Latest & greatest articles for heart failure

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Top results for heart failure

101. 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 After 6 months, patients in the continued treatment group had treatment withdrawn by the same method.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

102. 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

103. 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

104. 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

105. 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

106. 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

107. 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

108. 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

109. 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

110. Genetic and Tissue Engineering Approaches to Modeling the Mechanics of Human Heart Failure for Drug Discovery Full Text available with Trip Pro

Genetic and Tissue Engineering Approaches to Modeling the Mechanics of Human Heart Failure for Drug Discovery Heart failure is the leading cause of death in the western world and as such, there is a great need for new therapies. Heart failure has a variable presentation in patients and a complex etiology; however, it is fundamentally a condition that affects the mechanics of cardiac contraction, preventing the heart from generating sufficient cardiac output under normal operating pressures. One (...) of the major issues hindering the development of new therapies has been difficulties in developing appropriate in vitro model systems of human heart failure that recapitulate the essential changes in cardiac mechanics seen in the disease. Recent advances in stem cell technologies, genetic engineering, and tissue engineering have the potential to revolutionize our ability to model and study heart failure in vitro. Here, we review how these technologies are being applied to develop personalized models

2018 Frontiers in cardiovascular medicine

111. Chronic heart failure in adults: diagnosis and management

not routinely offer coronary revascularisation to people who have heart failure with reduced ejection fraction and coronary artery disease. [2018] [2018] Cardiac tr Cardiac transplantation ansplantation 1.8.2 Specialist referral for transplantation should be considered for people with severe refractory symptoms or refractory cardiogenic shock. [2003] [2003] Implantable cardio Implantable cardiov verter defibrillators and cardiac resynchronisation ther erter defibrillators and cardiac resynchronisation (...) Cardiac rehabilitation 21 1.10 Palliative care 21 T erms used in this guideline 22 Putting this guideline into practice 23 Context 25 Key facts and figures 25 Current practice 25 More information 25 Recommendations for research 26 1 Diuretic therapy for managing fluid overload in people with advanced heart failure in the community . 26 2 Cardiac MRI versus other imaging techniques for diagnosing heart failure 26 3 The impact of atrial fibrillation on the natriuretic peptide threshold for diagnosing

2018 National Institute for Health and Clinical Excellence - Clinical Guidelines

112. Evaluation and Management of Right-Sided Heart Failure

of right-sided heart failure (RHF) include, among others, primary cardiomyopathies with right ventricular (RV) involvement, RV ischemia and infarction, volume loading caused by cardiac lesions associated with congenital heart disease and valvular pathologies, and pressure loading resulting from pulmonic stenosis or pulmonary hypertension from a variety of causes, including left-sided heart disease. Progressive RV dysfunction in these disease states is associated with increased morbidity and mortality (...) , is associated with poor clinical outcomes independently of the underlying mechanism of disease: across the spectrum of left ventricular (LV) ejection fraction (EF) in patients with acute and chronic heart failure (HF), after cardiac surgery, acute myocardial infarction (MI), congenital heart disease (CHD), and PH. To distinguish right-sided HF (RHF) from structural RVD, we define RHF as a clinical syndrome with signs and symptoms of HF resulting from RVD. RHF is caused by the inability of the RV to support

2018 International Society for Heart and Lung Transplantation

113. Myocardial expression of the anaphylatoxin receptor C3aR is associated with cardiac inflammation and prognosis in patients with non‐ischaemic heart failure Full Text available with Trip Pro

Myocardial expression of the anaphylatoxin receptor C3aR is associated with cardiac inflammation and prognosis in patients with non‐ischaemic heart failure The aim of this study is to analyse the prognostic value of complement anaphylatoxin receptors in patients with non-ischaemic cardiomyopathy undergoing endomyocardial biopsy.In 102 patients (72.5% male patients, median age 54 years) with non-ischaemic cardiomyopathy, myocardial expression of C3aR was assessed among other parameters (...) was a strong independent predictor for the primary endpoint in Cox regression analysis [hazard ratio 0.46 (0.26-0.82, P = 0.009)].C3aR-positive cells are found more often in patients with inflammatory cardiomyopathy. The relevance of C3aR-positive cells in patients with non-ischaemic cardiomyopathy should be further evaluated as potential predictors or modulators of adverse cardiac remodelling, the substrate of progressive heart failure.© 2018 The Authors. ESC Heart Failure published by John Wiley & Sons

