Open Access. Powered by Scholars. Published by Universities.®

Medicine and Health Sciences Commons

Open Access. Powered by Scholars. Published by Universities.®

Articles 1 - 30 of 141

Full-Text Articles in Medicine and Health Sciences

Diagnostic Tests, Drug Prescriptions, And Follow-Up Patterns After Incident Heart Failure: A Cohort Study Of 93,000 Uk Patients, Nathalie Conrad, Andrew Judge, Dexter Canoy, Jenny Tran, Johanna O'Donnell, Milad Nazarzadeh, Gholamreza Salimi-Khorshidi, Richard Hobbs, John G. Cleland, John J. V. Mcmurray, Kazem Rahimi Jan 2019

Diagnostic Tests, Drug Prescriptions, And Follow-Up Patterns After Incident Heart Failure: A Cohort Study Of 93,000 Uk Patients, Nathalie Conrad, Andrew Judge, Dexter Canoy, Jenny Tran, Johanna O'Donnell, Milad Nazarzadeh, Gholamreza Salimi-Khorshidi, Richard Hobbs, John G. Cleland, John J. V. Mcmurray, Kazem Rahimi

Faculty of Health Sciences Publications

Background Effective management of heart failure is complex, and ensuring evidence-based practice presents a major challenge to health services worldwide. Over the past decade, the United Kingdom introduced a series of national initiatives to improve evidence-based heart failure management, including a landmark pay-for-performance scheme in primary care and a national audit in secondary care started in 2004 and 2007, respectively. Quality improvement efforts have been evaluated within individual clinical settings, but patterns of care across its continuum, although a critical component of chronic disease management, have not been studied. We have designed this study to investigate patients’ trajectories of care ...


Higher Body Mass Index In Adolescence Predicts Cardiomyopathy Risk In Midlife: Long-Term Follow-Up Among Swedish Men, Josefina Robertson, Maria Schaufelberger, Martin Lindgren, Martin Adiels, Linus Schiöler, Kjell Torén, John J. V. Mcmurray, Naveed Sattar, Maria Åberg, Annika Rosengren Jan 2019

Higher Body Mass Index In Adolescence Predicts Cardiomyopathy Risk In Midlife: Long-Term Follow-Up Among Swedish Men, Josefina Robertson, Maria Schaufelberger, Martin Lindgren, Martin Adiels, Linus Schiöler, Kjell Torén, John J. V. Mcmurray, Naveed Sattar, Maria Åberg, Annika Rosengren

Faculty of Health Sciences Publications

Background: Modifiable lifestyle factors in relation to risk for cardiomyopathy, a common and increasing cause of heart failure in the young, have not been widely studied. We sought to investigate a potential link between obesity, a recognized predictor of early heart failure, in adolescence and being diagnosed with cardiomyopathy in adulthood. Methods: This was a nationwide register-based prospective cohort study of 1 668 893 adolescent men (mean age, 18.3 years; SD, 0.7 years) who enlisted for compulsory military service from 1969 to 2005. At baseline, body mass index (BMI), blood pressure, and medical disorders were registered, along with ...


A Trial To Evaluate The Effect Of The Sodium-Glucose Co-Transporter 2 Inhibitor Dapagliflozin On Morbidity And Mortality In Patients With Heart Failure And Reduced Left Ventricular Ejection Fraction (Dapa-Hf), John J. V. Mcmurray, David L. Demets, Silvio E. Inzucchini, Lars Køber, Mikhail N. Kosiborod, Anna M. Langkilde, Felipe A. Martinez, Olof Bengtsson, Piotr P. Ponikowski, Marc S. Sabatine, Mikaela Sjöstrand, Scott D. Solomon Jan 2019

A Trial To Evaluate The Effect Of The Sodium-Glucose Co-Transporter 2 Inhibitor Dapagliflozin On Morbidity And Mortality In Patients With Heart Failure And Reduced Left Ventricular Ejection Fraction (Dapa-Hf), John J. V. Mcmurray, David L. Demets, Silvio E. Inzucchini, Lars Køber, Mikhail N. Kosiborod, Anna M. Langkilde, Felipe A. Martinez, Olof Bengtsson, Piotr P. Ponikowski, Marc S. Sabatine, Mikaela Sjöstrand, Scott D. Solomon

Faculty of Health Sciences Publications

Background Sodium–glucose co‐transporter 2 (SGLT2) inhibitors have been shown to reduce the risk of incident heart failure hospitalization in individuals with type 2 diabetes who have, or are at high risk of, cardiovascular disease. Most patients in these trials did not have heart failure at baseline and the effect of SGLT2 inhibitors on outcomes in individuals with established heart failure (with or without diabetes) is unknown. Design and methods The Dapagliflozin And Prevention of Adverse‐outcomes in Heart Failure trial (DAPA‐HF) is an international, multicentre, parallel group, randomized, double‐blind, study in patients with chronic heart failure ...


Winter Peaks In Heart Failure: An Inevitable Or Preventable Consequence Of Seasonal Vulnerability?, Simon Stewart, Trine T. Moholdt, Louise M. Burrell, Karen Sliwa, Ana O. Mocumbi, John J. V. Mcmurray, Ashley K. Keates, John A. Hawley Jan 2019

Winter Peaks In Heart Failure: An Inevitable Or Preventable Consequence Of Seasonal Vulnerability?, Simon Stewart, Trine T. Moholdt, Louise M. Burrell, Karen Sliwa, Ana O. Mocumbi, John J. V. Mcmurray, Ashley K. Keates, John A. Hawley

Faculty of Health Sciences Publications

Climate change is a major contributor to annual winter peaks in cardiovascular events across the globe. However, given the paradoxical observation that cardiovascular seasonality is observed in relatively mild as well as cold climates, global warming may not be as positive for the syndrome of heart failure (HF) as some predict. In this article, we present our Model of Seasonal Flexibility to explain the spectrum of individual responses to climatic conditions. We have identified distinctive phenotypes of resilience and vulnerability to explain why winter peaks in HF occur. Moreover, we identify how better identification of climatic vulnerability and the use ...


