G Michael Felker

..Circulating troponins are a prognostic marker in patients with ADHF. Contemporary assays with greater sensitivity require reassessment of the significance of troponin elevation in HF...

..This review summarizes available data on the use of both diuretics and UF in ADHF patients and identifies challenges and unresolved questions for each approach...

..Data from other ongoing trials will continue to inform our understanding of the optimal role for loop diuretics in the treatment of heart failure...

..We evaluated the association between galectin-3 and long-term clinical outcomes in ambulatory heart failure patients enrolled in the HF-ACTION study...

..The creation of an alternate list to match recipients with contraindications to traditional HT with sub-optimal donor organs has been implemented at some centers, but outcomes using this approach are uncertain...

..Although often overlooked in clinical training and practice, the cardiovascular response to the Valsalva maneuver is a potentially useful, noninvasive means of evaluating filling pressures in patients with heart failure...

..Although heart failure in the setting of preserved systolic function (PSF) is an important clinical problem, the relationship between anemia and outcomes in patients with PSF has not been carefully evaluated...

..Exacerbation of myocardial ischemia in patients with heart failure, coronary disease, and anaemia patients has been suggested as a potential mechanism underlying this association...

..Loop diuretics are an essential component of therapy for patients with acute decompensated heart failure, but there are few prospective data to guide their use...

..The goal of this study was to identify potentially novel laboratory markers of risk in chronic heart failure patients...

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..We performed a quantitative meta-analysis of available randomized controlled trials to determine whether titration of therapy based on natriuretic peptide measurements improves mortality in chronic heart failure...

..Future research will be required to assess whether benefits of this drug combination seen in AHeFT can be extended to the wider population of patients with advanced heart failure...

..To examine the relationship between N-terminal pro-brain natriuretic peptide (NT-proBNP) and exercise capacity in a large contemporary cohort of patients with chronic heart failure...

..Ongoing research into the role of biomarkers as surrogates may lead to better clinical trial design and more efficient development of new therapies for heart failure...

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..Lower baseline hemoglobin is associated with risk of short-term adverse clinical outcomes in this population, even after controlling for other baseline differences...

..Pre-transplant VAD and prolonged ischemic times are more important determinants of PGD. These data support continued aggressive utilization of marginal donor hearts in AL HT...

..Although unadjusted clinical outcomes are better for African Americans presenting with ADHF, these differences diminished after adjustment for baseline characteristics...

..Our study sought to validate the prognostic value of RDW in heart failure and to explore the potential mechanisms underlying this association...

..We hypothesized that other adverse outcomes, principally determined by recipient characteristics, occur at a higher rate in extended criteria recipients...

..Further research into the validity of this model in independent samples will potentially aid in the development of risk stratification strategies...

..To determine the correlation between differential white blood cell (WBC) count and characteristics and outcome of acute heart failure (AHF) syndromes...

..It is unknown if admission, discharge, or change from admission to discharge BNP measure is the most important predictor of long-term outcomes...

..The prevalence and importance of liver function test (LFT) abnormalities in a large contemporary cohort of heart failure patients have not been systematically evaluated...

..MR is common in patients with LV systolic dysfunction and heart failure. After adjusting for other clinical variables, the presence of MR independently predicted worsened survival...

..7-6.3). Early WHF is a common adverse event in patients admitted with AHF, and is associated with AHF severity and excessive 6-month mortality. WHF should be considered as a clinically important endpoint in AHF studies...

..These differential outcomes underscore the need for dedicated trials in these subpopulations...

..Recently, the Food and Drug Administration approved implantable left ventricular assist devices (LVAD) as destination therapy (DT) for end-stage heart failure patients who are ineligible for cardiac transplantation...

..Ultimately, this information might allow physicians to guide therapy, choose appropriate therapeutics, and improve HF outcomes...

..Studies in experimental and human heart failure suggest that phosphodiesterase-5 inhibitors may enhance cardiovascular function and thus exercise capacity in heart failure with preserved ejection fraction (HFPEF)...

..03) (5-year event rates 85% vs 87% and 77% vs 73%, respectively). In conclusion, AP is common in patients with iCM despite medical therapy and previous revascularization and is associated with increased CV death or CV rehospitalization...

..These findings suggest that secondary pulmonary hypertension may have different biological features in myocarditis and that patients with pulmonary hypertension and myocarditis should be targeted for aggressive medical therapy...

..Although observing an effect on one of many endpoints due to chance is likely, observing concurrent positive trends across several outcomes by chance is usually unlikely...

