Interventional heart failure therapy: A new concept fighting against heart failure

Saku, Keita; Yokota, Shohei; Nishikawa, Takuya; Kinugawa, Koichiro

doi:10.1016/j.jjcc.2021.11.018

Cited by 23 publications

(11 citation statements)

References 90 publications

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“…Appropriate and timely treatment of VHD may present an opportunity for long-term benefits to patient care, as it has the potential to reduce the number of patients who progress to heart failure and thereby strategically manage healthcare spending. 40 Patients with severe VHD may be candidates for invasive treatment, 41 though VHD treatment decisions depend on the type, severity, symptoms, and surgical risk of patients. 19 The optimal timing of treatment depends on safety, efficacy, and long-term durability of available treatment options 41 and can be informed by recent advances in echocardiographic techniques that include early detection of left ventricular and left atrial dysfunction.…”

Section: Discussionmentioning

confidence: 99%

In-Hospital Outcomes of Heart Failure Patients with Valvular Heart Disease: Insights from Real-World Claims Data

Izumi¹,

Matsuyama²,

Yamabe³

et al. 2023

CEOR

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Purpose Heart failure (HF) is a serious public health burden that is rapidly increasing in the aging population. Valvular heart disease (VHD) is a known etiology of heart failure (HF); however, the impact of VHD on outcomes of patients with HF has not been well-studied in Japan. This study aimed to determine the rates of VHD in Japanese patients admitted for HF and explore associations of VHD with in-hospital outcomes through a claim-based analysis. Patients and methods We analyzed claims data from 86,763 HF hospitalizations (January 2017 through December 2019) from the Medical Data Vision database. Common etiologies of HF were examined, then hospitalizations were categorized into those with VHD and those without. Covariate-adjusted models were used to explore the association of VHD with in-hospital mortality, length of stay, and medical cost. Results Of 86,763 hospitalizations for HF, 13,183 had VHD and 73,580 did not. VHD was the second most frequent etiology of HF (15.2%). The most frequent type of VHD was mitral regurgitation (36.4% of all hospitalizations with VHD), followed by aortic stenosis (33.7%) and aortic regurgitation (16.4%). There was no significant difference in in-hospital mortality between hospitalizations with VHD vs those without (9.0% vs 8.9%; odds ratio [95% CI]: 1.01 [0.95–1.08]; p=0.723). Hospitalizations with VHD were associated with significantly longer length of stay (26.1 vs 24.8 days; incident rate ratio [95% CI]: 1.05 [1.03–1.07]; p<0.001) and higher medical costs (1536 vs 1195 thousand yen; rate ratio [95% CI]: 1.29 [1.25–1.32]; p<0.001). Conclusion VHD was a frequent etiology of HF that was associated with significant medical resource use. Future studies are needed to investigate whether timely VHD treatment could reduce HF progression and its associated healthcare resource utilization.

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Section: Discussionmentioning

confidence: 99%

In-Hospital Outcomes of Heart Failure Patients with Valvular Heart Disease: Insights from Real-World Claims Data

Izumi¹,

Matsuyama²,

Yamabe³

et al. 2023

CEOR

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“…Heart failure is a progressive clinical syndrome associated with impaired physical function and high morbidity and mortality. 1,2 The average age of patients with heart failure has been increasing partially because of the aging society. 3 Sarcopenia is a complex syndrome characterized by a progressive and generalized loss of skeletal muscle mass and function with advancing age.…”

Section: Introductionmentioning

confidence: 99%

“…Heart failure is a progressive clinical syndrome associated with impaired physical function and high morbidity and mortality 1,2 . The average age of patients with heart failure has been increasing partially because of the aging society 3 .…”

Section: Introductionmentioning

confidence: 99%

Predictive value of the Ishii score for sarcopenia and the prognosis of older patients hospitalized with heart failure

