scholarly journals Iron status and inflammatory biomarkers in patients with acutely decompensated heart failure: early in-hospital phase and 30-day follow-up

2017 ◽  
Vol 19 (8) ◽  
pp. 1075-1076 ◽  
Author(s):  
Lucas N.L. Van Aelst ◽  
Marjorie Abraham ◽  
Malha Sadoune ◽  
Thibaud Lefebvre ◽  
Philippe Manivet ◽  
...  
Keyword(s):  
Heart Failure ◽  
Iron Status ◽  
Decompensated Heart Failure ◽  
Inflammatory Biomarkers ◽  
Acutely Decompensated Heart Failure

scholarly journals Lack of Diuretic Efficiency (but Not Low Diuresis) Early in An Acutely Decompensated Heart Failure Episode Is Associated with Increased 180-Day Mortality

2017 ◽  
Vol 7 (2) ◽  
pp. 137-149 ◽  
Author(s):  
João Pedro Ferreira ◽  
Nicolas Girerd ◽  
Pedro Bettencourt Medeiros ◽  
Miguel Bento Ricardo ◽  
Tiago Almeida ◽  
...  
Keyword(s):  
Heart Failure ◽  
Emergency Room ◽  
Decompensated Heart Failure ◽  
University Hospital ◽  
Acutely Decompensated Heart Failure ◽  
All Cause Mortality ◽  
Diuretic Efficiency ◽  
Relevant Variables ◽  
Emergency Room Admission

Introduction: The assessment of the amount of urine produced by the dose of administered diuretic has been proposed as the main signal of interest in diuretic responsiveness - diuretic efficiency (DE). The main aim of our study is to determine if a low DE is associated with 180-day all-cause mortality (ACM). Methods: During a 3-year period, we retrospectively studied patients with acutely decompensated heart failure (ADHF) and respiratory insufficiency admitted to the emergency room of a tertiary university hospital in Porto, Portugal. A total of 170 patients (age 76.2 ± 10.3 years) were included. The outcome of ACM occurred in 43 (25.3%) patients during the 180-day follow-up period. DE was evaluated for a maximum of 3 h after emergency room admission. The lowest DE was defined as ≤140 mL of diuresis per 40 mg of furosemide equivalents. Results: No significant differences in age, comorbidities, baseline HF symptoms, or disease-modifying medication were found between the lowest and highest DE groups. The lowest DE group had higher blood urea and lower estimated glomerular filtration rate (eGFR) levels (41.3 ± 24.5 vs. 56.7 ± 23.2 mL/min/1.73 m2, p < 0.001). The patients with the lowest DE had significantly higher rates of ACM during the 180-day follow-up, even after adjustment for other clinically relevant variables: hazard ratio (HR) [95% CI] = 2.31 [1.16-4.58], p = 0.016. The lowest diuresis (≤300 mL) and the highest intravenous furosemide dose (>80 mg) alone were not significantly associated with the outcome. After adjustment for N-terminal prohormone of brain natriuretic peptide, the association between the lowest DE and the outcome lost strength (HR [95% CI] = 1.53 [0.75-3.13], p = 0.240). Conclusion: A low DE (≤140 mL/40 mg of furosemide) in the first 3 h after an ADHF episode was associated with increased mid-term mortality rates.

scholarly journals Heart Failure in the Time of COVID-19

Cardiology ◽  
2020 ◽  
Vol 145 (8) ◽  
pp. 481-484 ◽  
Author(s):  
Marta Jiménez-Blanco Bravo ◽  
David Cordero Pereda ◽  
Diego Sánchez Vega ◽  
Susana del Prado Díaz ◽  
Juan Manuel Monteagudo Ruiz ◽  
...  
Keyword(s):  
Heart Failure ◽  
Hospital Admissions ◽  
Decompensated Heart Failure ◽  
Healthcare Systems ◽  
Advanced Heart Failure ◽  
Heart Failure Unit ◽  
Acutely Decompensated Heart Failure ◽  
Outpatient Visits ◽  
Vulnerable Patients

Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has emerged as a new threat to healthcare systems. In this setting, heart failure units have faced an enormous challenge: taking care of their patients while at the same time avoiding patients’ visits to the hospital. Objective: The aim of this study was to evaluate the results of a follow-up protocol established in an advanced heart failure unit at a single center in Spain during the coronavirus disease 2019 (COVID-19) pandemic. Methods: During March and April 2020, a protocolized approach was implemented in our unit to reduce the number of outpatient visits and hospital admissions throughout the maximum COVID-19 spread period. We compared emergency room (ER) visits, hospital admissions, and mortality with those of January and February 2020. Results: When compared to the preceding months, during the COVID pandemic there was a 56.5% reduction in the ER visits and a 46.9% reduction in hospital admissions, without an increase in mortality (9 patients died in both time periods). A total of 18 patients required a visit to the outpatient clinic for decompensation of heart failure or others. Conclusion: Our study suggests that implementing an active-surveillance protocol in acutely decompensated heart failure units during the SARS-CoV-2 pandemic can reduce hospital admissions, ER visits and, potentially, viral transmission, in a cohort of especially vulnerable patients.

Insuficiencia cardíaca en tiempo de pandemia por COVID-19

2021 ◽  
pp. 1-3
Author(s):  
Flavio López-Miro-Espinosa
Keyword(s):  
Heart Failure ◽  
Hospital Admissions ◽  
Decompensated Heart Failure ◽  
Advanced Heart Failure ◽  
Heart Failure Unit ◽  
Acutely Decompensated Heart Failure ◽  
Outpatient Visits ◽  
Vulnerable Patients ◽  
Insuficiencia Cardiaca

<b>Background:</b> Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has emerged as a new threat to healthcare systems. In this setting, heart failure units have faced an enormous challenge: taking care of their patients while at the same time avoiding patients’ visits to the hospital. <b>Objective:</b> The aim of this study was to evaluate the results of a follow-up protocol established in an advanced heart failure unit at a single center in Spain during the coronavirus disease 2019 (COVID-19) pandemic. <b>Methods:</b> During March and April 2020, a protocolized approach was implemented in our unit to reduce the number of outpatient visits and hospital admissions throughout the maximum COVID-19 spread period. We compared emergency room (ER) visits, hospital admissions, and mortality with those of January and February 2020. <b>Results:</b> When compared to the preceding months, during the COVID pandemic there was a 56.5% reduction in the ER visits and a 46.9% reduction in hospital admissions, without an increase in mortality (9 patients died in both time periods). A total of 18 patients required a visit to the outpatient clinic for decompensation of heart failure or others. <b>Conclusion:</b> Our study suggests that implementing an active-surveillance protocol in acutely decompensated heart failure units during the SARS-CoV-2 pandemic can reduce hospital admissions, ER visits and, potentially, viral transmission, in a cohort of especially vulnerable patients.

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