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2. Multi-organ sonographic assessment of congestion has incremental prognostic value in outpatients with heart failure irrespective of left ventricular ejection fraction

Author

Pugliese, N R, primary, Pellicori, P, additional, Filidei, F, additional, Del Punta, L, additional, De Biase, N, additional, Balletti, A, additional, Di Fiore, V, additional, Mengozzi, A, additional, Taddei, S, additional, Gargani, L, additional, Mullens, W, additional, Cleland, J G F, additional, and Masi, S, additional

Published
2023
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7. Activation of the HeartLogic algorithm on top of heart failure care: a multicenter propensity-matched cohort analysis

Author

Feijen, M, primary, Beles, M, additional, Than, Y Z, additional, Cordon, A, additional, Dupont, M, additional, Treskes, R W, additional, Caputo, M, additional, Mullens, W, additional, Van Bokstal, K, additional, Auricchio, A, additional, Egorova, A D, additional, Maes, E, additional, Beeres, S L M A, additional, and Heggermont, W A, additional

Published
2022
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9. COVID-19 vaccination in patients with heart failure: a position paper of the Heart Failure Association of the European Society of Cardiology

Author

Rosano, G, Jankowska, E, Ray, R, Metra, M, Abdelhamid, M, Adamopoulos, S, Anker, S, Bayes-Genis, A, Belenkov, Y, Gal, T, Böhm, M, Chioncel, O, Cohen-Solal, A, Farmakis, D, Filippatos, G, González, A, Gustafsson, F, Hill, L, Jaarsma, T, Jouhra, F, Lainscak, M, Lambrinou, E, Lopatin, Y, Lund, L, Milicic, D, Moura, B, Mullens, W, Piepoli, M, Ponikowski, P, Rakisheva, A, Ristic, A, Savarese, G, Seferovic, P, Senni, M, Thum, T, Tocchetti, C, Van Linthout, S, Volterrani, M, Coats, A, Rosano G, Jankowska EA, Ray R, Metra M, Abdelhamid M, Adamopoulos S, Anker SD, Bayes-Genis A, Belenkov Y, Gal TB, Böhm M, Chioncel O, Cohen-Solal A, Farmakis D, Filippatos G, González A, Gustafsson F, Hill L, Jaarsma T, Jouhra F, Lainscak M, Lambrinou E, Lopatin Y, Lund LH, Milicic D, Moura B, Mullens W, Piepoli MF, Ponikowski P, Rakisheva A, Ristic A, Savarese G, Seferovic P, Senni M, Thum T, Tocchetti CG, Van Linthout S, Volterrani M, Coats AJS, Rosano, G, Jankowska, E, Ray, R, Metra, M, Abdelhamid, M, Adamopoulos, S, Anker, S, Bayes-Genis, A, Belenkov, Y, Gal, T, Böhm, M, Chioncel, O, Cohen-Solal, A, Farmakis, D, Filippatos, G, González, A, Gustafsson, F, Hill, L, Jaarsma, T, Jouhra, F, Lainscak, M, Lambrinou, E, Lopatin, Y, Lund, L, Milicic, D, Moura, B, Mullens, W, Piepoli, M, Ponikowski, P, Rakisheva, A, Ristic, A, Savarese, G, Seferovic, P, Senni, M, Thum, T, Tocchetti, C, Van Linthout, S, Volterrani, M, Coats, A, Rosano G, Jankowska EA, Ray R, Metra M, Abdelhamid M, Adamopoulos S, Anker SD, Bayes-Genis A, Belenkov Y, Gal TB, Böhm M, Chioncel O, Cohen-Solal A, Farmakis D, Filippatos G, González A, Gustafsson F, Hill L, Jaarsma T, Jouhra F, Lainscak M, Lambrinou E, Lopatin Y, Lund LH, Milicic D, Moura B, Mullens W, Piepoli MF, Ponikowski P, Rakisheva A, Ristic A, Savarese G, Seferovic P, Senni M, Thum T, Tocchetti CG, Van Linthout S, Volterrani M, and Coats AJS

Abstract

Patients with heart failure (HF) who contract SARS-CoV-2 infection are at a higher risk of cardiovascular and non-cardiovascular morbidity and mortality. Regardless of therapeutic attempts in COVID-19, vaccination remains the most promising global approach at present for controlling this disease. There are several concerns and misconceptions regarding the clinical indications, optimal mode of delivery, safety and efficacy of COVID-19 vaccines for patients with HF. This document provides guidance to all healthcare professionals regarding the implementation of a COVID-19 vaccination scheme in patients with HF. COVID-19 vaccination is indicated in all patients with HF, including those who are immunocompromised (e.g. after heart transplantation receiving immunosuppressive therapy) and with frailty syndrome. It is preferable to vaccinate against COVID-19 patients with HF in an optimal clinical state, which would include clinical stability, adequate hydration and nutrition, optimized treatment of HF and other comorbidities (including iron deficiency), but corrective measures should not be allowed to delay vaccination. Patients with HF who have been vaccinated against COVID-19 need to continue precautionary measures, including the use of facemasks, hand hygiene and social distancing. Knowledge on strategies preventing SARS-CoV-2 infection (including the COVID-19 vaccination) should be included in the comprehensive educational programmes delivered to patients with HF.

Published
2021

11. Cardiac remodelling – Part 1: From cells and tissues to circulating biomarkers. A review from the Study Group on Biomarkers of the Heart Failure Association of the European Society of Cardiology

Author

González, A, Richards, AM, de Boer, RA, Thum, T, Arfsten, H, Hülsmann, M, Falcao-Pires, I, Díez, J, Foo, RS, Chan, MYY, Aimo, A, Anene-Nzelu, GC, Abdelhamid, M, Adamopoulos, S, Anker, SD, Belenkov, Y, Gal, TB, Cohen-Solal, A, Böhm, M, Chioncel, O, Delgado, V, Emdin, M, Jankowska, EA, Gustafsson, F, Hill, L, Jaarsma, T, Januzzi, JL, Jhund, PS, Lopatin, Y, Lund, LH, Metra, M, Milicic, D, Moura, B, Mueller, C, Mullens, W, Núñez, J, Piepoli, MF, Rakisheva, A, Ristic, A, Rossignol, P, Savarese, G, Tocchetti, CG, Van Linthout, S, Volterrani, M, Seferovic, P, Rosano, G, Coats, AJ, and Bayes-Genis, A

Abstract

Cardiac remodelling refers to changes in left ventricular structure and function over time, with a progressive deterioration that may lead to heart failure (HF) development (adverse remodelling) or vice versa a recovery (reverse remodelling) in response to HF treatment. Adverse remodelling predicts a worse outcome, whilst reverse remodelling predicts a better prognosis. The geometry, systolic and diastolic function and electric activity of the left ventricle are affected, as well as the left atrium and on the long term even right heart chambers. At a cellular and molecular level, remodelling involves all components of cardiac tissue: cardiomyocytes, fibroblasts, endothelial cells and leucocytes. The molecular, cellular and histological signatures of remodelling may differ according to the cause and severity of cardiac damage, and clearly to the global trend toward worsening or recovery. These processes cannot be routinely evaluated through endomyocardial biopsies, but may be reflected by circulating levels of several biomarkers. Different classes of biomarkers (e.g. proteins, non-coding RNAs, metabolites and/or epigenetic modifications) and several biomarkers of each class might inform on some aspects on HF development, progression and long-term outcomes, but most have failed to enter clinical practice. This may be due to the biological complexity of remodelling, so that no single biomarker could provide great insight on remodelling when assessed alone. Another possible reason is a still incomplete understanding of the role of biomarkers in the pathophysiology of cardiac remodelling. Such role will be investigated in the first part of this review paper on biomarkers of cardiac remodelling.

Published
2022

13. Cardiac remodelling - Part 2: Clinical, imaging and laboratory findings. A review from the Study Group on Biomarkers of the Heart Failure Association of the European Society of Cardiology

Author

Aimo, A, Vergaro, G, Gonzalez, A, Barison, A, Lupon, J, Delgado, V, Richards, AM, de Boer, RA, Thum, T, Arfsten, H, Hulsmann, M, Falcao-Pires, I, Diez, J, Foo, RSY, Chan, MYY, Anene-Nzelu, CG, Abdelhamid, M, Adamopoulos, S, Anker, SD, Belenkov, Y, Gal, TB, Cohen-Solal, A, Bohm, M, Chioncel, O, Jankowska, EA, Gustafsson, F, Hill, L, Jaarsma, T, Januzzi, JL, Jhund, P, Lopatin, Y, Lund, LH, Metra, M, Milicic, D, Moura, B, Mueller, C, Mullens, W, Nunez, J, Piepoli, MF, Rakisheva, A, Ristic, AD, Rossignol, P, Savarese, G, Tocchetti, CG, van Linthout, S, Volterrani, M, Seferovic, P, Rosano, G, Coats, AJS, Emdin, M, and Bayes-Genis, A

Subjects
Ejection fraction, Predictors, Therapies, Remodelling, Heart failure, Biomarkers, Imaging
Abstract

In patients with heart failure, the beneficial effects of drug and device therapies counteract to some extent ongoing cardiac damage. According to the net balance between these two factors, cardiac geometry and function may improve (reverse remodelling, RR) and even completely normalize (remission), or vice versa progressively deteriorate (adverse remodelling, AR). RR or remission predict a better prognosis, while AR has been associated with worsening clinical status and outcomes. The remodelling process ultimately involves all cardiac chambers, but has been traditionally evaluated in terms of left ventricular volumes and ejection fraction. This is the second part of a review paper by the Study Group on Biomarkers of the Heart Failure Association of the European Society of Cardiology dedicated to ventricular remodelling. This document examines the proposed criteria to diagnose RR and AR, their prevalence and prognostic value, and the variables predicting remodelling in patients managed according to current guidelines. Much attention will be devoted to RR in patients with heart failure with reduced ejection fraction because most studies on cardiac remodelling focused on this setting.

Published
2022

14. Impact analysis of heart failure across European countries: an ESC-HFA position paper

Author

Rosano, GMC, Seferovic, P, Savarese, G, Spoletini, I, Lopatin, Y, Gustafsson, F, Bayes-Genis, A, Jaarsma, T, Abdelhamid, M, Miqueo, AG, Piepoli, M, Tocchetti, CG, Ristic, AD, Jankowska, E, Moura, B, Hill, L, Filippatos, G, Metra, M, Milicic, D, Thum, T, Chioncel, O, Ben Gal, T, Lund, LH, Farmakis, D, Mullens, W, Adamopoulos, S, Bohm, M, Norhammar, A, Bollmann, A, Banerjee, A, Maggioni, AP, Voors, A, Solal, AC, Coats, AJS, Maggioni, Aldo Pietro/0000-0003-2764-6779, Hill, Loreena/0000-0001-5232-0936, Gustafsson, Finn/0000-0003-2144-341X, Rosano, Giuseppe M. C., Seferovic, Petar, Savarese, Gianluigi, Spoletini, Ilaria, Lopatin, Yuri, Gustafsson, Fin, Bayes-Genis, Antoni, Jaarsma, Tiny, Abdelhamid, Magdy, Miqueo, Arantxa Gonzalez, Piepoli, Massimo, Tocchetti, Carlo G., Ristic, Arsen D., Jankowska, Ewa, Moura, Brenda, Hill, Loreena, Filippatos, Gerasimos, Metra, Marco, Milicic, Davor, Thum, Thomas, Chioncel, Ovidiu, Ben Gal, Tuvia, Lund, Lars H., Farmakis, Dimitrios, MULLENS, Wilfried, Adamopoulos, Stamatis, Bohm, Michael, Norhammar, Anna, Bollmann, Andreas, Banerjee, Amitava, Maggioni, Aldo P., Voors, Adriaan, Solal, Alain Cohen, and Coats, Andrew J. S.

Subjects
Quality of life, Impact, Epidemiology, Heart failure, Mortality, Morbidity, Prognosis
Abstract

Heart failure (HF) is a long-term clinical syndrome, with increasing prevalence and considerable healthcare costs that are further expected to increase dramatically. Despite significant advances in therapy and prevention, mortality and morbidity remain high and quality of life poor. Epidemiological data, that is, prevalence, incidence, mortality, and morbidity, show geographical variations across the European countries, depending on differences in aetiology, clinical characteristics, and treatment. However, data on the prevalence of the disease are scarce, as are those on quality of life. For these reasons, the ESC-HFA has developed a position paper to comprehensively assess our understanding of the burden of HF in Europe, in order to guide future policies for this syndrome. This manuscript will discuss the available epidemiological data on HF prevalence, outcomes, and human costs-in terms of quality of life-in European countries.

Published
2022

15. Evaluation of the effect of intravenous nitroglycerine on short-term survival of patients with acute heart failure according to congestion and perfusion status at emergency department arrival

Author

Miró Ò, Espinosa B, Gil V, Jacob J, Alquézar-Arbé A, Masip J, Llauger L, Tost J, Andueza JA, Garrido JM, Mojarro EM, Urbano CA, Núñez J, Chioncel O, Mullens W, Cotter G, and Llorens P

Abstract

We investigated if the phenotypic classification of acute heart failure (AHF) based on the number of signs/symptoms of congestion and hypoperfusion at emergency department (ED) arrival identifies subgroups in which intravenous (IV) nitroglycerine (NTG) use improves short-term survival. We included consecutive AHF patients diagnosed in 45 Spanish EDs, who were grouped according to phenotype severity. The main outcome was 30-day all-cause death. Propensity scores (PS) for NTG use were generated using variables associated with death. Analysis of interaction was performed in subgroups of patients based on congestion, hypoperfusion, age, sex, coronary artery disease (CAD), left ventricular ejection fraction (LVEF) and SBP. We analyzed 16 437 AHF patients (median = 83 years; women = 56%); 1882 received NTG (11.4%). In the whole cohort, the cumulative 30-day mortality in patients receiving NTG was higher (11.5% vs. 9.6%; unadjusted HR, 1.19; 95% CI, 1.04-1.36), but not in the PS-matched cohorts (1698 pairs of patients; 11.5% vs. 10.5%; HR, 1.10; 95% CI, 0.90-1.35). Mortality was increased in NTG-treated patients with mild congestion (HR, 2.09; 95% CI, 1.19-3.67), especially in those without hypoperfusion (HR, 2.51; 95% CI, 1.24-5.10). Interaction analysis of the PS-matched cohorts confirmed detrimental effects of NTG use in less congested patients, whereas beneficial effects were only observed in patients with decreased LVEF (

