WorldWideScience

Sample records for chronic congestive heart

  1. Decreased renal clearance of digoxin in chronic congestive heart failure.

    Science.gov (United States)

    Naafs, M A; van der Hoek, C; van Duin, S; Koorevaar, G; Schopman, W; Silberbusch, J

    1985-01-01

    Renal digoxin clearance was compared in patients suffering from atrial fibrillation with well preserved cardiac function (n = 9; salt intake +/- 170 mmol daily) and patients with chronic congestive heart failure (n = 10; salt intake 50 mmol daily and maintenance treatment with diuretics). There was no difference between the groups concerning digoxin dosage, creatinine clearance, diuresis or sodium excretion in the urine. Digoxin clearance in chronic heart failure proved to be significantly lower than in atrial fibrillation (48 +/- 21 vs 71 +/- 36 ml X min-1, p less than 0.05), and Cdig/Ccreat was similarly reduced at 0.73 +/- 0.15 compared to 1.09 +/- 0.27 (p less than 0.005). Steady state serum digoxin concentration was significantly higher in patients with congestive heart failure (1.44 +/- 0.47 vs 0.87 +/- 0.33 micrograms X 1(-1), p less than 0.01). Chronic congestive heart failure is a state with reduced digoxin clearance by the kidney, which could lead to digoxin intoxication not explicable by overdose, reduced renal function or the effect of interacting drugs. PMID:4007028

  2. Hemostatic biomarkers in dogs with chronic congestive heart failure

    DEFF Research Database (Denmark)

    Tarnow, Inge; Falk, Torkel; Tidholm, Anna;

    2007-01-01

    Background: Chronic congestive heart failure (CHF) in humans is associated with abnormal hemostasis, and abnormalities in hemostatic biomarkers carry a poor prognosis. Alterations in hemostatic pathways can be involved in the pathogenesis of CHF in dogs, and microthrombosis in the myocardium could...... contribute to increased mortality. Hypothesis: That plasma concentration or activity of hemostatic biomarkers is altered in dogs with CHF and that these factors predict mortality. Animals: Thirty-four dogs with CHF caused by either dilated cardiomyopathy (DCM, n = 14) or degenerative valvular disease (CDVD......, n = 20) compared with 23 healthy age-matched control dogs were included in this study. Dogs with CHF were recruited from 2 referral cardiology clinics, and control dogs were owned by friends or colleagues of the investigators. Methods: Clinical examination and echocardiography were performed in all...

  3. Congestive heart failure in patients with chronic kidney disease

    Directory of Open Access Journals (Sweden)

    Poskurica Mileta

    2014-01-01

    Full Text Available Cardiovascular disorders are the most frequent cause of death (46-60% among patients with advanced chronic renal failure (CRF, and on dialysis treatment. Uremic cardiomyopathy is the basic pathophysiologic substrate, whereas ischemic heart disease (IHD and anemia are the most important contributing factors. Associated with well-know risk factors and specific disorders for terminal kidney failure and dialysis, the aforementioned factors instigate congestive heart failure (CHF. Suspected CHF is based on the anamnesis, clinical examination and ECG, while it is confirmed and defined more precisely on the basis of echocardiography and radiology examination. Biohumoral data (BNP, NT-proBNP are not sufficiently reliable because of specific volemic fluctuation and reduced natural clearance. Therapy approach is similar to the one for the general population: ACEI, ARBs, β-blockers, inotropic drugs and diuretics. Hypervolemia and most of the related symptoms can be kept under control effectively by the isolated or ultrafiltation, in conjunction with dialysis, during the standard bicarbonate hemodialysis or hemodiafiltration. In the same respect peritoneal dialysis is efficient for the control of hypervolemia symptoms, mainly during the first years of its application and in case of the lower NYHA class (II°/III°. In general, heart support therapy, surgical interventions of the myocardium and valve replacement are rarely used in patients on dialysis, whereas revascularization procedures are beneficial for associated IHD. In selected cases the application of cardiac resynchronization and/or implantation of a cardioverter defibrillator are advisable.

  4. Quality of life in patients with chronic congestive heart failure

    Directory of Open Access Journals (Sweden)

    Anca D. Farcaş

    2011-12-01

    Full Text Available Objective: Quality of life (QOL is severely decreased in patients with chronic heart failure (CHF. Our study aims to identify the factors affecting the evaluation of QOL. Material and Methods: Clinical, demographic, social and economic data was collected from patients with CHF in NYHA class III and IV as part of a complex workup. The Minnesota Living with Heart Failure Questionnaire (MLHFQ was used to evaluate QOL. Results: QOL decreases as the NYHA class increases. Women evaluate their QOL as more severely affected than men. Age, social and economic factors modulate the perception of QOL. Conclusion: Combining demographic, social and economic data and evaluation of QOL can provide valuable and useful information for the medical management of patients with CHF.

  5. Bed rest and increased diuretic treatment in chronic congestive heart failure

    DEFF Research Database (Denmark)

    Abildgaard, U; Aldershvile, J; Ring-Larsen, H;

    1985-01-01

    To elucidate the effect of bed rest used as an adjunct to increased diuretic treatment, twelve patients with chronic congestive heart failure (CHF) had a 50% increase in loop diuretic dosage and were allocated to either continuous bed rest or bed rest during nights only. The 24-hour bed rest group...... is a reasonable adjunct to diuretic treatment in patients with CHF....

  6. Pulmonary Congestion at Rest and Abnormal Ventilation During Exercise in Chronic Systolic Heart Failure

    OpenAIRE

    G. Malfatto; Caravita, S; Giglio, A.; Rossi, J.; Perego, G.; Facchini, M.; Parati, G.

    2015-01-01

    Background In patients with chronic heart failure, abnormal ventilation at cardiopulmonary testing (expressed by minute ventilation-to-carbon dioxide production, or VE/VCO2 slope, and resting end-tidal CO2 pressure) may derive either from abnormal autonomic or chemoreflex regulation or from lung dysfunction induced by pulmonary congestion. The latter hypothesis is supported by measurement of pulmonary capillary wedge pressure, which cannot be obtained routinely but may be estimated noninvasiv...

  7. Importance of chronic obstructive pulmonary disease for prognosis and diagnosis of congestive heart failure in patients with acute myocardial infarction

    DEFF Research Database (Denmark)

    Kjøller, Erik; Køber, Lars; Iversen, Kasper;

    2004-01-01

    AIMS: To evaluate the importance of chronic obstructive pulmonary disease for prognosis and diagnosis of congestive heart failure in patients with acute myocardial infarction. METHOD AND RESULTS: Prospective registration of 6669 consecutive patients admitted with infarction and screened.......35-1.65). In multivariate analysis the relative risk was 1.15 (1.04-1.28). The prevalence of congestive heart failure was 65.9% in patients with chronic obstructive pulmonary disease and 52.0% in patients without. This difference was most distinct in patients with normal or only slightly decreased left ventricular systolic...... function. In patients without congestive heart failure, chronic obstructive pulmonary disease was of prognostic importance [RR=1.44 (1.17-1.78)], but not in patients with congestive heart failure [RR=1.09 (0.96-1.23)]. CONCLUSION: Chronic obstructive pulmonary disease is a predictor of long-term mortality...

  8. A perspective on sympathetic renal denervation in chronic congestive heart failure.

    Science.gov (United States)

    Madanieh, Raef; El-Hunjul, Mohammed; Alkhawam, Hassan; Kosmas, Constantine E; Madanieh, Abed; Vittorio, Timothy J

    2016-01-01

    Medical therapy has indisputably been the mainstay of management for chronic congestive heart failure. However, a significant percentage of patients continue to experience worsening heart failure (HF) symptoms despite treatment with multiple therapeutic agents. Recently, catheter-based interventional strategies that interrupt the renal sympathetic nervous system have shown promising results in providing better symptom control in patients with HF. In this article, we will review the pathophysiology of HF for better understanding of the interplay between the cardiovascular system and the kidney. Subsequently, we will briefly discuss pivotal renal denervation (RDN) therapy trials in patients with resistant hypertension and then present the available evidence on the role of RDN in HF therapy.

  9. Chronic congestive heart failure. Description and survival of 190 consecutive patients with a diagnosis of chronic congestive heart failure based on clinical signs and symptoms

    DEFF Research Database (Denmark)

    Madsen, B K; Hansen, J F; Stokholm, K H;

    1994-01-01

    The prognosis, and clinical findings related to prognosis, were examined in a consecutive series of 190 patients under 76 years of age (mean 64 years) with congestive heart failure (CHF). The aetiology of CHF was ischaemic heart disease in 66%, hypertension in 11% and cardiomyopathy in 23%. The 2...

  10. The Administration and Effect of Sodium Nitroprusside in the Treatment of Chronic Congestive Heart Failure

    Institute of Scientific and Technical Information of China (English)

    Sun Ming; Wang Wenmeng; Wu Qiong

    2000-01-01

    To prove the effectiveness and safety of sodium nitroprusside (SNP) in the treatment of chronic congestive heart failure, 58 patients with heart failure and normal renal and hepatic function were selected and divided into 3 groups and treated differently. Group A was treated with routine vasodilators; Group B was treaeted intermittently with SNP (12.5 -75mg/24hrs);Group C was treated continuously with SNP (continuous infusion of 100-300mg/24hrs) Positively inotropie agents and diuretic agents were used in each group.The results showed that the highly effective rates of the three groups were 46.9% (15/32), 90.5% (19/21)and 100% (12/12) respectively. The effective rates were 81.3% (26/32), 100% (21/21), 100%(12/12) respectively. The highly effective rates of group B and C were much higher than that of group A (P<0.005, P< 0.005) . The reduction of blood pressure of group B and C was greater than that of group A ( P < 0. 025) . Among the patients we studied, no body had severe side effects. We concluded that the use of SNP in the treatment of chronic congestive heart failure is safe, with better effect than routine treatment,and continous infusion of SNP is the best choice.

  11. Serum Levels of Soluble Fas Ligand and Soluble Fas Receptor in Patients with Chronic Congestive Heart Failure

    Institute of Scientific and Technical Information of China (English)

    李刚; 令狐华; 魏良明

    2002-01-01

    @@ To understand the pathophysiologic significances of soluble Fas Ligand (sFasL) and soluble Fas receptor (sFas) in chronic congestive heart failure (CHF) and to determine the relationship of circulating levels of sFasL and sFas to the severity of CHF, the serum sFasL and sfas levels were evaluated in patients with CHF.

  12. Associations between cardiac pathology and clinical, echocardiographic and electrocardiographic findings in dogs with chronic congestive heart failure

    DEFF Research Database (Denmark)

    Falk, Bo Torkel; Jönsson, Lennart; Olsen, Lisbeth Høier;

    2010-01-01

    The objective of this study was to correlate defined pathological features with clinical findings in dogs with naturally occurring congestive heart failure (CHF). Fifty-eight dogs with CHF were examined clinically and using echocardiography and electrocardiography. Detailed cardiac post...

  13. The effect of theophylline on sleep-disordered breathing in patients with stable chronic congestive heart failure

    Institute of Scientific and Technical Information of China (English)

    胡克; 李清泉; 杨炯; 胡苏萍; 陈喜兰

    2003-01-01

    Objective To determine the prevalence of sleep-disordered breathing in patients with stable, optimally treated chronic congestive heart failure and the effect of short-term oral theophylline therapy on periodic breathing in these patients.Methods Patients with stable, optimally treated chronic congestive heart failure were monitored by polysomnography during nocturnal sleep. The effects of theophylline therapy on periodic breathing associated with stable heart failure were observed before and after treatment.Results Patients were divided into two groups. GroupⅠ(n=21) consisted of individuals with 15 episodes of apnea and hypopnea [as determined by the apnea-hypopnea index (AHI)] per hour or less; Group Ⅱ (n=15, 41.7%) individuals had an index of more than 15 episodes per hour. In group Ⅱ, the AHI varied from 16.8 to 78.8 (42.6±15.5) in which the obstructive AHI was 11.1±8.4 and the central AHI was 31.5±9.6. Group Ⅱ had significantly more arousals (36.8±21.3 compared with 19.4±11.2 in group Ⅰ) that were directly attributable to episodes of apnea and hypopnea, lower arterial oxyhemoglobin saturation (76.7%±4.6% compared with 86.5%±2.8%) and lower left ventricular ejection fraction (24.2%±8.8% compared with 31.5%±10.6%). Thirteen patients with compensated heart failure and periodic breathing received theophylline orally (at an average dose of 4.3 mg/kg) for five to seven days. After treatment, the mean plasma theophylline concentration was (11.3±2.5) μg/ml. Theophylline therapy resulted in significant decreases in the number of AHI (20.8±13.2 vs. 42.6±15.5; P<0.001) and the number of episodes of central apnea-hypopnea per hour (10.1±7.6 vs. 31.5±9.6; P<0.001). Furthermore, the percentage of total sleep time during which arterial oxyhemoglobin saturation (SaO2) was less than 90 percent (8.8%±8.6% vs. 23.4%±24.1%; P<0.05) and the arousals per hour (18.7±21.2 vs. 36.8±21.3; P<0.05) were also lower. There were no significant differences in the

  14. Arteriosclerotic changes in the myocardium, lung, and kidney in dogs with chronic congestive heart failure and myxomatous mitral valve disease

    DEFF Research Database (Denmark)

    Falk, Bo Torkel; Jönsson, Lennart; Olsen, Lisbeth Høier;

    2006-01-01

    Background: The occurrence of small vessel arteriosclerosis in the myocardium, kidney, and lung in dogs with naturally occurring myxomatous mitral valve disease has not been previously investigated systematically. Methods: Twenty-one dogs with naturally occurring congestive heart failure and 21 age......-matched, sex-matched, and weight-matched control dogs underwent extensive pathological and histopathological examination. Morphometry and scoring of tissue sections were used to measure arterial narrowing and fibrosis in the myocardium, kidney, and lung; and intimal thickness and plaque formation in the aorta...... and pulmonary artery. Results: Dogs with congestive heart failure had significantly more arterial narrowing in the left ventricle (Pdogs. However...

  15. Bisoprolol for congestive heart failure

    DEFF Research Database (Denmark)

    Rosenberg, J.; Gustafsson, F.

    2008-01-01

    Background: beta-Blockers are a cornerstone in the treatment of systolic heart failure treatment, but not all beta-blockers are effective or in this setting. Objective: To define the role of bisoprolol, a highly selective beta(1)-antagonist in congestive heart failure due to systolic dysfunction....... Methods: Using the keywords 'bisoprolol' and 'heart failure' PubMed and BIOSIS databases were searched for information regarding pharmacology and relevant randomised clinical trials. Supplementary publications were acquired by scrutinising reference lists of relevant papers. Additional information...... was obtained from the FDA website. Conclusion: Bisoprolol is an effective and well-tolerated first-line beta-blocker for patients with systolic heart failure. The knowledge is primarily based on study patients with moderate-to-severe heart failure from the three CIBIS trials Udgivelsesdato: 2008/2...

  16. Relationship Between Serum Leptin Concentration and Lipids & Body Mass Index in Patients With Chronic Congestive Heart Failure

    Institute of Scientific and Technical Information of China (English)

    Li Gang; Yan Qingbo; Wei Liangming

    2006-01-01

    Objectives To investigate the relationship of serum leptin concentration with the lipids and body mass index (BMI) in patients with chronic congestive heart failure(CHF). Methods The serum concentration of leptin in 39 patients with CHF (14 in cardiac function class Ⅱ , 21 in class Ⅲ , 4 in class Ⅳ , NYHA) and in 46 patients with cardiac function class Ⅰ (NYHA) were assessed by radioimmunoassay. Results The serum concentration of leptin were 9.018±4.519μg/l in CHF group (cardiac function class Ⅱ 11.492±5.649 μg/l, class Ⅲ 7.763±3.321 μg/l, class Ⅳ 6.100±2.657 μg/l);11.674±6.911 μg/l in class Ⅰ group. The serum concentrations of leptin were significantly lower in CHF group, as compared with class Ⅰ group (P<0.05). Moreover, the decrease of serum leptin concentration was significantly correlated with the decreased serum concentrations of total cholesterol, triglyceride, body mass index and left ventricular ejection fraction in CHF group, respectively (P<0.05). Conclusions The significance of the decrease in serum leptin in CHF patients needs further study.

  17. New auxiliary indicators for the differential diagnosis of functional cardiorespiratory limitation in patients with chronic obstructive pulmonary disease and congestive heart failure

    OpenAIRE

    Cesar Marcelo de Castro; Camelier Aquiles; Jardim José Roberto; Montesano Fábio Tadeu; Tebexreni Antonio Sérgio; Barros Turíbio Leite de

    2003-01-01

    OBJECTIVE: To differentiate the nature of functional cardiorespiratory limitations during exercise in individuals with chronic obstructive pulmonary disease (COPD) or congestive heart failure (CHF) and to determine indicators that may help their classifications. METHODS: The study comprised 40 patients: 23 with COPD and 17 with CHF. All individuals underwent maximal cardiopulmonary exercise testing on a treadmill. RESULTS: The values of peak gas exchange ratio (R peak), peak carbon dioxide pr...

  18. Detection and significance of a discrete very low frequency rhythm in RR interval variability in chronic congestive heart failure.

    Science.gov (United States)

    Ponikowski, P; Chua, T P; Amadi, A A; Piepoli, M; Harrington, D; Volterrani, M; Colombo, R; Mazzuero, G; Giordano, A; Coats, A J

    1996-06-15

    Although in advanced chronic congestive heart failure (CHF) very low frequency (discrete VLF rhythm (0.019 +/- 0.008 Hz) in RR variability. The presence of VLF rhythm was not related to any difference in clinical parameters (etiology, New York Heart Association class, ejection fraction, oxygen uptake) but rather to a different pattern in RR interval and blood pressure variability: lower LF power (2.8 +/- 1.6 ms2 natural logarithm [ln]) compared either to patients without VLF (4.0 +/- 1.3 ms2 ln) or to controls (5.9 +/- 0.7 ms2 ln), higher percentage of power within VLF band (86.3 +/- 8.3% vs 77.5 +/- 7.9% and 61.5 +/- 14.1%) and a markedly impaired coherence between RR interval and systolic blood pressure variability within the LF band (0.26 +/- 0.10 vs 0.42 +/- 0.18 and 0.63 +/- 0.15, in patients with vs without VLF peak and controls, respectively). Patients with VLF had significantly increased hypoxic chemosensitivity, and hyperoxic conditions were able to decrease VLF power and abolish the VLF rhythm in 5 of 6 patients with CHF. Discrete VLF oscillations in RR variability are common in patients with advanced CHF and appear to be related to severely impaired autonomic regulation and suppression of baroreceptor function, with enhancement of hypoxic chemosensitivity. We hypothesize that this rhythm represents an enhanced chemoreflex harmonic oscillation in CHF patients, which may have application for arrhythmogenesis. PMID:8677873

  19. Effects of thyroxine on cardiac function and lymphocyte β-adrenoceptors in patients with chronic congestive heart failure

    Institute of Scientific and Technical Information of China (English)

    卢新政; 黄峻; 张晓文; 李新华; 王赤京; 张佩生; 陈永生

    2003-01-01

    Objective To explore the effects of thyroid hormone (TH) on cardiac function and peripheral lymphocyte β-adrenoceptors (β-Ars) of patients with chronic congestive heart failure (CHF). Methods Twenty-eight patients with class Ⅲ or Ⅳ advanced CHF due to dilated cardiomyopathy (DCM) or ischemic cardiomyopathy (ICM) were randomly divided into groups A and B. L-thyroxine (L-T50) was administered to group B. Exercise tolerance, chest X-rays, and echocardiographic parameters were obtained before and after one month of treatment, Ficoll-hypaque solution was used to separate peripheral lymphocytes, and 125I-pindolol radioligand binding was used to measure β-AR levels in peripheral lymphocytes. Results L-T50 therapy improved cardiac output [CO, (2.98±0.31)L/min vs (3.24±0.28) L/min, P<0.01], left ventricular ejection fraction (LVEF, 26.21%±3.21% vs 37.93%±9.01%, P<0.01), and decreased isovolumetric relaxation time (IVRT, 0.12±0.04 vs 0.10±0.02, P<0.01). Serum TH levels and the maximal number of β-AR binding sites (βmax ) in peripheral lymphocytes were lower in patients with CHF than in normal healthy people, but L-T50 administration induced a β-AR up-regulation on peripheral lymphocyte surfaces. L-T50 was well tolerated without episodes of ischemia or arrhythmia. There was no significant change in heart rate or metabolic rate.Conclusion TH administration improves cardiac function and β-AR expression in peripheral lymphocytes of patients with CHF.

  20. Prognostic value of echocardiography in 190 patients with chronic congestive heart failure. A comparison with New York Heart Association functional classes and radionuclide ventriculography

    DEFF Research Database (Denmark)

    Madsen, B K; Videbaek, R; Stokholm, H;

    1996-01-01

    Survival in 190 consecutive patients with congestive heart failure, discharged from a general hospital, was studied. Sixteen patients were in New York Heart Association (NYHA) class I, 87 in II, 83 in III and 4 in IV. Median left ventricular ejection fraction (LVEF) from radionuclide...

  1. Effects of Ambient Air Pollution on Functional Status in Patients with Chronic Congestive Heart Failure: a Repeated-Measures Study

    OpenAIRE

    Phillips Russell S; Suh Helen H; Coull Brent A; Yeh Gloria Y; Wellenius Gregory A; Mittleman Murray A

    2007-01-01

    Abstract Background Studies using administrative data report a positive association between ambient air pollution and the risk of hospitalization for congestive heart failure (HF). Circulating levels of B-type natriuretic peptide (BNP) are directly associated with cardiac hemodynamics and symptom severity in patients with HF and, therefore, serves as a marker of functional status. We tested the hypothesis that BNP levels would be positively associated with short-term changes in ambient pollut...

  2. Effects of ambient air pollution on functional status in patients with chronic congestive heart failure: a repeated-measures study

    Directory of Open Access Journals (Sweden)

    Phillips Russell S

    2007-09-01

    Full Text Available Abstract Background Studies using administrative data report a positive association between ambient air pollution and the risk of hospitalization for congestive heart failure (HF. Circulating levels of B-type natriuretic peptide (BNP are directly associated with cardiac hemodynamics and symptom severity in patients with HF and, therefore, serves as a marker of functional status. We tested the hypothesis that BNP levels would be positively associated with short-term changes in ambient pollution levels among 28 patients with chronic stable HF and impaired systolic function. Methods BNP was measured in whole blood at 0, 6, and 12 weeks. We used linear mixed models to evaluate the association between fine particulate matter (PM2.5, carbon monoxide, sulfur dioxide, nitrogen dioxide, ozone, and black carbon and log(BNP. Lags of 0 to 3 days were considered in separate models. We calculated the intraclass correlation coefficient and within-subject coefficient of variation as measures of reproducibility. Results We found no association between any pollutant and measures of BNP at any lag. For example, a 10 μg/m3 increase in PM2.5 was associated with a 0.8% (95% CI: -16.4, 21.5; p = 0.94 increase in BNP on the same day. The within-subject coefficient of variation was 45% on the natural scale and 9% on the log scale. Conclusion These results suggest that serial BNP measurements are unlikely to be useful in a longitudinal study of air pollution-related acute health effects. The magnitude of expected ambient air pollution health effects appears small in relation to the considerable within-person variability in BNP levels in this population.

  3. The Serum Levels of Soluble Fas Ligand and Soluble Fas Receptor in Patients with chronic congestive heart failure

    Institute of Scientific and Technical Information of China (English)

    李刚; 令狐华; 魏良明; 陈运贞

    2002-01-01

    Objectives To investigate the association of soluble Fas ligand(sFasL) andsoluble Fas receptor(sFas)with human chronic congestive heart failure(CHF). Methods The serumlevel of sFasL and sFas in 33 patients with CHF (13in cardiac function class Ⅱ, 17 in class Ⅲ, 3 inclass IV, NYHA) was assessed with enzyme- linkedimmunosorbent assay, and was compared with that of18 age-, blood pressure- matched patients with cardiac function class I (NYHA). Results There wasno difference in the level of sFasL between the twogroups [CHF group: 231.50 + / - 84.50 (cardiacfunction class Ⅱ 216.50+/-96.00 , class Ⅲ226.80 + / - 85.70, class IV 244. 00 + / - 73.00 )vs. cardiac function class I group: 217.50+ /-89. 00 pg/mL, P>0. 05 ]. However, the level of sFaswas significantly higher in the patients with CHF thanthose of cardiac function class I group [CHF group:1353.30+/-507.71 (cardiac function class Ⅱ1154.85+/-371.20 , class Ⅲ 1412.88+/-493.62, class IV1875.67 + / - 806. 10) vs, cardiacfunction class I group: 983.11 + / -461.26 pg/mL,P<0. 05 ]. Conclusions sFasL was not associatedwith human CHF. However, the elevation of serumlevel of sFas was proportion to the severity of humanCHF. sFas may play an important role in the patho-genesis of human CHF.

  4. Focus on renal congestion in heart failure.

    Science.gov (United States)

    Afsar, Baris; Ortiz, Alberto; Covic, Adrian; Solak, Yalcin; Goldsmith, David; Kanbay, Mehmet

    2016-02-01

    Hospitalizations due to heart failure are increasing steadily despite advances in medicine. Patients hospitalized for worsening heart failure have high mortality in hospital and within the months following discharge. Kidney dysfunction is associated with adverse outcomes in heart failure patients. Recent evidence suggests that both deterioration in kidney function and renal congestion are important prognostic factors in heart failure. Kidney congestion in heart failure results from low cardiac output (forward failure), tubuloglomerular feedback, increased intra-abdominal pressure or increased venous pressure. Regardless of the cause, renal congestion is associated with increased morbidity and mortality in heart failure. The impact on outcomes of renal decongestion strategies that do not compromise renal function should be explored in heart failure. These studies require novel diagnostic markers that identify early renal damage and renal congestion and allow monitoring of treatment responses in order to avoid severe worsening of renal function. In addition, there is an unmet need regarding evidence-based therapeutic management of renal congestion and worsening renal function. In the present review, we summarize the mechanisms, diagnosis, outcomes, prognostic markers and treatment options of renal congestion in heart failure.

  5. Atrial Fibrillation in Congestive Heart Failure

    OpenAIRE

    Lubitz, Steven A.; Benjamin, Emelia J.; Ellinor, Patrick T.

    2010-01-01

    Atrial fibrillation and congestive heart failure are morbid conditions that share common risk factors and frequently coexist. Each condition predisposes to the other, and the concomitant presence of the two identifies individuals at increased risk for mortality. Recent data have emerged which help elucidate the complex genetic and non-genetic pathophysiological mechanisms that contribute to the development of atrial fibrillation in individuals with congestive heart failure. Clinical trial res...

  6. Efficacy of felodipine in chronic congestive heart failure: a placebo controlled haemodynamic study at rest and during exercise and orthostatic stress.

    Science.gov (United States)

    Kassis, E; Amtorp, O; Waldorff, S; Fritz-Hansen, P

    1987-11-01

    A vascular selective calcium antagonist, felodipine, was evaluated in a randomised, double blind, crossover trial in 18 patients with chronic congestive heart failure of ischaemic cause. Felodipine (10 mg twice daily) or a corresponding placebo was added to conventional treatment. After three weeks haemodynamic function was assessed at rest, during a standard supine leg exercise, and during 45 degrees passive upright tilt. In patients in the supine resting position, felodipine reduced the mean arterial pressure (9%) and systemic vascular resistance (24%) and increased the stroke volume (25%) and cardiac index (23%). The heart rate and right and left ventricular filling pressures were unchanged. During felodipine treatment the standard exercise was accomplished at a similar cardiac index but at a substantially lower heart rate (7%), arterial pressure (10%), systemic vascular resistance (17%), and left ventricular filling pressure (19%), and a higher stroke volume (13%). During both placebo and felodipine administration there were substantial reductions in cardiac filling pressure during upright tilting. Upright tilting during the placebo phase did not increase the heart rate. It also caused a greater fall in systemic vascular resistance while the arterial pulse pressure but not the mean pressure was maintained and the cardiac index and stroke volume increased. The reduced cardiac filling pressures during the felodipine upright tilt were accompanied by reductions in arterial pulse pressure and stroke volume and the patients were able to maintain the mean arterial pressure by an increase in both the heart rate and systemic vascular resistance. Thus three weeks treatment with felodipine improved haemodynamic function at rest and during standard exercise and normalised the baroreflex mediated haemodynamic response in patients with congestive heart failure. The haemodynamic efficacy of the drug in such patients may be associated with a baroreceptor mediated effect as

  7. THE METHODS OF TOTAL BODY BIOIMPEDANCE SPECTROSCOPY IN ANALYSIS THE FUNCTIONAL CLASS OF CONGESTIVE HEART FAILURE

    OpenAIRE

    Ivanov, G.; Dvornicov, V.; Niculina, L.; Kotlarova, L.; Bernshtein, Ju; Pavlovich, A.

    2004-01-01

    The article presented result of studies, which determined signs an studies of total body bioimpedance spectros-copy analysis in evaluate of functional class of chronic heart failure. Key words: biompedance, congestive heart failure.

  8. Aggressive therapy of congestive heart failure and associated chronic renal failure with medications and correction of anemia stops or slows the progression of both diseases.

    Science.gov (United States)

    Silverberg, D S; Wexler, D; Blum, M; Sheps, D; Schwartz, D; Yachnin, T; Baruch, R; Tchebiner, J; Zubkov, A; Shaked, M; Steinbruch, S; Keren, G; Iaina, A

    2001-01-01

    The prevalence of congestive heart failure (CHF) is increasing rapidly in the community. We and others have shown that the prevalence and severity of both anemia and chronic renal failure (CRF) increase steadily with increasing severity of CHF. We have also shown that CHF patients may be resistant to standard drug therapy for CHF as long as the associated anemia is not corrected, and that correction of the anemia with subcutaneous erythropoietin and intravenous iron sucrose (Venofer: Vifor International, St. Gallen, Switzerland) may improve both the CHF and CRF and markedly reduce hospitalizations without causing side effects. We report here our experience with correcting anemia in this manner in 126 cases of anemic-resistant CHF patients. As in our previous studies, correction of the anemia improved both CHF and CRF, and reduced hospitalizations. Our studies suggest that correction of even mild anemia in CHF may be an important addition to the treatment of patients with the combination of CHF and CRF.

  9. Congestive Heart Failure and Central Sleep Apnea.

    Science.gov (United States)

    Sands, Scott A; Owens, Robert L

    2016-03-01

    Congestive heart failure (CHF) is among the most common causes of admission to hospitals in the United States, especially in those over age 65. Few data exist regarding the prevalence CHF of Cheyne-Stokes respiration (CSR) owing to congestive heart failure in the intensive care unit (ICU). Nevertheless, CSR is expected to be highly prevalent among those with CHF. Treatment should focus on the underlying mechanisms by which CHF increases loop gain and promotes unstable breathing. Few data are available to determine prevalence of CSR in the ICU, or how CSR might affect clinical management and weaning from mechanical ventilation.

  10. Congestive Heart Failure and Central Sleep Apnea.

    Science.gov (United States)

    Sands, Scott A; Owens, Robert L

    2016-03-01

    Congestive heart failure (CHF) is among the most common causes of admission to hospitals in the United States, especially in those over age 65. Few data exist regarding the prevalence CHF of Cheyne-Stokes respiration (CSR) owing to congestive heart failure in the intensive care unit (ICU). Nevertheless, CSR is expected to be highly prevalent among those with CHF. Treatment should focus on the underlying mechanisms by which CHF increases loop gain and promotes unstable breathing. Few data are available to determine prevalence of CSR in the ICU, or how CSR might affect clinical management and weaning from mechanical ventilation. PMID:26972039

  11. Anemia, chronic renal disease and congestive heart failure--the cardio renal anemia syndrome: the need for cooperation between cardiologists and nephrologists.

    Science.gov (United States)

    Silverberg, Donald S; Wexler, Dov; Iaina, Adrian; Steinbruch, Shoshana; Wollman, Y; Schwartz, Doron

    2006-01-01

    Many patients with congestive heart failure (CHF) fail to respond to maximal CHF therapy and progress to end stage CHF with many hospitalizations, poor quality of life (QoL), progressive chronic kidney disease (CKD) which can lead to end stage kidney disease (ESKD), or die of cardiovascular complications within a short time. One factor that has generally been ignored in many of these people is the fact that they are often anemic. The anemia in CHF is due mainly to the frequently-associated CKD but also to the inhibitory effects of cytokines on erythropoietin production and on bone marrow activity, as well as to their interference with iron absorption from the gut and their inhibiting effect on the release of iron from iron stores. Anemia itself may further worsen cardiac and renal function and make the patients resistant to standard CHF therapy. Indeed anemia in CHF has been associated with increased severity of CHF, increased hospitalization, worse cardiac function and functional class, the need for higher doses of diuretics, progressive worsening of renal function and reduced QoL. In both controlled and uncontrolled studies of CHF, the correction of the anemia with erythropoietin (EPO) and oral or intravenous (IV) iron has been associated with improvement in many cardiac and renal parameters and an increased QoL. EPO itself may also play a direct role in improving the heart unrelated to the improvement of the anemia--by reducing apoptosis of cardiac and endothelial cells, increasing the number of endothelial progenitor cells, and improving endothelial cell function and neovascularization of the heart. Anemia may also play a role in the worsening of acute myocardial infarction and chronic coronary heart disease (CHD) and in the cardiovascular complications of renal transplantation. Anemia, CHF and CKD interact as a vicious circle so as to cause or worsen each other- the so-called cardio renal anemia syndrome. Only adequate treatment of all three conditions can

  12. Update in cardiomyopathies and congestive heart failure

    Directory of Open Access Journals (Sweden)

    The Heart Hospital, London, UK and Monaldi Hospital, Naples, Italy

    2012-05-01

    Full Text Available This abstract book contains four reports and all abstracts presented to the Joint Meeting: Update in cardiomyopathies and congestive heart failure, 22-23 September 2011 - Naples, Italy, endorsed by the Working Group on Myocardial and Pericardial Diseases (WG 21 of the European Society of Cardiology (ESC.

  13. Can complexity decrease in congestive heart failure?

    Science.gov (United States)

    Mukherjee, Sayan; Palit, Sanjay Kumar; Banerjee, Santo; Ariffin, M. R. K.; Rondoni, Lamberto; Bhattacharya, D. K.

    2015-12-01

    The complexity of a signal can be measured by the Recurrence period density entropy (RPDE) from the reconstructed phase space. We have chosen a window based RPDE method for the classification of signals, as RPDE is an average entropic measure of the whole phase space. We have observed the changes in the complexity in cardiac signals of normal healthy person (NHP) and congestive heart failure patients (CHFP). The results show that the cardiac dynamics of a healthy subject is more complex and random compare to the same for a heart failure patient, whose dynamics is more deterministic. We have constructed a general threshold to distinguish the border line between a healthy and a congestive heart failure dynamics. The results may be useful for wide range for physiological and biomedical analysis.

  14. SERUM CONCENTRATIONS OF HYALURONIC ACID, PROCOLLAGEN TYPE Ⅲ NH2-TERMINAL PEPTIDE, AND LAMININ IN PATIENTS WITH CHRONIC CONGESTIVE HEART FAILURE

    Institute of Scientific and Technical Information of China (English)

    Gang Li; Qing-bo Yan; Liang-ming Wei

    2006-01-01

    Objective To explore the role of serum fibrotic indices including hyaluronic acid (HA), procollagen type ⅢNH2-terminal peptide (PCⅢP), and laminin (LN) in assessing the severity of myocardial fibrosis in chronic congestive heart failure (CHF).Methods Serum levels of HA, PCⅢP, and LN in 39 patients with CHF [ 14 with New York Heart Association (NYHA) functional class Ⅱ, 21 with class Ⅲ, 4 with class Ⅳ] and in 46 patients with NYHA functional class Ⅰ were assessed by radioimmunoassay.Results The serum concentrations of HA, PCⅢP, and LN were 359.75 ± 84. 59 μg/L, 77.88±24. 67μg/L,86.73±23.90 μg/L in CHF group, and 211.60±54. 80μg/L, 64.82±23.99 μg/L, 82.26±23.98μg/L in NYHA functional class Ⅰ group, respectively. The HA level was significantly higher in CHF patients as compared with NYHA functional class Ⅰ group (P<0.05 ). However, no difference was found in the levels of PCⅢP and LN between CHF group and NYHA functional class Ⅰ group. The serum HA concentration was negatively correlated with left ventricular ejection fraction (r=-0.71, P<0.05 ).Conclusion Serum HA level may act as an indicator for myocardial fibrosis.

  15. Xamoterol in severe congestive heart failure

    DEFF Research Database (Denmark)

    Tangø, M; Lyngborg, K; Mehlsen, J;

    1992-01-01

    Twelve patients in severe congestive heart failure were given placebo, 100 mg xamoterol (Corwin) twice daily and 200 mg xamoterol twice daily, respectively, in 3 two-week periods in a double-blind randomised study. At the end of each treatment period the patients were evaluated. No differences were...... found between placebo and xamoterol in the following parameters: New York Heart Association function group index, heart volume, body weight, exercise duration on bicycle and treadmill, heart rate and systolic and diastolic blood pressure at rest. However, during exercise we found significantly lower...... heart rate and rate-pressure product during xamoterol treatment. This reduction is probably indicating occupation of beta-adrenoreceptors with concomitant reduced oxygen consumption during exercise....

  16. Relationship Between Prohormone Brain Natriuretic Peptide (NT-proBNP Level and Severity of Pulmonary Dysfunction in Patients With Chronic Congestive Heart Failure

    Directory of Open Access Journals (Sweden)

    Nazemiyeh Masoud

    2015-03-01

    Full Text Available Introduction: Congestive heart failure (CHF is a common disease and its prevalence is increasingin industrialized countries. NT-proBNP measurement is an established diagnostic test fordiagnosis of CHF in patients who present to emergency room with acute dyspnea. The primaryobject of this study was to determine the relationship between levels of brain natriuretic peptideprecursor and severity of lung function impairment in patients with chronic CHF.Methods: This cross-sectional and analytical study that performed in Tuberculosis andLung Disease Research Center of Tabriz University of Medical Sciences on 95 patients withchronic heart failure, and relation between NT-proBNP levels and pulmonary functionparameters were examined.Results: Sixty-four patients were male and 31 were female. The average age of male and femaleswas 62.90 ± 11.54 and 61.61 ± 11.98 years, respectively. A significant inverse linear correlationwas found between NT-proBNP and FEV1 (P<0.001, r = -0.367, FVC (P<0.001, r = -0.444,TLC (P=0.022, r = -0.238, maximal midexpiratory flow (MMEF (P=0.047, r = -0.207 andleft ventricular ejection fraction (LVEF (P<0.001, r = -0.461. A significant positive linearcorrelation was found between NT-proBNP and FEV1/FVC (P =0.013, r = 0.257, RV/TLC (P =0.003, r=0.303 and 5 Hz Raw (r = 0.231, P = 0.024.Conclusion: This study showed that, both restrictive and obstructive ventilator impairments canoccur in chronic CHF and as NT-proBNP increases appropriate to hemodynamic deterioration,pulmonary dysfunction increases.

  17. CONGESTIVE HEART FAILURE: EXPERIMENTAL MODEL

    Directory of Open Access Journals (Sweden)

    Antonio Francesco Corno

    2013-10-01

    Full Text Available INTRODUCTION.Surgically induced, combined volume and pressure overload has been used in rabbits to create a simplified and reproducible model of acute left ventricular (LV failure.MATERIALS AND METHODS.New Zealand white male rabbits (n=24, mean weight 3.1±0.2kg were randomly assigned to either the Control group (n=10 or to the Heart Failure group (HF, n=14. Animals in the Control group underwent sham procedures. Animals in the HF group underwent procedures to induce LV volume overload by inducing severe aortic valve regurgitation with aortic cusp disruption and pressure overload using an occlusive silver clip positioned around the pre-renal abdominal aorta.RESULTS.Following Procedure-1 (volume overload echocardiography confirmed severe aortic regurgitation in all animals in the HF group, with increased mean pulse pressure difference from 18±3mmHg to 38±3mmHg (P

  18. New auxiliary indicators for the differential diagnosis of functional cardiorespiratory limitation in patients with chronic obstructive pulmonary disease and congestive heart failure

    Directory of Open Access Journals (Sweden)

    Cesar Marcelo de Castro

    2003-01-01

    Full Text Available OBJECTIVE: To differentiate the nature of functional cardiorespiratory limitations during exercise in individuals with chronic obstructive pulmonary disease (COPD or congestive heart failure (CHF and to determine indicators that may help their classifications. METHODS: The study comprised 40 patients: 23 with COPD and 17 with CHF. All individuals underwent maximal cardiopulmonary exercise testing on a treadmill. RESULTS: The values of peak gas exchange ratio (R peak, peak carbon dioxide production (VCO2 peak, and peak oxygen ventilatory equivalent (V E O2 peak were higher in the patients with CHF than in those with COPD, and, therefore, those were the variables that characterized the differences between the groups. For group classification, the differentiating functions with the R peak, VCO2 peak (L/min, and V E O2 peak variables were used as follows: group COPD: - 44.886 + 78.832 x R peak + 5.442 x VCO2 peak + 0.336 x V E O2 peak; group CHF: - 69.251 + 89.740 x R peak + 8.461 x VCO2 peak + 0.574 x V E O2 peak. The differentiating function, whose result is greater, correctly classifies the patient's group as 90%. CONCLUSION: The R peak, VCO2 peak, and V E O2 peak values may be used to identify the cause of the functional cardiorespiratory limitations in patients with COPD and CHF.

  19. Abdominal contributions to cardiorenal dysfunction in congestive heart failure.

    Science.gov (United States)

    Verbrugge, Frederik H; Dupont, Matthias; Steels, Paul; Grieten, Lars; Malbrain, Manu; Tang, W H Wilson; Mullens, Wilfried

    2013-08-01

    Current pathophysiological models of congestive heart failure unsatisfactorily explain the detrimental link between congestion and cardiorenal function. Abdominal congestion (i.e., splanchnic venous and interstitial congestion) manifests in a substantial number of patients with advanced congestive heart failure, yet is poorly defined. Compromised capacitance function of the splanchnic vasculature and deficient abdominal lymph flow resulting in interstitial edema might both be implied in the occurrence of increased cardiac filling pressures and renal dysfunction. Indeed, increased intra-abdominal pressure, as an extreme marker of abdominal congestion, is correlated with renal dysfunction in advanced congestive heart failure. Intriguing findings provide preliminary evidence that alterations in the liver and spleen contribute to systemic congestion in heart failure. Finally, gut-derived hormones might influence sodium homeostasis, whereas entrance of bowel toxins into the circulatory system, as a result of impaired intestinal barrier function secondary to congestion, might further depress cardiac as well as renal function. Those toxins are mainly produced by micro-organisms in the gut lumen, with presumably important alterations in advanced heart failure, especially when renal function is depressed. Therefore, in this state-of-the-art review, we explore the crosstalk between the abdomen, heart, and kidneys in congestive heart failure. This might offer new diagnostic opportunities as well as treatment strategies to achieve decongestion in heart failure, especially when abdominal congestion is present. Among those currently under investigation are paracentesis, ultrafiltration, peritoneal dialysis, oral sodium binders, vasodilator therapy, renal sympathetic denervation and agents targeting the gut microbiota. PMID:23747781

  20. Effect of dyspnea and clinical variables on the quality of life and functional capacity in patients with chronic obstructive pulmonary disease and congestive heart failure

    Institute of Scientific and Technical Information of China (English)

    Hale Karapolat; Sibel Eyigor; Alev Atasever; Mehdi Zoghi; Sanem Nalbantgil; Berrin Durmaz

    2008-01-01

    Background Chronic obstructive pulmonary disease(COPD)and congestive heart failure(CHF)are two chronic diseases that affect negatively the functional condition and quality of life of patients.We assessed the effect of symptoms and clinical variables on the functional capacity and quality of life in COPD and CHF patients.Methods The study included 42 COPD and 39 CHF patients.In both patient groups,dyspnea was assessed using Borg scale;functional capacity by shuttle-walk and cardiopulmonary exercise test and quailty of life by short fOrm-36 (SF36).Results No statistically significant difference was found in neither of the two disease groups regarding the dyspnea score,shuttle-walk test and the maiority of subgroup scores of SF36 (P>0.05).A statistically significant difference was obsewed in peak VO2 in favor of COPD group(P<0.05).No significant relationship was established between dyspnea score and forced expiratory volume in one second(FEV1)in COPD patients,and left ventricular ejection fraction(L.VEF)in CHF patients (P>0.05).A significant negative correlation was obsewed between dyspnea score and functional capacity tests in both disease groups(P<0.05).On the other hand,no relationship was found between L-VEF and FEV1 and quailty of life and functional capacity (P>0.05),Conclusions It was revealed that symptoms have an impact on functional capacity and quality of life in both disease groups,however,objective indicators of disease severity do not show a similar relationship.Therefore,in addition to the objective data related to the disease,we recommend that symptoms should also be taken into consideration to assess cardiopulmonary rehabilitation program and during following-up.

  1. Stem Cell Therapy for Congestive Heart Failure

    Directory of Open Access Journals (Sweden)

    Gunduz E

    2011-01-01

    experience from this patient. ConclusionStudies in the era of cardiac stem cell therapy are heterogenous. It is not yet possible to comment on the most appropriate stem cell type and route of administration. When we assess the results from literature and the improvement in our own patient we think stem cell therapy can be an option for bridging to heart transplantation or an adjuvant therapy for CHF.References1.Ohnishi S, Ohgushi H, Kitamura S, Nagaya N. Mesenchymal stem cells for the treatment of heart failure. Int J Hematol 2007; 86: 17-21.2.Bukharovich IF, Kukin M. Optimal medical therapy for heart failure. Prog Cardiovasc Dis 2006; 48: 372-385.3.Tongers J, Losordo DW, Landmesser U. Stem and progenitor cell-based therapy in ischaemic heart disease: promise, uncertainties and challenges. Eur Heart J 2011. Epub ahead of print.4.Krause DS, Theise ND, Collector MI, Henegariu O, Hwang S, Gardner R, Neutzel S, Sharkis SJ. Multi-organ, multi-lineage engraftment by a single bone marrow-derived stem cell. Cell 2001; 105:369-377.5.Strauer BE, Yousef M, Schannwell CM. the acute and long term effects of intracoronary stem cell transplantation in 191 patients with chronic heart failure: the STAR-heart study. Eur J Heart Fail 2010; 12:721-729.6.Hamano K, Nishida M, Mirata K, Mikarno A, Li TS, Harada M, Miura T, Matsuzaki M, Esato K. Local implantation of autologous bone marrow cells for therapeutic angiogenesis in patients with ishemic heart disease: clinical trial and preliminary results Jpn Circ J. 2001; 65:845-847.7.Brehm M, Zeus T, Strauer BE. Stem cells-clinical application and perspectives. Herz 2002; 27:611-620.8.Ozbaran M, Omay SB, Nalbantgil S, Kultursay H, Kumanlioglu K, Nart D, Pektok E. Autologous peripheral stem cell transplantation in patients with congestive heart failure due to ischemic heart disease. Eur J Cardiothorac Surg. 2004; 25:342-350.9.Abdel-Latif A, Bolli R, Tleyjeh IM, Montori VM, Perin EC, Hornung CA, Zuba-Surma EK, Al-Mallah M, Dawn B. Adult bone marrow

  2. Takayasu Arteritis with Rheumatic Heart Disease with Congestive Cardiac Failure mimicking as having Infective Endocarditis

    OpenAIRE

    Upadhyay, Piyush

    2013-01-01

    Takayasu Arteritis (TA) is a chronic, idiopathic and granulomatous vasculitis of the large arteries. It involves primarily the aorta, especially aortic proximal branches, and occasionally the pulmonary arteries. We report a 10 year old boy with Takayasu arteritis with Rheumatic heart disease who developed congestive heart failure with valvular heart disease mimicking as having infective endocarditis. Complete aortogram revealed narrowing of abdominal aorta, superior ...

  3. Advanced Congestive Heart Failure Associated With Disseminated Intravascular Coagulopathy.

    Science.gov (United States)

    Sarcon, Annahita; Liu, Xiaoli; Ton, David; Haywood, James; Hitchcock, Todd

    2015-01-01

    Background. Disseminated intravascular coagulopathy (DIC) is a complication of an underlying disease and not a primary illness. It is most commonly associated with sepsis, trauma, obstetrical complications, and malignancies. There are very few cases in the literature illustrating the association between DIC and congestive heart failure. Findings. In this report, we present a case of severe congestive heart failure, leading to biventricular thrombi and subsequently DIC. Conclusion. We suggest that the association between congestive heart failure and DIC is an underrecognized one. Congestive heart failure continues to remain a major cause of morbidity and mortality despite advances in medical therapies. Thus far, the precise role of coagulation factors in congestive heart failure is unknown. Further investigations are needed to elucidate the pathophysiology of congestive heart failure and coagulation factors.

  4. Advanced Congestive Heart Failure Associated With Disseminated Intravascular Coagulopathy.

    Science.gov (United States)

    Sarcon, Annahita; Liu, Xiaoli; Ton, David; Haywood, James; Hitchcock, Todd

    2015-01-01

    Background. Disseminated intravascular coagulopathy (DIC) is a complication of an underlying disease and not a primary illness. It is most commonly associated with sepsis, trauma, obstetrical complications, and malignancies. There are very few cases in the literature illustrating the association between DIC and congestive heart failure. Findings. In this report, we present a case of severe congestive heart failure, leading to biventricular thrombi and subsequently DIC. Conclusion. We suggest that the association between congestive heart failure and DIC is an underrecognized one. Congestive heart failure continues to remain a major cause of morbidity and mortality despite advances in medical therapies. Thus far, the precise role of coagulation factors in congestive heart failure is unknown. Further investigations are needed to elucidate the pathophysiology of congestive heart failure and coagulation factors. PMID:26788528

  5. Cell therapy in congestive heart failure

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    Congestive heart failure (CHF) has emerged as a major worldwide epidemic and its main causes seem to be the aging of the population and the survival of patients with post-myocardial infarction. Cardiomyocyte dropout (necrosis and apoptosis) plays a critical role in the progress of CHF; thus treatment of CHF by exogenous cell implantation will be a promising medical approach. In the acute phase of cardiac damage cardiac stem cells (CSCs) within the heart divide symmetrically and/or asymmetrically in response to the change of heart homeostasis, and at the same time homing of bone marrow stem cells (BMCs) to injured area is thought to occur, which not only reconstitutes CSC population to normal levels but also repairs the heart by differentiation into cardiac tissue. So far, basic studies by using potential sources such as BMCs and CSCs to treat animal CHF have shown improved ventricular remodelling and heart function. Recently, however, a few of randomized, double-blind, placebo-controlled clinical trials demonstrated mixed results in heart failure with BMC therapy during acute myocardial infarction.

