Heart failure: what should be changed? Prof. Gerasimos Filippatos Attikon University Hospital
|
|
- Sydney Justin O’Connor’
- 5 years ago
- Views:
Transcription
1 Heart failure: what should be changed? Prof. Gerasimos Filippatos Attikon University Hospital
2 Disclosures Chair or Committee Member of trials or registries sponsored by Novartis, Bayer, Cardiorentis, Servier Research Grants: European Union Associate Editor: European Heart Journal, Int J Cardiol Journal of CV Medicine
3 EVERYTHING
4 Outcome in acute HF is still poor DOSE CARRESS-HF Death, Rehospitalization or ER visit 40% at 60 days
5 Chronic HF survival rates have improved over time with the advent of new therapies Temporal trends in 5-year mortality after the diagnosis of HF by gender show improvements in survival Survival (%) Men Survival (%) Women Years Years... nevertheless, the 5-year mortality rate remains high Population-based cohort study analysing data from the Rochester Epidemiology Project, Minnesota, USA. 4,537 patients with a diagnosis of HF between 1979 and 2000 were included. Framingham criteria and clinical criteria were used to validate the diagnosis. Roger et al. JAMA 2004;292:344 50
6 WE NEED Better Diagnosis Better Classification Study the Epidemiology around the world Understand better the pathophysiology Therapies that improve mortality and morbidity Is treatment of Acute HFPEF different from Acute HFREF?
7 Better Diagnosis Better Classification Study the Epidemiology around the world Understand better the pathophysiology Therapies that improve mortality and morbidity Is treatment of Acute HFPEF different from Acute HFREF?
8
9 Diagnostic algorithm for a diagnosis of heart failure of non-acute onset
10 Diagnostic algorithm for a diagnosis of heart failure of non-acute onset
11 Causes of elevation of natriuretic peptides levels Interpretation of Natriuretic Peptides
12 Better Diagnosis Better Classification Study the Epidemiology around the world Understand better the pathophysiology Therapies that improve mortality and morbidity Is treatment of Acute HFPEF different from Acute HFREF?
13 13 New Classification and Diagnosis New Classification! Heart failure with preserved, mid-range and reduced EF it is only in patients with HFrEF that therapies have been shown to reduce both morbidity and mortality
14 14 Signs (± symptoms) of HF Structural abnormalities LAVI >34ml/m 2 + HFpEF: EF 50% HFmrEF: EF 40-49% + Functional abnormalitie s E/e avg 13 Diagnosis of HFpEF/ HFmrEF Limited data (Unmet Need!) Cut-offs arbitrary More criteria; greater certainty of diagnosis Diastolic stress test? Invasive hemodynamic measurements? LVMI >115g/m 2 (m) >95 g/m 2 ( f ) e average (lateralseptal) < 9 cm/s
15 Heart Failure: TNM-Like Classification HLM ClassificationIn each column, different stages of heart (H-1 to H-4), lung (L-0 to L-3), and peripheral organ involvement (i.e., kidney, liver, and brain [M-0 to M-3] Francesco Fedele, Paolo Severino, Simone Calcagno, Massimo Mancone Journal of the American College of Cardiology, Volume 63, Issue 19, 2014,
16 from Filippatos et al Heart Fail Rev 2007 ESC Guidelines for the Diagnosis and Treatment of Acute and Chronic Heart Failure
17 Classification of AHFS ACS with Heart Failure PULMONARY EDEMA Hypertensive AHF or Vascular AHF or De Novo AHF Right Heart Failure Normotensive AHF or Cardiac Failure or Acutely Decompensated Chronic HF Hypotensive AHF/ Cardiogenic shock Filippatos G et al. Heart Failure Rev 2007
18
19 Management of patients with acute heart failure based on clinical profile during an early phase
20 Gheorghiade and Braunwald. JAMA 2011;305:
21 Better Diagnosis Better Classification Study the Epidemiology around the world Understand better the pathophysiology Therapies that improve mortality and morbidity Is treatment of Acute HFPEF different from Acute HFREF?
22 EVEREST Trials: Continental Differences 4133 patients admitted with AHF and reduced LVEF on standard medical therapy followed 9.9 months North America South America Western Europe Eastern Europe P-value 1-year Estimate, %, (95% CI) Death 30.4 ( ) 27.2 ( ) 27.1 ( ) 20.5 ( ) < CV death/hf hospitalization 52.5 ( ) 41.6 ( ) 47.3 ( ) 35.3 ( ) <0.0001
23 Variation in death and re-admission =30 days =1 year 40 Death 60 HF re-admission Proportion (%) Scotland Glasgow Alberta Turin Denmark 0 land gow erta urin ark
24 REPORT-HF Registry: Global Outreach # Modified from Filippatos et al. Eur J Heart Fail. 2015;17(5):527-33;
25 Better Diagnosis Better Classification Study the Epidemiology around the world Understand better the pathophysiology Therapies that improve mortality and morbidity Is treatment of Acute HFPEF different from Acute HFREF?
