Elevated Cystatin C Predicts Higher Mortality in Chronic Heart Failure Independently of Renal Function.

Introduction: Cystatin C (CysC) is a known prognostic marker in cardiovascular diseases and its role in acute heart failure (HF) has been documented.

Methods: We prospectively recruited HF patients followed in a HF clinic. Inclusion criteria: HF diagnosed ≥6 months, optimized evidence-based therapy, and ejection fraction <40% (Heart Failure with reduced ejection fraction).

Prognostic impact of red blood cell distribution width in chronic heart failure patients with left ventricular dysfunction.

Aims: Red blood cell (RBC) distribution width (RDW) measures RBC variations in size. Higher RDW values have been associated with poor outcome in acute heart failure (HF). We aimed to assess the prognostic impact of the RDW in chronic HF.

Clinical and Pathophysiologic Insights of Free triiodothyronine/Free thyroxine Ratio in Patients with Heart Failure with Preserved Ejection Fraction: Data from the NETDiamond Cohort.

Background: Thyroid dysfunction is common in patients with heart failure (HF). Impaired conversion of free T4 (FT4) into free T3 (FT3) is thought to occur in these patients, decreasing the availability of FT3 and contributing to HF progression. In HF with preserved ejection fraction (HFpEF), it is not known whether changes in conversion of thyroid hormones (THs) are associated with clinical status and outcomes.

Relaxin-2, pathophysiological insights and outcomes in heart failure with preserved ejection fraction: Findings from the NETDiamond cohort.

Aims: The role of relaxin-2 as a circulating marker in heart failure (HF) with preserved ejection fraction (HFpEF) is poorly understood. We aimed to characterize relaxin-2 circulating levels in a population of chronic HFpEF patients and their association with long-term prognosis.

Methods: Relaxin-2 serum levels were measured in 85 chronic HFpEF patients from a prospective cohort study (NETDiamond).

Prognostic impact of neurohormonal modulation in very old patients with chronic heart failure.

Background: A gap in evidence exists concerning the survival-benefit of neurohormonal blockade in older patients with chronic heart failure (HF). The purpose of our study was to investigate the neurohormonal modulation therapy in older HF patients.

Methods: We retrospectively analysed data on chronic HF patients with systolic dysfunction from January 2012 to May 2018 at a central tertiary academic hospital in Porto, Portugal.

The ratio of furosemide dosage to urinary sodium concentration predicts mortality in patients with chronic stable heart failure.

Introduction: The urinary sodium (UNa) concentration is associated with outcomes in patients with acute heart failure (HF). Its impact in individuals with chronic HF is unknown.

Objectives: This study examined the combined effect of diuretic dosage and UNa concentration in chronic HF.

Neurovascular Coupling Impairment in Heart Failure with Reduction Ejection Fraction.

The hemodynamic consequences of a persistent reduced ejection fraction and unknown cardiac output on the brain have not been thoroughly studied. We sought to explore the status of the mechanisms of cerebrovascular regulation in patients with heart failure with reduced (HFrEF) and recovered (HFrecEF) ejection fraction. We monitored cerebral blood flow velocity (CBFV) with transcranial Doppler and blood pressure.

An Unusual Case of Tricuspid Stenosis.

Unlabelled: Tricuspid stenosis is an uncommon valvular abnormality commonly associated with other valvular lesions. Ebstein's anomaly is a rare congenital heart malformation characterized primarily by abnormalities of the tricuspid valve and right ventricle. Endomyocardial fibrosis is a restrictive cardiomyopathy observed in tropical and subtropical regions.

Age affects the prognostic impact of diabetes in chronic heart failure.

Aims: Increasing age is an established prognostic determinant in chronic heart failure (HF). Diabetes often complicates HF in its course and appears to worsen HF prognosis. A differential impact of diabetes depending on patients' age was not yet studied.

Dipeptidyl peptidase-IV in chronic heart failure with reduced ejection fraction.

Background: An association between dipeptidyl peptidase-IV (DPP-IV) inhibitors with worse prognosis in HF has been suggested. We aimed to assess the serum DPP-IV levels in chronic stable HF patients and determine their association with prognosis.

Methods And Results: Chronic stable HF patients with optimized prognostic-modifying therapy were prospectively recruited.

Predictors of natriuretic peptide non-response in patients hospitalized with acute heart failure.

Increasing natriuretic peptide (NP) levels are associated with worse heart failure (HF) outcomes. Predictors of NP nonresponse have not been studied. The aim of this study was to identify predictors of nondecreasing NP levels during episodes of acute HF.

Low prealbumin is strongly associated with adverse outcome in heart failure.

Objective: Prealbumin is one of the best indicators of nutritional status. We previously showed that prealbumin predicted in-hospital mortality in heart failure (HF) patients. We evaluated if a low discharge prealbumin after admission with acute HF would predict morbidity and mortality.