Published
2022

16. 2021 ESC Guidelines on cardiac pacing and cardiac resynchronization therapy

Author

Glikson, M., Nielsen, J. C., Kronborg, M. B., Michowitz, Y., Auricchio, A., Barbash, I. M., Barrabes, J. A., Boriani, G., Braunschweig, F., Brignole, M., Burri, H., Coats, A. J. S., Deharo, J. -C., Delgado, V., Diller, G. -P., Israel, C. W., Keren, A., Knops, R. E., Kotecha, D., Leclercq, C., Merkely, B., Starck, C., Thylen, I., Tolosana, J. M., Leyva, F., Linde, C., Abdelhamid, M., Aboyans, V., Arbelo, E., Asteggiano, R., Baron-Esquivias, G., Bauersachs, J., Biffi, M., Birgersdotter-Green, U., Bongiorni, M. G., Borger, M. A., Celutkiene, J., Cikes, M., Daubert, J. -C., Drossart, I., Ellenbogen, K., Elliott, P. M., Fabritz, L., Falk, V., Fauchier, L., Fernandez-Aviles, F., Foldager, D., Gadler, F., De Vinuesa, P. G. G., Gorenek, B., Guerra, J. M., Hermann Haugaa, K., Hendriks, J., Kahan, T., Katus, H. A., Konradi, A., Koskinas, K. C., Law, H., Lewis, B. S., Linker, N. J., Lochen, M. -L., Lumens, J., Mascherbauer, J., Mullens, W., Nagy, K. V., Prescott, E., Raatikainen, P., Rakisheva, A., Reichlin, T., Ricci, R. P., Shlyakhto, E., Sitges, M., Sousa-Uva, M., Sutton, R., Suwalski, P., Svendsen, J. H., Touyz, R. M., Van Gelder, I. C., Vernooy, K., Waltenberger, J., Whinnett, Z., Witte, K. K., Qoriany, A., Centre recherche en CardioVasculaire et Nutrition = Center for CardioVascular and Nutrition research (C2VN), and Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)

Subjects
Pacemaker, Artificial, Cardiac pacing, medicine.medical_treatment, [SDV]Life Sciences [q-bio], Vascular damage Radboud Institute for Health Sciences [Radboudumc 16], cardiac resynchronization therapy, heart failure, temporary pacing, law.invention, law, atrial fibrillation, 610 Medicine & health, ComputingMilieux_MISCELLANEOUS, biology, Cardiac Pacing, Artificial, Syncope (genus), Atrial fibrillation, syncope, Cardiology, cardiovascular system, medicine.symptom, guidelines, cardiac pacing, pacemaker, conduction system pacing, pacing indications, alternate site pacing, complications, pacing in TAVI, bradycardia, Cardiology and Cardiovascular Medicine, Bradycardia, medicine.medical_specialty, Cardiac resynchronization therapy, Guidelines, Physiology (medical), Internal medicine, medicine, Humans, Task force, business.industry, Stroke Volume, 1103 Clinical Sciences, medicine.disease, biology.organism_classification, Heart Rhythm, Cardiovascular System & Hematology, Heart failure, Artificial cardiac pacemaker, business, Atrioventricular block
Abstract

These are the clinical practice guidelines of the European Society of Cardiology on cardiac pacing and cardiac resynchronization therapy, from 2021.

Published
2022
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18. NT-proBNP Response to Sacubitril/Valsartan in Hospitalized Heart Failure Patients With Reduced Ejection Fraction: TRANSITION Study

Author

Pascual-Figal, D, Wachter, R, Senni, M, Bao, W, Noe, A, Schwende, H, Butylin, D, Prescott, M, Gniot, J, Mozheiko, M, Lelonek, M, Dominguez, A, Horacek, T, Garcia del Rio, E, Kobalava, Z, Mueller, C, Cavusoglu, Y, Straburzynska-Migaj, E, Slanina, M, vom Dahl, J, Ryding, A, Moriarty, A, Robles, M, Villota, J, Quintana, A, Nitschke, T, Garcia Pinilla, J, Bonet, L, Chaaban, S, Filali zaatari, S, Spinar, J, Musial, W, Abdelbaki, K, Belohlavek, J, Fehske, W, Bott, M, Hoegalmen, G, Leiro, M, Ozcan, I, Mullens, W, Kryza, R, Al-Ani, R, Loboz-Grudzien, K, Ermoshkina, L, Hojerova, S, Fernandez, A, Spinarova, L, Lapp, H, Bulut, E, Almeida, F, Vishnevsky, A, Belicova, M, Witte, K, Wong, K, Droogne, W, Delforge, M, Peterka, M, Olbrich, H, Carugo, S, Nessler, J, Mcgill, T, Huegl, B, Akin, I, Moreira, I, Baglikov, A, Thambyrajah, J, Hayes, C, Barrionuevo, M, Yigit, Z, Kaya, H, Klimsa, Z, Radvan, M, Kadel, C, Landmesser, U, Di Tano, G, Lisik, M, Fonseca, C, Oliveira, L, Marques, I, Santos, L, Lenner, E, Letavay, P, Bueno, M, Mota, P, Wong, A, Bailey, K, Foley, P, Hasbani, E, Virani, S, Massih, T, Al-Saif, S, Taborsky, M, Kaislerova, M, Motovska, Z, Cohen, A, Logeart, D, Endemann, D, Ferreira, D, Brito, D, Kycina, P, Bollano, E, Basilio, E, Rubio, L, Aguado, M, Schiavi, L, Zivano, D, Lonn, E, El Sayed, A, Pouleur, A, Heyse, A, Schee, A, Polasek, R, Houra, M, Tribouilloy, C, Seronde, M, Galinier, M, Noutsias, M, Schwimmbeck, P, Voigt, I, Westermann, D, Pulignano, G, Vegsundvaag, J, Da Silva Antunes, J, Monteiro, P, Stevlik, J, Goncalvesova, E, Hulkoova, B, Castro Fernandez, A, Davies, C, Squire, I, Meyer, P, Sheppard, R, Sahin, T, Sochor, K, De Geeter, G, Schmeisser, A, Weil, J, Soares, A, Bulashova, O, Oshurkov, A, Sunderland, S, Glover, J, Exequiel, T, Decoulx, E, Meyer, S, Muenzel, T, Frioes, F, Arbolishvili, G, Tokarcikova, A, Karlstrom, P, Trullas Vila, J, Perez, G, Sankaranarayanan, R, Nageh, T, Alasia, D, Refaat, M, Demirkan, B, Al-Buraiki, J, Karabsheh, S, Pascual-Figal D., Wachter R., Senni M., Bao W., Noe A., Schwende H., Butylin D., Prescott M. F., Gniot J., Mozheiko M., Lelonek M., Dominguez A. R., Horacek T., Garcia del Rio E., Kobalava Z., Mueller C. E., Cavusoglu Y., Straburzynska-Migaj E., Slanina M., vom Dahl J., Ryding A., Moriarty A., Robles M. B., Villota J. N., Quintana A. G., Nitschke T., Garcia Pinilla J. M., Bonet L. A., Chaaban S., Filali zaatari S., Spinar J., Musial W., Abdelbaki K., Belohlavek J., Fehske W., Bott M. C., Hoegalmen G., Leiro M. C., Ozcan I. T., Mullens W., Kryza R., Al-Ani R., Loboz-Grudzien K., Ermoshkina L., Hojerova S., Fernandez A. A., Spinarova L., Lapp H., Bulut E., Almeida F., Vishnevsky A., Belicova M., Witte K., Wong K., Droogne W., Delforge M., Peterka M., Olbrich H. -G., Carugo S., Nessler J., McGill T. H., Huegl B., Akin I., Moreira I., Baglikov A., Thambyrajah J., Hayes C., Barrionuevo M. R., Yigit Z., Kaya H., Klimsa Z., Radvan M., Kadel C., Landmesser U., Di Tano G., Lisik M. B., Fonseca C., Oliveira L., Marques I., Santos L. M., Lenner E., Letavay P., Bueno M. G., Mota P., Wong A., Bailey K., Foley P., Hasbani E., Virani S., Massih T. A., Al-Saif S., Taborsky M., Kaislerova M., Motovska Z., Cohen A. A., Logeart D., Endemann D., Ferreira D., Brito D., Kycina P., Bollano E., Basilio E. G., Rubio L. F., Aguado M. G., Schiavi L. B., Zivano D. F., Lonn E., El Sayed A., Pouleur A. -C., Heyse A., Schee A., Polasek R., Houra M., Tribouilloy C., Seronde M. F., Galinier M., Noutsias M., Schwimmbeck P., Voigt I., Westermann D., Pulignano G., Vegsundvaag J., Da Silva Antunes J. A., Monteiro P., Stevlik J., Goncalvesova E., Hulkoova B., Castro Fernandez A. J., Davies C., Squire I., Meyer P., Sheppard R., Sahin T., Sochor K., De Geeter G., Schmeisser A., Weil J., Soares A. O., Bulashova O. V., Oshurkov A., Sunderland S. J., Glover J., Exequiel T., Decoulx E., Meyer S., Muenzel T., Frioes F., Arbolishvili G., Tokarcikova A., Karlstrom P., Trullas Vila J. C., Perez G. P., Sankaranarayanan R., Nageh T., Alasia D. C., Refaat M., Demirkan B., Al-Buraiki J., Karabsheh S., Pascual-Figal, D, Wachter, R, Senni, M, Bao, W, Noe, A, Schwende, H, Butylin, D, Prescott, M, Gniot, J, Mozheiko, M, Lelonek, M, Dominguez, A, Horacek, T, Garcia del Rio, E, Kobalava, Z, Mueller, C, Cavusoglu, Y, Straburzynska-Migaj, E, Slanina, M, vom Dahl, J, Ryding, A, Moriarty, A, Robles, M, Villota, J, Quintana, A, Nitschke, T, Garcia Pinilla, J, Bonet, L, Chaaban, S, Filali zaatari, S, Spinar, J, Musial, W, Abdelbaki, K, Belohlavek, J, Fehske, W, Bott, M, Hoegalmen, G, Leiro, M, Ozcan, I, Mullens, W, Kryza, R, Al-Ani, R, Loboz-Grudzien, K, Ermoshkina, L, Hojerova, S, Fernandez, A, Spinarova, L, Lapp, H, Bulut, E, Almeida, F, Vishnevsky, A, Belicova, M, Witte, K, Wong, K, Droogne, W, Delforge, M, Peterka, M, Olbrich, H, Carugo, S, Nessler, J, Mcgill, T, Huegl, B, Akin, I, Moreira, I, Baglikov, A, Thambyrajah, J, Hayes, C, Barrionuevo, M, Yigit, Z, Kaya, H, Klimsa, Z, Radvan, M, Kadel, C, Landmesser, U, Di Tano, G, Lisik, M, Fonseca, C, Oliveira, L, Marques, I, Santos, L, Lenner, E, Letavay, P, Bueno, M, Mota, P, Wong, A, Bailey, K, Foley, P, Hasbani, E, Virani, S, Massih, T, Al-Saif, S, Taborsky, M, Kaislerova, M, Motovska, Z, Cohen, A, Logeart, D, Endemann, D, Ferreira, D, Brito, D, Kycina, P, Bollano, E, Basilio, E, Rubio, L, Aguado, M, Schiavi, L, Zivano, D, Lonn, E, El Sayed, A, Pouleur, A, Heyse, A, Schee, A, Polasek, R, Houra, M, Tribouilloy, C, Seronde, M, Galinier, M, Noutsias, M, Schwimmbeck, P, Voigt, I, Westermann, D, Pulignano, G, Vegsundvaag, J, Da Silva Antunes, J, Monteiro, P, Stevlik, J, Goncalvesova, E, Hulkoova, B, Castro Fernandez, A, Davies, C, Squire, I, Meyer, P, Sheppard, R, Sahin, T, Sochor, K, De Geeter, G, Schmeisser, A, Weil, J, Soares, A, Bulashova, O, Oshurkov, A, Sunderland, S, Glover, J, Exequiel, T, Decoulx, E, Meyer, S, Muenzel, T, Frioes, F, Arbolishvili, G, Tokarcikova, A, Karlstrom, P, Trullas Vila, J, Perez, G, Sankaranarayanan, R, Nageh, T, Alasia, D, Refaat, M, Demirkan, B, Al-Buraiki, J, Karabsheh, S, Pascual-Figal D., Wachter R., Senni M., Bao W., Noe A., Schwende H., Butylin D., Prescott M. F., Gniot J., Mozheiko M., Lelonek M., Dominguez A. R., Horacek T., Garcia del Rio E., Kobalava Z., Mueller C. E., Cavusoglu Y., Straburzynska-Migaj E., Slanina M., vom Dahl J., Ryding A., Moriarty A., Robles M. B., Villota J. N., Quintana A. G., Nitschke T., Garcia Pinilla J. M., Bonet L. A., Chaaban S., Filali zaatari S., Spinar J., Musial W., Abdelbaki K., Belohlavek J., Fehske W., Bott M. C., Hoegalmen G., Leiro M. C., Ozcan I. T., Mullens W., Kryza R., Al-Ani R., Loboz-Grudzien K., Ermoshkina L., Hojerova S., Fernandez A. A., Spinarova L., Lapp H., Bulut E., Almeida F., Vishnevsky A., Belicova M., Witte K., Wong K., Droogne W., Delforge M., Peterka M., Olbrich H. -G., Carugo S., Nessler J., McGill T. H., Huegl B., Akin I., Moreira I., Baglikov A., Thambyrajah J., Hayes C., Barrionuevo M. R., Yigit Z., Kaya H., Klimsa Z., Radvan M., Kadel C., Landmesser U., Di Tano G., Lisik M. B., Fonseca C., Oliveira L., Marques I., Santos L. M., Lenner E., Letavay P., Bueno M. G., Mota P., Wong A., Bailey K., Foley P., Hasbani E., Virani S., Massih T. A., Al-Saif S., Taborsky M., Kaislerova M., Motovska Z., Cohen A. A., Logeart D., Endemann D., Ferreira D., Brito D., Kycina P., Bollano E., Basilio E. G., Rubio L. F., Aguado M. G., Schiavi L. B., Zivano D. F., Lonn E., El Sayed A., Pouleur A. -C., Heyse A., Schee A., Polasek R., Houra M., Tribouilloy C., Seronde M. F., Galinier M., Noutsias M., Schwimmbeck P., Voigt I., Westermann D., Pulignano G., Vegsundvaag J., Da Silva Antunes J. A., Monteiro P., Stevlik J., Goncalvesova E., Hulkoova B., Castro Fernandez A. J., Davies C., Squire I., Meyer P., Sheppard R., Sahin T., Sochor K., De Geeter G., Schmeisser A., Weil J., Soares A. O., Bulashova O. V., Oshurkov A., Sunderland S. J., Glover J., Exequiel T., Decoulx E., Meyer S., Muenzel T., Frioes F., Arbolishvili G., Tokarcikova A., Karlstrom P., Trullas Vila J. C., Perez G. P., Sankaranarayanan R., Nageh T., Alasia D. C., Refaat M., Demirkan B., Al-Buraiki J., and Karabsheh S.

