scholarly journals The treatment of mitral insufficiency in refractory heart failure

2020 ◽  
Vol 22 (Supplement_L) ◽  
pp. L93-L96
Author(s):  
Federico Cammertoni ◽  
Piergiorgio Bruno ◽  
Andrea Mazza ◽  
Massimo Massetti
Keyword(s):  
Heart Failure ◽  
Myocardial Revascularization ◽  
Left Ventricular ◽  
Mitral Insufficiency ◽  
Long Term Outcomes ◽  
Mitral Repair ◽  
Refractory Heart Failure ◽  
Patients With Heart Failure ◽  
Frequent Finding

Abstract Secondary mitral insufficiency (SMI) is caused by dilatation and left ventricular dysfunction and is a frequent finding in patients with heart failure (HF). It is associated with a mortality of between 40% and 50% at 3 years. The first-line treatment is represented by medical therapy, possibly associated, when indicated, with cardiac re-synchronization. If the patient remains symptomatic, corrective action should be considered. Surgery is indicated in cases of severe SMI with ejection fraction >30% and the need for myocardial revascularization. The management of patients in whom revascularization is not an option remains extremely complex and the evidence in this field is extremely limited. Percutaneous transcatheter therapies, reparative or replacement, are rapidly emerging as valid alternatives in cases of patients at high surgical risk. In particular, edge-to-edge repair (MitraClip) has proven effective in improving symptoms and reducing hospitalizations for HF. However, neither transcatheter nor surgical mitral repair or replacement has been shown to significantly improve prognosis, with mortality remaining high (14–20% at 1 year). Randomized trials aimed at assessing the effect of these treatments and establishing their long-term outcomes are urgently required.

scholarly journals Evaluation of different late left ventricular remodeling definitions for predicting long-term outcomes in acute myocardial infarction patients undergoing percutaneous coronary intervention

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
S Zhang ◽  
X Xie ◽  
C He ◽  
X Lin ◽  
M Luo ◽  
...  
Keyword(s):  
Heart Failure ◽  
Ventricular Remodeling ◽  
Cox Regression ◽  
Left Ventricular Remodeling ◽  
Left Ventricular ◽  
Long Term Outcomes ◽  
Cox Regression Analysis ◽  
Long Term Mortality

Abstract Background Late left ventricular remodeling (LLVR) after the index acute myocardial infarction (AMI) is a common complication, and is associated with poor outcome. However, the optimal definition of LLVR has been debated because of its different incidence and influence on prognosis. At present, there are limited data regarding the influence of different LLVR definitions on long-term outcomes in AMI patients undergoing percutaneous coronary intervention (PCI). Purpose To explore the impact of different definitions of LLVR on long-term mortality, re-hospitalization or an urgent visit for heart failure, and identify which definition was more suitable for predicting long-term outcomes in AMI patients undergoing PCI. Methods We prospectively observed 460 consenting first-time AMI patients undergoing PCI from January 2012 to December 2018. LLVR was defined as a ≥20% increase in left ventricular end-diastolic volume (LVEDV), or a >15% increase in left ventricular end-systolic volume (LVESV) from the initial presentation to the 3–12 months follow-up, or left ventricular ejection fraction (LVEF) <50% at follow up. These parameters of the cardiac structure and function were measuring through the thoracic echocardiography. The association of LLVR with long-term prognosis was investigated by Cox regression analysis. Results The incidence rate of LLVR was 38.1% (n=171). The occurrence of LLVR according to LVESV, LVEDV and LVEF definition were 26.6% (n=117), 31.9% (n=142) and 11.5% (n=51), respectively. During a median follow-up of 2 years, after adjusting other potential risk factors, multivariable Cox regression analysis revealed LLVR of LVESV definition [hazard ratio (HR): 2.50, 95% confidence interval (CI): 1.19–5.22, P=0.015], LLVR of LVEF definition (HR: 16.46, 95% CI: 6.96–38.92, P<0.001) and LLVR of Mix definition (HR: 5.86, 95% CI: 2.45–14.04, P<0.001) were risk factors for long-term mortality, re-hospitalization or an urgent visit for heart failure. But only LLVR of LVEF definition was a risk predictor for long-term mortality (HR: 6.84, 95% CI: 1.98–23.65, P=0.002). Conclusions LLVR defined by LVESV or LVEF may be more suitable for predicting long-term mortality, re-hospitalization or an urgent visit for heart failure in AMI patients undergoing PCI. However, only LLVR defined by LVEF could be used for predicting long-term mortality. FUNDunding Acknowledgement Type of funding sources: None. Association Between LLVR and outcomes Kaplan-Meier Estimates of the Mortality

scholarly journals Effects of a 9-Week Hybrid Comprehensive Telerehabilitation Program on Long-term Outcomes in Patients With Heart Failure

