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Tag Archives: heart failure

Planning for end-of-life care in heart failure: experience of two integrated cardiology-palliative care teams

May 2012 Br J Cardiol 2012;19:71–5 doi:10.5837/bjc.2012.014

Planning for end-of-life care in heart failure: experience of two integrated cardiology-palliative care teams

Miriam Johnson, Anne Nunn, Tracey Hawkes, Sharon Stockdale, Andrew Daley

Abstract

Introduction Landmark qualitative studies published within the last decade highlighted inequalities in end-of-life care between people with advanced heart failure (HF) and cancer.1-8 A palliative approach and access to specialist palliative care (SPC) services for people with advanced HF is now underlined in national and international policy.9-14 However, those with HF are still more likely to die in hospital in the UK than cancer patients,15 and UK 2010 national audit figures document less than 4% of people with HF referred for palliative care.16 Hospice referral seems higher in the USA and Canada.17,18 We have previously reported retrospect

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Optimised beta blocker therapy in heart failure: is there space for additional heart rate control?

March 2012 Br J Cardiol 2012;19:21–3 doi:10.5837/bjc.2012.001

Optimised beta blocker therapy in heart failure: is there space for additional heart rate control?

Stuart James Russell, Maria Oliver, Linda Edmunds, Joanne Davies, Hayley Rose, Helen Llewellyn-Griffiths, Victor Sim, Adrian Raybould, Richard Anderson, Zaheer Raza Yousef

Abstract

Introduction Beta-adrenoceptor blocking drugs (beta blockers) are an established prognostic therapy for chronic heart failure (HF).1-4 Of the many proposed mechanisms mediating these favourable effects, that of heart rate (HR) control is gaining interest. The Systolic Heart Failure Treatment with Iƒ Inhibitor Ivabradine Trial (SHIFT) reported that ivabradine significantly reduced a combined end point of cardiovascular death or HF hospitalisations in a relatively high-risk HF population with an elevated resting HR.5 HR control, therefore, appears to be both a modifiable risk factor and a disease modifying variable in patients with impaired l

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March 2012 Br J Cardiol 2012;19:25 doi:10.5837/bjc.2012.004

Hearing the voice of the heart failure patient: key experiences identified in qualitative interviews

Chad J Gwaltney, Ashley F Slagle, Mona Martin, Rinat Ariely, Yvonne Brede

Abstract

Introduction Clinical trials for new heart failure treatments have traditionally focused on mortality and hospitalisations as primary end points.1,2 Although clearly important, these end points tell us little about how heart failure (HF) patients experience their illness and treatment in their day-to-day life. HF may affect patients’ quality of life more than many other chronic diseases, including diabetes and arthritis.3,4 Symptoms and quality of life, as reported by patients, are correlated with mortality and hospitalisations,5-7 suggesting that these concepts may be indicative of an underlying process that ultimately manifests in death a

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February 2012 Br J Cardiol 2012;19:16

Care for the individual patient

Abstract

Bureaucracy The mortality rate for heart failure remains unchanged with 11.6% of heart failure (HF) admissions dying as inpatients, and 33% mortality at around one year, according to the most recent data from the National Heart Failure Audit.  This was presented to the meeting by Professor Theresa McDonagh (King’s College Hospital, London). Data collection continues to improve with 85% of NHS trusts submitting data over the preceding 12 month period, she said.  Access to cardiology services was associated with improved outcomes and a higher usage of evidence-based therapy and subsequent access to outpatient HF services. The likely challen

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Audit of the NT-ProBNP guided transthoracic echocardiogram service in Southend

August 2011 Br J Cardiol 2011;18:189–92

Audit of the NT-ProBNP guided transthoracic echocardiogram service in Southend

Abdul M Mozid, Sofia A Papadopoulou, Alison Skippen, Azhar A Khokhar

Abstract

Introduction Heart failure is one of the most common conditions in industrialised society. Today, in the UK, around 900,000 people have heart failure with a further similar number who have yet to develop symptoms.1 Heart failure is predominantly a disease of the elderly, and the increasing age of the population, combined with improvements in the treatment of ischaemic heart disease (IHD), account for the increasing prevalence. Heart failure has a poor prognosis: just under 40% of patients diagnosed with heart failure die within a year, depending on initial severity, although, thereafter, mortality is less than 10% per year. This suggests that

