Updates in heart failure: what last year brought to us

Dinatolo, Elisabetta; Sciatti, Edoardo; Anker, Markus S.; Lombardi, Carlo; Dasseni, Nicolò; Metra, Marco

doi:10.1002/ehf2.12385

Cited by 10 publications

(11 citation statements)

References 217 publications

(230 reference statements)

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“…Another explanation is that the mortality estimated in this meta-analysis was all-cause mortality, because it included studies that had enrolled patients with various comorbidities (e.g., atrial fibrillation, chronic obstructive pulmonary disease, chronic kidney disease, diabetes) and heart failure may have been just one of the multiple conditions that contributed to mortality. Previous studies have identified that heart failure patients with comorbidities have a poor survival rate [40,41]. In this context, support for managing comorbidities is essential in interventions for improving heart failure patients' self-care abilities.…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of Nurse-Led Heart Failure Self-Care Education on Health Outcomes of Heart Failure Patients: A Systematic Review and Meta-Analysis

Son

Choi

Lee

2020

IJERPH

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Poor self-care behaviors can lead to an increase in the risk of adverse health outcomes among patients with heart failure. Although a number of studies have investigated the effectiveness of nurse-led self-care education, the evidence regarding the effects of nurse-led intervention in heart failure remains uncertain. This study aimed to evaluate evidence on the effectiveness of nurse-led heart failure self-care education on health outcomes in patients with heart failure. To identify studies testing nurse-led education designed to improve self-care among heart failure patients, comprehensive search methods were used between January 2000 and October 2019 to systematically search six electronic databases: PubMed, CINAHL, Embase, Cochrane library, Web of Science, and SCOPUS. All the eligible study data elements were independently assessed and analyzed using random-effects meta-analysis methods. Of 612 studies, eight articles were eligible for this study. Nurse-led heart failure self-care education significantly reduced the risk of all-cause readmission (risk ratio (RR) = 0.75, 95% confidence interval (CI) = 0.66–0.85), heart failure specific readmission (RR = 0.60, 95% CI = 0.42–0.85), and all-cause mortality or readmission (RR = 0.71, 95% CI = 0.61–0.82). However, nurse-led heart failure self-care education was not associated with improvements in the quality of life and heart failure knowledge. Studies on the effectiveness of nurse-led heart failure self-care education mostly report only the positive effects on patients’ health outcomes, whereas evidence of the effectiveness of the nurse-led approach is still limited. Therefore, high quality randomized controlled trials with detailed and explicit descriptions on the components of the interventions are needed.

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Section: Discussionmentioning

confidence: 99%

Effectiveness of Nurse-Led Heart Failure Self-Care Education on Health Outcomes of Heart Failure Patients: A Systematic Review and Meta-Analysis

Son

Choi

Lee

2020

IJERPH

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“…HF treatment has progressed considerably in recent years, leading to a noticeable improvement in prognosis. This is true of pharmacological treatments such as combinations of angiotensin II receptor blockers and neprilysin inhibitors (valsartan/sacubitril) and gliflozins like empagliflozin and dapagliflozin [ 4 , 5 ]. Also effective are some non-pharmacological treatments, particularly the patient taking ownership of the disease, following dietary and lifestyle guidelines, and tackling sedentary behavior through a patient education program and the establishment of a clinical pathway for the follow-up of patients with CHF [ 6 , 7 ].…”

Section: Introductionmentioning

confidence: 99%

Benefit of Ambulatory Management of Patients with Chronic Heart Failure by Protocolized Follow-Up Therapeutic Education and Remote Monitoring Solution: An Original Study in 159 Patients

