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152. Predictive value of the baseline electrocardiogram ST-segment pattern in cardiogenic shock: Results from the CardShock Study.

Author

Javanainen, Tuija, Tolppanen, Heli, Lassus, Johan, Nieminen, Markku S., Sionis, Alessandro, Spinar, Jindrich, Silva‐Cardoso, José, Greve Lindholm, Matias, Banaszewski, Marek, Harjola, Veli‐Pekka, Jurkko, Raija, Silva-Cardoso, José, and Harjola, Veli-Pekka

Abstract

Background: The most common aetiology of cardiogenic shock (CS) is acute coronary syndrome (ACS), but even up to 20%-50% of CS is caused by other disorders. ST-segment deviations in the electrocardiogram (ECG) have been investigated in patients with ACS-related CS, but not in those with other CS aetiologies. We set out to explore the prevalence of different ST-segment patterns and their associations with the CS aetiology, clinical findings and 90-day mortality.Methods: We analysed the baseline ECG of 196 patients who were included in a multinational prospective study of CS. The patients were divided into 3 groups: (a) ST-segment elevation (STE). (b) ST-segment depression (STDEP). (c) No ST-segment deviation or ST-segment impossible to analyse (NSTD). A subgroup analysis of the ACS patients was conducted.Results: ST-segment deviations were present in 80% of the patients: 52% had STE and 29% had STDEP. STE was associated with the ACS aetiology, but one-fourth of the STDEP patients had aetiology other than ACS. The overall 90-day mortality was 41%: in STE 47%, STDEP 36% and NSTD 33%. In the multivariate mortality analysis, only STE predicted mortality (HR 1.74, CI95 1.07-2.84). In the ACS subgroup, the patients were equally effectively revascularized, and no differences in the survival were noted between the study groups.Conclusion: ST-segment elevation is associated with the ACS aetiology and high mortality in the unselected CS population. If STE is not present, other aetiologies must be considered. When effectively revascularized, the prognosis is similar regardless of the ST-segment pattern in ACS-related CS. [ABSTRACT FROM AUTHOR]

Published
2018
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153. Epidemiology, treatment and outcome of patients with lower respiratory tract infection presenting to emergency departments with dyspnoea (AANZDEM and EuroDEM studies).

Author

Rousseau, Geoffroy, Keijzers, Gerben, van Meer, Oene, Craig, Simon, Karamercan, Mehmet, Klim, Sharon, Body, Richard, Kuan, Win Sen, Harjola, Veli‐Pekka, Jones, Peter, Verschuren, Franck, Holdgate, Anna, Christ, Michael, Golea, Adela, Capsec, Jean, Barletta, Cinzia, Graham, Colin A, Garcia‐Castrillo, Luis, Laribi, Said, and Kelly, Anne‐Maree

Subjects
DYSPNEA, HOSPITAL emergency services, LONGITUDINAL method, EVALUATION of medical care, RESPIRATORY infections, COMORBIDITY, DESCRIPTIVE statistics
Abstract

Objective: Lower respiratory tract infection (LRTI) is a frequent cause of dyspnoea in EDs, and is associated with considerable morbidity and mortality. We described and compared the management of this disease in Europe and Oceania/South‐East Asia (SEA) cohorts. Methods: We conducted a prospective cohort study with three time points in Europe and Oceania/SEA. We included in this manuscript patients presenting to EDs with dyspnoea and a diagnosis of LRTI in ED. We collected comorbidities, chronic medication, clinical signs at arrival, laboratory parameters, ED management and patient outcomes. Results: A total of 1389 patients were included, 773 in Europe and 616 in SEA. The European cohort had more comorbidities including chronic heart failure, obesity, chronic obstructive pulmonary disease and smoking. Levels of inflammatory markers were higher in Europe. There were more patients with inflammatory markers in Europe and more hypercapnia in Oceania/SEA. The use of antibiotics was higher in SEA (72.2% vs 61.8%, P < 0.001) whereas intravenous diuretics, non‐invasive and invasive ventilation were higher in Europe. Intensive care unit admission rate was 9.9% in Europe cohort and 3.4% in Oceania/SEA cohort. ED mortality was 1% and overall in‐hospital mortality was 8.7% with no differences between regions. Conclusions: More patients with LRTI in Europe presented with cardio‐respiratory comorbidities, they received more adjunct therapies and had a higher intensive care unit admission rate than patients from Oceania/SEA, although mortality was similar between the two cohorts. [ABSTRACT FROM AUTHOR]

Published
2021
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154. External validation and comparison of the CardShock and IABP-SHOCK II risk scores in real-world cardiogenic shock patients.

Author

Rivas-Lasarte, Mercedes, Sans-Roselló, Jordi, Collado-Lledó, Elena, González-Fernández, Víctor, Noriega, Francisco J., Hernández-Pérez, Francisco J., Fernández-Martínez, Juan, Ariza, Albert, Lidón, Rosa-Maria, Viana-Tejedor, Ana, Segovia-Cubero, Javier, Harjola, Veli-Pekka, Lassus, Johan, Thiele, Holger, and Sionis, Alessandro

Published
2021
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155. Current Use and Impact on 30-Day Mortality of Pulmonary Artery Catheter in Cardiogenic Shock Patients: Results From the CardShock Study.

Author

Sionis, Alessandro, Rivas-Lasarte, Mercedes, Mebazaa, Alexandre, Tarvasmäki, Tuukka, Sans-Roselló, Jordi, Tolppanen, Heli, Varpula, Marjut, Jurkko, Raija, Banaszewski, Marek, Silva-Cardoso, Jose, Carubelli, Valentina, Lindholm, Matias Greve, Parissis, John, Spinar, Jindrich, Lassus, Johan, Harjola, Veli-Pekka, and Masip, Josep

Subjects
CARDIOGENIC shock, PULMONARY artery catheters, HOSPITAL mortality, HEMODYNAMICS, ARTIFICIAL respiration
Abstract

Background: Cardiogenic shock (CS) is the most life-threatening manifestation of acute heart failure. Its complexity and high inhospital mortality may justify the need for invasive monitoring with a pulmonary artery catheter (PAC). Methods: Patients with CS included in the CardShock Study, an observational, prospective, multicenter, European registry, were analyzed, aiming to describe the real-world use of PAC, evaluate its impact on 30-day mortality, and the ability of different hemodynamic parameters to predict outcomes. Results: Pulmonary artery catheter was used in 82 (37.4%) of the 219 patients. Cardiogenic shock patients who managed with a PAC received more frequently treatment with inotropes and vasopressors, mechanical ventilation, renal replacement therapy, and mechanical assist devices (P < .01). Overall 30-day mortality was 36.5%. Pulmonary artery catheter use did not affect mortality even after propensity score matching analysis (hazard ratio = 1.17 [0.59-2.32], P = .66). Cardiac index, cardiac power index (CPI), and stroke volume index (SVI) showed the highest areas under the curve for 30-day mortality (ranging from 0.752-0.803) and allowed for a significant net reclassification improvement of 0.467 (0.083-1.180), 0.700 (0.185-1.282), 0.683 (0.168-1.141), respectively, when added to the CardShock risk score. Conclusions: In our contemporary cohort of CS, over one-third of patients were managed with a PAC. Pulmonary artery catheter use was associated with a more aggressive treatment strategy. Nevertheless, PAC use was not associated with 30-day mortality. Cardiac index, CPI, and SVI were the strongest 30-day mortality predictors on top of the previously validated CardShock risk score. [ABSTRACT FROM AUTHOR]

Published
2020
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156. Nopeammin kotiin päivystyksestä

