Latest & greatest articles for heart failure

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Top results for heart failure

101. 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

102. Home oxygen therapy prescribed for 15 hours a day did not reduce breathlessness at six months and is hard to take for people with severe chronic heart failure

on the use of home oxygen therapy for people with chronic heart failure. However, the National Service Framework for coronary heart disease, published in 2000, recommends considering the potential benefit from “palliative care services and palliation aids (e.g. home oxygen)”. The British Thoracic Society recommends that home oxygen therapy may be helpful for people with severe chronic heart failure, though only if they also suffer from hypoxaemia, low levels of oxygen in the blood. What (...) five to six points on a 105 point scale. Only 11% of patients reported using the therapy as prescribed. Participants used the oxygen for an average of a little over five hours a day, rather than the 15 hours prescribed. What does current guidance say on this issue? NICE does not have guidance on the use of home oxygen therapy for people with chronic heart failure. However, the National Service Framework for coronary heart disease, published in 2000, recommends considering the potential benefit from

2018 NIHR Dissemination Centre

103. 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

104. 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

105. 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

106. 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

107. Reduced Salt Intake for Heart Failure: A Systematic Review (Abstract)

Reduced Salt Intake for Heart Failure: A Systematic Review Recent estimates suggest that more than 26 million people worldwide have heart failure. The syndrome is associated with major symptoms, significantly increased mortality, and extensive use of health care. Evidence-based treatments influence all these outcomes in a proportion of patients with heart failure. Current management also often includes advice to reduce dietary salt intake, although the benefits are uncertain.To systematically (...) review randomized clinical trials of reduced dietary salt in adult inpatients or outpatients with heart failure.Several bibliographic databases were systematically searched, including the Cochrane Central Register of Controlled Trials, MEDLINE, Embase, and CINAHL. The methodologic quality of the studies was evaluated, and data associated with primary outcomes of interest (cardiovascular-associated mortality, all-cause mortality, and adverse events, such as stroke and myocardial infarction

2018 EvidenceUpdates

108. Suspected New-Onset and Nonacute Heart Failure

changes in static images (ie, CTA; or, without the use ACR Appropriateness Criteria ® 6 Suspected New-Onset and Known Nonacute Heart Failure of intravenous contrast for coronary calcification, calcium scoring for risk stratification). Delayed imaging helps further the detection of fibrous or fatty tissue replacement in cardiac structures (eg, LV wall) [26,29,30]. Despite marked improvements, prevailing concerns about potential complications are still limitations to the use of this modality (...) of rest and stress MRI. CTA Coronary Arteries There is limited evidence to support the use of cardiac CTA as initial imaging for the evaluation of patients with newly suspected or potential HF. Arteriography Coronary The invasive nature of coronary angiography limits its use for the assessment of patients with newly suspected or potential HF. Variant 2: Differentiating new-onset heart failure with reduced ejection fraction (HFrEF) from new-onset heart failure with preserved ejection fraction (HFpEF

2018 American College of Radiology

109. Acute exacerbation of congestive heart failure

Acute exacerbation of congestive heart failure Acute exacerbation of congestive heart failure - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Acute exacerbation of congestive heart failure Last reviewed: February 2019 Last updated: October 2018 Summary Clinical syndrome of reduced cardiac output, tissue hypoperfusion, increased pulmonary pressure, and tissue congestion. Presents with dyspnoea, decreased exercise (...) tolerance, swelling of the legs, fatigue, and generalised weakness. Clinical diagnosis is supported by ancillary tests such as ECG, chest x-ray, B-type natriuretic peptide, and echocardiogram. In cases where echocardiographic images are suboptimal or when an unusual cause of heart failure is suspected, and for diagnosis of specific cardiomyopathies, other tests (e.g., cardiac catheterisation with haemodynamic measurements, computed tomography, and cardiac magnetic resonance imaging) are used. Diuretics

2018 BMJ Best Practice

110. Parity and Heart Failure in Postmenopausal Women

Parity and Heart Failure in Postmenopausal Women "Parity and Heart Failure in Postmenopausal Women" by Erin Dingman < > > > > > Title Author Date of Graduation Summer 8-11-2018 Degree Type Capstone Project Degree Name Master of Science in Physician Assistant Studies Rights . Abstract Background: Previous research has identified physiologic changes post-menopause with cardiovascular disease, but little research has been conducted investigating a link with heart failure or the influence of parity (...) for risk stratification. Methods: An exhaustive search of available medical literature was performed. MEDLINE OVID, CINAHL, and Web of Science databases were searched using the keywords nulliparity, postmenopause, and heart failure. The articles were evaluated using GRADE. Results: The search resulted in 2 studies evaluating the incidence of heart failure in a postmenopausal population and accounting for gravidity. Conclusion: There is an association between nulliparity, grand multiparity, and increase

