HAND-GRIP STRENGTH IN ACUTE DECOMPENSATED HEART FAILURE PATIENTS: ACCURACY AS A PREDICTOR OF MALNUTRITION AND PROGNOSTIC VALUE

Nutrition ◽  
2021 ◽  
pp. 111352
Author(s):  
Suena Medeiros Parahiba ◽  
Stefanny Ronchi Spillere ◽  
Priccila Zuchinali ◽  
Gabriela dos Reis Padilha ◽  
Melina Borba Duarte ◽  
...  
Keyword(s):  
Heart Failure ◽  
Grip Strength ◽  
Prognostic Value ◽  
Acute Decompensated Heart Failure ◽  
Decompensated Heart Failure ◽  
Hand Grip Strength ◽  
Heart Failure Patients ◽  
Hand Grip

P794Long-term prognostic value of the combination of AHEAD score and wasting syndrome in patients admitted for acute decompensated heart failure with reduced or preserved LV ejection fraction

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
T Yamada ◽  
T Morita ◽  
Y Furukawa ◽  
S Tamaki ◽  
M Kawasaki ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Heart Failure ◽  
Atrial Fibrillation ◽  
Prognostic Value ◽  
Acute Decompensated Heart Failure ◽  
Decompensated Heart Failure ◽  
Hemoglobin E ◽  
Heart Failure Patients ◽  
Wasting Syndrome ◽  
Ahead Score

Abstract Background Comorbidities are associated with poor clinical outcome in heart failure patients (pts). AHEAD (A: atrial fibrillation; H: hemoglobin; E: elderly; A: abnormal renal parameters; D: diabetes mellitus) score has been related to clinical outcomes in acute decompensated heart failure (ADHF) pts. On the other hand, heart failure is one of a number of disorders associated with the development of wasting syndrome. Previous studies have reported reduced mortality rates in heart failure patients with increased body mass index (BMI), so-called, obesity paradox. We sought to investigate the prognostic value of the combination of AHEAD score and the cachectic state in ADHF pts, relating to reduced or preserved LVEF (HFrEF or HFpEF). Methods and results We studied 303 pts admitted for ADHF and discharged with survival (HFrEF (LVEF <50%); n=163, HFpEF (LVEF ≥50%; n=140). We evaluated AHEAD score (range 0–5, atrial fibrillation, hemoglobin <13 mg/dL for men and 12 mg/dL for women, age >70 years, creatinine >130 μmol/L, and diabetes mellitus) and wasting syndrome was defined as BMI <20 kg/m2 and serum albumin level (Alb) <3.2 g/dl at the discharge. During a follow-up period of 5.1±4.2 years, 121 pts died. At multivariate Cox analysis, AHEAD score and wasting syndrome was significantly and independently associated with the total mortality, in pts with not only HFrEF but also HFpEF. Pts with both high AHEAD score (≥3: AUC 0.625 [0.542–0.709] in HFrEF and ≥3: AUC 0.611 [0514–0.708] in HFpEF, by ROC curve analysis) and wasting syndrome had a higher risk of mortality than those with either and none of them in HFrEF (71% vs 51% vs 40%, p<0.0001, respectively) and HFpEF (78% vs 33% vs 24%, p<0.0001, respectively). Conclusion The combination of AHEAD score and wasting syndrome would be useful for stratifying patients at risk for the mortality in ADHF pts, regardless of HFrEF or HFpEF.

Evaluation of hand grip strength as a marker of clinical deterioration in heart failure patients

2008 ◽  
Vol 7 ◽  
pp. 14-14
Author(s):  
L CASTILLOMARTINEZ ◽  
A OREATEJEDA ◽  
E COLINRAMIREZ ◽  
R SILVATINOCO ◽  
E ASENSIOLAFUENTE ◽  
...  
Keyword(s):  
Heart Failure ◽  
Grip Strength ◽  
Hand Grip Strength ◽  
Clinical Deterioration ◽  
Heart Failure Patients ◽  
Hand Grip

scholarly journals Impact of comorbidity on the predictive value of cystatin-C in patients admitted for acute decompensated heart failure: insights from a prospective study

