scholarly journals Features of coagulation hemostasis and anticoagulation system in patients with chronic heart failure due to ischemic heart disease

2015 ◽  
Vol 96 (5) ◽  
pp. 716-722 ◽  
Author(s):  
G Kh Mirsaeva ◽  
N N Mironchuk
Keyword(s):  
Heart Failure ◽  
Congestive Heart Failure ◽  
Heart Disease ◽  
International Normalized Ratio ◽  
Main Group ◽  
Functional Class ◽  
Control Group ◽  
General Group ◽  
Cofactor Activity ◽  
D Dimer

Aim. To study the features of coagulant and anticoagulant systems in patients with varoious functional classes of congestive heart failure secondary to coronary heart disease (according to New York Heart Association criteria) and to determine the most informative method for diagnosing the hemostasis disorders. Methods. 82 patients with congestive heart failure, who had previously survived myocardial infarction with Q-wave formation, and left ventricle ejection fraction (by Simpson) less than 50%, were included. Average age was 54.0 [50.0-64.0] years. Control group of 30 healthy people was formed. All patients were allocated to two groups. 1st group included patients with I-II functional class of congestive heart failure (n=57), 2nd group - patients with III-IV functional class of congestive heart failure (n=25). Activated partial thromboplastin time, prothrombin and fibrinogen levels, international normalized ratio, heparin cofactor activity of antithrombin, D-dimer level were measured in blood serum. Results. Only D-dimer level and heparin cofactor activity of antithrombin were changed in the main group compared to the controls. D-dimer level in patients of the general group was 0.2 [0.2-0.4] mg/L versus 0.2 [0.2-0.2] mg/L in control group (p=0.000064). There was no obvious deficit of heparin cofactor activity of antithrombin in patients with congestive heart failure, but the values were lower in the main group - 90.5 [82,7-100,4]% compared to the control group - 102 [90,0-104,0]% (p=0.0068). In subgroups, there were indicators (prothrombin, international normalized ratio, D-dimer) that changed according to the functional class. The lowest values of prothrombin were found in patients with III-IV functional class, the highest - in patients with I-II functional class. Indicators (prothrombin, INR, D-dimer) which changing with the growth of CHF FC were identified by separating the patients into subgroups. FC, the largest - in patients with FC I-II. Serum D-dimer level increased in accordance with congestive heart failure functional class (р1-2=0.0065). Conclusion. Congestive heart failure contributes to prothrombotic changes in hemostasis. The severity increases with increasing congestive heart failure functional class. D-dimer is the most sensitive marker of hemostasis activation at congestive heart failure. This parameter should be included in the routine hemostasis testing in patients with congestive heart failure.

scholarly journals Laporan Kasus: Anestesi Blok Peribulbar pada Pasien dengan Gagal Jantung Kongestif yang Dilakukan Enukleasi

2019 ◽  
Vol 7 (2) ◽  
pp. 134-138
Author(s):  
Muhamad Adli ◽  
Caroline Wullur
Keyword(s):  
Heart Failure ◽  
Congestive Heart Failure ◽  
Heart Disease ◽  
Mitral Regurgitation ◽  
Aortic Regurgitation ◽  
Hypertensive Heart Disease ◽  
Functional Class ◽  
Cardiac Depression ◽  
Peribulbar Block ◽  
Class Iv

