757 results on '"Harjola, Veli-Pekka"'
Search Results
102. International Perspectives on Emergency Department Crowding
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Pines, Jesse M., Hilton, Joshua A., Weber, Ellen J., Alkemade, Annechien J., Al Shabanah, Hasan, Anderson, Philip D., Bernhard, Michael, Bertini, Alessio, Gries, André, Ferrandiz, Santiago, Kumar, Vijaya Arun, Harjola, Veli-Pekka, Hogan, Barbara, Madsen, Bo, Mason, Suzanne, Öhlén, Gunnar, Rainer, Timothy, Rathlev, Niels, Revue, Eric, Richardson, Drew, Sattarian, Mehdi, and Schull, Michael J.
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- 2011
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103. Reduction in membrane component of diffusing capacity is associated with the extent of acute pulmonary embolism
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Piirilä, Päivi, Laiho, Mia, Mustonen, Pirjo, Graner, Marit, Piilonen, Anneli, Raade, Merja, Sarna, Seppo, Harjola, Veli-Pekka, and Sovijärvi, Anssi
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- 2011
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104. Survival and quality of life after early discharge in low-risk pulmonary embolism
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Barco, Stefano, primary, Schmidtmann, Irene, additional, Ageno, Walter, additional, Anušić, Toni, additional, Bauersachs, Rupert M., additional, Becattini, Cecilia, additional, Bernardi, Enrico, additional, Beyer-Westendorf, Jan, additional, Bonacchini, Luca, additional, Brachmann, Johannes, additional, Christ, Michael, additional, Czihal, Michael, additional, Duerschmied, Daniel, additional, Empen, Klaus, additional, Espinola-Klein, Christine, additional, Ficker, Joachim H., additional, Fonseca, Cândida, additional, Genth-Zotz, Sabine, additional, Jiménez, David, additional, Harjola, Veli-Pekka, additional, Held, Matthias, additional, Iogna Prat, Lorenzo, additional, Lange, Tobias J., additional, Lankeit, Mareike, additional, Manolis, Athanasios, additional, Meyer, Andreas, additional, Münzel, Thomas, additional, Mustonen, Pirjo, additional, Rauch-Kroehnert, Ursula, additional, Ruiz-Artacho, Pedro, additional, Schellong, Sebastian, additional, Schwaiblmair, Martin, additional, Stahrenberg, Raoul, additional, Valerio, Luca, additional, Westerweel, Peter E., additional, Wild, Philipp S., additional, and Konstantinides, Stavros V., additional
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- 2020
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105. Epidemiology, treatment and outcome of patients with lower respiratory tract infection presenting to emergency departments with dyspnoea ( AANZDEM and EuroDEM studies)
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Rousseau, Geoffroy, primary, Keijzers, Gerben, additional, van Meer, Oene, additional, Craig, Simon, additional, Karamercan, Mehmet, additional, Klim, Sharon, additional, Body, Richard, additional, Kuan, Win Sen, additional, Harjola, Veli‐Pekka, additional, Jones, Peter, additional, Verschuren, Franck, additional, Holdgate, Anna, additional, Christ, Michael, additional, Golea, Adela, additional, Capsec, Jean, additional, Barletta, Cinzia, additional, Graham, Colin A, additional, Garcia‐Castrillo, Luis, additional, Laribi, Said, additional, and Kelly, Anne‐Maree, additional
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- 2020
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106. Epidemiology, pathophysiology and contemporary management of cardiogenic shock – a position statement from the Heart Failure Association of the European Society of Cardiology
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Chioncel, Ovidiu, primary, Parissis, John, additional, Mebazaa, Alexandre, additional, Thiele, Holger, additional, Desch, Steffen, additional, Bauersachs, Johann, additional, Harjola, Veli‐Pekka, additional, Antohi, Elena‐Laura, additional, Arrigo, Mattia, additional, Ben Gal, Tuvia, additional, Celutkiene, Jelena, additional, Collins, Sean P., additional, DeBacker, Daniel, additional, Iliescu, Vlad A., additional, Jankowska, Ewa, additional, Jaarsma, Tiny, additional, Keramida, Kalliopi, additional, Lainscak, Mitja, additional, Lund, Lars H, additional, Lyon, Alexander R., additional, Masip, Josep, additional, Metra, Marco, additional, Miro, Oscar, additional, Mortara, Andrea, additional, Mueller, Christian, additional, Mullens, Wilfried, additional, Nikolaou, Maria, additional, Piepoli, Massimo, additional, Price, Susana, additional, Rosano, Giuseppe, additional, Vieillard‐Baron, Antoine, additional, Weinstein, Jean M., additional, Anker, Stefan D., additional, Filippatos, Gerasimos, additional, Ruschitzka, Frank, additional, Coats, Andrew J.S., additional, and Seferovic, Petar, additional
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- 2020
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107. External validation and comparison of the CardShock and IABP-SHOCK II risk scores in real-world cardiogenic shock patients
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Rivas-Lasarte, Mercedes, primary, Sans-Roselló, Jordi, additional, Collado-Lledó, Elena, additional, González-Fernández, Víctor, additional, Noriega, Francisco J, additional, Hernández-Pérez, Francisco J, additional, Fernández-Martínez, Juan, additional, Ariza, Albert, additional, Lidón, Rosa-Maria, additional, Viana-Tejedor, Ana, additional, Segovia-Cubero, Javier, additional, Harjola, Veli-Pekka, additional, Lassus, Johan, additional, Thiele, Holger, additional, and Sionis, Alessandro, additional
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- 2020
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108. Acute coronary syndromes and acute heart failure: a diagnostic dilemma and high‐risk combination. A statement from the Acute Heart Failure Committee of the Heart Failure Association of the European Society of Cardiology
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Harjola, Veli‐Pekka, primary, Parissis, John, additional, Bauersachs, Johann, additional, Brunner‐La Rocca, Hans‐Peter, additional, Bueno, Hector, additional, Čelutkienė, Jelena, additional, Chioncel, Ovidiu, additional, Coats, Andrew J.S., additional, Collins, Sean P., additional, de Boer, Rudolf A., additional, Filippatos, Gerasimos, additional, Gayat, Etienne, additional, Hill, Loreena, additional, Laine, Mika, additional, Lassus, Johan, additional, Lommi, Jyri, additional, Masip, Josep, additional, Mebazaa, Alexandre, additional, Metra, Marco, additional, Miró, Òscar, additional, Mortara, Andrea, additional, Mueller, Christian, additional, Mullens, Wilfried, additional, Peacock, W. Frank, additional, Pentikäinen, Markku, additional, Piepoli, Massimo F., additional, Polyzogopoulou, Effie, additional, Rudiger, Alain, additional, Ruschitzka, Frank, additional, Seferovic, Petar, additional, Sionis, Alessandro, additional, Teerlink, John R., additional, Thum, Thomas, additional, Varpula, Marjut, additional, Weinstein, Jean Marc, additional, and Yilmaz, Mehmet B., additional
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- 2020
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109. Imaging in patients with suspected acute heart failure: timeline approach position statement on behalf of the Heart Failure Association of the European Society of Cardiology
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Čelutkienė, Jelena, primary, Lainscak, Mitja, additional, Anderson, Lisa, additional, Gayat, Etienne, additional, Grapsa, Julia, additional, Harjola, Veli‐Pekka, additional, Manka, Robert, additional, Nihoyannopoulos, Petros, additional, Filardi, Pasquale Perrone, additional, Vrettou, Rosa, additional, Anker, Stefan D., additional, Filippatos, Gerasimos, additional, Mebazaa, Alexandre, additional, Metra, Marco, additional, Piepoli, Massimo, additional, Ruschitzka, Frank, additional, Zamorano, Jose Luis, additional, Rosano, Giuseppe, additional, and Seferovic, Petar, additional
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- 2020
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110. Circulating dipeptidyl peptidase 3 is a myocardial depressant factor: dipeptidyl peptidase 3 inhibition rapidly and sustainably improves haemodynamics
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Deniau, Benjamin, primary, Rehfeld, Linda, additional, Santos, Karine, additional, Dienelt, Anke, additional, Azibani, Feriel, additional, Sadoune, Malha, additional, Kounde, Paul R., additional, Samuel, Jane L., additional, Tolpannen, Heli, additional, Lassus, Johan, additional, Harjola, Veli‐Pekka, additional, Vodovar, Nicolas, additional, Bergmann, Andreas, additional, Hartmann, Oliver, additional, Mebazaa, Alexandre, additional, and Blet, Alice, additional
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- 2020
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111. CT‐IGFBP‐4 as a novel prognostic biomarker in acute heart failure
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Konev, Alexey A., primary, Kharitonov, Alexey V., additional, Rozov, Fedor N., additional, Altshuler, Evgeny P., additional, Serebryanaya, Daria V., additional, Lassus, Johan, additional, Harjola, Veli‐Pekka, additional, Katrukha, Alexey G., additional, and Postnikov, Alexander B., additional
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- 2020
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112. Markers of renal function and acute kidney injury in acute heart failure: definitions and impact on outcomes of the cardiorenal syndrome
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Lassus, Johan P.E., Nieminen, Markku S., Peuhkurinen, Keijo, Pulkki, Kari, Siirilä-Waris, Krista, Sund, Reijo, and Harjola, Veli-Pekka
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- 2010
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113. A pragmatic approach to the use of inotropes for the management of acute and advanced heart failure: An expert panel consensus
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Farmakis, Dimitrios, primary, Agostoni, Piergiuseppe, additional, Baholli, Loant, additional, Bautin, Andrei, additional, Comin-Colet, Josep, additional, Crespo-Leiro, Maria G., additional, Fedele, Francesco, additional, García-Pinilla, Jose Manuel, additional, Giannakoulas, George, additional, Grigioni, Francesco, additional, Gruchała, Marcin, additional, Gustafsson, Finn, additional, Harjola, Veli-Pekka, additional, Hasin, Tal, additional, Herpain, Antoine, additional, Iliodromitis, Efstathios K., additional, Karason, Kristjan, additional, Kivikko, Matti, additional, Liaudet, Lucas, additional, Ljubas-Maček, Jana, additional, Marini, Marco, additional, Masip, Josep, additional, Mebazaa, Alexandre, additional, Nikolaou, Maria, additional, Ostadal, Petr, additional, Põder, Pentti, additional, Pollesello, Piero, additional, Polyzogopoulou, Eftihia, additional, Pölzl, Gerhard, additional, Tschope, Carsten, additional, Varpula, Marjut, additional, von Lewinski, Dirk, additional, Vrtovec, Bojan, additional, Yilmaz, Mehmet Birhan, additional, Zima, Endre, additional, and Parissis, John, additional
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- 2019
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114. Haemodynamic Balance in Acute and Advanced Heart Failure: An Expert Perspective on the Role of Levosimendan
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Agostoni, Piergiuseppe, primary, Farmakis, Dimitrios T, additional, García-Pinilla, Jose M, additional, Harjola, Veli-Pekka, additional, Karason, Kristjan, additional, von Lewinski, Dirk, additional, Parissis, John, additional, Pollesello, Piero, additional, Pölzl, Gerhard, additional, Recio-Mayoral, Alejandro, additional, Reinecke, Alexander, additional, Yerly, Patrik, additional, and Zima, Endre, additional
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- 2019
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115. Short-Term Therapies for Treatment of Acute and Advanced Heart Failure—Why so Few Drugs Available in Clinical Use, Why Even Fewer in the Pipeline?
