scholarly journals The Role of Device Diagnostic Algorithms in the Assessment and Management of Patients with Systolic Heart Failure: A Review

2011 ◽  
Vol 2011 ◽  
pp. 1-7 ◽  
Author(s):  
Andrew C. T. Ha ◽  
Richard A. Leather ◽  
Paul G. Novak ◽  
Laurence D. Sterns ◽  
Anthony S. L. Tang
Keyword(s):  
Heart Failure ◽  
Systolic Heart Failure ◽  
Volume Overload ◽  
Cardiac Resynchronization ◽  
Implantable Cardioverter Defibrillators ◽  
Diagnostic Algorithms ◽  
Long Term Prognosis ◽  
Novel Algorithms

Hospitalization due to heart failure (HF) exacerbation represents a major burden in health care and portends a poor long-term prognosis for patients. As a result, there is considerable interest to develop novel tools and strategies to better detect onset of volume overload, as HF hospitalizations may be reduced if appropriate interventions can be promptly delivered. One such innovation is the use of device-based diagnostic parameters in HF patients with implantable cardioverter defibrillators (ICD) and/or cardiac resynchronization therapy (CRT) devices. These diagnostic algorithms can effectively monitor and detect changes in patients' HF status, as well as predict one's risk of HF hospitalization. This paper will review the role of these device diagnostics parameters in the assessment and management of HF patients in ambulatory settings. In addition, the integration of these novel algorithms in existing HF disease management models will be discussed.

scholarly journals Heart Failure Duration Combined with Left Atrial Dimension Predicts Super-Response and Long-Term Prognosis in Patients with Cardiac Resynchronization Therapy Implantation

2019 ◽  
Vol 2019 ◽  
pp. 1-8
Author(s):  
Zhinian Guo ◽  
Xiaoyan Liu ◽  
Chuan Liu ◽  
Jie Yang ◽  
Xiaofeng Cheng ◽  
...  
Keyword(s):  
Heart Failure ◽  
Cardiac Resynchronization Therapy ◽  
Left Atrial ◽  
Cardiac Resynchronization ◽  
Reverse Remodeling ◽  
Resynchronization Therapy ◽  
End Point ◽  
Long Term Prognosis ◽  
Robust Prediction

Background. Response to cardiac resynchronization therapy (CRT) varies significantly among patients. This study aimed to identify baseline characteristics that could predict super-response to CRT and to evaluate the long-term prognosis in super-responders. Methods. We retrospectively reviewed the data of 73 consecutive patients who received CRT. Patients were considered as super-responders after 6-month follow-up when NYHA class reduction to I or II combined with left ventricular ejection fraction (LVEF) ≥ 50% was observed. Patients were divided into super-responders group and non-super-responders group. All-cause mortality or hospitalization for heart failure (HF) was referred to the combined end point. Results. 17 (23.3%) patients were super-responders. HF duration, left atrial dimension (LAD), and left bundle branch block (LBBB) were independent predictors of super-response to CRT. The combination of HF duration and LAD could provide more robust prediction of super-response than standalone HF duration (0.899 versus 0.789, Z = 2.207, P = 0.027) or standalone LAD (0.899 versus 0.775, Z = 2.487, P = 0.013). super-responders had excellent LV reverse remodeling. The cumulative incidences of combined end point were significantly lower in the super-responders group, LAD ≤ 42mm group, and combination of HF duration ≤ 48 months and LAD ≤ 42mm group. LBBB remained associated with a lowered risk of the combined end point (HR: 0.19, 95% CI: 0.07-0.57, P = 0.003), whereas LAD was associated with a raised risk of the combined end point (HR: 1.09, 95% CI: 1.02-1.17, P = 0.014). Conclusions. HF duration, LAD, and LBBB independently predicted super-response. The combination of HF duration and LAD makes more robust prediction of CRT super-response. Super-responders had excellent LV reverse remodeling and decreased the incidences of the combined end point. LBBB and LAD were independently associated with the combined end point.

