American Registry of Ambulatory or Acute Decompensated Heart Failure

Overview

About this study

Characterize the population of patients with ambulatory or acute decompensated HF in the American continent.

Participation eligibility

Participant eligibility includes age, gender, type and stage of disease, and previous treatments or health concerns. Guidelines differ from study to study, and identify who can or cannot participate. There is no guarantee that every individual who qualifies and wants to participate in a trial will be enrolled. Contact the study team to discuss study eligibility and potential participation.

Inclusion Criteria:

  • Patient over 18 years old and one of the following:
    • Hospitalized patient with admission diagnosis of acute decompensated heart failure (HF); or
    • Outpatient with confirmed diagnosis (main or complementary) of HF.

Exclusion Criteria:

  • Hospitalized patient with principal diagnosis of another cardiovascular / non-cardiovascular pathology and who develops an acute decompensation of HF during hospitalization.
  • Patient on the waiting list for heart transplant.
  • Patient who has implanted or is in process of implanting a long-term ventricular assist device (e.g., Heart Mate II, Heart Mate III) as a target therapy or bridge therapy to other therapies.
  • Patient in whom palliative management has been previously defined for his/her cardiac condition (i.e., HF) or for another associated medical condition (cancer, COPD, etc.).
  • Patient who is discharged or referred to another institution within 48 hours of hospital stay.
  • Inability to comply with programmed follow-ups (telephone or in person) due to social, personal or other conditions considered by the principal investigator.
  • Expectancy of life less than 6 months given a condition other than HF (Cancer, COPD, etc.)

Participating Mayo Clinic locations

Study statuses change often. Please contact the study team for the most up-to-date information regarding possible participation.

Mayo Clinic Location Status Contact

Jacksonville, Fla.

Mayo Clinic principal investigator

Parag Patel, M.D.

Open for enrollment

Contact information:

