scholarly journals Prognostic value of D-dimer/fibrinogen ratio on in-hospital outcomes of patients with heart failure and COVID-19

2021 ◽  
Author(s):  
Selda Murat ◽  
Bektas Murat ◽  
Muhammet Dural ◽  
Gurbet Ozge Mert ◽  
Yuksel Cavusoglu
Keyword(s):  
Heart Failure ◽  
Prognostic Value ◽  
Independent Predictor ◽  
Hospital Outcomes ◽  
The Third ◽  
Patients With Heart Failure ◽  
The Relationship ◽  
Infection Markers ◽  
Length Of Icu Stay ◽  
D Dimer

Aim: In the present study, the relationship between D-dimer/fibrinogen ratio (DFR) and in-hospital outcomes was evaluated in patients with COVID-19 and a diagnosis of heart failure (HF). Materials & methods: In-hospital outcomes were compared in patients with high and low DFR values. Results: With regard to in-hospital outcomes, patients in the third tertile of DFR had a higher rate of mechanical ventilation, cardiogenic shock and death (p < 0.001). The length of ICU stay was longer in the third tertile group (p < 0.001). When evaluated together with infection markers, DFR was found to be an independent predictor of outcomes. Conclusion: DFR can be used as a prognostic marker in patients with COVID-19 with a diagnosis of HF, and perhaps more valuable than other infection markers.

scholarly journals Prognostic Value of Asymmetric Dimethylarginine in Patients with Heart Failure: A Systematic Review and Meta-analysis

2020 ◽  
Vol 2020 ◽  
pp. 1-9
Author(s):  
Wenjun Pan ◽  
Baotao Lian ◽  
Haining Lu ◽  
Pengda Liao ◽  
Liheng Guo ◽  
...  
Keyword(s):  
Heart Failure ◽  
Prognostic Value ◽  
Asymmetric Dimethylarginine ◽  
Independent Predictor ◽  
Meta Analysis ◽  
Continuous Variable ◽  
Inhospital Mortality ◽  
Categorical Variable ◽  
Clinical Events ◽  
Patients With Heart Failure

Objective. Asymmetric dimethylarginine (ADMA), an endogenous inhibitor of nitric oxide (NO) synthesis, is reported to be a risk factor for cardiovascular disease. The purpose of the present study is to investigate whether ADMA is an independent predictor for future mortality and adverse clinical events among patients with heart failure (HF). Methods. Electronic literature databases (Central, MEDLINE, and Embase) were searched for relevant observational studies on the prognostic value of ADMA in HF patients published before January 2019. Pooled hazard ratios (HRs) or odds ratio and the corresponding 95% confidence interval (CI) were calculated for risk evaluation. Results. 10 studies with 2195 participants were identified and analyzed. The pooled HR of composite clinical events for the highest vs. lowest quartiles from categorical variable results was 1.34 (95% CI: 1.15-1.57, P<0.001, I2=0%), which is 1.31 (95% CI: 1.10-1.55, P<0.005, I2=0%) in the subgroup of acute decompensated HF. The pooled HR of composite clinical events from continuous variable results was 1.41 (95% CI: 1.21-1.63, P<0.001, I2=21.9%), with 0.1 μM increment accounting for the increasing 25% risk for composite adverse clinical events. The pooled HR for all-cause mortality was 2.38 (95% CI: 1.48-3.82, P<0.001, I2=0%) after sensitivity analysis. Two studies reporting the HR of inhospital mortality in HF patients regarded it as a prognostic indicator, with categorical variable HR as 1.26 (95% CI: 1.07-1.84, P<0.05) and continuous variable OR as 2.15 (95% CI: 1.17–4.29, P<0.05). Conclusions. ADMA is an independent predictor for composite clinical outcomes among HF patients with both short-term and long-term prognostic value.

