Understanding worsening heart failure as a therapeutic target: another step forward?

Metra, Marco; Ravera, Alice; Filippatos, Gerasimos

doi:10.1002/ejhf.866

Cited by 14 publications

(20 citation statements)

References 46 publications

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“…The WHF concept is novel and of particular importance. WHF can be defined as ‘worsening symptoms and signs of HF in patients with pre‐existing HF, requiring intensification of treatment, most often diuretic therapy’, 33 or as ‘deterioration of HF signs and symptoms in patients with CHF, despite previous stable background therapy, that requires urgent escalation of therapy, including hospitalization, emergency department visit, or outpatient intravenous diuretic therapy ± outpatient oral therapy’ 34 . Traditionally, both trials and registries have captured WHF only if it resulted in hospitalization (AHF).…”

Section: Methodsmentioning

confidence: 99%

Rationale and design of the ESC Heart Failure III Registry – Implementation and discovery

Lund,

Crespo‐Leiro,

Laroche

et al. 2023

European J of Heart Fail

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AimsHeart failure outcomes remain poor despite advances in therapy. The European Society of Cardiology Heart Failure III Registry (ESC HF III Registry) aims to characterize HF clinical features and outcomes and to assess implementation of guideline‐recommended therapy in Europe and other ESC affiliated countries.MethodsBetween 1 November 2018 and 31 December 2020, 10 162 patients with chronic or acute/worsening HF with reduced, mildly reduced, or preserved ejection fraction were enrolled from 220 centres in 41 European or ESC affiliated countries. The ESC HF III Registry collected data on baseline characteristics (hospital or clinic presentation), hospital course, diagnostic and therapeutic decisions in hospital and at the clinic visit; and on outcomes at 12‐month follow‐up. These data include demographics, medical history, physical examination, biomarkers and imaging, quality of life, treatments, and interventions – including drug doses and reasons for non‐use, and cause‐specific outcomes.ConclusionThe ESC HF III Registry will provide comprehensive and unique insight into contemporary HF characteristics, treatment implementation, and outcomes, and may impact implementation strategies, clinical discovery, trial design, and public policy.

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Section: Methodsmentioning

confidence: 99%

Rationale and design of the ESC Heart Failure III Registry – Implementation and discovery

Lund,

Crespo‐Leiro,

Laroche

et al. 2023

European J of Heart Fail

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“…The early post‐discharge phase is associated with an increased risk of death and rehospitalizations in the patients hospitalized due to worsening HF 21,22 . The impact of non‐cardiac comorbidities were investigated in 1078 patients recently admitted for HF in the STRONG‐HF trial.…”

Section: Acute Heart Failure and Post‐discharge Managementmentioning

confidence: 99%

November 2023 at a glance: Focus on cardiogenic shock, post‐discharge outcomes and cardiomyopathies

Tomasoni,

Adamo,

Metra

2023

European J of Heart Fail

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“…Decongestion is the major goal of treatment for patients with acute HF decompensation 2,14–16 . CLOROTIC showed a greater decrease in body weight at 72 h and a greater diuretic response with the addition of hydrochlorothiazide (HCTZ), compared with placebo, on top of furosemide in patients hospitalized for acute HF 17 .…”

Section: Acute Heart Failure and Congestionmentioning

confidence: 99%

October 2023 at a glance: From prevention to diagnosis, prognosis and treatment of acute decompensation and comorbidities

Tomasoni,

Adamo,

Metra

2023

European J of Heart Fail

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Prevention of heart failure (HF) has a key role in our health care. 1,2 Multivariable prediction models are frequently used to estimate the risk of incident HF. A systematic Bayesian meta-analysis, including 36 studies and 59 models for the prediction of HF, showed their predictive accuracy. However, 77% of model results were at high risk of bias, certainty of evidence was low, and no model had a clinical impact assessment. 3 Monzo et al. 4 investigated the association of aldosterone concentrations with left ventricular (LV) remodelling after acute myocardial infarction (MI) in patients successfully treated by primary percutaneous coronary angioplasty for a first acute ST-elevation MI. LV volumes were measured within 4 days after acute MI using cardiac magnetic resonance and transthoracic echocardiography, 6 months later and, in a subset of cases, 3-9 years later. Aldosterone concentrations were associated with LV remodelling at 6 months, even in patients with an initial LV ejection fraction (LVEF) >40%, but not in the long term follow-up. Heart failure with preserved ejection fractionRecent data are showing the prognostic significance of LV global longitudinal strain (GLS) for the prediction of HF events. 5,6 Brann et al. 7 assessed GLS in patients with HF and preserved ejection fraction (HFpEF). Among the 311 patients studied, 128 (41%) had normal GLS (>-15.8%) and 183 (59%) had reduced GLS (<-15.8%). After a median follow-up of 4.6 years, patients with reduced GLS had a greater rate of the primary composite endpoint of cardiovascular (CV) mortality or HF hospitalization (hazard ratio 1.74, 95% confidence interval 1.3-2.4) and were more likely to develop LV ejection fraction (LVEF) deterioration.The diagnosis of HFpEF remains challenging. 2,[8][9][10] The detection of a pulmonary capillary wedge pressure (PAWP) ≥25 mmHg during exercise is a diagnostic criterion of HFpEF. 2,11,12 The diagnostic value of other diagnostic procedures is unknown. Wernhart et al.

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Understanding worsening heart failure as a therapeutic target: another step forward?

Cited by 14 publications

References 46 publications

Rationale and design of the ESC Heart Failure III Registry – Implementation and discovery

Rationale and design of the ESC Heart Failure III Registry – Implementation and discovery

November 2023 at a glance: Focus on cardiogenic shock, post‐discharge outcomes and cardiomyopathies

October 2023 at a glance: From prevention to diagnosis, prognosis and treatment of acute decompensation and comorbidities

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