Subjects -> MEDICAL SCIENCES (Total: 8529 journals)
    - ALLERGOLOGY AND IMMUNOLOGY (216 journals)
    - ANAESTHESIOLOGY (120 journals)
    - CARDIOVASCULAR DISEASES (332 journals)
    - CHIROPRACTIC, HOMEOPATHY, OSTEOPATHY (21 journals)
    - COMMUNICABLE DISEASES, EPIDEMIOLOGY (231 journals)
    - DENTISTRY (292 journals)
    - DERMATOLOGY AND VENEREOLOGY (164 journals)
    - EMERGENCY AND INTENSIVE CRITICAL CARE (120 journals)
    - ENDOCRINOLOGY (150 journals)
    - FORENSIC SCIENCES (41 journals)
    - GASTROENTEROLOGY AND HEPATOLOGY (186 journals)
    - GERONTOLOGY AND GERIATRICS (136 journals)
    - HEMATOLOGY (155 journals)
    - HYPNOSIS (4 journals)
    - INTERNAL MEDICINE (167 journals)
    - LABORATORY AND EXPERIMENTAL MEDICINE (99 journals)
    - MEDICAL GENETICS (58 journals)
    - MEDICAL SCIENCES (2342 journals)
    - NURSES AND NURSING (362 journals)
    - OBSTETRICS AND GYNECOLOGY (207 journals)
    - ONCOLOGY (381 journals)
    - OPHTHALMOLOGY AND OPTOMETRY (138 journals)
    - ORTHOPEDICS AND TRAUMATOLOGY (167 journals)
    - OTORHINOLARYNGOLOGY (82 journals)
    - PATHOLOGY (98 journals)
    - PEDIATRICS (273 journals)
    - PHYSICAL MEDICINE AND REHABILITATION (157 journals)
    - PSYCHIATRY AND NEUROLOGY (822 journals)
    - RADIOLOGY AND NUCLEAR MEDICINE (192 journals)
    - RESPIRATORY DISEASES (103 journals)
    - RHEUMATOLOGY (78 journals)
    - SPORTS MEDICINE (81 journals)
    - SURGERY (401 journals)
    - UROLOGY, NEPHROLOGY AND ANDROLOGY (153 journals)