26 AHF: Pathophysiology Myocardial injury Apoptosis Extracellular matrix Acute BP Arrhythmias Ischemia Age, LVH Renal dysfunction Impaired relaxation, Stiffness Neurohormonal activation Increased Afterload Filling pressures Stroke volume Filippatos G et al. Am J Physiol 1999;277:H445, Jain P et al. Am Heart J. 2003;
27 Potential pathogenetic pathways linking heart failure with renal dysfunction. Filippatos G et al. Eur Heart J 2014
28
29 From: Braunwald s Heart Disease. 9th ed. Philadelphia,
30 AHF (and WRF) in patients with or wo CKD
31 What to do next? 1. Increase furosemide dose 2. Ιntravenous infusion rather than bolus therapy 3. Substitution of an ineffective loop diuretic for another one 4. Add metolazone and/ or potasium sparing diuretic 5. Add dopamine at 2-5 mcg/k/m 6. Withdraw b-blocker and/ or ACE inhibitor 7. Add dobutamine 8. Add levosimendan 9. Start ultrafiltration 10. Start dialysis 11. Insert IABP 12. Insert another device Maisel A, Filippatos G. In: Heart Failure. Publisher Jaypoor, 2014
32 EURObservational Research Programme Acute HF: persisting congestion at discharge and all-cause mortality during the follow-up 81,6% 24,1% Pulmonary and/or Peripheral congestion At admission 11,3% p<.0001 No 20,8% At discharge Yes
33
34 Early drop in systolic blood pressure and worsening renal function in AHF: renal results of Pre-RELAX-AHF European Journal of Heart Failure vol 13, pages , 2014 DOI: /eurjhf/hfr060
35 Impact of Venous Congestion on Glomerular Net Filtration Pressure Jessup, M. et al. J Am Coll Cardiol 2009;53:
36 Better Diagnosis Better Classification Study the Epidemiology around the world Understand better the pathophysiology Therapies that improve mortality and morbidity Is treatment of Acute HFPEF different from Acute HFREF?
37 Treatment Algorithm Available online on Eur J Heart Fail We are HFA
38
39 Better Diagnosis Better Classification Study the Epidemiology around the world Understand better the pathophysiology Therapies that improve mortality and morbidity Is treatment of Acute HFPEF different from Acute HFREF?
40 OPTIMIZE-HF: distribution of patients LVEF Fonarow et al. J Am Coll Cardiol. 2007; 50(8):768
41 AHF with preserved vs reduced EF: effect of new therapies The two larger RCT trials of ultrafiltration in AHF (UNLOAD and CARRESS-HF) included AHF patients with HFpEF but did not find any significant differences in response to ultrafiltration in HFpEF versus HFrEF. Bart et al. N Engl J Med. 2012; 367(24): In ASCEND trial, nesiritide marginally improved symptom relief without effect on renal function or clinical outcomes, and there was no differential response according to EF (< or 40 %). O'Connor CM et al. N Engl J Med. 2011; 365(1):32 43 In RELAX-AHF, 45 % of patients had EF >40 %, while serelaxin improved dyspnea scores both in patients with HFpEF and HFrEF. Filippatos et al Eur Heart J 2013
42 Forget Anything?
43 0 % Public don t know how to recognise HF Proportion of general public recognising symptoms of heart failure (combination of breathlessness, tiredness and swollen ankles) NL France Spain Ital Romania UK Sweden Poland Germany
44 Public do recognise other cardiovascular conditions General public recognition of description of typical symptoms/signs of three common cardiovascular problems % heart 1 attack stroke 2 heart failure 3
45 MEMBERS: 56 National Cardiac Societies AFFILIATED MEMBERS: 26 National Cardiac Societies
46 29 April 2 May 2017 PARIS, France 4 days of scientific exchange healthcare professionals abstracts and cases submitted 110+ scientific sessions 300+ expert faculty members 100+ countries represented 45+ industry sessions/workshops Call for abstracts: November 3 January 13
Heart Failure and Renal Failure. Gerasimos Filippatos, MD, FESC, FHFA President HFA
Heart Failure and Renal Failure Gerasimos Filippatos, MD, FESC, FHFA President HFA Definition Epidemiology Pathophysiology Management (?) Recommendations for NHLBI in cardiorenal interactions related to
More informationROSE-AHF and Beyond. Gerasimos Filippatos, FESC, FHFA President Heart Failure Association
ROSE-AHF and Beyond Gerasimos Filippatos, FESC, FHFA President Heart Failure Association From: Braunwald s Heart Disease. 9th ed. Philadelphia, Elsevier, 2011 Determinants and forms of worsening renal
More informationGerasimos Filippatos MD, FESC, FCCP, FACC
Gerasimos Filippatos MD, FESC, FCCP, FACC Head of HF Unit at Athens University Hospital, Greece President (2014-2016) of the HF Association of the European Society of Cardiology (ESC) Served as Chair of
More informationOvercoming the Cardiorenal Syndrome
Overcoming the Cardiorenal Syndrome October 29, 2016 Randall C Starling MD MPH FACC FESC FHFSA FHFA Professor of Medicine Heart & Vascular Institute Cleveland Clinic Lerner College of Medicine Cleveland
More informationPivotal Role of Renal Function in Acute Heart failure
Pivotal Role of Renal Function in Acute Heart failure Doron Aronson MD, FESC Department of Cardiology RAMBAM Health Care Campus Haifa, Israel Classification and definitions of cardiorenal syndromes CRS
More informationManagement of Acute Heart Failure
Management of Acute Heart Failure Uri Elkayam, MD Professor of Medicine University of Southern California School of Medicine Los Angeles, California elkayam@usc.edu ADHF Treatments Goals.2 Improve symptoms.