2018 ESC heart failure

114. Rivaroxaban in Patients with Heart Failure, Sinus Rhythm, and Coronary Disease. Full Text available with Trip Pro

Rivaroxaban in Patients with Heart Failure, Sinus Rhythm, and Coronary Disease. Heart failure is associated with activation of thrombin-related pathways, which predicts a poor prognosis. We hypothesized that treatment with rivaroxaban, a factor Xa inhibitor, could reduce thrombin generation and improve outcomes for patients with worsening chronic heart failure and underlying coronary artery disease.In this double-blind, randomized trial, 5022 patients who had chronic heart failure, a left (...) ventricular ejection fraction of 40% or less, coronary artery disease, and elevated plasma concentrations of natriuretic peptides and who did not have atrial fibrillation were randomly assigned to receive rivaroxaban at a dose of 2.5 mg twice daily or placebo in addition to standard care after treatment for an episode of worsening heart failure. The primary efficacy outcome was the composite of death from any cause, myocardial infarction, or stroke. The principal safety outcome was fatal bleeding

2018 NEJM Controlled trial quality: predicted high

115. Efficacy of telemedical interventional management in patients with heart failure (TIM-HF2): a randomised, controlled, parallel-group, unmasked trial. (Abstract)

Efficacy of telemedical interventional management in patients with heart failure (TIM-HF2): a randomised, controlled, parallel-group, unmasked trial. Remote patient management in patients with heart failure might help to detect early signs and symptoms of cardiac decompensation, thus enabling a prompt initiation of the appropriate treatment and care before a full manifestation of a heart failure decompensation. We aimed to investigate the efficacy of our remote patient management intervention (...) on mortality and morbidity in a well defined heart failure population.The Telemedical Interventional Management in Heart Failure II (TIM-HF2) trial was a prospective, randomised, controlled, parallel-group, unmasked (with randomisation concealment), multicentre trial with pragmatic elements introduced for data collection. The trial was done in Germany, and patients were recruited from hospitals and cardiology practices. Eligible patients had heart failure, were in New York Heart Association class II or III

2018 Lancet Controlled trial quality: predicted high

116. Prediction of readmissions and mortality in patients with heart failure: lessons from the IMPEDANCE‐HF extended trial Full Text available with Trip Pro

Prediction of readmissions and mortality in patients with heart failure: lessons from the IMPEDANCE‐HF extended trial Readmissions for heart failure (HF) are a major burden. We aimed to assess whether the extent of improvement in pulmonary fluid content (ΔPC) during HF hospitalization evaluated by lung impedance (LI), or indirectly by other clinical and laboratory parameters, predicts readmissions.The present study is based on pre-defined secondary analysis of the IMPEDANCE-HF extended trial (...) with ΔPC ≤ median for all parameters evaluated in both study groups with the most pronounced difference predicted by LI (P < 0.01). Net reclassification improvement analysis showed that adding LI to the traditional clinical and laboratory parameters improved the predictive power significantly.The extent of ΔPC improvement, primarily the LI based, during HF-hospitalization, and study group allocation strongly predicted readmission and event-free survival time.© 2018 The Authors. ESC Heart Failure

