Clinical Outcomes of Women with Peripartum Cardiomyopathy With and Without Preeclampsia: a Population-based Study
|
|
- Thomasine Nelson
- 5 years ago
- Views:
Transcription
1 Clinical Outcomes of Women with Peripartum Cardiomyopathy With and Without Preeclampsia: a Population-based Study Isabelle Malhamé, MSc Candidate in Epidemiology, McGill University Obstetric Medicine Fellow, Brown University Natalie Dayan, Cristiano S. De Moura, Michelle Samuel, Evelyne Vinet, Louise Pilote
2 None Conflict of Interest
3 Background Preeclampsia is strongly associated with Peripartum Cardiomyopathy (PPCM) as both conditions may share a common pathophysiology 1,2 Not all women with PPCM present with co-incident preeclampsia Differences in clinical outcomes in women with PPCM with and without preeclampsia remain to be elucidated by large epidemiologic studies 1. Bello N, The relationship between pre-eclampsia and peripartum cardiomyopathy: a systematic review and meta-analysis. J Am Coll Cardiol 2013;62: Damp J, Relaxin-2 and Soluble Flt1 Levels in Peripartum Cardiomyopathy: Results of the Multicenter IPAC Study. JACC Heart failure 2016;4:380-8.
4 Objective To compare the occurrence of Major Adverse Cardiovascular Events (MACE) and death between women with PPCM and co-incident preeclampsia (peppcm) and women with PPCM without preeclampsia (PPCM) in a large population sample To compare pharmacologic treatment duration between women with peppcm and PPCM
5 Data Source A claims based administrative database from the United States: Commercial Plans and Encounters Database of the MarketScan Research Databases January 1 st, 2010 to December 31 st, 2014
6 Cohort selection: Study Population Women with obstetric deliveries No heart disease within 6 months prior to conception PPCM cases selection: ICD-9 code for PPCM Between 1 month prior to delivery and 5 months postpartum Mandatory procedure code for echocardiogram
7 Outcome Definition Major Adverse Cardiovascular Events (MACE) 1,2 Acute heart failure (including ventricular fibrillation and cardiac arrest) Pulmonary edema Acute respiratory distress Thromboembolism Puerperal cerebrovascular disorder Mechanical ventilation Mechanical circulatory support Heart transplantation Intra-cardiac device implantation Permanent pacemaker implantation Conversion of cardiac rhythm In-hospital death Within 6 months from diagnosis of PPCM 1. Sigakis MJ et al. The Validity of Discharge Billing Codes Reflecting Severe Maternal Morbidity. Anesthesia and analgesia. 2.Kolte D et al. Temporal trends in incidence and outcomes of peripartum cardiomyopathy in the United States: a nationwide population-based study. J Am Heart Assoc.
8 Treatment Duration Duration of guideline-based pharmacologic therapy for heart failure From initial prescription until discontinuation of medication
9 Statistical Methods Log binomial regression for relative risk (RR) of MACE and 95% confidence intervals (CI) Adjusted for advanced maternal age, multiple pregnancy, chronic hypertension, obesity, and diabetes mellitus (type 1, type 2, and gestational combined) Kruskal-Wallis test for significance between treatment duration in days Two-sided significance level 0.05
10 Flow Diagram Obstetric deliveries n = 1,557,409 Women no known cardiac disease n= 1,028,488 Total PPCM cases n= 804 peppcm n= 281 PPCM n = 523
11 Baseline Characteristics peppcm N= 281 PPCM N= 523 p Value* Timing of diagnosis in days (mean [sd]) 17.3 (31.0) 24.4 (38.6) Mean age (mean [sd]) 31.8 (6.7) 31.9 (5.7) 0.77 Age above 35 years 107 (38.1%) 182 (34.8%) 0.65 Multiple pregnancy 39 (13.9%) 39 (7.5%) <0.01 Gestational diabetes 85 (30.2%) 106 (20.3%) <0.01 Type 1 diabetes 7 (2.5%) 2 (0.4%) 0.01 Type 2 diabetes 38 (13.5%) 51 (9.8%) 0.10 Obesity 98 (34.9%) 125 (23.9%) <0.01 Chronic hypertension 198 (70.5%) 178 (34.0%) <0.01 Chronic kidney disease 17 (6.0%) 9 (1.7%) <0.01 Systemic autoimmune rheumatic disease + 5 (2.5%) 13 (1.8%) 1 *Comparing peppcm and PPCM
12 Frequency (%) Results peppcm PPCM Individual MACE components *p value <0.05 MACE = Major Adverse Cardiovascular Events
13 Results peppcm n(%) PPCM n(%) MACE 121 (43.1%) 162 (31.0%) Death 1 (0.4%) 6 (1.1%) Crude RR 95% CI Adjusted RR 95% CI MACE 1.39 (1.15, 1.67) 1.27 (1.04, 1.55) Death 0.31 (0.02, 1.80) There was a 27% increased risk of MACE in women with peppcm compared to women with PPCM
