Prevalence of Systolic Heart Failure in Patients with Dementia in Saudi Arabia: Single-center retrospective data review

Background: Dementia is one of the most common neurological diagnoses in older patients. Previous reports have proposed that heart failure could be a risk factor for dementia. Other studies have suggested that cardiovascular function could have a critical role in the pathogenesis of dementia. Aim: This study aimed to identify the prevalence of heart failure in patients diagnosed with dementia. Method: This was a chart review of medical records of patients followed at King Abdul-Aziz University Hospital and diagnosed with dementia with at least one echocardiogram completed after the diagnosis of dementia. Demographic variations and comorbidities of these patients were collected. Result: A total of 200 patients met the inclusion criteria, with a mean age of 76.28 years. In 10.5% of the participants, the ejection fraction was less than 40%. The dominant type of dementia in the participants was mixed/unspecified type (78.5%). Conclusion: The prevalence of systolic heart failure seems to be higher in patients with dementia when compared to similar age group populations reported in other studies. Multiple limitations are present in this study, and additional research is needed to further assess this possible correlation. Key words: Systolic heart failure, dementia, Saudi Arabia

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Association between Anemia with or without Renal Dysfunction and Rehospitalization among Systolic Heart Failure Patients, Medina, Saudi Arabia

International Journal of Medicine in Developing Countries ◽

10.24911/ijmdc.51-1601549545 ◽

2020 ◽

pp. 1904-1911

Author(s):

Raneem Alraheili ◽

Bayan Al-Alawi ◽

Mohammad Khalifah ◽

Mohammed Saeed ◽

Mansour Nozha ◽

...

Keyword(s):

Heart Failure ◽

Saudi Arabia ◽

Renal Dysfunction ◽

Systolic Heart Failure ◽

Heart Failure Patients

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Heart failure as a predictor of functional dependence in hospitalized elderly

Revista da Escola de Enfermagem da USP ◽

10.1590/s0080-623420150000500012 ◽

2015 ◽

Vol 49 (5) ◽

pp. 790-796 ◽

Cited By ~ 3

Author(s):

Sara de Oliveira Xavier ◽

Renata Eloah de Lucena Ferretti-Rebustini ◽

Eduesley Santana-Santos ◽

Paola Alves de Oliveira Lucchesi ◽

Karine Generoso Hohl

Keyword(s):

Heart Failure ◽

Medical Records ◽

Daily Living ◽

Functional Dependence ◽

Functional Decline ◽

University Hospital ◽

Geriatric Ward ◽

Hospitalized Elderly ◽

Katz Index ◽

Functional Deterioration

AbstractOBJECTIVEIdentify whether Heart Failure (HF) is a predictor of functional dependence for Basic Activities of Daily Living (BADL) in hospitalized elderly.METHODSWe investigated medical records and assessed dependence to BADL (by the Katz Index) of 100 elderly admitted to a geriatric ward of a university hospital. In order to verify if HF is a predictor of functional dependence, linear regression analyzes were performed.RESULTSThe prevalence of HF was 21%; 95% of them were dependent for BADLs. Bathing was the most committed ADL. HF is a predictor of dependence in hospitalized elderlies, increasing the chance of functional decline by 5 times (95% CI, 0.94-94.48), the chance of functional deterioration by 3.5 times (95% CI, 1.28-11.66; p <0.02) and reducing 0.79 points in the Katz Index score (p <0.05).CONCLUSIONHF is a dependency predictor of ADL in hospitalized elderly, who tend to be more dependent, especially for bathing.

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Adaptations in Protein Expression and Regulated Activity of Pyruvate Dehydrogenase Multienzyme Complex in Human Systolic Heart Failure

Oxidative Medicine and Cellular Longevity ◽

10.1155/2019/4532592 ◽

2019 ◽

Vol 2019 ◽

pp. 1-11 ◽

Cited By ~ 6

Author(s):

Freya L. Sheeran ◽

Julie Angerosa ◽

Norman Y. Liaw ◽

Michael M. Cheung ◽

Salvatore Pepe

Keyword(s):

