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Each year,there are over one million hospitalizations for acute heart failure syndrome(AHFS)in the United States alone, with a similar number in Western Europe.These patients have very high short-term(2-6 months)mortality and readmission rates,while the healthcare system incurs substantial costs,Until recently,the clinical characteristics,management patterns,and outcomes of these patients have been poorly understood and,in consequence,risk stratification for these patients has not been well defined.Several risk prediction models that can accurately identify high-risk patients have been developed in the last year using data from clinical trials,large registries or administrative databases.Use of multi-variable risk models at the time of hospital admission or discharge offers better risk stratification and should be encouraged,as it allows for appropriate allocation of existing resources and development of clinical trials testing new treatment strategies for patients admitted with AHFS.The emerging observation that the prognosis for the ensuing three to six months may be obtained at presentation for AHFS has major implications for development of future therapies. 相似文献
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Metra M Ponikowski P Dickstein K McMurray JJ Gavazzi A Bergh CH Fraser AG Jaarsma T Pitsis A Mohacsi P Böhm M Anker S Dargie H Brutsaert D Komajda M;Heart Failure Association of the European Society of Cardiology 《European journal of heart failure》2007,9(6-7):684-694
Therapy has improved the survival of heart failure (HF) patients. However, many patients progress to advanced chronic HF (ACHF). We propose a practical clinical definition and describe the characteristics of this condition. Patients that are generally recognised as ACHF often exhibit the following characteristics: 1) severe symptoms (NYHA class III to IV); 2) episodes with clinical signs of fluid retention and/or peripheral hypoperfusion; 3) objective evidence of severe cardiac dysfunction, shown by at least one of the following: left ventricular ejection fraction<30%, pseudonormal or restrictive mitral inflow pattern at Doppler-echocardiography; high left and/or right ventricular filling pressures; elevated B-type natriuretic peptides; 4) severe impairment of functional capacity demonstrated by either inability to exercise, a 6-minute walk test distance<300 m or a peak oxygen uptake<12-14 ml/kg/min; 5) history of >1 HF hospitalisation in the past 6 months; 6) presence of all the previous features despite optimal therapy. This definition identifies a group of patients with compromised quality of life, poor prognosis, and a high risk of clinical events. These patients deserve effective therapeutic options and should be potential targets for future clinical research initiatives. 相似文献
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Petar M. Seferovi Stefan Stoerk Gerasimos Filippatos Viacheslav Mareev Ausra Kavoliuniene Arsen D. Risti Piotr Ponikowski John McMurray Aldo Maggioni Frank Ruschitzka Dirk J. van Veldhuisen Andrew Coats Massimo Piepoli Theresa McDonagh Jillian Riley Arno Hoes Burkert Pieske Milan Dobri Zoltan Papp Alexandre Mebazaa John Parissis Tuvia Ben Gal Dragos Vinereanu Dulce Brito Johann Altenberger Plamen Gatzov Ivan Milinkovi Jaromír Hradec Jean‐Noel Trochu Offer Amir Brenda Moura Mitja Lainscak Josep Comin Gerhard Wikstrm Stefan Anker 《European journal of heart failure》2013,15(9):947-959
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Type 2 diabetes mellitus and heart failure: a position statement from the Heart Failure Association of the European Society of Cardiology 下载免费PDF全文
Petar M. Seferović Mark C. Petrie Gerasimos S. Filippatos Stefan D. Anker Giuseppe Rosano Johann Bauersachs Walter J. Paulus Michel Komajda Francesco Cosentino Rudolf A. de Boer Dimitrios Farmakis Wolfram Doehner Ekaterini Lambrinou Yuri Lopatin Massimo F. Piepoli Michael J. Theodorakis Henrik Wiggers John Lekakis Alexandre Mebazaa Mamas A. Mamas Carsten Tschöpe Arno W. Hoes Jelena P. Seferović Jennifer Logue Theresa McDonagh Jillian P. Riley Ivan Milinković Marija Polovina Dirk J. van Veldhuisen Mitja Lainscak Aldo P. Maggioni Frank Ruschitzka John J.V. McMurray 《European journal of heart failure》2018,20(5):853-872
