scholarly journals Interleukin-6 Could Be a Potential Prognostic Factor in Ambulatory Elderly Patients with Stable Heart Failure: Results from a Pilot Study

2021 ◽  
Vol 10 (3) ◽  
pp. 504
Author(s):  
Marina Povar-Echeverría ◽  
Pablo Esteban Auquilla-Clavijo ◽  
Emmanuel Andrès ◽  
Francisco Javier Martin-Sánchez ◽  
María Victoria Laguna-Calle ◽  
...  
Keyword(s):  
Heart Failure ◽  
Atrial Fibrillation ◽  
Renal Failure ◽  
Interleukin 6 ◽  
Kaplan Meier ◽  
Patients With Heart Failure ◽  
Potential Prognostic Factor ◽  
Fundamental Phenomenon ◽  
Group 2

Introduction: Inflammation is a fundamental phenomenon in heart failure, but the prognostic or therapeutic role of markers such as interleukin-6 (IL-6) has not yet been clarified. The objective of this study is to describe the clinical profile of patients with elevated IL-6 and determine if they have worse clinical outcomes. Methods: A retrospective c.ohort observational study including 78 patients with heart failure followed up at the Heart Failure Outpatient Clinic of the Internal Medicine Department. IL-6 was determined in all patients, who were then assigned into two groups according to IL-6 level (normal or high). Clinical and prognostic data were collected to determine the differences in both groups. Results: The average age was 79 years, 60% female. A total of 53.8% of the patients had elevated IL-6 (group 2). Patients with elevated IL-6 presented more frequently with anemia mellitus (64.3% vs. 41.7%; p = 0.046), atrial fibrillation (83.3% vs. 61.9% p = 0.036), dyslipidemia (76.2% vs. 58.2%; p = 0.03), higher creatinine levels (1.35 mg/dL vs. 1.08 mg/dL; p = 0.024), lower glomerular filtration rate (43.6 mL/min/m2 vs. 59.9 mL/min/m2; p = 0.007), and anemia 25% vs. 52.4% p = 0.014. The factors independently associated with the increase in IL-6 were anemia 3.513 (1.163–10.607) and renal failure 0.963 (0.936–0.991), p < 0.05. Mortality was higher in the group with elevated IL-6 levels (16% vs. 2%; p = 0.044) with a log-rank p = 0.027 in the Kaplan–Meier curve. Conclusion: Patients with heart failure and elevated IL-6 most often have atrial fibrillation, diabetes mellitus, dyslipidemia, anemia, and renal failure. In addition, mortality was higher and a tendency of higher hospital admission was observed in stable HF patients with elevated IL-6.

Evaluation of a multimarker panel in chronic heart failure: a 10-year follow-up

2021 ◽  
Author(s):  
Susanne Bauer ◽  
Christina Strack ◽  
Ekrem Ücer ◽  
Stefan Wallner ◽  
Ute Hubauer ◽  
...  
Keyword(s):  
Heart Failure ◽  
Prognostic Role ◽  
Blood Samples ◽  
Kaplan Meier ◽  
Risk Of Mortality ◽  
Patients With Heart Failure ◽  
All Cause Mortality ◽  
Long Time

Aim: We assessed the 10-year prognostic role of 11 biomarkers with different pathophysiological backgrounds. Materials & methods/results: Blood samples from 144 patients with heart failure were analyzed. After 10 years of follow-up (median follow-up was 104 months), data regarding all-cause mortality were acquired. Regarding Kaplan–Meier analysis, all markers, except TIMP-1 and GDF-15, were significant predictors for all-cause mortality. We created a multimarker model with nt-proBNP, hsTnT and IGF-BP7 and found that patients in whom all three markers were elevated had a significantly worse long-time-prognosis than patients without elevated markers. Conclusion: In a 10-year follow-up, a combination of three biomarkers (NT-proBNP, hs-TnT, IGF-BP7) identified patients with a high risk of mortality.

Atrial natriuretic peptides in man

1987 ◽  
Vol 65 (8) ◽  
pp. 1697-1700 ◽  
Author(s):  
M. Gary Nicholls ◽  
Hamid Ikram ◽  
Ian G. Crozier ◽  
Eric A. Espiner ◽  
Tim G. Yandle
Keyword(s):  
Heart Failure ◽  
Renal Failure ◽  
Physiological Role ◽  
High Sodium ◽  
Patients With Heart Failure ◽  
Normal Man ◽  
Urine Electrolytes ◽  
Pulmonary Arterial ◽  
Atrial Natriuretic

Research on the physiological role of atrial peptides in man is limited, and the potential for these peptides, or more stable analogues, in therapeutics is uncertain. It is clear, however, that plasma levels of immunoreactive atrial natriuretic peptide (IR-ANP) are increased in volunteers taking a high sodium diet, and are elevated in patients with heart failure, chronic renal failure, and primary aldosteronism. There is suggestive evidence that IR-ANP levels are increased also in essential hypertension, although overlap with normotensives is considerable. Injection or infusion of artrial peptides into man results in a diuresis, an increased output of urine electrolytes, a fall in blood pressure and a rise in heart rate, suppression of aldosterone and sometimes of renin also, and stimulation of norepinephrine. In essential hypertensives, urinary effects may be greater than in normotensives. Heart failure patients show a rise in cardiac output and falls in both systemic and pulmonary arterial pressure. Over the next few years and especially if specific antagonists can be developed, the physiologic and pathophysiologic roles of atrial peptides in normal man and in clinical disorders should be clarified. It is possible that stable analogues of atrial peptides will find a place in the treatment of cardiac failure, renal failure, and perhaps hypertension.

