13 research outputs found
Sex differences in patients with acute decompensated heart failure in Japan: observation from the KCHF registry
Aims: The association between sex and longāterm outcome in patients hospitalized for acute decompensated heart failure (ADHF) has not been fully studied yet in Japanese population. The aim of this study was to determine differences in baseline characteristics and management of patients with ADHF between women and men and to compare 1āyear outcomes between the sexes in a largeāscale database representing the current realāworld clinical practice in Japan. Methods and results: Kyoto Congestive Heart Failure registry is a prospective cohort study enrolling consecutive patients hospitalized for ADHF in Japan among 19 centres. Baseline characteristics, clinical presentation, management, and 1āyear outcomes were compared between men and women. A total of 3728 patients who were alive at discharge constituted the current study population. There were 1671 women (44.8%) and 2057 men. Women were older than men [median (IQR): 83 (76ā88) years vs. 77 (68ā84) years, P < 0.0001]. Hypertensive and valvular heart diseases were more prevalent in women than in men (28.0% vs. 22.5%, P = 0.0001; and 26.9% vs. 14.0%, P < 0.0001, respectively), whereas ischaemic aetiology was less prevalent in women than in men (20.0% vs. 32.5%, P < 0.0001). Women less often had reduced left ventricular ejection fraction (<40%) than men (27.5% vs. 45.1%, P < 0.0001). The cumulative incidence of allācause death or hospitalization for heart failure was not significantly different between women and men (33.6% vs. 34.3%, P = 0.71), although women were substantially older than men. After multivariable adjustment, the risk of allācause death or hospitalization for heart failure was significantly lower among women (adjusted hazard ratio: 0.84, 95% confidence interval: 0.74ā0.96, P = 0.01). Conclusions: Women with heart failure were older and more often presented with preserved EF with a nonāischaemic aetiology and were associated with a reduced adjusted risk of 1āyear mortality compared with men in the Japanese population
809-3 Desipramine Attenuates the Cardiac Sympathetic Nerve Terminal Abnormalities in Congestive Heart Failure
Mitral valve nonbacterial thrombotic endocarditis: a rare multi-surgery-tolerant survivor of Trousseauās syndrome
Abstract Background Few previous reports have documented cases of nonbacterial thrombotic endocarditis associated with Trousseauās syndrome for which surgery proved possible for both the primary tumor and the cardiac lesion. The effectiveness of direct oral anticoagulants in patients with Trousseauās syndrome has also received scant attention. Case presentation A 69-year-old man with repeated episodes of cerebral infarction was diagnosed as having nonbacterial thrombotic endocarditis after mitral valve replacement surgery. Stroke recurred preoperatively under apixaban administration. A stomach biopsy also identified gastric adenocarcinoma, and gastric surgery was performed on the 40th postoperative day. The patient was discharged from the hospital and has been free of thromboembolism under a regime of subcutaneous heparin self-injection thereafter. Conclusions We have reported a rare multi-surgery-tolerant survivor of Trousseauās syndrome in whom subcutaneous heparin injection was useful for preventing thromboembolic events over a long period
Desipramine attenuates loss of cardiac sympathetic neurotransmitters produced by congestive heart failure and NE infusion
Differential pre- and postsynaptic effects of desipramine on cardiac sympathetic nerve terminals in RHF
Impact of citrus fruit intake on the mental health of patients with chronic heart failure
Background: The full impact of the intake of citrus fruits on the risk of depression in individuals with chronic heart failure (HF) is unknown. Here, we examined the associations between the estimated habitual intakes of citrus fruits and depressive symptoms in patients with chronic HF. Methods: We enrolled 150 stable outpatients with chronic HF who had a history of worsening HF. To assess the patients' daily dietary patterns, we used a brief self-administered diet-history questionnaire to calculate the daily consumption of foods and nutrients. To assess the patients' mental state, we used a nine-item Patient Health Questionnaire (PHQ-9). Results: Twelve patients (8%) were identified as having moderate-to-severe depression (PHQ-9 score > 10). The patients with PHQ-9 > 10 had lower daily intakes of citrus fruits compared to those with no or mild depressive symptoms (PHQ-9 10, accompanied by higher serum levels of 8-isoprostane (an oxidative stress marker). A multivariate logistic regression analysis using forward selection showed that a lowered daily intake of citrus fruits was an independent predictor of the comorbidity of moderate-to-severe depression in patients with chronic HF, after adjustment for age, gender, and the hemoglobin value. Conclusions: A lower daily consumption of citrus fruits was associated with higher prevalence of depression in patients with chronic HF. Our findings support the hypothesis that a daily consumption of citrus fruits has a beneficial effect on the prevention and treatment of depression in chronic HF patients. (C)2021 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved