scholarly journals A Simple Risk Score Based on Routine Clinical Parameters Can Predict Frailty in Hospitalized Heart Failure Patients

2021 ◽  
Vol 10 (24) ◽  
pp. 5963
Author(s):  
Marta Kałużna-Oleksy ◽  
Agata Kukfisz ◽  
Jacek Migaj ◽  
Magdalena Dudek ◽  
Helena Krysztofiak ◽  
...  
Keyword(s):  
Heart Failure ◽  
Biochemical Parameters ◽  
Systolic Pressure ◽  
Roc Curves ◽  
Clinical Parameters ◽  
Frailty Syndrome ◽  
Predictive Values ◽  
Reduced Ejection Fraction ◽  
Simple Tool ◽  
Proposed Model

Frailty syndrome (FS) has recently attracted attention as one of the major predictors of heart failure (HF) course severity. We aimed to develop a simple tool for predicting frailty in hospitalized HF patients using routine clinical parameters. A total of 153 hospitalized patients diagnosed with heart failure with reduced ejection fraction (HFrEF) were included in the study. Presence of FS was assessed with the SHARE-FI questionnaire. Clinical and biochemical parameters were collected. Using ROC curves and logistic regression analysis, a model predicting FS presence was developed and tested. Proposed model includes five variables with following cut-off values (1 point for each variable): age > 50 years, systolic pressure on admission < 110 mmHg, total cholesterol < 4.85 mmol/L, bilirubin ≥ 15.5 mmol/L, and alanine aminotransferase ≤ 34 U/L. Receiving 5 points was considered a high risk of FS with positive and negative predictive values (NPV), 83% and 72%, respectively, and specificity of 97%. Awarding 2 points or less ruled out FS in the studied group with negative predictive value 94%. The presented novel, simple score predicts FS in HFrEF patients with routine clinical parameters and has good positive and negative predictive values.

scholarly journals It is easy to see, but it is better to foresee: a case report on the favourable alliance between CardioMEMS and levosimendan

2020 ◽  
Vol 4 (4) ◽  
pp. 1-5
Author(s):  
Valeria Visco ◽  
Cristina Esposito ◽  
Paolo Vitillo ◽  
Carmine Vecchione ◽  
Michele Ciccarelli
Keyword(s):  
Heart Failure ◽  
Hospital Admissions ◽  
Systolic Pressure ◽  
Pulmonary Artery Systolic Pressure ◽  
Optimal Management ◽  
Reduced Ejection Fraction ◽  
The Past ◽  
Case Summary ◽  
Pressure Profiles ◽  
Patients With Heart Failure

Abstract Background In the past years, different devices have been investigated to help in identifying early decompensation events in patients with heart failure (HF) and reduced ejection fraction (EF), reducing hospital admissions. In this report, we present the first patient experience with levosimendan infusion led by CardioMEMS. Case summary A 68-year-old man with HF and reduced EF with more than 20 hospitalizations for exacerbation of HF was enrolled in our HF Clinic from October 2017. Echocardiogram showed a dilated left ventricle with severely reduced EF (29%) and increased pulmonary artery systolic pressure (40 mmHg). From October 2017 to May 2019, the patient went through numerous hospitalizations, despite optimal medical therapy; subsequently, was adopted a strategy of levosimendan infusions guided by CardioMEMS. Levosimendan infusions improved haemodynamic and pressure profiles. The patient was monitored daily by CardioMEMS, and from June to December 2019, he had only two hospitalizations scheduled for levosimendan infusion and none for HF exacerbation. Discussion Our case supports the combination of CardioMEMS and levosimendan for the optimal management of patients with advanced HF. These results further strengthen the development of a randomized clinical trial to demonstrate the clinical usefulness of this device in combination with the levosimendan infusion programme in advanced HF patients.

scholarly journals Relationship between Nutritional Status and Clinical and Biochemical Parameters in Hospitalized Patients with Heart Failure with Reduced Ejection Fraction, with 1-year Follow-Up

