Abstract：
BACKGROUND AND AIMS:The diagnosis of heart failure is an important clinical problem and yet reported diagnostic accuracy in primary care is less than 50%. We established a Rapid Access Heart Failure Clinic (RAHFC) in a district general hospital serving a population of 292,000 in SE London, UK, to diagnose and manage new cases of heart failure presenting for the first time in the community. METHODS:Patients with suspected new onset heart failure were referred by their Primary Care Physician without appointment for clinical assessment on the same or next working day. Assessment by a specialist registrar in cardiology included history, examination, chest X-ray, electrocardiogram (ECG) and echocardiogram. When a diagnosis of heart failure was made appropriate treatment, including angiotensin converting enzyme inhibitors (ACEI), was started. RESULTS:Over 15 months 383 patients were seen (0.4 cases/100,000 population/weekday) 178/383 (46%) were considered to have definite or possible heart failure at the initial assessment in the RAHFC. A normal ECG (negative predictive value 94%) and chest X-ray virtually excluded the diagnosis of heart failure. After subsequent specialist investigations and follow-up, including a trial of therapy where appropriate, 101/383 (26%) were finally diagnosed as clinical heart failure. ACEI therapy was commenced in 56/57 (98%) of patients in whom it was considered appropriate. CONCLUSION:The RAHFC provided rapid assessment, prompt diagnosis and early introduction of life prolonging therapy for patients presenting with suspected heart failure in the community.
journal_name
Eur J Heart Failjournal_title
European journal of heart failureauthors
Fox KF,Cowie MR,Wood DA,Coats AJ,Poole-Wilson PA,Sutton GCdoi
10.1016/s1388-9842(00)00108-2keywords:
subject
Has Abstractpub_date
2000-12-01 00:00:00pages
423-9issue
4eissn
1388-9842issn
1879-0844pii
S1388984200001082journal_volume
2pub_type
杂志文章abstract：AIMS:Risk stratification in patients admitted with worsening heart failure (HF) is essential for tailoring therapy and counselling. Risk models are available but rarely used, in part because many require laboratory and imaging results that are not routinely available. Body temperature is associated with prognosis in ot...
journal_title：European journal of heart failure
pub_type： 杂志文章,多中心研究,随机对照试验
doi：10.1093/eurjhf/hft113
更新日期：2013-12-01 00:00:00
abstract：BACKGROUND:Carvedilol is a beta-blocker with similar affinity for beta1- and beta2 receptors, while bisoprolol has higher beta1 affinity. The respiratory system is characterized by beta2-receptor prevalence. Airway beta receptors regulate bronchial tone and alveolar beta receptors regulate alveolar fluid re-absorption ...
journal_title：European journal of heart failure
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.ejheart.2007.04.006
更新日期：2007-08-01 00:00:00
abstract：BACKGROUND AND AIM:The choice of optimal treatment strategy in patients with coronary artery disease (CAD) and severe left ventricular (LV) dysfunction is often difficult. The aim of this study was to compare long-term results of patients with chronic CAD, severe heart failure and a defined scope of myocardial viabilit...
journal_title：European journal of heart failure
pub_type： 杂志文章
doi：10.1016/s1388-9842(02)00089-2
更新日期：2003-01-01 00:00:00
abstract：BACKGROUND:It has been suggested that oxidative stress may play a role in the pathogenesis of heart failure, this may have potential implications for therapeutic strategies. However, measures of oxidative stress are subject to confounding inaccuracies. IgG antibodies to oxidized LDL reflect exposure to the lipoprotein ...
journal_title：European journal of heart failure
pub_type： 杂志文章
doi：10.1016/j.ejheart.2005.04.015
更新日期：2006-01-01 00:00:00
abstract：AIMS:We investigated which patients with heart failure (HF) should receive specialist palliative care (SPC) by first creating a definition of need for SPC in patients hospitalised with HF using patient-reported outcome measures (PROMs) and then testing this definition using the outcome of days alive and out of hospital...
