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Diuretics in chf

Hesham R Omar, Maya Guglin
BACKGROUND: Diuretic requirements in patients with acute decompensated heart failure (ADHF) and hyponatraemia versus normonatraemia on admission has not been previously explored. METHODS: The Evaluation Study of Congestive Heart Failure and Pulmonary Artery Catheterization Effectiveness (ESCAPE) trial dataset was utilised to examine the characteristics and diuretic requirements of patients with ADHF with hyponatraemia or normonatraemia on admission. RESULTS: Patients with ADHF and admission hyponatraemia (n = 103, average Na 130...
January 28, 2019: Heart, Lung & Circulation
Anna Belfiore, Vincenzo Ostilio Palmieri, Carla Di Gennaro, Enrica Settimo, Maria Grazia De Sario, Stefania Lattanzio, Margherita Fanelli, Piero Portincasa
Chronic heart failure (CHF) is one of the main disabilities in elderly patients requiring frequent hospitalizations with high health care costs. We studied the outcome of CHF outpatient management in reducing hospitalization after discharge from a division of Internal Medicine at a large 3rd referral regional Hospital. 147 CHF inpatients (M:F: 63:84; mean age 76 ± 9.6 years) admitted for acute exacerbation of CHF were followed up as outpatients at 1, 6, 12 and 24 months after discharge. At baseline, patients underwent: laboratory tests, ECG, echocardiogram and a dedicated-intensive health care educational program involving also their families...
January 18, 2019: Internal and Emergency Medicine
Jia Yi Anna Ne, Vincent Chow, Leonard Kritharides, Austin Chin Chwan Ng
BACKGROUND: Congestive heart failure (CHF) is a risk factor for pulmonary embolism (PE). PE is also an independent predictor of death or re-hospitalization among CHF patients. We assessed the incidence of CHF admission following acute PE using population-linkage analysis. METHODS: Patients were identified from a comprehensive single-center PE database and CHF admissions or death after their PE were tracked from the statewide Admitted Patient Data Collection and Death registries respectively...
December 27, 2018: International Journal of Cardiology
Hesham R El-Seedi, Shaden A M Khalifa, Eman A Taher, Mohamed A Farag, Aamer Saeed, Mohamed Gamal, Mohamed-Elamir F Hegazy, Diaa Youssef, Syed G Musharraf, Muaaz M Alajlani, Jianbo Xiao, Thomas Efferth
Cardiac glycosides (CGs) are a class of naturally occurring steroid-like compounds, and members of this class have been in clinical use for more than 1500 years. They have been used in folk medicine as arrow poisons, abortifacients, heart tonics, emetics, and diuretics as well as in other applications. The major use of CGs today is based on their ability to inhibit the membrane-bound Na+ /K+ -ATPase enzyme, and they are regarded as an effective treatment for congestive heart failure (CHF), cardiac arrhythmia and atrial fibrillation...
December 20, 2018: Pharmacological Research: the Official Journal of the Italian Pharmacological Society
Joanna L Kaplan, Joshua A Stern, Andrea J Fascetti, Jennifer A Larsen, Hannah Skolnik, Gordon D Peddle, Richard D Kienle, Andrew Waxman, Michael Cocchiaro, Catherine T Gunther-Harrington, Tyler Klose, Kendra LaFauci, Bonnie Lefbom, Maggie Machen Lamy, Rebecca Malakoff, Satoko Nishimura, Maureen Oldach, Steven Rosenthal, Christopher Stauthammer, Lynne O'Sullivan, Lance C Visser, Regan William, Eric Ontiveros
INTRODUCTION: Golden retrievers are over-represented in cases of taurine-deficient dilated cardiomyopathy and recently a surge in cases has prompted further investigation. OBJECTIVE: To describe the clinical, dietary, and echocardiographic features in golden retrievers diagnosed with taurine deficiency and dilated cardiomyopathy, and to determine specific dietary associations. A second aim was to determine the whole blood taurine concentrations in a representative sample of healthy golden retrievers...
2018: PloS One
Olli-Pekka Ryynänen, Timo Leppänen, Pekka Kekolahti, Esa Mervaala, Juha Töyräs
Objectives: The association between obstructive sleep apnea (OSA) and mortality or serious cardiovascular events over a long period of time is not clearly understood. The aim of this observational study was to estimate the clinical effectiveness of continuous positive airway pressure (CPAP) treatment on an outcome variable combining mortality, acute myocardial infarction (AMI), and cerebrovascular insult (CVI) during a follow-up period of 15.5 years (186 ± 58 months). Methods: The data set consisted of 978 patients with an apnea-hypopnea index (AHI) ≥5...
October 2018: Healthcare Informatics Research
Lily A Parkinson, Christoph Mans
OBJECTIVE To evaluate the diuretic effects and associated changes in hematologic and plasma biochemical values following SC furosemide administration to water-deprived inland bearded dragons (Pogona vitticeps). ANIMALS 9 bearded dragons. PROCEDURES In a crossover study design, furosemide (5 or 10 mg/kg) was administered SC every 12 hours for 4 doses or no treatment (control treatment) was provided for the same period. Food and water were withheld. Body weight was recorded before (baseline) and 12 hours after treatment sessions ended and then after 5 minutes of soaking in a water bath...
