677 results found
Benjafield AV, Woehrle H, Vettorazzi E, et al., 2022, NEW TREATMENTS FOR CENTRAL SLEEP APNOEA IN HEART FAILURE: SAMPLE SIZE REQUIRED TO DETECT A SAFETY SIGNAL, Publisher: ELSEVIER, Pages: S259-S260, ISSN: 1389-9457
Cowie MR, Bozkurt B, Butler J, et al., 2022, How can we optimise health technology assessment and reimbursement decisions to accelerate access to new cardiovascular medicines?, Int J Cardiol, Vol: 365, Pages: 61-68
Regulatory approvals of, and subsequent access to, innovative cardiovascular medications have declined. How much of this decline relates to the final step of gaining reimbursement for new treatments is unknown. Payers and health technology assessment (HTA) bodies look beyond efficacy and safety to assess whether a new drug improves patient outcomes, quality of life, or satisfaction at a cost that is affordable compared to existing treatments. HTA bodies work within a limited healthcare budget, and this is one of the reasons why only half of newly approved drugs are accepted for reimbursement, or receive restricted or "optimised" recommendations from HTA bodies. All stakeholders have the common goal of facilitating access to safe, effective, and affordable treatments to appropriate patients. An important strategy to expedite this is providing optimal data. This is demonstrably facilitated by early (and ongoing) discussions between all stakeholders. Many countries have formal programmes to provide collaborative regulatory and HTA advice to developers. Other strategies include aligning regulatory and HTA processes, increasing use of real-world evidence, formally defining the decision-making process, and educating stakeholders on the criteria for positive decision making. Industry should focus on developing treatments for unmet medical needs, seek early engagement with HTA and regulatory bodies, improve methodologies for optimal price setting, develop internal systems to collaborate with national and international stakeholders, and conduct post-approval studies. Patient involvement in all stages of development, including HTA, is critical to capture the lived experience and priorities of those whose lives will be impacted by new treatment approvals.
Cowie MR, Mourilhe-Rocha R, Chang H-Y, et al., 2022, The impact of the COVID-19 pandemic on heart failure management: Global experience of the OPTIMIZE Heart Failure Care network, INTERNATIONAL JOURNAL OF CARDIOLOGY, Vol: 363, Pages: 240-246, ISSN: 0167-5273
Williams K, Modi RN, Dymond A, et al., 2022, Cluster randomised controlled trial of screening for atrial fibrillation in people aged 70 years and over to reduce stroke: protocol for the pilot study for the SAFER trial, BMJ OPEN, Vol: 12, ISSN: 2044-6055
Amirova A, Lucas R, Cowie MR, et al., 2022, Perceived barriers and enablers influencing physical activity in heart failure: A qualitative one-to-one interview study, PLOS ONE, Vol: 17, ISSN: 1932-6203
Baumert M, Cowie MR, Redline S, et al., 2022, Sleep characterization with smart wearable devices: a call for standardization and consensus recommendations, SLEEP, ISSN: 0161-8105
McBeath K, Cowie MR, 2022, Heart failure: classification and pathophysiology, Medicine (United Kingdom), Vol: 50, Pages: 471-478, ISSN: 1357-3039
Heart failure (HF) is a clinical syndrome in which there are characteristic signs and symptoms (e.g. oedema, breathlessness, fatigue) resulting from an underlying abnormality of cardiac function. Understanding the cause of the cardiac dysfunction and the body's response to it is essential in effective management. HF can present acutely, for example as a consequence of an acute myocardial infarction, or in a chronic form in which acute decompensation can then occur. HF results in a plethora of changes in the heart, at the cellular, microscopic and macroscopic levels, with the heart remodelling in response to these abnormal conditions. The underlying cardiac dysfunction also triggers the activation of an array of neuro-hormonal compensatory mechanisms that ultimately become deleterious to cardiac and other organ function; these include sodium and fluid retention, increased sympathetic tone, altered breathing patterns, arrhythmia and, in more advanced stages, an inflammatory state with immune activation.