CARDIOVASCULAR DISEASES (332 journals)                  1 2 | Last

Showing 1 - 200 of 337 Journals sorted alphabetically
Acta Angiologica     Open Access   (Followers: 5)
Acta Cardiologica     Hybrid Journal   (Followers: 2)
Acute Cardiac Care     Hybrid Journal   (Followers: 8)
Adipositas - Ursachen, Folgeerkrankungen, Therapie     Hybrid Journal  
AJP Heart and Circulatory Physiology     Hybrid Journal   (Followers: 12)
Aktuelle Kardiologie     Hybrid Journal   (Followers: 1)
American Heart Journal     Hybrid Journal   (Followers: 59)
American Journal of Cardiology     Hybrid Journal   (Followers: 67)
American Journal of Cardiovascular Drugs     Hybrid Journal   (Followers: 17)
American Journal of Hypertension     Hybrid Journal   (Followers: 28)
Anales de Cirugia Vascular     Full-text available via subscription   (Followers: 1)
Anatolian Journal of Cardiology     Open Access   (Followers: 6)
Angiología     Full-text available via subscription  
Angiologia e Cirurgia Vascular     Open Access   (Followers: 1)
Angiology     Hybrid Journal   (Followers: 3)
Annales de Cardiologie et d'Angéiologie     Full-text available via subscription   (Followers: 1)
Annals of Circulation     Open Access   (Followers: 1)
Annals of Noninvasive Electrocardiology     Hybrid Journal   (Followers: 1)
Annals of Pediatric Cardiology     Open Access   (Followers: 12)
AORTA     Open Access  
Archives of Cardiovascular Diseases     Full-text available via subscription   (Followers: 5)
Archives of Cardiovascular Diseases Supplements     Full-text available via subscription   (Followers: 3)
Archives of Cardiovascular Imaging     Open Access   (Followers: 2)
Archivos de cardiología de México     Open Access   (Followers: 1)
Argentine Journal of Cardiology (English edition)     Open Access   (Followers: 2)
Arquivos Brasileiros de Cardiologia     Open Access   (Followers: 2)
Arrhythmia & Electrophysiology Review     Open Access  
Arteriosclerosis, Thrombosis and Vascular Biology     Full-text available via subscription   (Followers: 32)
Artery Research     Hybrid Journal   (Followers: 4)
ARYA Atherosclerosis     Open Access  
ASAIO Journal     Hybrid Journal   (Followers: 3)
ASEAN Heart Journal     Open Access   (Followers: 2)
Asian Cardiovascular and Thoracic Annals     Hybrid Journal   (Followers: 2)
Aswan Heart Centre Science & Practice Services     Open Access   (Followers: 1)
Atherosclerosis : X     Open Access  
Bangladesh Heart Journal     Open Access   (Followers: 3)
Basic Research in Cardiology     Hybrid Journal   (Followers: 10)
BMC Cardiovascular Disorders     Open Access   (Followers: 22)
Brain Circulation     Open Access   (Followers: 1)
British Journal of Cardiology     Full-text available via subscription   (Followers: 18)
Canadian Journal of Cardiology     Hybrid Journal   (Followers: 18)
Cardiac Cath Lab Director     Full-text available via subscription  
Cardiac Electrophysiology Review     Hybrid Journal   (Followers: 2)
Cardiac Failure Review     Open Access  
Cardiocore     Full-text available via subscription   (Followers: 1)
Cardiogenetics     Open Access   (Followers: 3)
Cardiology     Full-text available via subscription   (Followers: 20)
Cardiology and Angiology: An International Journal     Open Access   (Followers: 1)
Cardiology and Therapy     Open Access   (Followers: 12)
Cardiology Clinics     Full-text available via subscription   (Followers: 14)
Cardiology in Review     Hybrid Journal   (Followers: 8)
Cardiology in the Young     Hybrid Journal   (Followers: 34)
Cardiology Journal     Open Access   (Followers: 6)
Cardiology Plus     Open Access   (Followers: 1)
Cardiology Research     Open Access   (Followers: 15)
Cardiology Research and Practice     Open Access   (Followers: 10)
Cardiopulmonary Physical Therapy Journal     Hybrid Journal   (Followers: 8)
Cardiorenal Medicine     Full-text available via subscription   (Followers: 1)
Cardiothoracic Surgeon     Open Access   (Followers: 1)
CardioVasc     Full-text available via subscription   (Followers: 1)
Cardiovascular & Haematological Disorders - Drug Targets     Hybrid Journal   (Followers: 1)
Cardiovascular & Hematological Agents in Medicinal Chemistry     Hybrid Journal   (Followers: 2)
CardioVascular and Interventional Radiology     Hybrid Journal   (Followers: 15)
Cardiovascular and Thoracic Open     Open Access  
Cardiovascular Diabetology     Open Access   (Followers: 10)
Cardiovascular Drugs and Therapy     Hybrid Journal   (Followers: 14)
Cardiovascular Endocrinology & Metabolism     Hybrid Journal   (Followers: 1)
Cardiovascular Engineering     Hybrid Journal   (Followers: 1)
Cardiovascular Engineering and Technology     Hybrid Journal   (Followers: 1)
Cardiovascular Intervention and Therapeutics     Hybrid Journal   (Followers: 5)
Cardiovascular Journal     Open Access   (Followers: 6)
Cardiovascular Journal of Africa     Full-text available via subscription   (Followers: 5)
Cardiovascular Journal of South Africa     Full-text available via subscription   (Followers: 1)
Cardiovascular Medicine in General Practice     Full-text available via subscription   (Followers: 7)
Cardiovascular Pathology     Hybrid Journal   (Followers: 4)
Cardiovascular Regenerative Medicine     Open Access  
Cardiovascular Research     Hybrid Journal   (Followers: 15)
Cardiovascular Revascularization Medicine     Hybrid Journal   (Followers: 1)
Cardiovascular System     Open Access  
Cardiovascular Therapeutics     Open Access   (Followers: 1)
Cardiovascular Toxicology     Hybrid Journal   (Followers: 6)
Cardiovascular Ultrasound     Open Access   (Followers: 5)
Case Reports in Cardiology     Open Access   (Followers: 7)
Catheterization and Cardiovascular Interventions     Hybrid Journal   (Followers: 3)
Cerebrovascular Diseases     Full-text available via subscription   (Followers: 3)
Cerebrovascular Diseases Extra     Open Access  
Chest     Full-text available via subscription   (Followers: 102)
Choroby Serca i Naczyń     Open Access   (Followers: 1)
Circulation     Hybrid Journal   (Followers: 254)
Circulation : Cardiovascular Imaging     Hybrid Journal   (Followers: 15)
Circulation : Cardiovascular Interventions     Hybrid Journal   (Followers: 18)
Circulation : Cardiovascular Quality and Outcomes     Hybrid Journal   (Followers: 11)
Circulation : Genomic and Precision Medicine     Hybrid Journal   (Followers: 16)
Circulation : Heart Failure     Hybrid Journal   (Followers: 26)
Circulation Research     Hybrid Journal   (Followers: 36)
Cirugía Cardiovascular     Open Access  
Clínica e Investigación en Arteriosclerosis     Full-text available via subscription  
Clínica e Investigación en arteriosclerosis (English Edition)     Hybrid Journal  
Clinical and Experimental Hypertension     Hybrid Journal   (Followers: 3)
Clinical Cardiology     Hybrid Journal   (Followers: 11)
Clinical Hypertension     Open Access   (Followers: 5)
Clinical Medicine Insights : Cardiology     Open Access   (Followers: 6)
Clinical Research in Cardiology     Hybrid Journal   (Followers: 6)
Clinical Research in Cardiology Supplements     Hybrid Journal  
Clinical Trials and Regulatory Science in Cardiology     Open Access   (Followers: 4)
Congenital Heart Disease     Hybrid Journal   (Followers: 6)
Congestive Heart Failure     Hybrid Journal   (Followers: 4)
Cor et Vasa     Full-text available via subscription   (Followers: 1)
Coronary Artery Disease     Hybrid Journal   (Followers: 2)
CorSalud     Open Access  
Critical Pathways in Cardiology     Hybrid Journal   (Followers: 4)
Current Cardiology Reports     Hybrid Journal   (Followers: 7)
Current Cardiology Reviews     Hybrid Journal   (Followers: 4)
Current Cardiovascular Imaging Reports     Hybrid Journal   (Followers: 1)
Current Cardiovascular Risk Reports     Hybrid Journal  
Current Heart Failure Reports     Hybrid Journal   (Followers: 5)
Current Hypertension Reports     Hybrid Journal   (Followers: 6)
Current Hypertension Reviews     Hybrid Journal   (Followers: 6)
Current Opinion in Cardiology     Hybrid Journal   (Followers: 14)
Current Problems in Cardiology     Hybrid Journal   (Followers: 3)
Current Research : Cardiology     Full-text available via subscription   (Followers: 1)
Current Treatment Options in Cardiovascular Medicine     Hybrid Journal   (Followers: 1)
Current Vascular Pharmacology     Hybrid Journal   (Followers: 5)
CVIR Endovascular     Open Access   (Followers: 1)
Der Kardiologe     Hybrid Journal   (Followers: 2)
Echo Research and Practice     Open Access   (Followers: 2)
Echocardiography     Hybrid Journal   (Followers: 4)
Egyptian Heart Journal     Open Access   (Followers: 2)
Egyptian Journal of Cardiothoracic Anesthesia     Open Access  
ESC Heart Failure     Open Access   (Followers: 4)
European Cardiology Review     Open Access  
European Heart Journal     Hybrid Journal   (Followers: 67)
European Heart Journal - Cardiovascular Imaging     Hybrid Journal   (Followers: 10)
European Heart Journal - Cardiovascular Pharmacotherapy     Full-text available via subscription   (Followers: 2)
European Heart Journal - Quality of Care and Clinical Outcomes     Hybrid Journal  
European Heart Journal : Acute Cardiovascular Care     Hybrid Journal   (Followers: 1)
European Heart Journal : Case Reports     Open Access   (Followers: 1)
European Heart Journal Supplements     Hybrid Journal   (Followers: 8)
European Journal of Cardio-Thoracic Surgery     Hybrid Journal   (Followers: 9)
European Journal of Cardio-Thoracic Surgery Supplements     Full-text available via subscription   (Followers: 2)
European Journal of Cardiovascular Nursing     Hybrid Journal   (Followers: 5)
European Journal of Heart Failure     Hybrid Journal   (Followers: 14)
European Journal of Preventive Cardiology.     Hybrid Journal   (Followers: 6)
European Stroke Organisation     Hybrid Journal   (Followers: 3)
Experimental & Translational Stroke Medicine     Open Access   (Followers: 9)
Expert Review of Cardiovascular Therapy     Full-text available via subscription   (Followers: 3)
Folia Cardiologica     Open Access  
Forum Zaburzeń Metabolicznych     Hybrid Journal  
Frontiers in Cardiovascular Medicine     Open Access   (Followers: 1)
Future Cardiology     Hybrid Journal   (Followers: 6)
General Thoracic and Cardiovascular Surgery     Hybrid Journal   (Followers: 3)
Global Cardiology Science and Practice     Open Access   (Followers: 5)
Global Heart     Hybrid Journal   (Followers: 3)
Heart     Hybrid Journal   (Followers: 48)
Heart and Mind     Open Access  
Heart and Vessels     Hybrid Journal  
Heart Failure Clinics     Full-text available via subscription   (Followers: 2)
Heart Failure Reviews     Hybrid Journal   (Followers: 3)
Heart India     Open Access   (Followers: 2)
Heart International     Full-text available via subscription  
Heart Rhythm     Hybrid Journal   (Followers: 11)
Heart Views     Open Access   (Followers: 2)
HeartRhythm Case Reports     Open Access  
Hellenic Journal of Cardiology     Open Access   (Followers: 1)
Herz     Hybrid Journal   (Followers: 3)
High Blood Pressure & Cardiovascular Prevention     Full-text available via subscription   (Followers: 2)
Hypertension     Full-text available via subscription   (Followers: 23)
Hypertension in Pregnancy     Hybrid Journal   (Followers: 9)
Hypertension Research     Hybrid Journal   (Followers: 5)
Ibrahim Cardiac Medical Journal     Open Access  
IJC Heart & Vessels     Open Access   (Followers: 1)
IJC Heart & Vasculature     Open Access   (Followers: 1)
IJC Metabolic & Endocrine     Open Access   (Followers: 1)
Indian Heart Journal     Open Access   (Followers: 5)
Indian Journal of Cardiovascular Disease in Women WINCARS     Open Access  
Indian Journal of Thoracic and Cardiovascular Surgery     Hybrid Journal  
Indian Pacing and Electrophysiology Journal     Open Access   (Followers: 1)
Innovations : Technology and Techniques in Cardiothoracic and Vascular Surgery     Hybrid Journal   (Followers: 1)
Insuficiencia Cardíaca     Open Access  
Interactive CardioVascular and Thoracic Surgery     Hybrid Journal   (Followers: 7)
International Cardiovascular Forum Journal     Open Access  
International Journal of Angiology     Hybrid Journal   (Followers: 2)
International Journal of Cardiology     Hybrid Journal   (Followers: 18)
International Journal of Cardiology Hypertension     Open Access   (Followers: 1)
International Journal of Cardiovascular and Cerebrovascular Disease     Open Access   (Followers: 2)
International Journal of Cardiovascular Imaging     Hybrid Journal   (Followers: 2)
International Journal of Cardiovascular Research     Hybrid Journal   (Followers: 6)
International Journal of Heart Rhythm     Open Access  
International Journal of Hypertension     Open Access   (Followers: 8)
International Journal of Hyperthermia     Open Access  
International Journal of Stroke     Hybrid Journal   (Followers: 32)
International Journal of the Cardiovascular Academy     Open Access  
Interventional Cardiology Clinics     Full-text available via subscription   (Followers: 2)
Interventional Cardiology Review     Open Access  
JACC : Basic to Translational Science     Open Access   (Followers: 5)
JACC : Cardiovascular Imaging     Hybrid Journal   (Followers: 18)
JACC : Cardiovascular Interventions     Hybrid Journal   (Followers: 18)
JACC : Heart Failure     Full-text available via subscription   (Followers: 14)
JAMA Cardiology     Hybrid Journal   (Followers: 30)
JMIR Cardio     Open Access  

