Relationship between pulmonary hypertension and outcomes among patients with heart failure with reduced ejection fraction.

Objectives: To identify predictors of pulmonary hypertension (PHT) and the predictive value of PHT for rehospitalization among patients with heart failure with reduced ejection fraction (HFrEF). Methods: A retrospective study of 351 hospitalized patients with heart failure (HF). Patients 18 years and above with HFrEF secondary to non-ischemic cardiomyopathy were reviewed. Patients with coronary artery disease, preserved ejection fraction and other secondary causes of PHT apart from HF were excluded. PHT as a predictor of 30-day and six-month re-admission was assessed as well as important possible predictors of PHT. Cox regression analysis, multiple linear regression as well as other statistical tools were employed as deemed appropriate. Results: Thirty-seven (37) and 99 patients were re-hospitalized within 30 days and 6 months after discharge for decompensated HF, respectively. After Cox regression analysis, higher hemoglobin reduced the odds of rehospitalization for decompensated HF (p = 0.015) within 30 days after discharge while higher pulmonary artery systolic pressure (PASP) (p = 0.002) and blood urea nitrogen (BUN) (p = 0.041) increased the odds of rehospitalization within 6 months of discharge. The predictors of the PHT among patients with HFrEF after multiple linear regression were low BMI (p = 0.027), increasing age (p = 0.006) and increased left atrial diameter (LAD) on echocardiography (p = 0.0001). Conclusion: Patients with HFrEF have a high predisposition to developing PHT if at admission, they have low BMI, dilated left atrium or are older. Patients with one or more of these attributes may need more intensive therapy to reduce the risk of developing PHT and in turn reduce readmission rates.

Trombosis de los senos intracraneales: Reporte de tres casos y revision de la literatura / Intracranial sinuses thrombosis: Report of three cases and literature review

La trombosis venosa intracraneal es un tipo de accidente cerebrovascular poco frecuente cuyo diagnóstico muchas veces ha sido demorado debido a sus diversas causas y presentaciones. Sin embargo, hoy en día su diagnóstico está aumentando debido al mayor empleo de la resonancia magnética nuclear, la angioresonancia y a la mejor comprensión del cuadro clínico. Se presentan los casos de tres mujeres con cefalea y déficit focal de evolución subaguda. Los estudios de neuroimágenes fueron compatibles con trombosis venosa intracraneal. Las pacientes tuvieron diferentes factores de riesgo, fueron tratadas con heparina y presentaron buena respuesta al tratamiento...

Intracranial sinuses thrombosis is an infrequent cerebrovascular accident whose diagnosis is usually delayed due to diverse causes and varying clinical presentations. However, with the advent of magnetic resonance imaging, angioresonance and with better knowledge of the clinical picture its diagnosis has improved nowadays. We present here three women cases with headache and focal deficits of sub-acute onset. Neuroimaging studies were compatible with intracranial sinuses thrombosis. Patients had different risk factors; they were treated with heparin and responded well to treatment...