Abstract：
BACKGROUND:Guyana is a small developing country with a high burden of cardiovascular disease and extensive barriers to optimal care delivery. We investigated the effectiveness of a newly established multidisciplinary inpatient cardiology service in this setting. METHODS:We performed an interrupted time-series cohort study of heart failure (HF) patients admitted to the Georgetown Public Hospital Corporation from January to December 2015 and July 2016 to December 2017. The primary outcome was discharge on guideline-directed medical therapy (GDMT). Secondary outcomes included length of hospitalization and all-cause mortality. RESULTS:We identified 740 patients, 347 (46.9%) of whom were admitted after service implementation. The postimplementation cohort was more likely to be discharged on a beta-blocker (66.6% vs 41.7%; P < .01) and mineralocorticoid receptor antagonist (31.7% vs 15.3%; P = .01). They were also more likely to undergo echocardiography (60.8% vs 40.5%; P < .01) and chest x-rays (70.6% vs 46.6%; P < .01). Hospitalization length (10.0 ± 13.1 vs 9.8 ± 10.1 days) and readmissions within 90 days (19.0% vs 19.1%) were not significantly different. There were fewer deaths in the postimplementation cohort compared with the preimplementation cohort (12/347 vs 28/393). CONCLUSIONS:Establishment of a multidisciplinary inpatient cardiology service demonstrated increased adherence to GDMT without extending length of hospitalization.
journal_name
J Card Failjournal_title
Journal of cardiac failureauthors
Klassen SL,Miller RJH,Hao R,Warnica JW,Fine NM,Carpen M,Isaac DLdoi
10.1016/j.cardfail.2018.07.002subject
Has Abstractpub_date
2018-12-01 00:00:00pages
835-841issue
12eissn
1071-9164issn
1532-8414pii
S1071-9164(18)30271-9journal_volume
24pub_type
杂志文章abstract：BACKGROUND:The prognostic value of LA functional measures in heart failure patients with reduced ejection fraction (HFrEF) is unclear. Therefore, this study investigated the prognostic value of left atrial (LA) functional measures such as the left atrial emptying fraction (LAEF) and the minimal LA volume compared with ...
journal_title：Journal of cardiac failure
pub_type： 杂志文章
doi：10.1016/j.cardfail.2018.11.016
更新日期：2019-02-01 00:00:00
abstract：BACKGROUND:Activated vitamin D analog, paricalcitol, has been shown to attenuate the development of cardiac hypertrophy in Dahl salt sensitive (DSS) rats. To determine whether an antihypertrophic effect is class specific, we tested if doxercalciferol (a pro-hormone vitamin D2 analog) could also attenuate the developmen...
journal_title：Journal of cardiac failure
pub_type： 杂志文章
doi：10.1016/j.cardfail.2011.08.006
更新日期：2011-12-01 00:00:00
abstract：OBJECTIVE:Disease management programs (DMPs) may reduce short-term readmission or death after heart failure (HF) hospitalization. We sought to determine if targeting of DMP to the highest-risk patients could improve efficiency. METHODS AND RESULTS:Patients (n = 412) admitted with HF were randomized to usual care or an...
journal_title：Journal of cardiac failure
pub_type： 杂志文章,多中心研究,随机对照试验
doi：10.1016/j.cardfail.2019.01.015
更新日期：2019-05-01 00:00:00
abstract：BACKGROUND:Therapies for heart failure (HF) with a low ejection fraction (EF) have delayed disease progression and prolonged survival, but the implications of these therapies on the end stages of HF have not been examined. METHODS AND RESULTS:Patients seen by the Brigham and Women's cardiomyopathy service with an EF <...
journal_title：Journal of cardiac failure
pub_type： 杂志文章
doi：10.1016/j.cardfail.2005.08.001
更新日期：2006-02-01 00:00:00
abstract：BACKGROUND:Although heart failure (HF) guidelines recommend alcohol abstinence, existing evidence indicates that alcohol may not worsen survival and no data about associations between alcohol and health status (patients' symptoms, function, and quality of life) exist. METHODS AND RESULTS:Alcohol use was quantified in ...