14 Treatment Duration Group Patients treated Median (days) IQR p Value Loop Diuretics Mineralocorticoid Receptor Antagonists Angiotensin Converting Enzyme Inhibitors Beta-Blockers Nitroglycerine- Hydralazine Angiotensin Receptor Blockers peppcm 81 (28.9 %) PPCM 104 (19.9 %) peppcm 31 (11.0 %) PPCM 33 (6.3 %) peppcm 96 (34.2 %) PPCM 107 (20.5 %) peppcm 113 (40.2 %) PPCM 142 (27.2 %) peppcm 6 (2.1 %) PPCM 6 (1.1 %) peppcm 7 (2.5 %) PPCM 15 (2.9 %)
15 Summary We found an overall higher incidence of MACE in women with co-incident preeclampsia This was mostly driven by a higher incidence of acute heart failure and pulmonary edema Despite this, there may be a lower mortality risk for women with co-incident preeclampsia Duration of therapy with ACEI may be longer for women without preeclampsia, possibly reflecting a longer time to recovery
16 Discussion Other studies in different geographic settings with smaller sample sizes have also reported worse initial outcomes for women with co-incident preeclampsia 1,2,3 This may be explained by several mechanisms: Distinctions in left ventricular remodeling seen on echocardiography 3 peppcm concentric remodeling PPCM eccentric remodeling Preeclampsia is associated with increased afterload and increased capillary permeability independently from PPCM The long term prognosis of women with preeclampsia may however be better, with shorter time to LVEF recovery 1,2,3,4 1. Ntusi NB, PloS one Ersboll AS, European journal of heart failure Lindley KJ, Circulation Heart failure Barasa A, The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstet 2017:1-8.
17 Discussion Strength: Large population sample Strict selection criteria for PPCM Indicators of morbidity validated in pregnancy Limitations: Retrospective study Administrative database Generalizability limited to insured women in US Clinical parameters lacking
18 Conclusion Our findings lend further support to the notion that peppcm and PPCM present important distinctions within the PPCM syndrome 1,2 Future studies are warranted to determine whether preeclampsia affects the efficacy of novel therapies and patients long term prognosis 1. Lindley KJ, Mann DL. Impact of Preeclampsia on Clinical and Functional Outcomes in Women With Peripartum Cardiomyopathy. Circulation Heart failure Bauersachs J. Poor Outcomes in Poor Patients?: Peripartum Cardiomyopathy-Not Just Black and White. JAMA cardiology 2017
19 Thank you! Painting by Darlene Young, 589 Montreal winter, Plateau Mont-Royal
Peripartum cardiomyopathy: review and practice guidelines. Hanan ALBackr Associate Professor King Saud university, King Fahad Cardaic center -Riyadh
Peripartum cardiomyopathy: review and practice guidelines Hanan ALBackr Associate Professor King Saud university, King Fahad Cardaic center -Riyadh Outlines Definition of PPCM Dignostic Critaria for peripartum
More informationPeripartum Cardiomyopathy. Lavanya Rai Manipal
Peripartum Cardiomyopathy Lavanya Rai Manipal Definition - PPCM - Dilated cardiomyopathy of unknown cause resulting in cardiac failure that occurs in the peripartum period in women without any preexisting
More informationConsiderations on Phasing Out Medications In the Treatment of Peripartum Cardiomyopathy After Full Recovery James D. Fett, MD
Considerations on Phasing Out Medications In the Treatment of Peripartum Cardiomyopathy After Full Recovery James D. Fett, MD Co-Director, Peripartum Cardiomyopathy Network, Coordinating Center, University
More informationPeripartum kardiomyopati
Fall 3 Peripartum kardiomyopati Roman A roch 2017 01 26 2 3 Dg. PPCM Symptoms ECG, pro-bnp echocardiography 4 Peripartum cardiomyopathy: a systematic literature review Acta Obstetricia et Gynecologica
More informationRisk of Subsequent Pregnancy in Women with a History of Peripartum Cardiomyopathy Uri Elkayam, MD
Risk of Subsequent Pregnancy in Women with a History of Peripartum Cardiomyopathy Uri Elkayam, MD Professor of Medicine / Cardiology Professor of Obstetrics and Gynecology University of Southern California
More informationReversible peripartum cardiomyopathy in a triplet pregnancy
Reversible peripartum cardiomyopathy in a triplet pregnancy BY EDVARD GALIĆ, DARIO GULIN, KREŠIMIR KORDIĆ, BERIVOJ MIŠKOVIĆ, OLIVER VASILJ, JOZICA ŠIKIĆ Abstract Peripartum cardiomyopathy (PPCM) is a rare
More informationAssociation between RV Function in PPCM and LV Recovery & Clinical Outcome
Association between RV Function in PPCM and LV Recovery & Clinical Outcome Lori A Blauwet, MD, MA Associate Professor of Medicine Co-Director, Cardio-OB Clinic Mayo Clinic Rochester, MN USA 2016 MFMER
More informationThe NEW Heart Failure Guidelines
The NEW Heart Failure Guidelines Daily Practice HF scenario of the Case Presentations HF as a complex and heterogeneous syndrome Several proposed pathophysiological mechanisms involving the heart and the
