scholarly journals Acute Pulmonary Embolism Is an Independent Predictor of Adverse Events in Severe Decompensated Heart Failure Patients

CHEST Journal ◽  
2007 ◽  
Vol 131 (6) ◽  
pp. 1838-1843 ◽  
Author(s):  
Eduardo S. Darze ◽  
Adriana L. Latado ◽  
Aloyra G. Guimarães ◽  
Rodrigo A.V. Guedes ◽  
Alessandra B. Santos ◽  
...  
Keyword(s):  
Heart Failure ◽  
Pulmonary Embolism ◽  
Adverse Events ◽  
Acute Pulmonary Embolism ◽  
Independent Predictor ◽  
Decompensated Heart Failure ◽  
Heart Failure Patients

scholarly journals Early rehabilitation in cardiology – heart failure: The ERIC-HF protocol, a novel intervention to decompensated heart failure patients rehabilitation

2020 ◽  
Vol 19 (7) ◽  
pp. 592-599 ◽  
Author(s):  
Bruno Miguel Delgado ◽  
Ivo Lopes ◽  
Bárbara Gomes ◽  
André Novo
Keyword(s):  
Heart Failure ◽  
Adverse Events ◽  
Aerobic Exercise ◽  
Functional Capacity ◽  
Exercise Tolerance ◽  
Nyha Class ◽  
Training Group ◽  
Decompensated Heart Failure ◽  
Heart Failure Patients ◽  
Training Protocol

Background: Decompensated heart failure patients are characterised by functional dependence and low exercise tolerance. Aerobic exercise can improve symptoms, functional capacity and an increase in exercise tolerance. However, the benefits of early rehabilitation have not yet been validated. Objective: To evaluate the safety and feasibility of an aerobic exercise training programme in functional capacity of decompensated heart failure patients. Methodology: A single centre, parallel, randomised controlled, open label trial, with 100 patients. The training group (TG, n=50) performed the training protocol and the control group (CG, n=50) performed the usual rehabilitation procedures. The London chest activity of daily living (LCADL) scale, the Barthel index (BI) and the 6 minute walking test (6MWT) at discharge were used to evaluate the efficacy of the protocol. Safety was measured by the existence of adverse events. Results: The mean age of the patients was 70 years, 20% were New York Heart Association (NYHA) class IV and 80% NYHA class III at admission. The major heart failure aetiology was ischaemic (35 patients) and valvular disease (25 patients). There were no significant differences between groups at baseline in terms of sociodemographic or pathophysiological characteristics. There was a statistically significant difference of 54.2 meters for the training group ( P=0.026) in the 6MWT and at LCADL 12 versus 16 ( P=0.003), but the BI did not: 96 versus 92 ( P=0.072). No major adverse events occurred. Conclusions: The training protocol demonstrated safety and efficacy, promoting functional capacity. This study elucidated about the benefits of a systematised implementation of physical exercise during the patient’s clinical stabilisation phase, which had not yet been demonstrated. Trial registration: Clinicaltrials.gov NCT03838003, URL: https://clinicaltrials.gov/ct2/show/NCT03838003 .

scholarly journals Effects of Widespread Inotrope Use in Acute Heart Failure Patients

2018 ◽  
Vol 7 (10) ◽  
pp. 368 ◽  
Author(s):  
Jeehoon Kang ◽  
Hyun-Jai Cho ◽  
Hae-Young Lee ◽  
Sangjun Lee ◽  
Sue Park ◽  
...  
Keyword(s):  
Heart Failure ◽  
Blood Pressure ◽  
Propensity Score ◽  
Adverse Events ◽  
Acute Heart Failure ◽  
Total Population ◽  
Independent Predictor ◽  
Event Rate ◽  
Heart Failure Patients ◽  
Current Guidelines

Current guidelines recommend that inotropes should not be used in patients with normal systolic blood pressure (SBP). However, this is not supported with concrete evidence. We aimed to evaluate the effect of inotropes in acute heart failure (HF) patients from a nationwide HF registry. A total of 5625 patients from the Korean Acute Heart Failure (KorAHF) registry were analyzed. The primary outcomes were in-hospital adverse events and 1-month mortality. Among the total population, 1703 (31.1%) received inotropes during admission. Inotrope users had a higher event rate than non-users (in-hospital adverse events: 13.3% vs. 1.4%, p < 0.001; 1-month mortality: 5.5% vs. 2.5%, p < 0.001), while inotrope use was an independent predictor for clinical outcomes (in-hospital adverse events: ORadjusted 5.459, 95% CI 3.622–8.227, p < 0.001; 1-month mortality: HRadjusted 1.839, 95% CI 1.227–2.757, p = 0.003). Subgroup analysis showed that inotrope use was an independent predictor for detrimental outcomes only in patients with normal initial SBP (≥90 mmHg) (in-hospital adverse events: ORadjusted 5.931, 95% CI 3.864–9.104, p < 0.001; 1-month mortality: HRadjusted 3.584, 95% CI 1.280–10.037, p = 0.015), and a propensity score-matched population showed consistent results. Clinicians should be cautious with the usage of inotropes in acute heart failure patients, especially in those with a normal SBP.