The role of atrial fibrillation catheter ablation in patients with heart failure

2021 ◽  
Vol 66 ◽  
pp. 80-85
Author(s):  
Michael L. Bernard ◽  
Francis Benn ◽  
Cody M. Williams ◽  
A. Elise Hiltbold ◽  
Paul A. Rogers ◽  
...  
Keyword(s):  
Heart Failure ◽  
Atrial Fibrillation ◽  
Catheter Ablation ◽  
Patients With Heart Failure

The Role of Antithrombotic Therapy in Heart Failure

2020 ◽  
Vol 26 (23) ◽  
pp. 2735-2761
Author(s):  
Christina Chrysohoou ◽  
Nikolaos Magkas ◽  
Christos-Konstantinos Antoniou ◽  
Panagiota Manolakou ◽  
Aggeliki Laina ◽  
...  
Keyword(s):  
Heart Failure ◽  
Atrial Fibrillation ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Antithrombotic Therapy ◽  
Left Ventricular Ejection ◽  
Heart Failure Patients ◽  
Patients With Heart Failure ◽  
Artery Disease

: Heart failure is a major contributor to global morbidity and mortality burden affecting approximately 1-2% of adults in developed countries, mounting to over 10% in individuals aged >70 years old. Heart failure is characterized by a prothrombotic state and increased rates of stroke and thromboembolism have been reported in heart failure patients compared with the general population. However, the impact of antithrombotic therapy on heart failure remains controversial. Administration of antiplatelet or anticoagulant therapy is the obvious (and well-established) choice in heart failure patients with cardiovascular comorbidity that necessitates their use, such as coronary artery disease or atrial fibrillation. In contrast, antithrombotic therapy has not demonstrated any clear benefit when administered for heart failure per se, i.e. with heart failure being the sole indication. Randomized studies have reported decreased stroke rates with warfarin use in patients with heart failure with reduced left ventricular ejection fraction, but at the expense of excessive bleeding. Non-vitamin K oral anticoagulants have shown a better safety profile in heart failure patients with atrial fibrillation compared with warfarin, however, current evidence about their role in heart failure with sinus rhythm is inconclusive and further research is needed. In the present review, we discuss the role of antithrombotic therapy in heart failure (beyond coronary artery disease), aiming to summarize evidence regarding the thrombotic risk and the role of antiplatelet and anticoagulant agents in patients with heart failure.

scholarly journals Update on management of atrial fibrillation in heart failure: a focus on ablation

Heart ◽  
2021 ◽  
pp. heartjnl-2020-318081
Author(s):  
Bart A Mulder ◽  
Michiel Rienstra ◽  
Isabelle C Van Gelder ◽  
Yuri Blaauw
Keyword(s):  
Risk Factors ◽  
Heart Failure ◽  
Atrial Fibrillation ◽  
Symptomatic Relief ◽  
Critical Evaluation ◽  
Rhythm Control ◽  
Rate Versus ◽  
Patients With Heart Failure ◽  
Post Hoc

Atrial fibrillation is increasingly encountered in patients with heart failure. Both diseases have seen tremendous rises in incidence in recent years. In general, the treatment of atrial fibrillation is focused on relieving patients from atrial fibrillation-related symptoms and risk reduction for thromboembolism and the occurrence or worsening of heart failure. Symptomatic relief may be accomplished by either (non-)pharmacological rate or rhythm control in combination with optimal therapy of underlying cardiovascular morbidities and risk factors. Atrial fibrillation ablation has been performed in patients without overt heart failure successfully for many years. However, in recent years, attempts have been made for patients with heart failure as well. In this review, we discuss the current literature describing the treatment of atrial fibrillation in heart failure. We highlight the early rate versus rhythm control studies, the importance of addressing underlying conditions and treatment of risk factors. A critical evaluation will be performed of the catheter ablation studies that have been performed so far in light of larger (post-hoc) ablation studies. Furthermore, we will hypothesise the role of patient selection as next step in optimising outcome for patient with atrial fibrillation and heart failure.

