ESC Guidelines for the Diagnosis And Treatment of Acute And Chronic Heart Failure 2008

Dickstein, Kenneth; Cohen‐Solal, Alain; Filippatos, Gerasimos; McMurray, John J.V.; Ponikowski, Piotr; Poole‐Wilson, Philip A.; Strömberg, Anna; Veldhuisen, Dirk J. van; Atar, Dan; Hoes, Arno W.; Keren, Andre; Mebazaa, Alexandre; Nieminen, Markku S.; Priori, Silvia G.; Swedberg, Karl

doi:10.1016/s1885-5857(09)60059-1

Cited by 116 publications

(210 citation statements)

References 56 publications

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“…Despite this, determining borrelia serology status in patients with dilated cardiomyopathy and heart block is recommended,70 although seropositivity for Borrelia does not confirm LD as the cause 71 72…”

Section: Late Lbmentioning

confidence: 99%

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Lyme disease in the United Kingdom

Dubrey

Bhatia

Woodham

et al. 2013

Postgraduate Medical Journal

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Lyme disease, while still an uncommon disease in the UK, is on the increase. Case numbers have increased by 3.6-fold since 2001, with over 950 cases reported by the Health Protection Agency (HPA) in 2011, compared with less than 500 cases annually pre-2004. HPA indications of the true incidence are suggested to be closer to 3000 cases/year, of which around 82% of cases are indigenously acquired. Three genospecies, Borrelia burgdorferi sensu stricto, Borrelia afzelli and Borrelia garinii, represent the predominant pathogenic variants in the UK. Erythema migrans is the commonest manifestation, occurring in 60%-91% of cases. In the UK, neuroborelliosis is the most common complication, while myocarditis is unusual, and death from either conduction disease or carditis is extremely rare. The role of Borrelia infection in chronic dilated cardiomyopathy in the UK remains unproven. Controversy over the existence of either 'chronic Lyme disease' and/or 'post-Lyme disease syndrome' continues unabated. National medical societies, patient advocacy groups, insurance companies, lawyers, doctors, the private health medical sector and scientific journals have all become embroiled in this bitter controversy. New developments include diagnostic tests able to detect Lyme disease at an earlier stage, shorter durations of antibiotic therapy and potential advances in vaccines against Borrelia.

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Section: Late Lbmentioning

confidence: 99%

“…This term is widely used in North America and increasingly in Europe. Prolonged courses of antibiotics have not shown benefit in randomised prospective trials 6 70 110. Moreover, other spirochaetal infections (ie, leptospirosis, syphilis or relapsing fever) do not require prolonged or repeated courses of antibiotics.…”

Section: Chronic Lyme Diseasementioning

confidence: 99%

Lyme disease in the United Kingdom

Dubrey

Bhatia

Woodham

et al. 2013

Postgraduate Medical Journal

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“…The infusion rate may be increased once stability is confirmed. In patients with a systolic blood pressure of <100 mm Hg, the infusion should be started without a bolus dose to avoid hypotension 7. A randomised clinical trial (the Pimobendan in Congestive Heart Failure (PICO) trial) employed pimobendan, another calcium sensitiser, added to conventional failure treatment in 317 patients with stable symptomatic heart failure improved exercise duration (bicycle ergometry) by 6% (p=0.03 and 0.05) after 24 weeks of treatment with no significant effects on oxygen consumption and on quality of life.…”

mentioning

confidence: 99%

“…The latest guideline from the ESC recommends that inotropic agents be administered only in patients with low systolic blood pressure or a low measured cardiac index in the presence of signs of hypoperfusion (cold, clammy skin, significant acidosis, renal impairment, liver dysfunction or impaired mentation) or congestion (Class IIa, Level of Evidence B) 7 Table 1. summarises the dose and class of recommendation according to the ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure 2008.…”

mentioning

confidence: 99%

“…AHF treatment strategy according to systolic blood pressure as recommended by the European Society of Cardiology guidelines for the diagnosis and treatment of acute and chronic heart failure 2008 7. AHF, acute heart failure; ARB, angiotensin receptor blocker; ACEI, angiotensin converting enzyme inhibitor; NIV, non-invasive ventilation; NTG, nitoglycerine; PAC, pulmonary artery catheterization; PDEI, phosphoDiesterase inhibitor; SBP, systolic blood pressure.…”

mentioning

confidence: 99%

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Positive inotropes in heart failure: a review article

Amin

Maleki

2012

Heart Asia

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Increasing myocardial contractility has long been considered a big help for patients with systolic heart failure, conferring an augmented haemodynamic profile in terms of higher cardiac output, lower cardiac filling pressure and better organ perfusion. Though concerns have been raised over the safety issues regarding the clinical trials of different inotropes in hearts with systolic dysfunction, they still stand as a main therapeutic strategy in many centres dealing with such patients. They must be used as short in duration, low in dose and stopped as early as possible. Evidence-based guidelines have provided clinicians with valuable data for better applying inotropes in heart failure patients. In this paper, the authors address clinical trials with different agents used for increasing cardiac contractility in heart failure patients. Furthermore, the authors focus on recent guidelines on making the most out of inotropes in heart failure patients.

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Cocoa flavanols reduce N‐terminal pro‐B‐type natriuretic peptide in patients with chronic heart failure

et al. 2015

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AimsPoor prognosis in chronic heart failure (HF) is linked to endothelial dysfunction for which there is no specific treatment currently available. Previous studies have shown reproducible improvements in endothelial function with cocoa flavanols, but the clinical benefit of this effect in chronic HF has yet to be determined. Therefore, the aim of this study was to assess the potential therapeutic value of a high dose of cocoa flavanols in patients with chronic HF, by using reductions in N‐terminal pro‐B‐type natriuretic peptide (NT‐proBNP) as an index of improved cardiac function.Methods and resultsThirty‐two patients with chronic HF, stable on guideline‐directed medical therapy, were randomized to consume 50 g/day of high‐flavanol dark chocolate (HFDC; 1064 mg of flavanols/day) or low‐flavanol dark chocolate (LFDC; 88 mg of flavanols/day) for 4 weeks and then crossed over to consume the alternative dark chocolate for a further 4 weeks. Twenty‐four patients completed the study. After 4 weeks of HFDC, NT‐proBNP (mean decrease % ± standard deviation) was significantly reduced compared with baseline (−44 ± 69%), LFDC (−33 ± 72%), and follow‐up (−41 ± 77%) values. HFDC also reduced diastolic blood pressure compared with values after LFDC (−6.7 ± 10.1 mmHg).ConclusionsReductions in blood pressure and NT‐proBNP after HFDC indicate decreased vascular resistance resulting in reduced left ventricular afterload. These effects warrant further investigation in patients with chronic HF.

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ESC Guidelines for the Diagnosis And Treatment of Acute And Chronic Heart Failure 2008

Cited by 116 publications

References 56 publications

Lyme disease in the United Kingdom

Lyme disease in the United Kingdom

Positive inotropes in heart failure: a review article

Cocoa flavanols reduce N‐terminal pro‐B‐type natriuretic peptide in patients with chronic heart failure

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