Congestive heart failure最新文献

{"title":"Lessons learned from the national heart failure project: a center for medicare and medicaid services initiative to improve the care of medicare beneficiaries with heart failure.","authors":"E. Havranek, F. Masoudi, G. L. Smith, P. Wolfe, D. Ralston, H. Krumholz, D. Ordin","doi":"10.1111/J.1527-5299.2001.00273.X","DOIUrl":"https://doi.org/10.1111/J.1527-5299.2001.00273.X","url":null,"abstract":"This column is the seventh in a series reporting on the efforts of the Center for Medicare and Medicaid Services (CMS), formerly known as the Health Care Financing Administration, to improve care for Medicare beneficiaries with heart failure. In previous columns we have described the overall structure of Medicare quality improvement efforts, detailed the structure of the national inpatient fee-for-service program known as the National Heart Failure project, and discussed the baseline quality indicator rates for the project, which are focused on rates of ejection fraction documentation and angiotensin-converting enzyme inhibitor prescription. In more recent columns, we reported on quality improvement projects from several participating hospitals, and on a pilot project exploring quality improvement efforts for heart failure based in physicians' offices. This column will focus on ways in which systematic examination of data, such as those from the National Heart Failure project, might shape future quality improvement and research efforts. The National Heart Failure project's quality indicator data are collected primarily to guide and evaluate the efforts of the CMS contractor peer-review organizations to facilitate quality improvement efforts in hospitals throughout the United States. (c)2001 CHF, Inc.","PeriodicalId":10536,"journal":{"name":"Congestive heart failure","volume":"1 1","pages":"334-336"},"PeriodicalIF":0.0,"publicationDate":"2001-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90725133","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Yet another milestone for CHF!","authors":"M. Silver","doi":"10.1111/J.1527-5299.2001.01378.X","DOIUrl":"https://doi.org/10.1111/J.1527-5299.2001.01378.X","url":null,"abstract":"","PeriodicalId":10536,"journal":{"name":"Congestive heart failure","volume":"11 1","pages":"294-295"},"PeriodicalIF":0.0,"publicationDate":"2001-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79949294","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nuggets, pearls, and vignettes of master heart failure clinicians. Part 2-the physical examination.","authors":"C. Leier, Young Jb, T. Levine, I. Piña, P. Armstrong, M. Fowler, L. Warner-Stevenson, J. Cohn, J. O’Connell, M. Bristow, J. Nicklas, J. De, J. Howlett, H. Ventura, T. Giles, B. Greenberg, K. Chatterjee, R. Bourge, C. Yancy, Gottleib Ss","doi":"10.1111/J.1527-5299.2001.01167.X","DOIUrl":"https://doi.org/10.1111/J.1527-5299.2001.01167.X","url":null,"abstract":"","PeriodicalId":10536,"journal":{"name":"Congestive heart failure","volume":"113 1","pages":"297-308"},"PeriodicalIF":0.0,"publicationDate":"2001-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89462986","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Atrial Flutter: From Mechanism to Treatment","authors":"M. Kukin","doi":"10.1111/j.1527-5299.2001.01245.x","DOIUrl":"https://doi.org/10.1111/j.1527-5299.2001.01245.x","url":null,"abstract":"","PeriodicalId":10536,"journal":{"name":"Congestive heart failure","volume":"77 1","pages":"337-337"},"PeriodicalIF":0.0,"publicationDate":"2001-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74909165","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relation of functional capacity with the oxidative stress and antioxidants in chronic heart failure.","authors":"A. Serdar, D. Yeşilbursa, Z. Serdar, M. Dirican, B. Turel, J. Cordan","doi":"10.1111/J.1527-5299.2001.00261.X","DOIUrl":"https://doi.org/10.1111/J.1527-5299.2001.00261.X","url":null,"abstract":"Chronic heart failure is a common, disabling disorder with high mortality. Oxidative stress may have both functional and structural effects on the myocardium, leading to myocardial decompensation. In this study, the authors examined the relationship of oxidative stress and functional capacity in patients with varying degrees of heart failure. Fifty-one patients with chronic heart failure and 31 control subjects were studied. The functional capacity of patients was determined. Plasma malondialdehyde, vitamin E, and beta-carotene levels were measured. The malondialdehyde levels were significantly different between control subjects and heart failure patients (p=0.03). There was a positive correlation between patients' malondialdehyde levels and New York Heart Association functional class (r=0.59; p<0.0001). There was a negative correlation between the functional class and vitamin E and beta-carotene levels (r=20.43; p<0.0001 and r=20.25; p<0.01, respectively). These data demonstrate that oxidative