Acute heart failure syndromes: potential strategies to improve post-discharge outcomes.

Hospitalization for acute heart failure syndromes (AHFS) is a significant negative predictor of prognosis. Although patients' presenting symptoms generally improve throughout hospitalization in response to therapy, post-discharge event rates, defined as rehospitalization and/or mortality, remain unacceptably high. In the past decade, many lifesaving therapies for heart failure, such as beta-blockers, aldosterone antagonists, and cardiac resynchronization therapy (CRT), have been defined.

The contribution of specific causes of death to sex differences in mortality.

Objective: Men have higher mortality rates than women for most causes of death. This study was conducted to determine the contribution of specific causes of death to the sex difference in years of potential life lost (YPLL).

Methods: The authors examined data from the National Health Interview Survey with linked mortality data through 1997.

Women have higher left ventricular ejection fractions than men independent of differences in left ventricular volume: the Dallas Heart Study.

Background: Although gender-specific criteria are common for defining cardiac traits such as left ventricular hypertrophy, left ventricular ejection fraction (LVEF) thresholds widely used in clinical practice have traditionally been the same for women and men, perhaps because it remains uncertain whether there is a systematic difference in LVEF between genders.

Methods And Results: Using cardiac magnetic resonance imaging in a probability-based sample of Dallas County residents aged 30 to 65 years (1435 women and 1183 men), we compared LVEF in women and men. The association of gender with stroke volume independent of end-diastolic volume (EDV) or other potential confounders was assessed by multivariable analysis.

Relation of coronary atherosclerosis determined by electron beam computed tomography and plasma levels of n-terminal pro-brain natriuretic peptide in a multiethnic population-based sample (the Dallas Heart Study).

Elevated plasma levels of B-type natriuretic peptide (BNP) and N-terminal pro-BNP (NT-pro-BNP) are seen in the setting of cardiac ischemia and are associated with adverse outcomes in patients with coronary artery disease. The mechanisms leading to natriuretic peptide elevation in patients with coronary artery disease, including the contribution of coronary atherosclerosis itself, have not been fully elucidated. Measurement of NT-pro-BNP, electron beam computed tomography, and cardiac magnetic resonance imaging were performed in 2,445 subjects from the Dallas Heart Study who were free of heart failure and renal insufficiency.

Impact of body mass and body composition on circulating levels of natriuretic peptides: results from the Dallas Heart Study.

Background: The association between higher body mass index (BMI) and lower B-type natriuretic peptide (BNP) level is thought to be mediated by expression of the natriuretic peptide clearance receptor (NPR-C) in adipose tissue. To explore this association, we tested 2 hypotheses: (1) that N-terminal (NT)-proBNP, which is not believed to bind NPR-C, would not be associated with BMI and (2) that lower BNP would be more closely associated with fat mass than with lean mass.

Methods And Results: Measurements of BNP, NT-proBNP, and body composition by direct dual energy x-ray absorptiometry (DEXA) were performed in 2707 subjects from the Dallas Heart Study.