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
K Kayama ◽  
T Yamada ◽  
T Watanabe ◽  
T Morita ◽  
Y Furukawa ◽  
...  
Keyword(s):  
Heart Failure ◽  
Cystatin C ◽  
Charlson Comorbidity Index ◽  
Prognostic Value ◽  
Roc Analysis ◽  
Acute Decompensated Heart Failure ◽  
Decompensated Heart Failure ◽  
Heart Failure Patients ◽  
Comorbidity Index ◽  
The Impact

Abstract Background Comorbidities are strongly associated with poor clinical outcome in heart failure patients. The Age-adjusted Charlson comorbidity index (ACCI), which is well-known widely used comorbidity index, recently has been used as a robust prognostic model in heart failure patients. On the other hand, Cystatin C, as a novel and important biomarker of renal function, has been recently reported as a useful long-term risk stratification score in heart failure patients. However, there is no information available on the impact of comorbidities on the prognostic value of cystatin-C in patients admitted for acute decompensated heart failure (ADHF). Methods We prospectively studied 458 consecutive ADHF patients with survival discharge. Patients with hemodialysis were excluded. Echocardiography and venous blood sampling were performed just before discharge and serum cystatin-C level was measured. Comorbidity was measured with the Age-adjusted Charlson comorbidity index (ACCI). ACCI was commonly used for the evaluation of the comorbid condition which is weighted and scored, with additional points added for age. The endpoint was all-cause death (ACD). Results During a follow-up period of 2.8±1.5 years, 132 patients had ACD. At multivariate Cox analysis, ACCI (p=0.0015) and cystatin-C level (p=0.0145) were significantly and independently associated with ACD. Patients with high ACCI (≥6: determined by ROC analysis) had a significantly greater risk of ACD (37.2% vs 17.8%, p&lt;0.0001, HR 2.45 [1.61–3.70]). In the subgroup of higher ACCI, patients with higher cystatin-C level (≥1.56: determined by ROC analysis) had a significantly higher risk of ACD (50.3% vs 23.4%). Furthermore, in the subgroup of lower ACCI, patients with higher cystatin-C level had also significantly higher risk of ACD (34.2% vs 12.1%). Conclusions The prognostic value of cystatin-C is not affected by comorbidities and cystatin-C provide prognostic information even in patients admitted for ADHF, irrespective of comorbid burden. All-cause death-free rate in ADHF pts Funding Acknowledgement Type of funding source: None

Abstract 14708: Prothrombin Time is a Novel Marker for Congestion in Acute Decompensated Heart Failure Patients Without Anticoagulants

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Atsushi Okada ◽  
Yasuo Sugano ◽  
Toshiyuki Nagai ◽  
Satoshi Honda ◽  
Yasuhide Asaumi ◽  
...  
Keyword(s):  
Heart Failure ◽  
Prothrombin Time ◽  
Cardiovascular Mortality ◽  
Prognostic Value ◽  
Independent Predictor ◽  
Acute Decompensated Heart Failure ◽  
Decompensated Heart Failure ◽  
Right Atrial ◽  
Heart Failure Patients ◽  
All Cause Mortality

Background: Where prothrombin time is widely used to monitor anticoagulation in cardiology patients, it is also a classical marker of liver damage. However, the clinical significance of prothrombin time in heart failure patients without anticoagulants is unknown. Therefore, we investigated the prevalence, relationship with clinical characteristics, and prognostic value of prothrombin time in acute decompensated heart failure (ADHF). Method: We prospectively studied 651 consecutive patients admitted for ADHF. Prothrombin time internationalized normalized ratio (PT-INR) was measured on admission in all patients. By excluding patients with oral anticoagulants, acute coronary syndrome and liver diseases, 308 patients were assessed. We assessed the relationship between PT-INR and blood tests, echocardiogram, and hemodynamic parameters from right heart catheterization. Cox regression hazard analysis was performed to assess prognostic value of PT-INR on all-cause mortality and cardiovascular mortality. Results: Of the 308 patients (75±13 years, 192 male), the mean PT-INR value was 1.10. Patients with prolonged PT-INR(>1.10, n=104) had significantly higher total bilirubin, alkaline phosphatase and gamma-glutamyl transpeptidase (all p<0.05), however, had similar LVEF, blood urea nitrogen, creatinine, and BNP compared to those with less PT-INR(≦1.10, n=204). PT-INR value had strong correlation with pulmonary capillary wedge pressure (r=-0.61, p<0.01) and right atrial pressure (r=-0.59, p<0.01), but not with cardiac index (r=0.23, p=ns.). Twenty-two patients (7%) died during a mean follow up of 317 days, and Cox proportional hazards analysis showed that PT-INR was an independent predictor of both all-cause mortality (HR=1.14, p<0.05) and cardiovascular mortality (HR=1.12, p<0.05) even after adjusted by age, sex, LVEF, creatinine, BNP and hemoglobin. Conclusion: Prolonged PT-INR in ADHF patients without anticoagulants was associated with clinical markers of hepatic congestion and elevated right sided pressure. It was also an independent predictor of all-cause and cardiovascular mortality.