journal_title：European journal of heart failure
pub_type： 杂志文章
doi：10.1002/ejhf.1240
更新日期：2018-09-01 00:00:00
abstract：AIMS:Although pulse pressure (PP) is a recognized risk factor for various cardiovascular diseases, its association with cardiovascular outcomes in patients with heart failure with preserved ejection fraction (HFpEF) is uncertain. METHODS AND RESULTS:We enrolled 512 of 951 consecutive HFpEF patients admitted to the Kum...
journal_title：European journal of heart failure
pub_type： 杂志文章
doi：10.1002/ejhf.559
更新日期：2016-11-01 00:00:00
abstract：AIMS:Pronounced trabeculation is presented in both left ventricular non-compaction (LVNC) and dilated cardiomyopathy (DCM), which sometimes makes the differentiation difficult. We hypothesized that echocardiographic deformation analysis would help to differentiate these two cardiomyopathies. METHODS AND RESULTS:We inv...
journal_title：European journal of heart failure
pub_type： 杂志文章
doi：10.1093/eurjhf/hfr164
更新日期：2012-02-01 00:00:00
abstract：AIMS:The MITRA-FR trial showed that among symptomatic patients with severe secondary mitral regurgitation, percutaneous repair did not reduce the risk of death or hospitalization for heart failure at 12 months compared with guideline-directed medical treatment alone. We report the 24-month outcome from this trial. MET...
journal_title：European journal of heart failure
pub_type： 杂志文章,多中心研究,随机对照试验
doi：10.1002/ejhf.1616
更新日期：2019-12-01 00:00:00
abstract：AIMS:To assess cardiac gene expression in peripheral blood cells of patients with idiopathic dilated cardiomyopathy (IDCM) and its relationship to echocardiographic left ventricular (LV) function. METHODS AND RESULTS:A complete echocardiographic study and blood sampling were performed in 65 consecutive stable IDCM pat...
journal_title：European journal of heart failure
pub_type： 杂志文章
doi：10.1093/eurjhf/hfq057
更新日期：2010-06-01 00:00:00
abstract：AIMS:Congestive heart failure (CHF) is associated with impaired renal function. Previously, we have demonstrated that rats with decompensated CHF exhibited exaggerated sensitivity to the adverse renal effects of increased increased intra-abdominal pressure (IAP) as compared with normal controls. This study tested wheth...
journal_title：European journal of heart failure
pub_type： 杂志文章
doi：10.1093/eurjhf/hfs102
更新日期：2012-10-01 00:00:00
abstract：AIMS:To investigate temporal trends in the risk of heart failure (HF) complicating acute myocardial infarction (AMI) and to determine whether these trends differ by gender or age. METHODS AND RESULTS:The national Swedish hospital discharge and death registries from 1993 to 2004 were used to calculate age- and gender-s...
journal_title：European journal of heart failure
pub_type： 杂志文章
doi：10.1093/eurjhf/hfq205
更新日期：2011-02-01 00:00:00
abstract：UNLABELLED:We compare the effectiveness of direct adenoviral angiopoietin-1 (Ad-Ang-1) injection with transplantation of skeletal myoblasts (SkMs) over-expressing angiopoietin-1 (Ang-1) for angiogenic response and improvement of heart function in an experimental porcine model of myocardial infarction (MI). METHODS:Ad-...
journal_title：European journal of heart failure
pub_type： 杂志文章
doi：10.1016/j.ejheart.2006.10.022
更新日期：2007-05-01 00:00:00
abstract：AIMS:Leucocyte telomere length is considered a marker of biological ageing and has been suggested to be shorter in patients with CAD and heart failure compared with healthy controls. The aim of this study was to determine whether telomere length is associated with clinical outcomes in patients with ischaemic heart fail...