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Pollesello, Piero, primary, Ben Gal, Tuvia, additional, Bettex, Dominique, additional, Cerny, Vladimir, additional, Comin-Colet, Josep, additional, Eremenko, Alexandr A., additional, Farmakis, Dimitrios, additional, Fedele, Francesco, additional, Fonseca, Cândida, additional, Harjola, Veli-Pekka, additional, Herpain, Antoine, additional, Heringlake, Matthias, additional, Heunks, Leo, additional, Husebye, Trygve, additional, Ivancan, Visnja, additional, Karason, Kristian, additional, Kaul, Sundeep, additional, Kubica, Jacek, additional, Mebazaa, Alexandre, additional, Mølgaard, Henning, additional, Parissis, John, additional, Parkhomenko, Alexander, additional, Põder, Pentti, additional, Pölzl, Gerhard, additional, Vrtovec, Bojan, additional, Yilmaz, Mehmet B., additional, and Papp, Zoltan, additional
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- 2019
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116. Epidemiology of patients presenting with dyspnea to emergency departments in Europe and the Asia-Pacific region
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Laribi, Said, primary, Keijzers, Gerben, additional, van Meer, Oene, additional, Klim, Sharon, additional, Motiejunaite, Justina, additional, Kuan, Win Sen, additional, Body, Richard, additional, Jones, Peter, additional, Karamercan, Mehmet, additional, Craig, Simon, additional, Harjola, Veli-Pekka, additional, Holdgate, Anna, additional, Golea, Adela, additional, Graham, Colin, additional, Verschuren, Franck, additional, Capsec, Jean, additional, Christ, Michael, additional, Grammatico-Guillon, Leslie, additional, Barletta, Cinzia, additional, Garcia-Castrillo, Luis, additional, and Kelly, Anne-Maree, additional
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- 2019
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117. Dinámica de microARN circulantes en pacientes con infarto agudo de miocardio con elevación del segmento ST con shock cardiogénico
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Iborra-Egea, Oriol, primary, Rueda, Ferran, additional, Lakkisto, Päivi, additional, Harjola, Veli-Pekka, additional, García-García, Cosme, additional, and Bayes-Genis, Antoni, additional
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- 2019
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118. Circulating MiRNA Dynamics in ST-Segment Elevation Myocardial Infarction-driven Cardiogenic Shock
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Iborra-Egea, Oriol, primary, Rueda, Ferran, additional, Lakkisto, Päivi, additional, Harjola, Veli-Pekka, additional, García-García, Cosme, additional, and Bayes-Genis, Antoni, additional
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- 2019
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119. Characteristics, outcomes, and predictors of mortality at 3 months and 1 year in patients hospitalized for acute heart failure
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Harjola, Veli-Pekka, Follath, Ferenc, Nieminen, Markku S., Brutsaert, Dirk, Dickstein, Kenneth, Drexler, Helmut, Hochadel, Matthias, Komajda, Michel, Lopez-Sendon, Jose L., Ponikowski, Piotr, and Tavazzi, Luigi
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- 2010
120. Time delays to reach dispatch centres in different regions in Europe. Are we losing the window of opportunity? - The EUROCALL study
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Nikolaou, Nikolaos, Castren, Maaret, Monsieurs, Koenraad G., Cimpoesu, Diana, Georgiou, Marios, Raffay, Violetta, Koster, Rudolph, Hunyadi-Anticevic, Silvija, Truhlar, Anatolij, Bossaert, Leo, EUROCALL Invest, Harjola, Veli-Pekka, EUROCALL Invest, Department of Diagnostics and Therapeutics, Clinicum, Anestesiologian yksikkö, HUS Emergency Medicine and Services, Amsterdam Cardiovascular Sciences, Cardiology, and ACS - Heart failure & arrhythmias
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Time delays ,medicine.medical_specialty ,Emergency Medical Services ,Time Factors ,medicine.medical_treatment ,030204 cardiovascular system & hematology ,Emergency Nursing ,Out of hospital cardiac arrest ,03 medical and health sciences ,0302 clinical medicine ,Medical dispatch ,medicine ,Emergency medical services ,Emergency medical services response times ,Humans ,Cardiopulmonary resuscitation ,Prospective Studies ,Window of opportunity ,Emergency medical service calls ,business.industry ,Telephone call ,HOSPITAL CARDIAC-ARREST ,030208 emergency & critical care medicine ,3126 Surgery, anesthesiology, intensive care, radiology ,medicine.disease ,Cardiopulmonary Resuscitation ,3. Good health ,Telephone ,Europe ,CARDIOPULMONARY-RESUSCITATION ,Median time ,3121 General medicine, internal medicine and other clinical medicine ,Emergency medicine ,SURVIVAL ,Emergency Medicine ,Emergency medical services Medical dispatch Emergency medical service calls Emergency medical services response times Cardiopulmonary Resuscitation ,Medical emergency ,Human medicine ,Cardiology and Cardiovascular Medicine ,business ,Regional differences - Abstract
Aim: In out of hospital cardiac arrest (OHCA) the start of Cardiopulmonary Resuscitation (CPR) by a single rescuer may be delayed considerably if the total time (TT) to connect the telephone call to the Emergency Medical Communication Centre (EMCC) is prolonged. EUROCALL investigated the TT-EMCC and its components using different calling procedures. Methods: This prospective, multicentre, randomised study was performed in April 2013. Telephone calls were randomly allocated to time of call, and to those connecting directly to the EMCC (1-step procedure) and those diverted before connecting to the EMCC (2-step procedure). Results: Twenty-one EMCCs from 11 countries participated in the study. Time to first ringtone was similar between 1-step 3.7 s (IQR 1.0-5.2) and 2-step calls 4.0 s (IQR 2.4-5.2). For the 1878 1-step calls, the median TT-EMCC was 11.7 s (IQR 8.7-18.5). For the 1550 2-step calls, the median time from first ringtone to first call-taker was 7 s (IQR 4.6-11.9) and from first call-taker to EMCC was 18.7 s (IQR 13.4-29.9). Median TT-EMCC was 33.2 s (IQR 24.7-46.1) and was significantly longer than the TT-EMCC observed with the 1-step procedure (P
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- 2017
121. Contemporary management of octogenarians hospitalized for heart failure in Europe: Euro Heart Failure Survey II
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Komajda, Michel, Hanon, Olivier, Hochadel, Matthias, Lopez-Sendon, Jose Luis, Follath, Ferenc, Ponikowski, Piotr, Harjola, Veli-Pekka, Drexler, Helmut, Dickstein, Kenneth, Tavazzi, Luigi, and Nieminen, Markku
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- 2009
122. Levosimendan in Cardiac Surgery
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Siirilä-Waris, Krista, Suojaranta-Ylinen, Raili, and Harjola, Veli-Pekka
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- 2005
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123. Definition and Epidemiology of Acute Heart Failure Syndromes
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Nieminen, Markku S. and Harjola, Veli-Pekka