Abstract

Objectives: This study examined the effects of sacubitril/valsartan on N-terminal pro–B-type natriuretic peptide (NT-proBNP) levels and determined patient characteristics associated with favorable NT-proBNP reduction response. Background: NT-proBNP levels reflect cardiac wall stress and predict event risk in patients with acute decompensated heart failure (ADHF). Methods: Post-hoc analysis of the TRANSITION (Comparison of Pre- and Post-discharge Initiation of Sacubitril/Valsartan Therapy in HFrEF Patients After an Acute Decompensation Event) study, including stabilized ADHF patients with reduced ejection fraction, randomized to open-label sacubitril/valsartan initiation in-hospital (pre-discharge) versus post-discharge. NT-proBNP was measured at randomization (baseline), discharge, and 4 and 10 weeks post-randomization. A favorable NT-proBNP response was defined as reduction to ≤1,000 pg/ml or >30% from baseline. Results: In patients receiving sacubitril/valsartan in-hospital, NT-proBNP was reduced by 28% at discharge, with 46% of patients obtaining favorable NT-proBNP reduction response compared with a 4% reduction and 18% favorable response rate in patients initiated post-discharge (p < 0.001). NT-proBNP was reduced similarly in patients initiating sacubitril/valsartan pre- and post-discharge (reduction at 4 weeks: 25%/22%; 10 weeks: 38%/34%) with comparable favorable response rates (46%/42% and 51%/48% at 4 and 10 weeks, respectively). NT-proBNP favorable response at 4 weeks was associated with lower risk of first heart failure (HF) rehospitalization or cardiovascular death through 26 weeks (hazard ratio: 0.57; 95% confidence interval [CI]: 0.38 to 0.86; p = 0.007). Predictors of a favorable response at 4 weeks were starting dose ≥49/51 mg twice daily, higher baseline NT-proBNP, lower baseline serum creatinine, de novo HF, no atrial fibrillation, angiotensin-converting enzyme inhibitor–naive or angiotensin receptor blocker–naive, and no prior myocardial inf

Published
2020

19. Association between loop diuretic dose changes and outcomes in chronic heart failure: observations from the ESC-EORP Heart Failure Long-Term Registry

Author

Kapelios, C. J., Laroche, C., Crespo-Leiro, M. G., Anker, S. D., Coats, A. J. S., Diaz-Molina, B., Filippatos, G., Lainscak, M., Maggioni, A. P., Mcdonagh, T., Mebazaa, A., Metra, M., Moura, B., Mullens, W., Piepoli, M. F., Rosano, G. M. C., Ruschitzka, F., Seferovic, P. M., Lund, L. H., Gale, C. P., Beleslin, B., Budaj, A., Chioncel, O., Dagres, N., Danchin, N., Erlinge, D., Emberson, J., Glikson, M., Gray, A., Kayikcioglu, M., Maggioni, A., Nagy, K. V., Nedoshivin, A., Petronio, A. -S., Roos-Hesselink, J., Wallentin, L., Zeymer, U., Crespo-Leiro, M., Anker, S., Coats, A., Ferrari, R., Goda, A., Diez, M., Fernandez, A., Fruhwald, F., Gatzov, P., Kurlianskaya, A., Hullin, R., Christodoulides, T., Hradec, J., Nielsen, O. W., Nedjar, R., Uuetoa, T., Jimenez, J. F. D., Harjola, V. -P., Logeart, D., Tousoulis, D., Milicic, D., Merkely, B., Amir, O., Shotan, A., Shafie, D., Mirrakhimov, E., Kavoliuniene, A., Erglis, A., Otljanska, M., Kostovska, E. S., Demarco, D. C., Drozdz, J., Fonseca, C., Dekleva, M., Dahlstrom, U., Goncalvesova, E., Estrago, V., Bajraktari, G., Auer, J., Ablasser, K., Dolze, T., Brandner, K., Gstrein, S., Poelzl, G., Moertl, D., Reiter, S., Muslibegovic, A., Vasilj, M., Fazlibegovic, E., Cesko, M., Zelenika, D., Palic, B., Pravdic, D., Cuk, D., Vitlianova, K., Katova, T., Kurteva, T., Kamenova, D., Antova, M., Krejci, J., Spinar, J., Krupicka, J., Malek, F., Hegarova, M., Lazarova, M., Monhart, Z., Hassanein, M., El Messiry, F., El Shazly, A. H., Elrakshy, Y., Youssef, A., Moneim, A. A., Noamany, M., Dayem, T. K. A., Farag, N., Halawa, S. I., Hamid, M. A., Saleh, A., Ebeid, H., Hanna, R., Louis, O., Enen, M. A., Ibrahim, B. S., Nasr, G., Elbahry, A., Sobhy, H., Ashmawy, M., Gouda, M., Aboleineen, W., Bernard, Y., Meneveau, N., Pillot, M., Morel, M., Seronde, M. -F., Schiele, F., Briand, F., Delahaye, F., Damy, T., Eicher, J. -C., de Groote, P., Fertin, M., Lamblin, N., Isnard, R., Thevenin, S., Hagege, A., Le Marcis, V., J. -F., Ly, Coisne, D., Lequeux, B., Le Moal, V., Mascle, S., Lotton, P., Behar, N., Donal, E., Ridard, C., Reynaud, A., Basquin, A., Bauer, F., Codjia, R., Galinier, M., Tourikis, P., Stavroula, M., Stefanadis, C., Chrysohoou, C., Kotrogiannis, I., Matzaraki, V., Karavidas, A., Tsitsinakis, G., Kapelios, C., Nanas, J., Kampouri, H., Nana, E., Kaldara, E., Eugenidou, A., Vardas, P., Saloustros, I., Tsaknakis, T., Evangelou, S., Tziourganou, H., Tsaroucha, A., Papadopoulou, A., Douras, A., Polgar, L., Kosztin, A., Nyolczas, N., Nagy, A. C., Halmosi, R., Elber, J., Fuhrmann, A. V., Romano, S., Marcon, S., Penco, M., Di Mauro, M., Lemme, E., Carubelli, V., Rovetta, R., Bulgari, M., Quinzani, F., Bosi, S., Schiavina, G., Squeri, A., Di Tano, G., Pirelli, S., Fucili, A., Passero, T., Musio, S., Di Biase, M., Correale, M., Salvemini, G., Brognoli, S., Zanelli, E., Giordano, A., Agostoni, P., Salvioni, E., Copelli, S., Modena, M. G., Valenti, C., Olaru, A., Bandino, S., Deidda, M., Mercuro, G., Marino, P. N., Di Ruocco, M. V., Piccinino, C., Parrinello, G., Licata, G., Torres, D., Giambanco, S., Busalacchi, S., Arrotti, S., Novo, S., Inciardi, R. M., Pieri, P., Galifi, M. A., Teresi, G., Buccheri, D., Minacapelli, A., Veniani, M., Frisinghelli, A., Priori, S. G., Cattaneo, S., Opasich, C., Gualco, A., Pagliaro, M., Mancone, M., Fedele, F., Cinque, A., Vellini, M., Scarfo, I., Romeo, F., Ferraiuolo, F., Sergi, D., Anselmi, M., Melandri, F., Leci, E., Iori, E., Bovolo, V., Frea, S., Bergerone, S., Botta, M., Canavosio, F. G., Gaita, F., Merlo, M., Cinquetti, M., Sinagra, G., Ramani, F., Fabris, E., Artico, J., Miani, D., Fresco, C., Daneluzzi, C., Proclemer, A., Cicoira, M., Zanolla, L., Marchese, G., Torelli, F., Vassanelli, C., Voronina, N., Tamakauskas, V., Smalinskas, V., Karaliute, R., Petraskiene, I., Rumbinaite, E., Brazyte-Ramanauskiene, R., Petraskiene, D., Sinkiewicz, W., Gilewski, W., Pietrzak, J., Orzel, T., Kardaszewicz, P., Lazorko-Piega, M., Mosakowska, K., Bellwon, J., Rynkiewicz, A., Raczak, G., Lewicka, E., Dabrowska-Kugacka, A., Bartkowiak, R., Wozakowska-Kaplon, B., Krzeminski, A., Zabojszcz, M., Grzegorzko, A., Bury, K., Nessler, J., Zalewski, J., Furman, A., Poliwczak, A., Bala, A., Zycinski, P., Rudzinska, M., Jankowski, L., Kasprzak, J. D., Michalak, L., Soska, K. W., Huziuk, I., Flis, P., Weglarz, J., Bodys, A., Grajek, S., Straburzynska-Migaj, E., Dankowski, R., Szymanowska, K., Szyszka, A., Nowicka, A., Samcik, M., Wolniewicz, L., Komorowska, K., Poprawa, I., Komorowska, E., Sajnaga, D., Zolbach, A., Abdulkarim, A. -F., Lauko-Rachocka, A., Kaminski, L., Kostka, A., Cichy, A., Ruszkowski, P., Splawski, M., Fitas, G., Szymczyk, A., Serwicka, A., Fiega, A., Zysko, D., Krysiak, W., Szabowski, S., Skorek, E., Pruszczyk, P., Bienias, P., Ciurzynski, M., Welnicki, M., Mamcarz, A., Folga, A., Zielinski, T., Rywik, T., Leszek, P., Sobieszczanska-Malek, M., Kozar-Kaminska, K., Komuda, K., Wisniewska, J., Tarnowska, A., Marchel, M., Opolski, G., Kaplon-Cieslicka, A., Gil, R. J., Mozenska, O., Gil, K., Pawlak, A., Michalek, A., Krzesinski, P., Piotrowicz, K., Stanczyk, A., Skrobowski, A., Ponikowski, P., Jankowska, E., Rozentryt, P., Polonski, L., Nowalany-Kozielska, E., Kuczaj, A., Kalarus, Z., Szulik, M., Klys, J., Prokop-Lewicka, G., Kleinrok, A., Tavaresaguiar, C., Ventosa, A., Pereira, S., Faria, R., Chin, J., Dejesus, I., Santos, R., Silva, P., Moreno, N., Lourenco, C., Pereira, A., Castro, A., Andrade, A., Oliveiraguimaraes, T., Martins, S., Placido, R., Lima, G., Brito, D., Francisco, A. R., Proenca, M., Araujo, I., Marques, F., Campelo, M., Silva-Cardoso, J., Rodrigues, J., Rangel, I., Martins, E., Peres, M., Marta, L., Severino, D., Durao, D., Leao, S., Magalhaes, P., Moreira, I., Ferreira, C., Araujo, C., Ferreira, A., Baptista, A., Radoi, M., Bicescu, G., Vinereanu, D., Sinescu, C. -J., Macarie, C., Popescu, R., Daha, I., Dan, G. -A., Stanescu, C., Dan, A., Craiu, E., Nechita, E., Christodorescu, R., Otasevic, P., Simeunovic, D., Ristic, A. D., Celic, V., Pavlovic-Kleut, M., Stojcevski, B., Pencic, B., Stevanovic, A., Andric, A., Simic, D., Asanin, M., Iric-Cupic, V., Jovic, M., Milanov, S., Mitic, V., Atanaskovic, V., Antic, S., Pavlovic, M., Stanojevic, D., Stoickov, V., Ilic, S., Deljaninilic, M., Petrovic, D., Stojsic, S., Kecojevic, S., Dodic, S., Adic, N. C., Cankovic, M., Stojiljkovic, J., Mihajlovic, B., Radin, A., Radovanovic, S., Krotin, M., Klabnik, A., Pernicky, M., Murin, J., Kovar, F., Kmec, J., Strasek, M., Iskra, M. S., Ravnikar, T., Suligoj, N. C., Fras, Z., Jug, B., Glavic, T., Losic, R., Bombek, M., Krunic, B., Horvat, S., Kovac, D., Rajtman, D., Letonja, M., Winkler, R., Melihen-Bartolic, C., Bartolic, A., Kladnik, M., Pusnik, C. S., Marolt, A., Klen, J., Drnovsek, B., Leskovar, B., Anguita, M. J. F., Gallegopage, J. C., Martinez, F. M. S., Andres, J., Bayes-Genis, A., Mirabet, S., Mendez, A., Garcia-Cosio, L., Leon, V., Gonzalez-Costello, J., Muntane, G., Garay, A., Alcade-Martinez, V., Fernandez, S. L., Rivera-Lopez, R., Fernandez-Alvarez, M., Serrano-Martinez, J. L., Grille-Cancela, Z., Marzoa-Rivas, R., Paniagua-Martin, M. J., Barge-Caballero, E., Gonzalez-Gallarza, R. D., Salvadormontanes, O., Manjavacas, A. M. I., Conde, A. C., Araujo, A., Soria, T., Gomez-Bueno, M., Cobo-Marcos, M., Alonso-Pulpon, L., Segoviacubero, J., Sayago, I., Gonzalez-Segovia, A., Briceno, A., Subias, P. E., Cano, M. J. R., Sanchez, M. A. G., Pinilla, J. M. G., de la Villa, B. G., Sahuquillo, A., Marques, R. B., Calvo, F. T., Perez-Martinez, M. T., Garrido-Bravo, I. P., Pastor-Perez, F., Pascual-Figal, D. A., Molina, B. D., Orus, J., Gonzalo, F. E., Bertomeu, V., Valero, R., Martinez-Abellan, R., Quiles, J., Mateo, I., Elamrani, A., Fernandez-Vivancos, C., Valero, D. B., Almenar-Bonet, L., Sanchez-Lazaro, I. J., Marques-Sule, E., Facila-Rubio, L., Perez-Silvestre, J., Garcia-Gonzalez, P., Garcia-Escriva, D., Pellicer-Cabo, A., de laFuente Galan, L., Diaz, J. L., Platero, A. R., Arias, J. C., Blasco-Peiro, T., Julve, M. S., Sanchez-Insa, E., Portoles-Ocampo, A., Melin, M., Hagglund, Stenberg, A., Lindahl, I. -M., Asserlund, B., Olsson, L., Afzelius, M., Karlstrom, P., Tengvall, L., Olsson, B., Kalayci, S., Cavusoglu, Y., Gencer, E., Yilmaz, M. B., Gunes, H., Kapelios, C. J., Laroche, C., Crespo-Leiro, M. G., Anker, S. D., Coats, A. J. S., Diaz-Molina, B., Filippatos, G., Lainscak, M., Maggioni, A. P., Mcdonagh, T., Mebazaa, A., Metra, M., Moura, B., Mullens, W., Piepoli, M. F., Rosano, G. M. C., Ruschitzka, F., Seferovic, P. M., Lund, L. H., Gale, C. P., Beleslin, B., Budaj, A., Chioncel, O., Dagres, N., Danchin, N., Erlinge, D., Emberson, J., Glikson, M., Gray, A., Kayikcioglu, M., Maggioni, A., Nagy, K. V., Nedoshivin, A., Petronio, A. -S., Roos-Hesselink, J., Wallentin, L., Zeymer, U., Crespo-Leiro, M., Anker, S., Coats, A., Ferrari, R., Goda, A., Diez, M., Fernandez, A., Fruhwald, F., Gatzov, P., Kurlianskaya, A., Hullin, R., Christodoulides, T., Hradec, J., Nielsen, O. W., Nedjar, R., Uuetoa, T., Jimenez, J. F. D., Harjola, V. -P., Logeart, D., Tousoulis, D., Milicic, D., Merkely, B., Amir, O., Shotan, A., Shafie, D., Mirrakhimov, E., Kavoliuniene, A., Erglis, A., Otljanska, M., Kostovska, E. S., Demarco, D. C., Drozdz, J., Fonseca, C., Dekleva, M., Dahlstrom, U., Goncalvesova, E., Estrago, V., Bajraktari, G., Auer, J., Ablasser, K., Dolze, T., Brandner, K., Gstrein, S., Poelzl, G., Moertl, D., Reiter, S., Muslibegovic, A., Vasilj, M., Fazlibegovic, E., Cesko, M., Zelenika, D., Palic, B., Pravdic, D., Cuk, D., Vitlianova, K., Katova, T., Kurteva, T., Kamenova, D., Antova, M., Krejci, J., Spinar, J., Krupicka, J., Malek, F., Hegarova, M., Lazarova, M., Monhart, Z., Hassanein, M., El Messiry, F., El Shazly, A. H., Elrakshy, Y., Youssef, A., Moneim, A. A., Noamany, M., Dayem, T. K. A., Farag, N., Halawa, S. I., Hamid, M. A., Saleh, A., Ebeid, H., Hanna, R., Louis, O., Enen, M. A., Ibrahim, B. S., Nasr, G., Elbahry, A., Sobhy, H., Ashmawy, M., Gouda, M., Aboleineen, W., Bernard, Y., Meneveau, N., Pillot, M., Morel, M., Seronde, M. -F., Schiele, F., Briand, F., Delahaye, F., Damy, T., Eicher, J. -C., de Groote, P., Fertin, M., Lamblin, N., Isnard, R., Thevenin, S., Hagege, A., Le Marcis, V., Ly, J. -F., Coisne, D., Lequeux, B., Le Moal, V., Mascle, S., Lotton, P., Behar, N., Donal, E., Ridard, C., Reynaud, A., Basquin, A., Bauer, F., Codjia, R., Galinier, M., Tourikis, P., Stavroula, M., Stefanadis, C., Chrysohoou, C., Kotrogiannis, I., Matzaraki, V., Karavidas, A., Tsitsinakis, G., Kapelios, C., Nanas, J., Kampouri, H., Nana, E., Kaldara, E., Eugenidou, A., Vardas, P., Saloustros, I., Tsaknakis, T., Evangelou, S., Tziourganou, H., Tsaroucha, A., Papadopoulou, A., Douras, A., Polgar, L., Kosztin, A., Nyolczas, N., Nagy, A. C., Halmosi, R., Elber, J., Fuhrmann, A. V., Romano, S., Marcon, S., Penco, M., Di Mauro, M., Lemme, E., Carubelli, V., Rovetta, R., Bulgari, M., Quinzani, F., Bosi, S., Schiavina, G., Squeri, A., Di Tano, G., Pirelli, S., Fucili, A., Passero, T., Musio, S., Di Biase, M., Correale, M., Salvemini, G., Brognoli, S., Zanelli, E., Giordano, A., Agostoni, P., Salvioni, E., Copelli, S., Modena, M. G., Valenti, C., Olaru, A., Bandino, S., Deidda, M., Mercuro, G., Marino, P. N., Di Ruocco, M. V., Piccinino, C., Parrinello, G., Licata, G., Torres, D., Giambanco, S., Busalacchi, S., Arrotti, S., Novo, S., Inciardi, R. M., Pieri, P., Galifi, M. A., Teresi, G., Buccheri, D., Minacapelli, A., Veniani, M., Frisinghelli, A., Priori, S. G., Cattaneo, S., Opasich, C., Gualco, A., Pagliaro, M., Mancone, M., Fedele, F., Cinque, A., Vellini, M., Scarfo, I., Romeo, F., Ferraiuolo, F., Sergi, D., Anselmi, M., Melandri, F., Leci, E., Iori, E., Bovolo, V., Frea, S., Bergerone, S., Botta, M., Canavosio, F. G., Gaita, F., Merlo, M., Cinquetti, M., Sinagra, G., Ramani, F., Fabris, E., Artico, J., Miani, D., Fresco, C., Daneluzzi, C., Proclemer, A., Cicoira, M., Zanolla, L., Marchese, G., Torelli, F., Vassanelli, C., Voronina, N., Tamakauskas, V., Smalinskas, V., Karaliute, R., Petraskiene, I., Rumbinaite, E., Brazyte-Ramanauskiene, R., Petraskiene, D., Sinkiewicz, W., Gilewski, W., Pietrzak, J., Orzel, T., Kardaszewicz, P., Lazorko-Piega, M., Mosakowska, K., Bellwon, J., Rynkiewicz, A., Raczak, G., Lewicka, E., Dabrowska-Kugacka, A., Bartkowiak, R., Wozakowska-Kaplon, B., Krzeminski, A., Zabojszcz, M., Grzegorzko, A., Bury, K., Nessler, J., Zalewski, J., Furman, A., Poliwczak, A., Bala, A., Zycinski, P., Rudzinska, M., Jankowski, L., Kasprzak, J. D., Michalak, L., Soska, K. W., Huziuk, I., Flis, P., Weglarz, J., Bodys, A., Grajek, S., Straburzynska-Migaj, E., Dankowski, R., Szymanowska, K., Szyszka, A., Nowicka, A., Samcik, M., Wolniewicz, L., Komorowska, K., Poprawa, I., Komorowska, E., Sajnaga, D., Zolbach, A., Abdulkarim, A. -F., Lauko-Rachocka, A., Kaminski, L., Kostka, A., Cichy, A., Ruszkowski, P., Splawski, M., Fitas, G., Szymczyk, A., Serwicka, A., Fiega, A., Zysko, D., Krysiak, W., Szabowski, S., Skorek, E., Pruszczyk, P., Bienias, P., Ciurzynski, M., Welnicki, M., Mamcarz, A., Folga, A., Zielinski, T., Rywik, T., Leszek, P., Sobieszczanska-Malek, M., Kozar-Kaminska, K., Komuda, K., Wisniewska, J., Tarnowska, A., Marchel, M., Opolski, G., Kaplon-Cieslicka, A., Gil, R. J., Mozenska, O., Gil, K., Pawlak, A., Michalek, A., Krzesinski, P., Piotrowicz, K., Stanczyk, A., Skrobowski, A., Ponikowski, P., Jankowska, E., Rozentryt, P., Polonski, L., Nowalany-Kozielska, E., Kuczaj, A., Kalarus, Z., Szulik, M., Klys, J., Prokop-Lewicka, G., Kleinrok, A., Tavaresaguiar, C., Ventosa, A., Pereira, S., Faria, R., Chin, J., Dejesus, I., Santos, R., Silva, P., Moreno, N., Lourenco, C., Pereira, A., Castro, A., Andrade, A., Oliveiraguimaraes, T., Martins, S., Placido, R., Lima, G., Brito, D., Francisco, A. R., Proenca, M., Araujo, I., Marques, F., Campelo, M., Silva-Cardoso, J., Rodrigues, J., Rangel, I., Martins, E., Peres, M., Marta, L., Severino, D., Durao, D., Leao, S., Magalhaes, P., Moreira, I., Ferreira, C., Araujo, C., Ferreira, A., Baptista, A., Radoi, M., Bicescu, G., Vinereanu, D., Sinescu, C. -J., Macarie, C., Popescu, R., Daha, I., Dan, G. -A., Stanescu, C., Dan, A., Craiu, E., Nechita, E., Christodorescu, R., Otasevic, P., Simeunovic, D., Ristic, A. D., Celic, V., Pavlovic-Kleut, M., Stojcevski, B., Pencic, B., Stevanovic, A., Andric, A., Simic, D., Asanin, M., Iric-Cupic, V., Jovic, M., Milanov, S., Mitic, V., Atanaskovic, V., Antic, S., Pavlovic, M., Stanojevic, D., Stoickov, V., Ilic, S., Deljaninilic, M., Petrovic, D., Stojsic, S., Kecojevic, S., Dodic, S., Adic, N. C., Cankovic, M., Stojiljkovic, J., Mihajlovic, B., Radin, A., Radovanovic, S., Krotin, M., Klabnik, A., Pernicky, M., Murin, J., Kovar, F., Kmec, J., Strasek, M., Iskra, M. S., Ravnikar, T., Suligoj, N. C., Fras, Z., Jug, B., Glavic, T., Losic, R., Bombek, M., Krunic, B., Horvat, S., Kovac, D., Rajtman, D., Letonja, M., Winkler, R., Melihen-Bartolic, C., Bartolic, A., Kladnik, M., Pusnik, C. S., Marolt, A., Klen, J., Drnovsek, B., Leskovar, B., Anguita, M. J. F., Gallegopage, J. C., Martinez, F. M. S., Andres, J., Bayes-Genis, A., Mirabet, S., Mendez, A., Garcia-Cosio, L., Leon, V., Gonzalez-Costello, J., Muntane, G., Garay, A., Alcade-Martinez, V., Fernandez, S. L., Rivera-Lopez, R., Fernandez-Alvarez, M., Serrano-Martinez, J. L., Grille-Cancela, Z., Marzoa-Rivas, R., Paniagua-Martin, M. J., Barge-Caballero, E., Gonzalez-Gallarza, R. D., Salvadormontanes, O., Manjavacas, A. M. I., Conde, A. C., Araujo, A., Soria, T., Gomez-Bueno, M., Cobo-Marcos, M., Alonso-Pulpon, L., Segoviacubero, J., Sayago, I., Gonzalez-Segovia, A., Briceno, A., Subias, P. E., Cano, M. J. R., Sanchez, M. A. G., Pinilla, J. M. G., de la Villa, B. G., Sahuquillo, A., Marques, R. B., Calvo, F. T., Perez-Martinez, M. T., Garrido-Bravo, I. P., Pastor-Perez, F., Pascual-Figal, D. A., Molina, B. D., Orus, J., Gonzalo, F. E., Bertomeu, V., Valero, R., Martinez-Abellan, R., Quiles, J., Mateo, I., Elamrani, A., Fernandez-Vivancos, C., Valero, D. B., Almenar-Bonet, L., Sanchez-Lazaro, I. J., Marques-Sule, E., Facila-Rubio, L., Perez-Silvestre, J., Garcia-Gonzalez, P., Garcia-Escriva, D., Pellicer-Cabo, A., de laFuente Galan, L., Diaz, J. L., Platero, A. R., Arias, J. C., Blasco-Peiro, T., Julve, M. S., Sanchez-Insa, E., Portoles-Ocampo, A., Melin, M., Hagglund, Stenberg, A., Lindahl, I. -M., Asserlund, B., Olsson, L., Afzelius, M., Karlstrom, P., Tengvall, L., Olsson, B., Kalayci, S., Cavusoglu, Y., Gencer, E., Yilmaz, M. B., Gunes, H., University of Zurich, and Kapelios, Chris J

