Increased oxidative stress during exercise predicts poor prognosis in patients with acute decompensated heart failure

We report a rare case of common atrium and acute decompensated heart failure most likely precipitated by acute bacterial pericarditis leading to premature death, in a 25-year-old male footballer. The silent course of the disease for decades as well as the diagnostic and management pitfalls of this case illustrates the importance of early detection by echocardiography and urgent appropriate treatment in intensive care settings to limit the poor prognosis of the condition.

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Impact of polypharmacy on prognosis in patients with acute decompensated heart failure: from the CURE-HF registry

European Heart Journal ◽

10.1093/eurheartj/ehab724.0909 ◽

2021 ◽

Vol 42 (Supplement_1) ◽

Author(s):

M Kanai ◽

H Motoki ◽

T Okano ◽

K Kimura ◽

M Minamisawa ◽

...

Keyword(s):

Heart Failure ◽

Poor Prognosis ◽

Acute Decompensated Heart Failure ◽

Decompensated Heart Failure ◽

Left Ventricular ◽

Left Ventricular Ejection ◽

Study Cohort ◽

Cardiac Events ◽

Ventricular Ejection Fraction ◽

Funding Sources

Abstract Background Polypharmacy would be associated with poor prognosis in patients with heart failure (HF). Methods In 863 patients who discharged after treatment for HF were prospectively enrolled. Number of tablets prescribed at discharge was counted. Death, non-fatal myocardial infarction, non-fatal stroke, and hospitalization for HF were tracked. Results In our study cohort (median age, 78), 447 patients experienced adverse events during median 503 days follow-up. In Kaplan-Meier analysis, a greater number of prescribed tablets was associated with future adverse cardiac events in the crude population. Although patients with the greater number of non-HF medications showed worse outcome, those of HF medications were not associate with the outcome (Figure). Furthermore, the number of tablets was an independent predictor of future cardiovascular events after adjustment for age, gender, B-type natriuretic peptide, hemoglobin, albumin, estimated glomerular filtration rate, and left ventricular ejection fraction (HR 95% CI: 1.295 (1.066–1.573), p=0.009). Conclusions Polypharmacy was associated with poor prognosis. Although the numbers of tablets and non-HF medications were significantly associated with worse out come in HF patients, the number of HF medications was not. FUNDunding Acknowledgement Type of funding sources: None.

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Abstract P013: Prevalence and Prognostic Impact of Kidney Dysfunction among Patients with Acute Decompensated Heart Failure in Community: The ARIC Community Surveillance

Circulation ◽

10.1161/circ.129.suppl_1.p013 ◽

2014 ◽

Vol 129 (suppl_1) ◽

Author(s):

Kunihiro Matsushita ◽

Noorie Hyun ◽

Sunil K Agarwal ◽

Laura R Loehr ◽

Hanyu Ni ◽

...

Keyword(s):

Heart Failure ◽

Poor Prognosis ◽

Average Length ◽

Acute Decompensated Heart Failure ◽

Strong Predictor ◽

Decompensated Heart Failure ◽

Prognostic Impact ◽

Racial Groups ◽

Washington County ◽

Kidney Dysfunction

Introduction: Several studies reported that kidney dysfunction is prevalent and is associated with poor prognosis in patients with acute decompensated heart failure (ADHF). However, most of these reports were from clinical trials or a single hospital, limiting their generalizability to clinical practice in the community. Methods: We tackled these questions using data from community-based surveillance for ADHF conducted as a part of the ARIC Study from 2005 to 2009 for residents aged ≥55 years in 4 US communities (Jackson, Mississippi; Washington County, Maryland; Minneapolis, Minnesota; and Forsyth County, North Carolina). All analyses were weighted to account for the stratified sampling design. The association of kidney function with mortality (in-hospital, 28-day, and 1-year) was assessed using logistic regression. The CKD-EPI equation with worst serum creatinine during hospitalization was used to calculate estimated glomerular filtration rate (eGFR), and persons from nonblack and nonwhite racial groups or with missing key variables were excluded. Results: Among 10,450 sampled hospitalizations, 3,651 ADHF events adjudicated as definite or probable were included in this analysis, corresponding to weighted 17,378 events after applying sample weights (average length of stay, 8.3 days). The prevalence of reduced eGFR (defined as <60 ml/min/1.73m 2 ) was 83.4% overall, and 37.7% of ADHF cases had eGFR <30. Lower eGFR, particularly eGFR <30, was significantly associated with higher mortality during hospitalization or 1 year of follow-up independently of potential confounders (Table). The association was largely consistent across demographic and clinical subgroups. Conclusion: Severely reduced eGFR (<30 ml/min/1.73m 2 ) was observed in ~38% of ADHF cases during hospitalization and was a strong predictor of poor prognosis during hospitalization or after discharge in community. These findings suggest that ADHF patients with kidney dysfunction warrant special attention in the management for ADHF.

