Chronic heart failure

Oxford Handbook of Cardiac Nursing ◽

10.1093/med/9780198832447.003.0010 ◽

2020 ◽

pp. 217-240

Keyword(s):

Heart Failure ◽

Chronic Heart Failure ◽

Mortality Rate ◽

Adult Population ◽

Age Groups ◽

Severe Heart Failure ◽

Signs And Symptoms ◽

Developed Countries ◽

Clinical Syndrome ◽

The Uk

Heart failure is a complex clinical syndrome of signs and symptoms that suggest the ability of the heart to pump effectively has been impaired. It is distinguished by dyspnoea, effort intolerance, fluid retention, and poor survival. The prevalence of heart failure is around 1–2% in the adult population in developed countries, and 920 000 people in the UK have heart failure. The incidence of heart failure has decreased; however, the number of people newly diagnosed with heart failure has increased. This is thought to be largely due to an ageing population, improvement in the management and survival of people with ischaemic heart disease, and effective treatment of heart failure. The condition can occur in all age groups; however, the incidence and prevalence steeply increase with age. The average age at first diagnosis is typically 77yrs. Chronic heart failure (CHF) has a poor prognosis, the mortality rate for CHF being worse than for many cancers. It is estimated that 70% of those hospitalized for the first time with severe heart failure will die within 5yrs. However, this has been improving, with 6mth mortality rate ↓ from 26% in 1995, 15% in 2009, to 8.9% in 2016. This chapter will outline the aetiology, pathophysiology, and management of CHF, including considerations for palliative care.

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Chronic heart failure

Oxford Handbook of Cardiac Nursing ◽

10.1093/med/9780199651344.003.0010 ◽

2014 ◽

pp. 193-212

Keyword(s):

Heart Failure ◽

Chronic Heart Failure ◽

Mortality Rate ◽

Poor Prognosis ◽

Age Groups ◽

Severe Heart Failure ◽

Clinical Syndrome ◽

Coronary Syndromes ◽

The Uk ◽

First Time

Heart failure is a clinical syndrome distinguished by dyspnoea, effort intolerance, fluid retention, and poor survival. Although the management of acute coronary syndromes (ACS) has improved, with a resultant decrease in mortality, the numbers of people who subsequently go on to develop chronic heart failure (CHF) are increasing. The prevalence of heart failure is around 2–3% in the overall population and approximately 900 000 people in the UK have heart failure. It is estimated that there will be an increase in prevalence of 50% in the next 20 years, attributed to better outcomes for CHF. The condition can occur in all age groups, however the incidence and prevalence steeply increases with age. The average age at first diagnosis is typically 76, with the prevalence in the 70–80 age groups, rising to between 10–20%. CHF has a poor prognosis, the mortality rate for CHF being worse than for many cancers. It is estimated that 70% of those hospitalized for the first time with severe heart failure will die within 5 years. However, this has been improving, with 6-month mortality rate decreasing from 26% in 1995, to 14% in 2005. This chapter outlines the aetiology, pathophysiology, and management of CHF, including considerations for palliative care.

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Neprilysin: A Potential Therapeutic Target of Arterial Hypertension?

Current Cardiology Reviews ◽

10.2174/1573403x15666190625160352 ◽

2020 ◽

Vol 16 (1) ◽

pp. 25-35 ◽

Cited By ~ 2

Author(s):

Juan Salazar ◽

Joselyn Rojas-Quintero ◽

Clímaco Cano ◽

José L. Pérez ◽

Paola Ramírez ◽

...