        1 2 | Last

Similar Journals
Journal Cover
Journal of Cardiac Failure
Journal Prestige (SJR): 2.035
Citation Impact (citeScore): 3
Number of Followers: 1  
 
  Hybrid Journal Hybrid journal (It can contain Open Access articles)
ISSN (Print) 1071-9164 - ISSN (Online) 1532-8414
Published by Elsevier Homepage  [3203 journals]
  • DETERMINANTS OF LEFT VENTRICULAR HYPERTROPHY AND DIASTOLIC DYSFUNCTION IN
           AN HIV CLINICAL COHORT
    • Abstract: Publication date: Available online 30 June 2018Source: Journal of Cardiac FailureAuthor(s): Nwora Lance Okeke, Fawaz Alenezi, Gerald S. Bloomfield, Allison Dunning, Meredith E. Clement, Svati H. Shah, Susanna Naggie, Eric J. VelazquezABSTRACTObjectiveTo investigate determinants of structural myocardial abnormalities in persons living with HIV (PLWH).MethodsWe reviewed archived transthoracic echocardiograms (TTE) performed on PLWH at Duke University Medical Center between 2001 and 2012. The primary outcomes were presence of left ventricular hypertrophy (LVH) or diastolic dysfunction (DD).ResultsTTEs for 498 HIV-infected persons were reviewed (median age 44 yrs, 38% female, 72% Black, 34% with hypertension, 15% with diabetes). Among those with usable images, LVH was detected in 174 of 473 persons (37%) by LV mass criteria and 99 of 322 persons (31%) by American Society of Echocardiography (ASE) LV mass index (LVMI) criteria. Definite DD was detected in 18 of 224 (8%) persons. LVH was more common in PLWH with a CD4 count ≤ 200 cells/mm3 proximal to TTE (adjusted OR 1.68, 95% CI 1.08-2.62), CD4 nadir ≤ 200 cells/mm3 (adjusted OR 1.63, 95% CI 1.04-2.54) and less common in persons with viral suppression (OR 0.46, 95% CI 0.27-0.80). Lower CD4 nadirs (p = 0.002) and proximal CD4 counts (p = 0.002) were also associated with DD.ConclusionsPersons with a history of advanced HIV-associated immune suppression are at higher risk of LVH and DD than infected persons with preserved immune function.
       
  • Efficient, efficacious, effective: still a long way to go for diuretic
           treatment of acute decompensated heart failure
    • Abstract: Publication date: Available online 25 June 2018Source: Journal of Cardiac FailureAuthor(s): Renata De Maria
       
  • Relationship of central venous pressure to body fluid volume status and
           its prognostic implication in patients with acute decompensated heart
           failure
    • Abstract: Publication date: Available online 9 June 2018Source: Journal of Cardiac FailureAuthor(s): Taiki Sakaguchi, Akio Hirata, Kazunori Kashiwase, Yoshiharu Higuchi, Tomohito Ohtani, Yasushi Sakata, Yoshio Yasumura Background: Although central venous pressure (CVP) is a surrogate measure of preload in patients with acute decompensated heart failure (ADHF), it is a multifactorial index influenced not only by fluid volume status, but also by cardiac pump function and other factors. We aimed to elucidate the individual pathophysiologic factors of CVP elevation in ADHF patients by assessing the relationship between CVP and extracellular fluid volume status (EVS).Methods and Results: We quantified EVS in 100 ADHF patients using bioelectrical impedance analysis. CVP was also measured at the same time point. Subjects were categorized into tertiles according to their CVP/EVS ratios, and patient characteristics and clinical outcomes were compared among these tertiles. The upper tertile group had a higher incidence of impaired right ventricular pump function, whereas the lower tertile group had higher incidences of severe inflammation, hypoalbuminemia, and renal dysfunction. Patients in both the upper and lower tertiles had a significantly higher cardiac event rate than those in the middle tertile.Conclusions: The combined assessment of CVP and EVS provides insight into both the total volume status and distribution of body fluid in ADHF patients, and may have applications in guiding decongestive therapy and improving prognostic predictions.
       