2018 Pacific University EBM Capstone Project

111. Heart Failure After Ischemic Stroke or TIA in Insulin-Resistant Patients Without Diabetes Treated with Pioglitazone Full Text available with Trip Pro

Heart Failure After Ischemic Stroke or TIA in Insulin-Resistant Patients Without Diabetes Treated with Pioglitazone The IRIS trial (Insulin Resistance Intervention After Stroke) demonstrated that pioglitazone reduced the risk for both cardiovascular events and diabetes mellitus in insulin-resistant patients. However, concern remains that pioglitazone may increase the risk for heart failure (HF) in susceptible individuals.In IRIS, patients with insulin resistance but without diabetes mellitus

2018 EvidenceUpdates

112. The Metabolic Syndrome, Cardiovascular Fitness and Survival in Patients With Advanced Systolic Heart Failure (Abstract)

The Metabolic Syndrome, Cardiovascular Fitness and Survival in Patients With Advanced Systolic Heart Failure The metabolic syndrome (MetS), which incorporates insulin resistance, visceral adiposity, and dyslipidemia, is an independent risk factor for incident heart failure (HF), but the impact on survival is uncertain. We sought to determine the relation between the metabolic syndrome and survival in ambulatory systolic HF patients and the impact of MetS on cardiopulmonary exercise test (CPET

2018 EvidenceUpdates

113. Treatment of Hypertension in Association With Heart Failure

. Hjalmarson A, Goldstein S, Fagerberg B, et al., for the MERIT-HF Study Group. Effects of controlled-release metoprolol on coral mortality, hospitalizations, and well-being in patients with heart failure. JAMA 2000;283:1295-302. CIBIS-II lnvestigators and Committees. The Cardiac Insufficiency Bisoprolol Study II (CIBIS- II): a randomised trial. Lancet 1999;353:9-13. Heidenreich PA, Lee TT, Massie BM. Effect of beta-blockade on mortality in patients with heart failure: a meta-analysis of randomized (...) Treatment of Hypertension in Association With Heart Failure VII. Treatment of Hypertension in Association With Heart Failure | Hypertension Canada Guidelines Subgroup Members: Simon W. Rabkin, MD; Gordon W. Moe, MD, MSc; Jonathan G. Howlett, MD Central Review Committee: Stella S. Daskalopoulou, MD MSc DIC PhD (Chair); Kaberi Dasgupta, MD MSc; Kelly B. Zarnke, MD MSc; Kara Nerenberg, MD, MSc; Alexander A. Leung, MD MPH; Kevin C. Harris, MD MHSc; Kerry McBrien, MD MPH; Sonia Butalia, BSc MD MSc

2018 Hypertension Canada

114. Transcatheter Mitral-Valve Repair in Patients with Heart Failure. Full Text available with Trip Pro

Transcatheter Mitral-Valve Repair in Patients with Heart Failure. Among patients with heart failure who have mitral regurgitation due to left ventricular dysfunction, the prognosis is poor. Transcatheter mitral-valve repair may improve their clinical outcomes.At 78 sites in the United States and Canada, we enrolled patients with heart failure and moderate-to-severe or severe secondary mitral regurgitation who remained symptomatic despite the use of maximal doses of guideline-directed medical (...) therapy. Patients were randomly assigned to transcatheter mitral-valve repair plus medical therapy (device group) or medical therapy alone (control group). The primary effectiveness end point was all hospitalizations for heart failure within 24 months of follow-up. The primary safety end point was freedom from device-related complications at 12 months; the rate for this end point was compared with a prespecified objective performance goal of 88.0%.Of the 614 patients who were enrolled in the trial

2018 NEJM Controlled trial quality: predicted high

115. Genetic and Tissue Engineering Approaches to Modeling the Mechanics of Human Heart Failure for Drug Discovery Full Text available with Trip Pro

Genetic and Tissue Engineering Approaches to Modeling the Mechanics of Human Heart Failure for Drug Discovery Heart failure is the leading cause of death in the western world and as such, there is a great need for new therapies. Heart failure has a variable presentation in patients and a complex etiology; however, it is fundamentally a condition that affects the mechanics of cardiac contraction, preventing the heart from generating sufficient cardiac output under normal operating pressures. One (...) of the major issues hindering the development of new therapies has been difficulties in developing appropriate in vitro model systems of human heart failure that recapitulate the essential changes in cardiac mechanics seen in the disease. Recent advances in stem cell technologies, genetic engineering, and tissue engineering have the potential to revolutionize our ability to model and study heart failure in vitro. Here, we review how these technologies are being applied to develop personalized models

2018 Frontiers in cardiovascular medicine

116. The impact of high-intensity inspiratory muscle training on exercise capacity and inspiratory muscle strength in heart failure with reduced ejection fraction: a systematic review and meta-analysis (Abstract)

