Advanced Heart Failure Epidemiology and Outcomes: A Population-Based Study

Dunlay, Shannon M.; Roger, Véronique L.; Killian, Jill M.; Weston, Susan A.; Schulte, Phillip J.; Subramaniam, Anna V.; Blecker, Saul; Redfield, Margaret M.

doi:10.1016/s0735-1097(21)01926-4

Cited by 9 publications

(20 citation statements)

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“…Interestingly, analysis of the proportions of emergency hospitalizations showed that it was highest in HFpEF. Similar findings have also been reported in studies on advanced HF [11], but contrary results were observed in elderly subjects with acute HF [12]. The observed discrepancies may have been due to the specificity of the tertiary cardiac center.…”

Section: Discussionsupporting

confidence: 87%

“…Based on the results of biochemical tests, which reflect organ functioning, it can be speculated that abnormalities are due to decreased cardiac output and congestion, as patients with HFrEF had both right and left ventricle involvement. On the other hand, the hemoglobin level was the lowest in HFpEF, as in previous publications [7,9,11]. Leukocyte count, which is a risk factor for a poor prognosis [26], was comparable in patients with all subtypes of HF, as in other reports [9,12].…”

Section: Discussionsupporting

confidence: 81%

“…The level of NT-proBNP is modified by the clinical status of the patients. Therefore, the values reported in this manuscript are between ambulatory and hospitalized patients with advanced HF [7,11,18]. The lowest values in patients with HFmrEF were also documented in the ESC-LT registry, supporting the idea that a significant number of these patients are in the improvement phase and have a better clinical condition [4,5].…”

Section: Discussionsupporting

confidence: 69%

“…According to previous publications, patients with HFrEF were younger and more frequently male compared to HFpEF and HFmrEF, while the opposite was true for HFpEF. This pattern was achieved regardless of the clinical setting from which the patients were included in the study [5,7,[9][10][11]19,21]. It should also be underlined that in general the Polish HF population is younger compared to studies in other countries [14,22].…”

Section: Discussionmentioning

confidence: 75%

“…However, since 2016 the HF phenotyping principles in relation to EF had been established and HF was classified as HFrEF (for EF <40%), with mid-range/mildly reduced ejection fraction HFmrEF, (EF 40-49%) and HFpEF (EF ≥50%) [3]. The individual specificity of patients with HF from these subtypes is characterized by a different distribution of comorbidities, demographic characteristics, and potentially a different prognosis [5][6][7][8][9][10][11][12]. Most studies based on Polish HF patients did not distinguish the subtypes of HF [2,[13][14][15][16].…”

Section: Introductionmentioning

confidence: 99%

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Epidemiology and clinical characteristics of hospitalized heart failure patients with a reduced, mildly reduced and preserved ejection fraction

Rywik¹,

Doryńska²,

Wiśniewska³

et al. 2022

Polish Archives of Internal Medicine

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The definition of heart failure (HF) phenotypes is relatively new. There is scarce evidence on the true characteristics of patients with HF in the Polish population, which are classified into three categories. The presented study provides a broad characterization of the relevant phenotypes of patients hospitalized for HF. Furthermore, the information retrieved from the electronic database was validated for the diagnosis of HF, which makes a significant difference compared to studies based on the electronic registry. Furthermore, we identified predictors for each HF subtype. Conclusions: To our knowledge, this is the first publication on different subtypes of HF with a confirmed diagnosis, providing a broad description of hospitalized patients with HF of the Polish population.

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Section: Discussionsupporting

confidence: 87%

Section: Discussionsupporting

confidence: 81%

Section: Discussionsupporting

confidence: 69%

Section: Discussionmentioning

confidence: 75%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Epidemiology and clinical characteristics of hospitalized heart failure patients with a reduced, mildly reduced and preserved ejection fraction

Rywik¹,

Doryńska²,

Wiśniewska³

et al. 2022

Polish Archives of Internal Medicine

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Advanced heart failure: guideline‐directed medical therapy, diuretics, inotropes, and palliative care

et al. 2022

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Heart failure (HF) is a major cause of mortality, hospitalizations, and reduced quality of life and a major burden for the healthcare system. The number of patients that progress to an advanced stage of HF is growing. Only a limited proportion of these patients can undergo heart transplantation or mechanical circulatory support. The purpose of this review is to summarize medical management of patients with advanced HF. First, evidence‐based oral treatment must be implemented although it is often not tolerated. New therapeutic options may soon become possible for these patients. The second goal is to lessen the symptomatic burden through both decongestion and haemodynamic improvement. Some new treatments acting on cardiac function may fulfil both these needs. Inotropic agents acting through an increase in intracellular calcium have often increased risk of death. However, in the recent Global Approach to Lowering Adverse Cardiac Outcomes Through Improving Contractility in Heart Failure (GALACTIC‐HF) trial, omecamtiv mecarbil was safe and effective in the reduction of the primary outcome of cardiovascular death or HF event compared with placebo (hazard ratio, 0.92; 95% confidence interval, 0.86–0.99; P = 0.03) and its effects were larger in those patients with more severe left ventricular dysfunction. Patients with severe HF who received omecamtiv mecarbil experienced a significant treatment benefit, whereas patients without severe HF did not (P = 0.005 for interaction). Lastly, clinicians should take care of the end of life with an appropriate multidisciplinary approach. Medical treatment of advanced HF therefore remains a major challenge and a wide open area for further research.

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