JCS 2017/JHFS 2017 Guideline on Diagnosis and Treatment of Acute and Chronic Heart Failure　― Digest Version ―

Tsutsui, Hiroyuki; Isobe, Mitsuaki; Itoh, Hiroshi; Okumura, Ken; Ōno, Minoru; Kitakaze, Masafumi; Kinugawa, Koichiro; Kihara, Yasuki; Goto, Yoichi; Komuro, Issei; Saiki, Yoshikatsu; Saito, Yoshihiko; Sakata, Yasushi; Sato, Naoki; Sawa, Yoshiki; Shiose, Akira; Shimizu, Wataru; Shimokawa, Hiroaki; Seino, Yoshihiko; Node, Koichi; Higo, Taiki; Hirayama, Atsushi; Makaya, Miyuki; Masuyama, Tohru; Murohara, Toyoaki; Momomura, Shin‐ichi; Yano, Masafumi; Yamazaki, Kenji; Yamamoto, Kazuhide; Yoshikawa, Tsutomu; Yoshimura, Michihiro; Akiyama, Mitoshi; Anzai, Toshihisa; Ishihara, Shiro; Inomata, Takayuki; Imamura, Teruhiko; Iwasaki, Yu‐ki; Ohtani, Tomohito; Onishi, Katsuya; Kasai, Takatoshi; Kato, Masashi; Kikuchi, Makoto; Kinugasa, Yoshiharu; Kinugawa, Shintaro; Kuratani, Toru; Kobayashi, Shigeki; Sakata, Yasuhiko; Tanaka, Atsushi; Toda, Köichi; Noda, Takashi; Nochioka, Kotaro; Hatano, Masaru; Hidaka, Takayuki; Fujino, Takeo; Makita, Shigeru; Yamaguchi, Osamu; Ikeda, Uichi; Kimura, Takeshi; Kohsaka, Shun; Kosuge, Masami; Yamagishi, Masakazu; Yamashina, Akira

doi:10.1253/circj.cj-19-0342

Cited by 522 publications

(524 citation statements)

References 509 publications

Supporting

Mentioning

515

Contrasting

Unclassified

Order By: Relevance

“…4 HFbEF patients present a mild systolic dysfunction, but in the clinical setting, there are many cases with a similar pathophysiology as HFpEF. 5 Therefore, HFbEF patients are often treated with guideline-directed Figure 2 Survival curve adjusted for age. After adjusting for age, the analysis revealed that heart failure with preserved ejection fraction (HFpEF) patients with a low geriatric nutritional risk index (GNRI) had an increased risk of all-cause death compared with patients in the high GNRI group (P = 0.009, n = 110; hazard ratio = 3.334; 95% confidence interval = 1.354-8.207).…”

Section: Discussionmentioning

confidence: 99%

“…Heart failure with preserved ejection fraction was defined as follows: (i) presence of HF symptoms defined by the Framingham criteria 22 ; (ii) preserved LVEF ≥ 50%, as previously described [3][4][5] ; and (iii) absence of HF aetiologies, including severe valve disease, congenital disease, hypertrophic cardiomyopathy, acute myocarditis, cardiac amyloidosis, pericardial disease, primary pulmonary hypertension, or acute myocardial infarction.…”

Section: Assessment Of Heart Failure With Preserved Ejection Fractionmentioning

confidence: 99%

“…2 In previous studies, the LVEF value used to define the 'pEF' ranged from 40 to 55%, but current guidelines recommend a partition value of 50%. [3][4][5] According to a recent analysis of a large national registrybased cohort, 6 cardiovascular and HF rehospitalizations rates are higher for patients with HFrEF (LVEF ≤ 40%) and those with HF with borderline ejection fraction (HFbEF) (LVEF 41-49%) than for those with HFpEF (LVEF ≥ 50%). However, patients with HFrEF, HFbEF, and HFpEF had very high rates of 5 year mortality (75-76%) and rehospitalization (82-86%) rates, which were similar.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Geriatric nutritional risk index predicts all‐cause deaths in heart failure with preserved ejection fraction

