Latest & greatest articles for heart failure

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Top results for heart failure

1. Impact of Exercise Rehabilitation on Exercise Capacity and Quality-of-Life in Heart Failure: Individual Participant Meta-Analysis

Impact of Exercise Rehabilitation on Exercise Capacity and Quality-of-Life in Heart Failure: Individual Participant Meta-Analysis Previous systematic reviews have indicated that exercise-based cardiac rehabilitation (ExCR) for patients with heart failure (HF) has a beneficial effect on health-related quality-of-life (HRQoL) and exercise capacity. However, there is uncertainty regarding potential differential effects of ExCR across HF patient subgroups.The authors sought to undertake (...) international clinical guidelines that ExCR should be offered to all HF patients. (Exercise Training for Chronic Heart Failure [ExTraMATCH II]: protocol for an individual participant data meta-analysis; PROSPERO: international database of systematic reviews CRD42014007170).Copyright © 2019. Published by Elsevier Inc.

2019 EvidenceUpdates

2. Intramyocardial Injection of Mesenchymal Precursor Cells and Successful Temporary Weaning From Left Ventricular Assist Device Support in Patients With Advanced Heart Failure: A Randomized Clinical Trial. (PubMed)

Intramyocardial Injection of Mesenchymal Precursor Cells and Successful Temporary Weaning From Left Ventricular Assist Device Support in Patients With Advanced Heart Failure: A Randomized Clinical Trial. Left ventricular assist device (LVAD) therapy improves myocardial function, but few patients recover sufficiently for explant, which has focused attention on stem cells to augment cardiac recovery.To assess efficacy and adverse effects of intramyocardial injections of mesenchymal precursor (...) cells (MPCs) during LVAD implant.A randomized phase 2 clinical trial involving patients with advanced heart failure, undergoing LVAD implant, at 19 North American centers (July 2015-August 2017). The 1-year follow-up ended August 2018.Intramyocardial injections of 150 million allogeneic MPCs or cryoprotective medium as a sham treatment in a 2:1 ratio (n = 106 vs n = 53).The primary efficacy end point was the proportion of successful temporary weans (of 3 planned assessments) from LVAD support within

2019 JAMA

3. Heart failure drug treatment. (PubMed)

Heart failure drug treatment. Heart failure is the most common cardiovascular reason for hospital admission for people older than 60 years of age. Few areas in medicine have progressed as remarkably as heart failure treatment over the past three decades. However, progress has been consistent only for chronic heart failure with reduced ejection fraction. In acutely decompensated heart failure and heart failure with preserved ejection fraction, none of the treatments tested to date have been (...) definitively proven to improve survival. Delaying or preventing heart failure has become increasingly important in patients who are prone to heart failure. The prevention of worsening chronic heart failure and hospitalisations for acute decompensation is also of great importance. The objective of this Series paper is to provide a concise and practical summary of the available drug treatments for heart failure. We support the implementation of the international guidelines. We offer views on the basis of our

2019 Lancet

4. Multimodality imaging in ischaemic heart failure. (PubMed)

Multimodality imaging in ischaemic heart failure. In heart failure, extensive evaluation with modern non-invasive imaging modalities is needed to assess causes, pathophysiology, and haemodynamics, to determine prognosis and consider therapeutic options. This systematic evaluation includes a stepwise assessment of left ventricular size and function, the presence and severity of coronary artery disease, mitral regurgitation, pulmonary hypertension, right ventricular dilation and dysfunction

2019 Lancet

5. Beyond pharmacological treatment: an insight into therapies that target specific aspects of heart failure pathophysiology. (PubMed)

Beyond pharmacological treatment: an insight into therapies that target specific aspects of heart failure pathophysiology. Heart failure is a common syndrome associated with substantial morbidity and mortality. The management of symptoms and the strategies for improving prognosis have largely been based on pharmacological treatments. The pathophysiology of heart failure is complex because of the multiple causes responsible for this syndrome. This Series paper presents some examples of advances (...) in heart failure management, in which the treatment specifically targets the underlying pathophysiological mechanisms responsible for the symptoms. These treatments include treatment of electromechanical dyssynchrony and dysrhythmia by cardiac resynchronisation and implantable cardioverter-defibrillators; neurohumoral modification by baroreflex and vagal stimulation; prevention of adverse cardiac remodelling by interatrial shunts; and finally targeting the myocardium directly by cell therapy

2019 Lancet

6. Association of genetically predicted testosterone with thromboembolism, heart failure, and myocardial infarction: mendelian randomisation study in UK Biobank. (PubMed)

