scholarly journals EPIDEMILOGICAL, CLINICAL AND ECHOCARDIOGRAPHIC FEATURES OF HEART FAILURE IN MOROCCO

2021 ◽  
Vol 9 (11) ◽  
pp. 521-526
Author(s):  
A. Maliki Alaoui ◽  
◽  
Y. Fihri ◽  
A. Ben El Mekki ◽  
H. Bouzelmat ◽  
...  

Heart failure (HF) is a major public issue taking an epidemic dimension globally. Its incidence is continuing to rise because of a growing and aging population. We held a cross-sectional retrospective studyin the cardiology department of Mohamed V military teaching hospital of Rabat in morocco fromSeptember 2019 toSeptember 2021, including 104 patients admitted with HF. The mean age was 68.5 ±10.3year. Hypertension and diabetes mellitus are the most common risk factors. HF with reduced ejection fraction represents about 49%. Forty-four percent had dilated cardiomyopathy. Ischemic heart disease is the first cause of HF.

2020 ◽  
Vol 36 (4) ◽  
Author(s):  
Nouradden Noman Aljaber ◽  
Zohoor Ali Mattash ◽  
Sultan Abdulwadoud Alshoabi ◽  
Fahad Hassan Alhazmi

Background and objectives: Ejection fraction (EF) is a measurement of heart function that reflects the portion of pumped out blood from the filled left ventricle per each heartbeat. The current study aimed to investigate the prevalence of left ventricular thrombus in patients with EF lower than 35% by using Transthoracic Echocardiography (TTE). Methods: In this prospective study, 82 cardiac patients underwent TTE procedure in order to assess the presence of left ventricular thrombus (LVT) from January 1st to December 31st 2017 at the Military Cardiac Centre in Sana’a, Yemen. Results: Out of 82 patients enrolled in this study, the mean age was 49.13 ± 14.8 years and 87.8% were male. The mean of EF was 31.16% and LVT was found in 6.1%. The spontaneous contrast was seen in 25.6% of patients indicating strong relationship with low EF (p < 0.001). Among patients with low EF, ischemic heart disease (IHD) was identified in 50%, hypertension in 30.5%, diabetes mellitus (DM) type 2 in 23.2%, and hyperlipidemia 12.2%. Exactly 80% of LVT were detected in IHD patients with dilated cardiomyopathy (DCMP) and 80% of detected LVT were apical in site. Conclusion: Cardiac patients with low ejection fraction developed left ventricular thrombosis, and most of the affected patients were ischemic heart disease with dilated cardiomyopathy. Interestingly, spontaneous contrast was found high significantly in these patients, which may reflect the continuous process of thrombus formation. Abbreviations:EF: ejection fraction, ASE: American society of echocardiography, EACVI: European association of cardiovascular imaging, LV: left ventricle, LVEF: left ventricular ejection fraction, HFpEF: heart failure with preserved ejection fraction, HFrEF: heart failure with reduced ejection fraction, MI: myocardial infarction, DCMP: dilated cardiomyopathy, AF: atrial fibrillation, TTE: Transthoracic echocardiography, TEE: trans-esophageal echocardiography, RHD: rheumatic heart disease, HTN: hypertension, DM: diabetes mellitus, CHF: congestive heart failure, JVP: jugular venous pressure, CBC: complete blood count, LFT: liver function tests, RFT: renal function test, LVT: left ventricular thrombus, ECG: electrocardiography, LVT: left ventricular thrombus, EDV: end diastolic volume, ESV: end systolic volume, SPSS: statistical package for the social sciences, IBM: international business machines, SD: standard deviation. doi: https://doi.org/10.12669/pjms.36.4.1972 How to cite this:Aljaber NN, Mattash ZA, Alshoabi SA, Alhazmi FA. The prevalence of left ventricular thrombus among patients with low ejection fraction by trans-thoracic echocardiography. Pak J Med Sci. 2020;36(4):---------. doi: https://doi.org/10.12669/pjms.36.4.1972 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Paul B Tabereaux ◽  
Todd M Brown ◽  
Jose Osorio ◽  
G. N Kay ◽  
Dawn M Bravada

