Circulation. Heart failure
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Randomized Controlled Trial Comparative Study
Low-sodium DASH diet improves diastolic function and ventricular-arterial coupling in hypertensive heart failure with preserved ejection fraction.
Heart failure with preserved ejection fraction (HFPEF) involves failure of cardiovascular reserve in multiple domains. In HFPEF animal models, dietary sodium restriction improves ventricular and vascular stiffness and function. We hypothesized that the sodium-restricted dietary approaches to stop hypertension diet (DASH/SRD) would improve left ventricular diastolic function, arterial elastance, and ventricular-arterial coupling in hypertensive HFPEF. ⋯ URL: http://www.clinicaltrials.gov. Unique identifier: NCT00939640.
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Randomized Controlled Trial Comparative Study
Soluble concentrations of the interleukin receptor family member ST2 and β-blocker therapy in chronic heart failure.
Concentrations of soluble (s)ST2 predict prognosis in heart failure. We recently found changing doses of β-blocker (BB) may affect sST2 concentrations. It remains unclear whether sST2 concentrations identify benefit of BB therapy, however. ⋯ URL: http://www.clinicaltrials.gov. Unique identifier: NCT00351390.
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Heart failure is a common Emergency Department (ED) presentation but whether ED volume influences patient outcomes is unknown. ⋯ Low-volume EDs were more likely to discharge patients with heart failure home, but low-volume ED cases exhibited worse outcomes (driven largely by readmissions or repeat ED visits). Interventions to improve management of acute heart failure are required at low-volume sites.
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Contemporary therapeutic options have led to substantial improvement in survival of patients with heart failure. However, limited evidence is available specifically on idiopathic dilated cardiomyopathy. We thus examined changes in prognosis of a large idiopathic dilated cardiomyopathy cohort systematically followed during the past 30 years. ⋯ Evidence-based treatment has led to dramatic improvement in the prognosis of idiopathic dilated cardiomyopathy during the past 3 decades. The benefits of controlled randomized trials can be replicated in the real world, emphasizing the importance of tailored follow-up and long-term continuity of care.
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Review
Risk prediction models for mortality in ambulatory patients with heart failure: a systematic review.
Optimal management of heart failure requires accurate assessment of prognosis. Many prognostic models are available. Our objective was to identify studies that evaluate the use of risk prediction models for mortality in ambulatory patients with heart failure and describe their performance and clinical applicability. ⋯ Externally validated heart failure models showed inconsistent performance. The Heart Failure Survival Score and Seattle Heart Failure Model demonstrated modest discrimination and questionable calibration. A new model derived from contemporary patient cohorts may be required for improved prognostic performance.