scholarly journals MANAGEMENT OF PATIENTS WITH HEART FAILURE AND COVID-19

2021 ◽  
pp. 38-48
Author(s):  
Iurii Rudyk ◽  
Оlena Medentseva ◽  
Denys Babichev ◽  
Iryna Kravchenko
Keyword(s):  
Heart Failure ◽  
Healthcare Professionals ◽  
Distress Syndrome ◽  
Epidemiological Features ◽  
New Variant ◽  
Patients With Heart Failure ◽  
High Prevalence ◽  
Coronavirus Infection ◽  
Sepsis And Septic Shock ◽  
Correct Understanding

Coronavirus Disease 2019 (COVID-19) is an infectious disease caused by Coronavirus 2 (SARS-CoV-2) severe acute respiratory syndrome. The virus was discovered in December 2019 in Wuhan, China. The advent of COVID-19 has posed challenges for healthcare professionals to quickly diagnose and provide medical care to patients. Currently, there is an intensive study of the clinical and epidemiological features of the disease, the development of new means of its prevention and treatment. The most common clinical manifestation of a new variant of coronavirus infection is bilateral pneumonia; in 3–4 % of patients the development of acute respiratory distress syndrome was recorded. In some patients, hypercoagulable syndrome with thrombosis and thromboembolism develops, other organs and systems (central nervous system, myocardium, kidneys, liver, gastrointestinal tract, endocrine and immune systems) are also affected, and sepsis and septic shock may develop. A high prevalence of concomitant diseases of the cardiovascular system has been shown, as well as their significant impact on the course of COVID-19 in such patients. Patients with pre-established medical conditions such as heart failure are at particularly high risk of morbidity and mortality from COVID-19. The risk of complications may be higher in patients with heart failure, not only because they are older and have more comorbidities, but also because of the specific characteristics of the syndrome. A correct understanding of the interaction between heart failure drugs and proposed drugs for the treatment of COVID-19 can help in the management of this category of patients. The article presents the main mechanisms of the influence of COVID-19 infection on the development of heart failure, the features of the course of this disease against the background of COVID-19. The authors describe the key methods of examining patients with heart failure with suspected COVID-19 disease, the features of the use of the main groups of drugs recommended for patients with heart failure, as well as moments of interaction between pharmacological drugs and the development of adverse side effects. Keywords: heart failure, COVID-19, SARS-CoV-2, comorbidity, pharmacotherapy.

scholarly journals Expert consensus regarding treatment of iron deficiency in stable and decompensated patients with heart failure

Kardiologiia ◽  
2021 ◽  
Vol 61 (4) ◽  
pp. 73-78
Author(s):  
Yu. V. Mareev ◽  
S. R. Gilarevsky ◽  
Yu. L. Begrambekova ◽  
Yu. M. Lopatin ◽  
A. A. Garganeeva ◽  
...  
Keyword(s):  
Heart Failure ◽  
Iron Deficiency ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Ferric Carboxymaltose ◽  
Ventricular Ejection Fraction ◽  
Patients With Heart Failure ◽  
High Prevalence ◽  
Acute Decompensation

In recent years there has been significant interest in treating iron deficiency (ID) in patients with heart failure (HF) due to its high prevalence and detrimental effects in this population. As stated in the 2020 Russain HF guidelines, Intravenous ferric carboxymaltose remains the only proven therapy for ID.This document was prompted by the results from the recent AFFIRM-AHF trial which demonstrates that treatment of ID after acute HF decompensation reduces the risk of future decompensations. Experts have concluded that in HF patients with acute decompensation, a left ventricular ejection fraction of < 50% and ID, Intravenous ferric carboxymaltose reduces future HF hospitalisations. Patients with stable HF may also benefit from treatment of ID to improve quality of life and alleviate symptoms.  It is, therefore, reasonable to screen for and treat ID in patients with HF.