More information2016 ESC Heart Failure Guidelines: what is new? Piotr Ponikowski Wroclaw, Poland
2016 ESC Heart Failure Guidelines: what is new? Piotr Ponikowski Wroclaw, Poland Disclosures Consultancy fees and speaker s honoraria from: Amgen, Servier, Novartis, Johnson & Johnson, Merck, Berlin Chemie,
More informationACUTE HEART FAILURE. Julie Gorchynski MD, MSc, FACEP, FAAEM. Department of Emergency Medicine Emergency Residency Program UTHSC, San Antonio TCEP 2014
ACUTE HEART FAILURE Julie Gorchynski MD, MSc, FACEP, FAAEM Department of Emergency Medicine Emergency Residency Program UTHSC, San Antonio TCEP 2014 No disclosures Objectives Overview Cases Current Therapy
More informationBeta-blockers in Patients with Mid-range Left Ventricular Ejection Fraction after AMI Improved Clinical Outcomes
Beta-blockers in Patients with Mid-range Left Ventricular Ejection Fraction after AMI Improved Clinical Outcomes Seung-Jae Joo and other KAMIR-NIH investigators Department of Cardiology, Jeju National
More informationMedical Treatment for acute Decompensated Heart Failure. Vlasis Ninios Cardiologist St. Luke s s Hospital Thessaloniki 2011
Medical Treatment for acute Decompensated Heart Failure Vlasis Ninios Cardiologist St. Luke s s Hospital Thessaloniki 2011 2010 HFSA guidelines for ADHF 2009 focused update of the 2005 American College
More informationMedical Management of Acute Heart Failure
Critical Care Medicine and Trauma Medical Management of Acute Heart Failure Mary O. Gray, MD, FAHA Associate Professor of Medicine University of California, San Francisco Staff Cardiologist and Training
More informationTreating the patient with acute heart failure. What do we really know? Principles of acute heart failure treatment
ESC 2012 27Aug - 3Sep, 2012, Munich, Germany Treating the patient with acute heart failure. What do we really know? Principles of acute heart failure treatment Marco Metra, MD, FESC Cardiology University
More informationPearls in Acute Heart Failure Management
Pearls in Acute Heart Failure Management Best Practices Juan M. Aranda Jr., M.D. Professor of Medicine Medical Director of Heart Failure/ Transplant Program University of Florida College of Medicine Disclosures:
More informationΟξεία καρδιακή ανεπάρκεια: Ποιες παράμετροι συμβάλλουν στη διαστρωμάτωση κινδύνου των ασθενών;
Οξεία καρδιακή ανεπάρκεια: Ποιες παράμετροι συμβάλλουν στη διαστρωμάτωση κινδύνου των ασθενών; Γ. Φιλιππάτος, MD, FACC, FESC, FCCP Επ. Καθηγητής Καρδιολογίας Πανεπ. Αθηνών Clinical Outcomes in Patients
More informationSlide 1. Slide 2. Slide 3. Managing Acute Heart Failure Trials and Tribulations. Declaration of
Slide 1 Managing Acute Heart Failure Trials and Tribulations Martin R Cowie MD MSc FRCP FRCP (Ed) FESC Professor of Cardiology, Imperial College London m.cowie@imperial.ac.uk @ProfMartinCowie Slide 2 Declaration
More informationKeynote Address II Managing Acute Heart Failure: What Can We Do to Improve Outcomes?
Keynote Address II Managing Acute Heart Failure: What Can We Do to Improve Outcomes? 24 th Annual San Diego Heart Failure Symposium June 1-2, 2018 La Jolla, CA Barry Greenberg, MD Distinguished Professor
More informationΜαρία Μπόνου Διευθύντρια ΕΣΥ, ΓΝΑ Λαϊκό
Μαρία Μπόνου Διευθύντρια ΕΣΥ, ΓΝΑ Λαϊκό Diastolic HF DD: Diastolic Dysfunction DHF: Diastolic HF HFpEF: HF with preserved EF DD Pathophysiologic condition: impaired relaxation, LV compliance, LV filling
More informationAcute heart failure syndromes: clinical challenges. Pathophysiology. ESC Congress August. Paris, France. Marco Metra
ESC Congress 2011 27-31 August. Paris, France. Acute heart failure syndromes: clinical challenges. Pathophysiology Marco Metra Cardiology, Dept. Of experimental and applied medicine. University of Brescia.
More informationState of the Art: acute heart failure Is it just congestion?
