scholarly journals Impact of COVID-19 on heart failure hospitalizations: one year after

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
R Gonzalez-Manzanares ◽  
G Heredia Campos ◽  
C Fernandez-Aviles Irache ◽  
A Resua Collazo ◽  
C Pericet-Rodriguez ◽  
...  
Keyword(s):  
Heart Failure ◽  
Clinical Characteristics ◽  
First Year ◽  
Hospital Outcomes ◽  
Major Health Problem ◽  
Funding Sources ◽  
Heart Failure Unit ◽  
One Year ◽  
The Impact ◽  
Pandemic Wave

Abstract Background Coronavirus disease 2019 (COVID-19) rapidly spread worldwide since it first emerged in December 2019, with more than 100 million cases reported to date, causing a great impact on healthcare systems. Heart failure (HF) is a major health problem. It affects about 10 million people in Europe and is the leading cause of hospitalization for patients older than 65 years. During the first wave of COVID-19 there was an important decrease in HF hospitalizations. Data regarding HF admissions during the second and third waves and inter-waves periods is scarce. Purpose To examine the impact of COVID-19 on HF hospitalizations during the first year of the pandemic and to compare the clinical characteristics and in-hospital outcomes of patients admitted during the three pandemic waves with those admitted the previous year during the same periods. Methods Data from a tertiary Heart Failure Unit in Southern Spain between 1 March 2020 and 28 February 2021 were compared to the corresponding time period in the previous year. The impact of the pandemic on weekly hospitalizations was assessed using a Poisson Regression model, with year, season and pandemic wave as covariates. Clinical characteristics and in-hospital outcomes of patients admitted during the three waves were compared to those admitted during the same periods one year after. Results A significantly lower weekly number of admissions for HF was observed during the three pandemic wave periods compared to all other included periods (inter-wave periods and same periods in the previous year) (p=0.002, IRR 0.81, 0.77–0.86). Figure 1 shows monthly HF admissions between 1 March 2020 and 28 February 2021 (pandemic year) and the previous year, as well as COVID-19 hospitalized cases in our area. Clinical characteristics and in-hospital outcomes of patients admitted during the COVID-19 waves and the same periods in the previous year are shown in Figure 2. Patients admitted during the COVID-19 waves were younger, and fewer had diabetes mellitus (DM), atrial fibrillation (AF) and valvular heart disease (VHD). There were no differences in clinical outcomes (intensive care unit admission, in-hospital mortality). Conclusion There was decline in HF hospitalization during the three waves of the pandemic year, but not during the inter-wave periods. Patients admitted during the wave periods had some clinical differences but similar in-hospital outcomes. FUNDunding Acknowledgement Type of funding sources: None. Figure 1 Figure 2

Winter LVAD implantation is associated with adverse clinical outcomes

2020 ◽  
pp. 039139882095181
Author(s):  
Teruhiko Imamura ◽  
Pamela Combs ◽  
Umar Siddiqi ◽  
William Cohen ◽  
Stephanie Besser ◽  
...  
Keyword(s):  
Heart Failure ◽  
Seasonal Variation ◽  
Confidence Interval ◽  
Clinical Outcomes ◽  
Winter Season ◽  
Left Ventricular ◽  
First Year ◽  
Ventricular Assist ◽  
One Year ◽  
The Impact

Background: The seasonal variation of incidence and severity of heart failure is well known. However, the impact of seasonal variation on clinical outcomes following left ventricular assist device (LVAD) implantation remains unknown. Methods: We retrospectively reviewed consecutive patients who received LVAD implantation between January 2014 and December 2016 along with their first year of post-implant outcomes. Clinical outcomes were compared between those with winter LVAD implantation (between October and March) and those with non-winter LVAD implantation. Results: 168 patients with a median age of 57 years and 130 males were included. There was no seasonal difference in the number of LVAD implantations. One-year survival free from major adverse events was significantly lower in the winter implant group ( n = 88) compared to the non-winter group ( n = 80) (44% vs 61%) with an adjusted hazard ratio of 1.81 (95% confidence interval 1.11–2.90, p = 0.014), largely due to a higher rate of heart failure readmission in the winter implant patients (incidence rate ratio 2.29, 95% confidence interval 0.89–5.84). Conclusion: Patients who underwent LVAD implantation during the winter season had a higher heart failure readmission rate. A detailed mechanism and therapeutic strategy given our findings warrant further investigation.

