scholarly journals PROBLEMS AND SPECIFICITY OF DIAGNOSTICS OF ACUTE HEART FAILURE IN PATIENTS WITH INTERMEDIATE EJECTION FRACTION AT THE НОSPITAL STAGE

2018 ◽  
Vol 19 (1) ◽  
pp. 16-19 ◽  
Author(s):  
E. G. Skorodumova ◽  
V. A. Kostenko ◽  
E. A. Skorodumova ◽  
A. V. Rysev
Keyword(s):  
Heart Failure ◽  
Acute Coronary Syndrome ◽  
Ejection Fraction ◽  
Acute Heart Failure ◽  
Diagnostic Errors ◽  
Coronary Syndrome ◽  
Acute Decompensation

We analyzed ambulance diagnoses of patients with acute decompensation of heart failure with the background of the intermediate ejection fraction. In this category of patients acute decompensation of heart failure was diagnosed in-hospital, not associated with acute coronary syndrome, or other cardiological diseases. 78 variants of different diagnoses of referral of patients to the hospital at the prehospital stage were found, with a true diagnosis of acute decompensation of heart failure being established in only patients. All diagnoses were divided into 6 groups with the subsequent analysis of the causes of diagnostic errors.

scholarly journals Prognostic Significance of I-Month Postdischarge BNP in Identifying Patients at High Risk of Mortality and Readmission After Decompensated Heart Failure

2020 ◽  
Vol 1 (2) ◽  
pp. 59-66
Author(s):  
Vinod Kumar ◽  
Pravin K. Goel ◽  
Roopali Khanna ◽  
Aditya Kapoor ◽  
Kunal Mahajan
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Acute Heart Failure ◽  
Prognostic Significance ◽  
Decompensated Heart Failure ◽  
P Value ◽  
Coronary Syndrome ◽  
Risk Of Mortality ◽  
Acute Decompensation

Objective: The B-type natriuretic peptide (BNP) levels could predict future cardiovascular events in congestive heart failure patients. Most studies have correlated basal BNP levels to long-term outcomes. Limited data exist on the prognostic significance of 1-month postdischarge BNP levels after acute heart failure. Methods: Consecutive patients admitted for worsening heart failure were enrolled. BNP was measured at admission, predischarge and at 1-month following discharge. Patients were followed for 1 year for end points of death and rehospitalization. Results: A total of 150 patients (mean age 60.8 + 13.8 years) were included in the heart failure study. 81 (54%) patients had acute heart failure secondary to acute coronary syndrome, while the rest (46%) had acute decompensation of chronic heart failure irrespective of etiology. Mean ejection fraction was 28.6 + 8.9%. 14 patients expired during hospitalization. BNP at admission was an important predictor of in hospital mortality ( P value = .003). Following discharge, 7 events (3 deaths and 4 rehospitalizations) occurred over next 1 month. 1-month outcome was predicted by baseline BNP ( P value = .01) as well as discharge BNP value ( P value = .001). A total of 55 events (26 rehospitalization and 29 deaths) occurred at follow-up of 1 year. Age > 50years, ejection fraction at baseline and all time sequential BNP levels (at admission, discharge, as well as 1 month) were univariate predictors of death and rehospitalization at 1 year. The BNP at 1 month had best discriminative power and remained the lone significant predictor in the multivariate analysis ( P = < .001). Conclusions: 1-month postdischarge BNP level is a useful prognostic factor that predicts mortality and rehospitalization at 1-year follow-up, in patients admitted with heart failure, and helps in identifying patients who need more intensive drug treatment and closer follow-up.

scholarly journals The role of levosimendan in acute heart failure complicating acute coronary syndrome: A review and expert consensus opinion

2016 ◽  
Vol 218 ◽  
pp. 150-157 ◽  
Author(s):  
Markku S. Nieminen ◽  
Michael Buerke ◽  
Alain Cohen-Solál ◽  
Susana Costa ◽  
István Édes ◽  
...  
Keyword(s):  
Heart Failure ◽  
Acute Coronary Syndrome ◽  
Acute Heart Failure ◽  
Expert Consensus ◽  
Coronary Syndrome ◽  
Consensus Opinion

Outcome of Allogeneic Stem Cell Transplantation in Patients with Low Ventricular Ejection Fraction

Blood ◽  
2008 ◽  
Vol 112 (11) ◽  
pp. 3306-3306
Author(s):  
Ziad U. Khan ◽  
Rima M Saliba ◽  
Suhail Qureshi ◽  
Chitra Hosing ◽  
Sergio A Giralt ◽  
...  
Keyword(s):  
Heart Failure ◽  
Congestive Heart Failure ◽  
Acute Coronary Syndrome ◽  
Stem Cell ◽  
Ejection Fraction ◽  
Stem Cell Transplantation ◽  
Cardiac Toxicity ◽  
Hematologic Malignancies ◽  
Ventricular Ejection Fraction ◽  
Coronary Syndrome

