Latest & greatest articles for heart failure

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Top results for heart failure

1. Hand-held ultrasound devices for cardiac assessment and diagnosis of heart failure

Hand-held ultrasound devices for cardiac assessment and diagnosis of heart failure Hand-held ultrasound devices - Health Technology Wales > Hand-held ultrasound devices Hand-held ultrasound devices Topic Status Complete Hand-held ultrasound devices for cardiac assessment and diagnosis of heart failure, in the community or primary care setting. Outcome of the appraisal Hand-held ultrasound devices (HUDs) show promise in the diagnosis of heart failure in a primary care or community setting (...) , but the current evidence is insufficient to support routine adoption. HUDs have the potential to reduce secondary care referrals if heart failure is excluded and to facilitate earlier treatment if confirmed, but convincing evidence is needed to substantiate any clinical and system benefits. HTW recommends further research to investigate the benefits of implementing HUDs in a primary care or community setting in Wales; see Guidance for more information. Why was this topic appraised? Heart failure is a common

2019 Health Technology Wales

2. The OPTIMIZER smart system for managing heart failure

The OPTIMIZER smart system for managing heart failure The OPTIMIZER smart system for managing The OPTIMIZER smart system for managing heart failure heart failure Medtech innovation briefing Published: 27 June 2019 www.nice.org.uk/guidance/mib186 pathways Summary Summary The technology technology described in this briefing is the OPTIMIZER smart system. It is a programmable cardiac stimulation device for people with chronic heart failure. The system is for people who still have symptoms after (...) failure. The main points from the e main points from the evidence vidence summarised in this briefing are from 6 studies (1 randomised controlled trial, 1 case-control study, 3 observational studies and 1 retrospective analysis) including 633 adults. The studies show that the OPTIMIZER smart system could be more effective than drug therapy alone in patients with heart failure. K Ke ey uncertainties y uncertainties around the evidence or technology are that there is only 1 comparative study, which

2019 National Institute for Health and Clinical Excellence - Advice

3. Analysis of How Emergency Physicians' Decisions to Hospitalize or Discharge Patients With Acute Heart Failure Match the Clinical Risk Categories of the MEESSI-AHF Scale

Analysis of How Emergency Physicians' Decisions to Hospitalize or Discharge Patients With Acute Heart Failure Match the Clinical Risk Categories of the MEESSI-AHF Scale The Multiple Estimation of Risk Based on the Emergency Department Spanish Score in Patients With Acute Heart Failure (MEESSI-AHF) is a validated clinical decision tool that characterizes risk of mortality in emergency department (ED) acute heart failure patients. The objective of this study is to compare the distribution of risk (...) categories between hospitalized and discharged ED patients with acute heart failure.We included consecutive acute heart failure patients from 34 Spanish EDs. Patients were retrospectively classified according to MEESSI-AHF risk categories. We calculated the odds of hospitalization (versus direct discharge from the ED) across MEESSI-AHF risk categories. Next, we assessed the following 30-day postdischarge outcomes: ED revisit, hospitalization, death, and their combination. We used Cox hazards models

2019 EvidenceUpdates

4. Effect of Neladenoson Bialanate on Exercise Capacity Among Patients With Heart Failure With Preserved Ejection Fraction: A Randomized Clinical Trial. (PubMed)

Effect of Neladenoson Bialanate on Exercise Capacity Among Patients With Heart Failure With Preserved Ejection Fraction: A Randomized Clinical Trial. Heart failure with preserved ejection fraction (HFpEF) lacks effective treatments. Based on preclinical studies, neladenoson bialanate, a first-in-class partial adenosine A1 receptor agonist, has the potential to improve several heart failure-related cardiac and noncardiac abnormalities but has not been evaluated to treat HFpEF.To determine (...) whether neladenoson improves exercise capacity, physical activity, cardiac biomarkers, and quality of life in patients with HFpEF and to find the optimal dose.Phase 2b randomized clinical trial conducted at 76 centers in the United States, Europe, and Japan. Patients (N = 305) with New York Heart Association class II or III HFpEF with elevated natriuretic peptide levels were enrolled between May 10, 2017, and December 7, 2017 (date of final follow-up: June 20, 2018).Participants were randomized (1:2:2

2019 JAMA

5. Impact of Exercise Rehabilitation on Exercise Capacity and Quality-of-Life in Heart Failure: Individual Participant Meta-Analysis

Impact of Exercise Rehabilitation on Exercise Capacity and Quality-of-Life in Heart Failure: Individual Participant Meta-Analysis Previous systematic reviews have indicated that exercise-based cardiac rehabilitation (ExCR) for patients with heart failure (HF) has a beneficial effect on health-related quality-of-life (HRQoL) and exercise capacity. However, there is uncertainty regarding potential differential effects of ExCR across HF patient subgroups.The authors sought to undertake (...) international clinical guidelines that ExCR should be offered to all HF patients. (Exercise Training for Chronic Heart Failure [ExTraMATCH II]: protocol for an individual participant data meta-analysis; PROSPERO: international database of systematic reviews CRD42014007170).Copyright © 2019. Published by Elsevier Inc.