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- 2005
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124. 2019 ESC Guidelines for the diagnosis and management of acute pulmonary embolism developed in collaboration with the European Respiratory Society (ERS)
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Konstantinides, Stavros V., Meyer, Guy, Becattini, Cecilia, Bueno, Hector, Geersing, Geert-Jan, Harjola, Veli-Pekka, Huisman, Menno V., Humbert, Marc, Jennings, Catriona Sian, Jimenez, David, Kucher, Nils, Lang, Irene Marthe, Lankeit, Mareike, Lorusso, Roberto, Mazzolai, Lucia, Meneveau, Nicolas, Ni Ainle, Fionnuala, Prandoni, Paolo, Pruszczyk, Piotr, Righini, Marc, Torbicki, Adam, Van Belle, Eric, Luis Zamorano, Jose, Nazzareno, Galié, J Simon, R Gibbs, Victor, Aboyans, Walter, Ageno, Stefan, Agewall, Ana, G Almeida, Felicita, Andreotti, Emanuele, Barbato, Johann, Bauersachs, Andreas, Baumbach, Farzin, Beygui, Jørn, Carlsen, Marco De Carlo, Marion, Delcroix, Victoria, Delgado, Pilar Escribano Subias, Donna, Fitzsimons, Sean, Gaine, Samuel, Z Goldhaber, Deepa, Gopalan, Gilbert, Habib, Sigrun, Halvorsen, David, Jenkins, Hugo, A Katus, Barbro, Kjellström, Mitja, Lainscak, Patrizio, Lancellotti, Geraldine, Lee, Grégoire Le Gal, Emmanuel, Messas, Joao, Morais, Steffen, E Petersen, Anna Sonia Petronio, Massimo Francesco Piepoli, Susanna, Price, Marco, Roffi, Aldo, Salvi, Olivier, Sanchez, Evgeny, Shlyakhto, Iain, A Simpson, Stefan, Stortecky, Matthias, Thielmann, Anton Vonk Noordegraaf, Cecilia, Becattini, Héctor, Bueno, Geert-Jan, Geersing, Veli-Pekka, Harjola, Menno, V Huisman, Marc, Humbert, Catriona Sian Jennings, David, Jiménez, Nils, Kucher, Irene Marthe Lang, Mareike, Lankeit, Roberto, Lorusso, Lucia, Mazzolai, Nicolas, Meneveau, Fionnuala Ní Áinle, Paolo, Prandoni, Piotr, Pruszczyk, Marc, Righini, Adam, Torbicki, Eric, Vanbelle, José, Luiszamorano, Stephan, Windecker, Colin, Baigent, Jean-Philippe, Collet, Veronica, Dean, Chris, P Gale, Diederick, Grobbee, Gerhard, Hindricks, Bernard, Iung, Peter, Jüni, Ulf, Landmesser, Christophe, Leclercq, Maddalena, Lettino, Basil, S Lewis, Bela, Merkely, Christian, Mueller, Dimitrios, J Richter, Miguel, Sousa-Uva, Rhian, M Touyz, Naima, Hammoudi, Hamlet, Hayrapetyan, Julia, Mascherbauer, Firdovsi, Ibrahimov, Oleg, Polonetsky, Mariya, Tokmakova, Bosko, Skoric, Ioannis, Michaloliakos, Martin, Hutyra, Søren, Mellemkjaer, Mansour, Mostafa, Julia, Reinmets, Pertti, Jääskeläinen, Denis, Angoulvant, George, Giannakoulas, Endre, Zima, Vizza, Carmine Dario, Akhmetzhan, Sugraliyev, Ibadete, Bytyçi, Aija, Maca, Egle, Ereminiene, Steve, Huijnen, Robert, Xuereb, Nadejda, Diaconu, Nebojsa, Bulatovic, Ilyasse, Asfalou, Marijan, Bosevski, Bożena, Sobkowicz, Daniel, Ferreira, Antoniu Octavian Petris, Olga, Moiseeva, Marco, Zavatta, Slobodan, Obradovic, Iveta, Šimkova, Peter, Radsel, Borja, Ibanez, Gerhard, Wikström, Drahomir, Aujesky, Cihangir, Kaymaz, Alexander, Parkhomenko, Joanna, Pepke-Zaba, University of Zurich, Konstantinides, Stavros V, Unité de Recherche sur les Maladies Cardiovasculaires, du Métabolisme et de la Nutrition = Institute of cardiometabolism and nutrition (ICAN), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pitié-Salpêtrière [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Konstantinides S.V., Meyer G., Bueno H., Galie N., Gibbs J.S.R., Ageno W., Agewall S., Almeida A.G., Andreotti F., Barbato E., Baumbach A., Beygui F., Carlsen J., De Carlo M., Delcroix M., Subias P.E., Gaine S., Goldhaber S.Z., Gopalan D., Habib G., Jenkins D., Kjellstrom B., Lainscak M., Lee G., Le Gal G., Messas E., Morais J., Piepoli M.F., Price S., Salvi A., Sanchez O., Stortecky S., Thielmann M., Noordegraaf A.V., Becattini C., Geersing G.-J., Harjola V.-P., Huisman M.V., Humbert M., Jennings C.S., Jimenez D., Kucher N., Lang I., Lankeit M., Lorusso R., Mazzolai L., Meneveau N., Ainle F.N., Prandoni P., Pruszczyk P., Righini M., Torbicki A., Van Belle E., Zamorano J.L., Windecker S., Aboyans V., Baigent C., Collet J.-P., Dean V., Delgado V., Fitzsimons D., Gale C.P., Grobbee D.E., Hindricks G., Iung B., Juni P., Katus H.A., Landmesser U., Leclercq C., Lettino M., Lewis B.S., Merkely B., Mueller C., Petersen S.E., Petronio A.S., Richter D.J., Roffi M., Shlyakhto E., Simpson I.A., Sousa-Uva M., Touyz R.M., Hammoudi N., Hayrapetyan H., Mascherbauer J., Ibrahimov F., Polonetsky O., Lancellotti P., Tokmakova M., Skoric B., Michaloliakos I., Hutyra M., Mellemkjaer S., Mansour M., Reinmets J., Jaaskelainen P., Angoulvant D., Bauersachs J., Giannakoulas G., Zima E., Vizza C.D., Sugraliyev A., Bytyci I., Maca A., Ereminiene E., Huijnen S., Xuereb R., Diaconu N., Bulatovic N., Asfalou I., Bosevski M., Halvorsen S., Sobkowicz B., Ferreira D., Petris A.O., Moiseeva O., Zavatta M., Obradovic S., Simkova I., Radsel P., Ibanez B., Wikstrom G., Aujesky D., Kaymaz C., Parkhomenko A., Pepke-Zaba J., CTC, MUMC+: MA Med Staf Spec CTC (9), and RS: Carim - V04 Surgical intervention
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ORAL ANTICOAGULANT-THERAPY ,diagnosis ,[SDV]Life Sciences [q-bio] ,Medizin ,030204 cardiovascular system & hematology ,Embolectomy ,Guideline ,RECURRENT VENOUS THROMBOEMBOLISM ,0302 clinical medicine ,Pregnancy ,Daily practice ,Diagnosis ,Pulmonary medicine ,Venous thrombosis ,Pulmonary Medicine ,Thrombolytic Therapy ,DEEP-VEIN THROMBOSIS ,Disease management (health) ,Societies, Medical ,ComputingMilieux_MISCELLANEOUS ,health care economics and organizations ,Risk assessment ,ddc:616 ,RIGHT-VENTRICULAR DYSFUNCTION ,Disease Management ,Shock ,MOLECULAR-WEIGHT HEPARIN ,Thrombolysis ,humanities ,3. Good health ,Pulmonary embolism ,Europe ,Anticoagulation ,Biomarkers ,Dyspnoea ,Echocardiography ,Guidelines ,Heart failure ,Right ventricle ,Treatment ,Venous thromboembolism ,medicine.vein ,Acute Disease ,Medical emergency ,Cardiology and Cardiovascular Medicine ,guidelines ,pulmonary embolism ,venous thrombosis ,shock dyspnoea ,heart failure: right ventricle: diagnosis ,risk assessment: echocardiography ,biomarkers ,treatment ,anticoagulation ,thrombolysis ,pregnancy ,venous thromboembolism ,embolectomy ,Diagnosi ,education ,Cardiology ,MEDLINE ,Thrombolysi ,610 Medicine & health ,Inferior vena cava ,2705 Cardiology and Cardiovascular Medicine ,EXTRACORPOREAL MEMBRANE-OXYGENATION ,03 medical and health sciences ,Medical ,medicine ,Humans ,RIGHT HEART THROMBI ,VENTILATION-PERFUSION SCINTIGRAPHY ,Health professionals ,business.industry ,INFERIOR VENA-CAVA ,10031 Clinic for Angiology ,Anticoagulants ,030229 sport sciences ,Biomarker ,medicine.disease ,INHALED NITRIC-OXIDE ,Societies ,business - Abstract
Guidelines summarize and evaluate available evidence with the aim of assisting health professionals in proposing the best management strategies for an individual patient with a given condition. Guidelines and their recommendations should facilitate decision making of health professionals in their daily practice. However, the final decisions concerning an individual patient must be made by the responsible health professional(s) in consultation with the patient and caregiver as appropriate.
