Latest & greatest articles for heart failure

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Top results for heart failure

81. High vs. low oxygen therapy in patients with acute heart failure: HiLo-HF pilot trial. Full Text available with Trip Pro

High vs. low oxygen therapy in patients with acute heart failure: HiLo-HF pilot trial. Most patients with acute heart failure (AHF) are treated with supplemental oxygen during hospitalization. In this study, we investigated the effect of oxygen titrated to high vs. low pulse oximetry targets in patients hospitalized with AHF.In a pilot, open-label randomized controlled trial (RCT), 50 patients who were admitted with AHF were randomized to either high (≥96%) or low (90-92%) SpO2 targets. Oxygen (...) , -1253) pg/mL in the high SpO2 group and -2093 (-5692, -353) pg/mL in the low SpO2 group (P = 0.46), and the 72 h to baseline NT-proBNP ratio was similar between groups (0.7 vs. 0.6, P = 0.51). There were no differences between arms in change in dyspnoea VAS (P = 0.86), PGA (P = 0.91), PEF (P = 0.52), in-hospital mortality (4.0% vs. 8.0%, P = 0.50), or 30 day heart failure readmission rates (20.8% vs. 8.7%, P = 0.22).In this study, no differences were observed in the primary or secondary outcomes

2019 ESC heart failure Controlled trial quality: predicted high

82. Neuromuscular electrical stimulation is feasible in patients with acute heart failure. Full Text available with Trip Pro

Neuromuscular electrical stimulation is feasible in patients with acute heart failure. In acute heart failure (AHF), immobilization is caused because of unstable haemodynamics and dyspnoea, leading to protein wasting. Neuromuscular electrical stimulation (NMES) has been reported to preserve muscle mass and improve functional outcomes in chronic disease. NMES may be effective against protein wasting frequently manifested in patients with AHF; however, whether NMES can be implemented safely (...) immediately after admission.© 2019 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of the European Society of Cardiology.

2019 ESC heart failure Controlled trial quality: uncertain

83. General medicine: Angiotensin receptor neprilysin inhibitors in older patients with heart failure

General medicine: Angiotensin receptor neprilysin inhibitors in older patients with heart failure Angiotensin receptor neprilysin inhibitors in older patients with heart failure | BMJ Evidence-Based Medicine Log in using your username and password For personal accounts OR managers of institutional accounts Username * Password * your user name or password? Search for this keyword Search for this keyword Main menu Log in using your username and password For personal accounts OR managers (...) of institutional accounts Username * Password * your user name or password? You are here Angiotensin receptor neprilysin inhibitors in older patients with heart failure Article Text EBM opinion and debate General medicine Angiotensin receptor neprilysin inhibitors in older patients with heart failure Anthony T Sharkey 1 , Mohd Zaquan Ghafar 1 , Shaun T O’Keeffe 1 , Eamon C Mulkerrin 1 , 2 Statistics from Altmetric.com Introduction Heart failure affects approximately 1.5% of the adult population in developed

2019 Evidence-Based Medicine

84. Linagliptin Effects on Heart Failure and Related Outcomes in Individuals With Type 2 Diabetes Mellitus at High Cardiovascular and Renal Risk in CARMELINA Full Text available with Trip Pro

Linagliptin Effects on Heart Failure and Related Outcomes in Individuals With Type 2 Diabetes Mellitus at High Cardiovascular and Renal Risk in CARMELINA Individuals with type 2 diabetes mellitus are at increased risk for heart failure (HF), particularly those with coexisting atherosclerotic cardiovascular disease and/or kidney disease. Some but not all dipeptidyl peptidase-4 inhibitors have been associated with increased HF risk. We performed secondary analyses of HF and related outcomes

2019 EvidenceUpdates

85. Heart failure - chronic

categories with either a reduced or preserved ejection fraction. Symptoms are classified according to severity using the New York Heart Association (NYHA) functional classification. The most common underlying cause is coronary artery disease. Complications include arrhythmias, depression, cachexia, chronic kidney disease, sexual dysfunction, and sudden cardiac death. About 50% of people with heart failure die within 5 years of diagnosis, and about 40% of people admitted to hospital with heart failure die (...) nocturnal dyspnoea). Fluid retention (ankle swelling, bloated feeling, abdominal swelling, or weight gain). Fatigue, decreased exercise tolerance, or increased recovery time after exercise. Light headedness or history of syncope. Ask about risk factors: Coronary artery disease including previous history of myocardial infarction, hypertension, atrial fibrillation, and diabetes mellitus. Drugs, including alcohol. Family history of heart failure or sudden cardiac death under the age of 40 years. Examine

2019 NICE Clinical Knowledge Summaries

86. Oral modified release morphine for breathlessness in chronic heart failure: a randomized placebo-controlled trial. Full Text available with Trip Pro

Oral modified release morphine for breathlessness in chronic heart failure: a randomized placebo-controlled trial. Morphine is shown to relieve chronic breathlessness in chronic obstructive pulmonary disease. There are no definitive data in people with heart failure. We aimed to determine the effectiveness and cost-effectiveness of 12 weeks morphine therapy for the relief of chronic breathlessness in people with chronic heart failure compared with placebo.Parallel group, double-blind (...) .We could not answer our primary objectives due to inadequate power. However, we provide novel placebo-controlled medium-term benefit and safety data useful for clinical practice and future trial design. Morphine should only be prescribed in this population when other measures are unhelpful and with early management of side effects.© 2019 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of the European Society of Cardiology.

