Congestive heart failure (Greenwich, Conn.)最新文献_第5页

Patient-Reported Selective Adherence to Heart Failure Self-Care Recommendations: A Prospective Cohort Study: The Atlanta Cardiomyopathy Consortium 患者报告的选择性坚持心力衰竭自我护理建议:一项前瞻性队列研究:亚特兰大心肌病协会

Congestive heart failure (Greenwich, Conn.) Pub Date : 2012-09-09 DOI: 10.1111/j.1751-7133.2012.00308.x

Catherine N. Marti MD, Vasiliki V. Georgiopoulou MD, Grigorios Giamouzis MD, PhD, Robert T. Cole MD, Anjan Deka MD, W. H. W. Tang MD, Sandra B. Dunbar RN, DSN, Andrew L. Smith MD, Andreas P. Kalogeropoulos MD, Javed Butler MD, MPH

{"title":"Patient-Reported Selective Adherence to Heart Failure Self-Care Recommendations: A Prospective Cohort Study: The Atlanta Cardiomyopathy Consortium","authors":"Catherine N. Marti MD, Vasiliki V. Georgiopoulou MD, Grigorios Giamouzis MD, PhD, Robert T. Cole MD, Anjan Deka MD, W. H. W. Tang MD, Sandra B. Dunbar RN, DSN, Andrew L. Smith MD, Andreas P. Kalogeropoulos MD, Javed Butler MD, MPH","doi":"10.1111/j.1751-7133.2012.00308.x","DOIUrl":"10.1111/j.1751-7133.2012.00308.x","url":null,"abstract":"©2012 Wiley Periodicals, Inc.Simultaneous adherence with multiple self-care instructions among heart failure (HF) patients is not well described. Patient-reported adherence to 8 recommendations related to exercise, alcohol, medications, smoking, diet, weight, and symptoms was assessed among 308 HF patients using the Medical Outcomes Study Specific Adherence Scale questionnaire (0=“never” to 5=“always,” maximum score=40). A baseline cumulative score of ≥32/40 (average ≥80%) defined good adherence. Clinical events (death/transplantation/ventricular assist device), resource utilization, functional capacity (6-minute walk distance), and health status (Kansas City Cardiomyopathy Questionnaire [KCCQ]) were compared among patients with and without good adherence. The mean follow-up was 2.0±1.0 years, and adherence ranged from 26.3% (exercise) to 89.9% (medications). A cumulative score indicating good adherence was reported by 35.7%, whereas good adherence with every behavior was reported by 9.1% of patients. Good adherence was associated with fewer hospitalizations (all-cause 87.8 vs 107.6; P=.018; HF 29.6 vs 43.8; P=.007) and hospitalized days (all-cause 422 vs 465; P=.015; HF 228 vs 282; P<.001) per 100-person-years and better health status (KCCQ overall score 70.1±24.6 vs 63.8±22.8; P=.011). Adherence was not associated with clinical events or functional capacity. Patient-reported adherence with HF self-care recommendations is alarmingly low and selective. Good adherence was associated with lower resource utilization and better health status.","PeriodicalId":83668,"journal":{"name":"Congestive heart failure (Greenwich, Conn.)","volume":"19 1","pages":"16-24"},"PeriodicalIF":0.0,"publicationDate":"2012-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/j.1751-7133.2012.00308.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30888944","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: 81

Heart Rate Control in Patients With Chronic Atrial Fibrillation and Heart Failure 慢性心房颤动和心力衰竭患者的心率控制

Congestive heart failure (Greenwich, Conn.) Pub Date : 2012-09-09 DOI: 10.1111/j.1751-7133.2012.00309.x

