Search results for "FAILURE"

The new clinical standard of integrated quadruple stress echocardiography with ABCD protocol

2018

Abstract Background The detection of regional wall motion abnormalities is the cornerstone of stress echocardiography. Today, stress echo shows increasing trends of utilization due to growing concerns for radiation risk, higher cost and stronger environmental impact of competing techniques. However, it has also limitations: underused ability to identify factors of clinical vulnerability outside coronary artery stenosis; operator-dependence; low positivity rate in contemporary populations; intermediate risk associated with a negative test; limited value of wall motion beyond coronary artery disease. Nevertheless, stress echo has potential to adapt to a changing environment and overcome its c…

Long-term LVEF trajectories in patients with type 2 diabetes and heart failure: diabetic cardiomyopathy may underlie functional decline

2020

Abstract Background Left ventricular ejection fraction (LVEF) trajectories and functional recovery with current heart failure (HF) management is increasingly recognized. Type 2 diabetes mellitus (T2D) leads to a worse prognosis in HF patients. However, it is unknown whether T2D interferes with LVEF trajectories. The aim of this study was to prospectively assess very long-term (up to 15 years) LVEF trajectories in patients with and without T2D and underlying HF. Methods Ambulatory patients admitted to a multidisciplinary HF clinic were prospectively evaluated by scheduled two-dimensional echocardiography at baseline, 1 year, and then every 2 years afterwards, up to 15 years. Statistical anal…

Prognostic Value of Pulmonary Vascular Resistance by Magnetic Resonance in Systolic Heart Failure

2016

Abstract Background: Pulmonary hypertension is associated with poor prognosis in heart failure. However, non-invasive diagnosis is still challenging in clinical practice. Objective: We sought to assess the prognostic utility of non-invasive estimation of pulmonary vascular resistances (PVR) by cardiovascular magnetic resonance to predict adverse cardiovascular outcomes in heart failure with reduced ejection fraction (HFrEF). Methods: Prospective registry of patients with left ventricular ejection fraction (LVEF) < 40% and recently admitted for decompensated heart failure during three years. PVRwere calculated based on right ventricular ejection fraction and average velocity of the pulmonary…

Refractory congestive heart failure: when the solution is outside the heart

2020

Abstract Refractory congestive heart failure is associated with an ominous prognosis in which the treatments strategies remain scarce and not well validated. In the last years, continuous ambulatory peritoneal dialysis (CAPD) has emerged as a therapeutic alternative in this subset of patients. So far, it has been associated with a significant improvement in functional capacity and quality of life, together with a striking reduction in the risk of readmissions. We present the case of an elderly patient with severe left ventricular dysfunction and severe mitral and tricuspid regurgitation who presents recurrent admissions for anasarca. After its inclusion in a CAPD programme, the patient expe…

The validity of heart failure diagnoses in the Finnish Hospital Discharge Register.

2019

Background: Contemporary validation studies of register-based heart failure diagnoses based on current guidelines and complete clinical data are lacking in Finland and internationally. Our objective was to assess the positive and negative predictive values of heart failure diagnoses in a nationwide hospital discharge register. Methods: Using Finnish Hospital Discharge Register data from 2013–2015, we obtained the medical records for 120 patients with a register-based diagnosis for heart failure (cases) and for 120 patients with a predisposing condition for heart failure, but without a heart failure diagnosis (controls). The medical records of all patients were assessed by a physician who c…

Detectable interleukin-9 plasma levels are associated with impaired cardiopulmonary functional capacity and all-cause mortality in patients with chro…

2016

Inflammatory activation plays a pivotal role in chronic heart failure (CHF) through the increased expression of pro-inflammatory cytokines [1]. Decreased plasma levels of Interleukin (IL-) 5, IL-7 and Interferon-γ (IFN-γ) and increased levels of IL-9 have been already described in CHF [2], and a negative correlation was also reported between IL-9 and left ventricular ejection fraction (LVEF) [2]. Yet, there are only limited data exploring the association between cytokines and functional capacity in CHF and their prognostic role [3]; therefore, primary end-point of the current study was to evaluate all-cause mortality according to changes in cytokines plasma levels in CHF patients.  

Validity of the Seattle Heart Failure Model after heart failure hospitalization.

2019

Abstract Aims Heart failure hospitalization is a sentinel event associated with increased mortality risk. Whether long‐term heart failure risk models such as the Seattle Heart Failure Model (SHFM) accurately assess risk in the post‐hospital setting is unknown. Methods and results The SHFM was applied to a cohort of 2242 consecutive patients (50% women; mean age 73) on discharge after acute heart failure hospitalization and analysed for the primary endpoint of all‐cause mortality. Model discrimination and calibration were assessed. Direct patient‐level comparison between our study cohort and the original SHFM cohorts was also performed to confirm and quantify the degree and extent of increas…

'Pulmonary thrombosis in situ': risk factors, clinic characteristics and long-term evolution.

2020

: Pulmonary embolism typically occurs from deep venous thrombosis (DVT). However, not always a DVT can be identified, and 'in situ' generation of pulmonary embolism has been considered, referred to in the literature as 'De novo pulmonary embolism' (DNPE). The objective of the study is to assess risk factors, comorbidities, clinic characteristics and long-term evolution of patients with pulmonary embolism in the absence of an identified source. Retrospective study of 280 patients with pulmonary embolism, 190 pulmonary embolisms with DVT group and 90 (32%) pulmonary embolism without DVT (DNPE group), admitted to an Internal Medicine Department of a tertiary hospital from January 2012 to Decem…

Iron deficiency and functional capacity in patients with advanced heart failure with preserved ejection fraction.

2015

Impact of atrial fibrillation/flutter on the in-hospital mortality of surgical patients – Results from the German nationwide cohort

2020

To investigate the impact of atrial fibrillation/flutter (AF) on adverse in-hospital outcomes in hospitalized surgical patients.The nationwide German inpatient sample of the years 2005-2018 was used for this analysis. Surgical patients were stratified by AF and compared. Logistic regression models were used to investigate the impact of AF on in-hospital outcomes.In total, 96,589,627 hospitalizations with surgery were included in the present analysis in Germany (2005-2018). Among these, 6,680,261 were additionally coded with AF (6.9%). In-hospital death rate was substantially higher in surgical patients with AF (6.3%) than without (1.1%). Proportion of surgical patients with AF increased fro…