Prognostic Implications Of Changes In Amino-Terminal Pro–B-Type Natriuretic Peptide In Acute Decompensated Heart Failure: Insights From Ascend-Hf [Accepted Manuscript], Justin L. Grodin, Max J. Liebo, Javed Butler, Marco Metra, G. Michael Felker, Adrian F. Hernandez, Adriaan A. Voors, John J. V. Mcmurray, Paul W. Armstrong, Christopher M. O'Connor, Randall C. Starling, Richard W. Troughton, W. H. Wilson Tang Jan 2019

Prognostic Implications Of Changes In Amino-Terminal Pro–B-Type Natriuretic Peptide In Acute Decompensated Heart Failure: Insights From Ascend-Hf [Accepted Manuscript], Justin L. Grodin, Max J. Liebo, Javed Butler, Marco Metra, G. Michael Felker, Adrian F. Hernandez, Adriaan A. Voors, John J. V. Mcmurray, Paul W. Armstrong, Christopher M. O'Connor, Randall C. Starling, Richard W. Troughton, W. H. Wilson Tang

Faculty of Health Sciences Publications

Background: Amino-terminal pro–B-type natriuretic peptide (NTproBNP) is closely associated with prognosis in acute decompensated heart failure (ADHF). As a result, there has been great interest measuring it during the course of treatment. The prognostic implications in both short-term and follow-up changes in NTproBNP need further clarification. Methods: Baseline, 48–72 hour, and 30-day NTproBNP levels were measured in 795 subjects in the ASCEND-HF trial. Multivariable logistic and Cox-proportional hazards models were used to test the association between static, relative, and absolute changes in NTproBNP with outcomes during and after ADHF. Results: The median NTproBNP at baseline was 5773 (2981 ...


Health Care Professionals’ Perceptions Of Home Telemonitoring In Heart Failure Care: Cross-Sectional Survey, Ina Thon Aamodt, Edita Lycholip, Jelena Celutkiene, Anna Strömberg, Dan Atar, Ragnhild Sørum Falk, Thomas G. Von Lueder, Ragnhild Hellesø, Tiny Jaarsma, Irene Lie Jan 2019

Health Care Professionals’ Perceptions Of Home Telemonitoring In Heart Failure Care: Cross-Sectional Survey, Ina Thon Aamodt, Edita Lycholip, Jelena Celutkiene, Anna Strömberg, Dan Atar, Ragnhild Sørum Falk, Thomas G. Von Lueder, Ragnhild Hellesø, Tiny Jaarsma, Irene Lie

Faculty of Health Sciences Publications

Background: Noninvasive telemonitoring (TM) can be used in heart failure (HF) patients to perform early detection of decompensation at home, prevent unnecessary health care utilization, and decrease health care costs. However, the evidence is not sufficient to be part of HF guidelines for follow-up care, and we have no knowledge of how TM is used in the Nordic Baltic region. Objective: The aim of this study was to describe health care professionals’ (HCPs) perception of and presumed experience with noninvasive TM in daily HF patient care, perspectives of the relevance of and reasons for applying noninvasive TM, and barriers to ...


Heart Failure With Reduced Ejection Fraction: Comparison Of Patient Characteristics And Clinical Outcomes Within Asia And Between Asia, Europe And The Americas, Pooja Dewan, Pardeep S. Jhund, Li Shen, Mark C. Petrie, William T. Abraham, M. Atif Ali, Chen-Huan Chen, Akshay S. Desai, Kenneth Dickstein, Jun Huang, Songsak Kiatchoosakun, Kee-Sik Kim, Lars Køber, Wen-Ter Lai, Yuhua Liao, Ulrik M. Mogensen, Byung-Hee Oh, Milton Packer, Jean L. Rouleau, Victor C. Shi, Antonio S. Sibulo, Scott D. Solomon, Piyamitr Sritara, Karl Swedberg, Hiroyuki Tsutsui, Michael R. Zile, John J. V. Mcmurray Jan 2019

Heart Failure With Reduced Ejection Fraction: Comparison Of Patient Characteristics And Clinical Outcomes Within Asia And Between Asia, Europe And The Americas, Pooja Dewan, Pardeep S. Jhund, Li Shen, Mark C. Petrie, William T. Abraham, M. Atif Ali, Chen-Huan Chen, Akshay S. Desai, Kenneth Dickstein, Jun Huang, Songsak Kiatchoosakun, Kee-Sik Kim, Lars Køber, Wen-Ter Lai, Yuhua Liao, Ulrik M. Mogensen, Byung-Hee Oh, Milton Packer, Jean L. Rouleau, Victor C. Shi, Antonio S. Sibulo, Scott D. Solomon, Piyamitr Sritara, Karl Swedberg, Hiroyuki Tsutsui, Michael R. Zile, John J. V. Mcmurray

Faculty of Health Sciences Publications

Aims Nearly 60% of the world's population lives in Asia but little is known about the characteristics and outcomes of Asian patients with heart failure with reduced ejection fraction (HFrEF) compared to other areas of the world. Methods and results We pooled two, large, global trials, with similar design, in 13 174 patients with HFrEF (patient distribution: China 833, India 1390, Japan 209, Korea 223, Philippines 223, Taiwan 199 and Thailand 95, Western Europe 3521, Eastern Europe 4758, North America 613, and Latin America 1110). Asian patients were younger (55.0–63.9 years) than in Western Europe (67 ...