The prognostic value of myocardial deformational patterns is reduced in patients with heart failure

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
A Holm ◽  
P Brainin ◽  
M Sengeloev ◽  
P.G Joergensen ◽  
N.E Bruun ◽  
...  
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Prognostic Value ◽  
Left Ventricular ◽  
Volume Index ◽  
Left Ventricular Ejection ◽  
Patients With Heart Failure ◽  
All Cause Mortality ◽  
The Relationship ◽  
Maximal Strain

Abstract Background Early systolic lengthening (ESL) and postsystolic shortening are considered highly specific for myocardial ischemia. We aimed to investigate the prognostic potential of both deformational patterns in patients with heart failure (HF) and to determine if a history of ischemic heart disease modified this relationship. Method A total of 884 patients with systolic HF (66±12 years, male 73%, mean ejection fraction 28±9%) underwent speckle tracking echocardiography. Of these, 61% suffered from ischemic cardiomyopathy (ICM). Patients were followed for all-cause mortality. We assessed the ESL index: [−100x (peak positive strain/maximal strain)] and the postsystolic index (PSI): [100x (postsystolic strain/maximal strain)]. Both parameters were averaged across 18 myocardial segments. Results During a median follow-up of 3.4 years [interquartile range 1.9 to 4.8], 132 patients (15%) died. In multivariable survival analyses adjusted for potential confounders (age, sex, BMI, mean arterial pressure, cholesterol, heart rate, CABG/PCI, left ventricular ejection fraction and mass index, left atrial volume index, tricuspid annular plane systolic excursion, E-wave, E/e', deceleration time, and global longitudinal strain) neither the ESL index (HR 1.02 per 1% increase [0.97 to 1.08], P=0.40) nor PSI (HR 1.00 per 1% increase [0.98 to 1.01], P=0.69) were associated with all-cause mortality. ICM modified the relationship (P interaction unadjusted/adjusted=0.001/0.008; Figure) such that per 1% increase in ESL index in patients with ICM was significantly associated with all-cause mortality (unadjusted: HR 1.09 [1.04 to 1.15], P&lt;0.001 and adjusted: HR 1.06 [1.00 to 1.13], P=0.045) but not in those without (unadjusted: HR 1.02 [1.01 to 1.03], P=0.002 and adjusted: HR 0.99 [0.90 to 1.09], P=0.086). ICM did not modify the relationship between PSI and all-cause mortality (P interaction unadjusted/adjusted=0.15/0.13). Conclusion Our results indicate that in this cohort of undifferentiated HF patients with reduced ejection fraction the prognostic value of deformational patterns was reduced. However, the ESL index may provide some information on prognosis in patients with ICM. ESL and interaction with ICM Funding Acknowledgement Type of funding source: None

Prognostic value of global longitudinal layer specific strain for patients with heart failure with reduced ejection fraction

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
C Johnsen ◽  
M Sengeloev ◽  
P Joergensen ◽  
N Bruun ◽  
D Modin ◽  
...  
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Prognostic Value ◽  
Left Ventricular ◽  
Volume Index ◽  
Funding Source ◽  
Reduced Ejection Fraction ◽  
Patients With Heart Failure ◽  
All Cause Mortality ◽  
Echocardiographic Parameters