  6. 葶丹生脉汤治疗慢性充血性心力衰竭52例%The Draba Dan Shengmai for 52 cases with Chronic Congestive Heart Failure

    Institute of Scientific and Technical Information of China (English)

    景晓玲; 李录花

    2012-01-01

    目的:观察葶丹生脉汤治疗慢性充血性心力衰竭的临床疗效.方法:选取慢性充血性心力衰竭患者102例,随机分为治疗组52例,对照组50例,对照组口服单硝酸异山梨酯缓释片、阿司匹林肠溶片等基础治疗,治疗组加服葶丹生脉汤,疗程均为2周.结果:治疗组总有效率明显高于对照组.结论:葶丹生脉汤治疗充血性心力衰竭疗效可靠.%Objective: To observe the clinical efficacy of Draba Dan Shengmai soup for chronic congestive heart failure. Methods; 102 cases patients with chronic congestive heart failure, were randomly divided into 52 cases treatment group with the Draba Dan Shengmai stirred and 50 cases control group with basic treatments such as mononitrate isosorbide mononitrate sustained release tablets, aspirin, enteric-coated tablets for lasted two weeks. Results; the treatment group was significantly higher efficiency. Conclusion; Draba Dan Shengmai soup for congestive heart failure is effective and reliable.

  7. Congestive heart failure in acromegaly: A review of 6 cases

    OpenAIRE

    Dutta, P.; Das, S; Bhansali, A; S K Bhadada; B V Rajesh; Reddy, K. S.; Vaiphei, K; K. K. Mukherjee; Pathak, A.; Shah, V N

    2012-01-01

    Background: Though cardiac involvement is common in acromegaly, overt congestive heart failure is uncommon. Materials and Methods: This is retrospective analysis of hospital record between 1996 and 2007. We analyzed records of 150 consecutive patients with acromegaly. We included the patients with acromegaly those who had overt congestive heart failure either at presentation or during the course of illness for the present analysis. The diagnosis of acromegaly and congestive cardiac failure we...

  8. Ivabradine, heart failure and chronic kidney disease

    Directory of Open Access Journals (Sweden)

    Luca Di Lullo

    2015-12-01

    Full Text Available The incidence and prevalence of congestive heart failure are actually increasing worldwide, especially in Western countries. In Europe and the United States, congestive heart failure represents a disabling clinical disease, accountable for increased hospitalization and health care costs. European guidelines have underlined the importance of pharmacological treatment to improve both patients’ outcomes and quality of life. The latest clinical trials to evaluate ivabradine’s efficacy have underlined its usefulness as a stand-alone medication and in combination with conventional congestive heart failure therapy, including in chronic kidney disease patients.

  9. Clinical analysis of thyroid hormone changes in patients with chronic congestive heart failure%慢性充血性心力衰竭患者甲状腺激素变化临床分析

    Institute of Scientific and Technical Information of China (English)

    袁云华; 郑文武; 汪代杰

    2009-01-01

    目的 观察慢性充血性心力衰竭(CHF)患者血清甲状腺激素的变化情况.方法 用化学发光免疫分析技术微粒子酶免分析法测定72例CHF患者和48例健康者血清甲状腺激素水平.结果 CHF患者与健康者相比血清三碘甲状腺原氨酸、游离三碘甲状腺原氨酸明显降低,差异具有统计学意义(P<0.05);而总甲状腺素浓度、游离甲状腺素、促甲状腺激素2组间相似,差异无统计学意义(P0.05).结论 慢性充血性心力衰竭患者常合并正常甲状腺功能病态综合征.%Objective To observe the thyroid hormones changes in patients with chronic congestive heart failure. Methods Serum thyroid hormones levels were analyzed in 72 patients with chronic congestive heart failure and forty-eight healthy people by the chemiluminescence immune analytical technique. Results T4、FT4、TSH showed no difference between the two groups. Conclusion Patients with chronic congestive heart failure usually develop euthroid sick syndrome(ESS).

  10. Impact of β-blocker selectivity on long-term outcomes in congestive heart failure patients with chronic obstructive pulmonary disease

    Directory of Open Access Journals (Sweden)

    Kubota Y

    2015-03-01

    Full Text Available Yoshiaki Kubota, Kuniya Asai, Erito Furuse, Shunichi Nakamura, Koji Murai, Yayoi Tetsuou Tsukada, Wataru Shimizu Department of Medicine (Division of Cardiology, Nippon Medical School, Bunkyo-ku, Tokyo, Japan Background: Chronic obstructive pulmonary disease (COPD is present in approximately one-third of all congestive heart failure (CHF patients, and is a key cause of underprescription and underdosing of β-blockers, largely owing to concerns about precipitating respiratory deterioration. For these reasons, the aim of this study was to evaluate the impact of β-blockers on the long-term outcomes in CHF patients with COPD. In addition, we compared the effects of two different β-blockers, carvedilol and bisoprolol. Methods: The study was a retrospective, non-randomized, single center trial. Acute decompensated HF patients with COPD were classified according to the oral drug used at discharge into β-blocker (n=86; carvedilol [n=52] or bisoprolol [n=34] and non-β-blocker groups (n=46. The primary endpoint was all-cause mortality between the β-blocker and non-β-blocker groups during a mean clinical follow-up of 33.9 months. The secondary endpoints were the differences in all-cause mortality and the hospitalization rates for CHF and/or COPD exacerbation between patients receiving carvedilol and bisoprolol. Results: The mortality rate was higher in patients without β-blockers compared with those taking β-blockers (log-rank P=0.039, and univariate analyses revealed that the use of β-blockers was the only factor significantly correlated with the mortality rate (hazard ratio: 0.41; 95% confidence interval: 0.17–0.99; P=0.047. Moreover, the rate of CHF and/or COPD exacerbation was higher in patients treated with carvedilol compared with bisoprolol (log-rank P=0.033. In the multivariate analysis, only a past history of COPD exacerbation significantly increased the risk of re-hospitalization due to CHF and/or COPD exacerbation (adjusted hazard

  11. Oral amrinone for the treatment of chronic congestive heart failure: results of a multicenter randomized double-blind and placebo-controlled withdrawal study.

    Science.gov (United States)

    DiBianco, R; Shabetai, R; Silverman, B D; Leier, C V; Benotti, J R

    1984-11-01

    A placebo-controlled study was employed to evaluate the effects of oral amrinone in patients with congestive heart failure. After a baseline period of at least 4 weeks of standard treatment for refractory congestive heart failure, oral amrinone was added to the treatment regimen of 173 patients. Patients were predominantly male (89%), aged 24 to 76 years (mean 54), with ischemic (52%) or idiopathic (37%) dilated cardiomyopathy, in New York Heart Association functional class II (40%), III (59%) and IV (1%) and having a mean (+/- standard deviation) left ventricular ejection fraction of 25 +/- 15%. Phase 1: After the addition of amrinone (113 +/- 33 mg three times daily), 52 patients (30%) showed a maximal increase in treadmill exercise time exceeding 2 minutes (Naughton protocol), 72 (42%) had a lesser increase, 24 (14%) developed limiting adverse reactions, 20 (12%) died and 5 dropped out of the study. Fifty-two "responders" (30%) who were free of limiting side effects and had a greater than 2 minute increase in exercise time were randomized in double-blind fashion to continued amrinone or switched to placebo (each plus standard treatment) for an additional 12 weeks. Phase 2: Comparison of 31 of these 52 responders who continued to receive amrinone with the remaining 21 randomized to placebo revealed no significant differences in vital signs, indexes of left ventricular size and function, systolic time intervals or maximal exercise time. Continued follow-up study of patients receiving either amrinone or placebo revealed decreases in exercise times of 7 and 10%, respectively (both p less than 0.05 compared with before randomization). Episodes of worsened congestive heart failure severe enough to mandate termination of double-blind treatment were as frequent in patients taking placebo (4[18%] of 21) as in those taking amrinone (4[13%] of 31; p = NS). The average symptom score and functional class of each treatment group remained comparable. Adverse effects such as

  12. CONGESTIVE HEART FAILURE IN DOGS IS ASSOCIATED WITH INCREASED PLATELET LEUKOCYTE AGGREGATION MEASURED BY FLOW CYTOMETRY

    DEFF Research Database (Denmark)

    Tarnow, Inge; Andreasen, Susanne SH; Olsen, Lisbeth Høier;

    2010-01-01

    Sciences, Faculty of Life Science, University of Copenhagen, Denmark. Chronic congestive heart failure (CHF) in humans is associated with abnormal hemostasis, and changes in hemostatic biomarkers carry a poor prognosis. CHF in dogs has been associated with plasma markers of hypercoagulability, however......CONGESTIVE HEART FAILURE IN DOGS IS ASSOCIATED WITH ENHANCED PLATELET-LEUKOCYTE AGGREGATES - A MARKER FOR PLATELET ACTIVATION. I Tarnow1, LH Olsen2, SHS Andreasen2, SG Moesgaard2, CE Rasmussen2, AT Kristensen1, T Falk2. 1Departments of Small Animal Clinical Sciences and 2Animal and Veterinary Basic......, platelet activation markers have not been investigated in dogs with clinical signs of heart disease. We hypothesized that platelet surface activation markers are higher in dogs with CHF compared to age-matched controls without clinical signs of heart failure. Dogs with compensated congestive heart failure...

  13. 酒石酸美托洛尔注射液治疗慢性充血性心力衰竭的临床分析%Clinical Analysis of Metoprolol in Treatment of Chronic Congestive Heart Failure

    Institute of Scientific and Technical Information of China (English)

    朱丽翠; 马凯

    2015-01-01

    目的:分析酒石酸美托洛尔注射液治疗慢性充血性心力衰竭的效果。方法88例患者分为治疗组(常规治疗+酒石酸美托洛尔注射液)和对照组(常规治疗)各44例。结果两组治疗效果与治疗后心功能变化对比,P<0.05。结论酒石酸美托洛尔注射液治疗慢性充血性心力衰竭效果较好。%Objective To analyze the effect of metoprolol on chronic congestive heart failure. Methods 88 patients were divided into treatment group (conventional treatment+tartaric acid and metoprolol injection) and control group (routine treatment) , 44 cases in each group. Results Two groups of treatment effect and the middle of the back function changes in contrast, P<0.05. Conclusion The effect of metoprolol in treatment of chronic congestive heart failure is good.

  14. 温阳活血利水方治疗慢性充血性心力衰竭临床观察%Effect of Warming Yang Promoting Blood Deleting Urine Prescription on Patients with Chronic Congestive Heart Failure

    Institute of Scientific and Technical Information of China (English)

    郭美珠; 肖燕倩

    2011-01-01

    Objective: To evaluate the effect of warming Yang promoting blood deleting urine prescription on the patients with chronic congestive heart failure. Method; In the study, 61 patients with chronic congestive heart failure have been randomly divided into treatment group and control group. The 30 patients in the treatment group have been given warming Yang promoting blood deleting urine prescription and western medicine, and 31 patients in the control group were treated with western medicine. Four weeks were taken as a whole course. The symptoms and related items were measured and recorded before and after treatment Results; Warming Yang promoting blood deleting urine prescription can improve the disease more significantly than that in the control group , such as cardiac function, clinical symptoms and life quality of patients. Conclusion: Wanning Yang promoting blood deleting urine prescription is safe and effective in treating chronic congestive heart failure.%目的:观察温阳活血利水方治疗慢性充血性心力衰竭的临床疗效。方法:将61例慢性充血性心力衰竭患者随机分为2组,治疗组30例,给予基础治疗加温阳活血利水方口服,对照组31例给予基础治疗,4周为一个疗程,观察2组患者治疗前后的心功能、中医证候积分、生活质量积分。结果:温阳活血利水方有明显提高心功能、改善临床症状、改善生活质量积分的作用。结论:温阳活血利水方疗效确切,服用安全,无不良反应。

  15. Metoprolol for chronic congestive heart failure: a clinical analysis of 46 cases%46例无创正压治疗COPD急性加重期伴呼吸衰竭临床分析

    Institute of Scientific and Technical Information of China (English)

    许进雄

    2010-01-01

    目的 探讨无创正压治疗COPD急性加重期伴呼衰的临床疗效.方法 选择2007年1月-2009年12月收治于我院的COPD急性加重期伴呼衰患者92例,随机分为观察组(46例)和对照组(46例),对照组采用常规疗法治疗;治疗组在常规治疗的基础上加用无创正压通气治疗.比较两组治疗效果.结果 观察组在治疗后PaCO2(42.24±6.22)mmHg、呼吸频率(21.2±1.3)次/分、PaO2(89.26±9.27)mmHg,治疗效果显著优于对照组(P<0.05).结论 无创正压通气治疗COPD急性加重期伴呼衰患者,能有效的降低PaCO2、呼吸频率和提高PaO2等,具有较好的临床疗效.%Objective To explore the efficay of metoprolol for chronic congestive heart failure. Methods 92 patients with chronic congestive heart failure admitted during the period of January 2008 to December 2009 were randomly assigned to receive combination therapy with cardiac glycosides, diuretics, and ACE inhibitors (control group) or the combination therapy plus metoprolol (study group). The efficacy was compared between the two groups. Results 6 months after treatment, the study group was superior to the control group in efficacy (91.3% vs. 76.1% for total effective rate, P<0.05). Conclusions Metoprolol for chronic congestive heart failure can improve LVEF, LVDd, and LVPWT, resulting in a better clinical efficacy.

  16. Gene transfer for congestive heart failure: update 2013.

    Science.gov (United States)

    Tang, Tong; Hammond, H Kirk

    2013-04-01

    Congestive heart failure is a major cause of morbidity and mortality with increasing social and economic costs. There have been no new high impact therapeutic agents for this devastating disease for more than a decade. However, many pivotal regulators of cardiac function have been identified using cardiac-directed transgene expression and gene deletion in preclinical studies. Some of these increase function of the failing heart. Altering the expression of these pivotal regulators using gene transfer is now either being tested in clinical gene transfer trials, or soon will be. In this review, we summarize recent progress in cardiac gene transfer for clinical congestive heart failure.

  17. Case of congestive heart failure induced by therapeutic irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Kushigami, Motohiko; Suruda, Hidetoshi; Mizukoshi, Masato; Umemoto, Masaaki; Fujiwara, Setsuko; Yamamoto, Katsuhiro; Ueno, Yuji; Nishio, Ichiro; Masuyama, Yoshiaki

    1985-02-01

    Valvular insufficiency in radiation-induced heart disease is very rare. We described a patient, 53 years old woman, who developed congestive heart failure 2.5 years later following radiotherapy for esophageal carcinoma. The findings on examinations including cardiac catheterization revealed pericarditis with effusion, mitral and tricuspid valve insufficiency and pulmonary infarction. (author).

  18. Self-perceived symptoms and care needs of patients with severe to very severe chronic obstructive pulmonary disease, congestive heart failure or chronic renal failure and its consequences for their closest relatives: the research protocol

    Directory of Open Access Journals (Sweden)

    Schols Jos MGA

    2008-05-01

    Full Text Available Abstract Background Recent research shows that the prevalence of patients with very severe chronic obstructive pulmonary disease (COPD, congestive heart failure (CHF and chronic renal failure (CRF continues to rise over the next years. Scientific studies concerning self-perceived symptoms and care needs in patients with severe to very severe COPD, CHF and CRF are scarce. Consequently, it will be difficult to develop an optimal patient-centred palliative care program for patients with end-stage COPD, CHF or CRF. The present study has been designed to assess the symptoms, care needs, end-of-life care treatment preferences and communication needs of patients with severe to very severe COPD, CHF or CRF. Additionally, family distress and care giving burden of relatives of these patients will be assessed. Methods/design A cross-sectional comparative and prospective longitudinal study in patients with end-stage COPD, CHF or CRF has been designed. Patients will be recruited by their treating physician specialist. Patients and their closest relatives will be visited at baseline and every 4 months after baseline for a period of 12 months. The following outcomes will be assessed during home visits: self-perceived symptoms and care needs; daily physical functioning; general health status; end-of-life care treatment preferences; end-of-life care communication and care-giver burden of family caregivers. Additionally, end-of-life care communication and prognosis of survival will be assessed with the physician primarily responsible for the management of the chronic organ failure. Finally, if patients decease during the study period, the baseline preferences with regard to life-sustaining treatments will be compared with the real end-of-life care. Discussion To date, the symptoms, care needs, caregiver burden, end-of-life care treatment preferences and communication needs of patients with very severe COPD, CHF or CRF remain unknown. The present study will

  19. Increased walking variability in elderly persons with congestive heart failure

    Science.gov (United States)

    Hausdorff, J. M.; Forman, D. E.; Ladin, Z.; Goldberger, A. L.; Rigney, D. R.; Wei, J. Y.

    1994-01-01

    OBJECTIVES: To determine the effects of congestive heart failure on a person's ability to walk at a steady pace while ambulating at a self-determined rate. SETTING: Beth Israel Hospital, Boston, a primary and tertiary teaching hospital, and a social activity center for elderly adults living in the community. PARTICIPANTS: Eleven elderly subjects (aged 70-93 years) with well compensated congestive heart failure (NY Heart Association class I or II), seven elderly subjects (aged 70-79 years) without congestive heart failure, and 10 healthy young adult subjects (aged 20-30 years). MEASUREMENTS: Subjects walked for 8 minutes on level ground at their own selected walking rate. Footswitches were used to measure the time between steps. Step rate (steps/minute) and step rate variability were calculated for the entire walking period, for 30 seconds during the first minute of the walk, for 30 seconds during the last minute of the walk, and for the 30-second period when each subject's step rate variability was minimal. Group means and 5% and 95% confidence intervals were computed. MAIN RESULTS: All measures of walking variability were significantly increased in the elderly subjects with congestive heart failure, intermediate in the elderly controls, and lowest in the young subjects. There was no overlap between the three groups using the minimal 30-second variability (elderly CHF vs elderly controls: P congestive heart failure when using the overall variability. For all four measures, there was no overlap in any of the confidence intervals, and all group means were significantly different (P < 0.05).

  20. Prognostic impact of carboxylesterase 1 gene variants in patients with congestive heart failure treated with angiotensin-converting enzyme inhibitors

    DEFF Research Database (Denmark)

    Nelveg-Kristensen, Karl E; B. Madsen, Majbritt; Torp-Pedersen, Christian;

    2016-01-01

    with congestive heart failure (CHF). METHODS: Danish patients with chronic CHF enrolled in the previously reported Echocardiography and Heart Outcome Study were categorized according to their CES1 variants and followed up for up to 10 years. Risk for cardiovascular death and all-cause death was modeled by Cox...

  1. Dronedarone in patients with congestive heart failure: insights from ATHENA

    DEFF Research Database (Denmark)

    Hohnloser, Stefan H; Crijns, Harry J G M; van Eickels, Martin;

    2010-01-01

    Dronedarone is a new multichannel blocking antiarrhythmic drug for treatment of atrial fibrillation (AF). In patients with recently decompensated congestive heart failure (CHF) and depressed LV function, the drug was associated with excess mortality compared with a placebo group. The present study...

  2. Teaching Congestive Heart Failure to Doctor of Pharmacy Students.

    Science.gov (United States)

    Parker, Robert B.

    1992-01-01

    This paper summarizes a lecture given to pharmacy students that emphasizes the pathophysiologic mechanisms causing congestive heart failure and the effects of drugs on these mechanisms. The approach shows the importance of drug therapy in this disorder and how this knowledge can improve patient care. An appendix provides a case study. (GLR)

  3. Effects of Traditional Chinese Medicine on Congestive Heart Failure

    Institute of Scientific and Technical Information of China (English)

    任海玲; 李海芸; 江时森

    2002-01-01

    Congestive heart failure (CHF) belongs to the category of "palpitation", "chest pain", "retention of phlegm and fluid" etc. in traditional Chinese medicine (TCM). The medical books of past generations recorded a lot of important prescriptions to treat above-mentioned symptoms. This article briefly summarized certain TCM prescriptions on pharmacological actions and therapeutic effects of CHF.

  4. Psychobiology of depression/distress in congestive heart failure

    OpenAIRE

    York, Kaki M.; Hassan, Mustafa; Sheps, David S.

    2008-01-01

    Heart failure affects millions of Americans and new diagnosis rates are expected to almost triple over the next 30 years as our population ages. Affective disorders including clinical depression and anxiety are common in patients with congestive heart failure. Furthermore, the presence of these disorders significantly impacts quality of life, medical outcomes, and healthcare service utilization. In recent years, the literature has attempted to describe potential pathophysiologic mechanisms re...

  5. Respiratory sleep disorders in patients with congestive heart failure.

    Science.gov (United States)

    Naughton, Matthew T

    2015-08-01

    Respiratory sleep disorders (RSD) occur in about 40-50% of patients with symptomatic congestive heart failure (CHF). Obstructive sleep apnea (OSA) is considered a cause of CHF, whereas central sleep apnea (CSA) is considered a response to heart failure, perhaps even compensatory. In the setting of heart failure, continuous positive airway pressure (CPAP) has a definite role in treating OSA with improvements in cardiac parameters expected. However in CSA, CPAP is an adjunctive therapy to other standard therapies directed towards the heart failure (pharmacological, device and surgical options). Whether adaptive servo controlled ventilatory support, a variant of CPAP, is beneficial is yet to be proven. Supplemental oxygen therapy should be used with caution in heart failure, in particular, by avoiding hyperoxia as indicated by SpO2 values >95%.

  6. An intriguing association between congestive heart failure and An intriguing association between congestive heart failure and diabetes mellitus

    Institute of Scientific and Technical Information of China (English)

    SHEN Wei-feng

    2010-01-01

    @@ The prevalence of type 2 diabetes is rising at an alarming rate in China due to aging of the population,increased frequency of obesity, and suboptimal nutritional habits.~1 Although many diabetic Patients now survive severe coronary lesions or myocardial infarction as a result of dramatic advances in the management of ischemic heart disease in general and acute myocardial infarction specifically,~(2,3) they are subsequently succumbing to the consequences of myocardial damage, with an increased incidence of congestive heart failure (CHF).~4

  7. Congestive heart failure in acromegaly: A review of 6 cases

    Directory of Open Access Journals (Sweden)

    P Dutta

    2012-01-01

    Full Text Available Background: Though cardiac involvement is common in acromegaly, overt congestive heart failure is uncommon. Materials and Methods: This is retrospective analysis of hospital record between 1996 and 2007. We analyzed records of 150 consecutive patients with acromegaly. We included the patients with acromegaly those who had overt congestive heart failure either at presentation or during the course of illness for the present analysis. The diagnosis of acromegaly and congestive cardiac failure were based on standard criteria. Results:Out of 150 patients with acromegaly, 6 patients had overt CHF (4.0%, of which 4 presented with the features of CHF and 2 developed during the course of illness. Three patients had hypertension and 1 had diabetes. Baseline echocardiography showed severe biventricular dysfunction and global hypokinesia in all. Angiography showed dilated hypokinetic left ventricle with normal coronaries in 3, it was confirmed at autopsy in 1. Three underwent trans-sphenoidal surgery, 1 received somatostatin analogue as primary treatment modality. Normalization of growth hormone and IGF-1 led to improvement in cardiac function in 1, 1 patient lost to follow up, and 4 died during the course of illness. In 1 patient, autopsy was performed and cardiac specimen revealed normal coronaries, concentric ventricular hypertrophy, and dilatation with myofibrolysis and interfascicular fibrosis. Conclusion:Prevalence of overt CHF is 4% in present series. Overt CHF carries poor prognosis and hence, this complication should be recognized at earliest, and medical management to normalized cardiac function should be given utmost priority.

  8. Cardiac sympathetic nerve terminal function in congestive heart failure

    Institute of Scientific and Technical Information of China (English)

    Chang-seng LIANG

    2007-01-01

    Increased cardiac release of norepinephrine (NE) and depleted cardiac stores of NE are two salient features of the human failing heart. Researches from my labo-ratory have shown that these changes are accompanied by a functional defect of NE uptake in the cardiac sympathetic nerve terminals. Our studies have shown that the decrease of NE uptake is caused by reduction of NE transporter density in the sympathetic nerve endings, and this change is responsible, at least in part, for the increased myocardial interstitial NE, decreased myocardial adrenoceptor density, and increased myocyte apoptosis in experimental cardiomyopathies. We have also provided evidence in both intact animals and cultured PC12 cells that the decrease of NE transporter is induced by the actions of oxidative metabolites of exogenous NE, involving endoplasmic reticulum stress and impaired N-glycosylation of the NE transporter. This change in the cardiac sympathetic NE uptake function, as demonstrated by [123I] metaiodobenzylguanidine in human studies, may not only serve as an important prognostic variable in patients with congestive heart failure, but also be used as a surrogate for the efficacies of various therapeutic interventions for heart failure. Finally, increasing evidence suggests and further studies are needed to show that the cardiac sympathetic nerve terminal function may be a direct target for pharmacologic treatment of congestive heart failure.

  9. Low-salt diet and hyponatremia in chronic congestive heart failure%慢性充血性心力衰竭低盐饮食与低钠血症

    Institute of Scientific and Technical Information of China (English)

    姚亚丽; 李俨; 秦建茹; 张博

    2009-01-01

    目的 探讨慢性充血性心力衰竭(CHF)患者合并低钠血症的病因、后果及治疗措施.方法 120例慢性CHF患者,心功能NYHA分级Ⅲ~Ⅳ级,按就诊先后随机分为观察组60例和对照组60例.观察组给予常规抗心力衰竭治疗和低盐饮食,对照组给予常规抗心力衰竭治疗和正常饮食,观察期3个月.结果 观察组中有32例发生轻度低钠血症,8例出现严重低钠血症,2例因严重低钠血症合并碱中毒和严重低钠血症致心功能恶化死亡;对照组中有2例发生轻度低钠血症,没有发生严重低钠血症及死亡.结论 对于心功能Ⅲ~Ⅳ级慢性CHF患者需长期或间断服用利尿剂,适当补充钠盐或者放宽钠盐的摄入,可有效防止低钠血症及并发症的发生,对已发生低钠血症患者口服钠盐安全有效.%Objective To investigate the causes,prognosis and treatments of chronic congestive heart failure (CHF) with hyponatremia. Methods 120 patients with chronic CHF at Ⅲ~Ⅳ heart function levels were randomly divided into study group and control group with 60 cases in each. The study group received standard heart failure therapy along with low-salt diet while the control group received standard heart failure therapy along with normal diet. All cases were observed for 3 months. Results In the study group,32 cases had mild hyponatremia,8 cases had severe hyponatremia,and 2 cases died of severe hyponatremia with alkalosis and deterioration of heart function. In the control group,2 cases suffered from mild hyponatremia but no cases had sever hyponatremia and died. Conclusion For CHF at Ⅲ~Ⅳ heart function levels,long-term or intermittent diuretic administration accompanied by proper sodium salt supply or loosening the restriction of sodium salt intake may effectively prevent hyponatremia and its complications. For the patients with hyponatremia,oral administration of sodium salt is safe and effective.

  10. A novel distributed model of the heart under normal and congestive heart failure conditions.

    Science.gov (United States)

    Ravanshadi, Samin; Jahed, Mehran

    2013-04-01

    Conventional models of cardiovascular system frequently lack required detail and focus primarily on the overall relationship between pressure, flow and volume. This study proposes a localized and regional model of the cardiovascular system. It utilizes noninvasive blood flow and pressure seed data and temporal cardiac muscle regional activity to predict the operation of the heart under normal and congestive heart failure conditions. The analysis considers specific regions of the heart, namely, base, mid and apex of left ventricle. The proposed method of parameter estimation for hydraulic electric analogy model is recursive least squares algorithm. Based on simulation results and comparison to clinical data, effect of congestive heart failure in the heart is quantified. Accumulated results for simulated ejection fraction percentage of the apex, mid and base regions of the left ventricle in congestive heart failure condition were 39 ± 6, 36 ± 9 and 38 ± 8, respectively. These results are shown to satisfactorily match those found through clinical measurements. The proposed analytical method can in effect be utilized as a preclinical and predictive tool for high-risk heart patients and candidates for heart transplant, assistive device and total artificial heart.

  11. Team management of congestive heart failure across the continuum.

    Science.gov (United States)

    Venner, G H; Seelbinder, J S

    1996-01-01

    Despite an increased incidence of congestive heart failure and frequency of hospital admissions for the Medicare population, there is little information available on improving outcomes for these patients. As changes in health care lead toward capitation, efficient care with limited use of expensive inpatient hospital resources is a necessity. The coordination of three critical components--inpatient, outpatient, and home care--can lead to positive outcomes in terms of functional capacity changes, length of stay, readmission rates, patient self-care knowledge, and patient satisfaction.

  12. Role of Diuretics and Ultrafiltration in Congestive Heart Failure

    Science.gov (United States)

    Shchekochikhin, Dmitry; Al Ammary, Fawaz; Lindenfeld, JoAnn; Schrier, Robert

    2013-01-01

    Volume overload in heart failure (HF) results from neurohumoral activation causing renal sodium and water retention secondary to arterial underfilling. Volume overload not only causes signs and symptoms of congestion, but can impact myocardial remodeling and HF progression. Thus, treating congestion is a cornerstone of HF management. Loop diuretics are the most commonly used drugs in this setting. However, up to 30% of the patients with decompensated HF present with loop-diuretic resistance. A universally accepted definition of loop diuretic resistance, however, is lacking. Several approaches to treat diuretic-resistant HF are available, including addition of distal acting thiazide diuretics, natriuretic doses of mineralocorticoid receptor antagonists (MRAs), or vasoactive drugs. Slow continuous veno-venous ultrafiltration is another option. Ultrafiltration, if it is started early in the course of HF decompensation, may result in prominent decongestion and a reduction in re-hospitalization. On the other hand, ultrafiltration in HF patients with worsening renal function and volume overload after aggressive treatment with loop diuretics, failed to show benefit compared to a stepwise pharmacological approach, including diuretics and vasoactive drugs. Early detection of congested HF patients for ultrafiltration treatment might improve decongestion and reduce readmission. However, the best patient characteristics and best timing of ultrafiltration requires further evaluation in randomized controlled studies. PMID:24276318

  13. Role of Diuretics and Ultrafiltration in Congestive Heart Failure

    Directory of Open Access Journals (Sweden)

    Jo Ann Lindenfeld

    2013-07-01

    Full Text Available Volume overload in heart failure (HF results from neurohumoral activation causing renal sodium and water retention secondary to arterial underfilling. Volume overload not only causes signs and symptoms of congestion, but can impact myocardial remodeling and HF progression. Thus, treating congestion is a cornerstone of HF management. Loop diuretics are the most commonly used drugs in this setting. However, up to 30% of the patients with decompensated HF present with loop-diuretic resistance. A universally accepted definition of loop diuretic resistance, however, is lacking. Several approaches to treat diuretic-resistant HF are available, including addition of distal acting thiazide diuretics, natriuretic doses of mineralocorticoid receptor antagonists (MRAs, or vasoactive drugs. Slow continuous veno-venous ultrafiltration is another option. Ultrafiltration, if it is started early in the course of HF decompensation, may result in prominent decongestion and a reduction in re-hospitalization. On the other hand, ultrafiltration in HF patients with worsening renal function and volume overload after aggressive treatment with loop diuretics, failed to show benefit compared to a stepwise pharmacological approach, including diuretics and vasoactive drugs. Early detection of congested HF patients for ultrafiltration treatment might improve decongestion and reduce readmission. However, the best patient characteristics and best timing of ultrafiltration requires further evaluation in randomized controlled studies.

  14. Sex-linked differences in the course of chronic kidney disease and congestive heart failure: a study in 5/6 nephrectomized Ren-2 transgenic hypertensive rats with volume overload induced using aorto-caval fistula.

    Science.gov (United States)

    Červenka, Luděk; Škaroupková, Petra; Kompanowska-Jezierska, Elzbieta; Sadowski, Janusz

    2016-10-01

    The role of hypertension and the renin-angiotensin system (RAS) in sex-related differences in the course of chronic kidney disease (CKD) and congestive heart failure (CHF) remain unclear, especially when the two diseases are combined. In male and female Ren-2 transgenic rats (TGR), a model of hypertension with activation of endogenous RAS, CKD was induced by 5/6 renal mass reduction (5/6 NX) and CHF was elicited by volume overload achieved by creation of an aorto-caval fistula (ACF). The primary aim of the study was to examine long-term CKD- and CHF-related mortality, especially in animals with CKD and CHF combined, with particular interest in the potential sex-related differences. The follow-up period was 23 weeks after the first intervention (5/6 NX). We found, first, that TGR did not exhibit sexual dimorphism in the course of 5/6 NX-induced CKD. Second, in contrast, TGR exhibited important sex-related differences in the course of ACF-induced CHF-related mortality: intact female TGR showed higher survival rate than male TGR. This situation is reversed in the course of combined 5/6 NX-induced CKD and ACF-induced CHF-related mortality: intact female TGR exhibited poorer survival than male TGR. Third, the survival rate in animals with combined 5/6 NX-induced CKD and ACF-induced CHF was significantly worsened as compared with rat groups that were exposed to 'single organ disease'. Collectively, our present results clearly show that CKD aggravates long-term mortality of animals with CHF. In addition, TGR exhibit remarkable sexual dimorphism with respect to CKD- and CHF-related mortality, especially in animals with combined CKD and CHF.

  15. DETECTING CONGESTIVE HEART FAILURE USING HEART RATE SEQUENTIAL TREND ANALYSIS PLOT

    Directory of Open Access Journals (Sweden)

    SRINIVAS KUNTAMALLA,

    2010-12-01

    Full Text Available Heart rate variability analysis is gaining acceptance as a potential non-invasive means of autonomic nervous system assessment in research as well as clinical domains. In this study, a nonlinear analysis method is developed to detect congestive heart failure. The data obtained from an online and widely used public database (i.e., MIT/BIH physionet database, is used for testing the performance of the method. The method developed is based on the sequential trend analysis plot of heart rate variability and correlates well with the characteristic autonomic nervous system regulations in congestive heart failure. The proposed method can be used for screening as well as diagnosing the heart failure patients. The algorithm is computationally simple and can be implemented in a real time processing hardware. This method classifies 31 out of 32 subjects and has the highest discrimination power in terms of sensitivity, specificity and accuracy.

  16. Congestive heart failure from suspected ductal closure in utero.

    Science.gov (United States)

    Arcilla, R A; Thilenius, O G; Ranniger, K

    1969-07-01

    This is the 1st case report of a ductal closure occurring during fetal growth. The case was a spontaneous delivery in cephalic presentation from a 31-year-old gravida 3, para 3 Black woman who had been treated with isoniazid and spreptomycin up to 2 months before her delivery. Gestational age was 37 weeks when the fetus was delivered weighing 3.15 kgm. The cord had been wrapped around the fetus's neck, and breathing was delayed 2 minutes. In the nursery, the baby's general condition was poor, and congestive heart failure was diagnosed. The newborn had trieuspid insufficiency, severe heart failure, and acidosis at birth. These disappeared the next day. Hemodynamic studies when the baby was 4 hours old showed a large cone-shaped ductus arteriousus extending from the pulmonary artery but ending blindly at the aortic end.

  17. Decrease of cardiac chaos in congestive heart failure

    Science.gov (United States)

    Poon, Chi-Sang; Merrill, Christopher K.

    1997-10-01

    The electrical properties of the mammalian heart undergo many complex transitions in normal and diseased states. It has been proposed that the normal heartbeat may display complex nonlinear dynamics, including deterministic chaos,, and that such cardiac chaos may be a useful physiological marker for the diagnosis and management, of certain heart trouble. However, it is not clear whether the heartbeat series of healthy and diseased hearts are chaotic or stochastic, or whether cardiac chaos represents normal or abnormal behaviour. Here we have used a highly sensitive technique, which is robust to random noise, to detect chaos. We analysed the electrocardiograms from a group of healthy subjects and those with severe congestive heart failure (CHF), a clinical condition associated with a high risk of sudden death. The short-term variations of beat-to-beat interval exhibited strongly and consistently chaotic behaviour in all healthy subjects, but were frequently interrupted by periods of seemingly non-chaotic fluctuations in patients with CHF. Chaotic dynamics in the CHF data, even when discernible, exhibited a high degree of random variability over time, suggesting a weaker form of chaos. These findings suggest that cardiac chaos is prevalent in healthy heart, and a decrease in such chaos may be indicative of CHF.

  18. Assessing the effect of perindopril combined with bisoprolol on chronic congestive heart failure%比索洛尔联合培哚普利治疗慢性收缩性心力衰竭的疗效观察

    Institute of Scientific and Technical Information of China (English)

    梁伟东; 钟毅

    2011-01-01

    Objective To observe and compare the effect of perindopril plus bisoprolol and perindopril on chronic congestive heart failure ( CHF ).Methods 75 cases of CHF were randomly divided into control group ( group A, 37 cases )and treatment group ( group B, 38 cases ).Heart rate, blood pressure, heart function, LVDd, LVEF, CO, SV, A/E rate and FS between the two groups on the time point of before and after the treatment were compared.Results The blood pressure had declined significantly after treatment in the two groups( P < 0.01 ), the heart rate had declined significantly in group B compared with group A( P < 0.01 ).The heart function was improved significantly after treatment in the two groups ( P < 0.01 ),and the improvement in group B was more significant than that in group A ( P <0.01 ).The LVDd didn't show significant difference between the two groups at the time point of before and after treatment( P > 0.05 ).The A/E rate significantly declined after treatment in the two groups( P <0.01 ),group B was better than that of group A( P <0.01 ).CO and SV significantly improved after treatment both in the two groups( P < 0.01 ), but didn' t show significant difference( P > 0.05 ) between the two groups.The LVEF significantly improved after treatment in the two groups( P < 0.01 ), and group B was better than that of group A( P < 0.05 ).Conclusion The treatment of combining perindopril and bisoprolol is more effective than only use perindopril in improving the prognosis of the patients with CHF.%目的 观察比较比索洛尔和培哚普利联合应用与单用培哚普利对慢性收缩性心力衰竭患者的疗效.方法 将75例慢性收缩性心力衰竭的患者随机分为培哚普利组(A组)37例和比索洛尔加培哚普利组(B组)38例,比较2组治疗前后心率、血压、心功能、左室舒张末内径(LVDd)、左室射血分数(LVEF)、心排出量(CO)、每搏量(SV)、A峰/E峰比值(A/E比值)、小轴缩短率 (FS).结果 2

  19. Spironolactone therapy in infants with congestive heart failure secondary to congenital heart disease.

    OpenAIRE

    Hobbins, S M; Fowler, R. S.; Rowe, R D; Korey, A G

    1981-01-01

    The efficacy of treatment with spironolactone for congestive heart failure secondary to congenital heart disease was studied in 21 infants under 1 year of age. All received digoxin and chlorothiazide. In addition, group A (n = 10) was given supplements of potassium and group B (n = 11) received spironolactone. Daily clinical observations of vital signs, weight, hepatomegaly, and vomiting were recorded. Paired t test analysis showed significant reduction in liver size and weight (P less than 0...

  20. Complexity in congestive heart failure: A time-frequency approach

    Science.gov (United States)

    Banerjee, Santo; Palit, Sanjay K.; Mukherjee, Sayan; Ariffin, MRK; Rondoni, Lamberto

    2016-03-01

    Reconstruction of phase space is an effective method to quantify the dynamics of a signal or a time series. Various phase space reconstruction techniques have been investigated. However, there are some issues on the optimal reconstructions and the best possible choice of the reconstruction parameters. This research introduces the idea of gradient cross recurrence (GCR) and mean gradient cross recurrence density which shows that reconstructions in time frequency domain preserve more information about the dynamics than the optimal reconstructions in time domain. This analysis is further extended to ECG signals of normal and congestive heart failure patients. By using another newly introduced measure—gradient cross recurrence period density entropy, two classes of aforesaid ECG signals can be classified with a proper threshold. This analysis can be applied to quantifying and distinguishing biomedical and other nonlinear signals.

  1. Characteristics and Therapeutic Efficacy of Digoxin in Elderly patients with Chronic Congestive Heart Failure%老年慢性充血性心力衰竭应用地高辛的特点及疗效观察

    Institute of Scientific and Technical Information of China (English)

    尹红英

    2013-01-01

    目的观察隔日1次口服地高辛0.125 mg 治疗老年慢性充血性心力衰竭( CHF)的临床疗效及安全性。方法选择2010年1月至2013年1月在我科住院的92例为观察对象,随机分为地高辛治疗组(A组)和常规对照组(B组)各46例,两组年龄、性别、病程、基础疾病构成等临床基线有可比性,两组采用相同的基础治疗,治疗组予隔日1次口服地高辛0.125 mg,疗程2个月,比较两组患者治疗后的有效率及6min 步行距离、心率情况,观察洋地黄中毒发生情况。结果1.临床疗效比较:A、B两组总有效率分别为86.9%和65.2%。A组明显优于B组(Pchronic congestive heart failure (CHF). Methods 92 cases of inpatients in our department selected from January 2010 to January 2013 were randomly divided into digoxin treatment group (A) and normal control group (B group), 46 cases each. Two groups had comparability in age, gender, disease duration and so forth constituting the underlying disease clinical baseline and were subject to the same basic treatment with the treatment group orally given 125 mg digoxin every other day for a course of 2 months. The comparison was made between two groups after the treatment in efficiency, 6min walking distance, and heart, and the observation made on digitalis intoxication. Results 1. Clinical efficacy comparison: For A and B groups, total efficiency was 86.9% and 65.2%, respectively. A group was significantly better than in group B (P<0.05). 2. For the two groups of patients, 6min walking distance and heart rate were improved with the treatment group

  2. 96例慢性充血性心力衰竭患者临床治疗效果及安全性研究%Clinical Curative Effect in 96 patients with Chronic Congestive Heart Fail-ure and Its Safety

    Institute of Scientific and Technical Information of China (English)

    魏笑天

    2015-01-01

    Objective To discuss the treatment of patients with chronic congestive heart failure and its effect. Methods 96 patients suffering from chronic congestive heart failure admitted to our hospital between October 2013 and March 2015 were randomized into observation group in which the 48 patients were treated with carvedilol, and control group in which the 48 patients were treat-ed with metoprolol. The therapeutic effect and safety were compared between the two groups. Results Total improved efficiency of the heart function was higher in the observation group than in the control group (95.8%vs 81.3%), and the difference was statisti-cally significant(P0.05)。结论对于慢性充血性心力衰竭患者,使用卡维地洛进行治疗,其效果要明显优于美托洛尔,并且不良反应较少,所以值得临床推广。

  3. Fluid Volume Overload and Congestion in Heart Failure: Time to Reconsider Pathophysiology and How Volume Is Assessed.

    Science.gov (United States)

    Miller, Wayne L

    2016-08-01

    Volume regulation, assessment, and management remain basic issues in patients with heart failure. The discussion presented here is directed at opening a reassessment of the pathophysiology of congestion in congestive heart failure and the methods by which we determine volume overload status. Peer-reviewed historical and contemporary literatures are reviewed. Volume overload and fluid congestion remain primary issues for patients with chronic heart failure. The pathophysiology is complex, and the simple concept of intravascular fluid accumulation is not adequate. The dynamics of interstitial and intravascular fluid compartment interactions and fluid redistribution from venous splanchnic beds to central pulmonary circulation need to be taken into account in strategies of volume management. Clinical bedside evaluations and right heart hemodynamic assessments can alert clinicians of changes in volume status, but only the quantitative measurement of total blood volume can help identify the heterogeneity in plasma volume and red blood cell mass that are features of volume overload in patients with chronic heart failure and help guide individualized, appropriate therapy-not all volume overload is the same. PMID:27436837

  4. Fluid Volume Overload and Congestion in Heart Failure: Time to Reconsider Pathophysiology and How Volume Is Assessed.

    Science.gov (United States)

    Miller, Wayne L

    2016-08-01

    Volume regulation, assessment, and management remain basic issues in patients with heart failure. The discussion presented here is directed at opening a reassessment of the pathophysiology of congestion in congestive heart failure and the methods by which we determine volume overload status. Peer-reviewed historical and contemporary literatures are reviewed. Volume overload and fluid congestion remain primary issues for patients with chronic heart failure. The pathophysiology is complex, and the simple concept of intravascular fluid accumulation is not adequate. The dynamics of interstitial and intravascular fluid compartment interactions and fluid redistribution from venous splanchnic beds to central pulmonary circulation need to be taken into account in strategies of volume management. Clinical bedside evaluations and right heart hemodynamic assessments can alert clinicians of changes in volume status, but only the quantitative measurement of total blood volume can help identify the heterogeneity in plasma volume and red blood cell mass that are features of volume overload in patients with chronic heart failure and help guide individualized, appropriate therapy-not all volume overload is the same.

  5. ACE inhibitors and calcium antagonists in the treatment of congestive heart failure

    DEFF Research Database (Denmark)

    Hansen, J F

    1995-01-01

    The increased mortality after myocardial infarction is related to the risk of reinfarction, sudden death, and the development and progression of heart failure; in congestive heart failure it is due to the progression of heart failure and sudden death. ACE inhibitors have been proven to prevent...... cardiovascular events, especially the progression of heart failure, in postinfarct patients with reduced ejection fraction and heart failure in the SAVE and AIRE trials. In patients with congestive heart failure, ACE inhibitor treatment has prevented cardiovascular death and reduced morbidity due to progressive...... heart failure in the SOLVD trials. In post-myocardial infarction patients, the calcium antagonist nifedipine did not affect mortality or morbidity; diltiazem improved prognosis in patients without congestive heart failure and in patients with non-Q-wave infarction; and verapamil improved prognosis...

  6. 甲状腺功能与老年慢性充血性心力衰竭患者心功能、左心室重构的关系研究%Relationship Between Thyroid Function and Cardiac Function/Left Ventricular Remodeling of Elderly Patients With Chronic Congestive Heart Failure

    Institute of Scientific and Technical Information of China (English)

    张萍; 赵东升

    2016-01-01

    with chronic congestive heart failure. Methods A total of 90 elderly patients with chronic congestive heart failure(equal or over 60 years old)admitted to the Second People′s Hospital of Hengshui from January 2013 to January 2015 were selected as A group,77 elderly patients without chronic congestive heart failure were selected as B group at the same time. Index of thyroid function,cardiac function and left ventricular remodeling were compared between the two groups, index of thyroid function was compared in elderly chronic congestive heart failure patients with different NYHA cardiac function grades,the correlation between index of thyroid function and cardiac function was analyzed. Results The NYHA cardiac function grades of B group were all Ⅰ - grade;of A group,37 cases′ NYHA cardiac function grades were Ⅱ - grade,36 cases′were Ⅲ - grade,17 cases′ were Ⅳ - grade. TSH,TT3 ,TT4 ,FT3 ,FT4 and LVEF of A group were statistically significantly lower than those of B group,while LVESD,LVEDD and LVMI of A group were statistically significantly lower than those of B group(P < 0. 05). TSH,TT3 and FT3 of chronic congestive heart failure patients with Ⅲ - grade NYHA cardiac function grades were statistically significantly lower than those of chronic congestive heart failure patients with Ⅱ - grade NYHA cardiac function grades(P < 0. 05);TSH,TT3 ,TT4 ,FT3 and FT4 of chronic congestive heart failure patients with Ⅳ - grade NYHA cardiac function grades were statistically significantly lower than those of chronic congestive heart failure patients with Ⅱ - grade NYHA cardiac function grades,TT3 ,FT3 and FT4 of chronic congestive heart failure patients with Ⅳ - grade NYHA cardiac function grades were statistically significantly lower than those of chronic congestive heart failure patients with Ⅲ - grade NYHA cardiac function grades. Of patients with chronic congestive heart failure,TSH was negatively correlated with LVEDD( r = - 0. 598) and LVMI(r = - 0

  7. Serum digoxin concentrations in canine congestive heart failure.

    Science.gov (United States)

    Tobias, A H; Bland-van den Berg, P; Kruse, M M; Tubbesing, U H; Berry, W L

    1989-03-01

    Digoxin was administered to dogs (n = 10) in congestive heart failure, at an oral dosage rate of 0.01 mg kg-1 lean body mass twice daily. Lean body mass was determined by reducing gross mass by the estimated degree of ascites and body fat. The dose was further adjusted for factors such as renal and hepatic function, the bioavailability of different formulations, and the size of the patient. Trough and peak serum digoxin concentrations were determined after 10 days of digitalisation, or when signs of toxicity became apparent. Serum digoxin concentrations in 6 of the 10 dogs were found to be partially or completely in the toxic or subtherapeutic range. This indicates that an oral digoxin dosage rate of 0.01 mg kg-1 lean body mass administered twice daily, even when adjusted appropriately for factors that affect digoxin pharmacokinetics, provides no more than a rough approximation of the precise dose required to provide serum digoxin concentrations within the therapeutic range. The observations also lend support to a recent recommendation that the digoxin dosage rate should be based on body surface area, although even when administered on this basis, serum digoxin concentrations outside of the therapeutic range could be anticipated. PMID:2724277

  8. Clinical Significance of Serum Cardiac Troponin T and Serum uric acid levels in Aged Patients with Chronic Congestive Heart Failure%老年慢性心力衰竭患者血清肌钙蛋白T及尿酸检测的临床意义

    Institute of Scientific and Technical Information of China (English)

    李莉

    2011-01-01

    目的 探讨老年慢性心力衰竭(CHF)患者血清肌钙蛋白T(cTnT)及尿酸(UA)水平检测的意义.方法 回顾性分析200例老年慢性心力衰竭患者临床资料,心功能Ⅰ级为对照组,Ⅱ、Ⅲ、Ⅳ级患者为观察组,每组50例.分析血UA、cTnT与慢性心力衰竭的发生是否存在相关性.按cTnT浓度分为正常组和增高组,比较其住院期间及随访2年发生的心脏事件(心力衰竭反复或加重、死亡)的发生情况.结果 观察组cTnT与UA含量明显高于对照组.cTnT增高组患者心脏事件的发生率明显高于正常组(P<0.05).结论 心衰越重,cTnT与UA增高越明显,血尿酸、肌钙蛋白T与充血性心力衰竭密切相关,是充血性心力衰竭发病的危险因素,二者联合可作为评价老年心力衰竭严重程度的指标.cTnT对判断老年慢性心力衰竭患者的预后有较好的预测价值.%Objective To evaluate the correlations of serum cardiac troponin T and serum uric acid levels in in aged patients with chronic congestive heart failure(CHF) and the effect of cardiac troponin T(cTnT) on the prognosis of the CHF. Methods 200 cases of congestive heart failure patients(Cardiac function NYHA class Ⅰ-Ⅳ) were enrolled for retrospective analysis and divided into four groups ,50 cases per group;randomly picked 50 cases of pantients with cardiac function NYHA class Ⅰ as a control group; and analyzed the relationship of serum uric (UA) and cTnT level and the occurrence of CHF. All the patients were arranged into normal group and higher group according to cTnT concentration. Cardiac events, including repeated or aggravated heart failure or cardiac death,in patients with increased cTnT during hospitalization were compared to those without it. Results In congestive heart failure group (Cardiac function NYHA class Ⅱ-Ⅳ) ,the cTnT and UA contents increased significantly than that in control group.Incidence of cardiac events was higher in patients with increased c

  9. Breathing disorders in congestive heart failure: gender, etiology and mortality

    Directory of Open Access Journals (Sweden)

    R.S. Silva

    2008-03-01

    Full Text Available We investigated the relationship between sleep-disordered breathing (SDB and Cheyne-Stokes respiration (CSR while awake as well as mortality. Eighty-nine consecutive outpatients (29 females with congestive heart failure (CHF; left ventricular ejection fraction, LVEF 5 and >15, respectively. CHF etiologies were similar according to the prevalence of SDB and sleep pattern. Males and females were similar in age, body mass index, and LVEF. Males presented more SDB (P = 0.01, higher apnea-hypopnea index (P = 0.04, more light sleep (stages 1 and 2; P < 0.05, and less deep sleep (P < 0.001 than females. During follow-up (25 ± 10 months, 27% of the population died. Non-survivors had lower LVEF (P = 0.01, worse New York Heart Association (NYHA functional classification (P = 0.03, and higher CSR while awake (P < 0.001 than survivors. As determined by Cox proportional model, NYHA class IV (RR = 3.95, 95%CI = 1.37-11.38, P = 0.011 and CSR while awake with a marginal significance (RR = 2.96, 95%CI = 0.94-9.33, P = 0.064 were associated with mortality. In conclusion, the prevalence of SDB and sleep pattern of patients with Chagas' disease were similar to that of patients with CHF due to other etiologies. Males presented more frequent and more severe SDB and worse sleep quality than females. The presence of CSR while awake, but not during sleep, may be associated with a poor prognosis in patients with CHF.

