HFSA 2006 Comprehensive Heart Failure Practice Guideline: Introduction and Table of Contents

Adams, Kirkwood F.; Lindenfeld, Jo Ann; Arnold, J. Malcolm O.; Baker, David W.; Barnard, Denise H.; Baughman, Kenneth L.; Boehmer, John; Deedwania, Prakash; Dunbar, Sandra B.; Elkayam, Uri; Gheorghiade, Mihai; Howlett, Jonathan G.; Konstam, Marvin A.; Kronenberg, Marvin W.; Massie, Barry M.; Mehra, Mandeep R.; Miller, Alan B.; Moser, Debra K.; Patterson, J. Herbert; Rodeheffer, Richard J.; Sackner‐Bernstein, Jonathan; Silver, Marc A.; Starling, Randall C.; Stevenson, Lynne Warner; Wagoner, Lynne E.

doi:10.1016/j.cardfail.2005.11.005

Cited by 271 publications

(16 citation statements)

References 77 publications

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“…(27;28) Women were more likely to be on an ARB than the men and more likely to be on an aldosterone receptor antagonist. This difference may be related to the higher prevalence of ACEI cough in women.…”

Section: Discussionmentioning

confidence: 99%

Baseline differences in the HF-ACTION trial by sex

Piña

Kokkinos

Kao

et al. 2009

American Heart Journal

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In patients with heart failure (HF), assessment of functional capacity plays an important prognostic role. Both 6 min walk and cardiopulmonary exercise testing (CPX) have been used to determine physical function and to determine prognosis and even listing for transplantation. However, as in HF trials, the number of women reported has been small and the cutoffs for transplantation have been representative of male populations and extrapolated to women. It is also well known that peak VO2 as a determinant of fitness is inherently lower in women than in men and potentially much lower in the presence of HF. Values for a female population from which to draw for this important determination are lacking. The HF-ACTION trial randomized 2331 patients (28% women) with NYHA Class II–IV HF due to systolic dysfunction to either a formal exercise program in addition to optimal medical therapy or to optimal medical therapy alone without any formal exercise training. In order to characterize differences between men and women in the interpretation of final CPX models, the interaction of individual covariates with sex was investigated in the models of (1) VE/VCO2, (2) VO2 at VT, (3) distance on the 6 minute walk, and (4) peak VO2. The women were younger than the men and more likely to have a non-ischemic etiology and a higher EF. Dose of ACEI was lower in the women, on average. The lower ACEI dose may reflect the higher use of ARBs in women. Both the peak VO2 and the 6 min walk distance were significantly lower in the women than in the men. Perhaps the most significant finding in this dataset of baseline characteristics is that the peak VO2 for women was significantly lower than the men with similar ventricular function and health status. Therefore, in a well-medicated, stable, Class II–IV HF cohort of patients who are able to exercise, women have statistically significantly lower peak VO2 and 6 min walk distance than men with similar health status and ventricular function. These data should prompt careful thought when considering prognostic markers for women and listing for cardiac transplant.

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Section: Discussionmentioning

confidence: 99%

Baseline differences in the HF-ACTION trial by sex

Piña

Kokkinos

Kao

et al. 2009

American Heart Journal

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“…3,19 Thus decision-making about the timing of discharge in patients admitted with AHF relies on subjective criteria that vary widely among physicians.…”

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confidence: 99%

Improvements in Signs and Symptoms During Hospitalization for Acute Heart Failure Follow Different Patterns and Depend on the Measurement Scales Used: An International, Prospective Registry to Evaluate the Evolution of Measures of Disease Severity in Acute Heart Failure (MEASURE-AHF)

Allen

Metra

Milo-Cotter

et al. 2008

Journal of Cardiac Failure

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Background The natural evolution of signs and symptoms during acute heart failure (AHF) is poorly characterized. Methods and Results We followed a prospective international cohort of 182 patients hospitalized with AHF. Patient-reported dyspnea and general well-being (GWB) were measured daily using 7-tier Likert (–3 to +3) and visual analog scales (VAS, 0–100). Physician assessments were also recorded daily. Mean age was 69 years and 68% had ejection fraction <40%. Likert measures of dyspnea initially improved rapidly (day 1, 0.22; day 2, 1.31; P <.001) with no significant improvement thereafter (day 7, 1.51; day 2 versus 7 P = .16). In contrast, VAS measure of dyspnea improved throughout hospitalization (day 1, 50.1; day 2, 64.7; day 7, 83.2; day 1 versus 2 P < .001, day 2 versus 7 P < .001). Symptoms of dyspnea and GWB tracked closely (correlation r = .813, P < .001). Physical signs resolved more completely than did symptoms (eg, from day 1 to discharge/day 7, absence of edema increased from 33% to 72% of patients, whereas significant improvements in dyspnea increased from 27% to 52% of patients; P < .001). Conclusions Changes in patient-reported symptoms and physician-assessed signs followed different patterns during an AHF episode and are influenced by the measurement scales used. Multiple clinical measures should be considered in discharge decisions and evaluation of AHF therapies.

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“…Hydralazine and nitrates continue to have a time-honored place in heart failure management, especially in those intolerant of ACE-inhibitors or ARBs or persistent renal compromise 39. Loop diuretic therapy has a central role for symptomatic relief but has not been shown to confer a survival benefit 1–3. Despite being available since the 18 th century, digitalis glycosides such as digoxin reduce hospitalizations for heart failure and provide modest symptomatic relief, but they do not prolonged survival 4041…”

Section: Medical Therapies For Advanced Heart Failurementioning

confidence: 99%

Management of end-stage heart failure: a perspective on the Arab Gulf states

Habeeb

Stewart

Mudge

2009

Annals of Saudi Medicine

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The ever expanding epidemic of end-stage heart failure represents one of the greatest challenges of modern cardiovascular medicine. With medical treatments hampered by significant limitations, physicians caring for patients with advanced heart disease have turned to cardiac transplantation and durable mechanical circulatory assist devices as definitive therapies. These advanced therapeutic modalities are not widely available outside the United States and Europe, but nevertheless offer enormous potential for patients in the Arab Gulf suffering from end-stage heart failure. This review will discuss the management of end-stage heart failure in the Gulf States, with an emphasis on therapies best utilized within a framework of regional cooperation and coordination.

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HFSA 2006 Comprehensive Heart Failure Practice Guideline: Introduction and Table of Contents

Cited by 271 publications

References 77 publications

Baseline differences in the HF-ACTION trial by sex

Baseline differences in the HF-ACTION trial by sex

Improvements in Signs and Symptoms During Hospitalization for Acute Heart Failure Follow Different Patterns and Depend on the Measurement Scales Used: An International, Prospective Registry to Evaluate the Evolution of Measures of Disease Severity in Acute Heart Failure (MEASURE-AHF)

Management of end-stage heart failure: a perspective on the Arab Gulf states

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