  • In-hospital and 3-year outcomes of heart failure patients in South India:
           The Trivandrum Heart Failure Registry,
    • Abstract: Publication date: Available online 7 June 2018Source: Journal of Cardiac FailureAuthor(s): Ganapathi Sanjay, Panniyammakal Jeemon, Anubha Agarwal, Sunitha Viswanathan, Madhu Sreedharan, Vijayaraghavan Govindan, Bahuleyan Charantharalyil Gopalan, R. Biju, Tiny Nair, N. Prathapkumar, G. Krishnakumar, N. Rajalekshmi, Krishnan Suresh, Lawrence P. Park, Mark D. Huffman, Sivadasanpillai Harikrishnan BackgroundLong-term data on outcomes of participants hospitalized with heart failure (HF) from low and middle-income countries are limited.Methods and resultsIn the Trivandrum Heart Failure Registry (THFR) in 2013, 1205 participants from 18 hospitals in Trivandrum, India were enrolled. Data were collected on demographics, clinical presentation, treatment and outcomes. We performed survival analyses, compared groups and evaluated the association between HF type and mortality, adjusting for covariates that predicted mortality in a global HF risk score. The mean (SD) age of participants was 61.2 (13.7) years. Ischemic heart disease was the most common etiology (72%). In-hospital mortality was higher for participants with heart-failure with reduced ejection fraction (HFrEF) (9.7%) compared to those with heart-failure with preserved ejection fraction (HFpEF) (4.8%, p = 0.003). After three years, 540 (44.8%) of all participants had died. All-cause mortality was lower for participants with HFpEF (40.8%) compared to HFrEF (46.2%, p = 0.049). In multivariable models, older age (hazard ratio [HR] 1.24 per decade, 95% CI 1.15, 1.33), NYHA class-IV symptoms (HR 2.80, 95% CI 1.43, 5.48), and higher serum creatinine (HR 1.12 per mg/dl, 95%CI 1.04, 1.22) were associated with all-cause mortality.ConclusionsParticipants with HF in the THFR have high three-year all-cause mortality. Targeted hospital-based quality improvement initiatives are needed to improve survival during and after hospitalization for heart failure.
       
  • Failing Hearts Are More Vulnerable to Sympathetic, but not Vagal
           Stimulation Induced Atrial Fibrillation: Ameliorated with Dantrolene
           Treatment
    • Abstract: Publication date: Available online 7 June 2018Source: Journal of Cardiac FailureAuthor(s): Matthew S. Delfiner, Colleen Nofi, Ying Li, A. Martin Gerdes, Youhua Zhang BackgroundBoth vagal (VS) and sympathetic (SS) stimulations can increase atrial fibrillation (AF) inducibility, with VS being known as more arrhythmogenic in normal hearts. Heart failure (HF) results in autonomic dysfunction (characterized by sympathetic activation and vagal withdrawal) and is associated with an increased AF incidence. This study investigated whether failing hearts, compared to normal-controls, respond differently to autonomic stimulation induced AF arrhythmogenesis and the effect of dantrolene on SS enhanced AF in HF.Methods and ResultsA rat myocardial infarction (MI)-HF model was used. In experiment 1, AF inducibility was compared in 9 MI-HF rats versus 10 sham-control animals at baseline, during VS, and during SS with isoproterenol infusion. In experiment 2, dantrolene treatment (n=8) was compared with placebo-control (n=9) on SS induced AF inducibility in HF. Compared with sham-controls, baseline AF inducibility was higher in MI-HF group. AF inducibility was augmented in both groups by autonomic stimulation. However, under VS the increased magnitude was less in the MI-HF group (49±11% versus 80±10%, P=0.029), but was significantly more under SS (53±8% versus 6±7%, P
       
  • Associations With and Prognostic and Discriminatory Role of N-Terminal
           Pro–B-Type Natriuretic Peptide in Heart Failure With Preserved Versus
           Mid-range Versus Reduced Ejection Fraction
    • Abstract: Publication date: June 2018Source: Journal of Cardiac Failure, Volume 24, Issue 6Author(s): Gianluigi Savarese, Nicola Orsini, Camilla Hage, Ulf Dahlström, Ola Vedin, Giuseppe M.C. Rosano, Lars H. Lund BackgroundThe aim of this study was to characterize N-terminal pro–B-type natriuretic peptide (NT-proBNP) in terms of determinants of levels and of its prognostic and discriminatory role in heart failure with mid-range (HFmrEF) versus preserved (HFpEF) and reduced (HFrEF) ejection fraction.Methods and ResultsIn 9847 outpatients with HFpEF (n = 1811; 18%), HFmrEF (n = 2122; 22%) and HFrEF (n = 5914; 60%) enrolled in the Swedish Heart Failure Registry, median NT-proBNP levels were 1428, 1540, and 2288 pg/mL, respectively. Many determinants of NT-proBNP differed by ejection fraction, with atrial fibrillation (AF) more important in HFmrEF and HFpEF, diabetes and hypertension in HFmrEF, and age and body mass index in HFrEF and HFmrEF, whereas renal function, New York Heart Association functional class, heart rate, and anemia were similar. Hazard ratios for death and death/HF hospitalization for NT-proBNP above the median ranged from 1.48 to 2.00 and were greatest for HFmrEF and HFpEF. Areas under the receiver operating characteristic curve for death and death/HF hospitalization were greater in HFmrEF than in HFpEF and HFrEF and were reduced by AF in HFpEF and HFmrEF but not in HFrEF.ConclusionsIn HFpEF and especially HFmrEF, NT-proBNP was more prognostic and discriminatory, but also more affected by confounders such as AF. These data support the use of NT-proBNP for eligibility, enrichment, and surrogate end points in HFpEF and HFmrEF trials, and suggest that cutoff levels for eligibility should be carefully tailored to comorbidity.
       
  • Using Artificial Intelligence in an Intelligent Way to Improve Efficiency
           of a Heart Failure Care Team
    • Abstract: Publication date: June 2018Source: Journal of Cardiac Failure, Volume 24, Issue 6Author(s): Griffin M. Weber
       
  • Spot Urinary Sodium in Decompensated Heart Failure as a Prognostic Metric
           for Successful Ambulatory Decongestion
    • Abstract: Publication date: June 2018Source: Journal of Cardiac Failure, Volume 24, Issue 6Author(s): Pieter Martens, Wilfried Mullens
       
