scholarly journals Clinical Epidemiology: Principles Revisited in an Approach to Study Heart Failure

10.5772/32074 ◽  
2012 ◽  
Author(s):  
Ana Azevedo
Keyword(s):  
Heart Failure ◽  
Clinical Epidemiology

scholarly journals Clinical epidemiology of heart failure with preserved ejection fraction (HFpEF) in comparatively young hospitalized patients

2016 ◽  
Vol 202 ◽  
pp. 918-921 ◽  
Author(s):  
Michael Zacharias ◽  
Samuel Joffe ◽  
Elizabeth Konadu ◽  
Theo Meyer ◽  
Michael Kiernan ◽  
...  
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Clinical Epidemiology ◽  
Hospitalized Patients ◽  
Preserved Ejection Fraction

scholarly journals Clinical course and related costs of patients with diabetes and heart failure and/or chronic kidney disease, drawn from a sample of more than 7 million people

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
A.P Maggioni ◽  
C Piccinni ◽  
S Calabria ◽  
L Dondi ◽  
G Ronconi ◽  
...  
Keyword(s):  
Heart Failure ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Metabolic Diseases ◽  
Clinical Epidemiology ◽  
Community Setting ◽  
Private Company ◽  
Funding Sources ◽  
Patients With Diabetes ◽  
Artery Disease

Abstract Background Diabetes (T2DM), heart failure (HF) and chronic kidney disease (CKD) are among the leading causes of mortality and hospitalization worldwide. This analysis of the Ricerca e Salute (ReS) database is aimed to describe clinical epidemiology, 2-year outcomes and direct costs of T2DM patients with HF, CKD or both in a community setting. Methods Analyses were performed on the ReS database including 7,365,716 subjects. During 2015, subjects with T2DM were selected and subsequently split in the following mutually exclusive cohorts (Figure): – “healthy” T2DM patients, subjects with T2DM but without coronary artery disease (CAD), HF, stroke, TIAs, peripheral artery disease (PAD) and CKD. – Patients affected by T2DM and HF. – Patients affected by T2DM and CKD. – Patients affected by T2DM and both HF and CKD. Results Table shows the baseline characteristics, hospitalization reasons, and related costs of the 4 cohorts. In the 2-year follow-up, T2DM patients with comorbidities are older, more frequently males, and more often admitted for CV and renal reasons. T2DM patients with both HF and CKD have the worst outcome profile. The cost per patient per year is 5 times more for T2DM patients with both HF and CKD than for those with T2DM without these comorbidities. Conclusions Coexistence of HF and/or CKD in patients with T2DM ia associated with a very high clinical and economical burden. Instead of treating each condition individually, the most appropriate approach should be to adopt a collaborative approach that embraces CV, renal and metabolic diseases. FUNDunding Acknowledgement Type of funding sources: Private company. Main funding source(s): This research was partially supported by an unrestricted grant from Astra Zeneca. Astra Zeneca was not involved in data collection, analysis and interpretation, in writing the report, nor in deciding to submit the article for publication.

scholarly journals Clinical epidemiology of heart failure

Heart ◽  
2007 ◽  
Vol 93 (9) ◽  
pp. 1137-1146 ◽  
Author(s):  
A. Mosterd ◽  
A. W Hoes
Keyword(s):  
Heart Failure ◽  
Clinical Epidemiology

scholarly journals Heart Failure With Mid-range Ejection Fraction: Every Coin Has Two Sides

2021 ◽  
Vol 8 ◽  
Author(s):  
Kaiyuan Zhu ◽  
Teng Ma ◽  
Yang Su ◽  
Xin Pan ◽  
Rongrong Huang ◽  
...  
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Clinical Epidemiology ◽  
Current Knowledge ◽  
Management Strategies ◽  
Cardiovascular Morbidity ◽  
Effective Management ◽  
Aggressive Management ◽  
Cardiovascular Morbidity And Mortality ◽  
Two Sides

This review summarizes current knowledge regarding clinical epidemiology, pathophysiology, and prognosis for patients with HFmrEF in comparison to HFrEF and HFpEF. Although recommended treatments currently focus on aggressive management of comorbidities, we summarize potentially beneficial therapies that can delay the process of heart failure by blocking the pathophysiology mechanism. More studies are needed to further characterize HFmrEF and identify effective management strategies that can reduce cardiovascular morbidity and mortality of patients with HFmrEF.

