Diagnostic informativity of hemodynamic identification of circulatory syndromes in heart failure

Показана диагностическая информативность антропофизиологического и системного подхода в гемодинамической идентификации циркуляторных синдромов сердечной недостаточности (СН). Методы. Антропофизиологическая диагностика сердечно-сосудистой системы (ССС) осуществляли с использованием созданного нами аппаратно-программного комплекса на основе реографии. Результаты. По использованному алгоритму диагностики идентифицируются базовые циркуляторные синдромы СН по артериальной (перфузионной) и венозной недостаточности по малому и большому кругу кровообращения, а также возрастные, половые и позные особенности их проявления. Заключение. Показано, что по всем возрастным группам превалируют перфузионные формы СН. При этом проявления циркуляторных синдромов СН значительно выше в положении тела стоя. The aim of the study was to demonstrate diagnostic informativity of the anthropophysiological and systemic approach to hemodynamic identification of circulatory syndromes in heart failure (HF). Methods. Anthropophysiological diagnostics of the cardiovascular system (CVS) was performed using a hardware-software complex created by us on the basis of rheography. Results. Based on the used diagnostic algorithm, essential circulatory HF syndromes were identified by arterial (perfusion) and venous insufficiency in the systemic and pulmonary circulation, age, sex, and postural features of the HF syndrome manifestations. Conclusion. Perfusion forms of HF prevailed in all age groups. Furthermore, manifestations of circulatory HF syndromes were much more pronounced in the standing body position.

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Evaluation of the cardiovascular system status in children with rheumatic diseases by means of the hardware-software complex «Cardio-plus P»

SOVREMENNAYA PEDIATRIYA ◽

10.15574/sp.2017.88.59 ◽

2018 ◽

pp. 59-67

Author(s):

O.A. Oshlianska ◽

◽

I.A. Chaikovskyi ◽

A.H. Artsymovych ◽

M.O. Dordiienko ◽

...

Keyword(s):

Cardiovascular System ◽

Rheumatic Diseases ◽

Software Complex

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Computer assisted instruction for therapy of heart failure based on simulation of cardiovascular system

ACM SIGBIO Newsletter ◽

10.1145/25065.25066 ◽

1987 ◽

Vol 9 (1) ◽

pp. 57-61

Author(s):

Toshiro Sato ◽

Akihiro Takeuchi ◽

Jun Yamagami ◽

Hareaki Yamamoto ◽

Shigeaki Akiyama ◽

...

Keyword(s):

Heart Failure ◽

Cardiovascular System ◽

Computer Assisted Instruction ◽

Computer Assisted ◽

Assisted Instruction

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Right ventricular function and its coupling with the pulmonary circulation in acute heart failure

European Heart Journal ◽

10.1093/ehjci/ehaa946.1218 ◽

2020 ◽

Vol 41 (Supplement_2) ◽

Author(s):

M Barki ◽

M Losito ◽

M.M Caracciolo ◽

F Bandera ◽

M Rovida ◽

...

Keyword(s):

