scholarly journals Prognostic impact over time of ischaemic heart disease vs. non‐ischaemic heart disease in heart failure

2020 ◽  
Vol 7 (1) ◽  
pp. 265-274
Author(s):  
Jonas Silverdal ◽  
Helen Sjöland ◽  
Entela Bollano ◽  
Aldina Pivodic ◽  
Ulf Dahlström ◽  
...  
Keyword(s):  
Heart Failure ◽  
Heart Disease ◽  
Ischaemic Heart Disease ◽  
Prognostic Impact ◽  
Over Time

P6340Mortality and prognostic factors in dilated cardiomyopathy versus ischaemic heart disease in patients with heart failure with reduced ejection fraction - a Swedish population-based study

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
J Silverdal ◽  
E Bollano ◽  
H Sjoland ◽  
A Pivodic ◽  
U Dahlstrom ◽  
...  
Keyword(s):  
Heart Failure ◽  
Heart Disease ◽  
Ejection Fraction ◽  
Dilated Cardiomyopathy ◽  
Ischaemic Heart Disease ◽  
Age Groups ◽  
Reduced Ejection Fraction ◽  
Probability Of Survival ◽  
Patients With Heart Failure ◽  
Over Time

Abstract Background In heart failure with left ventricular ejection fraction reduction <40% (HFrEF) the increased mortality in patients with underlying ischaemic heart disease (IHD) compared to multi-aetiological non-ischaemic HFrEF is established. The prognostic difference over time in comparison with dilated cardiomyopathy (DCM) is less clear. Purpose To evaluate the difference in mortality between IHD and DCM in HFrEF, overall, in specific subgroups and over time. Methods By applying multivariable Cox regression analyses on Swedish Heart Failure Registry data from the years 2000 to 2012 (including 51,060 patients), the incidence of mortality in 8,982 patients with non-valvular clinical IHD-HFrEF was compared to 2,220 patients with DCM-HFrEF overall and for subgrouping variables of age category, sex and EF group (<30% and 30–39%), adjusted for additional 23 baseline variables. Results The overall mortality was higher in IHD-HFrEF with the crude mortality of 42.1% and the event rate 15.4 (95% confidence interval [CI]: 14.9 - 15.9) per 100 person years compared with 19.4% and 5.5 (95% CI: 5.0–6.1) in DCM-HFrEF. The probability of survival in IHD-HFrEF was lower than in DCM-HFrEF (Figure). After multivariable adjustment the risk for mortality in IHD-HFrEF remained increased with a hazard ratio (HR) of 1.34 (95% CI: 1.18–1.50). The adjusted HR was higher in all groups of age <80 years and in both sexes, with a significantly higher risk in women than in men (HR 1.85 vs 1.22, p for interaction = 0.002). Overall, HR was increased regardless of EF group but analyses by both age group and EF group revealed significantly increased mortality in EF <30% only for age groups <80 years. No significant temporal trend was seen between IHD-HFrEF and DCM-HFrEF. Probability of survival Conclusions In patients with heart failure and reduced ejection fraction, ischaemic heart disease compared to dilated cardiomyopathy was associated with increased mortality in all age groups below 80 years of age, throughout the 13-year study period. Acknowledgement/Funding The Swedish Heart-Lung Foundation. The regional ALF agreement between Västra Götalandsregionen and University of Gothenburg (ALFGBG-72196, prof.Fu)

Abstract 693: Right Ventricular Dilation in Patients with Mild and Moderate Heart Failure: Implications in Morbidity and Mortality

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Christos V Bourantas ◽  
Huan P Loh ◽  
Alan S Rigby ◽  
Thanjuvar Bragadeesh ◽  
Elena I Lukaschuk ◽  
...  
Keyword(s):  
Heart Failure ◽  
Heart Disease ◽  
Right Ventricular ◽  
Ischaemic Heart Disease ◽  
Cox Regression ◽  
Normal Subjects ◽  
Left Ventricular ◽  
Common Finding ◽  
Prognostic Impact ◽  
Moderate Heart Failure

