Treatment Patterns and Clinical Outcomes Among Patients <65 Years with a Worsening Heart Failure Event

2021 ◽  
Author(s):  
Javed Butler ◽  
Mei Yang ◽  
Baanie Sawhney ◽  
Sreya Chakladar ◽  
Lingfeng Yang ◽  
...  
Keyword(s):  
Heart Failure ◽  
Clinical Outcomes ◽  
Treatment Patterns ◽  
Heart Failure Event ◽  
Failure Event

scholarly journals Clinical Outcomes and Response to Vericiguat According to Index Heart Failure Event

2020 ◽  
Author(s):  
Carolyn S. P. Lam ◽  
Anna Giczewska ◽  
Karen Sliwa ◽  
Frank Edelmann ◽  
Jens Refsgaard ◽  
...  
Keyword(s):  
Heart Failure ◽  
Clinical Outcomes ◽  
Heart Failure Event ◽  
Failure Event

Clinical Trajectory of Patients with a Worsening Heart Failure Event and Reduced Ventricular Ejection Fraction

2021 ◽  
Author(s):  
Anthony P Carnicelli ◽  
Robert M. Clare ◽  
Paul Hofmann ◽  
Karen Chiswell ◽  
Adam D. DeVore ◽  
...  
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Ventricular Ejection ◽  
Ventricular Ejection Fraction ◽  
Heart Failure Event ◽  
Failure Event

scholarly journals Left Ventricular Enlargement, Cardiac Resynchronization Therapy Efficacy, and Impact of MultiPoint Pacing

2020 ◽  
Vol 13 (11) ◽  
Author(s):  
Niraj Varma ◽  
James Baker ◽  
Gery Tomassoni ◽  
Charles J. Love ◽  
David Martin ◽  
...  
Keyword(s):  
Heart Failure ◽  
Left Ventricular ◽  
Single Site ◽  
Composite Score ◽  
Cardiac Resynchronization ◽  
Resynchronization Therapy ◽  
Heart Failure Event ◽  
Therapy Efficacy ◽  
Failure Event

Background: Left ventricular (LV) epicardial pacing results in slowly propagating paced wavefronts. We postulated that this effect might limit cardiac resynchronization therapy efficacy in patients with LV enlargement using conventional biventricular pacing with single-site LV pacing, but be mitigated by LV stimulation from 2 widely spaced sites using MultiPoint pacing with wide anatomic separation (MPP-AS: ≥30 mm). We tested this hypothesis in the multicenter randomized MPP investigational device exemption trial. Methods: Following implant, quadripolar biventricular single-site pacing was activated in all patients (n=506). From 3 to 9 months postimplant, among patients with available baseline LV end-diastolic volume (LVEDV) measures, 188 received biventricular single-site pacing and 43 received MPP-AS. Patients were dichotomized by median baseline LVEDV indexed to height (LVEDVI Median ). Outcomes were measured by the clinical composite score (primary efficacy end point), quality of life, LV structural remodeling (↑EF >5% and ↓ESV 10%) and heart failure event/cardiovascular death. Results: LVEDVI Median was 1.1 mL/cm. Baseline characteristics differed in patients with LVEDVI >Median versus LVEDVI ≤Median . Among patients with LVEDVI >Median , biventricular single-site pacing was less efficacious compared to patients with LVEDVI ≤Median (clinical composite score, 65% versus 79%). In contrast, MPP-AS programming generated greater clinical composite score response (92% versus 65%, P =0.023) and improved quality of life (−31.0±29.7 versus −15.7±22.1, P =0.038) versus biventricular single-site pacing in patients with LVEDVI >Median . Reverse remodeling trended better with MPP-AS programming. In patients with LVEDVI >Median , heart failure event rate increased following the 3-month randomization point with biventricular single-site pacing (0.0150±0.1725 in LVEDVI >Median versus −0.0190±0.0808 in LVEDVI ≤Median , P =0.012), but no heart failure event occurred in patients with MPP-AS programming between 3 and 9 months in LVEDVI >Median . All measured outcomes did not differ in patients receiving MPP-AS and biventricular single-site pacing with LVEDVI ≤Median . Conclusions: Conventional biventricular single-site pacing, even with a quadripolar lead, has reduced efficacy in patients with LV enlargement. However, the greatest response rate in patients with larger hearts was observed when programmed to MPP-AS pacing.

scholarly journals Heart failure event definitions in drug trials in patients with type 2 diabetes

