Search results for "acute decompensated heart failure"
showing 10 items of 11 documents
Acute decompensated heart failure: Decision pathways for older people
2015
Introduction: Acute decompensated heart failure (ADHF) is a common condition in older people, but little research has been conducted on the appropriate decision pathways for this population. The aim of this review was to explore ADHF management in older people, paying particular attention to the comprehensive geriatric assessment (CGA). Material and methods: A search was run in the PubMed literature database, combining the term "acute heart failure" with "management", "geriatric" "multidisciplinary", "co-management", "co-care", "approach", and "comprehensive geriatric assessment", from the databases inception to 1st January 2015. A manual check was also conducted on the reference lists in t…
Levosimendan in the treatment of patients with acute cardiac conditions: an expert opinion of the Association of Intensive Cardiac Care of the Polish…
2020
Levosimendan is a new inodilator which involves 3 main mechanisms: increases the calcium sensitivity of cardiomyocytes, acts as a vasodilator due to the opening of potassium channels, and has a cardioprotective effect. Levosimendan is mainly used in the treatment of acute decompensated heart failure (class IIb recommendation according to the European Society of Cardiology guidelines). However, numerous clinical trials indicate the validity of repeated infusions of levosimendan in patients with stable heart failure as a bridge therapy to heart transplantation, and in patients with accompanying right ventricular heart failure and pulmonary hypertension. Due to the complex mechanism of action,…
Fluid therapy in non-septic, refractory acute decompensated heart failure patients – The cautious role of central venous pressure
2019
Purpose Fluid therapy in congestive acute decompensated heart failure (ADHF) patients might be inappropriate and worsening the prognosis. The aim of our study was to analyze the effect of fluid administration on mortality in non-septic, ADHF patients with reduced ejection fraction. Material and methods We analyzed 41 ADHF consecutive ‘cold-wet’ patients (mean age 69.3 ± 14.9 years, 27 men, LVEF 22.8 ± 11.1%, lactates 2.2 ± 1.6 mmol/L) without sepsis. At admission central venous pressure (CVP) was measured (17.6 ± 7.2 cm H2O), and ultrasound examination of inferior vena cava (IVC) was performed (IVC min. 18.6 ± 7.3 mm and IVC max. 24.6 ± 4.3 mm). Moreover, the groups were compared (survivors…
The Usefulness of Bioelectrical Impedance Analysis in Differentiating Dyspnea Due to Decompensated Heart Failure
2007
Acute dyspnea poses a diagnostic challenge for physicians, and the current methods in differentiating cardiac from non-cardiac causes have been limited to date. Recently, the brain natriuretic peptide (BNP) rapid test has been validated in the emergency room. Nevertheless, the early accumulation of fluid in the interstitial space in the body and in the lungs, which characterizes patients with ADHF, is well estimated by BIA. We investigate whether bioelectrical impedance analysis (BIA) can serve as a noninvasive diagnostic tool in the differential diagnosis of acute decompensated heart failure (ADHF) in the emergency department (ED).A total of 292 patients presenting with acute dyspnea to th…
Risk score for early risk prediction by cardiac magnetic resonance after acute myocardial infarction.
2022
BACKGROUND: Cardiac magnetic resonance (CMR) performed early after ST-segment elevation myocardial infarction (STEMI) can improve major adverse cardiac event (MACE) risk prediction. We aimed to create a simple clinical-CMR risk score for early MACE risk stratification in STEMI patients.; METHODS: We performed a multicenter prospective registry of reperfused STEMI patients (n=1118) in whom early (1-week) CMR-derived left ventricular ejection fraction (LVEF), infarct size and microvascular obstruction (MVO) were quantified. MACE was defined as a combined clinical endpoint of cardiovascular (CV) death, non-fatal myocardial infarction (NF-MI) or re-admission for acute decompensated heart failur…
Early serum creatinine changes and outcomes in patients admitted for acute heart failure: the cardio-renal syndrome revisited.
2017
Background: The changes in renal function that occurred in patients with acute decompensated heart failure (ADHF) are prevalent, and have multifactorial etiology and dissimilar prognosis. To what extent the prognostic role of such changes may vary according to the presence of renal insufficiency at admission is not clear. Accordingly, we sought to determine whether early creatinine changes (Cr) (admission to 48-72 hours) had an effect on 1-year mortality relative to the presence of renal insufficiency at admission. Methods: We included 705 consecutive patients admitted with the diagnosis of ADHF. Admission renal insufficiency was defined as serum creatinine 1.4mg/dl (A-RIcr) or estimated gl…
Prognostic implications of arterial blood gases in acute decompensated heart failure
2010
The prognostic value of arterial blood gases (ABG) in patients with acute decompensated heart failure (ADHF) is not well-established. We therefore conducted the present study to determine the relationship between ABG on admission and long-term mortality in patients with ADHF.We studied 588 patients consecutively admitted to our department with ADHF. ABG and classical prognostic variables were determined at patients' arrival to the emergency department. The independent association among the main variables of ABG (pO2, pCO2 and pH) and mortality was assessed with Cox regression analysis.At a median follow-up of 23months, 221 deaths (37.6%) were registered. 308 (52.4%), 54 (9.2%) and 50 (8.5%)…
The glucocorticoid in acute decompensated heart failure: Dr Jekyll or Mr Hyde?
2012
Glucocorticoid administration is not recommended in patients with heart failure because of its related sodium and fluid retention. However, previous experimental and clinical studies have demonstrated that glucocorticoids can also induce a diuretic effect and improve renal function in patients with acute decompensated heart failure (ADHF) with refractory diuretic resistance. We report the case of a 65-year-old man with a known diagnosis of aortic stenosis, systolic ventricular dysfunction, and chronic obstructive pulmonary disease who was admitted for ADHF. After 3 days, during which resistance to conventional therapy was observed, intravenous methylprednisolone (60 mg/d) was added to ongoi…
Optimal decongestive therapy in acute decompensated heart failure syndromes: Far from being solved
2014
We have read with great interest the article entitled “Efficacy and safety of high dose versus low dose furosemide with or without dopamine infusion: The Dopamine in Acute Decompensated Heart Failure II (DAD-HF II) Trial” [1]. First, we would like to commend the authors for their effort in carrying out this investigator-initiated clinical trial by testing the prognostic effect of three decongestive strategies in the management of patients with acute decompensated heart failure (ADHF). The analysis of the data revealed no-significant differences in the in-hospital and post-discharge outcomes between high (HDF) vs low-dose furosemide infusion (LDFD); the addition of low-dose dopamine infusion…
Effects of intravenous furosemide plus small-volume hypertonic saline solutions on markers of heart failure.
2021
Aims: We sought to compare the effects of furosemide + hypertonic saline solution (HSS) treatment in patients with acute decompensated heart failure in comparison with furosemide alone and the response in a compensated state after an acute saline load with regard to serum levels of heart failure biomarkers. Methods and results: We enrolled 141 patients with acute decompensated heart failure with reduced ejection fraction admitted to our Internal Medicine ward from March 2017 to November 2019. A total of 73 patients were randomized to treatment with i.v. high-dose furosemide plus HSS, whereas 68 patients were randomized to i.v. high-dose furosemide alone. Patients treated with furosemide plu…