ESC CONGRESS 2017 Barcelona, 26. 30. August 2017 State of the Art: acute heart failure Is it just congestion? S.B. Felix, FESC Klinik für Innere Medizin B Ernst-Moritz-Arndt-Universität Greifswald 1456
More informationCardio-Renal Syndrome in Acute Heart Failure:
Cardio-Renal Syndrome in Acute Heart Failure: Target for Therapy Marvin A. Konstam, M.D. Research support and/or consulting relevant to this lecture: Merck, Otsuka, Johnson & Johnson; Amgen; Cardiokine
More informationStopping the Revolving Door of ADHF
Stopping the Revolving Door of ADHF Ileana L. Piña, MD, MPH Professor of Medicine and Epidemiology/Population Health Associate Chief for Academic Affairs -- Cardiology Montefiore-Einstein Medical Center
More informationMedical Management of Acutely Decompensated Heart Failure. William T. Abraham, MD Director, Division of Cardiovascular Medicine
Medical Management of Acutely Decompensated Heart Failure William T. Abraham, MD Director, Division of Cardiovascular Medicine Orlando, Florida October 7-9, 2011 Goals of Acute Heart Failure Therapy Alleviate
More informationManagement of acute decompensated heart failure and cardiogenic shock. Arintaya Phrommintikul Department of Medicine CMU
Management of acute decompensated heart failure and cardiogenic shock Arintaya Phrommintikul Department of Medicine CMU Acute heart failure: spectrum Case 64 y/o M with Hx of non-ischemic DCM (LVEF=25-30%)
More informationThe Cardiorenal Syndrome in Heart Failure
The Cardiorenal Syndrome in Heart Failure Van N Selby, MD Assistant Professor of Medicine Advanced Heart Failure Program, UCSF October 9, 2015 Disclosures None 1 Cardiorenal Syndrome (CRS) A pathophysiologic
More informationDIAGNOSIS AND MANAGEMENT OF ACUTE HEART FAILURE
DIAGNOSIS AND MANAGEMENT OF ACUTE HEART FAILURE Mefri Yanni, MD Bagian Kardiologi dan Kedokteran Vaskular RS.DR.M.Djamil Padang The 3rd Symcard Padang, Mei 2013 Outline Diagnosis Diagnosis Treatment options
More informationPractical Points in Cardiorenal Syndrome
Practical Points in Cardiorenal Syndrome Vichai Senthong, MD. Cardiovascular Unit, Faculty of Medicine Khon Kaen university HFCT Annual Scientific Meeting June 16, 2017, Eastin Grand Sathorn Hotel, Bangkok
More informationPravin Manga Division of Cardiology Department of Medicine University of Witwatersrand
Pravin Manga Division of Cardiology Department of Medicine University of Witwatersrand Overview Definition Epidemiology Biomarkers Treatment Clinical Heart Failure: Syndrome in which patients have typical
More informationThe Art and Science of Diuretic therapy
The Art and Science of Diuretic therapy Dr. Fayez EL Shaer Associate Professour of cardiology Consultant cardiologist MD, MSc, PhD, CBNC, NBE FESC, ACCP, FASNC,HFA KKUH, KFCC Heart failure: fluid overload
More informationHFpEF: How to optimise management
HFpEF: How to optimise management Burkert Pieske M.D. Berlin, Germany Department of Internal Medicine and Cardiology, Campus Virchow Klinikum, Charité University Medicine Berlin, and Department of Internal
More informationIntravenous Inotropic Support an Overview
Intravenous Inotropic Support an Overview Shaul Atar, MD Western Galilee Medical Center, Nahariya Affiliated with the Faculty of Medicine of the Galilee, Safed, Israel INOTROPES in Acute HF (not vasopressors)
More informationSGK 2016 Session: Postgraduate Course in Heart Failure Lausanne, 15. June 2016 Heart Failure Guidelines 2016
SGK 2016 Session: Postgraduate Course in Heart Failure Lausanne, 15. June 2016 Heart Failure Guidelines 2016 Matthias Nägele, MD University Hospital Zurich Disclosures I have nothing to disclose. The new
More informationRecognizing and Treating Patients with the Cardio-Renal Syndrome
Recognizing and Treating Patients with the Cardio-Renal Syndrome Joachim H. Ix, MD, MAS, FASN Professor of Medicine Chief; Division of Nephrology-Hypertension University of California San Diego 1 Conflicts
More informationHeart Failure and Renal Disease Cardiorenal Syndrome
Advanced Heart Failure: Clinical Challenges Heart Failure and Renal Disease Cardiorenal Syndrome 17 th Apr 2015 Ju-Hee Lee, M.D Cardiovascular Center, Chungbuk National University Hospital Chungbuk National
More informationSystolic and Diastolic Dysfunction: Four Upcoming Challenges
Systolic and Diastolic Dysfunction: Four Upcoming Challenges Promoting Early Detection HFrEF: Beyond Neprilysin/Enalapril HFmrEF: What Is It and How Does One Manage It? HFpEF: Etiopathogenetic Role and
More informationMANAGEMENT OF ACUTE PULMONARY EDEMA. Pr. NOUIRA Semir Emergency Department Fattouma Bourguiba University Hospital
MANAGEMENT OF ACUTE PULMONARY EDEMA Pr. NOUIRA Semir Emergency Department Fattouma Bourguiba University Hospital ACUTE HEART FAILURE 35% 10% Goals of Acute Management Rapidly improve symptoms while preserving
More informationAcute HF is a complex and often life-threatening clinical condition. 1 Existing
ACUTE HEART FAILURE: WHAT IS NEW? John Parissis, MD, PhD; Vasiliki Bistola, MD Author affiliations: Heart Failure Unit, University of Athens, Athens, Greece Address for correspondence: John Parissis, Navarinou
More informationThe Approach to Patients with Heart Failure and Mid-Range (40-50%) Ejection Fraction (HFmrEF)
The Approach to Patients with Heart Failure and Mid-Range (40-50%) Ejection Fraction (HFmrEF) 22 nd Annual Heart Failure 2018 an Update on Therapy April 21, 2018 Los Angeles, CA Barry Greenberg, M.D. Distinguished
More informationHow to define the target population?
