Congestive heart failure (Greenwich, Conn.)最新文献_第4页

Noninvasive Hemodynamic Monitoring in Heart Failure: Utilization of Impedance Cardiography 心衰无创血流动力学监测:阻抗心动图的应用

Congestive heart failure (Greenwich, Conn.) Pub Date : 2012-11-23 DOI: 10.1111/j.1751-7133.2003.tb00021.x

Clyde Yancy MD, William T. Abraham MD

{"title":"Noninvasive Hemodynamic Monitoring in Heart Failure: Utilization of Impedance Cardiography","authors":"Clyde Yancy MD, William T. Abraham MD","doi":"10.1111/j.1751-7133.2003.tb00021.x","DOIUrl":"10.1111/j.1751-7133.2003.tb00021.x","url":null,"abstract":"The annual health care cost incurred by heart failure patients is about $56 billion, two thirds of which is spent on management of acutely decompensated patients. Hemodynamic evaluation is helpful for optimization of treatment, monitoring clinical outcomes, and overall prognostication of heart failure patients, but historically could only be obtained via costly invasive procedures that carry substantial risks. Impedance cardiography (ICG) is a noninvasive and economical outpatient procedure that has been shown to provide reliable hemodynamic values comparable to those obtained from pulmonary artery catheterization. Recent clinical studies involving hundreds of patients have validated the accuracy and reproducibility of ICG compared with invasive techniques. The direct and derived measurements and the clinical applications of ICG in the diagnosis and treatment of heart failure are presented, as are three clinical case studies demonstrating the utility of ICG in the hemody-namic-guided management of heart failure. ICG is a viable, noninvasive technique in early- and late-stage heart failure that provides assistance in diagnostic evaluation, longitudinal prognostication, and therapeutic decisions.","PeriodicalId":83668,"journal":{"name":"Congestive heart failure (Greenwich, Conn.)","volume":"9 5","pages":"241-250"},"PeriodicalIF":0.0,"publicationDate":"2012-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/j.1751-7133.2003.tb00021.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24032151","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 107

The Role of Angiotensin II Receptor Blockers in the Treatment of Heart Failure Patients 血管紧张素受体阻滞剂在心力衰竭患者治疗中的作用

Congestive heart failure (Greenwich, Conn.) Pub Date : 2012-11-23 DOI: 10.1111/j.1751-7133.2003.tb00019.x

Michael Theal BSc, MD, Catherine Demers MD, MSc, Robert S. McKelvie MD, PhD

引用次数: 8

Cardiogenic Shock: A Summary of the Randomized SHOCK Trial 心源性休克:随机休克试验综述

Congestive heart failure (Greenwich, Conn.) Pub Date : 2012-11-23 DOI: 10.1111/j.1751-7133.2003.tb00020.x

Venu Menon MD, Rupert Fincke MD

{"title":"Cardiogenic Shock: A Summary of the Randomized SHOCK Trial","authors":"Venu Menon MD, Rupert Fincke MD","doi":"10.1111/j.1751-7133.2003.tb00020.x","DOIUrl":"10.1111/j.1751-7133.2003.tb00020.x","url":null,"abstract":"Cardiogenic shock is the most common cause of death for patients hospitalized with acute myocardial infarction. The Should We Emergently Revascularize Occluded Coronaries for Cardiogenic Shock (SHOCK) trial randomly assigned 302 patients with predominant left ventricular failure following an acute myocardial infarction to a strategy of emergency revascularization or initial medical stabilization. Emergency revascularization by either coronary artery bypass grafting or angioplasty was required within 6 hours of randomization. Patients assigned to initial medical stabilization could undergo delayed revascularization at a minimum of 54 hours post-randomization. The primary end point of the study was 30-day all-cause mortality. Overall survival at 30 days did not differ significantly between the emergency revascularization and initial medical stabilization groups (53% vs. 44%; p=0.109). However, at the 6- and 12-month follow-up, there was a significant survival benefit with early revascularization (50% vs. 37%; p=0.027 and 47% vs. 34%; p=0.025, respectively). The benefit appeared to be greatest for those less than 75 years of age, with 20 lives saved at 6 months per 100 patients treated. According to the results of the SHOCK trial, the American College of Cardiology/American Heart Association guidelines for myocardial infarction now recommend emergency revascularization for patients younger than 75 years with cardiogenic shock.","PeriodicalId":83668,"journal":{"name":"Congestive heart failure (Greenwich, Conn.)","volume":"9 1","pages":"35-39"},"PeriodicalIF":0.0,"publicationDate":"2012-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/j.1751-7133.2003.tb00020.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22219981","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 30

