scholarly journals PATOMEKANISME PENYAKIT GAGAL JANTUNG KONGESTIF

el–Hayah ◽  
2014 ◽  
Vol 4 (2) ◽  
pp. 81 ◽  
Author(s):  
Lailia Nur Rachma
Keyword(s):  
Heart Failure ◽  
Clinical Manifestations ◽  
The United States ◽  
Clinical Syndrome ◽  
The Body ◽  
Reduced Ejection Fraction ◽  
Patients With Heart Failure ◽  
Male Patients ◽  
Failure Prognosis ◽  
The Cost

<em>Heart failure is a clinical syndrome characterized by abnormalities in the structure or function of the heart, resulting in inability of heart to pump blood to meet the metabolic needs of the body tissue. Heart failure is characterized by clinical manifestations such as circulation congestion, tightness, fatigue, and weakness. Heart failure is a major problem in industrial and developing Country. Currently, the incidence and prevalence of heart failure tends to increase, it is also accompanied by an increase in mortality of heart failure cases. In the United States, 1 million patients hospitalized due to heart failure cases, which contribute to 50,000 deaths each year. While the number of visits to the hospital due to heart failure estimated at 6.5 million. Heart failure prognosis is generally poor despite the patients accepted adequate therapy. From the data obtained, only about 35% of male patients and 50% female patients who survived after the onset of acute heart failure. Generaly, the data obtained high mortality are occurs in patients with grade IV (presence of symptoms at rest) is about 30-70%, grade III (presence of symptoms with mild activity) 10-20%, class II (presence of symptoms when the activity being 5-10 %). Higher mortality was found in older patients, men, patients with reduced ejection fraction, and in patients with coronary disease. Once someone is suffering from heart failure, then he shall bear the very high cost. In America, the cost of issued for heart failure therapy between 15-40 trillion US$. In this review, we will discuss about pathomechanism of heart failure. So it is expected to be a reference to the diagnosis of patients with heart failure, which is expected to be recognized early on that could ultimately improve the quality of heart failure patient life, and reduce the number of mortality due to heart failure</em>

Abstract 17470: Racial Disparities in Goal Directed Medical Therapy in Patients With Systolic Heart Failure- A Single Center Study

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Ayesha Azmeen ◽  
Naga Vaishnavi Gadela ◽  
Vergara Cunegundo
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Racial Disparities ◽  
Beta Blockers ◽  
Systolic Heart Failure ◽  
The United States ◽  
Clinical Syndrome ◽  
Single Center ◽  
Geographic Variations ◽  
Reduced Ejection Fraction

Introduction: Heart failure(HF) is a clinical syndrome that is widely prevalent affecting approximately 6.5 million people in the United States. It accounts for the ever-rising health care costs in the US due to recurrent hospitalizations. Despite advancements in medical management, the mortality and the rate of hospitalizations continues to be high with geographic variations and racial disparities. Through this descriptive study, we sought to analyze the health disparities among Hispanic, African American (AA) and Caucasian population in a single-center. Methods: We identified a total of 178 patients with HF with reduced ejection fraction from our outpatient clinic by utilizing the ICD-10 codes. Patients with ejection fraction >50% have been excluded. A retrospective chart review of their ethnic background, medications, and number of heart failure exacerbations per year has been performed. Results: 178 patients (mean age 62 years, 35.56% of females) including Hispanics (n=102), AA(n=44), and Caucasians (n=32) were included in the study. Although all patients were started on Beta-blockers, only 76.4% and 37.2% of Hispanics were started on ACEi/ARBs and spironolactone respectively. Similarly, 72.7% and 45.4% of AA were started on ACEi/ARBs and spironolactone respectively. This is in contrast to Caucasians population, where a majority of patients were on started on GDMT; 90% and 75% were started on ACEi/ARBs and spironolactone respectively. This was also reflected by the number of admissions due to HF exacerbations which ranged from 2-4/year for Hispanics and AA populations and 0-1/year for Caucasians. Conclusions: GDMT for HF is known to reduce heart failure exacerbations, mortality and the ever rising cost of the healthcare system. We have observed that despite recommendations to initiate GDMT in all patients with HF with reduced ejection fraction, racial disparities exist. Physicians should be mindful of initiating GDMT in all patients.

scholarly journals Cost-Effectiveness Evaluation of Add-on Empagliflozin in Patients With Heart Failure and a Reduced Ejection Fraction From the Healthcare System's Perspective in the Asia-Pacific Region