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P2527Accumulative impact of poor nutrition and frailty on 1-year mortality among acute decompensated heart failure patients

European Heart Journal ◽

10.1093/eurheartj/ehz748.0856 ◽

2019 ◽

Vol 40 (Supplement_1) ◽

Author(s):

T Sumi ◽

M Oguri ◽

K Takahara ◽

N Umemoto ◽

K Shimizu ◽

...

Keyword(s):

Heart Failure ◽

Regression Analysis ◽

Poor Prognosis ◽

Cox Regression ◽

Acute Decompensated Heart Failure ◽

Decompensated Heart Failure ◽

Cox Regression Analysis ◽

Frailty Status ◽

Kaplan Meier ◽

Poor Nutrition

Abstract Background Several studies have proved that both poor nutrition (PN) and Frail are associated with poor prognosis among heart failure patients. However, it has not been fully revealed whether PN and frail could have impact on prognosis accumulatively. Purpose The purpose of the present study was to evaluate the impact of nutritional and Frailty status on 1-year mortality among hospitalized patients with acute decompensated heart failure (ADHF). Methods Study subjects comprised of 315 hospitalized patients with ADHF. To evaluate the nutritional and Frailty status, we calculated the controlling nutritional status (CONUT) score and the Study of Osteoporotic Fractures (SOF) index at hospital admission. PN and Frailty were defined as the CONUT score ≥5 and SOF index ≥2, respectively. Results z Sixty-nine subjects (21.9%) were died within 1-year. PN and Frailty were observed in 33.3% and 55.6% of study subjects, respectively. Both PN and Frailty were similarly related to the 1-year mortality by univariate cox regression analysis (Hazard Ratio (HR) 2.43, 95% confidence interval (CI) 1.51–3.91, p=0.0003: HR 3.13, 95% CI 1.83–5.66, p<0.0001, respectively). Study subjects were classified into 4 groups according to the nutritional and frailty status: control (normal nutrition without Frailty, n=110), PN alone (PN without Frailty, n=30), Frailty alone (Frailty without PN, n=100), and PN + Frailty (PN with Frailty, n=75). The Kaplan-Meier event curves for 1-year all-cause mortality illustrated that subjects with PN + Frailty had a significantly higher mortality than in subjects with control, PN alone and Frailty alone (log rank p=0.0001, 0.0180, 0.0070, respectively). As well as, cox regression analysis revealed that PN + Frailty showed significantly higher mortality than control, PN alone and Frailty alone. (HR 5.33, 95% CI 2.75–11.1, p<0.0001: HR 2.99, 95% CI 1.26–8.78, p=0.011: HR 2.07, 95% CI 1.21–3.61, p=0.008, respectively). Moreover, multivariate cox regression analysis also revealed that PN with Frailty was independently associated with 1-year mortality even after adjustment for age, body mass index, systolic blood pressure, and chronic kidney disease. (HR 3.40, 95% CI 1.69–7.32, adjusted p<0.001) Kaplan-Meier curve for 1year mortality Conclusions The combination assessment consisted with nutrition and frailty could identify poor prognosis patients with ADHF.

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Acute decompensated heart failure is associated with increased serum level of oxidative stress

European Journal of Heart Failure Supplements ◽

10.1016/s1567-4215(08)60189-7 ◽

2008 ◽

Vol 7 ◽

pp. 69-69

Author(s):

O AMIR ◽

S SHNIZER ◽

R WOLFF ◽

H PAZ ◽

R AMIR ◽

...

Keyword(s):

Oxidative Stress ◽

Heart Failure ◽

Serum Level ◽

Acute Decompensated Heart Failure ◽

Decompensated Heart Failure

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Treating Patients Following Hospitalisation for Acute Decompensated Heart Failure: An Insight into Reducing Early Rehospitalisations

Cardiac Failure Review ◽

10.15420/cfr.2018.46.2 ◽

2019 ◽

Vol 5 (2) ◽

pp. 78-82

Author(s):

Attilio Iacovoni ◽

Emilia D’Elia ◽

Mauro Gori ◽

Fabrizio Oliva ◽

Ferdinando Luca Lorini ◽

...

Keyword(s):

Heart Failure ◽

Adverse Events ◽

Hospital Readmission ◽

Poor Prognosis ◽

Acute Decompensated Heart Failure ◽

Survival Rates ◽

Decompensated Heart Failure ◽

Tailored Approach ◽

Insight Into

Heart failure (HF) is a pandemic syndrome characterised by raised morbidity and mortality. An acute HF event requiring hospitalisation is associated with a poor prognosis, in both the short and the long term. Moreover, early rehospitalisation after discharge negatively affects HF management and survival rates. Cardiovascular and non-cardiovascular conditions combine to increase rates of HF hospital readmission at 30 days. A tailored approach for HF pharmacotherapy while the patient is in hospital and immediately after discharge could be useful in reducing early adverse events that cause rehospitalisation and, consequently, prevent worsening HF and readmission during the vulnerable phase after discharge.

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