Heart Failure

Heart failure occurs when the heart cannot pump as much blood as the body requires. This ineffective pumping can lead to enlargement of the heart as the myocardium works harder pump the same amount of blood. Heart failure may be caused by defects in the myocardium, such as an a heart attack infarct, or due to structural issues such as severe heart valve regurgitation. Heart failure can be divided into HF with preserved ejection fraction (HFpEF), and HF with reduced ejection fraction (HFrEF). The disease is further divided into four New York Heart Association (NYHA) classes. Stage IV heart failure is when the heart is completely failing and requires a heart transplant or hemodynamic support from a left ventricular assist device (LVAD).

Guideline-directed heart failure treatment cost effective

Treating heart failure with angiotensin-converting enzyme (ACE) inhibitors, beta-blockers and aldosterone antagonists provided the largest gains in quality-adjusted life years compared with treatments that did not include all three agents. Treatment according to guidelines resulted in an incremental cost-effectiveness ratio of less than $1,500 per quality-adjusted life year.

Length of stay, mortality rate drops in elderly HF but not younger patients

Younger patients have not experienced comparable declines in heart failure (HF) hospital stay, length of stay and in-hospital mortality as older patients, and black men remain a vulnerable population for HF hospital stay, according to a study published March 12 in the Journal of the American College of Cardiology.

ACC: Heart failure assessment varies across hospital type, location

SAN FRANCISCO—Measurement of left ventricular ejection fraction (LVEF) in hospitalized heart failure patients varies, with patients outside of hospitals with tertiary services at a disadvantage, according to a scientific poster presented March 10 at the American College of Cardiology (ACC) scientific session.

Spironolactone results underwhelming, but were the wrong HF patients studied?

Spironolactone, a mineralocorticoid receptor antagonist, showed some clinical efficacy as a treatment for heart failure (HF) patients with preserved ejection fraction although it offered no improvements in symptoms after one year. But an accompanying editorial questioned whether the study population truly was experiencing HF.

EC gives $16M to heart failure consortium

The European Commission (EC) has awarded a grant of almost $16 million to the Heart Omics in Ageing consortium project, which aims to prevent heart failure through identifying more specific biomarkers for heart failure and then developing methods for earlier diagnosis and –omic profile targeted treatment of elderly patients at risk of heart failure.    

MRAs reduce SCD risk in some patients

Mineralocorticoid receptor antagonists (MRAs) reduce the risk of sudden cardiac death (SCD) in patients with left ventricular systolic dysfunction (LVSD), according to a meta-analysis.

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CCTA in ED leads to lower costs but more invasive procedures

A meta-analysis of randomized, controlled trials of coronary CT angiography (CCTA) in the emergency department (ED) for patients presenting with chest pain found CCTA use was associated with shorter lengths of stay and decreased costs but increased invasive coronary angiography and revascularization.

HeartWare warns of safety concern with HVAD pump

HeartWare initiated a voluntary field correction advising healthcare professionals Feb. 7 to inspect the driveline connector housing of the HVAD pump during routine clinic visits due to a potential safety concern.

Around the web

Ron Blankstein, MD, professor of radiology, Harvard Medical School, explains the use of artificial intelligence to detect heart disease in non-cardiac CT exams.

Eleven medical societies have signed on to a consensus statement aimed at standardizing imaging for suspected cardiovascular infections.

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