Heart failure with reduced ejection fraction due topolycythemia vera

ABSTRACT Polycythemia vera is a rare hematological disorder that can cause heart failure with reduced ejection fraction from chronic micro-vascular ischemia. Appropriately recognizing the underlying cause of cardiomyopathy is essential to decrease morbidity and mortality. Patients can present with elevated troponin level and have patent epicardial coronary arteries on coronary angiogram, hence presenting a diagnostic challenge for health care professionals. Furthermore, the presentation can mimic myocarditis. Herein, we report a case of a 61-year-old female who presented with heart failure due to microvascular thrombotic complication associated with polycythemia vera. Laboratory investigation and coronary angiogram were inconclusive. A high degree of clinical suspicion and utilizing non-invasive techniques, such as cardiac imaging, can describe myocardial pathology and aid with the diagnosis.

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POLYCYTHEMIA VERA A RARE CAUSE OF HEART FAILURE WITH REDUCED EJECTION FRACTION

Journal of the American College of Cardiology ◽

10.1016/s0735-1097(21)03535-x ◽

2021 ◽

Vol 77 (18) ◽

pp. 2180

Author(s):

Muhammad Omer Zaman ◽

Narmadan A. Kumarasamy ◽

David Silber ◽

Robert Berkowitz ◽

Bernard Kim

Keyword(s):

Heart Failure ◽

Ejection Fraction ◽

Polycythemia Vera ◽

Reduced Ejection Fraction

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Economic burden of chronic heart failure with preserved vs. reduced ejection fraction - an analysis from the German Competence Network Heart Failure

Das Gesundheitswesen ◽

10.1055/s-0033-1354196 ◽

2013 ◽

Vol 75 (08/09) ◽

Cited By ~ 1

Author(s):

J Biermann ◽

T Neumann ◽

S Störk ◽

S Stauffenberg ◽

CE Angermann ◽

...

Keyword(s):

Heart Failure ◽

Chronic Heart Failure ◽

Ejection Fraction ◽

Economic Burden ◽

Competence Network ◽

Reduced Ejection Fraction

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Heart Failure with Preserved Ejection Fraction – A Review

US Cardiology Review ◽

10.15420/usc.2012.9.2.90 ◽

2012 ◽

Vol 9 (1) ◽

pp. 90-95 ◽

Cited By ~ 1

Author(s):

Otto A Smiseth ◽

Anders Opdahl ◽

Espen Boe ◽

Helge Skulstad

Keyword(s):

Heart Failure ◽

Ejection Fraction ◽

Diastolic Heart Failure ◽

The Elderly ◽

Left Ventricular ◽

Filling Pressure ◽

Left Ventricular Ejection ◽

Ventricular Ejection Fraction ◽

Reduced Ejection Fraction ◽

Objective Evidence

Heart failure with preserved left ventricular ejection fraction (HF-PEF), sometimes named diastolic heart failure, is a common condition most frequently seen in the elderly and is associated with arterial hypertension and left ventricular (LV) hypertrophy. Symptoms are attributed to a stiff left ventricle with compensatory elevation of filling pressure and reduced ability to increase stroke volume by the Frank-Starling mechanism. LV interaction with stiff arteries aggravates these problems. Prognosis is almost as severe as for heart failure with reduced ejection fraction (HF-REF), in part reflecting co-morbidities. Before the diagnosis of HF-PEF is made, non-cardiac etiologies must be excluded. Due to the non-specific nature of heart failure symptoms, it is essential to search for objective evidence of diastolic dysfunction which, in the absence of invasive data, is done by echocardiography and demonstration of signs of elevated LV filling pressure, impaired LV relaxation, or increased LV diastolic stiffness. Antihypertensive treatment can effectively prevent HF-PEF. Treatment of HF-PEF is symptomatic, with similar drugs as in HF-REF.

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Evaluation of the Efficacy of ST2 and NT-proBNP in the Diagnosis and Prediction of Short- Term Prognosis in Heart Failure with Reduced Ejection Fraction

International Journal of Pharmaceutical and Clinical Research ◽

10.25258/ijpcr.v9i04.8539 ◽

2017 ◽

Vol 9 (04) ◽

Author(s):

Shivananda B Nayak ◽

Dharindra Sawh ◽

Brandon Scott ◽

Vestra Sears ◽

Kareshma Seebalack ◽

...

Keyword(s):

Heart Failure ◽

Ejection Fraction ◽

Cardiac Biomarkers ◽

Double Blind Study ◽

Short Term ◽

Double Blind ◽

Reduced Ejection Fraction ◽

The Mean ◽

Design And Methods ◽

The Relationship

Purpose: i) To determine the relationship between the cardiac biomarkers ST2 and NT-proBNP with ejection fraction (EF) in heart failure (HF) patients. ii) Assess whether a superiority existed between the aforementioned cardiac markers in diagnosing the HF with reduced EF. iii) Determine the efficacy of both biomarkers in predicting a 30-day cardiovascular event and rehospitalization in patients with HF with reduced EF iv) To assess the influence of age, gender, BMI, anaemia and renal failure on the ST2 and NT-proBNP levels. Design and Methods: A prospective double-blind study was conducted to obtain data from a sample of 64 cardiology patients. A blood sample was collected to test for ST2 and NT-proBNP. An echocardiogram (to obtain EF value), electrocardiogram and questionnaire were also obtained. Results: Of the 64 patients enrolled, 59.4% of the population had an EF less than 40%. At the end of the 30- day period, 7 patients were warded, 37 were not warded, one died and 17 were non respondent. Both biomarkers were efficacious at diagnosing HF with a reduced EF. However, neither of them were efficacious in predicting 30-day rehospitalization. The mean NT-proBNP values being: not rehospitalized (2114.7486) and 30 day rehospitalization (1008.42860) and the mean ST2 values being: not rehospitalized (336.1975), and 30-day rehospitalization. (281.9657). Conclusion: Neither ST2 or NT-proBNP was efficacious in predicting the short- term prognosis in HF with reduced EF. Both however were successful at confirming the diagnosis of HF in HF patients with reduced EF.

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