Long‑term prognosis and risk factors for cardiac adverse events in patients with chronic systolic heart failure due to hypertension

2008 ◽  
Vol 118 (5) ◽  
pp. 280-288
Author(s):  
Bożena Szyguła‑Jurkiewicz ◽  
Aleksander Owczarek ◽  
Agata Duszańska ◽  
Jacek Sikora ◽  
Andrzej Lekston ◽  
...  
Keyword(s):  
Risk Factors ◽  
Heart Failure ◽  
Adverse Events ◽  
Systolic Heart Failure ◽  
Chronic Systolic Heart Failure ◽  
Long Term Prognosis ◽  
Cardiac Adverse Events

Abstract 13016: Tissue Mitral Annular Displacement (TMAD) Predicts Long-term Prognosis in Heart Failure Patients Receiving Cardiac Resynchronization Therapy

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Katsuomi Iwakura ◽  
Atsunori Okamura ◽  
Yasushi Koyama ◽  
Motoo Date ◽  
Koichi Inoue ◽  
...  
Keyword(s):  
Heart Failure ◽  
Cardiovascular Events ◽  
Severe Heart Failure ◽  
Left Ventricular ◽  
Cardiac Resynchronization ◽  
Lateral Part ◽  
Medical Systems ◽  
Cardiac Events ◽  
Long Term Prognosis

Introduction: Assessment of left ventricular (LV) dyssynchrony by echocardiography has only a limited ability to predict response to cardiac resynchronizing therapy (CRT) because of high variability of the measurement.Tissue mitral annular displacement (TMAD) is a rapid and robust method for the assessment of left ventricular (LV) longitudinal deformity. We previously reported that TMAD predicts good responders to CRT among patients with severe heart failure (AHA scientific meeting 2012). In the present study, we investigated whether TMAD could predict the long-term prognosis after CRT implantation. Methods: We performed echocardiography study in 41 patients with dilated cardiomyopathy (DCM) before and at 6 month of CRT, using iE33 (Philips Medical Systems). TMAD was measured on an apical 4-chamber image using QLAB software (Philips Medical Systems) to assess the movement of septal- and lateral part of mitral annulus toward apex. We measured the interval between QRS complex to peak of displacement on both regions, and calculated the differences in time-to-peak (dTTP). We defined good response to CRT as decrease in LV end-systolic volume (LVESV) > 15% at 6 month of CRT. We followed the patients to observe cardiovascular events including death, myocardial infarction, stroke and hospital admission for heart failure. Results: The 27 good responders (65.8%) had significantly longer dTTP than the non-responders (156±64 vs. 63±61 msec, p<0.0001). Using 104 msec as a cutoff value, TMAD detected CRT responders with sensitivity of 79% and specificity of 78% (AUC=0.83). We observed 20 cardiac events during follow-up period of 1182±635 days. We found that dTTP was significantly associated with cardiovascular events (p=0.048 by Cox proportional hazard model), and that patients with dTTP≥104ms had better prognosis than others (Figure). Conclusion: TMAD is a promising method for predicting long-term prognosis in patients with DCM receiving CRT.

scholarly journals Impact of Chronic Total Occlusion of the Coronary Artery on Long-Term Prognosis in Patients With Ischemic Systolic Heart Failure

2016 ◽  
Vol 9 (17) ◽  
pp. 1790-1797 ◽  
Author(s):  
Mateusz Tajstra ◽  
Łukasz Pyka ◽  
Jarosław Gorol ◽  
Damian Pres ◽  
Marek Gierlotka ◽  
...  
Keyword(s):  
Heart Failure ◽  
Coronary Artery ◽  
Chronic Total Occlusion ◽  
Systolic Heart Failure ◽  
Total Occlusion ◽  
Long Term Prognosis

U-shaped association of sphingosine-1-phosphate level with mortality in chronic systolic heart failure

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
Y Xue ◽  
Q Ma ◽  
S Chen ◽  
X Wang ◽  
A Ma
Keyword(s):  
Heart Failure ◽  
Systolic Heart Failure ◽  
Normal Range ◽  
Republic Of China ◽  
Heart Failure Patients ◽  
All Cause Mortality ◽  
Sphingosine 1 Phosphate ◽  
Chronic Systolic Heart Failure ◽  
Long Term Prognosis

