theHeart.org - Heart failure

Sen Grassley questions top medical schools about ghostwriting

Fri, 20 Nov 2009 13:15:28 EST

As part of his mission to see more financial transparency in medicine, Sen Grassley has asked eight top US medical schools about their policies on ghostwriting.

EFFECT: Public reporting of hospital performance improves quality of care?

Thu, 19 Nov 2009 10:00:55 EST

Publicly released report cards based on hospital performance did not result in a measurably greater systemwide improvement in two composite AMI or CHF process-of-care indicators in a Canadian study. But they did appear to stimulate some important changes in delivery of care that could have led to some better outcomes.

Baseline function data from STICH no help in pinpointing patients who benefit from SVR

Wed, 18 Nov 2009 10:45:20 EST

Measures of left ventricular dysfunction or wall motion identified by different imaging modalities at baseline offer no clues as to whether a subset of patients treated with surgical ventricular reconstruction might benefit from the procedure.

JCHF: Are low doses of carvedilol effective in heart failure?

Wed, 18 Nov 2009 09:00:00 EST

Doses of carvedilol as low as 2.5 mg daily may be effective in Japanese patients with heart failure, according to this study. But experts said the trial was far too small to draw any meaningful conclusions.

HEAAL: High-dose trumps low-dose ARB for heart failure in the ACE-inhibitor intolerant

Tue, 17 Nov 2009 08:15:58 EST

UPDATED WITH COMMENTARY // The randomized trial, which compared losartan dosages of 150 mg/day and 50 mg/day, "makes a strong case for the value of incremental inhibition of the renin-angiotensin system," its authors say.

FAIR-HF: Symptom improvement, functional gains follow correction of iron deficiency in heart failure

Tue, 17 Nov 2009 08:00:00 EST

UPDATED WITH COMMENTARY // The randomized, placebo-controlled study's intriguing wrinkle: the benefits after 24 weeks of treatment with an injectable form of iron were independent of whether the patients were anemic.

HeartMate II continuous-flow VAD sets new benchmark in destination-therapy trial

Tue, 17 Nov 2009 08:00:00 EST

UPDATED WITH COMMENTARY // Thoratec's HeartMate II continuous-flow VAD keeps about half of patients alive and stroke- or reintervention-free after two years in pivotal destination therapy trial.

RECORD AF: Better success with rhythm control, but no difference in outcomes

Mon, 16 Nov 2009 17:00:40 EST

New registry data presented this week showed that cardiologists are more likely to select rhythm control over rate control for the treatment of atrial fibrillation, and this strategy is more likely to lead to successful treatment of AF than the rate-control-based approach. Both strategies are equivalent in terms of their effect on clinical outcomes.

Plasma renin activity associated with cardiovascular events and mortality in HOPE

Mon, 16 Nov 2009 14:45:00 EST

Patients with elevated baseline plasma renin activity levels had a twofold increased risk of total or cardiovascular mortality compared with those with low levels, and the strength of the association persisted after multiple adjustments, including the HOPE score, CRP, and BNP.

REPLACE registry finds 15.3% six-month complication rate with pacer and ICD lead replacements

Mon, 16 Nov 2009 09:30:42 EST

The REPLACE registry finds "sobering" comprehensive risk rates with pacemaker and ICD upgrades.

PACE: BiV pacing protects against RV pacing's adverse ventricular effects in randomized trial

Sun, 15 Nov 2009 16:30:23 EST

In patients with conventional indications for pacing and normal systolic function, preservation of synchrony with biventricular pacing prevented the adverse remodeling effects of right-ventricular-only pacing. But some question the trial's methods.

FRANCE: Transcatheter-valve registry permits "observation" of CoreValve, Sapien differences

Sun, 15 Nov 2009 09:45:44 EST

Results from one of the first registries to evaluate contemporary use of both the Edwards Sapien transcatheter valve and the CoreValve bioprosthesis show that complication rates are low and similar, following a short training period, and that mortality, at least out to six months, is "acceptable" for both types of devices.

SGR repair bill failure could cool physician support for healthcare reform

Thu, 12 Nov 2009 15:00:58 EST

Now that the US House of Representatives has passed a healthcare reform bill, organized medicine anticipates another vote—possibly next week—on a second bill that would rewrite Medicare's controversial sustainable-growth-rate formula for physician reimbursement.