The coexistence of type 2 diabetes mellitus (T2DM) and heart failure (HF), either with reduced (HFrEF) or preserved ejection fraction (HFpEF), is frequent (30–40% of patients) and associated with a higher risk of HF hospitalization, all‐cause and cardiovascular (CV) mortality. The most important causes of HF in T2DM are coronary artery disease, arterial hypertension and a direct detrimental effect of T2DM on the myocardium. T2DM is often unrecognized in HF patients, and vice versa, which emphasizes the importance of an active search for both disorders in the clinical practice. There are no specific limitations to HF treatment in T2DM. Subanalyses of trials addressing HF treatment in the general population have shown that all HF therapies are similarly effective regardless of T2DM. Concerning T2DM treatment in HF patients, most guidelines currently recommend metformin as the first‐line choice. Sulphonylureas and insulin have been the traditional second‐ and third‐line therapies although their safety in HF is equivocal. Neither glucagon‐like preptide‐1 (GLP‐1) receptor agonists, nor dipeptidyl peptidase‐4 (DPP4) inhibitors reduce the risk for HF hospitalization. Indeed, a DPP4 inhibitor, saxagliptin, has been associated with a higher risk of HF hospitalization. Thiazolidinediones (pioglitazone and rosiglitazone) are contraindicated in patients with (or at risk of) HF. In recent trials, sodium–glucose co‐transporter‐2 (SGLT2) inhibitors, empagliflozin and canagliflozin, have both shown a significant reduction in HF hospitalization in patients with established CV disease or at risk of CV disease. Several ongoing trials should provide an insight into the effectiveness of SGLT2 inhibitors in patients with HFrEF and HFpEF in the absence of T2DM. 相似文献
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Luis M. Pérez-Belmonte MD PhD Jaime Sanz-Cánovas MD Mercedes Millán-Gómez MD PhD Julio Osuna-Sánchez MD Almudena López-Sampalo MD Michele Ricci MD Manuel Jiménez-Navarro MD PhD Maria D. López-Carmona MD PhD María Rosa Bernal-López PhD Miguel A. Barbancho MD PhD José P. Lara MD PhD Ricardo Gómez-Huelgas MD PhD 《Journal of the American Geriatrics Society》2022,70(3):862-871
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The increasing number of patients with heart failure HF and comorbidities is due to aging population and increase of life expectancy of patients with cardiovascular disease. Encouraging results derived by recent trials may suggest some comorbidities as new targets for new drugs, highlighting the need for a better understanding of the comorbidities’ effects in HF patients and the need of a multidisciplinary approach for the management of chronic HF with comorbidities. We report a brief review about main cardiovascular and non-cardiovascular comorbidities in HF patients in order to update physicians and researchers engaged in the HF research or in “fight against heart failure.” 相似文献
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Finn Gustafsson Kevin Damman Sanem Nalbantgil Linda W. Van Laake Laurens F. Tops Thomas Thum Stamatis Adamopoulos Michael Bonios Andrew JS Coats Maria G. Crespo-Leiro Mandeep R. Mehra Gerasimos Filippatos Loreena Hill Marco Metra Ewa Jankowska Nicolaas de Jonge David Kaye Marco Masetti John Parissis Davor Milicic Petar Seferovic Giuseppe Rosano Tuvia Ben Gal 《European journal of heart failure》2023,25(4):457-468
This clinical consensus statement reviews the use of inotropic support in patients with advanced heart failure. The current guidelines only support use of inotropes in the setting of acute decompensated heart failure with evidence of organ malperfusion or shock. However, inotropic support may be reasonable in other patients with advanced heart failure without acute severe decompensation. The clinical evidence supporting use of inotropes in these situations is reviewed. Particularly, patients with persistent congestion, systemic hypoperfusion, or advanced heart failure with need for palliation, and specific situations relevant to implantation of left ventricular assist devices or heart transplantation are discussed. Traditional and novel drugs with inotropic effects are discussed and use of guideline-directed therapy during inotropic support is reviewed. Finally, home inotropic therapy is described, and palliative care and end-of-life aspects are reviewed in relation to management of ongoing inotropic support (including guidance for maintenance and weaning of chronic inotropic therapy support). 相似文献