Keyword(s):

Heart Failure ◽

Arterial Hypertension ◽

Adult Population ◽

Significant Risk ◽

Cardiovascular Pharmacology ◽

Significant Risk Factor ◽

Developed Countries ◽

Clinical Syndrome ◽

Major Health Problem ◽

Neprilysin Inhibitor

Arterial hypertension is the most prevalent chronic disease in the adult population of developed countries and it constitutes a significant risk factor in the development of cardiovascular disease, contributing to the emergence of many comorbidities, among which heart failure excels, a clinical syndrome that nowadays represents a major health problem with uncountable hospitalizations and the indolent course of which progressively worsens until quality of life decreases and lastly death occurs prematurely. In the light of this growing menace, each day more efforts are invested in the field of cardiovascular pharmacology, searching for new therapeutic options that allow us to modulate the physiological systems that appear among these pathologies. Therefore, in the later years, the study of natriuretic peptides has become so relevant, which mediate beneficial effects at the cardiovascular level such as diuresis, natriuresis, and decreasing cardiac remodeling; their metabolism is mediated by neprilysin, a metalloproteinase, widely expressed in the human and capable of catalyzing many substrates. The modulation of these functions has been studied by decades, giving room to Sacubitril, the first neprilysin inhibitor, which in conjunction with an angiotensin receptor blocker has provided a high efficacy and tolerability among patients with heart failure, for whom it has already been approved and recommended. Nonetheless, in the matter of arterial hypertension, significant findings have arisen that demonstrate the potential role that it will play among the pharmacological alternatives in the upcoming years.

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Hyponatremia in Patients with Heart Failure: a Prognostic Marker

Revista de Chimie ◽

10.37358/rc.18.5.6263 ◽

2018 ◽

Vol 69 (5) ◽

pp. 1071-1074

Author(s):

Camelia Cristina Diaconu ◽

Maria Manea ◽

Mihaela Adela Iancu ◽

Ana Maria Alexandra Stanescu ◽

Bogdan Socea ◽

...

Keyword(s):

Heart Failure ◽

Chronic Heart Failure ◽

Mortality Rate ◽

Treatment Strategies ◽

Developed Countries ◽

Heart Failure Patients ◽

Patients With Heart Failure ◽

High Prevalence ◽

Prognostic Implications ◽

Internal Medicine Clinic

Due to the high prevalence of cardiovascular diseases and better treatment strategies, with increased survival, heart failure is a condition with increasing prevalence, especially in developed countries. Heart failure patients often present electrolytic disorders, the most frequent one being hyponatremia. The objective of the study was to evaluate the frequency of hyponatremia in patients with chronic heart failure hospitalized in the Internal Medicine Clinic of the Clinical Emergency Hospital of Bucharest and to assess the clinical and paraclinical correlations, as well as prognostic implications of hyponatremia in these patients. We performed an observational retrospective study on 400 chronic heart failure patients hospitalized between January 1st 2014 and August 31st 2015. From these patients, 60 patients have been diagnosed with hyponatremia (defined as a serum natrium [135 mEq/L) and represented our group of study. The values of the serum natrium at admission in the study group ranged between 110-132 mmol/L. Most patients had advanced heart failure, according to NYHA classes� classification. The proportion of patients discharged with persistent hyponatremia was 48.33%, lower than the patients discharged with corrected serum sodium (51.67%), indicating an effective treatment of hyponatremia during hospitalization. The mortality rate during hospitalization in patients with corrected hyponatremia was 8.33%, smaller than the mortality rate in patients with persistent hyponatremia despite the correct administration of hydroelectrolytic rebalancing treatment (18.33%). Persistent hyponatremia may be considered a marker of a poor prognosis in hospitalized heart failure patients.

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Pharmacology of Ivabradine and the Effect on Chronic Heart Failure

Current Topics in Medicinal Chemistry ◽

10.2174/1568026619666190809093144 ◽

2019 ◽

Vol 19 (21) ◽

pp. 1878-1901 ◽

Cited By ~ 3

Author(s):

Yue Zhou ◽

Jian Wang ◽

Zhuo Meng ◽

Shuang Zhou ◽

Jiayu Peng ◽

...