What's going to be hot at AHA 2009?

Wed, 11 Nov 2009 09:00:54 EST

Anticipation is building for full trial results from ARBITER 6-HALTS, plus a better understanding of what went wrong with cangrelor in the CHAMPION trials. Also in the lineup are updates from PLATO, RE-LY, ALLHAT, BARI 2D, STICH, CASCADE, POPULAR, HEARTMATE II, and many more. Indeed, this year's "late-breaking" sessions include more than 30 trials over five days.

Walking speed predicts CV mortality in older people

Tue, 10 Nov 2009 19:01:00 EST

Fast walkers should find themselves less likely to succumb to cardiovascular death, according to a new French study in older adults. Measuring general fitness in this way could easily be incorporated into a general global assessment of cardiovascular risk, say the researchers.

One in four discharged after heart-failure hospitalization are back within a month

Tue, 10 Nov 2009 16:00:00 EST

What's behind the high rehospitalization rate, the same one seen year after year, for patients discharged after a hospitalization for heart failure, in an analysis covering three years of Medicare data? The authors propose one reason.

Echocardiographic evidence of PAH often doesn't trigger referral to a specialist

Tue, 10 Nov 2009 11:00:48 EST

Only one in four patients with echocardiographic evidence of pulmonary arterial hypertension is being referred for further evaluation.

Ambrisentan effective long-term for pulmonary arterial hypertension

Mon, 09 Nov 2009 17:00:00 EST

New data from the extension phase of two pivotal trials of the endothelin-receptor antagonist ambrisentan support its use as part of a long-term strategy for the treatment of pulmonary arterial hypertension.

Obesity may top hypertension as risk factor for LA enlargement

Mon, 09 Nov 2009 17:00:00 EST

Obesity and hypertension were major independent risk factors for left atrial enlargement (itself a risk factor for atrial fibrillation) in an observational, population-based study, but obesity was the strongest predictor.

Interventional cardiologist Donald Baim dies

Fri, 06 Nov 2009 18:22:01 EST

UPDATED // Interventional cardiologist Dr Donald Baim, chief medical and scientific officer at Boston Scientific, has died.

CORONA analysis reopens door for statins in heart failure

Tue, 03 Nov 2009 10:45:33 EST

Statins for heart failure? After they failed to show much effect in two large randomized trials? Yes—maybe; at least in patients with ischemic heart failure who start the drugs early enough, suggests a post hoc analysis based on one of the trials.

Benefits of targeted lead placement with CRT devices supported by long-term mortality data

Thu, 29 Oct 2009 15:00:55 EDT

An additional year of data from the INCREMENTAL study showed that echo-targeted LV lead positioning increased the likelihood of a response to device therapy by about 40% over standard lead placement. But does that difference translate into better long-term outcomes for the patient?

Underutilization of ICDs in CABG patients is worst in women and elderly, Halifax study shows

Wed, 28 Oct 2009 16:45:37 EDT

Only 101 of 1169 post-bypass-surgery patients eligible for an ICD got one over a 13-year period in Nova Scotia.

NT-proBNP "remarkable predictor" of incident atrial fibrillation

Fri, 23 Oct 2009 16:30:37 EDT

The fact that elevated baseline NT-proBNP levels predict a diagnosis of AF even 16 years later suggests that peptide elevations precede the onset of arrhythmia, according to the researchers.

HCM transmitted by sperm donation: A case report

Thu, 22 Oct 2009 15:45:36 EDT

The donor, who was later shown to be affected by a novel beta-myosin heavy-chain mutation that causes HCM, is responsible for at least nine children known to be genetically affected with HCM.

Cardiovascular disease increases risk of hip fracture

Tue, 20 Oct 2009 16:00:00 EDT

Swedish researchers have confirmed a link between stroke and subsequent hip fracture in older people and identified for the first time that a diagnosis of heart failure also increases the risk for this fracture. They also identify a large genetic component to this association, via their use of a twin registry.

Just one-third of heart-failure patients receive aldosterone antagonists

Tue, 20 Oct 2009 16:00:00 EDT

Just one-third of hospitalized HF patients who meet the criteria for an aldosterone antagonist receive the drugs upon discharge. On the plus side, few patients with contraindications are prescribed the medication.

