Spironolactone Treatment and Clinical Outcomes in Patients With Systolic Dysfunction and Mild Heart Failure Symptoms: A Retrospective Analysis

2006 ◽  
Vol 12 (4) ◽  
pp. 250-256 ◽  
Author(s):  
Ragavendra R. Baliga ◽  
Prathiba Ranganna ◽  
Bertram Pitt ◽  
Todd M. Koelling
Keyword(s):  
Heart Failure ◽  
Retrospective Analysis ◽  
Clinical Outcomes ◽  
Systolic Dysfunction ◽  
Mild Heart Failure

scholarly journals Heterogeneity of Diastolic Characteristics by the Same Level of Systolic Dysfunction in Mild Heart Failure: The AREA-IN-CHF Study

2007 ◽  
Vol 14 (3) ◽  
pp. 145-196
Author(s):  
G F Mureddu ◽  
G de Simone ◽  
M Benincasa ◽  
G Cacciatore ◽  
D Girfoglio ◽  
...  
Keyword(s):  
Heart Failure ◽  
Systolic Dysfunction ◽  
Mild Heart Failure

scholarly journals Update on Cardiac Resynchronisation Therapy for Heart Failure

2014 ◽  
Vol 9 (2) ◽  
pp. 100
Author(s):  
David D Daly ◽  
Michael R Gold ◽  
◽  
Keyword(s):  
Heart Failure ◽  
Systolic Dysfunction ◽  
Systolic Heart Failure ◽  
Cardiac Resynchronisation Therapy ◽  
Left Ventricular ◽  
Conduction Delay ◽  
Lead Placement ◽  
Mild Heart Failure ◽  
Cardiac Resynchronisation ◽  
Resynchronisation Therapy

Cardiac resynchronisation therapy (CRT) is well accepted therapy for the treatment of symptomatic systolic heart failure in defined patient subgroups. Large clinical trials over the past 20 years have shown that patients with a left ventricular (LV) systolic dysfunction and interventricular conduction delay benefit from this therapy. Recent advances in this field include the expansion indications for CRT to patients with mild heart failure and to those with a mildly depressed ejection fraction that require frequent right ventricular pacing. In addition, although CRT guidelines have included indications in atrial fibrillation, it is now clear that this is most effective when pacing is utilised nearly 100 % of the time, often requiring atrioventricular (AV) junction ablation. Strategies for optimising LV lead placement based on identifying late mechanical contraction or electrical delay are promising for maximising CRT response. Finally, the role of routine AV delay optimisation is no longer recommended based on the results of multicentre trials.

scholarly journals Clinical outcomes of chemotherapy-induced subclinical left ventricular systolic dysfunction among breast cancer patients detected using echocardiographic global longitudinal strain

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
J.G.G Manaloto ◽  
M.K Cruz-Tan ◽  
R.H Tiongco ◽  
R.M Jimenez ◽  
G.H Cornelio
Keyword(s):  
Breast Cancer ◽  
Heart Failure ◽  
Cancer Patients ◽  
Clinical Outcomes ◽  
Longitudinal Strain ◽  
Systolic Dysfunction ◽  
Global Longitudinal Strain ◽  
Left Ventricular ◽  
Breast Cancer Patients ◽  
All Cause Mortality

Abstract Background Echocardiographic global longitudinal strain (GLS) detects early subclinical left ventricular (LV) systolic dysfunction, before the occurrence of a decreased LV ejection fraction. However, our local data is lacking to determine its impact to clinical outcomes. Purpose The study aimed to determine the clinical outcomes of breast cancer patients who developed subclinical LV systolic dysfunction as determined by an abnormal GLS post-chemotherapy. Methods This retrospective cohort study included 99 breast cancer patients who underwent anthracycline and/or HER-2 receptor inhibitor chemotherapy from January 1, 2016 to December 31, 2018 in a single tertiary hospital. Clinical outcomes of all-cause mortality and overt heart failure were compared between those with normal and abnormal GLS post-chemotherapy. Results The prevalence of subclinical LV systolic dysfunction was 18%, wherein 28% of them had subsequent overt heart failure, and 33% expired. Abnormal GLS occurred at a mean 3.5 months (range 1–8 months) after initiation of chemotherapy and at 8 months (range 6–10 months) after the entire chemotherapy sessions. Development into heart failure was observed at a mean of 6.7 months (range 4–12 months) after occurrence of abnormal GLS. Hypertension and age >56 years were determined to be risk factors. Beta-blockers, ACE inhibitors and statins seemed to be non-protective in our cohort. Abnormalities in GLS were observed at a mean dose of 260 mg/m2 of epirubicin, lower than the dose described as high risk in the literature (600 mg/m2 for epirubicin). In trastuzumab, abnormal GLS occurred as early as 1 month after initiation. LVEF had no significant change within 2 months (p=0.56), but was significantly lower within 12 months post-chemotherapy (p=0.005). All-cause mortality was 3-fold higher (RR=3.00; p=0.02), and the risk to develop heart failure was 4 times higher (RR=4.74; p=0.008) in those with abnormal GLS. Conclusion The development of abnormal GLS post-chemotherapy was associated with subsequent development of overt heart failure and increased all-cause mortality. Abnormal GLS occurred at lower doses of epirubicin and as early as 1 month after initiating trastuzumab. We recommend echo surveillance with GLS monitoring beginning >250 mg/m2 with anthracycline (and after 1–2 months of Trastuzumab), and to repeat at 1–2 months and 9–12 months post-chemotherapy. Funding Acknowledgement Type of funding source: None

scholarly journals B-PO03-191 PERMANENT ATRIAL PACING IN PATIENTS WITH HEART FAILURE AND PRESERVED LV EJECTION FRACTION: A RETROSPECTIVE ANALYSIS OF CLINICAL OUTCOMES

Heart Rhythm ◽  
2021 ◽  
Vol 18 (8) ◽  
pp. S267
Author(s):  
Bich Lien Nguyen ◽  
Francesco Accardo ◽  
Vania Chianta, Flavio Giuseppe Biccirè ◽  
Ilaria Cardillo, Roberto Scacciavillani ◽  
Kenneth A. Ellenbogen ◽  
...  
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Retrospective Analysis ◽  
Clinical Outcomes ◽  
Atrial Pacing ◽  
Patients With Heart Failure ◽  
Lv Ejection Fraction
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