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Validation of heartfailure quality of life tool and usage to predict all-cause mortality in acute heartfailure in Uganda: the Mbarara heartfailure registry (MAHFER). The health-related quality of life (HRQoL) is an important treatment goal that could serve as low-cost prognostication tool in resource poor settings. We sought to validate the Kansas City Cardiomyopathy Questionnaire (KCCQ) and evaluate its use as a predictor of 3 months all-cause mortality among heartfailure participants (...) in rural Uganda.The Mbarara HeartFailure Registry Cohort study observes heartfailure patients during hospital stay and in the community in rural Uganda. Participants completed health failure evaluations and HRQoL questionnaires at enrollment, 1 and 3 months of follow-up. We used Cronbach's alpha coefficients to define internal consistency, intraclass correlation coefficients as a reliability coefficient, and Cox proportional hazard models to predict the risk of 3 months all-cause mortality.Among
incorporat- ing N-terminal pro-B-type natriuretic peptide levels: a European coLlabo- ration on Acute decompeNsated HeartFailure: ELAN-HF Score. Heart. 2014;100:115–25. 109. Flint KM, Allen LA, Pham M, et al. B-type natriuretic peptide predicts 30- day readmission for heartfailure but not readmission for other causes. J Am Heart Assoc. 2014;3:e000806. 110. Kociol RD, Horton JR, Fonarow GC, et al. Admission, discharge, or change in B-type natriuretic peptide and long-term outcomes: data from Organized (...) 2017 ACC/AHA/HFSA Focused Update of the 2013 ACCF/AHA Guideline for the Management of HeartFailure: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the HeartFailure Society of Amer CLINICAL STATEMENTS AND GUIDELINES Circulation. 2017;136:e137–e161. DOI: 10.1161/CIR.0000000000000509 August 8, 2017 e137 WRITING GROUP MEMBERS* Clyde W. Yancy, MD, MSc, MACC, FAHA, FHFSA, Chair Mariell Jessup, MD, FACC, FAHA, Vice Chair
Medical Therapy for HeartFailureCaused by Ischemic Heart Disease. Patients with heartfailure (HF) syndromes have been categorized as those with reduced ejection fraction (EF) or preserved EF (HFpEF), and ischemia plays a key role in both types. HF remains a major cause of morbidity and mortality worldwide, and with the aging of our population this burden continues to rise, predominantly as a result of hospitalizations for HFpEF. Patients with obstructive coronary artery disease more likely (...) presentations and findings, in patients with HFpEF. Also, emerging evidence indicates that impaired myocardial perfusion and inflammation secondary to multiple comorbidities are key mechanisms in HFpEF. We will thoroughly review the role of ischemic heart disease in the pathogenesis of HF with reduced EF and HFpEF, and discuss the medical management strategies available for these conditions.
directly or indirectly can cause angioedema. 32,33 An ARNI should not be administered within 36 hours of switching from or to an ACE inhibitor. Recommendations for Renin-Angiotensin System Inhibition With ACe Inhibitor or ARb or ARNI (Continued) CoR Loe Recommendations (Continued ) Downloaded from http://ahajournals.org by on March 27, 2019CLINICAL St AteMeNtS ANd GuIdeLINeS HeartFailure Focused Update on Pharmacological Therapy Circulation. 2016;134:e282-e293. DOI: 10.1161/CIR.0000000000000435 (...) 2016 ACC/AHA/HFSA Focused Update on New Pharmacological Therapy for HeartFailure: An Update of the 2013 ACCF/AHA Guideline for the Management of HeartFailure: A Report of the American College of Cardiology/American Heart Association Task Force on Clinic ACC/AHA/HFSA FoCuSed upd Ate September 27, 2016 Circulation. 2016;134:e282–e293. DOI: 10.1161/CIR.0000000000000435 e282 Developed in Collaboration With the American College of Chest Physi- cians and International Society for Heart and Lung
with NYHA class III symptomatic heartfailure and EF less than 40%. Location: Hong Kong. Intervention and comparator(s) The OPTIMIZER smart system (mean follow-up 75 months). No comparator. Key outcomes The results showed that all-cause mortality for the entire cohort was significantly reduced in the OPTIMIZER group 41% compared with the control 71% (p=0.001). Subgroup analysis showed that the all-cause mortality of OPTIMIZER patients with an EF of less than 25% did not significant differ compared (...) The OPTIMIZER smart system for managing heartfailure The OPTIMIZER smart system for managing The OPTIMIZER smart system for managing heartfailureheartfailure 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 heartfailure. The system is for people who still have symptoms after
causes for symptoms of heartfailure in people with NT- proBNP levels below 400 ng/litre. If there is still concern that the symptoms might be related to heartfailure, discuss with a physician with subspeciality training in heartfailure.   1.2.7 Be aware that: obesity, African or African–Caribbean family origin, or treatment with diuretics, angiotensin-converting enzyme (ACE) inhibitors, beta-blockers, angiotensin II receptor blockers (ARBs) or mineralocorticoid receptor antagonists (...) (MRAs) can reduce levels of serum natriuretic peptides high levels of serum natriuretic peptides can have causes other than heartfailure (for example, age over 70 years, left ventricular hypertrophy, ischaemia, tachycardia, right ventricular overload, hypoxaemia [including pulmonary embolism], renal dysfunction [eGFR less than 60 ml/minute/1.73 m 2 ], sepsis, chronic obstructive pulmonary disease, diabetes, or cirrhosis of the liver). [2010, amended 2018] [2010, amended 2018] 1.2.8 Perform