Heart Failure 2011 22-24 May. Gothenburg, Sweden Mortality or morbidity as target in acute heart failure trials How to define the target population? Marco Metra, Brescia The Burden of Acute HF Acute HF
More informationAccepted Manuscript. Tolvaptan in Acute Heart Failure: Time to Move On. Randall C. Starling, MD MPH, James B. Young, MD
Accepted Manuscript Tolvaptan in Acute Heart Failure: Time to Move On Randall C. Starling, MD MPH, James B. Young, MD PII: S0735-1097(16)35324-4 DOI: 10.1016/j.jacc.2016.09.005 Reference: JAC 22962 To
More informationHeart Failure Guidelines For your Daily Practice
Heart Failure Guidelines For your Daily Practice Juan M. Aranda, Jr., MD, FACC, FHFSA Professor of Medicine Director of Heart Failure and Cardiac Transplantation University of Florida College of Medicine
More informationUltrafiltration in Decompensated Heart Failure. Description
Subject: Ultrafiltration in Decompensated Heart Failure Page: 1 of 7 Last Review Status/Date: September 2016 Ultrafiltration in Decompensated Heart Failure Description Ultrafiltration is a technique being
More informationTips & tricks on how to treat an acute heart failure patient with low cardiac output and diuretic resistance
Tips & tricks on how to treat an acute heart failure patient with low cardiac output and diuretic resistance J. Parissis Attikon University Hospital, Athens, Greece Disclosures ALARM investigator received
More informationManagement of Stage B Heart Failure
KSC 2017 Management of Stage B Heart Failure Byung Su Yoo, MD., PhD. Division of Cardiology, Wonju College of Medicine, Yonsei University, South Korea Focused on Symptom ASLVSD, ASLVDD LVH HF progression
More informationHFpEF. April 26, 2018
HFpEF April 26, 2018 (J Am Coll Cardiol 2017;70:2476 86) HFpEF 50% or more (40-71%) of patients with CHF have preserved LV systolic function. HFpEF is an increasingly frequent hospital discharge. Outcomes
More informationESC Guidelines for the Diagnosis and Treatment of Acute and Chronic Heart Failure
Patients t with acute heart failure frequently develop chronic heart failure Patients with chronic heart failure frequently decompensate acutely ESC Guidelines for the Diagnosis and A clinical response
More informationHFpEF, Mito or Realidad?
HFpEF, Mito or Realidad? Ileana L. Piña, MD, MPH Professor of Medicine and Epidemiology/Population Health Associate Chief for Academic Affairs -- Cardiology Montefiore-Einstein Medical Center Bronx, NY
More informationHFPEF Echo with Strain vs. MRI T1 Mapping
HFPEF Echo with Strain vs. MRI T1 Mapping Erik Schelbert, MD MS Director, Cardiovascular Magnetic Resonance Assistant Professor of Medicine Heart & Vascular Institute University of Pittsburgh Disclosures
More informationAdvanced Care for Decompensated Heart Failure
Advanced Care for Decompensated Heart Failure Sara Kalantari MD Assistant Professor of Medicine, University of Chicago Advanced Heart Failure, Mechanical Circulatory Support and Cardiac Transplantation
More informationCOPD as a comorbidity of heart failure in elderly patients
COPD as a comorbidity of heart failure in elderly patients Professor Mitja Lainscak, MD, PhD, FESC, FHFA Departments of Cardiology and Research&Education, General Hospital Celje Faculty of Medicine, University
More informationCongestive Heart Failure: Outpatient Management
The Chattanooga Heart Institute Cardiovascular Symposium Congestive Heart Failure: Outpatient Management E. Philip Lehman MD, MPP Disclosure No financial disclosures. Objectives Evidence-based therapy
More informationImpact of Nicorandil on Renal Function in Patients With Acute Heart Failure and Pre-Existing Renal Dysfunction
Impact of Nicorandil on Renal Function in Patients With Acute Heart Failure and Pre-Existing Renal Dysfunction Masahito Shigekiyo, Kenji Harada, Ayumi Okada, Naho Terada, Hiroyoshi Yoshikawa, Akira Hirono,
More informationΒασιλική Κατσή. Καρδιολόγος ΓNA Ιπποκράτειο
Βασιλική Κατσή Καρδιολόγος ΓNA Ιπποκράτειο 40 διαφάνειες ίσως Και πρέπει και δικαιούνται ΣΥΧΝΟΤΕΡΑ 76-96% 3343 men and 4199 women followed for 25 years, no HF at baseline BP (mm Hg)
More informationHFpEF 2016 : Comorbidities and Outcomes
HFpEF 2016 : Comorbidities and Outcomes Christopher M. O Connor, MD, FACC CEO and Executive Director, Inova Heart and Vascular Institute Professor of Medicine, Duke University Editor in Chief, JACC: Heart
More informationHeFSSA Practitioners Program 2017 Theme The Patient Journey: Feel Good and Live Long. Case Study 2
HeFSSA Practitioners Program 2017 Theme The Patient Journey: Feel Good and Live Long Case Study 2 HEART FAILURE WITH MID-RANGE EJECTION FRACTION TREATMENT OPTIONS CLINICAL CASE MEDICAL HISTORY 59-year-old
More informationState-of-the-Art: Treatment of Renal Dysfunction in Heart Failure. W. H. Wilson Tang, MD Cleveland Clinic, U.S.A.
