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Tag Archives: heart failure

February 2024 Br J Cardiol 2024;31:7–8 doi:10.5837/bjc.2024.005

Rewriting the heart failure pillars toward less burdensome heart failure care pathways

Rosalynn C Austin

Abstract

Dr Rosalynn C Austin Burden of treatment is a concept that describes the balance between an individual’s capacity (their abilities and available resources) and the workload (tasks assigned by healthcare professionals) related to treating their illness.5 When workload exceeds capacity, engagement with self-care, quality of life and clinical outcomes worsen.6–9 Research in people with HF has shown a relationship between symptom severity and the difficulty reported with workload associated with their illness (treatment burden).10,11 Medications were reported as part of ‘troublesome self-care’.12 But it appears that the burden lies not in

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January 2024 Br J Cardiol 2024;31:23–6 doi:10.5837/bjc.2024.003

Inpatient initiation of sodium-glucose cotransporter-2 inhibitors: the prescribing learning curve

Charlotte Gross, Hiba Hammad, Thomas A Slater, Sam Straw, Thomas Anderton, Caroline Coyle, Melanie McGinlay, John Gierula, V Kate Gatenby, Vikrant Nayar, Jiv N Gosai, Klaus K Witte

Abstract

Introduction Sodium-glucose cotransporter-2 inhibitors (SGLT2i) improve symptoms,1 reduce hospitalisations and extend longevity2,3 for patients who have heart failure with reduced ejection fraction (HFrEF). These beneficial effects are observed very early following initiation,4 prompting calls for these agents to be given equal priority to more established therapies,5,6 which has been reflected in recent guidelines.7 Hospitalisation with heart failure (HF) offers the opportunity for optimisation of guideline-directed medical therapy (GDMT) including SGLT2i,8,9 however, the feasibility of doing so has not been reported outside of the artifici

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June 2023 Br J Cardiol 2023;30:74 doi:10.5837/bjc.2023.018

Diabetic cardiomyopathy: an educational review

Su-Lee Xiao, Emilia Bober, Xenophon Kassianides, Francesco Medici, Han B Xiao

Abstract

Introduction Diabetes mellitus is a major global health burden, with type 2 diabetes representing approximately 90% of cases. It is estimated that there were 451 million people with diabetes worldwide in 2017, and there will be 690 million by 2045.1–3 Unfortunately, almost half (49.7%) of the patients with diabetes remain undiagnosed. Diabetes accounts for 10% of global all-cause mortality and is a major risk factor for numerous cardiovascular diseases, including coronary artery disease, hypertension, peripheral vascular disease and heart failure.1 The link between diabetes and cardiovascular disease appears to be at both macrovascular and

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February 2023 Br J Cardiol 2023;30:7–9 doi:10.5837/bjc.2023.003

SGLT2 inhibitors in CKD and HFpEF: two new large trials and two new meta-analyses

Kaitlin J Mayne, David Preiss, William G Herrington

Abstract

Vaduganathan et al. aggregated results from five heart failure trials,3 and the Nuffield Department of Population Health Renal Studies Group with the SGLT2 inhibitor Meta-Analysis Cardio-Renal Trialists’ Consortium combined standardised data from 13 large placebo-controlled SGLT2 inhibitor trials from three different patient populations. It included results from trials studying 42,568 patients with type 2 diabetes at high risk of atherosclerotic cardiovascular disease, 21,974 patients in heart failure trials, and 25,898 patients in CKD trials.4 Across the 13 trials, the risk of the composite of hospitalisation for heart failure or cardiovas

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January 2023 Br J Cardiol 2023;30:21–5 doi:10.5837/bjc.2023.002

Evaluating initiation and real-world tolerability of dapagliflozin for the management of HFrEF

Alyson Hui Ling Tee, Gayle Campbell, Andrew D’Silva

Abstract

Introduction The prevalence of heart failure (HF) in the UK is estimated to be 920,000, with 200,000 new diagnoses every year.1 HF is the most common cause of admission for people over 65 years old and accounts for 2% of the National Health Service (NHS) total budget, which is approximately £2 billion. Seventy per cent of these costs are attributed to HF hospitalisation, amounting to £3,796 per episode of HF hospital admission, based on an average length of stay of 13 days.2 Additionally, untreated heart failure with reduced ejection fraction (HFrEF) has a mortality rate of approximately 40%,3,4 therefore, evidence-based pharmacological tre