Prediction of 30-Day All-Cause Readmissions in Patients Hospitalized for HeartFailure: Comparison of Machine Learning and Other Statistical Approaches. Several attempts have been made at developing models to predict 30-day readmissions in patients with heartfailure, but none have sufficient discriminatory capacity for clinical use. Machine-learning (ML) algorithms represent a novel approach and may have potential advantages over traditional statistical modeling.To develop models using a ML (...) approach to predict all-cause readmissions 30 days after discharge from a heartfailure hospitalization and to compare ML model performance with models developed using "conventional" statistically based methods.Models were developed using ML algorithms, specifically, a tree-augmented naive Bayesian network, a random forest algorithm, and a gradient-boosted model and compared with traditional statistical methods using 2 independently derived logistic regression models (a de novo model and an a priori
Exercise-based cardiac rehabilitation for adults with heartfailure. Chronic heartfailure (HF) is a growing global health challenge. People with HF experience substantial burden that includes low exercise tolerance, poor health-related quality of life (HRQoL), increased risk of mortality and hospital admission, and high healthcare costs. The previous (2014) Cochrane systematic review reported that exercise-based cardiac rehabilitation (CR) compared to no exercise control shows improvement (...) , number needed to treat: 25). After CR, a clinically important improvement in short-term disease-specific health-related quality of life may be evident (Minnesota Living With HeartFailure questionnaire - 17 trials, 18 comparisons (1995 participants): mean difference (MD) -7.11 points, 95% CI -10.49 to -3.73; low-quality evidence). Pooling across all studies, regardless of the HRQoL measure used, shows there may be clinically important improvement with exercise (26 trials, 29 comparisons (3833
Disease management interventions for heartfailure. Despite advances in treatment, the increasing and ageing population makes heartfailure an important cause of morbidity and death worldwide. It is associated with high healthcare costs, partly driven by frequent hospital readmissions. Disease management interventions may help to manage people with heartfailure in a more proactive, preventative way than drug therapy alone. This is the second update of a review published in 2005 and updated (...) , comparing disease management interventions to usual care for adults who had been admitted to hospital at least once with a diagnosis of heartfailure. There were three main types of intervention: case management; clinic-based interventions; multidisciplinary interventions.We used standard methodological procedures expected by Cochrane. Outcomes of interest were mortality due to heartfailure, mortality due to any cause, hospital readmission for heartfailure, hospital readmission for any cause, adverse
; a thorough history and physical examination should be obtained to identify cardiac and non-cardiac disorders or behaviours that might cause congestive heartfailure or accelerate progression. The single most useful diagnostic test in the evaluation of patients is the comprehensive 2-dimensional echocardiogram coupled with Doppler flow studies. Measurement of B-type natriuretic peptide can be useful in the evaluation of patients at initial presentation. Interventions that have a proven beneficial impact (...) Chronic congestive heartfailure Chronic congestive heartfailure - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search Chronic congestive heartfailure 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
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 (...) Evaluation and Management of Right-Sided HeartFailure: A Scientific Statement From the American Heart Association Evaluation and Management of Right-Sided HeartFailure: A Scientific Statement From the American Heart Association | Circulation Search Hello Guest! Login to your account Email Password Keep me logged in Search March 2019 March 2019 March 2019 March 2019 March 2019 February 2019 February 2019 February 2019 February 2019 January 2019 January 2019 January 2019 January 2019 January
