Congestive heart failure (Greenwich, Conn.)最新文献

{"title":"Prognostic Implications of Left Ventricular Dilation in Patients With Nonischemic Heart Failure: Interactions With Restrictive Filling Pattern and Mitral Regurgitation","authors":"Stefano Ghio MD, FESC,&nbsp;Pier L. Temporelli MD,&nbsp;Nina A. Marsan MD,&nbsp;Katrina Poppe MSc,&nbsp;Pantaleo Giannuzzi MD, FESC,&nbsp;Frank L. Dini MD, FESC,&nbsp;Andrea Rossi MD,&nbsp;Robert N. Doughty MD, FRACP,&nbsp;Gillian Whalley PhD,&nbsp;on behalf of the MeRGE HF collaborators","doi":"10.1111/j.1751-7133.2011.00281.x","DOIUrl":"10.1111/j.1751-7133.2011.00281.x","url":null,"abstract":"<p>Congest Heart Fail. ****;**:**–**. ©2012 Wiley Periodicals, Inc.</p><p>The aim of this study was to evaluate whether small left ventricular (LV) volumes increase the negative prognostic impact of a restrictive filling pattern (RFP) and that of mitral regurgitation (MR) in patients with nonischemic heart failure (HF). The Meta-analysis Research Group in Echocardiography (MeRGE) is a meta-analysis that collated individual patient data from several prospective echocardiography outcome studies. This analysis was restricted to 10 studies and 601 patients with nonischemic HF. The role of MR was tested in a subgroup of 252 patients. A total of 106 deaths occurred during a median follow-up of 32 months. At multivariate analysis, RFP (hazard ratio [HR], 4.16; 95% confidence interval [CI], 1.54–11.23; <i>P</i>=.005) and New York Heart Association class III or IV (HR, 2.15; 95% CI, 1.33–3.47; <i>P</i>=.001) were the independent predictors of poor prognosis, and there was no statistically significant interaction between LV dilation and RFP. Moderate/severe MR was associated with poorer outcome in the group of patients with normal volumes, whereas it was not a significant predictor of mortality in patients with any degree of LV dilation. In patients with nonischemic HF, RFP is the most important indicator of poor prognosis, irrespective of the degree of LV dilation. Normal LV volumes increase the negative prognostic impact of moderate to severe MR.</p>","PeriodicalId":83668,"journal":{"name":"Congestive heart failure (Greenwich, Conn.)","volume":"18 4","pages":"198-204"},"PeriodicalIF":0.0,"publicationDate":"2012-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/j.1751-7133.2011.00281.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30579653","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Etiology-Filling Pattern-Pulmonary Artery Pressure Score: A Simple Tool for Risk Stratification of Patients with Systolic Heart Failure","authors":"Alessandro Vallebona MD,&nbsp;Guido Gigli MD,&nbsp;Sandro Orlandi MD,&nbsp;Davide Orlandi MD,&nbsp;Lorenzo Gigli PhD,&nbsp;Giorgio Reggiardo PhD","doi":"10.1111/j.1751-7133.2012.00294.x","DOIUrl":"10.1111/j.1751-7133.2012.00294.x","url":null,"abstract":"<p>©2012 Wiley Periodicals, Inc.</p><p>Heart failure (HF) is a leading cause of morbidity and mortality. The detection of patients at high risk for death is a major challenge in HF management. The authors compared the prognostic value of 23 clinical Doppler echocardiography and cardiopulmonary exercise indexes in a stable, moderately symptomatic, systolic HF outpatient population receiving optimal medical therapy. The end point was the incidence of overall mortality. Between January 2002 and December 2008, a total of 146 patients with left ventricular (LV) ejection fraction 0.31±0.8 and New York Heart Association functional class II or III were enrolled. The prognostic power of single variables was assessed using chi-square test for categoric variables and <i>t</i> test for continuous variables. Variables associated with the prespecified end point were included as predictors in a binary logistic regression multivariate model. At multivariate analysis, “restrictive” LV filling pattern (<i>P</i>=.004), ischemic etiology (<i>P</i>=.022), pulmonary artery systolic pressure (PASP) ≥50 mm Hg (<i>P</i>=.027), and peak oxygen uptake (VO₂) &lt;15.9 mL/kg/min (<i>P</i>=.046) resulted independent predictors of the outcome. A simple risk score was then obtained using these significant independent variables, excluding peak VO₂ because of only borderline significance. Patients with ischemic etiology, restrictive LV filling pattern, and PASP ≥50 mm Hg have a very high risk of death (odds ratio, 33.77; 95% confidence interval, 5.74–198.8; <i>P</i>&lt;.001, compared with patients with no risk factors). In this high-risk group, evaluation of peak VO₂ could be superfluous. A very simple clinical echocardiographic model based on etiology-LV filling and pulmonary pressure is a powerful tool for risk stratification of systolic HF in ambulatory patients.