GENDER DIFFERENCES IN RATES OF HOSPITALIZATIONS FOR DECOMPENSATED HEART FAILURE AMONG ADULTS WITH CONGENITAL HEART DISEASES IN THE UNITED STATES: A 15 YEAR EXPERIENCE

Background: The lifetime risk of developing Heart Failure (HF) is 20% for Americans ≥40 years of age. In the United States, greater than 650,000 new HF cases are diagnosed annually. About 5.1 million persons in the United States have clinically manifest HF. Additionally, HF has high absolute mortality rates of approximately 50% within 5 years of diagnosis. HF carries substantial health and economic burden. It is the primary diagnosis in >1 million hospitalizations annually. Patients hospitalized for HF are at high risk for all-cause re hospitalization. The total cost of HF care in the United States exceeds $30 billion annually. Objective: The study objective was to investigate the prevalence of valvular heart disease among patients hospitalized for HF in a largely Hispanic population. Methods: This is a retrospective study with aims inclusive of: analyzing the hospitalization and 4 months, 6 months, 2 year- re-hospitalization rates of HF in University Medical Center between Oct 2010 and Oct 2013; evaluating the association between valvular heart disease and hospitalizations for HF. Inclusion criteria were: admission/re hospitalizations with HF (with reduced, preserved and borderline EF). Echocardiographic determination of at least moderate valvular disease was utilized in this study as significant. Exclusion criteria were: patients lost to follow-up, death in hospital, transfer to another acute care facility, and discharge against medical advice. Demographics were also collected. Results: Hospitalizations involving 195 patients (120 men and 75 women) were randomly analyzed. The racial spread showed 77.4% (151 of 195) Hispanics and 22.6% (44 of 195) non-Hispanics. Out of the 195 index hospitalizations, the 4 month, 6 months and 2 years rehospitalization visits were 17.4% (34 of 195), 22.5% (44 of 195) and 38.5% (75 of 195) respectively. The prevalence of significant valvular heart disease was 45.9% (90 of 195), while the prevalence of no valvular heart disease was 54.1% (105 of 195) (p < 0.05). Conclusion: Multiple, prior studies have shown that valvular heart diseases have a comparatively low association with clinical Heart Failure. This study raises a valid point that in some population groups (the Hispanic), the burden of valvular heart disease may be greater than has been published in other groups. This calls for more studies, and has lots of potential implications in Heart Failure management.

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OUTCOMES OF HEART FAILURE RELATED ADMISSIONS IN ADULTS WITH CONGENITAL HEART DISEASE IN THE UNITED STATES: A POPULATION BASED STUDY

Journal of the American College of Cardiology ◽

10.1016/s0735-1097(11)60460-9 ◽

2011 ◽

Vol 57 (14) ◽

pp. E460 ◽

Cited By ~ 1

Author(s):

Fred H. Rodriguez ◽

Douglas S. Moodie ◽

Dhaval R. Parekh ◽

Wayne J. Franklin ◽

David L.S. Morales ◽

...

Keyword(s):

United States ◽

Heart Failure ◽

Congenital Heart Disease ◽

Heart Disease ◽

Congenital Heart ◽

The United States ◽

Population Based ◽

Population Based Study

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Comparison of management and outcomes of ED patients with acute decompensated heart failure between the Canadian and United States’ settings

CJEM ◽

10.1017/cem.2015.43 ◽

2015 ◽

Vol 18 (2) ◽

pp. 81-89 ◽

Cited By ~ 1

Author(s):

Anita Lai ◽

Elliott Tenpenny ◽

David Nestler ◽

Erik Hess ◽

Ian G. Stiell

Keyword(s):

