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

{"title":"Risk Score Model for Predicting Mortality in Advanced Heart Failure Patients Followed in a Heart Failure Clinic","authors":"Barak Zafrir MD,&nbsp;Yaron Goren MSc,&nbsp;Hagar Paz RN,&nbsp;Rafael Wolff MD,&nbsp;Nabia Salman MD,&nbsp;Dina Merhavi RN,&nbsp;Idit Lavi MA,&nbsp;Basil S. Lewis MD, FRCP,&nbsp;Offer Amir MD","doi":"10.1111/j.1751-7133.2012.00286.x","DOIUrl":"10.1111/j.1751-7133.2012.00286.x","url":null,"abstract":"<p>©2012 Wiley Periodicals, Inc.</p><p>The prevalence of heart failure (HF) in the population is increasing, concomitant with high incidence of rehospitalizations and mortality. The aim of this study was to characterize a prognostic risk score model for patients with chronic HF. A total of 500 patients followed at the HF clinic were evaluated by clinical, functional, laboratory, imaging, and therapeutic variables that were correlated to mortality during a follow-up period of 25 months. Risk stratification was carried out by applying a risk score model based on multivariate analysis. Predictors correlated with mortality during follow-up were systolic blood pressure &lt;110 mm Hg, male sex, age older than 70 years, 6-minute walk distance &lt;300 m, lack of β-blocker therapy, hyperuricemia (&gt;7.5 mg/dL), hyponatremia, and prolonged QTc interval (&gt;450 ms). Based on these variables, a risk score model (score 0–55) was established and included low risk, score &lt;21 (9% mortality during 2-year follow-up); moderate risk, 21 to 29 (22%); high risk, 30 to 35 (35%), and very high risk: ≥36 points (62% 2-year mortality). The risk model had good discrimination ability (concordance index 0.75), which was better than the performance of the Seattle Heart Failure Model on our cohort (0.69). Simple noninvasive characteristics examined during the initial admission to the HF clinic can serve as prognostic markers for mortality and may help in the process of therapeutic decision-making in patients with HF.</p>","PeriodicalId":83668,"journal":{"name":"Congestive heart failure (Greenwich, Conn.)","volume":"18 5","pages":"254-261"},"PeriodicalIF":0.0,"publicationDate":"2012-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/j.1751-7133.2012.00286.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30920253","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":"Initial Description of Cerebral Oximetry Measurement in Heart Failure Patients","authors":"Luay Rifai MD,&nbsp;James Winters MS,&nbsp;Eli Friedman MS,&nbsp;Marc A. Silver MD","doi":"10.1111/j.1751-7133.2011.00284.x","DOIUrl":"10.1111/j.1751-7133.2011.00284.x","url":null,"abstract":"<p>Cerebral oximetry is a noninvasive technology using near-infrared spectroscopy (NIRS) to monitor regional cerebral tissue oxygen saturation (SctO₂). NIRS has been widely used for assessing cerebral tissue oxygenation in a variety of populations including the fields of neonatology, anesthesiology, neurology, and cardiac surgery.However, little information has been reported on cerebral oximetry in heart failure (HF) patients. In this observational study, we enrolled 30 patients (15 men) aged 23 to 82 years (mean 67 years) with stage C HF. All patients had New York Heart Association (NYHA) functional class I to III. All patients were on stable HF medical therapy. SctO₂ measurements were recorded from the left and right forehead simultaneously, using FORE-SIGHT cerebral oximeter (CAS Medical Systems Inc, Branford, CT). Feasible associations with SctO₂ risk factors, known to correlate with HF, were recorded. The mean SctO₂ value was 67.4% (range, 47.6%–76.3%), while the mean peripheral tissue saturation (SpO₂) was 97% (range, 92%–100%). The mean difference between cerebral and peripheral tissue oxygenation (SpO₂−SctO₂) was 29.2% (range, 19.2%–51.4%). There was also a significant positive correlation between