State-of-the-Art: Treatment of Renal Dysfunction in Heart Failure W. H. Wilson Tang, MD Cleveland Clinic, U.S.A. Heart Failure Exacerbates Renal Insufficiency ADHERE Registry: Prevalence of CKD by egfr
More informationΟξεία Καρδιακή Ανεπάρκεια: Κλινική εικόνα, ταξινόμηση κινδύνου & προγνωστικοί δείκτες
Οξεία Καρδιακή Ανεπάρκεια: Κλινική εικόνα, ταξινόμηση κινδύνου & προγνωστικοί δείκτες Στράτος Θεοφιλογιαννάκος, MD, PhD Ιατρείο Καρδιακής Ανεπάρκειας, Γ Πανεπιστημιακή Καρδιολογική Κλινική ΑΠΘ, ΠΓΝ Ιπποκράτειο
More informationCardiorenal Syndrome
Cardiorenal Syndrome Peenida Skulratanasak, M.D. Division of Nephrology, Department of Medicine, Faculty of Medicine, Siriraj Hospital, Mahidol University Definition of Cardiorenal syndrome (CRS) Structural
More informationEstimated 5.7 million Americans with HF. 915, 000 new HF cases annually, HF incidence approaches
Heart Failure: Management of a Chronic Disease Jenny Bauerly RN, CHFN, APRN-BC Heart Failure (HF) Definition A complex clinical syndrome that can result from any structural or functional cardiac disorder
More informationCardiorenal Syndrome
SOCIEDAD ARGENTINA DE CARDIOLOGIA Cardiorenal Syndrome Joint session ESC-SAC ESC Congress 2012, Munich César A. Belziti Hospital Italiano de Buenos Aires I have no conflicts of interest to declare Cardiorenal
More informationCase Presentation. This presentation is the intellectual property of the author. Contact them for permission to reprint and/or distribute.
Worsening Renal Function in Heart Failure Patients Mark Drazner, MD, MSc Clinical Chief of Cardiology Medical Director, CHF/VAD/Transplant James M. Wooten Chair in Cardiology UT Southwestern Medical Center
More informationAldosterone Antagonist. Hyd/ISDN*
Μedical management of heart failure: Update 2014 Dr John T Parissis Attikon University Hospital Athens, Greece Disclosures: Received honoraria as consultant or research grants by Orion- Pharma, Servier,
More informationTHE KIDNEY IN HYPOTENSIVE STATES. Benita S. Padilla, M.D.
THE KIDNEY IN HYPOTENSIVE STATES Benita S. Padilla, M.D. Objectives To discuss what happens when the kidney encounters low perfusion To discuss new developments and clinical application points in two scenarios
More informationAcute heart Failure. Critical cardiac care: update Markku S. Nieminen Helsinki, Finland. M S Nieminen, AHF ,ESC Stockholm
Acute heart Failure Critical cardiac care: update 2010 Markku S. Nieminen Helsinki, Finland M S Nieminen, AHF 300810,ESC Stockholm Acute heart Failure Critical cardiac care: update 2010 Markku S. Nieminen
More informationObjectives 6/14/2016. Cardiorenal Syndrome: Critical Link Between Heart and Kidney
Cardiorenal Syndrome: Critical Link Between Heart and Kidney Chris M. Bell, ACNP Cardiology Associates of North Mississippi Objectives Review the 5 Subtypes of the Cardiorenal Syndrome (CRS) Discuss the
More informationUPDATES IN MANAGEMENT OF HF
UPDATES IN MANAGEMENT OF HF Jennifer R Brown MD, MS Heart Failure Specialist Medstar Cardiology Associates DC ACP Meeting Fall 2017 Disclosures: speaker bureau for novartis speaker bureau for actelion
More informationMortality as an Efficacy or Safety Endpoint : Lessons Learned from the Heart Failure Trials
Mortality as an Efficacy or Safety Endpoint : Lessons Learned from the Heart Failure Trials Christopher M. O Connor, MD Professor of Medicine Director, Duke Heart Center Acting Chief, Division of Cardiology
More informationHyponatremia as a Cardiovascular Biomarker
Hyponatremia as a Cardiovascular Biomarker Uri Elkayam, MD Professor of Medicine University of Southern California Keck School of Medicine elkayam@usc.edu Disclosure Research grant from Otsuka for the
More informationThe right heart: the Cinderella of heart failure
The right heart: the Cinderella of heart failure Piotr Ponikowski, MD, PhD, FESC Medical University, Centre for Heart Disease Clinical Military Hospital Wroclaw, Poland none Disclosure Look into the Heart