2019 ESC heart failure Controlled trial quality: predicted high

87. Adult nursing: Home management of heart failure based solely on symptom and fluid management, adherence and knowledge may not fully meet the complex needs of patients

Adult nursing: Home management of heart failure based solely on symptom and fluid management, adherence and knowledge may not fully meet the complex needs of patients Home management of heart failure based solely on symptom and fluid management, adherence and knowledge may not fully meet the complex needs of patients | Evidence-Based Nursing Log in using your username and password For personal accounts OR managers of institutional accounts Username * Password * your user name or password (...) ? Search for this keyword Search for this keyword Main menu Log in using your username and password For personal accounts OR managers of institutional accounts Username * Password * your user name or password? You are here Home management of heart failure based solely on symptom and fluid management, adherence and knowledge may not fully meet the complex needs of patients Article Text Commentary Adult nursing Home management of heart failure based solely on symptom and fluid management, adherence

2019 Evidence-Based Nursing

88. Association of the Hospital Readmissions Reduction Program With Mortality Among Medicare Beneficiaries Hospitalized for Heart Failure, Acute Myocardial Infarction, and Pneumonia. Full Text available with Trip Pro

Association of the Hospital Readmissions Reduction Program With Mortality Among Medicare Beneficiaries Hospitalized for Heart Failure, Acute Myocardial Infarction, and Pneumonia. The Hospital Readmissions Reduction Program (HRRP) has been associated with a reduction in readmission rates for heart failure (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

2018 JAMA

89. Association of Renin-Angiotensin Inhibitor Treatment With Mortality and Heart Failure Readmission in Patients With Transcatheter Aortic Valve Replacement. Full Text available with Trip Pro

Association of Renin-Angiotensin Inhibitor Treatment With Mortality and Heart Failure 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 heart failure 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

2018 JAMA

90. Economic and Quality-of-Life Outcomes of Natriuretic Peptide-Guided Therapy for Heart Failure Full Text available with Trip Pro

Economic and Quality-of-Life Outcomes of Natriuretic Peptide-Guided Therapy for Heart Failure The GUIDE-IT (GUIDing Evidence Based Therapy Using Biomarker Intensified Treatment in Heart Failure) trial prospectively compared the efficacy of an N-terminal pro-B-type natriuretic peptide (NT-proBNP)-guided heart failure treatment strategy (target NT-proBNP level <1,000 pg/ml) with optimal medical therapy alone in high-risk patients with heart failure and reduced ejection fraction. When the study (...) $5,919 higher in the biomarker-guided strategy (95% CI: -$1,795, +$13,602) over 15-month median follow-up.A strategy of NT-proBNP-guided HF therapy had higher total costs and was not more effective than usual care in improving QOL outcomes in patients with heart failure and a reduced ejection fraction. (Guiding Evidence Based Therapy Using Biomarker Intensified Treatment [GUIDE-IT]; NCT01685840).Copyright © 2018 American College of Cardiology Foundation. All rights reserved.

2018 EvidenceUpdates

91. Angiotensin-Neprilysin Inhibition in Acute Decompensated Heart Failure. Full Text available with Trip Pro

Angiotensin-Neprilysin Inhibition in Acute Decompensated Heart Failure. Acute decompensated heart failure 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 heart failure is unknown.We enrolled patients with heart failure with reduced ejection fraction who were hospitalized for acute decompensated heart failure 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 heart failure with reduced ejection

2018 NEJM Controlled trial quality: predicted high

92. Withdrawal of pharmacological treatment for heart failure in patients with recovered dilated cardiomyopathy (TRED-HF): an open-label, pilot, randomised trial. Full Text available with Trip Pro

Withdrawal of pharmacological treatment for heart failure 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 heart failure 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 heart failure, at which point

2018 Lancet Controlled trial quality: predicted high

93. Effect of Inorganic Nitrite vs Placebo on Exercise Capacity Among Patients With Heart Failure With Preserved Ejection Fraction: The INDIE-HFpEF Randomized Clinical Trial. Full Text available with Trip Pro

Effect of Inorganic Nitrite vs Placebo on Exercise Capacity Among Patients With Heart Failure With Preserved Ejection Fraction: The INDIE-HFpEF Randomized Clinical Trial. There are few effective treatments for heart failure 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 heart failure 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.