2019 EvidenceUpdates

6. Intramyocardial Injection of Mesenchymal Precursor Cells and Successful Temporary Weaning From Left Ventricular Assist Device Support in Patients With Advanced Heart Failure: A Randomized Clinical Trial. (PubMed)

Intramyocardial Injection of Mesenchymal Precursor Cells and Successful Temporary Weaning From Left Ventricular Assist Device Support in Patients With Advanced Heart Failure: A Randomized Clinical Trial. Left ventricular assist device (LVAD) therapy improves myocardial function, but few patients recover sufficiently for explant, which has focused attention on stem cells to augment cardiac recovery.To assess efficacy and adverse effects of intramyocardial injections of mesenchymal precursor (...) cells (MPCs) during LVAD implant.A randomized phase 2 clinical trial involving patients with advanced heart failure, undergoing LVAD implant, at 19 North American centers (July 2015-August 2017). The 1-year follow-up ended August 2018.Intramyocardial injections of 150 million allogeneic MPCs or cryoprotective medium as a sham treatment in a 2:1 ratio (n = 106 vs n = 53).The primary efficacy end point was the proportion of successful temporary weans (of 3 planned assessments) from LVAD support within

2019 JAMA

7. Heart failure drug treatment. (PubMed)

Heart failure drug treatment. Heart failure is the most common cardiovascular reason for hospital admission for people older than 60 years of age. Few areas in medicine have progressed as remarkably as heart failure treatment over the past three decades. However, progress has been consistent only for chronic heart failure with reduced ejection fraction. In acutely decompensated heart failure and heart failure with preserved ejection fraction, none of the treatments tested to date have been (...) definitively proven to improve survival. Delaying or preventing heart failure has become increasingly important in patients who are prone to heart failure. The prevention of worsening chronic heart failure and hospitalisations for acute decompensation is also of great importance. The objective of this Series paper is to provide a concise and practical summary of the available drug treatments for heart failure. We support the implementation of the international guidelines. We offer views on the basis of our

2019 Lancet

8. Multimodality imaging in ischaemic heart failure. (PubMed)

Multimodality imaging in ischaemic heart failure. In heart failure, extensive evaluation with modern non-invasive imaging modalities is needed to assess causes, pathophysiology, and haemodynamics, to determine prognosis and consider therapeutic options. This systematic evaluation includes a stepwise assessment of left ventricular size and function, the presence and severity of coronary artery disease, mitral regurgitation, pulmonary hypertension, right ventricular dilation and dysfunction

2019 Lancet

9. Beyond pharmacological treatment: an insight into therapies that target specific aspects of heart failure pathophysiology. (PubMed)

Beyond pharmacological treatment: an insight into therapies that target specific aspects of heart failure pathophysiology. Heart failure is a common syndrome associated with substantial morbidity and mortality. The management of symptoms and the strategies for improving prognosis have largely been based on pharmacological treatments. The pathophysiology of heart failure is complex because of the multiple causes responsible for this syndrome. This Series paper presents some examples of advances (...) in heart failure management, in which the treatment specifically targets the underlying pathophysiological mechanisms responsible for the symptoms. These treatments include treatment of electromechanical dyssynchrony and dysrhythmia by cardiac resynchronisation and implantable cardioverter-defibrillators; neurohumoral modification by baroreflex and vagal stimulation; prevention of adverse cardiac remodelling by interatrial shunts; and finally targeting the myocardium directly by cell therapy

2019 Lancet

10. Association of genetically predicted testosterone with thromboembolism, heart failure, and myocardial infarction: mendelian randomisation study in UK Biobank. (PubMed)

Association of genetically predicted testosterone with thromboembolism, heart failure, and myocardial infarction: mendelian randomisation study in UK Biobank. To determine whether endogenous testosterone has a causal role in thromboembolism, heart failure, and myocardial infarction.Two sample mendelian randomisation study using genetic variants as instrumental variables, randomly allocated at conception, to infer causality as additional randomised evidence.Reduction by Dutasteride of Prostate (...) Cancer Events (REDUCE) randomised controlled trial, UK Biobank, and CARDIoGRAMplusC4D 1000 Genomes based genome wide association study.3225 men of European ancestry aged 50-75 in REDUCE; 392 038 white British men and women aged 40-69 from the UK Biobank; and 171 875 participants of about 77% European descent, from CARDIoGRAMplusC4D 1000 Genomes based study for validation.Thromboembolism, heart failure, and myocardial infarction based on self reports, hospital episodes, and death.Of the UK Biobank

