المؤلفون: Stephen J. Greene, Robert J. Mentz, Adrian F. Hernandez, Andrew P. Ambrosy, Rajeev Malhotra, Marat Fudim, Abhinav Sharma, Adrian Coles, Gregory D. Lewis, Javed Butler, Aaron D. Jones

المصدر: Journal of Cardiovascular Medicine. 20:223-225

مصطلحات موضوعية: Male, medicine.medical_specialty, Time Factors, Anemia, Administration, Oral, 030204 cardiovascular system & hematology, Ventricular Function, Left, law.invention, 03 medical and health sciences, 0302 clinical medicine, Double-Blind Method, Randomized controlled trial, law, Internal medicine, Post-hoc analysis, medicine, Humans, In patient, 030212 general & internal medicine, Aged, Heart Failure, Exercise Tolerance, Ejection fraction, Anemia, Iron-Deficiency, business.industry, Transferrin, Stroke Volume, Recovery of Function, General Medicine, Stroke volume, Middle Aged, medicine.disease, Treatment Outcome, Heart failure, Dietary Supplements, Ferritins, Hematinics, Quality of Life, Cardiology, Iron supplementation, Female, Cardiology and Cardiovascular Medicine, business, Biomarkers, Iron Compounds

الوصف: The IRONOUT-HF trial previously demonstrated that oral iron supplementation minimally increased iron stores and did not improve exercise capacity in patients with heart failure with a reduced ejection fraction (HFrEF) and iron deficiency.The IRONOUT-HF trial was a double-blind, placebo-controlled, randomized clinical trial designed to test the efficacy and safety of oral iron polysaccharide compared to matching placebo among patients with HFrEF and iron deficiency. Study participants received oral iron polysaccharide 150 mg twice daily or matching placebo for 16 weeks. Response to oral iron was defined as a ferritin level300 ng/mL or a ferritin level 100-300 ng/mL with a transferrin saturation20% at the end of the study.The final analytical cohort included 98 patients with HFrEF and iron deficiency at baseline. Study participants had a median (25, 75) age of 63 years (54 years, 71 years), included 40% women (N = 39). After 16 weeks of therapy, 24 patients (24%) responded to oral iron supplementation while 74 patients (76%) remained iron deficient despite treatment. There was no association between response to oral iron supplementation and improvement in functional status (i.e. peak VO2 or anaerobic threshold), myocardial stress (i.e. NT-proBNP levels), or HRQOL (i.e. Kansas City Cardiomyopathy Questionnaire) at week 16.This study failed to identify a subset of responders more likely to derive a clinical benefit from oral iron therapy and does not support its routine use in patients with symptomatic HFrEF and iron deficiency.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::e719270dd806fcbaaa5e452d5579fc44Test
https://doi.org/10.2459/jcm.0000000000000736Test

المؤلفون: Mihai Gheorghiade, Cezar Macarie, Sean P. Collins, Muthiah Vaduganathan, Stephen J. Greene, Javed Butler, Ovidiu Chioncel, Andrew P. Ambrosy

المصدر: Journal of Cardiovascular Medicine. 17:556-568

مصطلحات موضوعية: medicine.medical_specialty, medicine.drug_class, Decision Making, 030204 cardiovascular system & hematology, Natriuretic peptide testing, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, Natriuretic Peptide, Brain, Natriuretic peptide, medicine, Humans, 030212 general & internal medicine, Disease management (health), Intensive care medicine, Clinical syndrome, Heart Failure, Clinical Trials as Topic, biology, business.industry, Disease Management, General Medicine, Prognosis, medicine.disease, Troponin, Clinical trial, Heart failure, Usual care, biology.protein, Cardiology and Cardiovascular Medicine, business, Biomarkers

الوصف: Heart failure is a clinical syndrome that manifests from various cardiac and noncardiac abnormalities. Accordingly, rapid and readily accessible methods for diagnosis and risk stratification are invaluable for providing clinical care, deciding allocation of scare resources, and designing selection criteria for clinical trials. Natriuretic peptides represent one of the most important diagnostic and prognostic tools available for the care of heart failure patients. Natriuretic peptide testing has the distinct advantage of objectivity, reproducibility, and widespread availability.The concept of tailoring heart failure management to achieve a target value of natriuretic peptides has been tested in various clinical trials and may be considered as an effective method for longitudinal biomonitoring and guiding escalation of heart failure therapies with overall favorable results.Although heart failure trials support efficacy and safety of natriuretic peptide-guided therapy as compared with usual care, the relationship between natriuretic peptide trajectory and clinical benefit has not been uniform across the trials, and certain subgroups have not shown robust benefit. Furthermore, the precise natriuretic peptide value ranges and time intervals of testing are still under investigation. If natriuretic peptides fail to decrease following intensification of therapy, further work is needed to clarify the optimal pharmacologic approach. Despite decreasing natriuretic peptide levels, some patients may present with other high-risk features (e.g. elevated troponin). A multimarker panel investigating multiple pathological processes will likely be an optimal alternative, but this will require prospective validation.Future research will be needed to clarify the type and magnitude of the target natriuretic peptide therapeutic response, as well as the duration of natriuretic peptide-guided therapy in heart failure patients.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::da7b8973c4080bf40a1a10bce15d996cTest
https://doi.org/10.2459/jcm.0000000000000329Test

