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
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.
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Multicenter Study Comparative Study
Multiple biomarkers for risk prediction in chronic heart failure.
Prior studies have suggested using a panel of biomarkers that measure diverse biological processes as a prognostic tool in chronic heart failure. Whether this approach improves risk prediction beyond clinical evaluation is unknown. ⋯ In ambulatory chronic heart failure patients, a score derived from multiple biomarkers integrating diverse biological pathways substantially improves prediction of adverse events beyond current metrics.