Atrial natriuretic peptide in patients with heart failure and chronic atrial fibrillation: Role of duration of atrial fibrillation

1998 ◽  
Vol 135 (2) ◽  
pp. 242-244 ◽  
Author(s):  
Maarten P. Van Den Berg ◽  
Harry J.G.M. Crijns ◽  
Dirk J. Van Veldhuisen ◽  
Isabelle C. Van Gelder ◽  
Pieter J. De Kam ◽  
...  
Keyword(s):  
Heart Failure ◽  
Atrial Fibrillation ◽  
Atrial Natriuretic Peptide ◽  
Natriuretic Peptide ◽  
Chronic Atrial Fibrillation ◽  
Patients With Heart Failure ◽  
Atrial Natriuretic

scholarly journals CAN THE PRESENCE OF ATRIAL FIBRILLATION INFLUENCE THE LEVELS OF HEART FAILURE - SPECIFIC BIOMARKERS IN OVERWEIGHT AND OBESE PATIENTS WITH HEART FAILURE?

2019 ◽  
Vol 70 (6) ◽  
pp. 2294-2300
Author(s):  
Alexandra Dadarlat ◽  
Dana Pop ◽  
Anca Daniela Farcas ◽  
Dumitru Zdrenghea ◽  
Gyorgy Bodizs ◽  
...  
Keyword(s):  
Heart Failure ◽  
Atrial Fibrillation ◽  
High Morbidity ◽  
Obese Patients ◽  
Chemiluminescence Method ◽  
Diagnosis And Prognosis ◽  
A Value ◽  
Patients With Heart Failure ◽  
Galectin 3

Heart failure continues to be a major worldwide medical issue, associated with high morbidity and mortality. The need for ideal biomarkers to aid the diagnosis and prognosis in certain situations, such as obesity or atrial fibrillation is still ongoing. Obese patients are commonly hyperleptinemic. The aim of the study is to assess the role of several biomarkers in overweight and obese patients diagnosed with heart failure, depending on the presence or absence of atrial fibrillation and also their relationship with leptin. The study included 88 overweight and obese patients, with a body mass index (BMI) ≥25 kg/m2, admitted for worsening heart failure. Of these, 52.2% had atrial fibrillation. Dosage of NT-proBNP was performed using the chemiluminescence method. MR-proANP, galectin-3 and leptin were dosed using the ELISA method. A value of P [0.05 was defined as statistically significant. The values of natriuretic peptides NT-proBNP and MR-proANP were significantly increased. Only NT-proBNP was significantly influenced by renal function. No statistically significant correlation was found between heart failure-specific biomarkers and leptin secretion. There were no significant differences in the biomarkers levels between the 2 groups of patients. No statistically significant correlation was found between heart failure-specific biomarkers and leptin secretion. Obese patients with heart failure had significantly increased values of all the studied parameters, but the presence of atrial fibrillation did not influence their levels. High leptin levels were not directly correlated with the levels of heart failure-specific biomarkers.

scholarly journals Cardiac arrhythmias in COVID-19: Mechanisms, outcomes and the potential role of proarrhythmia

EP Europace ◽  
2021 ◽  
Vol 23 (Supplement_3) ◽  
Author(s):  
JL Merino ◽  
J Caro ◽  
JR Rey ◽  
S Castrejon ◽  
M Martinez-Cossiani
Keyword(s):  
Heart Failure ◽  
Atrial Fibrillation ◽  
Ventricular Arrhythmias ◽  
Potential Role ◽  
Multivariable Analysis ◽  
Funding Sources ◽  
Kaplan Meier ◽  
Single Centre Study ◽  
Funding Acknowledgements

Abstract Funding Acknowledgements Type of funding sources: None. Cardiac arrhythmia seems to be a risk factor for mortality in coronavirus disease 2019 (COVID-19). However, the mechanisms, risk factors and outcomes of new arrhythmic events (NAEs) in this disease are unclear. Methods All patients with confirmed COVID-19 were retrospectively included in this single centre study. Patients who were alive and admitted &lt;30 days before the database lock were excluded. Results 3416 consecutive patients were reviewed and 1476 finally enrolled (65.9 ± 20.9 years, 57.3% male). 76 (5.1%) patients had NAEs. Most of them were new atrial fibrillation episodes (48 patients, 3.2%), mostly seen in patients with no previous arrhythmia (38 patients, 79.2%). Atrial flutter (AFL) accounted for 20% of all NAEs. Ventricular arrhythmias were seen in 9 (0.6%) patients. Multivariable analysis showed that prior AFL, heart failure, dyslipidaemia, lopinavir/ritonavir, and combined hydroxychloroquine and azithromycin were independently associated with NAEs. 66 (86.8%) patients with NAEs died. The Kaplan-Meier analysis showed a lower survival of patients with NAEs (P &lt; 0.001). Eight out of 9 (88.9%) and 41 out of 48 (85.4%) patients with ventricular arrhythmias and atrial fibrillation respectively died. Older age, male gender and NAEs were independently associated with death. NAEs and other outcomes, such as heart failure, thromboembolism, and bleeding independently predicted death. Conclusions NAEs are relatively uncommon in COVID-19 patients and mainly have an atrial mechanism. AFL is particularly frequent in this disease. The use of hydroxychloroquine, azithromycin and lopinavir/ritonavir, is associated with them, especially when used in combination. NAEs are independently and strongly associated with death. Abstract Figure.

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