751 Long-term benefit of a hospital based heart failure programme: downgrading the risk of class IV patients

Aim of the study. To investigate preoperative status and results of surgery of patients with confirmed diagnosis of aortic root infection. Materials and methods. We have analyzed data of 21 patients who were operated on at the Heart Surgery Center, Vilnius University, since January 1, 1997, till December 31, 2006. All these patients underwent surgery because of aortic root infection. The patients were aged 25–72 years (mean age, 53±14 years). There were 17 (80.9%) male patients. Sixteen patients (76%) preoperatively were in NYHA class IV. The abscesses of aortic root were confirmed preoperatively by means of esophageal echocardiography in 18 patients (86%). Blood cultures positive for Staphylococcus aureus were found in four patients (19.9%). All the patients underwent replacement of the aortic valve by mechanic prosthesis; one of these patients was reoperated because of persistent sepsis, and replacement of the aortic root with homograft was performed. The duration of follow-up of the patients was 1 to 10 years. Results. Inhospital mortality rate was 14.3%. The causes of death included sustained heart failure and sepsis. All these patients were in NYHA functional class IV preoperatively; one of these patients had culture positive for Staphylococcus aureus. Inhospital survival was 85.7%, one-year postoperative survival – 80.9%, and both five-year and ten-year survivals were 76.0%. The long-term survival was negatively influenced by recurrent infective endocarditis, heart failure, and age. Death occurred in 1 patient (11.1%) of the 9 patients who at the time of surgery were younger than 50 years and 4 patients (33.3%) of the 12 who were older than 50 years at the time of operation. Conclusions. The infection of aortic root is not common pathology; however, it is a complicated disease. Esophageal echocardiography is an informative method while diagnosing aortic root abscesses. The inhospital mortality is increased by the heart failure persisting after the operation and sepsis. The long-term survival is decreased by preoperative infective endocarditis of the prosthesis and heart failure. The mortality rate of patients older than 50 years is 3-fold higher than mortality rate of younger ones.

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Navigating Your Acute Heart Failure Patient in Emergency and Pre-Discharge Phase

ACI (Acta Cardiologia Indonesiana) ◽

10.22146/aci.47680 ◽

2019 ◽

Vol 5 (1 (P)) ◽

pp. 34

Author(s):

Budi Yuli Setianto

Keyword(s):

Heart Failure ◽

Heart Failure Patient ◽

Myocardial Injury ◽

Wall Stress ◽

Hemodynamic Instability ◽

Ambulatory Setting ◽

Cardiac Wall ◽

Wide Range ◽

Term Benefit

Heart failure (HF) leads to frequent hospitalizations. The presence of re-hospitalization risk among patientshospitalized for heart failure is important, especially hemodynamic instability and neurohormonal over activation. ARNI is needed to restore the balance of neurohormonal system in HF. PARADIGM-HF study provide insight on long term benefit of ARNI (i.e. sacubitril/valsartan) in ambulatory setting. How is the evidence of ARNI use for in hospitalization phase of HF? PIONEER and TRANSITION showed that initiation of sacubitril/valsartan shortly after an ADHF event is feasible and well tolerated. In-hospital initiation of sacubitril/valsartan is associated with early and sustained improvements in biomarkers of cardiac wall stress and myocardial injury, indicating pathophysiological benefits in a wide range of HFrEF patients.

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743 Redefining outlook for survivors of class IV heart failure admission: Long term follow up of 536 patients in a hospital based disease management programme

European Journal of Heart Failure Supplements ◽

10.1016/s1567-4215(06)80494-7 ◽

2006 ◽

Vol 5 (1) ◽

pp. 175-175

Author(s):

C OLOUGHLIN ◽

N MURPHY ◽

C CONLON ◽

C TRAYNOR ◽

C RYAN ◽

...

