Worsening Renal Function during Management for Chronic Heart Failure with Reduced Ejection Fraction: Results From the Pro-BNP Outpatient Tailored Chronic Heart Failure Therapy (PROTECT) Study

2017 ◽  
Vol 23 (2) ◽  
pp. 121-130 ◽  
Author(s):  
Nasrien E. Ibrahim ◽  
Hanna K. Gaggin ◽  
Dustin J. Rabideau ◽  
Parul U. Gandhi ◽  
Aditi Mallick ◽  
...  
Keyword(s):  
Heart Failure ◽  
Renal Function ◽  
Chronic Heart Failure ◽  
Ejection Fraction ◽  
Heart Failure Therapy ◽  
Reduced Ejection Fraction ◽  
Worsening Renal Function ◽  
Protect Study

scholarly journals Associations of worsening renal function with loop diuretics in patients with heart failure with different ejection fraction categories

2020 ◽  
Author(s):  
Marvin Owusu-Ayeman ◽  
Xin He ◽  
Weihao Liang ◽  
Wengen Zhu ◽  
Yuzhong Wu ◽  
...  
Keyword(s):  
Heart Failure ◽  
Renal Function ◽  
Ejection Fraction ◽  
Equivalent Dose ◽  
Loop Diuretics ◽  
Close Monitoring ◽  
Odds Ratios ◽  
Reduced Ejection Fraction ◽  
Worsening Renal Function ◽  
Patients With Heart Failure

Abstract Background Heart failure patients with preserved ejection fraction (HFpEF) and reduced ejection fraction (HFrEF) have different sensitivity to plasma volume change after decongestion, but the possible differential effects of loop diuretics dosage on worsening renal function (WRF) in heart failure (HF) categories remain unclear. Methods In 972 patients with HFpEF and 427 patients with HFrEF, we assessed the risk of WRF with the average daily furosemide equivalent dose, using multivariable logistic regression. WRF was defined as an increase in serum creatinine levels of more than 26.5 mmol/L during hospitalization. Results In patients with HFpEF and HFrEF, between-group differences in average daily furosemide equivalent dose (18.9 mg/d vs. 26.8 mg/d) and the prevalence of WRF (25.3% vs. 14.3%) were significant (p < 0.001). In multivariable-adjusted analyses, a doubling of the average furosemide equivalent dose was associated with higher risk of WRF in all patients, patients with HFpEF and HFrEF, with odds ratios amounting to 1.42, 1.41 and 1.60 (p ≤ 0.022), respectively. There was no interaction between heart failure categories and average furosemide equivalent dose (p = 0.37). The adjusted odds ratios of risk of WRF associated with intravenous furosemide were 1.26 (95% confidence interval [CI], 1.08–1.46; p = 0.002) in HFpEF but not significant in HFrEF(p = 0.099). Conclusions The risk of WRF was associated with higher furosemide dosage in both HF subtypes. Our observations highlight that close monitoring is required to prevent further renal impairment in all HF patients while using loop diuretics.

scholarly journals Egyptian Association of Vascular Biology and Atherosclerosis Consensus on The Usage of SGLT2 Inhibitors in Heart Failure

2021 ◽  
Vol 23 (Supplement_D) ◽  
Author(s):  
Ashraf Reda ◽  
Ahmed Shawky Elserafy ◽  
Elsayed Farag ◽  
Tamer Mostafa ◽  
Nabil Farag ◽  
...  
Keyword(s):  
Heart Failure ◽  
Renal Function ◽  
Chronic Heart Failure ◽  
Ejection Fraction ◽  
Consensus Statement ◽  
Sglt2 Inhibitors ◽  
Heart Failure Hospitalization ◽  
Glucose Lowering ◽  
Reduced Ejection Fraction ◽  
Early Use

Abstract Aims Analysis of SGLT2i data from DAPA-HF and EMPEROR- reduced trials to put a simplified consensus statement on the use of these glucose lowering agents in patients with established heart failure. Methods and Results Sixty experts in the field of cardiology revised the literature of the SGLT2i in heart failure, their recommended indications, and their contraindications. Data from DAPA-HF and EMPEROR-reduced trials were tabulated and statistically analysed. SGLT2 inhibitors investigated initially for their glucose lowering capability, have shown a significant benefit in chronic heart failure eit reduced ejection fraction (HFrEF). Conclusions We recommend early use of dapagliflozin 10 mg, or empagliflozin 10 mg in patients suffering from symptomatic chronic HFrEF, whether the patient is diabetic or non, to improve heart failure hospitalization, death, symptoms, and decline of renal function.

Worsening Renal Function and Outcomes in Heart Failure Patients With Reduced Ejection Fraction

2021 ◽  
Vol 30 ◽  
pp. S143-S144
Author(s):  
R. Ravikulan ◽  
J. Gunton ◽  
J. Harris ◽  
Y. Sharma ◽  
S. Sumanadasa ◽  
...  
Keyword(s):  
Heart Failure ◽  
Renal Function ◽  
Ejection Fraction ◽  
Reduced Ejection Fraction ◽  
Heart Failure Patients ◽  
Worsening Renal Function

scholarly journals Levosimendan use in patients with acute heart failure and reduced ejection fraction with or without severe renal dysfunction in critical cardiac care units: a multi-institution database study

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Cze-Ci Chan ◽  
Kuang-Tso Lee ◽  
Wan-Jing Ho ◽  
Yi-Hsin Chan ◽  
Pao-Hsien Chu
Keyword(s):  
Heart Failure ◽  
Renal Function ◽  
Ejection Fraction ◽  
Acute Heart Failure ◽  
Cardiac Care ◽  
Chang Gung Memorial Hospital ◽  
Research Database ◽  
Cohort Entry ◽  
Reduced Ejection Fraction ◽  
Abnormal Renal Function

Abstract Background Acute heart failure is a life-threatening clinical condition. Levosimendan is an effective inotropic agent used to maintain cardiac output, but its usage is limited by the lack of evidence in patients with severely abnormal renal function. Therefore, we analyzed data of patients with acute heart failure with and without abnormal renal function to examine the effects of levosimendan. Methods We performed this retrospective cohort study using data from the Chang Gung Research Database (CGRD) of Chang Gung Memorial Hospital (CGMH). Patients admitted for heart failure with LVEF ≤ 40% between January 2013 and December 2018 who received levosimendan or dobutamine in the critical cardiac care units (CCU) were identified. Patients with extracorporeal membrane oxygenation (ECMO) were excluded. Outcomes of interest were mortality at 30, 90, and 180 days after the cohort entry date. Results There were no significant differences in mortality rate at 30, 90, and 180 days after the cohort entry date between the levosimendan and dobutamine groups, or between subgroups of patients with an estimated glomerular filtration rate (eGFR) ≥ 30 mL/min/1.73 m2 and eGFR < 30 mL/min/1.73 m2 or on dialysis. The results were consistent before and after propensity score matching. Conclusions Levosimendan did not increase short- or long-term mortality rates in critical patients with acute heart failure and reduced ejection fraction compared to dobutamine, regardless of their renal function. An eGFR less than 30 mL/min/1.73 m2 was not necessarily considered a contraindication for levosimendan in these patients.

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