Natriuretic peptides in aortic stenosis.

Aortic stenosis (AS) is the most prevalent valvular heart disease in developed countries. Diagnosis, risk stratification and monitoring are usually based on clinical and echocardiographic parameters. Complementary methods are needed to improve management and outcome, particularly in patients with severe asymptomatic AS, whose management remains controversial.

Statin-induced low cholesterol is not associated with poor outcome in chronic heart failure.

Background: Low cholesterol levels are associated with a worse outcome in patients with heart failure (HF). Use of statins in HF remains controversial. We aimed to assess whether the prognosis of patients with intrinsically low cholesterol levels differed from that of those with pharmacologically induced low cholesterol.

Prognostic implications of diuretic dose in chronic heart failure.

Background: Prognostic implications of diuretics dose are not completely understood. We aim to study the association between diuretic doses and long-term prognosis in patients with chronic stable heart failure (HF).

Methods And Results: We conducted a retrospective cohort study of 244 patients followed at an outpatient HF clinic.

Higher C-reactive protein predicts worse prognosis in acute heart failure only in noninfected patients.

Background: The prognostic role of C-reactive protein (CRP) in acute heart failure (HF) is not fully understood, and the impact of an infectious process in its risk-stratification power was not previously evaluated.

Hypothesis: As CRP is an inflammatory marker, its prognostic value in acute HF is probably different in patients with and without concurrent infection.

Methods: We recruited patients admitted to our hospital due to acute HF from October 2006 to October 2007.

Natriuretic peptide system is not exhausted in severe heart failure.

Objective: We aimed to investigate the prognostic value of amino-terminal B-type natriuretic peptide (NT-pro-BNP) in severe heart failure.

Methods: We retrospectively assessed 133 patients admitted to the hospital for decompensated heart failure, in New York Heart Association class III or IV, with depressed left ventricular ejection fraction and an NT-pro-BNP measurement within 24 h of admission. Patients were followed up for 6 months.

Nutritional markers and prognosis in cardiac cachexia.

Background: Cachexia frequently complicates chronic heart failure (CHF) and predicts an ominous prognosis. Hormonal and inflammatory environment differ between cachectic and non-cachectic patients. Nutritional markers of cardiac cachexia and prognostic predictors in this context are not completely understood.

Adiponectin is increased in cardiac cachexia irrespective of body mass index.

Aims: Cardiac cachexia (CC) is a complication of chronic heart failure (CHF). Little is known about the mechanisms leading to CC. Adiponectin, leptin, and ghrelin are important regulators of energy metabolism and body weight.

Prognostic value of high-sensitivity C-reactive protein in heart failure: a systematic review.

Background: Several studies have suggested that high-sensitivity C-reactive protein (hsCRP) is a strong independent predictor of acute myocardial infarction and cardiovascular death. In the specific heart failure (HF) context, a low-grade inflammatory state can contribute to HF progression.

Aims: To perform a systematic review on the current knowledge about low-grade inflammation, as assessed by hsCRP, in the prediction of HF in general and in high-risk populations as well as its prognostic value in established HF.

The cyclic guanosine monophosphate/B-type natriuretic peptide ratio and mortality in advanced heart failure.

Aims: Attenuation of the effects of natriuretic peptides has been demonstrated in animal models but studies in humans are scarce, particularly concerning renal attenuation. We investigated the attenuation of B-type natriuretic peptide (BNP) in chronic advanced heart failure (HF).

Methods And Results: We included 62 outpatients with HF and severe left ventricular systolic dysfunction.

Cholesterol--a marker of nutritional status in mild to moderate heart failure.

Objective: To assess the association between serum cholesterol and nutritional status in patients with stable mild to moderate chronic heart failure (CHF).

Background: Hypercholesterolemia is a well-established risk factor for mortality and morbidity in coronary heart disease. In an apparent paradox, lower serum cholesterol has been associated with worse prognosis in CHF.

Amino terminal B-type natriuretic peptide, renal function, and prognosis in acute heart failure: a hospital cohort study.

Background: Amino-terminal pro-brain natriuretic peptide (NT-proBNP) is a valuable diagnostic and prognostic test in heart failure (HF). Limited information is available concerning its use in patients with renal failure, in whom dependence on renal clearance may negatively affect its performance.

Methods And Results: We evaluated influence of renal function on NT-proBNP levels and on its prognostic value after hospital discharge in 283 acute HF patients.

Intraindividual variation of amino-terminal pro-B-type natriuretic peptide levels in patients with stable heart failure.

This study aimed to evaluate how large the variation between measurements of N-terminal pro-B-type natriuretic peptide (NT-pro-BNP) can be in patients with clinically stable heart failure (HF). The fluctuation of NT-pro-BNP in patients with HF has not been previously evaluated. Patients with chronic, stable HF were evaluated at 3-week intervals.