et al. 2019

View full text Add to dashboard Cite

Aims The objective of the study was to evaluate whether the geriatric nutritional risk index (GNRI) at discharge may be helpful in predicting the long‐term prognosis of patients hospitalized with heart failure (HF) with preserved ejection fraction (HFpEF, left ventricular ejection fraction ≥50%), a common HF phenotype in the elderly. Methods and results Overall, 110 elderly HFpEF patients (≥65 years) from the Ibaraki Cardiovascular Assessment Study‐HF ( n = 838) were enrolled. The mean age was 78.5 ± 7.2 years, and male patients accounted for 53.6% ( n = 59). All‐cause mortality was compared between the low GNRI (<92) with moderate or severe nutritional risk group and the high GNRI (≥92) with no or low nutritional risk group. Cox proportional hazard regression models were constructed to evaluate the influence of the GNRI on all‐cause death with the following covariates using forward stepwise selection: age, sex, nutritional status based on the GNRI as a categorical variable, history of HF hospitalization, haemoglobin level, estimated glomerular filtration rate, log brain natriuretic peptide levels (logBNP), history of hypertension, log C‐reactive protein levels, left ventricular ejection fraction, left ventricular mass index, and the New York Heart Association functional classification (I/II or III class). The prognostic value of the GNRI was compared with that of serum albumin using C‐statistics. The GNRI was added to the logBNP, serum albumin or the body mass index was added to the logBNP, and the C‐statistic was compared using DeLong's test. Cox regression analysis revealed that age and a low GNRI were independent predictors of all‐cause death ( P < 0.05, n = 103; hazard ratio = 1.095, 95% confidence interval = 1.031–1.163, for age, and hazard ratio = 3.075, 95% confidence interval = 1.244–7.600, for the GNRI). DeLong's test for the two correlated receiver operating characteristic curves [area under the receiver operating characteristic curve (AUROC) of serum albumin, 0.71; AUROC of the GNRI, 0.75] demonstrated significant differences between the groups ( P = 0.038). Adding the GNRI to the logBNP increased the AUROC for all‐cause death significantly (0.71 and 0.80, respectively; P = 0.040, n = 105). The addition of serum albumin or the body mass index to the logBNP did not significantly increase the AUROC for all‐cause death ( P = 0.082 and P = 0.29, respectively). Conclusions Nutritional screening using the GNRI at discharge is helpful to predict the long‐term prognosis of elderly HFpEF patients.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Assessment Of Heart Failure With Preserved Ejection Fractionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Geriatric nutritional risk index predicts all‐cause deaths in heart failure with preserved ejection fraction

et al. 2019

View full text Add to dashboard Cite

show abstract

“…On the other hand, changes in cardiac parameters are difficult to detect in patients with diastolic HF. Thus, we added two definitions regarding previous hospital admission and plasma BNP levels (>100 pg/mL) . Plasma BNP level will not be affected by HF medication because valsartan /sacubitril have not yet been approved in Japan.…”

Section: Methodsmentioning

confidence: 99%

Randomized controlled trial of an oral appliance (SomnoDent) for sleep‐disordered breathing and cardiac function in patients with heart failure

Matsumoto

Kasai

Suda

et al. 2018

Clinical Cardiology

Self Cite

View full text Add to dashboard Cite

In patients with heart failure (HF), sleep-disordered breathing (SDB) is a common comorbidity and a risk factor for poor clinical outcomes. SDB can be ameliorated by continuous positive airway pressure; however, inadequate adherence remains a major cause of treatment failure. On the other hand, the efficacy of oral appliance (OA) has been proved in orthodontics and otolaryngology, although the efficacy of OA in patients with HF remains to be elucidated. This trial aims to determine the efficacy of OA for SDB in patients with HF. Patients with HF undergoing optimal medical therapy who were diagnosed as having SDB (apnea-hypopnea index [AHI] ≥ 10 and percentage of central AHI per total AHI ≤ 70%) by using polysomnography (PSG) will be enrolled in the present study. Either patients with HF with reduced ejection fraction (left ventricular ejection fraction [LVEF] ≤ 50%) or HF with preserved ejection fraction (history of hospitalization because of acute decompensated HF) or plasma B-type natriuretic peptide (BNP) level ≥ 100 pg/mL will be included. Each patient will be randomly assigned into active OA or sham OA. PSG, laboratory, and echocardiographic data will be obtained after 3 months of intervention. The main outcome measures are AHI, plasma BNP, and E/e' determined with echocardiography. Furthermore, overnight urinary catecholamine, 6-min walk distance, Epworth sleepiness scale, and health-related quality of life will be assessed simultaneously. This trial started on April 1, 2017, and the projected end date is March 31, 2019. This study was registered in the University Hospital Medical Information Network (UMIN000025731).

