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Latest & greatest articles for heart failure
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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
Therapeutic implications of a combined diagnostic workup including endomyocardial biopsy in an allâ€comer population of patients with heartfailure: a retrospective analysis Aetiology of heartfailure (HF) often remains obscure. We therefore evaluated the usefulness of a combined diagnostic approach including cardiac magnetic resonance imaging (CMRI) and endomyocardial biopsy (EMB) to assess the cause of unexplained cardiomyopathy underlying HF.We retrospectively investigated 100 consecutive (...) patients (36% women, mean age 53.6 ± 18.8 years) presenting with unexplained cardiomyopathy (HF with reduced ejection fraction or left ventricular hypertrophy; excluding ischaemic and valvular heart disease; left ventricular ejection fraction 31.6 ± 13.9%, Left ventricular end-diastolic pressure 18.2 ± 9.3 mmHg, heart rate 89 ± 26.6 b.p.m.; mean ± SEM) at the University Medical Center Mainz. We performed electrocardiography, echocardiography, CMRI, and cardiac catheterization with EMB analysed
Ivabradine (Lancora) - chronic heartfailure Search Page - Drug and Health Product Register Language selection Search and menus Search Search website Search Topics menu You are here: Summary Basis of Decision - - Health Canada Expand all Summary Basis of Decision (SBD) for Contact: Summary Basis of Decision (SBD) documents provide information related to the original authorization of a product. The for is located below. Recent Activity for SBDs written for approved after September 1, 2012
”. The application was transferred to IQWiG on 27 November 2015. According to the applicant, the method applied – hereinafter referred to as “PA pressure monitoring” – aims to detect early haemodynamic changes in the pulmonary circulation of heartfailure patients to help optimize drug treatment and avoid symptoms, cardiac decompensation and hospitalization. Results from a randomized controlled trial (RCT) were available for the method “measurement and monitoring of pulmonary artery pressure via an implanted (...) Measurement and monitoring of pulmonary artery pressure via an implanted sensor for treatment optimization in heartfailure 1 Translation of the executive summary of the assessment of potential Messung und Monitoring des pulmonalarteriellen Druckes mittels implantiertem Sensor zur Therapieoptimierung bei Herzinsuffizienz (Version 1.0; Status: 8 January 2016). Please note: This translation is provided as a service by IQWiG to English-language readers. However, solely the German original text
Measurement and monitoring of pulmonary artery pressure via an implanted sensor for treatment optimization in heartfailure ? Addendum to Commission E15-04 1 Translation of the executive summary of the addendum Messung und Monitoring des pulmonalarteriellen Druckes mittels implantiertem Sensor zur Therapieoptimierung bei Herzinsuffizienz – Addendum zum Auftrag E15-04 (Version 1.0; Status: 20 April 2016). Please note: This translation is provided as a service by IQWiG to English-language readers (...) . However, solely the German original text is absolutely authoritative and legally binding. Executive Summary IQWiG Reports – Commission No. E16-02 Measurement and monitoring of pulmonary artery pressure via an implanted sensor for treatment optimization in heartfailure – Addendum to Commission E15-04 1 Executive summary of Addendum E16-02 Version 1.0 PA pressure monitoring in heartfailure 20 April 2016 Institute for Quality and Efficiency in Health Care (IQWiG) - i - Publishing details Publisher
Pilot Randomized Controlled Trial to Reduce Readmission for HeartFailure Using Novel Tablet and Nurse Practitioner Education Heartfailure education programs are not standardized. The best form of education is unclear. We evaluated whether addition of a novel tablet application to nurse practitioner (NP) education was superior to NP education alone in reducing 30-day readmission after heartfailure hospitalization.From February 2015-March 2016, patients admitted to a quaternary academic center (...) with primary diagnosis of heartfailure were randomized to 1) treatment - NP education plus tablet application (interactive conditional logic program that flags patient questions to medical staff), or 2) control - NP education. The primary outcome was reduction in 30-day readmission rate. Secondary outcomes included satisfaction and education assessed via survey.Randomization included 60 patients to treatment and 66 to control. A total of 13 patients withdrew prior to intervention (treatment n = 4, control
Palliative care in the outpatient setting for patients with heartfailure or advanced lung disease Palliative care in the outpatient setting for patients with heartfailure or advanced lung disease Palliative care in the outpatient setting for patients with heartfailure or advanced lung disease Lavenberg JG, Umscheid, CA Record Status This is a bibliographic record of a published health technology assessment from a member of INAHTA. No evaluation of the quality of this assessment has been made (...) for the HTA database. Citation Lavenberg JG, Umscheid, CA. Palliative care in the outpatient setting for patients with heartfailure or advanced lung disease. Philadelphia: Center for Evidence-based Practice (CEP). 2018 Final publication URL Indexing Status Subject indexing assigned by CRD MeSH HeartFailure; Humans; Lung Diseases; Outpatients; Palliative Care; Quality of Life Language Published English Country of organisation United States English summary An English language summary is available. Address
Failure of Invasive Airway Placement on the First Attempt Is Associated With Progression to Cardiac Arrest in Pediatric Acute Respiratory Compromise PEDSCCM.org Criteria abstracted from series in Review Posted: founded 1995 Questions or comments?
