Online ISSN: 2515-8260

Keywords : Heart failure


CARDIORENAL SYNDROME AND HEART FAILURE: WHAT’S ASSOCIATION?

Dr. Devpriya Shukla, Dr. Pushpendra Singh Sengar, Dr. Anju Jha, Dr. Maneesh Jain

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 7, Pages 463-470

INTRODUCTION: -Heart failure is among key reasons of hospitalizations throughout the world. Prevalence is 1% among the ages of 50 and 59 years, gradually growing to >10% over age of 80 years. In patients with heart failure, concomitant and notable renal impairment is prevalent. Heart failure is increasingly being classified as a type of cardiorenal failure, in which there are contemporaneous cardiac and renal dysfunctions, each of which         accelerates the progress of the other.
AIMS AND OBJECTIVES:-To study the etiology, risk factors and clinical outcomes of heart failure and cardiorenal syndrome.
MATERIALS AND METHODS: - The present study is an observational study conducted at Sri Aurobindo medical college and Post Graduate Institute, Hospital ,Indore on 75 patients admitted in Medicine ward, Medicine emergency and Medicine ICU.
RESULTS:-The major risk factor which associated with mortality was coronary artery disease  73.5%.Type 2 diabetes mellitus was present in 62.5% patients while hypertension in 42.7%. Smoking was the risk factor in 46.2% and alcohol in 41.7% patients, COPD was present in 8.2% cases. NYHA grade 4 was more common and was seen in 79.2% while NYHA grade 3 in 22.8% cases.
CONCLUSION: Cardiorenal syndrome is very common in people who have heart failure. Patients with heart failure who have had two or more previous hospitalizations, sepsis, history of CAD and hypothyroidism are more likely to develop cardiorenal syndrome. The development of cardiorenal syndrome is an independent predictor of frequent readmissions, In addition to longer hospitalization and slower recovery, under treatment of the cardiorenal syndrome has the potential to be fatal on an individual level and have massive public health repercussions.

Effects of Carvedilol and Bisoprolol on Inflammation and Oxidative Damage in Patients with Chronic Heart Failure

J. Jacob Justin, Sabu Augustine

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 7, Pages 478-485

Background: Inflammation and oxidative stress contribute to persistent heart failure (CHF). Bisoprolol is better than carvedilol at protecting CHF patients' myocardium, according to our earlier clinical trial. Low high-sensitivity cardiac troponin T showed this (hsTnT).
Materials and Methods: From the 87 people who took part in the trial, 48 (26 in the bisoprolol group and 22 in the carvedilol group) were included in this study because they had measurements of derivatives of reactive oxygen metabolites (d-ROMs) as an indicator of oxidative stress at the beginning and end of the trial.
Results: High-sensitivity C-reactive protein (hsCRP), a marker of inflammation, went down in both groups, but the drop in the bisoprolol group was bigger than the drop in the carvedilol group. Both groups also had a drop in d-ROMs, but the drop in the bisoprolol group was not as big as the drop in the carvedilol group. The change in hsTnT was linked to the change in hsCRP for all 48 patients (R = 0.467, p = 0.003).
Conclusion: Bisoprolol might be better than carvedilol at reducing inflammation, but carvedilol might be better at reducing oxidative stress than bisoprolol. Patients with CHF could benefit from the right use of bisoprolol or carvedilol based on their own pathophysiology.

ROLE OF SERUM MAGNESIUM LEVELS IN CHRONIC HEART FAILURE

Dr. Mohammad Rafeek, Dr. Mirdulata Prajapati, Dr. Sarla

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 6, Pages 51-55

Background: The present study was conducted for evaluating the role of serum magnesium levels in chronic heart failure.
Materials & methods: A total of 100 patients with chronic heart failurenormal sinus rhythm were included in the present study. Blood samples were obtained and serum magnesium levels were assessed in all the patients. On the basis of magnesium levels, all the patients were divided into two study groups; 41 patients with normal magnesium levels (>2mEq/L) and 59 patients with low magnesium levels (≤ 2 mEq/L). Profile was compared among the two study groups. All the results were recorded in Microsoft excel sheet and were analysed by SPSS software.
Results: Significant higher proportion of subjects were diabetic among low magnesium level group. Age and diabetic status were found to be significantly correlated with low magnesium levels.  Blood pressure was significantly higher among subjects with low magnesium levels. Non-significant results were obtained while correlating serum potassium levels and Left ventricular ejection fraction with magnesium status.
Conclusion: Low serum magnesium levels were predictor of deranged cardiac and biochemical profile in chronic heart failure patients.

