Short-Term Change in Gait Speed and Clinical Outcomes in Older Patients With Acute Heart Failure

Background. Thyroid hormones (TH) are crucial for cardiovascular homeostasis. Recent evidence suggests that acute cardiovascular conditions, particularly acute heart failure (AHF), significantly impair the thyroid axis. Our aim was to evaluate the association of thyroid function with cardiovascular parameters and short- and long-term clinical outcomes in AHF patients. Methods. We performed a single-centre retrospective cohort study including patients hospitalized for AHF between January 2012 and December 2017. We used linear, logistic, and Cox proportional hazard regression models to analyse the association of thyroid-stimulating hormone (TSH) and free thyroxine (FT4) with inpatient cardiovascular parameters, in-hospital mortality, short-term adverse clinical outcomes, and long-term mortality. Two models were used: (1) unadjusted, and (2) adjusted for age and sex. Results. Of the 235 patients included, 59% were female, and the mean age was 77.5 (SD 10.4) years. In the adjusted model, diastolic blood pressure was positively associated with TSH [β = 2.68 (0.27 to 5.09); p = 0.030 ]; left ventricle ejection fraction (LVEF) was negatively associated with FT4 [β = -24.85 (-47.87 to -1.82); p = 0.035 ]; and a nonsignificant trend for a positive association was found between 30-day all-cause mortality and FT4 [OR = 3.40 (0.90 to 12.83); p = 0.071 ]. Among euthyroid participants, higher FT4 levels were significantly associated with a higher odds of 30-day all-cause death [OR = 4.40 (1.06 to 18.16); p = 0.041 ]. Neither TSH nor FT4 levels were relevant predictors of long-term mortality in the adjusted model. Conclusions. Thyroid function in AHF patients is associated with blood pressure and LVEF during hospitalization. FT4 might be useful as a biomarker of short-term adverse outcomes in these patients.

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Combination of Uric Acid and NT-ProBNP: A More Useful Prognostic Marker for Short-Term Clinical Outcomes in Patients with Acute Heart Failure

The Korean Journal of Internal Medicine ◽

10.3904/kjim.2010.25.3.253 ◽

2010 ◽

Vol 25 (3) ◽

pp. 253 ◽

Cited By ~ 15

Author(s):

Hyoung-Seob Park ◽

Hyungseop Kim ◽

Ji-Hyun Sohn ◽

Hong-Won Shin ◽

Yun-Kyeong Cho ◽

...

Keyword(s):

Heart Failure ◽

Uric Acid ◽

Clinical Outcomes ◽

Acute Heart Failure ◽

Prognostic Marker ◽

Short Term

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Hemodynamic Congestion at Hospital Discharge Predicts Rehospitalization during Short Term Follow Up in Acute Heart Failure Patients

Indonesian Journal of Cardiology ◽

10.30701/ijc.v40i3.805 ◽

2019 ◽

Vol 40 (3) ◽

Author(s):

Yoga Waranugraha ◽

Mohammad Saifur Rohman ◽

Setyasih Anjarwani

Keyword(s):