  10. Effects of tolvaptan on congestive heart failure complicated with chylothorax in a neonate.

    Science.gov (United States)

    Sato, Nikiko; Sugiura, Tokio; Nagasaki, Rika; Suzuki, Kazutaka; Ito, Koichi; Kato, Takenori; Inukai, Sachiko; Saitoh, Shinji

    2015-10-01

    Tolvaptan is an oral vasopressin type 2 receptor antagonist that can be used for heart failure patients with hyponatremia or symptomatic congestion. Although the effects of tolvaptan in adults have been well documented, only limited information is available in children. The case of a neonate with congestive heart failure complicated with chylothorax after palliative surgery for transposition of the great arteries treated with tolvaptan is reported. Slow up-titration to 0.1 mg/kg successfully increased urine output and improved refractory congestive heart failure without hypernatremia. Subsequently, bodyweight and chylothorax decreased gradually. Moreover, the use of tolvaptan reduced the dosage of furosemide. Tolvaptan could be an alternative drug for neonates with congestive heart failure. Further large studies are needed to confirm the efficacy and identify the appropriate dose of tolvaptan in neonates.

  11. Altered neuropeptide Y Y1 responses in mesenteric arteries in rats with congestive heart failure

    DEFF Research Database (Denmark)

    Bergdahl, A; Nilsson, T; Sun, X Y;

    1998-01-01

    The aim of the present study was to elucidate if the potentiating effect of neuropeptide Y on various vasoactive agents in vitro is (1) altered in mesenteric arteries from rats with congestive heart failure and (2) mediated by the neuropeptide Y Y1 receptor. The direct vascular effects...... of the neuropeptide Y Y1 antagonist, BIBP3226 (BIBP3226¿(R)-N2-(diphenylacetyl)-N-[(4-hydroxyphenyl)methyl ]-D-arginine-amide¿). Neuropeptide Y, per se, had no vasoactive effect in the arteries. The potency of endothelin-1 was significantly decreased in congestive heart failure rats. Neuropeptide Y and neuropeptide Y......-(13-36) potentiated the endothelin-1-induced contraction in congestive heart failure mesenteric arteries. In 20% of the congestive heart failure rats, sarafotoxin 6c induced a contraction of 31+/-4%. Neuropeptide Y also potentiated U46619- and noradrenaline-induced contractions but not 5-HT...

  12. Congestive heart failure induces downregulation of P2X1-receptors in resistance arteries

    DEFF Research Database (Denmark)

    Malmsjö, M; Bergdahl, A; Möller, S;

    1999-01-01

    OBJECTIVE: Congestive heart failure (CHF) is accompanied by enhanced peripheral sympathetic nerve activity, increased vascular resistance and impaired peripheral blood flow. Besides noradrenaline and neuropeptide Y, the sympathetic nervous system also releases ATP, which has contractile effects...

  13. Recompensation of Heart and Kidney Function after Treatment with Peritoneal Dialysis in a Case of Congestive Heart Failure

    OpenAIRE

    Andrew Remppis; Christian Zugck; Vinzent Hankel; Kihm, Lars P; Vedat Schwenger

    2011-01-01

    We report the case of a 57-year-old woman suffering from congestive heart failure. Due to refractory congestions despite optimised medical treatment, the patient was listed for heart transplantation and peritoneal dialysis was initiated. Peritoneal dialysis led to a significant weight loss, reduction of hyperhydration and extracellular water obtained by bioimpedance measurement, and a significant improvement in clinical and echocardiographic examination. Furthermore, residual kidney function ...

  14. Congestive Heart Failure Consumer Information on the Web: How Accessible Is the Evidence?

    OpenAIRE

    Boren, Suzanne Austin; Gunlock, Teira L.

    2006-01-01

    The objective of this pilot study was to assess the accessibility of congestive heart failure consumer information on the web. Twenty-seven education trials involving 5589 patients with congestive heart failure were analyzed. Education topics and outcomes were abstracted. Twenty education topics were linked to outcomes. A sample of 15 websites missed 56.7% of education topics and 61.8% of technical website characteristics that have suggested accuracy, reliability, and timeliness of content.

  15. Digoxin:A systematic review in atrial fibrillation,congestive heart failure and post myocardial infarction

    Institute of Scientific and Technical Information of China (English)

    Sebastiano; Virgadamo; Richard; Charnigo; Yousef; Darrat; Gustavo; Morales; Claude; S; Elayi

    2015-01-01

    AIM: To review digoxin use in systolic congestive heart failure, atrial fibrillation, and after myocardial infarction. METHODS: A comprehensive Pub Med search was performed using the key words "digoxin and congestive heart failure", "digoxin and atrial fibrillation", "digoxin, atrial fibrillation and systolic congestive heart failure", and "digoxin and myocardial infarction". Only articles written in English were included in this study. We retained studies originating from randomized controlled trials, registries and included at least 500 patients. The studies included patients with atrial fibrillation or heart failure or myocardial infarction and had a significant proportion of patients(at least 5%) on digoxin. A table reviewing the different hazard ratios was developed based on the articles selected. Our primary endpoint was the overall mortality in the patients on digoxin vs those without digoxin, among patients with atrial fibrillation and also among patients with atrial fibrillation and systolic heart failure. We reviewed the most recent international guidelines to discuss current recommendations.RESULTS: A total of 18 studies were found that evaluated digoxin and overall mortality in different clinical settings including systolic congestive heart failure and normal sinus rhythm(n = 5), atrial fibrillation with and without systolic congestive heart failure(n = 9), and myocardial infarction(n = 4). Overall, patients with systolic congestive heart failure with normal sinus rhythm, digoxin appears to have a neutral effect on mortality especially if close digoxin level monitoring is employed. However, most of the observational studies evaluating digoxin use in atrial fibrillation without systolic congestive heart failure showed an increase in overall mortality when taking digoxin. In the studies evaluated in this systematic review, the data among patients with atrial fibrillation and systolic congestive heart failure, as well as post myocardial infarction were

  16. Importance of congestive heart failure and interaction of congestive heart failure and left ventricular systolic function on prognosis in patients with acute myocardial infarction

    DEFF Research Database (Denmark)

    Køber, L; Torp-Pedersen, C; Pedersen, O D;

    1996-01-01

    Left ventricular (LV) systolic function and congestive heart failure (CHF) are important predictors of long-term mortality after acute myocardial infarction. The importance of transient CHF and the interaction of CHF and LV function on prognosis has not been studied in detail previously...

  17. 螺内酯联合贝那普利治疗慢性充血性心力衰竭47例疗效观察%Clinical Effect Observation of Spironolactone Combined with Benazepri in Treatment of 47 Cases with Chronic Congestive Heart Failure

    Institute of Scientific and Technical Information of China (English)

    王林华

    2013-01-01

    Objective To explore the clinical effect of spironolactone combined with benazepri in treatment of chronic congestive heart failure. Methods 94 patients with chronic congestive heart failure in our hospital were randomly divided into spironolactone combined with benazepri treatment group (observation group) and benazepri treatment group (control group), 47 cases in each group, compared the clinical effect of patients in two groups. Results The total effective rate of patients in observation group was 91.5%, significantly higher than that in control group (74.5%), there was significant difference between two groups (P<0.05). There were no obvious adverse reactions during treatment. Conclusion Taking spironolactone combined with benazepri in the treatment of chronic congestive heart failure has effective clinical effect, worthy of further clinical application.%目的:探讨螺内酯联合贝那普利治疗慢性充血性心力衰竭的疗效。方法将我院收治的94例慢性充血性心力衰竭患者随机分为螺内酯联合贝那普利治疗组(观察组)和贝那普利治疗组(对照组),每组各47例,比较两组患者的临床疗效。结果观察组患者治疗总有效率为91.5%,显著高于对照组患者的74.5%,组间差异有统计学意义(P<0.05)。两组患者治疗期间均未出现明显不良反应。结论螺内酯联合贝那普利治疗慢性充血性心力衰竭临床疗效确切,值得临床进一步推广使用。

  18. Periodontitis in Chronic Heart Failure.

    Science.gov (United States)

    Fröhlich, Hanna; Herrmann, Kristina; Franke, Jennifer; Karimi, Alamara; Täger, Tobias; Cebola, Rita; Katus, Hugo A; Zugck, Christian; Frankenstein, Lutz

    2016-08-01

    Periodontal disease has been associated with an increased risk of cardiovascular events. The purpose of our study was to investigate whether a correlation between periodontitis and chronic heart failure exists, as well as the nature of the underlying cause. We enrolled 71 patients (mean age, 54 ± 13 yr; 56 men) who had stable chronic heart failure; all underwent complete cardiologic and dental evaluations. The periodontal screening index was used to quantify the degree of periodontal disease. We compared the findings to those in the general population with use of data from the 4th German Dental Health Survey. Gingivitis, moderate periodontitis, and severe periodontitis were present in 17 (24%), 17 (24%), and 37 (52%) patients, respectively. Severe periodontitis was more prevalent among chronic heart failure patients than in the general population. In contrast, moderate periodontitis was more prevalent in the general population (P <0.00001). The severity of periodontal disease was not associated with the cause of chronic heart failure or the severity of heart failure symptoms. Six-minute walking distance was the only independent predictor of severe periodontitis. Periodontal disease is highly prevalent in chronic heart failure patients regardless of the cause of heart failure. Prospective trials are warranted to clarify the causal relationship between both diseases.

  19. Periodontitis in Chronic Heart Failure

    Science.gov (United States)

    Fröhlich, Hanna; Herrmann, Kristina; Franke, Jennifer; Karimi, Alamara; Täger, Tobias; Cebola, Rita; Katus, Hugo A.; Zugck, Christian

    2016-01-01

    Periodontal disease has been associated with an increased risk of cardiovascular events. The purpose of our study was to investigate whether a correlation between periodontitis and chronic heart failure exists, as well as the nature of the underlying cause. We enrolled 71 patients (mean age, 54 ± 13 yr; 56 men) who had stable chronic heart failure; all underwent complete cardiologic and dental evaluations. The periodontal screening index was used to quantify the degree of periodontal disease. We compared the findings to those in the general population with use of data from the 4th German Dental Health Survey. Gingivitis, moderate periodontitis, and severe periodontitis were present in 17 (24%), 17 (24%), and 37 (52%) patients, respectively. Severe periodontitis was more prevalent among chronic heart failure patients than in the general population. In contrast, moderate periodontitis was more prevalent in the general population (P periodontal disease was not associated with the cause of chronic heart failure or the severity of heart failure symptoms. Six-minute walking distance was the only independent predictor of severe periodontitis. Periodontal disease is highly prevalent in chronic heart failure patients regardless of the cause of heart failure. Prospective trials are warranted to clarify the causal relationship between both diseases. PMID:27547136

  20. Periodontitis in Chronic Heart Failure.

    Science.gov (United States)

    Fröhlich, Hanna; Herrmann, Kristina; Franke, Jennifer; Karimi, Alamara; Täger, Tobias; Cebola, Rita; Katus, Hugo A; Zugck, Christian; Frankenstein, Lutz

    2016-08-01

    Periodontal disease has been associated with an increased risk of cardiovascular events. The purpose of our study was to investigate whether a correlation between periodontitis and chronic heart failure exists, as well as the nature of the underlying cause. We enrolled 71 patients (mean age, 54 ± 13 yr; 56 men) who had stable chronic heart failure; all underwent complete cardiologic and dental evaluations. The periodontal screening index was used to quantify the degree of periodontal disease. We compared the findings to those in the general population with use of data from the 4th German Dental Health Survey. Gingivitis, moderate periodontitis, and severe periodontitis were present in 17 (24%), 17 (24%), and 37 (52%) patients, respectively. Severe periodontitis was more prevalent among chronic heart failure patients than in the general population. In contrast, moderate periodontitis was more prevalent in the general population (P <0.00001). The severity of periodontal disease was not associated with the cause of chronic heart failure or the severity of heart failure symptoms. Six-minute walking distance was the only independent predictor of severe periodontitis. Periodontal disease is highly prevalent in chronic heart failure patients regardless of the cause of heart failure. Prospective trials are warranted to clarify the causal relationship between both diseases. PMID:27547136

  1. New approach for new target: adaptive servo-ventilation on Cheyne-Stokes respiration in congestive heart failure

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    @@ Cheyne-Stokes respiration with central sleep apnea (CSR-CSA) occurs when periods of hyperventilation with waxing/waning tidal volume alternated with periods of central hypopnea/apnea. It is present in approximately 40 percent of patients with severe congestive heart failure (CHF). CSR-CSA may contribute to the progression of heart failure by causing repetitive arterial oxygen desaturation, sleep fragmentation, increased left ventricular afterload, activation of sympathetic nervous system, and oscillations in heart rate and blood pressure. There are evidences indicating that CSR-CSA is associated with a remarkable increase in mortality and is also an independent risk factor for cardiac transplantation; furthermore, treatment of CSR-CSA in combination with optimal medical therapy may influence the course of chronic heart failure, improve quality of life and the survival of patients.1 The paper by Zhang et al2 highlights the importance of recognizing this pathological breathing pattern as a potential therapeutic target.

  2. Insomnia Self-Management in Heart Failure

    Science.gov (United States)

    2016-05-11

    Cardiac Failure; Heart Failure; Congestive Heart Failure; Heart Failure, Congestive; Sleep Initiation and Maintenance Disorders; Chronic Insomnia; Disorders of Initiating and Maintaining Sleep; Fatigue; Pain; Depressive Symptoms; Sleep Disorders; Anxiety

  3. Long-term outcome of patients with acromegaly and congestive heart failure.

    Science.gov (United States)

    Bihan, Hélène; Espinosa, Consuelo; Valdes-Socin, Hernan; Salenave, Sylvie; Young, Jacques; Levasseur, Suzanne; Assayag, Patrick; Beckers, Albert; Chanson, Philippe

    2004-11-01

    Cardiovascular complications are a major cause of morbidity and mortality in patients with acromegaly. Normalization of GH secretion is associated with an improvement in structural and functional cardiac abnormalities. However, the long-term cardiac effects of treatment for acromegaly have not been studied in patients who have already developed chronic congestive heart failure (CHF). We reviewed the charts of 330 consecutive patients with acromegaly treated in two French and Belgian centers since 1985. Ten patients with both acromegaly and CHF (eight men, two women, mean age 49.7 yr) were studied retrospectively. One of them was excluded because CHF was due to severe aortic stenosis.CHF (New York Heart Association stages III-IV and echocardiography showing dilated hypokinetic cardiomyopathy with left ventricular systolic dysfunction and a left ventricular ejection fraction less than 45%) was diagnosed before, concomitantly, or after acromegaly in, respectively, two, five, and two patients. Three patients were referred with terminal heart failure requiring transplantation.One patient had transient CHF associated with a hypertensive crisis. The other eight patients had symptomatic chronic CHF. Control of GH hypersecretion failed, totally or partially, in three patients: one had a long-term survival, and the two others died at 1 and 5 yr. Good GH control was achieved in five patients: four of these are still alive 2-16 yr after diagnosis of CHF, their clinical status is stable or improved, and their quality of life is good. Overall, the 1- and 5-yr mortality (or transplantation) rates for patients with chronic symptomatic CHF were 25% (2 of 8 patients) and 37.5% (3 of 8 patients), respectively. In conclusion, less than 3% of acromegalic patients developed CHF in this study. Although effective treatment of acromegaly improved short-term cardiovascular status, its impact on long-term survival is questionable.

  4. Paradox of circulating advanced glycation end product concentrations in patients with congestive heart failure and after heart transplantation

    OpenAIRE

    A. Heidland; Šebeková, K.; Frangiosa, A; De Santo, L S; Cirillo, M.; Rossi, F.; Cotrufo, M.; Perna, A; Klassen, A; Schinzel, R; De Santo, N G

    2004-01-01

    Objectives: To analyse circulating concentrations of advanced glycation end products (AGEs) in patients with severe congestive heart failure (CHF) and after heart transplantation; to identify the potential contribution of kidney function to plasma AGE concentrations; and to determine whether AGE concentrations and parameters of oxidative stress are interrelated.

  5. Recompensation of heart and kidney function after treatment with peritoneal dialysis in a case of congestive heart failure.

    Science.gov (United States)

    Kihm, Lars P; Hankel, Vinzent; Zugck, Christian; Remppis, Andrew; Schwenger, Vedat

    2011-01-01

    We report the case of a 57-year-old woman suffering from congestive heart failure. Due to refractory congestions despite optimised medical treatment, the patient was listed for heart transplantation and peritoneal dialysis was initiated. Peritoneal dialysis led to a significant weight loss, reduction of hyperhydration and extracellular water obtained by bioimpedance measurement, and a significant improvement in clinical and echocardiographic examination. Furthermore, residual kidney function increased during the long-term followup, and subsequently peritoneal dialysis was ceased. Pulmonary artery pressure and left ventricular ejection fraction remained stable and the patient did well. This case demonstrates the possibility of treating hyperhydration due to congestive heart failure with peritoneal dialysis resulting in recompensation of both heart and kidney functions. PMID:22162698

  6. Recompensation of Heart and Kidney Function after Treatment with Peritoneal Dialysis in a Case of Congestive Heart Failure

    Directory of Open Access Journals (Sweden)

    Lars P. Kihm

    2011-01-01

    Full Text Available We report the case of a 57-year-old woman suffering from congestive heart failure. Due to refractory congestions despite optimised medical treatment, the patient was listed for heart transplantation and peritoneal dialysis was initiated. Peritoneal dialysis led to a significant weight loss, reduction of hyperhydration and extracellular water obtained by bioimpedance measurement, and a significant improvement in clinical and echocardiographic examination. Furthermore, residual kidney function increased during the long-term followup, and subsequently peritoneal dialysis was ceased. Pulmonary artery pressure and left ventricular ejection fraction remained stable and the patient did well. This case demonstrates the possibility of treating hyperhydration due to congestive heart failure with peritoneal dialysis resulting in recompensation of both heart and kidney functions.

  7. Ultrasound lung comets for serial assessment of pulmonary congestion in heart failure

    OpenAIRE

    Gargani, Luna; Frassi, Francesca; Prado, Aldo; Tesorio, Tullio; Soldati, Gino; Viola, Umberto; Porcari, Alberto; Mottola, Gaetano; Picano, Eugenio

    2007-01-01

    Background: Serial chest radiographs are too insensitive and therefore NOT recommended for monitoring pulmonary congestion in heart failure patients (AHA/ACC guidelines 2006). Ultrasound lung comets (ULCs) are a simple, quantitative chest sonography sign of pulmonary congestion, originating from water-thickened interlobular septa, and might represent a convenient alternative to chest x-ray in this clinical setting. Aim: To assess whether dynamic changes in ULCs could mirror variations in clin...

  8. Classification tree for risk assessment in patients suffering from congestive heart failure via long-term heart rate variability

    OpenAIRE

    Melillo, Paolo; De Luca, Nicola; Bracale, Marcello; Pecchia, Leandro

    2013-01-01

    This study aims to develop an automatic classifier for risk assessment in patients suffering from congestive heart failure (CHF). The proposed classifier separates lower risk patients from higher risk ones, using standard long-term heart rate variability (HRV) measures. Patients are labeled as lower or higher risk according to the New York Heart Association classification (NYHA). A retrospective analysis on two public Holter databases was performed, analyzing the data of 12 patients suffering...

  9. Effects of spironolactone on electrical and structural remodeling of atrium in congestive heart failure dogs

    Institute of Scientific and Technical Information of China (English)

    YANG Shu-sen; XIU Chun-hong; LI Wei-min; HAN Wei; ZHOU Hong-yan; DONG Guo; WANG Bai-chun; HUO Hong; WEI Na; CAO Yong; ZHOU Guo

    2008-01-01

    Background Renin-angiotensin-aldosterone System has been demonstrated to be associated with both congestive heart failure (CHF) and atrial fibrillation (AF). This study investigated the effects of spironolactone, a kind of aldosterone antagonist, on atrial electrical remodeling and fibrosis in CHF dogs induced by chronic rapid ventricular pacing. Methods Twenty one dogs were randomly divided into sham-operated group, control group, and spironolactone group. In control group and spironolactone group, dogs were ventricular paced at 220 beats per minute for 6 weeks. Additionally, spironolactone at 15 mg·kg-1·d-1 was given to dogs 1 week before rapid ventricular pacing until pacing stopped. Transthoracic and transoesophageal echocardiographic examinations were performed to detect structural and functional changes of the atrium. Swan2 Ganz floating catheters were used to measure hemadynamics variances. Atrial effective refractory period (AERP), AERP dispersion (AERPd), intra- and inter-atrium conduction time (CT) and intra-atrium conduction velocity (CV) were determined. The inducibility and duration of AF were also measured in all groups. Finally, atrial fibrosis was quantified with Massen staining.Results AERP did not change significantly after dogs were ventricular paced for 6 weeks. However, AERPd, intra- and inter-atrium CT increased significantly, and CV decreased apparently, which was negatively correlated to the atrial fibrosis (r=-0.74, P<0.05). Simultaneously, left atriums were enlarged and cardiac hemadynamics worsened in pacing dogs. Although spironolactone could not affect cardiac hemadynamics effectively, it can obviously improve left atrial ejection fraction (P<0.05). Spironolactone treatment did not alter AERP duration, but this medicine dramatically decreased AERPd (P<0.05), shortened intra- and inter-atrium conduction time (P<0.05), and increased atrium CV. Moreover, spironolactone decreased the inducibility and duration of AF (P<0.05),as

  10. Dopaminergic drugs in congestive heart failure: hemodynamic and neuroendocrine responses to ibopamine, dopamine, and dihydroergotoxine.

    Science.gov (United States)

    Metra, M; Missale, C; Spano, P F; Cas, L D

    1995-05-01

    Ibopamine has hemodynamic and neurohumoral effects potentially useful for the treatment of congestive heart failure (CHF), but its mechanism of action is not completely clear. To evaluate the role of dopaminergic receptor stimulation in the hemodynamic and neurohumoral activity of ibopamine, we compared the effects of ibopamine, 100 mg orally (p.o.) with those of the dopamine 2, 4, and 6 micrograms/kg/min intravenously (i.v.) and of the DA2 agonist dihydroergotoxine 6 micrograms/kg i.v. in 13 patients with chronic CHF [left ventricular ejection fraction (LVEF) index (CI) with a 23 and 25% increase in stroke volume (SV) and stroke work indexes (SWI), respectively, and an 18% reduction in systemic vascular resistance (SVR). Similar changes were observed after DA infused at the doses of 2 and 4 micrograms/kg/min, whereas with the dose of 6 micrograms/kg/min heart rate (HR) increased by 23% and SV index (SVI) did not change further. Dihydroergotoxine administration induced only a significant 9% decrease in mean arterial pressure (MAP), with a 13% reduction in SVR.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:7630152

  11. Supplying sodium and chlorine is effective on patients with congestive heart failure

    Institute of Scientific and Technical Information of China (English)

    Yu Li; Changcong Cui

    2005-01-01

    Objective: To analyze the relationship of severity of heart failure and the concentration of serum sodium(Na + ) and chlorine(Cl- ) and to explore the effect of supplying sodium and chlorine on patients with Congestive heart failure. Methods: 80 patients with congestive heart failure were divided into two groups, namely supplying and control group. Serum sodium and chlorine were measured in all these patients. All treatments but supplying sodium and chlorine were same between the supplying and control groups. Results:According to NYHA, patients who were in class Ⅳ had lower level of serum sodium and chlorine than those in class Ⅱ ( P < 0.05). The heart function was improved after the level of serum sodium and chlorine were raised. Conclusions: The concentration of serum sodium and chlorine relates to the severity of heart failure. The therapy of supplying sodium and chlorine is an effective way to decrease death rate.

  12. Loss of lag-response curvilinearity of indices of heart rate variability in congestive heart failure

    Directory of Open Access Journals (Sweden)

    Smith Michael L

    2006-06-01

    Full Text Available Abstract Background Heart rate variability (HRV is known to be impaired in patients with congestive heart failure (CHF. Time-domain analysis of ECG signals traditionally relies heavily on linear indices of an essentially non-linear phenomenon. Poincaré plots are commonly used to study non-linear behavior of physiologic signals. Lagged Poincaré plots incorporate autocovariance information and analysis of Poincaré plots for various lags can provide interesting insights into the autonomic control of the heart. Methods Using Poincaré plot analysis, we assessed whether the relation of the lag between heart beats and HRV is altered in CHF. We studied the influence of lag on estimates of Poincaré plot indices for various lengths of beat sequence in a public domain data set (PhysioNet of 29 subjects with CHF and 54 subjects with normal sinus rhythm. Results A curvilinear association was observed between lag and Poincaré plot indices (SD1, SD2, SDLD and SD1/SD2 ratio in normal subjects even for a small sequence of 50 beats (p value for quadratic term 3 × 10-5, 0.002, 3.5 × 10-5 and 0.0003, respectively. This curvilinearity was lost in patients with CHF even after exploring sequences up to 50,000 beats (p values for quadratic term > 0.5. Conclusion Since lagged Poincaré plots incorporate autocovariance information, these analyses provide insights into the autonomic control of heart rate that is influenced by the non-linearity of the signal. The differences in lag-response in CHF patients and normal subjects exist even in the face of the treatment received by the CHF patients.

  13. 慢性充血性心力衰竭外周甲状腺素水平变化%Alteration of peripheral thyroid hormone in patients with chronic congestive heart failure

    Institute of Scientific and Technical Information of China (English)

    姜腾勇; 吴学思

    2001-01-01

    Objective:This study is to ev aluate the prevelence and the pathophysiological significance of sick euthyroid syndro me in patients with chronic cardiovascular diseases,especially in chronic conges tive heart fa ilure(CHF).Method:The study population included 54 patients with ch ronic heart f ailure and 20 patients with chronic cardiovascular diseases.Blood sample were as sessed after a fast-night.SES was defined as the serum total triiodothyronine(T 3) l evel was less than the lowest normal limit (<0.8ng/ml)with the normal serum thy roid stimulating hormone and quiiodothyronine(T4).Result:SES was founded in 33/74(4 4%)patients,as high as 51%(28/54)in CHF patients.The prevalence of SES increase d as th e degree of chronic heart failure increased.The function status(NYHA),end diasto l ic diameter and ejecton fraction of left ventricle and T4 concentration in ser um exited a significantly difference.between the CHF patients with and without S ES,and the functional index of liver and kindey.physical characteristics did not exist significantly difference.Conclusion:The sick euthyroid syndro me presents i n chronic cardiovascular diseases,and the higher of its prevalvence,the more sev erve of cardiac function insufficiency.The functional status of liver and kidney was not the major determinant of SES in CHF patients.To recognize the phenomeno n of SES in patients with CHF may offer a valuable train of thought in management of CHF.%目的: 观察评价慢性心血管病,尤其是慢性心衰患者甲状腺功能正常病态综合症(SES)发生情况 并探讨其病理生理意义。方法:病史大于2年的慢 性心衰(CHF)病人54例和同期住院非CHF的慢性心血管病人20例,病情平稳后抽取空腹血临床 生化检验和甲状腺素测定。SES定义为血清总3-碘甲腺原氨酸(T3)低于正常值的低限(<0 .8 ng/ml),4-碘甲腺原氨酸(T4)和促甲状腺素正常。结果:74 例受试者中有33例发生SES,CH F

  14. Baroreflex Activation Therapy in Congestive Heart Failure: Novel Findings and Future Insights.

    Science.gov (United States)

    Grassi, Guido; Brambilla, GianMaria; Pizzalla, Daniela Prata; Seravalle, Gino

    2016-08-01

    Congestive heart failure is characterized by hemodynamic and non-hemodynamic abnormalities, the latter including an activation of the sympathetic influences to the heart and peripheral circulation coupled with an impairment of baroreceptor control of autonomic function. Evidence has been provided that both these alterations are hallmark features of the disease with a specific relevance for the disease progression as well as for the development of life-threatening cardiac arrhythmias. In addition, a number of studies have documented in heart failure the adverse prognostic role of the sympathetic and baroreflex alterations, which both are regarded as major independent determinants of cardiovascular morbidity and mortality. This represents the pathophysiological and clinical background for the use of carotid baroreceptor activation therapy in the treatment of congestive heart failure. Promising data collected in experimental animal models of heart failure have supported the recent performance of pilot small-scale clinical studies, aimed at providing initial information in this area. The results of these studies demonstrated the clinical safety and efficacy of the intervention which has been tested in large-scale clinical studies. The present paper will critically review the background and main results of the published studies designed at defining the clinical impact of baroreflex activation therapy in congestive heart failure patients. Emphasis will be given to the strengths and limitations of such studies, which represent the background for the ongoing clinical trials testing the long-term effects of the device in heart failure patients.

  15. Baroreflex Activation Therapy in Congestive Heart Failure: Novel Findings and Future Insights.

    Science.gov (United States)

    Grassi, Guido; Brambilla, GianMaria; Pizzalla, Daniela Prata; Seravalle, Gino

    2016-08-01

    Congestive heart failure is characterized by hemodynamic and non-hemodynamic abnormalities, the latter including an activation of the sympathetic influences to the heart and peripheral circulation coupled with an impairment of baroreceptor control of autonomic function. Evidence has been provided that both these alterations are hallmark features of the disease with a specific relevance for the disease progression as well as for the development of life-threatening cardiac arrhythmias. In addition, a number of studies have documented in heart failure the adverse prognostic role of the sympathetic and baroreflex alterations, which both are regarded as major independent determinants of cardiovascular morbidity and mortality. This represents the pathophysiological and clinical background for the use of carotid baroreceptor activation therapy in the treatment of congestive heart failure. Promising data collected in experimental animal models of heart failure have supported the recent performance of pilot small-scale clinical studies, aimed at providing initial information in this area. The results of these studies demonstrated the clinical safety and efficacy of the intervention which has been tested in large-scale clinical studies. The present paper will critically review the background and main results of the published studies designed at defining the clinical impact of baroreflex activation therapy in congestive heart failure patients. Emphasis will be given to the strengths and limitations of such studies, which represent the background for the ongoing clinical trials testing the long-term effects of the device in heart failure patients. PMID:27334011

  16. A history of arterial hypertension does not affect mortality in patients hospitalised with congestive heart failure

    DEFF Research Database (Denmark)

    Gustafsson, F; Torp-Pedersen, C; Seibaek, M;

    2006-01-01

    OBJECTIVES: To evaluate the importance of a history of hypertension on long-term mortality in a large cohort of patients hospitalised with congestive heart failure (CHF). DESIGN: Retrospective analysis of 5491 consecutive patients, of whom 24% had a history of hypertension. 60% of the patients had...

  17. Bootstrapping Results of Exercise Therapy and Education for Patients with Congestive Heart Failure

    Science.gov (United States)

    Witta, E. Lea; Brubaker, Craig

    2003-01-01

    When studies are conducted over a period of time, the sample size typically decreases. In a study of the effects of exercise therapy and education with recovering congestive heart failure (CHF) patients (Brubaker, Witta, & Angelopoulus, 2003), the sample size decreased from over 40 to 9 participants after an 18-month time span. Although the…

  18. Enhanced endothelin-1-induced contractions in mesenteric arteries from rats with congestive heart failure

    DEFF Research Database (Denmark)

    Bergdahl, A; Valdemarsson, S; Adner, M;

    2001-01-01

    Studies of congestive heart failure (CHF) in man and in experimental CHF have demonstrated elevated circulating levels of endothelin (ET). In order to examine whether there are concomitant ET receptor alterations, the vasomotor effects of endothelin-1 (ET-1) and sarafotoxin 6c (S6c) were examined...

  19. Post-Acute Home Care and Hospital Readmission of Elderly Patients with Congestive Heart Failure

    Science.gov (United States)

    Li, Hong; Morrow-Howell, Nancy; Proctor, Enola K.

    2004-01-01

    After inpatient hospitalization, many elderly patients with congestive heart failure (CHF) are discharged home and receive post-acute home care from informal (family) caregivers and formal service providers. Hospital readmission rates are high among elderly patients with CHF, and it is thought that use of informal and formal services may reduce…

  20. The Impact of Family Functioning on Caregiver Burden among Caregivers of Veterans with Congestive Heart Failure

    Science.gov (United States)

    Moore, Crystal Dea

    2010-01-01

    A cross-sectional study of 76 family caregivers of older veterans with congestive heart failure utilized the McMaster model of family functioning to examine the impact of family functioning variables (problem solving, communication, roles, affective responsiveness, and affective involvement) on caregiver burden dimensions (relationship burden,…

  1. Parvovirus B19-Induced Constellation of Acute Renal Failure, Elevated Aminotransferases and Congestive Heart Failure

    Directory of Open Access Journals (Sweden)

    Iain W McAuley

    1997-01-01

    Full Text Available This report details a case of acute renal failure and elevated aminotransferases with subsequent development of congestive heart failure in a patient with history of exposure to parvovirus B19 and serological evidence of acute infection with this agent. This constellation of organ involvement has not been previously reported in the literature.

  2. Plasma immunoreactive neuropeptide Y in congestive heart failure at rest and during exercise

    DEFF Research Database (Denmark)

    Madsen, B K; Husum, D; Videbaek, R;

    1993-01-01

    The purpose of the study described here was to study plasma immunoreactive Neuropeptide Y (NPY) at rest and during exercise in patients with congestive heart failure (CHF) and in healthy subjects. Thirty-five patients, mean age 64 years, with CHF in optimal treatment and with a mean ejection...

  3. Phlegmonous enteritis in a patient with congestive heart failure and colon cancer

    Energy Technology Data Exchange (ETDEWEB)

    Namkung, Sook; Yoo, Yoon Sik; Hwang, Im Kyung; Kim, Bong Soo; Bae, Sang Hoon; Choi, Young Hee [Hallym University, Chuncheon (Korea, Republic of)

    2001-12-01

    Phlegmonous enteritis is a rare infective inflammatory disease of the intestine, predominantly involving the submucosal layer. It is difficult to diagnose and often fatal. Its association with alcoholism and various liver diseases, although rarely reported, is well documented. We report a case of phlegmonous enteritis in a male patient with congestive heart failure and colon cancer, and describe the ultrasonographic and CT findings.

  4. Optimized cardiac resynchronization therapy in patients with congestive heart failure

    Institute of Scientific and Technical Information of China (English)

    NIU Hong-xia; HUA Wei; ZHANG Shu; SUN Xin; CHEN Ke-ping; WANG Fang-zheng; CHEN Xin

    2007-01-01

    @@ Heart failure was a major and increasing public health problem, with an almost "epidemic increase in the number of patients.1 Despite recent advances in pharmacotherapy, the prognosis remains poor. Cardiac resynchronization therapy (CRT), by pacing right and left ventricles, has been proved to improve symptoms and reduce mortality for heart failure patients with cardiac dyssynchrony.

  5. Pneumoconiosis increases the risk of congestive heart failure: A nationwide population-based cohort study.

    Science.gov (United States)

    Yen, Chia-Ming; Lin, Cheng-Li; Lin, Ming-Chia; Chen, Huei-Yong; Lu, Nan-Han; Kao, Chia-Hung

    2016-06-01

    The purpose of the study was to determine the relationship between pneumoconiosis and congestive heart failure (CHF).We collected data from the National Health Insurance Research Database in Taiwan. The study sample comprised 8923 patients with pneumoconiosis and 35,692 nonpneumoconiosis controls enrolled from 2000 to 2011. Patients were followed up until the end of 2011 to evaluate the incidence of CHF. The risk of CHF was analyzed using Cox proportional hazard regression models, and the analysis accounted for factors such as sex, age, comorbidities, and air pollutants (μg/m).The overall incidence of CHF was higher in the pneumoconiosis cohort (15.7 per 1000 person-y) than in the nonpneumoconiosis cohort (11.2 per 1000 person-y), with a crude hazard ratio (HR) of 1.40 (P pneumoconiosis cohort than in the nonpneumoconiosis cohort (P pneumoconiosis cohort compared with the nonpneumoconiosis cohort was significant for men (adjusted HR = 1.40, 95% confidence interval = 1.21-1.62, P pneumoconiosis patients had a higher relative risk of CHF for all age group.Patients with pneumoconiosis were at higher risk for developing CHF than patients in the nonpneumoconiosis cohort, particularly in cases with coexisting coronary artery disease, hypertension, and chronic obstructive pulmonary disease. PMID:27336897

  6. Enhanced Ca2+-induced contractions and attenuated alpha-adrenoceptor responses in resistance arteries from rats with congestive heart failure

    DEFF Research Database (Denmark)

    Bergdahl, A; Valdemarsson, S; Sun, X Y;

    2001-01-01

    AIM: The aim of the present study was to examine the role of Ca2+-mediated contractile responses in isolated mesenteric resistance arteries from rats with congestive heart failure (CHF). METHODS: Heart failure was induced by ligation of the left coronary artery. Rats exposed to the same surgical......-adrenoceptors and a difference of Ca2+-mediated vascular contractility in resistance arteries of congestive heart failure rats....

  7. Pioglitazone-induced congestive heart failure and pulmonary edema in a patient with preserved ejection fraction

    Directory of Open Access Journals (Sweden)

    Vaneet Jearath

    2016-01-01

    Full Text Available Pioglitazone-induced heart failure is known in patients with underlying heart disease, but is not well documented in patients with normal left ventricular function. Pioglitazone has been very popular as it is an insulin sensitizer and insulin resistance is prevalent among Indians. Fluid retention exacerbates pre-existing heart failure or precipitates heart failure in a patient with underlying left ventricular dysfunction. However, pathogenesis of heart failure in a patient with normal left ventricular function is not known. Probably it is due to dose-related effect on pulmonary endothelial permeability, rather than alterations in left ventricular mass or ejection fraction. We report a patient who developed congestive heart failure and pulmonary edema with normal left ventricular function within 1 year of starting pioglitazone therapy. We have to be careful in monitoring all possible side effects during followup when patients are on pioglitazone therapy.

  8. Pioglitazone-induced congestive heart failure and pulmonary edema in a patient with preserved ejection fraction.

    Science.gov (United States)

    Jearath, Vaneet; Vashisht, Rajan; Rustagi, Vipul; Raina, Sujeet; Sharma, Rajesh

    2016-01-01

    Pioglitazone-induced heart failure is known in patients with underlying heart disease, but is not well documented in patients with normal left ventricular function. Pioglitazone has been very popular as it is an insulin sensitizer and insulin resistance is prevalent among Indians. Fluid retention exacerbates pre-existing heart failure or precipitates heart failure in a patient with underlying left ventricular dysfunction. However, pathogenesis of heart failure in a patient with normal left ventricular function is not known. Probably it is due to dose-related effect on pulmonary endothelial permeability, rather than alterations in left ventricular mass or ejection fraction. We report a patient who developed congestive heart failure and pulmonary edema with normal left ventricular function within 1 year of starting pioglitazone therapy. We have to be careful in monitoring all possible side effects during followup when patients are on pioglitazone therapy.

  9. Pioglitazone-induced congestive heart failure and pulmonary edema in a patient with preserved ejection fraction

    Science.gov (United States)

    Jearath, Vaneet; Vashisht, Rajan; Rustagi, Vipul; Raina, Sujeet; Sharma, Rajesh

    2016-01-01

    Pioglitazone-induced heart failure is known in patients with underlying heart disease, but is not well documented in patients with normal left ventricular function. Pioglitazone has been very popular as it is an insulin sensitizer and insulin resistance is prevalent among Indians. Fluid retention exacerbates pre-existing heart failure or precipitates heart failure in a patient with underlying left ventricular dysfunction. However, pathogenesis of heart failure in a patient with normal left ventricular function is not known. Probably it is due to dose-related effect on pulmonary endothelial permeability, rather than alterations in left ventricular mass or ejection fraction. We report a patient who developed congestive heart failure and pulmonary edema with normal left ventricular function within 1 year of starting pioglitazone therapy. We have to be careful in monitoring all possible side effects during followup when patients are on pioglitazone therapy. PMID:27127397

  10. Heart rate increment analysis is not effective for sleep-disordered breathing screening in patients with chronic heart failure.

    OpenAIRE

    Damy, Thibaud; d'Ortho, Marie-Pia; Estrugo, Brigitte; Margarit, Laurent; Mouillet, Gauthier; Mahfoud, Mohannad; Roudot-Thoraval, Francoise; Vermes, Emmanuelle; Hittinger, Luc; Roche, Frederic; Macquin-Mavier, Isabelle

    2010-01-01

    Frequency domain analysis of heart rate variation has been suggested as an effective screening tool for sleep-disordered breathing (SDB) in the general population. The aim of this study was to assess this method in patients with chronic congestive heart failure (CHF). We included prospectively 84 patients with stable CHF, left ventricular ejection fraction (LVEF) or =15 h(-1) was diagnosed in 57.4% of patients. Percent VLFI was not correlated with AHI (r = 0.12). Receiver-operating character...

  11. Implementing home telemanagement of congestive heart failure using Xbox gaming platform.

    Science.gov (United States)

    Finkelstein, Joseph; Wood, Jeffrey

    2011-01-01

    Gaming platforms have been recognized for user-friendly interface which does not require previous computer-related experience. Easy to use and wide availability of these platforms at patient households make them an attractive means to facilitate consumer health. The potential of such widely used platforms as Xbox for self-management of chronic health conditions has not yet been fully uncovered. We developed a Home Automated Telemanagement (HAT) system which utilizes Xbox to access personal health record, receive self-care support and exchange information with health care providers. The system questions patients with congestive heart failure (CHF) to monitor symptoms, weight changes, medication adherence and quality of life while educating the patient on their disease. The patients receive an instant feedback on their condition in the form of a 3-zone CHF action plan. The patient self-management information can be reviewed by a provider on a designated web site. The system is programmed to run on the Microsoft Xbox videogame console using an active internet connection and a connection to a computer running Windows Media Center. The system is designed to be as simple as possible making it usable by patients with no prior computer or videogame experience. The feasibility of this approach was tested in ten adults with no previous Xbox experience who completed attitudinal surveys and semi-structured qualitative interviews after using the system. All participants claimed that they did not have any problems in using the system and that they would use the system in the future if necessary. An Xbox-based telemanagement system has potential to optimize the care of patients with CHF and other chronic conditions.

  12. B-type Natriuretic Peptide Assay in Differentiating Congestive Heart Failure from Lung Disease in Patients Presenting with Dyspnea.

    Science.gov (United States)

    Islam, M A; Bari, M S; Islam, M N; Bari, M A; Siddique, S R; Islam, M Z; Begum, M S; Ahammed, S U; Rahman, M A

    2016-07-01

    This cross-sectional analytical study was conducted in Cardiology & Medicine Department of Mymensingh Medical College Hospital. After fulfilling the exclusion & inclusion criteria, B-type natriuretic peptide concentrations were measured in a convenience sample of 100 predominantly male (94%) dyspnic patients who got admitted in Cardiology & Medicine Department of Mymensingh Medical College & Hospital from November 2013 to October 2014. The diagnosis of Congestive Heart Failure (CHF) was based on generally accepted Framingham criteria with corroborative information including hospital course (response to diuretics, vasodilators, inotropes or hemodynamic monitoring) and results of further cardiac testing, including echocardiography. Patients with right heart failure from cor pulmonale were classified as having CHF. Pulmonary disease was confirmed by using the following diagnostic tools: i) A chest X-ray without signs of heart enlargement or pulmonary venous hypertension or a chest X-ray with signs of chronic obstructive lung disease, ii) Normal heart function as seen by echocardiography, iii) Abnormal pulmonary function tests or follow-up results and iv) A positive response to treatment with steroids, nebulizers or antibiotics in hospital. Patients with CHF (n=50) had mean BNP level 1146.72pg/ml (range 103 to 5000pg/ml), which is significantly higher than the group of patients with a final diagnosis of pulmonary disease (n=50) whose BNP was 34pg/ml (range 10 to 90pg/ml) (pcongestive heart failure from lung disease in patients presenting with dyspnea.

  13. 31P-NMR analysis of congestive heart failure in the SHHF/Mcc-facp rat heart.

    Science.gov (United States)

    Michael O'Donnell, J; Narayan, P; Bailey, M Q; Abduljalil, A M; Altschuld, R A; McCune, S A; Robitaille, P M

    1998-02-01

    31P-NMR was used to monitor myocardial bioenergetics in compensated and failing SHHF/MCC-fa(cp) (SHF) rat hearts. The SHHF/Mcc-fa(cp) (spontaneous hypertension and heart failure) rat is a relatively new genetic model in which all individuals spontaneously develop congestive heart failure, most during the second year of life. Failing SHF rat hearts displayed a pronounced decrease in resting PCr:ATP ratios (Ppressure products (RRP, mmHg X beats/min) from 44.5+/-1.4 to 66.6+/-3. 4 K with dobutamine infusion, whereas hearts in end-stage failure were able to increase their RPP from baseline values of 27+/-4 K to only 37+/-7 K. The data indicate that a pronounced decline in PCr and total creatine signals the transition from compensatory hypertrophy to decompensation and failure in the SHF rat model of hypertensive cardiomyopathy. PMID:9515000

  14. Decreasing Congestive Heart Failure Readmission Rates Within 30 Days at the Tampa VA.

    Science.gov (United States)

    Messina, William

    2016-01-01

    High hospital readmission rates contribute to the problem of escalating costs and fragmented quality in the US health care system. This article describes the implementation of a home telehealth (HT) performance improvement project with subsequent cost-avoidance savings. The HT project was designed to potentiate communication between and among patients, clinicians, and administrative staff, in addition to reducing readmissions for patients with congestive heart failure at the James A. Haley Veterans Hospital in Tampa, Florida. Pre- and post-HT implementation comparisons were made of readmission rates, costs, and veteran satisfaction from the same 4-month periods in 2012 and 2013. The application of telehealth and phone care initiatives reduced the congestive heart failure hospital readmission rate by 5%, decreased costs, and improved veteran satisfaction with overall care experience.

  15. Can antiarrhythmic drugs save lives in patients with congestive heart failure?

    DEFF Research Database (Denmark)

    Brendorp, Bente; Pedersen, Ole Dyg; Elming, Hanne;

    2003-01-01

    Although arrhythmic death is a common cause of death in patients with congestive heart failure (CHF), numerous trials involving prophylactic antiarrhythmic drug treatment have yielded few gains. To date, only beta-blockers have shown a distinct mortality-reducing effect and despite the antiarryth......Although arrhythmic death is a common cause of death in patients with congestive heart failure (CHF), numerous trials involving prophylactic antiarrhythmic drug treatment have yielded few gains. To date, only beta-blockers have shown a distinct mortality-reducing effect and despite...... to obtain sinus rhythm. This paper outlines the results of the large clinical trials dealing with antiarrhythmic drug treatment in CHF patients with or without atrial fibrillation and certain subgroup analysis and future treatment possibilities are discussed....

  16. A case report of primary cardiac myxofibrosarcoma presenting with severe congestive heart failure

    OpenAIRE

    Ujihira, Kosuke; Yamada, Akira; Nishioka, Naritomo; Iba, Yutaka; Maruyama, Ryushi; Nakanishi, Katsuhiko; Shimizu, Ai; Hatanaka, Kanako C.; Mitsuhashi, Tomoko; Shinohara, Toshiya; Ueda, Hatsue Ishibashi

    2016-01-01

    Background Primary cardiac sarcomas are extremely rare. Furthermore, the myxofibrosarcomas are one of the rarest forms of cardiac sarcomas, and its prognosis is known to be quite poor. Case presentation This is a case of a 23-year-old man who presented with acute severe congestive heart failure caused by almost complete obstruction of the mitral valve due to a large left atrial tumor. The patient required endotracheal intubation before his arrival to the hospital, and underwent an emergent su...