Seorang pria berusia 73 tahun datang ke Instalasi Gawat Darurat Pusat Mata Nasional Rumah Sakit Mata Cicendo pada bulan November 2018 dengan keluhan nyeri mata yang mengeluarkan darah dan disertai dengan keluhan sesak. Pemeriksaan mata menunjukkan prolaps okuli dan direncanakan untuk dilakukan enukleasi. Ahli kardiologi mendiagnosis sebagai hypertensive heart disease, congestive heart failure functional class IV, moderate mitral regurgitation, moderate aortic regurgitation. Laporan kasus ini bertujuan memaparkan keberhasilan tata laksana anestesi pada pasien usia lanjut dengan gagal jantung kongestif yang dilakukan enukleasi dalam blok peribulbar. Teknik blok peribulbar dipilih agar tidak memperberat masalah kardiovaskular serta untuk meminimalisir depresi kardiak. Teknik ini dilakukan dengan menyuntikkan obat anestesi lokal levobupivakain 0,5% pada inferotemporal, medial kantus, dan superonasal. Operasi berlangsung tanpa keluhan nyeri dan fluktuasi hemodinamik yang signifikan. Pascaoperasi pasien sadar penuh dengan skala nyeri NRS 60 menit pascaoperasi 0. Hal ini menunjukkan bahwa teknik anestesi blok peribulbar memberikan hasil memuaskan pada tindakan enukleasi. Enucleation under Peribulbar Block Anesthesia in Patients with Congestive Heart Failure: A Case ReportA 73-year-old male patient was presented to the emergency department of the National Eye Center Cicendo Hospital with a painful and bloody eye as well as shortness of breath. Eye examination revealed ocular prolapse and patient was scheduled for enucleation. The cardiologist diagnosed the patient with hypertensive heart disease, congestive heart failure functional class IV, moderate mitral regurgitation, and moderate aortic regurgitation. Patient then underwent treatment for six days. This case report aimed to describe the successful management of anesthesia in elderly patients with congestive heart failure who underwent peribulbar block for enucleation procedure. To prevent further cardiac problems and to minimize the risk of cardiac depression in this patient, the anesthetic technique chosen was peribulbar block with the injection of local anesthetic drug levobupivacaine 0.5% at the inferotemporal, medial canthus, and superonasal. The surgary took place without complaints of intraoperative pain and without significant hemodynamic fluctuations. Postoperatively, the patient was fully conscious and sixty minutes postoperative pain scale (Numeric Rating Scale) in this patient was 0. This shows that the peribulbar block anesthesia technique can provide satisfactory results for enucleation procedure.

Effect of transplantation of cord blood total nucleated cells on the manifestation and prognosis of refractory congestive heart failure

2016 ◽  
Vol 4 (1) ◽  
pp. 10-13
Author(s):  
O. Usenko ◽  
A. Yakushev ◽  
M. Kostylyev ◽  
V. Onischenko
Keyword(s):  
Heart Failure ◽  
Congestive Heart Failure ◽  
Cord Blood ◽  
Exercise Tolerance ◽  
Severe Heart Failure ◽  
Functional Class ◽  
Control Group ◽  
Observation Study ◽  
Death Risk ◽  
Increased Risk

The results of a prospective non-randomized observation study without control group to assess the course of heart failure in patients who underwent of cord blood total nucleated cells (CB TNCs) transplantation combined with traditional drug therapy have been presented. Materials. The study included 20 patients with congestive heart failure (CHF) IIA-IIB stage, functional class III-IV by the NYHA. CB TNCs transplantation was performed by a single intravenous dose of cell product "Cryopreserved human cord blood". Before and 1, 3, 6 and 9 months after CB TNC transplantation patients underwent echocardiographic study, the results of tests with the 6-minute walk determined exercise tolerance. The concentration of brain natriuretic peptide precursor (NT-proBNP) in blood was determined. The cardiovascular death risk was calculated using the scale MAGGIC. Results. Initial patients’ status was characterized by the presence of severe heart failure with reduced contractility of the myocardium and increased risk of 1- and 3-year death. Traditional conservative therapy (beta blockers, ACE inhibitors, diuretics) was not effective. After CB TNC transplantation there was registered a significant improvement of general condition of patients, an increase in exercise tolerance and, therefore, reduce of HF functional class by NYHA (before transplantation average FC was 3.2, in the post-transplant period – from 2.1 to 2, 8). Also after TNCs transplantation levels of biochemical markers of HF significantly decreased (before CB TNCs transplantation the level of NT-proBNP was 2370.3 ± 448.9 pg/mL, after CB TNCs transplantation – from 1198,6 ± 396,3 to 2300,7 ± 403,0 pg/mL ) and the same was estimated death risk from HF (1-year – 10.1-37.4 %, 3 years - 9.1-42.3 % relative to the data of the initial state). Reduced HF manifestations after CB TNCs transplantation allowed to reduce significantly the diuretics dose. Conclusion. Thus, transplantation of cord blood total nucleated cells in complex treatment of congestive heart failure has led to a greater efficiency of therapy and a significant reduce of CHF manifestations in patients.

scholarly journals Hemostatic Markers in Congestive Heart Failure Dogs with Mitral Valve Disease

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Kreangsak Prihirunkit ◽  
Amornrate Sastravaha ◽  
Chalermpol Lekcharoensuk ◽  
Phongsak Chanloinapha
Keyword(s):  
Heart Failure ◽  
Congestive Heart Failure ◽  
Mitral Valve ◽  
Mitral Valve Disease ◽  
Valve Disease ◽  
Factor Vii ◽  
Control Group ◽  
Total Plasma Protein ◽  
At Iii ◽  
D Dimer

Prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen, D-dimer, antithrombin III (AT III), protein C (PC), factor VII (F.VII), and factor VIII (F.VIII), as well as hematocrit (HCT), platelets number (PLT), total plasma protein (TP), and albumin (ALB), were studied on fifty-eight congestive heart failure (CHF) dogs with mitral valve disease (MVD) and fifty control dogs. All of variables of MVD group, except APTT, were significantly different (P<0.5) from control group. The variables were also compared among functional classes of CHF dogs and control dogs. It was determined that the higher the functional class of CHF dogs was, the greater the levels of fibrinogen and D-dimer were, whereas the lesser the activities of AT III and PC were presented. Additionally, TP had linear correlation with fibrinogen, D-dimer, HCT, and PLT (r=0.31, 0.30, 0.43, and 0.38, resp., P<0.5). These findings suggested that fibrinogen and D-dimer were the factors predisposing hypercoagulability through an increase in blood viscosity. The hemorheological abnormalities would shift an overall hemostatic balance toward a more thrombotic state in CHF dogs with MVD.

scholarly journals Features of haemostasis in patients with coronary heart disease

2012 ◽  
Vol 93 (1) ◽  
pp. 3-7
Author(s):  
G S Galyautdinov ◽  
E A Chudakova
Keyword(s):  
Acute Coronary Syndrome ◽  
Heart Disease ◽  
Ischemic Heart Disease ◽  
International Normalized Ratio ◽  
Functional Class ◽  
Activated Partial Thromboplastin Time ◽  
Control Group ◽  
Coronary Syndrome ◽  
Von Willebrand ◽  
Willebrand Factor

Aim. To identify the nature of changes in the hemostasis system in patients with chronic and acute ischemic heart disease. Methods. The first group was comprised of 46 patients with stable angina of the II-III functional class, the second group was comprised of 42 patients with acute coronary syndrome, the control group included 28 healthy individuals. In all of the examined individuals determined were the number of platelets, the amount of antithrombin III, activated partial thromboplastin time, international normalized ratio, fibrinogen content, soluble fibrin monomer-complexes, von Willebrand factor, protein C and S in blood plasma. Results. In patients with stable angina of the II-III functional class originally noted was an increase in the level of the von Willebrand factor in plasma by 43%, while in patients with acute coronary syndrome - by 67% compared with the control figures, the content of fibrinogen in blood plasma exceeded the control values by 18.8% and 68.8%, respectively. In patients with acute coronary syndrome the concensoluble fibrin monomer-complexes was initially increased. In the evaluation of plasma hemostasis in patients of both groups revealed was a significant decrease of the international normalized ratio and activated partial thromboplastin time values, which was more pronounced during acute coronary syndrome than in the control group. Conclusion. In patients with ischemic heart disease present was a thrombogenic shift of the hemostasis indices toward hypercoagulation, which is most evident in acute coronary syndrome, suggesting the presence of chronic intravascular blood coagulation.

scholarly journals A simple nomogram to predict contrast-induced acute kidney injury in patients with congestive heart failure undergoing coronary angiography

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
L Lei ◽  
Y He ◽  
Z Guo ◽  
B Liu ◽  
J Liu ◽  
...  
Keyword(s):  
Heart Failure ◽  
Congestive Heart Failure ◽  
Acute Kidney Injury ◽  
Coronary Angiography ◽  
Prediction Models ◽  
Validation Cohort ◽  
Kidney Injury ◽  
Class Ii ◽  
Functional Class ◽  
Killip Class

Abstract Background Patients with congestive heart failure (CHF) are vulnerable to contrast-induced acute kidney injury (CI-AKI), but few prediction models are currently available. Objectives We aimed to establish a simple nomogram for CI-AKI risk assessment for patients with CHF undergoing coronary angiography. Methods A total of 1876 consecutive patients with CHF (defined as New York Heart Association functional class II-IV or Killip class II-IV) were enrolled and randomly (2:1) assigned to a development cohort and a validation cohort. The endpoint was CI-AKI defined as serum creatinine elevation of ≥0.3 mg/dL or 50% from baseline within the first 48–72 hours following the procedure. Predictors for the nomogram were selected by multivariable logistic regression with a stepwise approach. The discriminative power was assessed using the area under the receiver operating characteristic (ROC) curve and was compared with the classic Mehran score in the validation cohort. Calibration was assessed using the Hosmer–Lemeshow test and 1000 bootstrap samples. Results The incidence of CI-AKI was 9.06% (n=170) in the total sample, 8.64% (n=109) in the development cohort and 9.92% (n=61) in the validation cohort (p=0.367). The simple nomogram including four predictors (age, intra-aortic balloon pump, acute myocardial infarction and chronic kidney disease) demonstrated a similar predictive power as the Mehran score (area under the curve: 0.80 vs 0.75, p=0.061), as well as a well-fitted calibration curve. Conclusions The present simple nomogram including four predictors is a simple and reliable tool to identify CHF patients at risk of CI-AKI, whereas further external validations are needed. Figure 1 Funding Acknowledgement Type of funding source: None

