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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Comparative Study
Physician volume, specialty, and outcomes of care for patients with heart failure.
There is an urgent need to improve outcomes and reduce costs for patients with heart failure (HF). Physician volume is associated with better outcomes for patients undergoing procedures, but its association with outcomes for medically managed diseases, such as HF, is not well understood. ⋯ Physician volume is associated with lower mortality for HF, particularly in low-volume institutions and among noncardiologist physicians. Our findings suggest that clinician expertise may play an important role in HF care.
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Comparative Study
Brain natriuretic peptide and cardiac resynchronization therapy in patients with mildly symptomatic heart failure.
There are limited data on the prognostic implications of brain natriuretic peptide (BNP) assessment in patients with mildly symptomatic heart failure (HF) who receive cardiac resynchronization therapy with a defibrillator (CRT-D). ⋯ Our findings suggest that assessment of baseline and follow-up BNP provides important prognostic implications in patients with mildly symptomatic HF who receive CRT.