BACKGROUND: Microalbuminuria is considered a major risk factor predisposing to cardiovascular morbidity and mortality. Microalbuminuria levels in patients with or without diabetes have been associated with a higher risk of chronic heart failure (HF). However, there are limited data regarding prevalence of microalbuminuria in chronic heart failure and its prognostic ...

BACKGROUND AND OBJECTIVE: The SENIORS trial demonstrated that nebivolol is effective in the treatment of heart failure in elderly patients (e.g. > or = 70 years). This analysis evaluates the cost effectiveness of nebivolol compared with standard treatment. METHODS: An individual patient-simulation model based on a Markov modelling framework was ...

BACKGROUND: It has been suggested that low thyroid hormones levels may be associated with increased mortality in patients with cardiovascular disease. AIM: To evaluate the prognostic role of thyroid function deficiency in patients with chronic heart failure (CHF). METHODS: We evaluated 338 consecutive outpatients with stable CHF receiving conventional therapy, ...

AIMS AND OBJECTIVES: The present study was under taken to determine the spectrum, clinical profile and outcome of patients with congenital heart disease (CHD) admitted to a tertiary care hospital. MATERIALS AND METHODS: This is a retrospective, observational hospital based study conducted during January 2006 to December 2006. Out of ...

Patients with anorexia nervosa or bulimia nervosa often have signs of autonomic dysfunction potentially deleterious to the heart. The aim of this study was to ascertain the nonlinear properties of heart rate variability in patients with eating disorders. A group of 33 women with eating disorders (14 anorexia, 19 bulimia) ...

BACKGROUND: Adherence to heart failure therapy is important in reducing morbidity and mortality over the course of the disease process. The aim of this study was to examine factors associated with non-adherence to warfarin in chronic heart failure patients. METHODS: Eighty patients receiving warfarin therapy in 2002 were included. Adherence ...

BACKGROUND: Congestive heart failure is a common cardiac disorder associated with a high mortality. There are a limited number of prognostic scales predicting in-hospital outcomes after an acute episode of congestive heart failure. OBJECTIVES: The goal of this investigation was to develop a simple prognostic score predicting in-hospital outcome in ...

BACKGROUND: Heart failure is a major and growing public health problem worldwide. The prognosis of Heart Failure (HF) is uniformly poor despite advances in treatment. The aims of the present study were to determine the causes of HF among patients admitted to a Nigerian tertiary medical centre, to determine the ...

Chronic heart failure (CHF) is common, and increases in incidence and prevalence with age. There are compelling data demonstrating reduced mortality and hospitalizations with adrenergic blockade in older patients with CHF. Despite this, many older patients remain undertreated. The aim of the present article is to review the potential mechanisms ...

BACKGROUND: Cardiovascular magnetic resonance (CMR) of patients with congenital heart disease (CHD) has become routine clinical practice. However, existing CMR protocols focus predominantly on patients with ischemic heart disease, and information is limited on the types of patient with CHD who benefit from CMR investigation, and in what ways. Therefore ...

Carcinoid heart disease (CHD), reported in 50% to 70% of patients with carcinoid syndrome, is thought to be related to the production of 5-hydroxytryptamine by the tumor. The development of new therapeutic modalities designed to reduce tumor hormone production may have altered the development of CHD. Currently, echocardiography is performed ...

PURPOSE: We have shown previously that reduced integer heart rate variability (HRVi) predicts death in trauma patients. We hypothesized that heart rate multiscale entropy (MSE), a potential measurement of physiologic complexity, would predict death more robustly than HRVi. MATERIALS AND METHODS: Two hundred eighty-five patients had heart rate data meeting ...

An increasing survival rate for adult patients with congenital heart defects has been related to increased hospitalization and a greater risk of incidences during physical activity. The limited follow-up of these adult patients is partly due to a lack of knowledge about the number of adult patients in need of ...