Early Surgical Intervention for Infective Endocarditis

2002 ◽  
Vol 10 (4) ◽  
pp. 298-301 ◽  
Author(s):  
Hong Sheng Zhu ◽  
Pei Yan Yao ◽  
Jia Hao Zheng ◽  
A Thomas Pezzella
Keyword(s):  
Heart Failure ◽  
Congestive Heart Failure ◽  
Heart Disease ◽  
Infective Endocarditis ◽  
Complex Disease ◽  
Surgical Intervention ◽  
Elective Surgery ◽  
Postoperative Bleeding ◽  
Arterial Embolization ◽  
Early Surgical Intervention

Infective endocarditis remains a serious and complex disease with significant morbidity and mortality. Sixty cases of infective endocarditis were retrospectively reviewed, consisting of 41 males and 19 females aged 7 to 50 years (mean, 30 years). Congenital heart disease was diagnosed in 19 of the patients and rheumatic heart disease in 41. Congestive heart failure occurred in 36 and systemic embolism in 8 cases. Blood cultures were positive in only 21.7% of the cases, while vegetations were detected by 2-dimensional echocardiography in 70%. Elective surgery was performed in 57 patients and emergent operation for systemic arterial embolization and/or intractable congestive heart failure in 3 patients. Two patients required reoperation for postoperative bleeding. All but 2 patients had been followed up for 6 to 160 months with no evidence of reinfection. Three patients with mechanical valve implantation later died of intracranial bleeding due to over-anticoagulation. The remaining 55 resumed normal activity. The encouraging outcomes were the result of an aggressive diagnostic approach and early surgical intervention.

scholarly journals The mechanism of adaptation of the organism of patients with chronic heart failure combined with vitamin D deficiency and the morphofunctional state of peripheral blood erythrocytes

2019 ◽  
Vol 10 (3) ◽  
pp. 352-357
Author(s):  
N. I. Baryla ◽  
I. P. Vakaliuk ◽  
S. L. Pоpеl’
Keyword(s):  
Heart Failure ◽  
Vitamin D ◽  
Chronic Heart Failure ◽  
Red Blood Cells ◽  
Vitamin D Deficiency ◽  
Peripheral Blood ◽  
Blood Cells ◽  
Functional Class ◽  
Exercise Stress ◽  
Control Group

The problem of structural changes in peripheral blood erythrocytes in patients with chronic heart failure in combination with vitamin D deficiency during exercise stress remains insufficiently studied. Vitamin receptors are located on smooth myocytes, endothelial cells, cardiomyocytes and blood cells. It affects the state of the cell membrane, the contractile function of the myocardium, the regulation of blood pressure, cardiac remodeling and reduction of left ventricular hypertrophy. Therefore, it is important to assess the level of vitamin D in blood plasma in individuals with chronic heart failure and to identify the effect of its deficiency on the state of peripheral red blood cells when performing a 6-minute walk test. A total of 75 patients of the main group with chronic heart failure stage II A, I–II functional class with different levels of vitamin D deficiency were examined. The control group included 25 patients with chronic heart failure stage II A, functional class I–II without signs of vitamin D deficiency. The average age of patients was 57.5 ± 7.5 years. All patients were asked to undergo the 6 minutes walking test. The level of total vitamin D in plasma was determined by enzyme immunoassay. Morphological studies of erythrocytes were performed on the light-optical and electron-microscopic level. The obtained results showed that patients of the main group with chronic heart failure had a decrease in vitamin D by 2.2 times compared with the control group. Correlation analysis showed a directly proportional relationship between vitamin D deficiency and the number of red blood cells of a modified form and red blood cells with low osmotic resistance. Dosed exercise stress in patients with chronic heart failure against a background of vitamin D deficiency leads to an increase in the number of reversibly and irreversibly deformed erythrocytes and a decrease in their osmotic stability. This indicates a disorder in the structural integrity of their membrane and can have negative consequences for the somatic health of such patients.

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