women: a prospective, observational, cohort study. Guideline-recommended doses of angiotensin-converting-enzyme (ACE) inhibitors or angiotensin-receptor blockers (ARBs), and β blockers are similar for men and women with heartfailure with reduced ejection fraction (HFrEF), even though there are known sex differences in pharmacokinetics of these drugs. We hypothesised that there might be sex differences in the optimal (...) dose of ACE inhibitors or ARBs and β blockers in patients with HFrEF.We did a post-hoc analysis of BIOSTAT-CHF, a prospective study in 11 European countries of patients with heartfailure in whom initiation and up-titration of ACE inhibitors or ARBs and β blockers was encouraged by protocol. We included only patients with left ventricular ejection fraction less than 40%, and excluded those who died within the first 3 months. Primary outcome was a composite of time to all-cause mortality
Cardiac rehabilitation for heartfailure can improve quality of life and fitness. The studyTaylor RS, Walker S, Ciani O, et al. Exercise-based cardiac rehabilitation for chronic heartfailure: the EXTRAMATCH II individual participant data meta-analysis. Health Technol Assess 2019;23:1-98.This project was funded by the NIHR Health Technology Assessment Programme (project number 15/80/30).To read the full NIHR Signal, go to https://discover.dc.nihr.ac.uk/content/signal-000803/cardiac (...) -rehabilitation-for-heart-failure-can-improve-quality-of-life-and-fitness.Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.