Author

Kankaanpää, Meri, Raitakari, Maria, Muukkonen, Leila, Gustafsson, Siv, Heitto, Merja, Palomäki, Ari, Suojanen, Kimmo, Harjola, Veli-Pekka, HUS Akuutti, Diagnostis-terapeuttinen osasto, HUSLAB, Clinicum, Kliinisen kemian ja hematologian osasto, Medicum, and Anestesiologian yksikkö

Subjects
3111 Biolääketieteet, 3126 Kirurgia, anestesiologia, tehohoito, radiologia
Abstract

Vieritestaus lyhensi kävelemään kykenevien potilaiden läpimenoaikaa Jorvin sairaalan päivystyksessä. Siihen liitetty ensiarviotyöparimalli nopeutti potilaiden kotiutumista edelleen. Kaikkiaan laboratoriokokeita tarvinneiden potilaiden käynti lyheni 46 minuutilla. Tutkimus on julkaistu aiemmin Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine -lehdessä (Kankaanpää M ym. Use of point-of-care testing and early assessment model reduces length of stay for ambulatory patients in an emergency department. Scand J Trauma Resusc Emerg Med 2016;24:125) ja tulokset julkaistaan tässä alkuperäisen julkaisijan luvalla.

Published
2017

157. External validation and comparison of the CardShock and IABP-SHOCK II risk scores in real-world cardiogenic shock patients

Author

Rivas-Lasarte, Mercedes, Sans-Roselló, Jordi, Collado-Lledó, Elena, González-Fernández, Víctor, Noriega, Francisco J, Hernández-Pérez, Francisco J, Fernández-Martínez, Juan, Ariza, Albert, Lidón, Rosa-Maria, Viana-Tejedor, Ana, Segovia-Cubero, Javier, Harjola, Veli-Pekka, Lassus, Johan, Thiele, Holger, and Sionis, Alessandro

Abstract

Background: Mortality from cardiogenic shock remains high and early recognition and risk stratification are mandatory for optimal patient allocation and to guide treatment strategy. The CardShock and the Intra-Aortic Balloon Counterpulsation in Acute Myocardial Infarction Complicated by Cardiogenic Shock (IABP-SHOCK II) risk scores have shown good results in predicting short-term mortality in cardiogenic shock. However, to date, they have not been compared in a large cohort of ischaemic and non-ischaemic real-world cardiogenic shock patients.Methods: The Red-Shock is a multicentre cohort of non-selected cardiogenic shock patients. We calculated the CardShock and IABP-SHOCK II risk scores in each patient and assessed discrimination and calibration.Results: We included 696 patients. The main cause of cardiogenic shock was acute coronary syndrome, occurring in 62% of the patients. Compared with acute coronary syndrome patients, non-acute coronary syndrome patients were younger and had a lower proportion of risk factors but higher rates of renal insufficiency; intra-aortic balloon pump was also less frequently used (31% vs 56%). In contrast, non-acute coronary syndrome patients were more often treated with mechanical circulatory support devices (11% vs 3%, p<0.001 for both). Both risk scores were good predictors of in-hospital mortality in acute coronary syndrome patients and had similar areas under the receiver-operating characteristic curve (area under the curve: 0.742 for the CardShock vs 0.752 for IABP-SHOCK II, p=0.65). Their discrimination performance was only modest when applied to non-acute coronary syndrome patients (0.648 vs 0.619, respectively, p=0.31). Calibration was acceptable for both scores (Hosmer-Lemeshow p=0.22 for the CardShock and 0.68 for IABP-SHOCK II).Conclusions: In our cohort, both the CardShock and the IABP-SHOCK II risk scores were good predictors of in-hospital mortality in acute coronary syndrome-related cardiogenic shock.

Published
2024
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158. Pre‐hospital management protocols and perceived difficulty in diagnosing acute heart failure.

Author

Harjola, Pia, Miró, Òscar, Martín‐Sánchez, Francisco J., Escalada, Xavier, Freund, Yonathan, Penaloza, Andrea, Christ, Michael, Cone, David C., Laribi, Said, Kuisma, Markku, Tarvasmäki, Tuukka, and Harjola, Veli‐Pekka

Subjects
HEART failure, EMERGENCY medical services, EMERGENCY medicine, MEDICAL protocols, POINT-of-care testing
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. [ABSTRACT FROM AUTHOR]

Published
2020
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159. Early discharge and home treatment of patients with low-risk pulmonary embolism with the oral factor Xa inhibitor rivaroxaban: an international multicentre single-arm clinical trial.

Author

Barco, Stefano, Schmidtmann, Irene, Ageno, Walter, Bauersachs, Rupert M, Becattini, Cecilia, Bernardi, Enrico, Beyer-Westendorf, Jan, Bonacchini, Luca, Brachmann, Johannes, Christ, Michael, Czihal, Michael, Duerschmied, Daniel, Empen, Klaus, Espinola-Klein, Christine, Ficker, Joachim H, Fonseca, Cândida, Genth-Zotz, Sabine, Jiménez, David, Harjola, Veli-Pekka, and Held, Matthias

Abstract

Aims To investigate the efficacy and safety of early transition from hospital to ambulatory treatment in low-risk acute PE, using the oral factor Xa inhibitor rivaroxaban. Methods and results We conducted a prospective multicentre single-arm investigator initiated and academically sponsored management trial in patients with acute low-risk PE (EudraCT Identifier 2013-001657-28). Eligibility criteria included absence of (i) haemodynamic instability, (ii) right ventricular dysfunction or intracardiac thrombi, and (iii) serious comorbidities. Up to two nights of hospital stay were permitted. Rivaroxaban was given at the approved dose for PE for ≥3 months. The primary outcome was symptomatic recurrent venous thromboembolism (VTE) or PE-related death within 3 months of enrolment. An interim analysis was planned after the first 525 patients, with prespecified early termination of the study if the null hypothesis could be rejected at the level of α = 0.004 (<6 primary outcome events). From May 2014 through June 2018, consecutive patients were enrolled in seven countries. Of the 525 patients included in the interim analysis, three (0.6%; one-sided upper 99.6% confidence interval 2.1%) suffered symptomatic non-fatal VTE recurrence, a number sufficiently low to fulfil the condition for early termination of the trial. Major bleeding occurred in 6 (1.2%) of the 519 patients comprising the safety population. There were two cancer-related deaths (0.4%). Conclusion Early discharge and home treatment with rivaroxaban is effective and safe in carefully selected patients with acute low-risk PE. The results of the present trial support the selection of appropriate patients for ambulatory treatment of PE. [ABSTRACT FROM AUTHOR]

Published
2020
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160. Epinephrine Versus Norepinephrine for Cardiogenic Shock After Acute Myocardial Infarction

Author

Levy, Bruno, primary, Clere-Jehl, Raphael, additional, Legras, Annick, additional, Morichau-Beauchant, Tristan, additional, Leone, Marc, additional, Frederique, Ganster, additional, Quenot, Jean-Pierre, additional, Kimmoun, Antoine, additional, Cariou, Alain, additional, Lassus, Johan, additional, Harjola, Veli-Pekka, additional, Meziani, Ferhat, additional, Louis, Guillaume, additional, Rossignol, Patrick, additional, Duarte, Kevin, additional, Girerd, Nicolas, additional, Mebazaa, Alexandre, additional, Vignon, Philippe, additional, Mattei, Mathieu, additional, Thivilier, Carine, additional, Perez, Pierre, additional, Auchet, Thomas, additional, Fritz, Caroline, additional, Boisrame-Helme, Julie, additional, Mercier, Emmanuelle, additional, Garot, Denis, additional, Perny, Jessica, additional, Gette, Sebastien, additional, Hammad, Emmanuelle, additional, Vigne, Coralie, additional, Dargent, Auguste, additional, Andreu, Pascal, additional, and Guiot, Philippe, additional