scholarly journals Effect of Carperitide on Plasma Adiponectin Levels in Acute Decompensated Heart Failure Patients With Diabetes Mellitus

2009 ◽  
Vol 73 (12) ◽  
pp. 2264-2269 ◽  
Author(s):  
Masayuki Yamaji ◽  
Takayoshi Tsutamoto ◽  
Toshinari Tanaka ◽  
Chiho Kawahara ◽  
Keizo Nishiyama ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Heart Failure ◽  
Acute Decompensated Heart Failure ◽  
Decompensated Heart Failure ◽  
Plasma Adiponectin ◽  
Heart Failure Patients ◽  
Patients With Diabetes

scholarly journals Noninvasive Ventilation Outcomes in 2,430 Acute Decompensated Heart Failure Patients: An ADHERE Registry Analysis

2008 ◽  
Vol 15 (4) ◽  
pp. 355-362 ◽  
Author(s):  
Thomas A. Tallman ◽  
W. Frank Peacock ◽  
Charles L. Emerman ◽  
Margarita Lopatin ◽  
Jamie Z. Blicker ◽  
...  
Keyword(s):  
Heart Failure ◽  
Noninvasive Ventilation ◽  
Acute Decompensated Heart Failure ◽  
Decompensated Heart Failure ◽  
Heart Failure Patients ◽  
Registry Analysis

Short-term effects of low-dose tolvaptan in acute decompensated heart failure patients with severe aortic stenosis: the LOHAS registry

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
Y Watanabe ◽  
Y Nara ◽  
H Hioki ◽  
H Kawashima ◽  
A Kataoka ◽  
...  
Keyword(s):  
Heart Failure ◽  
Aortic Stenosis ◽  
Low Dose ◽  
Acute Decompensated Heart Failure ◽  
Severe Aortic Stenosis ◽  
Decompensated Heart Failure ◽  
Funding Source ◽  
Short Term ◽  
Heart Failure Patients ◽  
Short Term Effects

Abstract Background Tolvaptan exerts potent diuretic effects in heart failure patients without hemodynamic instability. Nonetheless, its clinical efficacy for acute decompensated heart failure (ADHF) due to severe aortic stenosis (AS) remains unclear. This study aimed to evaluate the short-term effects of tolvaptan in ADHF patients with severe AS. Methods The LOw-Dose Tolvaptan (7.5 mg) in Decompensated Heart Failure Patients with Severe Aortic Stenosis (LOHAS) registry is a multicenter (7 centers) prospective registry that assessed the short-term effects of tolvaptan in subjects hospitalized for ADHF with severe AS. A total of 59 subjects were enrolled between September 2014 and December 2017. The primary endpoints were changes in body weight and fluid balance measured daily from baseline up to 4 days. Results The median [interquartile range] patient age and aortic valve area were 85.0 [81.0–89.0] years and 0.58 [0.42–0.74] cm2, respectively. Body weight continuously decreased, and fluid balance was maintained from baseline to day 4 (p&lt;0.001, p=0.194, respectively). Median serum B-type natriuretic peptide concentration significantly decreased from 910.5 to 740.0 pg/mL by day 4 (p=0.002). However, systolic blood pressure and heart rate were non-significantly changed (p=0.250, p=0.656, respectively). Hypernatremia (&gt;150 mEq/L) and worsening renal function occurred in 2 (3.4%) and 4 (6.8%) patients, respectively. Conclusions Short-term treatment with low-dose tolvaptan is safe and effective, providing stable hemodynamic parameters in patients with ADHF and severe AS. Funding Acknowledgement Type of funding source: Private company. Main funding source(s): This research was supported by Otsuka Pharmaceutical Co., Ltd.

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