BACKGROUND: Chronic heart failure (CHF) is associated with a high risk of sudden cardiac death (SCD). Most frequently SCD occurs in patients with NYHA class II and III. AIM: To evaluate the influence of prolonged carvedilol therapy on SCD risk in CHF patients. METHODS: The study included 86 patients (81 ...

CONTEXT: The clinical benefit of glucose-insulin-potassium (GIK) infusion in patients with ST-segment elevation myocardial infarction (STEMI) is unclear. While some smaller trials suggest benefit, in the CREATE-ECLA trial, GIK infusion had no effect on 30-day mortality in 20,201 patients. OBJECTIVES: To determine the association between GIK infusion therapy and 30-day ...

BACKGROUND: A long pentraxin, PTX3, is produced by vascular cells or inflammatory cells and released into the circulation, possibly reflecting local inflammation in the cardiovascular system. AIM: This study was designed to assess the clinical significance of plasma pentraxin 3 (PTX3) levels in chronic heart failure (CHF). METHODS: We measured ...

INTRODUCTION: Cachexia is common in chronic heart failure (CHF) and may be due to a combination of reduced appetite, and increased metabolic rate due to immune activation. This hypermetabolism, with an increase in acute phase protein turnover, also seen in cancer cachexia, might contribute to weight loss seen in severe ...

BACKGROUND: Beta-blockers (BB) are under prescribed in elderly heart failure (HF) patients. We analysed predictors of BB treatment in relation to age in community patients seen at an HF clinic with nurse specialist support. METHODS: BB prescription was assessed in 357 subjects, in relation to age tertiles:<67 (n=120), 67-73 (n=105) ...

Chronic heart failure (CHF) is a common and disabling condition with morbidity and mortality that increase dramatically with advancing age. There is some evidence available about beta-blocker therapy in the elderly. The Study of the Effects of Nebivolol Intervention on Outcomes and Rehospitalisation in Seniors with Heart Failure (SENIORS) and ...

BACKGROUND: Indications for cardiac-resynchronization therapy (CRT) in patients with heart failure include a prolonged QRS interval (> or =120 msec), in addition to other functional criteria. Some patients with narrow QRS complexes have echocardiographic evidence of left ventricular mechanical dyssynchrony and may also benefit from CRT. METHODS: We enrolled 172 ...

BACKGROUND: Cardiac resynchronisation therapy (CRT) improves symptoms and prognosis in patients with heart failure and cardiac dyssynchrony. Guidelines from the National Institute of Health and Clinical Excellence in the United Kingdom recommend CRT for patients with recent or persistent moderate or severe symptoms of heart failure. This analysis investigated whether ...

Compared with earlier models, current pumps are much smaller, simpler, and more efficient, offering long-term or even permanent support. They fit a wider size range of patients and are less invasive to implant. Because they have few moving parts, they are less susceptible to infection and failure. Additionally, they offer ...

OBJECTIVE: To investigate autonomic nervous system (ANS) function in mitochondrial disorders (MD). BACKGROUND: MD are characterized by a wide range of clinical features, including heart abnormalities and peripheral and central nervous systems involvement. Rarely autonomic symptoms have been reported. METHODS: 22 patients with MD underwent a battery of cardiovascular reflex ...

OBJECTIVE: The aim of this study was to evaluate whether the heart drawings of patients with heart failure are associated with their psychological, functional, and clinical status. METHODS: Sixty patients with heart failure completed a written questionnaire that included a heart drawing task, measures of psychological functioning, and illness perceptions. ...

PURPOSE: The occurrence of myoclonus associated with continuous i.v. infusion of dobutamine in a patient with end-stage renal disease (ESRD) is described. SUMMARY: A 65-year-old Caucasian man was admitted to the hospital on January 26, 2006, for worsening congestive heart failure (CHF). He had been receiving dobutamine 3 mug/kg/min by ...