Keyword(s):

Heart Failure ◽

Heart Rate ◽

Chronic Heart Failure ◽

Underlying Mechanism ◽

Clinical Syndrome ◽

Hcn Channels ◽

Therapeutic Effects ◽

Diastolic Depolarization ◽

High Incidence ◽

Spontaneous Phase

Chronic Heart Failure (CHF) is a complex clinical syndrome with a high incidence worldwide. Although various types of pharmacological and device therapies are available for CHF, the prognosis is not ideal, for which, the control of increased Heart Rate (HR) is critical. Recently, a bradycardic agent, ivabradine, is found to reduce HR by inhibiting the funny current (If). The underlying mechanism states that ivabradine can enter the Hyperpolarization-activated Cyclic Nucleotide-gated (HCN) channels and bind to the intracellular side, subsequently inhibiting the If. This phenomenon can prolong the slow spontaneous phase in the diastolic depolarization, and thus, reduce HR. The clinical trials demonstrated the significant effects of the drug on reducing HR and improving the symptoms of CHF with fewer adverse effects. This review primarily introduces the chemical features and pharmacological characteristics of ivabradine and the mechanism of treating CHF. Also, some expected therapeutic effects on different diseases were also concluded. However, ivabradine, as a typical If channel inhibitor, necessitates additional research to verify its pharmacological functions.

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Real world heart failure epidemiology and outcome: a population-based analysis of 1,990,162 heart failure patients

European Heart Journal ◽

10.1093/ehjci/ehaa946.0968 ◽

2020 ◽

Vol 41 (Supplement_2) ◽

Author(s):

P Leszek ◽

M Zaleska-Kociecka ◽

D Was ◽

K Witczak ◽

K Bartolik ◽

...

Keyword(s):

Heart Failure ◽

Real World ◽

Age Groups ◽

Developed Countries ◽

Funding Source ◽

Newly Diagnosed ◽

The European Union ◽

Ministry Of Health ◽

The Real ◽

Incidence Prevalence

Abstract Background Heart failure (HF) is the leading cause of death and hospitalization in developed countries. Most of the information about HF is based on selected cohorts, the real epidemiology of HF is scarce. Purpose To assess trends in the real world incidence, prevalence and mortality of all in-and outpatients with HF who presented in public health system in 2009–2018 in Poland. Methods It is a retrospective analysis of 1,990,162 patients who presented with HF in Poland in years 2009–2018. It is a part of nationwide Polish Ministry of Health registry that collects detailed information for the entire Polish population (38,495,659 in 2013) since 2009. Detailed data within the registry were collected since 2013. HF was recorded if HF diagnosis was coded (ICD-10). Results The incidence of HF in Poland fell down from 2013 to reach 127,036 newly diagnosed cases (330 per 100,000 population) in 2018 that equals to 43.6% drop. This decrease was mainly driven by marked reduction in females (p<0.001; Fig. 1A) and HF of ischaemic etiology (HF-IE vs HF-nonIE, Fig. 1B. p<0.001). The HF incidence per 100,000 population decreased across all age groups with the greatest drop in the youngest (Table 1). The prevalence rose by 11.6% to reach 1,242,129 (3233 per 100,000 population) in 2018 with significantly greater increase in females and HF-IE (both p<0.0001, Fig. 1C and D, respectively). The HF prevalence per 100,000 population increased across all age groups except for the 70–79 years old. (Table 1). Mortality increased by 28.5% to reach 142,379 cases (370 per 100,000 population) in 2018. The rise was more pronounced among females (p=0.015, Fig. 1E) and in HF-IE (p<0.001, Fig. 1F). The HF mortality per 100 000 population increased across all age groups, except for the 50–59 subgroup (Table 1). Conclusions Heart failure incidence plummeted in years 2013–2018 in Poland due to drop in newly diagnosed HF-IE. Despite that fact, the prevalence and mortality increased with rising trends in HF-IE. Figure 1. Incidence, prevalence, mortality trends Funding Acknowledgement Type of funding source: Public grant(s) – EU funding. Main funding source(s): The project is co-financed by the European Union from the European Social Fund under the Operational Programme Knowledge Education Development and it is being carried out by the Analyses and Strategies Department of the Polish Ministry of Health

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Levosimendan treatment of severe acute congestive heart failure refractory to dobutamine/milrinone in children

Vojnosanitetski pregled ◽

10.2298/vsp1111979p ◽

2011 ◽

Vol 68 (11) ◽

pp. 979-984

Author(s):

Sergej Prijic ◽

Sanja Rakic ◽

Ljubica Nikolic ◽

Bosiljka Jovicic ◽

Mila Stajevic ◽

...

