Circulation. Heart failure
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Randomized Controlled Trial Multicenter Study
Anxiety sensitivity moderates prognostic importance of rhythm-control versus rate-control strategies in patients with atrial fibrillation and congestive heart failure: insights from the Atrial Fibrillation and Congestive Heart Failure Trial.
Patients with high anxiety sensitivity (AS) become extremely anxious with heart rate increases, palpitations, and symptoms of psychological arousal. AS predicts panic attacks. In atrial fibrillation (AF), AS correlates with symptom preoccupation and reduced quality of life. We assessed whether AS is associated with outcomes of rhythm-control versus rate-control in congestive heart failure (CHF) patients with AF. ⋯ URL: http://www.clinicaltrials.gov. Unique identifier: NCT88597077.
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Experimental cell therapy attenuates maladaptive cardiac remodeling and improves heart function. Paracrine mechanisms have been proposed. The effect of cell therapy on post infarction cardiac fibroblast and extracellular matrix (ECM) regulation was examined. ⋯ Extracellular matrix dysregulation post myocardial infarction is improved by cell therapy. These data suggest that cell transplantation attenuates myofibroblast activation and subsequent maladaptive structural chamber remodeling through paracrine mechanisms involving bFGF and TIMP-2.
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Multicenter Study Comparative Study
Presence of atrial fibrillation is independently associated with adverse outcomes in patients hospitalized with heart failure: an analysis of get with the guidelines-heart failure.
It is unclear if the presence of atrial fibrillation (AF) on admission is associated with worse in-hospital outcomes in patients hospitalized with heart failure (HF). This study evaluated the clinical characteristics, management, length of stay, and mortality of HF patients with and without AF. ⋯ In patients hospitalized with HF, AF is present in one-third and is independently associated with adverse hospital outcomes and longer length of stay. Whether prompt restoration of sinus rhythm would improve outcomes in patients hospitalized with HF and new-onset or paroxysmal AF is unclear and requires further study.
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Multicenter Study Comparative Study
Decline in heart transplant wait list mortality in the United States following broader regional sharing of donor hearts.
A change in allocation algorithm in July 2006 allowed broader regional sharing of donor hearts in the United States (US). We assessed if the allocation change has been associated with a decline in wait list mortality in the US. ⋯ The risk of death on the wait list or becoming too sick to transplant has decreased by 17% in the US since the allocation algorithm allowing broader regional sharing was implemented in 2006. The shift in hearts to sicker candidates has not resulted in higher in-hospital or first year post-transplant mortality.
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Multicenter Study Comparative Study
Risk prediction for early in-hospital mortality following heart transplantation in the United States.
Risk factors for early mortality after heart transplant (HT) have not been used for quantitative risk prediction. We sought to develop and validate a risk prediction model for posttransplant in-hospital mortality in HT recipients. ⋯ The proposed model allows risk stratification of HT candidates for early posttransplant mortality and may be useful in counseling patients with regard to their posttransplant prognosis. The model with additional donor-related variables may be useful during donor selection.