Subjects
medicine.medical_specialty, medicine.drug_class, medicine.medical_treatment, 610 Medicine & health, 030204 cardiovascular system & hematology, 2705 Cardiology and Cardiovascular Medicine, Loop diuretics, 03 medical and health sciences, 0302 clinical medicine, Interquartile range, Furosemide, Internal medicine, medicine, Loop diuretic, Mortality, Ejection fraction, business.industry, Hazard ratio, medicine.disease, Prognosis, Chronic heart failure, 3. Good health, Blood pressure, Heart failure, Drug titration, 10209 Clinic for Cardiology, Cardiology, Diuretic, Cardiology and Cardiovascular Medicine, business, medicine.drug
Abstract

[Abstract] Aims. Guidelines recommend down-titration of loop diuretics (LD) once euvolaemia is achieved. In outpatients with heart failure (HF), we investigated LD dose changes in daily cardiology practice, agreement with guideline recommendations, predictors of successful LD down-titration and association between dose changes and outcomes. Methods and results. We included 8130 HF patients from the ESC-EORP Heart Failure Long-Term Registry. Among patients who had dose decreased, successful decrease was defined as the decrease not followed by death, HF hospitalization, New York Heart Association class deterioration, or subsequent increase in LD dose. Mean age was 66±13 years, 71% men, 62% HF with reduced ejection fraction, 19% HF with mid-range ejection fraction, 19% HF with preserved ejection fraction. Median [interquartile range (IQR)] LD dose was 40 (25–80) mg. LD dose was increased in 16%, decreased in 8.3% and unchanged in 76%. Median (IQR) follow-up was 372 (363–419) days. Diuretic dose increase (vs. no change) was associated with HF death [hazard ratio (HR) 1.53, 95% confidence interval (CI) 1.12–2.08; P = 0.008] and nominally with cardiovascular death (HR 1.25, 95% CI 0.96–1.63; P = 0.103). Decrease of diuretic dose (vs. no change) was associated with nominally lower HF (HR 0.59, 95% CI 0.33–1.07; P = 0.083) and cardiovascular mortality (HR 0.62 95% CI 0.38–1.00; P = 0.052). Among patients who had LD dose decreased, systolic blood pressure [odds ratio (OR) 1.11 per 10 mmHg increase, 95% CI 1.01–1.22; P = 0.032], and absence of (i) sleep apnoea (OR 0.24, 95% CI 0.09–0.69; P = 0.008), (ii) peripheral congestion (OR 0.48, 95% CI 0.29–0.80; P = 0.005), and (iii) moderate/severe mitral regurgitation (OR 0.57, 95% CI 0.37–0.87; P = 0.008) were independently associated with successful decrease. Conclusion. Diuretic dose was unchanged in 76% and decreased in 8.3% of outpatients with chronic HF. LD dose increase was associated with worse outcomes, while the LD dose decrease group showed a trend for better outcomes compared with the no-change group. Higher systolic blood pressure, and absence of (i) sleep apnoea, (ii) peripheral congestion, and (iii) moderate/severe mitral regurgitation were independently associated with successful dose decrease.