Clinical Studies Unit

(904) 953-2255

More information

Publications

  • Heart failure (HF) data in Latin America (LA) were reviewed to guide health service planning in the prevention and treatment of HF. The HF epidemiology and the adequacy of relevant health service provision related to HF in LA are not well delineated. A systematic search of the electronic databases and the World Health Organization website was undertaken for HF in LA. LA countries have reduced gross income and lower total expenditure on health per capita. LA is a heterogeneous region with HF risk factors of developed and nondeveloped countries, including lower risk of raised blood glucose levels, obesity, tobacco, and aging, whereas systemic hypertension (SH), rheumatic fever, and Chagas' disease (C'D) are higher in LA. Main etiologies of HF in LA are idiopathic dilated cardiomyopathy (from 1.3% to 37%), C'D (from 1.3% to 21%), ischemic (from 68% to 17%), SH (from 14% to 76%), valvular (from 3% to 22%), and alcohol related (from 1.1% to 8%). The prognosis of C'D HF is worse than for other etiologies. Chronic HF is the cause of death in 6.3% of cases. Decompensated HF is the main cause of cardiovascular hospitalization. The prevalence of systolic HF varies from 64% to 69%. LA is under the awful paradox of having the HF risk factors and HF epidemiology of developed countries with the added factors of SH, C'D, and rheumatic fever. Overall, in the scenario of lower total expenditure on health per capita and lower gross national income per capita, new strategies are essential for prevention and treatment of HF in LA. Read More on PubMed
  • Differences in clinical characteristics and outcome of patients with established heart failure with preserved ejection fraction (HFpEF) and heart failure with reduced ejection fraction (HFrEF) are well established. Data on epidemiology and prediction of new onset HFpEF, compared with HFrEF, have not been described. Read More on PubMed
  • Cardiovascular disease is the principle cause of death in Latin America. Data from the World Health Organization indicate that the region is currently experiencing a large-scale epidemic of cardiovascular disease. This could be attributable to demographic and lifestyle changes inherent in the epidemiologic transition: one consequence of increased life-expectancy is longer exposure to cardiovascular risk factors, which results in a higher probability of adverse events. Latin America is one of the regions of the world with the highest burden of cardiovascular risk factors, particularly overweight, dyslipidemia and diabetes mellitus. These factors will have a significant impact on the incidence of coronary events and heart failure in the near future. In addition, infectious conditions, especially Chagas disease and rheumatic fever, affect large sections of the population in the region. Unless preventive measures are introduced in the next three to four decades, the number of deaths due to cardiovascular disease in the region will increase by more than 200%. Data currently available indicate that mortality in patients with acute coronary syndrome is greater in Latin America than in developed countries. Among the possible factors that could explain this finding are the underuse of therapies that have been shown to be effective and the more conservative and later use of surgical and percutaneous interventions. In Latin America, heart failure occurs in younger subjects than in the rest of the world and is most frequently related to ischemic heart disease. However, Chagas disease is close to hypertension as the second most common cause. There is an urgent need for well-designed epidemiologic studies to guide the implementation of preventive measures and appropriate treatment. Read More on PubMed
  • Heart failure with preserved ejection fraction (HFPEF) is increasingly recognized as a major public health problem worldwide. Significant advances have been made in our understanding of the epidemiology of HFPEF over the past two decades, with the publication of numerous population-based epidemiological studies, large heart failure registries, and randomized clinical trials. These recent studies have provided detailed characterization of larger numbers of patients with HFPEF than ever before. This review summarizes the state of current knowledge with regards to the disease burden, patient characteristics, clinical course, and outcomes of HFPEF. Despite the wealth of available data, substantive gaps in knowledge were identified. These gaps represent opportunities for further research in HFPEF, a syndrome that is clearly a rising societal burden and that is associated with substantial morbidity and mortality. Read More on PubMed
  • Guidelines on how to diagnose and treat patients with heart failure (HF) are published regularly. However, many patients do not fulfil the diagnostic criteria and are not treated with recommended drugs. The Swedish Heart Failure Registry (S-HFR) is an instrument which may help to optimize the handling of HF patients. Read More on PubMed
