- Increased blood lactate is prevalent and identifies poor prognosis in patients with acute heart failure without overt peripheral hypoperfusion. [Journal Article]
- EJEur J Heart Fail 2018 Feb 12
- CONCLUSIONS: An elevated blood lactate on admission is common in AHF patients without overt clinical evidence of peripheral hypoperfusion and is associated with markers of organ dysfunction/damage and a worse prognosis.
- Clinical characteristics and causes of heart failure, adherence to treatment guidelines, and mortality of patients with acute heart failure: Experience at Groote Schuur Hospital, Cape Town, South Africa. [Journal Article]
- SAS Afr Med J 2018 Feb 01; 108(2):94-98
- CONCLUSIONS: In Cape Town, the main causes of AHF are cardiomyopathy, IHD and RHD. AHF affects a young population and is associated with a high rate of rehospitalisation and mortality. There is serious under-use of beta-blockers, aldosterone antagonists and digoxin. Emphasis on the rigorous application of treatment guidelines is needed to reduce readmission and mortality.
- Long-term prognostic significance of urinary sodium concentration in patients with acute heart failure. [Journal Article]
- IJInt J Cardiol 2018 Mar 01; 254:189-194
- CONCLUSIONS: Lower UNa was associated with worse long-term clinical outcomes along with increased neurohormonal activities, impaired response to diuretics and higher incidence of worsening renal function in patients with AHF.
- Basal functional status predicts one-year mortality after a heart failure hospitalization in elderly patients - The RICA prospective study. [Journal Article]
- IJInt J Cardiol 2018 Mar 01; 254:182-188
- CONCLUSIONS: Among elderly AHF patients, the presence of severe (BI≤60) preadmission dependence for basic ADL confers a significant and independent risk of one-year post-discharge mortality.
- [Diagnostic value of lung ultrasound B-line score in acute heart failure]. [Journal Article]
- ZWZhonghua Wei Zhong Bing Ji Jiu Yi Xue 2018; 30(2):156-159
- CONCLUSIONS: Lung ultrasound B-line score was highly specific, but moderately sensitive for identifying patients with AHF.
- Long-Term Prognostic Significance of Plasma B-Type Natriuretic Peptide Level in Patients With Acute Heart Failure With Reduced, Mid-Range, and Preserved Ejection Fractions. [Journal Article]
- AJAm J Cardiol 2017 Dec 23
- Plasma B-type natriuretic peptide (BNP) is an important prognostic marker in patients with acute heart failure (AHF). However, it is unclear which BNP parameter, on admission, at discharge, or change...
Plasma B-type natriuretic peptide (BNP) is an important prognostic marker in patients with acute heart failure (AHF). However, it is unclear which BNP parameter, on admission, at discharge, or change during hospitalization, has the highest predictive performance for long-term adverse outcomes, and whether its prognostic impact differs according to the new European heart failure (HF) phenotype classification by left ventricular ejection fraction: heart failure with reduced ejection fraction (HFrEF), heart failure with mid-range ejection fraction (HFmrEF), and heart failure with preserved ejection fraction (HFpEF). We examined 1,792 patients with AHF consisting of 860 (48%) HFrEFs, 318 (18%) HFmrEFs, and 614 (34%) HFpEFs. Prognostic performance of each BNP parameter was assessed by the Harrell c-index. During a median follow-up of 664 days, 344 (19%) patients died. Discharge BNP had the highest c-index (0.69) for mortality among all BNP parameters (p <0.001). In multivariate Cox proportional hazard modeling, discharge BNP was associated with mortality in HFrEF, HFmrEF, and HFpEF patients with significant interaction (hazard ratio [HR] 1.95, 95% confidence interval [CI] 1.57 to 2.41; HR 1.76, 95% CI 1.10 to 2.82; HR 1.46, 95% CI 1.12 to 1.91, respectively; p = 0.011 for interaction). Moreover, the c-index of discharge BNP for mortality in HFrEF patients (0.72) was higher than that in HFmrEF patients (0.68) and HFpEF patients (0.65). Similar results were obtained for mortality or HF rehospitalization as alternative outcomes, except there was no statistically significant interaction among HF phenotypes. In conclusion, discharge BNP is a more reliable marker than other BNP parameters on long-term outcome prediction in patients with AHF, but its prognostic impact may be weakened in HFmrEF and HFpEF compared with HFrEF.