Nutrients ◽  
2020 ◽  
Vol 12 (8) ◽  
pp. 2330
Author(s):  
Marta Kałużna-Oleksy ◽  
Helena Krysztofiak ◽  
Jacek Migaj ◽  
Marta Wleklik ◽  
Magdalena Dudek ◽  
...  
Keyword(s):  
Heart Failure ◽  
At Risk ◽  
Ejection Fraction ◽  
Nutritional Status ◽  
Natriuretic Peptides ◽  
Biochemical Parameters ◽  
Mini Nutritional Assessment ◽  
Reduced Ejection Fraction ◽  
The Impact

Heart Failure (HF) is a cardiovascular disease with continually increasing morbidity and high mortality. The purpose of this study was to analyze nutritional status in patients diagnosed with HF with reduced ejection fraction (HFrEF) and evaluate the impact of malnutrition on their prognosis. The Polish version of MNA form (Mini Nutritional Assessment) was used to assess the patients’ nutritional status. The New York Heart Association (NYHA) class, exacerbation of HF, chosen echocardiographic and biochemical parameters, e.g., natriuretic peptides or serum albumin, were also analyzed. Among the 120 consecutive patients, 47 (39%) had a normal nutritional status, 62 (52%) were at risk of malnutrition and 11 (9%) were malnourished. The patients with malnutrition more frequently presented with HF exacerbation in comparison to those with normal nutritional status (82% vs. 30% respectively, p = 0.004). There were no significant differences between the investigated groups as to natriuretic peptides; however, both the malnourished patients and those at risk of malnutrition tend to show higher B-type natriuretic peptide (BNP) and NT-proBNP concentrations. During the average 344 days of follow-up 19 patients died and 25 were hospitalized due to decompensated HF. Malnutrition or being at risk of malnutrition seems to be associated with both worse outcomes and clinical status in HFrEF patients.

Diagnosis of heart failure using urinary natriuretic peptides

2004 ◽  
Vol 106 (2) ◽  
pp. 129-133 ◽  
Author(s):  
L. L. NG ◽  
S. GEERANAVAR ◽  
S. C. JENNINGS ◽  
I. LOKE ◽  
R. J. O'BRIEN
Keyword(s):  
Heart Failure ◽  
Natriuretic Peptide ◽  
Natriuretic Peptides ◽  
High Throughput Screening ◽  
Failure Detection ◽  
Roc Curves ◽  
Diagnostic Efficiency ◽  
Roc Curve Analysis ◽  
Predictive Values ◽  
Heart Failure Patients

In the present study, we assessed the use of urinary natriuretic peptides [N-terminal proatrial natriuretic peptide (N-ANP) and N-terminal pro-brain natriuretic peptide (N-BNP) and C-type natriuretic peptide (CNP)] in the diagnosis of heart failure. Thirty-four consecutive hospitalized heart failure patients (median age, 75.5 years; 14 female) were compared with 82 age- and gender-matched echocardiographically normal controls. All subjects provided plasma and urine specimens. Plasma was assayed for N-BNP, and urine was assayed for N-ANP, N-BNP and CNP. The diagnostic efficiency of peptides was assessed using receiver operating characteristic (ROC) curve analysis. All three urinary natriuretic peptides were significantly elevated in heart failure patients (P<0.001). Urine N-BNP was correlated with plasma N-BNP (rs=0.53, P<0.0005). Areas under the ROC curves for urinary N-ANP, N-BNP and CNP were 0.86, 0.93 and 0.70 and for plasma N-BNP was 0.96. Correcting urinary peptide levels using urine creatinine produced ROC areas of 0.89, 0.93 and 0.76 respectively. A urine N-BNP level cut-off point of 11.6 fmol/ml had a sensitivity and specificity for heart failure detection of 97% and 78% respectively, with positive and negative predictive values of 64.7 and 98%. In conclusion, although all three natriuretic peptides were elevated in urine in heart failure, urinary N-BNP had diagnostic accuracy comparable with plasma N-BNP. Use of urinary N-BNP for heart failure diagnosis may be suitable for high-throughput screening, especially in subjects reluctant to provide blood samples.