scholarly journals Ethnic comparison in takotsubo syndrome: novel insights from the International Takotsubo Registry

2021 ◽  
Author(s):  
Yoichi Imori ◽  
Ken Kato ◽  
Victoria L. Cammann ◽  
Konrad A. Szawan ◽  
Manfred Wischnewsky ◽  
...  
Keyword(s):  
Hospital Mortality ◽  
Clinical Characteristics ◽  
Ethnic Disparities ◽  
Japanese Patients ◽  
Learning Approach ◽  
Takotsubo Syndrome ◽  
Unique Identifier ◽  
Hospital Outcomes ◽  
Machine Learning Approach ◽  
The Impact

Abstract Background Ethnic disparities have been reported in cardiovascular disease. However, ethnic disparities in takotsubo syndrome (TTS) remain elusive. This study assessed differences in clinical characteristics between Japanese and European TTS patients and determined the impact of ethnicity on in-hospital outcomes. Methods TTS patients in Japan were enrolled from 10 hospitals and TTS patients in Europe were enrolled from 32 hospitals participating in the International Takotsubo Registry. Clinical characteristics and in-hospital outcomes were compared between Japanese and European patients. Results A total of 503 Japanese and 1670 European patients were included. Japanese patients were older (72.6 ± 11.4 years vs. 68.0 ± 12.0 years; p < 0.001) and more likely to be male (18.5 vs. 8.4%; p < 0.001) than European TTS patients. Physical triggering factors were more common (45.5 vs. 32.0%; p < 0.001), and emotional triggers less common (17.5 vs. 31.5%; p < 0.001), in Japanese patients than in European patients. Japanese patients were more likely to experience cardiogenic shock during the acute phase (15.5 vs. 9.0%; p < 0.001) and had a higher in-hospital mortality (8.2 vs. 3.2%; p < 0.001). However, ethnicity itself did not appear to have an impact on in-hospital mortality. Machine learning approach revealed that the presence of physical stressors was the most important prognostic factor in both Japanese and European TTS patients. Conclusion Differences in clinical characteristics and in-hospital outcomes between Japanese and European TTS patients exist. Ethnicity does not impact the outcome in TTS patients. The worse in-hospital outcome in Japanese patients, is mainly driven by the higher prevalence of physical triggers. Trial Registration URL: https://www.clinicaltrials.gov; Unique Identifier: NCT01947621.

scholarly journals Mortality trends in an ambulatory multidisciplinary heart failure unit from 2001 to 2018

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Giosafat Spitaleri ◽  
Josep Lupón ◽  
Mar Domingo ◽  
Evelyn Santiago-Vacas ◽  
Pau Codina ◽  
...  
Keyword(s):  
Heart Failure ◽  
Linear Regression ◽  
Cardiovascular Mortality ◽  
Clinical Characteristics ◽  
Real Life ◽  
Cardiovascular Death ◽  
Progressive Decrease ◽  
Mortality Trends ◽  
Heart Failure Unit ◽  
Ambulatory Patients

AbstractTo assess mortality trends at 1 and 3 years from 2001 to 2018 in a real-life cohort of HF outpatients from different etiologies with depressed and preserved LVEF. A total of 2368 consecutive patients with HF (mean age 66.4 ± 12.9 years, 71% men, 15.4% with preserved LVEF) admitted to a HF clinic from August 2001 to September 2018 were included in the study. Patients were divided into five quintiles (Q) according to the period of admission. Trends for all-cause and cardiovascular mortality from Q1 to Q5 were assessed by linear regression. Patients with LVEF < 50% had a progressive decrease in the rates of all-cause and cardiovascular death at 1 year (12.1% in Q1 to 6.5% in Q5, p = 0.003; and 8.4% in Q1 to 3.8% in Q5, p = 0.007, respectively) and 3 years (30.5% in Q1 to 17.0% in Q5, p = 0.003; and 23.9% in Q1 to 9.8% in Q5, p = 0.003, respectively). These trends remained significant after adjusting for clinical characteristics and risk. No significant trend in mortality was observed in patients with LVEF ≥ 50%. In a cohort of real-life ambulatory patients with HF, mortality progressively declined in patients with LVEF < 50%, but the same trend was not observed in patients with preserved LVEF.

