Intra-cardiac microcomputer allows for innovative telemedicine in chronic heart failure during coronavirus disease-2019 pandemic: a case report

Abstract Background Heart failure patient management guided by invasive intra-cardiac and pulmonary pressure measurements through permanent intra-cardiac micro-sensors has recently been published as a strategy to individualize the therapy of patients with chronic heart failure to reduce re-hospitalization and optimize quality of life. Furthermore, the use of telemedicine could have an important impact on infective disease spread during the current coronavirus disease-2019 pandemic. Case summary Emergent hospitalization of a patient with acute on chronic heart failure, who is currently in self-isolation as a result of his comorbid profile that exposes him to high risk for severe course and mortality in case of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection was prevented using a last generation telemedicine tool. Discussion Further implementation of invasive telemedicine could prevent hospitalization for acute decompensated heart failure and consecutive exposure to a potential hospital infection with SARS-CoV-2 in high-risk patients.

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Nurse-based educational intervention in a heart failure unit improves outcomes in self-care, quality of life and depression of high-risk patients with chronic heart failure

European Heart Journal ◽

10.1093/eurheartj/eht307.p643 ◽

2013 ◽

Vol 34 (suppl 1) ◽

pp. P643-P643 ◽

Cited By ~ 1

Author(s):

S. Lopez-Fernandez ◽

M. Puga-Martinez ◽

M. Jimenez-Fernandez ◽

M. J. Molina-Lerma ◽

V. Alcalde-Martinez ◽

...

Keyword(s):

Quality Of Life ◽

Heart Failure ◽

High Risk ◽

Chronic Heart Failure ◽

Educational Intervention ◽

Self Care ◽

Care Quality ◽

Heart Failure Unit ◽

Risk Patients

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Evolution of B-type natriuretic peptide and N-terminal pro-brain natriuretic peptide during acute decompensated heart failure in a chronic heart failure patient with reduced ejection fraction treated with Sacubitril/Valsartan: a case report

European Heart Journal - Case Reports ◽

10.1093/ehjcr/ytz108 ◽

2019 ◽

Vol 3 (3) ◽

Author(s):

Ambre Tiepolo ◽

Hélène Nougué ◽

Charles Damoisel ◽

Jean-Marie Launay ◽

Nicolas Vodovar ◽

...

Keyword(s):

Heart Failure ◽

Chronic Heart Failure ◽

Ejection Fraction ◽

Natriuretic Peptide ◽

Acute Decompensated Heart Failure ◽

Decompensated Heart Failure ◽

Chronic Heart Failure Patient ◽

Reduced Ejection Fraction ◽

Case Summary ◽

Acute Decompensation

Abstract Background B-type natriuretic peptide (BNP) and the N-terminal proBNP (NT-proBNP) exhibit different evolution in chronic heart failure patients with reduced ejection fraction treated with Sacubitril/Valsartan; BNP increasing or remaining stable, while NT-proBNP decreases. However, how this difference translates upon acute decompensation is unknown. Case summary Herein, we described in a 78-year-old woman with chronic heart failure with reduced ejection fraction treated with Sacubitril/Valsartan who had acute decompensated heart failure (ADHF). BNP and NT-proBNP were markedly high during ADHF and showed parallel return to baseline level after clinical improvement. Discussion BNP and NT-proBNP retained similar value for the diagnosis of ADHF in patient treated with Sacubitril/Valsartan. These findings strongly suggest that either BNP or NT-proBNP can be used indifferently in this context, while their relative use is debated in chronic heart failure.

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An m-Health intervention to improve education, self-management, and outcomes in patients admitted for acute decompensated heart failure: barriers to effective implementation

European Heart Journal - Digital Health ◽

10.1093/ehjdh/ztab085 ◽

2021 ◽

Author(s):

Georgios Zisis ◽

Melinda J Carrington ◽

Brian Oldenburg ◽

Kristyn Whitmore ◽

Maria Lay ◽

...

Keyword(s):

