P0200KEEP ON (KEEPING RAAS INHIBITION TREATMENT WITH OPTIMAL POTASSIUM CONTROL). DESIGN OF A CLINICAL TRIAL OF USING SODIUM ZIRCONIUM CYCLOSILICATE FOR KEEPING RAAS INHIBITION AND/OR MRAS IN PATIENTS WITH CKD AND CONGESTIVE HEART FAILURE HISTORY

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Maria Jesãºs Puchades Montesa ◽  
Nayara Panizo Gonzalez ◽  
Luis D'Marco ◽  
Miguel Gonzalez-Rico ◽  
Patricia Tomas ◽  
...  
Keyword(s):  
Heart Failure ◽  
Congestive Heart Failure ◽  
Cardiorenal Syndrome ◽  
Serum Electrolytes ◽  
Sodium Zirconium ◽  
Multifrequency Bioimpedance ◽  
Threatening Condition ◽  
Life Threatening ◽  
Sodium Zirconium Cyclosilicate ◽  
Nephroprotective Effect

Abstract Background and Aims Hyperkalemia (HK) is a potentially life-threatening condition, in patients with chronic kidney disease (CKD) and congestive heart failure (CHF). The majority of patients affected with CKD or CHF, must be treated with inhibitors of renin angiotensin aldosterone system (RAASi) and mineralocorticoid receptor antagonists (MRAs). However, the treatments previously mentioned, increase the risk of HK episodes, which is the main cause of RAASi and MRAs downtitration or discontinuation, representing an undesirable clinical scenario, given that the patients are at high risk of be deprived of their nephroprotective effect and cardio-renal benefits The aim of the study is: to analyze if, in patients with HK, CKD and CHF treated with RAASi and/or MRA, serum potassium (sK) reduction by Sodium zirconium cyclosilicate (SZC) treatment is non-inferior to RAASi and/or MRAs discontinuation or downtitration. Method Results The study will demonstrate results on serum electrolytes, renal function, albuminuria, KDQoL questionnaire and changes in relative overhydration (multifrequency bioimpedance -BCM Fresenius-) Conclusion The KEEP ON study will define the ability of SZC to facilitate the use of RAAS-I and / or MRA in patients with HK and cardiorenal syndrome allowing the maintenance of the medications recommended by international guidelines for the treatment of CHF at different degrees of CKD while maintaining the potential cardio-renal and nephroprotective benefit.

scholarly journals Necrotizing myopathy presenting as congestive heart failure and life-threatening ventricular arrhythmias: a case report

2021 ◽  
Vol 5 (6) ◽  
Author(s):  
Kyunghee Lim ◽  
Jong Sung Park ◽  
Byeol-A Yoon ◽  
Song-Hee Han
Keyword(s):  
Heart Failure ◽  
Congestive Heart Failure ◽  
Ventricular Arrhythmias ◽  
High Dose ◽  
Respiratory Impairment ◽  
Motor Weakness ◽  
High Dose Steroid ◽  
Necrotizing Autoimmune Myopathy ◽  
Life Threatening ◽  
Autoimmune Myopathy

Abstract Background Necrotizing autoimmune myopathy is a rare subtype of idiopathic inflammatory myopathy; however, it can be associated with fatal cardiac manifestations. Case summary A 58-year-old female patient was referred for congestive heart failure with dysrhythmia. Electrocardiograms showed ventricular arrhythmias of various QRS complex morphologies and coupling intervals with beat-to-beat differences. Despite optimal medical therapy for heart failure, the patient was admitted for the progression of dyspnoea and generalized motor weakness. The burden of non-sustained ventricular tachycardia gradually increased, and ventricular fibrillation eventually occurred. In view of a differential diagnosis of an inflammatory myocardial diseases such as sarcoidosis, a cardiac biopsy was performed. However, pathologic examinations revealed only necrotic muscle fibres without granuloma. Further examinations revealed proximal dominant motor weakness, an elevated serum creatinine-phosphokinase level, myogenic potentials on needle electromyography, and biceps muscle biopsy findings that were compatible with necrotizing autoimmune myopathy. High-dose steroid therapy improved the patient’s motor weakness, including her respiratory impairment, and successfully suppressed ventricular arrhythmias. Discussion This case suggests that intensive immunosuppressive therapy with high-dose steroid could be useful in the necrotizing autoimmune myopathy manifested as congestive heart failure and life-threatening ventricular arrhythmias.