Heart Failure ◽

Acute Heart Failure ◽

Acute Phase ◽

Pulmonary Circulation ◽

Heart Function ◽

Systolic Pressure ◽

Left Ventricular ◽

Response To Treatment ◽

The Right ◽

B Lines

Abstract Background The right ventricle (RV) is extremely sensitive to hemodynamic changes and increased impedance. In acute heart failure (AHF), the development of pulmonary venous congestion and the increase of left ventricular (LV) filling pressures favors pulmonary vascular adverse remodeling and ultimately RV dysfunction, leading to the onset of symptoms and to a further decay of cardiac dynamics. Purpose The aim of the study was to evaluate RV morphology and functional dynamics at admission and discharge in patients hospitalized for AHF, analyzing the role and the response to treatment of the RV and its coupling with pulmonary circulation (PC). Methods Eighty-one AHF patients (mean age 75.75±10.6 years, 59% males) were prospectively enrolled within 24–48 hours from admission to the emergency department (ED). In either the acute phase and at pre-discharge all patients underwent M-Mode, 2-Dimensional and Doppler transthoracic echocardiography (TTE), as well as lung ultrasonography (LUS), to detect an increase of extravascular lung water (EVLW) and development of pleural effusion. Laboratory tests were performed in the acute phase and at pre-discharge including the evaluation of NT-proBNP. Results At baseline we observed a high prevalence of RV dysfunction as documented by a reduced RV systolic longitudinal function [mean tricuspid annular plane systolic excursion (TAPSE) at admission of 16.47±3.86 mm with 50% of the patients exhibiting a TAPSE<16mm], a decreased DTI-derived tricuspid lateral annular systolic velocity (50% of the subjects showed a tricuspid s' wave<10 cm/s) and a reduced RV fractional area change (mean FAC at admission of 36.4±14.6%). Furthermore, an increased pulmonary arterial systolic pressure (PASP) and a severe impairment in terms of RV coupling to PC was detected at initial evaluation (mean PASP at admission: 38.8±10.8 mmHg; average TAPSE/PASP at admission: 0.45±0.17 mm/mmHg). At pre-discharge a significant increment of TAPSE (16.47±3.86 mm vs. 17.45±3.88; p=0.05) and a reduction of PASP (38.8±10.8 mmHg vs. 30.5±9.6mmHg, p<0.001) was observed. Furthermore, in the whole population we assisted to a significant improvement in terms of RV function and its coupling with PC as demonstrated by the significant increase of TAPSE/PASP ratio (TAPSE/PASP: 0.45±0.17 mm/mmHg vs 0.62±0.20 mm/mmHg; p<0.001). Patients significantly reduced from admission to discharge the number of B-lines and NT-proBNP (B-lines: 22.2±17.1 vs. 6.5±5 p<0.001; NT-proBNP: 8738±948 ng/l vs 4227±659 ng/l p<0.001) (Figure 1). Nonetheless, no significant changes of left atrial and left ventricular dimensions and function were noted. Conclusions In AHF, development of congestion and EVLW significantly impact on the right heart function. Decongestion therapy is effective for restoring acute reversal of RV dysfunction, but the question remains on how to impact on the biological properties of the RV. Funding Acknowledgement Type of funding source: None

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Does body position, age, and heart rate induce IOP’s changes?

European Journal of Ophthalmology ◽

10.1177/11206721211023313 ◽

2021 ◽

pp. 112067212110233

Author(s):

Marcelina Sobczak ◽

Magdalena Asejczyk ◽

Malwina Geniusz

Keyword(s):

Heart Rate ◽

Body Position ◽

Age Groups ◽

Cardiovascular Parameters ◽

Entire Cohort ◽

Significant Difference ◽

Group A ◽

The Difference ◽

Group B ◽

Effect Of Age

Objectives: The main goal of this research was to determine the differences between the values of intraocular pressure (IOP) in the supine and sitting positions, and to assess the effect of age and cardiovascular parameters. Methods: Seventy-two healthy adults were enrolled and classified into age groups: 20–30 years (group A), 31–40 years (group B), and 41–71 years (group C). Corneal biometry and cardiovascular parameters, such as heart rate (HR), were measured. IOP measurements were taken in the sitting position (IOPS) and in the supine position (IOPL) using the iCare® Pro tonometer. Results: A significant difference between the IOPS and IOPL in the entire cohort was found ( p < 0.001). Regarding the age subgroups, a significant difference ( p < 0.001) between the IOPS and IOPL was obtained in group A (2.6 ± 1.6 mmHg) and group C (1.5 ± 1.3 mmHg). There were no significant differences in the IOPS between groups. The highest IOP values were obtained for group A. The correlations between HR and IOPS are statistically significant for group A and group B, and for HR and IOPL-S for group B only. Multivariate analysis showed that HR has a significant influence on the difference in IOP in the two body positions. Conclusion: A statistically significant difference between the effect of age and the values of IOPS and IOPL was shown. Cardiovascular parameters showed some relevant statistical dependencies, but with a rather marginal significance in young people. The influence of body position for the measurement of IOP for healthy subjects does not seem to matter, despite the fact that there are some dependencies that are statistically significant.