2021 ◽  
Vol 8 ◽  
Author(s):  
Chia-Te Liao ◽  
Chun-Ting Yang ◽  
Fang-Hsiu Kuo ◽  
Mei-Chuan Lee ◽  
Wei-Ting Chang ◽  
...  
Keyword(s):  
Heart Failure ◽  
Cost Effectiveness ◽  
Ejection Fraction ◽  
Standard Therapy ◽  
Cost Effective ◽  
Asia Pacific ◽  
Reduced Ejection Fraction ◽  
Patients With Heart Failure ◽  
The Cost ◽  
Country Specific

Background: EMPEROR-Reduced trial provides promising evidence on the efficacy of empagliflozin adding to the standard treatment in patients with heart failure and reduced ejection fraction (HFrEF). This study aimed to investigate the cost-effectiveness of add-on empagliflozin vs. standard therapy alone in HFrEF from the perspective of the Asia-Pacific healthcare systems.Methods: A Markov model was constructed to simulate HFrEF patients and to project the lifetime direct medical costs and quality-adjusted life years (QALY) of both therapies. Transitional probabilities were derived from the EMPEROR-Reduced trial. Country-specific costs and utilities were extracted from published resources. Incremental cost-effectiveness ratio (ICER) against willingness to pay (WTP) threshold was used to examine the cost-effectiveness. A series of sensitivity analyses was performed to ensure the robustness of the results.Results: The ICERs of add-on empagliflozin vs. standard therapy alone in HFrEF were US$20,508, US$24,046, US$8,846, US$53,791, US$21,543, and US$20,982 per QALY gained in Taiwan, Japan, South Korea, Singapore, Thailand, and Australia, respectively. Across these countries, the probabilities of being cost-effective for using add-on empagliflozin under the WTP threshold of 3-times country-specific gross domestic product per capita were 93.7% in Taiwan, 95.6% in Japan, 96.3% in South Korea, 94.2% Singapore, 51.9% in Thailand, and 95.9% in Australia. The probabilities were reduced when shortening the time horizon, assuming the same cardiovascular mortality for both treatments, and setting lower WTP thresholds.Conclusion: Adding empagliflozin to HFrEF treatment is expected to be a cost-effective option among the Asia-Pacific countries. The cost-effectiveness is influenced by the WTP thresholds of different countries.

Comprehensive Guideline for Care of Patients With Heart Failure

2014 ◽  
Vol 25 (2) ◽  
pp. 151-162
Author(s):  
Denise Buonocore ◽  
Elizabeth Wallace
Keyword(s):  
Heart Failure ◽  
American Heart ◽  
Heart Association ◽  
The United States ◽  
Clinical Syndrome ◽  
American Heart Association Guideline ◽  
United States Today ◽  
Patients With Heart Failure ◽  
Ventricular Filling

Heart failure (HF) is a complex clinical syndrome that results from any structural or functional impairment of ventricular filling or ejection of blood. More than 5.1 million people are living with HF in the United States today. This number will continue to rise with the increase in the aging population. With so many people living with HF, nurses need to be well versed on how best to care for them. The 2013 American College of Cardiology Foundation/American Heart Association guideline for the management of HF is a comprehensive guide for all clinicians caring for patients with HF. The updated guideline was developed to assist providers in decision making in the diagnosis and treatment of HF. The goals of the writing committee were to improve quality of care for patients with HF, optimize their outcomes, and improve the efficient use of various resources in the treatment of patients with HF.

Heart Failure

2014 ◽  
pp. 830-842
Author(s):  
Garrick C. Stewart
Keyword(s):  
Heart Failure ◽  
Poor Quality ◽  
Clinical Syndrome ◽  
The Body ◽  
Structural Abnormality ◽  
Cardiac Diseases ◽  
Cardiac Structure ◽  
Patients With Heart Failure ◽  
End Stage

Heart failure is a complex clinical syndrome occurring in patients with an abnormality of cardiac structure or function that impairs the ability of the heart to fill with or eject blood. Patients with heart failure develop a constellation of symptoms (dyspnea and fatigue) and signs (edema and rales) that lead to frequent hospitalizations, poor quality of life, and a shortened life expectancy. Heart failure has also been defined as the failure of the heart to pump enough blood to meet the metabolic demands of the body, or the ability to do so only at elevated filling pressures. Congestive heart failure is the end stage for many cardiac diseases. Cardiomyopathy refers to any condition in which there is a structural abnormality of the myocardium itself.