Non-sarcomeric causes of heartfailure: a Sydney Heart Bank perspective 30022358 2018 11 14 1867-2450 10 4 2018 Aug Biophysical reviews Biophys Rev Non-sarcomeric causes of heartfailure: a Sydney Heart Bank perspective. 949-954 10.1007/s12551-018-0441-4 Dos Remedios C G CG Sydney Heart Bank, Bosch Institute, Anderson Stuart Building (F13), University of Sydney, Sydney, 2006, Australia. email@example.com. Li A A Sydney Heart Bank, Bosch Institute, Anderson Stuart Building (F13 (...) ), University of Sydney, Sydney, 2006, Australia. Lal S S Sydney Heart Bank, Bosch Institute, Anderson Stuart Building (F13), University of Sydney, Sydney, 2006, Australia. eng Journal Article Review 2018 07 18 Germany Biophys Rev 101498573 1867-2450 2018 07 02 2018 07 03 2018 7 20 6 0 2018 7 20 6 1 2018 7 20 6 0 ppublish 30022358 10.1007/s12551-018-0441-4 10.1007/s12551-018-0441-4 PMC6082304 J Cell Biol. 2010 Dec 13;191(6):1159-72 21149568 J Mol Cell Cardiol. 2002 Apr;34(4):413-26 11991731 Electrophoresis
Gender differences in association between uric acid and all-cause mortality in patients with chronic heartfailure. Elevated serum uric acid (SUA) is associated with poor prognosis in patients with cardiovascular disease, yet it is still not decided whether the role of SUA is causal or only reflects an underlying disease. The purpose of the study was to investigate if SUA was an independent predictor of 5-year all-cause mortality in a propensity score matched cohort of chronic heartfailure (HF (...) ) outpatients. Furthermore, to assess whether gender or renal function modified the effect of SUA.Patients (n = 4684) from the Norwegian HeartFailure Registry with baseline SUA were included in the study. Individuals in the highest gender-specific SUA quartile were propensity score matched 1:1 with patients in the lowest three SUA quartiles. The propensity score matching procedure created 928 pairs of patients (73.4% males, mean age 71.4 ± 11.5 years) with comparable baseline characteristics. Kaplan Meier
Effect of vitamin D on all-cause mortality in heartfailure (EVITA): a 3-year randomized clinical trial with 4000 IU vitamin D daily Circulating 25-hydroxyvitamin D (25OHD) levels <75 nmol/L are associated with a nonlinear increase in mortality risk. Such 25OHD levels are common in heartfailure (HF). We therefore examined whether oral vitamin D supplementation reduces mortality in patients with advanced HF.Four hundred HF patients with 25OHD levels <75 nmol/L were randomized to receive 4000 IU (...) vitamin D daily or matching placebo for 3 years. Primary endpoint was all-cause mortality. Key secondary outcome measures included hospitalization, resuscitation, mechanical circulatory support (MCS) implant, high urgent listing for heart transplantation, heart transplantation, and hypercalcaemia. Initial 25OHD levels were on average <40 nmol/L, remained around 40 nmol/L in patients assigned to placebo and plateaued around 100 nmol/L in patients assigned to vitamin D. Mortality was not different
Atrial fibrillation among adults with heartfailure in sub-Saharan Africa - prevalence, incidence and all-cause mortality: a systematic review and meta-analysis protocol. Heartfailure (HF) remains a major non-communicable disease in sub-Saharan Africa (SSA) associated with high rates of readmission, mortality and loss of economic productivity as it affects mostly young and economically active adults. Atrial fibrillation (AFib) is a major determinant of mortality among patients with HF in SSA (...) . Meanwhile, the use of anti-arrhythmic medications in the region remains unacceptably low. This review aims to evaluate the prevalence and incidence of AFib in adult patients with HF in SSA, and the all-cause mortality rate among patients with HF and AFib.The Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Protocols 2015 statement was used to prepare this protocol. All eligible studies from database inception to December, 31 2018 in MEDLINE, Embase, Google Scholar, Web of science
Impact of Hospice and Palliative Care Service Utilization on All-Cause 30-Day Readmission Rate for Older Adults Hospitalized With HeartFailure. Acute decompensated heartfailure (HF) is the leading cause for hospital readmission. Large-scale sustainable interventions to reduce readmission rate have not been fully explored or proven effective.We studied the impact of hospice and palliative care service utilization on 30-day all-cause hospital readmissions for patients with HF.Data were (...) of older US Veterans, utilization of hospice and palliative care services was associated with a higher 30-day all-cause readmission rate among hospitalized patients with HF. Further prospective studies should be conducted to confirm results and test generalizability outside the Veterans Affairs system of care.
Causes and impact on survival of underuse of angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers in heartfailure. Guidelines recommend angiotensin-converting enzyme inhibitors (ACEi) and angiotensin II receptor blockers (ARB) for treatment of heartfailure with reduced ejection fraction (HFrEF), but these medications are underprescribed in clinical practice. We reviewed the records of HF patients receiving a first visit in a tertiary outpatient clinic from January 1st (...) with an almost twofold increased risk of all-cause mortality (HR 1.97, 95%CI 1.39-2.80). ACEi/ARB underuse in HFrEF is a standing issue with dramatic prognostic consequences. Efforts are needed to eliminate perceived contraindications to these drugs and ensure their implementation in real-life cardiology.