Income Inequality And Outcomes In Heart Failure, Pooja Dewan, Rasmus Rørth, Pardeep S. Jhund, Joao Pedro Ferreira, Faiez Zannad, Li Shen, Lars Køber, William T. Abraham, Akshay S. Desai, Kenneth Dickstein, Milton Packer, Jean L. Rouleau, Scott D. Solomon, Karl Swedberg, Michael R. Zile, John J. V. Mcmurray Jan 2019

Income Inequality And Outcomes In Heart Failure, Pooja Dewan, Rasmus Rørth, Pardeep S. Jhund, Joao Pedro Ferreira, Faiez Zannad, Li Shen, Lars Køber, William T. Abraham, Akshay S. Desai, Kenneth Dickstein, Milton Packer, Jean L. Rouleau, Scott D. Solomon, Karl Swedberg, Michael R. Zile, John J. V. Mcmurray

Faculty of Health Sciences Publications

Objectives This study examined the relationship between income inequality and heart failure outcomes. Background The income inequality hypothesis postulates that population health is influenced by income distribution within a society, with greater inequality associated with worse outcomes. Methods This study analyzed heart failure outcomes in 2 large trials conducted in 54 countries. Countries were divided by tertiles of Gini coefficients (where 0% represented absolute income equality and 100% represented absolute income inequality), and heart failure outcomes were adjusted for standard prognostic variables, country per capita income, education index, hospital bed density, and health worker density. Results Of the 15,126 ...


Metformin Use And Cardiovascular Events In Patients With Type 2 Diabetes And Chronic Kidney Disease [Accepted Manuscript], David M. Charytan, Scott D. Solomon, Peter Ivanovich, Giuseppe Remuzzi, Mark E. Cooper, Janet B. Mcgill, Hans-Henrik Parving, Patrick Parfrey, Ajay K. Singh, Emmanuel A. Burdmann, Andrew S. Levey, Kai-Uwe Eckardt, John J. V. Mcmurray, Larry A. Weinrauch, Jiankang Liu, Brian L. Claggett, Eldrin F. Lewis, Marc A. Pfeffer Jan 2019

Metformin Use And Cardiovascular Events In Patients With Type 2 Diabetes And Chronic Kidney Disease [Accepted Manuscript], David M. Charytan, Scott D. Solomon, Peter Ivanovich, Giuseppe Remuzzi, Mark E. Cooper, Janet B. Mcgill, Hans-Henrik Parving, Patrick Parfrey, Ajay K. Singh, Emmanuel A. Burdmann, Andrew S. Levey, Kai-Uwe Eckardt, John J. V. Mcmurray, Larry A. Weinrauch, Jiankang Liu, Brian L. Claggett, Eldrin F. Lewis, Marc A. Pfeffer

Faculty of Health Sciences Publications

Aims Metformin could have benefits on cardiovascular disease and kidney disease progression but is often withheld from individuals with diabetes and chronic kidney disease (CKD) because of a concern that it may increase the risk of lactic acidosis. Materials and methods All‐cause mortality, cardiovascular death, cardiovascular events (death, hospitalization for heart failure, myocardial infarction, stroke or myocardial ischemia), end stage renal disease (ESRD) and the kidney disease composite (ESRD or death) were compared in metformin users and non‐users with diabetes and CKD enrolled in the Trial to Reduce Cardiovascular Events with Aranesp (darbepoeitin‐alfa) Therapy (TREAT) (NCT00093015). Outcomes ...


Outcomes And Effect Of Treatment According To Etiology In Hfref: An Analysis Of Paradigm-Hf, Craig Balmforth, Joanne Simpson, Li Shen, Pardeep S. Jhund, Martin P. Lefkowitz, Adel R. Rizkala, Jean L. Rouleau, Victor C. Shi, Scott D. Solomon, Karl Swedberg, Michael R. Zile, Milton Packer, John J. V. Mcmurray Jan 2019

Outcomes And Effect Of Treatment According To Etiology In Hfref: An Analysis Of Paradigm-Hf, Craig Balmforth, Joanne Simpson, Li Shen, Pardeep S. Jhund, Martin P. Lefkowitz, Adel R. Rizkala, Jean L. Rouleau, Victor C. Shi, Scott D. Solomon, Karl Swedberg, Michael R. Zile, Milton Packer, John J. V. Mcmurray

Faculty of Health Sciences Publications

Objectives The purpose of this study was to compare outcomes (and the effect of sacubitril/valsartan) according to etiology in the PARADIGM-HF (Prospective comparison of angiotensin-receptor-neprilysin inhibitor [ARNI] with angiotensin-converting-enzyme inhibitor [ACEI] to Determine Impact on Global Mortality and morbidity in Heart Failure) trial. Background Etiology of heart failure (HF) has changed over time in more developed countries and is also evolving in non-Western societies. Outcomes may vary according to etiology, as may the effects of therapy. Methods We examined outcomes and the effect of sacubtril/valsartan according to investigator-reported etiology in PARADIGM-HF. The outcomes analyzed were the primary composite ...


Sacubitril/Valsartan In Asian Patients With Heart Failure With Reduced Ejection Fraction, Pooja Dewan, Kieran F. Docherty, John J. V. Mcmurray Jan 2019

Sacubitril/Valsartan In Asian Patients With Heart Failure With Reduced Ejection Fraction, Pooja Dewan, Kieran F. Docherty, John J. V. Mcmurray

Faculty of Health Sciences Publications

The Prospective comparison of Angiotensin Receptor-neprilysin inhibitor (ARNI) with Angiotensin converting enzyme inhibitor (ACEI) to Determine Impact on Global Mortality and morbidity in Heart Failure (HF) trial (PARADIGM-HF) showed that adding a neprilysin inhibitor (sacubitril) to a renin-angiotensin system blocker (and other standard therapy) reduced morbidity and mortality in ambulatory patients with chronic HF with reduced ejection fraction (HFrEF). In PARADIGM-HF, valsartan combined with sacubitril (a so-called ARNI) was superior to the current gold standard of an ACEI, specifically enalapril, reducing the risk of the primary composite outcome of cardiovascular (CV) death or first HF hospitalization by 20% and all-cause ...


