Characteristics and outcome of acute heart failure in infective endocarditis: focus on cardiogenic shock

2021 ◽  
Author(s):  
Juan M Pericàs ◽  
Marta Hernández-Meneses ◽  
Patricia Muñoz ◽  
Manuel Martínez-Sellés ◽  
Ana Á lvarez-Uria ◽  
...  
Keyword(s):  
Heart Failure ◽  
Cardiac Surgery ◽  
Cardiogenic Shock ◽  
Acute Heart Failure ◽  
Heart Block ◽  
Left Ventricle Ejection Fraction ◽  
Regression Analyses ◽  
Risk Of Mortality ◽  
The Impact ◽  
Very High

Abstract Background Studies investigating the impact of cardiogenic shock (CS) on endocarditis are lacking. We aimed to investigate the characteristics and outcomes of endocarditis patients presenting with acute heart failure (AHF), particularly of those developing CS. Methods Prospectively collected cohort from 35 Spanish centers (2008-2018). Logistic regression analyses were performed to identify risk factors for developing CS and predictors of mortality. Results Amongst 4,856 endocarditis patients, 1,652 (34%) had AHF and 244 (5%) CS. Compared to patients without AHF and AHF but no CS, patients with CS presented higher rates of surgery (40.5%, 52.5% and 68%,p<.001) and in-hospital mortality (16.3%,39.1%, and 52.5%). Compared to patients with septic shock, CS patients presented higher rates of surgery (42.5% vs. 68%, p<.001), and lower rates of in-hospital and 1-year mortality (62.3% vs. 52.5%,p.008;and 65.3% vs. 57.4%,p.030). Severe aortic and mitral regurgitation (OR 2.47, 95%CI 1.82-3.35 and OR 3.03, 95%CI 2.26-4.07, both p<.001), left-ventricle ejection fraction<60% (OR 1.72, 95%CI 1.22-2.40, p.002), heart block (OR 2.22, 95%CI 1.41-3.47, p.001), tachyarrhythmias (OR 5.07,95%CI 3.13-8.19, p<.001) and acute kidney failure (OR 2.29, 95%CI 1.73-3.03,p<.001) were associated to a higher likelihood of developing CS. Prosthetic endocarditis (OR 2.03, 95%CI 1.06-3.88, p.032), S. aureus (OR 3.10, 95%CI 1.16-8.30, p.024), tachyarrhythmias (OR 3.09,95%CI 1.50-10.13, p.005), and not performing cardiac surgery (OR 11.40, 95%CI 4.83-26.90, p<.001) were associated to a higher risk of mortality. Conclusions Acute heart failure is common among patients with endocarditis. Cardiogenic shock is associated to very high mortality and should be promptly identified and assessed for cardiac surgery.

scholarly journals Sociodemographic, Clinico-Laboratory Characteristics with Short Outcome among Acute Heart Failure Patients Admitted for First Time in a Tertiary Care Hospital: a Real Life Experience

2021 ◽  
Vol 28 (2) ◽  
pp. 192-198
Author(s):  
AKM Humayon Kabir ◽  
SK Jakaria Been Sayeed ◽  
Prodip Kumar Biswas ◽  
Mohammad Zaid Hossain ◽  
Sabrina Rahman ◽  
...  
Keyword(s):  
Heart Failure ◽  
Cardiac Arrest ◽  
Clinical Outcome ◽  
Cardiogenic Shock ◽  
Acute Heart Failure ◽  
Cardiac Arrhythmia ◽  
Heart Block ◽  
Care Hospital ◽  
Cardiac Events ◽  
Common Causes

Acute heart failure is one of the common causes of morbidity & mortality among the patients admitted in hospital. This prospective observational study was done to characterize sociodemographic, clinical & laboratory characteristics with short clinical outcome. Total 110 patients of acute heart failure were included in this study where mean age was 53.88 (± 14.6) years. Majority of the patients were aged between 51-60 years 35 (32%). 79(72%) of them smoker and 12(11%) were alcoholic. Major comorbidities were hypertension 59 (53.63%), ischemic heart disease 42 (38.18%), DM 39(35.45%), chronic kidney disease 25(22.72%). Most common symptoms at presentation were shortness of breath110(100%) along with palpitation 96(87.27%), orthopnea 85(77.27%), paroxysmal nocturnal dyspnea 59(53.63%), ankle edema 71(64.54%), raised JVP 75(68.18%), bilateral basal crepitation on auscultation 80(72.72%), anemia 19 (17.27%) & oliguria 23(20.90%) where mean duration of symptoms was 11 ± 2 days. Lab investigations revealed decreased Hemoglobin (10.71 ± 1.49) g/dl, proteinuria in 31 (28.18%), ketone body 5 (4.5%), raised creatinine in 23(20.93%), hyponatremia 38 (34.54%), hypernatremia 6 (5.45%), hypokalemia 6 (5.45%), hyperkalemia 3 (2.72%). Regarding cardiac events 37(33.63%) encounter myocardial infarction, cardiogenic shock 29(26.36%), Cardiac arrhythmia 27 (24.5%), cardiac arrest 6 (5.45%), non-cardiac events like stroke 6(5.45%), hyperosmolar hyperglycemic state 2(1.8%), diabetic ketoacidosis 5(5.45%), acute kidney injury 23(20.90%). However, among cardiac arrhythmia atrial fibrillation found 13(11.81%) followed by multiple ventricular ectopic 12 (10.90%), ventricular tachycardia 7 (6.36%), Complete heart block 6 (5.45%), variable heart block 4 (3.63%), long QT 2(1.8%). Regarding short clinical outcome 52(47.27%) were improved, 40 (36.36%) had persistent symptoms & rest 18 (16.36%) expired. Most common causes of those deceased person were cardiogenic shock 9(50%) followed by cardiac arrest 6 (6.33%). In conclusion we can say clinical characteristics are more or less similar but those who have reduced ejection fraction with comorbidities are very prone to develop cardiac arrhythmia causing sudden cardiac death in heart failure. J Dhaka Medical College, Vol. 28, No.2, October, 2019, Page 192-198

