European journal of heart failure
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Eur. J. Heart Fail. · Jun 2012
The PROTECT in-hospital risk model: 7-day outcome in patients hospitalized with acute heart failure and renal dysfunction.
In patients with acute heart failure (AHF), early worsening heart failure (WHF) predicts a significant proportion of post-discharge readmissions and mortality. We aimed to identify the predictors of 7-day heart failure events or death in patients hospitalized with AHF. ⋯ Using the PROTECT 7-day risk model and score, the main determinants of an adverse outcome for AHF patients included impaired metabolic status, neurohormonal activation, and reduced cardiac performance, gauged by BUN, serum albumin and cholesterol levels, systolic blood pressure, heart rate, and respiratory rate.
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Eur. J. Heart Fail. · Jun 2012
Randomized Controlled TrialLong-term mortality with cardiac resynchronization therapy in the Cardiac Resynchronization-Heart Failure (CARE-HF) trial.
The Cardiac Resynchronization-Heart Failure (CARE-HF) study helped establish an important role for cardiac resynchronization therapy (CRT) in the management of selected patients with heart failure. We now report the long-term outcome during and subsequent to the randomized trial. ⋯ The effect of CRT on mortality observed during the randomized CARE-HF trial persisted during long-term follow-up. A high rate of CRT device implantation in the control group after completion of the randomized phase of the study may have prevented further divergence of the survival curves.
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Eur. J. Heart Fail. · Jun 2012
Lack of significant renal tubular injury despite acute kidney injury in acute decompensated heart failure.
Acute kidney injury (AKI) is a strong predictor of adverse events with an incompletely understood pathophysiology. Neutrophil gelatinase-associated lipocalin (NGAL) is proposed as an early marker of renal tubular injury. Our aim is to determine whether AKI during treatment of acute decompensated heart failure (ADHF) is accompanied by renal tubular injury. ⋯ In patients with ADHF who develop AKI following diuretic therapy, a minor rise in uNGAL precedes AKI. However, the degree of renal tubular insult was much lower than that observed in other forms of AKI.
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Eur. J. Heart Fail. · Jun 2012
Impact of heart failure and changes to volume status on liver stiffness: non-invasive assessment using transient elastography.
The impact of cardiac dysfunction on the liver is known as cardiac hepatopathy. In certain instances this can result in significant hepatic fibrosis or cirrhosis. The validity of non-invasive tools to assess hepatic fibrosis, such as FibroScan(®) which measures liver stiffness (LSM), has not been established in this setting. We examined the impact of cardiac dysfunction on LSM using FibroScan(®) and the influence of volume changes on LSM. ⋯ Our findings support the concept of increased LSM in the cardiac failure population. LSM was not altered to a statistically significant level with acute volume changes.