Heart Failure In Sub-Saharan Africa, Okechukwu Ogah, Adewole Adebiyi, Karen Sliwa-Hahnle Jan 2019

Heart Failure In Sub-Saharan Africa, Okechukwu Ogah, Adewole Adebiyi, Karen Sliwa-Hahnle

Faculty of Health Sciences Publications

Sub-Saharan Africa (SSA) is currently experiencing multiple burden of disease as a result of demographic and epidemiologic transition. This is occasioned rapid urbanization, unhealthy diets rich in fats and salt, western lifestyle and sedentary living. Heart failure (HF) has become a global public health issue. It is associated with high morbidity and mortality, frequent hospitalization and high economic cost. In SSA, HF is a disease of young and middle-aged adults with the attendant high disability-adjusted life years. This is unlike to the clinical profile and pattern of HF in high-income countries of North America, Western Europe and Japan where HF ...


Personalized Medicine And Hospitalization For Heart Failure: If We Understand It, We May Be Successful In Treating It, Faheem A. Ahmad, Mark C. Petrie, John J. V. Mcmurray, Ninian N. Lang Jan 2019

Personalized Medicine And Hospitalization For Heart Failure: If We Understand It, We May Be Successful In Treating It, Faheem A. Ahmad, Mark C. Petrie, John J. V. Mcmurray, Ninian N. Lang

Faculty of Health Sciences Publications

Randomized trials in patients with hospitalized heart failure (HHF) continue to frustrate the cardiology community. Promising haemodynamic, structural and biomarker findings from phase 2 studies consistently fail to deliver substantive benefits in larger outcome trials. What underlies these recurrent failures? Why are persistently high readmission and post‐discharge mortality rates not being reduced? Challenging any pre‐conceived ideas about the existence of a ‘typical’ acutely decompensated heart failure patient is fundamental, as is the adoption of a carefully personalized approach. These individuals come from a remarkably heterogeneous group. Surely precise phenotyping should translate to a more successful therapeutic approach?


The Effect Of Minimally Invasive Surgical Aortic Valve Replacement On Postoperative Pulmonary And Skeletal Muscle Function [Accepted Manuscript], Hajar Boujemaa, Alaaddin Yilmaz, Boris Robic, Katrien Koppo, Guido Claessen, Ines Frederix, Paul Dendale, Heinz Völler, Luc J. C. Van Loon, Dominique Hansen Jan 2019

The Effect Of Minimally Invasive Surgical Aortic Valve Replacement On Postoperative Pulmonary And Skeletal Muscle Function [Accepted Manuscript], Hajar Boujemaa, Alaaddin Yilmaz, Boris Robic, Katrien Koppo, Guido Claessen, Ines Frederix, Paul Dendale, Heinz Völler, Luc J. C. Van Loon, Dominique Hansen

Faculty of Health Sciences Publications

Suboptimal post‐operative improvements in functional capacity are often observed after minimally invasive aortic valve replacement (mini‐AVR). It remains to be studied how AVR affects the cardiopulmonary and skeletal muscle function during exercise to explain these clinical observations and to provide a basis for improved/tailored post‐operative rehabilitation. Twenty‐two patients with severe aortic stenosis (AS) (aortic valve area (AVA) <1.0 cm²) were pre‐operatively compared to 22 healthy controls during submaximal constant‐workload endurance‐type exercise for oxygen uptake (urn:x-wiley:09580670:media:eph12495:eph12495-math-0001), carbon dioxide output (urn:x-wiley:09580670:media:eph12495:eph12495-math-0002), respiratory gas exchange ratio, expiratory volume (urn:x-wiley:09580670:media:eph12495:eph12495-math-0003), ventilatory equivalents for O2 (urn:x-wiley:09580670:media:eph12495:eph12495-math-0004/urn:x-wiley:09580670:media:eph12495:eph12495-math-0005) and CO2 (urn:x-wiley:09580670:media:eph12495:eph12495-math-0006/urn:x-wiley:09580670:media:eph12495:eph12495-math-0007), respiratory rate (RR), tidal volume (Vt), heart rate (HR), oxygen pulse (urn:x-wiley:09580670:media:eph12495:eph12495-math-0008/HR), blood lactate, Borg ratings of perceived exertion (RPE) and exercise‐onset urn:x-wiley:09580670:media:eph12495:eph12495-math-0009 kinetics. These exercise tests were repeated at 5 and 21 days after AVR surgery (n = 14), along with echocardiographic examinations. Respiratory exchange ratio and ventilatory equivalents (urn:x-wiley:09580670:media:eph12495:eph12495-math-0010/urn:x-wiley:09580670:media:eph12495:eph12495-math-0011 and urn:x-wiley:09580670:media:eph12495:eph12495-math-0012/urn:x-wiley:09580670:media:eph12495:eph12495-math-0013) were significantly elevated, urn:x-wiley:09580670:media:eph12495:eph12495-math-0014 and urn:x-wiley:09580670:media:eph12495:eph12495-math-0015/HR were significantly lowered, and exercise‐onset urn:x-wiley:09580670:media:eph12495:eph12495-math-0016 kinetics were significantly slower in AS patients vs. healthy controls (P < 0.05). Although the AVA was restored by mini‐AVR in AS patients, urn:x-wiley:09580670:media:eph12495:eph12495-math-0017/urn:x-wiley:09580670:media:eph12495:eph12495-math-0018 and urn:x-wiley:09580670:media:eph12495:eph12495-math-0019/urn:x-wiley:09580670:media:eph12495:eph12495-math-0020 further worsened significantly within 5 days after surgery, accompanied by elevations in Borg RPE, urn:x-wiley:09580670:media:eph12495:eph12495-math-0021 and RR, and lowered Vt. At 21 days after mini‐AVR, exercise‐onset urn:x-wiley:09580670:media:eph12495:eph12495-math-0022 kinetics further slowed significantly (P < 0.05). A decline in pulmonary function was observed early after mini‐AVR surgery, which was followed by a decline in skeletal muscle function in the subsequent weeks of recovery. Therefore, a tailored rehabilitation programme should include training modalities for the respiratory and peripheral muscular system.