A Study of Anemia in Hospitalized Patients of Heart Failure with Reduced Ejection

Dr Mayuri Singh, Dr Dhwani Shah, Dr Lalit Solanki, Dr Kunjal Kasta

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 6, Pages 305-315

INTRODUCTION: Heart failure is a complex clinical syndrome resulting from structural and functional impairment of ventricular filling or ejection of blood, which in turn leads to the cardinal clinical symptoms of dyspnea and fatigue and signs of HF, namely edema and rales.[1] According to the World Health Organization (WHO), anemia is defined as hemoglobin (Hb) levels <12.0 g/dL in women and <13.0 g/dL in men.[2] Anemia in HF decreases the oxygen delivery to the tissues leading to dyspnea and fatigue which worsens the quality of lives of the patients. The guidelines of the American College of Cardiology Foundation/American Heart Association and the European Society of Cardiology both recognize anemia as an important comorbidity in patients with HF. [3,4] Management recommendations focus on determining the underlying etiology and subsequent treatment, although, often no specific cause is found. In this study, we evaluated the patients of heart failure for anemia.
AIMS AND OBJECTIVES: To study anemia in hospitalized patients of heart failure with reduced ejection fraction.
METHOD AND MATERIAL: This is a hospital based cross sectional study of 140 patients of heart failure with reduced ejection fraction admitted in the Department of General Medicine, NHL Medical college, Ahmedabad, Gujarat. The material for this study was formed by adult patients admitted in the hospital between October 2019 to 2021 fulfilling the inclusion and the exclusion criteria.
RESULT: Out of 140 patients admitted heart with reduced ejection fraction, 58 (41.3%) had anemia with 59% being male. The mean age of patients in the anemic group was 58.5±9.95 years and iron deficiency anemia (53.44%) was the most common cause of anemia in patients of HFrEF with mean Hb being 8.42±1.62 g/dl. We found an inverse relationship between NYHA class grading and mean Hb but no correlation between EF severity and mean Hb.
CONCLUSION:
Anemia is a common comorbid condition in patients with HFrEF and has been associated with poor clinical outcome. In this study, nutritional anemia is the most common cause, hence by providing adequate nutrition and awareness we can reduce the burden and can attenuate worse outcomes in patients of heart failure.

Effect of IV iron sucrose versus IV carboxymaltose in patients with heart failure

Rambabu Singh, Rajat Jain, Shreya Srivastava

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 2, Pages 1218-1221

Iron deficiency either absolute or functional, is an independent predictor of all cause and cardiovascular mortality and a major contributor to exercise intolerance, even in absence of anemia. Correcting these comorbidities is attractive and novel therapies targets to improve outcomes. At present, IV iron is preferred route for treatment in such patients. Most studies have used IV iron sucrose (max dose of 200mg/setting) or ferric carboxymaltose (max dose of 1000mg/setting). Our study determines advantage of IV iron carboxymaltose over iron sucrose by being cost effective, requiring fewer injections, lesser duration of hospital stay with minimum adverse effect and equivocal improvement in quality of life and hematological profile in patients with heart failure with either preserved or reduced ejection fraction.

Is Digoxin a Risk Factor or a Risk Marker in Heart Failure with a Low Ejection Fraction?

1Narendra, 2Nayan Kumar Patel, 3Rekha Manjhi, 4Sudarsan Pothal, 5Aurobindo Behera, 6Pravati Dutta .

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 3253-3263

Digoxin is a compound that has been utilised in cardiovascular therapy for a long time. Nonetheless, its mode of action and, more crucially, its clinical value have been a source of contention. Digoxin has positive inotropic and neurohormonal modulation effects, and it has been the mainstay of heart failure therapies for decades. Digoxin prescription rates have been in free decrease since the introduction of β-blockers and aldosterone antagonists as part of modern heart failure medical care. The fact that digoxin is still recommended as a treatment option in both American and European heart failure guidelines hasn't changed specialists' minds.A succession of papers based primarily on observational studies and post hoc analysis has raised questions about the clinical efficacy and long-term safety of digoxin since the release of the initial Digitalis Investigation Group trial findings. We will conduct a thorough assessment of the available clinical evidence on the efficacy and safety of digoxin in heart failure patients with a lower ejection fraction in this paper. Individual studies' methodological challenges, strengths, and limitations will be emphasised.