Utility of Right Ventricular Strain Imaging in Predicting Pulmonary Vascular Resistance in Patients With Pulmonary Hypertension 右心室应变成像在预测肺动脉高压患者肺血管阻力中的应用

Congestive heart failure (Greenwich, Conn.) Pub Date : 2012-11-05 DOI: 10.1111/chf.12009

Nasim Naderi MD, Zahra Ojaghi Haghighi MD, Ahmad Amin MD, Farah Naghashzadeh MD, Hooman Bakhshandeh MD, Sepide Taghavi MD, Majid Maleki MD

{"title":"Utility of Right Ventricular Strain Imaging in Predicting Pulmonary Vascular Resistance in Patients With Pulmonary Hypertension","authors":"Nasim Naderi MD, Zahra Ojaghi Haghighi MD, Ahmad Amin MD, Farah Naghashzadeh MD, Hooman Bakhshandeh MD, Sepide Taghavi MD, Majid Maleki MD","doi":"10.1111/chf.12009","DOIUrl":"10.1111/chf.12009","url":null,"abstract":"Pulmonary vascular resistance (PVR) has important prognostic implications in the assessment of patients with pulmonary hypertension. Using echocardiography to measure PVR would have the advantage of being able to follow patients serially and to assess their response to treatment noninvasively. The authors sought to assess whether right ventricular strain rate imaging (SRI) can predict PVR in patients with pulmonary hypertension. The study population consisted of 46 patients referred for right heart catheterization. The inclusion criteria was mean pulmonary artery pressure ≥25 mm Hg in right heart catheterization in patients with pulmonary hypertension including chronic systolic heart failure. Echocardiography was performed to obtain SRI just before right heart catheterization. Mean values of peak systolic longitudinal strain and strain rate obtained from basal and mid-right ventricular free wall were calculated. The control group consisted of 35 healthy adults matched for age and sex. The most significant correlations were between basal right ventricular strain and strain rate (SR) and mean pulmonary arterial pressure (r=0.63, P=.000), transpulmonary gradient (r=0.6, P=.001), and PVR (r=0.5, P=.003). SR was independently correlated with PVR (PVR=26.9−16.9×basal right ventricular SR; r=0.53, P=.003). The present study shows that basal right ventricular free wall strain and SR could be independently correlated with PVR in patients with pulmonary hypertension.","PeriodicalId":83668,"journal":{"name":"Congestive heart failure (Greenwich, Conn.)","volume":"19 3","pages":"116-122"},"PeriodicalIF":0.0,"publicationDate":"2012-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/chf.12009","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31023195","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 20

Low-Density Lipoprotein Levels in Patients With Acute Heart Failure 急性心力衰竭患者的低密度脂蛋白水平

Congestive heart failure (Greenwich, Conn.) Pub Date : 2012-10-16 DOI: 10.1111/chf.12006

Mark R. Kahn MD, Constantine E. Kosmas MD, PhD, Gabriel Wagman MD, Gregory W. Serrao MSE, Arzhang Fallahi MD, Kathleen M. Grady MSN, ANP, Timothy J. Vittorio MS, MD

{"title":"Low-Density Lipoprotein Levels in Patients With Acute Heart Failure","authors":"Mark R. Kahn MD, Constantine E. Kosmas MD, PhD, Gabriel Wagman MD, Gregory W. Serrao MSE, Arzhang Fallahi MD, Kathleen M. Grady MSN, ANP, Timothy J. Vittorio MS, MD","doi":"10.1111/chf.12006","DOIUrl":"10.1111/chf.12006","url":null,"abstract":"Statins do not appear to have a significant benefit in heart failure (HF) as they do in coronary artery disease (CAD). Significant evidence exists that low serum cholesterol levels may be harmful in HF. This study sought to determine the optimal low-density lipoprotein (LDL) level in patients hospitalized with acute HF. Patients were included if they presented to the hospital with acute HF and had a lipid panel drawn during admission. The primary outcome was all-cause mortality, and secondary outcomes were rates of major cardiovascular (CV) events, left ventricular assist device (LVAD) implantation, and orthotopic heart transplantation (OHT). A total of 2428 patients were followed for a mean of 2.9±2.2 years. For the entire cohort, when compared with those with LDL levels >130 mg/dL, all-cause mortality was higher in those with LDL levels <71 mg/dL (hazard ratio, 1.68; 95% confidence interval, 1.31–2.167; P<.01). Results were similar when analyzing patients with LVEF ≤40%, HF of ischemic etiology only, and in statin users. The rates of CV events, LVAD implantation, or OHT in any comparison did not differ. Low LDL levels (<71 mg/dL), similar to low total cholesterol levels, were associated with a poorer prognosis and higher overall mortality in patients with HF, regardless of etiology and systolic function.","PeriodicalId":83668,"journal":{"name":"Congestive heart failure (Greenwich, Conn.)","volume":"19 2","pages":"85-91"},"PeriodicalIF":0.0,"publicationDate":"2012-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/chf.12006","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30977559","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 15