stress is increased systemically in patients with chronic heart failure. It seems that this increase correlates with functional class. (c)2001 CHF, Inc.","PeriodicalId":10536,"journal":{"name":"Congestive heart failure","volume":"2 1","pages":"309-311"},"PeriodicalIF":0.0,"publicationDate":"2001-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86745492","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Angiotensin II and Thirst: Therapeutic Considerations","authors":"D. Sica","doi":"10.1111/J.1527-5299.2001.00274.X","DOIUrl":"https://doi.org/10.1111/J.1527-5299.2001.00274.X","url":null,"abstract":"Angiotensin II is the effector peptide of the renin-angiotensin system and is involved in a wide range of physiologic functions that relate to volume control. In this regard, angiotensin II maintains and regulates salt and water balance, is critically involved in cardiovascular function, and governs thirst. When present in excess, angiotensin II can pathologically influence each of these functions. The role of angiotensin II in controlling sodium balance, in both renal insufficiency states and congestive heart failure, is clearly recognized. Alternatively, it is poorly appreciated that angiotensin II plays an important role in both normal and pathologic thirst states. The latter is a potential problem in both end-stage renal disease and congestive heart failure. Angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor antagonists (AT1-RAs) have both been shown to reduce abnormal thirst drive. Whether an ACE inhibitor or an AT1-RA lessens thirst drive to any significant degree relates to its capacity to penetrate the blood-brain barrier. Head-to-head comparisons of ACE inhibitors and AT1-RAs, as to their effect on thirst drive, have not been undertaken in a systematic fashion; thus, until otherwise established, the effect of these compounds on thirst should be viewed as a class effect, albeit one that is likely to be dosedependent.","PeriodicalId":10536,"journal":{"name":"Congestive heart failure","volume":"36 1","pages":"325-328"},"PeriodicalIF":0.0,"publicationDate":"2001-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82751387","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimal use of spironolactone for treatment of heart failure.","authors":"K. Parker, N. Houston Miller, R. Debusk","doi":"10.1111/J.1527-5299.2001.00270.X","DOIUrl":"https://doi.org/10.1111/J.1527-5299.2001.00270.X","url":null,"abstract":"Spironolactone has recently been shown to have a favorable impact on the prognosis and functional status of patients with left ventricular systolic dysfunction and severe symptoms who are receiving standard therapy. However, participants in clinical studies of spironolactone represent a selected group. Clinicians managing a less selected group must be mindful of selection criteria and appropriate methods to monitor patients who are initiated on these medications. In this review, two case studies are described that demonstrate the importance of careful selection of candidates for spironolactone, the need for close laboratory and symptom monitoring, and the need for patients' active participation in reporting changes in their clinical status. (c)2001 CHF, Inc.","PeriodicalId":10536,"journal":{"name":"Congestive heart failure","volume":"10 1","pages":"315-318"},"PeriodicalIF":0.0,"publicationDate":"2001-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72935553","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ambulatory blood pressure monitoring: technique and application in the study of cardiac dysfunction and congestive heart failure.","authors":"G. Mansoor, A. Abiose, W. White","doi":"10.1111/J.1527-5299.2001.00272.X","DOIUrl":"https://doi.org/10.1111/J.1527-5299.2001.00272.X","url":null,"abstract":"Ambulatory blood pressure monitoring has become a widely used method of blood pressure and heart rate evaluation in the free-living subject. Recently, ambulatory monitoring has become covered by Medicare for the evaluation of \"white-coat\" hypertension. Although the technique provides only intermittent readings throughout the 24-hour period, average blood pressures obtained in this way correlate well with a variety of hypertensive disease processes and are also a better prognostic marker for future cardiovascular events than office blood pressure. Ambulatory blood pressure averages also correlate well with indices of diastolic dysfunction. In patients with congestive cardiac failure and systolic dysfunction, ambulatory monitoring suggests an impaired circadian blood pressure profile with high nocturnal blood pressure. Further research is needed on the relationship between ambulatory blood pressure and cardiac dysfunction, as well as the impact of observed circadian blood pressure changes on outcome. (c)2001 CHF, Inc.","PeriodicalId":10536,"journal":{"name":"Congestive heart failure","volume":"3 