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Clinical phenotypes and outcome of patients hospitalized for acute heart failure: the ESC Heart Failure Long‐Term Registry 下载免费PDF全文
Ovidiu Chioncel Alexandre Mebazaa Veli‐Pekka Harjola Andrew J. Coats Massimo Francesco Piepoli Maria G. Crespo‐Leiro Cecile Laroche Petar M. Seferovic Stefan D. Anker Roberto Ferrari Frank Ruschitzka Silvia Lopez‐Fernandez Daniela Miani Gerasimos Filippatos Aldo P. Maggioni 《European journal of heart failure》2017,19(10):1242-1254
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Mihai Gheorghiade Ferenc Follath Piotr Ponikowski Jeffrey H. Barsuk John E.A. Blair John G. Cleland Kenneth Dickstein Mark H. Drazner Gregg C. Fonarow Tiny Jaarsma Guillaume Jondeau Jose Lopez Sendon Alexander Mebazaa Marco Metra Markku Nieminen Peter S. Pang Petar Seferovic Lynne W. Stevenson Dirk J. van Veldhuisen Faiez Zannad Stefan D. Anker Andrew Rhodes John J.V. McMurray Gerasimos Filippatos 《European journal of heart failure》2010,12(5):423-433
Patients with acute heart failure (AHF) require urgent in‐hospital treatment for relief of symptoms. The main reason for hospitalization is congestion, rather than low cardiac output. Although congestion is associated with a poor prognosis, many patients are discharged with persistent signs and symptoms of congestion and/or a high left ventricular filling pressure. Available data suggest that a pre‐discharge clinical assessment of congestion is often not performed, and even when it is performed, it is not done systematically because no method to assess congestion prior to discharge has been validated. Grading congestion would be helpful for initiating and following response to therapy. We have reviewed a variety of strategies to assess congestion which should be considered in the care of patients admitted with HF. We propose a combination of available measurements of congestion. Key elements in the measurement of congestion include bedside assessment, laboratory analysis, and dynamic manoeuvres. These strategies expand by suggesting a routine assessment of congestion and a pre‐discharge scoring system. A point system is used to quantify the degree of congestion. This score offers a new instrument to direct both current and investigational therapies designed to optimize volume status during and after hospitalization. In conclusion, this document reviews the available methods of evaluating congestion, provides suggestions on how to properly perform these measurements, and proposes a method to quantify the amount of congestion present. 相似文献
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Tiny Jaarsma James M. Beattie Mary Ryder Frans H. Rutten Theresa McDonagh Paul Mohacsi Scott A. Murray Thomas Grodzicki Ingrid Bergh Marco Metra Inger Ekman Christiane Angermann Marcia Leventhal Antonis Pitsis Stefan D. Anker Antonello Gavazzi Piotr Ponikowski Kenneth Dickstein Etienne Delacretaz Lynda Blue Florian Strasser John McMurray 《European journal of heart failure》2009,11(5):433-443
Heart failure is a serious condition and equivalent to malignant disease in terms of symptom burden and mortality. At this moment only a comparatively small number of heart failure patients receive specialist palliative care. Heart failure patients may have generic palliative care needs, such as refractory multifaceted symptoms, communication and decision making issues and the requirement for family support. The Advanced Heart Failure Study Group of the Heart Failure Association of the European Society of Cardiology organized a workshop to address the issue of palliative care in heart failure to increase awareness of the need for palliative care. Additional objectives included improving the accessibility and quality of palliative care for heart failure patients and promoting the development of heart failure‐orientated palliative care services across Europe. This document represents a synthesis of the presentations and discussion during the workshop and describes recommendations in the area of delivery of quality care to patients and families, education, treatment coordination, research and policy. 相似文献
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Wilfried Mullens Kevin Damman Veli‐Pekka Harjola Alexandre Mebazaa Hans‐Peter Brunner‐La Rocca Pieter Martens Jeffrey M. Testani W.H. Wilson Tang Francesco Orso Patrick Rossignol Marco Metra Gerasimos Filippatos Petar M. Seferovic Frank Ruschitzka Andrew J. Coats 《European journal of heart failure》2019,21(2):137-155