show abstract

“…LVMD can be quantitatively evaluated using three-dimensional temporal and spatial contraction data by mathematical fitting of regional cardiac cycles with higher ordered Fourier phase analysis in gated myocardial perfusion imaging (MPI) study. [7][8][9][10] Recent investigations 4,12-15 strongly suggest the clinical advantages of assessment of LV hypertrophy and LVMD and of clarification of high-risk candidates for an invasive HF strategy.…”

Section: Introductionmentioning

confidence: 99%

Synergistic prognostication of left ventricular hypertrophy and three‐dimensional mechanical dyssynchrony in heart failure

et al. 2020

View full text Add to dashboard Cite

Aims In this study, we investigated the prognostic interplay of left ventricular hypertrophy and mechanical dyssynchrony (LVMD), both of which can be measured three‐dimensionally by gated myocardial perfusion imaging (MPI), in patients with chronic systolic heart failure (HF). Methods and results In 829 consecutive HF patients with reduced left ventricular ejection fraction less than 50%, LVMD was evaluated as a standard deviation (phase SD) of regional onset of mechanical contraction phase angles. A phase histogram was created by Fourier phase analysis applied to regional time‐activity curves obtained by gated MPI. Left ventricular mass index (LVMI) was measured by Corridor 4DM version 6.0. Patients were followed up with a primary endpoint of lethal cardiac events (CE) for a mean interval of 34 months. CE were documented in 223 (27%) of the HF patients. The CE group had a greater phase SD and a greater LVMI than those in the non‐CE group. Patients in the CE group had a more advanced age, greater New York Heart Association (NYHA) functional class, left ventricular cavity size, and left atrial diameter or septal E/e' and lower kidney or cardiac function than did patients in the non‐CE group. Phase SD > 37 and LVMI > 122.7 g/m2 were identified as optimal cut‐off values by receiver operating characteristic analyses for discrimination of the most increased risk HF subgroup from others (P < 0.0001). When classified into four patient subgroups using both cut‐off values, HF patients with phase SD > 37 (LVMD) and LVMI > 122.7g/m2 had the highest CE rate among the subgroups (P < 0.0001). Univariate analysis and subsequent multivariate analysis with a Cox proportional hazards model showed that phase SD and LVMI were significant independent predictors of CE with hazard ratios of 1.038 (confidence interval [CI], 1.024–1.051, P < 0.0001) and 1.005 (CI, 1.001–1.008, P = 0.0073), respectively, as well as conventional clinical parameters such as age, NYHA class, estimated glomerular filtration rate (eGFR), and BNP concentration. Patients with increased phase SD and LVMI had incrementally improved prognostic values of clinical parameters including age, NYHA functional class, eGFR, and BNP with increases in the global χ2 value: 5.9 for age; 139.5 for age and NYHA; 157.9 for age, NYHA, and eGFR; 163.9 for age, NYHA, eGFR, and BNP; 183.4 for age, NYHA, eGFR, BNP, and phase SD; and 192.5 for age, NYHA, eGFR, BNP, phase SD, and LVMI. Conclusions Three‐dimensionally assessed LVMD has independent prognostic values and can improve the risk stratification of chronic HF patients synergistically in combination with conventional clinical parameters.

show abstract

JCS 2017/JHFS 2017 Guideline on Diagnosis and Treatment of Acute and Chronic Heart Failure　― Digest Version ―

Cited by 522 publications

References 509 publications

Geriatric nutritional risk index predicts all‐cause deaths in heart failure with preserved ejection fraction

Geriatric nutritional risk index predicts all‐cause deaths in heart failure with preserved ejection fraction

Randomized controlled trial of an oral appliance (SomnoDent) for sleep‐disordered breathing and cardiac function in patients with heart failure

Synergistic prognostication of left ventricular hypertrophy and three‐dimensional mechanical dyssynchrony in heart failure

Contact Info

Product

Resources

About

JCS 2017/JHFS 2017 Guideline on Diagnosis and Treatment of Acute and Chronic Heart Failure ― Digest Version ―

Cited by 522 publications

References 509 publications

Geriatric nutritional risk index predicts all‐cause deaths in heart failure with preserved ejection fraction

Geriatric nutritional risk index predicts all‐cause deaths in heart failure with preserved ejection fraction

Randomized controlled trial of an oral appliance (SomnoDent) for sleep‐disordered breathing and cardiac function in patients with heart failure

Synergistic prognostication of left ventricular hypertrophy and three‐dimensional mechanical dyssynchrony in heart failure

Contact Info

Product

Resources

About

JCS 2017/JHFS 2017 Guideline on Diagnosis and Treatment of Acute and Chronic Heart Failure　― Digest Version ―