- [Cell-Free and Concentrated Ascites Reinfusion Therapy for Malignant Intractable Ascites from Colorectal Cancer]. [Journal Article]
- GTGan To Kagaku Ryoho 2017; 44(12):1556-1558
- Malignant intractable ascites worsens not only patient symptoms but also their daily activities. It often leads to a patient discontinuing or postponing chemotherapy. In the present study, we introdu...
Malignant intractable ascites worsens not only patient symptoms but also their daily activities. It often leads to a patient discontinuing or postponing chemotherapy. In the present study, we introduced cell-free and concentrated ascites reinfusion therapy(CART)for malignant intractable ascites from colorectal cancer. Six patients underwent 12 CART treatments using AHF-WMO as the ascites filterand AHF-UP as the concentrator(Asahi Kasei Medical Co., Ltd.)from January 2014 to January 2017. The patients included 2 men and 4 women aged 67-89 years. Primary locations were 3 rectums, 1 transverse colon, 1 descending colon, and 1 cecum. Five patients had peritoneal dissemination, and 1 patient had liver metastasis. All the patients were administrated diuretics, but they were all refractory to the treatment. The median punctured ascites volume was 3,850 mL, and the ascites reinfusion after CART was 485 mL, the median concentration was 7.5. Only one patient had a fever. Performance status(PS)improved significantly after the treatment, and appetite score also improved. One patient was fit to undergo chemotherapy after the treatment. In summary, we found that CART is a safe and acceptable procedure for malignant intractable ascites in colorectal cancer patients.
- Predictors of Post-discharge Mortality Among Patients Hospitalized for Acute Heart Failure. [Journal Article]
- CFCard Fail Rev 2017; 3(2):122-129
- Acute Heart Failure (AHF) is a " multi-event disease" and hospitalisation is a critical event in the clinical course of HF. Despite relatively rapid relief of symptoms, hospitalisation for AHF is fol...
Acute Heart Failure (AHF) is a " multi-event disease" and hospitalisation is a critical event in the clinical course of HF. Despite relatively rapid relief of symptoms, hospitalisation for AHF is followed by an increased risk of death and re-hospitalisation. In AHF, risk stratification from clinically available data is increasingly important in evaluating long-term prognosis. From the perspective of patients, information on the risk of mortality and re-hospitalisation would be helpful in providing patients with insight into their disease. From the perspective of care providers, it may facilitate management decisions, such as who needs to be admitted and to what level of care (i.e. floor, step-down, ICU). Furthermore, risk-stratification may help identify patients who need to be evaluated for advanced HF therapies (i.e. left-ventricle assistance device or transplant or palliative care), and patients who need early a post-discharge follow-up plan. Finally, risk stratification will allow for more robust efforts to identify among risk markers the true targets for therapies that may direct treatment strategies to selected high-risk patients. Further clinical research will be needed to evaluate if appropriate risk stratification of patients could improve clinical outcome and resources allocation.
- Sphingosine-1-phosphate (S1P) activates STAT3 to protect against de novo acute heart failure (AHF). [Journal Article]
- LSLife Sci 2018 Jan 23
- CONCLUSIONS: Our data suggest that S1P protects in an ex-vivo rat heart model of AHF by activation of STAT3 and provide further evidence for the usage of S1P as a potential therapy in patients suffering from AHF.
New Search Next
- [Epidemiological Clinical Characteristics of Acute Cardiac Insufficiency in a Tertiary Hospital in Lima, Peru]. [Journal Article]
- RPRev Peru Med Exp Salud Publica 2017 Oct-Dec; 34(4):655-659
- The objective of this study was to describe the clinical and epidemiological characteristics of acute heart failure (AHF) in 1,075 patients from a hospital in Lima, Peru. The average patient age was ...
The objective of this study was to describe the clinical and epidemiological characteristics of acute heart failure (AHF) in 1,075 patients from a hospital in Lima, Peru. The average patient age was 74 years and 55% of study subjects were men. Moreover, 39% of patients in the sample had AHF with low ejection fraction, 15% had intermediate ejection fraction, and 46% had preserved ejection fraction. The most common comorbidities were hypertension (52.6%) and coronary disease (51%). Moreover, 29.2% of patients had previous hospitalizations due to AHF. The median hospital stay was 3 days. The rate of in- hospital mortality from all causes was 7.2%. Hospitalization was more common in elderly patients with multiple comorbidities. The low use of prescription drugs together with the high rate of previous hospitalizations may explain the high mortality rate reported in this study.