Published
2020

20. NT-proBNP Response to Sacubitril/Valsartan in Hospitalized Heart Failure Patients With Reduced Ejection Fraction: TRANSITION Study

Author

Pascual-Figal D., Wachter R., Senni M., Bao W., Noe A., Schwende H., Butylin D., Prescott M. F., Gniot J., Mozheiko M., Lelonek M., Dominguez A. R., Horacek T., Garcia del Rio E., Kobalava Z., Mueller C. E., Cavusoglu Y., Straburzynska-Migaj E., Slanina M., vom Dahl J., Ryding A., Moriarty A., Robles M. B., Villota J. N., Quintana A. G., Nitschke T., Garcia Pinilla J. M., Bonet L. A., Chaaban S., Filali zaatari S., Spinar J., Musial W., Abdelbaki K., Belohlavek J., Fehske W., Bott M. C., Hoegalmen G., Leiro M. C., Ozcan I. T., Mullens W., Kryza R., Al-Ani R., Loboz-Grudzien K., Ermoshkina L., Hojerova S., Fernandez A. A., Spinarova L., Lapp H., Bulut E., Almeida F., Vishnevsky A., Belicova M., Witte K., Wong K., Droogne W., Delforge M., Peterka M., Olbrich H. -G., Carugo S., Nessler J., McGill T. H., Huegl B., Akin I., Moreira I., Baglikov A., Thambyrajah J., Hayes C., Barrionuevo M. R., Yigit Z., Kaya H., Klimsa Z., Radvan M., Kadel C., Landmesser U., Di Tano G., Lisik M. B., Fonseca C., Oliveira L., Marques I., Santos L. M., Lenner E., Letavay P., Bueno M. G., Mota P., Wong A., Bailey K., Foley P., Hasbani E., Virani S., Massih T. A., Al-Saif S., Taborsky M., Kaislerova M., Motovska Z., Cohen A. A., Logeart D., Endemann D., Ferreira D., Brito D., Kycina P., Bollano E., Basilio E. G., Rubio L. F., Aguado M. G., Schiavi L. B., Zivano D. F., Lonn E., El Sayed A., Pouleur A. -C., Heyse A., Schee A., Polasek R., Houra M., Tribouilloy C., Seronde M. F., Galinier M., Noutsias M., Schwimmbeck P., Voigt I., Westermann D., Pulignano G., Vegsundvaag J., Da Silva Antunes J. A., Monteiro P., Stevlik J., Goncalvesova E., Hulkoova B., Castro Fernandez A. J., Davies C., Squire I., Meyer P., Sheppard R., Sahin T., Sochor K., De Geeter G., Schmeisser A., Weil J., Soares A. O., Bulashova O. V., Oshurkov A., Sunderland S. J., Glover J., Exequiel T., Decoulx E., Meyer S., Muenzel T., Frioes F., Arbolishvili G., Tokarcikova A., Karlstrom P., Trullas Vila J. C., Perez G. P., Sankaranarayanan R., Nageh T., Alasia D. C., Refaat M., Demirkan B., Al-Buraiki J., Karabsheh S., Pascual-Figal, D, Wachter, R, Senni, M, Bao, W, Noe, A, Schwende, H, Butylin, D, Prescott, M, Gniot, J, Mozheiko, M, Lelonek, M, Dominguez, A, Horacek, T, Garcia del Rio, E, Kobalava, Z, Mueller, C, Cavusoglu, Y, Straburzynska-Migaj, E, Slanina, M, vom Dahl, J, Ryding, A, Moriarty, A, Robles, M, Villota, J, Quintana, A, Nitschke, T, Garcia Pinilla, J, Bonet, L, Chaaban, S, Filali zaatari, S, Spinar, J, Musial, W, Abdelbaki, K, Belohlavek, J, Fehske, W, Bott, M, Hoegalmen, G, Leiro, M, Ozcan, I, Mullens, W, Kryza, R, Al-Ani, R, Loboz-Grudzien, K, Ermoshkina, L, Hojerova, S, Fernandez, A, Spinarova, L, Lapp, H, Bulut, E, Almeida, F, Vishnevsky, A, Belicova, M, Witte, K, Wong, K, Droogne, W, Delforge, M, Peterka, M, Olbrich, H, Carugo, S, Nessler, J, Mcgill, T, Huegl, B, Akin, I, Moreira, I, Baglikov, A, Thambyrajah, J, Hayes, C, Barrionuevo, M, Yigit, Z, Kaya, H, Klimsa, Z, Radvan, M, Kadel, C, Landmesser, U, Di Tano, G, Lisik, M, Fonseca, C, Oliveira, L, Marques, I, Santos, L, Lenner, E, Letavay, P, Bueno, M, Mota, P, Wong, A, Bailey, K, Foley, P, Hasbani, E, Virani, S, Massih, T, Al-Saif, S, Taborsky, M, Kaislerova, M, Motovska, Z, Cohen, A, Logeart, D, Endemann, D, Ferreira, D, Brito, D, Kycina, P, Bollano, E, Basilio, E, Rubio, L, Aguado, M, Schiavi, L, Zivano, D, Lonn, E, El Sayed, A, Pouleur, A, Heyse, A, Schee, A, Polasek, R, Houra, M, Tribouilloy, C, Seronde, M, Galinier, M, Noutsias, M, Schwimmbeck, P, Voigt, I, Westermann, D, Pulignano, G, Vegsundvaag, J, Da Silva Antunes, J, Monteiro, P, Stevlik, J, Goncalvesova, E, Hulkoova, B, Castro Fernandez, A, Davies, C, Squire, I, Meyer, P, Sheppard, R, Sahin, T, Sochor, K, De Geeter, G, Schmeisser, A, Weil, J, Soares, A, Bulashova, O, Oshurkov, A, Sunderland, S, Glover, J, Exequiel, T, Decoulx, E, Meyer, S, Muenzel, T, Frioes, F, Arbolishvili, G, Tokarcikova, A, Karlstrom, P, Trullas Vila, J, Perez, G, Sankaranarayanan, R, Nageh, T, Alasia, D, Refaat, M, Demirkan, B, Al-Buraiki, J, and Karabsheh, S

Subjects
Heart Failure, acute decompensated heart failure, Aminobutyrates, Biphenyl Compounds, Aftercare, Stroke Volume, TRANSITION study, Patient Discharge, Peptide Fragments, Angiotensin Receptor Antagonists, Drug Combinations, sacubitril/valsartan, Natriuretic Peptide, Brain, Humans, Valsartan, heart failure with reduced ejection fraction, N-terminal pro–B-type natriuretic peptide
Abstract

Objectives: This study examined the effects of sacubitril/valsartan on N-terminal pro–B-type natriuretic peptide (NT-proBNP) levels and determined patient characteristics associated with favorable NT-proBNP reduction response. Background: NT-proBNP levels reflect cardiac wall stress and predict event risk in patients with acute decompensated heart failure (ADHF). Methods: Post-hoc analysis of the TRANSITION (Comparison of Pre- and Post-discharge Initiation of Sacubitril/Valsartan Therapy in HFrEF Patients After an Acute Decompensation Event) study, including stabilized ADHF patients with reduced ejection fraction, randomized to open-label sacubitril/valsartan initiation in-hospital (pre-discharge) versus post-discharge. NT-proBNP was measured at randomization (baseline), discharge, and 4 and 10 weeks post-randomization. A favorable NT-proBNP response was defined as reduction to ≤1,000 pg/ml or >30% from baseline. Results: In patients receiving sacubitril/valsartan in-hospital, NT-proBNP was reduced by 28% at discharge, with 46% of patients obtaining favorable NT-proBNP reduction response compared with a 4% reduction and 18% favorable response rate in patients initiated post-discharge (p < 0.001). NT-proBNP was reduced similarly in patients initiating sacubitril/valsartan pre- and post-discharge (reduction at 4 weeks: 25%/22%; 10 weeks: 38%/34%) with comparable favorable response rates (46%/42% and 51%/48% at 4 and 10 weeks, respectively). NT-proBNP favorable response at 4 weeks was associated with lower risk of first heart failure (HF) rehospitalization or cardiovascular death through 26 weeks (hazard ratio: 0.57; 95% confidence interval [CI]: 0.38 to 0.86; p = 0.007). Predictors of a favorable response at 4 weeks were starting dose ≥49/51 mg twice daily, higher baseline NT-proBNP, lower baseline serum creatinine, de novo HF, no atrial fibrillation, angiotensin-converting enzyme inhibitor–naive or angiotensin receptor blocker–naive, and no prior myocardial infarction. Conclusions: In-hospital initiation of sacubitril/valsartan produced rapid reductions in NT-proBNP, statistically significant at discharge. A favorable NT-proBNP response over time was associated with a better prognosis and predicted by higher starting dose and predisposing clinical profile. (Comparison of Pre- and Post-discharge Initiation of LCZ696 Therapy in HFrEF Patients After an Acute Decompensation Event [TRANSITION]; NCT02661217)

Published
2020

24. Patient profiling in heart failure for tailoring medical therapy. A consensus document of the Heart Failure Association of the European Society of Cardiology

Author

Rosano, G.M.C. Moura, B. Metra, M. Böhm, M. Bauersachs, J. Ben Gal, T. Adamopoulos, S. Abdelhamid, M. Bistola, V. Čelutkienė, J. Chioncel, O. Farmakis, D. Ferrari, R. Filippatos, G. Hill, L. Jankowska, E.A. Jaarsma, T. Jhund, P. Lainscak, M. Lopatin, Y. Lund, L.H. Milicic, D. Mullens, W. Pinto, F. Ponikowski, P. Savarese, G. Thum, T. Volterrani, M. Anker, S.D. Seferovic, P.M. Coats, A.J.S.

Abstract

Despite guideline recommendations and available evidence, implementation of treatment in heart failure (HF) is poor. The majority of patients are not prescribed drugs at target doses that have been proven to positively impact morbidity and mortality. Among others, tolerability issues related to low blood pressure, heart rate, impaired renal function or hyperkalaemia are responsible. Chronic kidney disease plays an important role as it affects up to 50% of patients with HF. Also, dynamic changes in estimated glomerular filtration rate may occur during the course of HF, resulting in inappropriate dose reduction or even discontinuation of decongestive or neurohormonal modulating therapy in clinical practice. As patients with HF are rarely naïve to pharmacologic therapies, the challenge is to adequately prioritize or select the most appropriate up-titration schedule according to patient profile. In this consensus document, we identified nine patient profiles that may be relevant for treatment implementation in HF patients with a reduced ejection fraction. These profiles take into account heart rate (70 bpm), the presence of atrial fibrillation, symptomatic low blood pressure, estimated glomerular filtration rate (30 mL/min/1.73 m2) or hyperkalaemia. The pre-discharge patient, frequently still congestive, is also addressed. A personalized approach, adjusting guideline-directed medical therapy to patient profile, may allow to achieve a better and more comprehensive therapy for each individual patient than the more traditional, forced titration of each drug class before initiating treatment with the next. © 2021 European Society of Cardiology

Published
2021

25. 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

Author

Miró Ò, Harjola P, Rossello X, Gil V, Jacob J, Llorens P, Martín-Sánchez FJ, Herrero P, Martínez-Nadal G, Aguiló S, López-Grima ML, Fuentes M, Álvarez Pérez JM, Rodríguez-Adrada E, Mir M, Tost J, Llauger L, Ruschitzka F, Harjola VP, Mullens W, Masip J, Chioncel O, Peacock WF, Müller C, Mebazaa A, ICA-SEMES Research Group, and University of Zurich

Subjects
medicine.medical_specialty, Emergency Medical Services, New York Heart Association Class, 610 Medicine & health, 030204 cardiovascular system & hematology, Critical Care and Intensive Care Medicine, 03 medical and health sciences, 0302 clinical medicine, Furosemide, Internal medicine, Epidemiology, medicine, Emergency medical services, Humans, 030212 general & internal medicine, Mortality, Original Scientific Papers, Diuretics, Outcome, Heart Failure, business.industry, Emergency department, Acute heart failure, Atrial fibrillation, General Medicine, Odds ratio, medicine.disease, 3. Good health, Heart failure, Acute Disease, 10209 Clinic for Cardiology, Cardiology and Cardiovascular Medicine, business, Emergency Service, Hospital, medicine.drug
Abstract

Aims The effect of early administration of intravenous (IV) furosemide in the emergency department (ED) on short-term outcomes of acute heart failure (AHF) patients remains controversial, with one recent Japanese study reporting a decrease of in-hospital mortality and one Korean study reporting a lack of clinical benefit. Both studies excluded patients receiving prehospital IV furosemide and only included patients requiring hospitalization. To assess the impact on short-term outcomes of early IV furosemide administration by emergency medical services (EMS) before patient arrival to the ED. Methods and results In a secondary analysis of the Epidemiology of Acute Heart Failure in Emergency Departments (EAHFE) registry of consecutive AHF patients admitted to Spanish EDs, patients treated with IV furosemide at the ED were classified according to whether they received IV furosemide from the EMS (FAST-FURO group) or not (CONTROL group). In-hospital all-cause mortality, 30-day all-cause mortality, and prolonged hospitalization (>10 days) were assessed. We included 12 595 patients (FAST-FURO = 683; CONTROL = 11 912): 968 died during index hospitalization [7.7%; FAST-FURO = 10.3% vs. CONTROL = 7.5%; odds ratio (OR) = 1.403, 95% confidence interval (95% CI) = 1.085–1.813; P = 0.009], 1269 died during the first 30 days (10.2%; FAST-FURO = 13.4% vs. CONTROL = 9.9%; OR = 1.403, 95% CI = 1.146–1.764; P = 0.004), and 2844 had prolonged hospitalization (22.8%; FAST-FURO = 25.8% vs. CONTROL = 22.6%; OR = 1.189, 95% CI = 0.995–1.419; P = 0.056). FAST-FURO group patients had more diabetes mellitus, ischaemic cardiomyopathy, peripheral artery disease, left ventricular systolic dysfunction, and severe decompensations, and had a better New York Heart Association class and had less atrial fibrillation. After adjusting for these significant differences, early IV furosemide resulted in no impact on short-term outcomes: OR = 1.080 (95% CI = 0.817–1.427) for in-hospital mortality, OR = 1.086 (95% CI = 0.845–1.396) for 30-day mortality, and OR = 1.095 (95% CI = 0.915–1.312) for prolonged hospitalization. Several sensitivity analyses, including analysis of 599 pairs of patients matched by propensity score, showed consistent findings. Conclusion Early IV furosemide during the prehospital phase was administered to the sickest patients, was not associated with changes in short-term mortality or length of hospitalization after adjustment for several confounders.

Published
2021

26. 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

Author

Miro, O, Harjola, P, Rossello, X, Gil, V, Jacob, J, Llorens, P, Martin-Sanchez, FJ, Herrero, P, Martinez-Nadal, G, Aguilo, S, Lopez-Grima, ML, Fuentes, M, Perez, JMA, Rodriguez-Adrada, E, Mir, M, Tost, J, Llauger, L, Ruschitzka, F, Harjola, VP, Mullens, W, Masip, J, Chioncel, O, Peacock, WF, Muller, C, Mebazaa, A, Alquezar A., Rizzi M.A., Herrera S., and ICA-SEMES Res Grp

Subjects
Furosemide, Emergency department, Acute heart failure, Mortality, Diuretics, Outcome
Abstract

Aims The effect of early administration of intravenous (IV) furosemide in the emergency department (ED) on short-term outcomes of acute heart failure (AHF) patients remains controversial, with one recent Japanese study reporting a decrease of in-hospital mortality and one Korean study reporting a lack of clinical benefit. Both studies excluded patients receiving prehospital IV furosemide and only included patients requiring hospitalization. To assess the impact on short-term outcomes of early IV furosemide administration by emergency medical services (EMS) before patient arrival to the ED. Methods and results In a secondary analysis of the Epidemiology of Acute Heart Failure in Emergency Departments (EAHFE) registry of consecutive AHF patients admitted to Spanish EDs, patients treated with IV furosemide at the ED were classified according to whether they received IV furosemide from the EMS (FAST-FURO group) or not (CONTROL group). In-hospital all-cause mortality, 30-day all-cause mortality, and prolonged hospitalization (>10 days) were assessed. We included 12 595 patients (FAST-FURO = 683; CONTROL = 11 912): 968 died during index hospitalization [7.7%; FAST-FURO = 10.3% vs. CONTROL=7.5%; odds ratio (OR) = 1.403, 95% confidence interval (95% CI) = 1.085-1.813; P = 0.009], 1269 died during the first 30 days (10.2%; FAST-FURO = 13.4% vs. CONTROL = 9.9%; OR = 1.403, 95% CI = 1.146-1.764; P = 0.004), and 2844 had prolonged hospitalization (22.8%; FAST-FURO = 25.8% vs. CONTROL = 22.6%; OR = 1.189, 95% CI = 0.995-1.419; P = 0.056). FAST-FURO group patients had more diabetes mellitus, ischaemic cardiomyopathy, peripheral artery disease, left ventricular systolic dysfunction, and severe decompensations, and had a better New York Heart Association class and had less atrial fibrillation. After adjusting for these significant differences, early IV furosemide resulted in no impact on short-term outcomes: OR = 1.080 (95% CI = 0.817-1.427) for in-hospital mortality, OR = 1.086 (95% CI = 0.845-1.396) for 30-day mortality, and OR = 1.095 (95% CI = 0.915-1.312) for prolonged hospitalization. Several sensitivity analyses, including analysis of 599 pairs of patients matched by propensity score, showed consistent findings. Conclusion Early IV furosemide during the prehospital phase was administered to the sickest patients, was not associated with changes in short-term mortality or length of hospitalization after adjustment for several confounders.