November 2018: American Journal of Veterinary Research
Shinichi Nonin, Shinichi Iwata, Asahiro Ito, Soichiro Tamura, Ryoko Kitada, Yu Kawai, Sera Ishikawa, Atsushi Doi, Akihisa Hanatani, Minoru Yoshiyama
Background: Tolvaptan is a vasopressin type 2 receptor antagonist used in heart failure (HF) with refractory diuretic resistance. However, since tolvaptan is also ineffective in some HF patients with reduced ejection fraction (HFrEF), the identification of responders is important. Methods: The study population consisted of 51 HFrEF patients who were administered tolvaptan (EF, 28 ± 7%). We defined responders as patients with a ≥50% increase in urine volume during the 24-hours after administration of tolvaptan...
December 2018: IJC Heart & Vasculature
Chandrika Chitturi, James E Novak
The leading cause of death worldwide is cardiovascular disease. The heart and the kidneys are functionally interdependent, such that dysfunction in one organ may cause dysfunction in the other. By one estimate, more than 60% of patients with congestive heart failure develop chronic kidney disease. Volume overload and congestion are hallmarks of heart failure, and these findings are associated with severe symptoms and poor outcomes. Given the importance of congestion, diuretics remain a cornerstone of heart failure management...
September 2018: Advances in Chronic Kidney Disease
Yuki Ikeda, Takayuki Inomata, Keisuke Kida, Yugo Shibagaki, Naoki Sato, Tohru Izumi, Junya Ako
We attempted to identify the difference in diuretic properties between tolvaptan (TLV) and furosemide (FUR) in congestive heart failure (CHF) patients with loop diuretic resistance and renal impairment. We investigated 81 CHF patients with loop diuretic treatment and renal impairment included in t he Kanagawa Aquaresis Investigators Trial of Tolvaptan on Heart Failure Patients with Renal Impairment (K-STAR). Predictive baseline factors and their changes during treatment periods were analyzed for correlation with percentage change in urine volume (%ΔUV) after additive introduction of TLV or increasing doses of FUR...
September 26, 2018: Heart and Vessels
Melanie J Hezzell, Chloë L Block, Danielle S Laughlin, Mark A Oyama
BACKGROUND: Treatment targeted to achieve reduction in N-terminal pro-B-type natriuretic peptide (NT-proBNP) improves outcomes in human congestive heart failure (CHF) patients. HYPOTHESIS: A pre-specified therapeutic algorithm that increased diuretic or pimobendan usage will reduce plasma NT-proBNP concentrations in dogs with CHF secondary to myxomatous mitral valve disease (MMVD). ANIMALS: Twenty-six dogs with clinically stable CHF secondary to MMVD...
September 2018: Journal of Veterinary Internal Medicine
Julio Núñez, Raquel Heredia, Ana Payá, Ignacio Sanchis, Susana Del Prado, Gema Miñana, Enrique Santas, Rafael de la Espriella, Eduardo Núñez, Juan Sanchis, Antoni Bayés-Genís
AIMS: Optimal diuretic treatment of patients with refractory congestive heart failure (CHF) remains to be elucidated. In this work, we aimed to evaluate the serial changes of functional class and surrogates of fluid overload (weight and antigen carbohydrate 125) after addition of oral acetazolamide in patients with refractory CHF. Likewise, serial changes in renal function, serum electrolytes and pH were evaluated. METHOD: This is an observational retrospective study in which 25 ambulatory patients with refractory CHF that received acetazolamide in addition to standard intensive diuretic strategy were evaluated...
December 2018: Cardiovascular Therapeutics
Yoshito Kadoya, Kan Zen, Satoaki Matoba
BACKGROUND: Transplant renal artery stenosis (TRAS) is a serious complication after renal transplantation, leading to hypertension, deterioration in renal function, and/or graft loss. The incidence of TRAS reportedly varies from 1 to 23%, depending on its definition or diagnostic tools. The hemodynamic definition or therapeutic indication of TRAS is unclear. CASE PRESENTATION: A 66-year-old man with a history of diabetes, chronic kidney disease, and angina presented with a 2-week history of dyspnea and leg edema...
August 22, 2018: BMC Cardiovascular Disorders
Richard M Cubbon, Judith E Lowry, Michael Drozd, Marlous Hall, John Gierula, Maria F Paton, Rowena Byrom, Lorraine C Kearney, Julian H Barth, Mark T Kearney, Klaus K Witte
PURPOSE: Low 25-hydroxyvitamin D (25[OH]D) concentrations have been associated with adverse outcomes in selected populations with established chronic heart failure (CHF). However, it remains unclear whether 25[OH]D deficiency is associated with mortality and hospitalisation in unselected patients receiving contemporary medical and device therapy for CHF. METHODS: We prospectively examined the prevalence and correlates of 25[OH]D deficiency in 1802 ambulatory patients with CHF due to left ventricular systolic dysfunction (left ventricular ejection fraction ≤ 45%) attending heart failure clinics in the north of England...
