Patients With Class III New York Heart Association Heart Failure May Benefit With Nasal High Flow Supportive Therapy

2012 ◽  
Author(s):  
Purificacion Perez-Teran ◽  
Oriol Roca ◽  
Lourdes Perez ◽  
Enrique Galve ◽  
Arturo Evangelista ◽  
...  
Keyword(s):  
Heart Failure ◽  
New York ◽  
Supportive Therapy ◽  
Heart Association ◽  
High Flow ◽  
Class Iii ◽  
New York Heart Association

Patients with New York Heart Association class III heart failure may benefit with high flow nasal cannula supportive therapy

2013 ◽  
Vol 28 (5) ◽  
pp. 741-746 ◽  
Author(s):  
Oriol Roca ◽  
Purificación Pérez-Terán ◽  
Joan R. Masclans ◽  
Lourdes Pérez ◽  
Enrique Galve ◽  
...  
Keyword(s):  
Heart Failure ◽  
New York ◽  
Supportive Therapy ◽  
Heart Association ◽  
High Flow ◽  
York Heart Association Class ◽  
Class Iii ◽  
High Flow Nasal Cannula ◽  
Association Class ◽  
New York Heart Association

scholarly journals Remote Hemodynamic‐Guided Therapy of Patients With Recurrent Heart Failure Following Cardiac Resynchronization Therapy

2021 ◽  
Author(s):  
Niraj Varma ◽  
Robert C. Bourge ◽  
Lynne Warner Stevenson ◽  
Maria Rosa Costanzo ◽  
David Shavelle ◽  
...  
Keyword(s):  
Heart Failure ◽  
New York ◽  
Cardiac Resynchronization Therapy ◽  
Area Under The Curve ◽  
Heart Association ◽  
Cardiac Resynchronization ◽  
Class Iii ◽  
Resynchronization Therapy ◽  
Heart Failure Questionnaire ◽  
New York Heart Association

Background Patients with recurring heart failure (HF) following cardiac resynchronization therapy fare poorly. Their management is undecided. We tested remote hemodynamic‐guided pharmacotherapy. Methods and Results We evaluated cardiac resynchronization therapy subjects included in the CHAMPION (CardioMEMS Heart Sensor Allows Monitoring of Pressure to Improve Outcomes in New York Heart Association Class III Heart Failure Patients) trial, which randomized patients with persistent New York Heart Association Class III symptoms and ≥1 HF hospitalization in the previous 12 months to remotely managed pulmonary artery (PA) pressure‐guided management (treatment) or usual HF care (control). Diuretics and/or vasodilators were adjusted conventionally in control and included remote PA pressure information in treatment. Annualized HF hospitalization rates, changes in PA pressures over time (analyzed by area under the curve), changes in medications, and quality of life (Minnesota Living with Heart Failure Questionnaire scores) were assessed. Patients who had cardiac resynchronization therapy (n=190, median implant duration 755 days) at enrollment had poor hemodynamic function (cardiac index 2.00±0.59 L/min per m 2 ), high comorbidity burden (67% had secondary pulmonary hypertension, 61% had estimated glomerular filtration rate <60 mL/min per 1.73 m 2 ), and poor Minnesota Living with Heart Failure Questionnaire scores (57±24). During 18 months randomized follow‐up, HF hospitalizations were 30% lower in treatment (n=91, 62 events, 0.46 events/patient‐year) versus control patients (n=99, 93 events, 0.68 events/patient‐year) (hazard ratio, 0.70; 95% CI, 0.51–0.96; P =0.028). Treatment patients had more medication up‐/down‐titrations (847 versus 346 in control, P <0.001), mean PA pressure reduction (area under the curve −413.2±123.5 versus 60.1±88.0 in control, P =0.002), and quality of life improvement (Minnesota Living with Heart Failure Questionnaire decreased −13.5±23 versus −4.9±24.8 in control, P =0.006). Conclusions Remote hemodynamic‐guided adjustment of medical therapies decreased PA pressures and the burden of HF symptoms and hospitalizations in patients with recurring Class III HF and hospitalizations, beyond the effect of cardiac resynchronization therapy. Registration URL: https://www.clinicaltrials.gov ; Unique identifier: NCT00531661.

