Burden of Recurrent Hospitalizations Following an Admission for Acute Heart Failure: Preserved Versus Reduced Ejection Fraction

2017 ◽  
Vol 70 (4) ◽  
pp. 239-246 ◽  
Author(s):  
Enrique Santas ◽  
Ernesto Valero ◽  
Anna Mollar ◽  
Sergio García-Blas ◽  
Patricia Palau ◽  
...  
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Acute Heart Failure ◽  
Reduced Ejection Fraction

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.

scholarly journals IMPACT OF RIGHT HEART CATHETERIZATION IN ACUTE HEART FAILURE WITH REDUCED EJECTION FRACTION

2021 ◽  
Vol 77 (18) ◽  
pp. 726
Author(s):  
Samarthkumar Thakkar ◽  
Harsh Patel ◽  
Kirtenkumar Patel ◽  
Ashish Kumar ◽  
Smit Patel ◽  
...  
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Acute Heart Failure ◽  
Right Heart Catheterization ◽  
Heart Catheterization ◽  
Right Heart ◽  
Reduced Ejection Fraction

507 Acute heart failure: A comparison of preserved and reduced ejection fraction in the emergency department

2011 ◽  
Vol 27 (5) ◽  
pp. S245-S246
Author(s):  
J.A. Ezekowitz ◽  
S. Lepage ◽  
S. Virani ◽  
R. Leader ◽  
M. White ◽  
...  
Keyword(s):  
Heart Failure ◽  
Emergency Department ◽  
Ejection Fraction ◽  
Acute Heart Failure ◽  
Reduced Ejection Fraction

scholarly journals P214 Clinical audit of in-patient echocardiography in acute heart failure: real world data from a tertiary hospital

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
C Monteiro ◽  
A Cojoianu ◽  
R Savage ◽  
R Bone ◽  
C Hammond ◽  
...  
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Acute Heart Failure ◽  
Tertiary Hospital ◽  
Respiratory Arrest ◽  
Medical Community ◽  
Real World Data ◽  
Reduced Ejection Fraction ◽  
The Mean

Abstract Background Over the last ten years, an increase in admission rates for acute heart failure (HF) has been noted in England and Wales, with one year mortality rates varying between 30% and 60%. Transthoracic echocardiography (TTE) is recommended within 48 hours of admission for suspected acute heart failure, so to guide treatment accordingly. Our centre has a specialist team who assesses patients with suspected HF on admission, and refers them for urgent in-patient TTE, using two priority in-patient echo slots per day. Patients are initially referred for HF assessment by general medics and geriatricians, across non-specialist medical wards. We audited the referrals and results of those who received TTE in this context. Methods and results We screened the medical notes of 252 patients admitted with suspected HF between January and December 2017, and reviewed the echocardiography results of those who received it during their admission. 50% of these patients were female and 59% were elderly (over 80 years old). 245 of these patients (97.2%) had in-patient echocardiography performed during their hospital stay. The mean wait for echocardiography was 0.58 days, with 92% of the scans being performed within 24 hours. The mean admission duration was 8.6 days (SD 10.9). 17.9% of patients were readmitted with suspected heart failure within six months, 69% of which were elderly. The majority of this cohort presented with heart failure with preserved ejection fraction (HFpEF), 50%), followed by heart failure with reduced ejection fraction (HFrEF, 29%) and heart failure with mid-range ejection fraction (HFmrEF, 16%). 41% of the patients who received an echocardiogram were in atrial fibrillation, 51% of which were diagnosed with HFpEF. All patients had their HF medical treatment optimised post-echocardiography and only 18.4% were readmitted within 6 months of the first admission. The majority of these patients was elderly (68.9%). 38.8% of patients who received echocardiography were referred for specialist clinic follow-up, with HFrEF patients more likely to be seen in this setting (42%). Six-month mortality occurred in 19.8% of patients; cause of death (COD) was undocumented in 25.8% of cases. In those where a post-mortem was conducted, the main COD was HF (16.7%), followed by sepsis (13.6%), cardiac (6.1%) and respiratory arrest (6.1%). 66% of the deceased patients were elderly and 48% presented with HFpEF. Conclusion Our cohort is an accurate representation of the current HF statistics seen nationwide. Appropriate treatment was offered to the large majority of patients who received in-patient echocardiography within the first 24 hours of their admission, with low six-month readmission rates. This approach also allowed for the inclusion of these patients on a systematic review plan, including specialist cardiology follow-up. Our numbers are consistent with the higher awareness about HFpEF currently seen in the medical community.

scholarly journals Comparison of Characteristics and 3-Year Outcomes in Patients With Acute Heart Failure With Preserved, Mid-Range, and Reduced Ejection Fraction

2019 ◽  
Vol 83 (2) ◽  
pp. 347-356 ◽  
Author(s):  
Jun Hwan Cho ◽  
Won-Seok Choe ◽  
Hyun-Jai Cho ◽  
Hae-Young Lee ◽  
Jieun Jang ◽  
...  
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Acute Heart Failure ◽  
Reduced Ejection Fraction
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