Objectives: To investigate the prognostic impact of right ventricular (RV) morphology in patients with mild and moderate heart failure. Methods: 80 normal subjects and 401 consecutive patients with left ventricular (LV) ejection fraction (EF)< 45%, on optimal treatment, underwent cardiac magnetic resonance imaging (C-MRI). The LV and the RV borders were detected from the short axis contiguous slices and drawn manually. Body surface area was used to index (I) the LV and RV mass (M) and volumes (V) measured at end-diastole (ED) and end-systole (ES). The indexed volumes were then used to calculate the LV and RV EF. RV dilatation was defined as mean RVESVI+2*SD in normal subjects. Results: 21 patients had incomplete data and excluded from the analysis. The median age for the remaining patients was 71 years and 86% were men. 77% had ischaemic heart disease and 78% had NYHA I/II breathlessness. The median LVEF was 33% and the RVEF 43%. 286 (75%) patients had normal and 94 (25%) dilated RV. Patients with RV dilation were more often male (92% vs. 84%, p=0.036), had lower systolic blood pressure (120mmHg vs. 129mmHg, p=0.003), and were more likely to have NYHA breathlessness III/IV (30% vs. 18%, p=0.006). Patients with normal RV had higher LVEF (34% vs. 31%, p=0.015), smaller LVEDVI (115ml/m 2 vs. 137ml/m 2 , p<0.0001) and LVESVI (77ml/m 2 vs. 92ml/m 2 , p<0.0001) and were more likely to tolerate β-blockers (91% vs. 74%, p=0.002). Patients were followed up for 45±22months. During that time, there were no significant differences between the two groups regarding the reasons for admissions and the time that they spent to the hospital. Within that time 108 patients died [35 (37%) with dilated and 69 (24%) with normal RV; log-rank=8.404, p=0.004]. In multivariable Cox regression model, including 15 variables only increasing RVESVI (HR: 1.009, 95%CI: 1.000–1.017; p=0.043), the presence of ischaemic heart disease (HR: 2.186, 95%CI: 1.049–4.557; p=0.037) and the presence of peripheral vascular disease (HR: 1.674, 95%CI: 1.036–2.705; p=0.037) were independent predictors of mortality but not LVESVI. Conclusions: RV dilation is a common finding in patients with mild and moderate heart failure and is associated with worse prognosis.

scholarly journals Incidence of atrial fibrillation, ischaemic heart disease and heart failure in patients with diabetes

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Amy Groenewegen ◽  
Victor W. Zwartkruis ◽  
Betül Cekic ◽  
Rudolf. A. de Boer ◽  
Michiel Rienstra ◽  
...  
Keyword(s):  
Heart Failure ◽  
Atrial Fibrillation ◽  
Heart Disease ◽  
Ischaemic Heart Disease ◽  
Incidence Rate ◽  
Diabetes Status ◽  
Increased Risk ◽  
Patients With Diabetes ◽  
Rate Ratios ◽  
Age And Sex

Abstract Background Diabetes has strongly been linked to atrial fibrillation, ischaemic heart disease and heart failure. The epidemiology of these cardiovascular diseases is changing, however, due to changes in prevalence of obesity-related conditions and preventive measures. Recent population studies on incidence of atrial fibrillation, ischaemic heart disease and heart failure in patients with diabetes are needed. Methods A dynamic longitudinal cohort study was performed using primary care databases of the Julius General Practitioners’ Network. Diabetes status was determined at baseline (1 January 2014 or upon entering the cohort) and participants were followed-up for atrial fibrillation, ischaemic heart disease and heart failure until 1 February 2019. Age and sex-specific incidence and incidence rate ratios were calculated. Results Mean follow-up was 4.2 years, 12,168 patients were included in the diabetes group, and 130,143 individuals in the background group. Incidence rate ratios, adjusted for age and sex, were 1.17 (95% confidence interval 1.06–1.30) for atrial fibrillation, 1.66 (1.55–1.83) for ischaemic heart disease, and 2.36 (2.10–2.64) for heart failure. Overall, incidence rate ratios were highest in the younger age categories, converging thereafter. Conclusion There is a clear association between diabetes and incidence of the major chronic progressive heart diseases, notably with heart failure with a more than twice increased risk.