</p>","PeriodicalId":83668,"journal":{"name":"Congestive heart failure (Greenwich, Conn.)","volume":"19 1","pages":"39-43"},"PeriodicalIF":0.0,"publicationDate":"2012-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/j.1751-7133.2012.00294.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30578050","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Age on Outcome on Patients Hospitalized With Heart Failure: From a 20-Year Registry in a Middle-Eastern Country (1991–2010)","authors":"Jassim Al Suwaidi MBChB,&nbsp;Nidal Asaad MBBS,&nbsp;Awad Al-Qahtani MBChB,&nbsp;Ayman El-Menyar MD, FRCP,&nbsp;Abdul Wahid Al-Mulla MBChB,&nbsp;Rajvir Singh PhD,&nbsp;Hajar A. AlBinali MD","doi":"10.1111/j.1751-7133.2012.00290.x","DOIUrl":"10.1111/j.1751-7133.2012.00290.x","url":null,"abstract":"<p>©2012 Wiley Periodicals, Inc.</p><p>The association between age, risk factors, and outcome of non-Caucasian patients hospitalized with heart failure (HF) is not clear. A total of 7066 consecutive patients hospitalized with HF at Hamad General Hospital, Doha, Qatar, from 1991 through 2010 were studied. Patients were divided into 3 groups according to age: group 1, 50 years and younger; group 2, older than 50 and up to 70 years; and group 3, older than 70 years. The prevalence of hypertension, chronic renal impairment, and atrial fibrillation increased with increased age. On admission, the older the age of the HF patient, the less likely they were to receive β-blockers and vasodilators. In-hospital mortality rate was higher in older patients when compared with the younger groups (10.6% group 3 vs 7% group 1 and 7.2% group 2; P=.001). During the study period, the relative reduction in mortality rates was higher in the younger when compared with the older patients (55%, 49%, and 41%, respectively). The clinical characteristics of Middle-Eastern HF patients vary considerably according to age. Over time, an overall marked improvement in hospital survival for HF was observed, which was associated with progressively increased treatment with evidence-based therapies. This survival improvement over time appears to be less pronounced in the elderly.</p>","PeriodicalId":83668,"journal":{"name":"Congestive heart failure (Greenwich, Conn.)","volume":"18 6","pages":"320-326"},"PeriodicalIF":0.0,"publicationDate":"2012-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/j.1751-7133.2012.00290.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30577464","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiogenic Shock as the Initial Presentation of Systemic Lupus Erythematosus: A Case Report and Review of the Literature","authors":"Giselle Baquero MD,&nbsp;Javier E. Banchs MD,&nbsp;Gerald V. Naccarelli MD,&nbsp;Mario Gonzalez MD,&nbsp;Deborah L. Wolbrette MD","doi":"10.1111/j.1751-7133.2011.00283.x","DOIUrl":"10.1111/j.1751-7133.2011.00283.x","url":null,"abstract":"<p>Manifestations of cardiovascular disease from systemic lupus erythematous (SLE) ranges from subclinical findings to life-threatening conditions and may involve all cardiac tissue. In order of prevalence, findings may include pericardial disease, myocardial dysfunction, valvular heart disease, conduction system abnormalities, and atheromatous disease.^1–3 There are few reports of heart failure (HF) and acute myocarditis as the initial manifestation of SLE.^6–10,14,18 These are not included within the standard diagnostic criteria for SLE developed by the American College of Rheumatology.^26–28 Therefore, high suspicion is necessary, since timely therapy may help achieve full recovery.^15,17–19 Treatment strategies for this presentation remain empirical use of corticosteroids and immunosuppressants, based on previous case reports and cohort studies with favorable outcomes. Literature on the treatment of lupus myocarditis and nephritis is limited to few series of cases with long-term follow-up.