Hernandez AF, Albert NM, Allen LA, et al., 2022, Multiple cArdiac seNsors for mAnaGEment of Heart Failure (MANAGE-HF) - Phase I Evaluation of the Integration and Safety of the HeartLogic Multisensor Algorithm in Patients With Heart Failure, JOURNAL OF CARDIAC FAILURE, Vol: 28, Pages: 1245-1254, ISSN: 1071-9164
Tamisier R, Pepin J-L, Cowie MR, et al., 2022, Effect of adaptive servo ventilation on central sleep apnea and sleep structure in systolic heart failure patients: polysomnography data from the SERVE-HF major sub study, JOURNAL OF SLEEP RESEARCH, ISSN: 0962-1105
Guasti L, Dilaveris P, Mamas MA, et al., 2022, Digital health in older adults for the prevention and management of cardiovascular diseases and frailty. A clinical consensus statement from the ESC Council for Cardiology Practice/Taskforce on Geriatric Cardiology, the ESC Digital Health Committee and the ESC Working Group on e-Cardiology, ESC HEART FAILURE, ISSN: 2055-5822
Jankowska EA, Liu P, Cowie MR, et al., 2022, Personalized care of patients with heart failure - REWOLUTION HF international survey on cardiologists' educational needs, Publisher: WILEY, Pages: 119-120, ISSN: 1388-9842
Jankowska EA, Liu P, Cowie MR, et al., 2022, Personalized care of patients with heart failure - REWOLUTION HF international survey on patients' needs and perceptions, Publisher: WILEY, Pages: 137-137, ISSN: 1388-9842
Rayman G, Akpan A, Cowie M, et al., 2022, Managing patients with comorbidities: future models of care., Future Healthc J, Vol: 9, Pages: 101-105, ISSN: 2514-6645
One in four adults in the UK have two or more medical conditions. One in three adults admitted to hospital in the UK have five or more conditions. People with multimorbidity have poorer functional status, quality of life and health outcomes, and are higher users of ambulatory and inpatient care than those without multimorbidity. The entire healthcare system needs to change so that it can provide a better service for patients with multimorbidity. The system of healthcare professional education needs to change also. Clinical decision support has a clear role in the management of patients with multimorbidity. But, until now, clinical decision support tools have offered no support when dealing with patients with comorbidities; they have covered single conditions only. In light of this, BMJ Best Practice recently launched the Comorbidities Manager. This enables healthcare professionals to add a patient's comorbidities to an existing management plan and get a tailored plan instantly. This article outlines the importance of taking into account comorbidities when managing patients and the role that the BMJ Comorbidities Manager can play in this regard.
Butler J, Stebbins A, Melenovsky V, et al., 2022, Vericiguat and Health-Related Quality of Life in Patients With Heart Failure With Reduced Ejection Fraction: Insights From the VICTORIA Trial, CIRCULATION-HEART FAILURE, Vol: 15, ISSN: 1941-3289
Leclercq C, Witt H, Hindricks G, et al., 2022, Wearables, telemedicine, and artificial intelligence in arrhythmias and heart failure: Proceedings of the European Society of Cardiology: Cardiovascular Round Table, EUROPACE, ISSN: 1099-5129
Fox KAA, Aboyans V, Debus ES, et al., 2022, Patients selected for dual pathway inhibition in clinical practice have similar characteristics and outcomes to those included in the COMPASS randomized trial: The XATOA Registry, EUROPEAN HEART JOURNAL-CARDIOVASCULAR PHARMACOTHERAPY, ISSN: 2055-6837
Cowie MR, Cleland JGF, 2022, The COVID-19 pandemic and heart failure: lessons from GUIDE-HF, EUROPEAN HEART JOURNAL, Vol: 43, Pages: 2619-2621, ISSN: 0195-668X
McBeath KCC, Angermann CE, Cowie MR, 2022, Digital Technologies to Support Better Outcome and Experience of Care in Patients with Heart Failure, CURRENT HEART FAILURE REPORTS, Vol: 19, Pages: 75-108, ISSN: 1546-9530
Konstam MA, Mann DL, Udelson JJE, et al., 2022, Advances in Our Clinical Understanding of Autonomic Regulation Therapy Using Vagal Nerve Stimulation in Patients Living With Heart Failure, FRONTIERS IN PHYSIOLOGY, Vol: 13
