European journal of heart failure
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Eur. J. Heart Fail. · Apr 2010
Randomized Controlled Trial Multicenter StudyIntravenous levosimendan vs. dobutamine in acute decompensated heart failure patients on beta-blockers.
The aim of this study is to compare the effects of a 24 h intravenous infusion of levosimendan and a 48 h infusion of dobutamine on invasive haemodynamics in patients with acutely decompensated chronic NYHA class III-IV heart failure. All patients were receiving optimal oral therapy including a beta-blocker. ⋯ A 24 h levosimendan infusion achieved haemodynamic and neurohormonal improvement that was at least comparable at 24 h and superior at 48 h to a 48 h dobutamine infusion.
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Eur. J. Heart Fail. · Mar 2010
Case ReportsHaemodynamic effects of acute intravenous metoprolol in apical ballooning syndrome with dynamic left ventricular outflow tract obstruction.
Takotsubo syndrome, also called apical ballooning syndrome, is a clinical entity characterized by transient hypokinesis, akinesis, or dyskinesis of the left ventricular mid-segments with or without apical involvement, and without obstructive coronary lesions. The contemporary presence of left ventricular outflow tract obstruction (LVOTO), systolic anterior motion of the anterior mitral leaflet, and acute mitral regurgitation might explain the worsening of the heart failure or the occurrence of cardiogenic shock in some patients with apical ballooning syndrome. ⋯ However, clear evidence of the direct haemodynamic effects of beta-blockers is still lacking. We present a case of apical ballooning syndrome complicated by dynamic LVOTO, treated with metoprolol.
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Eur. J. Heart Fail. · Feb 2010
ReviewMeasurement of breathlessness in clinical trials in patients with chronic heart failure: the need for a standardized approach: a systematic review.
Chronic breathlessness is a major symptom for patients with compensated chronic heart failure (CHF) and its impact is different to the breathlessness resulting from pulmonary oedema. This systematic review aims to establish which tools have been used for research into the subjective severity of breathlessness in patients with compensated CHF and to discuss recommendations for the future. ⋯ Despite breathlessness being an important and limiting problem for patients with CHF, we found no consensus on which tool should be used for breathlessness severity, little methodological research to develop such a tool, and a lack of focus on breathlessness as a symptom. A consistent approach to studying breathlessness in patients with CHF is needed in order to make headway in managing this key patient priority.
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Eur. J. Heart Fail. · Dec 2009
Randomized Controlled Trial'Hospital at home' care model as an effective alternative in the management of decompensated chronic heart failure.
The 'Hospital at home' (HaH) model avoids hospital admission by transferring healthcare and treatment to the patient's home. We aimed to compare the effectiveness and direct healthcare costs of treating elderly patients with decompensated heart failure (HF) using HaH care vs. inpatient hospital care (IHC) in a cardiology unit. ⋯ Hospital at home care allows an important reduction in the costs during the index episode compared with hospital care, whilst maintaining similar outcomes with respect to cardiovascular mortality and morbidity and quality of life at 1 year follow-up.