BACKGROUND: The literature is unclear as to the frequency and degree of vascular involvement among the various types of cardiac amyloidosis, specifically the senile type. METHODS: We analyzed the intramyocardial vascular involvement, both qualitatively and quantitatively, in 18 patients with autopsy-proven cardiac amyloidosis [11 with primary amyloidosis (AL) and 7 ...

OBJECTIVE: A problem facing doctors treating adults with congenitally malformed hearts is that a significant number of these patients are lost for follow-up. The purpose of our study is to describe the medical history and clinical findings in a group of such adults that was lost for follow-up. DESIGN, SETTINGS ...

BACKGROUND: Levosimendan is a relatively new cardiac inotropic agent with calcium sensitizing activity. This study was conducted to investigate the effects of levosimendan (L) and dobutamine (D) on renal function in patients hospitalized with decompensated heart failure (HF). METHOD: The present study included 88 consecutive patients hospitalized with acutely decompensated ...

BACKGROUND AND OBJECTIVES: Mortality in patients who are on maintenance hemodialysis and have congestive heart failure is high in small cohort studies. The aim of this study was to determine long-term survival in a large cohort of dialysis patients with congestive heart failure and suspected fluid overload or pulmonary edema. ...

The concept of CCR5 antagonists introduces an additional molecular target. Maraviroc (MVR) is approved by the FDA for use in HIV-1 infected patients for combination antiretroviral treatment of adults infected with only CCR5-tropic HIV-1 who have evidence of viral replication and HIV-1 strains resistant to multiple antiretroviral agents. Tropism and ...

BACKGROUND: Mild hyponatremia is relatively common in patients hospitalized with heart failure (HF). To our knowledge, the association of hyponatremia with outcomes has not been evaluated in the context of in-hospital clinical course including central hemodynamics and changes in serum sodium level. METHODS: The ESCAPE trial (Evaluation Study of Congestive ...

Patients with congenital heart disease often face the prospect of long-term haemodynamic or arrhythmic complications for which lifelong follow-up in specialist adult congenital heart disease (ACHD) centres is required. We describe the case of a 25-year-old man with repaired atrioventricular septal defect who was referred to our centre after a ...

Congestive heart failure affects 5 million patients each year and is more common in elderly patients. Cardiac resynchronization therapy (CRT) or biventricular pacing is the simultaneous pacing of both ventricles, an approach that can improve symptoms and survival in some heart failure (HF) patients. Although no randomized controlled trial has ...

BACKGROUND: Augmentation of the amplitude of ECG QRS complexes, correlating with loss of weight or fluid volume removed, has been documented in patients with congestive heart failure (CHF). METHODS: We investigated the effect of an ultrafiltration (UF) pump on the fluid removal and the amplitude of ECG QRS complexes in ...

The purpose of the present study was to evaluate cardiac autonomic nervous system (ANS) in patients with myotonic dystrophy type 1 (DM1). The function of ANS was studied in 20 patients with DM1 and 15 healthy controls. All subjects were investigated by a battery of six cardiovascular autonomic tests and ...

RATIONALE AND OBJECTIVES: This study was designed to evaluate the performance of radiology residents in interpreting emergency department (ED) chest radiographs for congestive heart failure and to characterize the factors associated with a subsequent amended interpretation by an attending radiologist. MATERIALS AND METHODS: We retrospectively reviewed all amended reports for ...

BACKGROUND: Structural remodelling of left ventricle is a common feature in the progression of congestive heart failure (CHF). Matrix metalloproteinases (MMPs) have been directly implicated as they degrade extracellular proteins. To test the hypothesis that MMP-and its inhibitor, tissue type inhibitor of matrix metalloproteinases (TIMP-1), could be related to functional ...

BACKGROUND: Refractory congestive heart failure (CHF) with diuretic resistance is life-threatening and predicts a short life expectancy. Glucocorticoids have been proven to have potent diuretic effects in animal studies; however, their efficacy in CHF patients with diuretic resistance is not known. METHODS: Thirteen CHF patients with significant volume overload and ...

