Latest & greatest articles for heart failure

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Top results for heart failure

101. Chronic congestive heart failure

Chronic congestive heart failure Chronic congestive heart failure - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Chronic congestive heart failure Last reviewed: February 2019 Last updated: January 2019 Summary A complex clinical syndrome that can result from any structural or functional cardiac disorder that impairs the ability of the ventricle to fill with or eject blood. It is a major and growing public health (...) problem. It is the only cardiovascular disease that is increasing in incidence and prevalence, partly because the population is ageing, but also because of improved cardiovascular interventions for disease processes that reduce early mortality but may result in cardiac changes that lead to heart failure. The key manifestations are dyspnoea and fatigue, which may limit exercise tolerance, and fluid retention, which may lead to pulmonary congestion and peripheral oedema. Diagnosis is largely clinical

2019 BMJ Best Practice

102. Motivational interviewing can support physical activity in elderly patients with diastolic heart failure: results from a pilot study. Full Text available with Trip Pro

Motivational interviewing can support physical activity in elderly patients with diastolic heart failure: results from a pilot study. Patients suffering from heart failure with preserved ejection fraction (HFpEF) report similar symptoms and reduction in quality of life to those with reduced ejection fraction but remain largely untreated. We conducted a preliminary evaluation of the acceptance, feasibility, and efficacy of a motivational interviewing (MI) intervention to support elderly patients (...) suffering from HFpEF in maintaining or starting physical activity.At the conclusion of the exercise training in diastolic heart failure parent trial that examined the effects of supervised exercise, patients with HFpEF were offered participation in a two-group pilot study. Based on their preference, consenting patients were assigned to either a 6 month MI intervention group (n = 19) or their physicians' usual care (n = 20). To support participants in increasing and/or maintaining their physical activity

2019 ESC heart failure Controlled trial quality: uncertain

103. Association of Rivaroxaban With Thromboembolic Events in Patients With Heart Failure, Coronary Disease, and Sinus Rhythm: A Post Hoc Analysis of the COMMANDER HF Trial. (Abstract)

Association of Rivaroxaban With Thromboembolic Events in Patients With Heart Failure, Coronary Disease, and Sinus Rhythm: A Post Hoc Analysis of the COMMANDER HF Trial. Whether anticoagulation benefits patients with heart failure (HF) in sinus rhythm is uncertain. The COMMANDER HF randomized clinical trial evaluated the effects of adding low-dose rivaroxaban to antiplatelet therapy in patients with recent worsening of chronic HF with reduced ejection fraction, coronary artery disease (CAD

2019 JAMA cardiology Controlled trial quality: predicted high

104. High vs. low oxygen therapy in patients with acute heart failure: HiLo-HF pilot trial. Full Text available with Trip Pro

High vs. low oxygen therapy in patients with acute heart failure: HiLo-HF pilot trial. Most patients with acute heart failure (AHF) are treated with supplemental oxygen during hospitalization. In this study, we investigated the effect of oxygen titrated to high vs. low pulse oximetry targets in patients hospitalized with AHF.In a pilot, open-label randomized controlled trial (RCT), 50 patients who were admitted with AHF were randomized to either high (≥96%) or low (90-92%) SpO2 targets. Oxygen (...) , -1253) pg/mL in the high SpO2 group and -2093 (-5692, -353) pg/mL in the low SpO2 group (P = 0.46), and the 72 h to baseline NT-proBNP ratio was similar between groups (0.7 vs. 0.6, P = 0.51). There were no differences between arms in change in dyspnoea VAS (P = 0.86), PGA (P = 0.91), PEF (P = 0.52), in-hospital mortality (4.0% vs. 8.0%, P = 0.50), or 30 day heart failure readmission rates (20.8% vs. 8.7%, P = 0.22).In this study, no differences were observed in the primary or secondary outcomes

2019 ESC heart failure Controlled trial quality: predicted high

105. Neuromuscular electrical stimulation is feasible in patients with acute heart failure. Full Text available with Trip Pro

Neuromuscular electrical stimulation is feasible in patients with acute heart failure. In acute heart failure (AHF), immobilization is caused because of unstable haemodynamics and dyspnoea, leading to protein wasting. Neuromuscular electrical stimulation (NMES) has been reported to preserve muscle mass and improve functional outcomes in chronic disease. NMES may be effective against protein wasting frequently manifested in patients with AHF; however, whether NMES can be implemented safely (...) immediately after admission.© 2019 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of the European Society of Cardiology.