Heart Failure ◽

Pyruvate Dehydrogenase ◽

Critical Role ◽

Systolic Heart Failure ◽

Left Ventricular ◽

Left Ventricular Myocardium ◽

Multienzyme Complex ◽

Acetyl Coa ◽

Altered Expression ◽

End Stage

Pyruvate dehydrogenase (PDH) complex, a multienzyme complex at the nexus of glycolytic and Krebs cycles, provides acetyl-CoA to the Krebs cycle and NADH to complex I thus supporting a critical role in mitochondrial energy production and cellular survival. PDH activity is regulated by pyruvate dehydrogenase phosphatases (PDP1, PDP2), pyruvate dehydrogenase kinases (PDK 1-4), and mitochondrial pyruvate carriers (MPC1, MPC2). As NADH-dependent oxidative phosphorylation is diminished in systolic heart failure, we tested whether the left ventricular myocardium (LV) from end-stage systolic adult heart failure patients (n=26) exhibits altered expression of PDH complex subunits, PDK, MPC, PDP, and PDH complex activity, compared to LV from nonfailing donor hearts (n=21). Compared to nonfailing LV, PDH activity and relative expression levels of E2, E3bp, E1α, and E1βsubunits were greater in LV failure. PDK4, MPC1, and MPC2 expressions were decreased in failing LV, whereas PDP1, PDP2, PDK1, and PDK2 expressions did not differ between nonfailing and failing LV. In order to examine PDK4 further, donor human LV cardiomyocytes were induced in culture to hypertrophy with 0.1 μM angiotensin II and treated with PDK inhibitors (0.2 mM dichloroacetate, or 5 mM pyruvate) or activators (0.6 mM NADH plus 50 μM acetyl CoA). In isolated hypertrophic cardiomyocytesin vitro, PDK activators and inhibitors increased and decreased PDK4, respectively. In conclusion, in end-stage failing hearts, greater expression of PDH proteins and decreased expression of PDK4, MPC1, and MPC2 were evident with higher rates of PDH activity. These adaptations support sustained capacity for PDH to facilitate glucose metabolism in the face of other failing bioenergetic pathways.

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Long-term outcomes of functional neurological disorder in children

Archives of Disease in Childhood ◽

10.1136/archdischild-2018-316519 ◽

2019 ◽

Vol 104 (12) ◽

pp. 1155-1160 ◽

Cited By ~ 3

Author(s):

Joseph Raper ◽

Victoria Currigan ◽

Sarah Fothergill ◽

Jon Stone ◽

Rob J Forsyth

Keyword(s):

Medical Records ◽

Neurological Disorder ◽

Chart Review ◽

Age Of Onset ◽

Remission Rate ◽

University Hospital ◽

Sensory Loss ◽

Long Term Outcomes ◽

Functional Neurological Disorder

ObjectivesTo establish the incidence and long-term outcomes (up to 21 years) of children presenting to a University hospital paediatric neurology service with symptoms due to functional neurological disorder (FND) with particular reference to occurrence of FND or similar symptoms in adulthood.MethodsRetrospective chart review to determine characteristics of the original paediatric FND presentation plus record-linkage with providers of Child and Adolescent Mental Health Services. Chart review of adult medical records for documentation of functional symptoms in adulthood.Results124 individuals (56% female) met entry criteria. The most common presentations were seizures (18%), sensory loss (18%) and motor symptoms (16%). Frequency gradually increased with age of onset with an incidence in paediatric neurological services of 6 per 100 000 children under 16. In up to 21 years’ follow-up (median 8.3 years), 114/124 attained their 16th birthdays by the study census date and were thus eligible for inclusion in an analysis of symptom persistence/recurrence in adulthood. 26/114 (23%) showed evidence of FND in adulthood of sufficient significance to be recorded in medical records.ConclusionPaediatric FND is commoner than previous estimates. Even in this selected population of children reaching specialist paediatric neurology services, a high long-term remission rate is observed.

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Assessment of Prescriber Compliance with Established Heart Failure Guidelines at a Major Medical Center

Hospital Pharmacy ◽

10.1177/001857870504000807 ◽

2005 ◽

Vol 40 (8) ◽

pp. 680-686

Author(s):

Kyle A Weant ◽

Kelly M. Smith ◽

Daniel A. Lewis

Keyword(s):

Heart Failure ◽

Treatment Guidelines ◽

Medical Center ◽

Beta Blockers ◽

Systolic Heart Failure ◽

Primary Diagnosis ◽

University Hospital ◽

Target Dose ◽

Major Medical Center ◽

Retrospective Data Collection

Purpose Treatment guidelines for systolic heart failure (HF), therapy for which largely relies on the combination of renin-angiotensin-aldosterone system (RAAS) agents and beta-blockers, focus on decreasing morbidity and mortality, and increasing quality of life. The objective of this study is to assess prescriber compliance with these guidelines in designing patient medication regimens prior to hospital admission, at discharge, and at readmission if within 30 days at a 473-bed tertiary university hospital. Methods Of 162 patients with a primary diagnosis of HF, 62 were selected for a retrospective data collection utilizing a random number table. Ten with an ejection fraction greater than or equal to 50% were excluded. Regimens were classified as suboptimal (absence of RAAS agent or beta-blocker), optimal, or optimal at target doses. Results Prior to admission (N = 52), 81% were prescribed diuretics, 54% were prescribed beta-blockers (8% target dose), and 50% were prescribed RAAS agents (11% target dose). Overall, 36% were optimal regimens; 2% were optimal and at optimal doses. Upon discharge, these values were 58% and 2%, respectively. Discharge medications included diuretics (92%), beta-blockers (79%; 10% target dose), and RAAS agents (75%; 11% target dose). Of the nine (17%) readmitted within 30 days, 67% were receiving suboptimal therapy; none were at target doses. Conclusions Optimal HF regimens were less common upon admission (36%) and improved upon discharge (58%). Most patients readmitted within 30 days of discharge were receiving suboptimal therapy. Clinical pharmacists are in a position to provide continuing prescriber education regarding proven HF therapies and target titration end points, both in ambulatory and acute care arenas.