Efficacy Of An Implantable Cardioverter-Defibrillator In Patients With Diabetes And Heart Failure And Reduced Ejection Fraction, Rasmus Rørth, Pooja Dewan, Søren L. Kristensen, Pardeep S. Jhund, Mark C. Petrie, Lars Køber, John J. V. Mcmurray Jan 2019

Efficacy Of An Implantable Cardioverter-Defibrillator In Patients With Diabetes And Heart Failure And Reduced Ejection Fraction, Rasmus Rørth, Pooja Dewan, Søren L. Kristensen, Pardeep S. Jhund, Mark C. Petrie, Lars Køber, John J. V. Mcmurray

Faculty of Health Sciences Publications

Background The effect of implantable cardioverter-defibrillator (ICD) therapy in patients with heart failure with reduced ejection fraction (HFrEF) and diabetes is not fully elucidated. Methods We examined the effect of ICD therapy on sudden cardiac death, cardiovascular death and all-cause mortality, according to diabetes status at baseline in the Sudden Cardiac Death in Heart Failure Trial (SCD-HeFT). The outcomes were analyzed by use of cumulative incidence curves and Cox regressions models. Results Of the 1676 patients randomized to an ICD or placebo, 540 (32%) had diabetes at baseline. Patients with diabetes were slightly older (61 vs 58 years) and were ...


Peripartum Cardiomyopathy: Disease Or Syndrome?, Lucia Baris, Jérôme Cornette, Mark R. Johnson, Karen Sliwa, Jolien W. Roos-Hesselink Jan 2019

Peripartum Cardiomyopathy: Disease Or Syndrome?, Lucia Baris, Jérôme Cornette, Mark R. Johnson, Karen Sliwa, Jolien W. Roos-Hesselink

Faculty of Health Sciences Publications

Peripartum cardiomyopathy (PPCM) is a rare form of pregnancy-associated heart failure and is considered to be a diagnosis of exclusion. There are many hypotheses on the aetiology of PPCM; however, the exact pathophysiological mechanism remains unknown. It shows many resemblances to other conditions, such as familial dilated cardiomyopathy or myocarditis, and therefore it can be hard to make a definite diagnosis. We describe four cases of peripartum-onset heart failure in women who were suspected of having PPCM. We discuss the differential diagnosis, pathophysiological mechanisms and various diagnostic modalities.


Reduced Loop Diuretic Use In Patients Taking Sacubitril/Valsartan Compared With Enelapril: The Paradigm-Hf Trial, Orly Vardeny, Brian L. Claggett, Jessica Kachadourian, Akshay S. Desai, Milton Packer, Jean L. Rouleau, Michael R. Zile, Karl Swedberg, Martin P. Lefkowitz, Victor C. Shi, John J. V. Mcmurray, Scott D. Solomon Jan 2019

Reduced Loop Diuretic Use In Patients Taking Sacubitril/Valsartan Compared With Enelapril: The Paradigm-Hf Trial, Orly Vardeny, Brian L. Claggett, Jessica Kachadourian, Akshay S. Desai, Milton Packer, Jean L. Rouleau, Michael R. Zile, Karl Swedberg, Martin P. Lefkowitz, Victor C. Shi, John J. V. Mcmurray, Scott D. Solomon

Faculty of Health Sciences Publications

Aims To assess differences in diuretic dose requirements in patients treated with sacubitril/valsartan compared with enalapril in the Prospective comparison of ARNI with ACEI to Determine Impact on Global Mortality and morbidity in Heart Failure (PARADIGM‐HF) trial. Methods and results Overall, 8399 patients with New York Heart Association class II–IV heart failure and reduced LVEF were randomized to sacubitril/valsartan 200 mg bid or enalapril 10 mg twice daily. Loop diuretic doses were assessed at baseline, 6, 12, and 24 months, and furosemide dose equivalents were calculated via multiplication factors (2x for torsemide and 40x for bumetanide ...


Statins In The Prevention And Treatment Of Heart Failure: A Review Of The Evidence, Matthew M. Y. Lee, Naveed Sattar, John J. V. Mcmurray, Chris J. Packard Jan 2019

Statins In The Prevention And Treatment Of Heart Failure: A Review Of The Evidence, Matthew M. Y. Lee, Naveed Sattar, John J. V. Mcmurray, Chris J. Packard

Faculty of Health Sciences Publications

Purpose of Review We summarize the best evidence for statins in the prevention and treatment of heart failure. Recent Findings In patients with cardiovascular risk factors or established atherosclerotic cardiovascular disease (but without heart failure), statins reduce the risk of incident heart failure—mainly by preventing myocardial infarction although an additional benefit from reducing myocardial ischemia cannot be excluded. However, in patients with established heart failure, statins do not reduce the risk of cardiovascular death, which is mainly caused by pump failure and ventricular arrhythmias. Retrospective analyses, however, suggest that statins may reduce the rate of heart failure hospitalization and ...