Heart Failure ◽

Clinical Outcomes ◽

Hospital Discharge ◽

Acute Heart Failure ◽

Optimal Dose ◽

Left Ventricular ◽

Short Term ◽

Significant Difference ◽

Β Blockers ◽

Symptoms And Signs

Background: Hemodynamic congestion is an increase in left ventricular diastolic pressure (LVEDP) without clinical symptoms and signs of congestion. Current acute heart failure (AHF) treatment goals only focused on improving clinical congestion. The purpose of this study was to investigate whether hemodynamic congestion measured by NT-proBNP level and ePCWP at hospital discharge could predict short term clinical outcomes in AHF patients. Method: This prospective cohort study was conducted at dr. Saiful Anwar General Hospital Malang from January to July 2018. All patients got AHF treatment according to the 2016 ESC guidelines for heart failure. All patients were discharged without symptoms and signs of clinical congestion. Hemodynamic congestion at hospital discharge was defined as failure of treatment during hospitalization to achieve a reduction in NT-proBNP level >30% and/or ePCWP at hospital discharge >16 mmHg. NT-proBNP level and ePCWP were measured at 0-12 hours after hospital admisssion and at hospital discharge. ePCWP was measured using echocardiography. The clinical outcomes assessed were AHF rehospitalization and cardiovascular mortality within 30 days after hospitral discharge. Subgroup analysis was performed to determine therapeutic regimens that are effective in improving hemodynamic congestion. Result: A total of 33 AHF patients were included in this study. 48% patients were discharged with hemodynamic congestion and 52% patients discharged without hemodynamic congestion. Patients with hemodynamic congestion at hospital discharge showed a higher rehospitalization within 30 days (8 [50%] vs 1 [5.9%]; P = 0.007). Mortality within 30 days in both groups did not show a significant difference (2 [12.5%] vs 0 [0%]; P = 0.277). Treatment regiment of optimal dose of ACEi/ARB, β-blockers, and diuretics was associated with improvement of hemodynamic congestion (P = 0.026; r = 0.454), a decrease in NT-proBNP> 66% (P = 0.02; r = 0,574), and achievement of ePCWP <16 (P = 0,013; r = 0,493) at hospital discharge in HFrEF patients. Conclusion: This study showed that hemodynamic congestion assessed with NT-proBNP level and ePCWP at hospital discharge increased 30 day rehospitalization in AHF patients. In HFrEF, improvements in hemodynamic congestion can be achieved by giving the treatment regiment of optimal dose of ACEi/ARB, β-blockers, and diuretics. Keyword: Acute heart failure, hemodynamic congestion, NT-proBNP, ePCWP

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Comparison of Prognostic Value of Red Cell Distribution Width and NT-proBNP for Short-Term Clinical Outcomes in Acute Heart Failure Patients

International Heart Journal ◽

10.1536/ihj.13-172 ◽

2014 ◽

Vol 55 (1) ◽

pp. 58-64 ◽

Cited By ~ 12

Author(s):

Wenyan He ◽

Jun Jia ◽

Jia Chen ◽

Shu Qin ◽

Hongmei Tao ◽

...

Keyword(s):

Heart Failure ◽

Clinical Outcomes ◽

Acute Heart Failure ◽

Prognostic Value ◽

Red Cell Distribution Width ◽

Red Cell ◽

Cell Distribution ◽

Short Term ◽

Distribution Width ◽

Heart Failure Patients

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Short-term Change on Pressure Pain Threshold and Vertical Jump when Foam Roll Exercises and Vibration Foam Roll Exercises

Archives of Orthopedic and Sports Physical Therapy ◽

10.24332/aospt.2017.14.1.16 ◽

2018 ◽

Vol 14 (1) ◽

pp. 137-145

Author(s):

Sangwan Han

Keyword(s):

Pain Threshold ◽

Vertical Jump ◽

Pressure Pain Threshold ◽

Short Term ◽

Pressure Pain ◽

Short Term Change ◽

Term Change

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The Relationship between Body Mass Index and Mammographic Density during a Premenopausal Weight Loss Intervention Study

Cancers ◽

10.3390/cancers13133245 ◽

2021 ◽

Vol 13 (13) ◽

pp. 3245

Author(s):

Emma C. Atakpa ◽

Adam R. Brentnall ◽

Susan Astley ◽

Jack Cuzick ◽

D. Gareth Evans ◽

...