  • Spot Urine Sodium as Triage for Effective Diuretic Infusion in an
           Ambulatory Heart Failure Unit
    • Abstract: Publication date: June 2018Source: Journal of Cardiac Failure, Volume 24, Issue 6Author(s): D. Marshall Brinkley, Laura J. Burpee, Sunit-Preet Chaudhry, Jennifer A. Smallwood, JoAnn Lindenfeld, Neal K. Lakdawala, Akshay S. Desai, Lynne W. Stevenson BackgroundAdmission for diuresis remains a common and costly event in patients with advanced heart failure (HF). We tested whether spot urine sodium could identify patients likely to respond to ambulatory diuretic infusion without hospitalization.Methods and ResultsWe prospectively followed 176 consecutive patients with advanced heart failure receiving intravenous furosemide for congestion in an ambulatory clinic. Spot urine sodium was measured in 1st voided urine after diuretic infusion and compared with 3-hour urine output and subsequent risk of 30-day hospitalization or emergency department (ED) visit.Spot urine sodium was significantly associated with urine output in a model adjusted for age, renal function, and blood urea nitrogen (P = .02). Higher urine sodium was associated with lower risk of hospitalization or ED visit within 30 days (odds ratio [OR] 0.82 [95% confidence interval 0.72–0.94] per 10 mmol/L increase; P 
       
  • The Importance of Using Correct Terms
    • Abstract: Publication date: June 2018Source: Journal of Cardiac Failure, Volume 24, Issue 6Author(s): Paul J. Hauptman
       
  • Information for Authors
    • Abstract: Publication date: June 2018Source: Journal of Cardiac Failure, Volume 24, Issue 6Author(s):
       
  • The Controversy Continues: What is the Role of Diastolic Function by
           Echo-Doppler in Patients with Heart Failure and Preserved Ejection
           Fraction'
    • Abstract: Publication date: June 2018Source: Journal of Cardiac Failure, Volume 24, Issue 6Author(s): John Gorcsan
       
  • Factors Associated With Adherence to 14-Day Office Appointments After
           Heart Failure Discharge
    • Abstract: Publication date: June 2018Source: Journal of Cardiac Failure, Volume 24, Issue 6Author(s): Karen Distelhorst, Renee Claussen, Kelly Dion, James F. Bena, Shannon L. Morrison, Donna Walker, Hua-Li Tai, Nancy M. Albert BackgroundFollow-up within 14 days after hospital discharge for heart failure (HF) may prevent 30-day hospital readmission, but adherence varies. The purpose of this study was to determine predictors of nonadherence to scheduled appointments.Methods and ResultsA medical record review included patients hospitalized for decompensated HF at 3 health system hospitals who had a scheduled 14-day office appointment. Patient demographics, and social, HF, and hospital factors were studied for association with appointment adherence. Multivariable modeling was used to determine the odds of missing scheduled appointments. Of 701 cases, mean (standard deviation) age was 73.5 (13.8) years, 46.4% were female and 38.9% were nonwhite. Appointment nonadherence was 16.2%. In multivariate analyses, 4 factors predicted missed appointments: drug use history (odds ratio [OR], 3.95; 95% confidence interval [CI], 1.70–9.20; P 
       
  • Sex-Specific Relations of Cardiovascular Risk Factors With Left
           Ventricular Diastolic Dysfunction/Heart Failure With Preserved Ejection
           Fraction Are Underreported: A Call for Action
    • Abstract: Publication date: June 2018Source: Journal of Cardiac Failure, Volume 24, Issue 6Author(s): Anouk L.M. Eikendal, Aisha Gohar, Frans H. Rutten, Michiel L. Bots, Yolande Appelman, Leonard Hofstra, Maarten Jan M. Cramer, Arno W. Hoes, Hester M. den Ruijter
       
  • Utility of Echocardiography in Heart Failure With Preserved Ejection
           Fraction
    • Abstract: Publication date: June 2018Source: Journal of Cardiac Failure, Volume 24, Issue 6Author(s): Bo Xu, Allan L. Klein
       
  • Echocardiographic Evaluation of Diastolic Function Is of Limited Value in
           the Diagnosis and Management of HFpEF
    • Abstract: Publication date: June 2018Source: Journal of Cardiac Failure, Volume 24, Issue 6Author(s): Gaurang Nandkishor Vaidya, Dmitry Abramov
       
  • Association of Serum Zinc Level With Prognosis in Patients With Heart
           Failure
    • Abstract: Publication date: June 2018Source: Journal of Cardiac Failure, Volume 24, Issue 6Author(s): Akiomi Yoshihisa, Satoshi Abe, Takatoyo Kiko, Yusuke Kimishima, Yu Sato, Shunsuke Watanabe, Yuki Kanno, Makiko Miyata-Tatsumi, Tomofumi Misaka, Takamasa Sato, Satoshi Suzuki, Masayoshi Oikawa, Atsushi Kobayashi, Takayoshi Yamaki, Hiroyuki Kunii, Kazuhiko Nakazato, Takafumi Ishida, Yasuchika Takeishi BackgroundZinc is an essential cofactor for energy transfer and physiological heart function, has antioxidant properties, and is involved in multiple signaling pathways. We aimed to investigate the associations between serum zinc levels with prognosis, as well as underlying cardiac function and exercise capacity, in patients with heart failure (HF).Methods and ResultsWe measured serum zinc levels in 968 consecutive hospitalized patients with decompensated HF, who were divided into 3 groups based on serum zinc levels (µg/dL): first (zinc ≥75, n = 323), second (62≤ zinc
       
  • Cardiac-Specific Overexpression of Oxytocin Receptor Leads to
           Cardiomyopathy in Mice
    • Abstract: Publication date: Available online 23 May 2018Source: Journal of Cardiac FailureAuthor(s): Christian Jung, Bernhard Wernly, Mikael Bjursell, John Wiseman, Therese Admyre, Johannes Wikström, Malin Palmér, Frank Seeliger, Michael Lichtenauer, Marcus Franz, Charlotte Frick, Ann-Katrin Andersson, Margareta Elg, John Pernow, Per-Ove Sjöquist, Mohammad Bohlooly-Y, Qing-Dong Wang BackgroundOxytocin (Oxt) and its receptor (Oxtr) gene system has been implicated in cardiomyogenesis and cardioprotection; however, effects of chronic activation of Oxtr are not known. We generated and investigated transgenic (TG) mice that overexpress Oxtr specifically in the heart.Methods and ResultsCardiac-specific overexpression of Oxtr was obtained by having the α-major histocompatibility complex promoter drive the mouse Oxtr gene (α-Mhc-Oxtr). Left ventricular (LV) function and remodeling were assessed by magnetic resonance imaging and echocardiography. In α-Mhc-Oxtr TG mice, LV ejection fraction was severely compromised at 14 weeks of age compared with wild-type (WT) littermates (25 ± 6% vs 63 ± 3%; P 
       
  • Peripheral Intravenous Volume Analysis (PIVA) for Quantitating Volume
           Overload in Patients Hospitalized With Acute Decompensated Heart
           Failure—A Pilot Study
    • Abstract: Publication date: Available online 16 May 2018Source: Journal of Cardiac FailureAuthor(s): Merrick Miles, Bret D. Alvis, Kyle Hocking, Franz Baudenbacher, Christy Guth, Joann Lindenfeld, Colleen Brophy, Susan Eagle BackgroundTo determine the feasibility of peripheral intravenous volume analysis (PIVA) of venous waveforms for assessing volume overload in patients admitted to the hospital with acute decompensated heart failure (ADHF).MethodsVenous waveforms were captured from a peripheral intravenous catheter in subjects admitted for ADHF and healthy age-matched controls. Admission PIVA signal, brain natriuretic peptide, and chest radiographic measurements were related to the net volume removed during diuresis.ResultsADHF patients had a significantly greater PIVA signal on admission compared with the control group (P = .0013, n = 18). At discharge, ADHF patients had a PIVA signal similar to the control group. PIVA signal, not brain natriuretic peptide or chest radiographic measures, accurately predicted the amount of volume removed during diuresis (R2 = 0.781, n = 14). PIVA signal at time of discharge greater than 0.20, demonstrated 83.3% 120-day readmission rate.ConclusionsThis study demonstrates the feasibility of PIVA for assessment of volume overload in patients admitted to the hospital with ADHF.
       