SctO₂ and mean arterial blood pressure (0.55, <i>P</i>&lt;.01). Statistically significant lower SctO₂ values were observed in patients with diabetes (<i>P</i>=.026; confidence interval [CI], 0.006–0.090) and in patients with dyslipidemia (<i>P</i>=.007; CI, 0.018–0.103). In this initial description of SctO₂ in patients with stage C HF, we noted a wide range of SctO₂ measurements. For most patients, there was a profound SpO₂−SctO₂ difference, despite near-normal peripheral oxygen saturations. The authors suggest that SctO₂ is a potentially important biomarker to measure in HF patients and may be a useful marker of target organ perfusion. ©2012 Wiley Periodicals, Inc.</p>","PeriodicalId":83668,"journal":{"name":"Congestive heart failure (Greenwich, Conn.)","volume":"18 2","pages":"85-90"},"PeriodicalIF":0.0,"publicationDate":"2012-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/j.1751-7133.2011.00284.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30516023","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":"Worsening Renal Function and Prognosis in Pulmonary Hypertension Patients Hospitalized for Right Heart Failure","authors":"Lisa M. Mielniczuk MD,&nbsp;George Chandy MD,&nbsp;Duncan Stewart MD,&nbsp;Vladamir Contreras-Dominguez MD,&nbsp;Haissam Haddad MD,&nbsp;C Pugliese RN,&nbsp;Ross A. Davies MD","doi":"10.1111/j.1751-7133.2011.00275.x","DOIUrl":"10.1111/j.1751-7133.2011.00275.x","url":null,"abstract":"<p>Increased central venous pressures have been associated with the development of worsening renal function (WRF), an important marker of prognosis. We sought to determine the incidence and prognostic significance of WRF in pulmonary hypertension patients (PH) with isolated right HF. A prospective study of PH clinic patients admitted to hospital for right HF. WRF was defined as a rise in creatinine of 26 μmol/L (0.3 mg/dL) within the first 48 hours of admission. A total of 32 patients were enrolled in this study, 67% of patients had moderate-severe chronic kidney disease with an eGFR≤60 mL/min and 34% (n=11) developed WRF during their admission. The mean right atrial pressure was higher in patients with WRF (19±7 mm Hg vs 12±6 mm Hg, P=.05). A total of 36% of patients with WRF died in hospital compared to 5% in the group that did not develop WRF (OR for hospital death 13.3±16, P=.03). The combined endpoint of death or readmission at 6 months was 45% in the WRF group and 43% in the group without WRF (P=.89). Significant renal dysfunction is common in patients with PH and an acute decline in renal function is an important marker of in hospital death and short term mortality in right heart failure. ©2012 Wiley Periodicals, Inc.</p>","PeriodicalId":83668,"journal":{"name":"Congestive heart failure (Greenwich, Conn.)","volume":"18 3","pages":"151-157"},"PeriodicalIF":0.0,"publicationDate":"2012-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/j.1751-7133.2011.00275.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30618912","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 of Low Plasma Adiponectin With Early Diastolic Dysfunction","authors":"Smita I. Negi MD,&nbsp;Euy-Myoung Jeong PhD,&nbsp;Irfan Shukrullah MBBS,&nbsp;Mihai Raicu MS,&nbsp;Samuel C. Dudley, Jr MD, PhD","doi":"10.1111/j.1751-7133.2011.00276.x","DOIUrl":"10.1111/j.1751-7133.2011.00276.x","url":null,"abstract":"<p>Diastolic dysfunction (DD) with preserved left ventricular (LV) ejection fraction (EF) has been linked to obesity. Adiponectin is a cytokine related to obesity and obesity-linked cardiovascular complications. The authors aimed to determine the independent association of DD with adiponectin. Fifty patients with impaired relaxation DD and a normal EF and age-matched normal controls were recruited. Plasma levels of total and high molecular weight (HMW) adiponectin were measured. Mid and low molecular weight (MMW+LMW) fractions