Introduction: Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia in the United States; however a paucity of population-based data about nonwhite individuals exist. The objectives of this study were to compare hospitalizations among Whites and African Americans (AA) and to determine whether race is an independent predictor of hospitalization for AF in the United States. Methods: Data was obtained from the National Hospital Discharge Survey (years 1996 –2005) and included hospitalizations with a principal diagnosis of AF for patients aged ≥18 yrs and race designated as either White or AA. Codes from the International Classification of Diseases -9th revision were used to define AF (427.31), hypertension (401– 405), ischemic heart disease (410 – 414), diabetes mellitus (250), heart failure (425,428) and valvular heart disease (424). Multivariable analysis with logistic regression was used to identify factors that were independently associated with AF hospitalizations Results: Among 297,962,043 hospitalizations between 1996 –2005, 3,676,787 (1.2%) had a principal diagnosis of AF. Among the hospitalizations for AF, white race was more common than AA race (2,393,659/186,904,962 of whites (1.3% of white’s hospitalized) and 209,788/33,972,665 of African Americans (0.6% of AA’s hospitalized), p<0.0001). After adjusting for the most common risk factors for AF (age, sex, hypertension, ischemic heart disease, diabetes mellitus, heart failure and valvular heart disease) AA race was independently associated with a decreased odds of hospitalizations for AF (Table 1 : adjusted OR=0.49, 95%CI 0.46 – 0.51). Conclusions: After adjusting for the most common risk factors for AF, the odds of hospitalization for AF in AA’s remained half that of whites. Race may be a novel and unaccounted risk factor for atrial fibrillation.


2019 ◽  
Vol 6 (2) ◽  
pp. 439
Author(s):  
Bansari S. Mistry ◽  
Krupa Pathak ◽  
Smita K. Trivedi

Background: The overall prevalence of heart failure (HF) is thought to be increasing, in part because current therapies for cardiac disorders such as myocardial infarction (MI), valvular heart disease and arrhythmias, are allowing patients to survive longer. Aims of the study were to know the presentation, causes, outcome of HF patients and to know the proportion of patients with heart failure with preserved ejection fraction (HFpEF) and heart failure with reduced ejection fraction (HFrEF).Methods: This was a cross-sectional observational study of heart failure patients for duration of one year, admitted in medicine department of medical college and SSG hospital, Vadodara, Gujarat, India.Results: Males constituted more than half of patients; however, HFpEF was more common in females in all age groups. Majority of patients had HFrEF. Breathlessness was the common presenting symptom. Common aetiologies found were ischaemic heart disease (IHD), hypertension (HTN), diabetes mellitus (DM) and valvular heart disease. 50-64 year patients constituted the major age group. IHD and DM were more common in this age group. Rheumatic heart disease (RHD) was seen commonly in 20-34 year of age group. In-hospital mortality rate though low has not much changed and contributes significantly considering the prevalence.Conclusions: Like developing countries, IHD contributes a major portion of patients with HF with risk factors like DM and HTN. Though, the contribution from RHD still cannot be ignored. There is little decrease in mortality but considering prevalence the burden is still high.


Author(s):  
Shivananda B Nayak ◽  
Dharindra Sawh ◽  
Brandon Scott ◽  
Vestra Sears ◽  
Kareshma Seebalack ◽  
...  

Purpose: i) To determine the relationship between the cardiac biomarkers ST2 and NT-proBNP with ejection fraction (EF) in heart failure (HF) patients. ii) Assess whether a superiority existed between the aforementioned cardiac markers in diagnosing the HF with reduced EF. iii) Determine the efficacy of both biomarkers in predicting a 30-day cardiovascular event and rehospitalization in patients with HF with reduced EF iv) To assess the influence of age, gender, BMI, anaemia and renal failure on the ST2 and NT-proBNP levels. Design and Methods: A prospective double-blind study was conducted to obtain data from a sample of 64 cardiology patients. A blood sample was collected to test for ST2 and NT-proBNP. An echocardiogram (to obtain EF value), electrocardiogram and questionnaire were also obtained. Results: Of the 64 patients enrolled, 59.4% of the population had an EF less than 40%. At the end of the 30- day period, 7 patients were warded, 37 were not warded, one died and 17 were non respondent. Both biomarkers were efficacious at diagnosing HF with a reduced EF. However, neither of them were efficacious in predicting 30-day rehospitalization. The mean NT-proBNP values being: not rehospitalized (2114.7486) and 30 day rehospitalization (1008.42860) and the mean ST2 values being: not rehospitalized (336.1975), and 30-day rehospitalization. (281.9657). Conclusion: Neither ST2 or NT-proBNP was efficacious in predicting the short- term prognosis in HF with reduced EF. Both however were successful at confirming the diagnosis of HF in HF patients with reduced EF.


2021 ◽  
Vol 11 (10) ◽  
pp. 4397
Author(s):  
Michael Lichtenauer ◽  
Peter Jirak ◽  
Vera Paar ◽  
Brigitte Sipos ◽  
Kristen Kopp ◽  
...  