^6,18</p><p>We report the case of a young woman without known cardiac risk factors who presented with a 2-month history of worsening HF symptoms that progressed to cardiogenic shock and hypoxemic respiratory failure. She was initially treated for a suspected infectious etiology. Subsequent evaluation demonstrated lupus myocarditis and nephritis leading to her dilated cardiomyopathy and HF symptoms. She responded successfully to induction therapy with cyclophosphamide and methylprednisolone. We review the current knowledge base for diagnosis and treatment of this presentation of SLE.</p><p>A 22-year-old Hispanic woman with a 6-week history of progressive dyspnea on exertion, nonproductive cough, and lower extremity edema presented to an outside facility complaining of new onset of fever, pleuritic chest pain, and fatigue. She was diagnosed with community-acquired pneumonia and started on empiric intravenous (IV) antibiotics. She was transferred to our institution after developing cardiogenic shock and hypoxemic respiratory failure that required inotropic support and mechanical ventilation. Her medical history was significant for fibromyalgia and first-degree family history of CREST syndrome. On physical examination, she was sedated, febrile, tachycardic, and hypotensive. She had jugular venous distension, bilateral decreased breath sounds with crackles at pulmonary bases, displaced apical heave lateral to mid-clavicular line with an S3 gallop, and +3 bilateral symmetric lower extremities pitting edema. Bilateral swelling of 2 through 5 proximal interphalangeal joints in her upper extremities and bilateral palpable knee effusions were also noted. A pulmonary artery catheter demonstrated elevated central venous, pulmonary artery, and wedge pressures with low cardiac output consistent with cardiogenic shock. Initial laboratory workup showed elevated serum urea nitrogen and creatinine levels at 33 mg/dL and 1.89 m","PeriodicalId":83668,"journal":{"name":"Congestive heart failure (Greenwich, Conn.)","volume":"18 6","pages":"337-341"},"PeriodicalIF":0.0,"publicationDate":"2012-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/j.1751-7133.2011.00283.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30577354","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Phosphodiesterase Inhibitors, Congestive Heart Failure, and Sudden Death: Time for Re-Evaluation","authors":"Amit Varma MD,&nbsp;Keyur B. Shah MD,&nbsp;Michael L. Hess MD","doi":"10.1111/j.1751-7133.2012.00293.x","DOIUrl":"10.1111/j.1751-7133.2012.00293.x","url":null,"abstract":"<p>©2012 Wiley Periodicals, Inc.</p><p>A 42-year-old diabetic man was admitted with systolic heart failure and pulmonary hypertension being treated with sildenafil for the previous year. With an increase in creatinine, he experienced 3 episodes of ventricular tachycardia and ventricular fibrillation. Withdrawal of the phosphodiesterase (PDE) inhibitor resulted in no further episodes of dysrhythmias. The basic pharmacology of PDE inhibitors is presented and the use of PDE-3 inhibitors for the treatment of heart failure causing an increase in sudden death is also reviewed. There have been several cases of sudden death associated with sildenafil use and with its increasing use in patients with severe pulmonary hypertension and decompensated heart failure. The authors also reviewed the electrophysiologic effects of PDE-5 inhibitors associated with their use. The crossover between PDE-3 and PDE-5 inhibitors is also discussed and caution is urged when contemplating the use of PDE-5 inhibitors in patients with systolic heart failure and pulmonary hypertension.</p>","PeriodicalId":83668,"journal":{"name":"Congestive heart failure (Greenwich, Conn.)","volume":"18 4","pages":"229-233"},"PeriodicalIF":0.0,"publicationDate":"2012-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/j.1751-7133.2012.00293.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30578207","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Comparison of Criterion Standard Methods to Diagnose Acute Heart Failure","authors":"Sean P. Collins MD, MSc,&nbsp;Christopher J. Lindsell PhD,&nbsp;Donald M. Yealy MD,&nbsp;David J. Maron MD,&nbsp;Allen J. Naftilan MD,&nbsp;John A. McPherson MD,&nbsp;Alan B. Storrow MD","doi":"10.1111/j.1751-7133.2012.00288.x","DOIUrl":"10.1111/j.1751-7133.2012.00288.x","url":null,"abstract":"<p>©2012 Wiley Periodicals Inc.