Published
2021

27. The management of secondary mitral regurgitation in patients with heart failure: a joint position statement from the Heart Failure Association (HFA), European Association of Cardiovascular Imaging (EACVI), European Heart Rhythm Association (EHRA), and European Association of Percutaneous Cardiovascular Interventions (EAPCI) of the ESC

Author

Coats, A.J.S. Anker, S.D. Baumbach, A. Alfieri, O. von Bardeleben, R.S. Bauersachs, J. Bax, J.J. Boveda, S. Čelutkienė, J. Cleland, J.G. Dagres, N. Deneke, T. Farmakis, D. Filippatos, G. Hausleiter, J. Hindricks, G. Jankowska, E.A. Lainscak, M. Leclercq, C. Lund, L.H. McDonagh, T. Mehra, M.R. Metra, M. Mewton, N. Mueller, C. Mullens, W. Muneretto, C. Obadia, J.-F. Ponikowski, P. Praz, F. Rudolph, V. Ruschitzka, F. Vahanian, A. Windecker, S. Zamorano, J.L. Edvardsen, T. Heidbuchel, H. Seferovic, P.M. Prendergast, B.

Abstract

Secondary (or functional) mitral regurgitation (SMR) occurs frequently in chronic heart failure (HF) with reduced left ventricular (LV) ejection fraction, resulting from LV remodelling that prevents coaptation of the valve leaflets. Secondary mitral regurgitation contributes to progression of the symptoms and signs of HF and confers worse prognosis. The management of HF patients with SMR is complex and requires timely referral to a multidisciplinary Heart Team. Optimization of pharmacological and device therapy according to guideline recommendations is crucial. Further management requires careful clinical and imaging assessment, addressing the anatomical and functional features of the mitral valve and left ventricle, overall HF status, and relevant comorbidities. Evidence concerning surgical correction of SMR is sparse and it is doubtful whether this approach improves prognosis. Transcatheter repair has emerged as a promising alternative, but the conflicting results of current randomized trials require careful interpretation. This collaborative position statement, developed by four key associations of the European Society of Cardiology—the Heart Failure Association (HFA), European Association of Percutaneous Cardiovascular Interventions (EAPCI), European Association of Cardiovascular Imaging (EACVI), and European Heart Rhythm Association (EHRA)—presents an updated practical approach to the evaluation and management of patients with HF and SMR based upon a Heart Team approach. © The Author(s) 2021. Published by Oxford University Press on behalf of the European Society of Cardiology.

Published
2021

28. Acetazolamide in Acute Decompensated Heart Failure with Volume Overload.

Author

Mullens, W., Dauw, J., Martens, P., Verbrugge, F. H., Nijst, P., Meekers, E., Tartaglia, K., Chenot, F., Moubayed, S., Dierckx, R., Blouard, P., Troisfontaines, P., Derthoo, D., Smolders, W., Bruckers, L., Droogne, W., Ter Maaten, J. M., Damman, K., Lassus, J., and Mebazaa, A.

Subjects
*LEFT heart ventricle, *CARBONIC anhydrase inhibitors, *DIURETICS, *ACETAZOLAMIDE, *RESEARCH, *SODIUM, *RESEARCH methodology, *WATER-electrolyte imbalances, *EVALUATION research, *TREATMENT effectiveness, *COMPARATIVE studies, *RANDOMIZED controlled trials, *RESEARCH funding, *STROKE volume (Cardiac output), *MEMBRANE proteins, *HEART physiology, *PEPTIDE hormones, *HEART failure
Abstract

Background: Whether acetazolamide, a carbonic anhydrase inhibitor that reduces proximal tubular sodium reabsorption, can improve the efficiency of loop diuretics, potentially leading to more and faster decongestion in patients with acute decompensated heart failure with volume overload, is unclear.Methods: In this multicenter, parallel-group, double-blind, randomized, placebo-controlled trial, we assigned patients with acute decompensated heart failure, clinical signs of volume overload (i.e., edema, pleural effusion, or ascites), and an N-terminal pro-B-type natriuretic peptide level of more than 1000 pg per milliliter or a B-type natriuretic peptide level of more than 250 pg per milliliter to receive either intravenous acetazolamide (500 mg once daily) or placebo added to standardized intravenous loop diuretics (at a dose equivalent to twice the oral maintenance dose). Randomization was stratified according to the left ventricular ejection fraction (≤40% or >40%). The primary end point was successful decongestion, defined as the absence of signs of volume overload, within 3 days after randomization and without an indication for escalation of decongestive therapy. Secondary end points included a composite of death from any cause or rehospitalization for heart failure during 3 months of follow-up. Safety was also assessed.Results: A total of 519 patients underwent randomization. Successful decongestion occurred in 108 of 256 patients (42.2%) in the acetazolamide group and in 79 of 259 (30.5%) in the placebo group (risk ratio, 1.46; 95% confidence interval [CI], 1.17 to 1.82; P<0.001). Death from any cause or rehospitalization for heart failure occurred in 76 of 256 patients (29.7%) in the acetazolamide group and in 72 of 259 patients (27.8%) in the placebo group (hazard ratio, 1.07; 95% CI, 0.78 to 1.48). Acetazolamide treatment was associated with higher cumulative urine output and natriuresis, findings consistent with better diuretic efficiency. The incidence of worsening kidney function, hypokalemia, hypotension, and adverse events was similar in the two groups.Conclusions: The addition of acetazolamide to loop diuretic therapy in patients with acute decompensated heart failure resulted in a greater incidence of successful decongestion. (Funded by the Belgian Health Care Knowledge Center; ADVOR ClinicalTrials.gov number, NCT03505788.). [ABSTRACT FROM AUTHOR]

Published
2022
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29. Sodium–glucose co‐transporter 2 inhibitors in heart failure: beyond glycaemic control. The position paper of the Heart Failure Association of the European Society of Cardiology

Author

Seferović, PM, Fragasso, G, Petrie, M, Mullens, W, Ferrari, R, Thum, T, Bauersachs, J, Anker, SD, Ray, R, Çavuşoğlu, Y, Polovina, M, Metra, M, Ambrosio, G, Prasad, K, Seferović, J, Jhund, PS, Dattilo, G, Čelutkiene, J, Piepoli, M, Moura, B, Chioncel, O, Gal, TB, Heymans, S, De Boer, RA, Jaarsma, T, Hill, L, Lopatin, Y, Lyon, AR, Ponikowski, P, Lainščak, M, Jankowska, E, Mueller, C, Cosentino, F, Lund, L, Filippatos, GS, Ruschitzka, F, Coats, AJS, and Rosano, GMC

Abstract

Heart failure (HF) is common and associated with a poor prognosis, despite advances in treatment. Over the last decade cardiovascular outcome trials with sodium–glucose co‐transporter 2 (SGLT2) inhibitors in patients with type 2 diabetes mellitus have demonstrated beneficial effects for three SGLT2 inhibitors (empagliflozin, canagliflozin and dapagliflozin) in reducing hospitalisations for HF. More recently, dapagliflozin reduced the risk of worsening HF or death from cardiovascular causes in patients with chronic HF with reduced left ventricular ejection fraction, with or without type 2 diabetes mellitus. A number of additional trials in HF patients with reduced and/or preserved left ventricular ejection fraction are ongoing and/or about to be reported. The present position paper summarises recent clinical trial evidence and discusses the role of SGLT2 inhibitors in the treatment of HF, pending the results of ongoing trials in different populations of patients with HF.

Published
2020

30. Association between loop diuretic dose changes and outcomes in chronic heart failure: observations from the ESC-EORP Heart Failure Long-Term Registry

Author

Kapelios, CJ, Laroche, C, Crespo-Leiro, MG, Anker, SD, Coats, AJS, Díaz-Molina, B, Filippatos, G, Lainscak, M, Maggioni, AP, McDonagh, T, Mebazaa, A, Metra, M, Moura, B, Mullens, W, Piepoli, MF, Rosano, GMC, Ruschitzka, F, Seferovic, PM, Lund, LH, and Heart Failure Long-Term Registry Investigators Group

Abstract

AIMS: Guidelines recommend down-titration of loop diuretics (LD) once euvolaemia is achieved. In outpatients with heart failure (HF), we investigated LD dose changes in daily cardiology practice, agreement with guideline recommendations, predictors of successful LD down-titration and association between dose changes and outcomes. METHODS AND RESULTS: We included 8130 HF patients from the ESC-EORP Heart Failure Long-Term Registry. Among patients who had dose decreased, successful decrease was defined as the decrease not followed by death, HF hospitalization, New York Heart Association class deterioration, or subsequent increase in LD dose. Mean age was 66 ± 13 years, 71% men, 62% HF with reduced ejection fraction, 19% HF with mid-range ejection fraction, 19% HF with preserved ejection fraction. Median [interquartile range (IQR)] LD dose was 40 (25-80) mg. LD dose was increased in 16%, decreased in 8.3% and unchanged in 76%. Median (IQR) follow-up was 372 (363-419) days. Diuretic dose increase (vs. no change) was associated with HF death [hazard ratio (HR) 1.53, 95% confidence interval (CI) 1.12-2.08; P = 0.008] and nominally with cardiovascular death (HR 1.25, 95% CI 0.96-1.63; P = 0.103). Decrease of diuretic dose (vs. no change) was associated with nominally lower HF (HR 0.59, 95% CI 0.33-1.07; P = 0.083) and cardiovascular mortality (HR 0.62, 95% CI 0.38-1.00; P = 0.052). Among patients who had LD dose decreased, systolic blood pressure [odds ratio (OR) 1.11 per 10 mmHg increase, 95% CI 1.01-1.22; P = 0.032], and absence of (i) sleep apnoea (OR 0.24, 95% CI 0.09-0.69; P = 0.008), (ii) peripheral congestion (OR 0.48, 95% CI 0.29-0.80; P = 0.005), and (iii) moderate/severe mitral regurgitation (OR 0.57, 95% CI 0.37-0.87; P = 0.008) were independently associated with successful decrease. CONCLUSION: Diuretic dose was unchanged in 76% and decreased in 8.3% of outpatients with chronic HF. LD dose increase was associated with worse outcomes, while the LD dose decrease group showed a trend for better outcomes compared with the no-change group. Higher systolic blood pressure, and absence of (i) sleep apnoea, (ii) peripheral congestion, and (iii) moderate/severe mitral regurgitation were independently associated with successful dose decrease.

Published
2020

31. Role of cardiovascular imaging in cancer patients receiving cardiotoxic therapies

Author

Celutkiene, J., Pudil, R., Lopez-Fernandez, T., Grapsa, J., Nihoyannopoulos, P., Bergler-Klein, J., Cohen-Solal, A., Farmakis, D., Tocchetti, C. G., Haehling, S., Barberis, V., Flachskampf, F. A., Ceponlene, J., Haegler-Laube, E., Suter, T., Lapinskas, T., Prasad, S., Boer, R. A., Wechalekar, K., Anker, M. S., Iakobishvili, Z., Bucciarelli-Ducci, C., Schulz-Menger, J., Cosyns, B., Gaemperli, O., Belenkov, Y., Hulot, J-S, Galderisi, M., Lancellotti, P., Bax, J., Marwick, T. H., Chioncel, O., Jaarsma, T., Mullens, W., Piepoli, M., Thum, T., Heymans, S., Mueller, C., Moura, B., Ruschitzka, F., Zamorano, J. L., Rosano, G., Coats, A. J. S., Asteggiano, R., Seferovic, P., Thor Edvardsen, Lyon, A. R., Cardiovascular Centre (CVC), Hulot, Jean-Sebastien/0000-0001-5463-6117, Edvardsen, Thor/0000-0002-3800-765X, Bucciarelli-Ducci, Chiara/0000-0002-2515-0852, Clinical sciences, Cardio-vascular diseases, Cardiology, Cardiologie, MUMC+: MA Med Staf Spec Cardiologie (9), and RS: Carim - H02 Cardiomyopathy

Subjects
Vascular Endothelial Growth Factor A, Global longitudinal strain, SPECKLE-TRACKING ECHOCARDIOGRAPHY, Cardiac magnetic resonance, Cardiology, Antineoplastic Agents, Heart failure, ANTHRACYCLINE CARDIOTOXICITY, Imaging, LEFT-VENTRICULAR FUNCTION, Neoplasms, MAGNETIC-RESONANCE, BREAST-CANCER, Humans, AMERICAN SOCIETY, Computed tomography, Cardiotoxicity, MYOCARDIAL STRAIN, DIASTOLIC FUNCTION, Cardio-oncology, Radiology Nuclear Medicine and imaging, Echocardiography, oncology, Female, CHAMBER QUANTIFICATION, Cardiology and Cardiovascular Medicine, Nuclear imaging
Abstract

Cardiovascular (CV) imaging is an important tool in baseline risk assessment and detection of CV disease in oncology patients receiving cardiotoxic cancer therapies. This position statement examines the role of echocardiography, cardiac magnetic resonance, nuclear cardiac imaging and computed tomography in the management of cancer patients. The Imaging and Cardio-Oncology Study Groups of the Heart Failure Association (HFA) of the European Society of Cardiology (ESC) in collaboration with the European Association of Cardiovascular Imaging (EACVI) and the Cardio-Oncology Council of the ESC have evaluated the current evidence for the value of modern CV imaging in the cardio-oncology field. The most relevant echocardiographic parameters, including global longitudinal strain and three-dimensional ejection fraction, are proposed. The protocol for baseline pre-treatment evaluation and specific surveillance algorithms or pathways for anthracycline chemotherapy, HER2-targeted therapies such as trastuzumab, vascular endothelial growth factor tyrosine kinase inhibitors, BCr-Abl tyrosine kinase inhibitors, proteasome inhibitors and immune checkpoint inhibitors are presented. The indications for CV imaging after completion of oncology treatment are considered. The typical consequences of radiation therapy and the possibility of their identification in the long term are also summarized. Special populations are discussed including female survivors planning pregnancy, patients with carcinoid disease, patients with cardiac tumours and patients with right heart failure. Future directions and ongoing CV imaging research in cardio-oncology are discussed. R.A.d.B. is supported by the Netherlands Heart Foundation (CVON DOSIS, grant 2014-40, CVON SHE-PREDICTS-HF, grant 2017-21, and CVON RED-CVD, grant 2017-11), and the European Research Council (ERC CoG 818715, SECRETE-HF). C.G.T. is supported by a Federico II University/Ricerca di Ateneo grant. Celutkiene, J (corresponding author), Vilnius Univ, Fac Med, Inst Clin Med, Clin Cardiac & Vasc Dis, Santariskiu 2, LT-08661 Vilnius, Lithuania. jelena.celutkiene@santa.lt

Published
2020

32. Optimized implementation of cardiac resynchronization therapy: a call for action for referral and optimization of care

Author

Mullens, W., Auricchio, A., Martens, P., Witte, K., Cowie, M.R., Delgado, V., Dickstein, K., Linde, C. van der, Vernooy, K., Leyva, F., Bauersachs, J., Israel, C.W., Lund, L.H., Donal, E., Boriani, G., Jaarsma, T., Berruezo, A., Traykov, V., Yousef, Z., Kalarus, Z., Nielsen, J.C., Steffel, J., Vardas, P., Coats, A., Seferovic, P., Edvardsen, T., Heidbuchel, H., Ruschitzka, F., Leclercq, C., Mullens, W., Auricchio, A., Martens, P., Witte, K., Cowie, M.R., Delgado, V., Dickstein, K., Linde, C. van der, Vernooy, K., Leyva, F., Bauersachs, J., Israel, C.W., Lund, L.H., Donal, E., Boriani, G., Jaarsma, T., Berruezo, A., Traykov, V., Yousef, Z., Kalarus, Z., Nielsen, J.C., Steffel, J., Vardas, P., Coats, A., Seferovic, P., Edvardsen, T., Heidbuchel, H., Ruschitzka, F., and Leclercq, C.