Urban Densification And 12-Year Changes In Cardiovascular Risk Markers, Manoj Chandrabose, Neville Owen, Billie Giles-Corti, Gavin Turrell, Alison Carver, Takemi Sugiyama Jan 2019

Urban Densification And 12-Year Changes In Cardiovascular Risk Markers, Manoj Chandrabose, Neville Owen, Billie Giles-Corti, Gavin Turrell, Alison Carver, Takemi Sugiyama

Faculty of Health Sciences Publications

Background Population densities of many cities are increasing rapidly, with the potential for impacts on cardiovascular health. This longitudinal study examined the potential impact of population‐density increases in urban areas (urban densification) on cardiovascular risk markers among Australian adults. Methods and Results Data were from the Australian Diabetes, Obesity and Lifestyle Study, in which adult participants’ cardiovascular risk markers were collected in 3 waves (in 1999–2000, 2004–2005, and 2011–2012). We included 2354 participants with a mean age of 51 years at baseline who did not change their residence during the study period. Outcomes were 12‐year ...


Global Unmet Needs In Cardiac Surgery, Peter Zilla, Magdi H. Yacoub, Liesl Joanna Zuhlke, Friedhelm Beyersdorf, Karen Sliwa-Hahnle, Gennadiy Khubulava, Abdelmalek Bouzid, Ana O. Mocumbi, Devagourou Velayoudam, Devi Shetty, Chima Ofoegbu, Agneta Geldenhuys, Johan Brink, Jacques Scherman, Henning Du Toit, Saeid Hosseini, Hao Zhang, Xin-Jin Luo, Wei C. Wang, Juan Mejia, Theodoros Kofidis, Robert S. D. Higgins, Jose Pomar, R. Morton Bolman, Bongani Mayosi, Rajhmun Madansein, Joseph Bavaria, Alberto A. Yanes-Quintana, A. Sampath Kumar, Oladapo Adeoye, Risenga Frank Chauke, David F. Williams Jan 2018

Global Unmet Needs In Cardiac Surgery, Peter Zilla, Magdi H. Yacoub, Liesl Joanna Zuhlke, Friedhelm Beyersdorf, Karen Sliwa-Hahnle, Gennadiy Khubulava, Abdelmalek Bouzid, Ana O. Mocumbi, Devagourou Velayoudam, Devi Shetty, Chima Ofoegbu, Agneta Geldenhuys, Johan Brink, Jacques Scherman, Henning Du Toit, Saeid Hosseini, Hao Zhang, Xin-Jin Luo, Wei C. Wang, Juan Mejia, Theodoros Kofidis, Robert S. D. Higgins, Jose Pomar, R. Morton Bolman, Bongani Mayosi, Rajhmun Madansein, Joseph Bavaria, Alberto A. Yanes-Quintana, A. Sampath Kumar, Oladapo Adeoye, Risenga Frank Chauke, David F. Williams

Faculty of Health Sciences Publications

More than 6 billion people live outside industrialized countries and have insufficient access to cardiac surgery. Given the recently confirmed high prevailing mortality for rheumatic heart disease in many of these countries together with increasing numbers of patients needing interventions for lifestyle diseases due to an accelerating epidemiological transition, a significant need for cardiac surgery could be assumed. Yet, need estimates were largely based on extrapolated screening studies while true service levels remained unknown. A multi-author effort representing 16 high-, middle-, and low-income countries was undertaken to narrow the need assessment for cardiac surgery including rheumatic and lifestyle cardiac diseases ...


'Better To Save One Life Than Build A Seven-Storied Pagoda': A Qualitative Study Of Health Education For Patients With Acute Coronary Syndrome And Type 2 Diabetes Mellitus In Shanghai, China, Xian-Liang Liu, Karen Willis, Chiung-Jung (Jo) Wu, Yan Shi, Maree Johnson Jan 2018

'Better To Save One Life Than Build A Seven-Storied Pagoda': A Qualitative Study Of Health Education For Patients With Acute Coronary Syndrome And Type 2 Diabetes Mellitus In Shanghai, China, Xian-Liang Liu, Karen Willis, Chiung-Jung (Jo) Wu, Yan Shi, Maree Johnson

Faculty of Health Sciences Publications

Objective: To describe, from the perspectives of health professionals, the health education currently being provided from hospital admission to discharge to home to patients who present with acute coronary syndrome who also have type 2 diabetes mellitus (T2DM). Methods: A qualitative study using semistructured interviews was undertaken in the coronary care unit (CCU) of a major hospital in Shanghai, China. Fifteen health professionals (nine registered nurses and six physicians) from the CCU who delivered health education to patients with acute coronary syndrome and T2DM participated. Participants also completed an Education Content Checklist containing topics consistent with existing national guidelines. Findings ...


Multimorbidity And The Risk Of All-Cause 30-Day Readmission In The Setting Of Multidisciplinary Management Of Chronic Heart Failure: A Retrospective Analysis Of 830 Hospitalized Patients In Australia, Joshua F. Wiley, Yih-Kai Chan, Yasmin Ahamed, Jocasta Ball, Melinda J. Carrington, Barbara Reigel, Simon Stewart Jan 2018

Multimorbidity And The Risk Of All-Cause 30-Day Readmission In The Setting Of Multidisciplinary Management Of Chronic Heart Failure: A Retrospective Analysis Of 830 Hospitalized Patients In Australia, Joshua F. Wiley, Yih-Kai Chan, Yasmin Ahamed, Jocasta Ball, Melinda J. Carrington, Barbara Reigel, Simon Stewart

Faculty of Health Sciences Publications

Background: Multimorbidity has an adverse effect on health outcomes in hospitalized individuals with chronic heart failure (CHF), but the modulating effect of multidisciplinary management is unknown. Objective: The aim of this study was to test the hypothesis that increasing morbidity would independently predict an increasing risk of 30-day readmission despite multidisciplinary management of CHF. Methods: We studied patients hospitalized for any reason with heart failure receiving nurse-led, postdischarge multidisciplinary management. We profiled a matrix of expected comorbidities involving the most common coexisting conditions associated with CHF and examined the relationship between multimorbidity and 30-day all-cause readmission. Results: A total of ...