More informationNeprilysin Inhibitor (Entresto ) Prior Authorization and Quantity Limit Program Summary
Neprilysin Inhibitor (Entresto ) Prior Authorization and Quantity Limit Program Summary FDA APPROVED INDICATIONS DOSAGE 1 Indication Entresto Reduce the risk of cardiovascular (sacubitril/valsartan) death
More informationCounseling and Long-term Follow up After Gestational Disorders
Counseling and Long-term Follow up After Gestational Disorders Tanya Melnik, MD Assistant Professor, University of Minnesota Sarina Martini, MD Ob/Gyn Resident, PGY4 University of Minnesota Counseling
More informationOnline Appendix (JACC )
Beta blockers in Heart Failure Collaborative Group Online Appendix (JACC013117-0413) Heart rate, heart rhythm and prognostic effect of beta-blockers in heart failure: individual-patient data meta-analysis
More informationESC Guidelines on the Management of Cardiovascular Diseases during Pregnancy
ESC Guidelines on the Management of Cardiovascular Diseases during Pregnancy Task force on the management of CVD during pregnancy of the ESC Chair: Vera Regitz-Zagrosek, Charite, Berlin None DECLARATION
More informationDialysis-Dependent Cardiomyopathy Patients Demonstrate Poor Survival Despite Reverse Remodeling With Cardiac Resynchronization Therapy
Dialysis-Dependent Cardiomyopathy Patients Demonstrate Poor Survival Despite Reverse Remodeling With Cardiac Resynchronization Therapy Evan Adelstein, MD, FHRS John Gorcsan III, MD Samir Saba, MD, FHRS
More informationManagement of Heart Failure and Cardiomyopathies in Pregnancy
Management of Heart Failure and Cardiomyopathies in Pregnancy Professor Sanjay Sharma Disclosures: None Epidemiology of Cardiac Disease In Pregnancy Cardiovascular disease in pregnancy is increasing in
More informationMANAGEMENT OF HYPERTENSION IN PREGNANCY, THE ALGORHITHM
MANAGEMENT OF HYPERTENSION IN PREGNANCY, THE ALGORHITHM Are Particular Anti-hypertensives More Effective or Harmful Than Others in Hypertension in Pregnancy? Existing data is inadequate Methyldopa and
More informationPerioperative use of angiotensin blockade
Perioperative use of angiotensin blockade Dr Fiona Chow on behalf of A/Prof Ian Fraser Epworth HealthCare 1 surgical_operation_with_surgeons_and_nurses_royalty_free_clipart_picture_100616-172691-620048.jpg
More informationAppropriate Use Criteria for Initial Transthoracic Echocardiography in Outpatient Pediatric Cardiology (scores listed by Appropriate Use rating)
Appropriate Use Criteria for Initial Transthoracic Echocardiography in Outpatient Pediatric Cardiology (scores listed by Appropriate Use rating) Table 1: Appropriate indications (median score 7-9) Indication
More informationNCAP NATIONAL CARDIAC AUDIT PROGR AMME NATIONAL HEART FAILURE AUDIT 2016/17 SUMMARY REPORT
NCAP NATIONAL CARDIAC AUDIT PROGR AMME NATIONAL HEART FAILURE AUDIT 2016/17 SUMMARY REPORT CONTENTS PATIENTS ADMITTED WITH HEART FAILURE...4 Demographics... 4 Trends in Symptoms... 4 Causes and Comorbidities
More informationClinicians and Facilities: RESOURCES WHEN CARING FOR WOMEN WITH ADULT CONGENITAL HEART DISEASE OR OTHER FORMS OF CARDIOVASCULAR DISEASE!!
Clinicians and Facilities: RESOURCES WHEN CARING FOR WOMEN WITH ADULT CONGENITAL HEART DISEASE OR OTHER FORMS OF CARDIOVASCULAR DISEASE!! Abha'Khandelwal,'MD,'MS' 'Stanford'University'School'of'Medicine'
More informationTEACH & TREAT Post-Myocardial Infarction Left Ventricular Systolic Dysfunction
TEACH & TREAT Post-Myocardial Infarction Left Ventricular Systolic Dysfunction Clare Murphy, Paul Forsyth, Steve McGlynn, Margaret Ryan, Anne Watson, Lynsey Moir, Iain Speirits, Mark Petrie, Ninian Lang,
More informationAngiogenic imbalance and residual myocardial dysfunction in women with Peripartum Cardiomyopathy and left ventricular function recovery
Angiogenic imbalance and residual myocardial dysfunction in women with Peripartum Cardiomyopathy and left ventricular function recovery Sorel Goland¹, Adi Zalik¹, Jan Mark Weinstein³, Liaz Zilberman¹,
More informationHeart Failure Management. Waleed AlHabeeb, MD, MHA Assistant Professor of Medicine Consultant Heart Failure Cardiologist
Heart Failure Management Waleed AlHabeeb, MD, MHA Assistant Professor of Medicine Consultant Heart Failure Cardiologist Heart failure prevalence is expected to continue to increase¹ 21 MILLION ADULTS WORLDWIDE
More information1/4/18. Heart Failure Guideline Review and Update. Disclosure. Pharmacist Objectives. Pharmacy Technician Objectives. What is Heart Failure?