Abstract 14708: Prothrombin Time is a Novel Marker for Congestion in Acute Decompensated Heart Failure Patients Without Anticoagulants

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Atsushi Okada ◽  
Yasuo Sugano ◽  
Toshiyuki Nagai ◽  
Satoshi Honda ◽  
Yasuhide Asaumi ◽  
...  
Keyword(s):  
Heart Failure ◽  
Prothrombin Time ◽  
Cardiovascular Mortality ◽  
Prognostic Value ◽  
Independent Predictor ◽  
Acute Decompensated Heart Failure ◽  
Decompensated Heart Failure ◽  
Right Atrial ◽  
Heart Failure Patients ◽  
All Cause Mortality

Background: Where prothrombin time is widely used to monitor anticoagulation in cardiology patients, it is also a classical marker of liver damage. However, the clinical significance of prothrombin time in heart failure patients without anticoagulants is unknown. Therefore, we investigated the prevalence, relationship with clinical characteristics, and prognostic value of prothrombin time in acute decompensated heart failure (ADHF). Method: We prospectively studied 651 consecutive patients admitted for ADHF. Prothrombin time internationalized normalized ratio (PT-INR) was measured on admission in all patients. By excluding patients with oral anticoagulants, acute coronary syndrome and liver diseases, 308 patients were assessed. We assessed the relationship between PT-INR and blood tests, echocardiogram, and hemodynamic parameters from right heart catheterization. Cox regression hazard analysis was performed to assess prognostic value of PT-INR on all-cause mortality and cardiovascular mortality. Results: Of the 308 patients (75±13 years, 192 male), the mean PT-INR value was 1.10. Patients with prolonged PT-INR(>1.10, n=104) had significantly higher total bilirubin, alkaline phosphatase and gamma-glutamyl transpeptidase (all p<0.05), however, had similar LVEF, blood urea nitrogen, creatinine, and BNP compared to those with less PT-INR(≦1.10, n=204). PT-INR value had strong correlation with pulmonary capillary wedge pressure (r=-0.61, p<0.01) and right atrial pressure (r=-0.59, p<0.01), but not with cardiac index (r=0.23, p=ns.). Twenty-two patients (7%) died during a mean follow up of 317 days, and Cox proportional hazards analysis showed that PT-INR was an independent predictor of both all-cause mortality (HR=1.14, p<0.05) and cardiovascular mortality (HR=1.12, p<0.05) even after adjusted by age, sex, LVEF, creatinine, BNP and hemoglobin. Conclusion: Prolonged PT-INR in ADHF patients without anticoagulants was associated with clinical markers of hepatic congestion and elevated right sided pressure. It was also an independent predictor of all-cause and cardiovascular mortality.

scholarly journals Fragmented QRS Complex Predicts In-Hospital Adverse Events and Long-Term Mortality in Patients with Acute Pulmonary Embolism

2015 ◽  
Vol 21 (5) ◽  
pp. 470-478 ◽  
Author(s):  
Mehmet Serkan Cetin ◽  
Elif Hande Ozcan Cetin ◽  
Fazil Arisoy ◽  
Mevlüt Serdar Kuyumcu ◽  
Serkan Topaloglu ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Adverse Events ◽  
Acute Pulmonary Embolism ◽  
Qrs Complex ◽  
Fragmented Qrs ◽  
Long Term Mortality

scholarly journals Effect of Carperitide on Plasma Adiponectin Levels in Acute Decompensated Heart Failure Patients With Diabetes Mellitus

2009 ◽  
Vol 73 (12) ◽  
pp. 2264-2269 ◽  
Author(s):  
Masayuki Yamaji ◽  
Takayoshi Tsutamoto ◽  
Toshinari Tanaka ◽  
Chiho Kawahara ◽  
Keizo Nishiyama ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Heart Failure ◽  
Acute Decompensated Heart Failure ◽  
Decompensated Heart Failure ◽  
Plasma Adiponectin ◽  
Heart Failure Patients ◽  
Patients With Diabetes

Prognostic value of signs and symptoms in heart failure patients using remote telemonitoring

2021 ◽  
pp. 1357633X2110394
Author(s):  
Arno Joachim Gingele ◽  
Lloyd Brandts ◽  
Kjeld Vossen ◽  
Christian Knackstedt ◽  
Josiane Boyne ◽  
...  
Keyword(s):  
Heart Failure ◽  
At Risk ◽  
Adverse Events ◽  
Confidence Interval ◽  
Odds Ratio ◽  
Hospital Admissions ◽  
Early Recognition ◽  
Signs And Symptoms ◽  
Clinical Deterioration ◽  
Heart Failure Patients

Introduction Heart failure is a serious burden on health care systems due to frequent hospital admissions. Early recognition of outpatients at risk for clinical deterioration could prevent hospitalization. Still, the role of signs and symptoms in monitoring heart failure patients is not clear. The heart failure coach is a web-based telemonitoring application consisting of a 9-item questionnaire assessment of heart failure signs and symptoms and developed to identify outpatients at risk for clinical deterioration. If deterioration was suspected, patients were contacted by a heart failure nurse for further evaluation. Methods Heart failure coach questionnaires completed between 2015 and 2018 were collected from 287 patients, completing 18,176 questionnaires. Adverse events were defined as all-cause mortality, heart failure- or cardiac-related hospital admission or emergency cardiac care visits within 30 days after completion of each questionnaire. Multilevel logistic regression analyses were performed to assess the association between the heart failure coach questionnaire items and the odds of an adverse event. Results No association between dyspnea and adverse events was observed (odds ratio 1.02, 95% confidence interval 0.79–1.30). Peripheral edema (odds ratio 2.21, 95% confidence interval 1.58–3.11), persistent chest pain (odds 2.06, 95% confidence interval 1.19–3.58), anxiety about heart failure (odds ratio 2.12, 95% confidence interval 1.44–3.13), and extensive struggle to perform daily activities (odds ratio 2.23, 95% confidence interval 1.38–3.62) were significantly associated with adverse outcome. Discussion Regular assessment of more than the classical signs and symptoms may be helpful to identify heart failure patients at risk for clinical deterioration and should be an integrated part of heart failure telemonitoring programs.

Sign in / Sign up

Export Citation Format

Share Document