December 2019 at a Glance: Economic Burden, Co-Morbidities, and Prognosis
Notice bibliographique
Résumé
Heart failure (HF) is associated with high healthcare costs, and trials to reduce them may be disappointing.1 Bundgaard et al.2 investigated direct and indirect costs of HF performing a 1:1 matched comparison between diseased and healthy subjects from the Danish nationwide registry. Patients with HF incurred an average of €17 039 in total annual direct (€11 926) and indirect (€5113) costs compared to €5936 in the control group, with most of the costs caused by hospitalizations. The cost related with HF peaked at the year of first diagnosis but started to increase as early as 2 years before diagnosis. Peripartum cardiomyopathy is a major complication of pregnancy.3 Moulig et al.4 reported 5-year results of their German registry. Most of the patients (95%) had an improvement in left ventricular function with 72% who achieved full recovery. Mortality was low (2%). Long-term use of HF drugs was observed in 70% of cases. We have no therapy for HF with preserved ejection fraction (HFpEF) and experimental models are difficult.5 Primessnig et al.6 tested a specific Na+/Ca2+ exchanger inhibitor in a rat model of HFpEF. Chronic treatment attenuated cardiac remodelling and diastolic dysfunction without no effect on blood pressure. Biomarkers predict prognosis in patients with acute HF.7 Wettersten et al.8 investigated the relationship between B-type natriuretic peptide (BNP) and worsening renal function (WRF) and its prognostic implications in a multicentre registry of patients with acute HF. Decreased BNP was associated with better early and mid-term outcomes regardless of WRF, while WRF was associated with poorer outcomes only in patients with no BNP reduction. Different from a previous analysis based on pre-discharge values,9 plasma renin activity measured on admission had a modest, but significant, association with outcomes in patients with acute HF.10 Abnormal breathing control is associated with poor prognosis in chronic HF.11 The detection of oscillatory ventilation during exercise predicted cardiovascular death, urgent heart transplant, and ventricular assist device implantation in patients with HF and mid-range or reduced ejection fraction.12 Atrial fibrillation (AF) is associated with poorer outcomes and worse symptoms in HF patients.13 The role of the left atrium in this relationship is poorly known. Inciardi et al.14 investigated the association between left atrial (LA) structure/function and risk of cardiovascular death or HF hospitalization in patients with AF enrolled in the Effective Anticoagulation with Factor Xa Next Generation in AF-Thrombolysis in Myocardial Infarction 48 (ENGAGE AF-TIMI 48) trial. The composite endpoint occurred in 15% of patients at a median follow-up of 2.5 years. Measures of impaired LA function, LA emptying fraction and LA expansion index, were the only independent predictors of clinical events. Cancer is a common co-morbidity in HF patients.15 De Boer et al.16 reviewed the most recent data regarding the relationship between HF and cancer. This review analyses the epidemiology, risk factors and pathophysiological mechanisms shared by these two conditions. Vericiguat may improve symptoms and quality of life in patients with chronic HF.17 The Vericiguat Global Study in Patients with Heart Failure with Reduced Ejection Fraction (VICTORIA) trial will establish the impact of vericiguat on outcomes. Baseline characteristics of the patients enrolled in this trial are reported showing a high-risk population despite optimal medical treatment.18 Lung ultrasound (LUS) is a useful tool to evaluate clinical congestion in HF patients.19 In the LUS-HF trial patients admitted for HF were randomized to either standard therapy or LUS-guided therapy up to 6 months. Tailored LUS-guided therapy reduced the risk of the primary endpoint (urgent visit or hospitalization for HF or death) and improved functional capacity.20 Iung et al.21 reported the 2-year results of the Percutaneous Repair with the MitraClip Device for Severe Functional/Secondary Mitral Regurgitation (MITRA-FR) trial, confirming the lack of benefit of percutaneous edge-to-edge mitral valve repair over medical therapy in reducing death or unplanned HF hospitalization in this trial.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 0,002 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; les deux têtes enseignantes s’accordent sur ce qui est montré ici.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».