2018 ESC heart failure

117. Iron deficiency in chronic heart failure: case‐based practical guidance Full Text available with Trip Pro

Iron deficiency in chronic heart failure: case‐based practical guidance In patients with chronic heart failure, iron deficiency, even in the absence of anaemia, can aggravate the underlying disease and have a negative impact on clinical outcomes and quality of life. The 2016 European Society of Cardiology guidelines for the diagnosis and treatment of acute and chronic heart failure recognize iron deficiency as a co-morbidity in chronic heart failure and recommend iron status screening in all (...) newly diagnosed patients with chronic heart failure. Furthermore, the guidelines specifically recommend considerations of intravenous iron therapy, ferric carboxymaltose, for the treatment of iron deficiency. However, in spite of these recommendations, iron deficiency remains often overlooked and undertreated. This may be due, in part, to the lack of clinical context and practical guidance accompanying the guidelines for the treating physician. Here, we provide practical guidance complemented

2018 ESC heart failure

118. Heart failure

, fluid retention, and fatigue; and signs including basal crepitations, and peripheral oedema. Heart failure is (...) classified into two main 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 (...) Factors for HF ( Hypertension , Diabetes Mellitus, Metabolic Syndrome, and Atherosclerotic Disease) e249 5. Cardiac Structural Abnormalities 2013 8. Evaluation and Management of Right-Sided Heart Failure : A Scientific Statement From the American Heart Association Evaluation and Management of Right-Sided Heart Failure : A Scientific Statement From the American Heart Association | Circulation Search for this keyword Search Search for this keyword Search Header Publisher Menu AHA Scientific Statement

2018 Trip Latest and Greatest

119. Sex differences in outcomes of heart failure in an ambulatory, population-based cohort from 2009 to 2013 Full Text available with Trip Pro

Sex differences in outcomes of heart failure in an ambulatory, population-based cohort from 2009 to 2013 Heart failure remains a substantial cause of morbidity and mortality in women. We examined the sex differences in heart failure incidence, mortality and hospital admission in a population-based cohort.All Ontario residents who were diagnosed with heart failure in an ambulatory setting between Apr. 1, 2009, and Mar. 31, 2014, were included in this study. Incident cases of heart failure were (...) captured through physician billing using a validated algorithm. Outcomes were mortality and hospital admission for heart failure within 1 year of the diagnosis. Probability of death and hospital admission were calculated using the Kaplan-Meier method. The hazard of death was assessed using a multivariable Cox proportional hazard model.A total of 90 707 diagnoses of heart failure were made in an ambulatory setting during the study period (47% women). Women were more likely to be older and more frail

2018 EvidenceUpdates

120. Letter to the Editor: His Bundle Pacing: A New Frontier in the Treatment of Heart Failure Full Text available with Trip Pro

Letter to the Editor: His Bundle Pacing: A New Frontier in the Treatment of Heart Failure 30416736 2018 12 07 2050-3369 7 3 2018 Aug Arrhythmia & electrophysiology review Arrhythm Electrophysiol Rev Letter to the Editor: His Bundle Pacing: A New Frontier in the Treatment of Heart Failure. 218-219 10.15420/aer.2018.7.3.L1 Theodoros Zografos Z eng Journal Article England Arrhythm Electrophysiol Rev 101637930 2050-3369 2018 11 13 6 0 2018 11 13 6 0 2018 11 13 6 1 ppublish 30416736 10.15420/aer (...) .2018.7.3.L1 PMC6141951 Circulation. 2013 Feb 5;127(5):613-23 23275383 Europace. 2012 Jan;14(1):81-91 21798880 ESC Heart Fail. 2018 Oct;5(5):965-976 29984912 Heart Rhythm. 2018 Mar;15(3):460-468 29107697 Pacing Clin Electrophysiol. 2006 Oct;29(10):1063-8 17038137 Arrhythm Electrophysiol Rev. 2018 Jun;7(2):103-110 29967682 N Engl J Med. 2013 Apr 25;368(17):1585-93 23614585 J Am Coll Cardiol. 1999 Feb;33(2):311-6 9973008 Arrhythm Electrophysiol Rev. 2017 Dec;6(4):159-160 29326829 Eur Heart J. 2015 Apr

2018 Arrhythmia & electrophysiology review