Disclosure Heart Failure Guideline Review and Update I have had no financial relationship over the past 12 months with any commercial sponsor with a vested interest in this presentation. Natalie Beiter,
More informationThe Failing Heart in Primary Care
The Failing Heart in Primary Care Hamid Ikram How fares the Heart Failure Epidemic? 4357 patients, 57% women, mean age 74 years HFSA 2010 Practice Guideline (3.1) Heart Failure Prevention A careful and
More informationHeart Failure Treatments
Heart Failure Treatments Past & Present www.philippelefevre.com Background Background Chronic heart failure Drugs Mechanical Electrical Background Chronic heart failure Drugs Mechanical Electrical Sudden
More informationSupplementary Online Content
Supplementary Online Content Song Z, Ayanian JZ, Wallace J, He Y, Gibson TB, Chernew ME. Unintended consequences of eliminating Medicare payments for consultations. JAMA Intern Med. Published online November
More informationESC Guidelines. ESC Guidelines Update For internal training purpose. European Heart Journal, doi: /eurheart/ehn309
ESC Guidelines Update 2008 ESC Guidelines Heart failure update 2008 For internal training purpose. 0 Agenda Introduction Classes of recommendations Level of evidence Treatment algorithm Changes to ESC
More informationNational Horizon Scanning Centre. Irbesartan (Aprovel) for heart failure with preserved systolic function. August 2008
Irbesartan (Aprovel) for heart failure with preserved systolic function August 2008 This technology summary is based on information available at the time of research and a limited literature search. It
More informationCardiovascular Nursing Practice: A Comprehensive Resource Manual and Study Guide for Clinical Nurses 2 nd Edition
Cardiovascular Nursing Practice: A Comprehensive Resource Manual and Study Guide for Clinical Nurses 2 nd Edition Table of Contents Volume 1 Chapter 1: Cardiovascular Anatomy and Physiology Basic Cardiac
More informationLCZ696 A First-in-Class Angiotensin Receptor Neprilysin Inhibitor
The Angiotensin Receptor Neprilysin Inhibitor LCZ696 in Heart Failure with Preserved Ejection Fraction The Prospective comparison of ARNI with ARB on Management Of heart failure with preserved ejection
More informationCatheter-based mitral valve repair MitraClip System
Percutaneous Mitral Valve Repair: Results of the EVEREST II Trial William A. Gray MD Director of Endovascular Services Associate Professor of Clinical Medicine Columbia University Medical Center The Cardiovascular
More informationMaternal And Fetal Outcome In Pregnancies Complicated With Maternal Cardiac Diseases: Experience At A Tertiary Care Hospital
ISPUB.COM The Internet Journal of Gynecology and Obstetrics Volume 19 Number 1 Maternal And Fetal Outcome In Pregnancies Complicated With Maternal Cardiac Diseases: Experience At A Tertiary Care Hospital
More informationObjectives. Systolic Heart Failure: Definitions. Heart Failure: Historical Perspective 2/7/2009
Objectives Diastolic Heart Failure and Indications for Echocardiography in the Asian Population Damon M. Kwan, MD UCSF Asian Heart & Vascular Symposium 02.07.09 Define diastolic heart failure and differentiate
More informationHeart Failure 101 The Basic Principles of Diagnosis & Management
Heart Failure 101 The Basic Principles of Diagnosis & Management Bill Tran, MD Non Invasive Cardiologist February 24, 2018 What the eye does not see and the mind does not know, does not exist. DH Lawrence
More informationAssessing Cardiac Risk in Noncardiac Surgery. Murali Sivarajan, M.D. Professor University of Washington Seattle, Washington
Assessing Cardiac Risk in Noncardiac Surgery Murali Sivarajan, M.D. Professor University of Washington Seattle, Washington Disclosure None. I have no conflicts of interest, financial or otherwise. CME
More informationEffects of heart rate reduction with ivabradine on left ventricular remodeling and function:
Systolic Heart failure treatment with the If inhibitor ivabradine Trial Effects of heart rate reduction with ivabradine on left ventricular remodeling and function: results of the SHIFT echocardiography
More informationInnovation therapy in Heart Failure
Innovation therapy in Heart Failure P. Laothavorn September 2015 Topics of discussion Basic Knowledge about heart failure Standard therapy New emerging therapy References: standard Therapy in Heart Failure
More informationSupplemental Digital Content: Definitions Based on the International Classification of Diseases, Ninth Revision, Clinical Modification
Supplemental Digital Content: Definitions Based on the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) Diagnose and Procedures Codes 1. ICD-9-CM definition of
More informationΧριστίνα Χρυσοχόου Καρδιολόγος Επι,Α Καρδιολογική Κλινική Πανεπιστηίου Αθηνών, ΙΓΝΑ
Χριστίνα Χρυσοχόου Καρδιολόγος Επι,Α Καρδιολογική Κλινική Πανεπιστηίου Αθηνών, ΙΓΝΑ Digitalisis a genus of about 20 species of herbaceousperennials, shrubs, and biennialsthat are commonly called foxgloves.