scholarly journals CardioMEMS Implantation Using Gadolinium-based Contrast Agent: A Case Report

2021 ◽  
Vol 7 ◽  
Author(s):  
Aniket S Rali ◽  
Lynne W Stevenson ◽  
Sandip K Zalawadiya
Keyword(s):  
Heart Failure ◽  
New York ◽  
Contrast Agent ◽  
Heart Association ◽  
York Heart Association Class ◽  
Class Iii ◽  
Device Implantation ◽  
Association Class ◽  
New York Heart Association ◽  
History Of

A 57-year-old woman with New York Heart Association Class III heart failure requiring multiple hospitalisations over the previous year presented for CardioMEMS implantation. Because of the patient’s allergy history of anaphylaxis to iodine-based contrast agent she underwent the device implantation with gadolinium-based contrast agent (Magnevist), which was successful.

scholarly journals Lower Rates of Heart Failure and All-Cause Hospitalizations During Pulmonary Artery Pressure-Guided Therapy for Ambulatory Heart Failure

2020 ◽  
Vol 13 (8) ◽  
Author(s):  
David M. Shavelle ◽  
Akshay S. Desai ◽  
William T. Abraham ◽  
Robert C. Bourge ◽  
Nirav Raval ◽  
...  
Keyword(s):  
Heart Failure ◽  
New York ◽  
Ejection Fraction ◽  
Pressure Sensor ◽  
Heart Association ◽  
Sensor Failure ◽  
Class Iii ◽  
Association Class ◽  
New York Heart Association ◽  
Guided Therapy

Background: Ambulatory hemodynamic monitoring with an implantable pulmonary artery (PA) sensor is approved for patients with New York Heart Association Class III heart failure (HF) and a prior HF hospitalization (HFH) within 12 months. The objective of this study was to assess the efficacy and safety of PA pressure-guided therapy in routine clinical practice with special focus on subgroups defined by sex, race, and ejection fraction. Methods: This multi-center, prospective, open-label, observational, single-arm trial of 1200 patients across 104 centers within the United States with New York Heart Association class III HF and a prior HFH within 12 months evaluated patients undergoing PA pressure sensor implantation between September 1, 2014, and October 11, 2017. The primary efficacy outcome was the difference between rates of adjudicated HFH 1 year after compared with the 1 year before sensor implantation. Safety end points were freedom from device- or system-related complications at 2 years and freedom from pressure sensor failure at 2 years. Results: Mean age for the population was 69 years, 37.7% were women, 17.2% were non-White, and 46.8% had preserved ejection fraction. During the year after sensor implantation, the mean rate of daily pressure transmission was 76±24% and PA pressures declined significantly. The rate of HFH was significantly lower at 1 year compared with the year before implantation (0.54 versus 1.25 events/patient-years, hazard ratio 0.43 [95% CI, 0.39–0.47], P <0.0001). The rate of all-cause hospitalization was also lower following sensor implantation (1.67 versus 2.28 events/patient-years, hazard ratio 0.73 [95% CI, 0.68–0.78], P <0.0001). Results were consistent across subgroups defined by ejection fraction, sex, race, cause of cardiomyopathy, presence/absence of implantable cardiac defibrillator or cardiac resynchronization therapy and ejection fraction. Freedom from device- or system-related complications was 99.6%, and freedom from pressure sensor failure was 99.9% at 1 year. Conclusions: In routine clinical practice as in clinical trials, PA pressure-guided therapy for HF was associated with lower PA pressures, lower rates of HFH and all-cause hospitalization, and low rates of adverse events across a broad range of patients with symptomatic HF and prior HFH. Registration: URL: https://www.clinicaltrials.gov . Unique identifier: NCT02279888.