Abstract

Contains fulltext : 238808.pdf (Publisher’s version ) (Closed access), Cardiac resynchronization therapy (CRT) is one of the most effective therapies for heart failure with reduced ejection fraction and leads to improved quality of life, reductions in heart failure hospitalization rates and all-cause mortality. Nevertheless, up to two-thirds of eligible patients are not referred for CRT. Furthermore, post-implantation follow-up is often fragmented and suboptimal, hampering the potential maximal treatment effect. This joint position statement from three European Society of Cardiology Associations, Heart Failure Association (HFA), European Heart Rhythm Association (EHRA) and European Association of Cardiovascular Imaging (EACVI), focuses on optimized implementation of CRT. We offer theoretical and practical strategies to achieve more comprehensive CRT referral and post-procedural care by focusing on four actionable domains: (i) overcoming CRT under-utilization, (ii) better understanding of pre-implant characteristics, (iii) abandoning the term 'non-response' and replacing this by the concept of disease modification, and (iv) implementing a dedicated post-implant CRT care pathway.

Published
2021

33. Heart failure in COVID-19: the multicentre, multinational PCHF-COVICAV registry

Author

Sokolski, M., Trenson, S., Sokolska, J. M., D'Amario, D., Meyer, P., Poku, N. K., Biering-Sorensen, T., Hojbjerg Lassen, M. C., Skaarup, K. G., Barge-Caballero, E., Pouleur, A. -C., Stolfo, D., Sinagra, G., Ablasser, K., Muster, V., Rainer, P. P., Wallner, M., Chiodini, A., Heiniger, P. S., Mikulicic, F., Schwaiger, J., Winnik, S., Cakmak, H. A., Gaudenzi, M., Mapelli, M., Mattavelli, I., Paul, M., Cabac-Pogorevici, I., Bouleti, C., Lilliu, M., Minoia, C., Dauw, J., Costa, J., Celik, A., Mewton, N., Montenegro, C. E. L., Matsue, Y., Loncar, G., Marchel, M., Bechlioulis, A., Michalis, L., Dorr, M., Prihadi, E., Schoenrath, F., Messroghli, D. R., Mullens, W., Lund, L. H., Rosano, G. M. C., Ponikowski, P., Ruschitzka, F., Flammer, A. J., D'Amario D., Sokolski, M., Trenson, S., Sokolska, J. M., D'Amario, D., Meyer, P., Poku, N. K., Biering-Sorensen, T., Hojbjerg Lassen, M. C., Skaarup, K. G., Barge-Caballero, E., Pouleur, A. -C., Stolfo, D., Sinagra, G., Ablasser, K., Muster, V., Rainer, P. P., Wallner, M., Chiodini, A., Heiniger, P. S., Mikulicic, F., Schwaiger, J., Winnik, S., Cakmak, H. A., Gaudenzi, M., Mapelli, M., Mattavelli, I., Paul, M., Cabac-Pogorevici, I., Bouleti, C., Lilliu, M., Minoia, C., Dauw, J., Costa, J., Celik, A., Mewton, N., Montenegro, C. E. L., Matsue, Y., Loncar, G., Marchel, M., Bechlioulis, A., Michalis, L., Dorr, M., Prihadi, E., Schoenrath, F., Messroghli, D. R., Mullens, W., Lund, L. H., Rosano, G. M. C., Ponikowski, P., Ruschitzka, F., Flammer, A. J., and D'Amario D.

Abstract

Aims: We assessed the outcome of hospitalized coronavirus disease 2019 (COVID-19) patients with heart failure (HF) compared with patients with other cardiovascular disease and/or risk factors (arterial hypertension, diabetes, or dyslipidaemia). We further wanted to determine the incidence of HF events and its consequences in these patient populations. Methods and results: International retrospective Postgraduate Course in Heart Failure registry for patients hospitalized with COVID-19 and CArdioVascular disease and/or risk factors (arterial hypertension, diabetes, or dyslipidaemia) was performed in 28 centres from 15 countries (PCHF-COVICAV). The primary endpoint was in-hospital mortality. Of 1974 patients hospitalized with COVID-19, 1282 had cardiovascular disease and/or risk factors (median age: 72 [interquartile range: 62–81] years, 58% male), with HF being present in 256 [20%] patients. Overall in-hospital mortality was 25% (n = 323/1282 deaths). In-hospital mortality was higher in patients with a history of HF (36%, n = 92) compared with non-HF patients (23%, n = 231, odds ratio [OR] 1.93 [95% confidence interval: 1.44–2.59], P < 0.001). After adjusting, HF remained associated with in-hospital mortality (OR 1.45 [95% confidence interval: 1.01–2.06], P = 0.041). Importantly, 186 of 1282 [15%] patients had an acute HF event during hospitalization (76 [40%] with de novo HF), which was associated with higher in-hospital mortality (89 [48%] vs. 220 [23%]) than in patients without HF event (OR 3.10 [2.24–4.29], P < 0.001). Conclusions: Hospitalized COVID-19 patients with HF are at increased risk for in-hospital death. In-hospital worsening of HF or acute HF de novo are common and associated with a further increase in in-hospital mortality.

Published
2021

34. Self-care of heart failure patients: practical management recommendations from the Heart Failure Association of the European Society of Cardiology

Author

Verplegingswetenschap, Circulatory Health, HAG Hart- Vaatziekten, JC onderzoeksprogramma Cardiovasculaire Epidemiologie, Jaarsma, T, Hill, L, Bayes-Genis, A, Brunner La Rocca, H P, Castiello, T, Čelutkienė, J, Marques-Sule, E, Plymen, C M, Piper, S E, Riegel, B, Rutten, F H, Ben Gal, T, Bauersachs, J, Coats, Ajs, Chioncel, O, Lopatin, Y, Lund, L H, Lainscak, M, Moura, B, Mullens, W, Piepoli, M F, Rosano, G, Seferovic, P, Strömberg, A, Verplegingswetenschap, Circulatory Health, HAG Hart- Vaatziekten, JC onderzoeksprogramma Cardiovasculaire Epidemiologie, Jaarsma, T, Hill, L, Bayes-Genis, A, Brunner La Rocca, H P, Castiello, T, Čelutkienė, J, Marques-Sule, E, Plymen, C M, Piper, S E, Riegel, B, Rutten, F H, Ben Gal, T, Bauersachs, J, Coats, Ajs, Chioncel, O, Lopatin, Y, Lund, L H, Lainscak, M, Moura, B, Mullens, W, Piepoli, M F, Rosano, G, Seferovic, P, and Strömberg, A

Published
2021

35. Illustrations of British birds

Author

Meyer, H. L. (Henry Leonard), 1864, Hale, W. G., Mullens, W. H. (William Herbert), 1866-1946, McGill University Library, Meyer, H. L. (Henry Leonard), 1864, Hale, W. G., and Mullens, W. H. (William Herbert), 1866-1946

Subjects
Birds, Great Britain, Pictorial works
Published
1835

36. A bibliography of British ornithology from the earliest times to the end of 1912, including biographical accounts of the principal writers and bibliographies of their published works

Author

Mullens, W. H. (William Herbert), 1866-1946, Swann, H. Kirke (Harry Kirke), 1871-1926, Smithsonian Libraries, Mullens, W. H. (William Herbert), 1866-1946, and Swann, H. Kirke (Harry Kirke), 1871-1926

Subjects
Bibliography, Bio-bibliography, Birds, Great Britain, Nomenclature, Ornithologists
Published
1917

37. A geographical bibliography of British ornithology : being a record of printed books, published articles, notes and records relating to local avifauna / by W.H. Mullens, H. Kirke Swann, F.C.R. Jourdain.

Author

Mullens, W. H. (William Herbert), 1866, Jourdain, F. C. R. 1865-1940, Swann, H. Kirke (Harry Kirke), 1871-1926, Gerstein - University of Toronto (archive.org), Mullens, W. H. (William Herbert), 1866, Jourdain, F. C. R. 1865-1940, and Swann, H. Kirke (Harry Kirke), 1871-1926

Subjects
Bibliography, Birds, Great Britain
Published
1919

38. A geographical bibliography of British ornithology from the earliest time to the end of 1918, arranged under counties, being a record of printed books, published articles, notes and records relating to local avifauna, by W. H. Mullens, H. Kirke Swann, F. C. R. Jourdain.

Author

Mullens, W. H. (William Herbert), 1866, Jourdain, F. C. R. 1865-1940, Swann, H. Kirke (Harry Kirke), 1871-1926, University of Connecticut Libraries (archive.org), Mullens, W. H. (William Herbert), 1866, Jourdain, F. C. R. 1865-1940, and Swann, H. Kirke (Harry Kirke), 1871-1926

Subjects
Bibliography, Birds, Great Britain
Published
1920

39. A geographical bibliography of British ornithology from the earliest time to the end of 1918, arranged under counties, being a record of printed books, published articles, notes and records relating to local avifauna,

Author

Mullens, W. H. (William Herbert), 1866-1946, Jourdain, F. C. R. (Francis Charles Robert), 1865-1940, Swann, H. Kirke (Harry Kirke), 1871-1926, American Museum of Natural History Library, Smithsonian Libraries, Mullens, W. H. (William Herbert), 1866-1946, Jourdain, F. C. R. (Francis Charles Robert), 1865-1940, and Swann, H. Kirke (Harry Kirke), 1871-1926

Subjects
Bibliography, Birds, Great Britain
Published
1920

40. Illustrations of British birds

Author

Meyer, H. L. (Henry Leonard), 1864, Hale, W. G., Mullens, W. H. (William Herbert), 1866-1946, McGill University Library, Meyer, H. L. (Henry Leonard), 1864, Hale, W. G., and Mullens, W. H. (William Herbert), 1866-1946

Subjects
Birds, Great Britain, Pictorial works

41. Illustrations of British birds

Author

Meyer, H. L. (Henry Leonard), 1864, Hale, W. G., Mullens, W. H. (William Herbert), 1866-1946, McGill University Library, Meyer, H. L. (Henry Leonard), 1864, Hale, W. G., and Mullens, W. H. (William Herbert), 1866-1946

Subjects
Birds, Great Britain, Pictorial works

42. Illustrations of British birds

Author

Meyer, H. L. (Henry Leonard), 1864, Hale, W. G., Mullens, W. H. (William Herbert), 1866-1946, McGill University Library, Meyer, H. L. (Henry Leonard), 1864, Hale, W. G., and Mullens, W. H. (William Herbert), 1866-1946

Subjects
Birds, Great Britain, Pictorial works

43. Illustrations of British birds

Author

Meyer, H. L. (Henry Leonard), 1864, Hale, W. G., Mullens, W. H. (William Herbert), 1866-1946, McGill University Library, Meyer, H. L. (Henry Leonard), 1864, Hale, W. G., and Mullens, W. H. (William Herbert), 1866-1946

Subjects
Birds, Great Britain, Pictorial works

44. A geographical bibliography of British ornithology : being a record of printed books, published articles, notes and records relating to local avifauna

Author

Mullens, W. H. (William Herbert), 1866-1946, Jourdain, F. C. R. (Francis Charles Robert), 1865-1940, Swann, H. Kirke (Harry Kirke), 1871-1926, University of Toronto - Gerstein Science Information Centre, Mullens, W. H. (William Herbert), 1866-1946, Jourdain, F. C. R. (Francis Charles Robert), 1865-1940, and Swann, H. Kirke (Harry Kirke), 1871-1926

Subjects
Bibliography, Birds, Great Britain

45. A geographical bibliography of British ornithology from the earliest time to the end of 1918, arranged under counties, being a record of printed books, published articles, notes and records relating to local avifauna

Author

Mullens, W. H. (William Herbert), 1866-1946, Jourdain, F. C. R. (Francis Charles Robert), 1865-1940, Swann, H. Kirke (Harry Kirke), 1871-1926, Smithsonian Libraries and Archives, Mullens, W. H. (William Herbert), 1866-1946, Jourdain, F. C. R. (Francis Charles Robert), 1865-1940, and Swann, H. Kirke (Harry Kirke), 1871-1926

Subjects
Bibliography, Birds, Great Britain

47. Baseline characteristics of patients in the Reduction of Events with Darbepoetin alfa in Heart Failure trial (RED-HF)