More informationWhat to do when a heart failure patient becomes pregnant
BSH Heart Failure Day for Revalidation and Training 2017 What to do when a heart failure patient becomes pregnant Dr Diane Barker Consultant Cardiologist Royal Stoke Hospital Conflicts of interest - sponsorship,
More informationPRESENTER DISCLOSURE INFORMATION. There are no potential conflicts of interest regarding current presentation
PRESENTER DISCLOSURE INFORMATION There are no potential conflicts of interest regarding current presentation Better synchrony and diastolic function for septal versus apical right ventricular permanent
More informationARRHYTHMIAS AND DEVICE THERAPY
Topic List A BASICS 1 History of Cardiology 2 Clinical Skills 2.1 History Taking 2.2 Physical Examination 2.3 Electrocardiography 2.99 Clinical Skills - Other B IMAGING 3 Imaging 3.1 Echocardiography 3.2
More informationDISCLAIMER: ECHO Nevada emphasizes patient privacy and asks participants to not share ANY Protected Health Information during ECHO clinics.
DISCLAIMER: Video will be taken at this clinic and potentially used in Project ECHO promotional materials. By attending this clinic, you consent to have your photo taken and allow Project ECHO to use this
More informationOptimizing Postpartum Maternal Health to Prevent Chronic Diseases
Optimizing Postpartum Maternal Health to Prevent Chronic Diseases Amy Loden, MD, FACP, NCMP Disclosures Research: None Financial: none applicable to this presentation PRIUM QEssentials Market Research
More informationCASE DISCUSSION. Dr JAYASREE VEERABOINA 2nd yr PG MS OBG
CASE DISCUSSION Dr JAYASREE VEERABOINA 2nd yr PG MS OBG Normal Cardiovascular changes in Pregnancy CARDIAC OUTPUT 5 th wk -- starts 12 wks -- 30-35% 30-32 wks -- 40% During labour -- 50% After delivery
More informationConsensus document: Screening and Prevention of Atrial Fibrillation
Consensus document: Screening and Prevention of Atrial Fibrillation Yong-Seog Oh, M.D.,Ph.D. Division of Cardiology, Department of Internal Medicine, Seoul St. Mary s Hospital, College of Medicine, The
More informationPeripartum Anesthetic Management in Patients with Left Ventricular Hypertrabeculation
Peripartum Anesthetic Management in Patients with Left Ventricular Hypertrabeculation Marissa L. Kauss, M.D. Fellow, Cardiovascular Anesthesia Mayo Clinic, Rochester, Minnesota Cardiac Problems in Pregnancy
More informationGuideline-Directed Medical Therapy
Guideline-Directed Medical Therapy Cardiovascular Outcomes Assessment of the MitraClip Percutaneous Therapy for Heart Failure Patients with Functional Mitral Regurgitation OPTIMAL THERAPY (As defined in
More informationHeart Failure Background, recognition, diagnosis and management
Heart Failure Background, recognition, diagnosis and management Speaker bureau: Novartis At the conclusion of this activity, participants will be able to: Recognize signs and symptoms of heart failure
More informationHeart Failure A Team Approach Background, recognition, diagnosis and management
Heart Failure A Team Approach Background, recognition, diagnosis and management Speaker bureau: Novartis At the conclusion of this activity, participants will be able to: Recognize signs and symptoms of
More informationPolicy REVISED: 6/30/2016 3:30 PM. Applies To: ObGyn Responsible Department: ObGyn Revised: June 30, 2016
Title: Antihypertensive Treatment for Severe Hypertension During Pregnancy Applies To: ObGyn Responsible Department: ObGyn Revised: June 30, 2016 Policy POLICY STATEMENT: Pregnant or postpartum patients
More informationPregnancy and Heart Disease
Pregnancy and Heart Disease Heidi M. Connolly, MD No disclosures 2011 MFMER 3138928-1 Regitz-Zagrosek V, Lundqvist C, Borghi C, et al. Pregnancy and the Heart 2% of pregnancies involve maternal CV disease
More informationACTIONABILITY PENETRANCE SIGNIFICANCE/BURDEN OF DISEASE NEXT STEPS. YES ( 1 of above) YES (Proceed to Stage II)
Stage I: Rule-Out Dashboard GENE/GENE PANEL: TNNT2, LMNA HGNC ID: 11949, 6636 ACTIONABILITY 1. Is there a qualifying resource, such as a practice guideline or systematic review, for the genetic condition?
