European journal of heart failure
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Eur. J. Heart Fail. · Mar 2012
Ventricular assist device support as a bridge to heart transplantation in patients with giant cell myocarditis.
Giant cell myocarditis (GCM) carries a poor prognosis and many patients require end-stage therapies. This study sought to determine the outcome of patients bridged with ventricular assist devices (VAD) to orthotopic heart transplantation (OHT). ⋯ Patients with end-stage GCM can be successfully bridged with VADs to OHT with very good post-OHT survival. The proper immunosuppressive regimen for this group needs further investigation given the frequency of rejection and GCM recurrence.
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Eur. J. Heart Fail. · Feb 2012
ReviewDetection, monitoring, and management of trastuzumab-induced left ventricular dysfunction: an actual challenge.
The antibody trastuzumab, targeted to inhibit the signalling of ErbB2, a tyrosine kinase receptor overexpressed in 20-30% of breast cancers, improves the prognosis in women affected by this tumour, but produces cardiotoxicity, since ErbB2 is also involved in myocardial homeostasis. In this review, we discuss the pathophysiology of trastuzumab cardiomyopathy and the complex interplay between ErbB2 inhibition and anthracyclines, and we focus on the actual challenges of detecting, monitoring, and managing trastuzumab cardiotoxicity: the research of new, sensitive markers of early trastuzumab toxicity, before the ejection fraction is reduced, is an active field of research.
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Eur. J. Heart Fail. · Jan 2012
Randomized Controlled Trial Multicenter StudyLink between decisions regarding resuscitation and preferences for quality over length of life with heart failure.
Survival preferences, ascertained from time-trade-off utilities, have not been studied in heart failure patients who designate a 'do not resuscitate' (DNR) status. Therefore, the aim of this study was to determine the association of heart failure patients' resuscitation preferences with survival preferences and mortality in the ESCAPE trial. ⋯ Heart failure patients' requests to forego resuscitation may signify more than simply 'what-if' directives for emergency care. DNR decisions may reflect preferences for intervention to enhance quality rather than prolong survival, which is particularly important as these patients have high early mortality.
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The European CRT Survey is a joint initiative of the Heart Failure Association (HFA) and the European Heart Rhythm Association (EHRA) of the European Society of Cardiology evaluating the contemporary implantation practice of cardiac resynchronization therapy (CRT) in Europe. ⋯ Outcomes including death and hospitalization in this European CRT survey were consistent with results from clinical trials of CRT. At 1 year follow-up, most patients who received a CRT device considered their symptoms improved compared with their pre-implant assessment. Although prospective, this is an observational study of successful CRT implantations, and outcomes in subgroup analyses must be interpreted with appropriate conservatism.
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Eur. J. Heart Fail. · Oct 2011
Multicenter StudyClinical and prognostic effects of atrial fibrillation in heart failure patients with reduced and preserved left ventricular ejection fraction.
Atrial fibrillation (AF) is common in heart failure (HF), but few data regarding the prognostic relevance of AF are available in HF patients with preserved left ventricular ejection fraction (HF-PEF). We aimed to study the clinical impact of AF vs. sinus rhythm (SR) in stabilized HF patients with reduced left ventricular ejection fraction (HF-REF) and in those with preserved left ventricular ejection fraction (HF-PEF). ⋯ Atrial fibrillation is equally common in patients with HF-PEF and HF-REF. In HF-PEF, but not in HF-REF patients, AF was associated with higher NT-proBNP levels and was independently related to death or HF hospitalization.