August 18, 2018: European Journal of Nutrition
Jamil Ibrahim, Azzour D Hazzan, Anna T Mathew, Vipul Sakhiya, Meng Zhang, Candice Halinski, Steven Fishbane
Background: Late-stage chronic kidney disease (LS-CKD) can be defined by glomerular filtration rate (GFR) 0-30 mL/min. It is a period of risk for medication discrepancies because of frequent hospitalizations, fragmented medical care, inadequate communication and polypharmacy. In this study, we sought to characterize medication discrepancies in LS-CKD. Methods: We analyzed all patients enrolled in Northwell Health's Healthy Transitions in LS-CKD program. All patients had estimated GFR 0-30 mL/min, not on dialysis...
August 2018: Clinical Kidney Journal
Rashmi Soori, Aanchal Dixit, Prabhat Tewari
Hypokalemia is defined as serum potassium level less than 3.5 mEq/L. When the serum level of potassium is less than 3 mEq/L, intravenous potassium supplementation is warranted. A 23 yr old adult female with complaints of dyspnoea (NYHA II) since 6 yrs, dyspnoea (NYHA III) and paroxysmal nocturnal dyspnoea on and off since 2 months, diagnosed with severe mitral stenosis, was posted for mitral valve replacement. After the release of ACC, ECG revealed sine wave pattern, Transesophageal echocardiographic examination revealed global hypokinesia and ABG showed potassium of 2...
July 2018: Annals of Cardiac Anaesthesia
Scott Martin Vouri, Joseph S van Tuyl, Margaret A Olsen, Hong Xian, Mario Schootman
OBJECTIVES: Dihydropyridine calcium channel blockers (DH-CCB) are associated with lower-extremity edema (LEE). Loop diuretics have been used inappropriately to treat DH-CCB-associated LEE, constituting a prescribing cascade (PC). The aim of this work was to identify the prevalence and factors associated with potential DH-CCB-LEE-loop diuretic PC. METHODS: The 2014 National Ambulatory Medical Care Survey was used to identify patient visits in which a DH-CCB was continued...
September 2018: Journal of the American Pharmacists Association: JAPhA
Joseph J Cuthbert, Pierpaolo Pellicori, Alan Rigby, Daniel Pan, Syed Kazmi, Parin Shah, Andrew L Clark
BACKGROUND: Low serum chloride is common in patients with chronic heart failure (CHF) and is associated with worse outcomes. We investigated the clinical and prognostic associations, including cause of death associations, of low serum chloride in patients referred to a secondary care clinic with suspected heart failure. METHODS AND RESULTS: Patients with echocardiogram and serum chloride were evaluated (n = 5613). CHF was defined as signs and symptoms of the disease and either left ventricular systolic dysfunction (LVSD) worse than mild [heart failure with reduced ejection fraction (HFrEF)] or LVSD mild or better and raised amino-terminal pro-B-type natriuretic peptide (NT-proBNP) levels (>125 ng/L) [heart failure with preserved ejection fraction (HFpEF)]...
June 26, 2018: European Journal of Heart Failure
Nasser Davarzani, Sandra Sanders-van Wijk, Micha T Maeder, Peter Rickenbacher, Evgueni Smirnov, Joël Karel, Thomas Suter, Rudolf A de Boer, Dirk Block, Vinzent Rolny, Christian Zaugg, Matthias E Pfisterer, Ralf Peeters, Hans-Peter Brunner-La Rocca
Background: It is uncertain whether repeated measurements of a multi-target biomarker panel may help to personalize medical heart failure (HF) therapy to improve outcome in chronic HF. Methods: This analysis included 499 patients from the Trial of Intensified versus standard Medical therapy in Elderly patients with Congestive Heart Failure (TIME-CHF), aged ≥ 60 years, LVEF ≤ 45%, and NYHA ≥ II, who had repeated clinical visits within 19 months follow-up...
June 2018: EPMA Journal
Per Wändell, Axel C Carlsson, Martin J Holzmann, Johan Ärnlöv, Jan Sundquist, Kristina Sundquist
OBJECTIVE: To study association between relevant cardiovascular pharmacotherapy and incident congestive heart failure (CHF) in patients with atrial fibrillation treated in primary health care. METHODS: Study population included all adults (n = 7975) aged 45 years and older diagnosed with atrial fibrillation at 75 primary care centers in Sweden between 2001 and 2007. Outcome was defined as a first diagnosis of CHF post-atrial fibrillation diagnosis. Association between CHF and treatment with relevant cardiovascular pharmacotherapies (beta blockers, calcium blockers, digitalis, diuretics, RAS blockers, and statins) was explored using Cox regression analysis with hazard ratios and 95% CIs...
September 2018: Journal of Hypertension
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