Trends and complications associated with acute new-onset heart failure: a National Readmissions Database–based cohort study

Mir, Tanveer; Uddin, Mohammed; Qureshi, Waqas; Shanah, Layla; Soubani, Ayman O.; Saydain, Ghulam; Afonso, Luís; Sheikh, Mujeeb

doi:10.1007/s10741-021-10152-3

Cited by 11 publications

(9 citation statements)

References 14 publications

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“…Assessing the temporal association of TI decrease and VT/VF events remains a challenging task also because only a minority of HF decompensations are accompanied with sustained ventricular arrhythmias. An analysis of a large National Readmission Database of 2.5 million acute HF admissions has recently shown that VT/VF was the primary complication in only 6% of admitted patients with reduced ejection fraction 7 . Conversely, not all VT/VF episodes are caused by lung fluid accumulation.…”

Section: Discussionmentioning

confidence: 99%

“…TI decrease has also been reported to correlate temporally with malignant ventricular arrhythmias 4–6 . This is not unexpected, since the risk of ventricular arrhythmias increases with acutely decompensated HF 7 . Analyses of ventricular episodes have shown that recurrences were more frequent on days when TI index was outside normal ranges or exceeding an alerting threshold 4 .…”

Section: Introductionmentioning

confidence: 90%

“…An analysis of a large National Readmission Database of 2.5 million acute HF admissions has recently shown that VT/VF was the primary complication in only 6% of admitted patients with reduced ejection fraction. 7 Conversely, not all VT/VF episodes are caused by lung fluid accumulation. Indeed, in our analysis, only a few episodes were associated with a concomitant TI decrease.…”

Section: Timing Of Ti Decrease To Vt/vf Episodesmentioning

confidence: 99%

“…[4][5][6] This is not unexpected, since the risk of ventricular arrhythmias increases with acutely decompensated HF. 7 Analyses of ventricular episodes have shown that recurrences were more frequent on days when TI index was outside normal ranges or exceeding an alerting threshold. 4 Most studies analyzed TI trends at the time of arrhythmia onset or close to it.…”

Section: Introductionmentioning

confidence: 99%

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Temporal association between drops in thoracic impedance and malignant ventricular arrhythmia: A longitudinal analysis of remote monitoring trends

Rodio

Iacopino²,

Pisanó

et al. 2023

Cardiovasc electrophysiol

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Introduction Thoracic impedance (TI) drops measured by implantable cardioverter‐defibrillators (ICDs) have been reported to correlate with ventricular tachycardia/fibrillation (VT/VF). The aim of our study was to assess the temporal association of decreasing TI trends with VT/VF episodes through a longitudinal analysis of daily remote monitoring data from ICDs and cardiac resynchronization therapy defibrillators (CRT‐Ds). Methods and Results Retrospective data from 2384 patients were randomized 1:1 into a derivation or validation cohort. The TI decrease rate was defined as the percentage of rolling weeks with a continuously decreasing TI trend. The derivation cohort was used to determine a TI decrease rate threshold for a ≥99% specificity of arrhythmia prediction. The associated risk of VT/VF episodes was estimated in the validation cohort by dividing the available follow‐up into 60‐day assessment intervals. Analyses were performed separately for 1354 ICD and 1030 CRT‐D patients. During a median follow‐up of 2.0 years, 727 patients (30.4%) experienced 3298 confirmed VT/VF episodes. In the ICD group, a TI decrease rate of >60% was associated with a higher risk of VT/VF episode in a 60‐day assessment interval (stratified hazard ratio, 1.42; 95% confidence interval (CI), 1.05–1.92; p = .023). The TI decrease preceded (40.8%) or followed (59.2%) the VT/VF episodes. In the CRT‐D group, no association between TI decrease and VT/VF episodes was observed (p = .84). Conclusion In our longitudinal analysis, TI decrease was associated with VT/VF episodes only in ICD patients. Preventive interventions may be difficult since episodes can occur before or after TI decrease.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 90%

Section: Timing Of Ti Decrease To Vt/vf Episodesmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Temporal association between drops in thoracic impedance and malignant ventricular arrhythmia: A longitudinal analysis of remote monitoring trends

Rodio

Iacopino²,

Pisanó

et al. 2023

Cardiovasc electrophysiol

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“…Data from the Nationwide US Readmission Database (NRD) including over 2.5 million patients with acute HF showed higher event rates of stroke in acute HF with reduced (4.7%) versus preserved (2.5%) ejection fraction. 183 A study in 2922 patients admitted with acute HF and AF showed that the predictive power of the CHA 2 DS 2 -VASc score for stroke risk prediction was similarly valid in HF patients with reduced as with preserved ejection fraction. 168 However, only a modest predictive power of the CHA 2 DS 2 -VASc score in patients with acute HF was observed in a HF registry from Korea.…”

Section: Cerebral Complications Including Stroke and Cognitive Declin...mentioning

confidence: 99%

Interaction of heart failure and stroke: A clinical consensus statement of the ESC Council on Stroke, the Heart Failure Association (HFA) and the ESC Working Group on Thrombosis

Doehner,

Böhm,

Boriani

et al. 2023

European J of Heart Fail

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Heart failure (HF) is a major disease in our society that often presents with multiple comorbidities with mutual interaction and aggravation. The comorbidity of HF and stroke is a high risk condition that requires particular attention to ensure early detection of complications, efficient diagnostic workup, close monitoring, and consequent treatment of the patient. The bi‐directional interaction between the heart and the brain is inherent in the pathophysiology of HF where HF may be causal for acute cerebral injury, and ‐ in turn ‐ acute cerebral injury via imbalanced neural and neurovegetative control of cardiovascular regulation may induce or aggravate HF.The present document represents the consensus view of the ESC Council on Stroke, the Heart Failure Association and the ESC Working Group on Thrombosis to summarize current insights on pathophysiologic interactions of the heart and the brain in the comorbidity of HF and stroke. Principal aspects of diagnostic workup, pathophysiologic mechanisms, complications clinical management in acute conditions and in long‐term care of patients with the comorbidity are presented and state of the art clinical management and current evidence from clinical trials is discussed. Beside the physicians perspective, also the patients values and preferences are taken into account.Interdisciplinary cooperation of cardiologists, stroke specialists, other specialists and primary care physicians is pivotal to ensure optimal treatment in acute events and in continued long‐term treatment of these patients. Key consensus statements are presented in a concise overview on mechanistic insights, diagnostic workup, prevention and treatment to inform clinical acute and continued care of patients with the comorbidity of heart failure and stroke.

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Cachexia Is Associated With Adverse Outcomes in Patients Admitted With Heart Failure

Alahmad

Acharya

Gibson

et al. 2023

The American Journal of Cardiology

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Trends and complications associated with acute new-onset heart failure: a National Readmissions Database–based cohort study

Cited by 11 publications

References 14 publications

Temporal association between drops in thoracic impedance and malignant ventricular arrhythmia: A longitudinal analysis of remote monitoring trends

Temporal association between drops in thoracic impedance and malignant ventricular arrhythmia: A longitudinal analysis of remote monitoring trends

Interaction of heart failure and stroke: A clinical consensus statement of the ESC Council on Stroke, the Heart Failure Association (HFA) and the ESC Working Group on Thrombosis

Cachexia Is Associated With Adverse Outcomes in Patients Admitted With Heart Failure

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