Helme Silvet MD, MPH, Lee Ann Hawkins RN, MSN, Alan K. Jacobson MD

{"title":"Heart Rate Control in Patients With Chronic Atrial Fibrillation and Heart Failure","authors":"Helme Silvet MD, MPH, Lee Ann Hawkins RN, MSN, Alan K. Jacobson MD","doi":"10.1111/j.1751-7133.2012.00309.x","DOIUrl":"10.1111/j.1751-7133.2012.00309.x","url":null,"abstract":"©2012 Wiley Periodicals, Inc.The goal of this study was to determine whether aggressive heart rate (HR) control in patients with both chronic atrial fibrillation (AF) and heart failure (HF) is associated with improved outcomes. HR control is one of the mainstays in management of patients with AF. However, rate control can be challenging in patients with HF. This study was designed as an interventional clinical trial, using patients with chronic AF and left ventricular systolic dysfunction with left ventricular ejection fraction ≤40% (n=20) as their own controls. Intervention consisted of increasing doses of metoprolol succinate to achieve target resting HR <70 beats per minute. Clinical data were collected at baseline and after intervention, with paired t test used to evaluate statistically significant change. After 3 months of intervention, average resting HR decreased from 94±14 beats per minute to 85±12 beats per minute. Average metoprolol succinate dose at the end of the study was 121 mg. None of the outcomes improved significantly after the intervention, including exercise tolerance (meters walked on 6-minute walk test 326±83 vs 330±86), quality of life (Minnesota Living With Heart Failure Questionnaire score of 42.5±19 vs 38±21), and brain natriuretic peptide (242±306 pg/mL vs 279±395 pg/mL). Aggressive HR control was difficult in this group of patients with chronic AF and HF due to patient intolerance of increasing doses of β-blockade, and not associated with improved outcomes. Further studies are needed to establish guidelines for target HR in patients with chronic AF who also have significant HF.","PeriodicalId":83668,"journal":{"name":"Congestive heart failure (Greenwich, Conn.)","volume":"19 1","pages":"25-28"},"PeriodicalIF":0.0,"publicationDate":"2012-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/j.1751-7133.2012.00309.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30887727","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: 17

Is Exercise Training Beneficial for Heart Failure Patients Taking β-Adrenergic Blockers? A Systematic Review and Meta-Analysis 运动训练对服用β-肾上腺素受体阻滞剂的心力衰竭患者有益吗?系统回顾和荟萃分析

Congestive heart failure (Greenwich, Conn.) Pub Date : 2012-09-09 DOI: 10.1111/chf.12000

Hashbullah Ismail MA, James McFarlane PhD, Neil A. Smart PhD

{"title":"Is Exercise Training Beneficial for Heart Failure Patients Taking β-Adrenergic Blockers? A Systematic Review and Meta-Analysis","authors":"Hashbullah Ismail MA, James McFarlane PhD, Neil A. Smart PhD","doi":"10.1111/chf.12000","DOIUrl":"10.1111/chf.12000","url":null,"abstract":"The authors sought to conduct a systematic review comparing the effects of exercise training in heart failure patients taking β-blockers vs those not. A systematic search of exercise training trials in chronic heart failure patients that compared groups who took β-blocker medication or compared selective and nonselective β-blockers during exercise training was conducted. Eight prospective studies met the criteria for the quantitative synthesis, which included data from 236 participants. The increment in peak oxygen consumption (VO2) was greater in exercising vs control participants, with a mean difference (MD) of 1.27 mL/kg/min (95% confidence interval [CI], 0.85–1.70; P<.00001). In exercising patients, the increment in peak VO2 was greater in the group taking β-blocker vs those taking placebo (MD, 1.66 mL/kg/min; 95% CI, 0.36–2.97; P=.01). In exercising patients, there was no difference in the increment of peak VO2 between nonselective β-blocker and selective β-blockers groups (MD, −0.09 mL/kg/min; 95% CI, −1.54–1.36; P=.09). Minnesota Quality of Life Score was significantly better in the exercise group vs sedentary control group (both groups taking β-blockers) (MD, −11.3; 95% CI, −15.9 to −6.8; P<.00001). Our analysis demonstrated that β-adrenergic blocker therapy did not reduce exercise capacity or exercise training adaptations and quality of life in heart failure patients.","PeriodicalId":83668,"journal":{"name":"Congestive heart failure (Greenwich, Conn.)","volume":"19 2","pages":"61-69"},"PeriodicalIF":0.0,"publicationDate":"2012-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/chf.12000","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30888940","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: 13

Cognitive Profile in Persons With Systolic and Diastolic Heart Failure 收缩期和舒张期心力衰竭患者的认知特征

Congestive heart failure (Greenwich, Conn.) Pub Date : 2012-09-09 DOI: 10.1111/chf.12001

Ponrathi Athilingam PhD, RN, ACNP, FAANP, Rita F. D’Aoust PhD, ANP-BC, CNE, FAANP, Leslie Miller MD, FACC, Leway Chen MD, MPH, FACC, FACP