scholarly journals Clinical Outcomes in Patients with Ischemic versus Non-Ischemic Cardiomyopathy after Angiotensin-Neprilysin Inhibition Therapy

2021 ◽  
Vol 10 (21) ◽  
pp. 4989
Author(s):  
Mohammad Abumayyaleh ◽  
Christina Pilsinger ◽  
Ibrahim El-Battrawy ◽  
Marvin Kummer ◽  
Jürgen Kuschyk ◽  
...  
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Ischemic Cardiomyopathy ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Ventricular Tachyarrhythmias ◽  
Ventricular Ejection Fraction ◽  
One Year ◽  
The Impact

Background: The angiotensin receptor-neprilysin inhibitor (ARNI) decreases cardiovascular mortality in patients with chronic heart failure with a reduced ejection fraction (HFrEF). Data regarding the impact of ARNI on the outcome in HFrEF patients according to heart failure etiology are limited. Methods and results: One hundred twenty-one consecutive patients with HFrEF from the years 2016 to 2017 were included at the Medical Centre Mannheim Heidelberg University and treated with ARNI according to the current guidelines. Left ventricular ejection fraction (LVEF) was numerically improved during the treatment with ARNI in both patient groups, that with ischemic cardiomyopathy (n = 61) (ICMP), and that with non-ischemic cardiomyopathy (n = 60) (NICMP); p = 0.25. Consistent with this data, the NT-proBNP decreased in both groups, more commonly in the NICMP patient group. In addition, the glomerular filtration rate (GFR) and creatinine changed before and after the treatment with ARNI in both groups. In a one-year follow-up, the rate of ventricular tachyarrhythmias (ventricular tachycardia and ventricular fibrillation) tended to be higher in the ICMP group compared with the NICMP group (ICMP 38.71% vs. NICMP 17.24%; p = 0.07). The rate of one-year all-cause mortality was similar in both groups (ICMP 6.5% vs. NICMP 6.6%; log-rank = 0.9947). Conclusions: This study shows that, although the treatment with ARNI improves the LVEF in ICMP and NICMP patients, the risk of ventricular tachyarrhythmias remains higher in ICMP patients in comparison with NICMP patients. Renal function is improved in the NICMP group after the treatment. Long-term mortality is similar over a one-year follow-up.

scholarly journals Five-Year Outcomes of Heart Failure with Preserved Ejection Fraction

2020 ◽  
Vol 14 (1) ◽  
pp. 18-26
Author(s):  
Cristina Macía-Rodríguez ◽  
Emilio Páez-Guillán ◽  
Vanesa Alende-Castro ◽  
Alba García-Villafranca ◽  
Lara Maria Mateo-Mosquera ◽  
...  
Keyword(s):  
Heart Failure ◽  
Atrial Fibrillation ◽  
Ejection Fraction ◽  
Clinical Characteristics ◽  
Hypertensive Heart Disease ◽  
Preserved Ejection Fraction ◽  
Related Factors ◽  
Factors Associated ◽  
Heart Failure Unit ◽  
High Level

Objective: The aim of this study was to describe the clinical characteristics of patients that have had a heart failure with preserved ejection fraction (HF-pEF) and to identify the factors associated with 5-year mortality and readmission. Methods: A prospective cohort study was conducted of patients followed by the Heart Failure Unit of the Internal Medicine Department. Clinical characteristics and outcomes were collected. Univariate and multivariate analyses were performed in order to identify factors associated with 5-year mortality and readmission. Results: A total of 209 patients with HF-pEF were followed, 59.3% of these were women, with a mean age 79 years. The main etiology was hypertensive heart disease and a high level of comorbidity (chronic renal failure, hypertension and atrial fibrillation) was observed. The 5-year mortality was 55.5%; the related variables were anemia (hazard ratio [HR]=1.7; 95% confidence interval [CI]: 1.2-2.5), in patients being treated with statins (HR=0.7; 95%CI 0.5-0.9) and spironolactone (HR= 1.6; 95% CI: 1.1-2.3); 24.5% of patients had >2 admission in 5 years, with the main related factors being atrial fibrillation (HR=2.7; 95%CI: 1.4-5.5), anemia (HR=1.9; 95%CI:1.0-3.3) and were being treated with spironolactone (HR=2.1; 95%CI:1.2-3.7). Conclusion: Patients with HF-pEF are old and present a high level of comorbidity. Furthermore, they have a high 5-year mortality and readmission rate. The only factor associated with lower mortality was the treatment with statins. The use of spironolactone was associated with a higher mortality risk.

