American Heart Association

HF patient death leads to poor spousal outcomes

Contributor: Elise Vo

Being the spouse of a HF patient is challenging. In a recent study, Dunlay and colleagues explored the link between spousal health and HF patient outcomes. Interestingly, spousal health did not correlate with HF patient death or hospitalization. However, spouse caregivers experienced worse outcomes following the death of their HF partner.

Olmsted County residents were screened for HF between 2002-2012 using ICD-9 codes. 905 patients met study criteria, 586 (65%) males with mean age of 73.3, 96% Caucasian, and average LVEF 47.7%. The spousal characteristics were: 584 (65%) female, mean age of 71, and 96% Caucasian. HF patient charts were reviewed for marriage.

Precision medicine for cardiac resynchronization: Predicting quality of life benefits

Contributor: Nicholas Hawkes

Who benefits from cardiac resynchronization therapy (CRT)? Studies show that among select HF patients CRT improves longevity, ventricular remodeling, and quality of life (QoL). The precision medicine approach asks the question, “Are there individual factors that predict QoL improvements?” Spertus and colleagues demonstrated that age, baseline QoL, and QRS duration predict individual QoL after CRT.

Decreased incidence yet increased prevalence of heart failure among Medicare beneficiaries

Contributor: Chris Sobowale

Over 6.5 million Americans have HF, costing over $31 billion annually. Those are big numbers, but what is the trend? Berry et al explored the epidemiology of heart failure by examining fee-for-service Medicare patients from 2002-2013. This was presented as a late-breaker at the AHA Scientific Sessions 2017 with simultaneous publication in Circulation: Heart Failure – the new editor teams’ first simultaneous publication – but hopefully not our last!

Outcomes in Chagasic heart failure worse than other HFrEF subtypes

Contributor: Elise Vo

A young Latin American female patient walks into clinic with signs and symptoms of HF, a right bundle branch block on 12-lead EKG, and reduced EF on echo. She has Chagas disease and HFrEF, but what is her prognosis?

Despite its high prevalence in South America, reports of morbidity and mortality of this disease have been variant. Using post-hoc analysis, McMurray et al evaluated outcomes in 2552 Latin American patients from the PARADIGM-HF and ATMOSPHERE trials where 195 (7.6%) had Chagasic HFrEF. The authors discovered that despite younger age and fewer comorbidities, the Chagasic HFrEF cohort had higher CV death and hospitalization when compared to ischemic and non-ischemic groups. Chagasic HFrEF patients had worse quality of life compared to the non-ischemic group, measured using the Kansas City Cardiomyopathy Questionnaire (KCCQ).

Sacubitril/Valsartan improves quality of life in patients with HFrEF

Contributor: Nicholas Hawkes

Quality not quantity. Why not both? It is established that sacubitril/valsartan is superior to enalapril (or dose-equivalent ACE-I) when it comes to mortality and morbidity in HFrEF. But what about quality of life (QoL)? Patients enrolled in PARADIGM-HF had increased quality of life when randomized to sacubitril/valsartan.