  • National Trends and Outcomes in Dialysis-Requiring Acute Kidney Injury in
           Heart Failure: 2002–2013
    • Abstract: Publication date: Available online 3 May 2018Source: Journal of Cardiac FailureAuthor(s): Ashish Correa, Achint Patel, Kinsuk Chauhan, Harshil Shah, Aparna Saha, Mihir Dave, Priti Poojary, Abhishek Mishra, Narender Annapureddy, Shaman Dalal, Ioannis Konstantinidis, Renu Nimma, Shiv Kumar Agarwal, Lili Chan, Girish Nadkarni, Sean Pinney BackgroundDialysis-requiring acute kidney injury (D-AKI) is a serious complication in hospitalized heart failure (HF) patients. However, data on national trends are lacking after 2002.MethodsWe used the Nationwide Inpatient Sample (2002–2013) to identify HF hospitalizations with and without D-AKI. We analyzed trends in incidence, in-hospital mortality, length of stay (LoS), and cost. We calculated adjusted odds ratios (aORs) for predictors of D-AKI and for outcomes including in-hospital mortality and adverse discharge (discharge to skilled nursing facilities, nursing homes, etc).ResultsWe identified 11,205,743 HF hospitalizations. Across 2002–2013, the incidence of D-AKI doubled from 0.51% to 1.09%. We found male sex, younger age, African-American and Hispanic race, and various comorbidities and procedures, such as sepsis and mechanical ventilation, to be independent predictors of D-AKI in HF hospitalizations. D-AKI was associated with higher odds of in-hospital mortality (aOR 2.49, 95% confidence interval [CI] 2.36–2.63; P 
       
  • Genetic Evaluation of Cardiomyopathy—A Heart Failure Society of
           America Practice Guideline
    • Abstract: Publication date: May 2018Source: Journal of Cardiac Failure, Volume 24, Issue 5Author(s): Ray E. Hershberger, Michael M. Givertz, Carolyn Y. Ho, Daniel P. Judge, Paul F. Kantor, Kim L. McBride, Ana Morales, Matthew R.G. Taylor, Matteo Vatta, Stephanie M. Ware This guideline describes the approach and expertise needed for the genetic evaluation of cardiomyopathy. First published in 2009 by the Heart Failure Society of America (HFSA), the guideline has now been updated in collaboration with the American College of Medical Genetics and Genomics (ACMG). The writing group, composed of cardiologists and genetics professionals with expertise in adult and pediatric cardiomyopathy, reflects the emergence and increased clinical activity devoted to cardiovascular genetic medicine. The genetic evaluation of cardiomyopathy is a rapidly emerging key clinical priority, because high-throughput sequencing is now feasible for clinical testing and conventional interventions can improve survival, reduce morbidity, and enhance quality of life. Moreover, specific interventions may be guided by genetic analysis. A systematic approach is recommended: always a comprehensive family history; an expert phenotypic evaluation of the proband and at-risk family members to confirm a diagnosis and guide genetic test selection and interpretation; referral to expert centers as needed; genetic testing, with pre- and post-test genetic counseling; and specific guidance as indicated for drug and device therapies. The evaluation of infants and children demands special expertise. The approach to managing secondary and incidental sequence findings as recommended by the ACMG is provided.
       
  • Updated Genetics Guidelines: An Important Step Forward
    • Abstract: Publication date: May 2018Source: Journal of Cardiac Failure, Volume 24, Issue 5Author(s): Paul J. Hauptman
       
  • Information for Authors
    • Abstract: Publication date: May 2018Source: Journal of Cardiac Failure, Volume 24, Issue 5Author(s):
       
  • Temporal Resolution Pattern of Myocardial Edema in Patients With Takotsubo
           Syndrome
    • Abstract: Publication date: May 2018Source: Journal of Cardiac Failure, Volume 24, Issue 5Author(s): Jorge Salamanca, Alberto Cecconi, Eduardo Pozo, Paula Antuña, Teresa Alvarado, Fernando Rivero, Luis Jesús Jiménez-Borreguero, Fernando Alfonso
       
  • Did Frédéric Chopin Die From Heart Failure'
    • Abstract: Publication date: May 2018Source: Journal of Cardiac Failure, Volume 24, Issue 5Author(s): Antonio Perciaccante, Philippe Charlier, Camilla Negri, Alessia Coralli, Otto Appenzeller, Raffaella Bianucci On October 17, 1849, Poland's greatest composer, Frédéric Chopin (1810–1849) died aged 39. His cause of death remains unknown. An investigation of the documental sources was performed to reconstruct the medical history of the artist. Since his earliest years, his life had been dominated by poor health. Recurrent episodes of cough, fever, headaches, lymphadenopathy- a series of symptoms that may be attributed to viral respiratory infections- manifested in his teens. Later in life, he had chest pain, hemoptysis, hematemesis, neuralgia, and arthralgia. Exhaustion and breathlessness characterized all his adult life. Coughing, choking, and edema of the legs and ankles manifested four months before his death. Several hypotheses ranging from cystic fibrosis to alpha-1 anti-trypsin deficiency and pulmonary tuberculosis have been proposed to explain Chopin's lifelong illness. We suggest that Chopin had dilated cardiomyopathy with consequent heart failure and cirrhosis that caused his death.
       
