Background Limited data exist about the impact of gender-specific outcomes in patients with heart failure (HF) who develop concomitant sepsis. Methods This is a retrospective cohort study of patients with HF who developed sepsis. Clinical outcomes, including in-hospital mortality, development of cardiogenic shock (CS), pulmonary edema requiring urgent intravenous diuretics (IVD), acute kidney injury (AKI), length of stay (LOS), and 30-day HF-related readmission, were evaluated in men vs. women. Results This cohort of 618 patients includes 272 (44%) women with a mean age of 75±14 years. Coronary artery disease (p<0.0001), diabetes mellitus (p=0.0213), stage ≥ 3 chronic kidney disease (p<0.0001), and HF with reduced ejection fraction (HFrEF) (p=0.0015) were more prevalent in men. The implementation of the Surviving Sepsis Campaign (i.e., intravenous (IV) crystalloids in the first six hours) was more aggressive in women (p=0.0192). There was no difference in in-hospital mortality (p=0.2385) between men and women. After adjusting for HF types, women with HF with preserved ejection fraction (HFpEF) developed more episodes of pulmonary edema requiring urgent IVD (p=0.0389), while men with HFpEF had more CS requiring inotropes (p=0.0400) and a longer LOS (p=0.0434). Conversely, women with HFrEF were most likely to develop CS requiring inotropes (p=0.0132). Conclusion Women with HF who developed sepsis receive a more aggressive implementation of the Surviving Sepsis Campaign than men, leading to more pulmonary edema events in women with HFpEF and more cardiogenic shock in women with HFrEF. A cautiously tailored approach is desperately needed for patients with HF who develop sepsis.

Background: Renal impairment is common among patients with heart failure and portends worse outcomes. We sought to describe the impact of euvolemia maintenance via pulmonary artery pressure-guided management of heart failure on the trajectory of kidney function. Hypothesis: We hypothesized that PAP-guided management is associated with slowing eGFR decline in heart failure patients. Methods: We retrospectively reviewed kidney function 1 year prior to implant, and 1 year after implantation of a wireless pulmonary-artery hemodynamic monitoring sensor (CardioMEMS, St Jude Medical, St Paul, MN). Glomerular filtration rate (eGFR) was estimated using standard equations (MDRD, Cockroft-Gault, and CKD-EPI). Standardized annual change in eGFR was compared prior to and after CardioMEMS implantation using related-samples Wilcoxon Signed Rank Test. Results: A total of 70 patients were included with a median age of 74 [67-79] years. Forty-two patients (60%) were male and 53 (76%) were white. Their median left ventricular ejection fraction was 41% . Median eGFR before CardioMEMS implantation decreased from 61 to 48 [30-64] ml/ min/1.73 m 2 (P<0.001) but did not change after CardioMEMs implantation (44 [30-67] ml/min/1.73 m 2 , P=0.17). Annualized rate of eGFR change was -6.1 [-18.6 to 2.2] ml/min/1.73 m 2 before vs -1.1 [-9.6 to 4.0] ml/min/1.73 m 2 after CardioMEMS (P=0.046). This difference was more pronounced among patients <74 years (P=0.009), with left ventricular ejection fraction 50% (P=0.039), RA pressure <10 mmHg (P=0.022), eGFR 60 (P=0.015), diabetes (P=0.019), not receiving ACE/ARB (P=0.025) and not receiving aldosterone antagonists (P=0.045). Conclusions: Decline in kidney function slows down after the maintenance of euvolemia with pulmonary artery pressure-guided therapy of heart failure.Background: In recent years, there has been an emphasis on multidisciplinary team (MDT) care of the heart failure (HF) patient. A dedicated HF MDT was created on the 1 st of January 2017 at Cleveland Clinic Abu Dhabi; consisting of HF cardiologists, clinical pharmacists and HF nurses. This study aims to assess the impact of a dedicated HF MDT on the mortality, length of stay and readmission rate in patients who are admitted with acute HF decompensation. Methods: A retrospective review of the patients' charts was conducted. We identified patients who were admitted for acute exacerbation of HF between the years 2015 and 2017. Group 1 consisted of 90 patients who were admitted prior to the creation of the HF MDT, while Group 2 consisted of 94 patients who were admitted after the establishment of the team. The groups were propensity-matched in order to account for any confounding variables between the two patient populations. Results: Table 1 shows the baseline characteristics on admission of patients in both Group 1 and Group 2. The majority of patients in both groups had HFrEF. There were no significant differences between the two groups in terms of the baseline characteristics outlined. Table 2 highlights the differences in outcom...

worsened PAH was identified in 83 (13.1%) cases. In the dasatinib PAH group (n=75, 90.4% of all PAH), mean age was 54.95 years and there were 45 (60%) women. In the nilotinib PAH group (n=3, 6% of all PAH), mean age was 69 years and there was 1 (33%) woman. In the imatinib PAH group (n=5, 3.6% of all PAH), mean age was 49.6 years and there were 3 (60%) women. Conclusions: Patients treated with TKIs, especially dasatinib, may develop PAH while the incidence of PAH with nilotinib and imatinib appears to be low. Further research is warranted to cover the gap of screening guidelines, which challenges the detection of CML patients treated with TKIs who develop PAH. As comparable outcomes are reported with first line therapy, in patients at risk for PAH, clinicians can opt for the therapy with decreased association with the syndrome.

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