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1.
001-es BibID:
BIBFORM079007
035-os BibID:
(Scopus)85070663061
Első szerző:
Oliva, Fabrizio
Cím:
Repetitive levosimendan treatment in the management of advanced heart failure / Fabrizio Oliva, Josep Comin-Colet, Francesco Fedele, Friedrich Fruhwald, Finn Gustafsson, Matti Kivikko, Borbély Attila, Gerhard Pölzl, Carsten Tschöpe
Dátum:
2018
ISSN:
1520-765X
Megjegyzések:
Inotropes may be an appropriate treatment for patients with advanced heart failure (AdHF) who remain highly symptomatic despite optimized standard therapies. Objectives for inotrope use in these situations include relief of symptoms and improvement of quality of life, and reduction in unplanned hospitalizations and the costs associated with such episodes. All of these goals must be attained without compromising survival. Encouraging findings with intermittent cycles of intravenous levosimendan have emerged from a range of exploratory studies and from three larger controlled trials (LevoRep, LION-HEART, and LAICA) which offered some evidence of clinical advantage. In these settings, however, obtaining statistically robust data may prove elusive due to the difficulties of endpoint assessment in a complex medical condition with varying presentation and trajectory. Adoption of a composite clinical endpoint evaluated in a hierarchical manner may offer a workable solution to this problem. Such an instrument can explore the proposition that repetitive administration of levosimendan early in the period after discharge from an acute episode of worsening heart failure may be associated with greater subsequent clinical stability vis-a`-vis standard therapy. The use of this methodology to develop a ♭stability score' for each patient means that all participants in such a trial contribute to the overall outcome analysis through one or more of the hierarchical endpoints; this has helpful practical implications for the number of patients needed and the length of follow-up required to generate endpoint data. The LeoDOR study (NCT03437226), outlined in this review, has been designed to explore this new approach to outcome assessment in AdHF.
Tárgyszavak:
Orvostudományok
Klinikai orvostudományok
idegen nyelvű folyóiratközlemény külföldi lapban
folyóiratcikk
Intermittent treatment
Repetitive inotrope
Quality of life
Rehospitalization
Outcome
Megjelenés:
European Heart Journal Supplements. - 20 : suppl. I (2018), p. I11-I20. -
További szerzők:
Comin-Colet, Josep
Fedele, Francesco
Fruhwald, Friedrich
Gustafsson, Finn
Kivikko, Matti
Borbély Attila (1978-) (kardiológus)
Pölzl, Gerhard
Tschöpe, Carsten
Internet cím:
Szerző által megadott URL
DOI
Intézményi repozitóriumban (DEA) tárolt változat
Borító:
Saját polcon:
2.
001-es BibID:
BIBFORM003763
Első szerző:
Paulus, Walter J.
Cím:
How to diagnose diastolic heart failure : a consensus statement on the diagnosis of heart failure with normal left ventricular ejection fraction by the Heart Failure and Echocardiography Associations of the European Society of Cardiology / Paulus, W. J., Tschope, C., Sanderson, J. E., Rusconi, C., Flachskampf, F. A., Rademakers, F. E., Marino, P., Smiseth, O. A., De Keulenaer, G., Leite-Moreira, A. F., Borbely, A., Edes, I., Handoko, M. L., Heymans, S., Pezzali, N., Pieske, B., Dickstein, K., Fraser, A. G., Brutsaert, D. L.
Dátum:
2007
Megjegyzések:
Diastolic heart failure (DHF) currently accounts for more than 50% of all heart failure patients. DHF is also referred to as heart failure with normal left ventricular (LV) ejection fraction (HFNEF) to indicate that HFNEF could be a precursor of heart failure with reduced LVEF. Because of improved cardiac imaging and because of widespread clinical use of plasma levels of natriuretic peptides, diagnostic criteria for HFNEF needed to be updated. The diagnosis of HFNEF requires the following conditions to be satisfied: (i) signs or symptoms of heart failure; (ii) normal or mildly abnormal systolic LV function; (iii) evidence of diastolic LV dysfunction. Normal or mildly abnormal systolic LV function implies both an LVEF > 50% and an LV end-diastolic volume index (LVEDVI) <97 mL/m(2). Diagnostic evidence of diastolic LV dysfunction can be obtained invasively (LV end-diastolic pressure >16 mmHg or mean pulmonary capillary wedge pressure >12 mmHg) or non-invasively by tissue Doppler (TD) (E/E' > 15). If TD yields an E/E' ratio suggestive of diastolic LV dysfunction (15 > E/E' > 8), additional non-invasive investigations are required for diagnostic evidence of diastolic LV dysfunction. These can consist of blood flow Doppler of mitral valve or pulmonary veins, echo measures of LV mass index or left atrial volume index, electrocardiographic evidence of atrial fibrillation, or plasma levels of natriuretic peptides. If plasma levels of natriuretic peptides are elevated, diagnostic evidence of diastolic LV dysfunction also requires additional non-invasive investigations such as TD, blood flow Doppler of mitral valve or pulmonary veins, echo measures of LV mass index or left atrial volume index, or electrocardiographic evidence of atrial fibrillation. A similar strategy with focus on a high negative predictive value of successive investigations is proposed for the exclusion of HFNEF in patients with breathlessness and no signs of congestion. The updated strategies for the diagnosis and exclusion of HFNEF are useful not only for individual patient management but also for patient recruitment in future clinical trials exploring therapies for HFNEF
Tárgyszavak:
Orvostudományok
Klinikai orvostudományok
idegen nyelvű folyóiratközlemény külföldi lapban
Biological Markers
blood
Consensus
diagnosis
Diagnosis,Differential
Diastole
Echocardiography
Echocardiography,Doppler
Heart Failure
Humans
methods
Natriuretic Peptides
physiology
Stroke Volume
therapy
ultrasonography
Megjelenés:
European Heart Journal. - 28 : 20 (2007), p. 2539-2550. -
További szerzők:
Tschöpe, Carsten
Sanderson, John E.
Rusconi, Cesare
Flachskampf, Frank A.
Rademakers, Frank E.
Marino, Paolo
Smiseth, Otto A.
De Keulenaer, Gilles
Leite-Moreira, Adelino F.
Borbély Attila (1978-) (kardiológus)
Édes István (1952-) (kardiológus)
Handoko, Martin Louis
Heymans, Stephane
Pezzali, Natalia
Pieske, Burkert
Dickstein, Kenneth
Fraser, Alan G.
Brutsaert, Dirk L.
Internet cím:
elektronikus változat
DOI
Borító:
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