scholarly journals Mitral Regurgitation Severity Dynamic During Acute Decompensated Heart Failure Treatment.

2021 ◽  
Author(s):  
Kamil Bugała ◽  
Paweł Rubiś ◽  
Mateusz K Hołda ◽  
Małgorzata Konieczyńska ◽  
Piotr Bijak ◽  
...  
Keyword(s):  
Heart Failure ◽  
Mitral Regurgitation ◽  
Left Atrial ◽  
Acute Decompensated Heart Failure ◽  
Decompensated Heart Failure ◽  
Laboratory Evaluation ◽  
Heart Failure Treatment ◽  
Severity Class ◽  
Echocardiographic Assessment ◽  
Atrial Area

Abstract Purpose: Acute decompensated heart failure (ADHF) treatment leads to significant hemodynamic changes. The aim of our study was to quantitatively analyze the dynamics of mitral regurgitation (MR) severity (evaluated by transthoracic echocardiography) which occur during the treatment of ADHF and to correlate these changes with the clinical condition of patients as well as heart failure biochemical markers. Methods: The study included 27 consecutive adult patients (40.7% females, mean age 71.19±11.2 years) who required hospitalization due to signs of acute HF. Echocardiographic assessment was performed upon admission and discharge together with clinical and laboratory evaluation. Results: Significant reduction in dyspnea intensity [0-100 scale] (81.48±9.07 vs. 45.00±11.04 pts, p<0.001), body weight (84.98±18.52 vs. 79.77±17.49 kg, p<0,001), and NT-proBNP level (7520.56±5288.62 vs. 4949.88±3687.86 pg/ml, p=0.001) was found. The severity of MR parameters decreased significantly (MR volume 44.92±22.83 vs. 30.88±18.77 ml, p<0.001; EROA 0.37±0.17 vs. 0.25±0.16 cm2, p<0.001; VC 6.21±1.48 vs. 5.26±1.61 mm, p<0.001). Left atrial area (35.86±9.11 vs. 32.47±9.37, p<0.001) and mitral annular diameter (42.33±6.63 vs. 39.72±5.05. p<0.001) also underwent statistically significant reductions. An increase in LVEF was observed (34.73±13.88 vs. 40.24±13.19 %, p<0.001). In 40.7% of patients, a change in MR severity class (transition from a higher class to a lower one) was observed: 6/8 (75%) patients transitioned from severe to moderate and 6/18 (33.3%) patients transitioned from moderate to mild class.Conclusions: Treatment of ADHF leads to a significant reduction in MR severity, together with significant reductions in left atrial and mitral annular dimensions. Quantitative measurement of MR dynamics offer valuable assistance for ADHF management.

scholarly journals Mitral regurgitation severity dynamic during acute decompensated heart failure treatment

2021 ◽  
Author(s):  
Kamil Bugała ◽  
Paweł Rubiś ◽  
Mateusz K. Hołda ◽  
Małgorzata Konieczyńska ◽  
Piotr Bijak ◽  
...  
Keyword(s):  
Heart Failure ◽  
Mitral Regurgitation ◽  
Left Atrial ◽  
Acute Decompensated Heart Failure ◽  
Decompensated Heart Failure ◽  
Laboratory Evaluation ◽  
Heart Failure Treatment ◽  
Severity Class ◽  
Echocardiographic Assessment ◽  
Atrial Area

AbstractAcute decompensated heart failure (ADHF) treatment leads to significant hemodynamic changes. The aim of our study was to quantitatively analyze the dynamics of mitral regurgitation (MR) severity (evaluated by transthoracic echocardiography) which occur during the treatment of ADHF and to correlate these changes with the clinical condition of patients as well as heart failure biochemical markers. The study included 27 consecutive adult patients (40.7% females, mean age 71.19 ± 11.2 years) who required hospitalization due to signs of acute HF. Echocardiographic assessment was performed upon admission and discharge together with clinical and laboratory evaluation. Significant reduction in dyspnea intensity [0–100 scale] (81.48 ± 9.07 vs. 45.00 ± 11.04 pts, p < 0.001), body weight (84.98 ± 18.52 vs. 79.77 ± 17.49 kg, p < 0.001), and NT-proBNP level (7520.56 ± 5288.62 vs. 4949.88 ± 3687.86 pg/ml, p = 0.001) was found. The severity of MR parameters decreased significantly (MR volume 44.92 ± 22.83 vs. 30.88 ± 18.77 ml, p < 0.001; EROA 0.37 ± 0.17 vs. 0.25 ± 0.16 cm2, p < 0.001; VC 6.21 ± 1.48 vs. 5.26 ± 1.61 mm, p < 0.001). Left atrial area (35.86 ± 9.11 vs. 32.47 ± 9.37, p < 0.001) and mitral annular diameter (42.33 ± 6.63 vs. 39.72 ± 5.05. p < 0.001) also underwent statistically significant reductions. An increase in LVEF was observed (34.73 ± 13.88 vs. 40.24 ± 13.19%, p < 0.001). In 40.7% of patients, a change in MR severity class (transition from a higher class to a lower one) was observed: 6/8 (75%) patients transitioned from severe to moderate and 6/18 (33.3%) patients transitioned from moderate to mild class. Treatment of ADHF leads to a significant reduction in MR severity, together with significant reductions in left atrial and mitral annular dimensions. Quantitative measurement of MR dynamics offer valuable assistance for ADHF management.