journal_title：European journal of heart failure
pub_type： 杂志文章,多中心研究,随机对照试验
doi：10.1002/ejhf.237
更新日期：2015-03-01 00:00:00
abstract：:We investigated the hypothesis that increased intracellular [Na+]i in heart failure contributes to preservation of SR Ca2+ load which may become particularly evident at slow heart rates. [Na+]i in SBFI-loaded myocytes from rabbits with pacing-induced heart failure (PHF) was significantly higher at each frequency as co...
journal_title：European journal of heart failure
pub_type： 杂志文章
doi：10.1016/j.ejheart.2006.01.013
更新日期：2006-11-01 00:00:00
abstract：AIMS:This study aimed to determine the prognostic value of serum uric acid (SUA) on outcomes in heart failure (HF) with preserved ejection fraction (HFpEF), and whether sacubitril-valsartan reduces SUA and use of SUA-related therapies. METHODS AND RESULTS:We analysed 4795 participants from the Prospective Comparison o...
journal_title：European journal of heart failure
pub_type： 杂志文章
doi：10.1002/ejhf.1984
更新日期：2020-11-01 00:00:00
abstract：AIMS:Recent studies have shown that microRNAs (miRNAs), besides being potent regulators of gene expression, can additionally serve as circulating biomarkers of disease. The aim of this study is to determine if plasma miRNAs can be used as indicators of disease progression or therapeutic efficacy in hypertension-induced...
journal_title：European journal of heart failure
pub_type： 杂志文章
doi：10.1093/eurjhf/hft018
更新日期：2013-06-01 00:00:00
abstract：AIMS:The aim of this study was to investigate the prognostic impact of right ventricular (RV) size in patients with chronic heart failure. METHODS AND RESULTS:Normal volunteers (n = 80) and patients (n = 380) with left ventricular (LV) ejection fraction <45% on echocardiography and on optimal treatment for heart failu...
journal_title：European journal of heart failure
pub_type： 杂志文章
doi：10.1093/eurjhf/hfq161
更新日期：2011-01-01 00:00:00
abstract：AIMS:The 'Hospital at home' (HaH) model avoids hospital admission by transferring healthcare and treatment to the patient's home. We aimed to compare the effectiveness and direct healthcare costs of treating elderly patients with decompensated heart failure (HF) using HaH care vs. inpatient hospital care (IHC) in a car...
journal_title：European journal of heart failure
pub_type： 杂志文章,随机对照试验
doi：10.1093/eurjhf/hfp143
更新日期：2009-12-01 00:00:00
abstract：BACKGROUND:Hospital management of CHF and predictors of hospital mortality remain unclear. METHODS:To address these issues, we analyzed the hospital admissions for CHF during 1996 in a large university hospital. Patients discharged with the principal diagnosis of CHF were considered eligible for the study. RESULTS:Am...
journal_title：European journal of heart failure
pub_type： 杂志文章
doi：10.1016/s1388-9842(01)00204-5
更新日期：2002-01-01 00:00:00
abstract：:Appropriate interpretation of changes in markers of kidney function is essential during the treatment of acute and chronic heart failure. Historically, kidney function was primarily assessed by serum creatinine and the calculation of estimated glomerular filtration rate. An increase in serum creatinine, also termed wo...
journal_title：European journal of heart failure
pub_type： 杂志文章
doi：10.1002/ejhf.1697
更新日期：2020-04-01 00:00:00
abstract：:Current pharmacological therapies for heart failure with reduced ejection fraction are largely either repurposed anti-hypertensives that blunt overactivation of the neurohormonal system or diuretics that decrease congestion. However, they do not address the symptoms of heart failure that result from reductions in card...
journal_title：European journal of heart failure
pub_type： 杂志文章,评审
doi：10.1002/ejhf.1557
更新日期：2019-09-01 00:00:00
abstract：AIMS:Rho kinases (ROCKs) are the best characterized effectors of the small G-protein RhoA, and play a role in enhanced vasoconstriction in animal models of congestive heart failure (CHF). This study examined if ROCK activity is increased in CHF and how it is associated with the outcome in CHF. METHODS AND RESULTS:Pati...
