Impact of sacubitril/valsartan on systolic heart failure: Right heart location and clustering analysis

Background. Ivabradine is an If ion current inhibitor that has proved to reduce mortality in patients with systolic heart failure by slowing heart rate without decreasing myocardial contractility. Photoplethysmography is a simple, low-cost optical technique that can evaluate vascular function and detect changes in blood flow, pulse, and swelling of tissular microvascular space.Objective. To evaluate the effect of ivabradine on endothelial function by photoplethysmography in diastolic and right heart failure patients.Methodology. 15 patients were included (mean age of 78.1 ± 9.2 years) with optimally treated diastolic and right heart failure. They underwent photoplethysmography before and after induced ischemia to evaluate the wave blood flow on the finger, using the maximum amplitude time/total time (MAT/TT) index. Two measurements were made before and after oral Ivabradine (mean 12.5 mg a day during 6 months of followup).Results. In the study group, the MAT/TT index was 29.1 ± 2.2 versus 24.3 ± 3.2 () in basal recording and 30.4 ± 2.1 versus 23.3 ± 2.9 (), before versus after ischemia and before versus after Ivabradine intervention, respectively.Conclusions. Ivabradine administration improves endothelial function (shear stress) in diastolic and right heart failure patients.

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Burden of atrial fibrillation in influenza hospitalizations: analysis from 2018 national inpatient sample

European Heart Journal ◽

10.1093/eurheartj/ehab724.0437 ◽

2021 ◽

Vol 42 (Supplement_1) ◽

Author(s):

H Thyagaturu ◽

K Shah ◽

S Li ◽

A Kumar

Keyword(s):

Heart Failure ◽

Atrial Fibrillation ◽

Length Of Stay ◽

Cardiogenic Shock ◽

Systolic Heart Failure ◽

Right Heart Failure ◽

National Inpatient Sample ◽

Right Heart ◽

Income Status ◽

Co Morbidity

Abstract Introduction Influenza infection could cause systemic inflammatory response and lead to increase sympathetic tone. The association and impact of atrial fibrillation (AF) on Influenza has not been well studied. Purpose To evaluate the association of atrial fibrillation with mortality and resource utilization in influenza hospitalizations. Methods We queried 2018 National Inpatient Sample (NIS) database to identify influenza and AF hospitalizations using appropriate ICD-10 codes. Influenza with AF group was compared to influenza without AF. Chi-square test and linear regression were used for categorical and continuous variables, respectively. Multivariate logistic regression was used to adjust for potential hospital and patient confounders (age, sex, race, diabetes, systolic heart failure, chronic kidney disease, obesity, charlson co-morbidity index, hospital location, teaching status, bed size and income status). Discharge weights provided in the database was used to calculate the national estimates. STATA 16.1 was used to perform all statistical analysis. Results 345,419 weighted influenza hospitalizations were identified. Of which, 78,824 (22.8%) of them had atrial fibrillation. Influenza patients with AF were older (mean age: 77 vs. 65 yrs; p<0.01) but had similar number of female (52% vs 48%; p<0.01) compared to influenza patients without AF. After adjusting for potential hospital and patient level confounders, we observed statistically significant increase in mortality [Adjusted Odds Ratio (aOR): 1.5 (1.4–1.7); p<0.01], length of stay [6.5 vs 5.4 days; p<0.01], total hospitalization charges [USD: $65,302 vs $54,149; p<0.01], right heart failure [aOR: 2.4 (1.6–3.6); p<0.01], cardiogenic shock [aOR: 1.9 (1.5–2.5); p<0.01] in influenza patients with AF when compared to those without AF. Conclusion Presence of AF is an independent predictor of mortality, length of stay, hospitalization charges, right heart failure and cardiogenic shock in hospitalized patients with influenza. This study helps to assume prognosis and raise awareness on the intensity of care needed toward these patients. FUNDunding Acknowledgement Type of funding sources: None.

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