  • The independence of association between elevated jugular venous pressure (JVP) and outcomes in heart failure (HF) has not been well studied. The objective of propensity-matched study was to determine if an elevated JVP had intrinsic associations with outcomes in chronic systolic and diastolic HF. Of the 7,788 participants in the Digitalis Investigation Group trial, 1,020 (13%) had elevated JVP at baseline. Propensity scores for elevated JVP were estimated for all patients based on 32 baseline characteristics and were used to match 827 pairs of patients with normal and elevated JVP. Hazard ratios (HR) and 95% confidence intervals (CI) were estimated to compare outcomes associated with elevated versus normal JVP during 34 months of median follow-up. Before matching, all-cause mortality occurred in 31% and 47% (unadjusted HR 1.70, 95% CI 1.54 to 1.88, p <0.0001), and all-cause hospitalization occurred in 60% and 71% (unadjusted HR 1.35, 95% CI 1.25 to 1.47, p <0.0001) of patients with normal and elevated JVP, respectively. After matching, all-cause mortality occurred in 48% and 45% (matched HR 0.95, 95% CI 0.80 to 1.12, p = 0.521), and all-cause hospitalization occurred in 70% and 70% (matched HR 0.97, 95% CI 0.87 to 1.09, p = 0.613) of patients with normal and elevated JVP, respectively. Elevated JVP had no intrinsic associations with cardiovascular mortality (matched HR 0.93, 95% CI 0.77 to 1.12, p = 0.440) or hospitalization for HF (matched HR 0.94, 95% CI 0.78 to 1.14, p = 0.532). In conclusion, an elevated JVP is a marker of higher burden of sickness and poor outcomes. However, elevated JVP had no intrinsic association with mortality or hospitalization in chronic HF. Read More on PubMed
  • We examined whether population-level hospitalization rates for heart failure (HF) and subsequent survival have continued to improve since the turn of the century. We also examined trends in the prescribing of evidence-based pharmacological treatment for HF. Read More on PubMed
  • The aim of this paper is to review the clinical epidemiology of heart failure. The last paper comprehensively addressing the epidemiology of heart failure in Heart appeared in 2000. Despite an increase in manuscripts describing epidemiological aspects of heart failure since the 1990s, additional information is still needed, as indicated by various editorials. Read More on PubMed
  • Therapy has improved the survival of heart failure (HF) patients. However, many patients progress to advanced chronic HF (ACHF). We propose a practical clinical definition and describe the characteristics of this condition. Patients that are generally recognised as ACHF often exhibit the following characteristics: 1) severe symptoms (NYHA class III to IV); 2) episodes with clinical signs of fluid retention and/or peripheral hypoperfusion; 3) objective evidence of severe cardiac dysfunction, shown by at least one of the following: left ventricular ejection fraction<30%, pseudonormal or restrictive mitral inflow pattern at Doppler-echocardiography; high left and/or right ventricular filling pressures; elevated B-type natriuretic peptides; 4) severe impairment of functional capacity demonstrated by either inability to exercise, a 6-minute walk test distance<300 m or a peak oxygen uptake<12-14 ml/kg/min; 5) history of >1 HF hospitalisation in the past 6 months; 6) presence of all the previous features despite optimal therapy. This definition identifies a group of patients with compromised quality of life, poor prognosis, and a high risk of clinical events. These patients deserve effective therapeutic options and should be potential targets for future clinical research initiatives. Read More on PubMed
  • An epidemic increase in heart failure (HF) mortality, hospitalization, and prevalence rates has been observed among older persons in recent years. It is unclear whether this reflects an increase in incidence or survival. Read More on PubMed
  • The ADHERE is designed to study characteristics, management, and outcomes in a broad sample of patients hospitalized with acute decompensated heart failure. Heart failure is a leading cause of hospitalization for adults older than 65 years in the United States. Most available data on these patients are limited by patient selection criteria and study design of clinical trials and single-center studies. Read More on PubMed
  • The epidemic of heart failure has yet to be fully investigated, and data on incidence, survival, and sex-specific temporal trends in community-based populations are limited. Read More on PubMed
  • Heart failure is a major public health problem. Long-term trends in the incidence of heart failure and survival after its onset in the community have not been characterized. Read More on PubMed
  • The incidence of congestive heart failure (CHF) has been increasing steadily in the United States during the past 2 decades. We studied risk factors for CHF and their corresponding attributable risk in the First National Health and Nutrition Examination Survey Epidemiologic Follow-up Study. Read More on PubMed
  • Congestive heart failure has become an increasingly frequent reason for hospital admission during the last 2 decades and clearly represents a major health problem. Data from the Framingham Heart Study indicate that the incidence of congestive heart failure increases with age and is higher in men than in women. Hypertension and coronary heart disease are the two most common conditions predating its onset. Diabetes mellitus and electrocardiographic left ventricular hypertrophy are also associated with an increased risk of heart failure. During the 1980s, the annual age-adjusted incidence of congestive heart failure among persons aged > or = 45 years was 7.2 cases/1,000 in men and 4.7 cases/1,000 in women, whereas the age-adjusted prevalence of overt heart failure was 24/1,000 in men and 25/1,000 in women. Despite improved treatments for ischemic heart disease and hypertension, the age-adjusted incidence of heart failure has declined by only 11%/calendar decade in men and by 17%/calendar decade in women during a 40-year period of observation. In addition, congestive heart failure remains highly lethal, with a median survival time of 1.7 years in men and 3.2 years in women and a 5-year survival rate of 25% in men and 38% in women. Read More on PubMed
  • - To study the relative and population-attributable risks of hypertension for the development of congestive heart failure (CHF), to assess the time course of progression from hypertension to CHF, and to identify risk factors that contribute to the development of overt heart failure in hypertensive subjects. Read More on PubMed