  17. Disparities in Patterns of Health Care Travel Among Inpatients Diagnosed With Congestive Heart Failure, Florida, 2011

    OpenAIRE

    Jia, Peng; Xierali, Imam M.

    2015-01-01

    Introduction Congestive heart failure (CHF) is a major public health problem in the United States and is a leading cause of hospitalization in the elderly population. Understanding the health care travel patterns of CHF patients and their underlying cause is important to balance the supply and demand for local hospital resources. This article explores the nonclinical factors that prompt CHF patients to seek distant instead of local hospitalization. Methods Local hospitalization was defined as...

  18. A multi-layer monitoring system for clinical management of Congestive Heart Failure

    OpenAIRE

    Guidi, Gabriele; Pollonini, Luca; Dacso, Clifford C; Iadanza, Ernesto

    2015-01-01

    Background Congestive Heart Failure (CHF) is a serious cardiac condition that brings high risks of urgent hospitalization and death. Remote monitoring systems are well-suited to managing patients suffering from CHF, and can reduce deaths and re-hospitalizations, as shown by the literature, including multiple systematic reviews. Methods The monitoring system proposed in this paper aims at helping CHF stakeholders make appropriate decisions in managing the disease and preventing cardiac events,...

  19. Impact of Telehealth on Healthcare Utilization by Congestive Heart Failure Patients

    OpenAIRE

    Craig A. Lehmann; Nancy Mintz; Jean Marie Giacini

    2006-01-01

    Background: Advances in telehealth are proving to be extremely conducive to effective management of congestive heart failure (CHF) and other disease states, particularly in ambulatory settings. In order to assess the impact of telehealth on healthcare utilization in CHF patients, telehealth technology was introduced into a demonstration project established by the Secretary of Health and Human Services. Demonstration projects examine health delivery factors that encourage the delivery of impro...

  20. Wavelet Based Method for Congestive Heart Failure Recognition by Three Confirmation Functions

    OpenAIRE

    K. Daqrouq; A. Dobaie

    2016-01-01

    An investigation of the electrocardiogram (ECG) signals and arrhythmia characterization by wavelet energy is proposed. This study employs a wavelet based feature extraction method for congestive heart failure (CHF) obtained from the percentage energy (PE) of terminal wavelet packet transform (WPT) subsignals. In addition, the average framing percentage energy (AFE) technique is proposed, termed WAFE. A new classification method is introduced by three confirmation functions. The confirmation m...

  1. Enhanced acetylcholine and P2Y-receptor stimulated vascular EDHF-dilatation in congestive heart failure

    DEFF Research Database (Denmark)

    Malmsjö, M; Bergdahl, A; Zhao, Xin;

    1999-01-01

    OBJECTIVE: Congestive heart failure (CHF) is accompanied by impaired peripheral blood flow and endothelial dysfunction with decreased release of nitric oxide (NO). Strong evidence supports the existence of another vasodilatory substance, endothelium derived hyperpolarising factor (EDHF), which has...

  2. Complications of cardiac resynchronization therapy in patients with congestive heart failure

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    Background Previous clinical studies have suggested that patients with congestive heart failure and intraventricular conduction delay could benefit from cardiac resynchronization therapy (CRT). Implantation of left ventricular lead is a complex procedure with some potential for complications. This study was conducted to analyse the complications of CRT in patients with congestive heart failure.Methods Totally 117 patients, 86 males and 31 females, mean age of 53 years, with congestive heart failure and intraventricular conduction delaywere enrolled in this study. Venography was performed on all patients. Different types of coronary sinus leads were used to pace the left ventricle. Results Left ventricular lead was attempted to implant through coronary sinus for all the 117 patients and was successfully implanted in 111 patients. The success rate was 94.9%. Main complications rate was 6.8%, including coronary sinus dissection in 4 patients, phrenic nerve stimulation required lead repositioning in 2 patients and lead dislodgement in 2 patients. Conclusions It is feasible and safe to pace left ventricle through coronary sinus. However, there are some procedural complications.

  3. [Intraoperative fluid therapy in infants with congestive heart failure due to intracranial pial arteriovenous fistula].

    Science.gov (United States)

    Arroyo-Fernández, F J; Calderón-Seoane, E; Rodríguez-Peña, F; Torres-Morera, L M

    2016-05-01

    Pial arteriovenous fistula is a rare intracranial congenital malformation (0.1-1: 100,000). It has a high blood flow between one or more pial arteries and drains into the venous circulation. It is usually diagnosed during the childhood by triggering an intracranial hypertension and/or congestive heart failure due to left-right systemic shunt. It is a rare malformation with a complex pathophysiology. The perioperative anaesthetic management is not well established. We present a 6-month-old infant diagnosed with pial arteriovenous fistula with hypertension and congestive heart failure due to left-right shunt. He required a craniotomy and clipping of vascular malformation. Anaesthetic considerations in patients with this condition are a great challenge. It must be performed by multidisciplinary teams with experience in paediatrics. The maintenance of blood volume during the intraoperative course is very important. Excessive fluid therapy can precipitate a congestive heart failure or intracranial hypertension, and a lower fluid therapy may cause a tissue hypoxia due to the bleeding.

  4. Female sex is associated with a better long-term survival in patients hospitalized with congestive heart failure

    DEFF Research Database (Denmark)

    Gustafsson, Finn; Torp-Pedersen, Christian; Burchardt, Hans;

    2004-01-01

    AIMS: Results of previous studies on the influence of gender on prognosis in heart failure have been conflicting and most studies have been conducted in selected populations. The aim of this study was determine whether mortality risk in women and men hospitalized with congestive heart failure...... is different. METHODS AND RESULTS: Survival analysis of 5491 consecutive patients admitted with congestive heart failure to 34 Danish hospitals between 1993-1996. Follow-up time was 5-8 years. Forty percent of the patients were female. Females were older, had less evidence of ischaemic heart disease...... with an increased risk of death (RR 1.25 (1.17-1.34)) and the increased risk was confirmed in a multivariate model containing several covariates. CONCLUSIONS: In patients hospitalized with congestive heart failure male gender is an independent predictor of mortality. Female heart failure patients may be under...

  5. Pharmacogenetic risk stratification in angiotensin-converting enzyme inhibitor-treated patients with congestive heart failure

    DEFF Research Database (Denmark)

    Nelveg-Kristensen, Karl Emil; Busk Madsen, Majbritt; Torp-Pedersen, Christian;

    2015-01-01

    BACKGROUND: Evidence for pharmacogenetic risk stratification of angiotensin-converting enzyme inhibitor (ACEI) treatment is limited. Therefore, in a cohort of ACEI-treated patients with congestive heart failure (CHF), we investigated the predictive value of two pharmacogenetic scores...... SNPs of the angiotensin-converting enzyme gene (rs4343) and ABO blood group genes (rs495828 and rs8176746). METHODS: Danish patients with CHF enrolled in the previously reported Echocardiography and Heart Outcome Study were included. Subjects were genotyped and categorized according to pharmacogenetic...

  6. Population pharmacokinetics of levosimendan in patients with congestive heart failure

    Science.gov (United States)

    Jonsson, E Niclas; Antila, Saila; McFadyen, Lynn; Lehtonen, Lasse; Karlsson, Mats O

    2003-01-01

    Aims The aim of this study was to characterize the population pharmacokinetics of levosimendan in patients with heart failure (NYHA grades III and IV) and its relationship to demographic factors, disease severity and concomitant use of digoxin and β-blocking agents. Methods Data from two efficacy studies with levosimendan administered by intravenous infusion were combined (190 patients in total). The data were analysed using a nonlinear mixed-effects modelling approach as implemented in the NONMEM program. The model development was done in three sequential steps. First the best structural model was determined (e.g. a one-, two- or three-compartment pharmacokinetic model). This was followed by the identification and incorporation of important covariates into the model. Lastly the stochastic part of the model was refined. Results A two-compartment model best described levosimendan pharmacokinetics. Clearance and the central volume of distribution were found to increase linearly with bodyweight. No other covariates, including concomitant use of digoxin and β-blocking agents, influenced the pharmacokinetics. In the final model, a 76-kg patient was estimated to have a clearance ± s.e. of 13.3 ± 0.4 l h−1 and a central volume of distribution of 16.8 ± 0.79 l. The interindividual variability was estimated to be 39% and 60% for clearance and central volume of distribution, respectively. Weight changed clearance by 1.5% [95% confidence interval (CI) 0.9%, 2.1%] and the central volume of distribution by 0.9% (95% CI 0.5%, 1.3%) per kg. Conclusions The population pharmacokinetics parameters of levosimendan in this patient group were comparable to those obtained by traditional methods in healthy volunteers and patients with mild heart failure. Bodyweight influenced the clearance and the central volume of distribution, which in practice is accounted for by weight adjusting doses. None of the other covariates, including digoxin and β-blocking agents, significantly

  7. Multifractal properties of ECG patterns of patients suffering from congestive heart failure

    Science.gov (United States)

    Dutta, Srimonti

    2010-12-01

    The multifractal properties of two-channel ECG patterns of patients suffering from severe congestive heart failure (New York Heart Association (NYHA) classes III-IV) are studied and are compared with those for normal healthy people using the multifractal detrended fluctuation analysis methodology. Ivanov et al (1999 Nature 399 461) have studied the multifractality of human heart rate dynamics using the wavelet transformation modulus maxima (WTMM) methodology. But it has been observed by several scientists that multifractal detrended fluctuation analysis (MFDFA) works better than the WTMM method in the detection of monofractal and multifractal characteristics of the data. Galaska et al (2008 Ann. Noninvasive Electrocardiol. 13 155) have observed that MFDFA is more sensitive compared to the WTMM method in the differentiation between multifractal properties of the heart rate in healthy subjects and patients with left ventricular systolic dysfunction. In the present work the variation of two parameters of the multifractal spectrum—its width W (related to the degree of multifractality) and the value of the Hölder exponent α0—for the healthy and congestive heart failure patients is studied. α0 is a measure of the degree of correlation. The degree of multifractality varies appreciably (85-90% C.L.) for the normal and the CHF sets for channel I. For channel II no significant change in the values is observed. The degree of correlation is found to be comparatively high for the normal healthy people compared to those suffering from CHF.

  8. Insomnia and chronic heart failure.

    Science.gov (United States)

    Hayes, Don; Anstead, Michael I; Ho, Julia; Phillips, Barbara A

    2009-09-01

    Insomnia is highly prevalent in patients with chronic disease including chronic heart failure (CHF) and is a significant contributing factor to fatigue and poor quality of life. The pathophysiology of CHF often leads to fatigue, due to nocturnal symptoms causing sleep disruption, including cough, orthopnea, paroxysmal nocturnal dyspnea, and nocturia. Inadequate cardiac function may lead to hypoxemia or poor perfusion of the cerebrum, skeletal muscle, or visceral body organs, which result in organ dysfunction or failure and may contribute to fatigue. Sleep disturbances negatively affect all dimensions of quality of life and is related to increased risk of comorbidities, including depression. This article reviews insomnia in CHF, cardiac medication side-effects related to sleep disturbances, and treatment options. PMID:18758945

  9. Sarcopenia, cachexia and congestive heart failure in the elderly.

    Science.gov (United States)

    Zamboni, Mauro; Rossi, Andrea P; Corzato, Francesca; Bambace, Clara; Mazzali, Gloria; Fantin, Francesco

    2013-03-01

    Skeletal muscle abnormalities and loss are frequently present in patients with mild or moderate cardiac heart failure (CHF) and may contribute to fatigue and dyspnea. These muscle abnormalities may be associated with age related body composition changes, such as sarcopenia. Muscle damage has also been observed in subjects with cardiac cahexia, a serious CHF complication, associated with poor prognosis independently of functional disease severity, age, and measures of exercise capacity and cardiac function. Loss of muscle mass is a feature of cachexia, whereas most sarcopenic subjects are not cachectic. Individuals with no weight loss, no anorexia, and no measurable systemic inflammatory response may be sarcopenic. Patients with severe CHF show multiple marked histological abnormalities of skeletal muscle, such as muscle fiber atrophy. These abnormalities are different in sarcopenia and cachexia. The majority of mechanisms involved in sarcopenia play a role even in the determination of cachexia and they are amplified in cachexia where they may induce both muscle damage as well as other abnormalities, such as fat and weight loss, through activation of lypolisis or anorexia. To distinguish cachexia and sarcopenia in CHF patients, even if not easy, should be clinically relevant, because no specific treatment is available for cachectic patients whereas treatment options are possible for sarcopenia. PMID:23369138

  10. Pneumoconiosis increases the risk of congestive heart failure: A nationwide population-based cohort study.

    Science.gov (United States)

    Yen, Chia-Ming; Lin, Cheng-Li; Lin, Ming-Chia; Chen, Huei-Yong; Lu, Nan-Han; Kao, Chia-Hung

    2016-06-01

    The purpose of the study was to determine the relationship between pneumoconiosis and congestive heart failure (CHF).We collected data from the National Health Insurance Research Database in Taiwan. The study sample comprised 8923 patients with pneumoconiosis and 35,692 nonpneumoconiosis controls enrolled from 2000 to 2011. Patients were followed up until the end of 2011 to evaluate the incidence of CHF. The risk of CHF was analyzed using Cox proportional hazard regression models, and the analysis accounted for factors such as sex, age, comorbidities, and air pollutants (μg/m).The overall incidence of CHF was higher in the pneumoconiosis cohort (15.7 per 1000 person-y) than in the nonpneumoconiosis cohort (11.2 per 1000 person-y), with a crude hazard ratio (HR) of 1.40 (P < 0.001). The HR for CHF was 1.38-fold greater in the pneumoconiosis cohort than in the nonpneumoconiosis cohort (P < 0.001) after the model was adjusted for age, sex, various comorbidities, and air pollutants (μg/m). The relative risk for CHF in the sex-specific pneumoconiosis cohort compared with the nonpneumoconiosis cohort was significant for men (adjusted HR = 1.40, 95% confidence interval = 1.21-1.62, P < 0.001). The incidence density rates of CHF increased with age; pneumoconiosis patients had a higher relative risk of CHF for all age group.Patients with pneumoconiosis were at higher risk for developing CHF than patients in the nonpneumoconiosis cohort, particularly in cases with coexisting coronary artery disease, hypertension, and chronic obstructive pulmonary disease.

  11. Responsiveness of the Chinese Quality of Life Instrument in Patients with Congestive Heart Failure

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    Objective:The Chinese Quality of Life Instrument (ChQOL) was developed as a valid generic health status instrument based on the well-established theory of health in Chinese medicine.Psychometric properties of the ChQOL were good.In the present study,the responsiveness of the ChQOL in patients with congestive heart failure (CHF) were investigated and compared with two generic questionnaires,the Medical Outcomes Study Short Form 36-item Health Survey (SF-36) and World Health Organization Quality of Life Assessment (WHOQOL-BREF),as well as one disease-specific questionnaire,the Minnesota Living with Heart Failure Questionnaire (MLHF).Methods:Thirty-nine in-patients with CHF who had undergone treatment with integrative medicine were recruited.The health status measurements were performed at enrolment and after a 4-week treatment.The following responsiveness indices were used:the effect size (ES) and standardized response mean (SRM).All patients were classified into those groups with stable measures and those groups with changes after a 4-week treatment,based upon both the doctor's global rating of changes in heart function tests,and the patient's global rating of changes in overall quality of life.Results:All domains of the ChQOL showed significant improvement.In the comparison of the responsiveness indices,the ChQOL was regarded as more responsive than the WHOQOL-BREF or SF-36 utility,but it was less responsive than the MLHF.Conclusions:The ChQOL was better in sensitivity and responsiveness for assessing congestive heart failure as a generic measure than the SF-36 and WHOQOL-BREF.The ChQOL is considered suitable as an outcome measure for clinical trials in patients with congestive heart failure.

  12. Iodine-123 metaiodobenzylguanidine imaging of the heart in idiopathic congestive cardiomyopathy and cardiac transplants

    Energy Technology Data Exchange (ETDEWEB)

    Glowniak, J.V.; Turner, F.E.; Gray, L.L.; Palac, R.T.; Lagunas-Solar, M.C.; Woodward, W.R.

    1989-07-01

    Iodine-123 metaiodobenzylguanidine ((/sup 123/I)MIBG) is a norepinephrine analog which can be used to image the sympathetic innervation of the heart. In this study, cardiac imaging with (/sup 123/I)MIBG was performed in patients with idiopathic congestive cardiomyopathy and compared to normal controls. Initial uptake, half-time of tracer within the heart, and heart to lung ratios were all significantly reduced in patients compared to normals. Uptake in lungs, liver, salivary glands, and spleen was similar in controls and patients with cardiomyopathy indicating that decreased MIBG uptake was not a generalized abnormality in these patients. Iodine-123 MIBG imaging was also performed in cardiac transplant patients to determine cardiac nonneuronal uptake. Uptake in transplants was less than 10% of normals in the first 2 hr and nearly undetectable after 16 hr. The decreased uptake of MIBG suggests cardiac sympathetic nerve dysfunction while the rapid washout of MIBG from the heart suggests increased cardiac sympathetic nerve activity in idiopathic congestive cardiomyopathy.

  13. Diuretic treatment in decompensated cirrhosis and congestive heart failure: effect of posture

    DEFF Research Database (Denmark)

    Ring-Larsen, H; Henriksen, Jens Henrik Sahl; Wilken, C;

    1986-01-01

    The diuretic effect of the supine position was evaluated in six patients with cirrhosis and ascites and six with congestive cardiac failure. After fasting overnight in bed the patients received bumetanide 1 mg intravenously and were then immediately randomly assigned to either bed rest in the sup......The diuretic effect of the supine position was evaluated in six patients with cirrhosis and ascites and six with congestive cardiac failure. After fasting overnight in bed the patients received bumetanide 1 mg intravenously and were then immediately randomly assigned to either bed rest...... in the supine position or normal daily activity in the upright position for the next six hours. Two days later the procedure was repeated, the patients being assigned to the other posture. The diuretic response was similar in patients with heart failure and cirrhosis, and was significantly greater in the supine...

  14. [Effects of hot water bath or sauna on patients with congestive heart failure: acute hemodynamic improvement by thermal vasodilation].

    Science.gov (United States)

    Tei, C; Horikiri, Y; Park, J C; Jeong, J W; Chang, K S; Tanaka, N; Toyama, Y

    1994-01-01

    The acute hemodynamic effects of thermal vasodilation caused by exposure to hot water bath or sauna in chronic congestive heart failure were investigated in 32 patients (mean age 57 +/- 15 years old) with dilated cardiomyopathy (25 idiopathic and 7 ischemic). The clinical symptoms were New York Heart Association Class II in 2 patients, III in 17 and IV in 13, and the mean ejection fraction was 25 +/- 9% (9-44%). Exposure to hot water bath was for 10 minutes at 41 degrees C in a semi-sitting position, and to sauna for 15 minutes at 60 degrees C in a supine position using a special far infrared ray sauna chamber. Blood pressure, electrocardiogram, two-dimensional and Doppler echocardiograms, expiration gas, and intracardiac pressure tracings were recorded before (control), during, and 30 minutes after hot water bath or sauna. 1. The increase in oxygen consumption was only 0.3 Mets during hot water bath or sauna, and returned to the control level 30 minutes later. 2. The deep temperature in the main pulmonary artery increased by 1.0-1.2 degrees C on average at the end of hot water bath or sauna. 3. Heart rate increased significantly (p sauna, while, diastolic blood pressure decreased significantly during (p sauna (p < 0.01), and after hot water bath (p < 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

  15. Use of sympathomimetic drugs leads to increased risk of hospitalization for arrhythmias in patients with congestive heart failure

    DEFF Research Database (Denmark)

    Bouvy, M L; Heerdink, E R; De Bruin, M L;

    2000-01-01

    BACKGROUND: Sympathomimetic agents have a direct positive chronotropic effect on heart rate and may cause hypokalemia, even when administered by inhalation. In selected patients (e.g., patients with congestive heart failure [CHF]) this can lead to arrhythmias. Despite the potential adverse effects...

  16. Diagnosis and treatment of congestive heart failure secondary to dilated cardiomyopathy in a hedgehog.

    Science.gov (United States)

    Delk, K W; Eshar, D; Garcia, E; Harkin, K

    2014-03-01

    A one-year-old African pygmy hedgehog (Atelerix albiventris) was evaluated for severe respiratory distress. Physical examination findings included marked dyspnoea, cyanosis and tachypnoea. Radiographic findings included an enlarged heart and pulmonary oedema, and dilated cardiomyopathy was confirmed via echocardiogram. The patient was treated for congestive heart failure because of dilated cardiomyopathy with furosemide, enalapril, pimobendan and l-carnitine. Within 24 hours of treatment, the pulmonary oedema and cyanosis had resolved. Following discharge, clinical improvement was noted by the owner and echocardiogram confirmed improved fractional shortening. Cardiomyopathy has been reported at post-mortem examination in hedgehogs, but there are no reports of ante-mortem diagnosis and treatment. Performing baseline cardiac assessment in hedgehogs is recommended, and treatment with l-carnitine and pimobendan may improve outcome, as carnitine deficiency is a possible cause of cardiomyopathy in hedgehogs. Successful emergency treatment of congestive heart failure in the hedgehog of this report may be effective for other hedgehogs presented with similar clinical signs. PMID:24372164

  17. Improved Cardiac Contractility of Human Recombinant Growth Hormone on the Congestive Heart Failure of Pig

    Institute of Scientific and Technical Information of China (English)

    Yang Ping; He Yu-quan; Zeng Hong; Ni Jin-song; Yun Qing-jun; Huang Xiao-ping; Li Shu-mei

    2005-01-01

    The enhanced cardiac contractility effect of human recombinant growth hormone (hr-GH) on the congestive heart failure (CHF) was studied on the pig. To build a pig model of congestive heart failure, a temporary artificial cardiac pacemaker was implanted in the pig's body and paced at 220 beats to 240 beats per minute for 1 week. After the model of congestive heart failure was successfully set up, the frequency of the pacemaker was changed to 150 beats to 180 beats per minute to maintain the CHF model stable. Pigs were divided into three groups: The hr-GH group in which 0.5 mg/kg per day of hr-GH was administrated intramuscularly for 15 days, the injection control group in which an equal amount of physiological saline was injected intramuscularly, and a normal control group. The left ventricular diastolic end pressure was (10.60±2.41 ) mmHg in the hr-GH group, but (19.00±3.81) mmHg in the saline control group (P<0.01); Cardiac output was (1.86±0.13) L/min in the hr-GH group, but (1.56 ±0.18) L/min in the saline control group (P<0.05); Peripheral min) -1 in the saline control group (P<0.05); ± dp/dtmax was (2900 ±316.23) and (2280 ±286.36) in the hr-HG group and the saline control group respectively (P<0.05). The results show that hr-GH enhances myocardial contractility of CHF, and the CHF model built by a temporary artificial cardiac pacemaker at a high rate of stimulation is reasonable and applicable.

  18. Congestive heart failure. Correlation between functional class and systolic and diastolic functions assessed by Doppler echocardiography

    Directory of Open Access Journals (Sweden)

    Kamel Cesar Selem

    2001-01-01

    Full Text Available OBJECTIVE: To evaluate the influence of systolic or diastolic dysfunction, or both on congestive heart failure functional class. METHODS: Thirty-six consecutive patients with a clinical diagnosis of congestive heart failure with sinus rhythm, who were seen between September and November of 1998 answered an adapted questionnaire about tolerance to physical activity for the determination of NYHA functional class. The patients were studied with transthoracic Doppler echocardiography. Two groups were compared: group 1 (19 patients in functional classes I and II and group 2 (17 patients in functional classes III and IV. RESULTS: The average ejection fraction was significantly higher in group 1 (44.84%±8.04% vs. 32.59%±11.48% with p=0.0007. The mean ratio of the initial/final maximum diastolic filling velocity (E/A of the left ventricle was significantly smaller in group 1 (1.07±0.72 vs. 1.98±1.49 with p=0.03. The average maximum systolic pulmonary venous velocity (S was significantly higher in group 1 (53.53cm/s ± 12.02cm/s vs. 43.41cm/s ± 13.55cm/s with p=0.02. The mean ratio of maximum systolic/diastolic pulmonary venous velocity was significantly higher in group 1 (1.52±0.48 vs. 1.08±0.48 with p=0.01. A predominance of pseudo-normal and restrictive diastolic patterns existed in group 2 (58.83% in group 2 vs. 21.06% in group 1 with p=0.03. CONCLUSION: Both the systolic dysfunction index and the patterns of diastolic dysfunction evaluated by Doppler echocardiography worsened with the evolution of congestive heart failure.

  19. Renal and cardiac function during alpha1-beta-blockade in congestive heart failure

    DEFF Research Database (Denmark)

    Heitmann, M; Davidsen, U; Stokholm, K H;

    2002-01-01

    The kidney and the neurohormonal systems are essential in the pathogenesis of congestive heart failure (CHF) and the physiologic response. Routine treatment of moderate to severe CHF consists of diuretics, angiotensin-converting enzyme (ACE) inhibition and beta-blockade. The need for control...... of renal function during initiation of ACE-inhibition in patients with CHF is well known. The aim of this study was to investigate whether supplementation by a combined alpha1-beta-blockade to diuretics and ACE-inhibition might improve cardiac function without reducing renal function....

  20. The economic impact of Medicare Part D on congestive heart failure.

    Science.gov (United States)

    Dall, Timothy M; Blanchard, Tericke D; Gallo, Paul D; Semilla, April P

    2013-05-01

    Medicare Part D has had important implications for patient outcomes and treatment costs among beneficiaries with congestive heart failure (CHF). This study finds that improved medication adherence associated with expansion of drug coverage under Part D led to nearly $2.6 billion in reductions in medical expenditures annually among beneficiaries diagnosed with CHF and without prior comprehensive drug coverage, of which over $2.3 billion was savings to Medicare. Further improvements in adherence could potentially save Medicare another $1.9 billion annually, generating upwards of $22.4 billion in federal savings over 10 years. PMID:23725537

  1. Determination of hepatic blood flow through radioactive colloidal gold in congestive heart foilure

    International Nuclear Information System (INIS)

    Hepatic blood flow as derermined by radioactive colloidal gold and its correlation with total blood valume are studied in 13 patients with predominantly right-side congestive heart failure. During the phase of cardiac compensation, the following events occur: 1) significant decrease of the half-life of the clearance of radioactive colloidal gold and of the total blood volume; 2) increase of the clearance constant of the radioactive substance and of hepatic blood flow; 3) significantion correlation between the clearance constant and the total blood volume

  2. A Rare Cause of Crazy-Paving and Mediastinal Lymphadenopathy: Congestive Heart Failure

    Directory of Open Access Journals (Sweden)

    Aysegul Senturk

    2013-01-01

    Full Text Available Crazy-paving sign is a pattern seen on multislice computed tomography images of the lungs. It is characterized by a reticular pattern superimposed on ground-glass opacity. It was first described in the late 1980s in patients with pulmonary alveolar proteinosis, but has now been described in some other diseases of the lung. Enlarged mediastinal lymph nodes can be seen in infectious and specific inflammatory diseases and malignancies. The present report describes a case of a 44-year-old man in whom congestive heart failure presented with a crazy-paving appearance and enlarged lymph nodes of the lungs on the chest computed tomography scan.

  3. Renal and cardiac neuropeptide Y and NPY receptors in a rat model of congestive heart failure.

    Science.gov (United States)

    Callanan, Ean Y; Lee, Edward W; Tilan, Jason U; Winaver, Joseph; Haramati, Aviad; Mulroney, Susan E; Zukowska, Zofia

    2007-12-01

    Neuropeptide Y (NPY) is coreleased with norepinephrine and stimulates vasoconstriction, vascular and cardiomyocyte hypertrophy via Y1 receptors (R) and angiogenesis via Y2R. Although circulating NPY is elevated in heart failure, NPY's role remains unclear. Activation of the NPY system was determined in Wistar rats with the aortocaval (A-V) fistula model of high-output heart failure. Plasma NPY levels were elevated in A-V fistula animals (115.7 +/- 15.3 vs. 63.1 +/- 17.4 pM in sham, P renal failure (urinary Na(+) excretion renal blood flow (RBF), and death within 5-7 days (DECOMP). Cardiac and renal tissue NPY decreased with heart failure, proportionate to the severity of renal complications. Cardiac and renal Y1R mRNA expression also decreased (1.5-fold, P failure. In contrast, Y2R expression increased up to 72-fold in the heart and 5.7-fold in the kidney (P failure and cardiac hypertrophy. Changes in receptor expression were confirmed since the Y1R agonist, [Leu31, Pro34]-NPY, had no effect on RBF, whereas the Y2R agonist (13-36)-NPY increased RBF to compensate for disease. Thus, in this model of heart failure, cardiac and renal NPY Y1 receptors decrease and Y2 receptors increase, suggesting an increased effect of NPY on the receptors involved in cardiac remodeling and angiogenesis, and highlighting an important regulatory role of NPY in congestive heart failure.

  4. Designing a technology enhanced practice for home nursing care of patients with congestive heart failure.

    Science.gov (United States)

    Casper, Gail R; Karsh, Ben-Tzion; Or, Calvin K L; Carayon, Pascale; Grenier, Anne-Sophie; Brennan, Patricia F

    2005-01-01

    This paper describes the process we used to design the HeartCare website to support Technology Enhanced Practice (TEP) for home care nurses engaged in providing care for patients with Congestive Heart Failure (CHF). Composed of communication, information, and self-monitoring functions, the HeartCare website is aimed at supporting best practice nursing care for these patients. Its unique focus is professional practice, thus the scope of this project is greater and more abstract than those focusing on a task or set of activities. A modified macroergonomic analysis, design work system analysis, and focus groups utilizing participatory design methodology were undertaken to characterize the nursing practice model. Design of the HeartCare website required synthesizing the extant practice model and the agency's evidence-based heart failure protocols, identifying aspects of practice that could be enhanced by supporting technology, and delineation of functional requirements of the Enhanced HeartCare technology. Validation and refinement of the website and planning for user training activities will be accomplished through a two-stage usability testing strategy. PMID:16779013

  5. 无创正压通气治疗2例慢性充血性心力衰竭合并陈-施呼吸患者经验总结及分析%Clinical experiences and analysis of non-invasive positive pressure ventilation in treating patients of chronic congestive heart failure with complications of Cheyne-Stoke respiration

    Institute of Scientific and Technical Information of China (English)

    肖高辉; 顾蕾; 席新蕊; 单晓宇; 黄席珍

    2009-01-01

    目的 比较两种无创呼吸机治疗慢性充血性心力衰竭合并陈-施呼吸(cheyne-stoke respiration,CSR)患者效果.方法 选取北京市公安医院2例慢性充血性心力衰竭合并CSR患者,针对患者病情给予患者常规治疗,并在常规治疗的基础上分别采用压力支持自动伺服通气(Autoset CS)以及双水平无创正压通气(Bilevel PAP)进行治疗.比较治疗前后的呼吸频率、心率、血气变化情况(pH、PaO2、PaCO2、SaO2)、收缩压、舒张压、左室射血分数等情况.同时注意观察患者接受治疗后的不良反应,例如:局部皮肤损伤、鼻炎、明显腹胀、气压伤、误吸、低血压等.结果 采用Autoset CS治疗CSR显示出不仅有睡眠质量的提高、白天嗜睡的减轻及认知度的改善,而且心力衰竭患者的左室射血分数及心功能都有明显改善.另外采用BilevelPAP经鼻无创通气治疗CSR其参数设定吸气压通常为10.0 cm H2O;呼气压通常为6~8 cm H2O即可.吸气时间较治疗慢性阻塞性肺疾病的参数有所延长,通常为0.5~0.6 s;呼气时间较治疗慢性阻塞性肺疾病的参数有所减少,通常为0.3 S.结论 Autoset CS治疗CSR采用自动调节的伺服通气运算,提供一种全新的无创正压通气治疗形式,更及时完全地控制CSR.BilevelPAP经鼻无创通气治疗CSR其参数设定与治疗慢性阻塞性肺疾病的参数设定显著的不同.%Objective To compare the effect of two non-invasive positive pressure ventilations in treating patients of chronic congestive heart failure with complications of Cheyne-Stoke respiration(CSR). Methods Two patients of chronic congestive heart failure with complications of CSR were given conventional treatment plus adaptive-service ventilation(Autoset CS) or Bilevel PAP respectively. Parameters including respiratory rate, heart rate, pH, PaO2, PaCO2, SaO2, SBP, DBP, left ventricular ejection factor (LVEF) were measured and compared for two patients before

  6. Safety and predictors of adherence of a new rehabilitation program for older women with congestive heart failure

    OpenAIRE

    Azad, Nahid A.; Bouchard, Kathy; Mayhew, Alain; Carter, Maureen; Molnar, Frank J.

    2012-01-01

    Objectives To assess the safety of a cardiac rehabilitation program for older women with Congestive Heart Failure (CHF) and determine if certain factors influence adherence. Methods Women over the age of 65 with CHF attended an exercise program supervised by a physiotherapist. Quality of life was measured by the Minnesota Living with Heart Failure Questionnaire (MLHFQ) and severity of disease by the New York Heart Association (NYHA) Class. Subjects were classified into those who attended 90% ...

  7. Congestive heart failure in 6 African grey parrots (Psittacus e erithacus).

    Science.gov (United States)

    Juan-Sallés, C; Soto, S; Garner, M M; Montesinos, A; Ardiaca, M

    2011-05-01

    Six African grey parrots (Psittacus e erithacus) were diagnosed with cardiomyopathy and congestive heart failure based on gross and microscopic findings. Ages ranged from 15 days to 8 years, and 5 of 6 parrots were either neonates or juveniles at the time of diagnosis. Two neonates and 2 juveniles came from the same breeding aviary; the 2 juveniles were born to the same breeding pair. The 2 other parrots were kept as pets. Clinical signs included distention of the coelomic cavity (4 of 6), rales (3 of 6), weakness (4 of 6), bradyarrhythmia (1 of 6), growth retardation (1 of 6), crop stasis (1 of 6), and regurgitation (1 of 6). Three parrots were euthanized and 3 died. Gross findings included cardiomegaly due to biventricular, right-, or left-sided cardiomyopathy (6 of 6); coelomic effusion (6 of 6); whitish or yellow foci in the liver (6 of 6); atrophy of the liver (particularly, the left lobe; 5 of 6); reddened or grey lungs (5 of 6); subcutaneous edema (2 of 6); hydropericardium (1 of 6); and bilateral thyroid gland enlargement (1 of 6). Relevant microscopic findings included passive hepatic congestion (6 of 6) and pulmonary congestion (2 of 6), lymphocytic thyroiditis (2 of 6), and diffuse thyroid follicular hyperplasia (2 of 6). Microscopically, the heart was unremarkable (2 of 6) or had mild lymphocytic myocarditis (2 of 6), mild multifocal cytoplasmic vacuolation of cardiomyocytes (2 of 6), mild lymphocytic myocardial (Purkinje cell) ganglioneuritis (1 of 6), and mild multifocal interstitial fibrosis and nuclear hypertrophy of cardiomyocytes (1 of 6). One parrot had concurrent proventricular dilatation disease (systemic ganglioneuritis). The cause of cardiomyopathy in these parrots was not determined.

  8. Patient medication adherence and physician prescribing among congestive heart failure patients of Yemen

    Directory of Open Access Journals (Sweden)

    K M Alakhali

    2013-01-01

    Full Text Available Congestive heart failure has been associated with high morbidity and mortality requiring hospitalisation and is further complicated by noncompliance and under prescriptions. We aim to determine medication adherence and percentage deviation among Asians population in general and Yemenis in particular. A cross-sectional, prospective observational study with purposive sampling was conducted at two cardiac outpatient centers in 70 congestive heart failure patients for a period of 3 months. An Arabic translated Morisky 4 item scale assessed the adherence of patients. Deviation in prescribing was determined by chart review. All 70 patients had mean age of 56.6΁16 years. Morisky 4 item scale predicted low adherence (n=33; 47.1% and overall nonadherencerate (n=38; 54.2% was slightly higher than adherence. Percentage nonadherence versus adherence was high with diuretics (53 vs. 46% and, digoxin (40 vs. 29%. The adherence percentage of angiotensin receptor blockers (9% and beta blockers (8% was low. Diuretics were the most prescribed drugs (n=69; 99%, followed by angiotensin converting enzyme inhibitors (n=51; 73%, cardiac glycoside (n=48; 69%, few patients were on angiotensin receptor blockers (n=8; 11% and (n=9; 13% beta blockers. The maximum prescribing rate deviation was seen with angiotensin receptor blockers (−89% and beta blockers (−87% followed by nitrates (−77%. Digoxin (−31% and angiotensin converting enzymes (−27% deviated comparatively less. Prescribing as well as utilisation rates generally were low resulting in nonachievement of therapeutic goals which could be resolved using multimodel approach.

  9. [Renal dysfunction in heart failure and hypervolumenia : Importance of congestion and backward failure].

    Science.gov (United States)

    Druml, W

    2014-05-01

    Traditionally, renal dysfunction in congestive heart failure (cardiorenal syndrome type 1) has been attributed to reduced cardiac output and low mean arterial perfusion pressure, which elicit a series of neurohumoral activations resulting in increased renal vascular resistance and decreased renal function.During the last decade, several studies have shown that the extent of renal dysfunction is not so closely associated with indices of forward failure-such as the cardiac index or mean arterial pressure-but rather with indicators of congestion, such as left ventricular enddiasystolic pressure or central venous pressure (CVP), which are indicators of backward failure. The impact of backward failure on renal function is not confined to an elevation of CVP, the renal drainage pressure, but includes a broad spectrum of mechanisms. Involved are the organ systems right heart, lung, the liver, the proinflammatory signals originating from the intestines, but also renal interstitial edema (renal compartment syndrome) and the intraabdominal pressure.The therapeutic measures must focus on the modulation of the preload adapted to the specific situation of an individual patient. This includes diuretics aiming at different segments of the tubulus system including antagonists of aldosteron and ADH, extracorporeal fluid elimination by ultrafiltration or peritoneal dialysis.

  10. CPAP in chronic heart failure

    Directory of Open Access Journals (Sweden)

    F. Lari

    2013-05-01

    Full Text Available BACKGROUND Chronic Heart Failure (CHF represents worldwide a clinical condition with increasing prevalence, high social, economical and epidemiological impact. Even if new pharmacological and non-pharmacological approachs have been recently used, mortality remains high in general population and quality of life is poor in these patients. DISCUSSION The association between CHF and sleep disorders is frequent but still undervalued: sleep apnoeas in CHF produce negative effects on cardiovascular system and an aggravation of prognosis. CPAP (Continuous Positive Airway Pressure is commonly used to treat sleep apnoeas in patients without cardiac involvement and it is also used in first line treatment of acute cardiogenic pulmonary oedema thanks to its hemodynamic and ventilatory effects. The addition of nightly CPAP to standard aggressive medical therapy in patients with CHF and sleep apnoeas reduces the number of apnoeas, reduces the blood pressure, and the respiratory and cardiac rate, reduces the activation of sympathetic nervous system, the left ventricular volume and the hospitalization rate; besides CPAP increases the left ventricular ejection fraction, amd the oxygenation, it improves quality of life, tolerance to exercise and seems to reduce mortality in patients with a higher apnoeas suppression. CONCLUSIONS These implications suggest to investigate sleep apnoeas in patients with CHF in order to consider a possible treatment with CPAP. Further studies need to be developed to confirm the use of CPAP in patients with CHF without sleep disorders.

  11. 穴位埋线对慢性心力衰竭大鼠血压与心功能的影响%Influence of Acupoint-catgut-implantation on Blood Pressure and Cardiac Function in Chronic Congestive Heart Failure Rats

    Institute of Scientific and Technical Information of China (English)

    邓元江; 梁伟雄; 程淑意

    2011-01-01

    Objective To observe the effect of acupoint-catgut-implantation on blood pressure and cardiac function in chronic heart failure (CHF) rats. Methods A total of 60 SD female rats were randomly divided into shem-operation group (sham), CHF model group, catgut-implantation group, Captopril group. CHF model was established by suprarenal abdominal artery constriction. Surgical catgut (No. 3-0, 2-3 mm length piece) was implanted into bilateral “Neiguan” (PC 6), “Xinshu” (BL 15) and “Zusanli” (ST 36) twice for 7 weeks. Rats of the Captopril group were treated with intragastric infusion of Captopril from the 50th day on after the operation, once daily for 7 weeks. Blood pressure (BP) including the systolic blood pressure (SBP), diastolic blood pressure (DBP) and mean blood pressure (MBP), heart rate (HR) and the left ventricular ejection fraction (LVEF)were detected respectively by cardiac sonography. Results On the 14th week after modeling, in comparison with the sham group, the SBP, DBP, MBP and HR in rats of the model group were increased significantly (P<0.01, P<0.05), while LVEF of the model group was decreased considerably (P<0.01). Compared with the model group, the SBP, DBP, MBP and HR after 7 weeks' treatment in rats of the catgut-implantation and Captopril groups were decreased considerably (P<0.01), while the LVEF of the catgut-implantation group was increased evidently (P<0.05). No significant differences were found between the catgut-implantation and Captopril groups in the SBP, DBP, MBP and HR levels, and between the model and Captopril groups in LVEF values (P>0.05). Conclusion Acupoint-catgut-implantation can down-regulate BP and HR, and increase LVEF in chronic congestive heart failure rats, which may contribute to its effect in ameliorating the cardiac function.%目的:探讨穴位理线对慢性心力衰竭大鼠血压与心功能的干预作用.方法:将雌性SD大鼠随机分为假手术组、心衰模型组、穴位埋线组

  12. CD28/B7 Deficiency Attenuates Systolic Overload-Induced Congestive Heart Failure, Myocardial and Pulmonary Inflammation, and Activated T Cell Accumulation in the Heart and Lungs.

    Science.gov (United States)

    Wang, Huan; Kwak, Dongmin; Fassett, John; Hou, Lei; Xu, Xin; Burbach, Brandon J; Thenappan, Thenappan; Xu, Yawei; Ge, Jun-Bo; Shimizu, Yoji; Bache, Robert J; Chen, Yingjie

    2016-09-01

    The inflammatory response regulates congestive heart failure (CHF) development. T cell activation plays an important role in tissue inflammation. We postulate that CD28 or B7 deficiency inhibits T cell activation and attenuates CHF development by reducing systemic, cardiac, and pulmonary inflammation. We demonstrated that chronic pressure overload-induced end-stage CHF in mice is characterized by profound accumulation of activated effector T cells (CD3(+)CD44(high) cells) in the lungs and a mild but significant increase of these cells in the heart. In knockout mice lacking either CD28 or B7, there was a dramatic reduction in the accumulation of activated effector T cells in both hearts and lungs of mice under control conditions and after transverse aortic constriction. CD28 or B7 knockout significantly attenuated transverse aortic constriction-induced CHF development, as indicated by less increase of heart and lung weight and less reduction of left ventricle contractility. CD28 or B7 knockout also significantly reduced transverse aortic constriction-induced CD45(+) leukocyte, T cell, and macrophage infiltration in hearts and lungs, lowered proinflammatory cytokine expression (such as tumor necrosis factor-α and interleukin-1β) in lungs. Furthermore, CD28/B7 blockade by CTLA4-Ig treatment (250 μg/mouse every 3 days) attenuated transverse aortic constriction-induced T cell activation, left ventricle hypertrophy, and left ventricle dysfunction. Our data indicate that CD28/B7 deficiency inhibits activated effector T cell accumulation, reduces myocardial and pulmonary inflammation, and attenuates the development of CHF. Our findings suggest that strategies targeting T cell activation may be useful in treating CHF.

  13. Secular trends in the etiology and comorbidity of hospitalized patients with congestive heart failure: A single-center retrospective study

    Institute of Scientific and Technical Information of China (English)

    Zhi-Yong Pei; Yu-Sheng Zhao; Jia-Yue Li; Qiao Xue; Lei Gao; Shi-Wen Wang

    2012-01-01

    Objective To assess the secular trends in the etiology and comorbidity of patients hospitalized with congestive heart failure (CHF). Methods Data of 7,319 patients (mean age 59.6 years, 62.1% male) with a primary discharge diagnosis of CHF, hospitalized from January 1, 1993 to December 31, 2007 at the Chinese People's Liberation Army (PLA) General Hospital were extracted and analyzed. These patients were divided into three groups according to hospitalization period: 1993-1997 (n = 1623), 1998-2002 (n = 2444), and 2003-2007 (n = 3252). The etiological characteristics and comorbidities were assessed. Results Over the study period, the proportion of patients with ischemic heart disease (IHD) increased from 37.2% during the period 1993-1997 to 46.8% during the period 2003-2007, while that with valvular heart disease (VHD) decreased from 35.2% during the period 1993-1997 to 16.6% during the period 2003-2007 (both P < 0.05). Atrial fibrillation (AF) was the most common comorbidity of heart failure (23.2%, 23.0% and 20.6%, respectively, in the three periods). Compared to that of the period of 1993-1997 with that of, the proportion of patients with myocardial infarction, pneumonia, renal function impairment and hepatic cirrhosis of the period of 2003-2007 increased significantly (P < 0.05) and the proportion of patients with chronic obstructive pulmonary disease and atrial fibrillation decreased significantly (P < 0.05). Conclusions This study implies that IHD has became a more common etiology of CHF, while VHD has deceased as an etiology of CHF in Chinese patients during the last two decades.

  14. Mechanical analysis of congestive heart failure caused by bundle branch block based on an electromechanical canine heart model

    Energy Technology Data Exchange (ETDEWEB)

    Dou Jianhong; Xia Ling; Zhang Yu; Shou Guofa [Department of Biomedical Engineering, Zhejiang University, Hangzhou 310027 (China); Wei Qing; Liu Feng; Crozier, Stuart [School of Information Technology and Electrical Engineering, University of Queensland, St Lucia, Brisbane, Queensland 4072 (Australia)], E-mail: xialing@zju.edu.cn

    2009-01-21

    understanding of the mechanical implications of congestive heart failure (CHF) caused by BBB.

  15. Mechanical analysis of congestive heart failure caused by bundle branch block based on an electromechanical canine heart model

    Science.gov (United States)

    Dou, Jianhong; Xia, Ling; Zhang, Yu; Shou, Guofa; Wei, Qing; Liu, Feng; Crozier, Stuart

    2009-01-01

    understanding of the mechanical implications of congestive heart failure (CHF) caused by BBB.

  16. Prolonged signal-averaged P wave duration as a prognostic marker for morbidity and mortality in patients with congestive heart failure

    DEFF Research Database (Denmark)

    Dixen, Ulrik; Wallevik, Laura; Hansen, Maja;

    2003-01-01

    To evaluate the prognostic roles of prolonged signal-averaged P wave duration (SAPWD), raised levels of natriuretic peptides, and clinical characteristics in patients with stable congestive heart failure (CHF).......To evaluate the prognostic roles of prolonged signal-averaged P wave duration (SAPWD), raised levels of natriuretic peptides, and clinical characteristics in patients with stable congestive heart failure (CHF)....

  17. Pharmacodynamics and pharmacokinetics of oral levosimendan and its metabolites in patients with severe congestive heart failure: a dosing interval study.

    Science.gov (United States)

    Põder, Pentti; Eha, Jaan; Sundberg, Stig; Antila, Saila; Heinpalu, Marika; Loogna, Imbrit; Planken, Ulle; Rantanen, Satu; Lehtonen, Lasse

    2004-10-01

    The objective of this study was to explore the pharmacodynamics and pharmacokinetics of oral levosimendan in patients with severe congestive heart failure. This was a randomized, parallel-group, double-blind, placebo-controlled trial. Oral levosimendan 2 to 8 mg daily or placebo was administered to 25 patients with New York Heart Association class III-IV congestive heart failure for 4 weeks. Pharmacodynamic variables consisted of heart rate-corrected electromechanical systole, heart rate, and systolic and diastolic blood pressure. The pharmacokinetics of levosimendan and its metabolites, OR-1855 and OR-1896, was assessed. The 4- to 8-mg daily doses of oral levosimendan showed moderate inotropic effects. Blood pressure remained unchanged with all doses. A moderate increase in heart rate was observed except with the 2-mg dose. Pharmacokinetic parameters of the metabolites increased linearly with the dose (P < or = .002 for Cmax and AUC0-8h for both treatment groups). It was concluded that oral levosimendan has inotropic and chronotropic effects in patients with severe congestive heart failure. Plasma concentrations of its metabolites increase dose dependently.

  18. Infantile Hepatic Hemangioendothelioma Associated With Congestive Heart Failure: Two Case Reports With Different Outcomes.

    Science.gov (United States)

    Wang, Tao; Wang, Yibin; Liang, Yun; Lu, Guoyan

    2015-12-01

    Infantile hepatic hemangioendothelioma (IHH) is rare which can regress spontaneously. Arteriovenous shunts within hemangiomas, however, may result in pulmonary artery hypertension (PAH) and congestive heart failure (CHF).The authors report 2 young infants suffering from multifocal IHH associated with CHF were both treated with glucocorticoid and transcatheter arterial embolization (TAE), but had different outcomes. The PAH decreased immediately and the symptoms of CHF were alleviated after TAE for both of them. For the Tibetan infant, the development was normal with tumor regression by follow-up. For the Han ethnic neonate, PAH increased again in the seventh day with progressive cardiovascular insufficiency. Ultrasound showed a persisting perfusion caused by collateralization around occluded main feeders. Furthermore, a pulmonary infection occurred and ventilation was performed. As a result, the infant died from multiorgan failure caused by CHF and infection.TAE is a treatment of reducing shunting for hemangiomas. Fistula recanalization in multifocal IHH, however, might be an important risk factor affecting the outcome of TAE. TAE should be further evaluated with special attention to anatomy of feeding and draining vessels, and cardiopulmonary conditions. In addition, the patients were susceptible to secondary pulmonary infection because of lung congestion. As well, the infant from the high altitude area showed better adaptability to hypoxia.

