scholarly journals Precipitating factors for acute decompensated heart failure in patients with stable chronic left ventricular systolic dysfunction

2018 ◽  
Vol 4 (1) ◽  
pp. 21
Author(s):  
Bishav Mohan ◽  
GajinderPal Singh Kaler ◽  
Dinesh Gupta ◽  
NavjotKaur Kaler ◽  
Mohil Garg ◽  
...  
Keyword(s):  
Heart Failure ◽  
Left Ventricular Systolic Dysfunction ◽  
Acute Decompensated Heart Failure ◽  
Systolic Dysfunction ◽  
Decompensated Heart Failure ◽  
Left Ventricular ◽  
Ventricular Systolic Dysfunction ◽  
Precipitating Factors

scholarly journals Severity of Functional Mitral Regurgitation on Admission for Acute Decompensated Heart Failure Predicts Long‐Term Risk of Rehospitalization and Death

2021 ◽  
Author(s):  
Rachna Kataria ◽  
Francesco Castagna ◽  
Shivank Madan ◽  
Paul Kim ◽  
Omar Saeed ◽  
...  
Keyword(s):  
Heart Failure ◽  
Left Ventricular Systolic Dysfunction ◽  
Acute Decompensated Heart Failure ◽  
Systolic Dysfunction ◽  
Decompensated Heart Failure ◽  
Left Ventricular ◽  
Functional Mitral Regurgitation ◽  
Ventricular Systolic Dysfunction ◽  
Post Discharge ◽  
All Cause Mortality

Background Functional mitral regurgitation (FMR) has emerged as a therapeutic target in patients with chronic heart failure and left ventricular systolic dysfunction. The significance of FMR in acute decompensated heart failure remains obscure. We systematically investigated the prevalence and clinical significance of FMR on admission in patients admitted with acute decompensated heart failure and left ventricular systolic dysfunction. Methods and Results The study was a single‐center, retrospective review of patients admitted with acute decompensated heart failure and left ventricular systolic dysfunction between 2012 and 2017. Patients were divided into 3 groups of FMR: none/mild, moderate, and moderate‐to‐severe/severe FMR. The primary outcome was 1‐year post‐discharge all‐cause mortality. We also compared these groups for 6‐month heart failure hospitalization rates. Of 2303 patients, 39% (896) were women. Median left ventricular ejection fraction was 25%. Four hundred and fifty‐three (20%) patients had moderate‐to‐severe/severe FMR, which was independently associated with 1‐year all‐cause mortality. Moderate or worse FMR was found in 1210 (53%) patients and was independently associated with 6‐month heart failure hospitalization. Female sex was independently associated with higher severity of FMR. Conclusions More than half of patients hospitalized with acute decompensated heart failure and left ventricular systolic dysfunction had at least moderate FMR, which was associated with increased readmission rates and mortality. Intensified post‐discharge follow‐up should be undertaken to eliminate FMR amenable to pharmacological therapy and enable timely and appropriate intervention for persistent FMR. Further studies are needed to examine sex‐related disparities in FMR.

scholarly journals A Change of Heart: Case Series of Peripartum Cardiomyopathy

2013 ◽  
Vol 2013 ◽  
pp. 1-4 ◽  
Author(s):  
Sean Martin ◽  
Daniel Short ◽  
Chih Mun Wong ◽  
Dina McLellan
Keyword(s):  
Heart Failure ◽  
Left Ventricular Systolic Dysfunction ◽  
Systolic Dysfunction ◽  
Significant Proportion ◽  
Case Series ◽  
Decompensated Heart Failure ◽  
Left Ventricular ◽  
Peripartum Cardiomyopathy ◽  
Ventricular Systolic Dysfunction ◽  
Diagnostic Challenge

Peripartum cardiomyopathy (PPCM) is an uncommon disease of pregnancy, occurring in about 1 in 2000 live births, and is characterized by the development of heart failure, due to left ventricular systolic dysfunction. It is associated with high rates of maternal and neonatal mortality. Cardiac disease is the leading cause of maternal death in the UK: PPCM accounts for about 17% of these. Clinical findings of decompensated heart failure (HF) are often masked by the normal physiological changes seen in pregnancy making the diagnosis challenging. A high index of suspicion is essential—prompting referral for echocardiogram, which is crucial for diagnosis. Favourable prognosis is dependent on the early initiation of HF medications. Although full recovery occurs in around half of cases, left ventricular systolic dysfunction persists in a significant proportion of patients with PPCM and the risk of recurrence in subsequent pregnancies is high. The pathophysiology of PPCM is under intense research. We present four patients with PPCM and a review of the literature. Owing to the diagnostic challenge of PPCM and decompensated HF in pregnant mothers and its high mortality rate without treatment, prompt investigation and referral are key to improving maternal survival.

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