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 informationMaternal Cardiac Disease In Pregnancy. August 25, 2017 PREGNANCY ECHO CONFERENCE
Maternal Cardiac Disease In Pregnancy August 25, 2017 PREGNANCY ECHO CONFERENCE Maternal Physiology Cardiac Output = HR x SV Non-pregnant: 4.5 L/min Pregnant: 6.0 L/min Increase most acute in first 10
More informationHeart failure for syndicate
Heart failure for syndicate By M.Wafaie Aboleineen,MD,FACC ESC Guidelines for the diagnosis and treatment of heart failure Part I 1 4 2 Common ECG abnormalities in HF 3 Common CXR abnormalities in HF Common
More informationTake-home Messages from Recent Heart Failure Trials: Heart Rate as a Target
Take-home Messages from Recent Heart Failure Trials: Heart Rate as a Target JEFFREY S. BORER, M.D. Professor and Chairman, Department of Medicine and Chief, Division of Cardiovascular Medicine; Director,
More informationPeripartum Cardiomyopathy
Peripartum Cardiomyopathy Denise Hilfiker-Kleiner Kardiologie & Angiologie MHH, Hannover Nothing to disclose Peri- or Postpartum Cardiomyopathy Peri- or postpartum cardiomyopathy (PPCM) is a disorder of
More informationRisk prediction in inherited conditions Laminopathies
Risk prediction in inherited conditions Laminopathies Karim Wahbi Cochin hospital, Paris karim.wahbi@aphp.fr Risk prediction in laminopathies Current approach for risk stratification A new score to predict
More informationIndex. Note: Page numbers of article titles are in boldface type.
Index Note: Page numbers of article titles are in boldface type. A Acid base balance pregnancy-related changes to, 640 Acquired heart disease, 731 Acute fatty liver of pregnancy (AFLP), 618 Acute kidney
More informationHeart Failure. Jay Shavadia
Heart Failure Jay Shavadia Definition Clinical syndrome characterized by: Symptoms: breathlessness at rest or on exercise, fatigue, tiredness or ankle swelling AND Signs: tachycardia, tachypnea, pulmonary
More information8:30-10:30 WS #4: Cardiology :00-13:00 WS #11: Cardiology 101 (Repeated)
Professor Ralph Stewart Cardiologist Auckland City Hospital Green Lane Cardiovascular Research Unit Auckland Heart Group Fiona Stewart Cardiologist Green Lane Hospital National Women's Hospital Professor
More informationThe University of Mississippi School of Pharmacy
LONG TERM PERSISTENCE WITH ACEI/ARB THERAPY AFTER ACUTE MYOCARDIAL INFARCTION: AN ANALYSIS OF THE 2006-2007 MEDICARE 5% NATIONAL SAMPLE DATA Lokhandwala T. MS, Yang Y. PhD, Thumula V. MS, Bentley J.P.
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 informationSummary/Key Points Introduction
Summary/Key Points Introduction Scope of Heart Failure (HF) o 6.5 million Americans 20 years of age have HF o 960,000 new cases of HF diagnosed annually o 5-year survival rate for HF is ~50% Classification
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 informationQuality Payment Program: Cardiology Specialty Measure Set
Quality Payment Program: Cardiology Specialty Set Title Number CMS Reporting Method(s) Heart Failure (HF): Angiotensin- Converting Enzyme (ACE) Inhibitor or Angiotensin Receptor Blocker (ARB) Therapy for
More informationStroke in Pregnancy. Stroke in Pregnancy 6/23/13
G5#$#Preven*ng#Maternal#Morbidity#and#Mortality#Via# Expanded#Scope#of#Nursing#Prac*ce#As#First#Responder# in#hypertensive#crisis#of#preeclampsia# The$presenter$reports$no$relevant,$influencing$financial$rela5onships.$
More informationSusan P. D Anna MSN, APRN BC February 14, 2019
Is there Equal Opportunity in Heart Failure?? Susan P. D Anna MSN, APRN BC February 14, 2019 Disclosures: I have no financial disclosures. I am not an expert on this topic, but see a lot of women with
More informationTarget dose achievement of evidencebased medications in patients with heart failure with reduced ejection fraction attending a heart failure clinic
Target dose achievement of evidencebased medications in patients with heart failure with reduced ejection fraction attending a heart failure clinic June Chen 1, Charlotte Galenza 1, Justin Ezekowitz 2,3,
More informationThe Author(s) This article is published with open access by ASEAN Federation of Cardiology
DOI 10.7603/s40602-014-0011-3 ASEAN Heart Journal http://www.aseanheartjournal.org/ Vol. 22, no. 1, 60 65 (2014) ISSN: 2315-4551 Erratum Erratum to: Impact Of Sex On Clinical Characteristics And In-Hospital
More informationChapter 4: Cardiovascular Disease in Patients with CKD
Chapter 4: Cardiovascular Disease in Patients with CKD The prevalence of cardiovascular disease (CVD) was 65.8% among patients aged 66 and older who had chronic kidney disease (CKD), compared to 31.9%
More informationYES NO UNKNOWN. Stage I: Rule-Out Dashboard Secondary Findings in Adults ACTIONABILITY PENETRANCE SIGNIFICANCE/BURDEN OF DISEASE NEXT STEPS
Stage I: Rule-Out Dashboard HGNC ID: 11949, 6636, 2928 OMIM ID: 191045, 150330, 302045 ACTIONABILITY PENETRANCE 1. Is there a qualifying resource, such as a practice guideline or systematic review, for
More informationBurden of Mitral Regurgitation (MR) in the US Why is This Important?