Patient Experiences Of Web-Based Cognitive Behavioral Therapy For Heart Failure And Depression: Qualitative Study, Johan Lundgren, Peter Johansson, Tiny Jaarsma, Gerhard Andersson, Anita Kärner Köhler Jan 2018

Patient Experiences Of Web-Based Cognitive Behavioral Therapy For Heart Failure And Depression: Qualitative Study, Johan Lundgren, Peter Johansson, Tiny Jaarsma, Gerhard Andersson, Anita Kärner Köhler

Faculty of Health Sciences Publications

Background: Web-based cognitive behavioral therapy (wCBT) has been proposed as a possible treatment for patients with heart failure and depressive symptoms. Depressive symptoms are common in patients with heart failure and such symptoms are known to significantly worsen their health. Although there are promising results on the effect of wCBT, there is a knowledge gap regarding how persons with chronic heart failure and depressive symptoms experience wCBT. Objective: The aim of this study was to explore and describe the experiences of participating and receiving health care through a wCBT intervention among persons with heart failure and depressive symptoms. Methods: In ...


Effects Of Leisure-Time And Transport-Related Physical Activities On The Risk Of Incident And Recurrent Myocardial Infarction And Interaction With Traffic-Related Air Pollution: A Cohort Study, Nadine Kubesch, Jeanette Therming Jørgensen, Barbara Hoffmann, Steffen Loft, Mark Nieuwenhuijsen, Ole Raaschou-Nielsen, Marie Pedersen, Ole Hertel, Kim Overvad, Anne Tjønneland, Eva Prescot, Zorana Jovanovic Andersen Jan 2018

Effects Of Leisure-Time And Transport-Related Physical Activities On The Risk Of Incident And Recurrent Myocardial Infarction And Interaction With Traffic-Related Air Pollution: A Cohort Study, Nadine Kubesch, Jeanette Therming Jørgensen, Barbara Hoffmann, Steffen Loft, Mark Nieuwenhuijsen, Ole Raaschou-Nielsen, Marie Pedersen, Ole Hertel, Kim Overvad, Anne Tjønneland, Eva Prescot, Zorana Jovanovic Andersen

Faculty of Health Sciences Publications

Background
Physical activity enhances the uptake of air pollutants, possibly reducing its beneficial effects. We examined the effects of leisure‐time and transport‐related physical activities on the risk of myocardial infarction (MI), and whether potential benefits on MI are reduced by exposure to traffic‐related air pollution.
Methods and Results
A group of 57 053 participants (50–65 years of age) from the Danish Diet, Cancer, and Health cohort reported physical activity at baseline (1993–1997) and were linked to registry data on hospital contacts and out‐of‐hospital deaths caused by MI, until December 2015. Nitrogen dioxide levels ...


Cost-Effectiveness Of Sacubitril/Valsartan In The Treatment Of Heart Failure With Reduced Ejection Fraction, John Mcmurray, David Trueman, Elizabeth Hancock, Martin R. Cowie, Andrew Briggs, Mathew Taylor, Juliet Mumby-Croft, Fionn Woodcock, Michael Lacey, Rola Haroun, Celine Deschaseaux Jan 2018

Cost-Effectiveness Of Sacubitril/Valsartan In The Treatment Of Heart Failure With Reduced Ejection Fraction, John Mcmurray, David Trueman, Elizabeth Hancock, Martin R. Cowie, Andrew Briggs, Mathew Taylor, Juliet Mumby-Croft, Fionn Woodcock, Michael Lacey, Rola Haroun, Celine Deschaseaux

Faculty of Health Sciences Publications

Objective
Chronic heart failure with reduced ejection fraction (HF-REF) represents a major public health issue and is associated with considerable morbidity and mortality. We evaluated the cost-effectiveness of sacubitril/valsartan (formerly LCZ696) compared with an ACE inhibitor (ACEI) (enalapril) in the treatment of HF-REF from the perspective of healthcare providers in the UK, Denmark and Colombia.
Methods
A cost-utility analysis was performed based on data from a multinational, Phase III randomised controlled trial. A decision-analytic model was developed based on a series of regression models, which extrapolated health-related quality of life, hospitalisation rates and survival over a lifetime horizon. The ...


Impact Of Chronic Inflammation, Assessed By Hs-Crp, On The Association Between Red Cell Distribution Width And Arterial Cardiovascular Disease: The Tromso Study, Jostein Lappegard, Trygve S. Ellingsen, Kristian Hindberg, Ellisiv Bøgeberg Mathiesen, Inger Njolstad, Tom Wilsgaard, Maja-Lisa Loechen, Sigrid Kufaas Braekkan, John-Bjarne Hansen Jan 2018

Impact Of Chronic Inflammation, Assessed By Hs-Crp, On The Association Between Red Cell Distribution Width And Arterial Cardiovascular Disease: The Tromso Study, Jostein Lappegard, Trygve S. Ellingsen, Kristian Hindberg, Ellisiv Bøgeberg Mathiesen, Inger Njolstad, Tom Wilsgaard, Maja-Lisa Loechen, Sigrid Kufaas Braekkan, John-Bjarne Hansen

Faculty of Health Sciences Publications

Red cell distribution width (RDW), a measure of variability in size of circulating erythrocytes, is associated with arterial cardiovascular disease (CVD), but the underlying mechanism remains unclear. We aimed to investigate the impact of chronic inflammation as measured by high-sensitivity C-reactive protein (hs-CRP) on this relationship, and explore whether RDW could be a mediator in the causal pathway between inflammation and arterial CVD. Baseline characteristics, including RDW and hs-CRP, were obtained from 5,765 individuals attending a population-based cohort study. We followed up participants from inclusion in the fourth survey of the Tromsø Study (1994/1995) until December 31, 2012 ...


