High prevalence of heart failure with reduced ejection fraction in patients with transthyretin cardiac amyloidosis

2020 ◽  
Vol 27 (3) ◽  
pp. 1044-1046
Author(s):  
Talal Asif ◽  
Tiago Araujo ◽  
Vasvi Singh ◽  
Saurabh Malhotra
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Cardiac Amyloidosis ◽  
Reduced Ejection Fraction ◽  
High Prevalence

scholarly journals HIGH PREVALENCE OF HEART FAILURE WITH REDUCED EJECTION FRACTION AMONG PATIENTS WITH TRANSTHYRETIN CARDIAC AMYLOIDOSIS

2020 ◽  
Vol 75 (11) ◽  
pp. 1728
Author(s):  
Talal Asif ◽  
Tiago Araujo ◽  
Vasvi Singh ◽  
Tareq Alyousef ◽  
Javier Gomez Valencia ◽  
...  
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Cardiac Amyloidosis ◽  
Reduced Ejection Fraction ◽  
High Prevalence

scholarly journals Iron Deficiency in Acute Decompensated Heart Failure

2019 ◽  
Vol 8 (10) ◽  
pp. 1569 ◽  
Author(s):  
Anna Beale ◽  
Davis Carballo ◽  
Jerome Stirnemann ◽  
Nicolas Garin ◽  
Thomas Agoritsas ◽  
...  
Keyword(s):  
Heart Failure ◽  
Iron Deficiency ◽  
Ejection Fraction ◽  
Acute Decompensated Heart Failure ◽  
Ferritin Level ◽  
Transferrin Saturation ◽  
Decompensated Heart Failure ◽  
Reduced Ejection Fraction ◽  
Tertiary Center ◽  
High Prevalence

The aim of this study was to characterize iron deficiency (ID) in acutely decompensated heart failure (ADHF) and identify whether ID is associated with dyspnea class, length of stay (LOS), biomarker levels, and echocardiographic indices of diastolic function in patients with reduced ejection fraction (HFrEF) and with preserved ejection fraction (HFpEF). Consecutive patients admitted with ADHF at a single tertiary center were included. Demographic information, pathology investigations, and metrics regarding hospital stay and readmission were recorded. Patients were classified as having ‘absolute’ ID if they had a ferritin level <100 ng/mL; or ‘functional’ ID if they had a ferritin 100–200 ng/mL and a transferrin saturation <20%. Of 503 patients that were recruited, 270 (55%) had HFpEF, 160 (33%) had HFREF, and 57 (12%) had heart failure with mid-range ejection fraction. ID was present in 54% of patients with HFrEF and 56% of patients with HFpEF. In the HFpEF group, ID was associated with a LOS of 11 ± 7.7 vs. 9 ± 6 days in iron replete patients, p = 0.036, and remained an independent predictor of increased LOS in a multivariate linear regression incorporating comorbidities, age, and ID status. This study corroborates a high prevalence of ID in both HFrEF and HFpEF, and further shows that in patients with HFpEF there is a prolongation of LOS not seen in HFrEF which may indicate a more prominent role for ID in HFpEF.

scholarly journals Development of new drugs for treatment of heart failure (adventures, disasters and joys)

ANALES RANM ◽  
2021 ◽  
Vol 138 (138(01)) ◽  
pp. 44-51
Author(s):  
Juan Tamargo
Keyword(s):  
Heart Failure ◽  
Clinical Trials ◽  
Ejection Fraction ◽  
New Drugs ◽  
Response To Treatment ◽  
Phase 3 ◽  
Reduced Ejection Fraction ◽  
High Prevalence ◽  
Large Phase ◽  
Made In

Heart failure (HF) represents an important healthcare problem due to its high prevalence, high rates of hospitalization and mortality, and significant healthcare costs. HF comprises a heterogeneous group of syndromes with different pathophysiology, clinical presentation, and response to treatment. In recent years, multiple therapeutic targets implicated in the pathogenesis of HF have been identified and numerous drugs have been developed against multiple targets. But despite important advances in the pharmacological treatment of HF with reduced ejection fraction, no treatment has convincingly shown to date to reduce mortality in HF patients with preserved ejection fraction. Furthermore, the vast majority of drugs that appeared very promising in animal models or in phase 2 clinical trials have not been able to be commercialized due to their lack of efficacy and / or safety in large phase 3 clinical trials. In this article we analyze the objectives of the treatment of HF, the progress made in recent years and the possible causes that could explain our repeated failures.

scholarly journals Cardiac amyloid presenting as cardiogenic shock: case series

2021 ◽  
Vol 5 (7) ◽  
Author(s):  
Monique Oye ◽  
Pooja Dhruva ◽  
Fadi Kandah ◽  
Melissa Oye ◽  
Emil Missov
Keyword(s):  
Heart Failure ◽  
African American ◽  
Ejection Fraction ◽  
Cardiogenic Shock ◽  
Cardiac Amyloidosis ◽  
Clinical Status ◽  
Case Series ◽  
Reduced Ejection Fraction ◽  
Cardiac Amyloid ◽  
First Case