1","pages":"319-324"},"PeriodicalIF":0.0,"publicationDate":"2001-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89031697","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Heart Failure in β‐Thalassemia","authors":"D. Kremastinos","doi":"10.1111/J.1527-5299.2001.00259.X","DOIUrl":"https://doi.org/10.1111/J.1527-5299.2001.00259.X","url":null,"abstract":"Heart failure remains the main cause of death in β-thalassemia despite the progress that has been made. Myocardial iron deposition alone does not affect left ventricular relaxation but directly causes left ventricular myocardial restriction with considerably elevated pulmonary pressure. This leads to symptoms and signs of predominantly right-sided heart failure, which is usually observed in elderly and severely hemosiderotic populations. Left ventricular systolic dysfunction and failure, which occurs in younger, less hemosiderotic populations, seems to be multifactorial in etiology. Apart from iron loading, immunogenetic risk factors trigger the mechanisms of left-sided heart failure development in the context of dilated-type cardiomyopathy.","PeriodicalId":10536,"journal":{"name":"Congestive heart failure","volume":"12 1","pages":"312-314"},"PeriodicalIF":0.0,"publicationDate":"2001-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85528502","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nuggets, pearls, and vignettes of master heart failure clinicians. Part 1--the medical history.","authors":"C. Leier, M. Silver, B. Massie, J. Young, M. Fowler, H. Ventura, R. E. Hershberger","doi":"10.1111/J.1527-5299.2001.00307.X","DOIUrl":"https://doi.org/10.1111/J.1527-5299.2001.00307.X","url":null,"abstract":"Last fall, the Editors of the journal Congestive Heart Failure, Drs. Marc Silver and John Strobeck, asked me to serve as Guest Editor for an issue of the journal. Accepting this honor was linked to the requirement that I had to generate a meaningful theme. The thought of delivering another series of articles on CHF trials and their interpretation, bench-to-bedside (and vice-versa) topics in heart failure, and similar efforts did little to excite me and, in fact, it threatened to exacerbate my narcoleptic condition. Besides, we have many colleagues more skilled at delivering this information and they truly enjoy doing so. \u0000 \u0000 \u0000 \u0000We have fortunately entered the era of “evidence-based medicine” this theme will likely remain with us for the entire lifetime of health care delivery. While most physicians have now joined this movement, it is remarkable how much of the day-to-day medical care of the patient with heart failure has not yet been addressed by statistically powered (i.e., evidence-based) trials. Much (probably most) of what we do to keep patients as healthy and functional as possible is still based on our experience as clinicians and on the information shared by colleagues (personal contact, consultation, conferences, written material). It is not often that data from a large treatment trial assist me in determining the optimal dose of a drug or doses of combinations in an individual patient, in optimizing the immediate care and management of a complexly ill patient, in addressing the emergency phone call at 2 a.m., and so forth. \u0000 \u0000 \u0000 \u0000Until statistically powered trials can address all aspects and details of patient care, “experience-based medicine” must fill the knowledge void. Unfortunately, much of this information is not available in textbooks, review articles, the Internet and other media. As the passionate fervor of evidence-based medicine soars to its fever pitch, there will be even less incentive to share in print potentially helpful information based on clinical experience. In his submission to this issue, Thomas D. Giles, MD, wrote, “I am fearful that valuable contributions to patient care will be lost and sacrificed on the altar of ‘evidenced-based’ medicine (usually referring to data from clinical trials). While I certainly believe that important concepts emanate from clinical trials, I also believe that there are other sources of guidance for the care of patients. The Reverend Bayes reminded us that intuition and prior experience are an integral part of the analysis of data.” Parenthetically, most of the questions addressed by trials and the design of trials are largely based on information gleaned from clinical experience. \u0000 \u0000 \u0000 \u0000It is in this spirit that the Editors, Drs. Silver and Strobeck, CHF, Inc., and I present to you the first installment in a four-part series. The fuel for this project has both a historical and a pragmatic thrust; “it would be a shame” if we allowed our venerable colleagues to advance into the autumn of","PeriodicalId":10536,"journal":{"name":"Congestive heart failure","volume":"87 1","pages":"245-249"},"PeriodicalIF":0.0,"publicationDate":"2001-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73203524","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}