It has been reported that anemia is a prognostic predictor in patients with diastolic heart failure (DHF), however, the relationship between anemia and sudden death in those patients is still unclear. We prospectively studied 357 stable DHF patients and the proportion of anemic patients was 39% of the study population. ...

Constrictive pericarditis is a rare but severely disabling consequence of the chronic inflammation of the pericardium, leading to an impaired filling of the ventricles and reduced ventricular function. Patients complain about fatigue, peripheral edema, breathlessness and abdominal swelling; signs and symptoms of right-sided heart failure. Besides history and physical examination, ...

PURPOSE: Little is known on the use of evidence-based medications in patients with acute myocardial infarction (AMI) across all ages. We undertook this study to describe the patterns of prescription and discontinuation of anti-platelet agents, beta-blockers, angiotensin converting enzyme (ACE) inhibitors and/or angiotensin receptor blockers (ARBs) and statins in all ...

The authors evaluated levels of inflammatory markers in 34 chronic heart failure (CHF) out-patients age 65 years and over, with (N=18) and without (N=16) major depressive disorder (MDD), and healthy-control subjects (N=13). Patients with CHF had left-ventricular ejection fractions <0.40 and were in the New York Heart Association functional class ...

Symptoms of intravascular volume overload and increased cardiac filling pressures in the systemic and pulmonary venous circulations are among the most common complaints in patients with chronic heart failure (CHF). The clinical utility of physical examination for estimation of intravascular volume status in patients with CHF is limited due to ...

In patients with chronic heart failure (CHF) and severe secondary mitral regurgitation (MR), the diagnostic usefulness and prognostic impact of tissue Doppler imaging (TDI) is unknown. This prospective study enrolled 370 patients with stable CHF. Severe secondary MR, defined as effective regurgitant orifice area >/=0.20 cm(2), was present in 92 ...

BACKGROUND: Heart failure (HF) is a major problem in the long-term follow-up of adolescents and adults with congenital heart disease (ACHD) after cardiac surgery. The functional status of ACHD may be assessed in terms of the NYHA classification or the Ability index (ABILITY). OBJECTIVE: The purpose of our study was ...

OBJECTIVE: Donor shortage and improved medical treatment of heart failure increase the prevalence of patients with extreme right ventricular failure and ascites to heart transplantation. The clinical outcome of heart transplantation in these patients has rarely been reported. Here, we sought to evaluate the clinical outcome of heart transplantation in ...

OBJECTIVE: While beta-blockers are routinely administered to patients prior to coronary computed tomography angiography (CTA), their effectiveness is unknown. We therefore assessed the efficacy of beta-blockade with regards to heart rate (HR) control and image quality in an unselected patient cohort. METHODS: We studied 150 consecutive patients (104 men/46 female; ...

It is unclear whether beta-blocker therapy should be reduced or withdrawn in patients who develop acute decompensated heart failure (HF). We studied the relationship between changes in beta-blocker dose and outcome in patients surviving a HF hospitalisation in COMET. Patients hospitalised for HF were subdivided on the basis of the ...

Studies of the prognostic importance of QRS duration in patients with heart failure (HF) have shown conflicting results and few studies have estimated the importance after myocardial infarction (MI). The Danish Investigations and Arrhythmia ON Dofetilide (DIAMOND) study randomised 3028 patients to dofetilide (class III antiarrhythmic) or placebo. The study ...

beta-blockade has a therapeutic role across the continuum of patients with heart failure (HF), with a demonstrated mortality benefit in stage II and III HF. Concerns regarding initiation and uptitration linger as patients with resting bradycardia, pulmonary, or vascular disease are often unnecessarily excluded from receiving therapy. We will review ...

BACKGROUND: Heart rate (HR) and systolic blood pressure (SBP) are currently not considered among common clinical indicators of prognosis in patients referred for heart transplant (Htx). We sought to determine whether an initial hemodynamic profile of HR and SBP could be used to predict outcomes in chronic heart failure patients ...

We report a case of multi-system organ failure as a result of unsuspected colchicine overdose in a patient with known gout and bulimia nervosa. The patient had initially presented with mild gastrointestinal symptoms with rapid progression to fulminant hepatic failure and multiple organ dysfunction before the causative agent was identified. ...

BACKGROUND: Common locations of death in patients with congestive heart failure (CHF) are unknown. In the SCD-HeFT, mortality of patients with CHF was assessed after randomization to an implantable cardioverter/defibrillator (ICD), amiodarone, or placebo. The aim of this study was to evaluate the location of deaths in SCD-HeFT. METHODS: Among ...

The aim of the present study is to elucidate the effect of bepridil on heart rate-dependent QT prolongation in patients with or without structural heart disease. QT intervals and the preceding R-R intervals were randomly measured by 24-hour Holter electrocardiogram in 29 patients with symptomatic arrhythmias. The slope of the ...

The aim of study was to asses the heart rate variability (HRV) differences in 128 post-myocardial infarction (MI) patients based on initial treatment during acute phase of disease. The patients were divided into groups: group 1 patients who underwent primary PCI, group 2 patients who received fibrinolysis and group 3 ...

