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  • Potenza, A  (3)
  • 1
    Online Resource
    Online Resource
    Oxford University Press (OUP) ; 2022
    In:  European Heart Journal Supplements Vol. 24, No. Supplement_C ( 2022-05-18)
    In: European Heart Journal Supplements, Oxford University Press (OUP), Vol. 24, No. Supplement_C ( 2022-05-18)
    Abstract: The evaluation of congestion play a central role in the management of patients with acute heart failure (AHF).The impact of gender on congestion in patients with HF is still a matter of debate. The objective of this analysis was to evaluate the impact of gender on congestion status at admission of patients hospitalized for AHF. Methods We consecutively enrolled 487 patients with AHF (50% female). We assessed peripheral edema, jugular venous distention ( & gt;10 cm), B–type natriuretic peptide (BNP), hydration status (by means of bioimpedance analysis), and estimated plasma volume (by means of the Duarte’s formula [D–ePVS] and Kaplan–Hakim formula [KH–ePVS] ). Results Home medications and body mass index were not different between women and men. Women were older (79 yrs vs 77 yrs, P = 0.005), showed better left ventricular ejection fraction (mean 50% vs 38%, P  & lt; 0.001), and increased plasma concentrations in blood urea nitrogen (40 mg/dL vs 25 mg/dL, P = 0.02) and serum creatinine (1.5 mg/dL vs 1.5 mg/dL, P = 0.8). At physical examination, the number of patients with peripheral edema and jugular venous distention was not significantly different between women and men (53% vs 45% and 60% vs 55%, respectively). BNP levels (median 1100 pg/mL vs 994 pg/mL) and hydration status (78% vs 79%) were similar in women and men, while ePVS was higher in women (D–ePVS 6.0 ± 1.6 dL/gr vs 5.1 ± 1.5 dL/gr, P  & lt; 0.001; KH–ePVS 7.9% ± 13% vs –7.3 ±12%, P  & lt; 0.001). Conclusions The evaluation of congestion in AHF using physical examination and multiparametric approaches was similar between women and gender. Women rather showed higher plasma volume as compared to male individuals.
    Type of Medium: Online Resource
    ISSN: 1520-765X , 1554-2815
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2022
    detail.hit.zdb_id: 2141255-8
    detail.hit.zdb_id: 1463769-8
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  • 2
    In: European Heart Journal Supplements, Oxford University Press (OUP), Vol. 24, No. Supplement_C ( 2022-05-18)
    Abstract: The assessment of long term mortality in acute decompensated heart failure (ADHF) is challenging. Respiratory failure and congestion play a fundamental role in risk stratification of ADHF patients. The aim of this study was to investigate the impact of arterial blood gases (ABG) and congestion on long–term mortality in patients with ADHF. Methods and Results We enrolled 252 patients with ADHF. Brain natriuretic peptide (BNP), blood urea nitrogen (BUN), phase angle as assessed by means of bioimpedance vector analysis (BIVA), and ABG analysis were collected at admission. The endpoint was all–cause mortality. At a median follow–up of 447 days, (IQR: 248–667), 72 patients died 1–840 days (median 106, IQR: 29–233) after discharge. Respiratory failure types I and II was observed in 78 (19%) and 53 (20%) patients, respectively. The ROC analyses revealed that the cut–off points for predicting death were: & gt;441 pg/mL for BNP, & gt;30 mg/dL for BUN, ≤ 69.7 mmHg for partial pressure in Oxygen (PaO2), and ≤4.9° for Phase Angle. Taken together, these four variables proved to be good predictors for long–term mortality in ADHF (AUC 0.78, 95% CI 0.72–0.78), thus explaining 60% of all deaths. A multiparametric score based on these variables was determined: each single–unit increase promoted a 2.2–fold augmentation of the risk for death (HR 2.2, 95% CI 1.8–2.8, P  & lt; 0.0001). Conclusions A multiparametric approach based on measurements of BNP, BUN, PaO2, and phase angle is a reliable approach for long–term prediction of mortality risk in patients with ADHF.
    Type of Medium: Online Resource
    ISSN: 1520-765X , 1554-2815
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2022
    detail.hit.zdb_id: 2141255-8
    detail.hit.zdb_id: 1463769-8
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
  • 3
    Online Resource
    Online Resource
    Oxford University Press (OUP) ; 2024
    In:  European Heart Journal Supplements Vol. 26, No. Supplement_2 ( 2024-05-16), p. ii93-ii93
    In: European Heart Journal Supplements, Oxford University Press (OUP), Vol. 26, No. Supplement_2 ( 2024-05-16), p. ii93-ii93
    Abstract: Some patients with acute heart failure (AHF) are initially treated with noninvasive ventilation (NIV). Today, it is not full explored the prognosis of subjects hospitalized with AHF and treated with NIV. Methods We retrospectively evaluated subjects hospitalized with AHF between 2022 and 2023 in intensive care unit. We determined the association between and mortality at 90–days using Cox proportional hazard and Kaplan–Meier analyses. Results We included 191 subjects who were hospitalized with AHF. Ninenty–days mortality occurred in 24% subjects. Seventy–five subjects were treated with NIV (32%) and showed higher mortality when compared with for those without NIV (55% vs 35%, p & lt;0.01). At 90–days, mortality was significantly associated with NIV (hazard ratio 2.3, 95% CI 1.3–4.0; p=0.005). Survival curves for mortality according to NIV use is in figure (logrank p= 0.004; chi–squared = 8.3). After adjustment for sex, age, BNP, renal and left ventricular functions, NIV treatment remained significantly associated to about 2–fold risk increase in mortality. Conclusions In subjects hospitalized with AHF the treatment with non–invasive ventilation was associated to short–term mortality independently from clinical parameters. This prognostic information should be weighted against structured trials in order to derive more specific clinical implications.
    Type of Medium: Online Resource
    ISSN: 1520-765X , 1554-2815
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2024
    detail.hit.zdb_id: 2141255-8
    detail.hit.zdb_id: 1463769-8
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
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