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News from the American College of Cardiology Scientific Session 2011

June 2011 Br J Cardiol 2011;18:105–8

News from the American College of Cardiology Scientific Session 2011

BJCardio Staff

Abstract

PARTNER: transcatheter valves just as good as surgery for high risk aortic stenosis Transcatheter aortic valve implantation (TAVI) is just as effective at reducing mortality as surgery for severe aortic stenosis in elderly patients whose age and overall health posed high risks for conventional surgery, according to the results of the PARTNER (Placement of AoRTic TraNscathetER Valve trial). However, stroke rates were higher in the trancatheter group. The transcatheter approach involves delivering a bioprosthetic valve to its target location with a catheter using either transfemoral access or trans-apical access (through the ribs) if peripheral

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Heart failure: what’s new? The 2011 BSH medical training meeting

June 2011 Br J Cardiol 2011;18:113–14

Heart failure: what’s new? The 2011 BSH medical training meeting

Abstract

Neurohormonal blockade A cardiac resynchronisation therapy pacemaker (CRT-P), provides cardiac resynchronisation therapy and diagnostics to assist in patient management The meeting set off to a stimulating start with Professor Theresa McDonagh (Kings College Hospital, Chair of the British Society of Heart Failure) reviewing primarily the growing evidence for aldosterone antagonists in the management of systolic heart failure (HF). Large clinical trials have established the role of aldosterone antagonists, such as spironolactone, in severe systolic HF (Randomised Aldactone Evaluation Study – RALES) and eplerenone in acute myocardial infarcti

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Mild hyponatraemia and short-term outcomes in patients with heart failure in the community

June 2011 Br J Cardiol 2011;18:133–7

Mild hyponatraemia and short-term outcomes in patients with heart failure in the community

Sudip Ghosh, Jude Smith, Jonathan Dexter, Colette Carroll-Hawkins, Noel O’Kelly

Abstract

Introduction Hyponatraemia is a common electrolyte disorder among patients with heart failure (HF), nephrotic syndrome or cirrhosis.1-3 It is recognised as a predictor of adverse outcomes in hospitalised patients with these conditions,4-5 and its prognostic implications are commonly attributed to the severity of the underlying pathology. Patients admitted to hospital with decompensated heart failure have a poor prognosis, with in-hospital mortality rates approaching 10%.5-7 Hyponatraemia associated with decompensation results in added adverse outcomes resulting in high 30–90-day mortality and re-hospitalisation rates.5-9 These results have

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News from the American Heart Association Scientific Sessions 2010

February 2011 Br J Cardiol 2011;18:11-3

News from the American Heart Association Scientific Sessions 2010

Abstract

Highlights of the American Heart Association 2010 meeting held in November 2010, in Chicago, USA, included a breakthrough for the treatment of resistant hypertension, and another oral anticoagulant that could be used instead of warfarin in atrial fibrillation patients, without the need for monitoring. RAFT: CRT reduces deaths and hospitalisations in mild heart failure Adding cardiac-resynchronisation therapy (CRT) to implantable cardioverter defibrillator (ICD) and medication, led to a reduction in deaths and heart failure hospitalistions among patients with mild-to-moderate symptoms of heart failure in the RAFT (Resynchronisation-Defibrilla

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Drugs for diabetes: part 3 thiazolidinediones

February 2011 Br J Cardiol 2011;18:24-7

Drugs for diabetes: part 3 thiazolidinediones

David McGrane, Miles Fisher, Gerard A McKay

Abstract

Introduction During the past 10 to 15 years, numerous drugs have been introduced for the treatment of patients with type 2 diabetes to prevent the complications of poor glycaemic control. Two such oral drugs, rosiglitazone and pioglitazone, belong to the class of drugs called thiazolidinediones (TZDs), also known as glitazones. Both were licensed for use as monotherapy or in combination with other hypoglycaemic drugs. Through their actions on peroxisome proliferator-activated receptor (PPARγ), they improve hyperglycaemia and alter dyslipidaemia. It was hoped this would translate into cardiovascular benefits for patients taking them. Recent e

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