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2019 BMJ

11. Prospective Validation of the Emergency Heart Failure Mortality Risk Grade for Acute Heart Failure

Prospective Validation of the Emergency Heart Failure Mortality Risk Grade for Acute Heart Failure Improved risk stratification of acute heart failure in the emergency department may inform physicians' decisions regarding patient admission or early discharge disposition. We aimed to validate the previously-derived Emergency Heart failure Mortality Risk Grade for 7-day (EHMRG7) and 30-day (EHMRG30-ST) mortality.We conducted a multicenter, prospective validation study of patients with acute heart (...) failure at 9 hospitals. We surveyed physicians for their estimates of 7-day mortality risk, obtained for each patient before knowledge of the model predictions, and compared these with EHMRG7 for discrimination and net reclassification improvement. We also prospectively examined discrimination of the EHMRG30-ST model, which incorporates all components of EHMRG7 as well as the presence of ST-depression on the 12-lead ECG.We recruited 1983 patients seeking emergency department care for acute heart

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2019 EvidenceUpdates

12. Anti-Inflammatory Therapy with Canakinumab for the Prevention of Hospitalization for Heart Failure

Anti-Inflammatory Therapy with Canakinumab for the Prevention of Hospitalization for Heart Failure Subclinical inflammation is associated with an increased risk of heart failure and with adverse prognosis in patients with established heart failure. Yet, treatments specifically directed at reducing inflammation in patients with heart failure have not yet shown improved clinical outcomes. We tested the hypothesis that the interleukin-1β inhibitor canakinumab would prevent hospitalization (...) for heart failure (HHF) and the composite of HHF or heart failure-related mortality.We randomized 10 061 patients with prior myocardial infarction and high-sensitivity C-reactive protein ≥2 mg/L to canakinumab 50, 150, or 300 mg or placebo, given subcutaneously once every 3 months. In total, 2173 (22%) reported a history of heart failure at baseline. We tested the hypothesis that canakinumab prevents prospectively collected HHF events and the composite of HHF or heart failure-related mortality.A total

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2019 EvidenceUpdates

13. Effect of Patient-Centered Transitional Care Services on Clinical Outcomes in Patients Hospitalized for Heart Failure: The PACT-HF Randomized Clinical Trial. (PubMed)

Effect of Patient-Centered Transitional Care Services on Clinical Outcomes in Patients Hospitalized for Heart Failure: The PACT-HF Randomized Clinical Trial. Health care services that support the hospital-to-home transition can improve outcomes in patients with heart failure (HF).To test the effectiveness of the Patient-Centered Care Transitions in HF transitional care model in patients hospitalized for HF.Stepped-wedge cluster randomized trial of 2494 adults hospitalized for HF across 10 (...) hospitals in Ontario, Canada, from February 2015 to March 2016, with follow-up until November 2016.Hospitals were randomized to receive the intervention (n = 1104 patients), in which nurse-led self-care education, a structured hospital discharge summary, a family physician follow-up appointment less than 1 week after discharge, and, for high-risk patients, structured nurse homevisits and heart function clinic care were provided to patients, or usual care (n = 1390 patients), in which transitional care

2019 JAMA

14. Trends in survival after a diagnosis of heart failure in the United Kingdom 2000-2017: population based cohort study. (PubMed)

Trends in survival after a diagnosis of heart failure in the United Kingdom 2000-2017: population based cohort study. To report reliable estimates of short term and long term survival rates for people with a diagnosis of heart failure and to assess trends over time by year of diagnosis, hospital admission, and socioeconomic group.Population based cohort study.Primary care, United Kingdom.Primary care data for 55 959 patients aged 45 and overwith a new diagnosis of heart failure and 278 679 age (...) and sex matched controls in the Clinical Practice Research Datalink from 1 January 2000 to 31 December 2017 and linked to inpatient Hospital Episode Statistics and Office for National Statistics mortality data.Survival rates at one, five, and 10 years and cause of death for people with and without heart failure; and temporal trends in survival by year of diagnosis, hospital admission, and socioeconomic group.Overall, one, five, and 10 year survival rates increased by 6.6% (from 74.2% in 2000 to 80.8

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2019 BMJ

15. Association of Left Ventricular Ejection Fraction and Symptoms With Mortality After Elective Noncardiac Surgery Among Patients With Heart Failure. (PubMed)