Initiation Of Domiciliary Care And Nursing Home Admission Following First Hospitalization Of Heart Failure Patients: A Nationwide Cohort Study, Rasmus Rørth, Emil L. Fosbøl, Kristian Kragholm, Ulrik M. Mogensen, Pardeep S. Jhund, Mark C. Petrie, Christian Torp-Pedersen, Gunnar H. Gislason, John J. V. Mcmurray, Lars Køber, Søren L. Kristensen Jan 2018

Initiation Of Domiciliary Care And Nursing Home Admission Following First Hospitalization Of Heart Failure Patients: A Nationwide Cohort Study, Rasmus Rørth, Emil L. Fosbøl, Kristian Kragholm, Ulrik M. Mogensen, Pardeep S. Jhund, Mark C. Petrie, Christian Torp-Pedersen, Gunnar H. Gislason, John J. V. Mcmurray, Lars Køber, Søren L. Kristensen

Faculty of Health Sciences Publications

Background: Heart failure (HF) has a major impact on a patient’s quality of life and functional status. This impact may be sufficiently profound to prevent independent living although how often this is the case is unknown. We examined the need for domiciliary assistance and admission to a nursing home following first HF hospitalization. Methods: In nationwide Danish registries, we identified a cohort of patients discharged alive after a first-time HF hospitalization in the period 2008–2014 who were matched 1:5 with comparison subjects based on age and sex and followed for 5 years. Results: We included 37,547 ...


Who Benefits From A Defibrillator - Balancing The Risk Of Sudden Versus Non-Sudden Death, Simon A. S. Beggs, Roy S. Gardner, John J. V. Mcmurray Jan 2018

Who Benefits From A Defibrillator - Balancing The Risk Of Sudden Versus Non-Sudden Death, Simon A. S. Beggs, Roy S. Gardner, John J. V. Mcmurray

Faculty of Health Sciences Publications

Purpose of Review: Treatment with a defibrillator can reduce the risk of sudden death by terminating ventricular arrhythmias. The identification of patient groups in whom this function reduces overall mortality is challenging. In this review, we summarise the evidence for who benefits from a defibrillator. Recent Findings: Recent evidence suggests that contemporary pharmacologic and non-defibrillator device therapies are altering the potential risks and benefits of a defibrillator. Summary: Who benefits from a defibrillator is determined by both the risk of sudden death and the competing risk of other, non-sudden causes of death. The balance of these risks is changing, which ...


Associations Of Context-Specific Sitting Time With Markers Of Cardiometabolic Risk In Australian Adults, Paddy C. Dempsey, Nyssa T. Hadgraft, Elisabeth A. H. Winkler, Bronwyn K. Clark, Mathew P. Buman, Paul A. Gardiner, Neville Owen, Brigid M. Lynch, David W. Dunstan Jan 2018

Associations Of Context-Specific Sitting Time With Markers Of Cardiometabolic Risk In Australian Adults, Paddy C. Dempsey, Nyssa T. Hadgraft, Elisabeth A. H. Winkler, Bronwyn K. Clark, Mathew P. Buman, Paul A. Gardiner, Neville Owen, Brigid M. Lynch, David W. Dunstan

Faculty of Health Sciences Publications

Background: High volumes of sitting time are associated with an elevated risk of type 2 diabetes and cardiovascular disease, and with adverse cardiometabolic risk profiles. However, previous studies have predominately evaluated only total sitting or television (TV) viewing time, limiting inferences about the specific cardiometabolic health impacts of sitting accumulated in different contexts. We examined associations of sitting time in four contexts with cardiometabolic risk biomarkers in Australian adults. Methods: Participants (n = 3429; mean ± SD age 58 ± 10 years) were adults without clinically diagnosed diabetes or cardiovascular disease from the 2011–2012 Australian Diabetes, Obesity and Lifestyle (AusDiab) study. Multiple ...


Cardiovascular Disease Risk Marker Responses To Breaking Up Prolonged Sedentary Time In Individuals With Paraplegia: The Spinal Cord Injury Move More (Scimm) Randomised Crossover Laboratory Trial Protocol, Thomas M. Withers, Louise Croft, Victoria L. Goosey-Tolfrey, David W. Dunstan, Christof A. Leicht, Daniel P. Bailey Jan 2018

Cardiovascular Disease Risk Marker Responses To Breaking Up Prolonged Sedentary Time In Individuals With Paraplegia: The Spinal Cord Injury Move More (Scimm) Randomised Crossover Laboratory Trial Protocol, Thomas M. Withers, Louise Croft, Victoria L. Goosey-Tolfrey, David W. Dunstan, Christof A. Leicht, Daniel P. Bailey

Faculty of Health Sciences Publications

Introduction: Sedentary behaviour is a distinct risk factor for cardiovascular disease (CVD) and could partly explain the increased prevalence of CVD in people with spinal cord injury (SCI). Interrupting prolonged sitting periods with regular short bouts of walking acutely suppresses postprandial glucose and lipids in able-bodied individuals. However, the acute CVD risk marker response to breaking up prolonged sedentary time in people with SCI has not been investigated. Methods and analysis: A randomised two-condition laboratory crossover trial will compare: (1) breaking up prolonged sedentary time with 2 min moderate-intensity arm-crank activity every 20 min, with (2) uninterrupted prolonged sedentary time ...