Keyword(s):

Heart Failure ◽

Disease Management ◽

Disease Management Programme ◽

Management Programme ◽

Long Term Follow Up ◽

Heart Failure Admission ◽

Class Iv

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Short-term and Long-term Benefit of Adaptive Servo Ventilation Therapy in Patients with Heart Failure after Cardiac Surgery

Journal of Cardiac Failure ◽

10.1016/j.cardfail.2014.07.125 ◽

2014 ◽

Vol 20 (10) ◽

pp. S152

Author(s):

Keita Goto ◽

Noriaki Takama ◽

Masahiko Kurabayashi

Keyword(s):

Heart Failure ◽

Cardiac Surgery ◽

Short Term ◽

Adaptive Servo Ventilation ◽

Patients With Heart Failure ◽

Term Benefit

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Long Term Survival of Class IV Heart Failure Patients Treated with Oral Amrinone

The Journal of Clinical Pharmacology ◽

10.1002/j.1552-4604.1989.tb03370.x ◽

1989 ◽

Vol 29 (6) ◽

pp. 494-499 ◽

Cited By ~ 8

Author(s):

John F. Moran ◽

Nancy Rad ◽

Patrick J. Scanlon

Keyword(s):

Heart Failure ◽

Term Survival ◽

Long Term Survival ◽

Heart Failure Patients ◽

Class Iv

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Abstract 14884: Patients with Renal Impairment Derive Long-Term Benefit from Cardiac Resynchronization Therapy: Results from the MADIT-CRT Long-Term Follow-Up

Circulation ◽

10.1161/circ.130.suppl_2.14884 ◽

2014 ◽

Vol 130 (suppl_2) ◽

Author(s):

Usama Daimee ◽

Arthur Moss ◽

Ilan Goldenberg ◽

Scott Solomon ◽

Scott McNitt ◽

...

Keyword(s):

Heart Failure ◽

Renal Function ◽

Cardiac Resynchronization ◽

Risk Of Death ◽

Mild Heart Failure ◽

All Cause Mortality ◽

Long Term Follow Up ◽

Term Benefit

Background: Whether patients with renal impairment experience benefit from cardiac resynchronization therapy plus an implantable cardioverter-defibrillator (CRT-ICD) during long-term follow-up is unknown. Hypothesis: We assessed the hypothesis that baseline renal function affects long-term risk of all-cause mortality and heart-failure events (HFEs) as well as benefit derived from CRT-ICD. Methods: We evaluated the impact of renal function in 1274 patients with mild heart failure and left-bundle branch block enrolled in MADIT-CRT. Patients with BUN>70 mg/dl or creatinine>3.0 mg/dl were excluded from the trial. Two subgroups were created based on the estimated glomerular filtration rate (GFR): GFR<60 and GFR≥60 ml/min/1.73 m2. Patients were studied over a follow-up period of 7 years for the end points of all-cause mortality and HFEs. Results: There were 413 patients with baseline GFR<60 ml/min/1.73 m2 (mean 48.1±8.3). Relative to those with GFR≥60 ml/min/1.73 m2 (mean 79.6±16.0), the low-GFR patients experienced greater risk of death (HR=2.14, 95% CI: 1.57-2.91, p<0.0001) and HFEs (HR= 1.31, 95% CI: 1.02-1.69, p=0.03). In both GFR groups, CRT-ICD relative to ICD alone was associated with significantly lower risk of death (GFR<60: HR=0.63, 95% CI: 0.42-0.94, p=0.024, absolute risk reduction [ARR]=12%; GFR≥60: HR=0.65, 95% CI: 0.42-0.99, p=0.049, ARR=8%) [Figure]. Similarly, there was significant reduction in the risk of HFEs (GFR<60: HR=0.36, 95% CI: 0.25-0.53, p<0.0001, ARR=27%; GFR≥60: HR= 0.42, 95% CI: 0.31-0.57, p<0.0001, ARR=17%). Conclusion: In conclusion, in mild heart failure patients, moderate renal dysfunction is associated with higher risk of all-cause mortality and HFEs relative to mildly impaired-to-normal renal function. While patients in both groups derive long-term benefit from CRT-ICD with similar relative reductions in all-cause mortality and HFEs, the greater absolute benefit occurs in patients with moderate renal disease.

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