Keyword(s):

Heart Failure ◽

Chronic Heart Failure ◽

Myocardial Contractility ◽

Severe Heart Failure ◽

Oxygen Demand ◽

Left Ventricular ◽

Myocardial Oxygen Demand ◽

Univentricular Heart ◽

Dilatative Cardiomyopathy ◽

Hemodynamic Improvement

Introduction. Levosimendan is a novel positive inotropic agent which, improves myocardial contractility through its calcium-sensitizing action, without causing an increase in myocardial oxygen demand. Also, by opening ATP-sensitive potassium channels, it causes vasodilatation with the reduction in both afterload and preload. Because of the long halflife, its effects last for up 7 to 9 days after 24-hour infusion. Case report. We presented three patients 2, 15 and 17 years old. All the patients had severe acute deterioration of the previously diagnosed chronic heart failure (dilatative cardiomyopathy; univentricular heart with bidirectional Glenn anastomosis and restrictive bulboventricular foramen; bacterial endocarditis on artificial aortic valve with severe stenosis and regurgitation). Signs and symptoms of severe heart failure, cardiomegaly (cardio-thoracic index 0.65) and left ventricular dilatation (end-diastolic diameter z-score 2.6; 4.1 and 4.0) were confirmed on admission. Also, myocardial contractility was poor with ejection fraction (EF - 27%, 25%, 35%), fractional shortening (FS - 13%, 11%, 15%) and stroke volume (SV - 40, 60, 72 mL/m2). The treatment with standard intravenous inotropic agents resulted in no improvement but in clinical deterioration. Thus, standard intravenous inotropic support was stopped and levosimendan treatment was introduced. All the patients received a continuous 24-h infusion 0.1 ?g/kg/min of levosimendan. In a single patient an initial loading dose of 11 ?g/kg over 10 min was administrated, too. Levosimendan treatment resulted in both clinical and echocardiography improvement with the improved EF (42%, 34%, 44%), FS (21%, 16%, 22%) and SV (59, 82, 93 mL/m2). Hemodynamic improvement was registered too, with the reduction in heart rate in all the treated patients from 134-138 bpm before, to less than 120 bpm after the treatment. These parameters were followed by the normalization of lactate levels. Nevertheless, left ventricular end-diastolic diameter did not change after the levosimendan treatment. Conclusion. Our initial experience demonstrates that administration of levosimendan in patients with severe chronic heart failure not responsive to standard intravenous inotropic treatment might result in a significant clinical and hemodynamic improvement and that, in selected patients, it might be life saving. According to our best knowledge patients presented are the first pediatric patients treated with levosimendan in our country.

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SUPPORTING DEVICES IN THE TREATMENT OF CHRONIC HEART FAILURE IN ELDERLY AND OLD PATIENTS

Pharmacy Formulas ◽

10.17816/phf41944 ◽

2020 ◽

Vol 2 (3) ◽

pp. 40-57

Author(s):

Gennadiy Hubulava ◽

Kirill L. Kozlov ◽

Andrey N. Bogomolov ◽

Aleksey Volkov ◽

Viktor N. Fedorets ◽

...

Keyword(s):

Quality Of Life ◽

Heart Failure ◽

Clinical Practice ◽

Chronic Heart Failure ◽

Severe Heart Failure ◽

Circulatory Support ◽

Old Patients ◽

Western Countries ◽

Surgical Methods

Chronic heart failure (CHF) is a widespread disease associated with high rates of disability and mortality, as well as a decrease in the quality of life. Moreover, the vast majority of patients are elderly and senile. Modern surgical methods of treating heart failure are able to increase the duration and quality of life of such patients, however, the need far exceeds the volume of this care, and some highly effective methods common in Western countries are still not used in Russian clinical practice. Elderly age is a risk factor for the development of senile asthenia (frailty) and concomitant pathology. Large abdominal surgery is often contraindicated for patients with signs of senile asthenia, and the method of choice in patients with severe heart failure is the implantation of devices for long-term mechanical circulatory support (LT-MCS). After implantation of LT-MCS, a regression of signs of senile asthenia may be observed. The topic of an integrated approach to non-drug treatment of heart failure in elderly and senile patients in Russia has not been studied enough. In particular, the implantation of LT-MCS is not used in Russian clinical practice, while in many Western countries for many years it has been the main and most effective treatment for severe heart failure. Systematization of the available up-to-date information on this topic could help increase the duration and quality of life of patients with severe heart failure.