Drugs and pacemakers for complete heart block

1967 ◽  
Vol 5 (5) ◽  
pp. 19-20
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Heart Rate ◽  
Heart Disease ◽  
Ischaemic Heart Disease ◽  
Heart Block ◽  
Complete Heart Block ◽  
Bundle Of His

Complete heart block can occur in ischaemic heart disease, and can acutely complicate myocardial infarction. Most other cases are associated with fibrosis of the bundle of His of unknown cause, or are congenital. In some patients with chronic heart block, especially the congenital type, adequate output is maintained. In other patients chronic or intermittent heart block may cause Stokes-Adams attacks, or heart failure may not respond to digitalis and diuretics until the heart rate is increased. These require treatment by drugs or, when this fails, by use of anartifical pacemaker.

scholarly journals Validation of an echocardiographic wall motion index in heart failure due to ischaemic heart disease

2001 ◽  
Vol 3 (6) ◽  
pp. 731-737 ◽  
Author(s):  
J.H. McGowan ◽  
W. Martin ◽  
M.I. Burgess ◽  
G. McCurrach ◽  
S.G. Ray ◽  
...  
Keyword(s):  
Heart Failure ◽  
Heart Disease ◽  
Ischaemic Heart Disease ◽  
Wall Motion

Abstract P205: Comorbities Predict Future Hospitalization Risk in Incident Myocardial Infarction Survivors

2011 ◽  
Vol 4 (suppl_2) ◽  
Author(s):  
Shannon M Dunlay ◽  
Susan Weston ◽  
Jill M Killian ◽  
Allan S Jaffe ◽  
Malcolm R Bell ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Heart Disease ◽  
Primary Reason ◽  
Olmsted County ◽  
St Segment ◽  
Repeated Events ◽  
St Elevation ◽  
Over Time

Background: Patients are surviving longer after myocardial infarction (MI), but little is known about the occurrence and predictors of subsequent hospitalizations. Methods: We identified all Olmsted Count residents with incident MI from 1987-2008 and evaluated Olmsted County hospitalizations through 2009. ICD-9 codes were used to determine the primary reason for hospitalization. To account for repeated events, Andersen-Gill models were used to examine the predictors of hospitalization post-MI. Patients were censored at death or last follow-up. Results: A total of 2617 patients (mean 67 years, 41% female, 32% with ST-elevation MI) were diagnosed with incident MI from 1987-2007 and survived MI hospitalization. Over a mean follow-up of 7.1 years, 10116 hospitalizations occurred equating to a median of 3 (range 0 to 43) per person. Only 37.5% (n=3793) of hospitalizations were due to cardiovascular causes, and of these, most were due to ischemic heart disease (n= 1865, 49.2%) and heart failure (n= 733, 19.3%). The proportion of non-cardiovascular hospitalizations increased over time and was higher in women than men, but did not differ by ST-segment status. Several factors were associated with the risk of hospitalization after adjusting for year of diagnosis and sex (Figure). Biomarker levels were not predictors of hospitalization risk. Conclusions: Two-thirds of hospitalizations among incident MI survivors in the community are for non-cardiovascular reasons, and this proportion has increased. Comorbidities are important predictors of recurrent hospitalizations. Therapies focused solely on MI management may be insufficient to prevent the majority of future admissions.

scholarly journals Association between plasma B-type natriuretic peptide and anaemia in heart failure with or without ischaemic heart disease: a retrospective study

BMJ Open ◽  
2019 ◽  
Vol 9 (3) ◽  
pp. e024194 ◽  
Author(s):  
Mitsutoshi Tominaga ◽  
Makoto Kawai ◽  
Kosuke Minai ◽  
Kazuo Ogawa ◽  
Yasunori Inoue ◽  
...  
Keyword(s):  
Heart Failure ◽  
Heart Disease ◽  
Retrospective Study ◽  
Ischaemic Heart Disease ◽  
Natriuretic Peptide ◽  
Left Ventricular ◽  
Path Model ◽  
Adverse Impact ◽  
Left Ventricular Ejection ◽  
Secondary Outcome

ObjectivesAnaemia is a risk of worsening heart failure. However, anaemia sometimes remains undetected because the superficial cardiac function does not precisely reflect the adverse impact of anaemia. Plasma B-type natriuretic peptide (BNP) could be helpful in these cases. However, the direct anaemic effects on BNP remain unknown. Herein, we compared the direct effect of anaemia on BNP and left ventricular ejection fraction (LVEF) using an advanced statistical procedure.DesignA retrospective study.SettingSecondary care (cardiology), single-centre study.ParticipantsThe study consisted of 3756 inpatients, including 684 without ischaemic heart disease (IHD) and 3072 with IHD.Primary and secondary outcome measuresRelationship between plasma BNP levels and LVEF values.ResultsA path model was constructed to simultaneously examine the adverse impact of anaemia on LVEF and plasma BNP, allowing for renal function. The path model revealed that LVEF increased in response to low haemoglobin (Hb), and the phenomenon was prominent in non-IHD (standardised regression coefficients (St.β): −0.264, p<0.001) rather than in IHD (St.β: 0.015, p=0.531). However, the response of BNP was commonly observed in both groups (non-IHD St.β: −0.238, IHD St.β: −0.398, p<0.001, respectively). Additionally, this study showed a direct link between low estimated glomerular filtration rate and high BNP independently of LVEF. Incrementally, Bayesian structural equation modelling in covariance structure analysis clearly supported this result. The scatter plots and simple regression analysis revealed that an adequate blood supply was approximately Hb 110 g/L and over in the non-IHD patients, whereas blood was not supplied in sufficient quantities even by Hb 130 g/L in patients with IHD.ConclusionThe current study demonstrated that anaemia was a substantial risk for worsening cardiac overload as estimated by plasma BNP. The anaemic response of LVEF likely changed depending on underlying cardiac disorders (IHD or not). However, the response of BNP was robustly observed.

Is isosorbide mononitrate better than the dinitrate?

1984 ◽  
Vol 22 (2) ◽  
pp. 7-8
Keyword(s):  
Heart Failure ◽  
Heart Disease ◽  
Ischaemic Heart Disease ◽  
Isosorbide Dinitrate ◽  
Slow Release ◽  
Haemodynamic Effects ◽  
Isosorbide Mononitrate ◽  
Better Than

Similar oral preparations of isosorbide mononitrate have recently been marketed by four unrelated companies. This is unusual but understandable for an unpatentable drug of promise. Like other nitrates this drug has anti-anginal and haemodynamic effects of value in the treatment of ischaemic heart disease and heart failure. The manufacturers claim that its 100% bioavailability should make it more effective, longer acting and more acceptable than slow-release isosorbide dinitrate (ISDN).

P5672Prognostic impact of ischemic heart disease in heart failure, and its trend over time

2018 ◽  
Vol 39 (suppl_1) ◽  
Author(s):  
J Silverdal ◽  
H Sjoland ◽  
E Bollano ◽  
A Pivodic ◽  
U Dahlstrom ◽  
...  
Keyword(s):  
Heart Failure ◽  
Heart Disease ◽  
Ischemic Heart Disease ◽  
Ischemic Heart ◽  
Over Time
Sign in / Sign up

Export Citation Format

Share Document