Cowie MR, McBeath KCC, Angermann CE, 2022, The Digital Future of Heart Failure Care, CURRENT HEART FAILURE REPORTS, Vol: 19, Pages: 109-113, ISSN: 1546-9530
Bottle R, Newson R, Faitna P, et al., 2022, Changes in heart failure management and long-term mortality over ten years: observational study, Open Heart, Vol: 9, ISSN: 2053-3624
Objectives: To estimate the long-term survival of two cohorts of people diagnosed with heart failure 10 years apart and to assess differences in patient characteristics, clinical guideline compliance and survival by diagnosis setting.Methods Data: for patients aged 18 and over with a new diagnosis of heart failure in the Clinical Practice Research Datalink in 2001–2002 (5966 patients in 156 practices) and 2011–2012 (12 827 patients in 331 practices). Survival rates since diagnosis were described using Kaplan-Meier plots. Compliance with national guidelines was summarised.Results: 2011/2012 patients were older than those diagnosed a decade before, with lower blood pressure and cholesterol but more comorbidity and healthcare contacts. For those diagnosed in 2001/2002, the 5-year survival was 40.0% (40.2% in the 2011/2012 cohort), 10-year survival was 20.8%, and 15-year survival 11.1%. Improvement in survival between the two time periods was seen only in those diagnosed in primary care (5-year survival 46.0% vs 57.4%, compared with 33.9% and 32.6% for hospital-diagnosed patients).Beta-blocker use rose from 24.3% to 39.1%; renin–angiotensin system blockers rose from 31.8% to 54.3% (both p<0.001). There was little change for loop diuretics and none for thiazide diuretics. For the 9963 patients with symptoms recorded by their general practitioner before diagnosis, brain natriuretic peptide (BNP) testing was low, but echocardiogram use rose from 8.3% to 19.3%, and specialist referral rose from 7.2% to 24.6% (all p<0.001).
Kouranos V, Khattar RS, Ahmed R, et al., 2022, MODE OF PRESENTATION, PROGNOSIS AND PREDICTORS OF OUTCOME IN A CONTEMPORARY CARDIAC SARCOIDOSIS POPULATION, Publisher: ELSEVIER SCIENCE INC, Pages: 553-553, ISSN: 0735-1097
Halliday B, Owen R, Gregson J, et al., 2022, Changes in clinical and imaging variables during withdrawal of heart failure therapy in recovered dilated cardiomyopathy, ESC Heart Failure, Vol: 9, ISSN: 2055-5822
Aims: To profile the changes in non-invasive clinical, biochemical and imaging markers during withdrawal of therapy in patients with recovered dilated cardiomyopathy, providing insights into the pathophysiology of relapse.Methods: Clinical, biochemical and imaging data from patients during phased withdrawal of therapy in the randomised or single-arm cross-over phases of TRED-HF were profiled. Clinical variables were measured at each study visit and imaging variables were measured at baseline, 16 weeks and 6 months. Results: Amongst the 49 patients (35% women, mean age 53.6 years [standard deviation 11.6]) who withdrew therapy, 20 relapsed. Increases in mean heart rate (7.6 beats per minute [95% CIs 4.5,10.7]), systolic blood pressure (6.6mmHg [95% CI 2.7,10.5]) and diastolic blood pressure (5.8mmHg [95% CI 3.1,8.5]) were observed within 4-8 weeks of starting to withdraw therapy. A rise in mean LV mass (5.1g/m2 [95%CI 2.8,7.3]) and LV end-diastolic volume (3.9ml/m2 [95% CI 1.1,6.7]) and a reduction in mean LV ejection fraction (-4.2 [95% CI -6.6, -1.8]) were seen by 16 weeks, the earliest imaging follow-up. Plasma NT-pro-BNP fell immediately after withdrawing beta-blockers and only tended to increase 6 months after beginning therapy withdrawal (mean change in log NT-pro-BNP at 6 months: 0.2, 95% CI -0.1,0.4). Conclusion: Changes in plasma NT-pro-BNP are a late feature of relapse, often months after a reduction in LV function. A rise in heart rate and blood pressure are observed soon after withdrawing therapy in recovered dilated cardiomyopathy, typically accompanied or closely followed by early changes in LV structure and function.
