Search

To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.amjmed.2009.01.038 Byline: Michael A. Chen Keywords: Aging; Diastolic heart failure; Heart failure; Heart failure with preserved ejection fraction Abstract: Age-associated physiologic changes predispose older adults to develop heart failure, even when left ventricular ejection fraction is normal or near normal. Heart failure with a preserved ejection fraction is particularly common in older hypertensive women, and hypertension plays a key role in its pathophysiology. In contrast with heart failure with a reduced ejection fraction, the treatment of heart failure with a preserved ejection fraction has a limited empiric basis, although some basic principles are useful. Ongoing studies provide hope of improving care of these patients. Author Affiliation: Division of Cardiology, Harborview Medical Center, University of Washington, Seattle Article Note: (footnote) Funding: None., Conflict of Interest: None., Authorship: Author had access to the data and played a role in writing this manuscript.

The case You have a 76-year-old patient with heart failure that was diagnosed 2 months ago. She has a history of hypertension, which is being treated with amlodipine. On her [...]

Practice recommendations * Use B-type natriuretic peptide (BNP) levels as an aid not only in the diagnosis of heart failure (HF), but to track its progression as well (A). * [...]

Introduction Chronic heart failure (HF) often describes a condition in which the heart loses its ability to meet the metabolic demands of the body due to an inadequate cardiac output. [...]

* Health care providers and health care systems are challenged to find cost-effective ways to address the costs associated with heart failure. * A multidisciplinary team of nurses, physicians, pharmacists, and dieticians was assembled at New Hanover Regional Medical Center (Wilmington, NC) to develop strategies to decrease the readmission rate without compromising patient care. * The team developed a disease management program that included comprehensive inpatient education, as well as an outpatient telephonic program to reinforce education after discharge. * Goals were to reduce readmissions of patients with heart failure, to decrease the cost per case of each patient with chronic heart failure, and to reduce the length of stay for patients who were readmitted. * The CHF Telephonic Program was extremely successful in meeting patient-focused and organizational goals related to readmissions, length of stay, and cost of care., CHRONIC HEART FAILURE (CHF) continues to be a major public health problem associated with high morbidity and mortality. There are 5 million people in the United States with heart failure [...]

2017 SEP 2 (NewsRx) -- By a News Reporter-Staff News Editor at Obesity, Fitness & Wellness Week -- Investigators publish new report on Heart Disorders and Diseases - Heart Failure. [...]

2017 AUG 5 (NewsRx) -- By a News Reporter-Staff News Editor at Obesity, Fitness & Wellness Week -- Investigators discuss new findings in Heart Disorders and Diseases - Heart Failure. [...]

2017 APR 15 (NewsRx) -- By a News Reporter-Staff News Editor at Obesity, Fitness & Wellness Week -- Investigators publish new report on Heart Disorders and Diseases - Heart Failure. [...]

2017 APR 15 (NewsRx) -- By a News Reporter-Staff News Editor at Obesity, Fitness & Wellness Week -- Investigators discuss new findings in Oncology - T-Cell Lymphoma. According to news [...]

This acronym will help you recognize the symptoms so that you can get help fast. F Fatigue A Activity limitation C Chest congestion E Edema/ankle swelling S Shortness of breath [...]

2017 APR 1 (NewsRx) -- By a News Reporter-Staff News Editor at Obesity, Fitness & Wellness Week -- Investigators discuss new findings in Heart Disorders and Diseases - Heart Failure. [...]

To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.amjmed.2006.05.066 Byline: John R. Kapoor (a), Mark A. Perazella (b) Keywords: Heart failure; Diuretics; Dobutamine; Nesiritide; B-type natriuretic peptide Abstract: Heart failure afflicts large numbers of patients and is the leading cause for hospitalizations in the United States. Diagnosis and management of decompensated heart failure present a clinical challenge, requiring complex decision-making. History and physical examination findings are important in the diagnosis of heart failure. Diagnostically, B-type natriuretic peptide levels appear very useful to separate cardiac from noncardiac causes of dyspnea and provide information about heart failure severity and prognosis. Immediate management goals include improvement of symptoms and hemodynamic parameters. Diuretics, vasodilators, and inotropic agents are useful in the acute setting. This article provides a systematic approach to the diagnosis and management of acute decompensated heart failure. Author Affiliation: (a) Division of Cardiology, Department of Medicine, Stanford University School of Medicine, Stanford, Calif (b) Section of Nephrology, Department of Medicine, Yale University School of Medicine, New Haven, Conn

Background: Total homocysteine (tHcy) has been linked to the severity of chronic heart failure (CHF). Elevated tHcy concentrations are mainly caused by folate and vitamin B-12 deficiencies. Objective: We hypothesized that folate and vitamin B-12 deficiencies can explain the relation between tHcy and the severity of CHF. Design: We investigated 987 CHF patients. All subjects underwent a physical examination and blood sampling. Cardiac catheterization was performed in 929 patients and echocardiography in 460 patients. Serum tHcy, folate, vitamin B-12, and N-terminal pro-B-type natriuretic-peptide (NT-proBNP) were measured and renal and hepatic function were studied. Results: tHcy increased with increasing New York Heart Association (NYHA) classes of heart failure (P < 0.001) and correlated with the left ventricular ejection fraction (EF; r = -0.150, P < 0.001). Contrary to the hypothesis, vitamin B-12 (P < 0.001) increased with NYHA class (P < 0.001) and was negatively correlated with EF (r = -0.080, P = 0.015). Folate showed no relation with NYHA class or EF. Comparable results were obtained for NT-proBNP (tHcy: r = 0.27, P < 0.001; vitamin B-12: r = 0.091, P = 0.004; folate: r = -0.045, P = 0.169). The correlations between tHcy, EF, and NT-proBNP were significantly stronger in patients without coronary artery disease (CAD) than in those with CAD. Regression analysis showed that tHcy, but not B vitamins, is a strong predictor of EF and NT-proBNP. Conclusions: This study showed that tHcy, but not folate and vitamin B-12, is related to clinical, echocardiographic, and laboratory variables of CHF, which indicates a relation between tHcy and the severity of CHF. This relation is stronger in patients without CAD. The lack of association of folate and the paradoxical relation of vitamin B-12 with CHF can possibly be explained by a disturbance in hepatic homeostasis. KEY WORDS Chronic heart failure, homocysteine, folate, vitamin B-12, NT-proBNP, ejection fraction, coronary artery disease