Congestive heart failure risk factors: Difference between revisions

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! colspan="2" style="background: PapayaWhip;" align="center" + |The above table adopted from 2021 ESC Guideline
! colspan="2" style="background: PapayaWhip;" align="center" + |The above table adopted from 2021 ESC Guideline
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|}<ref name="pmid34447992">{{cite journal |vauthors=McDonagh TA, Metra M, Adamo M, Gardner RS, Baumbach A, Böhm M, Burri H, Butler J, Čelutkienė J, Chioncel O, Cleland JGF, Coats AJS, Crespo-Leiro MG, Farmakis D, Gilard M, Heymans S, Hoes AW, Jaarsma T, Jankowska EA, Lainscak M, Lam CSP, Lyon AR, McMurray JJV, Mebazaa A, Mindham R, Muneretto C, Francesco Piepoli M, Price S, Rosano GMC, Ruschitzka F, Kathrine Skibelund A |title=2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure |journal=Eur Heart J |volume=42 |issue=36 |pages=3599–3726 |date=September 2021 |pmid=34447992 |doi=10.1093/eurheartj/ehab368 |url=}}</ref>
|}<ref name="pmid34447992">{{cite journal |vauthors=McDonagh TA, Metra M, Adamo M, Gardner RS, Baumbach A, Böhm M, Burri H, Butler J, Čelutkienė J, Chioncel O, Cleland JGF, Coats AJS, Crespo-Leiro MG, Farmakis D, Gilard M, Heymans S, Hoes AW, Jaarsma T, Jankowska EA, Lainscak M, Lam CSP, Lyon AR, McMurray JJV, Mebazaa A, Mindham R, Muneretto C, Francesco Piepoli M, Price S, Rosano GMC, Ruschitzka F, Kathrine Skibelund A |title=2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure |journal=Eur Heart J |volume=42 |issue=36 |pages=3599–3726 |date=September 2021 |pmid=34447992 |doi=10.1093/eurheartj/ehab368 |url=}}</ref>
#Demographic factors
#*Age (increased)
#*Low socioeconomic status
#Lifestyle-related factors
#*[[Tobacco]] and coffee consumption
#*[[Alcohol consumption]]
#*Dietary sodium intake
#*Recreational drug use: [[Cocaine]], [[methamphetamine]]s.
#Comorbidities
#*[[Hypertension]]
#*[[Left ventricular hypertrophy]]
#*[[Acute myocardial infarction|Myocardial infarction]]
#*[[Obesity]]
#*[[Diabetes mellitus]]
#*[[Valvular heart disease]]
#*[[Renal insufficiency]]
#*[[Dyslipidemia]]
#*[[Sleep apnea]]
#*[[Tachycardia]]
#*Impaired [[Lung function tests|lung function]]
#*[[Depression]]
#Echocardiographic factors
#*[[Ventricular]] dimension
#*[[Ventricular]] mass
#*[[Diastolic]] filling impairment
#Pharmacological factors
#*Chemotherapeutic agents
#*[[Non-steroidal anti-inflammatory drug]]s
#*[[Thiazolidinedione]]s
#*[[Doxazosin]]
#Biochemical
#*[[Albuminuria]]
#*[[Homocysteine]]: Elevated plasma [[homocysteine]] levels are associated with almost a 75% increase in risk for heart failure development.
#*[[Tumor necrosis factor-alpha]] ([[TNF-alpha]]): After adjustment for other [[risk factors]], every tertile increment in [[tumor necrosis factor-alpha]] ([[Tumor necrosis factor-alpha|TNF-alpha]]) levels was associated with a 60% increase in risk of heart failure. [[TNF-alpha]] has several negative [[pleiotropic]] effects and also negative [[inotropic]] properties that may be responsible for excessive heart failure risk. [[TNF-alpha]] is also associated with progression of heart failure.
#*[[Interleukin-6]]: IL-6 is a pro-inflammatory [[cytokine]] which associated with an excessive risk of development of heart failure.
#*[[C-reactive protein]]
#*[[Insulin-like growth factor-I]] ([[IGF-I]])
#*[[Natriuretic peptides]]
#Genetic risk factors
#*[[Genetic polymorphism]]
===Risk Factors Associated with Heart Failure Progression and Outcomes===
#Clinical
#*Etiology
#*Age
#*Gender
#*[[Symptom]] duration
#*[[NYHA class]]
#*[[Weight]]
#*[[Heart rate]]
#*[[Mean arterial pressure]]
#*[[S3|S3 gallop]]
#*[[Jugular venous pressure]]
#*Cardiothoracic ratio
#*Renal function
#*Serum [[sodium]]
#*[[Troponin T]]
#*History of [[Diabetes mellitus|diabetes]]
#*[[Anemia]]
#Echocardiographic
#*[[Ejection fraction]]
#*Exercise [[ejection fraction]]
#*[[Ventricular]] dimensions
#*Sphericity index
#*Prolonged isovolumic relaxation
#*Restrictive [[mitral]] filling
#*Changes in [[E/A ratio]]
#*[[Mitral regurgitation]]
#*Contractile reserve
#*Left [[ventricular]] mass
#Exercise Tolerance
#*Exercise duration
#*Peak O2 consumption
#*VE/VCO2
#*[[Anaerobic respiration|Anaerobic]] threshold 6-minute walk test
#Hemodynamics
#*[[Cardiac index]]
#*Pulmonary artery pressure
#*[[Pulmonary capillary wedge pressure|Pulmonary artery wedge pressure]]
#*[[Pulmonary vascular resistance]]
#*Stroke work index
#*Right atrial pressure
#*A-V oxygen difference
#*[[Coronary sinus]] O<sub>2</sub> content
#Electrophysiological
#*Conduction delay
#*[[Atrial arrhythmias|Atrial arrhythmia]]
#*Family history of sudden death
#*Presence of late potentials
#*QT dispersion
#*[[T wave alternans]]
#Neurohormonal
#*Renin-angiotensin system
#*[[Angiotensin II]]
#*[[Aldosterone]]
#*[[Plasma renin activity]]
#*[[Sympathetic nervous system]]
#*:*[[Norepinephrine]]
#*:*[[Epinephrine]]
#*:*Heart rate variability
#*:*[[Norepinephrine]] spillover
#Natriuretic factors
#*[[Atrial natriuretic peptide]] ([[Atrial natriuretic peptide|ANP]])
#*[[B-type natriuretic peptide]]
#*N-terminal-pro-[[Atrial natriuretic peptide|ANP]]
#[[Cytokines]] and others
#*[[TNF-alpha]]
#*[[Interleukin-6]]
#*[[Endothelin]]
#*[[ICAM-1]] and [[Neuropeptide Y]] (NPY)
#*[[Arginine vasopressin]]


