TPEAK TO TEND INTERVAL IS A SHORT TERM PROGNOSTIC FACTOR OF CARDIAC DEATH IN ACUTE HEART FAILURE SYNDROME PATIENTS WITH REDUCED EJECTION FRACTION

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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Levosimendan use in patients with acute heart failure and reduced ejection fraction with or without severe renal dysfunction in critical cardiac care units: a multi-institution database study

Annals of Intensive Care ◽

10.1186/s13613-021-00810-y ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Cze-Ci Chan ◽

Kuang-Tso Lee ◽

Wan-Jing Ho ◽

Yi-Hsin Chan ◽

Pao-Hsien Chu

Keyword(s):

Heart Failure ◽

Renal Function ◽

Ejection Fraction ◽

Acute Heart Failure ◽

Cardiac Care ◽

Chang Gung Memorial Hospital ◽

Research Database ◽

Cohort Entry ◽

Reduced Ejection Fraction ◽

Abnormal Renal Function

Abstract Background Acute heart failure is a life-threatening clinical condition. Levosimendan is an effective inotropic agent used to maintain cardiac output, but its usage is limited by the lack of evidence in patients with severely abnormal renal function. Therefore, we analyzed data of patients with acute heart failure with and without abnormal renal function to examine the effects of levosimendan. Methods We performed this retrospective cohort study using data from the Chang Gung Research Database (CGRD) of Chang Gung Memorial Hospital (CGMH). Patients admitted for heart failure with LVEF ≤ 40% between January 2013 and December 2018 who received levosimendan or dobutamine in the critical cardiac care units (CCU) were identified. Patients with extracorporeal membrane oxygenation (ECMO) were excluded. Outcomes of interest were mortality at 30, 90, and 180 days after the cohort entry date. Results There were no significant differences in mortality rate at 30, 90, and 180 days after the cohort entry date between the levosimendan and dobutamine groups, or between subgroups of patients with an estimated glomerular filtration rate (eGFR) ≥ 30 mL/min/1.73 m2 and eGFR < 30 mL/min/1.73 m2 or on dialysis. The results were consistent before and after propensity score matching. Conclusions Levosimendan did not increase short- or long-term mortality rates in critical patients with acute heart failure and reduced ejection fraction compared to dobutamine, regardless of their renal function. An eGFR less than 30 mL/min/1.73 m2 was not necessarily considered a contraindication for levosimendan in these patients.

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IMPACT OF RIGHT HEART CATHETERIZATION IN ACUTE HEART FAILURE WITH REDUCED EJECTION FRACTION

Journal of the American College of Cardiology ◽

10.1016/s0735-1097(21)02085-4 ◽

2021 ◽

Vol 77 (18) ◽

pp. 726

Author(s):

Samarthkumar Thakkar ◽

Harsh Patel ◽

Kirtenkumar Patel ◽

Ashish Kumar ◽

Smit Patel ◽

...

Keyword(s):

Heart Failure ◽

Ejection Fraction ◽

Acute Heart Failure ◽

Right Heart Catheterization ◽

Heart Catheterization ◽

Right Heart ◽

Reduced Ejection Fraction

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Prediction of sudden cardiac death in chronic heart failure patients with reduced ejection fraction by ADMIRE-HF risk score and early repolarization pattern

Journal of Nuclear Cardiology ◽

10.1007/s12350-019-01639-6 ◽

2019 ◽

Vol 27 (3) ◽

pp. 992-1001 ◽

Cited By ~ 2

Author(s):

Iyo Ikeda-Yorifuji ◽

Takahisa Yamada ◽

Shunsuke Tamaki ◽

Takashi Morita ◽

Yoshio Furukawa ◽

...

Keyword(s):

Heart Failure ◽

Sudden Cardiac Death ◽

Chronic Heart Failure ◽

Ejection Fraction ◽

Risk Score ◽

Cardiac Death ◽

Early Repolarization ◽

Reduced Ejection Fraction ◽

Heart Failure Patients

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Dynamic changes in cardiovascular and systemic parameters prior to sudden cardiac death in heart failure with reduced ejection fraction: a PARADIGM‐HF analysis

European Journal of Heart Failure ◽

10.1002/ejhf.2120 ◽

2021 ◽

Author(s):

Luis E. Rohde ◽

Muthiah Vaduganathan ◽

Brian L. Claggett ◽

Carisi A. Polanczyk ◽

Pranav Dorbala ◽

...