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- 2019
125. Pre-hospital management protocols and perceived difficulty in diagnosing acute heart failure
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Harjola, Pia, Miro, Oscar, Martin-Sanchez, Francisco J., Escalada, Xavier, Freund, Yonathan, Penaloza, Andrea, Christ, Michael, Cone, David C., Laribi, Said, Kuisma, Markku, Tarvasmaki, Tuukka, Harjola, Veli-Pekka, Dupriez, Florence, Hachimi Idrissi, Saïd, Leach, Robert, Mols, Pierre, Thys, Frederic, Vannuffelen, Marc, Vermylen, Olivier, Ezekowitz, Justin, Weiss, Dale, Gregor, Roman, Kruse, Nanna, Rognas, Leif, Korgvee, Ago, Hoppu, Sanna, Iirola, Timo, Kurola, Jouni, Lund, Vesa, Martikainen, Matti, Makela, Pekka, Torronen, Kari, Wilen, Susanna, Bot, Emilie, Braun, Fracnois, Chouihed, Tahar, Claret, Pierre-Geraud, Desmettre, Thibaut, Dyani, Mohammed, Goldstein, Patrick, Mansour, Cherif, Meyer, Isabelle, Mimoz, Olivier, Montassier, Emmanuel, Ricard-Hibon, Agnes, Reuter, Paul-Georges, Tazarourte, Karim, Moeckel, Martin, Di Somma, Salvatore, Metra, Marco, Celutkiene, Jelena, Pumputiene, Vanda, Claessens, Yann-Erick, Sandberg, Marten, Banaszewski, Marek, Rekosz, Jerzy, Han, Lim Swee, Lainscak, Mitja, Martin, Javier, Collins, Sean P., Dunne, Robert B., Goodloe, Jeffrey M., Guss, David, Harrell, Andrew J., Hazlitt, Melissa, Hong, Rick, Knapp, Joshua M., Lubin, Jeffrey S., Luk, Jeffrey H., MacNeal, James, McKinney, Jared, Mercer, Mary P., Portela, Roberto C., Pruett, Kim, Rosenberg, Paul, Swanson, Doug, Weisberg, Stacy N., Yee, Allen, Université Pierre et Marie Curie - Paris 6 (UPMC), Biomarqueurs CArdioNeuroVASCulaires (BioCANVAS), Université Paris 13 (UP13)-Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM), University of Helsinki, Čelutkienė, Jelena, Supporting clinical sciences, Research Group Critical Care and Cerebral Resuscitation, Department of Diagnostics and Therapeutics, HUS Emergency Medicine and Services, Clinicum, HUS Heart and Lung Center, Kardiologian yksikkö, UCL - SSS/IREC/MEDA - Pôle de médecine aiguë, UCL - SSS/IREC/EPID - Pôle d'épidémiologie et biostatistique, and UCL - (SLuc) Service des urgences
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lcsh:Diseases of the circulatory (Cardiovascular) system ,[SDV]Life Sciences [q-bio] ,030204 cardiovascular system & hematology ,Chest pain ,GUIDELINES ,Electrocardiography ,0302 clinical medicine ,Risk Factors ,Surveys and Questionnaires ,Original Research Articles ,Emergency medical services ,Medicine and Health Sciences ,Pre-hospital ,030212 general & internal medicine ,Myocardial infarction ,Hospital Mortality ,Original Research Article ,Stroke ,ComputingMilieux_MISCELLANEOUS ,CARDIOLOGY ,OUTCOMES ,EUROPEAN-SOCIETY ,3. Good health ,Pulmonary embolism ,TIME ,Europe ,Survival Rate ,Acute Disease ,Emergency care ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,medicine.medical_specialty ,Pre‐hospital ,ESC ,FUROSEMIDE ,Risk Assessment ,MORPHINE ,03 medical and health sciences ,ONE-YEAR MORTALITY ,medicine ,Humans ,Asthma ,Retrospective Studies ,Heart Failure ,business.industry ,Acute heart failure ,medicine.disease ,Advanced life support ,lcsh:RC666-701 ,3121 General medicine, internal medicine and other clinical medicine ,Heart failure ,REGISTRY ,Emergency medicine ,Dispatching centre ,business ,Follow-Up Studies - Abstract
Aim To illustrate the pre-hospital management arsenals and protocols in different EMS units, and to estimate the perceived difficulty of diagnosing suspected acute heart failure (AHF) compared with other common pre-hospital conditions. Methods and results A multinational survey included 104 emergency medical service (EMS) regions from 18 countries. Diagnostic and therapeutic arsenals related to AHF management were reported for each type of EMS unit. The prevalence and contents of management protocols for common medical conditions treated pre-hospitally was collected. The perceived difficulty of diagnosing AHF and other medical conditions by emergency medical dispatchers and EMS personnel was interrogated. Ultrasound devices and point-of-care testing were available in advanced life support and helicopter EMS units in fewer than 25% of EMS regions. AHF protocols were present in 80.8% of regions. Protocols for ST-elevation myocardial infarction, chest pain, and dyspnoea were present in 95.2, 80.8, and 76.0% of EMS regions, respectively. Protocolized diagnostic actions for AHF management included 12-lead electrocardiogram (92.1% of regions), ultrasound examination (16.0%), and point-of-care testings for troponin and BNP (6.0 and 3.5%). Therapeutic actions included supplementary oxygen (93.2%), non-invasive ventilation (80.7%), intravenous furosemide, opiates, nitroglycerine (69.0, 68.6, and 57.0%), and intubation 71.5%. Diagnosing suspected AHF was considered easy to moderate by EMS personnel and moderate to difficult by emergency medical dispatchers (without significant differences between de novo and decompensated heart failure). In both settings, diagnosis of suspected AHF was considered easier than pulmonary embolism and more difficult than ST-elevation myocardial infarction, asthma, and stroke. Conclusions The prevalence of AHF protocols is rather high but the contents seem to vary. Difficulty of diagnosing suspected AHF seems to be moderate compared with other pre-hospital conditions.
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- 2019
126. Acute heart failure congestion and perfusion status - impact of the clinical classification on in-hospital and long-term outcomes; insights from the ESC-EORP-HFA Heart Failure Long-Term Registry
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Chioncel, Ovidiu, Mebazaa, Alexandre, Maggioni, Aldo P, Harjola, Veli-Pekka, Rosano, Giuseppe, Laroche, Cecile, Piepoli, Massimo F, Crespo-Leiro, Maria G, Lainscak, Mitja, Ponikowski, Piotr, Filippatos, Gerasimos, Ruschitzka, Frank, Seferovic, Petar, Coats, Andrew J S, Lund, Lars H, ESC-EORP HFA Heart Failure Long-Term Registry Investigators, University of Zurich, and Chioncel, Ovidiu
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10209 Clinic for Cardiology ,610 Medicine & health ,2705 Cardiology and Cardiovascular Medicine - Published
- 2019
127. Serum Lactate and A Relative Change in Lactate as Predictors of Mortality in Patients With Cardiogenic Shock - Results from the Cardshock Study
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John Parissis, Jindrich Spinar, Johan Lassus, Marek Banaszewski, José Silva-Cardoso, Lars Køber, Valentina Carubelli, Harjola Veli-Pekka, Alexandre Mebazaa, Matias Greve Lindholm, Mari Hongisto, diSomma Salvatore, and Alessandro Sionis
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Adult ,Male ,medicine.medical_specialty ,acute heart failure ,medicine.medical_treatment ,A relative change in lactate ,Shock, Cardiogenic ,030204 cardiovascular system & hematology ,Critical Care and Intensive Care Medicine ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,medicine ,Humans ,In patient ,Myocardial infarction ,Lactic Acid ,Aged ,Proportional Hazards Models ,Aged, 80 and over ,lactate ,business.industry ,Cardiogenic shock ,cardiogenic shock ,Hazard ratio ,Hemodynamics ,Percutaneous coronary intervention ,030208 emergency & critical care medicine ,prediction ,Middle Aged ,medicine.disease ,mortality ,Confidence interval ,3. Good health ,lactate clearance ,Multivariate Analysis ,Emergency Medicine ,Cardiology ,Population study ,Female ,business ,Anaerobic exercise - Abstract
Introduction: Cardiogenic shock complicating acute myocardial infarction has a very high mortality. Our present study focuses on serial measurement of lactate during admission due to cardiogenic shock and the prognostic effect of lactate and a relative change in lactate in patients after admission and the institution of intensive care treatment. Methods and Results: This is a secondary analysis of the CardShock study. Data on lactate at baseline were available on 217 of 219 patients. In the study population, the median baseline lactate was 2.8 mmol/L (min-max range, 0.5-23.1 mmol/L). At admission, lactate was predictive of 30-day mortality with an adjusted Hazard ratio (HR) of 1.20 mmol/L (95% confidence interval, CI 1.14-1.27). Within the first 24 h of admission, baseline lactate remained predictive of 30-day mortality. Lactate at 6 h had a HR of 1.14 (95% CI 1.06-1.24) and corresponding values at 12 and 24 h had a HR of 1.10 (1.04-1.17), and of HR 1.19 (95% CI 1.07-1.32), respectively. A 50% reduction in lactate within 6 h resulted in a HR of 0.82 (95% CI 0.72-0.94). Corresponding hazard ratios at 12 and 24 h, were 0.87 (95% CI 0.76-0.98) and 0.74 (95% CI 0.60-0.91), respectively. Conclusion: The main findings of the present study are that baseline lactate is a powerful predictor of 30-day mortality, lactate at 6, 12, and 24 h after admission are predictors of 30-day mortality, and a relative change in lactate is a significant predictor of survival within the first 24 h after instituting intensive care treatment adding information beyond the information from baseline values.
