OBJECTIVES: We studied the effects of cardiac resynchronization therapy (CRT) on heart failure (HF) patients with central sleep apnea (CSA). BACKGROUND: Patients with advanced HF often suffer from CSA with Cheyne-Stokes respiration. Cardiac resynchronization therapy improves myocardial function and exercise capacity in HF patients with conduction disturbances. The relationship between ...

OBJECTIVES: This study aimed to investigate the prognostic importance of plasma erythropoietin (EPO) levels in chronic heart failure (CHF) patients. BACKGROUND: Anemia is common and is associated with an impaired survival in patients with CHF. Erythropoietin is a hematopoietic growth factor, upregulated in anemic conditions. Little is known about the ...

Analysis of high-frequency QRS components (HF-QRS) might provide an additional method when diagnosing various heart diseases, for example ischemic heart disease (IHD). This study compares HF-QRS in normal subjects to those in patients with IHD, and also analyzes HF-QRS considering gender and age. A total of 63 normal subjects and ...

OBJECTIVES: To examine outcomes of children with pacemakers over a 22-year period and identify risk factors for lead failure. BACKGROUND: Small patient size, structural cardiac abnormalities, and growth may complicate pediatric pacemaker management. Better knowledge of risk factors for lead failure in these patients may help improve future outcomes. METHODS: ...

OBJECTIVES: The aim of this article is to examine the frequency, timing of formation of aneurysm of the ventricular membranous septum (AVMS), and prognosis in patients with a perimembranous ventricular septal defect (VSD). PATIENTS: One hundred forty-eight patients were diagnosed with a perimembranous VSD within 90 days after birth. They ...

OBJECTIVES: To find the prevalence of anemia in patients hospitalized with the primary diagnosis of congestive heart failure (CHF). BACKGROUND: There is growing evidence that anemia is common in CHF and may contribute to the high morbidity and mortality associated with this condition. However, there is considerable disagreement about the ...

Heart failure (HF) is a public health problem with ever-growing costs. Signs such as jugular venous pressure and third heart sound have been associated with disease prognosis. Symptoms of heart failure are frequently subjective, and their real value is often overlooked. The authors aimed to assess the relationship between orthopnea ...

BACKGROUND: Renal dysfunction is a strong predictor of mortality in chronic heart failure (CHF). Most patients with CHF have atherosclerotic vascular disease, and several authors have suggested that impaired renal function is only a marker of advanced atherosclerosis. We compared renal function in patients with ischemic and nonischemic CHF and ...

AIMS: Due to a lack of clinical trials, scientific evidence regarding the management of patients with chronic heart failure and preserved left ventricular function (PLVF) is scarce. The EuroHeart Failure Survey provided information on the characteristics, treatment and outcomes of patients with PLVF as compared to patients with a left ...

BACKGROUND & AIM: Congestive heart failure (CHF) and anemia were reported to affect resting energy expenditure (REE). The aim of this study was to evaluate the effect of the correction of anemia on REE in subjects with CHF. PATIENTS AND METHODS: Nine anemic patients with compensated CHF and CRF were ...

BACKGROUND: Enhanced hypercapnic chemoreflex in chronic heart failure could modulate sympathetic nerve activity in a different manner depending on the severity of heart failure. This study was designed to evaluate the dynamic aspects of sympathoexcitation caused by central hypercapnic chemoreflex in patients with chronic heart failure. METHODS AND RESULTS: In ...

STUDY OBJECTIVE: To determine whether the effects of spironolactone on potassium homeostasis vary by race by comparing serum potassium concentrations and potassium supplement use in African-American and Caucasian patients receiving spironolactone for heart failure. DESIGN: Retrospective medical record review. SETTING: Two heart failure centers. PATIENTS: Fifty African-American and 67 Caucasian ...

BACKGROUND: Despite the fact that heart failure constitutes a major health problem there are only limited data regarding pharmacotherapy along with characterization and prognosis of heart failure in the community. AIM: The aim of this study was to investigate treatment pattern in ambulatory patients with heart failure. METHODS: The study ...

Heart failure is increasing in both North America and Europe. Although many similarities in the disease are apparent between the two continents, differences do exist. Heart failure with preserved systolic function appears to be increasingly important on both continents, and is associated more frequently with hypertension, aging, and female sex. ...

Traditional risk factors of a poor clinical outcome and mortality in the general population, including body mass index (BMI), serum cholesterol, and blood pressure (BP), are also found to relate to outcome in patients with chronic heart failure (CHF), but in an opposite direction. Obesity, hypercholesterolemia, and high values of ...

BACKGROUND: Epidemics of enterovirus 71 infection have caused the death of many children throughout the world. Rhombencephalitis, brain stem encephalitis, and heart failure were present in all of the fatal cases. However, no evidence of myocarditis was noted in the heart specimens, and the mechanism of heart failure remains unknown. ...

BACKGROUND: Heart rate recovery (HRR) after exercise correlates with decreased vagal tone and mortality. Patients with COPD may have altered autonomic tone. We sought to determine the association of HRR with spirometry measures of pulmonary function. METHODS: We analyzed 627 patients (mean [+/- SD] age, 58 +/- 12 years; 65% ...