scholarly journals Risk Stratification of Sudden Cardiac Death in Patients with Heart Failure: An update

2018 ◽  
Vol 7 (11) ◽  
pp. 436 ◽  
Author(s):  
Daniele Masarone ◽  
Giuseppe Limongelli ◽  
Ernesto Ammendola ◽  
Marina Verrengia ◽  
Rita Gravino ◽  
...  
Keyword(s):  
Heart Failure ◽  
Sudden Cardiac Death ◽  
Risk Stratification ◽  
Cardiac Death ◽  
Clinical Syndrome ◽  
Pump Failure ◽  
Reduced Ejection Fraction ◽  
Clinical Challenge ◽  
Patients With Heart Failure ◽  
Symptoms And Signs

Heart failure (HF) is a complex clinical syndrome in which structural/functional myocardial abnormalities result in symptoms and signs of hypoperfusion and/or pulmonary or systemic congestion at rest or during exercise. More than 80% of deaths in patients with HF recognize a cardiovascular cause, with most being either sudden cardiac death (SCD) or death caused by progressive pump failure. Risk stratification of SCD in patients with HF and preserved (HFpEF) or reduced ejection fraction (HFrEF) represents a clinical challenge. This review will give an update of current strategies for SCD risk stratification in both HFrEF and HFpEF.

scholarly journals Heart Failure Challenge in T2DM

2021 ◽  
Vol 23 (Supplement_D) ◽  
Author(s):  
Osama Elmaraghi
Keyword(s):  
Heart Failure ◽  
Sglt2 Inhibitor ◽  
Clinical Syndrome ◽  
Reduced Ejection Fraction ◽  
New Class ◽  
Glucose Reabsorption ◽  
Urinary Glucose ◽  
Patients With Heart Failure ◽  
Outcome Trial ◽  
Glucose Excretion

Abstract Introduction Heart failure is a clinical syndrome caused by a structural and/or functional cardiac abnormality, resulting in a reduced cardiac output and/or elevated intracardiac pressures at rest or during stress.1 There are 463 million patient with diabetes mellitus all over the world .2 People with diabetes have a 2- to 5-fold higher risk of developing HF3, On the other hand more than 30% of patients with heart failure also have diabetes. Patients with heart failure and diabetes have a worse prognosis than those without diabetes4. UKPDs, Accord and advance trials showed that Intensive glycaemic control has not been shown to significantly impact the risk of HF.5,6 SGLT2 inhibitor is a new class of drugs to treat diabetes by inhibiting SGT2 decreases glucose reabsorption and increases urinary glucose excretion, improving glucose control in the diabetic patient.7 At 2015 EMPA-REG OUTCOME trial showed that Empagliflozin in addition to reduction of HBa1c, reduced the 3MAC by 14%, CV death by 38% and HHF by 35%. Is these cardiovascular benefit were a chance? 8 Then DECLARE-TMI58, CNVAS and VIRTIS trials showed that Dapagliflizon, Canagliflozin and ertuglifozin respectively in addition to reduction of HBa1c, reduce HHFso it is a class effect. 9,10,11 Because in these trials starting treatment at the preclinical stage may prevent HF progression and improve outcomes. Objective We have 3 questions to be answered: There are 4 trials to answer these Questions DAPA HF, DELIVER, EMPEROR-Reduced and EMPEROR –Preserved. DAPA-HF and EMPEROR –Reduced include patients with HF with reduced ejection fraction, diabetic and non-diabetic the result of both was reduce the risk of worsening HF or death from cardiovascular causes regardless of the presence or absence of DM. 10,11 Conclusion The results of these trials FDA Approves Dapagliflozin for low EF-Heart Failure in diabetic and Non-diabetic. FDA had granted Fast Track status for empagliflozin. Waiting the result of other trials.12

β-Blockers on Discharge From Acute Atrial Fibrillation Are Associated With Decreased Mortality and Lower Cerebrovascular Accidents in Patients With Heart Failure and Reduced Ejection Fraction

Angiology ◽  
2017 ◽  
Vol 69 (4) ◽  
pp. 316-322 ◽  
Author(s):  
Charbel Abi Khalil ◽  
Mohammad Zubaid ◽  
Nidal Asaad ◽  
Wafa A. Rashed ◽  
Adel Khalifa Hamad ◽  
...  
Keyword(s):  
Heart Failure ◽  
Atrial Fibrillation ◽  
Emergency Department ◽  
Ejection Fraction ◽  
Transient Ischemic Attacks ◽  
Cerebrovascular Accidents ◽  
Reduced Ejection Fraction ◽  
Patients With Heart Failure ◽  
Β Blockers ◽  
The Cost