Abstract BACKGROUND: High-dose therapy and Allogeneic stem cell transplantation (allo SCT) is a potentially curative treatment for patients with hematologic malignancies. A high risk of regimen-related toxicity limits this treatment only for patients with excellent organ-system function. A low left ventricular ejection fraction (LVEF) of ≤ 45% is considered to be a major risk factor for post-transplant cardiac toxicity and nonrelapse mortality (NRM). However, several patients with advanced hematologic malignancies and low LVEF can potentially benefit from this therapy. To address this issue, we evaluated the frequency of cardiac toxicity and NRM in 56 patients with low LVEF undergoing allo SCT. METHODS: We performed a retrospective analysis on 56 patients with baseline low LVEF who received allo SCT between January 2000 and February 2006 at our institution. Pre-transplant evaluation included an electrocardiogram and bidimensional echocardiogram or gated cardiac scan. Cardiac toxicity was defined as congestive heart failure (CHF), atrial/ventricular arrhythmia or an acute coronary syndrome. Of the 56 patients, 22 received a myeloablative regimen (16 busulfan-based, 6 total body irradiation-based) while 34 patients received a fludarabine-based reduced intensity conditioning regimen. RESULTS: Twenty-three patients (41%) received allo SCT from an unrelated donor. Acute leukemia was the reason for allo SCT in 32 (57%) patients. Baseline LVEF within 30 days pre-transplant ranged 20 to 45%. At their 6 month follow-up, cardiac toxicity was seen in 7 (12%) patients. Toxicity included congestive heart failure (CHF) in 4 (7%) and atrial fibrillation (AF) in 4 (7%). One patient had both CHF and AF. There were no documented episodes of acute coronary syndrome. Cumulative incidence of NRM at 100 days was 12%; none of the deaths were attributable to cardiac causes. These results were comparable to allo SCT performed in patients with normal LVEF. Variables such as age, LVEF, type of transplant, or the underlying disease did not emerge as significant predictors of post-transplant cardiac toxicity or NRM. CONCLUSION: Patients with low LVEF (<45%) are acceptable candidates for allo SCT. A prospective study with stratification of cardiac risk factors is warranted in patients with low LVEF.

Carbohydrate antigen-125: additional accuracy in identifying patients at risk of acute heart failure in acute coronary syndrome

2009 ◽  
Vol 20 (4) ◽  
pp. 274-280 ◽  
Author(s):  
Luisa De Gennaro ◽  
Natale Daniele Brunetti ◽  
Rosa Bungaro ◽  
Deodata Montrone ◽  
Andrea Cuculo ◽  
...  
Keyword(s):  
Heart Failure ◽  
At Risk ◽  
Acute Coronary Syndrome ◽  
Acute Heart Failure ◽  
Carbohydrate Antigen ◽  
Carbohydrate Antigen 125 ◽  
Coronary Syndrome ◽  
Patients At Risk

scholarly journals Beta-blockers for post-acute coronary syndrome mid-range ejection fraction: a nationwide retrospective study

2019 ◽  
Vol 8 (7) ◽  
pp. 599-605 ◽  
Author(s):  
Fernando Montenegro Sá ◽  
Rita Carvalho ◽  
Catarina Ruivo ◽  
Luís Graça Santos ◽  
Alexandre Antunes ◽  
...  
Keyword(s):  
Heart Failure ◽  
Acute Coronary Syndrome ◽  
Ejection Fraction ◽  
Beta Blocker ◽  
Survival Benefit ◽  
Positive Impact ◽  
Inhospital Mortality ◽  
Invasive Strategy ◽  
Coronary Syndrome ◽  
Group 3

Background: Patients with mid-range ejection fraction (40–49%) are in focus due to the newly defined entity of heart failure with mid-range ejection fraction. Acute coronary syndromes are a major aetiology for heart failure with mid-range ejection fraction. We aim to evaluate which therapeutic decisions are associated with inhospital survival benefit in post-acute coronary syndrome patients categorised according to the ejection fraction. Methods and results: The authors analysed a cohort of a multicentre national registry enrolling acute coronary syndrome patients between 2010 and 2016, classified according to their ejection fraction before hospital discharge. Patients with previously known heart failure or with no ejection fraction evaluation were excluded. A total of 9429 patients were included and categorised in three groups: (a) ejection fraction of 50% or greater ( n=6113, 65%); (b) ejection fraction of 40–49% ( n=1926, 20%); and (c) ejection fraction less than 40% ( n=1390, 15%). The primary endpoint was inhospital mortality. To eliminate confounding factors, a multivariate logistic regression analysis was conducted, including acute coronary syndrome type, baseline characteristics, pharmacological treatment, clinical data, laboratory data and coronary anatomy when known. The overall inhospital mortality was 2.8% ( n=263): 0.9% ( n=53) in group 1, 2.4% ( n=37) in group 2 and 11.4% ( n=159) in group 3. After multivariate analysis, an invasive strategy had a positive impact in all groups, inhospital beta-blocker administration had a positive impact for groups 2 and 3, and angiotensin-converting enzyme inhibitor/angiotensin receptor blocker and spironolactone had a positive impact on group 3. Conclusion: Post-acute coronary syndrome mid-range ejection fraction patients represent an intermediate risk group in which beta-blocker administration was associated with inhospital survival benefit. An invasive strategy was a survival predictor for all groups, regardless of ejection fraction category.

scholarly journals Acute heart failure precipitated by acute coronary syndrome - patient characteristics, management and survival

2013 ◽  
Vol 34 (suppl 1) ◽  
pp. 1721-1721
Author(s):  
T. Tarvasmaki ◽  
V.- P. Harjola ◽  
J. Tolonen ◽  
K. Siirila-Waris ◽  
M. S. Nieminen ◽  
...  
Keyword(s):  
Heart Failure ◽  
Acute Coronary Syndrome ◽  
Acute Heart Failure ◽  
Acute Coronary Syndrome Patient ◽  
Patient Characteristics ◽  
Syndrome Patient ◽  
Coronary Syndrome
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