BACKGROUND: Numerous trials have demonstrated the effectiveness of cardiac resynchronization therapy (CRT) as an adjunct to medical therapy for the relief of heart failure (HF) symptoms in patients with a wide QRS duration (QRSd). Current guidelines recommend CRT in patients with an EF <35%, medically refractory NYHA Class III-IV HF ...

BACKGROUND: The reduction of hospitalizations in patients with heart failure (HF) may have clinical and economical implications. MATERIALS AND METHODS: In a case-control study, we compared the number of hospital admissions for congestive HF during the same follow-up period in two homogeneous groups of patients, each consisting of 27 consecutive ...

BACKGROUND: Patients with heart failure of any cause have elevated homocysteine compared to healthy controls. A number of studies in the UK and other western countries have documented higher levels of homocysteine among South Asian than among White European or African Caribbean subjects both in health and in disease, and ...

BACKGROUND: Oxidative stress is associated with maladaptive cardiac remodeling and vascular dysfunction and may be an important contributor to chronic heart failure (CHF) deterioration. We sought to investigate if the calcium sensitizer levosimendan beneficially modulates circulating markers of oxidative and nitrosative stress thus lessening their deleterious effects in patients with ...

BACKGROUND: Peak oxygen consumption derived from a maximal cardiopulmonary exercise test (CPET) is a standard prognostic indicator in patients with chronic heart failure (CHF). Tests with a peak respiratory exchange ratio (pRER)<1.0 are often taken to be submaximal, and data from such tests are treated as less helpful. The aim ...

OBJECTIVES: This study sought to investigate whether torasemide inhibits the enzyme involved in the myocardial extracellular generation of collagen type I molecules (i.e., procollagen type I carboxy-terminal proteinase [PCP]). BACKGROUND: Torasemide has been reported to reduce myocardial fibrosis in patients with chronic heart failure (HF). METHODS: Chronic HF patients received ...

Chronic functional pulmonary hypertension (FPH) secondary to end-stage cardiomyopathy constitutes a risk factor for graft right ventricular failure (RVF) after orthotopic heart transplantation (HTx). A novel form of mechanical assist circuit, the extracorporeal right to left atrium bypass (ECRLAB), has been proposed. Since 1998, at our institution, a total of ...

OBJECTIVES: This study evaluated the impact of left ventricular assist device (LVAD) support on survival and quality of life in inotrope-dependent heart failure patients ineligible for cardiac transplantation. BACKGROUND: The role for LVADs as a bridge to cardiac transplantation has been established, but data supporting their role as permanent therapy ...

BACKGROUND: Prognostic indicators and mortality in multiethnic Southeast Asian patients with heart failure (HF) may be different. METHODS AND RESULTS: The study population comprised 225 inpatients with HF with a left ventricular ejection fraction of 40% or less who were discharged alive. Five years later, survival and causes of death ...

PURPOSE: Early use of beta-blockers is a quality indicator for the treatment of patients with non-ST-segment elevation myocardial infarction (NSTEMI), despite limited data from randomized clinical trials in this population. We sought to determine the impact of acute beta-blocker therapy on outcomes in patients with NSTEMI. SUBJECTS AND METHODS: We ...

STUDY OBJECTIVES: To examine glycosylated hemoglobin (A1C) values longitudinally in patients who newly started metformin, sulfonylurea, or thiazolidinedione monotherapy; in a subset of patients whose A1C values were 7% or greater before starting therapy (baseline) and who achieved A1C goal (A1C < 7%) during therapy, rates of secondary failure (i.e., ...

We report a case of a 70-year-old female with considerable co-morbidities (Type 2 diabetes, Leiden factor V mutation, mild to moderate chronic obstructive pulmonary disease) and a recent biological aortic valve substitution, who was admitted due to circulatory collapse caused by severe heart failure with an ejection fraction of 10%. ...