Secondary (Functional) Mitral Regurgitation as a Target for Heart Failure Therapy William T. Abraham, MD, FACP, FACC, FAHA, FESC, FRCP Professor of Medicine, Physiology, and Cell Biology Chair of Excellence
More informationVest Prevention of Early Sudden Death Trial (VEST)
ACC Late Breaking Clinical Trials 2018 Vest Prevention of Early Sudden Death Trial (VEST) Jeffrey Olgin, MD, FACC Division of Cardiology, UCSF On behalf of the VEST Investigators Disclosures ClinicalTrials.gov
More information12 th Annual Biomarkers in Heart Failure and Acute Coronary Syndromes: Diagnosis, Treatment and Devices. Heart Rate as a Cardiovascular Biomarker
12 th Annual Biomarkers in Heart Failure and Acute Coronary Syndromes: Diagnosis, Treatment and Devices Heart Rate as a Cardiovascular Biomarker Inder Anand, MD, FRCP, D Phil (Oxon.) Professor of Medicine,
More informationThe Effect of Vagus Nerve Stimulation in Heart Failure: Primary Results of the INcrease Of VAgal TonE in chronic Heart Failure (INOVATE-HF) Trial
The Effect of Vagus Nerve Stimulation in Heart Failure: Primary Results of the INcrease Of VAgal TonE in chronic Heart Failure (INOVATE-HF) Trial Michael R Gold, Brett J Berman, Martin Borggrefe, Sanja
More informationVentricular tachyarrhythmia during pregnancy in women with heart disease: data from the ROPAC
Ventricular tachyarrhythmia during pregnancy in women with heart disease: data from the ROPAC Ebru Ertekin MD, Iris M. Van Hagen MD, Amar M. Salam MD, Titia P.E. Ruys MD PhD, Jolien W. Roos-Hesselink MD
More informationStudy Exposures, Outcomes:
GSK Medicine: Coreg IR, Coreg CR, and InnoPran Study No.: WWE111944/WEUSRTP3149 Title: A nested case-control study of the association between Coreg IR and Coreg CR and hypersensitivity reactions: anaphylactic
More informationSevere Maternal Morbidity, New York City
Severe Maternal Morbidity, New York City 2008-2012 Wendy C. Wilcox, MD, MPH Bureau of Maternal, Infant and Reproductive Health NYC Department of Health and Mental Hygiene NYC Health + Hospitals/Kings County
More informationUse of bromocriptine for the treatment of PPCM: are we there yet?