2016 ◽  
Vol 4 (4) ◽  
pp. 294-296 ◽  
Author(s):  
Abhinav Sharma ◽  
Deepak L Bhatt ◽  
Gonzalo Calvo ◽  
Nancy J Brown ◽  
Faiez Zannad ◽  
...  
Keyword(s):  
Heart Failure ◽  
Type 2 Diabetes ◽  
Drug Trials ◽  
Heart Failure Event ◽  
Failure Event

scholarly journals Readmission and death after an acute heart failure event: predictors and outcomes in sub-Saharan Africa: results from the THESUS-HF registry

2013 ◽  
Vol 34 (40) ◽  
pp. 3151-3159 ◽  
Author(s):  
K. Sliwa ◽  
B. A. Davison ◽  
B. M. Mayosi ◽  
A. Damasceno ◽  
M. Sani ◽  
...  
Keyword(s):  
Heart Failure ◽  
Acute Heart Failure ◽  
Sub Saharan Africa ◽  
Heart Failure Event ◽  
Failure Event ◽  
Sub Saharan

scholarly journals Incidence and predictors of 6 months mortality after an acute heart failure event in rural Uganda: The Mbarara Heart Failure Registry (MAHFER)

2018 ◽  
Vol 264 ◽  
pp. 113-117 ◽  
Author(s):  
Fardous Charles Abeya ◽  
Boniface Amanee Elias Lumori ◽  
Suzan Joan Akello ◽  
Brian H. Annex ◽  
Andrew J. Buda ◽  
...  
Keyword(s):  
Heart Failure ◽  
Acute Heart Failure ◽  
Heart Failure Event ◽  
Failure Event

Abstract 15903: Pulmonary Arterial Pressure During Recovery From Exercise Predicts Outcomes in Patients Undergoing Evaluation for Dyspnea

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
David S Olshan ◽  
Rohan Bhat ◽  
Robyn Farrell ◽  
Mark Schoenike ◽  
Liana Brooks ◽  
...  
Keyword(s):  
Heart Failure ◽  
Arterial Pressure ◽  
Pulmonary Arterial Pressure ◽  
Peak Exercise ◽  
Event Free Survival ◽  
Free Survival ◽  
Heart Failure Event ◽  
Failure Event ◽  
Pulmonary Arterial ◽  
Hemodynamic Measurements

Introduction: The post-exercise recovery period poses advantages over the within-exercise period for acquisition of hemodynamic measurements because of attenuated respirophasic changes, ability to time measurements precisely relative to peak exercise, and increased feasibility of multi-modality data acquisition (i.e. echocardiographic imaging). While several studies have linked rest and exercise hemodynamic measurements to outcomes, the prognostic significance of recovery hemodynamics in patients with dyspnea on exertion remains unknown. Hypothesis: Impaired recovery of mean pulmonary arterial pressure (mPAP) following exercise predicts poor clinical outcomes. Methods: Upright incremental ramp cycle ergometry cardiopulmonary exercise testing with invasive hemodynamic monitoring was performed in patients referred for evaluation of exertional dyspnea. mPAP was obtained at rest, peak exercise, and at two-minutes following peak exercise. In addition, maximum workload was recorded for each patient. mPAP elevation at recovery versus baseline, indexed to peak workload, was determined. Cox regression was performed using the primary outcome of heart failure event-free survival. Results: Among 272 patients with dyspnea on exertion and preserved LVEF [age 61 (IQR 49 – 70), 47% male, BMI 29 kg/m 2 (25 – 34), exercise duration 8.1 minutes (6.9 – 9.2), peak workload 91 watts (71 – 121)] we observed an increase in mPAP from 17 (14– 20) to 33 (28 – 41) mmHg with a fall in mPAP to 22 (18 – 29) at 2 minutes of recovery. Median mPAP elevation at recovery versus baseline mPAP, indexed to peak workload, was 0.057 (0.031 – 0.101) mmHg/W. Persistently elevated mPAP, indexed to peak workload, was associated with future risk of HF hospitalization or death both in unadjusted analysis (Cox hazard ratio 1.53 for every standard deviation increase, p=0.003), and when adjusted for age, sex, and BMI (HR 1.40, p=0.025). Conclusions: Among patients with dyspnea on exertion undergoing invasive hemodynamic evaluation during exercise, persistently elevated mPAP following exercise predicts future heart failure event-free survival and may be more feasible to estimate non-invasively than measures obtained at peak exercise.

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