P3553Right ventricular echocardiographic composite parameters in predicting major adverse cardiac events in patients with heart failure with reduced ejection fraction

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
M S Stefanovic ◽  
I S Srdanovic ◽  
A M Milovancev ◽  
S B Bjelic ◽  
A V Vulin ◽  
...  
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Right Ventricle ◽  
Predictive Value ◽  
Independent Predictor ◽  
Systolic Pressure ◽  
Reduced Ejection Fraction ◽  
Patients With Heart Failure ◽  
Relationship Of

Abstract Background Echocardiography assessment of right ventricle still play an indispensable role in diagnosis, decision-making for further therapy and risk assessment of patients with heart failure with reduced ejection fraction (HFrEF). Aims Our objective was to compare the predictive value of five composite echo parameters of right ventricle (RV) in decompensated patients with HFrEF. Methods and results A total of 191 NYHA III-IV patients admitted for decompensation of advanced HFrEF (EF=25.53±6,87%) were prospectively enrolled. During the follow-up period mean period of 340±84 days, 111 (58.1%) patients met the primary composite endpoint (MACE) of cardiac death, rehospitalization due to repeated decompensation, malignant rhythm disorders, heart attack or stroke. The average time of MACE occurrence was 110.5±98.7 days. Among group of patients with MACE, during the follow-up, there were 34 (30.6%) cardiac related deaths. Re-hospitalization due to cardiovascular causes had 77 patients (69.4%). The study was performed at our hospital between June 2016 and January 2018. Patients were assessed for the following combined echo parameters: (i) relationship of right and left ventricle basal diameter (RVb/LVb x0,1); (ii) relationship of tricuspid annular plane systolic excursion and right ventricle systolic pressure (TAPSE/RVSP mm/mmHg); (iii) relationship of tricuspid annular systolic velocity and right ventricle systolic pressure (TAs'x100/ RVSP cm/s/mmHg); (iv) product of tricuspid annular systolic velocity and pulmonic valve acceleration time (TAs'x PVAcT (cm/s2 x 1000)); (v) product of systolic and diastolic velocity of tricuspid annulus (TAs xTAe). The last three parameters were result of this study and were not mentioned in earlier researches. In this study, univariat analysis of combined RV echo parameters, TAPSE/RVSP, TAs'x100 /RVSP as well as TAs'xPVAcT have been shown to be highly significant predictors of MACE, p=0.001. The TAs'xTAe' product has been also distinguished as a significant predictor of MACE, p=0.04, as well as the ratio RVb/LVb x 0.1, p=0.007. Multivariate analysis of these five combined RV echo parameters shows that significant independent predictor of MACE turned out to be TAs'x100/RVSP (p<0.001, HR = 0.668 (0.531–0.840)). Obtained by reconstruction of the ROC curve (Area = 0.70 (95% CI 0.59–0.75); p<0.001, we have got cut off value of TAs'x100/RVSP = 1.92 (cm/s/mmHg). Kaplan-Meier curves were constructed by comparing the time to the occurrence of MACE. Patients with TAs'x100/RVSP ≤1.92 (cm/s/mmHg) have a significantly worse prognosis (Log Rank p<0.001). Conclusion New variable TAs'x100/RVSP, derived from this research, proved to be the most powerful combined RV echo parameter, independent predictor of one year MACE, with a better predictive value compared to the already described combined parameters in the literature.

The relationship between clinical parameters and natriuretic peptides and quality of life in patients with heart failure with reduced ejection fraction

2021 ◽  
Vol 28 (Supplement_1) ◽  
Author(s):  
F Sawczak ◽  
A Kukfisz ◽  
K Przytarska ◽  
M Szczechla ◽  
H Krysztofiak ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Heart Failure ◽  
Ejection Fraction ◽  
Natriuretic Peptides ◽  
Nyha Class ◽  
Clinical Parameters ◽  
Reduced Ejection Fraction ◽  
Patients With Heart Failure ◽  
The Relationship

