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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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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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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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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Clinical Characteristics of De Novo Heart Failure and Acute Decompensated Chronic Heart Failure: Are They Distinctive Phenotypes That Contribute to Different Outcomes?

Cardiac Failure Review ◽

10.15420/cfr.2020.20 ◽

2021 ◽

Vol 7 ◽

Author(s):

Wilson Matthew Raffaello ◽

Joshua Henrina ◽

Ian Huang ◽

Michael Anthonius Lim ◽

Leonardo Paskah Suciadi ◽

...

Keyword(s):

Heart Failure ◽

Clinical Trials ◽

Chronic Heart Failure ◽

Poor Prognosis ◽

Clinical Characteristics ◽

De Novo ◽

Heart Failure Patients ◽

Treat Heart Failure ◽

Patients With Heart Failure ◽

New Strategies

Heart failure is currently one of the leading causes of morbidity and mortality. Patients with heart failure often present with acute symptoms and may have a poor prognosis. Recent evidence shows differences in clinical characteristics and outcomes between de novo heart failure (DNHF) and acute decompensated chronic heart failure (ADCHF). Based on a better understanding of the distinct pathophysiology of these two conditions, new strategies may be considered to treat heart failure patients and improve outcomes. In this review, the authors elaborate distinctions regarding the clinical characteristics and outcomes of DNHF and ADCHF and their respective pathophysiology. Future clinical trials of therapies should address the potentially different phenotypes between DNHF and ADCHF if meaningful discoveries are to be made.

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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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Transcheter aortic valve implantation as a method of treatment of chronic heart failure in elderly and old patients: Literature review (part 1)

Успехи геронтологии ◽

10.34922/ae.2021.34.6.012 ◽

2022 ◽

pp. 901-909

Author(s):

К. Л. Козлов ◽

А.Н. Богомолов ◽

Е.И. Сенькина ◽

Н.Г. Лукьянов ◽

Л.В. Башкатова ◽

...

Keyword(s):

Heart Failure ◽

Chronic Heart Failure ◽

Aortic Valve ◽

Transcatheter Aortic Valve Implantation ◽

Age Groups ◽

Interventional Cardiology ◽

Old Patients ◽

Transcatheter Aortic Valve ◽

Aortic Valve Implantation ◽

Valve Implantation

Стеноз аортального клапана (АК) - самое частое приобретенное клапанное заболевание с растущей распространенностью из-за старения населения, требующее хирургического или эндоваскулярного вмешательства. Транскатетерная имплантация АК (Transcatheter Aortic Valve Implantation, TAVI) представляет собой настоящую революцию в области интервенционной кардиологии для лечения пациентов старческого возраста или из группы высокого риска с тяжелым симптомным стенозом АК. TAVI позволяет выполнять коррекцию аортального порока наиболее тяжелой группе больных ХСН с выраженной коморбидностью, которым противопоказано выполнение открытой операции по замене АК, для прерывания порочного круга в прогрессировании ХСН, стимуляции обратного ремоделирования миокарда, облегчения симптомов, улучшения качества жизни и прогноза больных, а также в качестве «моста» к трансплантации сердца. Благодаря разработке устройств нового поколения, TAVI превратилась из сложной и опасной процедуры в эффективную и безопасную методику. Наибольший научный интерес в настоящее время представляет изучение долговечности клапана и возможности расширения показаний к выполнению TAVI у категорий пациентов с низким хирургическим риском, а также более молодого возраста. Aortic valve (AV) stenosis is the most common acquired valvular disease with an increasing prevalence due to an aging population, requiring surgical or endovascular intervention. Transcatheter Aortic Valve Implantation (TAVI) represents a real revolution in the field of interventional cardiology for the treatment of elderly or high-risk patients with severe symptomatic AV stenosis. TAVI allows for the correction of aortic defect in the most severe group of patients with chronic heart failure (CHF) with severe comorbidity, who are contraindicated for open surgery to replace AV, in order to interrupt the vicious circle in the progression of CHF, stimulate reverse myocardial remodeling, alleviate symptoms, improve the quality of life, and prognosis of patients, and also as a «bridge» to heart transplantation. With the development of next-generation devices, TAVI has evolved from a complex and dangerous procedure to an effective and safe technique. Currently, the greatest scientific interest is the study of valve durability and the possibility of expanding the indications for performing TAVI in categories of patients with low surgical risk, as well as in younger age groups.

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COVID-19 in patients with heart failure: the new and the old epidemic

Postgraduate Medical Journal ◽

10.1136/postgradmedj-2020-138080 ◽

2020 ◽

Vol 97 (1145) ◽

pp. 175-179

Author(s):

Nicolò Sisti ◽

Serafina Valente ◽

Giulia Elena Mandoli ◽

Ciro Santoro ◽

Carlotta Sciaccaluga ◽

...

Keyword(s):

Heart Failure ◽

Intensive Care ◽

Cardiovascular Diseases ◽

Chronic Heart Failure ◽

Poor Prognosis ◽

Myocardial Injury ◽

Careful Monitoring ◽

Clinical Challenge ◽

Patients With Heart Failure ◽

Acute Decompensation

Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has spread in nearly 200 countries in less than 4 months since its first identification; accordingly, the coronavirus disease 2019 (COVID 2019) has affirmed itself as a clinical challenge. The prevalence of pre-existing cardiovascular diseases in patients with COVID19 is high and this dreadful combination dictates poor prognosis along with the higher risk of intensive care mortality. In the setting of chronic heart failure, SARS-CoV-2 can be responsible for myocardial injury and acute decompensation through various mechanisms. Given the clinical and epidemiological complexity of COVID-19, patiens with heart failure may require particular care since the viral infection has been identified, considering an adequate re-evaluation of medical therapy and a careful monitoring during ventilation.

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