Background: Inpatient admissions for Congestive Heart Failure (CHF) represent a substantial economic burden within the US healthcare system with patients experiencing high rates of 30-day readmission and mortality. To more efficiently and effectively serve complex cardiovascular (CV) patients at a major cardiac care center, Intermountain Health created a dedicated CV hospitalist service which has expanded [...]

Background: Heart failure is expected to increase in prevalence globally.(1) The increased incidence of metabolic disorders coupled with the increase in life expectancy in Singapore has contributed to this trend. Heart failure poses a great burden on patients, caregivers and the healthcare system.Previous European studies have suggested that patients managed by internists differ in baseline [...]

Background: Serum levels of pro-B-type natriuretic peptide (BNP) and N-terminal (NT) proBNP are measured at admission to assess likelihood of acutely decompensated heart failure (ADHF). Pro-BNP, released by myocardium due to cardiac wall distention, is cleaved into the active BNP and inactive NT-proBNP forms. Elevated NT-proBNP levels on initial presentation are a reliable marker of [...]

Background: Diuretic therapy is the mainstay of treatment for heart failure exacerbations but its optimal dosing strategy remains unclear. In 2011, the DOSE trial exhibited a trend toward improvement in patients’ global symptom assessments when utilizing a high-dose diuretic strategy, which used nearly 80mg intravenous furosemide three times daily in the first 72 hours on [...]

Background: Management of heart failure (HF) patients revolves around optimization of guideline directed medical therapy (GDMT) and routine monitoring. Substance use plays a major role as the etiology of HF, especially in a low socioeconomic area with ethnic and racial minority patients. The aim of this study is to find the correlation of alcohol, tobacco [...]

Background: Despite recent advancements in the medical management of acute and chronic Heart Failure (HF), smooth transitions of care for patients hospitalized with HF remain elusive for most health care systems. Use of home health services and other ancillary services have been promoted in recent years as a means of reducing readmission rates among HF [...]

Background: Mitochondrial disease (MD) refers to a group of clinically heterogeneous disorders that result from dysfunctional oxidative phosphorylation and subsequent cellular incapability to meet energy demands. Mitochondrial encephalopathy, lactic acidosis, and stroke-like episodes (MELAS), myoclonus, epilepsy, ataxia with ragged red fibers (MERRFs), chronic progressive ophthalmoplegia, Kearns–Sayre syndrome, and sensory ataxia neuropathy dysarthria ophthalmoplegia are among [...]

Background: In patients hospitalized with heart failure (HF) exacerbations, physicians routinely supplement potassium to maintain levels ≥4.0 mEq/L. The evidence basis for this practice is relatively weak. We aimed to evaluate the association between serum potassium levels and outcomes in patients hospitalized with HF. Methods: We identified patients admitted with acute HF exacerbations to hospitals [...]

Background: The treatment of acute decompensated heart failure (ADHF) and comorbid acute kidney injury (AKI) can be quite challenging. Many times the etiology of AKI in this setting is multifactorial and may involve cardiorenal syndrome (CRS). Arterial underfilling, sympathetic nervous system upregulation, and systemic venous congestion contribute to impaired glomerular filtration rate in ADHF patients. [...]

Background: The diagnosis of sepsis is often associated with high rates of morbidity and mortality. When it occurs in patients with Heart failure (HF), those rates increase dramatically. This study focuses on the differences in the outcomes in septic patients with Heart Failure with preserved Ejection Fraction (HFpEF) versus patients with Heart Failure with reduced [...]