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Start Over Author "S, De Feo" Journal european journal of heart failure
3 results on '"S, De Feo"'

1. The ‘real’ woman with heart failure. Impact of sex on current in-hospital management of heart failure by cardiologists and internists

Author

Cesare Tomasi, Lucio Gonzini, Giuseppe Ambrosio, A. Di Lenarda, Aldo P. Maggioni, G. Di Tano, Paolo Bellis, S. De Feo, D. Fico, Cristina Opasich, and R. Lavecchia

Subjects
Male, medicine.medical_specialty, Digoxin, Vasodilator Agents, Management of heart failure, MEDLINE, Amiodarone, Angiotensin-Converting Enzyme Inhibitors, Spironolactone, Patient Readmission, chemistry.chemical_compound, Sex Factors, medicine, Humans, Hospital Mortality, Practice Patterns, Physicians', Intensive care medicine, Aged, Heart Failure, business.industry, Atrial fibrillation, Length of Stay, Prognosis, medicine.disease, Italy, chemistry, Heart failure, Emergency medicine, Etiology, Female, Cardiology and Cardiovascular Medicine, business, medicine.drug
Abstract

Aim: To identify differences between sexes in the clinical profile, use of resources, management and outcome in a large population of ‘real world’ patients with heart failure (HF). Methods: A prospective cross-sectional survey was conducted on 2127 consecutive patients (47% women) admitted with HF to 167 cardiology and 250 internal medicine departments between February 14 and 25, 2000. Results: Women were older, had a higher prevalence of atrial fibrillation, and more frequently a hypertensive or valvular aetiology. Females were admitted more frequently in Medical than in Cardiology Departments. The rate of invasive and non-invasive procedures was lower in women than in men, slightly higher if managed by cardiologists. Women were less frequently prescribed ACE-inhibitors, amiodarone, and spironolactone, and more frequently prescribed digoxin. In-hospital mortality was similar, without difference between health-care providers. A 6-month follow-up was performed in 56.4% of the cases in both setting, but less frequently in women. Event rates were similar with nearly half of patients re-hospitalised at least once. Conclusion: The ‘real’ HF woman has generally a more severe disease; she is an old lady who is more frequently hospitalised in a medical unit, receives few diagnostic, and cardiovascular procedures and pharmacological therapy, has a relatively low probability of dying in hospital, but a high likelihood of requiring readmission.

Published
2004
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2. Functional mitral regurgitation predicts 1-year mortality in elderly patients with systolic chronic heart failure.

Author

Cioffi G, Tarantini L, De Feo S, Pulignano G, Del Sindaco D, Stefenelli C, Di Lenarda A, and Opasich C

Subjects
Aged, Disease Progression, Echocardiography, Doppler, Color, Female, Follow-Up Studies, Heart Failure complications, Heart Failure physiopathology, Humans, Male, Mitral Valve Insufficiency diagnostic imaging, Mitral Valve Insufficiency physiopathology, Prognosis, Retrospective Studies, Stroke Volume physiology, Survival Rate, Heart Failure mortality, Mitral Valve Insufficiency complications
Abstract

Background and Aim: Mitral regurgitation (MR) has been demonstrated to be a powerful predictor of adverse outcome in middle-aged patients with chronic heart failure (CHF). In this study, we sought to define the prognostic impact of functional mitral regurgitation in a population of elderly patients with systolic CHF., Methods: One hundred seventy-five outpatients aged >70 years with validated CHF and left ventricular ejection fraction <40% underwent clinical and echocardiographic evaluations at baseline. Mitral regurgitation was diagnosed by Color Doppler and quantified in 5 categorical values using a 0-4+ grading system. Outcome measures included 1-year mortality and hospitalization for worsening CHF., Results: The distribution of patients according to the 5 different degrees of MR detected at baseline was: absent=11%, 1+=31%, 2+=38%, 3+=16%, 4+=4%. The relationship between MR and mortality was direct and approximately linear (r=0.39, p=0.00001). The prevalence of death in the 5 subgroups was 0%, 7%, 15%, 45%, 57%, respectively. Multivariate logistic regression analysis showed that MR was the strongest predictor of death (OR 4.47, 95% CI 1.50-13.0), independently of the presence of diabetes mellitus, older age and larger left ventricular end-diastolic volume. No association was found between MR and hospitalization for worsening CHF (r=0.08, p=0.41)., Conclusions: This study establishes the direct and independent relationship between MR severity and one-year mortality among elders with systolic CHF. Conversely, MR does not provide useful information regarding the risk of subsequent hospitalization for worsening CHF.

Published
2005
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3. Pharmacological left ventricular reverse remodeling in elderly patients receiving optimal therapy for chronic heart failure.

Author

Cioffi G, Tarantini L, De Feo S, Pulignano G, Del Sindaco D, Stefenelli C, and Opasich C

Subjects
Age Factors, Aged, Aged, 80 and over, Analysis of Variance, Cardiomyopathy, Dilated diagnostic imaging, Cardiomyopathy, Dilated mortality, Case-Control Studies, Dose-Response Relationship, Drug, Drug Administration Schedule, Drug Therapy, Combination, Echocardiography, Doppler methods, Female, Geriatric Assessment, Heart Function Tests, Humans, Logistic Models, Male, Maximum Tolerated Dose, Probability, Prospective Studies, Reference Values, Risk Assessment, Severity of Illness Index, Survival Rate, Ventricular Dysfunction, Left diagnostic imaging, Ventricular Dysfunction, Left mortality, Ventricular Remodeling physiology, Adrenergic beta-Antagonists administration & dosage, Angiotensin-Converting Enzyme Inhibitors administration & dosage, Cardiomyopathy, Dilated drug therapy, Ventricular Dysfunction, Left drug therapy, Ventricular Remodeling drug effects
Abstract

Background and Aims: In recent years, reversal of established left ventricular (LV) dilatation has been increasingly recognized in middle-aged patients with dilated cardiomyopathy receiving angiotensin-converting enzyme (ACE) inhibitors and/or beta-blockers. We performed this prospective study to evaluate whether optimized therapy for heart failure also induces LV reverse remodeling in older patients., Methods: One hundred and twenty-four patients aged >70 years with LV ejection fraction <40% underwent clinical and echocardiographic evaluation at baseline and after 1 year. During the early stage of follow-up, pharmacological therapy was optimized. LV reverse remodeling was defined as a reduction in LV end-diastolic volume >25% from baseline to final evaluation., Results: LV reverse remodeling was recognized in 32 patients (26%). Compared to the subjects who did not improve LV geometry, those with reverse remodeling had, at baseline, higher arterial blood pressure, lower serum creatinine levels, shorter duration of symptoms of heart failure, more frequently received beta-blocker therapy and had predominantly nonischemic aetiology. The variables associated with the development of reverse remodeling in the multivariate analysis were shorter duration of symptoms of heart failure (Odds ratio: 7.7; CI: 2.5-23.3, p=0.0001) and beta-blocker therapy (Odds ratio: 6.0; CI: 1.6-23.3, p=0.01)., Conclusions: LV reverse remodeling takes place in elderly as well as in younger heart failure patients. A significant proportion of elderly patients undergoes this favourable process which occurs prevalently in patients receiving beta-blocker therapy with a short history of cardiac disease.

Published
2005
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