United States ◽

Heart Failure ◽

Acute Decompensated Heart Failure ◽

Admission Rate ◽

Decompensated Heart Failure ◽

The United States ◽

Health Records ◽

Male Sex ◽

Relapse Rates ◽

The U.S

AbstractIntroductionThe objective of this study was to compare the emergency department (ED) management and rate of admission of acute decompensated heart failure (ADHF) between two hospitals in Canada and the United States and to compare the outcomes of these patients.MethodsThis was a health records review of adults presenting with ADHF to two EDs in Canada and the United States between January 1 and April 30, 2010. Outcome measures were admission to the hospital, myocardial infarction (MI), and death or relapse rates to the ED. Data were analysed using descriptive, univariate and multivariate analyses.ResultsIn total, 394 cases were reviewed and 73 were excluded. Comparing 156 Canadian to 165 U.S. patients, respectively, mean age was 76.0 and 75.8 years; male sex was 54.5% and 52.1%. Canadian and U.S. ED treatments were noninvasive ventilation 7.7% v. 12.8% (p=0.13); IV diuretics 77.6% v. 36.0% (p<0.001); IV nitrates 4.5% v. 6.7% (p=0.39). There were significant differences in rate of admission (50.6% v. 95.2%, p<0.001) and length of stay in ED (6.7 v. 3.0 hours, p<0.001). Proportion of Canadian and U.S. patients who died within 30 days of the ED visit was 5.1% v. 9.7% (p=0.12); relapsed to the ED within 30 days was 20.8% v. 17.5% (p=0.5); and had MI within 30 days was 2.0% v. 1.9% (p=1.0).ConclusionsThe U.S. and Canadian centres saw ADHF patients with similar characteristics. Although the U.S. site had almost double the admission rate, the outcomes were similar between the sites, which question the necessity of routine admission for patients with ADHF.

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Characteristics and outcomes of patients hospitalized for heart failure in the United States: Rationale, design, and preliminary observations from the first 100,000 cases in the Acute Decompensated Heart Failure National Registry (ADHERE)

American Heart Journal ◽

10.1016/j.ahj.2004.08.005 ◽

2005 ◽

Vol 149 (2) ◽

pp. 209-216 ◽

Cited By ~ 1328

Author(s):

Kirkwood F. Adams ◽

Gregg C. Fonarow ◽

Charles L. Emerman ◽

Thierry H. LeJemtel ◽

Maria Rosa Costanzo ◽

...

Keyword(s):

United States ◽

Heart Failure ◽

Acute Decompensated Heart Failure ◽

Decompensated Heart Failure ◽

The United States ◽

National Registry

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Comparison of Angiotensin-Converting Enzyme Inhibitor (ACEI) and Angiotensin Receptor Blocker (ARB) for Heart Failure Treatment in Congenital Heart Diseases with Left-to-Right Shunt

The Indonesian Biomedical Journal ◽

10.18585/inabj.v12i1.997 ◽

2020 ◽

Vol 12 (1) ◽

pp. 62-8

Author(s):

Alit Utamayasa ◽

Mahrus Ahmad Rahman ◽

Teddy Ontoseno ◽

Budiono Budiono

Keyword(s):

Heart Failure ◽

Congenital Heart ◽

Heart Diseases ◽

Left Ventricular ◽

Congenital Heart Diseases ◽

Converting Enzyme ◽

Angiotensin Receptor ◽

Heart Failure Treatment ◽

Failure Treatment ◽

Pediatric Heart Failure

BACKGROUND: The angiotensin-converting enzyme inhibitors (ACEIs) have become the forefront of heart failure treatment for more than a decade. Currently, angiotensin receptor blockers (ARBs) are thought to have similar effectiveness. This study aimed to compare the impact of captopril, one of ACEI, and valsartan, one of ARB, on clinical presentation and echocardiographic, electrocardiographic, and chest x-ray improvement in patients with left-to-right shunt congenitalheart diseases.METHODS: This study used a double-blind randomized controlled trial of captopril and valsatran to children with left-to-right shunt congenital heart diseases who suffer from heart failure in the Dr. Soetomo General Hospital, Surabaya, Indonesia. Pediatric heart failure scores, echocardiography, electrocardiography (ECG), and chest photographs were examined at the beginning of the study and after 30 days of treatment.RESULTS: A decrease in pediatric heart failure scores were showed after the administration of ACEI (7.06±2.04 vs. 4.75±2.43; p<0.0001; 95% CI: −2.98 - 1.65); ARB (6.81±2.25 vs. 3.94±1.98; p<0.0001; 95% CI: −3.76 to 1.98). The echocardiography examination, an increase in left ventricular end-diastolic volume (LVEDV), left ventricular ejection fraction (LVEF), % fractional shortening (FS), and left ventricular (LV) dimension occurred after the administration of ACEI and ARB. The values also didn’t significantly differrent between the two groups. The ECG evaluation showed a decrease in heart rate frequency after the administration of ACEI (117.75±14.67 vs. 109.63±17.59; p=0.039; 95% CI: −15.78 to −0.46) and ARB (117.10±21.86 vs.108.6±20.66; p=0.006; 95% CI: −14.17 to −2.83).CONCLUSION: ARB showed better outcome in clinical condition, echocardiography, ECG, and chest radiographs.KEYWORDS: captopril, valsartan, heart failure, congenital heart disease, left to right shunt

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