scholarly journals The effect of foot massage on dyspnea ın heart faılure: Case report

2021 ◽  
Vol 2 (4) ◽  
pp. 01-03
Author(s):  
Arslan Gürcan
Keyword(s):  
Heart Failure ◽  
New York ◽  
Case Report ◽  
Nyha Class ◽  
Personal Data ◽  
Heart Association ◽  
Progressive Increase ◽  
Class Iii ◽  
Heart Failure Patients ◽  
New York Heart Association

Dyspnea is one of the reasons why many heart failure patients present to the emergency department. A 75 year-old female presented to a cardiologist with prominent dyspnea and orthopnea. Her heart failure was diagnosed by doctors as New York Heart Association (NYHA) Class III. Progressive increase in episodic shortness of breath forthe past 3 weeks. The patient had been in her normal state of health until 3 weeks ago that she had difficulty catching her breath while walking.The patient got 7 points from the first Borg Dyspnea Scale. The study is a case-report study. Personal Data Form (PDF), Borg Clinical Rating for Dyspnea (Borg CR-10) was evaluated by researcher. Classic foot massage was applied to each foot for a total of 30 minutes, up to 15 minutes, once a day for seven days. Dyspnea was measured after the massage following 10 min of resting. Foot massage was applied by the researcher. Distribution of dyspnea level first and seventh is given in Table 1. Dyspnea level of the patient intervention foot massage decreased to 5.00 from 7.00 at the end of seventh session. Foot massage which is an easy and safe method may be preferably used as a supportive treatment for elevated dyspnea. However, more studies are needed to examine the effect of foot massage on dyspnea level in heart failure patients.

scholarly journals Impact of Cardiorenal Anemia Syndrome on Short- and Long-Term Clinical Outcomes in Patients Hospitalized with Heart Failure

2016 ◽  
Vol 6 (4) ◽  
pp. 269-278
Author(s):  
Chan Joon Kim ◽  
Ik-Jun Choi ◽  
Hun-Jun Park ◽  
Tae Hoon Kim ◽  
Pum-Joon Kim ◽  
...  
Keyword(s):  
Heart Failure ◽  
New York ◽  
Primary Outcome ◽  
Heart Association ◽  
Class Iii ◽  
Increased Risk ◽  
New York Heart Association ◽  
Short And Long Term ◽  
The Impact

Background: Dysfunctional interplay between the heart and kidneys may lead to the development of anemia. The aim of this study was to evaluate the impact of cardiorenal anemia syndrome (CRAS) on short- and long-term outcomes among patients hospitalized with heart failure (HF). Methods: We enrolled 303 patients hospitalized with HF. We divided the patients into two groups: a CRAS group (n = 64) and a non-CRAS group (n = 239). We defined CRAS as HF accompanied by (1) an estimated glomerular filtration rate <60 ml/min/1.73 m2 calculated by the Modification of Diet in Renal Disease at admission and (2) a hemoglobin level <12 g/dl for females and <13 g/dl for males at admission. The primary outcome was a composite of cardiac death, non-fatal myocardial infarction and rehospitalization for HF. Results: During a median follow-up period of 25.6 months (range 0.1-35.3 months), the patients with CRAS had a significantly increased risk for the primary outcome (27.5 vs. 10.7%, p < 0.001) compared with the patients in the non-CRAS group. Using Cox proportional hazard analyses, the hazard ratio (HR) for the presence of CRAS was found to be 1.874 (95% confidence interval [CI] 1.011-3.475, p = 0.046); HRs were also computed for the presence of diabetes mellitus (HR = 2.241, 95% CI 1.221-4.112, p = 0.009), New York Heart Association class III or IV HF (HR = 2.948, 95% CI 1.206-7.205, p = 0.018) and the use of intravenous loop diuretics (HR = 2.286, 95% CI 0.926-5.641, p = 0.073). Conclusions: Renal dysfunction and anemia are a fatal combination and are associated with poor prognosis in patients with HF.

Sign in / Sign up

Export Citation Format

Share Document