Jenneve¹,

Lorenzo-Villalba

Courdier³

et al. 2020

JCM

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This study sought to determine whether the implementation of regular and structured follow-up of patients with chronic heart failure (CHF), combined with therapeutic education and remote monitoring solution, leads to better management. This was a single-center retrospective study conducted in a cohort of patients with proven CHF who were followed up in the Mulhouse region (France) between January 2016 and December 2017 by the Unité de Suivi des Patients Insuffisants Cardiaques (USICAR) unit. These patients received regular protocolized follow-up, a therapeutic education program, and several used a telemedicine platform for a two-year period. The primary endpoint was the number of days hospitalized for heart failure (HF) per patient per year. The main secondary endpoints included the number of days hospitalized for a heart condition other than HF and the number of hospital stays for HF per patient. These endpoints were collected during the year preceding enrollment, at one year of follow-up, and at two years of follow-up. The remote monitoring solution was evaluated on the same criterion. Overall, 159 patients with a mean age of 72.9 years were included in this study. They all had CHF, mainly NYHA Class I-II (88.7%), predominantly of ischemic origin (50.9%), and with altered left ventricular ejection fraction in 69.2% of cases. The mean number of days hospitalized for HF per patient per year was 8.33 (6.84–10.13) in the year preceding enrollment, 2.6 (1.51–4.47) at one year of follow-up, and 2.82 at two years of follow-up (1.30–6.11) (p < 0.01 for both comparisons). The mean number of days hospitalized for a heart condition other than HF was 1.73 (1.16–2.6), 1.81 (1.04–3.16), and 1.32 (0.57–3.08), respectively (p = ns). The percentage of hospitalization for HF for each patient was 69.5% (60.2–77.4), 16.2% (10–25.2), and 19.3% (11–31.8), respectively (p < 0.001 for both comparisons). In the group telemedicine, the mean number of days hospitalized for HF per patient per year was 8.33 during the year preceding enrollment, 2.3 during the first year of follow-up, and 1.7 during the second. This difference was significant (p < 0.001). The “number of days hospitalized for a heart condition other than HF” was significantly reduced in the group of patient’s beneficiating from the remote monitoring solution. This study demonstrates the value of a protocolized follow-up associated with a therapeutic optimization, therapeutic education program, and the use of a remote monitoring solution to improve the management of ambulatory patients with CHF, particularly of moderate severity.

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“…Current guidelines also differentiate LVEF in the range of 40-49% (HF with mid-range ejection fraction). 4,5 To date, HF with preserved ejection fraction is the most common manifestation of HF with a median prevalence of 4-7% as compared with 2-6% for HFrEF in patients aged 60 years and older, using echocardiography. 6 Left ventricular diastolic dysfunction without manifest HF is even more frequent in these patients with a median prevalence of 16-53% in comparison with 3-9% for systolic dysfunction.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of left ventricular function in patients with acute ischaemic stroke using cine cardiovascular magnetic resonance imaging

et al. 2020

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Aims Heart failure (HF) is frequent in patients with acute ischaemic stroke (AIS) and associated with higher morbidity and mortality. Assessment of cardiac function in AIS patients using cardiovascular MRI (CMR) may help to detect HF. We report the rate of systolic and diastolic dysfunction in a cohort of patients with AIS using CMR and compare cine real-time (CRT) sequences with the reference of segmented cine steady-state free precession sequences. Methods and results Patients with AIS without known atrial fibrillation were prospectively enrolled in the HEart and BRain Interfaces in Acute Ischemic Stroke (HEBRAS) study (NCT 02142413) and underwent CMR at 3 Tesla within 7 days after AIS. Validity of CRT sequences was determined in 50 patients. A total of 229 patients were included in the analysis (mean age 66 years; 35% women; HF 2%). Evaluation of cardiac function was successful in 172 (75%) patients. Median time from stroke onset to CMR was 82 h (interquartile range 56-111) and 54 h (interquartile range 31-78) from cerebral MRI to CMR. Systolic dysfunction was observed in 43 (25%) and diastolic dysfunction in 102 (59%) patients. Diagnostic yield was similar using CRT or segmented cine imaging (no significant difference in left ventricular ejection fraction, myocardial mass, time to peak filling rate, and peak filling rate ratio E/A). Intraobserver and interobserver agreement was high (κ = 0.78-1.0 for all modalities). Conclusions Cardiovascular MRI at 3 Tesla is an appropriate method for the evaluation of cardiac function in a selected cohort of patients with AIS. Systolic and diastolic dysfunction is frequent in these patients. CRT imaging allows reliable assessment of systolic and diastolic function.

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Updates in heart failure: what last year brought to us

Cited by 10 publications

References 217 publications

Effectiveness of Nurse-Led Heart Failure Self-Care Education on Health Outcomes of Heart Failure Patients: A Systematic Review and Meta-Analysis

Effectiveness of Nurse-Led Heart Failure Self-Care Education on Health Outcomes of Heart Failure Patients: A Systematic Review and Meta-Analysis

Benefit of Ambulatory Management of Patients with Chronic Heart Failure by Protocolized Follow-Up Therapeutic Education and Remote Monitoring Solution: An Original Study in 159 Patients

Evaluation of left ventricular function in patients with acute ischaemic stroke using cine cardiovascular magnetic resonance imaging

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