Tai Chi in Patients With Heart Failure With Preserved Ejection Fraction 太极对保留射血分数的心力衰竭患者的影响

Congestive heart failure (Greenwich, Conn.) Pub Date : 2012-10-12 DOI: 10.1111/chf.12005

Gloria Y. Yeh MD, MPH, Malissa J. Wood MD, Peter M. Wayne PhD, Mary T. Quilty BS, Lynne W. Stevenson MD, Roger B. Davis ScD, Russell S. Phillips MD, Daniel E. Forman MD

{"title":"Tai Chi in Patients With Heart Failure With Preserved Ejection Fraction","authors":"Gloria Y. Yeh MD, MPH, Malissa J. Wood MD, Peter M. Wayne PhD, Mary T. Quilty BS, Lynne W. Stevenson MD, Roger B. Davis ScD, Russell S. Phillips MD, Daniel E. Forman MD","doi":"10.1111/chf.12005","DOIUrl":"10.1111/chf.12005","url":null,"abstract":"Although exercise is an important component of heart failure management, optimal regimens, particularly in heart failure with preserved ejection fraction (HFPEF), are uncertain. Tai chi (TC) is a mind-body exercise that may have potential benefits but has not been studied in this population. The authors randomized 16 patients with HFPEF to either 12 weeks TC or aerobic exercise. Assessments included peak oxygen uptake, 6-minute walk, quality of life, echocardiography, mood, and self-efficacy at baseline and at 12 weeks. Cardiorespiratory measures during exercise were obtained to characterize training intensities. Baseline characteristics were as follows: age 66±12 years, E/A ratio 1.3±0.7, and E/e′ ratio 15.9±4.8. Overall, adherence was excellent (89% attendance). Change in peak oxygen uptake was similar between groups after 12 weeks, but 6-minute walk distance increased more after TC (69±46 m vs 10±31 m, P=.02). While both groups had improved Minnesota Living With Heart Failure scores and self-efficacy, Profile of Mood States (POMS)-Depression scores improved more with TC (−1.7±2.8 vs 1.6±3, P=.05). Cardiorespiratory assessment during TC showed lower oxygen uptake (4.3 mL/kg/min vs 9.4 mL/kg/min, P<.01), respiratory rate, and heart rate. TC is feasible and safe in HFPEF. Therepeutic endpoints appear similar with TC relative to aerobic exercise despite a lower aerobic training workload.","PeriodicalId":83668,"journal":{"name":"Congestive heart failure (Greenwich, Conn.)","volume":"19 2","pages":"77-84"},"PeriodicalIF":0.0,"publicationDate":"2012-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/chf.12005","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30971888","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 72

Elevated Levels of Interleukin 6 and C-Reactive Protein Associated With Cognitive Impairment in Heart Failure 心衰患者认知功能障碍与白细胞介素6和c反应蛋白水平升高有关

Congestive heart failure (Greenwich, Conn.) Pub Date : 2012-10-12 DOI: 10.1111/chf.12007

Ponrathi Athilingam PhD, RN, ACNP, FAANP, Jan Moynihan PhD, Leway Chen MD, MPH, FACC, FACP, Rita D’Aoust PhD, ANP-BC, CNE, FAANP, FNAP, Maureen Groer PhD, RN, FAAN, Kevin Kip PhD