Early use of cytokine adsorption in treatment of COVID-19 associated respiratory distress syndrome

2021 ◽  
pp. 71-75
Author(s):  
A. S. Rybalko ◽  
A. V. Voronin ◽  
A. O. Vagulin ◽  
A. S. Saryglar ◽  
L. V. Zabolotskaya ◽  
...  
Keyword(s):  
Monoclonal Antibodies ◽  
Lung Injury ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Cytokine Storm ◽  
Start Criteria ◽  
Coronavirus Infection ◽  
Cytokine Cascade ◽  
Sepsis And Septic Shock

Introduction. It is the recommendations for treatment of sepsis and septic shock combined with rheumatologists’ recommendations for monoclonal antibodies therapy that guide severe COVID-19 management in ICU. However, those recommendations may not be fully applied to patients with acute respiratory distress-syndrome associated with SARS-CoV-2, as there exists a difference in pathogenesis between sepsis and virus-associated pneumonias. Monoclonal antibodies therapy may contribute to cytokine cascade severity and promote lung injury. Cytokine storm aggravates the course of the disease. At present, there are two groups of methods described in literature for cytokine storm control and therapy: pharmacological and extracorporeal approaches.Materials and methods. We have performed a retrospective analysis of five COVID-19 patients with acute respiratory syndrome. Cytokine adsorption start criteria were respiratory insufficiency and IL-6 levels greater than 500 pg/ml. Adsorption therapy was initiated within 24 hours of ICU admission and continued for 48–120 hours in hemoperfusion mode on Multifiltrate machine (Fresenius Medical Care). The length of a single session of CytoSorb (Cytosorbents Inc.) therapy was 24 hours.Results. All patients demonstrated SpO2/FiO2 ratio growth and IL-6 concentration decrease by the end of hemoadsorption. We noted lymphocyte count rise as well as IgM и IgG SARS-CoV-2 antibodies titer substantial increase.Conclusions. Our observations suggest that the early start of hemoadsorption associates with gas-exchange stabilization and hinders respiratory distress progression. Hemoadsorption allows for pro-inflammatory cytokines concentrations decrease and prevents secondary lung injury. According to our data, hemoadsorption is beneficial to form a coronavirus infection specific immune response. Further research is needed for a detailed study of the results we here describe.

scholarly journals Clinical Implications of Oral Assessment in Elderly Patients with Acute Heart Failure: A Single-center, Retrospective Study

2020 ◽  
Author(s):  
Yusuke Uemura ◽  
Rei Shibata ◽  
Haruna Ishikawa ◽  
Ayumi Nagahori ◽  
Yuta Katsumi ◽  
...  
Keyword(s):  
Heart Failure ◽  
Oral Health ◽  
Elderly Patients ◽  
Acute Heart Failure ◽  
Barthel Index ◽  
Clinical Implications ◽  
Oral Assessment ◽  
Geriatric Conditions ◽  
Patients With Heart Failure ◽  
High Prevalence

Abstract Background: Oral health problems are common and are associated with various geriatric conditions in older adults. The importance of oral health has not been fully highlighted in the assessment and management of patients with heart failure. Here, we investigated the clinical implications of oral assessment in elderly patients with acute heart failure.Methods: We evaluated oral health using the revised oral assessment guide in 77 patients aged 65 years or older who were admitted to hospital for acute heart failure. Poor oral health was defined as a revised oral assessment guide score ≥ 9.Results: Poor oral health was identified in 66.2% of the patients. Patients with poor oral health had high prevalence of decreased physical function, undernutrition, and cognitive impairment. A reduction in the Barthel Index, as an indicator of activities of daily living during hospitalization, was significant in the enrolled patients. The Barthel Index decreased more in patients with poor oral health than those with normal oral health. Furthermore, the revised oral assessment guide score on admission was found to be the only independent predictor of changes in the Barthel Index during hospitalization in the multivariate regression analyses. Conclusions: Oral assessment using the revised oral assessment guide during hospitalization could provide useful information for the management of elderly heart failure patients. Trail registration: Patients were retrospectively registered.

scholarly journals New horizons in management of heart failure in older patients

2019 ◽  
Vol 49 (1) ◽  
pp. 16-19
Author(s):  
Maria Stefil ◽  
Luis Manzano ◽  
Manuel Montero-PéRez-Barquero ◽  
Andrew J S Coats ◽  
Marcus Flather
Keyword(s):  
Heart Failure ◽  
Older Patients ◽  
Symptom Control ◽  
Evidence Base ◽  
New Horizons ◽  
Patients With Heart Failure ◽  
High Prevalence ◽  
Atypical Presentations ◽  
Control And Management ◽  
Older Populations