Association of genetically predicted testosterone with thromboembolism, heart failure, and myocardial infarction: mendelian randomisation study in UK Biobank. To determine whether endogenous testosterone has a causal role in thromboembolism, heart failure, and myocardial infarction.Two sample mendelian randomisation study using genetic variants as instrumental variables, randomly allocated at conception, to infer causality as additional randomised evidence.Reduction by Dutasteride of Prostate (...) Cancer Events (REDUCE) randomised controlled trial, UK Biobank, and CARDIoGRAMplusC4D 1000 Genomes based genome wide association study.3225 men of European ancestry aged 50-75 in REDUCE; 392 038 white British men and women aged 40-69 from the UK Biobank; and 171 875 participants of about 77% European descent, from CARDIoGRAMplusC4D 1000 Genomes based study for validation.Thromboembolism, heart failure, and myocardial infarction based on self reports, hospital episodes, and death.Of the UK Biobank

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2019 BMJ

7. Effect of Patient-Centered Transitional Care Services on Clinical Outcomes in Patients Hospitalized for Heart Failure: The PACT-HF Randomized Clinical Trial. (PubMed)

Effect of Patient-Centered Transitional Care Services on Clinical Outcomes in Patients Hospitalized for Heart Failure: The PACT-HF Randomized Clinical Trial. Health care services that support the hospital-to-home transition can improve outcomes in patients with heart failure (HF).To test the effectiveness of the Patient-Centered Care Transitions in HF transitional care model in patients hospitalized for HF.Stepped-wedge cluster randomized trial of 2494 adults hospitalized for HF across 10 (...) hospitals in Ontario, Canada, from February 2015 to March 2016, with follow-up until November 2016.Hospitals were randomized to receive the intervention (n = 1104 patients), in which nurse-led self-care education, a structured hospital discharge summary, a family physician follow-up appointment less than 1 week after discharge, and, for high-risk patients, structured nurse homevisits and heart function clinic care were provided to patients, or usual care (n = 1390 patients), in which transitional care

2019 JAMA

8. Trends in survival after a diagnosis of heart failure in the United Kingdom 2000-2017: population based cohort study. (PubMed)

Trends in survival after a diagnosis of heart failure in the United Kingdom 2000-2017: population based cohort study. To report reliable estimates of short term and long term survival rates for people with a diagnosis of heart failure and to assess trends over time by year of diagnosis, hospital admission, and socioeconomic group.Population based cohort study.Primary care, United Kingdom.Primary care data for 55 959 patients aged 45 and overwith a new diagnosis of heart failure and 278 679 age (...) and sex matched controls in the Clinical Practice Research Datalink from 1 January 2000 to 31 December 2017 and linked to inpatient Hospital Episode Statistics and Office for National Statistics mortality data.Survival rates at one, five, and 10 years and cause of death for people with and without heart failure; and temporal trends in survival by year of diagnosis, hospital admission, and socioeconomic group.Overall, one, five, and 10 year survival rates increased by 6.6% (from 74.2% in 2000 to 80.8

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2019 BMJ

9. Association of Left Ventricular Ejection Fraction and Symptoms With Mortality After Elective Noncardiac Surgery Among Patients With Heart Failure. (PubMed)

Association of Left Ventricular Ejection Fraction and Symptoms With Mortality After Elective Noncardiac Surgery Among Patients With Heart Failure. Heart failure is an established risk factor for postoperative mortality, but how left ventricular ejection fraction and heart failure symptoms affect surgical outcomes is not fully described.To determine the risk of postoperative mortality among patients with heart failure at various levels of echocardiographic (left ventricular systolic dysfunction (...) ) and clinical (symptoms) severity compared with those without heart failure and to evaluate how risk varies across levels of surgical complexity.US multisite retrospective cohort study of all adult patients receiving elective, noncardiac surgery in the Veterans Affairs Surgical Quality Improvement Project database from 2009 through 2016. A total of 609 735 patient records were identified and analyzed with 1 year of follow-up after having surgery (final study follow-up: September 1, 2017).Heart failure, left

2019 JAMA

10. Post-discharge short message service improves short-term clinical outcome and self-care behaviour in chronic heart failure. (PubMed)

Post-discharge short message service improves short-term clinical outcome and self-care behaviour in chronic heart failure. In addition to giving optimal medical and device therapy, promoting self-care of chronic heart failure (CHF) patients also plays an important role in comprehensive disease management for better outcomes. The study was aimed to investigate whether short message service (SMS) would help to improve death or readmission-free survival and self-care behaviour in CHF (...) and improved self-care behaviour. SMS intervention could be integrated into CHF management.© 2018 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of the European Society of Cardiology.