The benefits of β-blockers in patients with heart failure (HF) with reduced ejection fraction (HFrEF) and atrial fibrillation (AF) are controversial. The Gulf Survey of Atrial Fibrillation Events was a prospective, multinational, observational registry of consecutive patients with AF recruited from the emergency department (ED). We studied the incidence of 6- and 12-month mortality, hospitalization for HF or AF, and stroke/transient ischemic attacks (TIAs) in patients with HFrEF, in relation to β-blockers on discharge from the ED or the subsequent hospital stay. Of the 344 patients with HFrEF and AF in the GULF-SAFE, 177 patients (53%) were discharged on β-blockers. Mortality was lower in those patients compared with the non-β-blockers group at 6 and 12 months (odds ratios [ORs] 0.31, 95% CI [0.16-0.61]; OR 0.30, 95% CI [0.16-0.55]; P = .001 for both, respectively), so was the risk of stroke/TIAs. However, hospitalizations for AF increased in the β-blockers group. Even after adjustment for several risk variables in 2 different models, the beneficial effect of β-blockers on mortality persisted, at the cost of more hospitalization for AF.

scholarly journals Melatonin in Heart Failure: A Promising Therapeutic Strategy?

Molecules ◽  
2018 ◽  
Vol 23 (7) ◽  
pp. 1819 ◽  
Author(s):  
Frederic Nduhirabandi ◽  
Gerald Maarman
Keyword(s):  
Heart Failure ◽  
Cardiovascular Health ◽  
Experimental Studies ◽  
Clinical Syndrome ◽  
The Body ◽  
Curative Therapy ◽  
Cardiometabolic Disorders ◽  
Patients With Heart Failure ◽  
Poor Outcomes

Heart failure is a multifactorial clinical syndrome characterized by the inability of the heart to pump sufficient blood to the body. Despite recent advances in medical management, poor outcomes in patients with heart failure remain very high. This highlights a need for novel paradigms for effective, preventive and curative strategies. Substantial evidence supports the importance of endogenous melatonin in cardiovascular health and the benefits of melatonin supplementation in various cardiac pathologies and cardiometabolic disorders. Melatonin plays a crucial role in major pathological processes associated with heart failure including ischemic injury, oxidative stress, apoptosis, and cardiac remodeling. In this review, available evidence for the role of melatonin in heart failure is discussed. Current challenges and possible limitations of using melatonin in heart failure are also addressed. While few clinical studies have investigated the role of melatonin in the context of heart failure, current findings from experimental studies support the potential use of melatonin as preventive and adjunctive curative therapy in heart failure.

scholarly journals Alpha-Klotho is a novel predictor of treatment responsiveness in patients with heart failure

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Manabu Taneike ◽  
Makoto Nishida ◽  
Kaori Nakanishi ◽  
Fusako Sera ◽  
Hidetaka Kioka ◽  
...  
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Left Ventricular ◽  
University Hospital ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction ◽  
Reduced Ejection Fraction ◽  
Patients With Heart Failure ◽  
Male Patients

AbstractHeart failure is a major cause of death with an increasing population of elderly individuals. Several studies have demonstrated the involvement of soluble alpha-Klotho (sαKl) in various diseases. However, the correlation between sαKl and heart failure remains to be understood. The aim of this study is to investigate the levels and role of sαKl in patients with heart failure. Twenty-eight consecutive patients with acute heart failure (19 male, 9 female), admitted to the Osaka University Hospital from 2010 to 2018, were enrolled in this study. Mean NYHA score, left ventricular ejection fraction and BNP were 3.3, 17.0% and 588 pg/mL, respectively. SαKl significantly increased in heart failure patients. SαKl on admission were significantly higher in patients with heart failure who showed improvement after intensive treatment than that in patients who did not show improvement after the treatment. SαKl levels decreased significantly in patients who showed improvement. Interestingly, sαKl levels increased in male patients with heart failure, but not in female patients. Our data suggest that soluble αKl may be a novel biomarker for the responsiveness against treatment in patients with heart failure with reduced ejection fraction. Our findings may help developing a personalized therapy for different patients with heart failure.

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