journal_title：Journal of cardiac failure
pub_type： 杂志文章,多中心研究
doi：10.1016/j.cardfail.2004.11.009
更新日期：2005-06-01 00:00:00
abstract：BACKGROUND:Patient activation influences patients' ability to meaningfully engage in critical heart failure self-care. The purpose of this study was to identify whether patient activation is associated with patient-reported health outcomes in an urban and racially diverse inpatient sample of patients with heart failure...
journal_title：Journal of cardiac failure
pub_type： 杂志文章
doi：10.1016/j.cardfail.2017.08.452
更新日期：2017-11-01 00:00:00
abstract：BACKGROUND:Some of the most frequent manifestations of heart involvement in human immunodeficiency virus (HIV) infection include right and left ventricular dysfunction. The pathogenesis remains obscure. METHODS AND RESULTS:This prospective clinical and echocardiographic study involved 181 patients at all stages of HIV...
journal_title：Journal of cardiac failure
pub_type： 临床试验,杂志文章
doi：10.1016/s1071-9164(98)90504-8
更新日期：1998-03-01 00:00:00
abstract：BACKGROUND:Pediatric heart failure (HF) patients have a suboptimal response to traditional HF medications, although phosphodiesterase-3 inhibition (PDE3i) has been used with greater success than in the adult HF population. We hypothesized that molecular alterations specific to children with HF and HF etiology may affec...
journal_title：Journal of cardiac failure
pub_type： 杂志文章
doi：10.1016/j.cardfail.2016.07.429
更新日期：2017-01-01 00:00:00
abstract：BACKGROUND:It has been reported that that the amount of 4-hydroxy-2-nonenal (HNE), which is a major lipid peroxidation product and a cytotoxic aldehyde, is increased in the human failing myocardium. This study was designed to determine whether HNE has a pro-oxidant effect in cardiac myocytes and whether HNE causes Ca(2...
journal_title：Journal of cardiac failure
pub_type： 杂志文章
doi：10.1016/j.cardfail.2009.04.008
更新日期：2009-10-01 00:00:00
abstract：BACKGROUND:Members of the nuclear receptor family proteins function as transcription factors upon ligand binding and thereby regulate gene expression in host cells. Aldosterone, the high-affinity endogenous ligand for the mineralocorticoid receptor, induces cardiac hypertrophy and fibrosis in a variety of animal models...
journal_title：Journal of cardiac failure
pub_type： 杂志文章
doi：10.1054/jcaf.2002.125369
更新日期：2002-06-01 00:00:00
abstract：BACKGROUND:There are few data on the prevalence and pattern of complementary and alternative medicine (CAM) supplement use among people with chronic heart failure (CHF). The aim of this survey was to characterize the prevalence, pattern, and reasons for use of CAM supplements among those with CHF. METHODS AND RESULTS:...
journal_title：Journal of cardiac failure
pub_type： 杂志文章
doi：10.1016/j.cardfail.2005.06.427
更新日期：2005-10-01 00:00:00
abstract：BACKGROUND:In the current era, where advanced heart failure (AHF) has become an American Board of Internal Medicine-certified subspecialty, new data are needed to benchmark and value levels of clinical effort performed by AHF specialists (AHFMDs). METHODS AND RESULTS:A 36-question survey was sent to 728 AHFMDs, member...
journal_title：Journal of cardiac failure
pub_type： 杂志文章
doi：10.1016/j.cardfail.2015.08.340
更新日期：2015-11-01 00:00:00
abstract：BACKGROUND:Prolonged electrocardiogram (ECG) QRS duration (>or=120 ms) is a risk factor for death in systolic heart failure, but its effects in heart failure with preserved systolic function (HFPSF) have not been extensively studied. We hypothesized that prolonged ECG QRS duration would independently predict long-term ...