of adiponectin were calculated by subtracting HMW fraction from total adiponectin. The DD group had significantly lower total (median, 4.4 vs 12.7 μg/mL; <i>P</i>=.001), HMW fraction (median, 1.3 vs 3.4 μg/mL; <i>P</i>=.02), and MMW+LMW fraction of adiponectin (median, 3.8 vs 7.2 μg/mL; <i>P</i>=.01). Body mass index (BMI) negatively correlated with total (<i>r</i>:−0.46, <i>P</i>=.003), HMW (<i>r</i>:−0.32, <i>P</i>=.038), and MMW+LMW (<i>r</i>:−0.40, <i>P</i>=.006) fractions of adiponectin. DD had an independent association with both BMI (<i>P</i>&lt;.05) and total adiponectin (<i>P</i>&lt;.001) in linear regression model using sex, BMI, blood pressure, and total adiponectin as covariates. DD was associated with BMI (<i>P</i>=.02), HMW fraction (<i>P</i>=.03), and MMW+LMW fraction (<i>P</i>=.004) in similar linear regression analyses. Adiponectin deficiency may be one explanation for the adiposity-related cardiac oxidation known to be involved in the pathogenesis of DD.</p>","PeriodicalId":83668,"journal":{"name":"Congestive heart failure (Greenwich, Conn.)","volume":"18 4","pages":"187-191"},"PeriodicalIF":0.0,"publicationDate":"2012-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/j.1751-7133.2011.00276.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30772504","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 Pulmonary Hypertension in Patients With End-Stage Heart Failure","authors":"Juan Torres-Macho PhD,&nbsp;Juan F. Delgado-Jiménez PhD,&nbsp;Javier Sanz-Salvo MD,&nbsp;Ana González-Mansilla PhD,&nbsp;Violeta Sánchez-Sánchez MD,&nbsp;Sergio Gámez-Díez MD,&nbsp;Pilar Escribano-Subías PhD,&nbsp;Carlos Sáenz de la Calzada PhD","doi":"10.1111/j.1751-7133.2011.00277.x","DOIUrl":"10.1111/j.1751-7133.2011.00277.x","url":null,"abstract":"<p>Pulmonary hypertension (PH) is associated with a greater mortality rate in patients with heart failure (HF) and it is a risk factor for right ventricular failure after heart transplantation. This study was designed to explore risk factors for PH development in patients with advanced heart failure and left ventricular dysfunction. In a retrospective observational study of 419 patients evaluated for heart transplantation due to end stage HF, different variables were analyzed to find predictors of PH (defined as a mean pulmonary pressure &gt;25 mmHg), reactive PH (defined as a transpulmonary gradient &gt;12 mmHg) and severe PH (defined as a mean pulmonary pressure &gt;40 mmHg and/or pulmonary vascular ressistance &gt;3 WU) using a multivariate stepwise logistic regression analysis. Prevalence of PH, out of proportion and severe PH was 62.2%, 23.8%, and 18.8% respectively. The presence of moderate-severe mitral regurgitation [2.1 (1.2–3.7); <i>P</i>=0.006], moderate-severe tricuspid regurgitation [OR 2.9 (1.3–6.4); <i>P</i>=0.005] and a duration of disease &gt;3 years [OR 1.7 (1.1–2.7); <i>P</i>=0.03] were independent risk factors associated with PH. Moreover, the presence of a moderate-severe mitral regurgitation and a duration of disease greater than 3 years, were independent predictors of out of proportion and severe PH.</p>","PeriodicalId":83668,"journal":{"name":"Congestive heart failure (Greenwich, Conn.)","volume":"18 4","pages":"212-216"},"PeriodicalIF":0.0,"publicationDate":"2012-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/j.1751-7133.2011.00277.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30772431","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":"Irreversible End-Stage Cardiomyopathy Following a Single Dose of Cyclophosphamide","authors":"Sina Dadfarmay MD,&nbsp;Robert Berkowitz MD, PhD,&nbsp;Bernard Kim MD","doi":"10.1111/j.1751-7133.2011.00279.x","DOIUrl":"10.1111/j.1751-7133.2011.00279.x","url":null,"abstract":"<p>Cyclophosphamide (CPA) is an alkylating agent used in a variety of chemotherapeutic regimens as well as for autoimmune disorders, the latter owing to its immunosuppressive effects. Its primary dose-limiting toxicities are bone marrow suppression and cardiomyopathy. The clinical course of CPA-induced cardiomyopathy varies widely. Most reported cases have described a transient, reversible course, similar to acute anthracycline toxicity.