Abstract Funding Acknowledgements Type of funding sources: None. Introduction Heart failure (HF) patients are exposed to severe symptoms of the disease, fatal prognosis, rehospitalizations and low quality of life status. Furthermore, it was observed that more patients with HF would rather live better than longer. Purpose The aim of the study was to determine the relationship between clinical parameters, natriuretic peptides level and quality of life (QoL) in patients with heart failure with reduced ejection fraction. Methods 111 patients hospitalized due to heart failure with reduced ejection fraction (HFrEF) were examined using WHOQOL-BREF questionnaire and divided into three groups of similar quantity due to their transformed score of somatic domain of QoL: first group with score &lt;45 - worst QoL (n = 33), second group with score between 45 and 55 (n = 42), and third with score &gt;55 - best QoL (n = 36). Then the group with highest scores, with best somatic QoL, was compared with those with lowest scores in respect of chosen clinical and biochemical parameters. Results Patients with the highest somatic domain score, comparing with the lowest, had significantly higher BMI (mean 29.8 ± 5.5 vs. 26.8 ± 5.7 kg/m2, p = 0.016), lower BNP level (465 vs. 967 pg/ml, median 275 vs. 690, p =0.005), higher LVEF (30.7 ± 12.0 vs. 23.9 ± 10.8%, p = 0.006), higher triglycerides level (2.02 ± 1.22 vs. 1.43 ± 0.76 mmol/l, p = 0.027) and iron level (17.8 ± 6.6 vs. 13.6 ± 5.5 µmol/l, p = 0.019) as well as transferrin saturation (28.0 ± 11.0 vs. 21.3 ± 8.9 %, p = 0.015). The percentage of patients with NYHA class I and II was higher in the group with the highest somatic domain score in comparison with the lowest (66.6% vs. 33.3% respectively, p = 0.034). Conclusions The somatic domain of WHOQOL-BREF in patients with HFrEF correlates with patients’ clinical state assessed with the NYHA class and BNP level. QoL status was not associated with age and gender which are depicted in the literature as the important aspects influencing QoL of the community.

scholarly journals Appetite and Nutritional Status as Potential Management Targets in Patients with Heart Failure with Reduced Ejection Fraction—The Relationship between Echocardiographic and Biochemical Parameters and Appetite

2021 ◽  
Vol 11 (7) ◽  
pp. 639
Author(s):  
Marta Kaluzna-Oleksy ◽  
Filip Sawczak ◽  
Agata Kukfisz ◽  
Magdalena Szczechla ◽  
Helena Krysztofiak ◽  
...  
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Nutritional Status ◽  
Biochemical Parameters ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Appetite Loss ◽  
Reduced Ejection Fraction ◽  
Nutritional Risk Index ◽  
Patients With Heart Failure

This study aimed to investigate the role of appetite loss and malnutrition in patients with heart failure with reduced ejection fraction (HFrEF). In this prospective, observational, single-center study, we enrolled 120 consecutive adults with HFrEF. We analyzed the selected clinical, echocardiographic, and biochemical parameters. Appetite loss and malnutrition were assessed by CNAQ (Council on Nutrition Appetite Questionnaire) and MNA (Mini Nutritional Assessment)/GNRI (Geriatric Nutritional Risk Index) questionnaires, respectively.Most patients were men (81.7%), mean age was 55.1 ± 11.3 years, and mean left ventricular ejection fraction was 23.9 ± 8.0%. The mean CNAQ score was 28.8 ± 3.9, mean MNA—23.1 ± 2.6, and mean GNRI—113.0 ± 12.3. Based on ROC curves, we showed that a sodium concentration <138 mmol/L had the greatest discriminating power for diagnosing impaired nutritional status (MNA ≤ 23.5) with a sensitivity of 54.5% and specificity of 77.8%. The threshold of HDL <0.97 mmol/L characterized 40.7% sensitivity and 86% specificity, B-type natriuretic peptide >738.6 pg/dL had 48.5% sensitivity and 80.8% specificity, high-sensitivity C-reactive protein >1.8 mg/L had 94.9% sensitivity and 42.9% specificity, and bilirubin >15 µmol/L had 78.2% sensitivity and 56.9% specificity. Nutritional status and appetite assessed by MNA/GNRI and CNAQ questionnaires showed poor correlations with other findings in HFrEF patients.

Sign in / Sign up

Export Citation Format

Share Document