  19. Core Measures for Congestive Heart Failure in a Tertiary Care Setting in Pakistan

    Science.gov (United States)

    Zafar, Rizwan; Haris, Muhammad; Shabbir, Muhammad Usman; Ghazanfar, Haider; Malik, Sarah A; Khalid, Tehreem; Abbas, Ali H; Saleem, Asad A

    2016-01-01

    significant association between gender and mean duration of hospitalization (p = 0.411). No significant association was found between EF ≤ 40% and mean duration of hospitalization (p = 0.426). Conclusion: We found that symptom assessment of congestive heart failure (CHF) patients, according to NYHA guidelines, are strikingly low. Also, a significant percentage of patients who need ACEi and BB are not prescribed the required medications despite echocardiography showing low left ventricular function. PMID:27630801

  20. 非那雄胺对慢性心力衰竭合并良性前列腺增生老年男性患者的疗效%Effects of finasteride for elderly male patients with chronic congestive heart failure combined with benign prostatic hyperplasia

    Institute of Scientific and Technical Information of China (English)

    廖伟光; 苏海龙; 陈协生; 李锦萍; 廖淑莲

    2012-01-01

    目的 探讨非那雄胺对慢性心力衰竭(chronic heart failure,CHF)合并良性前列腺增生(benign prostatic hyperplasia,BPH)的老年男性患者的疗效.方法 95例CHF合并BPH老年男性按数字表法随机分为治疗组及对照组,两组均根据患者的心功能情况规范使用抗心力衰竭治疗.治疗组使用非那雄胺,对照组使用安慰剂治疗2年.观察两组前列腺体积、国际前列腺症状评分表(IPSS)评分、BPH患者生活质量(QOL)评分、肌酐、血尿素氮、N末端脑钠肽前体、肌钙蛋白、左心室射血分数(LVEF)、急性尿潴留、需手术干预、心血管事件、心力衰竭再住院率、心功能的变化及主要副作用等指标,并进行比较.结果 治疗组心血管事件发生率[23.25%( 10/43) vs.47.61%(20/42),P<0.05]、心力衰竭再住院率[25.58%(11/43)vs.50.00%(21/42),P<0.05]、急性尿潴留率[ 13.95% (6/43) vs.42.85% (18/42),P<0.05]、需手术干预率[16.27% (7/43)vs.52.38% (22/42),P<0.05],明显低于对照组,差异有统计学意义.治疗组前列腺体积、国际前列腺症状评分表评分及肌酐、N末端脑钠肽前体浓度低于对照组,差异有统计学意义(P<0.05).两组治疗2年后在勃起功能障碍、性欲减退、乳腺增大、乳腺疼痛的发生率比较,差异无统计学意义(P>0.05).结论 对于CHF合并BPH的患者在规范的治疗心力衰竭的基础上应尽早长期使用非那雄胺,可显著降低患者的主要心血管事件发生率、心力衰竭再次住院率、急性尿潴留率、需手术干预率,缩小前列腺体积,改善下尿道症状及患者生活质量,而无明显增加副作用.%Objectives To observe the effects of finasteride for elderly male patients with chronic congestive heart failure (CHF) combined with benign prostatic hyperplasia (BPH). Methods A total of 95 BPH combined with CHF elderly male patients were randomly divided into treatment group and control group

  1. Classification tree for risk assessment in patients suffering from congestive heart failure via long-term heart rate variability.

    Science.gov (United States)

    Melillo, Paolo; De Luca, Nicola; Bracale, Marcello; Pecchia, Leandro

    2013-05-01

    This study aims to develop an automatic classifier for risk assessment in patients suffering from congestive heart failure (CHF). The proposed classifier separates lower risk patients from higher risk ones, using standard long-term heart rate variability (HRV) measures. Patients are labeled as lower or higher risk according to the New York Heart Association classification (NYHA). A retrospective analysis on two public Holter databases was performed, analyzing the data of 12 patients suffering from mild CHF (NYHA I and II), labeled as lower risk, and 32 suffering from severe CHF (NYHA III and IV), labeled as higher risk. Only patients with a fraction of total heartbeats intervals (RR) classified as normal-to-normal (NN) intervals (NN/RR) higher than 80% were selected as eligible in order to have a satisfactory signal quality. Classification and regression tree (CART) was employed to develop the classifiers. A total of 30 higher risk and 11 lower risk patients were included in the analysis. The proposed classification trees achieved a sensitivity and a specificity rate of 93.3% and 63.6%, respectively, in identifying higher risk patients. Finally, the rules obtained by CART are comprehensible and consistent with the consensus showed by previous studies that depressed HRV is a useful tool for risk assessment in patients suffering from CHF. PMID:24592473

  2. Ambient air pollution and hospitalization for congestive heart failure among elderly people in seven large US cities; Pollution atmospherique ambiante et hospitalisations pour insuffisance cardiaque congestive chez les personnes agees dans sept grandes villes des Etats-Unis

    Energy Technology Data Exchange (ETDEWEB)

    Morris, R.D.; Naumova, E.N.; Munasinghe, R.L.M.

    2001-01-01

    The aim of this study is the temporal associations between the urban atmospheric pollution, in particular the carbon monoxide, and the hospitalization for congestive heart failure in elderly people, in seven large US cities. (A.L.B.)

  3. Digital perfusion images for estimating redistribution of pulmonary perfusion in patients with congestive heart failure

    International Nuclear Information System (INIS)

    For estimating redistribution of pulmonary perfusion in congestive heart failure (CHF), Tc-99m MAA pulmonary perfusion images were computerized to digital perfusion images (DPLs), and 100%-70% discount area was defined as hyperperfusion area (H). Various types of DPI were obtained from patients with various degree of CHF; however, they were simply classified into six types according to patterns of H, that is, from basal triangle to apical circle. DPIs changed according to aggravation and improvement of CHF. Patients without H in the lower zone suffered from refractory CHF, and their 2-year mortality was high (59%; 13 of 22). DPIs were useful for determining therapeutic policy and estimating prognosis of patients with CHF

  4. Differential pathways of positive and negative health behavior change in congestive heart failure patients.

    Science.gov (United States)

    Chaves, Covadonga; Park, Crystal L

    2016-08-01

    This longitudinal study applied a stress and coping model to examine the differential pathways of perceived positive and negative health behavior changes. Participants with congestive heart failure completed self-report measures of psychological resources, coping strategies, and perceived behavior changes and were assessed again 6 months later. Patients with higher positive affect and spiritual well-being reported more positive health behavior changes over time, effects mediated by approach coping. Alternatively, patients with lower psychological resources reported more negative behavior changes over time, effects mediated by avoidance coping. The results suggest that different psychological resources are related to different types of coping which, in turn, are associated with perceived positive or negative changes in health behavior over time.

  5. [Gliptins, cardiovascular safety and congestive heart failure: state of the art after TECOS].

    Science.gov (United States)

    Scheen, A J

    2015-08-26

    The cardiovascular safety of dipeptidyl peptidase-4 inhibitors (gliptins) has been well studied. Favourable effects of these oral antidiabetic agents have been reported in meta-analyses of phase II-III randomised controlled trials. Three large prospective trials, which were specifically designed to investigate cardiovascular safety, showed non-inferiority of saxagliptin (SAVOR-TIMI 53), alogliptin (EXA-MINE) and sitagliptin (TECOS) versus placebo as far as major cardiovascular events are concerned, including mortality. The suspected increase in the rate of hospitalisation due to congestive heart failure reported in SAVOR-TIMI 53 was neither found in EXAMINE nor recently confirmed in TECOS. Direct comparative trials, evaluating not only safety but also efficacy, with other oral antidiabetic medications would be of major interest.

  6. A NEW APPROACH TO DETECT CONGESTIVE HEART FAILURE USING DETRENDED FLUCTUATION ANALYSIS OF ELECTROCARDIOGRAM SIGNALS

    Directory of Open Access Journals (Sweden)

    CHANDRAKAR KAMATH

    2015-02-01

    Full Text Available The aim of this study is to evaluate how far the detrended fluctuation analysis (DFA approach helps to characterize the short-term and intermediate-term fractal correlations in the raw electrocardiogram (ECG signals and thereby discriminate between normal and congestive heart failure (CHF subjects. The DFA-1 calculations were performed on normal and CHF short-term ECG segments, of the order of 20 seconds duration. Differences were found in shortterm and intermediate-term correlation properties and the corresponding scaling exponents of the two groups (normal and CHF. The statistical analyses show that short-term fractal scaling exponent alone is sufficient to distinguish between normal and CHF subjects. The receiver operating characteristic curve (ROC analysis confirms the robustness of this new approach and exhibits an average accuracy that exceeds 98.2%, average sensitivity of about 98.4%, positive predictivity of 98.00%, and average specificity of 98.00%.

  7. Echocardiographic evaluation of cardiac dyssynchrony in patients with congestive heart failure.

    Science.gov (United States)

    Qin, Chuan; Zhang, Li; Zhang, Zi-Ming; Wang, Bin; Ye, Zhou; Wang, Yong; Nanda, Navin C; Xie, Ming-Xing

    2016-06-01

    The present study investigated the application of echocardiography to evaluation of cardiac dyssynchrony in patients with congestive heart failure (CHF). A total of 348 consecutive CHF patients who were admitted for cardiac resynchronization (CRT) and presented with low ejection fraction (EF) and wide QRS duration were enrolled in this study, along with 388 healthy individuals. Dyssynchrony was assessed based on filling time ratio (FT/RR), left ventricular pre-ejection delay (PED), interventricular mechanical delay (IVMD), longitudinal opposing wall delay (LOWD) and radial septal to posterior wall delay (RSPWD). Response to CRT was defined as a ≥15% increase in EF. The results showed that FT/RR was decreased while PED, IVMD, LOWD and RSPWD were increased in the CHF group compared with the control group (Pcardiac dyssynchrony in patients with CHF.

  8. INSUFICIENCIA CARDÍACA CONGESTIVA O COR PULMONALE Congestive heart failure or Cor Pulmonale

    Directory of Open Access Journals (Sweden)

    Oscar Ernesto Amarís Peña

    2006-06-01

    Full Text Available La insuficiencia cardíaca es una de las principales causas de muerte cardiovascular y se presenta como consecuencia, en más del 70 por ciento de los casos, de las dos enfermedades cardiovasculares de mayor prevalencia: la hipertensión arterial y la enfermedad coronaria. La disnea y el edema en los miembros inferiores son los dos criterios más usados para el diagnóstico de insuficiencia cardíaca congestiva y estos son, justamente, las principales manifestaciones de los pacientes con Cor Pulmonale. Este documento propone algunos criterios para el diagnóstico diferencial de las dos entidades.Heart failure is one of the most important causes of cardiovascular death, as consequence of arterial hypertension or coronary heart disease. Dyspnea and legs edema are the commonest symptoms of congestive heart failure, but there are important symptoms in Cor Pulmonale, too. This paper propose some distinctive clues to differential diagnosis.

  9. Reduced Data Dualscale Entropy Analysis of HRV Signals for Improved Congestive Heart Failure Detection

    Science.gov (United States)

    Kuntamalla, Srinivas; Lekkala, Ram Gopal Reddy

    2014-10-01

    Heart rate variability (HRV) is an important dynamic variable of the cardiovascular system, which operates on multiple time scales. In this study, Multiscale entropy (MSE) analysis is applied to HRV signals taken from Physiobank to discriminate Congestive Heart Failure (CHF) patients from healthy young and elderly subjects. The discrimination power of the MSE method is decreased as the amount of the data reduces and the lowest amount of the data at which there is a clear discrimination between CHF and normal subjects is found to be 4000 samples. Further, this method failed to discriminate CHF from healthy elderly subjects. In view of this, the Reduced Data Dualscale Entropy Analysis method is proposed to reduce the data size required (as low as 500 samples) for clearly discriminating the CHF patients from young and elderly subjects with only two scales. Further, an easy to interpret index is derived using this new approach for the diagnosis of CHF. This index shows 100 % accuracy and correlates well with the pathophysiology of heart failure.

  10. The Role of Atrial Fibrillation Catheter Ablation in Patients with Congestive Heart Failure: “Burning”for a Cure

    OpenAIRE

    Dimpi Patel; Mohammed Khan

    2011-01-01

    Atrial Fibrillation (AF) and congestive heart failure (CHF) often co-exist. Catheter ablation is increasingly used to cure AF related to CHF.Clinical evidence supports the feasibil- ity of catheter ablation as a treatment option in drug refractory AF patients with CHF.Investiga- tors have reported an improvement in ejection fraction, quality of life, and functional capacity

  11. Dilatory responses to acetylcholine, calcitonin gene-related peptide and substance P in the congestive heart failure rat

    DEFF Research Database (Denmark)

    Bergdahl, A; Valdemarsson, S; Nilsson, T;

    1999-01-01

    It was examined to what extent congestive heart failure (CHF) in rats, induced by ligation of the left coronary artery, affects the vascular responses to the vasodilatory substances acetylcholine (ACh), calcitonin gene-related peptide (CGRP), and substance P (SP). After induction of CHF status...

  12. Sudden cardiovascular death following myocardial infarction: the importance of left ventricular systolic dysfunction and congestive heart failure

    DEFF Research Database (Denmark)

    Abildstrøm, Steen Zabell; Ottesen, Michael M; Rask-Madsen, Christian;

    2005-01-01

    BACKGROUND: To study the prognostic information of congestive heart failure (CHF) and left ventricular systolic dysfunction regarding sudden and non-sudden cardiovascular death (SCD and non-SCD) in patients with acute myocardial infarction (MI), as this may indicate the potential benefit...

  13. Qt dispersion has no prognostic information for patients with advanced congestive heart failure and reduced left ventricular systolic function

    DEFF Research Database (Denmark)

    Brendorp, B; Elming, H; Jun, L;

    2001-01-01

    BACKGROUND: QT dispersion is a potential prognostic marker of tachyarrhythmic events and death, but it is unclear whether this applies to patients with congestive heart failure (CHF). METHODS AND RESULTS: Of the 1518 patients with advanced CHF and left ventricular dysfunction enrolled in the Danish...

  14. Functional decline after congestive heart failure and acute myocardial infarction and the impact of psychological attributes. A prospective study

    NARCIS (Netherlands)

    Kempen, GIJM; Sanderman, R; Miedema, [No Value; Meyboom-de Jong, B; Ormel, J; Miedema, I.

    2000-01-01

    This article examines the influence of three pre-morbidly assessed psychological attributes (i.e. neuroticism, mastery and self-efficacy expectancies) on functional decline after congestive heart failure (CHF; n = 134) and acute myocardial infarction (AMI; n = 79) in late middle-aged and older perso

  15. Impact of congestive heart failure and left ventricular systolic function on the prognostic significance of atrial fibrillation and atrial flutter following acute myocardial infarction

    DEFF Research Database (Denmark)

    Pedersen, Ole Dyg; Bagger, Henning; Køber, Lars;

    2005-01-01

    BACKGROUND: Reports on the prognostic importance of atrial fibrillation following myocardial infarction have provided considerable variation in results. Thus, this study examined the impact of left ventricular systolic function and congestive heart failure on the prognostic importance of atrial...... and congestive heart failure were prospectively collected. Mortality was followed for 5 years. RESULTS: In patients with left ventricular ejection fraction... mortality. In patients with 0.250.35. In patients with congestive heart failure, atrial fibrillation/atrial flutter was associated with an increased in-hospital mortality (OR=1.5 (1.2-1.9); pcongestive heart...

  16. Plasma YKL-40 levels are elevated in patients with chronic heart failure

    DEFF Research Database (Denmark)

    Rathcke, C.N.; Kistorp, C.; Raymond, I.;

    2010-01-01

    Objectives. Congestive heart failure (CHF) has been associated with elevated biomarker levels reflecting chronic low-grade inflammation. YKL-40 is a biomarker with increasing levels in patients with cardiovascular disease (CVD) of increasing severity. Furthermore, YKL-40 is associated with all-cause...... or incident cardiovascular events. Most likely, elevated YKL-40 levels in CHF patients are explained by the presence of concomitant diseases but a role of YKL-40 in low-grade inflammation is not excluded...

  17. Combined effects of ramipril and angiotensin Ⅱ receptor blocker TCV116 on rat congestive heart failure after myocardial infarction

    Institute of Scientific and Technical Information of China (English)

    TAO Ze-wei; HUANG Yuan-wei; XIA Qiang; XU Qi-wen

    2005-01-01

    Background Congestive heart failure (CHF) is a major cause of morbidity and mortality worldwide and angiotensin converting-enzyme inhibitor (ACEI) is the cornerstone in its treatment. However, CHF continues to progress despite this therapy, perhaps because of production of angiotensin Ⅱ (Ang Ⅱ) by alternative pathways. The present study was conducted to examine the combined effects of a chronic ACEI, ramipril, and a chronic Ang Ⅱ type 1 receptor blocker, TCV116, on rat CHF after myocardial infarction (MI). Methods Congestive heart failure was caused by MI in rats, which was induced by ligating the left anterior descending coronary artery. The experiment protocol included sham-operated rats (Sham), MI-control rats (MI-control), MI rats treated with ramipril 3 mg/kg (MI-ramipril) or TCV116 2 mg/kg (MI-TCV116) per day, half dosage (MI-1/2R&T) or full dosage (MI-R&T) combination of the two. At 22 weeks, cardiac hemodynamic parameters such as mean arterial pressure (MAP), left ventricular systolic pressure (LVSP), maximal rate of left ventricule pressure development and decline (LV dP/dtmax) and left ventricular end diastolic pressure (LVEDP), and cardiac morphometric parameters such as heart weight (HW), left ventricular weight (LVW) and left ventricular cavity area (LVCA) were measured, mRNA expressions of cardiac molecule genes such as β myosin heavy chain (βMHC), B-type natriuretic peptide (BNP), transforming growth factor-β1 (TGF-β1), collagen I and Ⅲ were quantified with reverse transcription polymerase chain reaction (RT-PCR) in the surviving septum myocardium, and survival rates were calculated. Results There were no significant differences in MI sizes (%) among each MI related experimental groups (33±13, 34±14, 33±13, 35±13 and 33±14 for MI-control, MI-ramipril, MI-TCV116, MI-1/2R&T and MI-R&T, respectively, no statistical significance for all). Compared with sham-operated rats, MI rats without therapy showed significant increases in

  18. Radiographic and echocardiographic assessment of left atrial size in 100 cats with acute left-sided congestive heart failure.

    Science.gov (United States)

    Schober, Karsten E; Wetli, Ellen; Drost, Wm Tod

    2014-01-01

    The aims of this study were to evaluate left atrial size in cats with acute left-sided congestive heart failure. We hypothesized that left atrial size as determined by thoracic radiography can be normal in cats with acute left-sided congestive heart failure. One hundred cats with acute left-sided congestive heart failure in which thoracic radiography and echocardiography were performed within 12 h were identified. Left atrial size was evaluated using right lateral and ventrodorsal radiographs. Measurements were compared to two-dimensional echocardiographic variables of left atrial size and left ventricular size. On echocardiography, left atrial enlargement was observed in 96% cats (subjective assessment) whereas maximum left atrial dimension was increased (>15.7 mm) in 93% cats. On radiographs left atrial enlargement (subjective assessment) was found in 48% (lateral view), 53% (ventrodorsal view), and 64% (any view) of cats whereas left atrial enlargement was absent in 36% of cats in both views. Agreement between both methods of left atrial size estimation was poor (Cohen's kappa 0.17). Receiver operating characteristic curve analysis identified a maximum echocardiographic left atrial dimension of approximately 20 mm as the best compromise (Youden index) between sensitivity and specificity in the prediction of radiographic left atrial enlargement. Left atrial enlargement as assessed by thoracic radiography may be absent in a clinically relevant number of cats with congestive heart failure. Therefore, normal left atrial size on thoracic radiographs does not rule out presence of left-sided congestive heart failure in cats with clinical signs of respiratory distress.

  19. To evaluate the clinical curative effect of meglumine adenosine cyclophosphate combined with perindopril on patients with chronic congestive heart failure%环磷腺苷葡胺联合培哚普利治疗慢性心力衰竭疗效分析

    Institute of Scientific and Technical Information of China (English)

    胡勇钧; 彭定凤; 唐哨勇; 赵莹; 陈姣; 黄晴

    2014-01-01

    目的 通过观察慢性充血性心力衰竭(CHF)患者血浆氨基末端B型钠利尿肽前体(NT-proBNP)浓度与心力衰竭严重程度的相关性,探讨环磷腺苷葡胺(MAC)联合培哚普利对CHF患者左心功能、血浆NT-proBNP浓度的影响,评估其临床疗效与安全性.方法 选择2011年6月至2013年6月在普爱医院心内科心内科住院的126例慢性心力衰竭患者,随机(随机数字法)分为A组(42例,常规治疗)、B组(41例,常规治疗+培哚普利)、C组(43例,常规治疗+培哚普利+环磷腺苷葡胺),疗程为14 d.分别于给药前、给药14 d后测定左室射血分数(LVEF)、左室舒张末期内径(LVEDD)及血浆NT-proBNP浓度.结果 CHF患者血浆NT-proBNP浓度与纽约心脏病协会(NYHA)心功能分级及LVEDD呈正相关(r=0.617,P<0.01;r=0.412,P<0.01),与LVEF呈负相关(r=-0.372,P<0.01).与A组比较,B、C两组治疗后LVEF、LVEDD均有更明显改善(P<0.05),血浆NT-proBNP的浓度亦显著降低(P<0.05);C组与B组相比血浆NT-proBNP浓度降低更明显(P<0.05),但心功能参数两组则差异无统计学意义(P>0.05).结论 血浆NT-proBNP浓度与CHF患者的心衰严重程度密切相关,是心力衰竭诊断、治疗和预后评估的良好指标.培哚普利可降低CHF患者血浆NT-proBNP浓度并显著改善其心功能,MAC联合培哚普利虽不能进一步改善患者LVEF,但能使血浆NT-proBNP浓度进一步降低,且患者耐受性良好,治疗CHF疗效显著.%Objective To explore the relationship of plasma NT-proBNP level and severity of chronic congestive heart failure (CHF) and investigate the curative effect and security of meglumine adenosine cyclophosphate (MAC) combined with perindopril on patients with CHF.Methods From June 2011 to June 2013,126 inpatients with chronic congestive heart failure were randomly divided into A group (42 cases,routine therapy),B group (41 cases,routine therapy and perindopril) and C group (43 cases,routine therapy and

  20. Relation of systemic and local muscle exercise capacity to skeletal muscle characteristics in men with congestive heart failure

    Science.gov (United States)

    Massie, B. M.; Simonini, A.; Sahgal, P.; Wells, L.; Dudley, G. A.

    1996-01-01

    OBJECTIVES. The present study was undertaken to further characterize changes in skeletal muscle morphology and histochemistry in congestive heart failure and to determine the relation of these changes to abnormalities of systemic and local muscle exercise capacity. BACKGROUND. Abnormalities of skeletal muscle appear to play a role in the limitation of exercise capacity in congestive heart failure, but information on the changes in muscle morphology and biochemistry and their relation to alterations in muscle function is limited. METHODS. Eighteen men with predominantly mild to moderate congestive heart failure (mean +/- SEM New York Heart Association functional class 2.6 +/- 0.2, ejection fraction 24 +/- 2%) and eight age- and gender-matched sedentary control subjects underwent measurements of peak systemic oxygen consumption (VO2) during cycle ergometry, resistance to fatigue of the quadriceps femoris muscle group and biopsy of the vastus lateralis muscle. RESULTS. Peak VO2 and resistance to fatigue were lower in the patients with heart failure than in control subjects (15.7 +/- 1.2 vs. 25.1 +/- 1.5 ml/min-kg and 63 +/- 2% vs. 85 +/- 3%, respectively, both p congestive heart failure is associated with changes in the characteristics of skeletal muscle and local as well as systemic exercise performance. There are fewer slow twitch fibers, smaller fast twitch fibers and lower succinate dehydrogenase activity. The latter finding suggests that mitochondrial content of muscle is reduced in heart failure and that impaired aerobic-oxidative capacity may play a role in the limitation of systemic exercise capacity.

  1. Bilateral basal Xe-133 retention and ventilation/perfusion patterns in mild and subclinical congestive heart failure

    International Nuclear Information System (INIS)

    The Xe-133 ventilation pattern in congestive heart failure (CHF) was assessed using 24 inpatient ventilation/perfusion studies performed to rule out pulmonary embolism. Patients with histories of CHF, myocardial infarction (MI), and cardiomyopathy were included in the study. Frank pulmonary edema, pulmonary embolism, and other known lung diseases such as chronic obstructive lung disease, tumor, and pneumonia were excluded. Fifteen of the 24 patients had abnormal ventilation scans. Twelve of the 15 showed bilateral basal Xe-133 retention on washout; the remaining 3 showed diffuse, posterior regional retention. On perfusion scans, 14 of the 15 abnormal ventilation patients showed evidence of CHF such as inverted perfusion gradient, enlarged cardiac silhouette, or patchy perfusion, and all of them had a history of CHF or cardiac disease. Nine of the 24 patients had normal ventilation scans, including normal washout patterns. Seven of the nine had normal perfusion (p less than 0.01). Four of the nine normal ventilation patients had a history of cardiac disease or CHF but no recent acute MI. Bilateral basal regional Xe-133 retention, coupled with perfusion scan evidence of CHF such as inverted perfusion gradient, enlarged cardiac silhouette, and patchy perfusion pattern, appears to be a sensitive and characteristic ventilation/perfusion finding in mild or subclinical CHF

  2. Treatment with verapamil and trandolapril in patients with congestive heart failure and angina pectoris or myocardial infarction. The DAVIT Study Group. Danish Verapamil Infarction Trial

    DEFF Research Database (Denmark)

    Hansen, J F; Hagerup, L; Sigurd, B;

    1997-01-01

    In a double-blind, randomized trial in a consecutive group of postinfarct patients in treatment with diuretic agents for congestive heart failure, the 3 month rate of cardiac events (i.e., death, repeat infarction, unstable angina pectoris, or repeat admission because of heart failure) was 14....... These findings indicate that combined treatment with verapamil and trandolapril may be beneficial in patients with congestive heart failure....

  3. Thyrotropin-secreting pituitary tumor presenting with congestive heart failure and good response to dopaminergic agonist cabergoline.

    Science.gov (United States)

    Kao, Yu-Hsi; Chang, Tien-Jyun; Huang, Tien-Shang

    2013-11-01

    Hyperthyroidism is an important inducing factor in patients with atrial fibrillation, and may trigger heart failure. Thyrotropin (thyroid stimulating hormone, TSH)-secreting pituitary tumors are rare causes of hyperthyroidism. Here, we report a 66-year-old man with a pituitary TSH-secreting tumor who presented with hyperthyroidism and congestive heart failure. Endonasal trans-sphenoidal pituitary adenomectomy was performed. After the operation, the symptoms of hyperthyroidism and congestive heart failure were relieved, associated with normalization of thyroid function tests. Unfortunately, hand tremor and progressively elevated free T4 and TSH concentrations recurred 5 months after surgery. A dopaminergic agonist, cabergoline was administered and euthyroidism was restored for at least 11 months.

  4. Congestive heart failure with preserved left ventricular systolic function after acute myocardial infarction: clinical and prognostic implications

    DEFF Research Database (Denmark)

    Møller, Jacob Eifer; Brendorp, Bente; Ottesen, Michael;

    2003-01-01

    AIMS: To characterise the prevalence, in-hospital complications, management, and long-term outcome of patients with congestive heart failure but preserved left ventricular systolic function after acute myocardial infarction. METHODS: 3166 consecutive patients screened for entry in the Bucindolol...... and all cause mortality. RESULTS: Congestive heart failure was seen during hospitalisation in 1464 patients (46%), 717 patients had preserved left ventricular systolic function (wall motion index > or =1.3 corresponding to ejection fraction > or =0.40), and 732 patients had systolic dysfunction (wall.......3 (95% CI 2.8-4.0), and after adjustment for baseline characteristics and left ventricular systolic function in multivariate Cox proportional hazards analysis the risk was 2.1 (95% CI 1.7-2.6), PCongestive heart failure is frequently present in patients with preserved left...

  5. Clinical significance of I-123 MIBG myocardial scintigraphy for evaluating the severity of congestive heart failure

    International Nuclear Information System (INIS)

    We studied the significance of I-123 MIBG (metaiodobenzylguanidine) myocardial scintigraphy for evaluating the severity of congestive heart failure (CHF). I-123 MIBG scintigraphy was performed in 7 patients with CHF of NYHA class I-III (6 with dilated cardiomyopathy and 1 with adriamycine cardiomyopathy) and in 2 normals. The SPECT and anterior planar myocardial images were obtained 15 minutes after (initial images) and 4 hours after (delayed images) an injection of I-123 MIBG (111 MBq). Compared with normals, patients with CHF demonstrated (1) low myocardial uptake and (2) rapid myocardial washout of I-123 MIBG, indicating myocardial sympathetic disarrangement. Then, quantitating these abnormalities with the heart to upper mediastinum uptake ratio (H/B) and the percent washout rate (%WR) during 4 hours, respectively, we compared these two indices with LV ejection fraction (EF) at rest measured by echocardiography and exercise capacity (max VO2 and VO2 at anaerobic threshold (AT)) determined with respiratory gas exchange analysis during maximal bicycle exercise. H/B was lower and %WR was greater in patients with CHF than in normals. H/B correlated with EF (r=0.77, p2 (r=-0.74, p<0.05) and AT (r=-0.81, p<0.05). Thus, H/B and %WR were closely related to the severity of CHF. These results suggest that I-123 MIBG myocardial scintigraphy and the quantitative analysis of I-123 MIBG myocardial uptake provide useful information about the severity of CHF. (author)

  6. Prognosis of emergency room stabilization of decompensated congestive heart failure with high dose lasix

    Directory of Open Access Journals (Sweden)

    Mahboob Pouraghaei

    2015-06-01

    Full Text Available Objective: Congestive heart failure (CHF has become one of the most important health care problems in western countries. This article focuses on the outpatient diagnosis and management of heart failure. We want to compare the outcome of patients who were treated with high dose diuretics in the emergency department (ED without admission with patients who were admitted to hospital for standard treatment. Methods: This was a randomized prospective clinical trial study. The patients who came to the ED from March 20, 2008 up to August 20, 2008 were divided into two groups randomly. The length of ED stay in the experimental group was documented. Also, readmission and mortality in 6 months and satisfaction in both groups were taken into consideration. All data were analyzed using SPSS 15.0. Results: In experimental group, the rate of recurrent admission, expiration, discharge, clinic visit, and clinic admission was 8%, 4%, 29%, 18%, and 0% respectively. On the other hand, in control group it was 16%, 40%, 18%, 22%, and 2% respectively. Additionally, there was a significant difference between these groups (P = 0.00. Conclusion: This study is the first regional prospective trial to comprehensively examine the therapeutic management in patients with CHF. This study, comparing the high dose diuretic efficacy in the decreasing of hospital stay and readmission; and decreasing mortality rate with routine therapy, showed that there was a significant difference between these two strategies in the mortality rate, readmission, and length of hospital stay (P = 0.00.

  7. The hemodynamic effects of ibopamine, a dopamine congener, in patients with congestive heart failure.

    Science.gov (United States)

    Leier, C V; Ren, J H; Huss, P; Unverferth, D V

    1986-01-01

    Ten patients with congestive heart failure underwent noninvasive and invasive hemodynamic testing before and sequentially after the administration of ibopamine to determine the cardiovascular effects of this oral dopamine congener. Single doses of 200, 400 and 600 mg were administered to all patients and 5 repeated doses of 200 or 400 mg were studied in 8. Hemodynamic effects occurred as early as 30 minutes and lasted up to 4 hours after dosing. In general, ibopamine elicited statistically significant dose-related increases in cardiac output and reductions in the derived resistance of the systemic and pulmonary circulations. A biphasic response in central and peripheral pressures was observed; up to 1 hour after administration, ibopamine elevated mean right and left atrial pressures and pulmonary and systemic arterial pressures with a significant reduction of these measurements beyond 1 hour. It did not alter heart rate. Repeated doses qualitatively affected hemodynamics similar to the initial dose and did not appear to be accompanied by short-term tolerance. While oral ibopamine elicits some favorable hemodynamic effects in humans with cardiac failure, the biphasic hemodynamic response is generally undesirable in the majority of these patients.

  8. Optimal timing in screening patients with congestive heart failure and healthy subjects during circadian observation.

    Science.gov (United States)

    Jong, Tai-Lang; Chang, Ben; Kuo, Cheng-Deng

    2011-02-01

    Congestive heart failure (CHF) is a major medical challenge in developed countries. In order to screen patients with CHF and healthy subjects during circadian observation, accurate judgment and fast response are imperative. In this study, optimal timing during circadian observation via the heart rate variability (HRV) was sought. We tested 29 CHF patients and 54 healthy subjects in the control group from the interbeat interval databases of PhysioBank. By invoking the α1 parameter in detrended fluctuation analysis of HRV, we found that it could be used as an indicator to screen the patients with CHF and subjects in normal sinus rhythm (NSR) under Kruskal-Wallis test. By invoking Fano factor, the optimal timing to screen CHF patients and healthy subjects was found to be from 7 PM to 9 PM during the circadian observation. In addition, this result is robust in a sense that the same result can be achieved by using different ECG recording lengths of 2, 5, 10, … , and 120 min, respectively. Furthermore, a support vector machine was employed to classify CHF and NSR with α1 parameter of a moving half-hour ECG recordings via leave-one-out cross validation. The results showed that the superlative screening performance was obtained in the 7 pm-9 pm period during circadian observation. It is believed that this result of optimal timing will be helpful in the non-invasive monitoring and screening of CHF patients and healthy subjects in the clinical practice. PMID:20953708

  9. Plasma renin activity and its association with ischemic heart disease, congestive heart failure, and cerebrovascular disease in a large hypertensive cohort

    OpenAIRE

    Sim, John J.; Shi, Jiaxiao; Al-Moomen, Rushdy; Behayaa, Hind; Kalantar-Zadeh, Kamyar; Jacobsen, Steven J.

    2014-01-01

    Plasma renin activity (PRA) may be a surrogate for vascular damage. We hypothesize that PRA is associated with cardiovascular and cerebrovascular disease. Cross sectional study (1/1/1998–12/31/2009) on hypertensive individuals >/=18yrs using multivariable logistic regression models to estimate odds ratios (OR) for ischemic heart disease (IHD), congestive heart failure (CHF), and cerebrovascular disease (CED) based on PRA quartiles controlling for age, sex, race, diabetes mellitus (DM), and me...

  10. Loss of the eIF2α kinase GCN2 protects mice from pressure overload induced congestive heart failure without affecting ventricular hypertrophy

    Science.gov (United States)

    Lu, Zhongbing; Xu, Xin; Fassett, John; Kwak, Dongmin; Liu, Xiaoyu; Hu, Xinli; Wang, Huan; Guo, Haipeng; Xu, Dachun; Yan, Shuo; McFalls, Edward O.; Lu, Fei; Bache, Robert J.; Chen, Yingjie

    2016-01-01

    In response to a number of stresses, including nutrient deprivation, General Control Nonderepressible 2 kinase (GCN2) attenuates mRNA translation by phosphorylating eukaryotic initiation factor 2 alpha (eIF2αSer51). Energy starvation is known to exacerbate congestive heart failure (CHF) and eIF2αSer51 phosphorylation is increased in the failing heart. However, the impact of GCN2 during the evolution of CHF has not been tested. In this study we examined the influence of GCN2 expression in response to a cardiac stress by inducing chronic pressure overload with Transverse Aortic Constriction (TAC) in Wild Type (WT) and GCN2 knockout (GCN2−/−) mice. Under basal conditions, GCN2−/− had normal LV structure or function but following TAC, demonstrated less contractile dysfunction, less increase of lung weight, less increase of lung inflammation and vascular remodeling, and less myocardial apoptosis and fibrosis compared with WT mice, despite an equivalent degree of LV hypertrophy. As expected, GCN2−/− attenuated TAC induced cardiac eif2αSer51 phosphorylation and preserved Sarcoplasmic reticulum Ca2+ ATPase (Serca2a) expression compared with WT mice. Interestingly, expression of the anti-apoptotic protein Bcl-2 was significantly elevated in GCN2−/− hearts, while in isolated neonatal cardiomyocytes, selective knockdown of GCN2 increased Bcl-2 protein expression and enhanced myocyte resistance to an apoptotic stress. Collectively, our data support the notion that GCN2 impairs the ventricular adaptation to chronic pressure overload by reducing Bcl-2 expression and increasing cardiomyocyte susceptibility to apoptotic stimuli. Our findings suggest that strategies to reduce GCN2 activity in cardiac tissue may be a novel approach to attenuate congestive heart failure development. PMID:24166753

  11. Chronic Heart Failure: Contemporary Diagnosis and Management

    OpenAIRE

    Ramani, Gautam V.; Uber, Patricia A.; Mehra, Mandeep R.

    2010-01-01

    Chronic heart failure (CHF) remains the only cardiovascular disease with an increasing hospitalization burden and an ongoing drain on health care expenditures. The prevalence of CHF increases with advancing life span, with diastolic heart failure predominating in the elderly population. Primary prevention of coronary artery disease and risk factor management via aggressive blood pressure control are central in preventing new occurrences of left ventricular dysfunction. Optimal therapy for CHF...

  12. Mediastinal lymphadenopathy in congestive heart failure: a sequential CT evaluation with clinical and echocardiographic correlations

    Energy Technology Data Exchange (ETDEWEB)

    Chabbert, Valerie; Canevet, Guillaume; Otal, Philippe; Joffre, Francis [Department of Radiology, University of Toulouse, Avenue Jean-Poulhes, 31403, Toulouse (France); Baixas, Cecile; Galinier, Michel [Department of Cardiology, University of Toulouse, Avenue Jean-Poulhes, 31403, Toulouse (France); Deken, Valerie; Duhamel, Alain [Department of Medical Statistics, University of Lille, Place de Verdun, 59037, Lille Cedex (France); Remy, Jacques; Remy-Jardin, Martine [Department of Radiology, Hospital Calmette, University Center of Lille, Boulevard Jules Leclerc, 59037, Lille Cedex (France)

    2004-05-01

    The aim of this study was to evaluate the frequency and evolution after treatment of mediastinal lymphadenopathy associated with congestive left heart failure on CT scans in correlation with clinical and echocardiographic findings. Thirty-one consecutive patients with subacute left heart failure underwent a clinical evaluation using the NYHA classification, a CT examination, and transthoracic echocardiography at the time of initial presentation (T1). After initiation of medical treatment (T2), follow-up CT scans were systematically obtained together with a clinical evaluation. At T1, all patients showed severe (type III: n=12, 39%; type IV: n=12, 39%) to moderate (type I, n=1, 3%; type II, n=6, 19%) dyspnea with a mean ejection fraction of 39% (range 22-74%). On initial CT scans, enlarged mediastinal lymph nodes were seen in 13 patients (42%) with blurred contours in 5 patients (16%) and hazy mediastinal fat in 1 patient (3%). Significant decrease in the size of lymphadenopathy was observed between T1 and T2 (T1, n=13, 42% vs T2, n=10, 32%; p<0.05) with a concurrent decrease in the severity of dyspnea (grade III-IV dyspnea at T1, n=24, 78% vs grade I-II dyspnea at T2, n=26, 83.5%). Patients with enlarged lymph nodes at T1 showed: (a) a significantly lower ejection fraction at echocardiography than those without lymphadenopathy (mean{+-}SD value: 34{+-}12.9 vs 43{+-}13.8%; p=0.04); (b) a significantly larger diameter of the right superior pulmonary vein (mean{+-}SD value: 17{+-}2.75 vs 14{+-}3.9 mm; p=0.04); and (c) a higher frequency of abnormal peribronchovascular thickening (n=5 vs n=1; p=0.06). Mediastinal lymphadenopathy associated with subacute left heart failure was observed in 13 patients (42%), showing regression after initiation of treatment in 8 of 13 patients (62%). (orig.)

  13. Advanced glycation endproducts in chronic heart failure

    NARCIS (Netherlands)

    Smit, Andries J.; Hartog, Jasper W. L.; Voors, Adriaan A.; van Veldhuisen, Dirk J.; Schleicher, E; Somoza,; Shieberle, P

    2008-01-01

    Advanced glycation endproducts (AGEs) have been proposed as factors involved in the development and progression of chronic heart failure (CHF). Cross-linking by AGEs results in vascular and myocardial stiffening, which are hallmarks in the pathogenesis of CHE Additionally, stimulation of receptors b

  14. Body mass index in chronic heart failure

    DEFF Research Database (Denmark)

    Christensen, Heidi M; Schou, Morten; Goetze, Jens P;

    2013-01-01

    Low body mass index (BMI) is associated with a poor outcome in chronic heart failure (CHF). An inverse association between BMI and adiponectin and N-terminal pro-B-type natriuretic peptide (NT-proBNP) has been reported. The aim of the present study was to investigate whether novel markers...

  15. PULMONARY ARTERIAL DISEASE ASSOCIATED WITH RIGHT-SIDED CARDIAC HYPERTROPHY AND CONGESTIVE HEART FAILURE IN ZOO MAMMALS HOUSED AT 2,100 M ABOVE SEA LEVEL.

    Science.gov (United States)

    Juan-Sallés, Carles; Martínez, Liliana Sofía; Rosas-Rosas, Arely G; Parás, Alberto; Martínez, Osvaldo; Hernández, Alejandra; Garner, Michael M

    2015-12-01

    Subacute and chronic mountain sickness of humans and the related brisket disease of cattle are characterized by right-sided congestive heart failure in individuals living at high altitudes as a result of sustained hypoxic pulmonary hypertension. Adaptations to high altitude and disease resistance vary among species, breeds, and individuals. The authors conducted a retrospective survey of right-sided cardiac hypertrophy associated with pulmonary arterial hypertrophy or arteriosclerosis in zoo mammals housed at Africam Safari (Puebla, México), which is located at 2,100 m above sea level. Seventeen animals with detailed pathology records matched the study criterion. Included were 10 maras (Dolichotis patagonum), 2 cotton-top tamarins (Saguinus oedipus oedipus), 2 capybaras (Hydrochaeris hydrochaeris), and 1 case each of Bennet's wallaby (Macropus rufogriseus), nilgai antelope (Boselaphus tragocamelus), and scimitar-horned oryx (Oryx dammah). All had right-sided cardiac hypertrophy and a variety of arterial lesions restricted to the pulmonary circulation and causing arterial thickening with narrowing of the arterial lumen. Arterial lesions most often consisted of medial hypertrophy or hyperplasia of small and medium-sized pulmonary arteries. All maras also had single or multiple elevated plaques in the pulmonary arterial trunk consisting of fibrosis, accompanied by chondroid metaplasia in some cases. Both antelopes were juvenile and died with right-sided congestive heart failure associated with severe pulmonary arterial lesions. To the authors' knowledge, this is the first description of cardiac and pulmonary arterial disease in zoo mammals housed at high altitudes.

  16. PULMONARY ARTERIAL DISEASE ASSOCIATED WITH RIGHT-SIDED CARDIAC HYPERTROPHY AND CONGESTIVE HEART FAILURE IN ZOO MAMMALS HOUSED AT 2,100 M ABOVE SEA LEVEL.

    Science.gov (United States)

    Juan-Sallés, Carles; Martínez, Liliana Sofía; Rosas-Rosas, Arely G; Parás, Alberto; Martínez, Osvaldo; Hernández, Alejandra; Garner, Michael M

    2015-12-01

    Subacute and chronic mountain sickness of humans and the related brisket disease of cattle are characterized by right-sided congestive heart failure in individuals living at high altitudes as a result of sustained hypoxic pulmonary hypertension. Adaptations to high altitude and disease resistance vary among species, breeds, and individuals. The authors conducted a retrospective survey of right-sided cardiac hypertrophy associated with pulmonary arterial hypertrophy or arteriosclerosis in zoo mammals housed at Africam Safari (Puebla, México), which is located at 2,100 m above sea level. Seventeen animals with detailed pathology records matched the study criterion. Included were 10 maras (Dolichotis patagonum), 2 cotton-top tamarins (Saguinus oedipus oedipus), 2 capybaras (Hydrochaeris hydrochaeris), and 1 case each of Bennet's wallaby (Macropus rufogriseus), nilgai antelope (Boselaphus tragocamelus), and scimitar-horned oryx (Oryx dammah). All had right-sided cardiac hypertrophy and a variety of arterial lesions restricted to the pulmonary circulation and causing arterial thickening with narrowing of the arterial lumen. Arterial lesions most often consisted of medial hypertrophy or hyperplasia of small and medium-sized pulmonary arteries. All maras also had single or multiple elevated plaques in the pulmonary arterial trunk consisting of fibrosis, accompanied by chondroid metaplasia in some cases. Both antelopes were juvenile and died with right-sided congestive heart failure associated with severe pulmonary arterial lesions. To the authors' knowledge, this is the first description of cardiac and pulmonary arterial disease in zoo mammals housed at high altitudes. PMID:26667539

  17. Acromegaly with Normal Insulin-Like Growth Factor-1 Levels and Congestive Heart Failure as the First Clinical Manifestation.

    Science.gov (United States)

    Lee, Hyae Min; Lee, Sun Hee; Yang, In Ho; Hwang, In Kyoung; Hwang, You Cheol; Ahn, Kyu Jeung; Chung, Ho Yeon; Hwang, Hui Jeong; Jeong, In Kyung

    2015-09-01

    The leading cause of morbidity and mortality in patients with acromegaly is cardiovascular complications. Myocardial exposure to excessive growth hormone can cause ventricular hypertrophy, hypertension, arrhythmia, and diastolic dysfunction. However, congestive heart failure as a result of systolic dysfunction is observed only rarely in patients with acromegaly. Most cases of acromegaly exhibit high levels of serum insulin-like growth factor-1 (IGF-1). Acromegaly with normal IGF-1 levels is rare and difficult to diagnose. Here, we report a rare case of an acromegalic patient whose first clinical manifestation was severe congestive heart failure, despite normal IGF-1 levels. We diagnosed acromegaly using a glucose-loading growth hormone suppression test. Cardiac function and myocardial hypertrophy improved 6 months after transsphenoidal resection of a pituitary adenoma.

  18. Wavelet Based Method for Congestive Heart Failure Recognition by Three Confirmation Functions

    Directory of Open Access Journals (Sweden)

    K. Daqrouq

    2016-01-01

    Full Text Available An investigation of the electrocardiogram (ECG signals and arrhythmia characterization by wavelet energy is proposed. This study employs a wavelet based feature extraction method for congestive heart failure (CHF obtained from the percentage energy (PE of terminal wavelet packet transform (WPT subsignals. In addition, the average framing percentage energy (AFE technique is proposed, termed WAFE. A new classification method is introduced by three confirmation functions. The confirmation methods are based on three concepts: percentage root mean square difference error (PRD, logarithmic difference signal ratio (LDSR, and correlation coefficient (CC. The proposed method showed to be a potential effective discriminator in recognizing such clinical syndrome. ECG signals taken from MIT-BIH arrhythmia dataset and other databases are utilized to analyze different arrhythmias and normal ECGs. Several known methods were studied for comparison. The best recognition rate selection obtained was for WAFE. The recognition performance was accomplished as 92.60% accurate. The Receiver Operating Characteristic curve as a common tool for evaluating the diagnostic accuracy was illustrated, which indicated that the tests are reliable. The performance of the presented system was investigated in additive white Gaussian noise (AWGN environment, where the recognition rate was 81.48% for 5 dB.

  19. Wavelet Based Method for Congestive Heart Failure Recognition by Three Confirmation Functions.

    Science.gov (United States)

    Daqrouq, K; Dobaie, A

    2016-01-01

    An investigation of the electrocardiogram (ECG) signals and arrhythmia characterization by wavelet energy is proposed. This study employs a wavelet based feature extraction method for congestive heart failure (CHF) obtained from the percentage energy (PE) of terminal wavelet packet transform (WPT) subsignals. In addition, the average framing percentage energy (AFE) technique is proposed, termed WAFE. A new classification method is introduced by three confirmation functions. The confirmation methods are based on three concepts: percentage root mean square difference error (PRD), logarithmic difference signal ratio (LDSR), and correlation coefficient (CC). The proposed method showed to be a potential effective discriminator in recognizing such clinical syndrome. ECG signals taken from MIT-BIH arrhythmia dataset and other databases are utilized to analyze different arrhythmias and normal ECGs. Several known methods were studied for comparison. The best recognition rate selection obtained was for WAFE. The recognition performance was accomplished as 92.60% accurate. The Receiver Operating Characteristic curve as a common tool for evaluating the diagnostic accuracy was illustrated, which indicated that the tests are reliable. The performance of the presented system was investigated in additive white Gaussian noise (AWGN) environment, where the recognition rate was 81.48% for 5 dB. PMID:26949412

  20. Effects of 6-minute walk test on the QT dispersion in patients with congestive heart failure

    Institute of Scientific and Technical Information of China (English)

    惠海鹏; 许顶立; 李琦

    2003-01-01

    Objective: To investigate the clinical value of QT dispersion (QTd) and the effects of 6-minute walk test (6-MWT) mimicking the patients' daily activities on QTd in patients with congestive heart failure (CHF).Methods: Twenty-eight CHF patients and 22 normal subjects participated these study, who all completed 6-MWT without developing severe arrhythmias.Before and after 6-MWT, standardized 12-lead surface ECGs were obtained to measure QTd and corrected QTd (QTcd).Results: Both before and after 6-MWT, the QTd and QTcd in CHF patients were longer than those in the controls (P<0.001), and QTd and QTcd after 6-MWT were significantly shorter than those before 6-MWT in CHF patients (P=0.007, and 0.018).There was no significant difference in the measurement in the control group.Conclusion: QTd and QTcd are longer in CHF patients than in normal subjects.Moderate exercise may improve the inhomogeneity of ventricular repolarization dispersion in CHF patients.

