K F Adams

..We investigated whether patients with mild heart failure due to left ventricular systolic dysfunction were at risk of worsening during digoxin withdrawal...

..The pathophysiology of heart failure is reviewed, with particular focus on the role of abnormal neurohormonal activation of the sympathetic nervous system and the renin-angiotensin-aldosterone axis in the pathophysiology of this syndrome...

....

..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...

..Although a potentially important pathophysiologic factor in heart failure, the prevalence and predictors of anemia have not been well studied in unselected patients with heart failure...

..1% to 21.9%. Although risk stratification alone cannot improve outcomes, identification of patients at high and low risk may improve resource utilization and better focus the intensity of care according to outcome...

..We prospectively evaluated the relationship between this marker and hematopoietic disturbances in heart failure...

..Further studies are needed to determine whether there are additional clinical benefits from the inhibition of adrenergic receptors beyond the proven benefits of b1-blockade...

..Most available data on these patients are limited by patient selection criteria and study design of clinical trials and single-center studies...

..The purpose of this study was to investigate the relationship of serum digoxin concentration (SDC) and outcomes in women with heart failure (HF)...

..These agents are capable of substantially reducing the morbidity and mortality associated with heart failure. However, the importance of enhanced physician and public awareness of heart failure remains critical in the future...

..Mechanistic and early clinical trials are reviewed, along with the results from CIBIS-II, MERIT-HF, and COPERNICUS. Barriers to the use of beta-blocker therapy also are discussed...

..Reduced hemoglobin has been associated with adverse outcomes in heart failure, but the relationship of hemoglobin to health-related quality of life in outpatients with this syndrome has not been well studied...

....

..We sought to determine whether there was a relationship between serum digoxin concentration (SDC), including SDCs typically regarded as low, and clinical efficacy related to digoxin in patients with symptomatic left ventricular dysfunction...

....

..This study investigates whether a similar survival advantage for women would be evident among patients with advanced heart failure...

..The recent guideline process for a specific chronic cardiovascular disease, heart failure, is used for illustration of the translation process...

..We conducted a multicenter, placebo-controlled trial designed to establish the efficacy and safety of carvedilol, a "third-generation" beta -blocking agent with vasodilator properties, in chronic heart failure...

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

....

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

..However, this interaction was of little clinical significance in our sample population...

..These data highlight the importance of enhancing physician and public awareness of heart failure. New methods of molecular epidemiology will point toward better and earlier detection of this common and frequently fatal condition...

..Accordingly, therapies for AHFS that are aimed at improving hemodynamics may affect long-term prognosis by either injuring or salvaging myocardium...

..Although intravenous inotropic therapy usually produces beneficial hemodynamic effects and is labeled for use in the care of such patients, the effect of such therapy on intermediate-term clinical outcomes is uncertain...

..Whether cardiac ultrasound and natriuretic peptides provide independent prognostic information is uncertain...

..However, patients with heart failure (HF) have been less frequently studied, and the effect of depression on prognosis, independent of disease severity, is uncertain...

..21 (95% CI, 0.80-1.84; P =.367). CONCLUSION: African American and white patients with symptomatic heart failure had similar survival rates in our database...

..Tezosentan is a dual endothelin receptor antagonist, and it has improved cardiac output and reduced pulmonary and systemic vascular resistance in experimental animal models and in initial human acute decompensated heart failure studies...

..In contrast to diuretics, the vasopressin antagonist tolvaptan may increase net volume loss in heart failure without adversely affecting electrolytes and renal function...

..Further investigation of these measures is required before routine implementation in drug development and clinical practice can be justified...

..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...

....

..We tested whether the ADRA2C insertion/deletion polymorphism was associated with beta-blocker response in heart failure, either alone or in combination with the ADRB1Arg389Gly polymorphism...

..We investigated whether beta-blocker therapy ameliorates left ventricular remodeling in asymptomatic patients with left ventricular systolic dysfunction...

....

..The association between baseline blood urea nitrogen (BUN) and clinical outcomes in patients admitted for ADHF was evaluated in a post-hoc analysis of the ACTIV in CHF trial...

..One hundred ninety-two patients were enrolled in this study. Patients with baseline cTnI values were included in this analysis, and the relation between cTnI and the composite clinical primary end point of RITZ-4 was evaluated...

..We examined the relation of maximal in-hospital diuretic dose to weight loss, changes in renal function, and mortality in hospitalised heart failure (HF) patients...

....

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

..Changes in hemodynamic measures often serve as surrogate end points in efficacy trials for advanced heart failure, although there are few objective data to support this practice...

..Tezosentan did not demonstrate pro-ischemic effects in this population. Symptomatic hypotension may have resulted in an increased number of adverse events in the treatment group. Further studies with lower tezosentan doses are warranted...

..As in patients with systolic HF, those with diastolic HF should be routinely evaluated for myocardial ischemia and managed accordingly...

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

..The goal of this study was to determine the influence of gender on baseline characteristics, response to treatment, and prognosis in patients with heart failure (HF) and impaired left ventricular ejection fraction (LVEF)...

..We also tested whether polymorphisms in the beta(2)-adrenergic receptor, G-protein alpha s subunit (G(s)alpha), and cytochrome P450 (CYP) 2D6 genes or S-metoprolol plasma concentrations were associated with beta-blocker tolerability...

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

..We hypothesized that polymorphisms at codon 389 (Arg389Gly) and 49 (Ser49Gly) in the beta1-adrenergic receptor (AR) gene were associated with LV reverse remodeling changes in response to beta-blocker therapy among heart failure patients...

..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...

..We sought to compare the in-hospital mortality of patients with acute decompensated heart failure (ADHF) who were receiving parenteral treatment with one of four intravenous vasoactive medications...

..Estimation of mortality risk in patients hospitalized with acute decompensated heart failure (ADHF) may help clinicians guide care...

....

..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...

..Although digoxin was tested in an appreciable number of diastolic heart failure patients in the Digitalis Investigation Group ancillary trial, detailed findings from this important study have not previously been published...

..Whether women with chronic heart failure are at less risk for hospitalization for worsening heart failure has not been well investigated...

....

..To determine the effects of digoxin on all-cause mortality and heart failure (HF) hospitalizations, regardless of ejection fraction, accounting for serum digoxin concentration (SDC)...

..Hyponatremia predicts poor outcome in patients with acute heart failure syndromes. This study evaluated the relationship between baseline serum sodium, change in serum sodium, and 60-day mortality in hospitalized heart failure patients...

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

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