European journal of heart failure
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Eur. J. Heart Fail. · Apr 2014
Implantable device diagnostics on day of discharge identify heart failure patients at increased risk for early readmission for heart failure.
We hypothesized that diagnostic data in implantable devices evaluated on the day of discharge from a heart failure hospitalization (HFH) can identify patients at risk for HF readmission (HFR) within 30 days. ⋯ Device-derived diagnostic criteria evaluated on the day of discharge identified patients at significantly higher risk of HFR.
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Eur. J. Heart Fail. · Mar 2014
ReviewContribution of ventricular assist devices to the recovery of failing hearts: a review and the Berlin Heart Center Experience.
Ventricular assist-device (VAD) implantation is a life-saving therapy which will later become either a bridge-to-transplantation or definitive therapy if heart transplantation (HTx) is not possible. VAD-supported failing hearts often recover at the molecular and cellular level, but translation of these changes into functionally stable cardiac recovery allowing long-term HTx/VAD-free outcomes after VAD removal is relatively rare, related to the aetiology, severity, and duration of myocardial damage. The reason for the discrepancy between high recovery rates on cellular and molecular levels and the low rate of cardiac recovery allowing VAD explantation is unknown. ⋯ The elective therapeutic use of VADs for heart failure (HF) reversal in its earlier stages is a future goal possibly achievable by development of tools to predict HF reversibility already before VAD implantation and increase the number of weaning candidates by improvement of adjunctive therapies to optimize unloading-promoted recovery. The present article summarizes the knowledge about unloading-promoted myocardial recovery and reviews the available data on its clinical relevance, its post-explant stability, and its assessment for decision-making in favour of or against VAD explantation. The review also aims to provide a theoretical and practical basis for clinicians intending to be engaged in this field.
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Eur. J. Heart Fail. · Mar 2014
Randomized Controlled TrialLevosimendan improves renal function in acute decompensated heart failure: possible underlying mechanisms.
The cardio-renal syndrome plays a critical role in acute heart failure (HF). Levosimendan, an inodilator drug, has a positive but controversial effect on kidney. Our aim was to evaluate its effects on both renal and systemic haemodynamic parameters as well as on renal function, explaining the possible mechanisms involved. ⋯ Levosimendan, in acute decompensated HF, has an immediate renoprotective effect, mediated by an increase in renal blood flow, due to a selective renal arterial and venous vasodilating action.
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Eur. J. Heart Fail. · Feb 2014
Observational StudyRestrictive mitral annuloplasty with or without surgical ventricular reconstruction in ischaemic cardiomyopathy: impacts on neurohormonal activation, reverse left ventricular remodelling and survival.
In the STICH trial, adding surgical ventricular reconstruction (SVR) to coronary artery bypass grafting (CABG) reduced LV end-systolic volume index (LVESVI) by 19%, as compared with 6% with CABG alone, providing no survival or functional benefits. Herein, we compared the efficacy of restrictive mitral annuloplasty (RMA) alone with that of RMA combined with SVR in patients with functional mitral regurgitation (MR). ⋯ RMA plus SVR reduced LVESVI to a greater degree than RMA alone, neutralizing anticipated worse prognosis. Selected patients with functional MR and advanced LV remodelling may benefit by adding SVR to RMA.
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Eur. J. Heart Fail. · Jan 2014
The Chronic Kidney Disease Epidemiology Collaboration equation outperforms the Modification of Diet in Renal Disease equation for estimating glomerular filtration rate in chronic systolic heart failure.
The Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) formula estimates glomerular filtration rate (GFR) better than the simplified Modification of Diet in Renal Disease (sMDRD) formula in numerous populations. It has not previously been validated in heart failure patients. ⋯ The CKD-EPI equation more accurately estimates measured GFR than the sMDRD equation in CHF patients, with less bias and greater accuracy and precision. The prognostic power of all GFR assessments was equivalent. Based on better performance and equal risk prediction, we believe the CKI-EPI equation should be the preferred creatinine-based GFR estimation method in heart failure patients, particularly those with preserved or moderately impaired renal function.