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October 2022 Br J Cardiol 2022;29:158–60 doi:10.5837/bjc.2022.033

Echocardiography in new-onset heart failure: a mid-ventricular Takotsubo case report

Milaras Nikias, Boli Aikaterini, Beneki Eirini, Nevras Vasilios, Zachos Panagiotis, Tsatiris Konstantinos

Abstract

Introduction Takotsubo cardiomyopathy (TTCM) is an often reversible injury of the myocardium caused by catecholamine excess, usually after a stressor.1 The first case series were described by Tsuchihashi et al. three decades ago, and it was named due to the resemblance of the left ventricle (LV) in ventriculography to a Japanese pot used to catch octopuses. It usually affects post-menopausal women and has a typical form involving the mid and apical segments of the LV (apical ballooning), and atypical forms (mid, basal and focal TTCM).2 Mid-ventricular TTCM is a rare variant that affects the mid-segments of the LV, and accounts for 14.6% of pa

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August 2022 Br J Cardiol 2022;29:106–8 doi:10.5837/bjc.2022.027

It’s time to ‘Build Back Fairer’: what can we do to reduce health inequalities in cardiology?

Cong Ying Hey

Abstract

Introduction Dr Cong Ying Hey Disparities in cardiovascular (CV) morbidity and mortality are among the major health and social care concerns in our modern society. In the UK, people living in the most deprived areas are four times more likely to die prematurely from CV disease (CVD) than those living in the least deprived areas.1 To address the disparities in CV outcomes, it is imperative to recognise the presence of inequalities at different interfaces of cardiology services. This article, therefore, aims to provide a focused discussion concerning potential measures to reduce health inequalities in cardiology through the lens of the challeng

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July 2022 Br J Cardiol 2022;29(suppl 2):S2

What’s new in heart failure guidance – a user’s guide: Introduction

Paul Kalra

Abstract

This supplement provides a user’s guide to what’s new in the guidelines for the diagnosis and treatment of heart failure. This primarily relates to recommendations provided in the updated (2021) European Society of Cardiology (ESC) guidelines for the diagnosis and treatment of acute and chronic heart failure. The articles summarise the contemporary guidance with respect to the diagnosis and investigation of patients presenting with heart failure; drug therapy (including the early implementation of the ‘four pillars’ of drug treatment for heart failure with reduced ejection fraction); and recommendations on lifestyle, rehabilitation,

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July 2022 Br J Cardiol 2022;29(suppl 2):S3–S6 doi:10.5837/bjc.2022.s06

New developments in the investigations and diagnosis of heart failure

Patricia Campbell

Abstract

Introduction The heart failure (HF) community has seen huge advances in the care of HF, and we see a turning point in the narrative of doom and gloom, which has traditionally been associated with HF – we see cause for optimism. We recognise the urgency of putting these advances to prompt use, as demonstrated by the 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic HF.1 The 2021 updated guidelines make it clear that we have the means to diagnose HF early, to classify it more accurately, the tools to change the HF trajectory, and the duty and ability to intervene – and to do so early. Diagnosis While the ESC diagnost

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July 2022 Br J Cardiol 2022;29(suppl 2):S7–S12 doi:10.5837/bjc.2022.s07

Drug therapy in heart failure – an update from the 2021 ESC heart failure guideline

Helen Hardy, Paul R Kalra

Abstract

Introduction Heart failure (HF) is a common condition and the majority of patients have multiple co-morbidities. It is therefore essential that all healthcare professionals (HCPs) are familiar with the contemporary management of these patients. Whilst HF specialists are integral to the delivery of optimal patient care, it is important to ensure that therapies are optimised at every opportunity and enable the best care for patients in the context of acute or chronic non-cardiovascular illness. Current practice is often suboptimal; for example, in the latest national HF audit (England and Wales), the number of patients leaving hospital on thre

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