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2019 ESC heart failure

11. Repetitive levosimendan infusions for patients with advanced chronic heart failure in the vulnerable post-discharge period. (PubMed)

Repetitive levosimendan infusions for patients with advanced chronic heart failure in the vulnerable post-discharge period. Hospitalization for acute heart failure (HF) is associated with a substantial morbidity burden and with associated healthcare costs and an increased mortality risk. However, few if any major medical innovations have been witnessed in this area in recent times. Levosimendan is a first-in-class calcium sensitizer and potassium channel opener indicated for the management (...) of acute HF. Experience in several clinical studies has indicated that administration of intravenous levosimendan in intermittent cycles may reduce hospitalization and mortality rates in patients with advanced HF; however, none of those trials were designed or powered to give conclusive insights into that possibility. This paper describes the rationale and protocol of LeoDOR (levosimendan infusions for patients with advanced chronic heart failure), a randomized, double-blind, placebo-controlled

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2019 ESC heart failure

12. Rapid 5 lb weight gain is not associated with readmission in patients with heart failure. (PubMed)

Rapid 5 lb weight gain is not associated with readmission in patients with heart failure. Heart failure (HF) patients are taught to identify a rapid 5 lb body-weight gain for early detection of cardiac decompensation. Few data support this common advice. The study aim was to determine whether a 5 lb weight gain in 1 week and signs and symptoms of HF increased risk for unplanned physician or emergency department (ED) visits or hospital admission in rural HF patients.This was a secondary (...) tracking of dyspnoea symptoms may be an important adjunct to daily weight to prevent hospitalization.© 2018 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of the European Society of Cardiology.

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2019 ESC heart failure

13. Effectiveness and safety of rivaroxaban vs. warfarin in patients with non-valvular atrial fibrillation and heart failure. (PubMed)

Effectiveness and safety of rivaroxaban vs. warfarin in patients with non-valvular atrial fibrillation and heart failure. Heart failure (HF) is a common co-morbidity in non-valvular atrial fibrillation (NVAF) patients and a potent risk factor for stroke, bleeding, and a decreased time-in-therapeutic range with warfarin. We assessed the real-world effectiveness and safety of rivaroxaban and warfarin in NVAF patients with co-morbid HF.Using US Truven MarketScan Commercial and Medicare (...) with co-morbid HF treated in routine practice. The general consistency between this real-world study and those from phase III randomized trial data of rivaroxaban should provide additional reassurance to clinicians regarding the use of rivaroxaban in NVAF patients with HF.© 2018 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of the European Society of Cardiology.

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2019 ESC heart failure

14. Pro-gastrin-releasing peptide and outcome in patients with heart failure and anaemia: results from the RED-HF study. (PubMed)

Pro-gastrin-releasing peptide and outcome in patients with heart failure and anaemia: results from the RED-HF study. Neuroendocrine activation is associated with poor outcome in heart failure (HF). The neuropeptide gastrin-releasing peptide (GRP), derived from the precursor proGRP1-125 (proGRP), has recently been implicated in inflammation and wound repair. We investigated the predictive value of proGRP on clinical outcomes in HF patients with reduced ejection fraction.The association between (...) plasma proGRP (time-resolved immunofluorometric assay) and the primary endpoint of death from any cause or first hospitalization for worsening of HF was evaluated using multivariable Cox proportional hazard models in 1541 patients with systolic HF and mild to moderate anaemia, enrolled in the Reduction of Events by Darbepoetin alfa in Heart Failure (RED-HF) trial. Median proGRP levels in the RED-HF cohort were markedly increased [95 ng/L (25th, 75th percentile, 69-129 ng/L)] with 64% patients above

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2019 ESC heart failure

15. Liraglutide and weight loss among patients with advanced heart failure and a reduced ejection fraction: insights from the FIGHT trial. (PubMed)

Liraglutide and weight loss among patients with advanced heart failure and a reduced ejection fraction: insights from the FIGHT trial. Obesity is present in up to 45% of patients with heart failure (HF). Liraglutide, a glucagon-like peptide-1 (GLP-1) receptor antagonist, facilitates weight loss in obese patients. The efficacy of liraglutide as a weight loss agent among patients with HF and reduced ejection fraction (HFrEF) and a recent acute HF hospitalization remains unknown.The Functional (...) Impact of GLP-1 for Heart Failure Treatment study randomized 300 patients with HFrEF (ejection fraction ≤ 40%), both with and without diabetes and a recent HF hospitalization to liraglutide or placebo. The primary outcome for this post hoc analysis was the change in weight from baseline to last study visit. We conducted an 'on-treatment' analysis of patients with at least one follow-up visit on study drug (123 on liraglutide and 124 on placebo). The median age was 61 years, 21% were female, and 69