</p><p>The authors sought to compare and contrast the clinical criterion standards currently used in a cohort of emergency department (ED) patients to diagnose acute heart failure syndromes (AHFS). In a prospective observational study of patients with signs and symptoms of AHFS, 3 criterion standards were examined: (1) the treating ED physician’s diagnosis; (2) the hospital discharge diagnosis; and (3) a diagnosis based on medical record review by a panel of cardiologists. Using Cohen’s kappa (κ) coefficient, the authors assessed agreement and then compared the different standards by repeatedly setting one as the criterion standard and the other two as index tests. A total of 483 patients were enrolled. Across all criterion standards, patients with AHFS were more likely to have a history of AHFS, congestion on physical examination and chest radiography, and elevated natriuretic peptide levels than those without AHFS. The standards agreed well (cardiology review vs hospital discharge diagnosis, κ=0.74; cardiology review vs ED diagnosis, κ=0.66; ED diagnosis vs hospital discharge diagnosis κ=0.59). Each method had similar sensitivity but differing specificities. Different criterion standards identify different patients from among those being evaluated for AHFS. Researchers should consider this when choosing between the various criterion standard approaches when evaluating new index tests.</p>","PeriodicalId":83668,"journal":{"name":"Congestive heart failure (Greenwich, Conn.)","volume":"18 5","pages":"262-271"},"PeriodicalIF":0.0,"publicationDate":"2012-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/j.1751-7133.2012.00288.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30920254","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictors of Right Ventricular Systolic Dysfunction in Compensated and Decompensated Heart Failure","authors":"Maya Guglin MD, PhD,&nbsp;Cho Mya Win MD,&nbsp;Nellie Darbinyan MPH,&nbsp;Yougui Wu MPH","doi":"10.1111/j.1751-7133.2012.00289.x","DOIUrl":"10.1111/j.1751-7133.2012.00289.x","url":null,"abstract":"<p>©2012 Wiley Periodicals Inc.</p><p>Current understanding of the mechanisms of right ventricular (RV) systolic dysfunction in heart failure (HF) is limited. The authors analyzed a limited access dataset from the Evaluation Study of Congestive Heart Failure and Pulmonary Artery Catheterization Effectiveness (ESCAPE) provided by the National Heart, Lung, and Blood Institute (NHLBI). RV systolic function was measured by echocardiography at baseline and at 3-month follow-up using fractional area change. Univariate and multivariate analysis was performed with linear regression. Of 433 patients enrolled in the ESCAPE trial, 190 had RV systolic function measured at baseline (decompensated HF) and 147 had it measured at 3-month follow-up. On both occasions, parameters of congestion were associated with RV systolic function. Interestingly, lower hematocrit level was also associated with better RV systolic function. In multivariate analysis, only wedge pressure remained a statistically significant predictor of RV dysfunction. In summary, cardiac diastolic pressures and corresponding echocardiographic parameters, as well as hematocrit level, predicted RV systolic function in both compensated and decompensated systolic HF.</p>","PeriodicalId":83668,"journal":{"name":"Congestive heart failure (Greenwich, Conn.)","volume":"18 5","pages":"278-283"},"PeriodicalIF":0.0,"publicationDate":"2012-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/j.1751-7133.2012.00289.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30920257","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Developments in Heart Failure 2011","authors":"Krishna K. Gaddam MD,&nbsp;Hector Ventura MD","doi":"10.1111/j.1751-7133.2012.00292.x","DOIUrl":"10.1111/j.1751-7133.2012.00292.x","url":null,"abstract":"<p>Last year, the authors reviewed all studies in the field of heart failure (HF) published in the year 2010. Another year of exciting new developments has gone by and several important papers have been published. Summarized are the important studies published in the year 2011 that may be a useful review for cardiologists and other health care professionals who care for patients with HF. ©2012 Wiley Periodicals, Inc.</p>","PeriodicalId":83668,"journal":{"name":"Congestive heart failure (Greenwich, Conn.)","volume":"18 2","pages":"112-126"},"PeriodicalIF":0.0,"publicationDate":"2012-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/j.1751-7133.2012.00292.