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- 2019
128. Hypoalbuminemia is a frequent marker of increased mortality in cardiogenic shock
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Jäntti, Toni, Tarvasmaki, Tuukka, Harjola, Veli-Pekka, Parissis, John, Pulkki, Kari, Javanainen, Tuija, Tolppanen, Heli, Jurkko, Raija, Hongisto, Mari, Kataja, Anu, Sionis, Alessandro, Silva-Cardoso, Jose, Banaszewski, Marek, Spinar, Jindrich, Mebazaa, Alexandre, Lassus, Johan, Kober, Lars, Metra, Marco, Di Somma, Salvatore, Koniari, Katerina, Voumvourakis, Astrinos, Karavidas, Apostolos, Sans-Rosello, Jordi, Vila, Montserrat, Duran-Cambra, Albert, Bulgari, Michela, Lazzarini, Valentina, Parenica, Jiri, Stipal, Roman, Ludka, Ondrej, Palsuva, Marie, Ganovska, Eva, Kubena, Petr, Lindholm, Matias G., Jarvinen, Kristiina, Nieminen, Tuomo, Soininen, Leena, Sund, Reijo, Tierala, Ilkka, Tolonen, Jukka, Varpula, Marjut, University of Helsinki, HYKS Sydän- ja keuhkokeskus, University of Helsinki, Clinicum, University of Helsinki, HYKS Leikkaussalit, teho- ja kivunhoito, University of Helsinki, Department of Medicine, University of Helsinki, Kardiologian yksikkö, University of Helsinki, Department of Diagnostics and Therapeutics, University of Helsinki, Dep. of Internal Medicine (Institute of Clinical Medicine) (-2009), University of Helsinki, Doctoral Programme in Clinical Research, University of Helsinki, Kliinisen kemian yksikkö (-2009), University of Helsinki, Public Health, University of Helsinki, University Management, HUS Heart and Lung Center, Kardiologian yksikkö, Clinicum, HUS Emergency Medicine and Services, Department of Diagnostics and Therapeutics, Department of Medicine, HUS Internal Medicine and Rehabilitation, Kliinisen kemian yksikkö (-2009), University Management, Faculty of Social Sciences, and HUSLAB
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Male ,Physiology ,LEVEL ,Myocardial Infarction ,Blood Pressure ,030204 cardiovascular system & hematology ,Biochemistry ,Vascular Medicine ,LEVELS PREDICT SURVIVAL ,0302 clinical medicine ,Risk Factors ,Cause of Death ,Odds Ratio ,Medicine and Health Sciences ,Coronary Heart Disease ,030212 general & internal medicine ,Myocardial infarction ,Hypoalbuminemia ,Hospital Mortality ,Prospective Studies ,Prospective cohort study ,Cause of death ,Multidisciplinary ,Cardiogenic shock ,Mortality rate ,ASSOCIATION ,Middle Aged ,SERUM-ALBUMIN CONCENTRATION ,ADMISSION ,3. Good health ,Body Fluids ,PROGNOSTIC VALUE ,Treatment Outcome ,Blood ,Shock (circulatory) ,Cardiology ,Medicine ,HEART-FAILURE ,Female ,medicine.symptom ,Anatomy ,Research Article ,medicine.medical_specialty ,Death Rates ,Science ,Shock, Cardiogenic ,3121 Internal medicine ,Blood Plasma ,03 medical and health sciences ,Population Metrics ,Internal medicine ,Albumins ,medicine ,MANAGEMENT ,Humans ,Aged ,Heart Failure ,RISK PREDICTION ,Population Biology ,business.industry ,Biology and Life Sciences ,Proteins ,Odds ratio ,Length of Stay ,medicine.disease ,3126 Surgery, anesthesiology, intensive care, radiology ,MYOCARDIAL-INFARCTION ,3121 General medicine, internal medicine and other clinical medicine ,business ,Ejection Fraction - Abstract
Altres ajuts: VPH was supported by the Aarne Koskelo Foundation (no grant number): http://www. aarnekoskelonsaatio.fi/, and the Finnish Cardiac Foundation (no grant number): https://www. fincardio.fi/. Laboratory kits were provided by Roche Diagnostics. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Introduction The prevalence of hypoalbuminemia, early changes of plasma albumin (P-Alb) levels, and their effects on mortality in cardiogenic shock are unknown. Materials and methods P-Alb was measured from serial blood samples in 178 patients from a prospective multinational study on cardiogenic shock. The association of hypoalbuminemia with clinical characteristics and course of hospital stay including treatment and procedures was assessed. Theprimary outcome was all-cause 90-day mortality. Results Hypoalbuminemia (P-Alb < 34g/L) was very frequent (75%) at baseline in patients with cardiogenic shock. Patients with hypoalbuminemia had higher mortality than patients with normal albumin levels (48% vs. 23%, p = 0.004). Odds ratio for death at 90 days was 2.4 [95% CI 1.5-4.1] per 10 g/L decrease in baseline P-Alb. The association with increased mortality remained independent in regression models adjusted for clinical risk scores developed for cardiogenic shock (CardShock score adjusted odds ratio 2.0 [95% CI 1.1-3.8], IABPSHOCK II score adjusted odds ratio 2.5 [95%CI 1.2-5.0]) and variables associated with hypoalbuminemia at baseline (adjusted odds ratio 2.9 [95%CI 1.2-7.1]). In serial measurements,albumin levels decreased at a similar rate between 0h and 72h in both survivors andnonsurvivors (ΔP-Alb -4.6 g/L vs. 5.4 g/L, p = 0.5). While the decrease was higher for patients with normal P-Alb at baseline (p 0.001 compared to patients with hypoalbuminemia at baseline), the rate of albumin decrease was not associated with outcome. Conclusions Hypoalbuminemia was a frequent finding early in cardiogenic shock, and P-Alb levels decreased during hospital stay. Low P-Alb at baseline was associated with mortality independently of other previously described risk factors. Thus, plasma albumin measurement should be part of the initial evaluation in patients with cardiogenic shock.
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- 2019
129. Treatments targeting inotropy: A position paper of the Committees on Translational Research and Acute Heart Failure of the Heart Failure Association of the European Society of Cardiology Heart failure/cardiomyopathy
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Maack, Christoph, Eschenhagen, Thomas, Hamdani, Nazha, Heinzel, Frank, Lyon, Alexander, Manstein, Dietmar, Metzger, Joseph, Papp, Zoltán, Tocchetti, Carlo, Birhan Yilmaz, M, Anker, Stefan, Balligand, Jean-Luc, Bauersachs, Johann, Brutsaert, Dirk, Carrier, Lucie, Chlopicki, Stefan, Cleland, John, De Boer, Rudolf, Dietl, Alexander, Fischmeister, Rodolphe, Harjola, Veli-Pekka, Heymans, Stephane, Hilfiker-Kleiner, Denise, Holzmeister, Johannes, de Keulenaer, Gilles, Limongelli, Giuseppe, Linke, Wolfgang, Lund, Lars, Masip, Josep, Metra, Marco, Mueller, Christian, Pieske, Burkert, Ponikowski, Piotr, Ristić, Arsen, Ruschitzka, Frank, Seferović, Petar, Skouri, Hadi, Zimmermann, Wolfram, Mebazaa, Alexandre, Department of Translational Research, Universitaetsklinikum Hamburg-Eppendorf = University Medical Center Hamburg-Eppendorf [Hamburg] (UKE), Royal Brompton Hospital, Hannover Medical School [Hannover] (MHH), University of Minnesota System, Signalisation et physiopathologie cardiaque, Université Paris-Sud - Paris 11 (UP11)-IFR141-Institut National de la Santé et de la Recherche Médicale (INSERM), University of Helsinki, Università degli Studi di Brescia [Brescia], Charité Campus Virchow-Klinikum (CVK), University Heart Centre Freiburg - Bad Krozingen, Département d'Anesthésie Réanimation SMUR [Paris], Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)
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[SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system ,ComputingMilieux_MISCELLANEOUS - Abstract
International audience
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- 2019
130. Haemodynamic Balance in Acute and Advanced Heart Failure: An Expert Perspective on the Role of Levosimendan
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Agostoni, Piergiuseppe Farmakis, Dimitrios T. García-Pinilla, Jose M. Harjola, Veli-Pekka Karason, Kristjan von Lewinski, Dirk Parissis, John Pollesello, Piero Pölzl, Gerhard Recio-Mayoral, Alejandro Reinecke, Alexander Yerly, Patrik Zima, Endre
- Abstract
Acute and advanced heart failure are associated with substantial adverse short- and longer-term prognosis. Both conditions necessitate complex treatment choices to restore haemodynamic stability and organ perfusion, relieve congestion, improve symptoms and allow the patient to leave the hospital and achieve an adequate quality of life. Among the available intravenous vasoactive therapies, inotropes constitute an option when an increase in cardiac contractility is needed to reverse a low output state. Within the inotrope category, levosimendan is well suited to the needs of both sets of patients since, in contrast to conventional adrenergic inotropes, it has not been linked in clinical trials or wider clinical usage with increased mortality risk and retains its efficacy in the presence of beta-adrenergic receptor blockade; it is further believed to possess beneficial renal effects. The overall haemodynamic profile and clinical tolerability of levosimendan, combined with its extended duration of action, have encouraged its intermittent use in patients with advanced heart failure. This paper summarises the key messages derived from a series of 12 tutorials held at the Heart Failure 2019 congress organised in Athens, Greece, by the Heart Failure Association of the European Society of Cardiology.