. Percutaneous edge-to-edge mitral valve repair (MitraClip) has emerged as an alternative to surgical valve repair to improve symptoms, functional capacity, heartfailure hospitalizations, and cardiac haemodynamics. Further new transcatheter strategies addressing MR are evolving. The Carillion, Cardioband, and Mitralign devices were designed to reduce the annulus dilatation, which is a frequent and important determinant of secondary MR. Several transcatheter mitral valve replacement systems (Tendyne, CardiAQ (...) Mitral valve interventions in heartfailure Secondary mitral regurgitation (MR) results from left ventricular dilatation and dysfunction. Quantification of secondary MR is challenging because of the underlying myocardial disease. Clinical and echocardiographic evaluation requires a multi-parametric approach. Severe secondary MR occurs in up to one-fourth of patients with heartfailure with reduced ejection fraction, which is associated with a mortality rate of 40% to 50% in 3 years
Early identification of acute heartfailure at the time of presentation: do natriuretic peptides make the difference? The early identification of patients with acute heartfailure (AHF) is challenging as many other diseases lead to a clinical presentation with dyspnea.The aim of the study was to evaluate the impact of natriuretic peptides at common HF study cut-offs on the diagnosis of patients with dyspnea at admission.For this post hoc analysis, we analysed n = 726 European Union (EU (...) ) patients from the prospective BACH (Biomarkers in Acute HeartFailure) study. Cut-offs were 350 ng/L (BNP), 300 pmol/L [pro-atrial natriuretic peptide (proANP)], and 1800 ng/L (NT-proBNP). These cut-offs had equivalent 90 days' mortality in the EU cohort of BACH. We analysed the effect of selection using these cut-offs on the prevalence of the gold standard diagnoses made in the BACH study and the respective mortality. The prevalence of AHF is increased from 47.5 to 75.6% (NT-proBNP criteria) up
ASB1 differential methylation in ischaemic cardiomyopathy: relationship with left ventricular performance in endâ€stage heartfailure patients Ischaemic cardiomyopathy (ICM) leads to impaired contraction and ventricular dysfunction, causing high rates of morbidity and mortality. Epigenomics allows the identification of epigenetic signatures in human diseases. We analyse the differential epigenetic patterns of the ASB gene family in ICM patients and relate these alterations (...) to their haemodynamic and functional status.Epigenomic analysis was carried out using 16 left ventricular (LV) tissue samples, eight from ICM patients undergoing heart transplantation and eight from control (CNT) subjects without cardiac disease. We increased the sample size up to 13 ICM and 10 CNT for RNA sequencing and to 14 ICM for pyrosequencing analyses. We found a hypermethylated profile (cg11189868) in the ASB1 gene that showed a differential methylation of 0.26Δβ (P = 0.016). This result was validated
Homozygous missense MYBPC3 Pro873His mutation associated with increased risk for heartfailure development in hypertrophic cardiomyopathy Hypertrophic cardiomyopathy (HCM) is a primary autosomal-dominant disorder of the myocardium with variable expressivity and penetrance. Occasionally, homozygous sarcomere genetic variants emerge while genotyping HCM patients. In these cases, a more severe HCM phenotype is generally seen. Here, we report a case of HCM that was diagnosed clinically at 39 years (...) of age. Initial symptoms were shortness of breath during exertion. Successively, he developed a wide array of severe clinical manifestations, which progressed to an ominous end-stage heartfailure that resulted in heart transplantation. Genotype analysis revealed a missense MYBPC3 variant NM_000256.3:c.2618C>A,p.(Pro873His) that presented in the homozygous form. Conflicting interpretations of pathogenicity have been reported for the Pro873His MYBPC3 variant described here. Our patient, presenting
Canagliflozin and HeartFailure in Type 2 Diabetes Mellitus: Results From the CANVAS Program (Canagliflozin Cardiovascular Assessment Study) Canagliflozin is a sodium glucose cotransporter 2 inhibitor that reduces the risk of cardiovascular events. We report the effects on heartfailure (HF) and cardiovascular death overall, in those with and without a baseline history of HF, and in other participant subgroups.The CANVAS Program (Canagliflozin Cardiovascular Assessment Study) enrolled 10 142