  1. Cortical Brain Connectivity and B-Type Natriuretic Peptide in Patients With Congestive Heart Failure.

    Science.gov (United States)

    Vecchio, Fabrizio; Miraglia, Francesca; Valeriani, Lavinia; Scarpellini, Maria Gabriella; Bramanti, Placido; Mecarelli, Oriano; Rossini, Paolo M

    2015-07-01

    The brain has a high level of complexity and needs continuous oxygen supply. So it is clear that any pathological condition, or physiological (aging) change, in the cardiovascular system affects functioning of the central nervous system. We evaluated linear aspects of the relationship between the slowness of cortical rhythms, as revealed by the modulation of a graph connectivity parameter, and congestive heart failure (CHF), as a reflection of neurodegenerative processes. Eyes-closed resting electroencephalographic (EEG) data of 10 patients with CHF were recorded by 19 electrodes positioned according the international 10-20 system. Graph theory function (normalized characteristic path length λ) was applied to the undirected and weighted networks obtained by lagged linear coherence evaluated by eLORETA software, therefore getting rid of volumetric propagation influences. The EEG frequency bands of interest were: delta (2-4 Hz), theta (4-8 Hz), alpha 1 (8-10.5 Hz), alpha 2 (10.5-13 Hz), beta 1 (13-20 Hz), beta 2 (20-30 Hz), and gamma (30-40 Hz). The analysis between B-type natriuretic peptide (BNP) values and λ showed positive correlation in delta, associated with a negative correlation in alpha 2 band. Namely, the higher the severity of the disease (as revealed by the BNP vales), the higher the λ in delta, and lower in alpha 2 band. Results suggest that delta and alpha λ indices are good markers of the severity of CHF.

  2. Clinical significance of serum cardiac troponin T in patients with congestive heart failure

    Institute of Scientific and Technical Information of China (English)

    薛春才; 于宏伟; 李瑞杰; 沃金善; 崔家玉; 程海宾; 王洪云; 管庆华; 索晓霞; 贾荣波

    2003-01-01

    Objective To determine whether the level of serum cardiac troponin T (cTnT) was increased in patients with congestive heart failure (CHF). Methods This study consisted of 265 patients with CHF and 75 healthy people. Serum cTnT was measured by electrochemiluminescence immunoassay using an Elecsys 1010 automatic analyzer. Results cTnT concentration was 0.181±0.536 ng/mL in CHF patients and 0.003±0.001 ng/mL in controls (P35%, cTnT was 0.07±0.0 5ng/mL (P0.05, class Ⅱ vs class Ⅲ P<0.01, class Ⅲ vs class Ⅳ P<0.01). A negative correlation was observed between serum cTnT concentration and LVEF in 265 patients with CHF (r=-0.493, P<0.001).Conclusions This study shows that the level of serum cTnT is increased in patients with CHF and that the increased level indicates the severity of CHF.

  3. Integrative Medical Care Plus Mindfulness Training for Patients With Congestive Heart Failure: Proof of Concept.

    Science.gov (United States)

    Kemper, Kathi J; Carmin, Cheryl; Mehta, Bella; Binkley, Phillip

    2016-10-01

    Congestive heart failure (CHF) has a high rate of morbidity and mortality. It is often accompanied by other medical and psychosocial comorbidities that complicate treatment and adherence. We conducted a proof of concept pilot project to determine the feasibility of providing integrative group medical visits plus mindfulness training for patients recently discharged with CHF. Patients were eligible if they had been discharged from an inpatient stay for CHF within the 12 months prior to the new program. The Compassionate Approach to Lifestyle and Mind-Body (CALM) Skills for Patients with CHF consisted of 8 weekly visits focusing on patient education about medications, diet, exercise, sleep, and stress management; group support; and training in mind-body skills such as mindfulness, self-compassion, and loving-kindness. Over two 8-week sessions, 8/11 (73%) patients completed at least 4 visits. The patients had an average age of 57 years. The most common comorbidities were weight gain, sleep problems, and fatigue. After the sessions, 100% of patients planned to make changes to their diet, exercise, and stress management practices. Over half of the patients who met with a pharmacist had a medication-related problem. Improvements were observed in depression, fatigue, and satisfaction with life. Integrative group visits focusing on healthy lifestyle, support, and skill-building are feasible even among CHF patients and should be evaluated in controlled trials as a patient-centered approach to improving outcomes related to improving medication management, depression, fatigue, and quality of life.

  4. Exogenous midkine administration prevents cardiac remodeling in pacing-induced congestive heart failure of rabbits.

    Science.gov (United States)

    Harada, Masahide; Hojo, Mayumi; Kamiya, Kaichiro; Kadomatsu, Kenji; Murohara, Toyoaki; Kodama, Itsuo; Horiba, Mitsuru

    2016-01-01

    Midkine (MK), a heparin-binding growth factor, has been shown to prevent cardiac remodeling after ischemic injury through its anti-apoptotic effect. Cell apoptosis is central to the pathophysiology of cardiac remodeling in congestive heart failure (CHF) of ischemic as well as non-ischemic origin. We hypothesized that MK exerts the anti-apoptotic cardioprotective effect in CHF of non-ischemic etiology. MK protein or vehicle (normal saline) was subcutaneously administered in tachycardia-induced CHF rabbits (right ventricular pacing, 350 beats/min, 4 weeks). The vehicle-treated rabbits (n = 19, control) demonstrated severe CHF and high mortality rate, whereas MK (n = 16) demonstrated a well-compensated state and a lower mortality rate. In echocardiography, left ventricular (LV) end-diastolic dimension decreased in MK versus control, whereas LV systolic function increased. In histological analysis (picrosirius red staining), MK decreased collagen deposition area compared with control. TUNEL staining showed that MK prevented cell apoptosis and minimized myocyte loss in the CHF rabbit ventricle, associated with activation of PI3-K/Akt signaling, producing a parallel decrease of Bax/Bcl-2 ratio. MK prevented progression of cardiac remodeling in the CHF rabbit, likely by activation of anti-apoptotic signaling. Exogenous MK application might be a novel therapeutic strategy for CHF due to non-ischemic origin.

  5. Management of congestive heart failure: a gender gap may still exist. Observations from a contemporary cohort

    Directory of Open Access Journals (Sweden)

    Weller Iris

    2003-02-01

    Full Text Available Abstract Background Unlike other cardiovascular diseases the incidence and prevalence of congestive heart failure (CHF continues to increase. While gender differences in coronary artery disease have been well described, to date, there has been a relative paucity of similar data in patients with CHF. We conducted a pilot study to evaluate the profile and management of patients with CHF at a tertiary care centre to determine if a gender difference exists. Methods A chart review was performed at a tertiary care centre on consecutive patients admitted with a primary diagnosis of CHF between June 1997 and 1998. Co-morbidity, diagnostic investigations, and management of CHF were recorded. Comparisons between male and female patients were conducted. Results One hundred and forty five patients were reviewed. There were 80 male (M and 65 female (F patients of similar age [71.6 vs. 71.3 (M vs. F, p = NS]. Male patients were more likely to have had a previous myocardial infarction (66% vs. 35%, p Conclusions This pilot study demonstrated that there seem to be important gender differences in the profile and management of patients with CHF. Importantly women were less likely to have an evaluation of LV function. As assessment of LV function has significant implications on patient management, this data justifies the need for larger studies to assess gender differences in CHF profile and treatment.

  6. A case of ACTH-independent bilateral macronodular adrenal hyperplasia and severe congestive heart failure.

    Science.gov (United States)

    Suri, D; Alonso, M; Weiss, R E

    2006-11-01

    Cortisol secretion in ACTH independent bilateral macronodular adrenal hyperplasia (AIMAH) can be regulated by aberrant adrenal receptors. We describe a patient with Cushing's syndrome (CS) due to AIMAH and concomitant Class IV congestive heart failure (CHF). Clinical testing for the presence of aberrant receptors revealed a pronounced serum cortisol (257%) and aldosterone response (212%) to the administration of ACTH and a partial serum cortisol (35%) and aldosterone (106%) response to upright posture. This suggested the possible presence of aberrant hormone receptors for ACTH [melanocortin 2 receptor (MC2-R)], vasopressin, catecholamines or angiotensin II (AT-II) on the patient's adrenal glands. Adrenal tissue from the patient demonstrated an eight-fold increased expression of MC2-R compared to normal adrenal tissue. This increased expression was consistent with the increase in cortisol and aldosterone seen in response to exogenous ACTH. We propose that the severe CHF resulted in activation of the renin-angiotensin system, with an increased production of AT-II. The elevated circulating levels of AT-II may have led to increased expression of MC2-R on the patient's adrenal glands and increased responsiveness to ACTH. This unusual case of CS may elucidate a heretofore unknown mechanism for the development of AIMAH.

  7. Hemostatic Markers in Congestive Heart Failure Dogs with Mitral Valve Disease

    Directory of Open Access Journals (Sweden)

    Kreangsak Prihirunkit

    2014-01-01

    Full Text Available Prothrombin time (PT, activated partial thromboplastin time (APTT, fibrinogen, D-dimer, antithrombin III (AT III, protein C (PC, factor VII (F.VII, and factor VIII (F.VIII, as well as hematocrit (HCT, platelets number (PLT, total plasma protein (TP, and albumin (ALB, were studied on fifty-eight congestive heart failure (CHF dogs with mitral valve disease (MVD and fifty control dogs. All of variables of MVD group, except APTT, were significantly different (P<0.5 from control group. The variables were also compared among functional classes of CHF dogs and control dogs. It was determined that the higher the functional class of CHF dogs was, the greater the levels of fibrinogen and D-dimer were, whereas the lesser the activities of AT III and PC were presented. Additionally, TP had linear correlation with fibrinogen, D-dimer, HCT, and PLT (r=0.31, 0.30, 0.43, and 0.38, resp., P<0.5. These findings suggested that fibrinogen and D-dimer were the factors predisposing hypercoagulability through an increase in blood viscosity. The hemorheological abnormalities would shift an overall hemostatic balance toward a more thrombotic state in CHF dogs with MVD.

  8. THE OCCURRENCE OF CHEYNE STOKES RESPIRATION IN CONGESTIVE HEART FAILURE: THE EFFECT OF AGE

    Directory of Open Access Journals (Sweden)

    Avivit Pe'Er

    2010-09-01

    Full Text Available Introduction: Up to 50% of adults with congestive heart failure (CHF and left ventricular dysfunction demonstrate Cheyne Stokes Respiration (CSR, although the mechanisms remain controversial. Because CSR has been minimally studied in children, we sought to assess the prevalence of CSR in children with low and high output cardiac failure. We hypothesized that the existence of CSR only in children with low output CHF would support the importance of circulatory delay as a CSR mechanism. Methods: Thirty patients participated: 10 children with CHF, 10 matched children with no heart disease, and 10 adults with CHF. All participants underwent an in-laboratory polysomnographic sleep study. Results: CHF Children’s average age (±SEM was 3.6±2.1 years vs. 3.7±2 years in the age-matched control group. The average ejection fraction of three children with low-output CHF was 22±6.8%. The remaining seven had normal-high cardiac output. Compared to control children, CHF children were tachypneic and tachycardic during stable sleep (55.1±6.7 vs. 26.9±3 breath/min and 127.6±8.7 vs. 97.6±6.9 beats/min, respectively, p<0.05 for both. They had shorter total sleep time (195±49 vs. 373±16 min, p<0.05 with a low sleep efficiency of 65.6±6%. None of the children had a pattern of CSR at any time during the studies while the adults with CHF had 40% prevalence of CSR. Conclusions: The complete absence of CSR in our sample of children with CHF compared to the 40% prevalence in the adults with CHF we studied, suggests that CSR may be an age-dependent phenomenon. Thus, we speculate that regardless of the exact mechanism which drives CSR, age is an over-riding factor.

  9. A Comparison of Selenium Concentrations Between Congestive Heart Failure Patients and Healthy Volunteers

    Directory of Open Access Journals (Sweden)

    Ali Ghaemian

    2012-06-01

    Full Text Available Background: Selenium (Se is an essential trace element mainly obtained from seafood, meat, and cereals. Se deficiency has been identified as a major contributing factor in the pathogenesis of certain congestive heart failure (CHF syndromes. Since there is controversy over the prevalence of Se deficiency among patient with CHF, the aim of this study was to assess the serum Se concentrations in patients with CHF and compared them with the Se status of healthy controls.Methods: The study included 77 patients (age, 68.4 ± 10.4 years old; 40.3% female and 73 healthy volunteers (64.9 ± 4.7 years old; 35.6% female. A complete medical/drug history and physical examination were performed for all patients and healthy volunteers. All patients had symptoms and signs of CHF and had a left ventricular ejection fraction (EF of < 40% obtained by echocardiography. The Se concentration was assessed by atomic absorption spectrometer with the Graphite Tube Atomizer. The limit of measurement was 5 μg/L. Results: The Se concentrations in CHF patients did not show a significant difference from those of healthy controls (185.9 ± 781.2 μg/L vs. 123.3 ± 115.5 μg/L, respectively; p value = 0.499. There was no correlation between serum Se concentrations and EF in both the normal group and the patients with heart failure (p value = 0.96 and 0.99; r = 0.006 and 0.002 for patients and healthy volunteers, respectively.Conclusion: In this study, serum Se levels in CHF patients were similar to those of controls and the Se concentrations did not correlate with the degree of left ventricular dysfunction.

  10. Particulate Air Pollution and the Rate of Hospitalization for Congestive Heart Failure among Medicare Beneficiaries in Pittsburgh, Pennsylvania.

    OpenAIRE

    Wellenius, Gregory A.; Bateson, Thomas F.; Mittleman, Murray A.; Schwartz, Joel

    2005-01-01

    We used a case-crossover approach to evaluate the association between ambient air pollution and the rate of hospitalization for congestive heart failure (CHF) among Medicare recipients (age ≥ 65) residing in Allegheny County (Pittsburgh area), PA, during 1987–1999. We also explored effect modification by age, gender, and specific secondary diagnoses. During follow-up, there were 55,019 admissions with a primary diagnosis of CHF. We found that particulate matter with aerodynamic diameter ≤ 10 ...

  11. Specialist Nurse-Led Intervention in Outpatients with Congestive Heart Failure: Impact on Clinical and Economic Outcomes

    OpenAIRE

    Palmer, Nicholas D.; Barbara Appleton; Erwin A. Rodrigues

    2003-01-01

    Congestive heart failure (CHF) encompasses a spectrum of clinical syndromes and presentations. It affects 1-2% of the population in the UK and is associated with significant mortality which is comparable to most cancers. It accounts for more than 5% of adult medical admissions in the UK, with significant annual re-admission rates. Improved understanding of the pathophysiology of CHF has resulted in significant advancements in CHF management. Current pharmacologic agents, such as ACE inhibitor...

  12. A Natural Language Processing System to Extract and Code Concepts Relating to Congestive Heart Failure from Chest Radiology Reports

    OpenAIRE

    Friedlin, Jeff; McDonald, Clement J.

    2006-01-01

    We have developed a natural language processing system for extracting and coding clinical data from free text reports. The system is designed to be easily modified and adapted to a variety of free text clinical reports such as admission notes, radiology and pathology reports, and discharge summaries. This report presents the results of this system to extract and code clinical concepts related to congestive heart failure from 39,000 chest radiology reports. The system detects the presence or a...

  13. Effectiveness of chest radiography, lung ultrasound and thoracic computed tomography in the diagnosis of congestive heart failure

    OpenAIRE

    Cardinale, Luciano; Priola, Adriano Massimiliano; Moretti, Federica; Volpicelli, Giovanni

    2014-01-01

    Hydrostatic pulmonary edema is as an abnormal increase in extravascular water secondary to elevated pressure in the pulmonary circulation, due to congestive heart failure or intravascular volume overload. Diagnosis of hydrostatic pulmonary edema is usually based on clinical signs associated to conventional radiography findings. Interpretation of radiologic signs of cardiogenic pulmonary edema are often questionable and subject. For a bedside prompt evaluation, lung ultrasound (LUS) may assess...

  14. Prolonged signal-averaged P wave duration as a prognostic marker for morbidity and mortality in patients with congestive heart failure

    DEFF Research Database (Denmark)

    Dixen, Ulrik; Wallevik, Laura; Hansen, Maja;

    2003-01-01

    To evaluate the prognostic roles of prolonged signal-averaged P wave duration (SAPWD), raised levels of natriuretic peptides, and clinical characteristics in patients with stable congestive heart failure (CHF)....

  15. Effect of dofetilide on QT dispersion and the prognostic implications of changes in QT dispersion for patients with congestive heart failure

    DEFF Research Database (Denmark)

    Brendorp, Bente; Elming, Hanne; Jun, Li;

    2002-01-01

    AIMS: Drug-induced changes in QT dispersion may be a way of detecting harmful repolarisation abnormalities for patients receiving antiarrhythmic drugs affecting ventricular repolarisation. METHODS AND RESULTS: In 463 congestive heart failure (CHF) patients enrolled in the Danish Investigations...

  16. Gas exchange during exercise in different evolutional stages of chronic Chagas' heart disease

    Directory of Open Access Journals (Sweden)

    Fátima Palha de Oliveira

    2000-12-01

    Full Text Available OBJECTIVE: To compare gas exchange at rest and during exercise in patients with chronic Chagas' heart disease grouped according to the Los Andes clinical/hemodynamic classification. METHODS: We studied 15 healthy volunteers and 52 patients grouped according to the Los Andes clinical/hemodynamic classification as follows: 17 patients in group IA (normal electrocardiogram/echocardiogram, 9 patients in group IB (normal electrocardiogram and abnormal echocardiogram, 14 patients in group II (abnormal electrocardiogram/echocardiogram, without congestive heart failure, and 12 patients in group III (abnormal electrocardiogram/echocardiogram with congestive heart failure. The following variables were analyzed: oxygen consumption (V O2, carbon dioxide production (V CO2, gas exchange rate (R, inspiratory current volume (V IC, expiratory current volume (V EC, respiratory frequency, minute volume (V E, heart rate (HR, maximum load, O2 pulse, and ventilatory anaerobic threshold (AT. RESULTS: When compared with the healthy group, patients in groups II and III showed significant changes in the following variables: V O2peak, V CO2peak, V ICpeak, V ECpeak, E, HR, and maximum load. Group IA showed significantly better results for these same variables as compared with group III. CONCLUSION: The functional capacity of patients in the initial phase of chronic Chagas' heart disease is higher than that of patients in an advanced phase and shows a decrease that follows the loss in cardiac-hemodynamic performance.

  17. Acquired post-traumatic aortic coarctation presenting as new-onset congestive heart failure: treatment with endovascular repair.

    Science.gov (United States)

    Thompson, Norris B; Hamidian Jahromi, Alireza; Ballard, David H; Rao, Vyas R; Samra, Navdeep S

    2015-01-01

    Acquired coarctation of the thoracic aorta is a rare phenomenon in adults. The etiology is often idiopathic, but severe stenosis can develop from prior surgery, blunt thoracic aortic injuries, or severe atherosclerotic/atheroembolic disease. Common symptomatic presentations include refractory upper extremity hypertension and new-onset congestive heart failure. We present the case of a 52-year-old man who developed acquired thoracic aortic coarctation 30 years after a blunt trauma and deceleration injuries to the aorta requiring open surgical aortic repair. He presented with poorly controlled hypertension and new-onset heart failure and was treated surgically with endovascular repair.

  18. Long-term survival in patients hospitalized with congestive heart failure: relation to preserved and reduced left ventricular systolic function

    DEFF Research Database (Denmark)

    Gustafsson, Finn; Torp-Pedersen, Christian; Brendorp, Bente;

    2003-01-01

    AIMS: The purpose of this study was to evaluate the influence of left ventricular systolic function on the survival in a large consecutive cohort of patients hospitalized with congestive heart failure and to determine how left ventricular systolic function interacts with co-morbid conditions in t...... (1 year mortality, 19%). CONCLUSION: In hospitalized heart failure patients, particularly in younger patients with ischemic heart disease, mortality risk is inversely related to left ventricular systolic function.......AIMS: The purpose of this study was to evaluate the influence of left ventricular systolic function on the survival in a large consecutive cohort of patients hospitalized with congestive heart failure and to determine how left ventricular systolic function interacts with co-morbid conditions in...... terms of prognosis. METHODS AND RESULTS: Analysis of survival data from 5491 patients admitted for new or worsening heart failure to 34 departments of cardiology or internal medicine in Denmark from 1993-1996 was carried out. A standardized echocardiogram was available for 95% of the patients, and left...

  19. A case of juvenile acromegaly that was initially diagnosed as severe congestive heart failure from acromegaly-induced dilated cardiomyopathy.

    Science.gov (United States)

    Sue, Mariko; Yoshihara, Aya; Okubo, Yoichiro; Ishikawa, Mayumi; Ando, Yasuyo; Hiroi, Naoki; Shibuya, Kazutoshi; Yoshino, Gen

    2010-01-01

    Acromegaly is characterized by chronic hypersecretion of growth hormone (GH) and is associated with increased mortality rate because of the potential complications such as cardiovascular disease, respiratory disease, or malignancy, which are probably caused by the long-term exposure of tissues to excess GH, for at least 10 years, before diagnosis and treatment. A 22-year-old man with a 2-month history of fatigue was admitted to our hospital because of chest discomfort, dyspnea, and pitting edema of the lower limbs experienced over a 1-month period. On admission, his height and body weight were 186 cm and 138.5 kg, respectively, with a BMI of 39.8 kg/m(2). He showed acromegalic features and elevated serum GH and IGF-1 levels, which were 11.5 ng/mL and 960 ng/mL, respectively. There was no GH suppression in the 75-g oral glucose tolerance test. Pituitary magnetic resonance imaging (MRI) revealed microadenoma. Chest X-ray revealed cardiomegaly, and echocardiogram showed dilated left ventricular (LV) cavity and diffuse hypokinesis with extremely decreased ejection fraction (EF). He was diagnosed as having acromegaly with congestive heart failure from diastolic cardiomyopathy. After the successful transsphenoidal resection of the pituitary adenoma, the level of GH was normalized. However, the cardiac dysfunction did not show any improvement even after the administration of β-blockers, angiotensin-converting enzyme inhibitor (ACE-I), or diuretics. The patient was re-hospitalized, and he died of cardiac failure at the age of 25 years. Patients with acromegaly have been reported to have about 30% higher mortality rate, and cardiovascular disease accounts for 60% of the deaths. We report a case of a patient with juvenile acromegaly who was diagnosed with severe cardiac failure at the time of diagnosis and failed to recover cardiac function even after the successful resection of the pituitary adenoma. Immediate diagnosis and treatment are required for better control of

  20. Effect of diosmin on chronic nonbacterial prostatitis caused by pelvic congestion in rats

    Directory of Open Access Journals (Sweden)

    Gong-ting CUI

    2014-08-01

    Full Text Available Objective To explore the effect of diosmin on chronic nonbacterial prostatitis (CNP in rats and its possible mechanisms. Methods Thirty-two healthy adult male SD rats were randomly divided into 4 groups: Sham-operated group (SO group, chronic prostatitis model group (CPM group, chronic prostatitis model + prostat treatment group (CPM-P group, and chronic prostatitis model + diosmin treatment group (CPM-D group. Rats in SO group underwent laparotomy only to expose the prostate, and those in other groups received prostatic vein ligation to reproduce pelvic congestion. HE staining was used for the examination of the prostate 35 days after the operation. 80mg/(kg.d of diosmin was given to the rats in CPM-D group, and 60mg/(kg.d of diosmin to the rats in CPM-P group twice a day by gavage for 7 days. Same volume of 5% acacia gum was given to rats in SO and CPM groups. All of the rats were sacrificed 1h after the last administration, and the serum levels of interleukin-10 (IL-10, IL-8, IL-1β, malondialdehyde (MDA, nitric oxide (NO were determined by ELISA, and the pathological changes in the prostate tissue were observed after HE staining and compared between the groups. Results The serum levels of IL-1β, IL-8 and NO were significantly lower in CPM-D group and CPM-P group than in CPM group (P<0.05, the serum level of IL-10 was significantly higher in CPM-D group and CPM-P group than in CPM group (P<0.05, and the serum MDA level was similar between the 3 groups. HE staining showed that chronic inflammatory changes in rats' prostate were reduced more significantly in CPM-P group and CPM-D group than in CPM group. Conclusion The therapeutic effect of diosmin on pelvic-congestion-induced chronic prostatitis is similar to that of prostat tablets, and its mechanism may be related to the alleviation of local inflammatory response by reducing the IL-1β, IL-8 and NO levels and increasing the IL-10 content in serum. DOI: 10.11855/j.issn.0577-7402.2014.06.04

  1. 慢性充血性心力衰竭患者血清syndecan-4水平及临床意义%Changes and clinical significance of serum level of syndecan-4 protein in patients with chronic congestive heart failure

    Institute of Scientific and Technical Information of China (English)

    马晓玲; 欧阳平; 张志能; 赖文岩; 许顶立

    2013-01-01

    Objective To detect serum level of syndecan-4 protein in patients with chronic congestive heart failure (CHF) and investigate its correlation with New York Heart Association (NYHA) class and echocardiographic parameters.Methods The concentration of serum syndecan-4 protein was measured by enzyme-linked immunosorbent assay (ELISA) in 40 patients with CHF and 40 healthy controls (NCD),respectively.The parameters such as left ventricle ejection fraction (LVEF),fraction shortening (FS),left ventricle end-diastolic diameter (LVDd),left ventricle end-systolic diameter (LVDs),left ventricle end-diastolic volume (LVEDV) and left ventricle end-systolic volume (LVESV) were detected by echocardiography in 40 patients of CHF.Meanwhile,the patients' cardiac function was graded according to NYHA class.Results The levels of serum syndecan-4 protein significantly increased in CHF group as compared with control group (P<0.01).In CHF group,as the increased grading of NYHA cardiac function,the levels of serum syndecan-4 protein significantly increased (P <0.05).The more upgraded the NYHA grading,the higher level of serum syndecan-4 protein.In bivariate correlations analysis showed that the level of serum syndecan-4 protein was significantly negatively correlated with LVEF and FS (P <0.05) and was significantly positively correlated with LVDd,LVDs,LVEDV and LVESV,respectively (P < 0.05).Conclusion Serum syndecan-4 concentration significantly increased in CHF patients,and it was closely correlated with NYHA class and left ventricle function parameters,so the level of serum syndecan-4 protein may have an important value in detection and surveillance of CHF.%目的 探讨慢性充血性心力衰竭(CHF)患者血清中syndecan-4浓度变化与CHF NYHA心功能分级及超声心动图指标变化的关系.方法 选择40名CHF患者和40位健康人;用ELISA检测外周血中的syndecan-4浓度,超声心动图测定左室射血分数(LVEF)、左室短轴缩短率(FS)、左室舒

  2. Effect of repeated intracoronary injection of bone marrow cells in patients with ischaemic heart failure the Danish stem cell study - congestive heart failure trial (DanCell-CHF)

    DEFF Research Database (Denmark)

    Diederichsen, A.C.; Møller, Jacob Eifer; Thayssen, P.;

    2008-01-01

    BACKGROUND: It has been suggested that myocardial regeneration may be achieved by a single intracoronary bone marrow derived stem cell infusion in selected patients with ischaemic heart disease. The effect is uncertain in patients with chronic ischaemic heart failure and it is not known whether...... repeated infusions would have additional positive effects. AIMS: To assess whether two treatments of intracoronary infusion of bone marrow stem cells, administered 4 months apart, could improve left ventricular (LV) systolic function in patients with chronic ischaemic heart failure. METHODS: The study......, NYHA class improved (pstem cell treatment in patients with chronic ischaemic heart failure Udgivelsesdato: 2008/7...

  3. Prospective memory and chronic heart failure

    OpenAIRE

    Habota, Tina; Cameron, Jan; McLennan, Skye N; Ski, Chantal F; Thompson, David R; Peter G Rendell

    2013-01-01

    Background Patients with chronic heart failure (CHF) experience a number of debilitating symptoms, which impact on activities of daily living and result in poor quality of life. Prospective memory, which is defined as memory to carry out future intentions, has not been investigated in this group. However, emerging evidence suggests CHF patients have difficulties with cognitive processes related to prospective memory. Self-care, which partly relies on prospective memory, is essential in sympto...

  4. Isometric exercise and chronic heart failure

    Directory of Open Access Journals (Sweden)

    Efthimia Zerva

    2013-07-01

    Full Text Available The resistance exercise is an important part of all rehabilitation programs in patients with chronic heart failure. Among several kinds of resistance exercises, the one mainly applied is isotonic exercise, whereas, in the contrary, isometric is not heavily used although it affects the daily lives of patients who, trying to look after themselves (moving, walking, lifting objects, twitch in an isometric way their peripheral muscles due to reduced cardiovascular endurance. Purpose: The purpose of the present review was to present the data available so far for isometric exercise in cardiovascular patients and to examine the importance of applying this kind of exercise in rehabilitation programs in the context of, firstly, evaluation, and secondly therapeutic intervention. Material - Methods: The methodology followed included searching inquiries and reviews from international databases (Pubmed, Medline, Scopus on the effects of isometric exercise in patients with chronic heart failure. The progress and development of the studies are of particular importance to this work and, to this end, the literature refers to the entire range of time in the last three decades, from 1985 to 2012 according the key words noted. Results: In rehabilitation programs for patients with chronic heart failure, resistance exercise if applied in an isotonic way helps improve hemodynamic and functional parameters. In contrast, resistance exercise applied in an isometric way requires further investigation because most findings are related to hemodynamic disturbances. The data which is encouraging for isometric exercise programs are few and, therefore, it cannot be directly recommended as a proper way to exercise. Conclusions: Isometric exercise has an important place in the evaluation of patients with chronic heart failure, and limits should be "placed" in its application as a therapeutic tool to prevent complications.

  5. Low-dose carvedilol reduces transmural heterogeneity of ventricular repolarization in congestive heart failure

    Institute of Scientific and Technical Information of China (English)

    Jiang-hua ZHONG; Xiao-pan CHEN; Mei-ling YUN; Wei-jing LI; Yan-fang CHEN; Zhen YAO

    2007-01-01

    Aim: To study the effects of carvedilol on the transmural heterogeneity of ven-tricular repolarization in rabbits with congestive heart failure (CHF). Methods:Rabbits were randomly divided into 3 groups: control, CHF and carvedilol treated CHF group. Monophasic action potential duration (MAPD) in the 3 myocardial layers was simultaneously recorded. Results: All the rabbits in the CHF group had signs of severe CHF. Compared with the control group, the mean blood pressure and cardiac output were significantly decreased, while peripheral resis-tance was significantly increased in the CHF group. This proved that the CHF model was successful created with adriamycin in this study. Compared to the control group, the ventricular fibrillation threshold (VFT) was remarkably decreased and all MAPD of the 3 myocardial layers were extended in rabbits with CHF. However, the extension of MAPD in the midmyocardium was more obvious. The transmural dispersion of repolarization (TDR) was significantly increased in CHF.Low-dose carvedilol (0.25 mg/kg, twice daily) had no effects on ventricular remodeling. Treatment with low-dose carvedilol significantly increased VFT. Al-though the MAPD of the 3 myocardial layers were further prolonged in the carvedilol treated CHF group, the prolongation of MAPD in the midmyocardium was shorter than those in the epicardium and endocardium. Treatment with low-dose carvedilol significantly decreased TDR in CHF. Conclusion: In the present study, the trans-mural heterogeneity of ventricular repolarization increased in the rabbits with CHF. Low-dose carvedilol decreased the transmural heterogeneity of ventricular repolarization in CHF, which may be related to its direct electrophysiological pro-perty rather than its effect on ventricular remodeling.

  6. Compromised Global and Regional Cerebral Blood Flow in Congestive Heart Failure

    Energy Technology Data Exchange (ETDEWEB)

    Kim, J. S.; Kim, J. J.; Im, K. C.; Moon, D. H. [College of Medicine, Univ. of Ulsan, Seoul (Korea, Republic of)

    2003-07-01

    It has been known that cerebral perfusion is maintained in patients with congestive heart failure (CHF) by a complex series of compensatory mechanisms. However cognitive impairment is a common problem experienced by patients with CHF and may result from deranged cerebral perfusion. We prospectively investigated the global and regional CBF of patients with CHF and compared the results with that of normal controls. Thirty two patients (M/F: 22/10, 4211 yr) with CHF (LVEF=218.1%) and 10 healthy controls (M/F: 6/4, 398 yr) were prospectively studied. No patients had cerebrovascular disease or other disease affecting cognitive function. All patients and normal controls underwent radionuclide angiography including cerebral hemispheres and aortic arch, and brain perfusion SPECT using Tc-99m ECD. Global CBF was measured non-invasively by the application of Patlak plot graphical analysis. Quantitative rCBF images were obtained from SPECT image using global CBF values, regional/global count ratios, and Lassen's linearization correction algorithm. Difference of regional CBF between CHF and normal control were assessed using a SPM99 without global count normalization (uncorrected p<0.0001, extent threshold>100 voxels). Global CBF (41.54.7 ml/min/100g) of the patients with CHF were significantly lower than those (49.15.7 ml/min/100g) of controls (p<0.001). Regional CBF was significantly decreased in frontal, temporal and parietal neocortex of both cerebral hemispheres compared to normal controls. Regional rCBF of basal ganglia, thalamus, and brain stem were preserved, even though global CBF was variably compromised. Our study show that global CBF is significantly decreased in CHF and regional CBF of frontal, parietal and temporal neocortex is compromised preferentially. Further studies would be needed to investigate the relationship of rCBF change and cognitive impairment in patients with CHF.

  7. Usefulness of running wheel for detection of congestive heart failure in dilated cardiomyopathy mouse model.

    Directory of Open Access Journals (Sweden)

    Masami Sugihara

    Full Text Available BACKGROUND: Inherited dilated cardiomyopathy (DCM is a progressive disease that often results in death from congestive heart failure (CHF or sudden cardiac death (SCD. Mouse models with human DCM mutation are useful to investigate the developmental mechanisms of CHF and SCD, but knowledge of the severity of CHF in live mice is necessary. We aimed to diagnose CHF in live DCM model mice by measuring voluntary exercise using a running wheel and to determine causes of death in these mice. METHODOLOGY/PRINCIPAL FINDINGS: A knock-in mouse with a mutation in cardiac troponin T (ΔK210 (DCM mouse, which results in frequent death with a t(1/2 of 70 to 90 days, was used as a DCM model. Until 2 months of age, average wheel-running activity was similar between wild-type and DCM mice (approximately 7 km/day. At approximately 3 months, some DCM mice demonstrated low running activity (LO: 5 km/day. In the LO group, the lung weight/body weight ratio was much higher than that in the other groups, and the lungs were infiltrated with hemosiderin-loaded alveolar macrophages. Furthermore, echocardiography showed more severe ventricular dilation and a lower ejection fraction, whereas Electrocardiography (ECG revealed QRS widening. There were two patterns in the time courses of running activity before death in DCM mice: deaths with maintained activity and deaths with decreased activity. CONCLUSIONS/SIGNIFICANCE: Our results indicate that DCM mice with low running activity developed severe CHF and that running wheels are useful for detection of CHF in mouse models. We found that approximately half of ΔK210 DCM mice die suddenly before onset of CHF, whereas others develop CHF, deteriorate within 10 to 20 days, and die.

  8. Efficacy of adaptive servoventilation in patients with congestive heart failure and Cheyne-Stokes respiration

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    Background Congestive heart failure (CHF) is associated with Cheyne-Stokes respiration (CSR), which may hasten CHF. Adaptive servoventilation (ASV) is a novel method of ventilatory support designed for removal of CSF in CHF patients. This study compares the efficacy of ASV in patients with CHF and CSR with the efficacy of oxygen therapy. Methods Fourteen patients with CHF and CSR were recruited. During sleep, nasal oxygen therapy and ASV treatment were each performed for two weeks. Comparison before and after each treatment was made for the following items: a) parameters of sleep respiration, sleep structure and quality; b) left ventricle ejection fraction (LVEF) and 6-minute walk distance. Results Compared with the baseline levels of apnoea hypopnoea index of 34.5±6.1 before treatment, the apnoea hypopnoea index significantly decreased following oxygen therapy to 27.8±8.2, P 0.05). LVEF was significantly higher on day 14 of ASV treatment (37.2±4.1)% than on day 14 of oxygen therapy (33.2±5.1)% and before treatment (30.2±4.6)% (all P<0.05). Six-minute walk distance was the shortest before treatment (226±28) m, longer on day 14 of oxygen therapy (289±26) m, and the longest on day 14 of ASV treatment (341±27) m (all P < 0.01). Conclusion ASV treatment is of better efficacy and greater clinical significance in improvement of CHF by eliminating CSR than oxygen therapy.

  9. Computerized lung sound analysis following clinical improvement of pulmonary edema due to congestive heart failure exacerbations

    Institute of Scientific and Technical Information of China (English)

    WANG Zhen; XIONG Ying-xia

    2010-01-01

    Background Although acute congestive heart failure (CHF) patients typically present with abnormal auscultatory findings on lung examination, lung sounds are not normally subjected to rigorous analysis. The goals of this study were to use a computerized analytic acoustic tool to evaluate lung sound patterns in CHF patients during acute exacerbation and after clinical improvement and to compare CHF profiles with those of normal individuals.Methods Lung sounds throughout the respiratory cycle was captured using a computerized acoustic-based imaging technique. Thirty-two consecutive CHF patients were imaged at the time of presentation to the emergency department and after clinical improvement. Digital images were created, geographical area of the images and lung sound patterns were quantitatively analyzed.Results The geographical areas of the vibration energy image of acute CHF patients without and with radiographically evident pulmonary edema were (67.9±4.7) and (60.3±3.5) kilo-pixels, respectively (P <0.05). In CHF patients without and with radiographically evident pulmonary edema (REPE), after clinical improvement the geographical area of vibration energy image of lung sound increased to (74.5±4.4) and (73.9±3.9) kilo-pixels (P <0.05), respectively. Vibration energy decreased in CHF patients with REPE following clinical improvement by an average of (85±19)% (P <0.01). Conclusions With clinical improvement of acute CHF exacerbations, there was more homogenous distribution of lung vibration energy, as demonstrated by the increased geographical area of the vibration energy image. Lung sound analysis may be useful to track in acute CHF exacerbations.

  10. Prevalence, prognostic significance, and treatment of atrial fibrillation in congestive heart failure with particular reference to the DIAMOND-CHF study

    DEFF Research Database (Denmark)

    Pedersen, Ole Dyg; Brendorp, Bente; Køber, Lars;

    2003-01-01

    failure and the prevalence increases with the severity of the disease. These two conditions seem to be linked together, and congestive heart failure may either be the cause or the consequence of atrial fibrillation. The prognosis of atrial fibrillation is controversial, but studies indicate that atrial...... fibrillation is a risk factor in congestive heart failure patients. In the last 10-15 years, significant advances in the treatment of heart failure have improved survival, whereas effective management of atrial fibrillation in heart failure patients still awaits similar progress. Empirically, two strategies......Atrial fibrillation is a growing health problem and the most common cardiac arrhythmia, affecting 5% of persons above the age of 65 years. The number of hospital discharges for atrial fibrillation has more than doubled in the past decade. It occurs very often in patients with congestive heart...

  11. Cardiac status assessment with a multi-signal device for improved home-based congestive heart failure management.

    Science.gov (United States)

    Muehlsteff, Jens; Carvalho, Paulo; Henriques, Jorge; Paiva, Rui P; Reiter, Harald

    2011-01-01

    State-of-the-Art disease management for Congestive Heart Failure (CHF) patients is still based on easy-to-acquire measures such as heart rate (HR), weight and blood pressure (BP). However, these measures respond late to changes of the patient health status and provide limited information to personalize and adapt medication therapy. This paper describes our concept called "Cardiac Status Assessment" we have been investigating within the European project "HeartCycle" towards next-generation home-based disease management of CHF. In our concept we analyze non-invasive surrogate measures of the cardio-vascular function in particular systolic time intervals and pulse wave characteristics to estimate Cardiac Output (CO) and Systemic Vascular Resistance (SVR) both are established clinical measures. We discuss the underlying concept, a developed measurement system and first results. PMID:22254450

  12. 阿托伐他汀对慢性充血性心力衰竭患者外周血Toll样受体表达的影响%Effect of atorvastatin on toll-like receptor 4 expression in peripheral blood of patients with chronic congestive heart failure

    Institute of Scientific and Technical Information of China (English)

    吴炎; 蒲红

    2012-01-01

    Objective To study the changes of toll-like receptor 4 (TLR4) expression In peripheral blood mononuclear cells (PBMCs) in the patients with chronic congestive heart failure (CCHF) after application of atorvastatin. Methods Eighty in-hospital CCHF patients were randomly divided into routine treatment group and atorvastatin group (n = 40). All the patients received routine treatment of CCHF. Moreover, the patients in atorvastatin group took atorvastatin (20 mg/d) orally. Forty healthy subjects were regarded as normal control. TLR4 expression in PBMCs was measured by flow cytometry and serum tumor necrosis factor (TNF)-α was detected by ELISA before treatment and one month after treatment. The correlation between TLR4 expression and TNF-α level was analyzed. Results Before treatment, TLR4 expression in routine treatment group and atorvastatin group was significantly higher than that in normal control (both P<0.05) and positively correlated with TNF-α level (r = 0.076, P<0.05). TLR4 expression and TNF-α level were significantly decreased one month after treatment (all P<0. 05). Conclusion CCHF may be associated with enhanced expression of TLR4. Atorvastatin can significantly decrease TLR4 expression in PBMCs, which indicates that the anti-inflammatory effect caused by atorvastatin may be partially due to down-regulation of TLR4-mediated immune reaction.%目的 探讨慢性充血性心力衰竭(CCHF)患者外周血单个核细胞Toll样受体4(TLR4)表达改变情况及阿托伐他汀对其的干预效应.方法 选取80例CCHF住院患者,其中40例按照标准治疗方案进行治疗(标准治疗组);另外40例在标准治疗的基础上口服阿托伐他汀20 mg/d(阿托伐他汀组).40名健康者为对照组.在治疗前和治疗后1个月,应用流式细胞仪检测外周血单个核细胞表面TLR4的表达,采用酶联免疫吸附试验检测血清肿瘤坏死因子(TNF)-α水平;并对TLR4的表达与血清TNF-α水平进行相关性分析.结果 标

  13. The predictive value of P-wave duration and dispersion and the chronic congestive heart failure in patients with paroxysmal atrial fibrillation%P波时限及离散度在慢性充血性心力衰竭并阵发性心房颤动的预测价值

    Institute of Scientific and Technical Information of China (English)

    谭志伟; 周怀根; 叶翠河; 阮国永

    2008-01-01

    Objective To evaluate the predictive value of P-wave duration and dispersion and the chronic congestive heart failure in patients with paroxysmal atrial fibrillation. Methods 65 cases diagnosed in a 12-lead ECG synchronization surface records( paper speed of 50 ram/s) ,four times a month,records from the baseline ECG smooth, cleargraphics cardiac cycle sampling measurement. 12-P-wave width measurement, from the largest P-wave duration(Pmax)and the smallest P-wave duration(Pmin) , the P-wave dispersion is less PminPmax Pmax≥110 ms and Pd≥40 ms are as positive standards,in 1 year follow-up,and all datas are for statistical analysis. Results Attack patients with paroxysmal atrial fibrillation, Pd and Pmaxsignificantly increased (P 110 ms) + (Pd≥40 ms) , And the positive predictive value was significantly lower than the latter two also. To which( Pmax 110 ms) joint(Pd≥40 ms)of the specificity and positive predictive value were highest. Also before and after the onset of atrial fibrillation in patients with left atrial diameter(LAD) and left ventricular ejection fraction(LVEF) changes in the statistical significance(P<0.05). Conclusion Pmax joint Pd in CHF patients with atrial fibrillation have a higher predictive value. To use this 2 indicators to predict atrial arrhythmia,Especially those who have not been confirmed surface electrocardiogram in patients with paroxysmal atrial fibrillation, have important clinical significance.%目的 探讨P波时限及离散度在慢性充血性心力衰竭(CHF)并阵发性心房颤动患者的预测价值.方法 对确诊65例患者采用12导联同步体表心电图记录(纸速50 mm/s),4次/月,记录的心电图取基线平稳,图形清晰的心动周期进行采样测量,12导联P波宽度测量后,取最大P波时限(Pmax及最小P波时限(Pmin),两者的差为P波离散度(Pd)(即Pd=Pmax-Pmin).以Pmax≥110 ms、Pd≥40 ms为阳性标准,随访1年,并对所有数据作统计学分析.结果 患者阵发性心房颤

  14. Increase in cardiac P2X1-and P2Y2-receptor mRNA levels in congestive heart failure

    DEFF Research Database (Denmark)

    Hou, M; Malmsjö, M; Möller, S;

    1999-01-01

    We wanted to study the expression of P2-receptors at the mRNA-level in the heart and if it is affected by congestive heart failure (CHF). To quantify the P2 receptor mRNA-expression we used a competitive RT-PCR protocol which is based on an internal RNA standard. The P2 receptor m...

  15. Common variants in IL-17A/IL-17RA axis contribute to predisposition to and progression of congestive heart failure

    Institute of Scientific and Technical Information of China (English)

    CHAUGAI Sandip; TAN Lun; HUANG Jin; LI Qing; NI Li; Katherine CIANFLONE; WANG Dao-wen

    2016-01-01

    AIM:Heart failure is characterized by immune activation leading to production and release of proinflammatory cytokines .Inter-leukin 17A (IL-17A) is a proinflammatory cytokine and multiple lines of evidence from animal and human studies suggest crucial roles of IL-17A in heart failure.Therefore, we investigated whether common polymorphisms of genes IL17A and IL17RA (coding interleukin 17 receptor A) gene contribute to genetic predisposition to heart failure and adverse clinical outcomes associated with it .METHODS AND RESULTS:A total of 1713 adults patients with congestive heart failure and 1713 age-and sex-matched controls were genotyped for promoter SNPs, rs2275913 and rs8193037 in IL17A and rs4819554 in IL17RA, to assess the relationship between individual SNPs and the risk of congestive heart failure .Results showed that rs8193037 in IL17A was associated with the risk of congestive heart failure (P<0.01) after adjustment for multiple cardiovascular risk factors including age , sex, smoking status, diabetes, hypertension and dyslipidemia.This association was evident in both ischemic and non-ischemic heart failure (P<0.05).Furthermore, prospective fol-low-up of 12.7 months for the occurrence of adverse clinical outcomes showed that rs 4819554 in IL17RA was significantly associated with cardiovascular mortality (P<0.05) after adjustments for multiple cardiovascular risk factors and New York Heart Association functional class.CONCLUSION:This study demonstrated associations of rs8193037 in the promoter of IL17A with the risk of conges-tive heart failure, and of rs4819554 in the promoter of IL17RA with the risk of cardiovascular mortality in patients with congestive heart failure.These data lend further support to the notion that immune activation and genetic polymorphisms contribute to heart failure path -ogenesis and progression .

  16. Incidence and predictors of ischemic stroke during hospitalization for congestive heart failure.

    Science.gov (United States)

    Hamatani, Yasuhiro; Iguchi, Moritake; Nakamura, Michikazu; Ohtani, Ryo; Yamashita, Yugo; Takagi, Daisuke; Unoki, Takashi; Ishii, Mitsuru; Masunaga, Nobutoyo; Ogawa, Hisashi; Hamatani, Mio; Abe, Mitsuru; Akao, Masaharu

    2016-07-01

    Heart failure (HF) increases the risk of ischemic stroke. Data regarding the incidence and predictors of ischemic stroke during hospitalization for HF are limited. The study population of this retrospective cohort study consisted of patients with congestive HF, consecutively admitted to our center from October 2010 to April 2014. We excluded patients complicated with acute myocardial infarction, infective endocarditis, and takotsubo cardiomyopathy. We also excluded those with dialysis or mechanical circulatory support. We investigated the incidence of ischemic stroke during hospitalization for HF. Thereafter, we divided the patients without oral anticoagulants at admission into two groups: patients with ischemic stroke and those without it, and explored the predictors of ischemic stroke. A total of 558 patients (287 without atrial fibrillation (AF), 271 with AF) were enrolled. The mean age was 76.8 ± 12.3 years, and 244 patients (44 %) were female. The mean left-ventricular ejection fraction was 47.4 %. Oral anticoagulants were prescribed in 147 patients (8 without AF, 139 with AF). During hospitalization (median length 18 days), symptomatic ischemic stroke (excluding catheter-related) occurred in 15 patients (2.7 % of the total, 8 without AF, 7 with AF). Predictors significantly associated with increased risk of ischemic stroke in patients without oral anticoagulants were as follows; short-term increases in blood urea nitrogen after admission (at day 3; odds ratio (per 1 md/dl): 1.06, 95 % confidence interval (CI) 1.01-1.11, p = 0.02, and at day 7; odds ratio: 1.03, 95 % CI 1.00-1.07, p = 0.03, respectively), and previous stroke (odds ratio; 3.33, 95 % CI 1.01-11.00, p = 0.04). The incidence of ischemic stroke during hospitalization for HF was high, even in patients without AF. Previous stroke and short-term increases in blood urea nitrogen was significantly associated with the incidence of ischemic stroke. PMID:26219729

  17. Evaluation of the efficacy of a nurse practitioner-led home-based congestive heart failure clinical pathway.

    Science.gov (United States)

    Moore, Jo-Ann Mary

    2016-01-01

    Frequent exacerbations of symptoms and financial penalties for 30-day hospital readmissions of patients with congestive heart failure (CHF) have led to new disease management approaches. A nurse practitioner (NP)-led interdisciplinary program for CHF management that included home telemonitoring and early NP assessments and interventions was piloted by a home health agency. A 4-month evaluation of the efficacy of a clinical pathway for CHF patients resulted in the enrollment of 22 CHF patients in the program. Two clients were readmitted within 30 days. The new program was effective in reducing 30-day readmission rates to 9% compared to the national average of 23%.

  18. Cardiac MRI and Transthoracic Echocardiography of Left Ventricular Myocardial Noncompaction in A Patient with Congestive Heart Failure: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Cho, Eui Min; Byun, Joo Nam [Chosun University Hospital College of Medicine, Gwangju (Korea, Republic of); Kim, Dong Hun [Soonchunhyang University Hospital Bucheon College of Medicine, Bucheon (Korea, Republic of)

    2010-11-15

    We report a case of a 38-year-old male presenting with new-onset dyspnea, that was diagnosed as left ventricular noncompaction by transthoracic echocardiographic and cardiac MR. The tests revealed left ventricular systolic dysfunction with prominent trabeculations associated with deep intertrabecular recesses and an enddiastolic noncompacted to compacted ratio of 2.5 in the whole apical wall and mid-ventricular anterolateral and inferolateral walls. Delayed gadolinium contrast-enhanced MRI revealed subepicardial mid-wall hyperenhancement of the midventricular anteroseptal and inferoseptal walls, which suggested myocardial fibrosis. We review the pathophysiology, clinical characteristics, and diagnostic approach of the left ventricular noncompaction associated with congestive heart failure

  19. [Chronic ischaemic heart disease in the elderly].