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2019 ESC heart failure

16. Exercise-based cardiac rehabilitation for adults with heart failure. (PubMed)

Exercise-based cardiac rehabilitation for adults with heart failure. Chronic heart failure (HF) is a growing global health challenge. People with HF experience substantial burden that includes low exercise tolerance, poor health-related quality of life (HRQoL), increased risk of mortality and hospital admission, and high healthcare costs. The previous (2014) Cochrane systematic review reported that exercise-based cardiac rehabilitation (CR) compared to no exercise control shows improvement (...) , number needed to treat: 25). After CR, a clinically important improvement in short-term disease-specific health-related quality of life may be evident (Minnesota Living With Heart Failure questionnaire - 17 trials, 18 comparisons (1995 participants): mean difference (MD) -7.11 points, 95% CI -10.49 to -3.73; low-quality evidence). Pooling across all studies, regardless of the HRQoL measure used, shows there may be clinically important improvement with exercise (26 trials, 29 comparisons (3833

2019 Cochrane

17. External Validation of the MEESSI Acute Heart Failure Risk Score: A Cohort Study. (PubMed)

External Validation of the MEESSI Acute Heart Failure Risk Score: A Cohort Study. The MEESSI-AHF (Multiple Estimation of risk based on the Emergency department Spanish Score In patients with AHF) score was developed to predict 30-day mortality in patients presenting with acute heart failure (AHF) to emergency departments (EDs) in Spain. Whether it performs well in other countries is unknown.To externally validate the MEESSI-AHF score in another country.Prospective cohort study (...) for missing values in the overall cohort of 1572 patients.External validation was done using a reduced model. Findings are specific to patients with AHF who present to the ED and are clinically stable enough to provide informed consent. Performance in patients with terminal kidney failure who are receiving long-term dialysis cannot be commented on.External validation of the MEESSI-AHF risk score showed excellent discrimination. Recalibration may be needed when the score is introduced to new

2019 Annals of Internal Medicine

18. Home-based cardiac rehabilitation for heart failure has high rates of participation

Home-based cardiac rehabilitation for heart failure has high rates of participation Home-based cardiac rehabilitation for heart failure has high participation Discover Portal Discover Portal Home-based cardiac rehabilitation for heart failure has high rates of participation Published on 8 January 2019 doi: Home-based cardiac rehabilitation for people with heart failure improves quality of life at 12 months compared with usual care. Among those allocated to rehabilitation, 90% remained (...) was this study needed? Heart failure affects around 900,000 people in the UK. Despite the effectiveness of cardiac rehabilitation in reducing re-admission and risk of death from heart disease, and in improving quality of life, availability and attendance in the UK are poor. On average, only 43% of people eligible actually attend, and this varies from 13 to 88% around the country. Efforts to improve access by exploring newer more accessible alternative strategies to hospital-based rehabilitation are required

2019 NIHR Dissemination Centre

19. Telemedicine programme can prolong life for heart failure patients

Telemedicine programme can prolong life for heart failure patients Telemedicine programme can prolong life for heart failure patients Discover Portal Discover Portal Telemedicine programme can prolong life for heart failure patients Published on 20 November 2018 doi: A comprehensive programme of daily telemedicine monitoring and 24-hour access to a physician-led hotline can reduce the number of deaths and the time spent in hospital, among patients with heart failure. A year-long study of 1,571 (...) patients who had been admitted to hospital with heart failure within the past 12 months found that those assigned to daily telemonitoring, monthly health education and telephone support from specialist staff, were 30% less likely to die than those assigned to usual care. This was a 3 percentage point reduction from 11% per year in the control group to 8% in the telemedicine group. This group also spent around a third fewer days in hospital. This suggests telemedicine could make a real difference

2019 NIHR Dissemination Centre

20. Uncertain benefits of BNP blood tests to monitor heart failure treatment

Uncertain benefits of BNP blood tests to monitor heart failure treatment Uncertain benefits of BNP blood tests to monitor heart failure treatment Discover Portal Discover Portal Uncertain benefits of BNP blood tests to monitor heart failure treatment Published on 6 February 2018 doi: In specialist clinics, using B-type natriuretic peptide (BNP) blood levels to guide treatment in people with chronic heart failure shows promise but did not improve survival for all groups. In this review (...) , the benefit was only seen in patients aged less than 75, who survived an extra 1.5 years on average, and possibly those with poor heart function (reduced ejection fraction). However, there was a reduction in hospital admissions for heart failure for everyone. BNP is a hormone released from the heart muscle, and higher levels may indicate more severe disease. It is currently used for diagnosis, but its use in monitoring treatment has become the subject of recent research interest. This research pooled data

2019 NIHR Dissemination Centre