The impact of high-intensity inspiratory muscle training on exercise capacity and inspiratory muscle strength in heart failure with reduced ejection fraction: a systematic review and meta-analysis Inspiratory muscle training (IMT) improves prognostic clinical variables in patients with heart failure. However, the optimal intensity for increasing those outcomes remains unclear. Thus, we aimed to determine whether high-intensity inspiratory muscle training (HIIMT) improves exercise capacity (...) and respiratory muscle strength in patients with heart failure with reduced ejection fraction (HFrEF).We searched for randomized controlled clinical trials at MEDLINE, the Cochrane Central Register of Controlled Trials, the Physiotherapy Evidence Database, SciELO and CINAHL from the earliest date available to May 2018. Primary studies on HIIMT against low-intensity IMT or sham-IMT that evaluated exercise capacity and inspiratory muscle strength were included. Two independent reviewers evaluated

2018 EvidenceUpdates

117. Chronic heart failure in adults: diagnosis and management

not routinely offer coronary revascularisation to people who have heart failure with reduced ejection fraction and coronary artery disease. [2018] [2018] Cardiac tr Cardiac transplantation ansplantation 1.8.2 Specialist referral for transplantation should be considered for people with severe refractory symptoms or refractory cardiogenic shock. [2003] [2003] Implantable cardio Implantable cardiov verter defibrillators and cardiac resynchronisation ther erter defibrillators and cardiac resynchronisation (...) Cardiac rehabilitation 21 1.10 Palliative care 21 T erms used in this guideline 22 Putting this guideline into practice 23 Context 25 Key facts and figures 25 Current practice 25 More information 25 Recommendations for research 26 1 Diuretic therapy for managing fluid overload in people with advanced heart failure in the community . 26 2 Cardiac MRI versus other imaging techniques for diagnosing heart failure 26 3 The impact of atrial fibrillation on the natriuretic peptide threshold for diagnosing

2018 National Institute for Health and Clinical Excellence - Clinical Guidelines

118. Evaluation and Management of Right-Sided Heart Failure

of right-sided heart failure (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 hypertension from a variety of causes, including left-sided heart disease. Progressive RV dysfunction in these disease states is associated with increased morbidity and mortality (...) , 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 heart failure (HF), after cardiac surgery, acute myocardial infarction (MI), congenital heart disease (CHD), and PH. To distinguish right-sided HF (RHF) from structural RVD, we define RHF as a clinical syndrome with signs and symptoms of HF resulting from RVD. RHF is caused by the inability of the RV to support

2018 International Society for Heart and Lung Transplantation

119. Myocardial expression of the anaphylatoxin receptor C3aR is associated with cardiac inflammation and prognosis in patients with non‐ischaemic heart failure Full Text available with Trip Pro

Myocardial expression of the anaphylatoxin receptor C3aR is associated with cardiac inflammation and prognosis in patients with non‐ischaemic heart failure The aim of this study is to analyse the prognostic value of complement anaphylatoxin receptors in patients with non-ischaemic cardiomyopathy undergoing endomyocardial biopsy.In 102 patients (72.5% male patients, median age 54 years) with non-ischaemic cardiomyopathy, myocardial expression of C3aR was assessed among other parameters (...) was a strong independent predictor for the primary endpoint in Cox regression analysis [hazard ratio 0.46 (0.26-0.82, P = 0.009)].C3aR-positive cells are found more often in patients with inflammatory cardiomyopathy. The relevance of C3aR-positive cells in patients with non-ischaemic cardiomyopathy should be further evaluated as potential predictors or modulators of adverse cardiac remodelling, the substrate of progressive heart failure.© 2018 The Authors. ESC Heart Failure published by John Wiley & Sons

2018 ESC heart failure

120. Rivaroxaban in Patients with Heart Failure, Sinus Rhythm, and Coronary Disease. Full Text available with Trip Pro

Rivaroxaban in Patients with Heart Failure, Sinus Rhythm, and Coronary Disease. Heart failure is associated with activation of thrombin-related pathways, which predicts a poor prognosis. We hypothesized that treatment with rivaroxaban, a factor Xa inhibitor, could reduce thrombin generation and improve outcomes for patients with worsening chronic heart failure and underlying coronary artery disease.In this double-blind, randomized trial, 5022 patients who had chronic heart failure, a left (...) ventricular ejection fraction of 40% or less, coronary artery disease, and elevated plasma concentrations of natriuretic peptides and who did not have atrial fibrillation were randomly assigned to receive rivaroxaban at a dose of 2.5 mg twice daily or placebo in addition to standard care after treatment for an episode of worsening heart failure. The primary efficacy outcome was the composite of death from any cause, myocardial infarction, or stroke. The principal safety outcome was fatal bleeding

2018 NEJM Controlled trial quality: predicted high