Abstract Background The immunomodulatory molecule sphingosine-1-phosphate (S1P) has received attention in the cardiovascular field due to its significant cardioprotective effects, as revealed in animal studies. Until now, it has been unclear what is the normal range of S1P in chronic heart failure patients and whether it is related to long term prognosis. Purpose The purpose of our study was to identify the distribution characteristics of S1P in systolic heart failure patients and the prognostic value of S1P for long-term prognosis. Methods We recruited 210 chronic systolic heart failure patients from June 2014 to December 2015. Meanwhile 54 healthy people in the same area were selected as controls. Plasma S1P was measured by mass spectrometry. Patients were grouped according to the baseline S1P level quartiles, and restricted cubic spline plots described a U-shaped association between S1P and all cause death. Cox proportional hazard analysis was used to determine the relationship between category of S1P and all-cause death. Survival curves were using the Kaplan-Meier method and the log-rank test was used for comparison. Results Compared with the control group, the plasma S1P in chronic heart failure patients demonstrated a higher mean level (1.269 μmol/L vs 1.122 μmol/L, P=0.006) and a larger standard deviation (0.441 vs 0.316, P=0.022). After a follow-up period of 31.7±10.3 months, the second quartile (0.967–1.192μml/L) with largely normal S1P levels had the lowest all-cause mortality and either an increase (HR=3.87, 95% CI 1.504–9.960, P=0.005, adjusted HR=3.134, 95% CI 1.211–8.111, P=0.019) or a decrease (HR=3.271, 95% CI 1.277–8.381, P=0.014, adjusted HR=1.90, 95% CI 0.711–5.083, P=0.200) predicted a worse prognosis. Conclusions Plasma S1P levels in systolic heart failure patients are related to the long-term all-cause mortality with a U-shaped correlation. Through restoring abnormal levels to a normal range instead of simply up regulation or down regulation, S1P may have the potential to be a therapeutic target for reducing the risk of death in patients with heart failure in the future. Funding Acknowledgement Type of funding source: Public grant(s) – National budget only. Main funding source(s): Ministry of Science and Technology of the People's Republic of China. Ministry of Finance of the People's Republic of China.

scholarly journals Are racial differences in the long-term prognosis of systolic heart failure independent of differences in etiology?

2002 ◽  
Vol 39 ◽  
pp. 191
Author(s):  
Kevin L. Thomas ◽  
Mark East ◽  
Robert Tuttle ◽  
Linda Shaw ◽  
Judy Battle ◽  
...  
Keyword(s):  
Heart Failure ◽  
Racial Differences ◽  
Systolic Heart Failure ◽  
Long Term Prognosis

scholarly journals Peripartum cardiomyopathy

2011 ◽  
Vol 2 (3) ◽  
pp. 161
Author(s):  
Rodolfo Citro ◽  
Roberta Giudice ◽  
Marco Mirra ◽  
Rosa Paolillo ◽  
Chiara Paolillo ◽  
...  
Keyword(s):  
Heart Failure ◽  
Systolic Dysfunction ◽  
Treatment Strategies ◽  
Current Treatment ◽  
Peripartum Cardiomyopathy ◽  
Multicenter Trials ◽  
Autoimmune Processes ◽  
Long Term Prognosis

Peripartum cardiomyopathy is an uncommon form of congestive heart failure associated with systolic dysfunction of left ventricle. The onset is characterised by symptoms of heart failure occurring between the last month of pregnancy and 5-6 months postpartum. The early diagnosis and the institution of medical treatment for this disease are essential because the inadequate management may affect the patient’s long-term prognosis and can lead to severe complications, including death.Currently its aetiology is not completely understood. Many aetiopathogenetic hypotheses have been formulated: inflammation, viral agents, autoimmune processes. In the last years, evidences aroused for a role of prolactin and its 16 kDa metabolite in reducing cardiomyocite metabolic activity and contraction. In this article we have reviewed the current literature with special emphasis on the role of prolactin and the related current treatment strategies. In particular, bromocriptine appears promising, even if women need to be informed that the drug stops the production of breastmilk. Further researchers, such as large multicenter trials, are needed to decide the best treatment for the women suffering of this disease.

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