scholarly journals P602Growth differentiation factor-15 predicts mortality in acute heart failure and cardiogenic shock

2017 ◽  
Vol 38 (suppl_1) ◽  
Author(s):  
W.S. Speidl ◽  
S.P. Kastl ◽  
K.A. Krychtiuk ◽  
M. Lenz ◽  
J. Wojta ◽  
...  
Keyword(s):  
Heart Failure ◽  
Cardiogenic Shock ◽  
Acute Heart Failure ◽  
Differentiation Factor

scholarly journals ANMCO POSITION PAPER: Role of intra-aortic balloon pump in patients with acute advanced heart failure and cardiogenic shock

2021 ◽  
Vol 23 (Supplement_C) ◽  
pp. C204-C220
Author(s):  
Roberta Rossini ◽  
Serafina Valente ◽  
Furio Colivicchi ◽  
Cesare Baldi ◽  
Pasquale Caldarola ◽  
...  
Keyword(s):  
Heart Failure ◽  
Cardiogenic Shock ◽  
Acute Heart Failure ◽  
Advanced Heart Failure ◽  
Position Paper ◽  
Present Position ◽  
Intra Aortic Balloon Pump ◽  
All Cause Mortality ◽  
Practical Recommendations

Abstract The treatment of patients with advanced acute heart failure is still challenging. Intra-aortic balloon pump (IABP) has widely been used in the management of patients with cardiogenic shock. However, according to international guidelines, its routinary use in patients with cardiogenic shock is not recommended. This recommendation is derived from the results of the IABP-SHOCK II trial, which demonstrated that IABP does not reduce all-cause mortality in patients with acute myocardial infarction and cardiogenic shock. The present position paper, released by the Italian Association of Hospital Cardiologists, reviews the available data derived from clinical studies. It also provides practical recommendations for the optimal use of IABP in the treatment of cardiogenic shock and advanced acute heart failure.

Acute heart failure and cardiogenic shock

2013 ◽  
pp. 309-316
Author(s):  
Demosthenes G. Katritsis ◽  
Bernard J. Gersh ◽  
A. John Camm
Keyword(s):  
Heart Failure ◽  
Cardiogenic Shock ◽  
Acute Heart Failure

The impact of cultural and linguistic diversity on hospital readmission in patients hospitalized with acute heart failure

2019 ◽  
Vol 6 (2) ◽  
pp. 121-129
Author(s):  
Michael Seman ◽  
Bill Karanatsios ◽  
Koen Simons ◽  
Roman Falls ◽  
Neville Tan ◽  
...  
Keyword(s):  
Heart Failure ◽  
Acute Heart Failure ◽  
Hospital Readmission ◽  
Limited English Proficiency ◽  
Linguistic Diversity ◽  
Linguistically Diverse ◽  
Cox Proportional Hazard ◽  
Increased Risk ◽  
Hospital Administrative ◽  
The Impact

Abstract Aims Health services worldwide face the challenge of providing care for increasingly culturally and linguistically diverse (CALD) populations. The aims of this study were to determine whether CALD patients hospitalized with acute heart failure (HF) are at increased risk of rehospitalization and emergency department (ED) visitation after discharge, compared to non-CALD patients, and within CALD patients to ascertain the impact of limited English proficiency (LEP) on outcomes. Methods and results A cohort of 1613 patients discharged from hospital following an episode of acute HF was derived from hospital administrative datasets. CALD status was based on both country of birth and primary spoken language. Comorbidities, HF subtype, age, sex and socioeconomic status, and hospital readmission and ED visitation incidences, were compared between groups. A Cox proportional hazard model was employed to adjust for potential confounders. The majority of patients were classified as CALD [1030 (64%)]. Of these, 488 (30%) were designated as English proficient (CALD-EP) and 542 (34%) were designated CALD-LEP. Compared to non-CALD, CALD-LEP patients exhibited a greater cumulative incidence of HF-related readmission and ED visitation, as expressed by an adjusted hazard ratio (HR) [1.27 (1.02–1.57) and 1.40 (1.18–1.67), respectively]; this difference was not significant for all-cause readmission [adjusted HR 1.03 (0.88–1.20)]. CALD-EP showed a non-significant trend towards increased rehospitalization and ED visitation. Conclusion This study suggests that CALD patients with HF, in particular those designated as CALD-LEP, have an increased risk of HF rehospitalization and ED visitation. Further research to elucidate the underlying reasons for this disparity are warranted.

Sign in / Sign up

Export Citation Format

Share Document