123I-metaiodobenzylguanidine (123I-MIBG) is useful for assessment of the severity and prognosis of patients with chronic heart failure (CHF). To examine 123I-MIBG kinetics in the early phase soon after tracer injection, we performed dynamic single photon emission computed tomography (SPECT) in 76 patients with CHF and 17 control subjects. The consecutive ...

The COMET trial was a prospective, double-blind, randomised trial comparing carvedilol, a comprehensive adrenergic receptor antagonist, with metoprolol, a beta-1-selective agent in patients with heart failure and left ventricular systolic dysfunction. The trial showed a reduction in mortality with carvedilol that was consistent across subgroups. The purpose of this report ...

BACKGROUND: It remains unclear whether circadian variation (CV) of cardiac autonomic nervous activity (CANA) is preserved in patients with chronic heart failure (CHF) as in healthy subjects. We have demonstrated that CANA in CHF patients is largely affected by patient recumbent position. METHODS: We studied eight mild to moderate CHF ...

BACKGROUND: Nesiritide (B-type natriuretic peptide) reduces preload and afterload, and causes natriuresis, diuresis and suppression of norepinephrine, endothelin-1 and aldosterone. In this study, we sought to explore the safety and efficacy of nesiritide in patients with acute congestive heart failure (CHF) and renal insufficiency (RI). METHODS: We studied the effects ...

BACKGROUND: The reported prevalence of preserved systolic function (PSF) heart failure (HF) varies widely and has not been well-studied in nonwhite patients. To estimate the prevalence of PSF HF resulting in hospital admission, we studied admissions to a large community hospital serving a racially diverse community. METHODS: The charts of ...

BACKGROUND: While treatment with either angiotensin-converting enzyme inhibitors (ACEi) and angiotensin receptor blockers (ARBs) is clearly superior to placebo in the treatment of heart failure patients, controversy still surrounds the effects of ARBs in patients already receiving an ACEi. Even more controversial is the wisdom of administering ARBs in patients ...

BACKGROUND: Chronic heart failure is a significant cause of cardiovascular morbidity and mortality. This study tested the hypothesis that restrictive filling pattern may provide useful prognostic data for identifying patients with chronic heart failure at high risk of all-cause cardiac death. METHODS: Ninety patients with chronic heart failure [70 men ...

The first objective of the study was to compare the levels of big endothelin and endothelin-1 and other noninvasive parameters used for evaluation of disease severity in patients with stable chronic heart failure (CHF). Endothelin-1 and big endothelin plasma concentrations were measured in 124 chronic heart failure patients. The second ...

We devised our own method of evaluating a patient's general condition at admission, and estimated the usefulness of this method for evaluating patients with femoral neck fractures and its relationship to prognosis, in particular, factors influencing poor functional and vital prognoses. We examined 83 patients between January 1992 and March ...

Microvascular blood flow alterations may impair tissue oxygenation and may participate in the development of multiple organ failure in patients with severe heart failure. We hypothesized that microvascular blood flow alterations are present in patients with severe heart failure and cardiogenic shock. We used an orthogonal polarization spectral imaging technique ...

Beta-adrenergic receptor blockade is an established treatment of chronic heart failure (HF). Previous studies have suggested a potential pharmacogenetic interaction between beta-blocker therapy and the angiotensin-converting enzyme (ACE) I/D polymorphism in patients with HF. We designed this study to analyze changes in myocardial function of HF patients in response to ...

A number of large randomized, placebo-controlled mortality trials provided evidence-based data to guide the treatment of patients with systolic heart failure, but, with one exception, similar trials in patients with diastolic heart failure (DHF) either are not yet completed or have not been conducted at all. However, randomized outcomes trials ...

Heart failure is a common and costly medical condition. Ischemic heart disease and hypertension account for most cases of heart failure in developed countries. Estimates of the one-year mortality rates for patients with New York Heart Association (NYHA) Class II, III, and IV are 10%, 20%, and 40%, respectively. Angiotensin-converting ...

OBJECTIVE: To determine the clinical and biochemical effects of fasting during Ramadan on patients with cardiac disease. METHODS: Eighty-six outpatients with heart disease with intention to fast were studied in the month of Ramadan 1996 (1416 H) at the King Fahd Armed Forces Hospital, Jeddah, Kingdom of Saudi Arabia. Detailed ...

It has been reported that matrix metalloproteinase (MMP) protein concentration and activity are upregulated in the failing human heart. However, there are few reports describing the role of elevated level of circulating MMPs in congestive heart failure (CHF) patients. This study examined whether circulating matrix metalloproteinases (MMPs) are also related ...

Heart failure with normal systolic function has been equated to diastolic heart failure (DHF). DHF appears to be quite common in the elderly, especially in elderly women with hypertension. Recent epidemiologic studies suggest that 30%-50% of patients with heart failure may have DHF. Morbidity for DHF is considerable and comparable ...

It could be conjectured that the hemorheological disorders are involved in development of the ischemic heart disease. But this fact was so far insufficiently cleared up. The present studies were carried out in patients with various forms of chronic ischemic heart disease. We investigated the most significant factor of rheological ...