¹ However, there have been a few cases of fulminant restrictive cardiomyopathy characterized by biventricular pump failure and a rapidly fatal course.² Unlike anthracycline toxicity, in which the cumulative dose over time is the main determinant predicting the development of cardiomyopathy, the primary risk factor for CPA-induced cardiotoxicity is the total dose administered per course.³ We report the case of a pulmonary hypertension patient taking long-term ambrisentan therapy who developed irreversible end-stage cardiomyopathy following a single dose of CPA at a dose well below that which has been previously reported.</p><p>A 61-year-old woman with a history of scleroderma with lung involvement and pulmonary hypertension presented with a 4-month history of worsening renal function. Her creatinine level had increased from 1.2 mg/dL to 4.5 mg/dL during this period and she experienced a gradual diminution in urine output. A renal biopsy was performed, which showed rapidly progressive crescenteric glomerulonephritis (RPGN), and she was admitted for initiation of dialysis. A routine echocardiogram done for follow-up of her pulmonary hypertension (PH) 3 weeks prior to admission showed an ejection fraction (EF) of 60%, normal diastolic function, normal chamber sizes, and a right ventricular systolic pressure (RVSP) of 27 mm Hg. The patient’s PH had been well-controlled on a regimen of sildenafil and ambrisentan and she had not experienced any signs or symptoms of right heart failure. She had no prior cardiac history nor was there a family history of cardiomyopathy. She was a nonsmoker and a nondrinker and denied any drug use.</p><p>Following the diagnosis of RPGN, the patient was given 3 days of intravenous pulse methylprednisolone (1 gm/d) and a single dose of CPA 870 mg (0.5 g/m²). Renal function did not improve despite treatment. Outpatient dialysis was initiated and the patient was subsequently discharged home on a course of prednisone.</p><p>Three weeks later, the patient was readmitted to the hospital with seizures and altered mental status secondary to steroid psychosis. Steroids were discontinued and the patient was started on phenytoin. On day 8 of admission, the patient suddenly developed respiratory distress, hypoxia (oxygen saturation 82% on room air), and metabolic acidosis (pH 7.21, bicarbonate 17). She was placed on bilevel positive airway pressure ventilation (BiPAP). Her blood pressure remained stable (130/88 mm Hg) but the patient was tachycardic (heart rate","PeriodicalId":83668,"journal":{"name":"Congestive heart failure (Greenwich, Conn.)","volume":"18 4","pages":"234-237"},"PeriodicalIF":0.0,"publicationDate":"2012-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/j.1751-7133.2011.00279.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30772434","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":"Subclinical Anthracycline Cardiotoxicity in Patients With Acute Promyelocytic Leukemia in Long-Term Remission After the AIDA Protocol","authors":"Pierpaolo Pellicori MD,&nbsp;Angela Calicchia MD,&nbsp;Francesco Lococo MD,&nbsp;Giuseppe Cimino MD,&nbsp;Concetta Torromeo MD","doi":"10.1111/j.1751-7133.2011.00278.x","DOIUrl":"10.1111/j.1751-7133.2011.00278.x","url":null,"abstract":"<p>Anthracycline chemotherapy remains a critical component of cancer treatment despite its established risk of cardiotoxicity. To investigate whether the AIDA protocol, which combines idarubicin, mitoxantrone, and all-trans retinoic acid (ATRA) for treatment of acute promyelocytic leukemia (APL) results in late cardiotoxicity, 34 APL patients in long-term remission were evaluated. The cumulative dose of idarubicin and mitoxantrone were 80 mg/m² and 50 mg/m², respectively. Median follow-up was 7 years. Segmental wall motion abnormalities (SWMAs) were detected in 11 AIDA patients who still presented with an ejection fraction (EF) within normal limits (EF 56% in the AIDA group vs 59% in the control group, <i>P</i>=.01). However, parameters of diastolic dysfunction were significantly impaired in the AIDA group (E/A ratio: 1.04 in the AIDA group vs 1.28 in the control group, <i>P</i>=.001; E/E’ lateral ratio: 10.04 in the AIDA group vs 5.79 in the control group, <i>P</i>≤.001) as well as left atrial volume (52 mL in the AIDA group vs 35 mL in the control group, <i>P</i>&lt;.001). Cardiac toxicity due to anthracycline therapy is often frequent. Changes in diastolic function are helpful in the detection of subclinical anthracycline cardiotoxicity in long-term cardiac follow-up despite a preserved systolic ventricular function.</p>","PeriodicalId":83668,"journal":{"name":"Congestive heart failure (Greenwich, Conn.)","volume":"18 4","pages":"217-221"},"PeriodicalIF":0.0,"publicationDate":"2012-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/j.1751-7133.2011.00278.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30772433","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 Effect of Nesiritide on Renal Function and Other Clinical Parameters in Patients With Decompensated Heart Failure and Preserved Ejection Fraction","authors":"Iosif Kelesidis MD,&nbsp;Jeremy Mazurek MD,&nbsp;Pankaj Khullar MD,&nbsp;Wajeeha Saeed MD,&nbsp;Timothy Vittorio MD,&nbsp;Ronald Zolty MD, PhD","doi":"10.1111/j.1751-7133.2011.00272.x","DOIUrl":"10.1111/j.1751-7133.2011.00272.x","url":null,"abstract":"<p>The role of nesiritide in patients with decompensated heart failure with preserved ejection fraction (dHFpEF) has not been previously studied. In this investigation, the authors retrospectively analyzed the effect of nesiritide on renal function and clinical outcomes in patients admitted with dHFpEF. Of the 658 patients included, 328 were treated with nesiritide while 330 patients were treated with standard diuretic therapy. In both the nesiritide and no nesiritide groups, there was a significant change in mean glomerular filtration rate (GFR) and creatinine at 72 hours as well as at day of discharge (<i>P</i>&lt;.001). This trend did not progress at 1 month in the nesiritide group, although it did in the no nesiritide group. At 1 month after therapy, however, there was a significant difference between the two groups in the mean change of GFR and creatinine (<i>P</i>&lt;.001). There was no significant difference in &gt;25% decrease of GFR anytime through day 30 (25% vs 29.69%, <i>P</i>=.236) between the two groups. On multivariate analysis, nesiritide was an important predictor of renal function at 1 month (<i>P</i>&lt;.05). Thus, nesiritide can be administered safely without negatively impacting long-term renal function in patients admitted with dHFpEF. ©2011 Wiley Periodicals, Inc.</p>","PeriodicalId":83668,"journal":{"name":"Congestive heart failure (Greenwich, Conn.)","volume":"18 3","pages":"158-164"},"PeriodicalIF":0.0,"publicationDate":"2011-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/j.1751-7133.2011.00272.