BACKGROUND: Due to the risk of vascular complications, the indication for heart transplantation (HTx) in patients with Marfan syndrome and end-stage heart disease remains controversial. We analyzed the results of such patients who underwent HTx at our institution. METHODS: Ten patients with Marfan syndrome (median age 36, range 19 to ...

BACKGROUND: Cardiac resynchronization therapy (CRT) has emerged as an established therapy for congestive heart failure. However, up to 30% of patients fail to respond to CRT despite prolonged QRS. OBJECTIVES: This study aimed at defining the prevalence of interventricular and intraventricular dyssynchrony in heart failure patients with different QRS durations. ...

BACKGROUND: The aim of this study was to evaluate feasibility and accuracy of a videophone-based system for remote cardiopulmonary examination of patients with heart failure. METHODS AND RESULTS: Fifty patients were examined by 2 cardiologists, 1 with a conventional stethoscope and 1 remotely with a videophone-based method, employing an electronic ...

BACKGROUND: C-reactive protein (CRP) has been tested in patients with systolic heart failure (HF) and mixed results have been obtained with regards to its potential predictive value. However, the role of C-reactive protein (CRP) in patients with diastolic HF is not established. We studied the predictive role of high sensitivity ...

This study investigates the influence of cardiac resynchronisation therapy (CRT) on sleep disordered breathing (SDB) in patients with severe heart failure (HF). Seventy-seven patients with HF (19 females; 62.6+/-10 years) eligible for CRT were screened for presence, type, and severity of SDB before and after CRT initiation (5.3+/-3 months) using ...

Mechanical alternans, an ominous sign of terminal systolic heart failure, could be indirectly shown by Doppler analysis. On the other hand, Levosimendan, a novel agent, improves contractility in patients with HF. We searched the effect of L versus dobutamin onto Doppler alternans in patients with systolic HF. We found that ...

OBJECTIVES: This study sought to determine, in patients with heart failure (HF), whether untreated moderate to severe obstructive sleep apnea (OSA) is associated with a higher mortality rate than in patients with mild to no sleep apnea (M-NSA). BACKGROUND: Obstructive sleep apnea is common in patients with HF and exposes ...

OBJECTIVES: Acute rheumatic fever (ARF) continues to affect millions of children in developing countries. Aim of the present study was to evaluate the role of myocardial dysfunction in the genesis of heart failure in patients with rheumatic carditis. There are limited studies on this subject. METHODS AND RESULTS: In this ...

The use of an NSAID by individuals with heart failure increases the likelihood of exacerbating the problem. Patients with heart failure were interviewed using a standardized questionnaire to determine their perceptions of the risks involved with the use of an NSAID. Of the 28 patients interviewed, 2 had been advised ...

Several life-prolonging therapies are available for the treatment of heart failure, yet they are underutilized in many patients. A treatment gap exists between patients who are eligible for a therapy and the number of patients who actually receive them. Suboptimal prescribing rates for angiotensin-converting enzyme inhibitors or angiotensin receptor blockers, ...

BACKGROUND: Patients with congestive heart failure (CHF) often have increased aldosterone activity that leads to hypomagnesemia. Hypomagnesemia can induce arrhythmias, an important cause of death in patients with CHF. We determined whether the aldosterone receptor antagonist spironolactone improved magnesium homeostasis and reduced arrhythmias in patients with CHF. METHODS AND RESULTS: ...

In chronic heart failure (CHF) it has been proposed that a dysfunction of the gastrointestinal barrier could lead to translocation of endotoxin into the systemic circulation. A secondary inflammatory reaction, observed as increased levels of cytokines, could negatively affect cardiac function. The aims of this paper were therefore to determine ...

OBJECTIVES: This study sought to test the hypothesis that patients with chronic heart failure (CHF) have shorter telomeres compared with age-balanced and gender-balanced healthy individuals. BACKGROUND: Telomere length is considered to be a marker of biological aging. Chronic heart failure might be viewed as a condition associated with accelerated biological ...

Patients with atrial fibrillation (AF) who also have heart failure have a worse outcome but the diagnosis of heart failure is often missed. To compare the effects of warfarin and ximelagatran on morbidity and mortality in patients with AF with and without markers of heart failure. Data for 7329 patients ...

A distinct advantage of implantable device diagnostics is that the data may be made available on a continuous basis, rather than at sporadic intervals associated with clinical testing. Recently, intrathoracic impedance monitoring has also become available in some implantable devices as an index of congestion and thoracic fluid accumulation secondary ...

OBJECTIVE: To evaluate the usefulness of cardiac iodine-123 (123I) metaiodobenzylguanidine (MIBG) imaging as a predictor of sudden death in patients with chronic heart failure (CHF). DESIGN AND SETTING: Prospective cohort study in a tertiary referral centre. PATIENTS: 97 outpatients with CHF with a radionuclide left ventricular ejection fraction <40% (mean ...