scholarly journals Anterior mitral valve aneurysm perforation in a patient with preexisting aortic regurgitation

2015 ◽  
Vol 78 (4) ◽  
Author(s):  
Rodolfo Citro ◽  
Angelo Silverio ◽  
Roberto Ascoli ◽  
Antonio Longobardi ◽  
Eduardo Bossone ◽  
...  
Keyword(s):  
Heart Failure ◽  
Mitral Valve ◽  
Connective Tissue ◽  
Mitral Regurgitation ◽  
Transesophageal Echocardiography ◽  
Aortic Regurgitation ◽  
Severe Mitral Regurgitation ◽  
Connective Tissue Disorders ◽  
Threatening Condition ◽  
Life Threatening

We report the case of a 71-year-old man hospitalized for acute heart failure. Transthoracic and transesophageal echocardiography showed mitral valve aneurysm (MVA) rupture and severe mitral regurgitation. No vegetations but significant aortic regurgitation were also observed. MVA perforation is a rare life-threatening condition that typically occurs as a complication of endocarditis but may also be associated with other diseases, in particular connective tissue disorders. In the present case, the absence of such etiology suggests a possible role for of aortic regurgitation in MVA rupture secondary to a “jet lesion” mechanism.

scholarly journals Effectiveness and Safety of Peritoneal Dialysis Treatment in Patients with Refractory Congestive Heart Failure due to Chronic Cardiorenal Syndrome

2018 ◽  
Vol 2018 ◽  
pp. 1-9 ◽  
Author(s):  
Qiuyuan Shao ◽  
Yangyang Xia ◽  
Min Zhao ◽  
Jing Liu ◽  
Qingyan Zhang ◽  
...  
Keyword(s):  
Heart Failure ◽  
Congestive Heart Failure ◽  
Peritoneal Dialysis ◽  
Survival Time ◽  
Heart Function ◽  
Cardiorenal Syndrome ◽  
Term Survival ◽  
Group A ◽  
Group B

Aims. To evaluate the effectiveness and safety of peritoneal dialysis (PD) in treating refractory congestive heart failure (RCHF) with cardiorenal syndrome (CRS).Methods. A total of 36 patients with RCHF were divided into type 2 CRS group (group A) and non-type 2 CRS group (group B) according to the patients’ clinical presentations and the ratio of serum urea to creatinine and urinary analyses in this prospective study. All patients were followed up till death or discontinuation of PD. Data were collected for analysis, including patient survival time on PD, technique failure, changes of heart function, and complications associated with PD treatment and hospitalization.Results. There were 27 deaths and 9 patients quitting PD program after a follow-up for 73 months with an average PD time of22.8±18.2months. A significant longer PD time was found in group B as compared with that in group A (29.0±19.4versus13.1±10.6months,p=0.003). Kaplan–Meier curves showed a higher survival probability in group B than that in group A (p<0.001). Multivariate regression demonstrated that type 2 CRS was an independent risk factor for short survival time on PD. The benefit of PD on the improvement of survival and LVEF was limited to group B patients, but absent from group A patients. The impairment of exercise tolerance indicated by NYHA classification was markedly improved by PD for both groups. The technique survival was high, and the hospital readmission was evidently decreased for both group A and group B patients.Conclusions. Our data suggest that PD is a safe and feasible palliative treatment for RCHF with type 2 CRS, though the long-term survival could not be expected for patients with the type 2 CRS. Registration ID Number isChiCTR1800015910.