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..Low oxygen saturation (SaO2) and systolic blood pressure (SBP) are signs of impending respiratory and circulatory failure that can be obtained quickly in patients with AHF...

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..The goal of this study was to assess the interaction between heart failure (HF) etiology and response to milrinone in decompensated HF...

..The safety, effectiveness and indications for ultrafiltration (UF) are not well established. We hypothesized that UF would not worsen renal function in patients with heart failure (HF) who were not responding to medical therapy...

..The natural evolution of signs and symptoms during acute heart failure (AHF) is poorly characterized...

..We examined whether the Arg389Gly polymorphism in ADRβ1 interacts with the dose requirements of beta-blockers in patients with systolic HF...

..However, referral for LVAD therapy may be limited secondary to reports of poor outcomes when mechanical circulatory support is required before transplantation...

..It also defines the current understanding of strategies for risk stratification in the setting of decompensated heart failure...

..Lymphocytic myocarditis presents as a primary disorder or in association with a systemic disease. Whether primary and secondary myocarditis have the same prognosis is unknown...

..The purpose of this review is to discuss emerging surgical therapies in heart failure, in particular, mechanical cardiac support and mitral valve repair...

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..02). In conclusion, unadjusted and adjusted analyses of patients in the Duke Databank for Cardiovascular Disease indicated a significant correlation between a period of stock market decrease and increased AMI rates in our local cohort...

..Baseline angiotensin-converting enzyme inhibitor plus beta-blocker use were associated with lower levels of CRP; no relation was found between CRP levels and aspirin or statin use...

..Although pilot work has provided encouraging results, appropriately designed, large-scale, prospective randomized trials are needed to confirm these preliminary findings and definitively establish this therapeutic approach...

..A better understanding of the factors affecting pain during EMBx could improve the comfort level of this procedure...

..He subsequently underwent uncomplicated heart transplantation. Nineteen months later, a routine surveillance endomyocardial biopsy specimen demonstrated recurrence of sarcoidosis in the transplanted heart...

..Multiple ongoing studies will provide definitive data on the balance of risks and benefits of anemia treatment in chronic HF...

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..To examine the characteristics associated with early dyspnoea relief during acute heart failure (HF) hospitalization, and its association with 30-day outcomes...

..Although diabetes is a common co-morbidity in heart failure, no prior study has considered the impact of serum glucose on this relationship...

..Anemia is associated with higher morbidity and mortality in patients with heart failure (HF), but its implications for heath care costs are not well described...

..These results also suggest that caution should be taken when withdrawing beta blockade in this population...

..Patients with chronic heart failure have impaired long-term survival, but their own expectations regarding prognosis have not been well studied...

..Obesity could attenuate diuretic effectiveness in treatment of acute decompensated heart failure (HF)...

..This article reviews the rationale, accumulated data, and unanswered questions for BGT in chronic HF...

..We will also discuss the potential role for these biomarkers within a multimarker-based strategy that could, in the future, lead to better care for these patients...

..Preoperative TR is associated with negative outcomes but the clinical benefit of concomitant tricuspid valve procedures has not been extensively studied...

..Hyponatremia is a well known predictor of short-term outcomes in heart failure (HF); however, its impact on long-term survival in HF patients with systolic dysfunction is not well established...

..Whether newer inotropes with differing mechanisms of action will realize the potential clinical benefits of inotropic therapy without the risk remains a subject of ongoing investigation...

..In this review, the authors analyze available data supporting the use of inflammatory markers both as biomarkers and as potential therapeutic targets...

..We performed a phase 2 randomized trial to evaluate the safety and feasibility of M118 in the setting of elective percutaneous coronary intervention...

..The ideal composite end point for studies of MCSDs is uncertain...

..Previous studies have suggested that a lower lymphocyte ratio (Ly%) in the white blood cell (WBC) differential count is related to worse outcomes in patients with acute heart failure (AHF) and other cardiovascular disorders...

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..CONCLUSION: New arrhythmia during an exacerbation of heart failure identifies a high-risk group with higher intrahospital and 60-day morbidity and mortality...

..Although blood pressure (BP) is elevated in patients with acute heart failure (AHF), first admission BP has not been meticulously recorded before treatment in previous studies...

..CONCLUSIONS: In patients hospitalized for worsening heart failure, admission serum sodium is an independent predictor of increased number of days hospitalized for cardiovascular causes and increased mortality within 60 days of discharge...

..Felker's development into an established independent clinical investigator with expertise in both complex clinical research methodology and the role of inflammation in the pathophysiology of heart failure. ..