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30569928","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 16 Weeks of Continuous vs Intermittent Exercise Training in Chronic Heart Failure Patients","authors":"Neil A. Smart PhD,&nbsp;Michael Steele PhD","doi":"10.1111/j.1751-7133.2011.00274.x","DOIUrl":"10.1111/j.1751-7133.2011.00274.x","url":null,"abstract":"<p>The authors compared the effects of continuous (CON) and intermittent (INT) exercise training programs on functional capacity, quality of life (QOL), and cardiac function in 23 congestive heart failure patients. Patients were randomized to CON exercise training (n=13; aged 66±7 years; peak oxygen consumption [VO₂], 12.4±2.5 mL/kg/min; weight, 83±12 kg; left ventricular ejection fraction [LVEF], 29.5%±7.2%) or INT exercise training (n=10; aged 59±11 years; VO₂, 12.2±6.5 mL/kg/min; weight, 87±24 kg; LVEF 27%±7.9%). These groups completed 16 weeks of stationary cycling at 70% VO₂ thrice weekly for 30 minutes continuously or 60 minutes (60 seconds work:60 seconds rest) intermittently; both groups completed the same absolute volume of work. Three QOL questionnaire responses, VO₂, LVEF, and regional tissue Doppler were quantified. After exercise training, VO₂ increased by 13% in the CON group (<i>P</i>=.12) and significantly by 21% in the INT group (<i>P</i>=.03), although not significantly between the groups (<i>P</i>=.72). In the CON group, Minnesota Living With Heart Failure score improved at 16 weeks (<i>P</i>=.02), while in the INT group, Hare–Davis scores improved (<i>P</i>=.02). Cardiac volumes, resting and peak LVEF, contractile reserve, and tissue velocities were all unchanged from baseline. Intermittent exercise may improve functional capacity to a greater extent than continuous exercise. QOL changes were variable between groups. Congest Heart Fail.</p>","PeriodicalId":83668,"journal":{"name":"Congestive heart failure (Greenwich, Conn.)","volume":"18 4","pages":"205-211"},"PeriodicalIF":0.0,"publicationDate":"2011-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/j.1751-7133.2011.00274.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30772503","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 Nesiritide in Isolated Right Ventricular Failure Secondary to Pulmonary Hypertension","authors":"Iosif Kelesidis MD,&nbsp;Jeremy A. Mazurek MD,&nbsp;Wajeeha Saeed MD,&nbsp;Ronak Chaudhari MD,&nbsp;Pradnya Velankar MD,&nbsp;Ronald Zolty MD, PhD","doi":"10.1111/j.1751-7133.2011.00273.x","DOIUrl":"10.1111/j.1751-7133.2011.00273.x","url":null,"abstract":"<p>Treatment of right ventricular failure (RVF) can be challenging due to the correlation between RVF and worsening renal function with diuretic therapy. Nesiritide has been studied in patients with left ventricular failure but has not been evaluated in isolated RVF. The authors retrospectively analyzed 140 patients admitted with RVF, pulmonary hypertension (PH), and preserved left ventricular systolic function. Seventy patients were treated with nesiritide while the remaining patients received only furosemide (no nesiritide group). Serum creatinine and GFR at baseline, 72 hours, discharge, and 1 month post-treatment, as well as hemodynamic data were compared between the groups. In the nesiritide group, there was a significant decrease in mean GFR (42.77±25.33, <i>P</i>&lt;.001) at day of discharge and 1 month post-nesiritide infusion (41.17±24.94, <i>P</i>&lt;.001) but not in the no nesiritide group. There was a significant difference in &gt;25% decrease in GFR anytime through day 30 (47.14% vs 25.71%, <i>P</i>=.036) between the two groups. On multivariate analysis, nesiritide remained an important predictor of renal function at discharge and at 1 month (<i>P</i>&lt;.01) as well as a predictor of &gt;25% decrease in GFR anytime through day 30 (<i>P</i>=.007). Thus, nesiritide is associated with worsening kidney function in patients with RVF in the setting of PH. <i>Congest Heart Fail.</i> 2012;18:18–24. ©2011 Wiley Periodicals, Inc.</p>","PeriodicalId":83668,"journal":{"name":"Congestive heart failure (Greenwich, Conn.)","volume":"18 1","pages":"18-24"},"PeriodicalIF":0.0,"publicationDate":"2011-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/j.1751-7133.2011.00273.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30413056","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}