scholarly journals Systolic-diastolic attitude in patients with acute decompensation of heart failure

2021 ◽  
Vol 22 (3) ◽  
pp. 19-23
Author(s):  
E. G. Skorodumova ◽  
V. A. Kostenko ◽  
E. A. Skorodumova ◽  
I. N. Gayvoronskiy ◽  
A. V. Siverina ◽  
...  
Keyword(s):  
Heart Failure ◽  
Left Ventricle ◽  
Ejection Fraction ◽  
Acute Heart Failure ◽  
Coronary Flow ◽  
Treatment Effectiveness ◽  
Lv Function ◽  
Different Types ◽  
Acute Decompensation ◽  
Heart Failure Decompensation

The aim of the study was to evaluate the systolic-diastolic ratio in patients with acute decompensation of heart failure against the background of the intermediate function of the left ventricle. This article is based on data from 585 electrocardiograms of 195 patients (98 males and 97 females), the average age was 64.6±14.8 years. By the level of the ejection fraction of left ventricle (LVEF), all patients were divided into three groups: with a reduced LVEF an intermediate LVEF and a preserved LVEF. As a result it was shown that in the groups of intermediate and low EF, when the systole of ventricles dominate over the diastole, but under the treatment ratio changed to the prevalence of diastole. In the preserved LVEF sample diastole dominates at all stages of the observation. Analysis of the ratio described may be useful for assessment of treatment effectiveness and coronary flow in patients with different types of LV function under acute heart failure decompensation.

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 Factors associated with plasma antigen carbohydrate 125 and amino-terminal pro-B-type natriuretic peptide concentrations in acute heart failure

2020 ◽  
Vol 9 (5) ◽  
pp. 437-447 ◽  
Author(s):  
Gema Miñana ◽  
Rafael de la Espriella ◽  
Anna Mollar ◽  
Enrique Santas ◽  
Eduardo Núñez ◽  
...  
Keyword(s):  
Heart Failure ◽  
Left Ventricle ◽  
Ejection Fraction ◽  
Acute Heart Failure ◽  
Natriuretic Peptide ◽  
Tricuspid Regurgitation ◽  
Left Ventricle Ejection Fraction ◽  
Factors Associated ◽  
Amino Terminal ◽  
Main Factors

Background: Plasma amino-terminal pro-B-type natriuretic peptide and antigen carbohydrate 125 levels are positively associated with a higher risk of adverse clinical outcomes in acute heart failure. As a proxy of congestion, antigen carbohydrate 125 has also been proposed as a right-sided heart failure marker. Thus, we aimed to determine in this population the main factors – including echocardiographic right-sided heart failure parameters – associated with antigen carbohydrate 125 and amino-terminal pro-B-type natriuretic peptide. Methods and results: We prospectively included 2949 patients admitted with acute heart failure. Amino-terminal pro-B-type natriuretic peptide and antigen carbohydrate 125 were used as dependent variables in a multivariable linear regression analysis. The mean age of the sample was 73.9±11.1 years; 48.9% were female, 35.8% showed ischaemic aetiology, and 51.6% exhibited heart failure with preserved ejection fraction. The median (interquartile range) for amino-terminal pro-B-type natriuretic peptide and antigen carbohydrate 125 were 4840 (2111–9204) pg/ml and 58 (26–129) U/ml, respectively. In a multivariable setting, and ranked in order of importance (R2), estimated glomerular filtration rate (43.7%), left ventricle ejection fraction (15.1%), age (12.4%) and high-sensitivity troponin T (10.9%) emerged as the most important factors associated with amino-terminal pro-B-type natriuretic peptide. The five main factors associated with antigen carbohydrate 125 were, in order of importance: the presence of pleural effusion (36.8%), tricuspid regurgitation severity (25.1%), age (11.9%), amino-terminal pro-B-type natriuretic peptide (6.5%) and peripheral oedema (4.3%). Conclusion: In patients with acute heart failure the main factors associated with amino-terminal pro-B-type natriuretic peptide were renal dysfunction, left ventricle ejection fraction and age. For antigen carbohydrate 125, clinical parameters of congestion and the severity of tricuspid regurgitation were the most important predictors. These results endorse the value of antigen carbohydrate 125 as a useful marker of right-sided heart failure.