    Science.gov (United States)

    Martínez-Sellés, Manuel; Gómez Huelgas, Ricardo; Abu-Assi, Emad; Calderón, Alberto; Vidán, María Teresa

    2016-01-01

    It is the aim of this manuscript to take into account the peculiarities and specific characteristics of elderly patients with chronic ischaemic heart disease from a multidisciplinary perspective, with the participation of the Spanish Society of Cardiology (sections of Geriatric Cardiology and Ischaemic Heart Disease/Acute Cardiovascular Care), the Spanish Society of Internal Medicine, the Spanish Society of Primary Care Physicians and the Spanish Society of Geriatrics and Gerontology. This consensus document shows that in order to adequately address these elderly patients a comprehensive assessment is needed, which includes comorbidity, frailty, functional status, polypharmacy and drug interactions. We conclude that in most patients medical treatment is the best option and that this treatment must take into account the above factors and the biological changes associated with aging. PMID:27102136

  20. Assessment of vasodilator therapy in patients with severe congestive heart failure: limitations of measurements of left ventricular ejection fraction and volumes

    International Nuclear Information System (INIS)

    Although noninvasive techniques are often used to assess the effect of vasodilator therapy in patients with congestive heart failure, it is unknown whether changes in noninvasively determined left ventricular ejection fraction, volume, or dimension reliably reflect alterations in intracardiac pressure and flow. Accordingly, we compared the acute effect of sodium nitroprusside on left ventricular volume and ejection fraction (determined scintigraphically) with its effect on intracardiac pressure and forward cardiac index (determined by thermodilution) in 12 patients with severe, chronic congestive heart failure and a markedly dilated left ventricle. Nitroprusside (infused at 1.3 +/- 1.1 [mean +/- standard deviation] microgram/kg/min) caused a decrease in mean systemic arterial, mean pulmonary arterial, and mean pulmonary capillary wedge pressure as well as a concomitant increase in forward cardiac index. Simultaneously, left ventricular end-diastolic and end-systolic volume indexes decreased, but the scintigraphically determined cardiac index did not change significantly. Left ventricular ejection fraction averaged 0.19 +/- 0.05 before nitroprusside administration and increased by less than 0.05 units in response to nitroprusside in 11 of 12 patients. The only significant correlation between scintigraphically and invasively determined variables was that between the percent change in end-diastolic volume index and the percent change in pulmonary capillary wedge pressure (r . 0.68, p . 0.01). Although nitroprusside produced changes in scintigraphically determined left ventricular ejection fraction, end-systolic volume index, and cardiac index, these alterations bore no predictable relation to changes in intracardiac pressure, forward cardiac index, or vascular resistance. Furthermore, nitroprusside produced a considerably greater percent change in the invasively measured variables than in the scintigraphically determined ones

  1. Diálise peritoneal (DP como tratamento da insuficiência cardíaca congestiva (ICC em pacientes com doença renal crônica estágio IV Peritoneal dialysis for treating congestive heart failure in patients with stage IV chronic kidney disease

    Directory of Open Access Journals (Sweden)

    Carlos Alberto Prompt

    2009-09-01

    Full Text Available A Insuficiência Cardíaca Congestiva (ICC é uma patologia com incidência crescente e que representa uma condição de grande impacto na saúde pública, com alta morbidade e mortalidade. O excesso de volume é uma complicação prevalente, presente em 80% dos pacientes atendidos com o diagnóstico de ICC. Estratégias farmacológicas e não farmacológicas no manejo terapêutico da ICC visam ao melhor manejo do volume e à redução no uso de diuréticos. A ultrafiltração extracorpórea tem evidenciado melhor controle de peso, redução nos dias de hospitalização e re-hospitalização dos pacientes com ICC. Neste artigo, relatamos dois casos atendidos no Hospital de Clínicas de Porto Alegre, relativos a pacientes com diagnóstico de ICC tratados com diálise peritoneal.Congestive heart failure (CHF has a growing incidence, a great impact on public health, and high morbidity and mortality. Excessive blood volume is a prevalent complication present in 80% of the patients diagnosed with CHF. Pharmacological and non-pharmacological strategies in the treatment of CHF aim to better manage blood volume and reduce the use of diuretics. Extracorporeal ultrafiltration has evidenced better weight control, and a reduction in the length of hospitalization and re-hospitalization of patients with CHF. We report the cases of 2 patients diagnosed with CHF and treated with peritoneal dialysis at Hospital de Clínicas de Porto Alegre.

  2. Effect of age on short and long-term mortality in patients admitted to hospital with congestive heart failure

    DEFF Research Database (Denmark)

    Gustafsson, Finn; Torp-Pedersen, Christian; Seibaek, Marie;

    2004-01-01

    age was 71.7+/-10.2 years, 60% were male and 63% were in NYHA class III-IV. Moderate to severe left ventricular (LV) systolic dysfunction was present in 41%. Short and long-term survival status was obtained after 30 days and 5-8 years, respectively. Older patients less frequently had LV systolic......AIMS: To describe the association between age and risk factors in patients hospitalised with congestive heart failure (CHF) and to determine the effect of age on mortality. METHODS AND RESULTS: Consecutive patients admitted to 34 hospitals with CHF during a period of 2 years were registered. Mean...... dysfunction, were under treated with ACE-inhibitors and were more often female. The prevalence of hypertension, diabetes and ischaemic heart disease increased with age, until the oldest age group (>80 years). Age was an independent predictor of short-term mortality (risk ratio (RR) per 10-year increase was 1...

  3. Sleeping and resting respiratory rates in dogs and cats with medically-controlled left-sided congestive heart failure.

    Science.gov (United States)

    Porciello, F; Rishniw, M; Ljungvall, I; Ferasin, L; Haggstrom, J; Ohad, D G

    2016-01-01

    Sleeping and resting respiratory rates (SRR and RRR, respectively) are commonly used to monitor dogs and cats with left-sided cardiac disease and to identify animals with left-sided congestive heart failure (L-CHF). Dogs and cats with subclinical heart disease have SRRmean values 40 breaths/min. Median feline RRRmean was 24 breaths/min (15-45 breaths/min); five cats had RRRmean ≥25 breaths/min; one had ≥30 breaths/min, and two had ≥40 breaths/min. These data suggest that most dogs and cats with CHF that is medically well-controlled and stable have SRRmean and RRRmean <30 breaths/min at home. Clinicians can use these data to help determine how best to control CHF in dogs and cats.

  4. Dofetilide in patients with congestive heart failure and left ventricular dysfunction. Danish Investigations of Arrhythmia and Mortality on Dofetilide Study Group

    DEFF Research Database (Denmark)

    Torp-Pedersen, C; Møller, M; Bloch-Thomsen, P E;

    1999-01-01

    patients with symptomatic congestive heart failure and severe left ventricular dysfunction at 34 Danish hospitals. We randomly assigned 762 patients to receive dofetilide, a novel class III antiarrhythmic agent, and 756 to receive placebo in a double-blind study. Treatment was initiated in the hospital......BACKGROUND: Atrial fibrillation occurs frequently in patients with congestive heart failure and commonly results in clinical deterioration and hospitalization. Sinus rhythm may be maintained with antiarrhythmic drugs, but some of these drugs increase the risk of death. METHODS: We studied 1518...... (hazard ratio for the recurrence of atrial fibrillation, 0.35; 95 percent confidence interval, 0.22 to 0.57; Pcases of torsade de pointes in the dofetilide group (3.3 percent) as compared with none in the placebo group. CONCLUSIONS: In patients with congestive heart failure...

  5. Cost Effectiveness of Intensive Lipid-Lowering Treatment for Patients with Congestive Heart Failure and Coronary Heart Disease in the US

    OpenAIRE

    Virginia M. Rosen; Douglas C.A. Taylor; Hemangi Parekh; Ankur Pandya; David Thompson; Andreas Kuznik; Waters, David D.; Michael Drummond; Weinstein, Milton C.

    2010-01-01

    Background: A recent study found fewer hospitalizations for congestive heart failure (CHF) patients receiving high-dose versus low-dose statin therapy. Objective: To examine the cost effectiveness of high-dose versus low-dose statin therapy in CHF patients. Methods: Two scenarios (literature-based [base-case scenario] vs trial-based post-event mortality [alternative scenario]) assessed the cost effectiveness of atorvastatin 80 mg/day (A80) versus atorvastatin 10 mg/day (A1...

  6. Usefulness of the Sum of Pulmonary Capillary Wedge Pressure and Right Atrial Pressure as a Congestion Index that Prognosticates Heart Failure Survival (from the Evaluation Study of Congestive Heart Failure and Pulmonary Artery Catheterization Effectiveness Trial).

    Science.gov (United States)

    Ma, Tony S; Paniagua, David; Denktas, Ali E; Jneid, Hani; Kar, Biswajit; Chan, Wenyaw; Bozkurt, Biykem

    2016-09-15

    In the Evaluation Study of Congestive Heart Failure and Pulmonary Artery Catheterization Effectiveness (ESCAPE) trial, use of a pulmonary artery catheter did not significantly affect advanced heart failure outcomes. However, the success of achieving the targeted hemodynamic goals of pulmonary capillary wedge pressure (PCWP) of 15 mm Hg and right atrial pressure (RAP) of 8 mm Hg and the association of these goals with clinical outcomes were not addressed. Furthermore, goals with 2 independent variables, PCWP and RAP, left room for uncertainties. We assessed the ability of a single hemodynamic target to achieve a threshold sum of PCWP and RAP as a predictor of all-cause mortality, death-or-transplantation (DT), or death-or-rehospitalization (DR) at 6 months in the pulmonary artery catheter-guided treatment arm of ESCAPE (n = 206). Patients with a posttreatment PCWP + RAP of <30 mm Hg had characteristics similar to those of the population who achieved the ESCAPE hemodynamic goals. This group had 8.7% mortality, 13.0% DT, and 58.7% DR at 6 months. The contrasting cohort with PCWP + RAP of ≥30 mm Hg had 45.3% mortality, 54.7% DT, and 84.9% DR at 6 months, with greater relative risk (RR) of death (RR 5.76), DT (RR 4.92), and DR (RR 1.80) and higher prevalence of jugular venous pulsation, edema, hepatomegaly, and ascites at admission and discharge. In conclusion, PCWP + RAP of 30 mm Hg posttreatment, obtained early in the index hospitalization, may represent as a simple congestion index that has prognostic value for heart failure survival and readmission rates at 6 months and as a warning signal for more aggressive intervention, thus warranting further validation.

  7. Hemodynamic and neurochemical determinates of renal function in chronic heart failure.

    Science.gov (United States)

    Gilbert, Cameron; Cherney, David Z I; Parker, Andrea B; Mak, Susanna; Floras, John S; Al-Hesayen, Abdul; Parker, John D

    2016-01-15

    Abnormal renal function is common in acute and chronic congestive heart failure (CHF) and is related to the severity of congestion. However, treatment of congestion often leads to worsening renal function. Our objective was to explore basal determinants of renal function and their response to hemodynamic interventions. Thirty-seven patients without CHF and 59 patients with chronic CHF (ejection fraction; 23 ± 8%) underwent right heart catheterization, measurements of glomerular filtration rate (GFR; inulin) and renal plasma flow (RPF; para-aminohippurate), and radiotracer estimates of renal sympathetic activity. A subset (26 without, 36 with CHF) underwent acute pharmacological intervention with dobutamine or nitroprusside. We explored the relationship between baseline and drug-induced hemodynamic changes and changes in renal function. In CHF, there was an inverse relationship among right atrial mean pressure (RAM) pressure, RPF, and GFR. By contrast, mean arterial pressure (MAP), cardiac index (CI), and measures of renal sympathetic activity were not significant predictors. In those with CHF there was also an inverse relationship among the drug-induced changes in RAM as well as pulmonary artery mean pressure and the change in GFR. Changes in MAP and CI did not predict the change in GFR in those with CHF. Baseline values and changes in RAM pressure did not correlate with GFR in those without CHF. In the CHF group there was a positive correlation between RAM pressure and renal sympathetic activity. There was also an inverse relationship among RAM pressure, GFR, and RPF in patients with chronic CHF. The observation that acute reductions in RAM pressure is associated with an increase in GFR in patients with CHF has important clinical implications.

  8. 充血性心力衰竭的中医药治疗进展%Congestive heart failure of traditional chinese medicine to progress

    Institute of Scientific and Technical Information of China (English)

    唐燕萍; 卢青; 陈新宇

    2011-01-01

    阐述了充血性心力衰竭的病因病机,从辨证论治和专方治疗两方面综述了中医药治疗充血性心力衰竭的研究进展,并对药物作用的机理研究做了概述.%Expounds congestive heart failure of the etiology and pathogenesis, syndrome differentiation and treatment from the treatment designed and reviewed the two traditional Chinese medicine for congestive heart failure is reviewed, and the mechanism of the effect of drug research is given.

  9. Evaluation of passive cardiomyoplasty using left- and right-ventricular volume measurements by EBCT and MRI in patients with chronic congestive heart failure; Evaluierung der passiven Kardiomyoplastie mittels links- und rechtsventrikulaerer EBCT- und MRT-Volumetrie bei Patienten mit chronischer Herzinsuffizienz

    Energy Technology Data Exchange (ETDEWEB)

    Lembcke, A.; Enzweiler, C.N.H.; Wiese, T.H.; Kivelitz, D.E.; Rogalla, P.; Hamm, B. [Inst. fuer Radiologie, Universitaetsklinikum Charite, Campus Charite Mitte, Humboldt Univ. zu Berlin (Germany); Hotz, H.; Dushe, S.; Konertz, W. [Klinik fuer Kardiovaskulaere Chirurgie, Universitaetsklinikum Charite, Campus Charite Mitte, Humboldt Univ. zu Berlin (Germany)

    2003-08-01

    Purpose: To evaluate the efficacy of passive cardiomyoplasty with the determination of biventricular volumes, global systolic function as well as left-ventricular muscle mass. Materials and Methods: In 19 patients with congestive heart failure of idiopathic or ischemic origin, a polyester mesh-graft was implanted around both ventricles for stabilization and functional support. Before and three months after surgery, 15 patients underwent EBCT and 4 patients with impaired renal function underwent MRI, for the evaluation of the volume and ejection fraction of both ventricles. Results: EBCT demonstrated a decrease from 385 to 310 ml in LV-EDV, from 312 to 242 ml in LV-ESV, from 209 to 160 ml in RV-EDV and from 149 to 87 ml in RV-ESV, and an increase from 20 to 26% in LV-EF and from 37 to 50% in RV-EF as well as a reduction of LV-MM from 300 to 274 g (p < 0.05 each). Similar results were obtained by MRI. Conclusion: Following passive cardiomyoplasty, EBCT and MRI revealed an improvement of the global systolic function as well as a reduction of biventricular volumes and left-ventricular muscle mass. (orig.) [German] Ziel: Evaluierung des Therapieerfolges der passiven Kardiomyoplastie durch Bestimmung der biventrikulaeren Volumina und global systolischen Funktion sowie der linksventrikulaeren Muskelmasse. Methoden: Bei 19 Patienten mit idiopathisch und ischaemisch bedingter Herzinsuffizienz erfolgte die Implantation eines Polyesternetzes um die Ventrikel zu deren Stabilisierung und funktioneller Unterstuetzung. Praeoperativ sowie drei Monate postoperativ wurden bei 15 Patienten durch EBCT und bei 4 Patienten mit eingeschraenkter Nierenfunktion durch MRT die Volumina und Ejektionsfraktion beider Ventrikel sowie die linksventrikulaere Muskelmasse bestimmt. Ergebnisse: Die EBCT zeigte eine Abnahme des LV-EDV von 385 auf 310 ml, des LV-ESV von 312 auf 242 ml, des RV-EDV von 209 auf 160 ml und des RV-ESV von 149 auf 87 ml, eine Zunahme der LV-EF von 20 auf 26% und der RV

  10. Home monitoring of chronic heart failure

    Directory of Open Access Journals (Sweden)

    Bockeria O. L.

    2012-06-01

    Full Text Available Being a common syndrome chronic heart failure (CHF results in high mortality among cardiosurgical patients and requires very high expenditures for the treatment. All over the world the number of patients with CHF syndrome is about 22 millions. Heart failure is difficult to treat because of high level of hospitalization due to decompensation. Care aimed at constant home observation of patients could have been more efficient and not only symptomatic and as a response to complications induced. There are methods controlling CHF patients at home. These methods vary from increase of self-care and telephone support to telemonitoring and remote monitoring of implantable devices. Self-care includes such components as maintenance of drug intake, keeping to a diet, physical exercises and active control over edemas. Telephone calls are also a source of monitoring and treatment of heart failure at home. Meta-analysis of programs for structured phone support showed that telephone support could reduce the level of readmission of HF patients approximately by 25%. Telemonitoring implies transmission of such physiological data as blood pressure, body weight, electrocardiographic signals or oxygen saturation using phone lines, broadband and satellite or wireless networks. Having cardiac pacemakers, implantable cardioverter defibrillators and cardiac resynchronization therapy devices that are placed in HF patients, it is possible to use their opportunities for the further evaluation of the patient. Some regularly controlled parameters can show the clinical state of the patient and predict the following heart failure. For example, atrial fibrillation, decrease of cardiac rhythm variability and decrease of the level of the patient`s activity (according to integrated accelerometer can predict clinical decompensation. Also, implantable hemodynamic monitors for immediate pressure measuring in the left atrium, sensor system of pressure measuring in the right atrium are

  11. Metabolic remodeling in chronic heart failure

    Institute of Scientific and Technical Information of China (English)

    Jing WANG; Tao GUO

    2013-01-01

    Although the management of chronic heart failure (CHF) has made enormous progress over the past decades,CHF is still a tremendous medical and societal burden.Metabolic remodeling might play a crucial role in the pathophysiology of CHF.The characteristics and mechanisms of metabolic remodeling remained unclear,and the main hypothesis might include the changes in the availability of metabolic substrate and the decline of metabolic capability.In the early phases of the disease,metabolism shifts toward carbohydrate utilization from fatty acids (FAs) oxidation.Along with the progress of the disease,the increasing level of the hyperadrenergic state and insulin resistance cause the changes that shift back to a greater FA uptake and oxidation.In addition,a growing body of experimental and clinical evidence suggests that the improvement in the metabolic capability is likely to be more significant than the selection of the substrate.

  12. Angiotensin II vaccine promising for patients with chronic heart failure

    Institute of Scientific and Technical Information of China (English)

    CHEN Yang-xin; YAO You-jie; NIE Ru-qiong; ZHOU Shu-xian; WANG Jing-feng

    2009-01-01

    @@ Chronic heart failure (CHF), as the end-stage presentation of all kinds of heart diseases, is a major public health problem as well as a pressing public policy issue. There are more than 5 million patients diagnosed with CHF in USA alone and approximately 550 000 new cases appear per year. About 0.4%-2% of the European population is affected by symptomatic heart failure. Hence heart failure is the leading cause of hospitalization especially in older people around the world.

  13. Increased serum C-reactive protein concentrations in dogs with congestive heart failure due to myxomatous mitral valve disease

    DEFF Research Database (Denmark)

    Reimann, M. J.; Ljungvall, I.; Hillstrom, A.;

    2016-01-01

    Cardiovascular disease in humans and dogs is associated with mildly increased circulating concentrations of C-reactive protein (CRP). Few studies have evaluated associations between circulating CRP and canine myxomatous mitral valve disease (MMVD) and the results reported have been divergent....... The aim of this study was to investigate whether serum concentrations of CRP, determined using a novel automated canine-specific high -sensitivity CRP assay (Gentian hsCRP), were associated with severity of MMVD and selected clinical variables in dogs. The study included 188 client-owned dogs...... with different severities of MMVD. Dogs were classified based on ACVIM consensus statement guidelines (group A, n = 58; group BI, n = 56; group B2, n = 38; group C, n = 36). Data were analysed using descriptive statistics and multiple regression analysis. Dogs with congestive heart failure (CHF; group C) had...

  14. Automated quality measurement in Department of the Veterans Affairs discharge instructions for patients with congestive heart failure.

    Science.gov (United States)

    Garvin, Jennifer H; Elkin, Peter L; Shen, Shuying; Brown, Steven; Trusko, Brett; Wang, Enlai; Hoke, Linda; Quiaoit, Ylenia; Lajoie, Joan; Weiner, Mark G; Graham, Pauline; Speroff, Theodore

    2013-01-01

    Quality measurement is an important issue for the United States Department of Veterans Affairs (VA). In this study, we piloted the use of an informatics tool, the Multithreaded Clinical Vocabulary Server (MCVS), which extracted automatically whether the VA Office of Quality and Performance measures of quality of care were met for the completion of discharge instructions for inpatients with congestive heart failure. We used a single document, the discharge instructions, from one section of the medical records for 152 patients and developed a reference standard using two independent reviewers to assess performance. When evaluated against the reference standard, MCVS achieved a sensitivity of 0.87, a specificity of 0.86, and a positive predictive value of 0.90. The automated process using the discharge instruction document worked effectively. The use of the MCVS tool for concept-based indexing resulted in mostly accurate data capture regarding quality measurement, but improvements are needed to further increase the accuracy of data extraction.

  15. Safety and predictors of adherence of a new rehabilitation program for older women with congestive heart failure

    Institute of Scientific and Technical Information of China (English)

    Nahid A. Azad; Kathy Bouchard; Alain Mayhew; Maureen Carter; Frank J. Molnar

    2012-01-01

    Objectives To assess the safety of a cardiac rehabilitation program for older women with Congestive Heart Failure (CHF) anddetermine if certain factors influence adherence. Methods Women over the age of 65 with CHF attended an exercise program supervisedby a physiotherapist. Quality of life was measured by the Minnesota Living with Heart Failure Questionnaire (MLHFQ) and severity ofdisease by the New York Heart Association (NYHA) Class. Subjects were classified into those who attended 90% or more of the sessionsand those who attended less than 90% of the sessions. Results Fifty-one subjects were studied. Eight subjects did not attend any sessions.Of the 43 attendees, the average percentage of sessions attended was 87%. There were no significant differences between the two groups inage, MLHFQ or NYHA Class. There was only one adverse event out of 280 participant attendances. Conclusions The program had a highlevel of adherence in this population. Age, MLHFQ or NYHA Class did not impact on session attendance. Our data suggests this program issafe for this population. Further research is needed to determine other predictors of attendance and the examination of safety issues andlong-term adherence to exercise in this population.

  16. Ca(2+) sensitisation of force production by noradrenaline in femoral conductance and resistance arteries from rats with postinfarction congestive heart failure

    DEFF Research Database (Denmark)

    Trautner, Simon; Amtorp, Ole; Boesgaard, Soren;

    2006-01-01

    In this study we tested the hypothesis that arterial myofilament Ca(2+) sensitivity and/or the Ca(2+) sensitising effect of noradrenaline (NA) is enhanced in post-infarction congestive heart failure (CHF), which could contribute to the high peripheral vascular resistance in this condition. Femoral...

  17. Survival after withdrawal of dofetilide in patients with congestive heart failure and a short baseline QTc interval; a follow-up on the Diamond-CHF QT substudy

    DEFF Research Database (Denmark)

    Brendorp, B; Torp-Pedersen, C; Elming, H;

    2003-01-01

    withdrawal of dofetilide. METHODS: Patients with congestive heart failure (CHF) and reduced left ventricular function enrolled in the Diamond-CHF (Danish Investigations of Arrhythmia and Mortality on Dofetilide-CHF) study were eligible for our QT substudy provided they were in sinus rhythm and had...

  18. 充血性心力衰竭的临床分析%To Explore the Clinical of Congestive Heart Failure

    Institute of Scientific and Technical Information of China (English)

    吴凤军

    2015-01-01

    目的:探讨充血性心力衰竭的临床治疗措施。方法回顾性分析从2012年6月~2013年12月我院收治的43例充血性心力衰竭患者的临床资料。结果对充血性心力衰竭患者进行针对性的临床治疗,显效20例,有效22例,无效1例,总有效率97.7%。结论充血性心力衰竭患者临床表现单一,诱因复杂,应采取综合方案进行治疗。%Objective To investigate the clinical treatment of congestive heart failure.Methods Selected 43 cases of congestive heart failure from 2012 June to 2013 December in our hospital analysis of clinical data. ResultsPatients with congestive heart failure targeted clinical treatment, 20 cases markedly effective, 1 case effective, the total efifciency of 97.7%. ConclusionThe clinical manifestations of congestive heart failure in patients with a single, complex incentives, should take a comprehensive treatment program.

  19. Qtc interval as a guide to select those patients with congestive heart failure and reduced left ventricular systolic function who will benefit from antiarrhythmic treatment with dofetilide

    DEFF Research Database (Denmark)

    Brendorp, B; Elming, H; Jun, L;

    2001-01-01

    AND RESULTS: This prospectively defined substudy included 703 patients enrolled in the Danish Investigations of Arrhythmia and Mortality on Dofetilide-Congestive Heart Failure (DIAMOND-CHF) study. Patients included had moderate to severe CHF and reduced left ventricular systolic function. Baseline QTc...

  20. COMPARISON OF EFFECTS ON PEAK OXYGEN-CONSUMPTION, QUALITY-OF-LIFE, AND NEUROHORMONES OF FELODIPINE AND ENALAPRIL IN PATIENTS WITH CONGESTIVE-HEART-FAILURE

    NARCIS (Netherlands)

    DEVRIES, RJM; QUERE, M; LOK, DJA; SIJBRING, P; BUCX, JJJ; VANVELDHUISEN, DJ; DUNSELMAN, PHJM

    1995-01-01

    Angiotensin-converting enzyme (ACE) inhibition is currently the cornerstone of congestive heart failure (CHF) therapy, but these drugs are not tolerated in up to 20% of patients, For these patients, therapeutic alternatives with comparable efficacy are needed. Felodipine, a vasoselective dihydropyri

  1. Endocardiosis and congestive heart failure in a captive ostrich (Struthio camelus

    Directory of Open Access Journals (Sweden)

    M.A.G. Kubba

    2013-11-01

    Full Text Available A seven-year-old blue-necked male ostrich was found dead after a few days of illness. The animal was living in an open yard of 25 square meters along with three other females. They were given concentrate-rich ration with free access to green leaves and water. Autopsy revealed cardiac enlargement due to left ventricular hypertrophy and right ventricular dilatation. The left aterioventricular valves were irregularly thickened and contracted. The lungs were engorged with blood and the liver had nutmeg appearance. The small intestine showed segmental sub-serosal petechial hemorrhages. Histological examination revealed myxomatous degeneration of the left aterioventricular valves, pulmonary congestion and edema, congestion of periacinar hepatic zone and fatty degeneration of outer zones, renal glomerulosclerosis and arteriosclerosis. The affected parts of the small intestine showed villous atrophy with lacteal distention. The venules in the affected intestinal segment were severely dilated while the arterioles had narrow lumen and irregular wall thickening with hyaline deposition. The current article reports an endocardiosis in ostrich and discusses other vascular disorders.

  2. Heart rate awareness in patients with chronic stable heart failure. A multi-center observational study.

    LENUS (Irish Health Repository)

    Moran, D

    2014-08-23

    We assessed adherence to European Society of Cardiology heart rate guidelines (i.e. heart rates less than 70bpm) in patients with chronic stable heart failure. We also investigated the percent of patients on target doses of rate controlling drugs.

  3. Efficacy of regional renal nerve blockade in patients with chronic refractory heart failure

    Institute of Scientific and Technical Information of China (English)

    DAI Qi-ming; FEN Yi; LU Jing; MA Gen-shan

    2013-01-01

    Background Increased renal sympathetic nerve activity can result in diuretic resistance in patients with chronic congestive heart failure.We investigated the effect of regional renal nerve blockade on the patients with chronic refractory heart failure and diuretic resistance.Methods Eighteen patients with chronic refractory heart failure were enrolled (mean age (64±11) years).The patients were randomly divided into two groups (renal nerve blockade group and standard therapy group,n=9 each).Renal nerve blockade was performed by percutaneous injection of local anaesthetic under computed tomographic guidance.Heart rate,mean arterial blood pressure,plasma and urine electrolytes,neurohormones,factional excretion of sodium (FENa),24-hour urine volume were monitored at baseline and the first 24 hours after therapy.Dyspnea and oedema were also evaluated.The major adverse cardiovascular events (MACE),plasma brain natriuretic peptide (BNP) level and left ventricular ejection fraction (LVEF) were compared between the two groups during the 3-12 months follow-up period.Results No complication was observed during the acute phase of renal nerve blockade.After renal nerve blockade,the 24-hour urine volume and FENa were significantly increased,while the level of plasma rennin,angiotensin Ⅱ,aldosterone,BNP and atrial natriuretic peptide as well as dyspnea and oedema were significantly reduced in renal nerve blockade group compared with baseline and standard therapy group.During three to 12 months of follow-up,the rate of MACE and plasma BNP level were significantly lower,while LVEF was significantly higher in renal nerve blockade group than those in standard therapy group.Conclusion Regional renal nerve blockade may be a safe and effective treatment for patients with chronic refractory heart failure.

  4. Common variants in IL-17A/IL-17RA axis contribute to predisposition to and progression of congestive heart failure.

    Science.gov (United States)

    Sandip, Chaugai; Tan, Lun; Huang, Jin; Li, Qing; Ni, Li; Cianflone, Katherine; Wang, Dao Wen

    2016-07-01

    Heart failure is characterized by immune activation leading to production and release of proinflammatory cytokines. Interleukin 17A (IL-17A) is a proinflammatory cytokine and multiple lines of evidence from animal and human studies suggest crucial roles of IL-17A in heart failure. Therefore, we investigated whether common polymorphisms of genes IL17A and IL17RA (coding interleukin 17 receptor A) contribute to genetic predisposition to heart failure and adverse clinical outcomes associated with it.A total of 1713 adult patients with congestive heart failure and 1713 age- and sex-matched controls were genotyped for promoter single nucleotide polymorphisms (SNPs), rs2275913 and rs8193037 in IL17A and rs4819554 in IL17RA, to assess the relationship between individual SNPs and the risk of congestive heart failure. Results showed that rs8193037 in IL17A was associated with the risk of congestive heart failure (odds ratio [OR] = 0.76; 95% confidence interval [CI] 0.63-0.90, adjusted P = 0.002) after adjustment for multiple cardiovascular risk factors including age, sex, smoking status, diabetes, hypertension, and dyslipidemia. This association was evident in both ischemic and nonischemic heart failure (P = 0.005 and P = 0.05, respectively). Furthermore, prospective follow-up of 12.7 months for the occurrence of adverse clinical outcomes showed that rs4819554 in IL17RA was significantly associated with cardiovascular mortality (hazard ratio [HR] = 1.28; 95% CI = 1.02-1.59, adjusted P = 0.03) after adjustments for multiple cardiovascular risk factors and New York Heart Association functional class.This study demonstrated associations of rs8193037 in the promoter of IL17A with the risk of congestive heart failure, and of rs4819554 in the promoter of IL17RA with the risk of cardiovascular mortality in patients with congestive heart failure. These data lend further support to the notion that immune activation and genetic polymorphisms contribute to heart failure pathogenesis

  5. Computer assisted optimisation on non-pharmacological treatment of congestive heart failure and supraventricular arrhythmia

    OpenAIRE

    Reumann, Matthias

    2007-01-01

    Heart Failure is the most common cardiac disease worldwide; supraventricular arrhythmia the most common cardiac arrhythmia. The understanding of these diseases advances treatment options. Ablation therapy and atrial antitachycardial pacing are non-pharmacological options in the treatment of atrial fibrillation. Cardiac resynchronization therapy with biventricular pacing devices has been shown successful in patients with severe heart failure. However, an optimization or even individual therapy...

  6. Progress in the study of the pulmonary embolism in congestive heart failure%心力衰竭并发肺动脉栓塞研究进展

    Institute of Scientific and Technical Information of China (English)

    陈远刚

    2014-01-01

    Many clinical manifestations of congestive heart failure are similar to that of pulmonary embolism. Pulmonary embolism is a common complication of heart failure. The prognosis will be worse when a heart failure patient was complicated with pulmonary embolism. Here we briefly review the progress in the study of the pulmonary embolism in congestive heart failure from the aspects of etiopathogenisis,risk factor,clinical manifestation,diagnosis and prognosis,precaution and treatment. We hope that it may provide some informa-tion and study strategies for the diagnosis and precaution of the pulmonary embolism in congestive heart failure.%充血性心力衰竭(CHF)在许多临床表现上与肺动脉栓塞相似,而前者易并发后者,两者一旦合并存在,即提示患者预后更为恶劣。该文从发病原因、危险因素、临床表现、诊断与预后、预防及治疗等方面复习近年心力衰竭并发肺动脉栓塞研究进展,以期能在诊断及预防CHF并发肺动脉栓塞等方面提供相关的信息和思路。

  7. A new approach to detect congestive heart failure using Teager energy nonlinear scatter plot of R-R interval series.

    Science.gov (United States)

    Kamath, Chandrakar

    2012-09-01

    A novel approach to distinguish congestive heart failure (CHF) subjects from healthy subjects is proposed. Heart rate variability (HRV) is impaired in CHF subjects. In this work hypothesizing that capturing moment to moment nonlinear dynamics of HRV will reveal cardiac patterning, we construct the nonlinear scatter plot for Teager energy of R-R interval series. The key feature of Teager energy is that it models the energy of the source that generated the signal rather than the energy of the signal itself. Hence, any deviations in the genesis of HRV, by complex interactions of hemodynamic, electrophysiological, and humoral variables, as well as by the autonomic and central nervous regulations, get manifested in the Teager energy function. Comparison of the Teager energy scatter plot with the second-order difference plot (SODP) for normal and CHF subjects reveals significant differences qualitatively and quantitatively. We introduce the concept of curvilinearity for central tendency measures of the plots and define a radial distance index that reveals the efficacy of the Teager energy scatter plot over SODP in separating CHF subjects from healthy subjects. The k-nearest neighbor classifier with RDI as feature showed almost 100% classification rate.

  8. Particulate Air Pollution and the Rate of Hospitalization for Congestive Heart Failure among Medicare Beneficiaries in Pittsburgh, Pennsylvania.

    Science.gov (United States)

    Wellenius, Gregory A.; Bateson, Thomas F.; Mittleman, Murray A.; Schwartz., Joel

    2006-01-01

    We used a case-crossover approach to evaluate the association between ambient air pollution and the rate of hospitalization for congestive heart failure (CHF) among Medicare recipients (age ≥ 65) residing in Allegheny County (Pittsburgh area), PA, during 1987–1999. We also explored effect modification by age, gender, and specific secondary diagnoses. During follow-up, there were 55,019 admissions with a primary diagnosis of CHF. We found that particulate matter with aerodynamic diameter ≤ 10 μm (PM10), carbon monoxide (CO), nitrogen dioxide (NO2), and sulfur dioxide – but not ozone – were positively and significantly associated with the rate of admission on the same day in single-pollutant models. The strongest associations were observed with CO, NO2 and PM10. The associations with CO and NO2 were the most robust in two-pollutant models, remaining statistically significant even after adjusting for other pollutants. Patients with a recent myocardial infarction were at greater risk of particulate-related admission, but there was otherwise no significant effect modification by age, gender, or other secondary diagnoses. These results suggest that short-term elevations in air pollution from traffic-related sources may trigger acute cardiac decompensation of heart failure patients and that those with certain comorbid conditions may be more susceptible to these effects. PMID:15901623

  9. Continuous infusion or bolus injection of loop diuretics for congestive heart failure?

    Science.gov (United States)

    Zepeda, Patricio; Rain, Carmen; Sepúlveda, Paola

    2016-04-22

    Loop diuretics are widely used in acute heart failure. However, there is controversy about the superiority of continuous infusion over bolus administration. Searching in Epistemonikos database, which is maintained by screening 30 databases, we identified four systematic reviews including 11 pertinent randomized controlled trials overall. We combined the evidence using meta-analysis and generated a summary of findings following the GRADE approach. We concluded continuous administration of loop diuretics probably reduces mortality and length of stay compared to intermittent administration in patients with acute heart failure.

  10. Prognostic importance of a short deceleration time in symptomatic congestive heart failure

    DEFF Research Database (Denmark)

    Akkan, Dilek; Kjaergaard, Jesper; Møller, Jacob Eifer;

    2008-01-01

    AIMS: A restrictive transmitral filling (RF) pattern predicts increased mortality in heart failure (HF) with reduced left ventricular (LV) systolic function. We performed a combined evaluation of LV function and RF for prognosis in patients with HF with and without systolic dysfunction. METHODS A...

  11. Anemia in chronic heart failure : etiology and treatment options

    NARCIS (Netherlands)

    Westenbrink, B. Daan; de Boer, Rudolf A.; Voors, Adriaan A.; van Gilst, Wiek H.; van Veldhuisen, Dirk J.

    2008-01-01

    Purpose of review Anemia is common in patients with chronic heart failure, and is related to increased morbidity and mortality. The etiology of anemia in heart failure is complex and still not fully resolved. The review will describe current advances in the understanding of the pathophysiology of an

  12. Study on Apoptosis and Expression of P53, Bcl-2, Bax in Cardiac Myocytys of Congestive Heart Failure Induced by Ventricular Pacing

    Institute of Scientific and Technical Information of China (English)

    QI; Benling; CAO; Linsheng; WANG; Lin; ZHOU; Jingqun

    2001-01-01

    The apoptosis and the expression of p53, bcl-2 and Bax in myocytes of chronic rapid ventricular pacing-induced congestive heart failure (CHF) in rabbits were investigated. The CHF rabbit model (P, n= 7) was established by chronic rapid ventricular pacing for 3 weeks. By using TUNEL technique the apoptosis in the myocytes in the rabbit model was studied and the expression of p53,bcl-2 and Bax in myocytes was detected by using immunohistochemical method. Sham-operated (C,n = 9) group served as control group. The results showed that there were about 4033± 884.56 apoptotic cells/106 myocytes in P group, but no apoptotic cells were found in C group. Myocytes positive for p53 immunoreactivity (18. 86±8. 48 vs 5. 06±0. 87, P<0.01) and positive for Bax immunoreactivity (7. 15±1.91 vs 0. 43±0. 09, P<0.01) were increased in P group as compared with those in C group, while the myocytes positive for bcl-2 immunoreactivity (7. 08±1.05 vs 14. 97±4.47,P<0. 01) and the ratio of bcl-2/Bax were decreased in P group as compared with those in C group.Apoptosis was involved in the development of CHF induced by continuously rapid ventricular pacing in rabbit. The expression of p53 and Bax was increased, while the expression of bcl-2 was inhibited.These might play an important role in the acceleration of the apoptosis.

  13. Treatment of Congestive Heart Failure in Children%小儿充血性心力衰竭治疗分析

    Institute of Scientific and Technical Information of China (English)

    许伟力

    2015-01-01

    目的:探讨小儿充血性心力衰竭的临床治疗。方法对30例小儿充血性心力衰竭患者临床治疗方法资料进行分析。结果经治疗显效21例,有效7例,无效2例,总有效率93.33%。结论通过对小儿充血性心力衰竭的临床治疗,消除其病因及诱因,改善血液动力学,维护衰竭的心脏。%Objective To investigate the clinical treatment of children with congestive heart failure.Methods30 cases of pediatric patients with congestive heart failure clinical treatment were analyzed.Results21 cases were cured after treatment, effective in 7 cases, 2 cases, the total efifciency of 93.33 %.Conclusion The clinical treatment of children with congestive heart failure, eliminate the cause and incentives, improve hemodynamics, maintain heart failure.

  14. Advances in the management of atrial fibrillation in congestive heart failure

    OpenAIRE

    Gopinathannair, Rakesh; Olshansky, Brian

    2009-01-01

    Atrial fibrillation, a common problem in patients with heart failure, is associated with increased mortality and morbidity. Pharmacological as well as invasive management and the endpoints of such management are complex. Recent randomized trials indicate that a rate-control strategy, along with anticoagulation treatment with warfarin, when appropriate, has a similar outcome in terms of mortality and morbidity as rhythm control, and could, therefore, be considered as the primary management str...

  15. Vitamin B-12 and folate deficiency in chronic heart failure

    NARCIS (Netherlands)

    van der Wal, Haye H.; Comin-Colet, Josep; Klip, Ijsbrand T.; Enjuanes, Cristina; Grote Beverborg, Niels; Voors, Adriaan A.; Banasiak, Waldemar; van Veldhuisen, Dirk J.; Bruguera, Jordi; Ponikowski, Piotr; Jankowska, Ewa A.; van der Meer, Peter

    2015-01-01

    Objective To determine the prevalence, clinical correlates and the effects on outcome of vitamin B-12 and folic acid levels in patients with chronic heart failure (HF). Methods We studied an international pooled cohort comprising 610 patients with chronic HF. The main outcome measure was all-cause m

  16. [Effects of xinshuaikang granule on cardiac function and atrial natriuretic polypeptide levels in rabbits with experimental congestive heart failure].

    Science.gov (United States)

    Jin, X C; Sun, J Z; Wang, X

    1996-07-01

    Xinshuaikang (XSK) granule mainly consisted of Radix Ginseng, Aconifum carmichaeli, Ligustici wallichii, Semen Lepidii seu Descurainiae, etc. Thirty-five white rabbits of Japanese strain with big ears were used and five groups were divided randomly. The models of chronic heart failure (CHF) was made by injection of adriamycin through the marginal vein of rabbit's ear. Only one group without adriamycin injection was taken as blank group. After the making of models, Xinbao (XB) was used to treat one group which was regarded as control group, XSK was used to treat two model groups, one used higher dose, the other one used lower dose. Fifteen days was taken as a course of treatment. The results were: the body weight of all model groups was heavier than that without adriamycin. After a course of treatment, the body weight of the groups treated by XSK or XB decreased rapidly, the general conditions of the three groups were improved; the two drugs could reduce heart rate and enhance heart function, at the same time they reduced the level of atrial natriuretic polypeptide (ANP) in plasma. The best results was obtained in XSK group with higher dose, the effect of XSK group with lower dose was equivalent to that of XB group. Hence, XSK granule could enhance the CHF rabbits' heart function, improve their heart endocrine activity, this drug had a reliable effect on CHF.

  17. Aldosterone and aldosterone receptor antagonists in patients with chronic heart failure

    Directory of Open Access Journals (Sweden)

    Nappi J

    2011-06-01

    Full Text Available Jean M Nappi, Adam SiegClinical Pharmacy and Outcome Sciences, South Carolina College of Pharmacy, Medical University of South Carolina Campus, Charleston, SC, USAAbstract: Aldosterone is a mineralocorticoid hormone synthesized by the adrenal glands that has several regulatory functions to help the body maintain normal volume status and electrolyte balance. Studies have shown significantly higher levels of aldosterone secretion in patients with congestive heart failure compared with normal patients. Elevated levels of aldosterone have been shown to elevate blood pressure, cause left ventricular hypertrophy, and promote cardiac fibrosis. An appreciation of the true role of aldosterone in patients with chronic heart failure did not become apparent until the publication of the Randomized Aldactone Evaluation Study. Until recently, the use of aldosterone receptor antagonists has been limited to patients with severe heart failure and patients with heart failure following myocardial infarction. The Eplerenone in Mild Patients Hospitalization and Survival Study in Heart Failure (EMPHASIS-HF study added additional evidence to support the expanded use of aldosterone receptor antagonists in heart failure patients. The results of the EMPHASIS-HF trial showed that patients with mild-to-moderate (New York Heart Association Class II heart failure had reductions in mortality and hospitalizations from the addition of eplerenone to optimal medical therapy. Evidence remains elusive about the exact mechanism by which aldosterone receptor antagonists improve heart failure morbidity and mortality. The benefits of aldosterone receptor antagonist use in heart failure must be weighed against the potential risk of complications, ie, hyperkalemia and, in the case of spironolactone, possible endocrine abnormalities, in particular gynecomastia. With appropriate monitoring, these risks can be minimized. We now have evidence that patients with mild-to-severe symptoms

  18. Impact of collaborative care on survival time for dogs with congestive heart failure and revenue for attending primary care veterinarians.

    Science.gov (United States)

    Lefbom, Bonnie K; Peckens, Neal K

    2016-07-01

    OBJECTIVE To assess the effects of in-person collaborative care by primary care veterinarians (pcDVMs) and board-certified veterinary cardiologists (BCVCs) on survival time of dogs after onset of congestive heart failure (CHF) and on associated revenue for the attending pcDVMs. DESIGN Retrospective cohort study. ANIMALS 26 small-breed dogs treated for naturally occurring CHF secondary to myxomatous mitral valve disease at a multilocation primary care veterinary hospital between 2008 and 2013. PROCEDURES Electronic medical records were reviewed to identify dogs with confirmed CHF secondary to myxomatous mitral valve disease and collect information on patient care, survival time, and pcDVM revenue. Data were compared between dogs that received collaborative care from the pcDVM and a BCVC and dogs that received care from the pcDVM alone. RESULTS Dogs that received collaborative care had a longer median survival time (254 days) than did dogs that received care from the pcDVM alone (146 days). A significant positive correlation was identified between pcDVM revenue and survival time for dogs that received collaborative care (ie, the longer the dog survived, the greater the pcDVM revenue generated from caring for that patient). CONCLUSIONS AND CLINICAL RELEVANCE Findings suggested that collaborative care provided to small-breed dogs with CHF by a BCVC and pcDVM could result in survival benefits for affected dogs and increased revenue for pcDVMs, compared with care provided by a pcDVM alone. PMID:27308884

  19. Methamphetamine-Associated Congestive Heart Failure: Increasing Prevalence and Relationship of Clinical Outcomes to Continued Use or Abstinence.

    Science.gov (United States)

    Sliman, Sean; Waalen, Jill; Shaw, David

    2016-10-01

    The purpose of this study was to determine the prevalence of methamphetamine-associated congestive heart failure (MAC) and to evaluate the relationship between methamphetamine abuse and EF and functional status over time. A retrospective review of records from 2009 to 2014 was carried out. Prevalence of methamphetamine abuse among all patients admitted with CHF was calculated for each of the 6 years of the study (n = 141) and was compared with prevalence of cocaine abuse and alcohol abuse. For patients with two or more admissions during the entire time period, the trajectories of NYHA functional class and EF over time were determined (n = 58). MAC has significantly increased from 1.8 to 5.6 % of total CHF patients admitted (n = 3705). Among patients who stopped using methamphetamine, NYHA functional class significantly improved, while among patients who continued methamphetamine use, NYHA was significantly worsened (p < 0.001). Significantly more patients with improved EF stopped using methamphetamine than continued (p = 0.05). There was a significant increase in the prevalence of MAC during the study period for all CHF patients admitted in our hospital system. Continued methamphetamine use is associated with worsening functional status, while cessation of methamphetamine is associated with improvement in functional status.

  20. Intervention Effect of Jianxin Decoction (健心汤) on Serum Cytokine Level of Congestive Heart Failure Patients

    Institute of Scientific and Technical Information of China (English)

    赵海滨; 沈承玲

    2004-01-01

    Objective: To investigate the intervention effect of Jianxin Decoction (健心汤, JXD) on the cytokine level in serum of patients with congestive heart failure (CHF). Methods: Sixty-six patients with CHF were randomly divided into the control group (n = 33) and the trial group (n = 33). The control group received conventional treatment, and the trial group was treated with conventional therapy plus JXD for 4 weeks. Before and after treatment, tumor necrosis factor-α( (TNF-α), interleukin-6 (IL-6) and nitrogen monoxide (NO) in serum and cardiac function were determined. Results: After treatment, the levels of TNF-α,IL-6 and NO were significantly lower than those before treatment (P<0. 05, or P<0. 01) in the two groups, and the lowering degree of the indices in the trial group was more significantly reduced than that in the control group (P<0.05). And cardiac functions in both groups were improved significantly (P<0.05, or P<0.01). Conclusion: JXD could prevent and reverse ventricular remodeling so as to ameliorate cardiac function throuah reaulatina the levels of cytokines.

  1. Intervention Effect of Jianxin Decoction(健心汤) on Serum Cytokine Level of Congestive Heart Failure Patients

    Institute of Scientific and Technical Information of China (English)

    赵海滨; 沈承玲

    2004-01-01

    Objective: To investigate the intervention effect of Jianxin Decoction (健心汤, JXD) on the cytokine level in serum of patients with congestive heart failure (CHF). Methods: Sixty-six patients with CHF were randomly divided into the control group (n=33) and the trial group (n=33). The control group received conventional treatment, and the trial group was treated with conventional therapy plus JXD for 4weeks. Before and after treatment, tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6) and nitrogen monoxide (NO) in serum and cardiac function were determined. Results: After treatment, the levels of TNF-α,IL-6 and NO were significantly lower than those before treatment (P<0.05, or P<0. 01) in the two groups,and the lowering degree of the indices in the trial group was more significantly reduced than that in the control group (P<0. 05). And cardiac functions in both groups were improved significantly (P < 0.05, or P <0.01). Conclusion: JXD could prevent and reverse ventricular remodeling so as to ameliorate cardiac function through regulating the levels of cytokines.

  2. Vibrational and thermal characterisation of a new chiral drug under investigation for the therapy of congestive heart failure

    Science.gov (United States)

    Taddei, Paola; Torreggiani, Armida; Fini, Giancarlo

    2002-12-01

    Racemic (5,6-bis 2-methyl propanoic acid-1,2,3,4-tetrahydro-naphtalen-2-yl)-methylammonium chloride, CHF-1035, under clinical investigation for the treatment of congestive heart failure, was here characterised by Raman and IR spectroscopies coupled with thermal analysis (thermogravimetry and differential scanning calorimetry). These techniques proved suitable for investigating the presence of different polymorphic forms, their relative stability and interconversion tendency in relation to industrial manufacturing processes undergone by the drug (i.e. grinding, compression, heating). Crystallisation experiments were carried out and two different CHF-1035 polymorphic forms were identified. Both grinding and heating revealed to cause a polymorphic transformation of the drug crystal form. It was hypothesised that a change in molecular packing occurs in the drug by effect of both treatments. The possible sources of polymorphism were identified in the -OCOCH(CH 3) groups and in the saturated ring. The non-ground sample showed two endothermic transitions; since they are reversible and not due to desolvation processes the system is probably enantiotropic.