{"title":"Elevated Levels of Interleukin 6 and C-Reactive Protein Associated With Cognitive Impairment in Heart Failure","authors":"Ponrathi Athilingam PhD, RN, ACNP, FAANP, Jan Moynihan PhD, Leway Chen MD, MPH, FACC, FACP, Rita D’Aoust PhD, ANP-BC, CNE, FAANP, FNAP, Maureen Groer PhD, RN, FAAN, Kevin Kip PhD","doi":"10.1111/chf.12007","DOIUrl":"10.1111/chf.12007","url":null,"abstract":"©2012 Wiley Periodicals, Inc.There is abundant evidence on inflammatory mechanisms in heart failure (HF) that are used for prognostication of the disease; however, data are lacking regarding the association between elevated cytokines, C-reactive protein (CRP), and cognition in HF. A cross-sectional pilot study of 38 patients with HF, aged 62 years (standard deviation± 9 years), predominantly men (68%) and Caucasian (79%) were screened for cognitive function using the Montreal Cognitive Assessment (MoCA). The study aimed to examine cognitive scores on MoCA with cytokines, interleukin 6 [IL-6] and tumor necrosis factor α [TNF-α], and CRP as indicators of early cognitive changes in HF. The result showed no direct correlation between cardiac variables and the MoCA score. The MoCA score, however, was inversely associated with IL-6 (r=−0.53, P=.001) and CRP (r=−0.34, P=.04), with no association to TNF-α. Regression analysis on the MoCA score and log-transformed IL-6 accounted for an additional 11% variation and remained statistically significant (P=.008) after controlling for covariates of education, living arrangements, and loneliness. The large effect size (R2=0.87) found in this pilot study provides rationale for a larger exploratory study to examine associations between cognitive function, cytokines, and CRP levels and help design future intervention studies.","PeriodicalId":83668,"journal":{"name":"Congestive heart failure (Greenwich, Conn.)","volume":"19 2","pages":"92-98"},"PeriodicalIF":0.0,"publicationDate":"2012-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/chf.12007","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30969089","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 53

Clinical Outcomes After Tricuspid Valve Annuloplasty in Addition to Mitral Valve Surgery 二尖瓣手术后三尖瓣环成形术的临床效果

Congestive heart failure (Greenwich, Conn.) Pub Date : 2012-10-01 DOI: 10.1111/chf.12004

Gille Koppers MS, David Verhaert MD, Frederik H. Verbrugge MD, Rozette Reyskens RN, Herbert Gutermann MD, Chris Van Kerrebroeck MD, PhD, Pieter Vandervoort MD, W. H. Wilson Tang MD, Robert Dion MD, PhD, Wilfried Mullens MD, PhD

{"title":"Clinical Outcomes After Tricuspid Valve Annuloplasty in Addition to Mitral Valve Surgery","authors":"Gille Koppers MS, David Verhaert MD, Frederik H. Verbrugge MD, Rozette Reyskens RN, Herbert Gutermann MD, Chris Van Kerrebroeck MD, PhD, Pieter Vandervoort MD, W. H. Wilson Tang MD, Robert Dion MD, PhD, Wilfried Mullens MD, PhD","doi":"10.1111/chf.12004","DOIUrl":"10.1111/chf.12004","url":null,"abstract":"©2012 Wiley Periodicals, inc.Current guidelines recommend tricuspid valve annuloplasty (TVP) together with mitral valve surgery in cases of tricuspid annulus dilation (≥40 mm) or functional tricuspid valve regurgitation >2/4. Baseline clinical and echocardiographic data of patients undergoing mitral valve surgery in a single tertiary care hospital between 2007 and 2010 were analyzed. Mortality and heart failure hospitalization data were collected and groups with or without TVP were compared. Patients with TVP (n=89) had similar baseline characteristics compared with patients without (n=86), except for lower right ventricular fractional area change and more concomitant aortic valve surgery. Mortality was higher in the TVP group at 30 days (14% vs 5%; P=.04), but the difference was no longer significant at the end of follow-up. More patients were hospitalized for heart failure in the TVP group (31% vs 17%; hazard ratio, 2.1; 95% confidence interval, 1.1–4.0; P=.05). Right ventricular sphericity index was the only preoperative parameter predicting death or heart failure hospitalizations. In conclusion, patients undergoing TVP in addition to mitral valve surgery are at high risk for early death or subsequent heart failure hospitalizations, which might be partly explained by more complex heart disease. The extent of preoperative right ventricular remodeling may be predictive of adverse outcomes.","PeriodicalId":83668,"journal":{"name":"Congestive heart failure (Greenwich, Conn.)","volume":"19 2","pages":"70-76"},"PeriodicalIF":0.0,"publicationDate":"2012-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/chf.12004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30940776","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 7

Relationship of Cardiac Magnetic Resonance Imaging and Myocardial Biopsy in the Evaluation of Nonischemic Cardiomyopathy 心脏磁共振成像与心肌活检在评估非缺血性心肌病中的关系

