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Latest & greatest articles for heart failure
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for HeartFailure) trial, we are investigating whether these acute haemodynamic improvements translate into improvements in exercise capacity and heartfailure symptoms.This multicentre, double-blind, randomized, crossover study aims to randomize 160 patients with PR prolongation (≥200 ms), LV impairment (EF ≤ 40%), and either narrow QRS (≤140 ms) or right bundle branch block. All patients receive a cardiac device with leads positioned in the right atrium and the His bundle. Eligible patients also (...) Rationale and design of the randomized multicentre His Optimized Pacing Evaluated for HeartFailure (HOPEâ€HF) trial In patients with heartfailure and a pathologically prolonged PR interval, left ventricular (LV) filling can be improved by shortening atrioventricular delay using His-bundle pacing. His-bundle pacing delivers physiological ventricular activation and has been shown to improve acute haemodynamic function in this group of patients. In the HOPE-HF (His Optimized Pacing Evaluated
studied subjects with HFpEF (n = 28) and HFrEF (n = 25) and without HF (n = 71). Left ventricular (LV) mass and left atrial (LA) volumes were measured with cardiac magnetic resonance imaging. Arginine vasopressin and ANP were measured with enzyme-linked immunosorbent assay. Arginine vasopressin levels were significantly greater in HFpEF [0.96 pg/mL; 95% confidence interval (CI) = 0.83-1.1 pg/mL] compared with subjects without HF (0.69 pg/mL; 95% CI = 0.6-0.77 pg/mL; P = 0.0002). Heartfailure (...) Association of arginine vasopressin with low atrial natriuretic peptide levels, left ventricular remodelling, and outcomes in adults with and without heartfailure The arginine vasopressin (AVP) pathway has been extensively studied in heartfailure (HF) with reduced ejection fraction (HFrEF), but less is known about AVP in HF with preserved EF (HFpEF). Furthermore, the association between AVP and atrial natriuretic peptide (ANP, a well-known inhibitor of AVP secretion) in HF is unknown.We
Heartfailure Evidence Maps - Trip Database or use your Google+ account Turning Research Into Practice ALL of these words: Title only Anywhere in the document ANY of these words: Title only Anywhere in the document This EXACT phrase: Title only Anywhere in the document EXCLUDING words: Title only Anywhere in the document Timeframe: to: Combine searches by placing the search numbers in the top search box and pressing the search button. An example search might look like (#1 or #2) and (#3 or #4
A novel cardiac output response to stress test developed to improve diagnosis and monitoring of heartfailure in primary care Primary care physicians lack access to an objective cardiac function test. This study for the first time describes a novel cardiac output response to stress (CORS) test developed to improve diagnosis and monitoring of heartfailure in primary care and investigates its reproducibility.Prospective observational study recruited 32 consecutive primary care patients (age, 63 (...) HeartFailure published by John Wiley & Sons Ltd on behalf of the European Society of Cardiology.
Actionable Metabolic Pathways in HeartFailure and Cancerâ€”Lessons From Cancer Cell Metabolism Recent advances in cancer cell metabolism provide unprecedented opportunities for a new understanding of heart metabolism and may offer new approaches for the treatment of heartfailure. Key questions driving the cancer field to understand how tumor cells reprogram metabolism and to benefit tumorigenesis are also applicable to the heart. Recent experimental and conceptual advances in cancer cell (...) metabolism provide the cardiovascular field with the unique opportunity to target metabolism. This review compares cancer cell metabolism and cardiac metabolism with an emphasis on strategies of cellular adaptation, and how to exploit metabolic changes for therapeutic benefit.