Abstract 17352: Differences in Clinical Characteristics, Risk Factors, Rate of Recurrence and 1-year Outcome Between Acute Heart Failure Patients With Stroke or TIA and Those Without This Co-morbidity. Results From the Gulf aCute heArt failuRe rEgistry (gulf Care)

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Mohammed A Al Hashemi ◽  
Kadhim Sulaiman ◽  
Jassim Al-Suwaidi ◽  
Khalid F AlHabib ◽  
Husam AlFaleh ◽  
...  
Keyword(s):  
Heart Failure ◽  
Acute Heart Failure ◽  
Clinical Characteristics ◽  
De Novo ◽  
Stroke Patients ◽  
Lv Dysfunction ◽  
Co Morbidity ◽  
History Of ◽  
One Year ◽  
Ischemic Attack

Background: Chronic heart failure (CHF) is a known risk for stroke and morbidities and mortalities are known to be higher in CHF patients compared to stroke patients without CHF we here study the prevalence and the clinical significance in a group of patient with stroke or transient ischemic attack (TIA) who were admitted to hospital with acute heart failure (AHF) compared to those without stroke and are admitted with acute heart failure Methods: Data were derived from a prospective, multicenter, multinational study of 5005 patients hospitalized with AHF from February 2013 to November 2012. Data were analyzed according to the presence or absence of Stroke or bronchial TIA. Demographic, management, in-hospital and 1-year outcomes were compared Results: Stroke patients were likely to have a decompensation of chronic failure rather than De-Novo AHF when compared to those without Stroke/TIA (see table). Stroke patients were older; more likely to be female, have history of DM, HTN, dyslipidemia and CKD. Stroke patients were likely to have Atrial fibrillation, PVD, systolic LV dysfunction as well as CAD when compared to those without Stroke, they were also more likely receive NIV, IV inotropes and likely to have had cardiac PCI prior to this admission with AHF. Stroke patients had higher recurrence of stroke and one-year mortality rates. Conclusion: Patients who presented with AHF and history of stroke/TIA were having different clinical characteristics as well as comorbidities as compared to those without Stroke, with worse in-hospital and one-year outcome. The current study underlies the need to aggressively manage these high-risk patients.

Abstract P298: The Impact of JNC VII Recommendations for Controlling Blood Pressure in a Heart Failure Disease Management Program

2011 ◽  
Vol 4 (suppl_1) ◽  
Author(s):  
George R Marzouka ◽  
Elyse Julian ◽  
Andre Dias ◽  
Leonardo Tamariz ◽  
Pat Trahan ◽  
...  
Keyword(s):  
Heart Failure ◽  
Blood Pressure ◽  
Disease Management ◽  
Pressure Control ◽  
Management Program ◽  
P Value ◽  
Baseline Visit ◽  
Heart Failure Disease Management ◽  
One Year ◽  
The Impact