More informationTherapeutic Targets and Interventions
Therapeutic Targets and Interventions Ali Valika, MD, FACC Advanced Heart Failure and Pulmonary Hypertension Advocate Medical Group Midwest Heart Foundation Disclosures: 1. Novartis: Speaker Honorarium
More informationCardiorenal Syndrome: What the Clinician Needs to Know. William T. Abraham, MD Director, Division of Cardiovascular Medicine
Cardiorenal Syndrome: What the Clinician Needs to Know William T. Abraham, MD Director, Division of Cardiovascular Medicine Orlando, Florida October 7-9, 2011 Renal Hemodynamics in Heart Failure Glomerular
More informationManagement of chronic heart failure: update J. Parissis Attikon University Hospital
Management of chronic heart failure: update 2015 J. Parissis Attikon University Hospital Disclosures: received honoraria for lectures from Servier, Pfizer, Novartis Discharges in Thousands Heart Failure
More informationWHAT S NEW IN HEART FAILURE
WHAT S NEW IN HEART FAILURE Drugs, Devices and Diagnostics John M. Herre, MD, FACC, FACP Director, Advanced Heart Failure Program Sentara Helathcare Professor of Medicine Eastern Virginia Medical School
More informationIntegrating Current Knowledge into Consensus Guidelines for Acute Decompensated Heart Failure
Integrating Current Knowledge into Consensus Guidelines for Acute Decompensated Heart Failure J. Herbert Patterson, Pharm.D., FCCP One of Four Continuing Education Programs in the Series, Acute Decompensated
More informationMonitoring of Renal Function in Heart Failure
Monitoring of Renal Function in Heart Failure Adriaan A. Voors, cardiologist The Netherlands Disclosures AAV received consultancy fees and/or research grants from: Alere, Bayer, Cardio3Biosciences, Celladon,
More information2016 Update to Heart Failure Clinical Practice Guidelines
2016 Update to Heart Failure Clinical Practice Guidelines Mitchell T. Saltzberg, MD, FACC, FAHA, FHFSA Medical Director of Advanced Heart Failure Froedtert & Medical College of Wisconsin Stages, Phenotypes
More informationHeart Failure with Reduced EF. Dino Recchia, MD, FACC, FHFSA
Heart Failure with Reduced EF Dino Recchia, MD, FACC, FHFSA Heart Failure HF is the end phenotype of almost all CV disorders Complex clinical syndrome resulting from any structural or functional impairment
More informationWhat s new in 2016 Guidelines of the European Society of Cardiology? HEART FAILURE. Marc Ferrini (Lyon Fr)
What s new in 2016 Guidelines of the European Society of Cardiology? HEART FAILURE Marc Ferrini (Lyon Fr) Palermo (I) 1 04 2017 Consulting Fees, Honoraria: BAYER PHARMA BOEHRINGER INGELHEIM BRISTOL MEYERS
More informationThe role of remote monitoring in preventing readmissions after acute heart failure
The role of remote monitoring in preventing readmissions after acute heart failure October 20, 2017 Randall C Starling MD MPH FACC FAHA FESA FHFSA Professor of Medicine Kaufman Center for Heart Failure
More informationDiastolic Heart Failure (HFpEF) Felix J. Rogers, DO, FACOI April 29, 2018
Diastolic Heart Failure (HFpEF) Felix J. Rogers, DO, FACOI April 29, 2018 Case presentation MSO, an 81 year old woman was admitted to HFWH because of progressive dyspnea and difficult to control hypertension
More informationThe new Guidelines: Focus on Chronic Heart Failure
The new Guidelines: Focus on Chronic Heart Failure Petros Nihoyannopoulos MD, FRCP, FESC Professor of Cardiology Imperial College London and National & Kapodistrian University of Athens 2 3 4 The principal
More informationState of the Art Treatment - Hyponatremia, Heart Rate, et al
State of the Art Treatment - Hyponatremia, Heart Rate, et al Uri Elkayam, MD Professor of Medicine University of Southern California Keck School of Medicine elkayam@usc.edu Disclosure Research grant from
More informationRaising expectations for Acute Heart Failure: What does the future bring to us?