journal_title：Journal of cardiac failure
pub_type： 杂志文章,多中心研究
doi：10.1016/j.cardfail.2009.02.002
更新日期：2009-09-01 00:00:00
abstract：BACKGROUND:A large V wave in a pulmonary capillary wedge pressure (PCWP) tracing is characteristic of mitral regurgitation. However, the V wave is often increased in patients without or with no significant mitral regurgitation. METHODS AND RESULTS:The V wave was in the PCWP tracing investigated in 65 patients using tr...
journal_title：Journal of cardiac failure
pub_type： 杂志文章
doi：10.1016/s1071-9164(96)80044-3
更新日期：1996-09-01 00:00:00
abstract：:Elevated plasma levels of endothelin (ET) have been reported to accompany the development of heart failure (HF), and therefore, this potent vasoconstrictive peptide has been postulated to contribute to the altered pulmonary hemodynamics that occur in this disease process. The overall goal of this study was to examine ...
journal_title：Journal of cardiac failure
pub_type： 杂志文章
doi：10.1016/s1071-9164(97)90025-7
更新日期：1997-12-01 00:00:00
abstract：BACKGROUND:This is the first study to examine the effect of acute (24-hour) beta-blocker withholding on ventilatory efficiency in patients with advanced chronic heart failure (CHF) during maximal incremental treadmill cardiopulmonary exercise test. METHODS AND RESULTS:Seventeen CHF patients were studied either 3 hours...
journal_title：Journal of cardiac failure
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.cardfail.2010.02.006
更新日期：2010-07-01 00:00:00
abstract：BACKGROUND:The role of matrix metalloproteinases (MMPs) polymorphisms on heart failure (HF) susceptibility, phenotypic characteristics, and prognosis has been poorly explored. METHODS AND RESULTS:We studied 313 HF patients with left ventricular systolic dysfunction and 367 healthy control subjects. Genotyping of MMP-1...
journal_title：Journal of cardiac failure
pub_type： 杂志文章
doi：10.1016/j.cardfail.2010.09.017
更新日期：2011-02-01 00:00:00
abstract：:Quantitative descriptions of the mechanical restitution curve as a description of variability in ventricular performance with coupling interval in isolated tissue preparations are widely available. In humans, however, in vivo examination of the force-interval relationship is restricted to test pulse intervals shorter ...
journal_title：Journal of cardiac failure
pub_type： 杂志文章
doi：10.1016/1071-9164(95)90002-0
更新日期：1995-09-01 00:00:00
abstract：:Heart failure (HF) is a syndrome characterized by high mortality, frequent hospitalization, reduced quality of life, and a complex therapeutic regimen. Knowledge about HF is accumulating so rapidly that individual clinicians may be unable to readily and adequately synthesize new information into effective strategies o...
journal_title：Journal of cardiac failure
pub_type： 杂志文章,实务指引
doi：10.1016/j.cardfail.2005.11.005
更新日期：2006-02-01 00:00:00
abstract：BACKGROUND:Recent studies have suggested a high prevalence of cardiac amyloidosis (CAm) in heart failure (HF) patients. CAm might be underdiagnosed owing to low clinical suspicion. METHODS AND RESULTS:We performed retrospective analysis of 259 patients with HF and ejection fraction (EF) ≥50% referred for endomyocardia...
journal_title：Journal of cardiac failure
pub_type： 杂志文章
doi：10.1016/j.cardfail.2016.12.006
更新日期：2017-04-01 00:00:00
abstract：BACKGROUND:We investigated the relationship between nonsustained ventricular tachycardia (NSVT) and left ventricular (LV) dilatation, function, remodeling, and scar tissue extent in patients with previous myocardial infarction (MI). METHODS AND RESULTS:Eighty-two patients (ages 64+/-10 years) with first previous MI we...
journal_title：Journal of cardiac failure
pub_type： 杂志文章
doi：10.1016/j.cardfail.2009.09.001
更新日期：2010-01-01 00:00:00
abstract：BACKGROUND:Anemia is associated with higher morbidity and mortality in patients with heart failure (HF), but its implications for heath care costs are not well described. METHODS AND RESULTS:We analyzed data on 1056 patients with symptomatic HF seen at Duke University between 2002 and 2006. Health care costs were obta...