Masip J, Peacok WF, Arrigo M, et al., 2022, Acute Heart Failure in the 2021 ESC Heart Failure Guidelines: a scientific statement from the Association for Acute CardioVascular Care (ACVC) of the European Society of Cardiology, EUROPEAN HEART JOURNAL-ACUTE CARDIOVASCULAR CARE, Vol: 11, Pages: 173-185, ISSN: 2048-8726
Mullens W, Coats A, Seferovic P, et al., 2022, Education and certification on heart failure of the Heart Failure Association of the European Society of Cardiology, EUROPEAN JOURNAL OF HEART FAILURE, Vol: 24, Pages: 249-253, ISSN: 1388-9842
Cowie MR, Flett A, Cowburn P, et al., 2022, Real-world evidence in a national health service: results of the UK CardioMEMS HF System Post-Market Study, ESC Heart Failure, Vol: 9, Pages: 48-56, ISSN: 2055-5822
AimsThe CardioMEMS HF System Post-Market Study (COAST) was designed to evaluate the safety, effectiveness, and feasibility of haemodynamic-guided heart failure (HF) management using a small sensor implanted in the pulmonary artery of New York Heart Association (NYHA) Class III HF patients in the UK, Europe, and Australia.Methods and resultsCOAST is a prospective, international, multicentre, open-label clinical study (NCT02954341). The primary clinical endpoint compares annualized HF hospitalization rates after 1 year of haemodynamic-guided management vs. the year prior to sensor implantation in patients with NYHA Class III symptoms and a previous HF hospitalization. The primary safety endpoints assess freedom from device/system-related complications and pressure sensor failure after 2 years. Results from the first 100 patients implanted at 14 out of the 15 participating centres in the UK are reported here. At baseline, all patients were in NYHA Class III, 70% were male, mean age was 69 ± 12 years, and 39% had an aetiology of ischaemic cardiomyopathy. The annualized HF hospitalization rate after 12 months was 82% lower [95% confidence interval 72–88%] than the previous 12 months (0.27 vs. 1.52 events/patient-year, respectively, P < 0.0001). Freedom from device/system-related complications and pressure sensor failure at 2 years was 100% and 99%, respectively.ConclusionsRemote haemodynamic-guided HF management, using frequent assessment of pulmonary artery pressures, was successfully implemented at 14 specialist centres in the UK. Haemodynamic-guided HF management was safe and significantly reduced hospitalization in a group of high-risk patients. These results support implementation of this innovative remote management strategy to improve outcome for patients with symptomatic HF.Clinical registration number: ClinicalTrials.gov identifier: NCT02954341.
Ivey-Miranda JB, Wetterling F, Gaul R, et al., 2022, Changes in inferior vena cava area represent a more sensitive metric than changes in filling pressures during experimental manipulation of intravascular volume and tone, EUROPEAN JOURNAL OF HEART FAILURE, Vol: 24, Pages: 455-462, ISSN: 1388-9842
Cowie MR, O'Connor CM, 2022, The digital future is now, JACC: Heart Failure, Vol: 10, Pages: 67-69, ISSN: 2213-1779
Kotecha D, Asselbergs FW, Achenbach S, et al., 2022, CODE-EHR best practice framework for the use of structured electronic healthcare records in clinical research, The BMJ, ISSN: 0959-8146
Big data is central to new developments in global clinical science aiming to improve the lives of patients. Technological advances have led to the routine use of structured electronic healthcare records with the potential to address key gaps in clinical evidence. The covid-19 pandemic has demonstrated the potential of big data and related analytics, but also important pitfalls. Verification, validation, and data privacy, as well as the social mandate to undertake research are key challenges. The European Society of Cardiology and the BigData@Heart consortium have brought together a range of international stakeholders, including patient representatives, clinicians, scientists, regulators, journal editors and industry. We propose the CODE-EHR Minimum Standards Framework as a means to improve the design of studies, enhance transparency and develop a roadmap towards more robust and effective utilisation of healthcare data for research purposes.
This data is extracted from the Web of Science and reproduced under a licence from Thomson Reuters. You may not copy or re-distribute this data in whole or in part without the written consent of the Science business of Thomson Reuters.