{"title":"Cognitive Profile in Persons With Systolic and Diastolic Heart Failure","authors":"Ponrathi Athilingam PhD, RN, ACNP, FAANP, Rita F. D’Aoust PhD, ANP-BC, CNE, FAANP, Leslie Miller MD, FACC, Leway Chen MD, MPH, FACC, FACP","doi":"10.1111/chf.12001","DOIUrl":"10.1111/chf.12001","url":null,"abstract":"©2012 Wiley Periodicals, Inc.Persons with heart failure (HF) have four times the risk of having cognitive impairment compared with the general population and display different patterns of cognitive impairment. This secondary analysis of a published cross-sectional study of 90 community-dwelling adults examined the Montreal Cognitive Assessment (MoCA) scores and HF differentiated as systolic and diastolic HF. Mean MoCA score was 22.9 (standard deviation±2.31) in persons with systolic HF (n=69) and 24.8 (standard deviation±2.76) in persons with diastolic HF (n=21) with statistically significant mean difference between groups (t=−2.025, P=.030). Independent t test on the eight MoCA domain scores and systolic and diastolic HF indicated significance on visuo-spatial/executive function (P=.026), attention (P=.049), abstraction (P=.014), and delayed recall (P=.048). Findings from this study support the need for including persons with systolic and diastolic HF in future researches on identifying varying cognitive profiles to plan tailored cognitive intervention.","PeriodicalId":83668,"journal":{"name":"Congestive heart failure (Greenwich, Conn.)","volume":"19 1","pages":"44-50"},"PeriodicalIF":0.0,"publicationDate":"2012-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/chf.12001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30890257","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: 36

Scope of Heart Failure Hospitalization 心力衰竭住院范围

Congestive heart failure (Greenwich, Conn.) Pub Date : 2012-08-14 DOI: 10.1111/j.1751-7133.2012.00305.x

Javed Butler MD, Catherine Marti MD, Ileana Pina MD, MPH, Christopher DeFilippi MD

引用次数: 11

Natriuretic Peptide Testing for Predicting Adverse Events Following Heart Failure Hospitalization 利钠肽检测预测心力衰竭住院后不良事件

Congestive heart failure (Greenwich, Conn.) Pub Date : 2012-08-14 DOI: 10.1111/j.1751-7133.2012.00306.x

James L. Januzzi Jr MD, Alan S. Maisel MD, Marc Silver MD, Yang Xue MD, Christopher DeFilippi MD

引用次数: 35

Post-Acute Care: The Role of Natriuretic Peptides 急性后护理:利钠肽的作用

Congestive heart failure (Greenwich, Conn.) Pub Date : 2012-08-14 DOI: 10.1111/j.1751-7133.2012.00304.x

Alan Maisel MD, James Januzzi MD, Yang Xue MD, Marc A. Silver MD

引用次数: 6

The Role of Natriuretic Peptides: From the Emergency Department Throughout Hospitalization 利钠肽的作用:从急诊科到整个住院过程

Congestive heart failure (Greenwich, Conn.) Pub Date : 2012-08-14 DOI: 10.1111/j.1751-7133.2012.00307.x

Peter S. Pang MD, Yang Xue MD, Christopher DeFilippi MD, Marc Silver MD, James Januzzi MD, Alan Maisel MD

{"title":"The Role of Natriuretic Peptides: From the Emergency Department Throughout Hospitalization","authors":"Peter S. Pang MD, Yang Xue MD, Christopher DeFilippi MD, Marc Silver MD, James Januzzi MD, Alan Maisel MD","doi":"10.1111/j.1751-7133.2012.00307.x","DOIUrl":"10.1111/j.1751-7133.2012.00307.x","url":null,"abstract":"Assessment of natriuretic peptide (NP) levels has a well-established role in the diagnosis and prognosis of acute heart failure (AHF) patients. Current guidelines recommend assessment of NPs when the diagnosis is in question, yet multiple studies suggest a broader value of NP assessment. Measurement of NP levels results in more efficient treatment, resource utilization (ie, reduced costs), and possibly improved short- and long-term outcomes. Given the large number of patients hospitalized every year with heart failure, combined with the high post-discharge mortality, rehospitalization rates, and subsequent large financial costs, improving outcomes for hospitalized HF patients remains an unmet need. In this review, we highlight the value of NP assessment, starting in the emergency department and throughout hospitalization. The contents of this review were generated from a roundtable discussion of AHF and biomarker experts held in Chicago in April 2012 and focused on addressing the burden of AHF and readmission. ©2012 Wiley Periodicals, Inc.","PeriodicalId":83668,"journal":{"name":"Congestive heart failure (Greenwich, Conn.)","volume":"18 s1","pages":"S5-S8"},"PeriodicalIF":0.0,"publicationDate":"2012-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/j.1751-7133.2012.00307.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30832167","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: 8

Hemodynamic, Echocardiographic, and Exercise-Related Effects of the HeartWare Left Ventricular Assist Device in Advanced Heart Failure 血流动力学、超声心动图和运动相关的心脏辅助装置在晚期心力衰竭中的作用

Congestive heart failure (Greenwich, Conn.) Pub Date : 2012-07-13 DOI: 10.1111/j.1751-7133.2012.00302.x

Adam McDiarmid MB, Brian Gordon PhD, Neil Wrightson BSc, Nicola Robinson-Smith BA, Thasee Pillay FRCS (CTh), Gareth Parry FRCP, Stephan Schueler MD, Guy A. MacGowan MD