Published
2018
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161. Comprehensive in‐hospital monitoring in acute heart failure: applications for clinical practice and future directions for research. A statement from the Acute Heart Failure Committee of the Heart Failure Association (HFA) of the European Society of Cardiology (ESC)

Author

Harjola, Veli‐Pekka, primary, Parissis, John, additional, Brunner‐La Rocca, Hans‐Peter, additional, Čelutkienė, Jelena, additional, Chioncel, Ovidiu, additional, Collins, Sean P., additional, De Backer, Daniel, additional, Filippatos, Gerasimos S., additional, Gayat, Etienne, additional, Hill, Loreena, additional, Lainscak, Mitja, additional, Lassus, Johan, additional, Masip, Josep, additional, Mebazaa, Alexandre, additional, Miró, Òscar, additional, Mortara, Andrea, additional, Mueller, Christian, additional, Mullens, Wilfried, additional, Nieminen, Markku S., additional, Rudiger, Alain, additional, Ruschitzka, Frank, additional, Seferovic, Petar M., additional, Sionis, Alessandro, additional, Vieillard‐Baron, Antoine, additional, Weinstein, Jean Marc, additional, de Boer, Rudolf A., additional, Crespo‐Leiro, Maria G., additional, Piepoli, Massimo, additional, and Riley, Jillian P., additional

Published
2018
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162. Corrigendum to ‘Role of cardiopulmonary exercise testing in clinical stratification in heart failure. A position paper from the Committee on Exercise Physiology and Training of the Heart Failure Association of the European Society of Cardiology’ [Eur J He

Author

Corrà, Ugo, primary, Agostoni, Pier Giuseppe, additional, Anker, Stefan D., additional, Coats, Andrew J.S., additional, Crespo Leiro, Maria G., additional, de Boer, Rudolph A., additional, Harjola, Veli-Pekka, additional, Hill, Loreena, additional, Lainscak, Mitja, additional, Lund, Lars H., additional, Metra, Marco, additional, Ponikowski, Piotr, additional, Riley, Jillian, additional, Seferović, Petar M., additional, and Piepoli, Massimo F., additional

Published
2018
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163. The BRONCH-AHF study: effects on short-term outcome of nebulized bronchodilators in emergency department patients diagnosed with acute heart failure.

Author

Miró, Òscar, Tost, Josep, Gil, Víctor, Martín‐Sánchez, Francisco Javier, Llorens, Pere, Herrero, Pablo, Mebazaa, Alexandre, Harjola, Veli‐Pekka, Ríos, José, Marco‐Hernández, Javier, Collins, Sean P., Peacock, W. Frank, Hollander, Judd E., Lorca, María T., Jacob, Javier, on behalf of the ICA‐SEMES Research Group, Martín-Sánchez, Francisco Javier, Harjola, Veli-Pekka, Marco-Hernández, Javier, and ICA-SEMES Research Group

Subjects
BRONCHODILATOR agents, AEROSOLS, HEART failure, DIURETICS, DYSPNEA, DRUG therapy for asthma, ASTHMA, COMPARATIVE studies, HOSPITAL emergency services, LONGITUDINAL method, OBSTRUCTIVE lung diseases, RESEARCH methodology, MEDICAL cooperation, RESEARCH, RESPIRATORY therapy equipment, TIME, EVALUATION research, DISEASE incidence, ACUTE diseases, DISEASE complications, DIAGNOSIS
Published
2018
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164. Acute kidney injury in cardiogenic shock: definitions, incidence, haemodynamic alterations, and mortality.

Author

Tarvasmäki, Tuukka, Haapio, Mikko, Mebazaa, Alexandre, Sionis, Alessandro, Silva‐Cardoso, José, Tolppanen, Heli, Lindholm, Matias Greve, Pulkki, Kari, Parissis, John, Harjola, Veli‐Pekka, Lassus, Johan, on behalf of the CardShock Study Investigators, Silva-Cardoso, José, Harjola, Veli-Pekka, and CardShock Study Investigators

Subjects
CARDIOGENIC shock, HEMODYNAMIC monitoring, KIDNEY injuries, CREATININE, MORTALITY
Abstract

Copyright of European Journal of Heart Failure is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Published
2018
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165. Antithrombotic therapy use and clinical outcomes following thrombo-embolic events in patients with atrial fibrillation: insights from ARISTOTLE

Author

Goto, Shinya, primary, Merrill, Peter, additional, Wallentin, Lars, additional, Wojdyla, Daniel M, additional, Hanna, Michael, additional, Avezum, Alvaro, additional, Easton, J Donald, additional, Harjola, Veli-Pekka, additional, Huber, Kurt, additional, Lewis, Basil S, additional, Parkhomenko, Alexander, additional, Zhu, Jun, additional, Granger, Christopher B, additional, Lopes, Renato D, additional, and Alexander, John H, additional

Published
2018
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166. Guía ESC 2017 sobre el tratamiento del infarto agudo de miocardio en pacientes con elevación del segmento ST

Author

Ibáñez, Borja, primary, James, Stefan, additional, Agewall, Stefan, additional, Antunes, Manuel J., additional, Bucciarelli-Ducci, Chiara, additional, Bueno, Héctor, additional, Caforio, Alida L.P., additional, Crea, Filippo, additional, Goudevenos, John A., additional, Halvorsen, Sigrun, additional, Hindricks, Gerhard, additional, Kastrati, Adnan, additional, Lenzen, Mattie J., additional, Prescott, Eva, additional, Roffi, Marco, additional, Valgimigli, Marco, additional, Varenhorst, Christoph, additional, Vranckx, Pascal, additional, Widimsk, Petr, additional, Collet, Jean-Philippe, additional, Kristensen, Steen Dalby, additional, Aboyans, Victor, additional, Baumbach, Andreas, additional, Bugiardini, Raffaele, additional, Mircea Coman, Ioan, additional, Delgado, Victoria, additional, Fitzsimons, Donna, additional, Gaemperli, Oliver, additional, Gershlick, Anthony H., additional, Gielen, Stephan, additional, Harjola, Veli-Pekka, additional, Katus, Hugo A., additional, Knuuti, Juhani, additional, Kolh, Philippe, additional, Leclercq, Christophe, additional, Lip, Gregory Y.H., additional, Morais, Joao, additional, Neskovic, Aleksandar N., additional, Neumann, Franz-Josef, additional, Niessner, Alexander, additional, Piepoli, Massimo Francesco, additional, Richter, Dimitrios J., additional, Shlyakhto, Evgeny, additional, Simpson, Iain A., additional, Steg, Gabriel, additional, Terkelsen, Christian Juhl, additional, Thygesen, Kristian, additional, Windecker, Stephan, additional, Zamorano, José Luis, additional, and Zeymer, Uwe, additional

Published
2017
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167. Repeated Measurements of Cardiac Biomarkers in Atrial Fibrillation and Validation of the ABC Stroke Score Over Time

Author

Hijazi, Ziad, primary, Lindahl, Bertil, additional, Oldgren, Jonas, additional, Andersson, Ulrika, additional, Lindbäck, Johan, additional, Granger, Christopher B., additional, Alexander, John H., additional, Gersh, Bernard J., additional, Hanna, Michael, additional, Harjola, Veli‐Pekka, additional, Hylek, Elaine M., additional, Lopes, Renato D., additional, Siegbahn, Agneta, additional, and Wallentin, Lars, additional