2019 ESC heart failure Controlled trial quality: uncertain

106. General medicine: Angiotensin receptor neprilysin inhibitors in older patients with heart failure

General medicine: Angiotensin receptor neprilysin inhibitors in older patients with heart failure Angiotensin receptor neprilysin inhibitors in older patients with heart failure | BMJ Evidence-Based Medicine Log in using your username and password For personal accounts OR managers of institutional accounts Username * Password * your user name or password? Search for this keyword Search for this keyword Main menu Log in using your username and password For personal accounts OR managers (...) of institutional accounts Username * Password * your user name or password? You are here Angiotensin receptor neprilysin inhibitors in older patients with heart failure Article Text EBM opinion and debate General medicine Angiotensin receptor neprilysin inhibitors in older patients with heart failure Anthony T Sharkey 1 , Mohd Zaquan Ghafar 1 , Shaun T O’Keeffe 1 , Eamon C Mulkerrin 1 , 2 Statistics from Altmetric.com Introduction Heart failure affects approximately 1.5% of the adult population in developed

2019 Evidence-Based Medicine

107. Linagliptin Effects on Heart Failure and Related Outcomes in Individuals With Type 2 Diabetes Mellitus at High Cardiovascular and Renal Risk in CARMELINA Full Text available with Trip Pro

Linagliptin Effects on Heart Failure and Related Outcomes in Individuals With Type 2 Diabetes Mellitus at High Cardiovascular and Renal Risk in CARMELINA Individuals with type 2 diabetes mellitus are at increased risk for heart failure (HF), particularly those with coexisting atherosclerotic cardiovascular disease and/or kidney disease. Some but not all dipeptidyl peptidase-4 inhibitors have been associated with increased HF risk. We performed secondary analyses of HF and related outcomes

2019 EvidenceUpdates

108. Oral modified release morphine for breathlessness in chronic heart failure: a randomized placebo-controlled trial. Full Text available with Trip Pro

Oral modified release morphine for breathlessness in chronic heart failure: a randomized placebo-controlled trial. Morphine is shown to relieve chronic breathlessness in chronic obstructive pulmonary disease. There are no definitive data in people with heart failure. We aimed to determine the effectiveness and cost-effectiveness of 12 weeks morphine therapy for the relief of chronic breathlessness in people with chronic heart failure compared with placebo.Parallel group, double-blind (...) .We could not answer our primary objectives due to inadequate power. However, we provide novel placebo-controlled medium-term benefit and safety data useful for clinical practice and future trial design. Morphine should only be prescribed in this population when other measures are unhelpful and with early management of side effects.© 2019 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of the European Society of Cardiology.

2019 ESC heart failure Controlled trial quality: predicted high

109. Adult nursing: Home management of heart failure based solely on symptom and fluid management, adherence and knowledge may not fully meet the complex needs of patients

Adult nursing: Home management of heart failure based solely on symptom and fluid management, adherence and knowledge may not fully meet the complex needs of patients Home management of heart failure based solely on symptom and fluid management, adherence and knowledge may not fully meet the complex needs of patients | Evidence-Based Nursing Log in using your username and password For personal accounts OR managers of institutional accounts Username * Password * your user name or password (...) ? Search for this keyword Search for this keyword Main menu Log in using your username and password For personal accounts OR managers of institutional accounts Username * Password * your user name or password? You are here Home management of heart failure based solely on symptom and fluid management, adherence and knowledge may not fully meet the complex needs of patients Article Text Commentary Adult nursing Home management of heart failure based solely on symptom and fluid management, adherence

