Tag Archives: heart failure

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

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

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

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

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

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

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

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

The new guideline, which covers the management of heart failure in adults in primary and secondary care, contains new and updated recommendations on diagnosis, pharmacological treatment, monitoring and rehabilitation. Key priorities for implementation in the guidance include: Referring patients with suspected heart failure and previous myocardial infarction (MI) to transthoracic Doppler 2D echocardiography and specialist assessment within two weeks. Measuring serum natriuretic peptides in patients with suspected heart failure without previous MI; referring those with very high levels of serum natriuretic peptides to urgent transthoracic Dopp

Highlights of this year’s European Society of Cardiology Congress, held in Stockholm, Sweden, from August 28th to September 1st included a new drug which benefits heart failure by slowing heart rate, and more exciting results from oral compounds that could replace warfarin in various indications. Highlights of this year’s European Society of Cardiology Congress, held in Stockholm, Sweden, from August 28th to September 1st included a new drug which benefits heart failure by slowing heart rate, and more exciting results from oral compounds that could replace warfarin in various indications. SHIFT: ivabradine shows benefit in heart failure