  • National Trends and Outcomes of Endomyocardial Biopsy for Patients With
           Myocarditis: From the National Inpatient Sample Database
    • Abstract: Publication date: May 2018Source: Journal of Cardiac Failure, Volume 24, Issue 5Author(s): Ayman Elbadawi, Islam Y. Elgendy, Le Dung Ha, Amgad Mentias, Gbolahan O. Ogunbayo, Muhammad Waqas Tahir, Nishit Biniwale, Odunayo Olorunfemi, Kirolos Barssoum, Maya Guglin BackgroundThe utility of endomyocardial biopsy (EMB) in the management of myocarditis in the era of advanced cardiac imaging has been challenged.Methods and ResultsThe Nationwide Inpatient Sample Database (years 1998–2013) was queried to identify hospitalization records with a primary diagnosis of myocarditis, and underwent EMB procedure. We identified 22,299 hospitalization records with a diagnosis of myocarditis during the study period. Of those, 798 (3.6%) underwent EMB procedures. There was an average decrease in the incidence of EMB for myocarditis by 0.15% (P 
       
  • The Mechanical Revolution
    • Abstract: Publication date: May 2018Source: Journal of Cardiac Failure, Volume 24, Issue 5Author(s): Esther Vorovich
       
  • Long-Term Mechanical Circulatory Support vs Heart Transplant: A
           Half-Century of Progress, but When Will the Tin Man Arrive'
    • Abstract: Publication date: May 2018Source: Journal of Cardiac Failure, Volume 24, Issue 5Author(s): James B. Young
       
  • Incident Hyperkalemia, Hypokalemia, and Clinical Outcomes During
           Spironolactone Treatment of Heart Failure With Preserved Ejection
           Fraction: Analysis of the TOPCAT Trial
    • Abstract: Publication date: May 2018Source: Journal of Cardiac Failure, Volume 24, Issue 5Author(s): Akshay S. Desai, Jiankang Liu, Marc A. Pfeffer, Brian Claggett, Jerome Fleg, Eldrin F. Lewis, Sonja McKinlay, Eileen O'Meara, Sanjiv J. Shah, Nancy K. Sweitzer, Scott Solomon, Bertram Pitt BackgroundIn patients with heart failure and preserved ejection fraction (HF-PEF) randomized in the Americas as part of the Treatment of Preserved Cardiac Function Heart Failure with an Aldosterone Antagonist (TOPCAT) trial, treatment with spironolactone enhanced the risk of hyperkalemia but reduced the risk of hypokalemia. We examined the clinical correlates and prognostic implications of incident hypo- and hyperkalemia during study follow-up.MethodsWe defined the region-specific incidence of hypokalemia (potassium [K+]
       
  • Early Recognition of Heart Failure: A Call for Action
    • Abstract: Publication date: May 2018Source: Journal of Cardiac Failure, Volume 24, Issue 5Author(s): Jalal K. Ghali
       
  • Heart Failure With Recovered Ejection Fraction in African Americans:
           Results From the African-American Heart Failure Trial
    • Abstract: Publication date: May 2018Source: Journal of Cardiac Failure, Volume 24, Issue 5Author(s): Kay-Won Chang, Neil Beri, Nghia H. Nguyen, Boris Arbit, Sutton Fox, Sean Mojaver, Paul Clopton, S. William Tam, Anne L. Taylor, Jay N. Cohn, Alan S. Maisel, Inder S. Anand BackgroundRecent studies have described the entity of heart failure with recovered ejection fraction (HFrecEF), but population-specific studies remain lacking. The aim of this study was to characterize patients enrolled in the African-American Heart Failure Trial (A-HeFT) who had significant improvement in their ejection fraction (EF) during the 1st 6 months of follow-up.Methods and ResultsSubjects with HFrecEF (improvement in EF from 40% in 6 months; n = 59) were compared with 259 subjects with heart failure and persistently reduced EF (HFrEF), defined as EF ≤40% at 6-month follow-up. The effects of improvement in EF on all-cause mortality and 1st and all hospitalizations were analyzed. Compared with HFrEF, subjects with HFrecEF had a nonsignificant trend toward lower mortality (hazard ratio [HR] 0.16, 95% confidence interval [CI] 0.02–1.15; P = .068), fewer 1st HF hospitalizations (HR 0.22, 95% CI 0.07–0.71; P = .011), fewer recurrent HF hospitalizations (HR 0.13, 95% CI 0.05–0.37; P 
       
  • Cost-Effectiveness Benefits of a Disease Management Program:The REMADHE
           Trial Results
    • Abstract: Publication date: Available online 30 April 2018Source: Journal of Cardiac FailureAuthor(s): Edimar Alcides Bocchi, Fátima das Dores da Cruz, Sara Michelly Brandão, Victor Issa, Silvia Moreira Ayub-Ferreira, Hans-Peter Brunner la Rocca, Sandra Sanders–van Wijk BackgroundPublished studies have generated mixed, controversial results regarding the cost-effectiveness of heart failure disease management programs (HF-DMPs). This study assessed the cost-effectiveness of an HF-DMP in ambulatory patients compared with usual care (UC).MethodsIn the prospective randomized REMADHE trial, we evaluated incremental costs per quality-adjusted life-year (QALY) and life-year (LY) gained as effectiveness ratios (ICERs) over a study period of 2.47 ± 1.75years.ResultsThe REMADHE HF-DMP was more effective and less costly than UC in terms of both QALYs and LYs (95% and 55% chance of dominance, respectively). Average saving was US$7345 (2.5%–97.5% bootstrapped confidence interval −16,573 to +921). The chance of DMP being cost-effective at a willingness to pay US$10,000 per QALY or LY was 99% and 96%, respectively. Cost-effectiveness of HF-DMP was highest in subgroups with left ventricular ejection fraction 50years, male sex, New York Heart Association (NYHA) functional class ≥III, and ischemic etiology. The chance of DMP being cost-effective at a willingness to pay US$10,000 per QALY was ≥90% in all subgroups apart from NYHA functional class I–II, where it was 70%. Even when the intervention costs increased by 500% or when excluding outliers in costs, DMP had a high chance of being cost-effective (87%–99%).ConclusionsThe HF-DMP of the REMADHE trial, which encompasses long-term repeated education alongside telephone monitoring, has a high probability of being cost-effective in ambulatory patients with HF.
       
  • Subclinical Volume Overload Across the Spectrum of Heart Failure: Lessons
           From Total Blood Volume Measurements
    • Abstract: Publication date: Available online 26 April 2018Source: Journal of Cardiac FailureAuthor(s): Brendan J. Carry, Stuart D. Katz
       
  • Assessment of Thoracic Blood Volume by Computerized Tomography in Patients
           With Heart Failure and Periodic Breathing
    • Abstract: Publication date: Available online 17 April 2018Source: Journal of Cardiac FailureAuthor(s): Caitlin C. Jorgenson, Steven C. Chase, Lyle J. Olson, Bruce D. Johnson BackgroundPeriodic breathing (PB) is often observed in patients with HF at rest, with sleep and during exercise. However, mechanisms underlying abnormal ventilatory control are not entirely established.MethodsEleven subjects with HF (10 males, age = 69 ± 12 y) and 12 age-matched control subjects (8 males, age = 65 ± 9 y) participated in the study. PB was defined as a peak in the 0.003–0.04 Hz frequency range of the flow signal during 6 minutes of awake resting breathing. Thoracic blood volumes (Vt, thorax; Vh, heart; Vp, pulmonary), mean transit times (MTTs), and extravascular lung water (EVLW) were quantified using computerized tomography.ResultsPB was observed in 7 subjects with HF and was associated with worse functional status. The HF PB-present group had thoracic blood volumes nearly double those of control and HF PB-absent subjects (volumes reported as mL/m2 body surface area, P values vs control: control = 813 ± 246, HF PB-absent = 822 ± 161 P = .981, HF PB-present = 1579 ± 548 P = .002). PB was associated with longer pulmonary MTT (control = 6.7 ± 1.2s, HF PB-absent = 6.0 ± 0.8s, HF PB-present = 8.4 ± 1.6 s; P = .033, HF PB-present vs HF PB-absent). EVLW was not elevated in the PB group.ConclusionsSubjects with HF and PB at rest have greater centralization of blood volume.
       