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 Portrait of the patient with intermediate ejection fraction of the left ventricle on the background of acute decompencation of heart failure

2018 ◽  
Vol 10 (2) ◽  
pp. 87-91
Author(s):  
E G Skorodumova ◽  
V A Kostenko ◽  
E A Skorodumova ◽  
A V Siverina ◽  
A V Rysev ◽  
...  
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Left Ventricle ◽  
Ejection Fraction ◽  
Statistical Processing ◽  
Risk Of Death ◽  
Acute Decompensation ◽  
Hemodynamic Profile ◽  
Comorbidity Index ◽  
Microsoft Office

Background. Medico-statistical portrait of patient are a fairly new concept. Materials and methods. 71 patients with intermediate ejection fraction of left ventricle (ILVEF) under acute decompensation of chronic heart failure were examined, 51 of them were male (71.8%) and 20 female (28.2%). Main cause of cronic heart failure was ischemic heart disease and arterial hypertension. The Charlson comorbidity index and Stevenson’s hemodynamic profile of patients. The average age of the individuals is 65.6 ± 12.1 years. Statistical processing of the data was carried out using the method of multifactor analysis using SPSS 23 and the Microsoft Office Excel 10.0 package. Results. Main features of portrait of a patient with ILVEF with acute decompensation of heart failure, which has an high risk of death, is a male aged 64 to 71 years, with a Charlson’s comorbidity index equal to 5 points and higher, as well as a hemodynamic profile of B or C. Portrait of a patient with ILVEF who has a low risk of death - a male / female aged 55 to 64 with a Charlson’s index from 1 to 4 points, as well as hemodynamic profile A and L. The conclusion. This article describes a creation of mathematical model for patients with ILVEF and acute decompensation of chronic heart failure under background of comorbidity and hemodynamics with a check of the obtained models using ROC-analysis. (For citation: Skorodumova EG, Kostenko VA, Skorodumova EA, et al. Portrait of the patient with intermediate ejection fraction of the left ventricle on the background of acute decompencation of heart failure. Herald of North-Western State Medical University named after I.I. Mechnikov. 2018;10(2):87-91. doi: 10.17816/mechnikov201810287-91).

scholarly journals A Practical Risk Score for Prediction of Early Readmission after a First Episode of Acute Heart Failure with Preserved Ejection Fraction

Diagnostics ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. 198
Author(s):  
Marilena-Brîndușa Zamfirescu ◽  
Liviu Nicolae Ghilencea ◽  
Mihaela-Roxana Popescu ◽  
Gabriel Cristian Bejan ◽  
Ileana Maria Ghiordanescu ◽  
...  
Keyword(s):  
Heart Failure ◽  
Left Ventricle ◽  
Ejection Fraction ◽  
Acute Heart Failure ◽  
Risk Score ◽  
Secondary Outcome ◽  
First Episode ◽  
Preserved Ejection Fraction ◽  
Time Integral ◽  
Baseline Characteristics

Background: The first admission for acute heart failure with preserved ejection fraction (HFpEF) drastically influences the short-term prognosis. Baseline characteristics may predict repeat hospitalization or death in these patients. Methods: A 103 patient-cohort, admitted for the first acute HFpEF episode, was monitored for six months. Baseline characteristics were recorded and their relation to the primary outcome of heart failure readmission (HFR) and secondary outcome of all-cause mortality was assessed. Results: We identified six independent determinants for HFR: estimated glomerular filtration rate (eGFR) (p = 0.07), hemoglobin (p = 0.04), left ventricle end-diastolic diameter (LVEDD) (p = 0.07), E/e’ ratio (p = 0.004), left ventricle outflow tract velocity-time integral (LVOT VTI) (p = 0.045), and diabetes mellitus (p = 0.06). Three of the variables were used to generate a risk score for HFR: LVEDD, E/e’, LVOT VTI -DEI Score = − 28.763 + 4.558 × log (LVEDD (mm)) + 1.961 × log (E/e’ ratio) + 1.759 × log (LVOT VTI (cm)). Our model predicts a relative amount of 20.50% of HFR during the first 6 months after the first acute hospitalization within the general population with HFpEF with a DEI Score over −0.747. Conclusions: We have identified three echocardiographic parameters (LVEDD, E/e’, and LVOT VTI) that predict HFR following an initial acute HFpEF hospitalization. The prognostic DEI score demonstrated good accuracy.