Keyword(s):

Body Mass Index ◽

Weight Loss ◽

Body Mass ◽

Breast Density ◽

Small Sample ◽

Weight Loss Intervention ◽

Short Term ◽

Dense Area ◽

Short Term Change ◽

Term Change

We evaluated the association between short-term change in body mass index (BMI) and breast density during a 1 year weight-loss intervention (Manchester, UK). We included 65 premenopausal women (35–45 years, ≥7 kg adult weight gain, family history of breast cancer). BMI and breast density (semi-automated area-based, automated volume-based) were measured at baseline, 1 year, and 2 years after study entry (1 year post intervention). Cross-sectional (between-women) and short-term change (within-women) associations between BMI and breast density were measured using repeated-measures correlation coefficients and multivariable linear mixed models. BMI was positively correlated with dense volume between-women (r = 0.41, 95%CI: 0.17, 0.61), but less so within-women (r = 0.08, 95%CI: −0.16, 0.28). There was little association with dense area (between-women r = −0.12, 95%CI: −0.38, 0.16; within-women r = 0.01, 95%CI: −0.24, 0.25). BMI and breast fat were positively correlated (volume: between r = 0.77, 95%CI: 0.69, 0.84, within r = 0.58, 95%CI: 0.36, 0.75; area: between r = 0.74, 95%CI: 0.63, 0.82, within r = 0.45, 95%CI: 0.23, 0.63). Multivariable models reported similar associations. Exploratory analysis suggested associations between BMI gain from 20 years and density measures (standard deviation change per +5 kg/m2 BMI: dense area: +0.61 (95%CI: 0.12, 1.09); fat volume: −0.31 (95%CI: −0.62, 0.00)). Short-term BMI change is likely to be positively associated with breast fat, but we found little association with dense tissue, although power was limited by small sample size.

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Preliminary results of the acute Heart Failure registry in the DELTA region of Egypt (DELTA-HF): a database and a quality initiative project

The Egyptian Heart Journal ◽

10.1186/s43044-019-0024-0 ◽

2019 ◽

Vol 71 (1) ◽

Author(s):

Abdelfatah Elasfar ◽

Sherif Shaheen ◽

Wafaa El-Sherbeny ◽

Hatem Elsokkary ◽

Suzan Elhefnawy ◽

...

Keyword(s):

Heart Failure ◽

Heart Disease ◽

Acute Heart Failure ◽

Valvular Heart Disease ◽

Beta Blockers ◽

Left Ventricular Ejection ◽

Systemic Hypertension ◽

Delta Region ◽

Device Therapy ◽

Short Term

Abstract Background Data about heart failure in Egypt is scarce. We aimed to describe the clinical characteristics and diagnostic and treatment options in patients with acute heart failure in the Delta region of Egypt and to explore the gap in the management in comparison to the international guidelines. Results DELTA-HF is a prospective observational cohort registry for all consecutive patients with acute heart failure (AHF) who were admitted to three tertiary care cardiac centers distributed in the Delta region of Egypt. All patients were recruited in the period from April 2017 to May 2018, during which, data were collected and short-term follow-up was done. A total of 220 patients (65.5% were males with a median age of 61.5 years and 50.9% had acute decompensation on top of chronic heart failure) was enrolled in our registry. The risk factors for heart failure included rheumatic valvular heart disease (10.9%), smoking (65.3%), hypertension (48.2%), diabetes mellitus (42.7%), and coronary artery disease (28.2%). Left ventricular ejection fraction (LVEF) was less than 40% in 62.6%. Etiologies of heart failure included ischemic heart disease (58.1%), valvular heart disease (16.3%), systemic hypertension (9.1%), and dilated non-ischemic cardiomyopathy (15.5%). Exacerbating factors included infections (28.1%), acute coronary syndromes (25.5%), non-compliance to HF medications (19.6%), and non-compliance to diet (23.2%) in acute decompensated heart failure (ADHF) patients. None of our patients had been offered heart failure device therapy and only 50% were put on beta-blockers upon discharge. In-hospital, 30 days and 90 days all-cause mortality were 18.2%, 20.7%, and 26% respectively. Conclusions There is a clear gap in the management of patients with acute heart failure in the Delta region of Egypt with confirmed under-utilization of heart failure device therapy and under-prescription of guideline-directed medical therapies particularly beta-blockers. The short-term mortality is high if compared with Western and other local registries. This could be attributed mainly to the low-resource health care system in this region and the lack of formal heart failure management programs.

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