2020 ◽  
Vol 5 (3) ◽  
pp. 300 ◽  
Author(s):  
Ewa Piotrowicz ◽  
Michael J. Pencina ◽  
Grzegorz Opolski ◽  
Wojciech Zareba ◽  
Maciej Banach ◽  
...  
Keyword(s):  
Heart Failure ◽  
Long Term Outcomes ◽  
Patients With Heart Failure

scholarly journals Long-Term Outcomes of Adults With Heart Failure by Left Ventricular Systolic Function Status

2018 ◽  
Vol 122 (6) ◽  
pp. 1008-1016 ◽  
Author(s):  
Harshith R. Avula ◽  
Thomas K. Leong ◽  
Keane K. Lee ◽  
Sue Hee Sung ◽  
Alan S. Go
Keyword(s):  
Heart Failure ◽  
Systolic Function ◽  
Left Ventricular Systolic Function ◽  
Left Ventricular ◽  
Long Term Outcomes ◽  
Ventricular Systolic Function

scholarly journals Discordant Short- and Long-Term Outcomes Associated With Diabetes in Patients With Heart Failure: Importance of Age and Sex

2008 ◽  
Vol 1 (4) ◽  
pp. 234-241 ◽  
Author(s):  
Michael R. MacDonald ◽  
Pardeep S. Jhund ◽  
Mark C. Petrie ◽  
James D. Lewsey ◽  
Nathaniel M. Hawkins ◽  
...  
Keyword(s):  
Heart Failure ◽  
Long Term Outcomes ◽  
Patients With Heart Failure ◽  
Short And Long Term ◽  
Age And Sex

scholarly journals Cardiac index predicts long-term outcomes in patients with heart failure

PLoS ONE ◽  
2021 ◽  
Vol 16 (6) ◽  
pp. e0252833
Author(s):  
Tatsuro Ibe ◽  
Hiroshi Wada ◽  
Kenichi Sakakura ◽  
Yusuke Ugata ◽  
Hisataka Maki ◽  
...  
Keyword(s):  
Heart Failure ◽  
Cardiac Index ◽  
Right Heart Catheterization ◽  
Right Atrial ◽  
Major Adverse Cardiovascular Events ◽  
Heart Catheterization ◽  
Long Term Outcomes ◽  
Cardiac Outcomes ◽  
Patients With Heart Failure

Background The role of cardiac index (CI) and right atrial pressure (RAP) for predicting long-term outcomes of heart failure has not been well established. The aim of this study was to investigate long-term cardiac outcomes in patients with heart failure having various combinations of CI and RAP. Methods A total of 787 heart failure patients who underwent right-heart catheterization were retrospectively categorized into the following four groups: Preserved CI (≥2.5 L/min/m2) and Low RAP (<8 mmHg) (PRE-CI/L-RAP; n = 285); Preserved CI (≥2.5 L/min/m2) and High RAP (≥8 mmHg) (PRE-CI/H-RAP; n = 242); Reduced CI (<2.5 L/min/m2) and Low RAP (<8 mmHg) (RED-CI/L-RAP; n = 123); and Reduced CI (<2.5 L/min/m2) and High RAP (≥8 mmHg) (RED-CI/H-RAP; n = 137). Survival analysis was applied to investigate which groups were associated with major adverse cardiovascular events (MACE). Results The RED-CI/L-RAP and RED-CI/H-RAP groups were significantly associated with MACE as compared with the PRE-CI/L-RAP and PRE-CI/H-RAP groups after adjustment for confounding factors (RED-CI/L-RAP vs. PRE-CI/L-RAP: HR 2.11 [95% CI 1.33–3.37], p = 0.002; RED-CI/H-RAP vs. PRE-CI/L-RAP: HR 2.18 [95% CI 1.37–3.49], p = 0.001; RED-CI/L-RAP vs. PRE-CI/H-RAP: HR 1.86 [95% CI 1.16–3.00], p = 0.01; RED-CI/H-RAP vs. PRE-CI/H-RAP: HR 1.92 [95% CI 1.26–2.92], p = 0.002), whereas the difference between the RED-CI/H-RAP and RED-CI/L-RAP groups was not significant (HR 1.03 [95% CI 0.64–1.66], p = 0.89). Conclusions The hemodynamic severity categorized by CI and RAP levels provided clear risk stratification in patients with symptomatic heart failure. Low CI was an independent predictor of long-term cardiac outcomes.

scholarly journals A051 Long-term Outcomes for Patients with Heart Failure in New Zealand according to Ejection Fraction Phenotype

2020 ◽  
Vol 29 ◽  
pp. S21-S22
Author(s):  
T. Evans ◽  
K. Poppe ◽  
C. Choi ◽  
G. Devlin ◽  
M. Lund ◽  
...  
Keyword(s):  
Heart Failure ◽  
New Zealand ◽  
Ejection Fraction ◽  
Long Term Outcomes ◽  
Patients With Heart Failure
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