2018 JAMA Controlled trial quality: predicted high

94. CardioMEMS for Heart Failure Monitoring

% CI 0.55 to 0.80, p 40% (62 [23%] in the experimental group vs. 57 [20%] in the control group) • Proportion of patients with coronary artery disease (182 [67%] in the experimental group vs. 202 [72%] in the control group) 10 ¦ CardioMEMS™ for Heart Failure Monitoring Approved 10/4/2018 • Proportion of patients with atrial flutter or atrial fibrillation (120 [44%] in the experimental group vs. 135 [48%] in the control group) • Proportion of patients on nitrates (64 [24%] in the experimental group (...) controlled trials, or clinical practice guidelines. 25 ¦ CardioMEMS™ for Heart Failure Monitoring Approved 10/4/2018 Appendix D. Applicable Codes Note: Inclusion on this list does not guarantee coverage. CODES DESCRIPTION CPT Codes 93451 Right heart catheterization including measurement(s) of oxygen saturation and cardiac output, when performed 93568 Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for pulmonary angiography (List separately

2018 Oregon Health Evidence Review Commission

95. Suspected New-Onset and Nonacute Heart Failure

changes in static images (ie, CTA; or, without the use ACR Appropriateness Criteria ® 6 Suspected New-Onset and Known Nonacute Heart Failure of intravenous contrast for coronary calcification, calcium scoring for risk stratification). Delayed imaging helps further the detection of fibrous or fatty tissue replacement in cardiac structures (eg, LV wall) [26,29,30]. Despite marked improvements, prevailing concerns about potential complications are still limitations to the use of this modality (...) of rest and stress MRI. CTA Coronary Arteries There is limited evidence to support the use of cardiac CTA as initial imaging for the evaluation of patients with newly suspected or potential HF. Arteriography Coronary The invasive nature of coronary angiography limits its use for the assessment of patients with newly suspected or potential HF. Variant 2: Differentiating new-onset heart failure with reduced ejection fraction (HFrEF) from new-onset heart failure with preserved ejection fraction (HFpEF

2018 American College of Radiology

96. Acute exacerbation of congestive heart failure

Acute exacerbation of congestive heart failure Acute exacerbation of congestive heart failure - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Acute exacerbation of congestive heart failure 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 heart failure 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

2018 BMJ Best Practice

97. Heart Failure After Ischemic Stroke or TIA in Insulin-Resistant Patients Without Diabetes Treated with Pioglitazone Full Text available with Trip Pro

Heart Failure 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 heart failure (HF) in susceptible individuals.In IRIS, patients with insulin resistance but without diabetes mellitus

2018 EvidenceUpdates

98. The Metabolic Syndrome, Cardiovascular Fitness and Survival in Patients With Advanced Systolic Heart Failure (Abstract)

The Metabolic Syndrome, Cardiovascular Fitness and Survival in Patients With Advanced Systolic Heart Failure The metabolic syndrome (MetS), which incorporates insulin resistance, visceral adiposity, and dyslipidemia, is an independent risk factor for incident heart failure (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

2018 EvidenceUpdates

99. Treatment of Hypertension in Association With Heart Failure

. Hjalmarson A, Goldstein S, Fagerberg B, et al., for the MERIT-HF Study Group. Effects of controlled-release metoprolol on coral mortality, hospitalizations, and well-being in patients with heart failure. JAMA 2000;283:1295-302. CIBIS-II lnvestigators and Committees. The Cardiac Insufficiency Bisoprolol Study II (CIBIS- II): a randomised trial. Lancet 1999;353:9-13. Heidenreich PA, Lee TT, Massie BM. Effect of beta-blockade on mortality in patients with heart failure: a meta-analysis of randomized (...) Treatment of Hypertension in Association With Heart Failure VII. Treatment of Hypertension in Association With Heart Failure | Hypertension Canada Guidelines Subgroup Members: Simon W. Rabkin, MD; Gordon W. Moe, MD, MSc; Jonathan G. Howlett, MD Central Review Committee: Stella S. Daskalopoulou, MD MSc DIC PhD (Chair); Kaberi Dasgupta, MD MSc; Kelly B. Zarnke, MD MSc; Kara Nerenberg, MD, MSc; Alexander A. Leung, MD MPH; Kevin C. Harris, MD MHSc; Kerry McBrien, MD MPH; Sonia Butalia, BSc MD MSc

2018 Hypertension Canada

100. Transcatheter Mitral-Valve Repair in Patients with Heart Failure. Full Text available with Trip Pro

Transcatheter Mitral-Valve Repair in Patients with Heart Failure. Among patients with heart failure who have mitral regurgitation due to left ventricular dysfunction, the prognosis is poor. Transcatheter mitral-valve repair may improve their clinical outcomes.At 78 sites in the United States and Canada, we enrolled patients with heart failure and moderate-to-severe or severe secondary mitral regurgitation who remained symptomatic despite the use of maximal doses of guideline-directed medical (...) therapy. Patients were randomly assigned to transcatheter mitral-valve repair plus medical therapy (device group) or medical therapy alone (control group). The primary effectiveness end point was all hospitalizations for heart failure within 24 months of follow-up. The primary safety end point was freedom from device-related complications at 12 months; the rate for this end point was compared with a prespecified objective performance goal of 88.0%.Of the 614 patients who were enrolled in the trial

2018 NEJM Controlled trial quality: predicted high