in PAP values in patients after MitraClip with PAP changes in patients without MitraClip.Among 28 patients with New York Heart Association III heartfailure with implanted PAP sensor for haemodynamic telemonitoring from a single centre, four patients (age 66 ± 6 years, left ventricular ejection fraction 21 ± 3%, and cardiac index 1.8 ± 0.3) received a MitraClip procedure and were compared with 24 patients (age 72 ± 8 years, left ventricular ejection fraction 26 ± 9.9%, and cardiac index 2.0 ± 1.0 (...) Daily nonâ€invasive haemodynamic telemonitoring for efficacy evaluation of MitraClipÂ® implantation in patients with advanced systolic heartfailure Patients with advanced systolic chronic heartfailure frequently suffer from progressive functional mitral regurgitation. We report our initial experience in patients with an implanted pulmonary artery pressure (PAP) sensor, who developed severe mitral regurgitation, which was treated with the MitraClip system. We non-invasively compared changes
HeartFailure. Heartfailure affects more than 6 million people in the United States and incurs a heavy toll in morbidity, mortality, and health care costs. It frequently coexists with other important disorders, including hypertension, coronary artery disease, diabetes, and obesity. Decades of clinical trials have shown that several medications and interventions are effective for improving outcomes; however, mortality and hospitalization rates remain high. More recently, additional medications (...) and devices have shown promise in reducing the health burden of heartfailure.
Treatment of Atrial Fibrillation in Patients with Co-existing HeartFailure and Reduced Ejection Fraction: Time to Revisit the Management Guidelines? AF in patients with heartfailure and reduced ejection fraction (HFrEF) is common and is associated with an increased risk of stroke, heartfailure hospitalisation and all-cause mortality. Rhythm control of AF in this population has been traditionally limited to the use of antiarrhythmic drugs. Clinical trials assessing superiority
Atrial Fibrillation Ablation in Patients with HeartFailure: One Size Does Not Fit All Atrial fibrillation (AF) is common in patients with heartfailure and is associated with poorer clinical outcomes compared with patients with heartfailure alone. Recent evidence has challenged previous treatment paradigms in which rate control was considered equivalent to rhythm control in this population. Catheter ablation has emerged as a safe and effective treatment strategy in selected patients (...) and overcomes the issues of limited efficacy and drug toxicities associated with pharmacological rhythm control. Numerous studies have explored the benefits of catheter ablation in patients with heartfailure, but these have included heterogeneous patient cohorts and variable ablation strategies. This state-of-the-art review explores the evidence from these trials and examines the need for tailored, patient-specific strategies for AF ablation in patients with heartfailure.
His Bundle Pacing: A New Frontier in the Treatment of HeartFailure Biventricular pacing has revolutionised the treatment of heartfailure in patients with sinus rhythm and left bundle branch block; however, left ventricular-lead placement is not always technically possible. Furthermore, biventricular pacing does not fully normalise ventricular activation and, therefore, the ventricular resynchronisation is imperfect. Right ventricular pacing for bradycardia may cause or worsen heartfailure (...) in some patients by causing dyssynchronous ventricular activation. His bundle pacing activates the ventricles via the native His-Purkinje system, resulting in true physiological pacing, and, therefore, is a promising alternate site for pacing in bradycardia and traditional CRT indications in cases where it can overcome left bundle branch block. Furthermore, it may open up new indications for pacing therapy in heartfailure, such as targeting patients with PR prolongation, but a narrow QRS duration
2018 Circulation. 2018;137:e578–e622 You are viewing the most recent version of this article. Previous versions: Abstract Background and Purpose: The diverse causes of right-sided heartfailure (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 (...) options and enhanced outcomes in patients with acute and chronic disorders of the right side of the heart. RV dysfunction (RVD), defined here as evidence of abnormal RV structure or function, 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 heartfailure (HF), after cardiac surgery, acute myocardial infarction (MI), congenital heart disease (CHD), and PH
Effectiveness of a transition plan at discharge of patients hospitalized with heartfailure: a beforeâ€andâ€after study We evaluated the effectiveness of a multidisciplinary transition plan to reduce early readmission among heartfailure patients.We conducted a before-and-after study in a tertiary internal medicine department, comparing 3 years of retrospective data (pre-intervention) and 13 months of prospective data (intervention period). Intervention was the introduction in 2013 (...) of a transition plan performed by a multidisciplinary team. We included all consecutive patients hospitalized with symptomatic heartfailure and discharged to home. The outcomes were the fraction of days spent in hospital because of readmission, based on the sum of all days spent in hospital, and the rate of readmission. The same measurements were used for those with potentially avoidable readmissions. Four hundred thirty-one patients were included and compared with 1441 patients in the pre-intervention