Published
2017
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168. 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

Author

Gorter, Thomas M., primary, van Veldhuisen, Dirk J., additional, Bauersachs, Johann, additional, Borlaug, Barry A., additional, Celutkiene, Jelena, additional, Coats, Andrew J.S., additional, Crespo‐Leiro, Marisa G., additional, Guazzi, Marco, additional, Harjola, Veli‐Pekka, additional, Heymans, Stephane, additional, Hill, Loreena, additional, Lainscak, Mitja, additional, Lam, Carolyn S.P., additional, Lund, Lars H., additional, Lyon, Alexander R., additional, Mebazaa, Alexandre, additional, Mueller, Christian, additional, Paulus, Walter J., additional, Pieske, Burkert, additional, Piepoli, Massimo F., additional, Ruschitzka, Frank, additional, Rutten, Frans H., additional, Seferovic, Petar M., additional, Solomon, Scott D., additional, Shah, Sanjiv J., additional, Triposkiadis, Filippos, additional, Wachter, Rolf, additional, Tschöpe, Carsten, additional, and de Boer, Rudolf A., additional

Published
2017
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169. Frequency and Prognostic Significance of Abnormal Liver Function Tests in Patients With Cardiogenic Shock

Author

Jäntti, Toni, primary, Tarvasmäki, Tuukka, additional, Harjola, Veli-Pekka, additional, Parissis, John, additional, Pulkki, Kari, additional, Sionis, Alessandro, additional, Silva-Cardoso, Jose, additional, Køber, Lars, additional, Banaszewski, Marek, additional, Spinar, Jindrich, additional, Fuhrmann, Valentin, additional, Tolonen, Jukka, additional, Carubelli, Valentina, additional, diSomma, Salvatore, additional, Mebazaa, Alexandre, additional, Lassus, Johan, additional, Koniari, Katerina, additional, Voumvourakis, Astrinos, additional, Karavidas, Apostolos, additional, Sans-Rosello, Jordi, additional, Vila, Montserrat, additional, Duran-Cambra, Albert, additional, Metra, Marco, additional, Bulgari, Michela, additional, Lazzarini, Valentina, additional, Parenica, Jiri, additional, Stipal, Roman, additional, Ludka, Ondrej, additional, Palsuva, Marie, additional, Ganovska, Eva, additional, Kubena, Petr, additional, Lindholm, Matias G., additional, Hassager, Christian, additional, Bäcklund, Tom, additional, Jurkko, Raija, additional, Järvinen, Kristiina, additional, Nieminen, Tuomo, additional, Soininen, Leena, additional, Sund, Reijo, additional, Tierala, Ilkka, additional, Varpula, Marjut, additional, Korva, Tuomas, additional, Pitkälä, Anne, additional, Marino, Rossella, additional, Sousa, Alexandra, additional, Sousa, Carla, additional, Paiva, Mariana, additional, Rangel, Inês, additional, Almeida, Rui, additional, Pinho, Teresa, additional, Maciel, Maria Júlia, additional, Stepinska, Janina, additional, Skrobisz, Anna, additional, and Góral, Piotr, additional

Published
2017
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171. Role of cardiopulmonary exercise testing in clinical stratification in heart failure. A position paper from the Committee on Exercise Physiology and Training of the Heart Failure Association of the European Society of Cardiology

Author

Corrà, Ugo, primary, Agostoni, Pier Giuseppe, additional, Anker, Stefan D., additional, Coats, Andrew J.S., additional, Crespo Leiro, Maria G., additional, de Boer, Rudolph A., additional, Harjola, Veli-Pekka, additional, Hill, Loreena, additional, Lainscak, Mitja, additional, Lund, Lars H., additional, Metra, Marco, additional, Ponikowski, Piotr, additional, Riley, Jillian, additional, Seferović, Petar M., additional, and Piepoli, Massimo F., additional

Published
2017
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173. Current real-life use of vasopressors and inotropes in cardiogenic shock - adrenaline use is associated with excess organ injury and mortality

Author

Tarvasmäki, Tuukka, Lassus, Johan, Varpula, Marjut, Sionis, Alessandro, Sund, Reijo, Kober, Lars, Spinar, Jindrich, Parissis, John, Banaszewski, Marek, Cardoso, Jose Silva, Carubelli, Valentina, Di Somma, Salvatore, Mebazaa, Alexandre, Harjola, Veli-Pekka, CardShock Study Investigators, Clinicum, Department of Diagnostics and Therapeutics, Department of Medicine, Kardiologian yksikkö, and Department of Social Research (2010-2017)

Subjects
Male, Letter, Survival, Propensity score, ILL PATIENTS, 030204 cardiovascular system & hematology, Critical Care and Intensive Care Medicine, 0302 clinical medicine, Inotropes, SUPPORT, Vasoconstrictor Agents, Myocardial infarction, Hospital Mortality, Cardiogenic shock, Middle Aged, 3. Good health, NOREPINEPHRINE, Shock (circulatory), Cardiology, adrenaline, cardiogenic shock, inotropes, mortality, propensity score, survival, vasoactive medication, vasopressors, HEART-FAILURE, Female, medicine.symptom, medicine.drug, Vasoactive medication, Adult, Mean arterial pressure, medicine.medical_specialty, ACUTE MYOCARDIAL-INFARCTION, Cardiotonic Agents, Vasopressors, Epinephrine, Shock, Cardiogenic, RENAL DYSFUNCTION, Adrenaline, 03 medical and health sciences, Internal medicine, LOW-DOSE DOPAMINE, medicine, MANAGEMENT, Humans, Mortality, Aged, Tissue Survival, business.industry, Hemodynamics, 030208 emergency & critical care medicine, Levosimendan, medicine.disease, 3126 Surgery, anesthesiology, intensive care, radiology, TRENDS, RANDOMIZED-TRIAL, Blood pressure, Heart failure, 3121 General medicine, internal medicine and other clinical medicine, Dobutamine, business
Abstract

Background: Vasopressors and inotropes remain a cornerstone in stabilization of the severely impaired hemodynamics and cardiac output in cardiogenic shock (CS). The aim of this study was to analyze current real-life use of these medications, and their impact on outcome and on changes in cardiac and renal biomarkers over time in CS. Methods: The multinational CardShock study prospectively enrolled 219 patients with CS. The use of vasopressors and inotropes was analyzed in relation to the primary outcome, i.e., 90-day mortality, with propensity score methods in 216 patients with follow-up data available. Changes in cardiac and renal biomarkers over time until 96 hours from baseline were analyzed with linear mixed modeling. Results: Patients were 67 (SD 12) years old, 26 % were women, and 28 % had been resuscitated from cardiac arrest prior to inclusion. On average, systolic blood pressure was 78 (14) and mean arterial pressure 57 (11) mmHg at detection of shock. 90-day mortality was 41 %. Vasopressors and/or inotropes were administered to 94 % of patients and initiated principally within the first 24 hours. Noradrenaline and adrenaline were given to 75 % and 21 % of patients, and 30 % received several vasopressors. In multivariable logistic regression, only adrenaline (21 %) was independently associated with increased 90-day mortality (OR 5.2, 95 % CI 1.88, 14.7, p = 0.002). The result was independent of prior cardiac arrest (39 % of patients treated with adrenaline), and the association remained in propensity-score-adjusted analysis among vasopressor-treated patients (OR 3.0, 95 % CI 1.3, 7.2, p = 0.013); this was further confirmed by propensity-score-matched analysis. Adrenaline was also associated, independent of prior cardiac arrest, with marked worsening of cardiac and renal biomarkers during the first days. Dobutamine and levosimendan were the most commonly used inotropes (49 % and 24 %). There were no differences in mortality, whether noradrenaline was combined with dobutamine or levosimendan. Conclusion: Among vasopressors and inotropes, adrenaline was independently associated with 90-day mortality in CS. Moreover, adrenaline use was associated with marked worsening in cardiac and renal biomarkers. The combined use of noradrenaline with either dobutamine or levosimendan appeared prognostically similar.