2019 Evidence-Based Nursing

110. Adult nursing: Multidisciplinary disease management programme with or without exercise training may reduce heart failure-related rehospitalisation

Adult nursing: Multidisciplinary disease management programme with or without exercise training may reduce heart failure-related rehospitalisation Multidisciplinary disease management programme with or without exercise training may reduce heart failure-related rehospitalisation | Evidence-Based Nursing Log in using your username and password For personal accounts OR managers of institutional accounts Username * Password * your user name or password? Search for this keyword Search (...) for this keyword Main menu Log in using your username and password For personal accounts OR managers of institutional accounts Username * Password * your user name or password? You are here Multidisciplinary disease management programme with or without exercise training may reduce heart failure-related rehospitalisation Article Text Commentary Adult nursing Multidisciplinary disease management programme with or without exercise training may reduce heart failure-related rehospitalisation Lesley Collier

2019 Evidence-Based Nursing

111. Heart failure - chronic: Angiotensin-II receptor antagonists

Heart failure - chronic: Angiotensin-II receptor antagonists Managing AIIRAs | Prescribing information | Heart failure - chronic | CKS | NICE Search CKS… Menu Managing AIIRAs Heart failure - chronic: Angiotensin-II receptor antagonists Last revised in January 2017 Angiotensin-II receptor antagonists Adverse effects of AIIRAs Adverse effects of angiotensin-II receptor antagonists (AIIRAs) include: Hypotension — which may cause dizziness and syncope. This occurs more commonly in people (...) intake and stop the AIIRA for 1–2 days until they recover. Stopping treatment for a short time is thought to avoid dehydration, hypotension, and acute kidney injury, and should not cause a sudden deterioration in heart failure. If symptoms persist beyond 2 days they should see a GP and have their renal function checked. For more information, see the section on . Table 2. Doses of recommended AIIRAs for heart failure. AIIRA Initial dose Target dose Candesartan 4 mg once a day 32 mg once a day Losartan

2019 NICE Clinical Knowledge Summaries

112. Heart failure - chronic

as a result of a structural or functional impairment of ventricular filling or ejection. This results in symptoms including breathlessness, 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 death. About 50% of people with heart failure die within 5 years of diagnosis, and about 40% of people admitted to hospital with heart failure die or are readmitted within 1 year. If heart failure is suspected clinically they should have their serum natriuretic peptide level measured. If the level is normal, a diagnosis of heart failure is unlikely. If levels are raised

2019 NICE Clinical Knowledge Summaries

113. Management of Heart Failure (4th Edition)

(CABG) or percutaneous coronary intervention (PCI)) should be considered in patients with HF and suitable coronary anatomy. Key message 7: Asymptomatic LV Dysfunction ? Identify patients who are at high risk of developing LV dysfunction and treat the underlying disease appropriately. ? ACE-I and ß-blockers (post MI) have been shown to slow down the onset of symptoms and reduce cardiac morbidity. Key message 8:Heart Failure with Preserved LV Function (HFpEF) ? HFpEF is a common cause of HF (...) bypass graft (CABG) or percutaneous coronary intervention (PCI)) should be considered in patients with HF and suitable coronary anatomy. Key message 7: Asymptomatic LV Dysfunction ? Identify patients who are at high risk of developing LV dysfunction and treat the underlying disease appropriately. ? ACE-I and ß-blockers (post MI) have been shown to slow down the onset of symptoms and reduce cardiac morbidity. Key message 8:Heart Failure with Preserved LV Function (HFpEF) ? HFpEF is a common cause

2019 Ministry of Health, Malaysia

114. Association of the Hospital Readmissions Reduction Program With Mortality Among Medicare Beneficiaries Hospitalized for Heart Failure, Acute Myocardial Infarction, and Pneumonia. Full Text available with Trip Pro