Maeda,

Matsue,

Kagiyama

et al. 2023

Geriatrics Gerontology Int

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AimsAlthough sarcopenia is common and associated with poor outcomes in patients with heart failure, its simple screening methods remain unclear. We aimed to investigate the predictive value of the Ishii score, which includes age, grip strength, and calf circumference, for sarcopenia and its prognostic predictability in patients with heart failure.MethodsThis was a subanalysis of the FRAGILE‐HF study. Receiver operating characteristic curves were used to evaluate the predictive value for sarcopenia. Patients were stratified into the high and low Ishii score groups based on the cutoff values of the Ishii score determined by the Youden index for sarcopenia, and the 1‐year mortality rates were compared.ResultsOf the 1262 study participants, 936 were evaluated with sarcopenia, and 184 (55 women, 129 men) were diagnosed with sarcopenia. The areas under the receiver operating characteristic curves for sarcopenia were 0.73 and 0.87 for women and men, respectively. The optimal cutoff values for predicting sarcopenia were 165 and 141 for women and men, respectively. Using these cutoff values, the sensitivity and specificity for sarcopenia were 70.9% and 68.5% for women and 88.4% and 69.7% for men, respectively. At 1 year, 151 (low Ishii score group, 98; high Ishii score group, 53) deaths were observed. Adjusted Cox proportional hazards analysis showed that the high Ishii score group was significantly associated with 1‐year mortality.ConclusionAmong older patients hospitalized for heart failure, the Ishii score is useful for predicting sarcopenia and 1‐year mortality. Geriatr Gerontol Int 2023; ••: ••–••.

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“…However, the impact of hypochloremia lasting for a longer duration is not clear. Because of a growing and aging population, the total number of heart failure patients still continues to rise [ 17 , 18 , 19 ]. In addition, each re-hospitalization sometimes requires intensive care, which is problematic due to the enormous medical costs involved [ 20 ].…”

Section: Introductionmentioning

confidence: 99%

Persistent Hypochloremia Is Associated with Adverse Prognosis in Patients Repeatedly Hospitalized for Heart Failure

Nozaki

Yoshihisa

Sato

et al. 2023

JCM

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Background: Hypochloremia reflects neuro-hormonal activation in patients with heart failure (HF). However, the prognostic impact of persistent hypochloremia in those patients remains unclear. Methods: We collected the data of patients who were hospitalized for HF at least twice between 2010 and 2021 (n = 348). Dialysis patients (n = 26) were excluded. The patients were divided into four groups based on the absence/presence of hypochloremia (<98 mmol/L) at discharge from their first and second hospitalizations: Group A (patients without hypochloremia at their first and second hospitalizations, n = 243); Group B (those with hypochloremia at their first hospitalization and without hypochloremia at their second hospitalization, n = 29); Group C (those without hypochloremia at their first hospitalization and with hypochloremia at their second hospitalization, n = 34); and Group D (those with hypochloremia at their first and second hospitalizations, n = 16). Results: a Kaplan–Meier analysis revealed that all-cause mortality and cardiac mortality were the highest in Group D compared to the other groups. A multivariable Cox proportional hazard analysis revealed that persistent hypochloremia was independently associated with both all-cause death (hazard ratio 3.490, p < 0.001) and cardiac death (hazard ratio 3.919, p < 0.001). Conclusions: In patients with HF, prolonged hypochloremia over two hospitalizations is associated with an adverse prognosis.

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Interventional heart failure therapy: A new concept fighting against heart failure

Cited by 23 publications

References 90 publications

In-Hospital Outcomes of Heart Failure Patients with Valvular Heart Disease: Insights from Real-World Claims Data

In-Hospital Outcomes of Heart Failure Patients with Valvular Heart Disease: Insights from Real-World Claims Data

Predictive value of the Ishii score for sarcopenia and the prognosis of older patients hospitalized with heart failure

Persistent Hypochloremia Is Associated with Adverse Prognosis in Patients Repeatedly Hospitalized for Heart Failure

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