NON-SPECIFIC AORTOARTERITS PRESENTING AS ACUTE DECOMPENSATED HEART FAILURE IN CHILDREN: IMMEDIATE AND SHORT-TERM OUTCOME OF PERCUTANEOUS TRANSLUMINAL RENAL ANGIOPLASTY

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<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 (>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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Acute decompensated heart failure in a non cardiology tertiary referral centre, Sarawak General Hospital (SGH-HF)

BMC Cardiovascular Disorders ◽

10.1186/s12872-020-01793-7 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Hwei Sung Ling ◽

Bui Khiong Chung ◽

Pin Fen Chua ◽

Kai Xin Gan ◽

Wai Leng Ho ◽

...

Keyword(s):

Heart Failure ◽

General Hospital ◽

Readmission Rate ◽

Acute Decompensated Heart Failure ◽

Decompensated Heart Failure ◽

Asia Pacific ◽

Socioeconomic Background ◽

Evidence Based ◽

Short Term ◽

Cardiopulmonary Support

Abstract Background Data on clinical characteristics of acute decompensated heart failure (ADHF) in Malaysia especially in East Malaysia is lacking. Methods This is a prospective observational study in Sarawak General Hospital, Medical Department, from October 2017 to September 2018. Patients with primary admission diagnosis of ADHF were recruited and followed up for 90 days. Data on patient’s characteristics, precipitating factors, medications and short-term clinical outcomes were recorded. Results Majority of the patients were classified in lower socioeconomic group and the mean age was 59 years old. Hypertension, diabetes mellitus and dyslipidaemia were the common underlying comorbidities. Heart failure with ischemic aetiology was the commonest ADHF admission precipitating factor. 48.6% of patients were having preserved ejection fraction HF and the median NT-ProBNP level was 4230 pg/mL. Prescription rate of the evidence-based heart failure medication was low. The in-patient mortality and the average length of hospital stay were 7.5% and 5 days respectively. 43% of patients required either ICU care or advanced cardiopulmonary support. The 30-day, 90-day mortality and readmission rate were 13.1%, 11.2%, 16.8% and 14% respectively. Conclusion Comparing with the HF data from West and Asia Pacific, the short-term mortality and readmission rate were high among the ADHF patients in our study cohort. Maladaptation to evidence-based HF prescription and the higher prevalence of cardiovascular risk factors in younger patients were among the possible issues to be addressed to improve the HF outcome in regions with similar socioeconomic background.

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Prognostic significance of endogenous erythropoietin in long-term outcome of patients with acute decompensated heart failure

European Journal of Heart Failure ◽

10.1002/ejhf.537 ◽

2016 ◽

Vol 18 (7) ◽

pp. 803-813 ◽

Cited By ~ 21

Author(s):

Toshiyuki Nagai ◽

Kunihiro Nishimura ◽

Takehiro Honma ◽

Aya Higashiyama ◽

Yasuo Sugano ◽

...

Keyword(s):

Heart Failure ◽

Acute Decompensated Heart Failure ◽

Prognostic Significance ◽

Decompensated Heart Failure ◽

Term Outcome ◽

Long Term Outcome ◽

Endogenous Erythropoietin

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Sex differences in clinical characteristics and long-term outcome in acute decompensated heart failure patients with preserved and reduced ejection fraction

AJP Heart and Circulatory Physiology ◽

10.1152/ajpheart.00602.2015 ◽

2016 ◽

Vol 310 (7) ◽

pp. H813-H820 ◽

Cited By ~ 21

Author(s):

Yasuki Nakada ◽

Rika Kawakami ◽

Tomoya Nakano ◽

Akihiro Takitsume ◽

Hitoshi Nakagawa ◽

...

Keyword(s):

Heart Failure ◽

Sex Differences ◽

Ejection Fraction ◽

Acute Decompensated Heart Failure ◽

Decompensated Heart Failure ◽

Term Outcome ◽

Long Term Outcome ◽

Reduced Ejection Fraction ◽

Female Patients ◽

Male Patients

In patients with acute decompensated heart failure (ADHF), sex differences considering clinical and pathophysiologic features are not fully understood. We investigated sex differences in left ventricular (LV) ejection fraction (LVEF), plasma B-type natriuretic peptide (BNP) levels, and prognostic factors in patients with ADHF in Japan. We studied 748 consecutive ADHF patients of 821 patients registered in the ADHF registry between January 2007 and December 2014. Patients were divided into four groups based on sex and LVEF [reduced (ejection fraction, or EF, <50%, heart failure with reduced EF, or HFrEF) or preserved (EF ≥50%, heart failure with preserved LVEF, or HFpEF)]. The primary endpoint was the combination of cardiovascular death and heart failure (HF) admission. The present study consisted of 311 female patients (50% HFrEF, 50% HFpEF) and 437 male patients (63% HFrEF, 37% HFpEF). There was significant difference between sexes in the LVEF distribution profile. The ratio of HFpEF patients was significantly higher in female patients than in male patients ( P = 0.0004). Although there were no significant sex differences in median plasma BNP levels, the prognostic value of BNP levels was different between sexes. Kaplan-Meier analysis revealed that the high BNP group had worse prognosis than the low BNP group in male but not in female patients. In multivariate analysis, log transformed BNP at discharge predicted cardiovascular events in male but not in female HF patients (female, hazard ratio: 1.169; 95% confidence interval: 0.981–1.399; P = 0.0806; male, hazard ratio: 1.289; 95% confidence interval: 1.120–1.481; P = 0.0004). In patients with ADHF, the distribution of LV function and the prognostic significance of plasma BNP levels for long-term outcome were different between the sexes.

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