Abstract Background Novel echocardiographic software allows for layer-specific evaluation of myocardial deformation by 2-dimensional speckle tracking echocardiography. Endocardial, epicardial- and whole wall global longitudinal strain (GLS) may be superior to conventional echocardiographic parameters in predicting all-cause mortality in patients with heart failure with reduced ejection fraction (HFrEF). Purpose The purpose of this study was to investigate the prognostic value of endocardial-, epicardial- and whole wall GLS in patients with HFrEF in relation to all-cause mortality. Methods We included and analyzed transthoracic echocardiographic examinations from 1,015 patients with HFrEF. The echocardiographic images were analyzed, and conventional and novel echocardiographic parameters were obtained. A p value in a 2-sided test &lt;0.05 was considered statistically significant. Cox proportional hazards regression models were constructed, and both univariable and multivariable hazard ratios (HRs) were calculated. Results During a median follow-up time of 40 months, 171 patients (16.8%) died. A lower endocardial (HR 1.17; 95% CI (1.11–1.23), per 1% decrease, p&lt;0.001), epicardial (HR 1.20; 95% CI (1.13–1.27), per 1% decrease, p&lt;0.001), and whole wall (HR 1.20; 95% CI (1.14–1.27), per 1% decrease, p&lt;0.001) GLS were all associated with higher risk of death (Figure 1). Both endocardial (HR 1.12; 95% CI (1.01–1.23), p=0.027), epicardial (HR 1.13; 95% CI (1.01–1.26), p=0.040) and whole wall (HR 1.13; 95% CI (1.01–1.27), p=0.030) GLS remained independent predictors of mortality in the multivariable models after adjusting for significant clinical parameters (age, sex, total cholesterol, mean arterial pressure, heart rate, ischemic cardiomyopathy, percutaneous transluminal coronary angioplasty and diabetes) and conventional echocardiographic parameters (left ventricular (LV) ejection fraction, LV mass index, left atrial volume index, deceleration time, E/e', E-velocity, E/A ratio and tricuspid annular plane systolic excursion). No other echocardiographic parameters remained an independent predictors after adjusting. Furthermore, endocardial, epicardial and whole wall GLS had the highest C-statistics of all the echocardiographic parameters. Conclusion Endocardial, epicardial and whole wall GLS are independent predictors of all-cause mortality in patients with HFrEF. Furthermore, endocardial, epicardial and whole wall GLS were superior prognosticators of all-cause mortality compared with all other echocardiographic parameters. Funding Acknowledgement Type of funding source: Public hospital(s). Main funding source(s): Herlev and Gentofte Hospital

P2263Prognostic impact of perceived social isolation in patients with heart failure

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
T Ikeda ◽  
K Iwatsu ◽  
K Matsumura ◽  
H Ashikawa ◽  
K Takabayashi ◽  
...  
Keyword(s):  
Heart Failure ◽  
Social Isolation ◽  
Roc Curve ◽  
Negative Impact ◽  
Roc Curve Analysis ◽  
Rehospitalization Rate ◽  
Kaplan Meier ◽  
Patients With Heart Failure ◽  
Perceived Social Isolation ◽  
The Relationship

Abstract Background Perceived social isolation (SI), the subjective sense of feelings of loneliness or isolation, has a negative impact on health outcomes, particularly in older adults. Although SI may also contribute to poor prognosis in patients with HF, evidence on the relationship between SI and outcomes in patients with HF is limited. Purpose The aim of this study was to investigate the relationship between SI and hospital readmission in patients with HF. Methods This study was a single center prospective cohort study. We consecutively enrolled 203 patients (mean age 72.9±11.7) who admitted for acute HF or exacerbation of chronic HF. At hospital discharge, we assessed perceived SI by using Lubben Social Network Scale - 6 (LSNS-6). Lower scores in LSNS-6 represents greater SI. Study outcome was rehospitalization for worsening HF within 180 days after discharge. We selected the optimal cutoff point of LSNS-6 that predict a worse outcome by the receiver operating characteristic (ROC) curve analysis. We investigate the association between SI and 180-days HF rehospitalization by using Cox proportional-hazard models, controlling for potential confounding factors. Results During follow up, A total of 40events (19.7%) were observed. The optimal cut-off point of LSNS-6 score was 17 points (the area under the ROC curve: 0.62, p<0.05, sensitivity: 82.5%, specificity 42.4%). Kaplan-Meier survival curves showed that those patients with greater SI (LSNS-6≤17) presented significantly higher HF rehospitalization rate (Figure). After adjusting for several pre-existing prognostic factors, LSNS-6≤17 was independently associated with HF rehospitalization (hazard ratio2.15,95% confidence interval 1.00–4.89). Conclusion The present study shows that SI is a independent predictor of HF rehospitalization in patients with HF. Assessing SI in the clinical practice with a brief screening tool may help identify patients with heart failure at greater risk of rehospitalization.

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