Abstract MP035: The Clinical Epidemiology of Fatigue in Newly Diagnosed Heart Failure

Circulation ◽  
2017 ◽  
Vol 135 (suppl_1) ◽  
Author(s):  
Brent Williams
Keyword(s):  
Heart Failure ◽  
Health Care Services ◽  
Proportional Hazards ◽  
Clinical Epidemiology ◽  
Cox Proportional Hazards ◽  
P Value ◽  
Newly Diagnosed ◽  
Volume Depletion ◽  
All Cause Mortality ◽  
Overall Mortality

Introduction: Fatigue is a common and distressing, but poorly understood symptom among patients with heart failure (HF). The underlying mechanisms of fatigue in HF have not been clearly elucidated, but may lie in both psychologic and physiologic factors. Whether fatigue remains associated with mortality independent of other common clinical attributes also remains unresolved. Accordingly, the current study sought to evaluate the prevalence, predictors, and prognostic value of clinically documented fatigue in newly diagnosed HF patients. Methods: This retrospective cohort study consisted of 12,285 newly diagnosed HF patients receiving health care services through the Geisinger Health System, with passive data collection through electronic medical records (EMR). Incident HF, fatigue, and other study variables were derived from coded data within EMRs. A collection of 87 candidate predictors were evaluated to ascertain the strongest independent predictors of fatigue using logistic regression. The collection of candidate variables was drawn from several domains including demographics, physical examination findings, medical history, laboratory results, and medications. Patients were followed for all-cause mortality for an average of 4.8 years. The associations between fatigue and six-month, 12-month, and overall mortality were evaluated with Cox proportional hazards regression. Results: Clinically documented fatigue was found in 4827 (39%) newly diagnosed HF patients. Among the 87 candidate predictors, 18 were independently associated with fatigue at a multivariable p-value threshold of 0.001. Depression was the strongest predictor of fatigue. Fatigue was often part of a symptom cluster, as other HF symptoms including dyspnea, chest pain, edema, syncope, and palpitations were significant predictors of fatigue. Volume depletion, low body mass index, and abnormal weight loss were also strong predictors of fatigue. Though fatigue was significantly associated with 6-month (HR=1.49, p<0.01), 12-month (HR=1.39, p<0.01), and all-cause mortality (HR=1.20, p<0.01) in unadjusted models, effect sizes were attenuated and non-significant after adjustment for clinical variables with HRs of 1.12 (p=0.16), 1.07 (p=0.26), and 1.00 (p=0.89), for 6-month, 12-month, and overall mortality, respectively. Conclusions: Fatigue is a commonly documented symptom among newly diagnosed HF patients with likely origins in both psychologic and physiologic factors. Though fatigue provided a prognostic signal in the short-term, this was largely explained by physiologic confounders.

scholarly journals Molecular Characterization of Phospholamban and Reninangiotensin System Genes Mutations and Clinical Epidemiology in Human Cardiomyopathy

2018 ◽  
Author(s):  
Gnana Veera Subhashini ◽  
Beesetti Swarna latha ◽  
mavuluri jayadev ◽  
Emmanuel C ◽  
K M Cherian
Keyword(s):  
Heart Failure ◽  
Congestive Heart Failure ◽  
Gene Polymorphism ◽  
Clinical Symptoms ◽  
Clinical Epidemiology ◽  
Mutation Screening ◽  
Gene Mutations ◽  
Renin Angiotensin System ◽  
Converting Enzyme ◽  
Patients At Risk

Background: Cardiomyopathy is commonly observed disease that may occurs due to mutations in either susceptible genes or modifier gene. People with broad age group are affected either attributable to spontaneous or inherited mutations of these genes. Various gene mutations are reported so far but only few of them were studied in detail. Methods: In the current study, we evaluated epidemiological variables like age, sex, familial status, parental consanguinity. &nbsp;We also described specific clinical symptoms associated with the cardiomyopathy condition in Indian population. Results: Our studies on mutation screening of phospholamban gene revealed two transitions (4880 C/T, 4887 T/G) in 5&rsquo; flanking region which might cause inherited dilated cardiomyopathy with refractory congestive heart failure are We further deliberated the gene polymorphism of renin angiotensin system gene angiotensin-1-converting enzyme as an associated marker/ modifier in cardiomyopathy patients and their family members. Conclusions: Information on epidemiological, clinical statistics, phospholamban gene mutation analysis and angiotensin-1-converting enzyme gene polymorphism is essential to guide the successful execution for future therapies and benefits us to identify those patients at risk for faster disease progression, congestive heart failure, and arrhythmia.