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Real world heart failure epidemiology and outcome: a population-based analysis of 1,990,162 heart failure patients

European Heart Journal ◽

10.1093/ehjci/ehaa946.0968 ◽

2020 ◽

Vol 41 (Supplement_2) ◽

Author(s):

P Leszek ◽

M Zaleska-Kociecka ◽

D Was ◽

K Witczak ◽

K Bartolik ◽

...

Keyword(s):

Heart Failure ◽

Real World ◽

Age Groups ◽

Developed Countries ◽

Funding Source ◽

Newly Diagnosed ◽

The European Union ◽

Ministry Of Health ◽

The Real ◽

Incidence Prevalence

Abstract Background Heart failure (HF) is the leading cause of death and hospitalization in developed countries. Most of the information about HF is based on selected cohorts, the real epidemiology of HF is scarce. Purpose To assess trends in the real world incidence, prevalence and mortality of all in-and outpatients with HF who presented in public health system in 2009–2018 in Poland. Methods It is a retrospective analysis of 1,990,162 patients who presented with HF in Poland in years 2009–2018. It is a part of nationwide Polish Ministry of Health registry that collects detailed information for the entire Polish population (38,495,659 in 2013) since 2009. Detailed data within the registry were collected since 2013. HF was recorded if HF diagnosis was coded (ICD-10). Results The incidence of HF in Poland fell down from 2013 to reach 127,036 newly diagnosed cases (330 per 100,000 population) in 2018 that equals to 43.6% drop. This decrease was mainly driven by marked reduction in females (p<0.001; Fig. 1A) and HF of ischaemic etiology (HF-IE vs HF-nonIE, Fig. 1B. p<0.001). The HF incidence per 100,000 population decreased across all age groups with the greatest drop in the youngest (Table 1). The prevalence rose by 11.6% to reach 1,242,129 (3233 per 100,000 population) in 2018 with significantly greater increase in females and HF-IE (both p<0.0001, Fig. 1C and D, respectively). The HF prevalence per 100,000 population increased across all age groups except for the 70–79 years old. (Table 1). Mortality increased by 28.5% to reach 142,379 cases (370 per 100,000 population) in 2018. The rise was more pronounced among females (p=0.015, Fig. 1E) and in HF-IE (p<0.001, Fig. 1F). The HF mortality per 100 000 population increased across all age groups, except for the 50–59 subgroup (Table 1). Conclusions Heart failure incidence plummeted in years 2013–2018 in Poland due to drop in newly diagnosed HF-IE. Despite that fact, the prevalence and mortality increased with rising trends in HF-IE. Figure 1. Incidence, prevalence, mortality trends Funding Acknowledgement Type of funding source: Public grant(s) – EU funding. Main funding source(s): The project is co-financed by the European Union from the European Social Fund under the Operational Programme Knowledge Education Development and it is being carried out by the Analyses and Strategies Department of the Polish Ministry of Health

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Weighing in on heart failure: the potential impact of bariatric surgery

Heart Failure Reviews ◽

10.1007/s10741-021-10078-w ◽

2021 ◽

Author(s):

Tanuka Datta ◽

Andrew J. Lee ◽

Rachel Cain ◽

Melissa McCarey ◽

David J. Whellan

Keyword(s):

Heart Failure ◽

Bariatric Surgery ◽

Weight Loss ◽

Cardiovascular System ◽

Economic Burden ◽

Treatment Strategies ◽

It Impacts ◽

Potential Impact ◽

The Individual ◽

Physiologic System

AbstractObesity is a growing worldwide epidemic with significant economic burden that carries with it impacts on every physiologic system including the cardiovascular system. Specifically, the risk of heart failure has been shown to increase dramatically in obese individuals. The purpose of this review is to provide background on the individual burdens of heart failure and obesity, followed by exploring proposed physiologic mechanisms that interconnect these conditions, and furthermore introduce treatment strategies for weight loss focusing on bariatric surgery. Review of the existing literature on patients with obesity and heart failure who have undergone bariatric surgery is presented, compared, and contrasted.