Heart Failure ◽

High Risk ◽

Chronic Conditions ◽

Acute Decompensated Heart Failure ◽

Controlled Trial ◽

Nyha Class ◽

Decompensated Heart Failure ◽

Class Iii ◽

Effective Delivery

Abstract Aims Effective and efficient education and patient engagement are fundamental to improve health outcomes in heart failure (HF). The use of artificial intelligence (AI) to enable more effective delivery of education is becoming more widespread for a range of chronic conditions. We sought to determine whether an avatar-based HF-app could improve outcomes by enhancing HF knowledge and improving patient quality of life and self-care behaviour. Methods and results In a randomized controlled trial of patients admitted for acute decompensated HF (ADHF), patients at high risk (≥33%) for 30-day hospital readmission and/or death were randomized to usual care or training with the HF-app. From August 2019 up until December 2020, 200 patients admitted to the hospital for ADHF were enrolled in the Risk-HF study. Of the 72 at high-risk, 36 (25 men; median age 81.5 years; 9.5 years of education; 15 in NYHA Class III at discharge) were randomized into the intervention arm and were offered education involving an HF-app. Whilst 26 (72%) could not use the HF-app, younger patients [odds ratio (OR) 0.89, 95% confidence interval (CI) 0.82–0.97; P < 0.01] and those with a higher education level (OR 1.58, 95% CI 1.09–2.28; P = 0.03) were more likely to enrol. Of those enrolled, only 2 of 10 patients engaged and completed ≥70% of the program, and 6 of the remaining 8 who did not engage were readmitted. Conclusions Although AI-based education is promising in chronic conditions, our study provides a note of caution about the barriers to enrolment in critically ill, post-acute, and elderly patients.

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SOFA score and short-term mortality in acute decompensated heart failure

Scientific Reports ◽

10.1038/s41598-020-77967-2 ◽

2020 ◽

Vol 10 (1) ◽

Author(s):

Adi Elias ◽

Reham Agbarieh ◽

Walid Saliba ◽

Johad Khoury ◽

Fadel Bahouth ◽

...

Keyword(s):

Heart Failure ◽

High Risk ◽

Hospital Mortality ◽

Sofa Score ◽

Acute Decompensated Heart Failure ◽

Decompensated Heart Failure ◽

Short Term ◽

High Risk Patients ◽

Short Term Mortality ◽

Risk Patients

AbstractAcute decompensated heart failure (ADHF) is one of the leading causes for hospitalization and mortality. Identifying high risk patients is essential to ensure proper management. Sequential Organ Function Assessment Score (SOFA) is considered an excellent score to predict short-term mortality in sepsis and other life-threatening conditions. To assess the capability of SOFA score in predicting short-term mortality in ADHF. We retrospectively identified patients with first hospitalization with primary diagnosis of ADHF between the years (2008–2018). The SOFA score was calculated for all patients. A total 3232 patients were included in the study. The SOFA score was significantly associated with in-hospital mortality and 30-day mortality. The odds ratios for 1-point increase in the SOFA score were 1.86 (95% CI 1.68–1.96) and 1.627 (95% CI 1.523–1.737) respectively. The SOFA Score demonstrated a good predictive accuracy. The areas under the curve of receiver operating characteristic curves for in-hospital mortality and 30-day mortality were 0.765 (95% CI 0.733–0.798) and 0.706 (95% CI 0.676–0.736) respectively. SOFA score is associated with increased risk of short-term mortality in ADHF. SOFA can be used as a complementary risk score to screen high risk patients who need strict monitoring.

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Physical Function, Frailty, Cognition, Depression, and Quality of Life in Hospitalized Adults ≥60 Years With Acute Decompensated Heart Failure With Preserved Versus Reduced Ejection Fraction

Circulation Heart Failure ◽

10.1161/circheartfailure.118.005254 ◽

2018 ◽

Vol 11 (11) ◽

Cited By ~ 24

Author(s):

Haider J. Warraich ◽

Dalane W. Kitzman ◽

David J. Whellan ◽

Pamela W. Duncan ◽

Robert J. Mentz ◽

...

Keyword(s):

Quality Of Life ◽

Heart Failure ◽

Ejection Fraction ◽

Physical Function ◽

Acute Decompensated Heart Failure ◽

Decompensated Heart Failure ◽

Reduced Ejection Fraction

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State-of-the-art Structural Interventions in Heart Failure

Cardiac Failure Review ◽

10.15420/cfr.2019.12.2 ◽

2019 ◽

Vol 5 (3) ◽

pp. 147-154 ◽

Cited By ~ 1

Author(s):

Jeffrey Park ◽

Hussam S Suradi

Keyword(s):

Heart Failure ◽

Acute Decompensated Heart Failure ◽

Structural Heart Disease ◽

Decompensated Heart Failure ◽

Structural Interventions ◽

The Past ◽

Effective Interventions ◽

The Us ◽

Multiple Trials

Heart failure (HF) is a leading cause of hospitalisation and healthcare costs worldwide. Acute decompensated heart failure accounts for more than 1 million hospitalisations in the US. Despite advances in the quality of acute and chronic HF disease management, gaps in knowledge about effective interventions to support the transition of care for patients with HF remain. Despite multiple trials of promising therapies, standard care consists of decongestion with IV diuretics and haemodynamic support with vasodilators and inotropes and this has remained largely unchanged during the past 45 years. Newer advances in medical innovations and structural heart disease interventions have now given promise to improved survival, outcomes and quality of life for patients with advanced HF of multiple aetiologies. In this article, we focus on structural interventions in the treatment of patients with HF.

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