Efficacy of the Hawthorn (Crataegus) preparation LI 132 in 78 patients with chronic congestive heart failure defined as NYHA functional class II

Abstract Background Patients with congestive heart failure (CHF) are vulnerable to contrast-induced acute kidney injury (CI-AKI), but few prediction models are currently available. Objectives We aimed to establish a simple nomogram for CI-AKI risk assessment for patients with CHF undergoing coronary angiography. Methods A total of 1876 consecutive patients with CHF (defined as New York Heart Association functional class II-IV or Killip class II-IV) were enrolled and randomly (2:1) assigned to a development cohort and a validation cohort. The endpoint was CI-AKI defined as serum creatinine elevation of ≥0.3 mg/dL or 50% from baseline within the first 48–72 hours following the procedure. Predictors for the nomogram were selected by multivariable logistic regression with a stepwise approach. The discriminative power was assessed using the area under the receiver operating characteristic (ROC) curve and was compared with the classic Mehran score in the validation cohort. Calibration was assessed using the Hosmer–Lemeshow test and 1000 bootstrap samples. Results The incidence of CI-AKI was 9.06% (n=170) in the total sample, 8.64% (n=109) in the development cohort and 9.92% (n=61) in the validation cohort (p=0.367). The simple nomogram including four predictors (age, intra-aortic balloon pump, acute myocardial infarction and chronic kidney disease) demonstrated a similar predictive power as the Mehran score (area under the curve: 0.80 vs 0.75, p=0.061), as well as a well-fitted calibration curve. Conclusions The present simple nomogram including four predictors is a simple and reliable tool to identify CHF patients at risk of CI-AKI, whereas further external validations are needed. Figure 1 Funding Acknowledgement Type of funding source: None

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Changing Strategies in the Management of Chronic Congestive Heart Failure

DICP ◽

10.1177/106002809102501214 ◽

1991 ◽

Vol 25 (12) ◽

pp. 1349-1354 ◽

Cited By ~ 1

Author(s):

Daniel E. Hilleman ◽

Syed M. Mohiuddin

Keyword(s):

Heart Failure ◽

Congestive Heart Failure ◽

Mortality Rate ◽

Heart Transplantation ◽

Nyha Class ◽

Class Ii ◽

Left Ventricular ◽

Fixed Dose ◽

Chronic Congestive Heart Failure ◽

Organ Systems

Recent studies have more clearly defined the role of drug therapy in patients with chronic congestive heart failure (CHF). Treatment of patients with asymptomatic left ventricular dysfunction (New York Heart Association [NYHA] class I) cannot be recommended at this time. The benefit of prophylactic treatment with angiotensin-converting enzyme inhibitors (ACEIs) or vasodilators in patients at high risk for developing symptomatic CHF is currently being evaluated. Treatment of patients with symptomatic CHF (NYHA class II-IV) should be initiated with a combination of a diuretic, digoxin, and an ACEI. This combination has been shown to reduce the mortality rate in patients with NYHA class II-IV CHF. Patients who remain symptomatic despite treatment with this combination may benefit from the addition of the direct-acting, nonspecific vasodilators—hydralazine and a nitrate. The addition of the nonspecific vasodilators to an ACEI has not been tested in controlled trials. In patients who remain symptomatic despite treatment with diuretics, digoxin, ACEIs, and nonspecific vasodilators, treatment options are not clear. The use of beta-agonists, phosphodiesterase inhibitors, and intermittent fixed-dose, fixed-interval dobutamine should be avoided as these agents are associated with a high mortality rate. Heart transplantation should be considered early in the course of CHF to allow for preservation of other vital organ systems. Unfortunately, heart transplantation is available to only a very small minority of potential transplant candidates.

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A Simple Nomogram to Predict Contrast-Induced Acute Kidney Injury in Patients with Congestive Heart Failure Undergoing Coronary Angiography

Cardiology Research and Practice ◽

10.1155/2021/9614953 ◽

2021 ◽

Vol 2021 ◽

pp. 1-10

Author(s):

Li Lei ◽

Yibo He ◽

Zhaodong Guo ◽

Bowen Liu ◽

Jin Liu ◽

...