Beta-blockers have been shown incontrovertibly to improve morbidity and survival in patients with heart failure. However, there is limited information regarding their use in clinical practice settings, and reasonable utilization targets for quality improvement initiatives have not been established. We identified 500 consecutive patients with chronic heart failure seen at ...

OBJECTIVE: To review the clinical benefits of beta-blockers as secondary prevention following a myocardial infarction (MI) and to address the reasons that clinicians are reluctant to use beta-blockers in specific patient populations. DATA SOURCES: MEDLINE was searched for articles published from January 1966 to October 2002. Relevant studies were identified ...

Thiazolidinediones (TZDs) can cause weight gain and fluid retention in some patients. In most cases, fluid retention is expressed as mild hemodilution. The incidence of clinically evident edema is relatively uncommon. In large clinical trials with rosiglitazone and pioglitazone, the frequency of edema in TZD-treated patients was about 3 to ...

OBJECTIVE: Vasoactive intestinal peptide (VIP) is a powerful vasodilatory neuropeptide with positive inotropic and chronotropic properties. The aim of the study was to investigate the pathophysiological role of VIP in heart failure. DESIGN AND RESULTS: VIP was assayed in plasma within the first in-hospital day in 52 patients with heart ...

To assess urinary 6-sulfatoxymelatonin excretion in patients admitted to the hospital because of congestive heart failure (CHF). Urinary 6-sulfatoxymelatonin was measured by a specific radioimmunoassay in 33 hospitalized patients with CHF and in 146 healthy ambulatory volunteers. Individuals with hepatic or renal failure were excluded from the sample. Data were ...

Congestive heart failure (CHF) has been proposed as a possible cause of cognitive dysfunction but only a few studies have directly assessed cognitive performance in CHF. The aim of the present study was to compare the cognitive patterns of patients with CHF and patients having cardiovascular diseases uncomplicated by CHF ...

BACKGROUND: The aim of this study was to determine the frequency of prior cerebrovascular events (CE) among patients with an acute coronary syndrome (ACS) and to compare the clinical characteristics, clinical course, treatment, and outcomes of patients with ACS with and without a prior CE. METHODS AND RESULTS: We prospectively ...

AIM: To investigate the relationship between severe acute pancreatitis (SAP) and organ failure. METHODS: Clinical data of 74 cases of SAP from Jan. 1993 to Dec. 2002 were retrospectively reviewed, and the relationship between organ failure and age, gender, etiology, extent of necrosis, infection of necrosis and mortality was analyzed. ...

Following an acute myocardial infarction (MI), the development of congestive heart failure (CHF) has been associated with a reduced ejection fraction (EF), pseudonormal or restrictive diastolic filling, and an increased index of myocardial performance (IMP). STUDY OBJECTIVES: To determine the comparative predictive value of EF, transmitral filling parameters, and IMP ...

OBJECTIVE: To explore the effects of thyroid hormone (TH) on cardiac function and peripheral lymphocyte beta-adrenoceptors (beta-ARs) of patients with chronic congestive heart failure (CHF). METHODS: Twenty-eight patients with class III or IV advanced CHF due to dilated cardiomyopathy (DCM) or ischemic cardiomyopathy (ICM) were randomly divided into groups A ...

It is now generally accepted that chronically extensive stimulation of the cytokine system-and of TNFalpha in particular-is detrimental to the heart and to peripheral tissue and that such stimulation may contribute to the pathogenesis of congestive heart failure of various causes. During the past decade, basic and clinical research has ...

OBJECTIVE: Wide-bandwidth electronic stethoscopy is reliable and accurate for pediatric telecardiology. We tested a much less expensive and more convenient system for the same purpose, a narrow-bandwidth telephonic stethoscope (TS). METHODS: Seventy-six consecutive patients (mean age: 10.0; standard deviation: 6.5 years) in a pediatric cardiology outpatient clinic were studied. One ...

BACKGROUND: Experimental studies and retrospective analyses of mortality trials with angiotensin-converting enzyme inhibitors (ACE-Is) have suggested that aspirin may reduce the beneficial effect of these drugs. The aim of this study was to assess a possible detrimental effect of aspirin on survival in stable patients with left ventricular systolic dysfunction ...

There is epidemiologic evidence that the prognosis of patients with nonischemic heart failure is better than that for patients with ischemic heart failure. In addition, studies have revealed that patients with ischemic heart failure show a poorer response to medical therapy. However, the pathophysiologic difference between ischemic and nonischemic heart ...

In this study the authors sought to determine the prevalence and long-term prognostic value of low triiodothyronine levels in elderly patients with heart failure and no thyroid disease. Lower levels of triiodothyronine are more prevalent in patients with advanced heart failure without thyroid disease, and this may have prognostic implications. ...

OBJECTIVE: The effect of long-term mechanical support on subsequent heart transplantation is still debated. METHODS: We report the outcome of 41 patients (42 +/- 12 years) bridged with left ventricular assist devices (VAD; 28 Novacor, 9 HeartMate, 2 Thoratec, and 2 DeBakey) for >100 days (218 +/- 76 days) between ...