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Diagnostic and prognostic evaluation of left ventricular systolic heart failure by plasma N-terminal pro-brain natriuretic peptide concentrations in a large sample of the general population

Heart ◽

10.1136/hrt.2003.026021 ◽

2004 ◽

Vol 90 (3) ◽

pp. 297-303 ◽

Cited By ~ 130

Author(s):

B A Groenning ◽

I Raymond ◽

P R Hildebrandt ◽

J C Nilsson ◽

M Baumann ◽

...

Keyword(s):

Heart Failure ◽

General Population ◽

Brain Natriuretic Peptide ◽

Natriuretic Peptide ◽

Hospital Admissions ◽

Systolic Heart Failure ◽

Left Ventricular ◽

University Hospital ◽

Predictive Values ◽

Background Population

Objective: To evaluate N-terminal pro-brain natriuretic peptide (NT-proBNP) as a diagnostic and prognostic marker for systolic heart failure in the general population.Design: Study participants, randomly selected to be representative of the background population, filled in a heart failure questionnaire and underwent pulse and blood pressure measurements, electrocardiography, echocardiography, and blood sampling and were followed up for a median (range) period of 805 (60−1171) days.Setting: Participants were recruited from four randomly selected general practitioners and were examined in a Copenhagen university hospital.Patients: 382 women and 290 men in four age groups (50−59 (n = 174); 60−69 (n = 204); 70−79 (n = 174); ⩾ 80 years (n = 120)).Main outcome measures: Value of NT-proBNP in evaluating patients with symptoms of heart failure and impaired left ventricular (LV) systolic function; prognostic value of NT-proBNP for mortality and hospital admissions.Results: In 38 (5.6%) participants LV ejection fraction (LVEF) was ⩽ 40%. NT-proBNP identified patients with symptoms of heart failure and LVEF ⩽ 40% with a sensitivity of 0.92, a specificity of 0.86, positive and negative predictive values of 0.11 and 1.00, and area under the curve of 0.94. NT-proBNP was the strongest independent predictor of mortality (hazard ratio (HR) = 5.70, p < 0.0001), hospital admissions for heart failure (HR = 13.83, p < 0.0001), and other cardiac admissions (HR = 3.69, p < 0.0001). Mortality (26 v 6, p = 0.0003), heart failure admissions (18 v 2, p = 0.0002), and admissions for other cardiac causes (44 v 13, p < 0.0001) were significantly higher in patients with NT-proBNP above the study median (32.5 pmol/l).Conclusions: Measurement of NT-proBNP may be useful as a screening tool for systolic heart failure in the general population.

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Abstract 17044: Gender Discrepancies in Management and Outcome of Hospitalized Heart Failure Patients

Circulation ◽

10.1161/circ.138.suppl_1.17044 ◽

2018 ◽

Vol 138 (Suppl_1) ◽

Author(s):

Idris Bare ◽

Rizwan Malik ◽

Yangzhao Cheng ◽

Prosanta Mondal ◽

Jason Orvold ◽

...

Keyword(s):

Heart Failure ◽

Chart Review ◽

Retrospective Chart Review ◽

University Hospital ◽

Clinical Factors ◽

Academic Hospital ◽

Review Study ◽

Baseline Characteristics ◽

Gender Discrepancies

Introduction: The incidence of heart failure (HF), particularly in women, is increasing rapidly. While earlier reports indicated that HF mortality was higher in men compared to women, recent studies have suggested higher HF mortality in women. The cause of this changing pattern is not well described. The purpose of this study was to explore different clinical factors and management patterns that could contribute to this. Methods: We conducted a retrospective chart review study of all the patients admitted to a tertiary academic hospital (Royal University Hospital, University of Saskatchewan, Canada) with a diagnosis of HF in 2015, with follow up analysis up to February 20, 2018. Results: In total, 379 patients were admitted with HF, of which 166 (43.8%) were women. Overall, the most important predictors of mortality on multivariate analysis include admission to non-cardiology services (NCS, p < 0.0001), age on admission (p<0.001), readmission (p=0.001), and haemoglobin on admission (P=0.004). Review of baseline characteristics showed that women with HF were older (p<0.001), and more likely to have HFpEF (26.3% vs. 46.4%, p<0.001) than men. However, women were less likely to have comorbidities including COPD, CKD, PVD, HTN, diabetes and dyslipidemia (p<0.001). In spite of this, there was a trend towards higher mortality among women over the follow up period (57.8% vs. 47.9%, p=0.055). Women were significantly less likely to be admitted to cardiology (62% vs. 71.4%, p=0.0084), and less likely to have follow up scheduled on discharge with either an internist or cardiologist (70.4% vs. 53.6%, p<0.001). Similar gender discrepancy in admission to cardiology was also observed among the subgroup of patients with HFrEF. Conclusions: In our study, women admitted with heart failure had worse overall prognosis than men, in spite of less associated comorbidities. Admission to cardiology service was the most significant positive prognostic factor overall. However, surprisingly, women were significantly less likely to be admitted to cardiology, possibly contributing to their observed poor outcome. Further studies to elucidate factors underlying this observed difference in admission pattern may help improve the management of women with HF.

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