Congestive heart failure (Greenwich, Conn.) Pub Date : 2012-09-11 DOI: 10.1111/chf.12003

Jennifer A. Dickerson MD, Subha V. Raman MD, Peter M. Baker MD, Carl V. Leier MD

{"title":"Relationship of Cardiac Magnetic Resonance Imaging and Myocardial Biopsy in the Evaluation of Nonischemic Cardiomyopathy","authors":"Jennifer A. Dickerson MD, Subha V. Raman MD, Peter M. Baker MD, Carl V. Leier MD","doi":"10.1111/chf.12003","DOIUrl":"10.1111/chf.12003","url":null,"abstract":"©2012 Wiley Periodicals, inc.This study was performed to determine the relative role of cardiac magnetic resonance (CMR) imaging and endomyocardial biopsy (EMB) in the evaluation of cardiomyopathy. Sixty-six patients with a clinical diagnosis of nonischemic dilated cardiomyopathy or restrictive cardiomyopathy underwent both EMB and CMR imaging as part of their diagnostic evaluation. The authors retrospectively reviewed the results of these two methods to determine their diagnostic impact and congruency. CMR imaging provided data on cardiac anatomy, left ventricular volumes, mass, and function in 85% of the patients, uncovered fibrosis in 31%, myocardial ischemia in 7%, and fibrofatty infiltration in two patients. EMB provided the histologic findings of cardiomyocyte hypertrophy in 77% of patients and substantial interstitial fibrosis in 59%. Six patients had EMB-proven amyloid heart disease, which was detected by CMR imaging in two. CMR imaging showed patterns of late gadolinium enhancement supportive of infiltrative disease or inflammation in 6 patients with EMB-proven definite (n=3) or borderline (n=3) myocarditis, but failed to do so in two other patients with borderline and two with resolving myocarditis. At the present time, CMR imaging and EMB remain complementary procedures in the evaluation of cardiomyopathic conditions.","PeriodicalId":83668,"journal":{"name":"Congestive heart failure (Greenwich, Conn.)","volume":"19 1","pages":"29-38"},"PeriodicalIF":0.0,"publicationDate":"2012-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/chf.12003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30891439","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 14

Rate of Change in Physical Fitness and Quality of Life and Depression Following Exercise Training in Patients With Congestive Heart Failure 充血性心力衰竭患者运动训练后身体健康、生活质量和抑郁的变化率

Congestive heart failure (Greenwich, Conn.) Pub Date : 2012-09-11 DOI: 10.1111/chf.12002

Neil A. Smart PhD, Robert Murison PhD

{"title":"Rate of Change in Physical Fitness and Quality of Life and Depression Following Exercise Training in Patients With Congestive Heart Failure","authors":"Neil A. Smart PhD, Robert Murison PhD","doi":"10.1111/chf.12002","DOIUrl":"10.1111/chf.12002","url":null,"abstract":"©2012 Wiley Periodicals, inc.Exercise training appears to improve peak oxygen consumption (VO2) and quality of life (QOL) in heart failure patients, although disease etiology, patient demographics and medication may alter the rate of adaptation. The authors sought to identify rate of change from baseline in fitness, QOL, and depression following exercise training in a cohort of patients with congestive heart failure. Thirty male systolic heart failure patients (aged 63.8±8.3 years, baseline peak VO2 12.2±4.8 mL/kg/min, left ventricular ejection fraction 28.2±9.4%, New York Heart Association class II/II 22/8) undertook 52 weeks of exercise training, 16 weeks as an outpatient and a further 36 weeks of home exercise. Peak VO2 and QOL was measured using the Minnesota Living With Heart Failure (MLWHF) questionnaire and depression using the Hare-Davis scale. The authors analyzed the rate of change in peak VO2 and MLWHF after grouping patients according to clinical, demographic, and pharmacologic characteristics. Peak VO2 measurements varied over time, with no effect of disease pathology or β-blocker on peak VO2. The rate of change in physical MLWHF score was significantly greater (improved) during 0 to 16 weeks in patients with dilated pathology, but was not significantly affected by β-blocker use or age. The exercise training venue and supervision, or lack thereof, is the major determinant of adaptation to the intervention in heart failure patients, although age, β-adrenergic medication, and heart failure etiology also explain some of the variation in adaptive responses observed.","PeriodicalId":83668,"journal":{"name":"Congestive heart failure (Greenwich, Conn.)","volume":"19 1","pages":"1-5"},"PeriodicalIF":0.0,"publicationDate":"2012-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/chf.12002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30893029","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 9