Keyword(s):

Heart Failure ◽

Sudden Cardiac Death ◽

Ejection Fraction ◽

Cardiac Death ◽

Dynamic Changes ◽

Reduced Ejection Fraction

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The Subclinical Hypothyroid State might Predict 30 Day Readmission in Patients with an Acute Heart Failure Syndrome and Reduced Left Ventricular Ejection Fraction.

Journal of Cardiac Failure ◽

10.1016/j.cardfail.2018.07.143 ◽

2018 ◽

Vol 24 (8) ◽

pp. S49

Author(s):

Muhammad Saad ◽

Andrisael Garcia Lacoste ◽

Pooja Balar ◽

Aiyi Zhang ◽

Timothy Vittorio

Keyword(s):

Heart Failure ◽

Left Ventricular Ejection Fraction ◽

Ejection Fraction ◽

Acute Heart Failure ◽

Left Ventricular ◽

Ventricular Ejection ◽

Left Ventricular Ejection ◽

Ventricular Ejection Fraction ◽

Acute Heart Failure Syndrome

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412 Sacubitril/valsartan promotes cardiac reverse remodeling and preserves renal function in a real-world heart failure and reduced ejection fraction (HFrEF) population

European Heart Journal - Cardiovascular Imaging ◽

10.1093/ehjci/jez319.1183 ◽

2020 ◽

Vol 21 (Supplement_1) ◽

Author(s):

M V Polito ◽

A Rispoli ◽

V Vitulano ◽

F D"auria ◽

A Silverio ◽

...

Keyword(s):

Heart Failure ◽

Renal Function ◽

Ejection Fraction ◽

Real World ◽

Cardiac Death ◽

Nyha Class ◽

P Value ◽

Composite Outcome ◽

Reduced Ejection Fraction ◽

Echocardiographic Parameters

Abstract Funding Acknowledgements none Aims. To evaluate the effects of Sacubitril/Valsartan (S/V) on clinical, laboratory and echocardiographic parameters and outcomes in a real-world population with heart failure with reduced ejection fraction (HFrEF). Methods and results. Prospective study enrolling consecutive patients with HFrEF treated with S/V.The primary outcome was HF rehospitalization;secondary outcomes were all-cause death, cardiac death and the composite of cardiac death and HF rehospitalization at 12 months follow up.The clinical outcome was compared with a retrospective cohort of 90 HFrEF patients treated with standard medical therapy by using propensity score weighting. At 6 months follow-up, changes in symptoms, echocardiographic parameters, eGFR and furosemide dose were also evaluated. The study population consisted of 90 patients (66.1 ± 11.7 years). At 6 months FU, a significant improvement in NYHA class, LVEF (from 31.0% to 34.0%; p = 0.001), LVESV (from 115.0 to 101.0 mL; p = 0.033) and sPAP (from 31.0 to 25.0 mmHg; p = 0.024) was observed. Moreover, S/V did not affect negatively eGFR and was associated with a significantly lower dose of furosemide prescribed. The propensity score weighting adjusted regression analysis showed a significantly lower risk for HF rehospitalization (HR, 0.131; 95% CI, 0.034-0.503; p = 0.003) and the composite outcome (HR, 0.162; 95% CI, 0.053-0.492; p = 0.001) among patients treated with S/V as compared to the standard therapy group. Conclusions In this real-world HFrEF population, S/V reduced HF rehospitalization and cardiac death at 1 year. Moreover, S/V improved significantly NYHA class, LVEF, LVESV and sPAP at 6 months, preserving renal function and reducing the need of furosemide. Table Study outcomes Unadjusted model HR 95% CI p-value HF rehospitalization 0.273 0.101-0.740 0.011 Cardiac death 0.443 0.137-1.440 0.176 Composite outcome 0.331 0.155-0.710 0.005 All-cause death 0.666 0.272-1.628 0.372 Adjusted model HR 95% CI p-value HF rehospitalization 0.131 0.034-0.503 0.003 Cardiac death 0.259 0.047-1.415 0.119 Composite outcome 0.162 0.053-0.492 0.001 All-cause death 0.713 0.201-2.529 0.601 Adjusted and unadjusted HR for the study outcomes. Abstract 412 Figure.

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