Background: A significant correlation between hypertension (HTN) and long-term risk for heart failure (HF) exists. The aim of this study was (i) to assess what percent of patients enrolled in a heart failure disease management program (HFDMP) reach the JNC VII target goals for blood pressure control; (ii) to assess if there is a disparity in HTN control by race or ethnicity; (iii) and to assess the impact of reaching JNC VII targets for blood pressure control on survival. Methods: Patients with an ejection fraction ≤40% were enrolled into HFDMPs and screened for HTN, defined as blood pressure (BP) ≥ 130/80. Patients were titrated to beta blocker therapy and ace inhibitor therapy following the ACC/AHA HF guidelines. Final BP was measured after one year. Results: Mean baseline systolic BP (SBP) (N = 648) was 149.9 mmHg and mean baseline diastolic BP (DBP) was 90.5 mmHg. At one year, mean SBP decreased to 138.0 mmHg, DBP to 81.8 mmHg. There was no significant increase in survival for patients with BP ≤130 and ≤80 versus patients with HTN. There was a significant disparity in BP control in Blacks and Hispanics compared to whites (p<0.001) Conclusion: Disease management programs are an effective way to reduce BP in hypertensive patients, as well as keeping normotensive patients within JNC VII guidelines however health disparities persisted by race and ethnicity. Mean SBP and DBP of cohort at baseline Vs. 12 Month Follow up Blood pressure ≤ 130/80 mmHg Baseline Visit Last Visit P-Value SBP,m sd 110.9 (12.6%) 120.9 (22.2%) <0.001 DBP , m sd 67.1 (8.6%) 72.4 (13.7%) <0.001 Blood pressure > 130/80 mmHg Baseline Visit Last Visit P-Value SBP , m sd 149.9 (21.4%) 138.0 (24.6%) <0.001 DBP , m sd 90.5 (16.3%) 81.8 (16.8%) <0.001

Differences in Clinical Characteristics and one-year outcomes of Hospitalized Heart Failure Patients in succeeding ESC-HF Registries ? Pilot and Long-Term

2018 ◽  
Vol 08 (04) ◽  
Author(s):  
Paweł Balsam ◽  
Krzysztof Ozierański ◽  
Agnieszka Kapłon-Cieślicka ◽  
Sonia Borodzicz ◽  
Agata Tymińska ◽  
...  
Keyword(s):  
Heart Failure ◽  
Clinical Characteristics ◽  
Heart Failure Patients ◽  
One Year

Clinical characteristics and one-year survival in heart failure patients more than 85years of age compared with younger

2013 ◽  
Vol 24 (4) ◽  
pp. 339-345 ◽  
Author(s):  
Alicia Conde-Martel ◽  
Francesc Formiga ◽  
Carmen Pérez-Bocanegra ◽  
Arola Armengou-Arxé ◽  
Alberto Muela-Molinero ◽  
...  
Keyword(s):  
Heart Failure ◽  
Clinical Characteristics ◽  
Heart Failure Patients ◽  
One Year

scholarly journals Timing of Susceptibility to Fusarium Head Blight in Winter Wheat

Plant Disease ◽  
2020 ◽  
Vol 104 (11) ◽  
pp. 2928-2939
Author(s):  
Christina Cowger ◽  
Giovanni Beccari ◽  
Yanhong Dong
Keyword(s):  
Winter Wheat ◽  
Fusarium Head Blight ◽  
Resistant Cultivar ◽  
First Year ◽  
Head Blight ◽  
Kernel Infection ◽  
Risk Forecasting ◽  
One Year ◽  
Moderately Resistant ◽  
The Impact

The duration of wheat susceptibility to Fusarium infection has implications for risk forecasting, fungicide timing, and the likelihood that visible kernel damage may underpredict deoxynivalenol (DON) contamination. A field experiment was conducted to explore the impact of varying infection timings on Fusarium head blight (FHB) development in winter wheat. Trials in four successive years (2010 to 2013) in North Carolina utilized one susceptible and one moderately resistant cultivar possessing similar maturity, stature, and grain quality. Inoculum was applied in the form of sprayed Fusarium graminearum conidia. In the first year, the nine infection timings were from 0 to 21 days after anthesis (daa), whereas in the following 3 years, they ranged from 0 to 13 daa. Infection progression was compared among inoculation timings by sampling spikes five to six times during grain-fill. Based on DON, percent kernel damage and kernel infection, and fungal spread as assayed via qPCR, the moderately resistant cultivar had at least a 2- to 3-day shorter window of susceptibility to damaging FHB infection than the susceptible cultivar. The results suggest that duration of susceptibility is an important aspect of cultivar resistance to FHB. In 2012, the window of susceptibility for both cultivars was extended by cold snaps during anthesis. After debranning in one year, the majority of DON was found to be in the bran fraction of kernels; there was also a trend for later infections to lead to a higher percentage of DON in the nonbran fraction, as well as a higher ratio of DON to FDK.

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