Published
2016

174. The role of levosimendan in acute heart failure complicating acute coronary syndrome: A review and expert consensus opinion

Author

Nieminen, Markku Sakari, Buerke, Michael, Cohen-Solal, Alain, Costa, Susana, Edes, Istvan, Erlikh, Alexey, Franco, Fatima, Gibson, Charles, Gorjuph, Vojka, Guarracino, Fabio, Gustafsson, Finn, Harjola, Veli-Pekka, Husebye, Trygve, Karason, Kristjan, Katsytadze, Igor, Kaul, Sundeep, Kivikko, Matti, Marenzi, Giancarlo, Masip, Josep, Matskeplishvili, Simon, Mebazaa, Alexandre, Moller, Jacob E., Nessler, Jadwiga, Nessler, Bohdan, Ntalianis, Argyrios, Oliva, Fabrizio, Pichler-Cetin, Emel, Poder, Pentti, Recio-Mayoral, Alejandro, Rex, Steffen, Rokyta, Richard, Strasser, Ruth H., Zima, Endre, Pollesello, Piero, Clinicum, Department of Medicine, and Department of Diagnostics and Therapeutics

Subjects
3121 General medicine, internal medicine and other clinical medicine, education, 3126 Surgery, anesthesiology, intensive care, radiology
Published
2016

175. Akuuttilääketiede muokkaa päivystystä

Author

Harjola, Veli-Pekka, Palomäki, Ari, and Clinicum

Subjects
3121 Yleislääketiede, sisätaudit ja muut kliiniset lääketieteet, Outpatient Clinics, Hospital, After-Hours Care, Ambulatory Care, Emergency Medicine
Abstract

Teema : Akuuttilääketiede

Published
2016

177. Laskimotukos ja keuhkoembolia : Käypä hoito -suosituksen päivitystiivistelmä

Author

Lassila, Riitta, Armstrong, Elina, Harjola, Veli-Pekka, Kaaja, Risto, Manninen, Hannu, Meinander, Tuula, Mustonen, Pirjo, Clinicum, Hematologian yksikkö, Sisätautien osasto, and Diagnostis-terapeuttinen osasto

Subjects
Venous Thrombosis, 3121 Yleislääketiede, sisätaudit ja muut kliiniset lääketieteet, +therapy, +prevention & control, Pulmonary Embolism
Abstract

English summary

Published
2016

178. Wytyczne ESC dotyczące diagnostyki i leczenia ostrej i przewlekłej niewydolności serca w 2016 roku

Author

Ponikowski, Piotr, Voors, Adriaan A, Anker, Stefan D, Bueno, Héctor, Cleland, John G F, Coats, Andrew J S, Falk, Volkmar, González-Juanatey, José Ramón, Harjola, Veli-Pekka, Jankowska, Ewa A, Jessup, Mariell, Linde, Cecilia, Nihoyannopoulos, Petros, Parissis, John T, Pieske, Burkert, Riley, Jillian P, Rosano, Giuseppe M C, Ruilope, Luis M, Ruschitzka, Frank, Rutten, Frans H, and van der Meer, Peter

Subjects
farmakoterapia, peptydy natriuretyczne, zaburzenia rytmu…, wytyczne, terapia resynchronizująca serca, mechaniczne wspomaganie krążenia, Practice Guideline, przeszczepianie serca, rozpoznanie, niewydolność serca, Journal Article, frakcja wyrzutowa, antagoniści neurohormonalni
Published
2016

179. 2016 ESC guidelines for the diagnosis and treatment of acute and chronic heart failure [Guía ESC 2016 sobre el diagnóstico y tratamiento de la insuficiencia cardiaca aguda y crónica]

Author

Ponikowski, Autores/Miembros del Grupo de Trabajo: Piotr, Voors, Adriaan A., Anker, Stefan D., Bueno, Héctor, Cleland, John G. F., Coats, Andrew J. S., Falk, Volkmar, González-Juanatey, José Ramón, Harjola, Veli-Pekka, Jankowska, Ewa A., Jessup, Mariell, Linde, Cecilia, Nihoyannopoulos, Petros, Parissis, John T., Pieske, Burkert, Riley, Jillian P., Rosano, Giuseppe M. C., Ruilope, Luis M., Ruschitzka, Frank, Rutten, Frans H., van der Meer, Peter, Filippatos, Revisores del documento: Gerasimos, Mcmurray, John J. V., Aboyans, Victor, Achenbach, Stephan, Agewall, Stefan, Al-Attar, Nawwar, James Atherton, John, Bauersachs, Johann, Camm, A. John, Carerj, Scipione, Ceconi, Claudio, Coca, Antonio, Elliott, Perry, Erol, Çetin, Ezekowitz, Justin, Fernández-Golfín, Covadonga, Fitzsimons, Donna, Guazzi, Marco, Guenoun, Maxime, Hasenfuss, Gerd, Hindricks, Gerhard, Hoes, Arno W., Iung, Bernard, Jaarsma, Tiny, Kirchhof, Paulus, Knuuti, Juhani, Kolh, Philippe, Konstantinides, Stavros, Lainscak, Mitja, Lancellotti, Patrizio, Lip, Gregory Y. H., Maisano, Francesco, Mueller, Christian, Petrie, Mark C., Piepoli, Massimo F., Priori, Silvia G., Torbicki, Adam, Tsutsui, Hiroyuki, van Veldhuisen, Dirk J., Windecker, Stephan, Yancy, Clyde, and Zamorano, José Luis

Subjects
Cardiology, Cardiovascular Medicine, Cardiology, Cardiovascular Medicine, NO
Published
2016

180. 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: The Task Force for the Diagnosis and Treatment of Acute and Chronic Heart Gailure of the European Society of Cardiology (ESC)

Author

Ponikowski, Piotr, Voors, Adriaan A., Anker, Stefan D., Bueno, Héctor, Cleland, John G. F., Coats, Andrew J. S., Falk, Volkmar, González-Juanatey, José Ramón, Harjola, Veli-Pekka, Jankowska, Ewa A., Jessup, Mariell, Linde, Cecilia, Nihoyannopoulos, Petros, Parissis, John T., Pieske, Burkert, Riley, Jillian P., Rosano, Giuseppe M. C., Ruilope, Luis Miguel, Ruschitzka, Frank, Rutten, Frans H., van der Meer, Peter, Filippatos, Gerasimos S., McMurray, John. J. V., Aboyans, Victor, Achenbach, Stephan, Agewall, Stefan, Al-Attar, Nawwar, Atherton, John J., Bauersachs, Johann, Camm, A. John, Carerj, Scipione, Ceconi, Claudio, Coca, Antonio, Elliott, Perry, Erol, Çetin, Ezekowitz, Justin A., Fernández-Golfín, Covadonga, Fitzsimmons, Donna, Guazzi, Marco, Guenoun, Maxime, Hasenfuss, Gerd, Hindricks, Gerhard, Hoes, Arno W., Iung, Bernard, Jaarsma, Tiny, Kirchhof, Paulus, Knuuti, Juhani, Kolh, Philippe, Konstantinides, Stavros, Lainscak, Mitja, Lancellotti, Patrizio, Lip, Gregory Y. H., Maisano, Francesco, Mueller, Christian, Petrie, Mark C., Piepoli, Massimo F., Priori, Silvia G., Torbicki, Adam, Tsutsui, Hiroyuki, van Veldhuisen, Dirk J., Windecker, Stephan, Yancy, Clyde, and Zamorano, Jose Luis