Acute heart failure with preserved ejection fraction and long-term Readmisions

2008 ◽  
Vol 7 ◽  
pp. 62-63
Author(s):  
J NUNEZ ◽  
L MAINAR ◽  
G MINANA ◽  
R ROBLES ◽  
J SANCHIS ◽  
...  
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Acute Heart Failure ◽  
Preserved Ejection Fraction

Life-threatening Takotsubo Cardiomyopathy

2011 ◽  
Vol 9 (2) ◽  
pp. 119 ◽  
Author(s):  
Karen Mrejen-Shakin ◽  
Ricardo Lopez ◽  
Mohandas M Shenoy ◽  
◽  
◽  
...  
Keyword(s):  
Heart Failure ◽  
Left Ventricle ◽  
Acute Heart Failure ◽  
Takotsubo Cardiomyopathy ◽  
Stress Test ◽  
Systolic Dysfunction ◽  
Apical Ballooning ◽  
Assisted Ventilation ◽  
Two Dimensional ◽  
Life Threatening

Objective:To report a case of seizure-induced takotsubo cardiomyopathy with rare etiology and rarer complications.Methods:A 50-year-old woman had multiple epileptic seizures and later developed acute heart failure complicated by ventricular fibrillation and shock. A two-dimensional echocardiogram revealed apical ballooning of the left ventricle resembling a takotsubo (a Japanese fisherman's pot used to trap octopi). The apex was also hypokinetic.Results:The hemodynamic abnormalities normalized with defibrillation, assisted ventilation, inotropic support, and pressor agents. More importantly, the apical ballooning deformity and systolic dysfunction reversed. The echocardiogram normalized three months later. A nuclear treadmill stress test was negative for ischemia.Conclusions:Apical ballooning of the left ventricle and hypokinesis are typical echocardiographic features in takotsubo cardiomyopathy, a stress-induced heart disease. It may follow severe emotional, physical, and neurologic stressors, in our rare case, grand mal seizures (0.2 % of all takotsubo disease patients). Also rare are life-threatening complications. Based on these observations, in a case with severe stress followed by acute heart failure, takotsubo cardiomyopathy should be a major diagnostic consideration. The dramatic initial triggering event, in our case an epileptic seizure, should not mask the possibility of coexisting takotsubo cardiomyopathy. Awareness of this disease, anticipation of complications, and two-dimensional echocardiography will help channel the management in the right direction.

Do Patients With Acute Heart Failure and Preserved Ejection Fraction Have Heart Failure at Follow-Up: Implications of the Framingham Criteria

2020 ◽  
Vol 26 (8) ◽  
pp. 673-684
Author(s):  
CAMILLA HAGE ◽  
ULRIKA LÖFSTRÖM ◽  
ERWAN DONAL ◽  
EMMANUEL OGER ◽  
AGNIESZKA KAPŁON-CIEŚLICKA ◽  
...  
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Acute Heart Failure ◽  
Preserved Ejection Fraction

scholarly journals Levosimendan use in patients with acute heart failure and reduced ejection fraction with or without severe renal dysfunction in critical cardiac care units: a multi-institution database study

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Cze-Ci Chan ◽  
Kuang-Tso Lee ◽  
Wan-Jing Ho ◽  
Yi-Hsin Chan ◽  
Pao-Hsien Chu
Keyword(s):  
Heart Failure ◽  
Renal Function ◽  
Ejection Fraction ◽  
Acute Heart Failure ◽  
Cardiac Care ◽  
Chang Gung Memorial Hospital ◽  
Research Database ◽  
Cohort Entry ◽  
Reduced Ejection Fraction ◽  
Abnormal Renal Function

Abstract Background Acute heart failure is a life-threatening clinical condition. Levosimendan is an effective inotropic agent used to maintain cardiac output, but its usage is limited by the lack of evidence in patients with severely abnormal renal function. Therefore, we analyzed data of patients with acute heart failure with and without abnormal renal function to examine the effects of levosimendan. Methods We performed this retrospective cohort study using data from the Chang Gung Research Database (CGRD) of Chang Gung Memorial Hospital (CGMH). Patients admitted for heart failure with LVEF ≤ 40% between January 2013 and December 2018 who received levosimendan or dobutamine in the critical cardiac care units (CCU) were identified. Patients with extracorporeal membrane oxygenation (ECMO) were excluded. Outcomes of interest were mortality at 30, 90, and 180 days after the cohort entry date. Results There were no significant differences in mortality rate at 30, 90, and 180 days after the cohort entry date between the levosimendan and dobutamine groups, or between subgroups of patients with an estimated glomerular filtration rate (eGFR) ≥ 30 mL/min/1.73 m2 and eGFR < 30 mL/min/1.73 m2 or on dialysis. The results were consistent before and after propensity score matching. Conclusions Levosimendan did not increase short- or long-term mortality rates in critical patients with acute heart failure and reduced ejection fraction compared to dobutamine, regardless of their renal function. An eGFR less than 30 mL/min/1.73 m2 was not necessarily considered a contraindication for levosimendan in these patients.

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