Heart failure (HF) and type 2 diabetes mellitus (T2DM) have a synergistic effect on cardiovascular (CV) morbidity and mortality in patients with established CV disease (CVD). The aim of this review is to summarize the knowledge regarding the discriminative abilities of conventional and novel biomarkers in T2DM patients with established HF or at higher risk of developing HF. While conventional biomarkers, such as natriuretic peptides and high-sensitivity troponins demonstrate high predictive ability in HF with reduced ejection fraction (HFrEF), this is not the case for HF with preserved ejection fraction (HFpEF). HFpEF is a heterogeneous disease with a high variability of CVD and conventional risk factors including T2DM, hypertension, renal disease, older age, and female sex; therefore, the extrapolation of predictive abilities of traditional biomarkers on this population is constrained. New biomarker-based approaches are disputed to be sufficient for improving risk stratification and the prediction of poor clinical outcomes in patients with HFpEF. Novel biomarkers of biomechanical stress, fibrosis, inflammation, oxidative stress, and collagen turn-over have shown potential benefits in determining prognosis in T2DM patients with HF regardless of natriuretic peptides, but their role in point-to-care and in routine practice requires elucidation in large clinical trials.


2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
U Zeymer ◽  
L.H Lund ◽  
V Barrios ◽  
C Fonseca ◽  
A.L Clark ◽  
...  

Abstract Background Heart failure (HF) is a major medical and economic burden that is often managed in office based practices. Recently, the angiotensin receptor neprilysin inhibitor (ARNI) sacubitril/valsartan (S/V) was introduced as novel therapeutic option into European guidelines for the management of HF. The ARIADNE registry aims to provide information on how outpatients with HF with reduced ejection fraction (HFrEF) are managed in Europe, in light of this novel treatment option. Methods ARIADNE was a prospective registry of patients with HFrEF treated by office-based cardiologists (OBC) or selected primary care physicians (recognized as HF specialists; PCP) in a real world setting. HFrEF patients were included prospectively, independently of whether treatment had been changed recently or not. 9069 patients were recruited from 687 centres in 17 European countries. Results The mean age of all patients was 68.1 years (S/V: 67.3 years, Non-S/V: 68.9 years). The majority of patients were in NYHA class II (61.3%), or NYHA class III (37.1%) overall, while more patients in the S/V group showed NYHA class III (S/V: 42.8%, Non-S/V: 30.9%). Mean LVEF was slightly lower in the S/V group than in the Non-S/V group (S/V: 32.7%, Non-S/V: 35.4%, overall 34.0%). The most frequently observed signs of HF were dyspnoea upon effort, followed by fatigue, palpitations on exertion at baseline. More patients tend to have more severe symptoms in the S/V groups (e.g. for dyspnoea on effort, Non-S/V: moderate 40.8%, severe 8.6%; S/V: moderate 46.4%, severe 14.1%). 44.0% of patients from the S/V group and 39.3% of non-S/V patients reported at least one hospitalization within 12 months prior to baseline, of which 73.3% in S/V and 69.9% in non-S/V patients were due to HF., At baseline, 44.7% of the patients used a CV device, of which most were implantable cardioverter defibrillator (ICD: Non-S/V 54.2%, S/V: 52.8%), implantable cardioverter defibrillator (CRT-ICD:Non-S/V 21.9%, S/V: 27.0%), and pacemaker (Non-S/V: 13.4%, S/V: 10.5%). The mean KCCQ overall summary score was 62.6 in the S/V group and 69.5 in the Non-S/V group at baseline. 83.9% of patients were treated with ARB or ACEi in Non-S/V group, (ACEi 57.3%, ARB 26.9%). The most frequently taken drug combinations in either group were ACEi/ ARB or S/V with β -blockers (Non-S/V 69.3%, S/V 67.3%). 40.2% in the Non-S/V group and 42.9% in S/V groups used a combination of ACEi/ARB or S/V, β-blocker and MRA. Conclusions The ARIADNE prospective registry provides insights and reflects variations in HF treatment practices in outpatients in Europe and the way S/V was introduced by OBCs and specialized PCPs in a real-world setting. In the observed population, S/V is more often prescribed to slightly younger patients with slightly lower LVEF, there was a greater observed percentage of S/V patients NYHA class III, with lower quality of life measurements and with more severe symptoms and recent hospitalizations for heart failure. Funding Acknowledgement Type of funding source: Private company. Main funding source(s): Novartis Pharma AG


2021 ◽  
Vol 9 (11) ◽  
pp. 1043-1046
Author(s):  
Shaista Alvi

Heart Failure is a growing concern now a days. Many drugs are available for the treatment of heart failure but still there is increasing prevalence of heart failure. SGLT 2 inhibitors were initially developed for diabetes mellitus but they are found to be effective for Heart Failure with reduced ejection also. Many large scale randomized controlled trials also confirmed this and now they are recommended in the treatment of heart failure with reduced ejection fraction.


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