Use of bromocriptine for the treatment of PPCM: are we there yet? Uri Elkayam, MD Professor of Medicine Professor of Obstetrics and Gynecology Director maternal cardiology University of Southern California
More informationPregnancy outcome in Peripartum Cardiomyopathy
Abstract Pregnancy outcome in Peripartum Cardiomyopathy Anuja Bhalerao, Richa Garg Department of Obstetrics and Gynaecology NKP Salve institute of medical sciences, Nagpur,India Email: anuja_bhalerao@yahoo.com,
More informationCardiomyopathies lessons learnt
Maternal Deaths from Cardiomyopathies lessons learnt Dr Sarah Vause St Mary s Hospital, Manchester Mrs Thomas Jefferson Mumtaz Mahal Charlotte Bronte Mrs Beeton Cardiomyopathy Dilated - acquired
More informationArkansas Health Care Payment Improvement Initiative Congestive Heart Failure Algorithm Summary
Arkansas Health Care Payment Improvement Initiative Congestive Heart Failure Algorithm Summary Congestive Heart Failure Algorithm Summary v1.2 (1/5) Triggers PAP assignment Exclusions Episode time window
More informationTable S1: Diagnosis and Procedure Codes Used to Ascertain Incident Hip Fracture
Technical Appendix Table S1: Diagnosis and Procedure Codes Used to Ascertain Incident Hip Fracture and Associated Surgical Treatment ICD 9 Code Descriptions Hip Fracture 820.XX Fracture neck of femur 821.XX
More informationDECLARATION OF CONFLICT OF INTEREST
DECLARATION OF CONFLICT OF INTEREST Warfarin and the risk of major bleeding events in patients with atrial fibrillation: a population-based study Laurent Azoulay PhD 1,2, Sophie Dell Aniello MSc 1, Teresa
More informationPregnancy in Non-Peripartum Cardiomyopathy
Pregnancy in Non-Peripartum Cardiomyopathy Avraham Shotan, Lubov Vasilenco, Michael Shochat, Mark Kazatsker, David Blondheim, Yaniv Levi, Simcha Meisel, Alicia Vazan Heart Institute, Hillel Yaffe Medical
More informationChapter 10. Learning Objectives. Learning Objectives 9/11/2012. Congestive Heart Failure
Chapter 10 Congestive Heart Failure Learning Objectives Explain concept of polypharmacy in treatment of congestive heart failure Explain function of diuretics Learning Objectives Discuss drugs used for
More informationPregnancy outcomes in women after an arterial switch operation for transposition of the great arteries
Pregnancy outcomes in women after an arterial switch operation for transposition of the great arteries Department of Obstetrics and Gynecology 1) Department of Pediatrics 2) National Cerebral and Cardiovascular
More informationPulmonary Hypertension: Definition and Unmet Needs
Heart Failure Center Hadassah University Hospital Pulmonary Hypertension: Definition and Unmet Needs Israel Gotsman The Heart Failure Center Hadassah University Hospital I DO NOT have a financial interest/
More informationCardiac disease in pre pr gnancy
IN THE NAME OF GOD Cardiac disease in pregn nancy MITRAL STENOSIS 33 y/o G3L2(2c/s) GA 34 + 5 CC: LP & dyspnea PMHx: MS sinse 4 yrs ago due to Rheumatism PSHx: 2c/s DHx: metoral 50 mg q6h/ ASA/ Enoxaparin
More information1.3 Sample Standard of Care from the Medical University of South Carolina
1.3 Sample Standard of Care from the Medical University of South Carolina Vitamin D Testing and Treatment Protocol MUSC Department of Ob-Gyn, Maternal-Fetal Medicine Division BACKGROUND: A rapidly evolving
More informationTopic Page: congestive heart failure
Topic Page: congestive heart failure Definition: congestive heart f ailure from Merriam-Webster's Collegiate(R) Dictionary (1930) : heart failure in which the heart is unable to maintain an adequate circulation
More informationVentricular Assist Device: Are Early Interventions Superior? Hamang Patel, MD Section of Cardiomyopathy & Heart Transplantation
Ventricular Assist Device: Are Early Interventions Superior? Hamang Patel, MD Section of Cardiomyopathy & Heart Transplantation Objectives Current rationale behind use of MCS Patient Selection Earlier?
More informationCHAPTER 12 HYPERTENSION IN SPECIAL GROUPS HYPERTENSION IN PREGNANCY
CHAPTER 12 HYPERTENSION IN SPECIAL GROUPS HYPERTENSION IN PREGNANCY v Mild preeclampsia is managed by close observation of the mother and fetus preferably in hospital. If the diastolic blood pressure remains
More information2017 Summer MAOFP Update
2017 Summer MAOFP Update. Cardiology Update 2017 Landmark Trials Change Practice Guidelines David J. Strobl, DO, FNLA Heart Failure: Epidemiology More than 4 million patients affected 400,000 new cases
More informationHeart Failure treatment during pregnancy
Heart Failure treatment during pregnancy Angeles Alonso García Hospital Universitario Puerta de Hierro. Majadahonda. Madrid. Spain European Society of Cardiology. Stockholm. 29 August 2010 Starting Point
More informationModule 1: Evidence-based Education for Health Care Professionals
Module 1: Evidence-based Education for Health Care Professionals Heart Failure is a HUGE Problem Prevalence Incidence Mortality Hospital Discharges Cost 1 5,300,000 660,000 284,965 1,084,000 $34.8 billion
More informationAWHONN Oregon Section 2014
AWHONN Oregon Section 2014 Carol J Harvey, MS, BSN, RNC-OB, C-EFM, CS Northside Hospital Atlanta Cherokee - Forsyth Hypertensive in Pregnancy Carol J Harvey, MS, RNC-OB, C-EFM Clinical Specialist Northside
More informationQuality Payment Program: Cardiology Specialty Measure Set
Measure Title * Reportable via PINNACLE α Reportable via Diabetes Collaborative CQMC v1.0 Measure High Priority Measure Cross Cutting Measure Heart Failure (HF): Angiotensin- Converting Enzyme (ACE) Inhibitor
More information