Thirty-seven consecutive patients with acute decompensated heart failure (ADHF) admitted to emergency departments for acute dyspnea were investigated. Ten patients with acute exacerbation of chronic obstructive pulmonary disease and 10 patients with hypertension crisis were also included as controls. For each patient, a plasma amino-terminal pro-B-type natriuretic peptide (NTproBNP) concentration ...

The number of grown-up patients with congenital heart disease (GUCH) is constantly increasing and will equal the number of children requiring surgery for congenital heart disease (CHD). Specialized centers dealing with the medical and paramedical problems of these patients are required. GUCH patients can be divided into the following groups: ...

We propose an integrated approach based on uniform quantization over a small number of levels for the evaluation and characterization of complexity of a process. This approach integrates information-domain analysis based on entropy rate, local nonlinear prediction, and pattern classification based on symbolic analysis. Normalized and non-normalized indexes quantifying complexity ...

BACKGROUND: Heart-type fatty acid-binding protein (H-FABP) is a small cytosolic protein and released into the circulation when the myocardium is injured. Previous studies have demonstrated that both H-FABP and troponin T (TnT) are detectable in venous blood samples in chronic heart failure (CHF) patients, suggesting the presence of ongoing myocardial ...

BACKGROUND: The 6 min walk test (6-MWT) is a simple and popular test for evaluating functional status in patients with chronic heart failure (CHF). However, the prognostic value of the 6-MWT in a large, representative sample of CHF patients, and in patients with different degrees of left ventricular systolic dysfunction ...

Mechanistic studies, observational evaluations, and randomized trials have consistently demonstrated the beneficial effects of cardiac resynchronization therapy (CRT) in patients with moderate-to-severe chronic systolic heart failure and ventricular dyssynchrony who have failed optimal medical treatment. However, despite the promising results, in some patients undergoing CRT, the symptoms of heart failure ...

AIMS: To evaluate the utility of intrathoracic impedance monitoring for detecting heart failure (HF) deterioration in patients with an implanted cardiac resynchronization/defibrillation device. METHODS AND RESULTS: Patients enrolled in the European InSync Sentry Observational Study were audibly alerted by a device algorithm if a decrease in intrathoracic impedance suggested fluid ...

The beneficial effects of beta-blocker therapy in patients with heart failure have been consistently shown by multi-center randomised trials. These agents are effective and also relatively well tolerated in the elderly and in patients with diabetes and advanced heart failure--traditionally considered as relative contraindications to their administration. However, the use ...

BACKGROUND: Inflammatory immune mechanisms are involved in the pathogenesis and progression of chronic heart failure (CHF), and also promote the development of generalised body wasting seen in this syndrome. We examined the activity of nuclear factor kappa-B (NF-kappaB), the major mediator of immune response, in peripheral blood mononuclear cells (PBMC) ...

Chronic severe heart failure is frequently associated with disturbances in the central control of breathing. During wakefulness, central breathing disorders could be ameliorated with beta-blocker treatment, but nothing is known about the effects of beta-blockers on the control of breathing during sleep. This study intends to determinate the prevalence and ...

Elevation of troponin I (TnI), a sensitive marker of myocardial cell injury, has been described in a portion of patients with chronic heart failure and acute decompensated heart failure. The proportion and characteristics of patients with TnI elevation in an unselected population with acute left heart failure (AHF) are, however, ...

Repolarization alternans, which can be detected clinically as microvolt-level T-wave alternans (TWA), is considered an important mechanism underlying the initiation of ventricular tachycardia/ventricular fibrillation (VT/VF) linked to sudden cardiac death (SCD). Recently, the rennin-angiotensin system (RAS) inhibitors have been suggested to have potential benefits in reducing SCD as well as ...

Leptospirosis is a re-emerging spirochetal zoonosis with a worldwide distribution affecting both animals and humans. The clinical syndromes may vary from a subclinical infection to a severe illness. Although it may potentially have a fulminant and fatal course, leptospirosis usually remains as an underdiagnosed cause of multiorgan failure. In this ...

BACKGROUND: Aldosterone antagonists have been proven to be beneficial in severe heart failure (HF) as a result of systolic dysfunction. We sought to determine if there is a disparity in their utilization compared with ACE inhibitors and beta-adrenoceptor antagonists (beta-blockers). METHODS: In the first part of the study, we asked ...

Background: The present study was aimed at possible modifications of resting HR induced by systematic physical training in patients of different age populations with ischemic heart disease (IHD) subjected to chronic therapeutic beta-blockade. Methods: The goal was the assessment of initial resting heart rate (HR) and its change after 6 ...

Patients who develop cardiogenic shock after acute myocardial infarction have a very high mortality rate despite early reperfusion therapy. Hemodynamic stabilization can often only be achieved by implanting a mechanical circulatory support system. When, in cases representing expansive myocardial impairment without any chance of recovery, pharmacological therapy and the use ...

The study was designed to evaluate the prognostic value of the 6-minute walk test in stable outpatients with heart failure. We prospectively studied 43 patients (6 women and 37 men) who had chronic heart failure secondary to ischemic heart disease or idiopathic cardiomyopathy. All patients had left ventricular systolic dysfunction ...