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- 2019
131. Prognostic value of cystatin C in acute heart failure in relation to other markers of renal function and NT-proBNP
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Lassus, Johan, Harjola, Veli-Pekka, Sund, Reijo, Siirilä-Waris, Krista, Melin, John, Peuhkurinen, Keijo, Pulkki, Kari, and Nieminen, Markku S.
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- 2007
132. New risk factors of heart failure?
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Siirilä-Waris, Krista, Lassus, Johan, and Harjola, Veli-Pekka
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- 2007
133. Characteristics, outcomes, and predictors of 1-year mortality in patients hospitalized for acute heart failure
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Siirilä-Waris, Krista, Lassus, Johan, Melin, John, Peuhkurinen, Keijo, Nieminen, Markku S., and Harjola, Veli-Pekka
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- 2006
134. EuroHeart Failure Survey II (EHFS II): a survey on hospitalized acute heart failure patients: description of population
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Nieminen, Markku S., Brutsaert, Dirk, Dickstein, Kenneth, Drexler, Helmut, Follath, Ferenc, Harjola, Veli-Pekka, Hochadel, Matthias, Komajda, Michel, Lassus, Johan, Lopez-Sendon, Jose Luis, Ponikowski, Piotr, and Tavazzi, Luigi
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- 2006
135. The FAST-FURO study: effect of very early administration of intravenous furosemide in the prehospital setting to patients with acute heart failure attending the emergency department.
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Miró, Òscar, Harjola, Pia, Rossello, Xavier, Gil, Víctor, Jacob, Javier, Llorens, Pere, Martín-Sánchez, Francisco Javier, Herrero, Pablo, Martínez-Nadal, Gemma, Aguiló, Sira, López-Grima, María Luisa, Fuentes, Marta, Álvarez Pérez, José María, Rodríguez-Adrada, Esther, Mir, María, Tost, Josep, Llauger, Lluís, Ruschitzka, Frank, Harjola, Veli-Pekka, and Mullens, Wilfried
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- 2021
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136. Mortality risk prediction in elderly patients with cardiogenic shock: results from the CardShock study.
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Hongisto, Mari, Lassus, Johan, Tarvasmäki, Tuukka, Sionis, Alessandro, Sans‐Rosello, Jordi, Tolppanen, Heli, Kataja, Anu, Jäntti, Toni, Sabell, Tuija, Lindholm, Matias Greve, Banaszewski, Marek, Silva Cardoso, Jose, Parissis, John, Di Somma, Salvatore, Carubelli, Valentina, Jurkko, Raija, Masip, Josep, and Harjola, Veli‐Pekka
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CARDIOGENIC shock ,CARDIOVASCULAR disease related mortality ,OLDER patients - Abstract
Aims: This study aimed to assess the utility of contemporary clinical risk scores and explore the ability of two biomarkers [growth differentiation factor‐15 (GDF‐15) and soluble ST2 (sST2)] to improve risk prediction in elderly patients with cardiogenic shock. Methods and results: Patients (n = 219) from the multicentre CardShock study were grouped according to age (elderly ≥75 years and younger). Characteristics, management, and outcome between the groups were compared. The ability of the CardShock risk score and the IABP‐SHOCK II score to predict in‐hospital mortality and the additional value of GDF‐15 and sST2 to improve risk prediction in the elderly was evaluated. The elderly constituted 26% of the patients (n = 56), with a higher proportion of women (41% vs. 21%, P < 0.05) and more co‐morbidities compared with the younger. The primary aetiology of shock in the elderly was acute coronary syndrome (84%), with high rates of percutaneous coronary intervention (87%). Compared with the younger, the elderly had higher in‐hospital mortality (46% vs. 33%; P = 0.08), but 1 year post‐discharge survival was excellent in both age groups (90% in the elderly vs. 88% in the younger). In the elderly, the risk prediction models demonstrated an area under the curve of 0.75 for the CardShock risk score and 0.71 for the IABP‐SHOCK II score. Incorporating GDF‐15 and sST2 improved discrimination for both risk scores with areas under the curve ranging from 0.78 to 0.84. Conclusions: Elderly patients with cardiogenic shock have higher in‐hospital mortality compared with the younger, but post‐discharge outcomes are similar. Contemporary risk scores proved useful for early mortality risk prediction also in the elderly, and risk stratification could be further improved with biomarkers such as GDF‐15 or sST2. [ABSTRACT FROM AUTHOR]
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- 2021
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137. Helical computerized tomography and NT-proBNP for screening of right ventricular overload on admission and at long term follow-up of acute pulmonary embolism
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Laiho Mia K, Harjola Veli-Pekka, Graner Marit, Piilonen Anneli, Raade Merja, and Mustonen Pirjo
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Non-high risk pulmonary embolism ,Follow-up ,right ventricular dysfunction ,NT-pro-BNP ,Echocardiography, helical CT ,CT pulmonary angiography ,Medical emergencies. Critical care. Intensive care. First aid ,RC86-88.9 - Abstract
Abstract Background Right ventricular dysfunction (RVD) in acute pulmonary embolism (APE) can be assessed with helical computerized tomography (CT) and transthoracic echocardiography (TTE). Signs of RVD and elevated natriuretic peptides like NT-proBNP and cardiac troponin (TnT) are associated with increased risk of mortality. However, the prognostic role of both initial diagnostic strategy and the use of NT-proBNP and TnT for screening for long-term probability of RVD remains unknown. The aim of the study was to determine the role of helical CT and NT-proBNP in detection of RVD in the acute phase. In addition, the value of NT-proBNP for ruling out RVD at long-term follow-up was assessed. Methods Sixty-three non-high risk APE patients were studied. RVD was assessed at admission in the emergency department by CT and TTE, and both NT-proBNP and TnT samples were taken. These, excepting CT, were repeated seven months later. Results At admission RVD was detected by CT in 37 (59 %) patients. RVD in CT correlated strongly with RVD in TTE (p < 0.0001). NT-proBNP was elevated (≥ 350 ng/l) in 32 (86 %) patients with RVD but in only seven (27 %) patients without RVD (p < 0.0001). All the patients survived until the 7-month follow-up. TTE showed persistent RVD in 6 of 63 (10 %) patients who all had RVD in CT at admission. All of them had elevated NT-proBNP levels in the follow-up compared with 5 (9 %) of patients without RVD (p < 0.0001). Conclusions TTE does not confer further benefit when helical CT is used for screening for RVD in non-high risk APE. All the patients who were found to have RVD in TTE at seven months follow-up had had RVD in the acute phase CT as well. Thus, patients without RVD in diagnostic CT do not seem to require further routine follow-up to screen for RVD later. On the other hand, persistent RVD and thus need for TTE control can be ruled out by assessment of NT-proBNP at follow-up. A follow-up protocol based on these findings is suggested.