  • Heart Failure Symptoms and Ecological Factors as Predictors of Chagas
           Disease Among Indigenous Communities in the Sierra Nevada de Santa Marta,
           Colombia
    • Abstract: Publication date: Available online 27 March 2018Source: Journal of Cardiac FailureAuthor(s): Gabriel Parra-Henao, Elise Amioka, Carlos Franco-Paredes, Kathryn L. Colborn, Andrés F. Henao-Martínez
       
  • Prognostic Impact of Pulmonary Artery Pulsatility Index (PAPi) in Patients
           With Advanced Heart Failure: Insights From the ESCAPE Trial
    • Abstract: Publication date: Available online 27 March 2018Source: Journal of Cardiac FailureAuthor(s): Stephanie Meller Kochav, Raul J. Flores, Lauren K. Truby, Veli K. Topkara BackgroundThe pulmonary artery pulsatility index (PAPi), defined as the ratio of pulmonary artery pulse pressure to right atrial pressure, emerged as a powerful predictor of right ventricular (RV) failure in patients with acute inferior myocardial infarction and those undergoing left ventricular assist device placement; however, its prognostic utility in the advanced heart failure population remains largely unknown.Methods and ResultsWe comparatively analyzed PAPi with traditional indices of RV function including RV stroke work index and right atrial/pulmonary capillary wedge pressure ratio (RAP/PCWP) in the Evaluation Study of Congestive Heart Failure and Pulmonary Artery Catheterization Effectiveness trial. Median PAPi score was 2.35 in 190 patients. PAPi was significantly associated with clinical (jugular venous distention, ascites, edema), echocardiographic (right atrial size, vena cava size, tricuspid regurgitation velocity), and hemodynamic signs of RV failure (RAP, PCWP); all P 
       
  • Determinants of Diuretic Responsiveness and Associated Outcomes During
           Acute Heart Failure Hospitalization: An Analysis From the NHLBI Heart
           Failure Network Clinical Trials
    • Abstract: Publication date: Available online 1 March 2018Source: Journal of Cardiac FailureAuthor(s): Michael S. Kiernan, Susanna R. Stevens, W.H. Wilson Tang, Javed Butler, Kevin J. Anstrom, Edo Y. Birati, Justin L. Grodin, Divya Gupta, Kenneth B. Margulies, Shane LaRue, Victor G. Dávila-Román, Adrian F. Hernandez, Lisa de las Fuentes, NHLBI Heart Failure Clinical Trials Network Investigators BackgroundPoor response to loop diuretic therapy is a marker of risk during heart failure hospitalization. We sought to describe baseline determinants of diuretic response and to further explore the relationship between this response and clinical outcomes.Methods and ResultsPatient data from the National Heart, Lung, and Blood Institute Heart Failure Network ROSE-AHF and CARRESS-HF clinical trials were analyzed to determine baseline determinants of diuretic response. Diuretic efficiency (DE) was defined as total 72-hour fluid output per total equivalent loop diuretic dose. Data from DOSE-AHF was then used to determine if these predictors of DE correlated with response to a high- versus low-dose diuretic strategy. At 72hours, the high-DE group had median fluid output of 9071ml (interquartile range: 7240–11775) with median furosemide dose of 320mg (220–480) compared with 8030ml (6300–9915) and 840mg (600–1215) respectively for the low DE group. Cystatin C was independently associated with DE (odds ratio 0.36 per 1mg/L increase; 95% confidence interval: 0.24–0.56; P < 0.001). Independently from baseline characteristics, reduced fluid output, weight loss and DE were each associated with increased 60day mortality. Among patients with estimated glomerular filtration rate below the median, those randomized to a high-dose strategy had improved symptoms compared with those randomized to a low-dose strategy.ConclusionsElevated baseline cystatin C, as a biomarker of renal dysfunction, is associated with reduced diuretic response during heart failure hospitalization. Higher loop diuretic doses are required for therapeutic decongestion in patients with renal insufficiency. Poor response identifies a high-risk population.
       
  • Clinical Significance of Early Fluid and Weight Change During Acute Heart
           Failure Hospitalization
    • Abstract: Publication date: Available online 11 January 2018Source: Journal of Cardiac FailureAuthor(s): John D. Groarke, Susanna R. Stevens, Robert J. Mentz, Lauren B. Cooper, Justin M. Vader, Omar F. AbouEzzeddine, Justin L. Grodin, Emer Joyce, Kevin J. Anstrom, G. Michael Felker, Margaret M. Redfield, Lynne Warner Stevenson, Anuradha Lala AimsTo explore the association of changes in weight and fluid during treatment for acute heart failure (AHF) with clinical endpoints.Methods and ResultsWeight and net fluid changes recorded at 72–96hours in 708 AHF patients enrolled in Diuretic Optimization Strategy Evaluation in Acute Decompensated Heart Failure, Cardiorenal Rescue Study in Acute Decompensated Heart Failure, and Renal Optimization Strategies Evaluation in Acute Heart Failure studies were compared with freedom from congestion at 72–96hours and a composite endpoint of death, rehospitalization, and unplanned hospital visit at 60days. Weight loss was concordant with net fluid loss in 55%, discordant and less than expected for fluid loss in 34%, and paradoxically discordant or more than expected for fluid loss in 11% of patients. Weight loss, but not fluid loss, was associated with freedom from congestion (odds ratio per 1-kg weight loss = 1.11 [1.03–1.19]) and a nominal reduction in the composite endpoint (hazard ratio per 1-kg weight loss = 0.98 [0.95–1.00]). Outcomes were similar in patients with concordant and discordant weight-fluid loss.ConclusionDuring treatment for AHF, early changes in weight may be more useful for identifying response to therapy and for predicting outcomes than net fluid output. Nearly one-half of patients receiving decongestive therapies demonstrate discordant changes in weight and fluid; however, discordance was not associated with outcomes.
       
 
JournalTOCs
School of Mathematical and Computer Sciences
Heriot-Watt University
Edinburgh, EH14 4AS, UK
Email: journaltocs@hw.ac.uk
Tel: +00 44 (0)131 4513762
 


Your IP address: 3.230.76.196
 
Home (Search)
API
About JournalTOCs
News (blog, publications)
JournalTOCs on Twitter   JournalTOCs on Facebook

JournalTOCs © 2009-