Abstract Heart failure has a high prevalence in older populations, is a common and growing cause for hospital admission and carries a high risk of morbidity and mortality. Important co-morbidities in older patients with heart failure include atrial fibrillation, renal impairment, hypertension and anaemia. Diagnosing and managing heart failure in older patients are complicated due to atypical presentations, co-morbidities and a relative lack of evidence for commonly used treatments in younger patients. The growing epidemic of heart failure is also under-recognised and resourced in most health systems. Despite potential differences, we recommend that the basic approach to manage heart failure patients with an ejection fraction (EF) of &lt;40% should be the same in older and younger. These treatments need to be started at low doses and titrated slowly along with the management of co-morbidities. Older patients with EF 40–49% can be treated in a similar manner to those with &lt;40%, while the treatment of those with EF ≥50% is pragmatic in nature based on symptom control and management of co-morbidities although the evidence base for these recommendations is lacking. Overall management must be holistic and continuous based on the patient’s social circumstances and ongoing needs. Finally, there is an urgent need for more research, evidence and resources directed towards older populations with heart failure to improve their care and the quality of life.

High Prevalence of Radiological Vertebral Fractures in Patients with Heart Failure

2011 ◽  
pp. P3-114-P3-114
Author(s):  
Gherardo Mazziotti ◽  
Matteo Baracca ◽  
Pier Paolo Vescovi ◽  
Andrea Giustina
Keyword(s):  
Heart Failure ◽  
Vertebral Fractures ◽  
Patients With Heart Failure ◽  
High Prevalence

scholarly journals High Prevalence of Sub-clinical Cerebral Infarctions in Patients with Heart Failure with Preserved Ejection Fraction

2015 ◽  
Vol 21 (8) ◽  
pp. S104-S105 ◽  
Author(s):  
Rebecca J. Cogswell ◽  
Faye L. Norby ◽  
Rebecca F. Gottesman ◽  
Lin Y. Chen ◽  
Scott D. Solomon ◽  
...  
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Preserved Ejection Fraction ◽  
Patients With Heart Failure ◽  
High Prevalence

scholarly journals Clinical Implications of Oral Assessment In Elderly Patients With Acute Heart Failure: A Single-Center, Retrospective Study

2021 ◽  
Author(s):  
Yusuke Uemura ◽  
Rei Shibata ◽  
Haruna Ishikawa ◽  
Ayumi Nagahori ◽  
Yuta Katsumi ◽  
...  
Keyword(s):  
Heart Failure ◽  
Oral Health ◽  
Elderly Patients ◽  
Acute Heart Failure ◽  
Barthel Index ◽  
Clinical Implications ◽  
Oral Assessment ◽  
Geriatric Conditions ◽  
Patients With Heart Failure ◽  
High Prevalence

Abstract Background: Oral health problems are common and are associated with various geriatric conditions in older adults. The importance of oral health has not been fully highlighted in the assessment and management of patients with heart failure. Here, we investigated the clinical implications of oral assessment in elderly patients with acute heart failure.Methods: We evaluated oral health using the revised oral assessment guide in 77 patients aged 65 years or older who were admitted to hospital for acute heart failure. Poor oral health was defined as a revised oral assessment guide score ≥ 9.Results: Poor oral health was identified in 66.2% of the patients. Patients with poor oral health had high prevalence of decreased physical function, undernutrition, and cognitive impairment. A reduction in the Barthel Index, as an indicator of activities of daily living during hospitalization, was significant in the enrolled patients. The Barthel Index decreased more in patients with poor oral health than those with normal oral health. Furthermore, the revised oral assessment guide score on admission was found to be the only independent predictor of changes in the Barthel Index during hospitalization in the multivariate regression analyses. Conclusions: Oral assessment using the revised oral assessment guide during hospitalization could provide useful information for the management of elderly heart failure patients.Trail registration: Patients were retrospectively registered.

scholarly journals High prevalence of asymptomatic nosocomial candiduria due to Candida glabrata among hospitalized patients with heart failure: a matter of some concern?

