Publications by authors named "Silvio Nunes Augusto"
The Duke activity status index (DASI), a self-administered 12-item questionnaire has been used to estimate functional capacity and recently demonstrated prognostic information. We aimed to develop an abbreviated version for clinical applications. Leveraging the Cleveland Clinic GeneBank Study, we developed an abbreviated DASI questionnaire (aDASI) with the machine learning XGBoost algorithm, with the goal of maintaining the accuracy and reliability of the original DASI.
View Article and Find Full Text PDFBackground: Guidelines recommend that intravenous iron should be considered to improve symptoms of heart failure (HF) and reduce the risk for HF admissions in patients after acute HF.
Objectives: This study sought to analyze the effect of intravenous iron on cardiovascular (CV) death and HF admissions in a broad population of HF patients with iron deficiency and the relation with baseline transferrin saturation (TSAT).
Methods: A systematic review of all published randomized controlled trials assessing the effect of intravenous iron in patients with iron deficiency and HF between January 1, 2000, and August 26, 2023, was performed.
Heart Failure-Related Iron Deficiency Anemia Pathophysiology and Laboratory Diagnosis.
Curr Heart Fail Rep
October 2023
Purpose Of Review: The goal of the current review is to give an overview regarding the pathophysiology of iron deficiency in heart failure and how different laboratory tests change in the setting of heart failure.
Recent Findings: Recent studies have questioned the current employed definition of iron deficiency in the field of heart failure, as patients with ferritin < 100ng/ml but TSAT > 20% have a better prognosis, no iron deficiency on bone marrow staining, and altered treatment response to ferric carboxymaltose. This review summarizes changes in iron parameters in the setting of heart failure and underscores the importance of a reduced bioavailability of iron documented by a low serum iron or TSAT, irrespective of the presence of anemia.
Article Synopsis
- * In a study of 462 patients, those treated with acetazolamide showed a significant increase in urinary sodium levels and total natriuresis, which correlated with quicker relief from symptoms and shorter hospital stays.
- * Higher urinary sodium excretion was also linked to reduced risks of death or hospital readmissions related to heart failure, suggesting UNa is a useful indicator for monitoring treatment effectiveness in future studies.
Article Synopsis
- Acetazolamide, used in the ADVOR trial for treating acute heart failure, helps improve fluid removal when given alongside standard diuretics, but its effectiveness may be influenced by patients' bicarbonate (HCO3) levels.
- A sub-analysis of 519 patients showed that those with higher bicarbonate levels (≥ 27 mmol/l) had a significantly better decongestive response to the medication compared to those with lower levels.
- Overall, elevated bicarbonate levels correlated with improved diuretic response and reduced congestion scores, highlighting the importance of baseline bicarbonate in managing heart failure with acetazolamide treatment.
Background: Acetazolamide inhibits proximal tubular sodium reabsorption and improved decongestion in the ADVOR (Acetazolamide in Decompensated Heart Failure with Volume Overload) trial. It remains unclear whether the decongestive effects of acetazolamide differ across the spectrum of left ventricular ejection fraction (LVEF).
Methods: This is a prespecified analysis of the randomized, double-blind, placebo-controlled ADVOR trial that enrolled 519 patients with acute heart failure (HF), clinical signs of volume overload (eg, edema, pleural effusion, or ascites), NTproBNP (N-terminal pro-B-type natriuretic peptide) >1000 ng/L, or BNP (B-type natriuretic peptide) >250 ng/mL to receive intravenous acetazolamide (500 mg once daily) or placebo in addition to standardized intravenous loop diuretics (twice that of the oral home maintenance dose).