المؤلفون: Andrew P. Ambrosy, Antoniu Petris, Sean P. Collins, Daniela Filipescu, Cezar Macarie, Mihai Gheorghiade, Ruxandra Christodorescu, Serban Bubenek, Ovidiu Chioncel, Dragos Vinereanu

المصدر: Journal of Cardiovascular Medicine. 17:92-104

مصطلحات موضوعية: Male, Inotrope, Tachycardia, medicine.medical_specialty, medicine.medical_treatment, Pulmonary Edema, 030204 cardiovascular system & hematology, Tachypnea, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, medicine, Humans, Registries, 030212 general & internal medicine, Aged, Aged, 80 and over, Heart Failure, Mechanical ventilation, Romania, Left bundle branch block, business.industry, Cardiogenic shock, General Medicine, Length of Stay, Middle Aged, medicine.disease, Pulmonary edema, Heart failure, Cardiology, Female, medicine.symptom, Cardiology and Cardiovascular Medicine, business

الوصف: Aim The objective of this study was to evaluate the clinical presentation, inpatient management, and in-hospital outcome of patients hospitalized for acute heart failure syndromes (AHFS) and classified as pulmonary edema (PE). Methods The Romanian Acute Heart Failure Syndromes (RO-AHFS) study was a prospective, national, multicenter registry of all consecutive patients admitted with AHFS over a 12-month period. Patients were classified at initial presentation by clinician-investigators into the following clinical profiles: acute decompensated HF, cardiogenic shock, PE, right HF, or hypertensive HF. Results RO-AHFS enrolled 3224 patients and 28.7% (n = 924) were classified as PE. PE patients were more likely to present with pulmonary congestion, tachypnea, tachycardia, and elevated systolic blood pressure and less likely to have peripheral congestion and body weight increases. Mechanical ventilation was required in 8.8% of PE patients. PE patients received higher doses (i.e. 101.4 ± 27.1 mg) of IV furosemide for a shorter duration (i.e. 69.3 ± 22.3 hours). Vasodilators were given to 73.6% of PE patients. In-hospital all-cause mortality (ACM) in PE patients was 7.4%, and 57% of deaths occurred on day one. Increasing age, concurrent acute coronary syndromes, life-threatening ventricular arrhythmias, elevated BUN, left bundle branch block, inotrope therapy, and requirement for invasive mechanical ventilation were independent risk factors for ACM. Conclusions In this national registry, the PE profile was found to be a high-acuity clinical presentation with distinctive treatment patterns and a poor short-term prognosis. Advances in the management of PE may necessitate both the development of novel targeted therapies as well as systems-based strategies to identify high-risk patients early in their course.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::f6471af7b63b6da5ed0cc3207b3f7c4dTest
https://doi.org/10.2459/jcm.0000000000000192Test

المؤلفون: Dwight Reynolds, Christopher M. O'Connor, Anne B. Curtis, Nancy M. Albert, Andrew P. Ambrosy, J. Thomas Heywood, Mandeep R. Mehra, Mary Norine Walsh, Gregg C. Fonarow, Mihai Gheorghiade, Clyde W. Yancy

المصدر: Journal of Cardiovascular Medicine. 13:360-367

مصطلحات موضوعية: Male, medicine.medical_specialty, Clinical variables, medicine.drug_class, MEDLINE, Ventricular Function, Left, Cohort Studies, Ambulatory care, Internal medicine, Natriuretic Peptide, Brain, Ambulatory Care, medicine, Natriuretic peptide, Humans, Prospective Studies, Registries, cardiovascular diseases, Prospective cohort study, Aged, Aged, 80 and over, Heart Failure, business.industry, Stroke Volume, General Medicine, Middle Aged, Prognosis, medicine.disease, Heart failure, Chronic Disease, Practice Guidelines as Topic, Ambulatory, Female, Guideline Adherence, Cardiology and Cardiovascular Medicine, business, human activities, hormones, hormone substitutes, and hormone antagonists, Cohort study