Author

McMurray, John J.V., Anand, Inder S., Diaz, Rafael, Maggioni, Aldo P., OʼConnor, Christopher, Pfeffer, Marc A., Solomon, Scott D., Tendera, Michal, van Veldhuisen, Dirk J., Albizem, Moetaz, Cheng, Sunfa, Scarlata, Debra, Swedberg, Karl, Young, James B., Amuchastegui, M., Belziti, C., Bluguermann, J., Caccavo, M., Cartasegna, L., Colque, R., Cuneo, C., Fernandez, A., Gabito, A., Goicochea, R., Gonzalez, M., Gorosito, V., Grinfeld, L., Hominal, M., Kevorkian, R., Litvak Bruno, M., Llanos, J., Mackinnon, I., Manuale, O., Marzetti, E., Nul, D., Perna, E., Riccitelli, M., Sanchez, A., Santos, D., Schygiel, P., Toblli, J., Vogel, D., Aggarwal, A., Amerena, J., De Looze, F., Fletcher, P., Hare, D., Ireland, M., Krum, H., Lattimore, J., Marwick, T., Sindone, A., Thompson, P., Waites, J., Altenberger, J., Ebner, C., Lenz, K., Pacher, R., Poelzl, G., Charlier, F., de Ceuninck, M., De Keulenaer, G., Dendale, P., Maréchal, P., Mullens, W., Thoeng, J., Vanderheyden, M., Vanhaecke, J., Weytjens, C., Wollaert, B., Albuquerque, D., Almeida, D., Aspe y Rosas, J., Bocchi, E., Bordignon, S., Clausell, N., Kaiser, S., Leaes, P., Martins Alves, S., Montera, M., Moura, L., Pereira de Castro, R., Rassi, S., Reis, A., Saraiva, J., Simões, M., Souza Neto, J., Teixeira, M., Benov, H., Chompalova, B., Donova, T., Georgiev, P., Gotchev, D., Goudev, A., Grigorov, M., Guenova, D., Hergeldjieva, V., Ivanov, D., Kostova, E., Manolova, A., Marchev, S., Nikolov, F., Popov, A., Raev, D., Tzekova, M., Czarnecki, W., Giannetti, N., Haddad, H., Heath, J., Huynh, T., Lepage, S., Liu, P., Lonn, E., Ma, P., Manyari, D., Moe, G., Parker, J., Pesant, Y., Rajda, M., Ricci, J., Roth, S., Sestier, F., Sluzar, V., Sussex, B., Vizel, S., Antezana, G., Bugueno, C., Castro, P., Conejeros, C., Manriquez, L., Martinez, D., Potthoff, S., Stockins, B., Vukasovic, J., Gregor, P., Herold, M., Jerabek, O., Jirmar, R., Kuchar, R., Linhart, A., Podzemska, B., Soucek, M., Spac, J., Spacek, R., Vodnansky, P., Bronnum-Schou, J., Clemmensen, K., Egstrup, K., Jensen, G., Kjoller-Hansen, L., Kober, L., Markenvard, J., Rokkedal, J., Skagen, K., Torp-Pedersen, C., Tuxen, C., Videbak, L., Laks, T., Vahula, V., Harjola, V., Kettunen, R., Kotila, M., Bauer, F., Cohen Solal, A., Coisne, D., Davy, J., De Groote, P., Dos Santos, P., Funck, F., Galinier, M., Gibelin, P., Isnard, R., Neuder, Y., Roul, G., Sabatier, R., Trochu, J., Anker, S., Denny, S., Dreykluft, T., Flesch, M., Genth-Zotz, S., Hambrecht, R., Hein, J., Jeserich, M., John, M., Kreider-Stempfle, H., Laufs, U., Muellerleile, K., Natour, M., Sandri, M., Schäufele, T., von Hodenberg, E., Weyland, K., Winkelmann, B., Tse, H., Yan, B., Barsi, B., Csikasz, J., Dezsi, C., Edes, I., Forster, T., Karpati, P., Kerekes, C., Kis, E., Kosa, I., Lupkovics, G., Nagy, A., Preda, I., Ronaszeki, A., Tomcsanyi, J., Zamolyi, K., Agarwal, D., Bahl, V., Bordoloi, A., Chockalingam, K., Chopda, M., Chopra, V., Dugal, J., Ghaisas, N., Ghosh, S., Grant, P., Hiremath, S., Iyengar, S., Jagadeesa Subramania, B., Jain, P., Joshi, A., Khan, A., Mullasari, A., Naik, S., Oomman, A., Pai, V., Pareppally Gopal, R., Parikh, K., Patel, T., Prakash, V., Sastry, B., Sathe, S., Sinha, N., Srikanthan, V., Subburamakrishnan, P., Thacker, H., Wander, G., Admon, D., Katz, A., Klainman, E., Lewis, B., Marmor, A., Moriel, M., Mosseri, M., Shotan, A., Weinstein, J., Zimlichman, R., Agostoni, P., Albanese, M., Alunni, G., Bini, R., Boccanelli, A., Bolognese, L., Campana, C., Carbonieri, E., Carpino, C., Checco, L., Cosmi, F., DʼAngelo, G., De Cristofaro, M., Floresta, A., Fucili, A., Galvani, M., Ivleva, A., Marra, S., Musca, G., Peccerillo, N., Perrone Filardi, P., Picchio, E., Russo, T., Scelsi, L., Senni, M., Tavazzi, L., Erglis, A., Jasinkevica, I., Kakurina, N., Veze, I., Volans, E., Bagdonas, A., Berukstis, E., Celutkiene, J., Dambrauskaite, A., Jarasuniene, D., Luksiene, D., Rudys, A., Sakalyte, G., Sliaziene, S., Aguilar-Romero, R., Cardona-Muñoz, E., Castro-Jimenez, J., Chavez-Herrera, J., Chuquiure Valenzuela, E., De la Pena, G., Herrera, E., Leiva-Pons, J., Lopez Alvarado, A., Mendez Machado, G., Ramos-Lopez, G., Basart, D., Buijs, E., Cornel, J., de Leeuw, M., Dijkgraaf, R., Dunselman, P., Freericks, M., Hamraoui, K., Lenderlink, T., Linssen, G., Lodewick, P., Lodewijks, C., Lok, D., Nierop, P., Ronner, E., Somsen, A., van Dantzig, J., van der Burgh, P., van Kempen, L., van Vlies, B., Voors, A., Wardeh, A., Willems, F., Dickstein, K., Gundersen, T., Hole, T., Thalamus, J., Westheim, A., Dabrowski, M., Gorski, J., Korewicki, J., Kuc, K., Miekus, P., Musial, W., Niegowska, J., Piotrowski, W., Podolec, P., Polonski, L., Ponikowski, P., Rynkiewicz, A., Szelemej, R., Trusz-Gluza, M., Ujda, M., Wojciechowski, D, Wysokinski, A., Camacho, A., Fonseca, C., Monteiro, P., Apetrei, E., Bruckner, I., Carasca, E., Coman, I., Datcu, M., Dragulescu, S., Ionescu, P., Iordachescu-Petica, D., Manitiu, I., Popa, V., Pop-Moldovan, A., Radoi, M., Stamate, S., Tomescu, M., Vita, I., Aroutiounov, G., Ballyuzek, M., Bart, B., Churina, S., Glezer, M., Goloshchekin, B., Ivleva, A., Kobalava, Z., Kostenko, V., Lopatin, Y., Martynov, A., Orlov, V., Semernin, E., Shogenov, Z., Sidorenko, B., Skvortsov, A., Storzhakov, G., Sulimov, V., Talibov, O., Tereshenko, S., Tsyrline, V., Zadionchenko, V., Zateyshchikov, D., Dzupina, A., Hranai, M., Kmec, J., Micko, K., Murin, J., Pella, D., Sojka, G., Spisak, V., Vahala, P., Vinanska, D., Badat, A., Bayat, J., Dawood, S., Delport, E., Ellis, G., Garda, R., Klug, E., Mabin, T., Naidoo, D., Pretorius, M., Ranjith, N., Van Zyl, L., Weich, H., Anguita, M., Berrazueta, J., Bruguera i Cortada, J., de Teresa, E., Gómez Sánchez, M., González Juanatey, J., Gonzalez-Maqueda, I., Jordana, R., Lupon, J., Manzano, L., Pascual Figal, D., Pulpón, L., Recio, J., Ridocci Soriano, F., Rodríguez Lambert, J., Roig Minguell, E., Roig Minguell, E., Romero, J., Valdovinos, P., Klintberg, L., Kronvall, T., Lycksell, M., Morner, S., Rydberg, E., Swedberg, K., Timberg, I., Wikstrom, G., Moccetti, T.4, Ashok, J., Banerjee, P., Carr-White, G., Cleland, J., Connolly, E., Francis, M., Greenbaum, R., Kadr, H., Lindsay, S., McMurray, J., Megarry, S., Memon, A., Murdoch, D., Senior, R., Squire, I., Tan, L., Witte, K., Adams, K., Adamson, P., Adler, A., Altschul, L., Altschuller, A., Amirani, H., Anand, I., Andreou, C., Ansari, M., Antonishen, M., Banchs, H., Banerjee, S., Banish, D., Bank, A., Barbagelata, A., Barnard, D., Bellinger, R., Benn, A., Berk, M., Berry, B., Bethala, V., Bilazarian, S., Bisognano, J., Bleyer, F., Blum, M., Boehmer, J., Bouchard, A., Boyle, A., Bozkurt, B., Brown, C., Burlew, B., Burnham, K., Butler, J., Call, J., Cambier, P., Cappola, T., Carlson, R., Chandler, B., Chandra, R., Chandraratna, P., Chernick, R., Colan, D., Colfer, H., Colucci, W., Connelly, T., Costantini, O., Dadkhah, S., Dauber, I., Davis, J., Davis, S., Denning, S., Drazner, M., Dunlap, S., Egbujiobi, L., Elkayam, U., Elliott, J., El-Shahawy, M., Essandoh, L., Ewald, G., Fang, J., Farhoud, H., Felker, G., Fernandez, J., Festin, R., Fishbein, G., Florea, V., Flores, E., Floro, J., Gabris, M., Garg, M., Gatewood, R., Geller, M., Ghali, J., Ghumman, W., Gibbs, G., Gillespie, E., Gilmore, R., Gogia, H., Goldberg, L., Gradus-Pizlo, I., Grainger, T., Gudmundsson, G., Gunawardena, D., Gupta, D., Hack, T., Hall, S., Hamroff, G., Hankins, S., Hanna, M., Hargrove, J., Haught, W., Hauptman, P., Hazelrigg, M., Herzog, C., Heywood, J., Hill, T., Hilton, T., Hirsch, H., Hunter, J., Ibrahim, H., Imburgia, M., Iteld, B., Jackson, B., Jaffrani, N., Jain, D., Jain, A., James, M., Jimenez, J., Johnson, E., Kale, P., Kaneshige, A., Kapadia, S., Karia, D., Karlsberg, R., Katholi, R., Kerut, E., Khoury, W., Kipperman, R., Klapholz, M., Kosinski, E., Kozinn, M., Kraus, D., Krueger, S., Krum, H., Kumar, S., Lader, E., Lee, C., Levy, W., Lewis, E., Light-McGroary, K., Loh, I., Lombardi, W., Machado, C., Maislos, F., Mancini, D., Markus, T., Mather, P., McCants, K., McGrew, F., McLaurin, B., McMillan, E., McNamara, D., Meyer, T., Meymandi, S., Miller, A., Minami, E., Modi, M., Mody, F., Mohanty, P., Moscoso, R., Moskowitz, R., Moustafa, M., Mullen, M., Naz, T., Noonan, T., OʼBrien, T., Oellerich, W., Oren, R., Pamboukian, S., Pereira, N., Pitt, W., Porter, C., Prabhu, S., Promisloff, S., Ratkovec, R., Richardson, R., Ross, A., Saleh, N., Saltzberg, M., Sarkar, S., Schmedtje, J., Schneider, R., Schuyler, G., Shanes, J., Sharma, A., Siegel, C., Siegel, R., Silber, D., Singh, V., Singh, N., Singh, J., Sklar, J., Small, R., Smith, A., Smith, E., Smith, E., Smull, D., Sotolongo, R., Staniloae, C., Stapleton, D., Steele, P., Stehlik, J., Stein, M., Tang, W., Thadani, U., Torre-Amoine, G., Trichon, B., Tsai, C., Tummala, R., Van Bakel, A., Vicari, R., Vijay, N., Vijayaraghavan, K., Vittorio, T., Vossler, M., Wagoner, L., Wallis, D., Ward, N., Widmer, M., Wight, J., Wilkins, C., Williams, C., Williams, G., Winchester, M., Winkel, E., Wittmer, B., Wood, D., Wormer, D., Wright, R., Xu, Z., Yasin, M., and Zolty, R.

Published
2013
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49. Heart Failure Association of the European Society of Cardiology update on sodium–glucose co-transporter 2 inhibitors in heart failure (an update on the sodium–glucose co-transporter 2 inhibitors in heart failure: beyond glycaemic control. A position paper of the Heart Failure Association of the European Society of Cardiology)

Author

Seferovic, P. M., Fragasso, G., Petrie, M., Mullens, W., Ferrari, R., Thum, T., Bauersachs, J., Anker, S. D., Ray, R., Cavusoglu, Y., Polovina, M., Metra, M., Ambrosio, G., Prasad, K., Seferovic, J., Jhund, P. S., Dattilo, G., Celutkiene, J., Piepoli, M., Moura, B., Chioncel, O., Ben Gal, T., Heymans, S., Jaarsma, T., Hill, L., Lopatin, Y., Lyon, A. R., Ponikowski, P., Lainscak, M., Jankowska, E., Mueller, C., Cosentino, F., Lund, L. H., Filippatos, G. S., Ruschitzka, F., Coats, A. J. S., and Rosano, G. M. C.

Subjects
Cardiovascular outcomes, Type 2 diabetes mellitus, Heart failure, Sodium–glucose co-transporter 2 inhibitors, Renal function
Published
2020

50. Higher doses of loop diuretics limit uptitration of angiotensin-converting enzyme inhibitors in patients with heart failure and reduced ejection fraction

Author

ter Maaten, J.M. Martens, P. Damman, K. Dickstein, K. Ponikowski, P. Lang, C.C. Ng, L.L. Anker, S.D. Samani, N.J. Filippatos, G. Cleland, J.G. Zannad, F. Hillege, H.L. van Veldhuisen, D.J. Metra, M. Voors, A.A. Mullens, W.

Subjects
cardiovascular diseases
Abstract

Background: Loop diuretics are frequently prescribed to patients with heart failure and reduced ejection fraction (HFrEF) for the treatment of congestion; however, they might hamper uptitration of inhibitors of the renin–angiotensin system. Methods: Loop diuretic dose at baseline was recorded in 2338 patients with HFrEF enrolled in BIOSTAT-CHF, an international study of HF patients on loop diuretic therapy who were eligible for uptitration of angiotensin-converting enzyme inhibitors (ACEi)/mineralocorticoid receptor antagonists (MRA). The association between loop diuretic dose and uptitration of ACEi/MRA to percentage of target dose was adjusted for a previously published model for likelihood of uptitration and a propensity score. Results: Baseline median loop diuretic dose was 40 [40–100] mg of furosemide or equivalent. Higher doses of loop diuretics were associated with higher NYHA class and higher levels of NT-proBNP, more severe signs and symptoms of congestion, more frequent MRA use, and lower doses of ACEi reached at 3 and 9 months (all P < 0.01). After propensity adjustment, higher doses of loop diuretics remained significantly associated with poorer uptitration of ACEi (Beta per log doubling of loop diuretic dose: − 1.66, P = 0.021), but not with uptitration of MRAs (P = 0.758). Higher doses of loop diuretics were independently associated with an increased risk of all-cause mortality or HF hospitalization [HR per doubling of loop diuretic dose: 1.06 (1.01–1.12), P = 0.021]. Conclusions: Higher doses of loop diuretics limited uptitration of ACEi in patients with HFrEF and were associated with a higher risk of death and/or HF hospitalization, independent of their lower likelihood of uptitration and higher baseline risk. Graphic abstract: This figure was created with images adapted from Servier Medical Art licensed under a Creative Commons Attribution 3.0[Figure not available: see fulltext.]. © 2020, The Author(s).

Published
2020

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