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30514293","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association Between Systemic Neutrophil Gelatinase–Associated Lipocalin and Anemia, Relative Hypochromia, and Inflammation in Chronic Systolic Heart Failure","authors":"Kevin Shrestha AB,&nbsp;Allen G. Borowski RDCS,&nbsp;Richard W. Troughton MBBS,&nbsp;Allan L. Klein MD,&nbsp;W. H. Wilson Tang MD","doi":"10.1111/j.1751-7133.2012.00287.x","DOIUrl":"10.1111/j.1751-7133.2012.00287.x","url":null,"abstract":"<p>©2012 Wiley Periodicals, Inc.</p><p>Neutrophil gelatinase–associated lipocalin (NGAL) is upregulated systemically and by renal tubular cells in response to inflammation and ischemia. Recent interests in NGAL have focused on its ability to predict worsening renal function. However, as an iron-regulatory glycoprotein, the relationship between systemic NGAL levels and indices of anemia has not been examined. In 130 patients with chronic systolic heart failure, the authors examined the relationship between plasma NGAL levels and indices of anemia independent of underlying renal function and systemic markers of inflammation and oxidant stress. Plasma NGAL levels were significantly elevated in patients with anemia vs without anemia (121 [interquartile range, 98–197] vs 72 [interquartile range, 57–98] ng/mL, <i>P</i>&lt;.001). Plasma NGAL levels were inversely correlated with indices of anemia including red blood cell count (<i>r</i>=−0.38, <i>P</i>&lt;.0001), hemoglobin (<i>r</i>=−0.41, <i>P</i>&lt;.0001), and red cell distribution width (<i>r</i>=0.25, <i>P</i>=.007), even in patients with relatively preserved renal function (estimated glomerular filtration rate ≥60 mL/min/1.73 m²; n=83, <i>P</i>&lt;.05 for all). Higher plasma NGAL levels were associated with presence of anemia independent of estimated glomerular filtration rate, plasma high-sensitivity C-reactive protein, and myeloperoxidase levels (odds ratio, 2.38; 95% confidence interval, 1.02–6.20; <i>P</i>=.045). Hence, systemic NGAL levels are independently associated with indices of anemia.</p>","PeriodicalId":83668,"journal":{"name":"Congestive heart failure (Greenwich, Conn.)","volume":"18 5","pages":"239-244"},"PeriodicalIF":0.0,"publicationDate":"2012-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/j.1751-7133.2012.00287.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30919808","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ultrasound Pleural Effusion Sign as a Useful Marker for Identifying Heart Failure Worsening in Established Heart Failure Patients During Follow-Up","authors":"Hajime Kataoka MD","doi":"10.1111/j.1751-7133.2012.00285.x","DOIUrl":"10.1111/j.1751-7133.2012.00285.x","url":null,"abstract":"<p>©2012 Wiley Periodicals, Inc.</p><p>Clinical significance of UltraSound Pleural Effusion (US-PLE) and test characteristics of this sign for identifying worsening heart failure (HF) during follow-up of HF patients are unclear. Clinical records of 83 established HF patients were examined. The diagnosis of worsening HF was classified as “highly certain,”“probable,”“uncertain,” or “no” based on the combination of the changes in symptoms/signs and B-type natriuretic peptide (BNP). Routine test included searching for the US-PLE sign. During a follow-up of 652±456 days, 1826 visits were evaluated. Among the 83 study patients, 78 had at least one of the following: worsening symptom(s), HF-related sign(s), and/or elevated BNP levels (≥3-fold increase) at one or more clinic visits. The US-PLE sign was present at 83 visits of 49 study patients. Its appearance was associated with the presence of HF-related symptom(s)/sign(s) and BNP elevation (odds ratio, 53–177, P&lt;.0001 each). The test characteristics of the US-PLE sign for diagnosis of high possibility of worsening HF status fulfilling the “highly certain” or “probable” criteria were: sensitivity (76.6%), specificity (98.6%), positive predictive value (71.1%), and negative predictive value (99.0%). The US-PLE sign has high diagnostic accuracy for identifying worsening HF, including asymptomatic events, in HF patients during follow-up.</p>","PeriodicalId":83668,"journal":{"name":"Congestive heart failure (Greenwich, Conn.)","volume":"18 5","pages":"272-277"},"PeriodicalIF":0.0,"publicationDate":"2012-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/j.1751-7133.2012.00285.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30920255","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}