Subjects
mechanical circulatory support, diagnosis, heart failure, cardiac resynchronization therapy, pharmacotherapy, co-morbidities, neuro-hormonal antagonists, multidisciplinary management, guidelines, natriuretic peptides, ejection fraction, arrhythmias, transplantation, hospitalization
Published
2016

181. Nykyaikainen päivystys

Author

Lukkarinen, Timo, Janhunen, Heikki, Harjola, Veli-Pekka, Clinicum, Yleislääketieteen ja perusterveydenhuollon osasto, and Diagnostis-terapeuttinen osasto

Subjects
After-Hours Care, 3142 Kansanterveystiede, ympäristö ja työterveys, Ambulatory Care, Critical Pathways, Medical Staff, Nursing Staff, Emergency Service, Hospital, +organization & administration
Abstract

Teema : Akuuttilääketiede. English summary

Published
2016

182. Quantifying Cardiac Hemodynamic Stress and Cardiomyocyte Damage in Ischemic and Nonischemic Acute Heart Failure

Author

Harjola Veli-Pekka, Corinna Heinisch, Christian Degen, Markku S. Nieminen, Philip Haaf, Tobias Reichlin, Nisha Arenja, Markus Noveanu, Thenral Socrates, Mihael Potocki, Beatrice Drexler, Stefan Osswald, Christian Mueller, Tobias Breidthardt, Christophe Meune, Cathrin Balmelli, Johan Lassus, and Krista Siirilä-Waris

Subjects
Male, medicine.medical_specialty, Myocardial Ischemia, 030204 cardiovascular system & hematology, Cohort Studies, Diagnosis, Differential, 03 medical and health sciences, 0302 clinical medicine, Troponin T, Internal medicine, Natriuretic Peptide, Brain, Humans, Medicine, Myocytes, Cardiac, 030212 general & internal medicine, Hemodynamic stress, Aged, Retrospective Studies, Aged, 80 and over, Heart Failure, Ischemic cardiomyopathy, biology, business.industry, Troponin I, Hemodynamics, Emergency department, medicine.disease, Troponin, 3. Good health, Heart failure, Acute Disease, Cardiology, biology.protein, Female, Emergency Service, Hospital, Cardiology and Cardiovascular Medicine, business, Biomarkers
Abstract

Background— The early and noninvasive differentiation of ischemic and nonischemic acute heart failure (AHF) in the emergency department (ED) is an unmet clinical need. Methods and Results— We quantified cardiac hemodynamic stress using B-type natriuretic peptide (BNP) and cardiomyocyte damage using 2 different cardiac troponin assays in 718 consecutive patients presenting to the ED with AHF (derivation cohort). The diagnosis of ischemic AHF was adjudicated using all information, including coronary angiography. Findings were validated in a second independent multicenter cohort (326 AHF patients). Among the 718 patients, 400 (56%) were adjudicated to have ischemic AHF. BNP levels were significantly higher in ischemic compared with nonischemic AHF (1097 [604–1525] pg/mL versus 800 [427–1317] pg/mL; P P P =0.002]). The diagnostic accuracy of BNP, cTnT, and s-cTnI for the diagnosis of ischemic AHF, as quantified by the area under the receiver-operating characteristic curve, was low (0.58 [95% CI, 0.54–0.63], 0.61 [95% CI, 0.57–0.66], and 0.59 [95% CI,0.54–0.65], respectively). These findings were confirmed in the validation cohort. Conclusions— At presentation to the ED, patients with ischemic AHF exhibit more extensive hemodynamic cardiac stress and cardiomyocyte damage than patients with nonischemic AHF. However, the overlap is substantial, resulting in poor diagnostic accuracy.

Published
2012

183. Combined Measurement of Soluble ST2 and Amino-Terminal Pro-B-Type Natriuretic Peptide Provides Early Assessment of Severity in Cardiogenic Shock Complicating Acute Coronary Syndrome

Author

Tolppanen, Heli, primary, Rivas-Lasarte, Mercedes, additional, Lassus, Johan, additional, Sadoune, Malha, additional, Gayat, Etienne, additional, Pulkki, Kari, additional, Arrigo, Mattia, additional, Krastinova, Evguenia, additional, Sionis, Alessandro, additional, Parissis, John, additional, Spinar, Jindrich, additional, Januzzi, James, additional, Harjola, Veli-Pekka, additional, and Mebazaa, Alexandre, additional

Published
2017
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185. Altered mental status predicts mortality in cardiogenic shock – results from the CardShock study

Author

Kataja, Anu, primary, Tarvasmäki, Tuukka, additional, Lassus, Johan, additional, Køber, Lars, additional, Sionis, Alessandro, additional, Spinar, Jindrich, additional, Parissis, John, additional, Carubelli, Valentina, additional, Cardoso, Jose, additional, Banaszewski, Marek, additional, Marino, Rossella, additional, Nieminen, Markku S, additional, Mebazaa, Alexandre, additional, and Harjola, Veli-Pekka, additional

Published
2017
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188. Disposition of emergency department patients diagnosed with acute heart failure: an international emergency medicine perspective

Author

Miró, Òscar, primary, Levy, Philip D., additional, Möckel, Martin, additional, Pang, Peter S., additional, Lambrinou, Ekaterini, additional, Bueno, Héctor, additional, Hollander, Judd E., additional, Harjola, Veli-Pekka, additional, Diercks, Deborah B., additional, Gray, Alasdair J., additional, DiSomma, Salvatore, additional, Papa, Ann M., additional, and Collins, Sean P., additional

Published
2017
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189. Adrenomedullin: a marker of impaired hemodynamics, organ dysfunction, and poor prognosis in cardiogenic shock

Author

Tolppanen, Heli, primary, Rivas-Lasarte, Mercedes, additional, Lassus, Johan, additional, Sans-Roselló, Jordi, additional, Hartmann, Oliver, additional, Lindholm, Matias, additional, Arrigo, Mattia, additional, Tarvasmäki, Tuukka, additional, Köber, Lars, additional, Thiele, Holger, additional, Pulkki, Kari, additional, Spinar, Jindrich, additional, Parissis, John, additional, Banaszewski, Marek, additional, Silva-Cardoso, Jose, additional, Carubelli, Valentina, additional, Sionis, Alessandro, additional, Harjola, Veli-Pekka, additional, and Mebazaa, Alexandre, additional

Published
2017
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190. 2016 ESC GUIDELINES FOR THE DIAGNOSIS AND TREATMENT OF ACUTE AND CHRONIC HEART FAILURE

Author

Ponikowski, Piotr, primary, A. Voors, Adriaan, additional, D. Anker, Stefan, additional, Bueno, Héctor, additional, G. F. Cleland, John, additional, J. S . Coats, Andrew, additional, Falk, Volkmar, additional, González-Juanatey, José Ramón, additional, Harjola, Veli-Pekka, additional, A. Jankowska, Ewa, additional, Jessup, Mariell, additional, Linde, Cecilia, additional, Nihoyannopoulos, Petros, additional, T . Parissis, John, additional, Pieske, Burkert, additional, P. Riley, Jillian, additional, M. C. Rosano, Giuseppe, additional, M. Ruilope, Luis, additional, Ruschitzka, Frank, additional, H. Rutten, Frans, additional, and Van der Meer, Peter, additional