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Obesity Paradox" – another look at the problem of cardiovascular disease

Obesity and metabolism ◽

10.14341/omet201343-9 ◽

2013 ◽

Vol 10 (4) ◽

pp. 3-9

Author(s):

O V Shpagina ◽

I Z Bondarenko

Keyword(s):

Heart Failure ◽

Chronic Heart Failure ◽

Obesity Paradox ◽

Developed Countries ◽

Epidemiologic Studies ◽

Normal Weight ◽

Overweight And Obesity ◽

Published Data ◽

Risk Of Death ◽

Cardiovascular Prognosis

Major epidemiologic studies over the last century demonstrated that obesity leads to several severe diseases such as diabetes mellitus, hypertension, coronary heart disease, chronic heart failure, cerebrovascular accidents. In developed countries cardiovascular diseases became the main cause of death. In the last 5–6 years some studies showed that people with overweight and obesity of the first degree have a higher life expectancy than people with normal weight. In 2009, the published data showed that the presence of obesity in patients with chronic heart failure does not impair cardiovascular prognosis. Overweight correlates with a decrease in overall mortality by 25%. And in a first degree of obesity the risk of death is reduced by 12%. This phenomenon is called "obesity paradox" and the causes of which are discussed in this review.

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Effects of the Wenyang Zhenshuai Granule on the Expression of LncRNA-MiR143HG/miR-143 Regulating ERK5 in H9C2 Cardiomyocytes

Evidence-based Complementary and Alternative Medicine ◽

10.1155/2021/6431007 ◽

2021 ◽

Vol 2021 ◽

pp. 1-8

Author(s):

Zelin Xu ◽

Xinyu Chen ◽

Qingyang Chen ◽

Huzhi Cai

Keyword(s):

Heart Failure ◽

Survival Rate ◽

Chronic Heart Failure ◽

Clinical Symptoms ◽

Malignant Tumors ◽

Clinical Syndrome ◽

Control Group ◽

Heart Insufficiency ◽

Injury Model ◽

H9c2 Cardiomyocytes

Chronic heart failure (CHF) is a complex clinical syndrome caused by a variety of heart problems, with a high incidence. The 5-year survival rate of patients with clinical symptoms is similar to that of malignant tumors. Wenyang Zhenshuai granules are a safe and effective granule of traditional Chinese medicine components, including aconite, dried ginger, licorice, and red ginseng. In contemporary clinical applications, it is widely used in acute and chronic heart insufficiency, coronary heart disease, and arrhythmia. This research cultured H9C2 cardiomyocytes and divided them into the normal control group, LncRNA-MiR143HG overexpression group, LncRNA-MiR143HG silence group, Adriamycin (ADR) group, ADR + medicated serum group, ADR + LncRNA-MiR143HG overexpression + medicated serogroup, and ADR + LncRNA-MiR143HG silence + medicated serogroup. The cells of each group were treated differently, and the survival rate of each group of cells and the expression levels of LncRNA-MiR143HG/miR-143 and ERK5 were detected at the end of the experiment, and the expression of LncRNA-MiR143HG/miR-143 in H9C2 cardiomyocytes was regulated by Wenyang Zhenshuai granules’ impact. The results of this study showed that, in the doxorubicin-induced H9C2 cardiomyocyte injury model, the expression of miR-143 was upregulated, and the expression of LncRNA-MiR143HG and ERK5 was significantly downregulated. Wenyang Zhenshuai granules can downregulate the expression of miR-143 to promote ERK5 protein expression and phosphorylation. The process is regulated by LncRNA-MiR143HG/miR-143, which may be one of its important mechanisms for the treatment of chronic heart failure.

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