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- 2012
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138. Focused echocardiography and lung ultrasound protocol for guiding treatment in acute heart failure
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Öhman, J., Harjola, Veli-Pekka, Karjalainen, P., Lassus, Johan, HUS Emergency Medicine and Services, Clinicum, University of Helsinki, Anestesiologian yksikkö, Department of Diagnostics and Therapeutics, HUS Heart and Lung Center, Department of Medicine, and Kardiologian yksikkö
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OUTCOMES ,RENAL-FUNCTION ,Cardiac filling pressures ,Lung ultrasound ,Acute heart failure ,ASSOCIATION ,Prognosis ,3126 Surgery, anesthesiology, intensive care, radiology ,CONGESTION ,Pulmonary congestion ,SCIENTIFIC STATEMENT ,Treatment ,KIDNEY ,Echocardiography ,3121 General medicine, internal medicine and other clinical medicine ,TRIAL - Abstract
Aims There is little evidence-based therapy existing for acute heart failure (AHF), hospitalizations are lengthy and expensive, and optimal monitoring of AHF patients during in-hospital treatment is poorly defined. We evaluated a rapid cardiothoracic ultrasound (CaTUS) protocol, combining focused echocardiographic evaluation of cardiac filling pressures, that is, medial E/e' and inferior vena cava index, with lung ultrasound (LUS) for guiding treatment in hospitalized AHF patients. Methods and results We enrolled 20 consecutive patients hospitalized for AHF, whose in-hospital treatment was guided using the CaTUS protocol according to a pre-specified treatment protocol targeting resolution of pulmonary congestion on LUS and lowering cardiac filling pressures. Treatment results of these 20 patients were compared with those of a standard care sample of 100 patients, enrolled previously for follow-up purposes. The standard care sample had CaTUS performed daily for follow-up and received standard in-hospital treatment without ultrasound guidance. All CaTUS exams were performed by a single experienced sonographer. The CaTUS-guided therapy resulted in significantly larger decongestion as defined by reduction in symptoms, cardiac filling pressures, natriuretic peptides, cumulative fluid loss, and resolution of pulmonary congestion (P
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- 2018
139. Right heart dysfunction and failure in heart failure with preserved ejection fraction: mechanisms and management. Position statement on behalf of the Heart Failure Association of the European Society of Cardiology
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Gorter, Thomas M, van Veldhuisen, Dirk J, Bauersachs, Johann, Borlaug, Barry A, Celutkiene, Jelena, Coats, Andrew J S, Crespo-Leiro, Marisa G, Guazzi, Marco, Harjola, Veli-Pekka, Heymans, Stephane, Hill, Loreena, Lainscak, Mitja, Lam, Carolyn S P, Lund, Lars H, Lyon, Alexander R, Mebazaa, Alexandre, Mueller, Christian, Paulus, Walter J, Pieske, Burkert, Piepoli, Massimo F, Ruschitzka, Frank, et al, and University of Zurich
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10209 Clinic for Cardiology ,610 Medicine & health ,Cardiology and Cardiovascular Medicine ,2705 Cardiology and Cardiovascular Medicine - Published
- 2018
140. Indications and practical approach to non-invasive ventilation in acute heart failure
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Masip, Josep, Peacock, W Frank, Price, Susanna, et al, Ruschitzka, Frank, Seferovic, Petar, Filippatos, Gerasimos, Zeymer, Uwe, Bueno, Hector, Lettino, Maddalena, Mebazaa, Alexandre, Harjola, Veli-Pekka, Mueller, Christian, University of Zurich, and Masip, Josep
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10209 Clinic for Cardiology ,610 Medicine & health ,2705 Cardiology and Cardiovascular Medicine - Published
- 2018
141. Circulating levels of 423-5p are associated with 90 day mortality in cardiogenic shock
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Jäntti, Toni, Segersvärd, Heli, Tolppanen, Heli, Tarvasmäki, Tuukka, Lassus, Johan, Devaux, Yvan, Vausort, Mélanie, Pulkki, Kari, Sionis, Alessandro, Bayés-Genís, Antoni, Tikkanen, Ilkka, Lakkisto, Päivi, Harjola, Veli-Pekka, and Universitat Autònoma de Barcelona. Departament de Medicina
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Mir-423-5p ,Acute coronary syndrome ,Mortality ,Prognosis ,Cardiogenic shock ,Microrna - Abstract
Ajuts: This work was supported by grants from the Finnish Foundation for Cardiovascular Research, Aarne Koskelo Foundation, Finnish Foundation for Laboratory Medicine, FinskaLäkaresällskapet, the Liv och Hälsa Foundation, and Finnish state funding for university-level research. The role of microRNAs has not been studied in cardiogenic shock. We examined the potential role of miR-423-5p level to predict mortality and associations of miR-423-5p with prognostic markers in cardiogenic shock. We conducted a prospective multinational observational study enrolling consecutive cardiogenic shock patients. Blood samples were available for 179 patients at baseline to determine levels of miR-423-5p and other biomarkers. Patients were treated according to local practice. Main outcome was 90 day all-cause mortality. Median miR-423-5p level was significantly higher in 90 day non-survivors [median 0.008 arbitrary units (AU) (interquartile range 0.003-0.017) vs. 0.004 AU (0.002-0.009), P = 0.003]. miR-423-5p level above median was associated with higher lactate (median 3.7 vs. 2.4 mmol/L, P = 0.001) and alanine aminotransferase levels (median 68 vs. 35 IU/L, P < 0.001) as well as lower cardiac index (1.8 vs. 2.4, P = 0.04) and estimated glomerular filtration rate (56 vs. 70 mL/min/1.73 m 2, P = 0.002). In Cox regression analysis, miR-423-5p level above median was associated with 90 day all-cause mortality independently of established risk factors of cardiogenic shock [adjusted hazard ratio 1.9 (95% confidence interval 1.2-3.2), P = 0.01]. In cardiogenic shock patients, above median level of miR-423-5p at baseline is associated with markers of hypoperfusion and seems to independently predict 90 day all-cause mortality.
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- 2018
142. Protein-based cardiogenic shock patient classifier
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Rueda, Ferran, primary, Borràs, Eva, additional, García-García, Cosme, additional, Iborra-Egea, Oriol, additional, Revuelta-López, Elena, additional, Harjola, Veli-Pekka, additional, Cediel, Germán, additional, Lassus, Johan, additional, Tarvasmäki, Tuukka, additional, Mebazaa, Alexandre, additional, Sabidó, Eduard, additional, and Bayés-Genís, Antoni, additional
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- 2019
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143. Treatment and outcome of adult patients with acute asthma in emergency departments in Australasia, South East Asia and Europe: Are guidelines followed? AANZDEM/EuroDEM study
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Craig, Simon, primary, Kuan, Win Sen, additional, Kelly, Anne‐Maree, additional, Van Meer, Oene, additional, Motiejunaite, Justina, additional, Keijzers, Gerben, additional, Jones, Peter, additional, Body, Richard, additional, Karamercan, Mehmet A, additional, Klim, Sharon, additional, Harjola, Veli‐Pekka, additional, Verschuren, Franck, additional, Holdgate, Anna, additional, Christ, Michael, additional, Golea, Adela, additional, Graham, Colin A, additional, Capsec, Jean, additional, Barletta, Cinzia, additional, Garcia‐Castrillo, Luis, additional, and Laribi, Said, additional
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- 2019
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144. Current Use and Impact on 30-Day Mortality of Pulmonary Artery Catheter in Cardiogenic Shock Patients: Results From the CardShock Study
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Sionis, Alessandro, primary, Rivas-Lasarte, Mercedes, additional, Mebazaa, Alexandre, additional, Tarvasmäki, Tuukka, additional, Sans-Roselló, Jordi, additional, Tolppanen, Heli, additional, Varpula, Marjut, additional, Jurkko, Raija, additional, Banaszewski, Marek, additional, Silva-Cardoso, Jose, additional, Carubelli, Valentina, additional, Lindholm, Matias Greve, additional, Parissis, John, additional, Spinar, Jindrich, additional, Lassus, Johan, additional, Harjola, Veli-Pekka, additional, and Masip, Josep, additional
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- 2019
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145. The use of diuretics in heart failure with congestion — a position statement from the Heart Failure Association of the European Society of Cardiology
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Mullens, Wilfried, primary, Damman, Kevin, additional, Harjola, Veli-Pekka, additional, Mebazaa, Alexandre, additional, Brunner-La Rocca, Hans-Peter, additional, Martens, Pieter, additional, M. Testani, Jeffrey, additional, Wilson Tang, W.H., additional, Orso, Francesco, additional, Rossignol, Patrick, additional, Metra, Marco, additional, Filippatos, Gerasimos, additional, M. Seferovic, Petar, additional, Ruschitzka, Frank, additional, and J. Coats, Andrew, additional
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- 2019
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146. The use of diuretics in heart failure with congestion - a position statement from the Heart Failure Association of the European Society of Cardiology.
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Mullens, Wilfried, Damman, Kevin, Harjola, Veli‐Pekka, Mebazaa, Alexandre, Brunner‐La Rocca, Hans‐Peter, Martens, Pieter, Testani, Jeffrey M., Tang, W.H. Wilson, Orso, Francesco, Rossignol, Patrick, Metra, Marco, Filippatos, Gerasimos, Seferovic, Petar M., Ruschitzka, Frank, Coats, Andrew J., Harjola, Veli-Pekka, and Brunner-La Rocca, Hans-Peter
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HEART failure ,DIURETICS ,HEART ,CARDIOLOGY ,CONSENSUS (Social sciences) ,MEDICAL societies ,RESEARCH funding ,STROKE volume (Cardiac output) - Abstract
The vast majority of acute heart failure episodes are characterized by increasing symptoms and signs of congestion with volume overload. The goal of therapy in those patients is the relief of congestion through achieving a state of euvolaemia, mainly through the use of diuretic therapy. The appropriate use of diuretics however remains challenging, especially when worsening renal function, diuretic resistance and electrolyte disturbances occur. This position paper focuses on the use of diuretics in heart failure with congestion. The manuscript addresses frequently encountered challenges, such as (i) evaluation of congestion and clinical euvolaemia, (ii) assessment of diuretic response/resistance in the treatment of acute heart failure, (iii) an approach towards stepped pharmacologic diuretic strategies, based upon diuretic response, and (iv) management of common electrolyte disturbances. Recommendations are made in line with available guidelines, evidence and expert opinion. [ABSTRACT FROM AUTHOR]
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- 2019
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147. Long‐term safety of intravenous cardiovascular agents in acute heart failure: results from the European Society of Cardiology Heart Failure Long‐Term Registry
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Mebazaa, Alexandre, Motiejunaite, Justina, Gayat, Etienne, Crespo-Leiro, María Generosa, Lund, Lars H., Maggioni, Aldo P., Chioncel, Ovidiu, Akiyama, Eiichi, Harjola, Veli-Pekka, Seferovic, Petar M., Laroche, Cécile, Sanz Julve, Marisa, Roig, Eulàlia, Ruschitzka, Frank, and Filippatos, Gerasimos
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Vasopressor ,Inotrope ,Vasodilator ,Acute heart failure ,Prognosis ,Long-term outcome - Abstract
[Abstract] Aims. The aim of this study was to assess long‐term safety of intravenous cardiovascular agents—vasodilators, inotropes and/or vasopressors—in acute heart failure (AHF). Methods and results. The European Society of Cardiology Heart Failure Long‐Term (ESC‐HF‐LT) registry was a prospective, observational registry conducted in 21 countries. Patients with unscheduled hospitalizations for AHF (n = 6926) were included: 1304 (18.8%) patients received a combination of intravenous (i.v.) vasodilators and diuretics, 833 (12%) patients received i.v. inotropes and/or vasopressors. Primary endpoint was long‐term all‐cause mortality. Main secondary endpoints were in‐hospital and post‐discharge mortality. Adjusted hazard ratio (HR) showed no association between the use of i.v. vasodilator and diuretic and long‐term mortality [HR 0.784, 95% confidence interval (CI) 0.596–1.032] nor in‐hospital mortality (HR 1.049, 95% CI 0.592–1.857) in the matched cohort (n = 976 paired patients). By contrast, adjusted HR demonstrated a detrimental association between the use of i.v. inotrope and/or vasopressor and long‐term all‐cause mortality (HR 1.434, 95% CI 1.128–1.823), as well as in‐hospital mortality (HR 1.873, 95% CI 1.151–3.048) in the matched cohort (n = 606 paired patients). No association was found between the use of i.v. inotropes and/or vasopressors and long‐term mortality in patients discharged alive (HR 1.078, 95% CI 0.769–1.512). A detrimental association with inotropes and/or vasopressors was seen in all geographic regions and, among catecholamines, dopamine was associated with the highest risk of death (HR 1.628, 95% CI 1.031–2.572 vs. no inotropes). Conclusions. Vasodilators did not demonstrate any association with long‐term clinical outcomes, while inotropes and/or vasopressors were associated with increased risk of all‐cause death, mostly related to excess of in‐hospital mortality in AHF.