{"title":"Hemodynamic, Echocardiographic, and Exercise-Related Effects of the HeartWare Left Ventricular Assist Device in Advanced Heart Failure","authors":"Adam McDiarmid MB, Brian Gordon PhD, Neil Wrightson BSc, Nicola Robinson-Smith BA, Thasee Pillay FRCS (CTh), Gareth Parry FRCP, Stephan Schueler MD, Guy A. MacGowan MD","doi":"10.1111/j.1751-7133.2012.00302.x","DOIUrl":"10.1111/j.1751-7133.2012.00302.x","url":null,"abstract":"©2012 Wiley Periodicals, Inc.The aim of this study was to determine the effects of the HeartWare left ventricular assist device (HVAD) (HeartWare International, Inc, Framingham, MA) on hemodynamics, ventricular function, and exercise capacity. Between July 2009 and March 2011, 46 patients with advanced heart failure had implantation of the HVAD. Of these patients, 30 had subsequent assessments for transplantation and these patients formed the study cohort. Thirty patients had assessments at a mean of 201±86 days and 13 went on to have a second assessment at 351±86 days. There were marked improvements in hemodynamics and exercise capacity at both assessments, with significant decreases in right and left heart filling pressures; increases in cardiac index, New York Heart Association class, and peak exercise oxygen consumption; and reduction in pulmonary vascular resistance (all P<.05). Left ventricular end-diastolic and end-systolic dimensions were unchanged at the first assessment, although there was a significant reduction in end-diastolic diameter at the second assessment (P<.01). There were no significant changes in a visual grade of right ventricular function. After up to 1 year of support, the HVAD system results in significant benefits in overall heart failure status, with improved hemodynamics and exercise capacity. This occurs in the absence of marked changes in left ventricular size or right ventricular function.","PeriodicalId":83668,"journal":{"name":"Congestive heart failure (Greenwich, Conn.)","volume":"19 1","pages":"11-15"},"PeriodicalIF":0.0,"publicationDate":"2012-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/j.1751-7133.2012.00302.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30768156","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: 24

Amino-Terminal Pro-B-Type Natriuretic Peptide for Risk Prediction in Acute Decompensated Heart Failure 氨基末端前b型利钠肽用于急性失代偿性心力衰竭的风险预测

Congestive heart failure (Greenwich, Conn.) Pub Date : 2012-07-04 DOI: 10.1111/j.1751-7133.2012.00301.x

Domenico Scrutinio MD, Pietro Guida PhD, Andrea Passantino MD, Rocco Lagioia MD, Silvana Pepe BSc, Raffaella Catanzaro MD, Daniela Santoro MD

{"title":"Amino-Terminal Pro-B-Type Natriuretic Peptide for Risk Prediction in Acute Decompensated Heart Failure","authors":"Domenico Scrutinio MD, Pietro Guida PhD, Andrea Passantino MD, Rocco Lagioia MD, Silvana Pepe BSc, Raffaella Catanzaro MD, Daniela Santoro MD","doi":"10.1111/j.1751-7133.2012.00301.x","DOIUrl":"10.1111/j.1751-7133.2012.00301.x","url":null,"abstract":"©2012 Wiley Periodicals Inc.Amino-terminal pro-B-type natriuretic peptide (NT-proBNP) has been associated with prognosis in heart failure. The aim of this study was to assess whether NT-proBNP enhances risk prediction in acute decompensated heart failure (ADHF). The authors enrolled 453 patients hospitalized for ADHF. The primary outcome was 12-month mortality. Two separate multivariable predictive models were built by using standard variables–only and NT-proBNP concentrations. The models were internally validated using the bootstrapping method. Twelve-month mortality was 28.3%. There was no statistical evidence of overfit. Compared with the standard variables–only model, the NT-proBNP model had a better predictive performance as judged by the Nagelkerke R2 (0.410 vs 0.374) and the Brier score (0.136 vs 0.141), which are measures of overall performance; the Akaike Information Criterion (399.2 vs 415.0), which is a tool for model selection; and the C index (0.844 vs 0.831), which is a measure of the discriminative ability. Both models were well calibrated, as judged by the Hosmer-Lemeshow chi-square test. Both models predicted 12-month mortality significantly better than the Enhanced Feedback for Effective Cardiology Treatment risk score. In conclusion, the NT-proBNP model improved risk prediction compared with the standard variables–only model.","PeriodicalId":83668,"journal":{"name":"Congestive heart failure (Greenwich, Conn.)","volume":"18 6","pages":"308-314"},"PeriodicalIF":0.0,"publicationDate":"2012-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/j.1751-7133.2012.00301.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30738146","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: 3