Published
2017
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191. The association of admission blood glucose level with the clinical picture and prognosis in cardiogenic shock – Results from the CardShock Study

Author

Kataja, Anu, primary, Tarvasmäki, Tuukka, additional, Lassus, Johan, additional, Cardoso, Jose, additional, Mebazaa, Alexandre, additional, Køber, Lars, additional, Sionis, Alessandro, additional, Spinar, Jindrich, additional, Carubelli, Valentina, additional, Banaszewski, Marek, additional, Marino, Rossella, additional, Parissis, John, additional, Nieminen, Markku S., additional, and Harjola, Veli-Pekka, additional

Published
2017
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192. 2016 ESC Guidelines for the Diagnosis and Treatment of Acute and Chronic Heart Failure

Author

Ponikowski, Piotr, primary, Voors, Adriaan A., additional, Anker, Stefan D., additional, Bueno, Héctor, additional, Cleland, John G.F., additional, Coats, Andrew J.S., additional, Falk, Volkmar, additional, González-Juanatey, José Ramón, additional, Harjola, Veli-Pekka, additional, Jankowska, Ewa A., additional, Jessup, Mariell, additional, Linde, Cecilia, additional, Nihoyannopoulos, Petros, additional, Parissis, John T., additional, Pieske, Burkert, additional, Riley, Jillian P., additional, Rosano, Giuseppe M.C., additional, Ruilope, Luis M., additional, Ruschitzka, Frank, additional, Rutten, Frans H., additional, and van der Meer, Peter, additional

Published
2016
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193. Guía ESC 2016 sobre el diagnóstico y tratamiento de la insuficiencia cardiaca aguda y crónica

Author

Ponikowski, Autores/Miembros del Grupo de Trabajo: Piotr, primary, Voors, Adriaan A., additional, Anker, Stefan D., additional, Bueno, Héctor, additional, Cleland, John G.F., additional, Coats, Andrew J.S., additional, Falk, Volkmar, additional, González-Juanatey, José Ramón, additional, Harjola, Veli-Pekka, additional, Jankowska, Ewa A., additional, Jessup, Mariell, additional, Linde, Cecilia, additional, Nihoyannopoulos, Petros, additional, Parissis, John T., additional, Pieske, Burkert, additional, Riley, Jillian P., additional, Rosano, Giuseppe M.C., additional, Ruilope, Luis M., additional, Ruschitzka, Frank, additional, Rutten, Frans H., additional, van der Meer, Peter, additional, Filippatos, Revisores del documento: Gerasimos, additional, McMurray, John J.V., additional, Aboyans, Victor, additional, Achenbach, Stephan, additional, Agewall, Stefan, additional, Al-Attar, Nawwar, additional, James Atherton, John, additional, Bauersachs, Johann, additional, Camm, A. John, additional, Carerj, Scipione, additional, Ceconi, Claudio, additional, Coca, Antonio, additional, Elliott, Perry, additional, Erol, Çetin, additional, Ezekowitz, Justin, additional, Fernández-Golfín, Covadonga, additional, Fitzsimons, Donna, additional, Guazzi, Marco, additional, Guenoun, Maxime, additional, Hasenfuss, Gerd, additional, Hindricks, Gerhard, additional, Hoes, Arno W., additional, Iung, Bernard, additional, Jaarsma, Tiny, additional, Kirchhof, Paulus, additional, Knuuti, Juhani, additional, Kolh, Philippe, additional, Konstantinides, Stavros, additional, Lainscak, Mitja, additional, Lancellotti, Patrizio, additional, Lip, Gregory Y.H., additional, Maisano, Francesco, additional, Mueller, Christian, additional, Petrie, Mark C., additional, Piepoli, Massimo F., additional, Priori, Silvia G., additional, Torbicki, Adam, additional, Tsutsui, Hiroyuki, additional, van Veldhuisen, Dirk J., additional, Windecker, Stephan, additional, Yancy, Clyde, additional, and Zamorano, José Luis, additional

Published
2016
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194. Levosimendan beyond inotropy and acute heart failure: Evidence of pleiotropic effects on the heart and other organs: An expert panel position paper

Author

Farmakis, Dimitrios, primary, Alvarez, Julian, additional, Gal, Tuvia Ben, additional, Brito, Dulce, additional, Fedele, Francesco, additional, Fonseca, Candida, additional, Gordon, Anthony C., additional, Gotsman, Israel, additional, Grossini, Elena, additional, Guarracino, Fabio, additional, Harjola, Veli-Pekka, additional, Hellman, Yaron, additional, Heunks, Leo, additional, Ivancan, Visnja, additional, Karavidas, Apostolos, additional, Kivikko, Matti, additional, Lomivorotov, Vladimir, additional, Longrois, Dan, additional, Masip, Josep, additional, Metra, Marco, additional, Morelli, Andrea, additional, Nikolaou, Maria, additional, Papp, Zoltán, additional, Parkhomenko, Alexander, additional, Poelzl, Gerhard, additional, Pollesello, Piero, additional, Ravn, Hanne Berg, additional, Rex, Steffen, additional, Riha, Hynek, additional, Ricksten, Sven-Erik, additional, Schwinger, Robert H.G., additional, Vrtovec, Bojan, additional, Yilmaz, M. Birhan, additional, Zielinska, Marzenna, additional, and Parissis, John, additional

Published
2016
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196. The role of levosimendan in acute heart failure complicating acute coronary syndrome: A review and expert consensus opinion

Author

Nieminen, Markku S., primary, Buerke, Michael, additional, Cohen-Solál, Alain, additional, Costa, Susana, additional, Édes, István, additional, Erlikh, Alexey, additional, Franco, Fatima, additional, Gibson, Charles, additional, Gorjup, Vojka, additional, Guarracino, Fabio, additional, Gustafsson, Finn, additional, Harjola, Veli-Pekka, additional, Husebye, Trygve, additional, Karason, Kristjan, additional, Katsytadze, Igor, additional, Kaul, Sundeep, additional, Kivikko, Matti, additional, Marenzi, Giancarlo, additional, Masip, Josep, additional, Matskeplishvili, Simon, additional, Mebazaa, Alexandre, additional, Møller, Jacob E., additional, Nessler, Jadwiga, additional, Nessler, Bohdan, additional, Ntalianis, Argyrios, additional, Oliva, Fabrizio, additional, Pichler-Cetin, Emel, additional, Põder, Pentti, additional, Recio-Mayoral, Alejandro, additional, Rex, Steffen, additional, Rokyta, Richard, additional, Strasser, Ruth H., additional, Zima, Endre, additional, and Pollesello, Piero, additional

Published
2016
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197. Renal Effects of Levosimendan: A Consensus Report