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- 2017
148. Effects of the intensity of prehospital treatment on short-term outcomes in patients with acute heart failure: the SEMICA-2 study
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Mirã³, Ã’Scar, Hazlitt, Melissa, Escalada, Xavier, Llorens, Pere, Gil, Vãctor, MartÃn-Sánchez, Francisco Javier, Harjola, Pia, Rico, Verã³nica, Herrero-Puente, Pablo, Jacob, Javier, Cone, David C., Mã¶ckel, Martin, Christ, Michael, Freund, Yonathan, Di Somma, Salvatore, Laribi, Said, Mebazaa, Alexandre, Harjola, Veli-Pekka, Fuentes, Marta, Gil, Cristina, Alonso, Hã©ctor, Garmila, Pablo, Adrada, Esther RodrÃguez, Escoda, Rosa, Xipell, Carolina, Sã¡nchez, Carolina, Gaytan, Josep Mª, Salvo, Eva, Pérez-Durá, MarÃa José, Noval, Antonio, Torres, José M., Juan-Gómez, Maria Ãngeles, López-Grima, MarÃa Luisa, Valero, Amparo, Aguirre, Alfons, Pedragosa, Maria Àngels, Alonso, Maria Isabel, Ruiz, Francisco, Franco, José Miguel, DIAZ DELGADO, ELENA LOPEZ, Mecina, Ana Belén, Tost, Josep, Sã¡nchez, Susana, Piã±era, Pascual, Torres-Garate, Raquel, Alquezar, Aitor, Rizzi, Miguel Alberto, Herrera, Sergio, Cabello, Irene, Ãlvarez-Pérez, José MarÃa, López-Diez, Maria Pilar, Vázquez-Alvarez, Joaquin, Sánchez-Gonzalez, Marta, Gil-Román, Jose Juan, Carratalã¡, José Manuel, Brouzet, Benjamin, Marquina, Vãctor, Jimã©nez, Inmaculada, Hernã¡ndez, Nã©stor, Romã¡n, Francisco, Antonio Andueza, Juan, Romero, Rodolfo, Calvache, Roberto, Lorca, Maria Teresa, Calderã³n, Luis, Arriaga, Beatriz Amores, Sierra, Beatriz, MartÃn-Mojarro, Enrique, TraverÃa-Bécquer, Lisette, Llauger-Garcia, Lluãs, Corominas-LaSalle, Gerard, Agüera-Urbano, Carmen, Soy-Ferrer, Ester, Charité - UniversitätsMedizin = Charité - University Hospital [Berlin], Université Pierre et Marie Curie - Paris 6 (UPMC), Biomarqueurs CArdioNeuroVASCulaires (BioCANVAS), Université Paris 13 (UP13)-Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM), Département d'Anesthésie Réanimation SMUR [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), and University of Helsinki
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Male ,Emergency Medical Services ,Time Factors ,[SDV]Life Sciences [q-bio] ,030204 cardiovascular system & hematology ,0302 clinical medicine ,Risk Factors ,Positive airway pressure ,Clinical endpoint ,Odds Ratio ,030212 general & internal medicine ,Hospital Mortality ,Registries ,ComputingMilieux_MISCELLANEOUS ,Aged, 80 and over ,Furosemide ,General Medicine ,Combined Modality Therapy ,3. Good health ,prehospital care ,Treatment Outcome ,Acute Disease ,advanced life support ,outcome ,Cardiology ,Breathing ,Female ,Cardiology and Cardiovascular Medicine ,medicine.drug ,medicine.medical_specialty ,acute heart failure ,mortality ,cardiology and cardiovascular medicine ,Advanced Cardiac Life Support ,03 medical and health sciences ,Internal medicine ,Statistical significance ,medicine ,Humans ,Aged ,Heart Failure ,Chi-Square Distribution ,business.industry ,Odds ratio ,Length of Stay ,medicine.disease ,Advanced life support ,Logistic Models ,Spain ,Heart failure ,Emergency medicine ,business - Abstract
Little is known about treatments provided by advanced life support (ALS) ambulance teams to patients with acute heart failure (AHF) during the prehospital phase, and their influence on short-term outcome. We evaluated the effect of prehospital care in consecutive patients diagnosed with AHF in Spanish emergency departments (EDs). We selected patients from the EAHFE registry arriving at the ED by ALS ambulances with available follow-up data. We recorded specific prehospital ALS treatments (supplemental oxygen, diuretics, nitroglycerin, non-invasive ventilation) and patients were grouped according to whether they received low- (LIPHT; 0/1 treatments) or high-intensity prehospital therapy (HIPHT; > 1 treatment) for AHF. We also recorded 46 covariates. The primary endpoint was all-cause 7-day mortality, and secondary endpoints were prolonged hospitalisation (> 10 days) and in-hospital and 30-day mortality. Unadjusted and adjusted odds ratios were calculated to compare the groups. We included 1493 patients [mean age 80.7 (10) years; women 54.8%]. Prehospital treatment included supplemental oxygen in 71.2%, diuretics in 27.9%, nitroglycerin in 13.5%, and non-invasive ventilation in 5.3%. The LIPHT group included 1041 patients (70.0%) with an unadjusted OR for 7-day mortality of 1.770 (95% CI 1.115–2.811; p = 0.016), and 1.939 (95% CI 1.114–3.287, p = 0.014) after adjustment for 16 discordant covariables. The adjusted ORs for all secondary endpoints were always > 1 in the LIPHT group, but none reached statistical significance. Patients finally diagnosed with AHF at then ED that have received LIPHT by the ALS ambulance teams have a poorer short-term outcome, especially during the first 7 days.
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- 2017
149. Use of levosimendan in acute heart failure
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Harjola, Veli-Pekka, primary, Giannakoulas, George, additional, von Lewinski, Dirk, additional, Matskeplishvili, Simon, additional, Mebazaa, Alexandre, additional, Papp, Zoltan, additional, Schwinger, Robert H G, additional, Pollesello, Piero, additional, and Parissis, John T, additional
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- 2018
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150. Treatments targeting inotropy
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Maack, Christoph, primary, Eschenhagen, Thomas, additional, Hamdani, Nazha, additional, Heinzel, Frank R, additional, Lyon, Alexander R, additional, Manstein, Dietmar J, additional, Metzger, Joseph, additional, Papp, Zoltán, additional, Tocchetti, Carlo G, additional, Yilmaz, M Birhan, additional, Anker, Stefan D, additional, Balligand, Jean-Luc, additional, Bauersachs, Johann, additional, Brutsaert, Dirk, additional, Carrier, Lucie, additional, Chlopicki, Stefan, additional, Cleland, John G, additional, de Boer, Rudolf A, additional, Dietl, Alexander, additional, Fischmeister, Rodolphe, additional, Harjola, Veli-Pekka, additional, Heymans, Stephane, additional, Hilfiker-Kleiner, Denise, additional, Holzmeister, Johannes, additional, de Keulenaer, Gilles, additional, Limongelli, Giuseppe, additional, Linke, Wolfgang A, additional, Lund, Lars H, additional, Masip, Josep, additional, Metra, Marco, additional, Mueller, Christian, additional, Pieske, Burkert, additional, Ponikowski, Piotr, additional, Ristić, Arsen, additional, Ruschitzka, Frank, additional, Seferović, Petar M, additional, Skouri, Hadi, additional, Zimmermann, Wolfram H, additional, and Mebazaa, Alexandre, additional
- Published
- 2018
- Full Text
- View/download PDF
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