Abstract Background Amyloidosis is a systemic infiltrative disease that can affect nearly every organ in the human body. It is characterized by the deposition of misfolded protein within various tissues and organs. Once there is cardiac involvement this portends a worse prognosis. Case summary We describe a case series of two patients with cardiac amyloidosis presenting as a cardiogenic shock. There were several missed opportunities in diagnosing cardiac amyloid prior to their fatal presentations. In the first case, a 65-year-old African-American male patient presented with worsening shortness of breath and signs of heart failure. Echocardiography revealed preserved ejection fraction. He was diagnosed with light chain subtype of cardiac amyloidosis, and rapidly deteriorated during his admission. Patient in the second case is a 75-year-old African-American female who presented with worsening heart failure and hypotension. Echocardiography revealed reduced ejection fraction. She was diagnosed with transthyretin cardiac amyloid. Her clinical status worsened during admission and she went into cardiogenic shock requiring multiple vasopressors. Discussion This case series discusses two incidences of cardiac amyloidosis presenting as cardiogenic shock in African-American patients. This article postulates that cardiac amyloidosis may be misdiagnosed for more common causes of heart failure especially among this demographic group. Once patients with cardiac amyloid present with cardiogenic shock their clinical course is typically rapidly fatal despite aggressive measures. Earlier detection is imperative to prevent poor outcomes.

scholarly journals The impact of gender in cardiovascular medicine: Lessons from the gender/sex-issue in heart failure

2018 ◽  
Vol 88 (3) ◽  
Author(s):  
Alberto M. Marra ◽  
Andrea Salzano ◽  
Michele Arcopinto ◽  
Lucrezia Piccioli ◽  
Valeria Raparelli
Keyword(s):  
Heart Failure ◽  
Health Care ◽  
Ejection Fraction ◽  
Preserved Ejection Fraction ◽  
Cardiovascular Medicine ◽  
Men And Women ◽  
Reduced Ejection Fraction ◽  
High Prevalence ◽  
The Impact ◽  
Care Costs

Heart Failure (HF) is a major healthcare issue, given its high prevalence and incidence, the rate of comorbidities, the related high health-care costs and its poor outcome. In the last years mounting evidence revealed several differences between men and women affected by this clinical condition. Apart from the well-known difference in phenotype (HF with reduced ejection fraction (HFrEF) occurs more commonly in men, and HF with preserved ejection fraction (HFpEF) is more frequent in women) other relevant sex-related issues dwell upon epidemiology, presentation, risk stratification and management. These differences shed new lights on the possibility to consider HF as a prototype of the impact of gender/sex issue in cardiovascular medicine. A call for action and future strategies might help in the achievement of a cleaver patient-care.

Heart Failure with Preserved Ejection Fraction – A Review

2012 ◽  
Vol 9 (1) ◽  
pp. 90-95 ◽  
Author(s):  
Otto A Smiseth ◽  
Anders Opdahl ◽  
Espen Boe ◽  
Helge Skulstad
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Diastolic Heart Failure ◽  
The Elderly ◽  
Left Ventricular ◽  
Filling Pressure ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction ◽  
Reduced Ejection Fraction ◽  
Objective Evidence

Heart failure with preserved left ventricular ejection fraction (HF-PEF), sometimes named diastolic heart failure, is a common condition most frequently seen in the elderly and is associated with arterial hypertension and left ventricular (LV) hypertrophy. Symptoms are attributed to a stiff left ventricle with compensatory elevation of filling pressure and reduced ability to increase stroke volume by the Frank-Starling mechanism. LV interaction with stiff arteries aggravates these problems. Prognosis is almost as severe as for heart failure with reduced ejection fraction (HF-REF), in part reflecting co-morbidities. Before the diagnosis of HF-PEF is made, non-cardiac etiologies must be excluded. Due to the non-specific nature of heart failure symptoms, it is essential to search for objective evidence of diastolic dysfunction which, in the absence of invasive data, is done by echocardiography and demonstration of signs of elevated LV filling pressure, impaired LV relaxation, or increased LV diastolic stiffness. Antihypertensive treatment can effectively prevent HF-PEF. Treatment of HF-PEF is symptomatic, with similar drugs as in HF-REF.

Evaluation of the Efficacy of ST2 and NT-proBNP in the Diagnosis and Prediction of Short- Term Prognosis in Heart Failure with Reduced Ejection Fraction

2017 ◽  
Vol 9 (04) ◽  
Author(s):  
Shivananda B Nayak ◽  
Dharindra Sawh ◽  
Brandon Scott ◽  
Vestra Sears ◽  
Kareshma Seebalack ◽  
...  
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Cardiac Biomarkers ◽  
Double Blind Study ◽  
Short Term ◽  
Double Blind ◽  
Reduced Ejection Fraction ◽  
The Mean ◽  
Design And Methods ◽  
The Relationship

Purpose: i) To determine the relationship between the cardiac biomarkers ST2 and NT-proBNP with ejection fraction (EF) in heart failure (HF) patients. ii) Assess whether a superiority existed between the aforementioned cardiac markers in diagnosing the HF with reduced EF. iii) Determine the efficacy of both biomarkers in predicting a 30-day cardiovascular event and rehospitalization in patients with HF with reduced EF iv) To assess the influence of age, gender, BMI, anaemia and renal failure on the ST2 and NT-proBNP levels. Design and Methods: A prospective double-blind study was conducted to obtain data from a sample of 64 cardiology patients. A blood sample was collected to test for ST2 and NT-proBNP. An echocardiogram (to obtain EF value), electrocardiogram and questionnaire were also obtained. Results: Of the 64 patients enrolled, 59.4% of the population had an EF less than 40%. At the end of the 30- day period, 7 patients were warded, 37 were not warded, one died and 17 were non respondent. Both biomarkers were efficacious at diagnosing HF with a reduced EF. However, neither of them were efficacious in predicting 30-day rehospitalization. The mean NT-proBNP values being: not rehospitalized (2114.7486) and 30 day rehospitalization (1008.42860) and the mean ST2 values being: not rehospitalized (336.1975), and 30-day rehospitalization. (281.9657). Conclusion: Neither ST2 or NT-proBNP was efficacious in predicting the short- term prognosis in HF with reduced EF. Both however were successful at confirming the diagnosis of HF in HF patients with reduced EF.

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