Author

Yilmaz, Mehmet B., Grossini, Elena, Silva Cardoso, Jose C., Edes, Istvan, Fedele, Francesco, Pollesello, Piero, Kivikko, Matti, Harjola, Veli-Pekka, Hasslacher, Julia, Mebazaa, Alexandre, Morelli, Andrea, le Noble, Jos, Oldner, Anders, Oulego Erroz, Ignacio, Parissis, John T., Parkhomenko, Alexander, Poelzl, Gerhard, Rehberg, Sebastian, Ricksten, Sven-Erik, Rodriguez Fernandez, Luis M., Salmenpera, Markku, Singer, Mervyn, Treskatsch, Sascha, Vrtovec, Bojan, Wikstrom, Gerhard, [Yilmaz, Mehmet B.] Cumhuriyet Univ, Sch Med, Dept Cardiol, Sivas, Turkey -- [Grossini, Elena] Univ Piemonte Orientale, Lab Fisiol, Dipartimento Med Traslaz, Piemonte, Italy -- [Silva Cardoso, Jose C.] Univ Porto, Fac Med, P-4100 Oporto, Portugal -- [Edes, Istvan] Univ Debrecen, Inst Cardiol, Med & Hlth Sci Ctr, H-4012 Debrecen, Hungary -- [Fedele, Francesco -- Morelli, Andrea] Univ Roma La Sapienza, Dept Cardiovasc Resp Nephrol & Geriatr Sci, I-00185 Rome, Italy -- [Pollesello, Piero -- Kivikko, Matti] Orion Pharma, Cardiol & Crit Care, Espoo, Finland -- [Harjola, Veli-Pekka] Helsinki Univ Hosp, Dept Cardiol, Helsinki, Finland -- [Hasslacher, Julia] Univ Klin Innere Med, Innsbruck, Austria -- [Mebazaa, Alexandre] Univ Paris, Dept Anaesthesia & Intens Care, INSERM UMR 942, Lariboisiere Hosp, F-75252 Paris, France -- [le Noble, Jos] VieCuri Med Ctr, Dept Intens Care, Venlo, Netherlands -- [Oldner, Anders] Karolinska Inst, Dept Physiol & Pharmacol, Sect Anaesthesiol & Intens CareMed, Stockholm, Sweden -- [Oulego Erroz, Ignacio -- Rodriguez Fernandez, Luis M.] Complejo Asistencial Univ Leon, Dept Pediat, Leon, Spain -- [Parissis, John T.] Attikon Univ Hosp, Heart Failure Unit, Athens, Greece -- [Parkhomenko, Alexander] Natl Sci Ctr, Strazhesko Inst Cardiol, Kiev, Ukraine -- [Poelzl, Gerhard] Med Univ Innsbruck, Dept Cardiol, A-6020 Innsbruck, Austria -- [Rehberg, Sebastian] Univ Munster, Dept Anesthesiol Intens Care & Pain Med, D-48149 Munster, Germany -- [Ricksten, Sven-Erik] Sahlgrens Univ Hosp, Dept Cardiothorac Anesthesia & Intens Care, Gothenburg, Sweden -- [Salmenpera, Markku] Helsinki Univ Hosp, Dept Anesthesiol & Intens Care Med, Helsinki, Finland -- [Singer, Mervyn] UCL, London, England -- [Treskatsch, Sascha] Charite, Dept Anesthesiol & Intens Care Med, Campus Charite Mitte, D-13353 Berlin, Germany -- [Treskatsch, Sascha] Campus Virchow Klinikum, Berlin, Germany -- [Vrtovec, Bojan] Univ Ljubljana, Med Ctr, Adv Heart Failure & Transplantat Ctr, Dept Cardiol, Ljubljana 61000, Slovenia -- [Wikstrom, Gerhard] Uppsala Univ, Akad Sjukhuset, Kardiologkliniken, Uppsala, Sweden, MORELLI, ANDREA -- 0000-0001-6065-1006, YILMAZ, Mehmet Birhan -- 0000-0002-8169-8628, YILMAZ, MEHMET BIRHAN -- 0000-0002-8169-8628, Oldner, Anders -- 0000-0003-1600-9221, Pollesello, Piero -- 0000-0001-6994-768X, Silva-Cardoso, Jose -- 0000-0002-9774-9864, CINTESIS -- 0000-0001-7248-2086, Singer, Mervyn -- 0000-0002-1042-6350, Vacca, Giovanni -- 0000-0002-0864-1887, Grossini, Elena -- 0000-0002-3012-259X, and Mebazaa, Alexandre -- 0000-0001-8715-7753

Subjects
Levosimendan, Renal dysfunction
Abstract

WOS: 000327094600012, PubMed ID: 23929366, Renal dysfunction is common in clinical settings in which cardiac function is compromised such as heart failure, cardiac surgery or sepsis, and is associated with high morbidity and mortality. Levosimendan is a calcium sensitizer and potassium channel opener used in the treatment of acute heart failure. This review describes the effects of the inodilator levosimendan on renal function. A panel of 25 scientists and clinicians from 15 European countries (Austria, Finland, France, Hungary, Germany, Greece, Italy, Portugal, the Netherlands, Slovenia, Spain, Sweden, Turkey, the United Kingdom, and Ukraine) convened and reached a consensus on the current interpretation of the renal effects of levosimendan described both in non-clinical research and in clinical study reports. Most reports on the effect of levosimendan indicate an improvement of renal function in heart failure, sepsis and cardiac surgery settings. However, caution should be applied as study designs differed from randomized, controlled studies to uncontrolled ones. Importantly, in the largest HF study (REVIVE I and II) no significant changes in the renal function were detected. As it regards the mechanism of action, the opening of mitochondrial K-ATP channels by levosimendan is involved through a preconditioning effect. There is a strong rationale for randomized controlled trials seeking beneficial renal effects of levosimendan. As an example, a study is shortly to commence to assess the role of levosimendan for the prevention of acute organ dysfunction in sepsis (LeoPARDS).

Published
2013

198. Recommendations on pre-hospital and early hospital management of acute heart failure: a consensus paper from the Heart Failure Association of the European Society of Cardiology, the European Society of Emergency Medicine and the Society of Academic Emergency Medicine - short version

Author

Mebazaa, Alexandre Yilmaz, M. Birhan Levy, Phillip and Ponikowski, Piotr Peacock, W. Frank Laribi, Said Ristic, Arsen D. Lambrinou, Ekaterini Masip, Josep Riley, Jillian P. and McDonagh, Theresa Mueller, Christian deFilippi, Christopher and Harjola, Veli-Pekka Thiele, Holger Piepoli, Massimo F. and Metra, Marco Maggioni, Aldo McMurray, John J. V. Dickstein, Kenneth Damman, Kevin Seferovic, Petar M. Ruschitzka, Frank and Leite-Moreira, Adelino F. Bellou, Abdelouahab Anker, Stefan D. Filippatos, Gerasimos

Published
2015

200. Recommendations on pre-hospital & early hospital management of acute heart failure: a consensus paper from the Heart Failure Association of the European Society of Cardiology, the European Society of Emergency Medicine and the Society of Academic Emergency Medicine

Author

Mebazaa, Alexandre Yilmaz, M. Birhan Levy, Phillip and Ponikowski, Piotr Peacock, W. Frank Laribi, Said Ristic, Arsen D. Lambrinou, Ekaterini Masip, Josep Riley, Jillian P. and McDonagh, Theresa Mueller, Christian deFilippi, Christopher and Harjola, Veli-Pekka Thiele, Holger Piepoli, Massimo F. and Metra, Marco Maggioni, Aldo McMurray, John Dickstein, Kenneth Damman, Kevin Seferovic, Petar M. Ruschitzka, Frank and Leite-Moreira, Adelino F. Bellou, Abdelouahab Anker, Stefan D. Filippatos, Gerasimos

Abstract

Acute heart failure is a fatal syndrome. Emergency physicians, cardiologists, intensivists, nurses and other health care providers have to cooperate to provide optimal benefit. However, many treatment decisions are opinion-based and few are evidenced-based. This consensus paper provides guidance to practicing physicians and nurses to manage acute heart failure in the pre-hospital and hospital setting. Criteria of hospitalization and of discharge are described. Gaps in knowledge and perspectives in the management of acute heart failure are also detailed. This consensus paper on acute heart failure might help enable contiguous practice.

Published
2015

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