scholarly journals Epidemiology of heart failure and long-term follow-up outcomes in a north-African population: Results from the NAtional TUnisian REgistry of Heart Failure (NATURE-HF)

PLoS ONE ◽  
2021 ◽  
Vol 16 (5) ◽  
pp. e0251658
Author(s):  
Leila Abid ◽  
Salma Charfeddine ◽  
Ikram Kammoun ◽  
Manel Ben Halima ◽  
Hedi Ben Slima ◽  
...  
Keyword(s):  
Heart Failure ◽  
Mortality Rate ◽  
Clinical Epidemiology ◽  
North African ◽  
Long Term Follow Up ◽  
North African Population ◽  
The Mean ◽  
Initial Hospitalization

The NATURE-HF registry was aimed to describe clinical epidemiology and 1-year outcomes of outpatients and inpatients with heart failure (HF). This is a prospective, multicenter, observational survey conducted in Tunisian Cardiology centers. A total of 2040 patients were included in the study. Of these, 1632 (80%) were outpatients with chronic HF (CHF). The mean hospital stay was 8.7 ± 8.2 days. The mortality rate during the initial hospitalization event for AHF was 7.4%. The all-cause 1-year mortality rate was 22.8% among AHF patients and 10.6% among CHF patients. Among CHF patients, the older age, diabetes, anemia, reduced EF, ischemic etiology, residual congestion and the absence of ACEI/ ARBs treatment were independent predictors of 1-year cumulative rates of rehospitalization and mortality. The female sex and the functional status were independent predictors of 1-year all-cause mortality and rehospitalization in AHF patients. This study confirmed that acute HF is still associated with a poor prognosis, while the mid-term outcomes in patients with chronic HF seems to be improved. Some differences across countries may be due to different clinical characteristics and differences in healthcare systems.

scholarly journals Heart failure clinical care analysis uncovers risk reduction opportunities for preserved ejection fraction subtype

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Rebecca T. Levinson ◽  
Nataraja Sarma Vaitinidin ◽  
Eric Farber-Eger ◽  
Dan M. Roden ◽  
Thomas A. Lasko ◽  
...  
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Older Women ◽  
Clinical Epidemiology ◽  
Clinical Care ◽  
Cardiac Injury ◽  
Preserved Ejection Fraction ◽  
Reduced Ejection Fraction ◽  
Routine Clinical Care ◽  
Prevalent Subtype

AbstractHeart failure (HF) has no cure and, for HF with preserved ejection fraction (HFpEF), no life-extending treatments. Defining the clinical epidemiology of HF could facilitate earlier identification of high-risk individuals. We define the clinical epidemiology of HF subtypes (HFpEF and HF with reduced ejection fraction [HFrEF]), identified among 2.7 million individuals receiving routine clinical care. Differences in patterns and rates of accumulation of comorbidities, frequency of hospitalization, use of specialty care, were defined for each HF subtype. Among 28,156 HF cases, 8322 (30%) were HFpEF and 11,677 (42%) were HFrEF. HFpEF was the more prevalent subtype among older women. 177 Phenotypes differentially associated with HFpEF versus HFrEF. HFrEF was more frequently associated with diagnoses related to ischemic cardiac injury while HFpEF was associated more with non-cardiac comorbidities and HF symptoms. These comorbidity patterns were frequently present 3 years prior to a HFpEF diagnosis. HF subtypes demonstrated distinct patterns of clinical co-morbidities and disease progression. For HFpEF, these comorbidities were often non-cardiac and manifested prior to the onset of a HF diagnosis. Recognizing these comorbidity patterns, along the care continuum, may present a window of opportunity to identify individuals at risk for developing incident HFpEF.

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