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Assessment of a novel device-based diagnostic algorithm to monitor patient status in moderate-to-severe heart failure: rationale and design of the CLEPSYDRA study

European Journal of Heart Failure ◽

10.1093/eurjhf/hfq170 ◽

2010 ◽

Vol 12 (12) ◽

pp. 1363-1371 ◽

Cited By ~ 8

Author(s):

Angelo Auricchio ◽

Josep Brugada ◽

Kenneth A. Ellenbogen ◽

Michael R. Gold ◽

Francisco Leyva ◽

...

Keyword(s):

Heart Failure ◽

Severe Heart Failure ◽

Diagnostic Algorithm ◽

Novel Device ◽

Patient Status

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The Pulmonary Circulation in Heart Failure

Revista Española de Cardiología (English Edition) ◽

10.1016/s1885-5857(10)70066-9 ◽

2010 ◽

Vol 63 (3) ◽

pp. 334-345 ◽

Cited By ~ 1

Author(s):

Juan F. Delgado

Keyword(s):

Heart Failure ◽

Pulmonary Circulation

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Abstract 228: National Prevalence of Substance Use Disorders Among Hospitalized Heart Failure Patients

Circulation Cardiovascular Quality and Outcomes ◽

10.1161/circoutcomes.11.suppl_1.228 ◽

2018 ◽

Vol 11 (suppl_1) ◽

Author(s):

Sarah C Snow ◽

Gregg C Fonarow ◽

Joseph A Ladapo ◽

Donna L Washington ◽

Katherine Hoggatt ◽

...

Keyword(s):

Heart Failure ◽

Substance Use ◽

Native American ◽

Drug Use ◽

Substance Use Disorders ◽

Age Groups ◽

Opioid Use ◽

Drug Use Disorders ◽

Increased Risk ◽

Drug Use Disorder

Background: Several cardiotoxic substances contribute to the development of heart failure (HF). The burden of comorbid substance use disorders (SUD) among patients with HF is under-characterized. Objectives: To describe the national burden of comorbid SUD (tobacco, alcohol, or drug use disorders) among hospitalized HF patients in the U.S. Methods: We used data from the 2014 National Inpatient Sample to calculate the proportion of hospitalizations for a primary HF admission with tobacco, alcohol, or drug use disorder diagnoses, accounting for demographic factors. Drug use disorder analysis was further sub-divided into specific illicit substance categories. Results: There were a total of 989,080 HF hospitalizations of which 35.3% (n=348,995) had a documented SUD. Tobacco use disorder (TUD) was most common (n= 327,220, 33.1%) followed by drug use disorder (DUD) (n=34,600, 3.5%) and alcohol use disorder (AUD) (n=34,285, 3.5%). Female sex was associated with less TUD (OR 0.59; 95% CI, 0.58-0.60), AUD (OR 0.23; 95% CI, 0.22-0.25) or DUD (OR 0.58; 95% CI 0.55-0.62). Tobacco, alcohol, cocaine, and opioid use disorders were highest among HF patients age 45 to 55, while cannabis and amphetamine use was highest in those <45 years. Native American race (versus White) was associated with increased risk of AUD (OR 1.67; 95% CI 1.27-2.20). Black race was associated with increased risk of AUD (OR 1.09; 95% CI 1.02-1.16) or DUD (OR 1.63; 95% CI 1.53-1.74). Medicaid insurance (versus Medicare) was associated with greater TUD (OR 1.27; 95% CI 1.23-1.32), AUD (OR 1.74; 95% CI 1.62-1.87), and DUD (OR 2.15; 95% CI 2.01-2.30). Decreasing quartiles of median household income were associated with increasing SUD. Conclusions: Comorbid SUD disproportionately affects certain HF populations, including men, younger age groups, lower SES patients, and race/ethnic minorities. Further research on interventions to improve prevention and treatment of SUD among hospitalized HF patients are needed given the high rates of SUD in this population. Systematically screening hospitalized HF patients for SUD may reveal opportunities for treatment and secondary prevention.

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