2021 ◽  
Author(s):  
Seyed Reza Aghili ◽  
Mahdi Abastabar ◽  
Ameneh Soleimani ◽  
Iman Haghani ◽  
Soheil Azizi
Keyword(s):  
Heart Failure ◽  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Candida Species ◽  
Candida Glabrata ◽  
Antifungal Susceptibility ◽  
Hospitalized Patients ◽  
Patients With Heart Failure ◽  
High Prevalence

Background and Purpose: Heart failure is a leading cause of hospitalization, and asymptomatic candiduria is common in hospitalized patients with low morbidity. However, in most patients, it is resolved spontaneously on the removal of the catheter. Despite the publication of guidelines, there are still controversies over the diagnosis and management of candiduria. However, in hospitalized patients with heart failure, the decision to treat candiduria is especially important since the nosocomial infections are associated with an increase in morbidity, mortality, length of hospital stay, and healthcare costs. Some species of Candida, such as Candida glabrata, are increasingly resistant to the first-line and second-line antifungal medications. The present study aimed to investigate the incidence of asymptomatic Candida urinary tract infection due to C. glabrata and antifungal susceptibility of Candida isolates in hospitalized patients with heart failure. Materials and Methods: In total, 305 hospitalized patients with heart failure were studied to identify asymptomatic nosocomial candiduria during 2016-17 in one private hospital in the north of Iran. The Sabouraud’s dextrose agar culture plates with a colony count of >104 colony-forming unit/ml of urine sample were considered as Candida urinary tract infection. Candida species were identified based on the morphology of CHROMagar Candida (manufactured by CHROMagar, France) and PCR-RFLP method with MspI restriction enzyme. Antifungal susceptibility testing of the isolates was performed using five mediations, including itraconazole, voriconazole, fluconazole, amphotericin B, and caspofungin by broth microdilution method according to CLSI M27-S4. Results: In this study, the rate of asymptomatic Candida urinary tract infection was 18.8%, which was more common in people above 51 years old and females (70%). In addition to the urinary and intravascular catheter, the occurrence of candiduria in hospitalized patients had significant relationships with a history of surgical intervention, diastolic heart failure, and use of systemic antibiotics (P>0.05). Among Candida spp., non-albicans Candida species was the most common infectious agent (59.7%). Moreover, C. glabrata (n=27, 40.3%) (alone or with other species) and Candida albicans (n=27, 40.3%) were the most common agents isolated in Candida urinary tract infection. Based on the results of the in vitro susceptibility test, the C. glabrata isolates were 15%, 59%, 70%, 74%, and 85% susceptible to caspofungin, amphotericin B, itraconazole, voriconazole, and fluconazole, respectively. Conclusion: According to the findings, there was a high prevalence of asymptomatic Candida urinary tract infection in hospitalized patients with heart failure. Besides, it was suggested that there was a shift towards non-albicans Candida, especially C. glabrata, in these patients. Therefore, asymptomatic candiduria in hospitalized patients with heart failure should be considered significant. Furthermore, the identification of Candida species along with antifungal susceptibility is essential and helps the clinicians to select the appropriate antifungal agent for better management of such cases.

Coronavirus infection in the practice of a general practitioner

2020 ◽  
pp. 78-81
Author(s):  
O. Gizinger
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
General Practitioner ◽  
Animal Species ◽  
Distress Syndrome ◽  
Viral Infections ◽  
Laboratory Diagnosis ◽  
Number Of Patients ◽  
New Variant ◽  
Coronavirus Infection ◽  
Respiratory Viral Infections

The article presents analysis of current information about the etiology, pathogenesis, and laboratory diagnosis of coronavirus 2019-nCoV. It has been shown that all animal species serve as the biological reservoirs for coronavirus. Historical moments in the study of coronavirus infection, methods of protection against viruses are considered. The most common clinical manifestation of a new variant of coronavirus infection is pneumonia, and acute respiratory distress syndrome has developed in a significant number of patients. The article is devoted to methods of protection and prevention of respiratory viral infections. The tactics for the general practitioner dealing with this pathology are indicated on the basis of global and Russian recommendations.

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