Association of the Hospital Readmissions Reduction Program With Mortality Among Medicare Beneficiaries Hospitalized for Heart Failure, Acute Myocardial Infarction, and Pneumonia. The Hospital Readmissions Reduction Program (HRRP) has been associated with a reduction in readmission rates for heart failure (HF), acute myocardial infarction (AMI), and pneumonia. It is unclear whether the HRRP has been associated with change in patient mortality.To determine whether the HRRP was associated

2018 JAMA

115. Association of Renin-Angiotensin Inhibitor Treatment With Mortality and Heart Failure Readmission in Patients With Transcatheter Aortic Valve Replacement. Full Text available with Trip Pro

Association of Renin-Angiotensin Inhibitor Treatment With Mortality and Heart Failure Readmission in Patients With Transcatheter Aortic Valve Replacement. Data are lacking on the effect of a renin-angiotensin system (RAS) inhibitor prescribed after transcatheter aortic valve replacement (TAVR). Treatment with a RAS inhibitor may reverse left ventricular remodeling and improve function.To investigate the association of prescription of a RAS inhibitor and outcomes after TAVR.Retrospective cohort (...) outcomes were all-cause death and readmission due to heart failure at 1 year after discharge, which were considered separately. The secondary outcome was health status assessed by the Kansas City Cardiomyopathy Questionnaire (KCCQ; score range: 0-100, with a higher score indicating less symptom burden and better quality of life; a small effect size was defined as 5 points) at 1 year.Among 21 312 patients who underwent TAVR at 417 US sites, 8468 patients (39.7%) were prescribed a RAS inhibitor

2018 JAMA

116. Economic and Quality-of-Life Outcomes of Natriuretic Peptide-Guided Therapy for Heart Failure Full Text available with Trip Pro

Economic and Quality-of-Life Outcomes of Natriuretic Peptide-Guided Therapy for Heart Failure The GUIDE-IT (GUIDing Evidence Based Therapy Using Biomarker Intensified Treatment in Heart Failure) trial prospectively compared the efficacy of an N-terminal pro-B-type natriuretic peptide (NT-proBNP)-guided heart failure treatment strategy (target NT-proBNP level <1,000 pg/ml) with optimal medical therapy alone in high-risk patients with heart failure and reduced ejection fraction. When the study (...) $5,919 higher in the biomarker-guided strategy (95% CI: -$1,795, +$13,602) over 15-month median follow-up.A strategy of NT-proBNP-guided HF therapy had higher total costs and was not more effective than usual care in improving QOL outcomes in patients with heart failure and a reduced ejection fraction. (Guiding Evidence Based Therapy Using Biomarker Intensified Treatment [GUIDE-IT]; NCT01685840).Copyright © 2018 American College of Cardiology Foundation. All rights reserved.

2018 EvidenceUpdates

117. Angiotensin-Neprilysin Inhibition in Acute Decompensated Heart Failure. Full Text available with Trip Pro

Angiotensin-Neprilysin Inhibition in Acute Decompensated Heart Failure. Acute decompensated heart failure accounts for more than 1 million hospitalizations in the United States annually. Whether the initiation of sacubitril-valsartan therapy is safe and effective among patients who are hospitalized for acute decompensated heart failure is unknown.We enrolled patients with heart failure with reduced ejection fraction who were hospitalized for acute decompensated heart failure at 129 sites (...) . -25.3%; ratio of change with sacubitril-valsartan vs. enalapril, 0.71; 95% confidence interval [CI], 0.63 to 0.81; P<0.001). The greater reduction in the NT-proBNP concentration with sacubitril-valsartan than with enalapril was evident as early as week 1 (ratio of change, 0.76; 95% CI, 0.69 to 0.85). The rates of worsening renal function, hyperkalemia, symptomatic hypotension, and angioedema did not differ significantly between the two groups.Among patients with heart failure with reduced ejection

2018 NEJM Controlled trial quality: predicted high

118. 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

119. 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

120. 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