==References==
==References==

Latest revision as of 11:08, 11 February 2022
Resident
Survival
Guide
Congestive Heart Failure Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Systolic Dysfunction
Diastolic Dysfunction
HFpEF
HFrEF

Causes

Differentiating Congestive heart failure from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Clinical Assessment

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

Chest X Ray

Cardiac MRI

Echocardiography

Exercise Stress Test

Myocardial Viability Studies

Cardiac Catheterization

Other Imaging Studies

Other Diagnostic Studies

Treatment

Invasive Hemodynamic Monitoring

Medical Therapy:

Summary
Acute Pharmacotherapy
Chronic Pharmacotherapy in HFpEF
Chronic Pharmacotherapy in HFrEF
Diuretics
ACE Inhibitors
Angiotensin receptor blockers
Aldosterone Antagonists
Beta Blockers
Ca Channel Blockers
Nitrates
Hydralazine
Positive Inotropics
Anticoagulants
Angiotensin Receptor-Neprilysin Inhibitor
Antiarrhythmic Drugs
Nutritional Supplements
Hormonal Therapies
Drugs to Avoid
Drug Interactions
Treatment of underlying causes
Associated conditions

Exercise Training

Surgical Therapy:

Biventricular Pacing or Cardiac Resynchronization Therapy (CRT)
Implantation of Intracardiac Defibrillator
Ultrafiltration
Cardiac Surgery
Left Ventricular Assist Devices (LVADs)
Cardiac Transplantation

ACC/AHA Guideline Recommendations

Initial and Serial Evaluation of the HF Patient
Hospitalized Patient
Patients With a Prior MI
Sudden Cardiac Death Prevention
Surgical/Percutaneous/Transcather Interventional Treatments of HF
Patients at high risk for developing heart failure (Stage A)
Patients with cardiac structural abnormalities or remodeling who have not developed heart failure symptoms (Stage B)
Patients with current or prior symptoms of heart failure (Stage C)
Patients with refractory end-stage heart failure (Stage D)
Coordinating Care for Patients With Chronic HF
Quality Metrics/Performance Measures

Implementation of Practice Guidelines

Congestive heart failure end-of-life considerations

Specific Groups:

Special Populations
Patients who have concomitant disorders
Obstructive Sleep Apnea in the Patient with CHF
NSTEMI with Heart Failure and Cardiogenic Shock

Congestive heart failure risk factors On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Congestive heart failure risk factors

CDC on Congestive heart failure risk factors

Congestive heart failure risk factors in the news

Blogs on Congestive heart failure risk factors

Directions to Hospitals Treating Congestive heart failure risk factors

Risk calculators and risk factors for Congestive heart failure risk factors

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Cafer Zorkun, M.D., Ph.D. [2]; Saleh El Dassouki, M.D. [3]; Atif Mohammad, M.D.

Overview

Several risk factors may predispose to heart failure. These risk factors can be demographic, genetic, associated with lifestyle or medications.

Risk Factors

Common risk factors associated with heart failure include:

Risk factors for heart failure Prevention strategies
Sedentary habit Regular physical activity
Cigarette smoking Cigarette smoking cessation
Obesity Physical activity and healthy diet
Excessive alcohol intake General population: no/light alcohol

intake is beneficial, avoiding alcohol in Patients with alcohol-induced CMP

Influenza Influenza vaccination
Microbes (Trypanosoma cruzi, Streptococci) Early diagnosis, antimicrobial therapy
Cardiotoxic drugs (anthracyclines) Cardiac function and side effect monitoring, dose adaptation, change of chemotherapy
Chest radiation Cardiac function and side effect monitoring, dose adaptation
Hypertension Life style modification, antihypertensive drugs
Hyperlipidemia Healthy diet, statins
Diabetes mellitus Physical activities, healthy diet, SGLT2 inhibitors
Coronary artery disease Life style modification, statins
The above table adopted from 2021 ESC Guideline

[1]

References

  1. ↑ McDonagh TA, Metra M, Adamo M, Gardner RS, Baumbach A, Böhm M, Burri H, Butler J, Čelutkienė J, Chioncel O, Cleland J, Coats A, Crespo-Leiro MG, Farmakis D, Gilard M, Heymans S, Hoes AW, Jaarsma T, Jankowska EA, Lainscak M, Lam C, Lyon AR, McMurray J, Mebazaa A, Mindham R, Muneretto C, Francesco Piepoli M, Price S, Rosano G, Ruschitzka F, Kathrine Skibelund A (September 2021). "2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure". Eur Heart J. 42 (36): 3599–3726. doi:10.1093/eurheartj/ehab368. PMID 34447992 Check |pmid= value (help). Vancouver style error: initials (help)

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