Entries Tagged as 'Herz'
Heart failure with normal ejection fraction. Pathophysiology, diagnosis, and treatment.
Herz. 2009 Mar;34(2):89-96
Authors: Tschöpe C, Westermann D
Symptoms of heart failure are documented in patients, in a manner independent of their current ejection fraction (EF). Today, about 50% of all heart failure patients have a normal EF (HFNEF) and their outcome regarding mortality and morbidity is as severe as in patients with reduced EF. Nevertheless, the awareness of this disease is still limited. Furthermore, the diagnostic criteria are still a challenge in the daily clinical setting. Here, the recent recommendations of the European Society of Cardiology (ESC) on how to diagnose HFNEF will be reviewed. Moreover, the recent pathologic understanding will be discussed as well, because alongside noncardiac reasons for HFNEF, diastolic as well as nondiastolic abnormalities are known to be important for the development of HFNEF. Treatment options will be reviewed including the recent clinical trials for this group of patients.
PMID: 19370324 [PubMed - indexed for MEDLINE]
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Antithrombotic therapy for patients with valvular heart disease.
Herz. 2008 Feb;33(1):44-51
Authors: Vahanian A
To avoid the devastating consequences of thromboembolism and bleeding in patients with valve disease, in particular those with prosthetic valves, it is of utmost importance to correctly manage anticoagulation.Patients with mitral stenosis and either permanent or paroxysmal atrial fibrillation should receive anticoagulation, whereas those in sinus rhythm should only receive it in selected cases.In patients with prosthetic valves, anticoagulation management should be governed by the risk-benefit ratio taking factors related both to the patient and the prosthesis into account. Aspirin should be added only when there is a specific indication, such as concomitant arterial disease or embolism.In the future, improvements will be the result of the development of less thrombogenic valve substitutes, increased performance of conservative procedures, development of new antithrombotic agents, and, finally, increased use of self-assessment by better-educated patients.
PMID: 18273577 [PubMed - indexed for MEDLINE]
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Oral anticoagulation after myocardial infarction.
Herz. 2008 Feb;33(1):38-43
Authors: Hurlen M, Arnesen H
In the present review, the role of oral anticoagulants (OAC) in the secondary prevention after myocardial infarction (MI) is discussed in the light of the results from large randomized clinical trials. In particular, recently published trials and meta-analyses including the combination of OAC and low-dose aspirin are presented. The data show a superiority of OAC over aspirin in reducing thromboembolic events after MI. The combined therapy with OAC and low-dose aspirin has been shown to be particularly beneficial, provided the intensity of anticoagulation is adequate (International Normalized Ratio [INR] 2.0-2.5). With this combined therapy, the risk of serious and fatal bleeding complications equals that with OAC alone. Preassumptions for the efficacy and safety of this treatment modality are good patient compliance and strict INR control.
PMID: 18273576 [PubMed - indexed for MEDLINE]
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