Raising expectations for Acute Heart Failure: What does the future bring to us? Piotr Ponikowski, MD, PhD, FESC Medical University, Centre for Heart Disease Clinical Military Hospital Wroclaw, Poland Speaker
More informationMechanical Cardiac Support in Acute Heart Failure. Michael Felker, MD, MHS Associate Professor of Medicine Director of Heart Failure Research
Mechanical Cardiac Support in Acute Heart Failure Michael Felker, MD, MHS Associate Professor of Medicine Director of Heart Failure Research Disclosures Research Support and/or Consulting NHLBI Amgen Cytokinetics
More informationHEART FAILURE IN WOMEN. Marian Limacher, MD Division of Cardiovascular Medicine University of Florida
HEART FAILURE IN WOMEN Marian Limacher, MD Division of Cardiovascular Medicine University of Florida Outline Epidemiology Clinical Overview Why HF is such a challenge State of the Field Heart Failure Adjudication
More informationMihai Gheorghiade MD
Mihai Gheorghiade MD Center for Cardiovascular Innovation, Northwestern University Feinberg School of Medicine, Chicago, Illinois On behalf of: Stephen J Greene MD; Javed Butler MD MPH MBA; Gerasimos Filippatos
More informationClinical Policy: Ultrafiltration for Heart Failure Reference Number: CP.MP.456
Clinical Policy: Reference Number: CP.MP.456 Effective Date: 11/16 Last Review Date: 11/17 Coding Implications Revision Log See Important Reminder at the end of this policy for important regulatory and
More informationHeart Failure: Guideline-Directed Management and Therapy
Heart Failure: Guideline-Directed Management and Therapy Guideline-Directed Management and Therapy (GDMT) was developed by the American College of Cardiology and American Heart Association to define the
More informationTHE PROPER APPROACH TO DIAGNOSING HEART FAILURE WITH PRESERVED EJECTION FRACTION
THE PROPER APPROACH TO DIAGNOSING HEART FAILURE WITH PRESERVED EJECTION FRACTION James C. Fang, MD, FACC Professor and Chief Cardiovascular Division University of Utah School of Medicine Disclosures Data
More informationHeart Failure with Preserved EF (HFPEF) Epidemiology and management
Heart Failure with Preserved EF (HFPEF) Epidemiology and management Karl Swedberg Senior Professor of Medicine Sahlgrenska Academy University of Gothenburg Gothenburg, Sweden e-mail: karl.swedberg@gu.se
More informationHyponatremia in Heart Failure: why it is important and what should we do about it?
Objectives Hyponatremia in Heart Failure: why it is important and what should we do about it? Pathophysiology of sodium and water retention in heart failure Hyponatremia in heart failure (mechanism and
More informationThe ACC Heart Failure Guidelines
The ACC Heart Failure Guidelines Fakhr Alayoubi, Msc,R Ph President of SCCP Cardiology Clinical Pharmacist Assistant Professor At King Saud University King Khalid University Hospital Riyadh-KSA 2017 ACC/AHA/HFSA
More informationAcute Heart Failure 2017
Acute Heart Failure 2017 Acute Heart Failure 2017 Heart Failure Definitions HFrEF, HFmrEF. EFpEF Acute Decompensated Heart Failure De Novo presentation Decompensation of Chronic Heart Failure Longer Term
More informationDisclosure Information : No conflict of interest
Intravenous nicorandil improves symptoms and left ventricular diastolic function immediately in patients with acute heart failure : a randomized, controlled trial M. Shigekiyo, K. Harada, A. Okada, N.
More informationNew CHF Patient in my Office: What Should I Do?
New CHF Patient in my Office: What Should I Do? Joseph Mishkin MD FACC Advanced Heart Failure, Transplantation and Mechanical Circulatory Support No disclosures Disclosures Clinical Presentation 38 year
More informationHeart failure hospitalizations with preserved or reduced ejection fraction
Clinical profile and in-hospital outcomes in patients admitted for heart failure with preserved or reduced ejection fraction. EPI-CARDIO prospective registry Tajer, C; Mariani, J; de Abreu, M; Charask,
More informationDiastolic Heart Failure Uri Elkayam, MD
Diastolic Heart Failure Uri Elkayam, MD Professor of Medicine University of Southern California School of Medicine Los Angeles, California elkayam@usc.edu Diastolic Heart Failure Clinical Definition A
More informationUltrafiltration in Decompensated Heart Failure. Description
Subject: Ultrafiltration in Decompensated Heart Failure Page: 1 of 9 Last Review Status/Date: September 2014 Ultrafiltration in Decompensated Heart Failure Description Ultrafiltration is a technique being
More informationUri Elkayam, MD. Professor of Medicine University of Southern California Keck School of Medicine
Mihai Gheorghiade, MD Memorial Lecture Use of Vasopressin Antagonists for the Management of Hyponatremia and Volume Overload Uri Elkayam, MD Professor of Medicine University of Southern California Keck
More informationESC Guidelines for diagnosis and management of HF 2012: What s new? John Parissis, MD Athens, GR
ESC Guidelines for diagnosis and management of HF 2012: What s new? John Parissis, MD Athens, GR Disclosures ALARM INVESTIGATOR RESEARCH GRANTS BY ABBOTT USA AND ORION PHARMA The principal changes from
More information2017 ACC/AHA/HFSA Focused Update of the 2013 ACCF/AHA Guideline for the Management of Heart Failure
2017 ACC/AHA/HFSA Focused Update of the 2013 ACCF/AHA Guideline for the Management of Heart Failure Developed in Collaboration With the American Academy of Family Physicians, American College of Chest
More information