scholarly journals Personalized Target Heart Rate for Patients with Heart Failure and Reduced Ejection Fraction

2022 ◽  
Vol 12 (1) ◽  
pp. 50
Author(s):  
Yusuke Yumita ◽  
Yuji Nagatomo ◽  
Makoto Takei ◽  
Mike Saji ◽  
Ayumi Goda ◽  
...  
Keyword(s):  
Heart Failure ◽  
Heart Rate ◽  
Ejection Fraction ◽  
Primary Endpoint ◽  
Prognostic Significance ◽  
Target Heart Rate ◽  
Reduced Ejection Fraction ◽  
Significant Difference ◽  
Patients With Heart Failure ◽  
The Difference

The optimal heart rate (HR) in patients with heart failure with reduced ejection fraction (HFrEF) has been ill-defined. Recently, a formula was proposed for estimating the target heart rate (THR), which eliminates the overlap between the E and A wave (E-A overlap). We aim to validate its prognostic significance in the multicenter WET-HF registry. This study used data from 647 patients with HFrEF hospitalized for acute decompensated HF (ADHF). The patients were divided into the 2 groups by THR. The primary endpoint was defined as the composite of all-cause death and ADHF readmission. The THR successfully discriminated the incidence of the primary endpoint, whereas no significant difference was observed in the primary endpoint when dividing the patients by uniform cutoff 70 bpm. HR at discharge ≤ THR was inversely associated with the primary endpoint. Restricted cubic spline analysis demonstrated the difference between HR at discharge, and THR (ΔHR) from −10 to ±0 was associated with a lower risk of primary endpoint and ΔHR from ±0 to +15 was associated with a higher risk. THR discriminated long-term outcomes in patients with HFrEF more efficiently than the uniform cutoff, suggesting that it may aid in tailored HR reduction strategies.

Prognostic significance of resting heart rate in atrial fibrillation patients with heart failure with reduced ejection fraction

2020 ◽  
Vol 35 (8) ◽  
pp. 1109-1115 ◽  
Author(s):  
Sho Suzuki ◽  
Hirohiko Motoki ◽  
Yusuke Kanzaki ◽  
Takuya Maruyama ◽  
Naoto Hashizume ◽  
...  
Keyword(s):  
Heart Failure ◽  
Atrial Fibrillation ◽  
Heart Rate ◽  
Ejection Fraction ◽  
Prognostic Significance ◽  
Resting Heart Rate ◽  
Reduced Ejection Fraction ◽  
Patients With Heart Failure

scholarly journals Oral Metolazone Versus Intravenous Chlorothiazide as an Adjunct to Loop Diuretics for Diuresis in Acute Decompensated Heart Failure With Reduced Ejection Fraction

2018 ◽  
Vol 54 (6) ◽  
pp. 351-357 ◽  
Author(s):  
Brian C. Bohn ◽  
Rim M. Hadgu ◽  
Hannah E. Pope ◽  
Jerrica E. Shuster
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Acute Decompensated Heart Failure ◽  
Decompensated Heart Failure ◽  
Oral Formulation ◽  
Loop Diuretics ◽  
Reduced Ejection Fraction ◽  
Significant Difference ◽  
Patients With Heart Failure ◽  
Total Urine