journal_title：European journal of heart failure
pub_type： 杂志文章
doi：10.1093/eurjhf/hfs068
更新日期：2012-09-01 00:00:00
abstract：BACKGROUND:Long-term prognosis of coronary artery disease (CAD) patients is worsened when stress ischemia persists on treatment, but the relationship with adverse cardiac remodelling had never been investigated. AIM:To analyze changes in blood markers of fibrosis in patients with chronic CAD exhibiting exercise ischae...
journal_title：European journal of heart failure
pub_type： 杂志文章
doi：10.1016/j.ejheart.2006.09.010
更新日期：2007-04-01 00:00:00
abstract：AIMS:Scarce data are available on the effect of the traditional Mediterranean diet (TMD) on heart failure biomarkers. We assessed the effect of TMD on biomarkers related to heart failure in a high cardiovascular disease risk population. METHODS AND RESULTS:A total of 930 subjects at high cardiovascular risk (420 men a...
journal_title：European journal of heart failure
pub_type： 杂志文章,多中心研究,随机对照试验
doi：10.1002/ejhf.61
更新日期：2014-05-01 00:00:00
abstract：AIMS:To investigate the relationship between central venous pressure (CVP) at presentation to the emergency room (ER) and the risk of cardiac rehospitalization and mortality in patients with decompensated heart failure (DHF). METHODS AND RESULTS:Central venous pressure was determined non-invasively using high-resoluti...
journal_title：European journal of heart failure
pub_type： 杂志文章
doi：10.1093/eurjhf/hfq024
更新日期：2010-05-01 00:00:00
abstract：AIMS:To determine the impact of internationally recognized criteria for the diagnosis of heart failure with preserved ejection fraction (HF-PEF) on the feasibility of recruitment into a HF-PEF trial. METHODS AND RESULTS:We reviewed the medical records of 5883 consecutive patients admitted with heart failure across eig...
journal_title：European journal of heart failure
pub_type： 杂志文章
doi：10.1002/ejhf.106
更新日期：2014-07-01 00:00:00
abstract：:Heart failure (HF) in elderly patients is associated with more diffuse symptoms and signs due to the presence of other noncardiac comorbidities. This can cause difficulties in assessing the correct diagnosis and initiating appropriate therapy. The four most frequently occurring noncardiac comorbidities and therapies u...
journal_title：European journal of heart failure
pub_type： 杂志文章,评审
doi：10.1016/j.ejheart.2005.01.008
更新日期：2005-03-16 00:00:00
abstract：BACKGROUND:In heart failure (HF), changes in lung mechanics and gas diffusion are limiting factors to exercise. Their contribution to an increased exercise ventilation to CO2 production (VE/VCO2) slope is undefined. METHODS:A total of 67 stable HF patients underwent cardiopulmonary exercise and pulmonary function test...
journal_title：European journal of heart failure
pub_type： 杂志文章
doi：10.1016/j.ejheart.2004.10.009
更新日期：2005-10-01 00:00:00
abstract：AIMS:Modulation of vagal tone using electrical vagal nerve stimulation or pharmacological acetylcholinesterase inhibition by donepezil exerts beneficial effects in an animal model of chronic heart failure (CHF). Considering different treatment mechanisms underlying renin-angiotensin system (RAS) suppression and parasym...
journal_title：European journal of heart failure
pub_type： 杂志文章
doi：10.1002/ejhf.164
更新日期：2014-10-01 00:00:00
abstract：AIMS:Beta-blockers (BBs) improve outcomes in heart failure. Results from the Cardiac Insufficiency Bisoprolol Study in Elderly (CIBIS-ELD) trial previously demonstrated the feasibility of heart rate, not maximum dose, as a treatment goal. In this pre-specified analysis, we investigated the prognostic value of achieved ...
journal_title：European journal of heart failure
pub_type： 杂志文章,随机对照试验
doi：10.1002/ejhf.121
更新日期：2014-08-01 00:00:00