الوصف: B-type natriuretic peptide (BNP) levels provide diagnostic and prognostic information in heart failure. This study determined the frequency of BNP assessment and analyzed demographic characteristics, clinical variables and the utilization of guideline-recommended heart failure therapies by BNP level in outpatients with reduced left ventricular ejection fraction (LVEF).The IMPROVE HF registry (The Registry to Improve the Use of Evidence-Based Heart Failure Therapies in the Outpatient Setting) is a prospective cohort study of patients at least 18 years of age with a LVEF 35% or less and chronic heart failure or previous myocardial infarction (MI) presenting to cardiology and multispecialty practices. The medical records of 15,381 patients were reviewed. BNP was measured in 4213 (27.4%) patients and the median plasma BNP level was 384 pg/ml (interquartile range 158-877 pg/ml). Patients were stratified by plasma BNP measurements into the following tertiles: 219 pg/ml or less, more than 219 to 649 pg/ml, and more than 649 pg/ml. Jugular venous distension, pedal edema, rales and systolic murmur on physical examination and elevated renal function parameters were associated with higher BNP levels. BNP assessment and elevated BNP levels were not associated with greater use of any of the quality of care measures. However, patients with a BNP in the top tertile were less likely to be treated with angiotensin-converting enzyme inhibitors/angiotensin receptor blockers or aldosterone antagonists compared with patients with a BNP in the bottom tertile.Among practices participating in IMPROVE HF, BNP was not measured in most outpatients with reduced LVEF and chronic heart failure or previous MI. BNP assessment or the BNP level in patients with recorded measurements, with few exceptions, did not impact the utilization of guideline-recommended therapies.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::b6d0f7989e7f27a9ba61ec7dc36be919Test
https://doi.org/10.2459/jcm.0b013e328353128cTest

المؤلفون: Chioncel, Ovidiu, Collins, Sean P., Greene, Stephen J., Ambrosy, Andrew P., Vaduganathan, Muthiah, Macarie, Cezar, Butler, Javed, Gheorghiade, Mihai

المصدر: Journal of Cardiovascular Medicine; Aug2016, Vol. 17 Issue 8, p556-568, 13p

المؤلفون: Ambrosy, Andrew P., Lewis, Gregory D., Malhotra, Rajeev, Jones, Aaron D., Greene, Stephen J., Fudim, Marat, Coles, Adrian, Butler, Javed, Sharma, Abhinav, Hernandez, Adrian F., Mentz, Robert J.

المصدر: Journal of Cardiovascular Medicine; Apr2019, Vol. 20 Issue 4, p223-225, 3p

المؤلفون: Chioncel, Ovidiu, Ambrosy, Andrew P., Bubenek, Serban, Filipescu, Daniela, Vinereanu, Dragos, Petris, Antoniu, Christodorescu, Ruxandra, Macarie, Cezar, Gheorghiade, Mihai, Collins, Sean P.

المصدر: Journal of Cardiovascular Medicine; Feb2016, Vol. 17 Issue 2, p92-104, 13p

المؤلفون: Chioncel, Ovidiu, Ambrosy, Andrew P., Filipescu, Daniela, Bubenek, Serban, Vinereanu, Dragos, Petris, Antoniu, Collins, Sean P., Macarie, Cezar, Gheorghiade, Mihai

المصدر: Journal of Cardiovascular Medicine; May2015, Vol. 16 Issue 5, p331-340, 10p

المؤلفون: Ambrosy, Andrew P., Fonarow, Gregg C., Albert, Nancy M., Curtis, Anne B., Heywood, J. Thomas, Mehra, Mandeep R., O’Connor, Christopher M., Reynolds, Dwight, Walsh, Mary N., Yancy, Clyde W., Gheorghiade, Mihai

المصدر: Journal of Cardiovascular Medicine; Jun2012, Vol. 13 Issue 6, p360-367, 8p

المؤلفون: Keeling, Aoife N, Flaherty, James D, Davarpanah, Amir H, Ambrosy, Andrew, Farrelly, Cormac T, Harinstein, Matthew E, Flamm, Steven L, Abecassis, Michael I, Skaro, Anton I, Carr, James C, Gheorghiade, Mihai

المصدر: Journal of Cardiovascular Medicine; Jul2011, Vol. 12 Issue 7, p460-468, 9p