scholarly journals Effects of early diuretic response to carperitide in acute decompensated heart failure treatment: A single-center retrospective study

PLoS ONE ◽  
2018 ◽  
Vol 13 (6) ◽  
pp. e0199263 ◽  
Author(s):  
Yoshitaka Okuhara ◽  
Masanori Asakura ◽  
Kohei Azuma ◽  
Yoshiyuki Orihara ◽  
Koichi Nishimura ◽  
...  
Keyword(s):  
Heart Failure ◽  
Retrospective Study ◽  
Acute Decompensated Heart Failure ◽  
Decompensated Heart Failure ◽  
Single Center ◽  
Heart Failure Treatment ◽  
Failure Treatment ◽  
Diuretic Response

Adverse cardiovascular outcome predicted by left atrial strain in acute decompensated heart failure

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
M Barki ◽  
M Losito ◽  
M Carrozzo ◽  
M.M Caracciolo ◽  
M Rovida ◽  
...  
Keyword(s):  
Heart Failure ◽  
Left Atrial ◽  
Acute Decompensated Heart Failure ◽  
Significant Proportion ◽  
Decompensated Heart Failure ◽  
Primary Role ◽  
Cox Regression Analysis ◽  
Coronary Syndrome ◽  
Non Invasive ◽  
B Lines

Abstract Background A significant proportion of patients hospitalized for acute decompensated heart failure (ADHF) are readmitted to the hospital within 30 days, resulting in a major social and economic burden. Thus, risk stratification and identification of targets of therapy is of basic importance. Non-invasive imaging modality such as transthoracic echocardiography (TTE) represents a cornerstone tool to approach this clinical scenario for early recognition of high-risk patients. Purpose To define whether left atrial (LA) dynamics, evaluated by means of speckle tracking echocardiography (STE), may represent a predictor of cardiac events and early re-hospitalization in patients admitted to the emergency department (ED) for ADHF, in comparison with other non-invasive established prognostic index in heart failure (HF) such as NT-proBNP, B-lines at lung ultrasonography (LUS) and right ventricular (RV) to Pulmonary Circulation (PC) uncoupling evaluated through Tricuspid Annular Plane Systolic Excursion (TAPSE)/Pulmonary Arterial Systolic Pressure (PASP) ratio. Methods Seventy patients (mean age 75.6±11 years, 57% males) presenting with ADHF were prospectively enrolled within 24–48 hours from admission. In the acute phase and at pre-discharge the following variables have been collected: NT-proBNP, B-lines, TAPSE/PASP ratio, Left Atrial Volume indexed (LAVi) and global-peak atrial longitudinal strain (G-PALS). Results During a median follow-up of nine months we observed 18 events consisting of 7 deaths, 8 re-hospitalizations for ADHF, 1 re-hospitalization for acute coronary syndrome, 1 stroke and 1 mitral valve replacement. Multivariate Cox-regression analysis identified LAVi and GPALS at discharge, along with NT-proBNP, B-lines and TAPSE/PASP ratio, as independent predictors of major adverse CV events (LAVi: p=0.04; GPALS: p=0.05; NT-proBNP: p&lt;0.001; B-lines: p=0.03; TAPSE/PASP: p&lt;0.001) (Table 1). Conclusions Short-term re-hospitalization in ADHF is crucial and the identification of a higher risk through sensitive and potentially new hemodynamic phenotypes is of relevance. Our findings, although preliminary, may suggest a primary role of LA dynamics in this context. Funding Acknowledgement Type of funding source: None

How should I treat a patient with severe mitral regurgitation and acute decompensated heart failure?

2015 ◽  
Vol 10 (9) ◽  
pp. e1-e6
Author(s):  
Michael Donahue ◽  
Maria Teresa Librera ◽  
Gabriella Visconti ◽  
Amelia Focaccio ◽  
Bruno Golia ◽  
...  
Keyword(s):  
Heart Failure ◽  
Mitral Regurgitation ◽  
Acute Decompensated Heart Failure ◽  
Decompensated Heart Failure ◽  
Severe Mitral Regurgitation
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