Keyword(s):

Heart Failure ◽

Congestive Heart Failure ◽

Coronary Angiography ◽

Prediction Models ◽

Validation Cohort ◽

Kidney Injury ◽

Heart Association ◽

Class Ii ◽

Functional Class ◽

Killip Class

Background. Patients with congestive heart failure (CHF) are vulnerable to contrast-induced kidney injury (CI-AKI), but few prediction models are currently available. Therefore, we aimed to establish a simple nomogram for CI-AKI risk assessment for patients with CHF undergoing coronary angiography. Methods. A total of 1876 consecutive patients with CHF (defined as New York Heart Association functional class II-IV or Killip class II-IV) were enrolled and randomly (2:1) assigned to a development cohort and a validation cohort. The endpoint was CI-AKI defined as serum creatinine elevation of ≥0.3 mg/dL or 50% from baseline within the first 48–72 hours following the procedure. Predictors for the simple nomogram were selected by multivariable logistic regression with a stepwise approach. The discriminative power was assessed using the area under the receiver operating characteristic (ROC) curve and was compared with the classic Mehran score in the validation cohort. Calibration was assessed using the Hosmer–Lemeshow test and 1000 bootstrap samples. Results. The incidence of CI-AKI was 9.06% (170) in the total sample, 8.64% (n = 109) in the development cohort, and 9.92% (n = 61) in the validation cohort ( P = 0.367 ). The simple nomogram including four predictors (age, intra-aortic balloon pump, acute myocardial infarction, and chronic kidney disease) demonstrated a similar predictive power as the Mehran score (area under the curve: 0.80 vs. 0.75, P = 0.061 ), as well as a well-fitted calibration curve. Conclusions. The present simple nomogram including four predictors is a simple and reliable tool to identify CHF patients at risk of CI-AKI, whereas further external validations are needed.

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Improvement in NYHA Functional Class 4 Congestive Heart Failure Patients with Nifedipine: A Hemodynamic Evaluation

The American Journal of the Medical Sciences ◽

10.1097/00000441-198803000-00005 ◽

1988 ◽

Vol 295 (3) ◽

pp. 188-192 ◽

Cited By ~ 1

Author(s):

Stephen C. Vlay ◽

Linda Olson

Keyword(s):

Heart Failure ◽

Congestive Heart Failure ◽

Functional Class ◽

Heart Failure Patients ◽

Nyha Functional Class ◽

Hemodynamic Evaluation

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Digoxin, Converting-Enzyme Inhibition (Quinapril), and the Combination in Patients with Congestive Heart Failure Functional Class II and Sinus Rhythm

Journal of Cardiovascular Pharmacology ◽

10.1097/00005344-199007000-00002 ◽

1990 ◽

Vol 16 (1) ◽

pp. 9-14 ◽

Cited By ~ 21

Author(s):

Eckhard P. Kromer ◽

Dietmar Elsner ◽

Günter A. J. Riegger

Keyword(s):

Heart Failure ◽

Congestive Heart Failure ◽

Sinus Rhythm ◽

Enzyme Inhibition ◽

Class Ii ◽

Functional Class ◽

Converting Enzyme ◽

Converting Enzyme Inhibition

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TORASEMIDE FOR THE TREATMENT OF HEART FAILURE

10.36106/ijsr/4526762 ◽

2021 ◽

pp. 27-30

Author(s):

Harshawardhan Dhanraj Ramteke ◽

Roshan Rajesh Menon

Keyword(s):

Heart Failure ◽

Congestive Heart Failure ◽

Loop Diuretic ◽

Symptomatic Relief ◽

Left Ventricular ◽

Functional Class ◽

Line Treatment ◽

Pharmacological Activities ◽

Nyha Functional Class

Diuretics play a major role in the rst line treatment for the Congestive Heart Failure (CHF). These diuretics are currently and majorly used for symptomatic relief. Torasemide, a loop diuretic, is a newly developed loop diuretic, which has a longer half-life, longer duration for action, and higher bioavailability as compared to the other loop diuretics like furosemide. Torasemide, also works more effectively for the anti-aldosterone effect and vasorelaxation effect. Several studies have also suggested that torasemide has superior pharmacokinetics and pharmacological activities than that of furosemide. Results of several studies state that torasemide helps in improving the left ventricular function, reduces the mortality, as well as the frequency and duration of heart failure. Torasemide also improves the quality of life, tolerance and NYHA functional class in patients suffering from CHF. Based on these results, torasemide appears to be a promising loop diuretic for the rst line treatment and for better management of the patients with CHF. In this review, we provide a panorama of existing knowledge on the properties of torasemide, aimed at using it as a rst line of treatment for the patients in Congestive Heart Failure (CHF).

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