journal_title：Journal of cardiac failure
pub_type： 杂志文章
doi：10.1016/j.cardfail.2009.06.435
更新日期：2009-12-01 00:00:00
abstract：BACKGROUND:Diabetes is associated with increased risk of mortality in heart failure. We examined the association of diabetes with expenditures, hospitalizations, and procedures among Medicare beneficiaries with heart failure during the last 6 months of life. METHODS AND RESULTS:In a 5% national Medicare sample, the pr...
journal_title：Journal of cardiac failure
pub_type： 杂志文章
doi：10.1016/j.cardfail.2011.09.011
更新日期：2012-01-01 00:00:00
abstract：BACKGROUND:In patients admitted for heart failure (HF), unrecognized elevation of left ventricular end-diastolic pressure (LVEDP) at the time of discharge may have a role in the high rehospitalization rate for HF on follow-up. METHODS AND RESULTS:In a small, prospective study (n = 50), patients admitted for HF were ra...
journal_title：Journal of cardiac failure
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.cardfail.2011.04.014
更新日期：2011-09-01 00:00:00
abstract：BACKGROUND:The abnormalities in coronary hemodynamics in systolic heart failure are frequent. Myocardial oxygen demand and consumption are increased and myocardial perfusion is also impaired, which may result in myocardial ischemia, necrosis, and apoptosis. This is potentially a contributing factor for progressive hear...
journal_title：Journal of cardiac failure
pub_type： 杂志文章,评审
doi：10.1016/j.cardfail.2009.01.001
更新日期：2009-03-01 00:00:00
abstract：BACKGROUND:Patients having heart failure with midrange ejection fraction (HFmrEF: 40% ≤ EF < 50%) are increasingly being considered a new subset of the population with heart failure. Despite recent advances in heart-failure treatment strategies, the prognosis of these patients has not improved substantially over time. ...
journal_title：Journal of cardiac failure
pub_type： 杂志文章,多中心研究
doi：10.1016/j.cardfail.2019.05.010
更新日期：2019-08-01 00:00:00
abstract：BACKGROUND:Reduced physical activity (PA) may be one factor that contributes to cognitive decline and dementia in heart failure (HF). Yet, the longitudinal relationship between PA and cognition in HF is poorly understood owing to limitations of past work, including single-time assessments of PA. This is the first study...
journal_title：Journal of cardiac failure
pub_type： 杂志文章,多中心研究
doi：10.1016/j.cardfail.2014.12.010
更新日期：2015-04-01 00:00:00
abstract：BACKGROUND:Evidence regarding the association of anger proneness with incidence of heart failure is lacking. METHODS AND RESULTS:Anger proneness was ascertained among 13,171 black and white participants of the Atherosclerosis Risk in Communities (ARIC) study cohort with the use of the Spielberger Trait Anger Scale. In...
journal_title：Journal of cardiac failure
pub_type： 杂志文章
doi：10.1016/j.cardfail.2014.09.010
更新日期：2014-12-01 00:00:00
abstract：BACKGROUND:Athletes use androgenic-anabolic steroids to increase strength and muscle mass. Several case reports suggest that it may lead to dilated cardiomyopathy. METHODS AND RESULTS:We report a case of a 41-year-old bodybuilder with severe systolic dysfunction and Class IV heart failure despite maximal medical thera...
journal_title：Journal of cardiac failure
pub_type： 杂志文章,评审
doi：10.1016/j.cardfail.2008.12.014
更新日期：2009-08-01 00:00:00
abstract：:In most mammalian species, activation of myocardial endothelin as well as alpha1-adrenergic and angiotensin receptors leads to an increase in contractile function and myocardial cell hypertrophy, in association with acceleration of PI hydrolysis and with resultant production of IP3 and diacylglycerol. Therefore, these...
journal_title：Journal of cardiac failure
pub_type： 杂志文章
doi：10.1016/s1071-9164(96)80058-3
更新日期：1996-12-01 00:00:00