Association of Left Ventricular Ejection Fraction and Symptoms With Mortality After Elective Noncardiac Surgery Among Patients With Heart Failure. Heart failure is an established risk factor for postoperative mortality, but how left ventricular ejection fraction and heart failure symptoms affect surgical outcomes is not fully described.To determine the risk of postoperative mortality among patients with heart failure at various levels of echocardiographic (left ventricular systolic dysfunction (...) ) and clinical (symptoms) severity compared with those without heart failure and to evaluate how risk varies across levels of surgical complexity.US multisite retrospective cohort study of all adult patients receiving elective, noncardiac surgery in the Veterans Affairs Surgical Quality Improvement Project database from 2009 through 2016. A total of 609 735 patient records were identified and analyzed with 1 year of follow-up after having surgery (final study follow-up: September 1, 2017).Heart failure, left

2019 JAMA

16. Post-discharge short message service improves short-term clinical outcome and self-care behaviour in chronic heart failure. (PubMed)

Post-discharge short message service improves short-term clinical outcome and self-care behaviour in chronic heart failure. In addition to giving optimal medical and device therapy, promoting self-care of chronic heart failure (CHF) patients also plays an important role in comprehensive disease management for better outcomes. The study was aimed to investigate whether short message service (SMS) would help to improve death or readmission-free survival and self-care behaviour in CHF (...) and improved self-care behaviour. SMS intervention could be integrated into CHF management.© 2018 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of the European Society of Cardiology.

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2019 ESC heart failure

17. Repetitive levosimendan infusions for patients with advanced chronic heart failure in the vulnerable post-discharge period. (PubMed)

Repetitive levosimendan infusions for patients with advanced chronic heart failure in the vulnerable post-discharge period. Hospitalization for acute heart failure (HF) is associated with a substantial morbidity burden and with associated healthcare costs and an increased mortality risk. However, few if any major medical innovations have been witnessed in this area in recent times. Levosimendan is a first-in-class calcium sensitizer and potassium channel opener indicated for the management (...) of acute HF. Experience in several clinical studies has indicated that administration of intravenous levosimendan in intermittent cycles may reduce hospitalization and mortality rates in patients with advanced HF; however, none of those trials were designed or powered to give conclusive insights into that possibility. This paper describes the rationale and protocol of LeoDOR (levosimendan infusions for patients with advanced chronic heart failure), a randomized, double-blind, placebo-controlled

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2019 ESC heart failure

18. Rapid 5 lb weight gain is not associated with readmission in patients with heart failure. (PubMed)

Rapid 5 lb weight gain is not associated with readmission in patients with heart failure. Heart failure (HF) patients are taught to identify a rapid 5 lb body-weight gain for early detection of cardiac decompensation. Few data support this common advice. The study aim was to determine whether a 5 lb weight gain in 1 week and signs and symptoms of HF increased risk for unplanned physician or emergency department (ED) visits or hospital admission in rural HF patients.This was a secondary (...) tracking of dyspnoea symptoms may be an important adjunct to daily weight to prevent hospitalization.© 2018 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of the European Society of Cardiology.

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2019 ESC heart failure

19. Effectiveness and safety of rivaroxaban vs. warfarin in patients with non-valvular atrial fibrillation and heart failure. (PubMed)

Effectiveness and safety of rivaroxaban vs. warfarin in patients with non-valvular atrial fibrillation and heart failure. Heart failure (HF) is a common co-morbidity in non-valvular atrial fibrillation (NVAF) patients and a potent risk factor for stroke, bleeding, and a decreased time-in-therapeutic range with warfarin. We assessed the real-world effectiveness and safety of rivaroxaban and warfarin in NVAF patients with co-morbid HF.Using US Truven MarketScan Commercial and Medicare (...) with co-morbid HF treated in routine practice. The general consistency between this real-world study and those from phase III randomized trial data of rivaroxaban should provide additional reassurance to clinicians regarding the use of rivaroxaban in NVAF patients with HF.© 2018 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of the European Society of Cardiology.

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2019 ESC heart failure

20. Pro-gastrin-releasing peptide and outcome in patients with heart failure and anaemia: results from the RED-HF study. (PubMed)

Pro-gastrin-releasing peptide and outcome in patients with heart failure and anaemia: results from the RED-HF study. Neuroendocrine activation is associated with poor outcome in heart failure (HF). The neuropeptide gastrin-releasing peptide (GRP), derived from the precursor proGRP1-125 (proGRP), has recently been implicated in inflammation and wound repair. We investigated the predictive value of proGRP on clinical outcomes in HF patients with reduced ejection fraction.The association between (...) plasma proGRP (time-resolved immunofluorometric assay) and the primary endpoint of death from any cause or first hospitalization for worsening of HF was evaluated using multivariable Cox proportional hazard models in 1541 patients with systolic HF and mild to moderate anaemia, enrolled in the Reduction of Events by Darbepoetin alfa in Heart Failure (RED-HF) trial. Median proGRP levels in the RED-HF cohort were markedly increased [95 ng/L (25th, 75th percentile, 69-129 ng/L)] with 64% patients above

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2019 ESC heart failure