Background: Thiazide diuretics are often utilized to overcome loop diuretic resistance when treating acute decompensated heart failure (ADHF). In addition to a large cost advantage, several pharmacokinetic advantages exist when administering oral metolazone (MTZ) compared with intravenous (IV) chlorothiazide (CTZ), yet many providers are reluctant to utilize an oral formulation to treat ADHF. The purpose of this study was to compare the increase in 24-hour total urine output (UOP) after adding MTZ or CTZ to IV loop diuretics (LD) in patients with heart failure with reduced ejection fraction (HFrEF). Methods and Results: From September 2013 to August 2016, 1002 patients admitted for ADHF received either MTZ or CTZ in addition to LD. Patients were excluded for heart failure with preserved ejection fraction (HFpEF) (n = 469), <24-hour LD or UOP data prior to drug initiation (n = 129), or low dose MTZ/CTZ (n = 91). A total of 168 patients were included with 64% receiving CTZ. No significant difference was observed between the increase in 24-hour total UOP after MTZ or CTZ initiation (1458 [514, 2401] mL vs 1820 [890, 2750] mL, P = .251). Conclusions: Both MTZ and CTZ similarly increased UOP when utilized as an adjunct to IV LD. These results suggest that while thiazide agents can substantially increase UOP in ADHF patients with HFrEF, MTZ and CTZ have comparable effects.

scholarly journals 0602 Daytime Sleepiness in Heart Failure with Preserved Versus Reduced Ejection Fraction

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A230-A230
Author(s):  
S G Schütz ◽  
A Nguyen-Phan ◽  
M Konerman ◽  
S Hummel ◽  
R D Chervin
Keyword(s):  
Heart Failure ◽  
Sleep Apnea ◽  
Ejection Fraction ◽  
Daytime Sleepiness ◽  
Diastolic Heart Failure ◽  
Apnea Hypopnea Index ◽  
Central Apnea ◽  
Reduced Ejection Fraction ◽  
Significant Difference ◽  
Patients With Heart Failure

Abstract Introduction Sleep apnea is common in patients with heart failure, though often not associated with significant daytime sleepiness in heart failure with reduced ejection fraction (HFrEF). The clinical presentation of sleep apnea in patients who have heart failure with borderline or preserved ejections fraction (HFbEF and HFpEF, respectively) is not well characterized. Methods Eighty patients with heart failure were identified retrospectively in data from University of Michigan Sleep Disorders Laboratories. Heart failure was categorized as heart failure with reduced ejection fraction (HFrEF)/systolic heart failure, heart failure with borderline ejection fraction (HFbEF) or heart failure with preserved ejection fraction (HFpEF)/diastolic heart failure. Clinical information and Epworth Sleepiness Scale (ESS) scores were extracted from medical records. A subset of subjects underwent a diagnostic polysomnogram. ANOVA was used to compare clinical characteristics in subjects with different heart failure types. Results ESS scores trended higher in 49 subjects with HFpEF (ESS mean 10.9±4.7 [sd]) compared to 9 with HFbEF (ESS 8.0±3.4) and 22 with HFrEF (ESS 8.4±5.0) (p=0.058). Among the 40 subjects who underwent diagnostic polysomnography, no statistically significant difference emerged in apnea-hypopnea index between subjects with HFpEF, HFbEF, and HFrEF (p=0.43). No significant differences emerged for the central apnea index (p=0.16), despite magnitudes of discrepancy that suggested a larger sample size might show different results CAI in participants with HFrEF showed a mean of 9.0±14.6/h, compared to 0.1±0.1/h in HFbEF and 3.1±6.3/h in HFpEF. Conclusion Among these patients with HFpEF, HFbEF, and HFrEF, subjects with HFpEF showed a trend towards increased subjective daytime sleepiness, though overall apnea and central apnea severity did not differ between groups. Further examination of clinical phenotypes in larger cohorts may help guide care in heterogeneous heart failure populations. Support National Institutes of Health grant NS107158

scholarly journals Prognostic significance of active and modified forms of endothelin 1 in patients with heart failure with reduced ejection fraction

2015 ◽  
Vol 48 (4-5) ◽  
pp. 292-296 ◽  
Author(s):  
Stephen S. Gottlieb ◽  
Kristie Harris ◽  
John Todd ◽  
Joel Estis ◽  
Robert H. Christenson ◽  
...  
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Prognostic Significance ◽  
Reduced Ejection Fraction ◽  
Endothelin 1 ◽  
Patients With Heart Failure ◽  
Modified Forms
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