The Association between T-Wave Morphology and Life-Threatening Ventricular Tachyarrhythmias in Patients with Congestive Heart Failure

2009 ◽  
Vol 32 (9) ◽  
pp. 1173-1177 ◽  
Author(s):  
YEN-HUNG LIN ◽  
LIAN-YU LIN ◽  
YING-SHREN CHEN ◽  
HUI-CHUN HUANG ◽  
JEN-KUANG LEE ◽  
...  
Keyword(s):  
Heart Failure ◽  
Congestive Heart Failure ◽  
Ventricular Tachyarrhythmias ◽  
T Wave ◽  
Wave Morphology ◽  
Life Threatening

scholarly journals Could it have been better? A patient with peripartum cardiomyopathy treated with conventional therapy

2012 ◽  
Vol 69 (6) ◽  
pp. 526-530
Author(s):  
Branislava Ivanovic ◽  
Marijana Tadic ◽  
Ruzica Maksimovic ◽  
Bojana Orbovic
Keyword(s):  
Heart Failure ◽  
Conventional Treatment ◽  
Ace Inhibitor ◽  
Ventricular Dysfunction ◽  
Complete Recovery ◽  
Left Ventricular ◽  
Peripartum Cardiomyopathy ◽  
Partial Recovery ◽  
Threatening Condition ◽  
Life Threatening

Introduction. Peripartum cardiomyopathy is a life threatening condition of unknown cause that occurs in previously healthy women. It is characterized by symptoms of heart failure due to left ventricular dysfunction that occurs in the last month of pregnancy or the first five months after delivery. Case report. We presented woman who underwent caesarean section due to preeclampsia. Two weeks after delivery first signs of heart failure appeared and only after six weeks following the onset of symptoms peripartal cardiomyopathy was recognized. A conventional treatment with diuretics, ACE inhibitor and beta blocker along with anticoagulant therapy was applied, which resulted in a complete recovery of the left ventricular function four months after. Conclusion. Timely detection and initiation of treatment are an important precondition for the complete or partial recovery.

Spironolactone to increase natriuresis in congestive heart failure with cardiorenal syndrome

2018 ◽  
Vol 74 (2) ◽  
pp. 100-107 ◽  
Author(s):  
Frederik H. Verbrugge ◽  
Pieter Martens ◽  
Koen Ameloot ◽  
Veerle Haemels ◽  
Joris Penders ◽  
...  
Keyword(s):  
Heart Failure ◽  
Congestive Heart Failure ◽  
Cardiorenal Syndrome

scholarly journals A Case Report of Acute Heart Failure Due to Infective Aortic Endocarditis Diagnosed by Point-of-care Ultrasound

2020 ◽  
Vol 4 (2) ◽  
pp. 193-196
Author(s):  
Ryan Gallagher ◽  
Michelle Wilson ◽  
Pamela Hite ◽  
Bradley Jackson
Keyword(s):  
Heart Failure ◽  
Case Report ◽  
Aortic Valve ◽  
Acute Heart Failure ◽  
Point Of Care ◽  
Point Of Care Ultrasound ◽  
Complication Rates ◽  
Threatening Condition ◽  
Valve Insufficiency ◽  
Life Threatening

Introduction: Infective endocarditis (IE) is a life-threatening condition with significant morbidity and mortality, and can require surgical repair. Case Report: A 36-year-old man presented to the emergency department for worsening dyspnea and chest pain. Point-of-care echocardiography demonstrated a mobile oscillating mass on the aortic valve with poor approximation of the valve leaflets, suggesting aortic valve insufficiency secondary to IE as the cause of acute heart failure. The patient underwent emergent aortic valve replacement within 24 hours. Discussion: While point-of-care echocardiography has been well documented in identifying tricuspid vegetations, aortic valve involvement and subsequent heart failure is less well described. Earlier recognition of aortic valve vegetations and insufficiency can expedite surgical intervention, with decreased complication rates linked to earlier antimicrobial therapy. Conclusion: This case report highlights the ability of point-of-care ultrasound to identify aortic vegetations, allowing for the earlier diagnosis and therapy.

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