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Thackray S Coletta A Jones P Dunn A Clark AL Cleland JG 《European journal of heart failure》2001,3(4):491-494
This article continues a series of reports summarising recent research developments pertinent to the topic of heart failure. This is a summary of presentations made at Scientific Sessions of Heart Failure 2001, a meeting of the Working Group on Heart Failure of the European Society of Cardiology. Clinical studies of particular interest to people caring for patients with heart failure include CONTAK-CD, CHRISTMAS and further updates on OPTIME-CHF. A brief review of the current status of cardiac resynchronisation therapy is included. 相似文献
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Cristiana Vitale Ewa Jankowska Loreena Hill Massimo Piepoli Wolfram Doehner Stefan D. Anker Mitja Lainscak Tiny Jaarsma Piotr Ponikowski Giuseppe M.C. Rosano Petar Seferovic Andrew J. Coats 《European journal of heart failure》2019,21(11):1299-1305
Heart failure (HF) and frailty are two distinct yet commonly associated conditions. The interplay between the two conditions is complex, due to overlaps in underlying mechanisms, symptoms and prognosis. The assessment of frailty in patients with HF is crucial, as it is associated with both unfavourable outcomes and reduced access and tolerance to treatments. However, to date a consensus definition of frailty in patients with HF remains lacking and the need for a validated assessment score, for identifying those HF patients with frailty, is high and timely. This position paper proposes a new definition of frailty for use by healthcare professionals in the setting of HF and creates a foundation for the design of a tailored and validated score for this common condition. 相似文献
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Long‐term safety of intravenous cardiovascular agents in acute heart failure: results from the European Society of Cardiology Heart Failure Long‐Term Registry 下载免费PDF全文
Alexandre Mebazaa Justina Motiejunaite Etienne Gayat Maria G. Crespo‐Leiro Lars H. Lund Aldo P. Maggioni Ovidiu Chioncel Eiichi Akiyama Veli‐Pekka Harjola Petar Seferovic Cecile Laroche Marisa Sanz Julve Eulalia Roig Frank Ruschitzka Gerasimos Filippatos 《European journal of heart failure》2018,20(2):332-341
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Marco Metra Marianna Adamo Daniela Tomasoni Alexandre Mebazaa Antoni Bayes-Genis Magdy Abdelhamid Stamatis Adamopoulos Stefan D. Anker Johann Bauersachs Yuri Belenkov Michael Böhm Tuvia Ben Gal Javed Butler Alain Cohen-Solal Gerasimos Filippatos Finn Gustafsson Loreena Hill Tiny Jaarsma Ewa A. Jankowska Mitja Lainscak Yuri Lopatin Lars H. Lund Theresa McDonagh Davor Milicic Brenda Moura Wilfried Mullens Massimo Piepoli Marija Polovina Piotr Ponikowski Amina Rakisheva Arsen Ristic Gianluigi Savarese Petar Seferovic Rajan Sharma Thomas Thum Carlo G. Tocchetti Sophie Van Linthout Cristiana Vitale Stephan Von Haehling Maurizio Volterrani Andrew J.S. Coats Ovidiu Chioncel Giuseppe Rosano 《European journal of heart failure》2023,25(7):1115-1131
Acute heart failure is a major cause of urgent hospitalizations. These are followed by marked increases in death and rehospitalization rates, which then decline exponentially though they remain higher than in patients without a recent hospitalization. Therefore, optimal management of patients with acute heart failure before discharge and in the early post-discharge phase is critical. First, it may prevent rehospitalizations through the early detection and effective treatment of residual or recurrent congestion, the main manifestation of decompensation. Second, initiation at pre-discharge and titration to target doses in the early post-discharge period, of guideline-directed medical therapy may improve both short- and long-term outcomes. Third, in chronic heart failure, medical treatment is often left unchanged, so the acute heart failure hospitalization presents an opportunity for implementation of therapy. The aim of this scientific statement by the Heart Failure Association of the European Society of Cardiology is to summarize recent findings that have implications for clinical management both in the pre-discharge and the early post-discharge phase after a hospitalization for acute heart failure. 相似文献