Transfusion in acute HF: No extra mortality risk

Mon, 19 Oct 2009 11:00:10 EDT

Blood transfusions for anemia in acute decompensated heart failure don't exacerbate outcomes, as may happen in some ACS cases, suggests a one-year experience of hospitals in Israel. On the contrary�.�.�.�

No link seen between heart failure and coffee intake

Fri, 16 Oct 2009 10:15:02 EDT

With few studies in the literature specifically looking at the issue, a prospective, population-based study in Sweden has found no significant rise or fall in risk of heart-failure hospitalization or death at increasing levels of coffee intake.

Racial background woefully underreported in CV trials

Thu, 15 Oct 2009 13:15:10 EDT

Two-thirds of the 156 trials considered by the AHA in preparing a recent guideline failed to even record the ethnic backgrounds of participants, a new study has found. The researchers call for the reporting of race/ethnicity to be mandatory in all clinical trials, and they suggest medical journals should enforce this policy.

A fish tale with merit: Omega-3 PUFAs underrated for heart failure

Wed, 14 Oct 2009 12:30:27 EDT

Are the data not shouting loud enough, or is cardiology hard of herring? Omega-3 fatty acids may have only a modest treatment effect in heart failure, but they've performed swimmingly in randomized and observational studies considering how few new HF drugs have been reeled in lately.

Hospital efficiency gauged by resource use vs outcomes

Tue, 13 Oct 2009 16:00:00 EDT

An analysis of Medicare data from heart-failure patients at six California hospitals challenges the notion advanced by some studies that hospital efficiency can be measured by looking back at resource use on behalf of patients who ultimately died.

Hopes build for natriuretic-peptide risk stratification before noncardiac surgery

Tue, 13 Oct 2009 10:00:10 EDT

Could a preoperative blood assay take the place of imaging studies or other more costly assessments of cardiovascular risk? A meta-analysis suggests yes. A massive randomized trial is looking into it now.

IRIS confirms: No survival gains from early post-MI primary-prevention ICDs

Wed, 07 Oct 2009 17:00:00 EDT

Defibrillators implanted within a month of acute MI may prevent sudden cardiac deaths, but they don't reduce overall mortality, according to a trial that supports current guidelines based primarily on the smaller 2004 trial DINAMIT.

Acute heart-failure prediction model blends clinical gestalt with natriuretic peptides

Mon, 05 Oct 2009 17:00:00 EDT

Its developers say the prediction model for guiding management of patients presenting with dyspnea can make a difference when clinicians aren't sure about the diagnosis based on clinical signs. An editorial takes issue.

New "principles" on authorship and COI from PhRMA get mixed response

Fri, 02 Oct 2009 12:00:10 EDT

The "Principles on Conduct of Clinical Trials and Communication of Clinical Trial Results" echo recent standards set by medical journal editors, but some observers say the document, which has no penalty component, lacks real teeth.

REVERSE, MADIT-CRT make case for extending CRT to mild heart failure: Should guidelines change?

Thu, 01 Oct 2009 10:30:49 EDT

Now in print after having been presented at meetings, the REVERSE randomized trial's European-cohort two-year results are consistent with the recently published, much larger MADIT-CRT trial in showing both clinical and LV structural benefits from resynchronization therapy in patients with NYHA class 1-2 heart failure.

Doctor-led "hospital-at-home" care subs for hospitalization in acute heart failure

Tue, 29 Sep 2009 12:00:05 EDT

They lived just as long, but in a small randomized trial, patients with acute decompensated heart failure who received hospital-quality care in their homes as an alternative to hospital admission after presentation to the emergency department benefited in ways missed by those managed as inpatients in the traditional manner.

New biomarker, galectin-3, shows risk-stratification potential in chronic heart failure

Mon, 28 Sep 2009 15:00:18 EDT

The proposed biomarker, which seems to apparently play a role in the progression of cardiomyopathy and heart failure, predicted mortality or HF hospitalization in a post hoc analysis from the already published COACH randomized trial.

BNP-boosting gene variant hints at possible screening, cardioprotective roles

Fri, 25 Sep 2009 10:45:02 EDT

A single-nucleotide polymorphism associated with chronically raised natriuretic-peptide levels is common enough to potentially influence interpretation of BNP and NT-proBNP assays under some circumstances, researchers say; there is increasing evidence that the gene variant may enhance survival in some patient groups.