  3. Impact of collaborative care on survival time for dogs with congestive heart failure and revenue for attending primary care veterinarians.

    Science.gov (United States)

    Lefbom, Bonnie K; Peckens, Neal K

    2016-07-01

    OBJECTIVE To assess the effects of in-person collaborative care by primary care veterinarians (pcDVMs) and board-certified veterinary cardiologists (BCVCs) on survival time of dogs after onset of congestive heart failure (CHF) and on associated revenue for the attending pcDVMs. DESIGN Retrospective cohort study. ANIMALS 26 small-breed dogs treated for naturally occurring CHF secondary to myxomatous mitral valve disease at a multilocation primary care veterinary hospital between 2008 and 2013. PROCEDURES Electronic medical records were reviewed to identify dogs with confirmed CHF secondary to myxomatous mitral valve disease and collect information on patient care, survival time, and pcDVM revenue. Data were compared between dogs that received collaborative care from the pcDVM and a BCVC and dogs that received care from the pcDVM alone. RESULTS Dogs that received collaborative care had a longer median survival time (254 days) than did dogs that received care from the pcDVM alone (146 days). A significant positive correlation was identified between pcDVM revenue and survival time for dogs that received collaborative care (ie, the longer the dog survived, the greater the pcDVM revenue generated from caring for that patient). CONCLUSIONS AND CLINICAL RELEVANCE Findings suggested that collaborative care provided to small-breed dogs with CHF by a BCVC and pcDVM could result in survival benefits for affected dogs and increased revenue for pcDVMs, compared with care provided by a pcDVM alone.

  4. Respiratory sound energy and its distribution patterns following clinical improvement of congestive heart failure: a pilot study

    Directory of Open Access Journals (Sweden)

    Gruber Karen N

    2010-01-01

    Full Text Available Abstract Background Although congestive heart failure (CHF patients typically present with abnormal auscultatory findings on lung examination, respiratory sounds are not normally subjected to additional analysis. The aim of this pilot study was to examine respiratory sound patterns of CHF patients using acoustic-based imaging technology. Lung vibration energy was examined during acute exacerbation and after clinical improvement. Methods Respiratory sounds throughout the respiratory cycle were captured using an acoustic-based imaging technique. Twenty-three consecutive CHF patients were imaged at the time of presentation to the emergency department and after clinical improvement. Digital images were created (a larger image represents more homogeneously distributed vibration energy of respiratory sound. Geographical area of the images and respiratory sound patterns were quantitatively analyzed. Data from the CHF patients were also compared to healthy volunteers. Results The median (interquartile range geographical areas of the vibration energy image of acute CHF patients without and with radiographically evident pulmonary edema were 66.9 (9.0 and 64.1(9.0 kilo-pixels, respectively (p p p Conclusions With clinical improvement of acute CHF exacerbations, there was more homogenous distribution of lung vibration energy, as demonstrated by the increased geographical area of the vibration energy image.

  5. Influence of renal dysfunction on clinical outcomes in patients with congestive heart failure complicating acute myocardial infarction.

    Science.gov (United States)

    Kim, Chang Seong; Kim, Min Jee; Kang, Yong Un; Choi, Joon Seok; Bae, Eun Hui; Ma, Seong Kwon; Ahn, Young-Keun; Jeong, Myung Ho; Kim, Young Jo; Cho, Myeong Chan; Kim, Chong Jin; Kim, Soo Wan

    2013-01-01

    The clinical course and medical treatment of patients with congestive heart failure (CHF) complicating acute myocardial infarction (AMI) are not well established, especially in patients with concomitant renal dysfunction. We performed a retrospective analysis of the prospective Korean Acute Myocardial Infarction Registry to assess the medical treatments and clinical outcomes of patients with CHF (Killip classes II or III) complicated by AMI, in the presence or absence of renal dysfunction. Of 13,498 patients with AMI, 2769 (20.5%) had CHF on admission. Compared to CHF patients with preserved renal function, in-hospital mortality and major adverse cardiac events were increased both at 1 month and at 1 year after discharge in patients with renal dysfunction (1154; 41.7%). Postdischarge use of aspirin, betablockers, calcium channel blockers, angiotensin-converting enzyme inhibitors, or angiotensin II receptor blockers and statins significantly reduced the 1-year mortality rate for CHF patients with renal dysfunction; such reduction was not observed for those without renal dysfunction, except in the case of aspirin. Patients with CHF complicating AMI, which is accompanied by renal dysfunction, are at higher risk for adverse cardiovascular outcomes than patients without renal dysfunction. However, they receive fewer medications proven to reduce mortality rates.

  6. Quantitative 1H MR spectroscopy of the brain in patients with congestive heart failure before and after cardiac transplantation

    International Nuclear Information System (INIS)

    To evaluate the effects of cardiac transplantation on the brain in patients with congestive heart failure (CHF), using quantitative 1H MR spectroscopy (1H-MRS). Ten patients with CHF underwent MRI and quantitative 1H-MRS before and 1-2 and 4-9 months after cardiac transplantation. MR spectra were obtained from parietal white matter (PWM) and occipital gray matter (OGM) using PROBE (PROton Brain Exam). Changes in MR signal intensity were evaluated, and the cerebral metabolic concentrations in PWM and OGM were compared. For comparative purposes, 20 normal volunteers were included. No abnormal MR signal intensity was seen in the brain before or after cardiac transplantation. Changes in cerebral metabolic concentrations were observed on 1H-MRS; concentrations of creatine (Cr) in PWM, and of N-acetylacepartate (NAA), Cr and myo-Inositol(mI) in OGM were significantly lower before transplantation. After successful transplantation, Cr levels returned to their normal range in PWM and OGM, while a slightly increase choline (Cho) level was observed in PWM. Cerebral hypoperfusion in CHF can be evaluated using 1H-MRS. MRS may play a substantial role in monitoring the effect of cardiac transplantation

  7. CARDIAC RISK STRATIFICATION IN PATIENTS WITH CONGESTIVE HEART FAILURE: A CATECHOLAMINES-β- ADRENOCEPTOR-cAMP PATHWAY

    Institute of Scientific and Technical Information of China (English)

    Ying-xin Peng; Jiang Shan; Su-jun Zhang; Chun-li Rong; Jun-ping Li; Na Wang; Hao Xue; Shi-ling Zheng; Min Wu

    2005-01-01

    Objective To investigate the stratification risk of catecholamines-β-adrenoceptor (β-AR)-cAMP pathway for cardiogenic death events in patients with congestive heart failure (CHF).Methods A total of 83 identified CHF patients with a baseline and follow-up plasma levels of norepinephrine (NE)and epinephrine (E), lymphocytes β-AR density (Bmax), and intralymphocyte cAMP content in peripheral blood were followed up. Major cardiogenic death events were registered.Results The period between the initial entry and the last follow-up measurement were 51± 16 months, the total duration of clinical follow-up after the last measurement were 14±8 months. During follow-up, 39 patients died of cardiogenic (sudden death 17 patients, worsening heart failure 22 patients). Persistence of high NE, E, and cAMP from baseline to follow-up were confirmed as risk predicting factors of cardiovascular events. Persistence NE above 4.0 nmol/L, E above adverse prognostic predictors. The major cardiogenic death events rates per 100 patients-years were 1.33 and 4.82 in patients with NE below and above 4.0 nmol/L (HR: 2.91; 95% CI: 1.08-7.33; P = 0.015); were 1.42 and 4.36 in the patients with E levels below and above 3.5 nmol/L (HR: 2.64; 95% CI: 1.02-6.41; P = 0.019); were 1.81 and 4.67 in the 0.017), but difference was not significant between the β-AR density below and above median.Conclusions Persistent increase in circulating catecholamines and intralymphocyte cAMP content may increase the long-term mortality in CHF patients.

  8. Dofetilide in patients with congestive heart failure and left ventricular dysfunction: safety aspects and effect on atrial fibrillation. The Danish Investigators of Arrhythmia and Mortality on Dofetilide (DIAMOND) Study Group

    DEFF Research Database (Denmark)

    Møller, M; Torp-Pedersen, C T; Køber, L

    2002-01-01

    INTRODUCTION. Atrial fibrillation is a frequent cause of worsening of symptoms in patients with congestive heart failure. The drugs currently available for maintenance of sinus rhythm all have major side effects. METHODS. In 34 Danish coronary care units, 1518 patients with congestive heart failure...... to sinus rhythm, 78%/43% of patients in the dofetilide/placebo groups remained in sinus rhythm for at least 1 year. There were 25 instances (3%) of torsade de pointes ventricular tachycardia in the dofetilide group and none in the placebo group. CONCLUSION. In patients with congestive heart failure......, dofetilide can effectively convert atrial fibrillation to sinus rhythm and maintain sinus rhythm after conversion. Hospitalization for congestive heart failure is reduced. Dofetilide does not affect mortality. (c)2001 by CHF, Inc....

  9. Acute changes in plasma renin activity, plasma aldosterone concentration and plasma electrolyte concentrations following furosemide administration in patients with congestive heart failure--interrelationships and diuretic response.

    Science.gov (United States)

    Mulder, H; Schopman, W; van der Lely, A J; Schopman, W

    1987-02-01

    We studied the effects of furosemide on plasma renin and plasma aldosterone in 8 patients with mild to moderate congestive heart failure. In particular, we tried to correlate these effects with changes in plasma electrolyte concentrations and with the diuretic response on furosemide. We concluded that the diuretic response in patients with congestive heart failure is not dependent on the initial serum renin nor on the initial serum aldosterone concentration. The diuretic response did not correlate either with the changes in serum renin and/or serum aldosterone concentration. Serum renin and serum aldosterone correlated mutually before and after intravenous furosemide. We confirmed the inverse correlation between serum sodium and serum renin. SeNa and SeK correlated at all times with serum aldosterone; SeCl correlated with serum aldosterone only before intravenous furosemide administration. Indirect evidence could be provided that in patients with congestive heart failure a decreased renal blood flow is present, using the urinary beta 2-microglobulin concentration. Aldosterone has again, indirectly, proved to be integrated in the renal magnesium handling. PMID:3549504

  10. Influence of age on the prognostic importance of left ventricular dysfunction and congestive heart failure on long-term survival after acute myocardial infarction. TRACE Study Group

    DEFF Research Database (Denmark)

    Køber, L; Torp-Pedersen, C; Ottesen, M;

    1996-01-01

    The aim of this study was to assess the importance of congestive heart failure and left ventricular (LV) systolic dysfunction after an acute myocardial infarction (AIM) on long-term mortality in different age groups. A total of 7,001 consecutive enzyme-confirmed AMIs (6,676 patients) were screened...... for entry into the TRAndolapril Cardiac Evaluation (TRACE) study. Medical history, echocardiographic estimation of LV systolic function determined as wall motion index, infarct complications, and survival were documented for all patients. To study the importance of congestive heart failure and wall motion......%, and 55%, respectively. The risk ratios (and 95% confidence limits) associated with congestive heart failure in the same 4 age strata were 1.9 (1.3 to 2.9), 2.8 (2.1 to 3.7), 1.8 (1.5 to 2.2) and 1.8 (1.5 to 2.2), respectively. The risk ratios associated with decreasing wall motion index were 6.5 (3...

  11. Congestive Heart Failure With Apparently Preserved Left Ventricular Systolic Function: A 10-Year Observational Study.

    Science.gov (United States)

    El-Menyar, Ayman; Shabana, Adel; Arabi, Abdulrahman; Al-Thani, Hassan; Asaad, Nidal; AlBinALi, Hajar; Singh, Rajvir; Gomaa, Mohammed; Gehani, A

    2015-09-01

    We analyzed the clinical presentation and outcomes (from 2003 to 2013) of heart failure (HF) with apparently normal systolic function (HFPEF). Based on the echocardiographic left ventricular ejection fraction (LVEF), patients were divided into 2 groups, group 1 (<50%) and group 2 (≥50%). Of 2212 patients with HF, 20% were in group 2. Patients in group 2 were more likely to be older, females, Arabs, hypertensive, and obese (P = .001). Patients in group 1 were mostly Asians and had more troponin-T positivity (P = .001). Inhospital cardiac arrest, shock, and deaths were significantly greater in group 1. On multivariate analysis, age, ST-segment elevation myocardial infarction, lack of on-admission β-blockers, and angiotensin-converting enzyme inhibitors use were independent predictors of mortality. HFPEF is associated with less mortality compared to those who presented with reduced LVEF. On admission, use of evidence-based medications could in part predict this difference in the hospital outcome. PMID:25248442

  12. RESIDENT PROGENITOR CARDIAC CELLS IN PATIENTS WITH DILATED CARDIOMYOPATHY AND CONGESTIVE HEART FAILURE

    Directory of Open Access Journals (Sweden)

    T. G. Kulikova

    2014-01-01

    Full Text Available Aim. To study content of resident progenitor cardiomyocytes in endomyocardial biopsy samples of patients with dilated cardiomyopathy (DCM and heart failure (HF at different disease stages and relate it to patient clinical characteristics.Material and methods. Resident progenitor cardiomyocytes were studied in endomyocardial biopsy samples from 14 patients (age from 26 to 52 years old with DCM and HF by immunofluorescence method. Results were analyzed individually for each patient.Results. Resident progenitor cardiomyocytes expressing simultaneously stem cell markers c-kit, MDR-1 and early cardiomyocyte differentiation markers GATA-4 and Nkx2.5 were found in endomyocardial biopsy samples from patients with DCM and HF. Resident progenitor cardiomyocytes detected by these cell markers were found in all patients at all disease stages.Conclusion. Results show that the myocardial regenerative processes exist at all stages of the disease progression.

  13. RESIDENT PROGENITOR CARDIAC CELLS IN PATIENTS WITH DILATED CARDIOMYOPATHY AND CONGESTIVE HEART FAILURE

    Directory of Open Access Journals (Sweden)

    T. G. Kulikova

    2015-09-01

    Full Text Available Aim. To study content of resident progenitor cardiomyocytes in endomyocardial biopsy samples of patients with dilated cardiomyopathy (DCM and heart failure (HF at different disease stages and relate it to patient clinical characteristics.Material and methods. Resident progenitor cardiomyocytes were studied in endomyocardial biopsy samples from 14 patients (age from 26 to 52 years old with DCM and HF by immunofluorescence method. Results were analyzed individually for each patient.Results. Resident progenitor cardiomyocytes expressing simultaneously stem cell markers c-kit, MDR-1 and early cardiomyocyte differentiation markers GATA-4 and Nkx2.5 were found in endomyocardial biopsy samples from patients with DCM and HF. Resident progenitor cardiomyocytes detected by these cell markers were found in all patients at all disease stages.Conclusion. Results show that the myocardial regenerative processes exist at all stages of the disease progression.

  14. Pathology of heart, lung, liver and kidney in broilers under chronic heat stress

    Directory of Open Access Journals (Sweden)

    Worapol Aengwanich

    2005-05-01

    Full Text Available The purpose of this experiment was to investigate pathological changes in broilers under chronic heat stress. Fifteen birds (n = 15, twenty-eight days old were kept at 33 + 1oC environmental temperature for 21 days. While broilers were maintained in environmental temperature at 33 + 1 oC, body temperature, respiratory rate and urine excretion rose. Macroscopic and microscopic lesions of heart, lung, liver and kidney were examined. Right atrium hypertrophy with excessive blood accumulation, heart enlargement and right ventricular hypertrophy were observed in 12 out of 15 broilers (80%. Congestion, edema and hyperemia in lung were present in all broilers. Yellow and pale livers were observed in 4 out of 15 broilers (26.67%. Kidneys were highly affected i.e. generalized edema and hemorrhage in subrenal capsule. Under microscopic examination of heart, massive myofibrillar degeneration with hemorrhage, general fatty degeneration /or/ vacuolation of myofibers and diffused myocarditis containing organisms were found in some areas. The principal histopathologic lesions in the lung were related to vein and arteriole massive congestion. Massive hemorrhage was largely observed in parabronchus and alveoli of all broilers. Liver cells showed “fatty degeneration” with dilation of sinusoid of all broilers. Besides, necrosis with heterophils and lymphocytes was observed in some parts of the liver, especially in the centritubular region. In the kidney, leukocytes such as heterophils accumulated in many inflammatory areas. Fatty degeneration was observed in renal tubular epithelia of all broilers. Glomeruli were damaged. A space between renal papillae increased and accumulated water. Moreover, ureters in 9 out of 15 (60% birds showed sac-like expansion “ureteral pseudobladder”. These sacs were filled with urine and similar to bladder in mammals.

  15. Anemia associated with chronic heart failure: current concepts

    Directory of Open Access Journals (Sweden)

    Shah R

    2013-02-01

    Full Text Available Ravish Shah, Anil K AgarwalDivision of Nephrology, The Ohio State University, Columbus, Ohio, USAAbstract: Anemia is a frequent comorbidity of heart failure and is associated with poor outcomes. Anemia in heart failure is considered to develop due to a complex interaction of iron deficiency, kidney disease, and cytokine production, although micronutrient insufficiency and blood loss may contribute. Currently, treatment of anemia of heart failure lacks clear targets and specific therapy is not defined. Intravenous iron use has been shown to benefit anemic as well as nonanemic patients with heart failure. Treatment with erythropoietin-stimulating agents has been considered alone or in combination with iron, but robust evidence to dictate clear guidelines is not currently available. Available and emerging new agents in the treatment of anemia of heart failure will need to be tested in randomized, controlled studies.Keywords: anemia, heart failure, chronic kidney disease, elderly population

  16. Effects of perindopril on cardiac sympathetic nerve activity in patients with congestive heart failure: comparison with enalapril

    Energy Technology Data Exchange (ETDEWEB)

    Kasama, Shu; Toyama, Takuji; Suzuki, Tadashi; Kurabayashi, Masahiko [Gunma University School of Medicine, Department of Cardiovascular Medicine, Maebashi, Gunma (Japan); Kumakura, Hisao; Takayama, Yoshiaki; Ichikawa, Shuichi [Cardiovascular Hospital of Central Japan, Department of Internal Medicine, Gunma (Japan)

    2005-08-01

    The production of aldosterone in the heart is suppressed by the angiotensin-converting enzyme (ACE) inhibitor perindopril in patients with congestive heart failure (CHF). Moreover, perindopril has been reported to have more cardioprotective effects than enalapril. Forty patients with CHF [left ventricular ejection fraction (LVEF) <45%; mean 33{+-}7%] were randomly assigned to perindopril (2 mg/day; n=20) or enalapril (5 mg/day; n=20). All patients were also treated with diuretics. The delayed heart/mediastinum count (H/M) ratio, delayed total defect score (TDS) and washout rate (WR) were determined from {sup 123}I-meta-iodobenzylguanidine (MIBG) images, and plasma brain natriuretic peptide (BNP) concentrations were measured before and 6 months after treatment. The left ventricular end-diastolic volume (LVEDV), left ventricular end-systolic volume (LVESV) and LVEF were also determined by echocardiography. After treatment, in patients receiving perindopril, TDS decreased from 39{+-}10 to 34{+-}9 (P<0.01), H/M ratios increased from 1.62{+-}0.27 to 1.76{+-}0.29 (P<0.01), WR decreased from 50{+-}14% to 42{+-}14% (P<0.05) and plasma BNP concentrations decreased from 226{+-}155 to 141{+-}90 pg/ml (P<0.0005). In addition, the LVEDV decreased from 180{+-}30 to 161{+-}30 ml (P<0.05) and the LVESV decreased from 122{+-}35 to 105{+-}36 ml (P<0.05). Although the LVEF tended to increase, the change was not statistically significant (from 33{+-}8% to 36{+-}12%; P=NS). On the other hand, there were no significant changes in these parameters in patients receiving enalapril. Plasma BNP concentrations, {sup 123}I-MIBG scintigraphic and echocardiographic parameters improved after 6 months of perindopril treatment. These findings indicate that perindopril treatment can ameliorate the cardiac sympathetic nerve activity and the left ventricular performance in patients with CHF. (orig.)

  17. Impaired mitochondrial function in chronically ischemic human heart

    DEFF Research Database (Denmark)

    Stride, Nis Ottesen; Larsen, Steen; Hey-Mogensen, Martin;

    2013-01-01

    , and finally to assess myocardial antioxidant levels. Mitochondrial respiration in biopsies from ischemic and nonischemic regions from the left ventricle of the same heart was compared in nine human subjects. Maximal oxidative phosphorylation capacity in fresh muscle fibers was lower in ischemic compared.......05), and the levels of antioxidant protein expression was lower. Diminished mitochondrial respiration capacity and excessive ROS production demonstrate an impaired mitochondrial function in ischemic human heart muscle. No chronic ischemic preconditioning effect was found....

  18. Predictors of sudden death and death from pump failure in congestive heart failure are different. Analysis of 24 h Holter monitoring, clinical variables, blood chemistry, exercise test and radionuclide angiography

    DEFF Research Database (Denmark)

    Madsen, B K; Rasmussen, Verner; Hansen, J F

    1997-01-01

    One hundred and ninety consecutive patients discharged with congestive heart failure were examined with clinical evaluation, blood chemistry, 24 h Holter monitoring, exercise test and radionuclide angiography. Median left ventricular ejection fraction was 0.30, 46% were in New York Heart Associat......One hundred and ninety consecutive patients discharged with congestive heart failure were examined with clinical evaluation, blood chemistry, 24 h Holter monitoring, exercise test and radionuclide angiography. Median left ventricular ejection fraction was 0.30, 46% were in New York Heart...

  19. Novel application of multi dynamic trend analysis as a sensitive tool for detecting the effects of aging and congestive heart failure on heart rate variability

    Science.gov (United States)

    Lin, Yu-Cheng; Lin, Yu-Hsuan; Lo, Men-Tzung; Peng, Chung-Kang; Huang, Norden E.; Yang, Cheryl C. H.; Kuo, Terry B. J.

    2016-02-01

    The complex fluctuations in heart rate variability (HRV) reflect cardiac autonomic modulation and are an indicator of congestive heart failure (CHF). This paper proposes a novel nonlinear approach to HRV investigation, the multi dynamic trend analysis (MDTA) method, based on the empirical mode decomposition algorithm of the Hilbert-Huang transform combined with a variable-sized sliding-window method. Electrocardiographic signal data obtained from the PhysioNet database were used. These data were from subjects with CHF (mean age = 59.4 ± 8.4), an age-matched elderly healthy control group (59.3 ± 10.6), and a healthy young group (30.3 ± 4.8); the HRVs of these subjects were processed using the MDTA method, time domain analysis, and frequency domain analysis. Among all HRV parameters, the MDTA absolute value slope (MDTS) and MDTA deviation (MDTD) exhibited the greatest area under the curve (AUC) of the receiver operating characteristics in distinguishing between the CHF group and the healthy controls (AUC = 1.000) and between the healthy elderly subject group and the young subject group (AUC = 0.834 ± 0.067 for MDTS; 0.837 ± 0.066 for MDTD). The CHF subjects presented with lower MDTA indices than those of the healthy elderly subject group. Furthermore, the healthy elderly subjects exhibited lower MDTA indices than those of the young controls. The MDTA method can adaptively and automatically identify the intrinsic fluctuation on variable temporal and spatial scales when investigating complex fluctuations in the cardiac autonomic regulation effects of aging and CHF.

  20. Comparison of Ventricular Electrophysiological Effects of Amiodarone in Canine Models With Congestive Heart Failure and Normal Dogs

    Institute of Scientific and Technical Information of China (English)

    Shuxian Zhou; Yuling Zhang; Juan Lei; Wei Wu; Xuming Zhang

    2008-01-01

    Objectives This study compared the effects of amiodarone on ventricular electrophysiological properties in normal dogs and CHF dogs.Methods Dogs(n=44) were randomized into four groups:Group 1(n=10)was the control.Group 2(n=10) was given amiodarone orally 300 mg·d-1 for4 to 5 weeks.Group 3(n=12)was the congestive heart failure(CHF)models induced by right ventricular rapid pacing(240 pulses·rain-1 for 4 to 5 weeks).Group 4 (n=12) was the CHF models given amiodarone orally 300 mg·d-1 for 4 to 5 weeks.The ventricular electrophysiological variables were evaluated by standard electric stimulation and monophasic action potential(MAP)recording.Results Amiodarone prolonged sinus cycle length(SCL),intra-ventricular conduction time(IVCT),MAP duration(MAPD90),ventricular effective period(VERP),ventricular activation time(VAT)and ventficular recovery time(VRT)without significant effects on the ratio of VERP to MAPD90 (VERP/MAPD90),ventricular fibrillation threshold(VFT),the dispersion of VRT(VRTD),and ventricular late repolarization duration(VLRD)in normal dogs.However,amiodarone did not further prolong the prolonged SCL,MAPD90,VERP,VAT and VRT,but further prolonged IVCT in CHF dogs.Amiodarone normalized the abnormal ventficular electrophysiological properties in CHF dogs as manifested by increasing the decreased VERP/MAPD90 and VFT,shortening the prolonged VLRD,and decreasing the increased VRTD.Amiodarone did not worsen the hemodynamic parameters in normal and CHF dogs.Conclusions Amiodarone had different effects on ventricular electrophysiological properties in normal and CHF dogs.The favorable effects of amiodarone in normalizing some abnormal cardiac electrophysiological properties in CHF models may have potential value on the prevention and treatment of ventricular arrhythmias and sudden cardiac death in CHF.

  1. Relationship of the plasma urotensin Ⅱ with proadrenomedullin N-terminal 20 peptide in patients with congestive heart failure

    Institute of Scientific and Technical Information of China (English)

    钟萍; 李志樑; 吴宏超; 唐朝枢; 陆青

    2003-01-01

    Objective: To understand the role of urotensin Ⅱ(UⅡ) and proadrenomedullin N-terminal 20 peptide (PAMP), a fragment of proadrenomedullin (proADM) possessing biological activity, in the pathophysiological process of congestive heart failure (CHF) by observing the variation of their plasma levels and exploring their interrelations. Methods: Plasma UⅡ and PAMP levels were measured by radioimmunoassay in 52 patients with CHF and 14 healthy subjects. Left ventricular ejection fraction (LVEF) and the ratio of E/A were determined by echocardiography. Results: The plasma UⅡ level was significantly lower in patients with CHF than the healthy subjects (1.5±1.0 pg/ml vs 4.3±1.2 pg/ml, P<0.05), while plasma PAMP level was significantly higher in the former group (30.6±5.8 pg/ml vs 21.0±6.6 pg/ml P<0.05). The levels of UⅡ and PAMP were parallel with the severity of CHF, and significant correlation of plasma levels of UⅡ with LVEF (r=0.530, P=0.000) and the ratio of E/A (r=0.618, P=0.000) was noted. LVEF and ratio of E/A were found to be inversely correlated with plasma PAMP levels in the patients (r=-0.568, P=0.000; r=-0.350, P=0.004). Also found was the significant correlation between plasma UⅡ and PAMP levels (r=-0.528, P=0.000). The treatment of the patients resulted in increased plasma UⅡ levels and lowered PAMP levels. Conclusion: The variations of plasma levels of UⅡ and PAMP are parallel with the severity of CHF, suggesting their cooperative actions in the pathophysiology of CHF.

  2. New Results in Magnitude and Sign Correlations in Heartbeat Fluctuations for Healthy Persons and Congestive Heart Failure (CHF) Patients

    Science.gov (United States)

    Diosdado, A. Muñoz; Cruz, H. Reyes; Hernández, D. Bueno; Coyt, G. Gálvez; González, J. Arellanes

    2008-08-01

    Heartbeat fluctuations exhibit temporal structure with fractal and nonlinear features that reflect changes in the neuroautonomic control. In this work we have used the detrended fluctuation analysis (DFA) to analyze heartbeat (RR) intervals of 54 healthy subjects and 40 patients with congestive heart failure during 24 hours; we separate time series for sleep and wake phases. We observe long-range correlations in time series of healthy persons and CHF patients. However, the correlations for CHF patients are weaker than the correlations for healthy persons; this fact has been reported by Ashkenazy et al. [1] but with a smaller group of subjects. In time series of CHF patients there is a crossover, it means that the correlations for high and low frequencies are different, but in time series of healthy persons there are not crossovers even if they are sleeping. These crossovers are more pronounced for CHF patients in the sleep phase. We decompose the heartbeat interval time series into magnitude and sign series, we know that these kinds of signals can exhibit different time organization for the magnitude and sign and the magnitude series relates to nonlinear properties of the original time series, while the sign series relates to the linear properties. Magnitude series are long-range correlated, while the sign series are anticorrelated. Newly, the correlations for healthy persons are different that the correlations for CHF patients both for magnitude and sign time series. In the paper of Ashkenazy et al. they proposed the empirical relation: αsign≈1/2(αoriginal+αmagnitude) for the short-range regime (high frequencies), however, we have found a different relation that in our calculations is valid for short and long-range regime: αsign≈1/4(αoriginal+αmagnitude).

  3. Effect of obesity and being overweight on long-term mortality in congestive heart failure: influence of left ventricular systolic function

    DEFF Research Database (Denmark)

    Gustafsson, Finn; Kragelund, Charlotte B; Torp-Pedersen, Christian;

    2004-01-01

    AIMS: Previous studies have suggested that a high body mass index (BMI) is associated with an improved outcome in congestive heart failure (CHF). However, the studies addressing this problem have not included enough patients with non-systolic heart failure to evaluate how left ventricular systoli.......01-1.45)]. CONCLUSION: Increasing BMI in CHF is associated with a lower mortality, but the influence is complex and depends on left ventricular systolic function. Hence, in patients with systolic dysfunction obesity may indicate an increased risk.......AIMS: Previous studies have suggested that a high body mass index (BMI) is associated with an improved outcome in congestive heart failure (CHF). However, the studies addressing this problem have not included enough patients with non-systolic heart failure to evaluate how left ventricular systolic...... function interacts with obesity on prognosis in CHF. The aim of this study was to evaluate how BMI influences mortality in patients hospitalized with CHF, and to address in particular whether the effect of BMI is influenced by left ventricular (LV) systolic function. METHODS AND RESULTS: Retrospective...

  4. Prognostic implication of physical signs of congestion in acute heart failure patients and its association with steady-state biomarker levels.

    Directory of Open Access Journals (Sweden)

    Sayoko Negi

    Full Text Available BACKGROUND: Congestive physical findings such as pulmonary rales and third heart sound (S3 are hallmarks of acute heart failure (AHF. However, their role in outcome prediction remains unclear. We sought to investigate the association between congestive physical findings upon admission, steady-state biomarkers at the time of discharge, and long-term outcomes in AHF patients. METHODS: We analyzed the data of 133 consecutive AHF patients with an established diagnosis of ischemic or non-ischemic (dilated or hypertrophic cardiomyopathy, admitted to a single-center university hospital between 2006 and 2010. The treating physician prospectively recorded major symptoms and congestive physical findings of AHF: paroxysmal nocturnal dyspnea, orthopnea, pulmonary rales, jugular venous distension (JVD, S3, and edema. The primary endpoint was defined as rehospitalization for HF. RESULTS: Majority (63.9% of the patients had non-ischemic etiology and, at the time of admission, S3 was seen in 69.9% of the patients, JVD in 54.1%, and pulmonary rales in 43.6%. The mean follow-up period was 726 ± 31 days. Patients with pulmonary rales (p < 0.001 and S3 (p  =  0.011 had worse readmission rates than those without these findings; the presence of these findings was also associated with elevated troponin T (TnT levels at the time of discharge (odds ratio [OR] 2.8; p  =  0.02 and OR 2.6; p  =  0.05, respectively. CONCLUSION: Pulmonary rales and S3 were associated with inferior readmission rates and elevated TnT levels on discharge. The worsening of the readmission rate owing to congestive physical findings may be a consequence of on-going myocardial injury.

  5. Bone marrow dysfunction in chronic heart failure patients

    NARCIS (Netherlands)

    Westenbrink, B. Daan; Voors, Adriaan A.; de Boer, Rudolf A.; Schuringa, Jan J.; Klinkenberg, Theo; van der Harst, Pim; Vellenga, Edo; van Veldhuisen, Dirk J.; van Gilst, Wiek H.

    2010-01-01

    To investigate whether chronic heart failure (CHF) is associated with a general dysfunction of the haematopoietic compartment. Bone marrow was obtained during coronary artery bypass graft surgery from 20 patients with CHF (age 67 +/- 6 years, 75% NYHA class >= III, LVEF 32 +/- 6%), and 20 age- and g

  6. Chronic obstructive pulmonary disease in patients admitted with heart failure

    DEFF Research Database (Denmark)

    Iversen, K K; Kjaergaard, J; Akkan, D;

    2008-01-01

    OBJECTIVE: Chronic obstructive pulmonary disease (COPD) is an important differential diagnosis in patients with heart failure (HF). The primary aims were to determine the prevalence of COPD and to test the accuracy of self-reported COPD in patients admitted with HF. Secondary aims were to study a...

  7. Complement activation, endothelial dysfunction, insulin resistance and chronic heart failure

    DEFF Research Database (Denmark)

    Bjerre, M.; Kistorp, C.; Hansen, T.K.;

    2010-01-01

    Objectives. Patients with chronic heart failure (CHF) have an exaggerated immune response, endothelial damage/dysfunction, and increased risk of diabetes mellitus (DM). The inter-relationship(s) between indices of complement activation (soluble membrane attack complex, sMAC), inflammation (hs......, IR was an independent predictor of sMAC in the CHF group beta = 0.37 (p complement system and thus...

  8. The case for statin therapy in chronic heart failure

    NARCIS (Netherlands)

    van der Harst, Pim; Boehm, Michael; van Gilst, Wiek H.; van Veldhuisen, Dirk J.

    2008-01-01

    Both primary and secondary prevention studies have provided a wealth of evidence that statin therapy effectively reduces cardiovascular events. However, this general statement on the efficacy and safety of statin treatment has not been validated in patients with chronic heart failure (CHF). Recently

  9. Discrimination power of long-term heart rate variability measures for Chronic Heart Failure detection

    OpenAIRE

    Melillo, Paolo; Fusco, Roberta; Sansone, Mario; Bracale, Marcello; Pecchia, Leandro

    2011-01-01

    The aim of this study was to investigate the discrimination power of standard long-term Heart Rate Variability (HRV) measures for the diagnosis of Chronic Heart Failure (CHF). We performed a retrospective analysis on 4 public Holter databases, analyzing the data of 72 normal subjects and 44 patients suffering from CHF. To assess the discrimination power of HRV measures, we adopted an exhaustive search of all possible combinations of HRV measures and we developed classifiers based on Classi...

  10. Therapeutic options in chronic heart failure. Findings on chest X-ray

    International Nuclear Information System (INIS)

    The contribution covers drugless therapeutic options for chronic heart failure: the implantable cardioverter/defibrillator (ICD), the cardiac resynchronization therapy (CRT), the interventional catheter treatment of functional mitral insufficiency, and mechanical heart supporting systems and heart transplantation.

  11. Remote patient monitoring in chronic heart failure.

    Science.gov (United States)

    Palaniswamy, Chandrasekar; Mishkin, Aaron; Aronow, Wilbert S; Kalra, Ankur; Frishman, William H

    2013-01-01

    Heart failure (HF) poses a significant economic burden on our health-care resources with very high readmission rates. Remote monitoring has a substantial potential to improve the management and outcome of patients with HF. Readmission for decompensated HF is often preceded by a stage of subclinical hemodynamic decompensation, where therapeutic interventions would prevent subsequent clinical decompensation and hospitalization. Various methods of remote patient monitoring include structured telephone support, advanced telemonitoring technologies, remote monitoring of patients with implanted cardiac devices such as pacemakers and defibrillators, and implantable hemodynamic monitors. Current data examining the efficacy of remote monitoring technologies in improving outcomes have shown inconsistent results. Various medicolegal and financial issues need to be addressed before widespread implementation of this exciting technology can take place. PMID:23018667

  12. Heart Failure Update: Chronic Disease Management Programs.

    Science.gov (United States)

    Fountain, Lorna B

    2016-03-01

    With high mortality and readmission rates among patients with heart failure (HF), multiple disease management models have been and continue to be tested, with mixed results. Early postdischarge care improves outcomes for patients. Telemonitoring also can assist in reducing mortality and HF-related hospitalizations. Office-based team care improves patient outcomes, with important components including rapid access to physicians, partnerships with clinical pharmacists, education, monitoring, and support. Pay-for-performance measures developed for HF, primarily use of angiotensin-converting enzyme inhibitors and beta blockers, also improve patient outcomes, but the influence of adherence to other measures has been minimal. Evaluating comorbid conditions, including diabetes and hypertension, and making drug adjustments for patients with HF to include blood pressure control and use of metformin, when possible, can reduce mortality and morbidity.

  13. Heart Failure Update: Chronic Disease Management Programs.

    Science.gov (United States)

    Fountain, Lorna B

    2016-03-01

    With high mortality and readmission rates among patients with heart failure (HF), multiple disease management models have been and continue to be tested, with mixed results. Early postdischarge care improves outcomes for patients. Telemonitoring also can assist in reducing mortality and HF-related hospitalizations. Office-based team care improves patient outcomes, with important components including rapid access to physicians, partnerships with clinical pharmacists, education, monitoring, and support. Pay-for-performance measures developed for HF, primarily use of angiotensin-converting enzyme inhibitors and beta blockers, also improve patient outcomes, but the influence of adherence to other measures has been minimal. Evaluating comorbid conditions, including diabetes and hypertension, and making drug adjustments for patients with HF to include blood pressure control and use of metformin, when possible, can reduce mortality and morbidity. PMID:26974003

  14. The change of cerebral blood flow after heart transplantation in congestive heart failure: a voxel-based and automatic VOl analysis of Tc-99m ECD SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Hong, I. K.; Kim, J. J.; Lee, C. H.; Lim, K. C.; Moon, D. H.; Rhu, J. S.; Kim, J. S. [Asan Medical Center, Seoul (Korea, Republic of)

    2007-07-01

    To investigate the change of global and regional cerebral blood flow after heart transplantation (HT) in congestive heart failure (CHF) patients. Twenty-one patients with CHF who underwent HT (45{+-}12 yrs, M/F=19/2) and 10 healthy volunteers (39{+-}13 yrs, M/F = 7/3) were prospectively included. All patients underwent echocardiography and radionuclide angiography including brain and aorta with brain SPECT which was performed after iv bolus injection of Tc-99m ECD (740MBq) before (175{+-}253 days) and after (129{+-}82 days) HT. Patients were divided into two groups according to the interval between HT and postoperative SPECT [early follow-up (f/u): <6 mo, n=14; late f/u: >6 mo, n=7]. Global CBF (gCBF) of bilateral hemispheres were calculated by Patlak graphical analysis. Absolute rCBF map was obtained from brain SPECT by Lassen's correction algorithm. Age-corrected voxel-based analysis using SPM2 and automatic VOl analysis were performed to assess the rCBF change. Cardiac ejection fraction of all patients improved after HT (20.8%{yields}64.0%). gCBF was reduced compared to normal before HT (35.7{+-}3.9 vs. 49.1{+-}3.0 ml/100g/min; p<0.001) and improved postoperatively (46.6{+-}5.4, p<0.001). The preoperative gCBFs of early and late f/u group were not different (34.6{+-}3.2 vs. 38.0{+-}4.4, p=0.149) but postoperative gCBF (43.9{+-}3.7) of late f/u group was higher than those (52.0{+-}4.0) of early f/u group (p<0.001). On voxel-based analysis, preoperative rCBF was reduced in entire brain but most severely in bilateral superior and inferior frontal cortex, supplementary motor area, precuneus and anterior cingulum, compared to normals (uncorrected p<0.001). After HT, rCBF of these areas improved more significantly in late f/u group than in early f/u group but still lower than normals. Global CBF was significantly reduced in CHF patients and improved after HT. rCBFs of the frontal cortex, precuneus and cingulum were most severely reduced and slowly improved after

  15. Determination of Sample Entropy and Fuzzy Measure Entropy Parameters for Distinguishing Congestive Heart Failure from Normal Sinus Rhythm Subjects

    Directory of Open Access Journals (Sweden)

    Lina Zhao

    2015-09-01

    Full Text Available Entropy provides a valuable tool for quantifying the regularity of physiological time series and provides important insights for understanding the underlying mechanisms of the cardiovascular system. Before any entropy calculation, certain common parameters need to be initialized: embedding dimension m, tolerance threshold r and time series length N. However, no specific guideline exists on how to determine the appropriate parameter values for distinguishing congestive heart failure (CHF from normal sinus rhythm (NSR subjects in clinical application. In the present study, a thorough analysis on the selection of appropriate values of m, r and N for sample entropy (SampEn and recently proposed fuzzy measure entropy (FuzzyMEn is presented for distinguishing two group subjects. 44 long-term NRS and 29 long-term CHF RR interval recordings from http://www.physionet.org were used as the non-pathological and pathological data respectively. Extreme (>2 s and abnormal heartbeat RR intervals were firstly removed from each RR recording and then the recording was segmented with a non-overlapping segment length N of 300 and 1000, respectively. SampEn and FuzzyMEn were performed for each RR segment under different parameter combinations: m of 1, 2, 3 and 4, and r of 0.10, 0.15, 0.20 and 0.25 respectively. The statistical significance between NSR and CHF groups under each combination of m, r and N was observed. The results demonstrated that the selection of m, r and N plays a critical role in determining the SampEn and FuzzyMEn outputs. Compared with SampEn, FuzzyMEn shows a better regularity when selecting the parameters m and r. In addition, FuzzyMEn shows a better relative consistency for distinguishing the two groups, that is, the results of FuzzyMEn in the NSR group were consistently lower than those in the CHF group while SampEn were not. The selections of m of 2 and 3 and r of 0.10 and 0.15 for SampEn and the selections of m of 1 and 2 whenever r (herein

  16. The analysis of CT and 3D-VRCT images in highly elderly patients with congestive heart failure/pulmonary edema

    International Nuclear Information System (INIS)

    In 20 elderly patients with congestive heart failure, the pulmonary/mediastinal findings of MPR images with 3D volume rendering (VR) CT were reviewed. Diffuse ground-glass areas and/or consolidation were observed along the bronchovascular bundle and dorsal dependent areas. Vascular enlargement of pulmonary vessels and interlobular septal thickenings were also observed The increased attenuation with a gravitaional anteroposterior (ventrodorsal) gradient was more apparent on sagittal reconstructed image than conventional axial images. 3DVR CT can demonstrate the inter-and intralobular septal lines predominating not only in the anterior portions of the middle and lingular lobe, but also the apical and lung base areas. (author)

  17. Effect of ketanserin on hemodynamics, plasma-catecholamine concentrations, and serotonin uptake by platelets in volunteers and patients with congestive heart failure

    OpenAIRE

    Grobecker, H; Gessler, I.; Delius, W.; Dominiak, P; Kees, Frieder K.

    1985-01-01

    Ketanserin, which preferentially blocks 5-HT2-serotonergic receptors, was injected intravenously (i.v.) to patients with congestive heart failure in a bolus dose of 10 mg, followed by an i.v. infusion of 3 mg/h over a period of 4 h. The drug caused a decrease in total peripheral resistance and, conversely, an increase in stroke volume. Right atrial and pulmonary artery pressures were decreased. Plasma noradrenaline rose twofold over the basal levels shortly after injection, but showed a disti...

  18. Tolvaptan Improves the Long-Term Prognosis in Patients With Congestive Heart Failure With Preserved Ejection Fraction as Well as in Those With Reduced Ejection Fraction.

    Science.gov (United States)

    Imamura, Teruhiko; Kinugawa, Koichiro

    2016-09-28

    Tolvaptan (TLV), an arginine vasopressin type 2 antagonist, has been shown to play a role in ameliorating symptomatic congestion and normalizing diluted hyponatremia in patients with congestive heart failure (HF). However, most evidence was derived from patients with HF with reduced ejection fraction (HFrEF), and the clinical efficacy of TLV in patients with HF with preserved ejection fraction (HFpEF) remains uncertain. In this study, we retrospectively enrolled 60 in-hospital patients with stage D HF, who had received TLV to treat symptomatic congestion at our institute between 2011 and 2013. As a control group, we also enrolled 60 background-matched HF patients who did not receive TLV therapy. Patients with HFpEF (n = 29), whose left ventricular ejection fraction was > 45%, had higher age and a lower urine aquaporin-2 level relative to the plasma arginine vasopressin concentration compared with those with HFrEF (n = 91). TLV therapy significantly reduced the 2-year readmission rates in both the HFrEF and HFpEF populations (P < 0.05 for both), indicating that TLV therapy may improve the long-term prognosis not only in patients with HFrEF but also in those with HFpEF.

  19. ST2 and patient prognosis in chronic heart failure.

    Science.gov (United States)

    Bayes-Genis, Antoni; Zhang, Yuhui; Ky, Bonnie

    2015-04-01

    Biomarkers of cardiovascular diseases are indispensable tools for diagnosis and prognosis, and the use of several biomarkers is now considered the standard of care. New markers continue to be developed, but few prove to be substantially better than established markers. Suppression of tumorigenicity 2 (ST2) is a marker of cardiomyocyte stress and fibrosis that provides incremental value to natriuretic peptides for risk stratification of patients with a wide spectrum of cardiovascular diseases. On the basis of all available data, the 2013 American College of Cardiology and American Heart Association guidelines now recommend measurement of ST2 for additive risk stratification in patients with acute or chronic ambulatory heart failure (HF). This report provides an up-to-date overview of the clinical studies that led to the endorsement of ST2 as a cardiovascular prognostic marker in chronic HF. The presented data suggest that the addition of ST2 to a model that includes established mortality risk factors, including natriuretic peptides, substantially improves the risk stratification for death and HF hospitalization in patients with HF. ST2's prognostic value remains strong even in the subset of patients with renal insufficiency and is superior to other remodeling-fibrosis biomarkers currently being evaluated. In conclusion, these results have been repeatedly validated; thus, ST2 could be rapidly incorporated into clinical practice for risk prediction. Indeed, the body of evidence supporting the use of ST2 in chronic HF stratification continues to grow, with consistent data from cohorts around the world in single-center (Barcelona, Brussels, and San Diego cohorts) and multicenter (Penn Heart Failure Study [PHFS] and Muerte Subita en Insuficiencia Cardiac [MUSIC]) studies and in post hoc studies from clinical trials (Prospective Randomized Amlodipine Survival Evaluation 2 [PRAISE-2], Heart Failure: A Controlled Trial Investigating Outcomes of Exercise Training [HF

  20. ST2 and patient prognosis in chronic heart failure.

    Science.gov (United States)

    Bayes-Genis, Antoni; Zhang, Yuhui; Ky, Bonnie

    2015-04-01

    Biomarkers of cardiovascular diseases are indispensable tools for diagnosis and prognosis, and the use of several biomarkers is now considered the standard of care. New markers continue to be developed, but few prove to be substantially better than established markers. Suppression of tumorigenicity 2 (ST2) is a marker of cardiomyocyte stress and fibrosis that provides incremental value to natriuretic peptides for risk stratification of patients with a wide spectrum of cardiovascular diseases. On the basis of all available data, the 2013 American College of Cardiology and American Heart Association guidelines now recommend measurement of ST2 for additive risk stratification in patients with acute or chronic ambulatory heart failure (HF). This report provides an up-to-date overview of the clinical studies that led to the endorsement of ST2 as a cardiovascular prognostic marker in chronic HF. The presented data suggest that the addition of ST2 to a model that includes established mortality risk factors, including natriuretic peptides, substantially improves the risk stratification for death and HF hospitalization in patients with HF. ST2's prognostic value remains strong even in the subset of patients with renal insufficiency and is superior to other remodeling-fibrosis biomarkers currently being evaluated. In conclusion, these results have been repeatedly validated; thus, ST2 could be rapidly incorporated into clinical practice for risk prediction. Indeed, the body of evidence supporting the use of ST2 in chronic HF stratification continues to grow, with consistent data from cohorts around the world in single-center (Barcelona, Brussels, and San Diego cohorts) and multicenter (Penn Heart Failure Study [PHFS] and Muerte Subita en Insuficiencia Cardiac [MUSIC]) studies and in post hoc studies from clinical trials (Prospective Randomized Amlodipine Survival Evaluation 2 [PRAISE-2], Heart Failure: A Controlled Trial Investigating Outcomes of Exercise Training [HF

  1. Experiences of air travel in patients with chronic heart failure

    OpenAIRE

    Ingle, Lee; Hobkirk, James; Damy, Thibaud; Nabb, Samantha; Clark, Andrew L.; Cleland, John G F

    2012-01-01

    Aim To conduct a survey in a representative cohort of ambulatory patients with stable, well managed chronic heart failure (CHF) to discover their experiences of air travel. Methods An expert panel including a cardiologist, an exercise scientist, and a psychologist developed a series of survey questions designed to elicit CHF patients' experiences of air travel (Appendix 1). The survey questions, information sheets and consent forms were posted out in a self-addressed envelope to 1293 CHF pati...

  2. Junctional Bradycardia as Early Sign of Digoxin Toxicity in a Premature Infant with Congestive Heart Failure due to a Left to Right Shunt.

    Science.gov (United States)

    Dasgupta, Soham; Aly, Ashraf M; Jain, Sunil K

    2016-03-01

    Introduction Congestive heart failure due to left to right cardiac shunt is usually managed medically with diuretics, angiotensin converting enzyme inhibitors, and, in some cases, with the addition of digoxin. Case We report a 31-week gestation premature male infant who did not respond to such treatment and developed hyperaldosteronism and severe hypokalemia secondary to activation of the renin angiotensin aldosterone system. The hypokalemia was not responsive to intravenous KCL supplementation and induced digoxin toxicity despite a relatively normal digoxin level. The earliest signs of digoxin toxicity in the patient were junctional rhythm and bradycardia. The discontinuation of digoxin and the administration of digoxin specific immunoglobulin fragments (Fab) reversed those changes. The addition of spironolactone (an aldosterone antagonist) had a dramatic effect, resulting in clinical improvement of the patient coupled with normalization of Q4 serum and urine electrolytes. Conclusion Serum Digoxin level alone may fail as an independent guide in the diagnosis of digoxin toxicity when hypokalemia is present. In premature infants with congestive heart failure and hypokalemia, addition of an aldosterone antagonist should be considered.

  3. The Effectiveness of Healthy Lifestyle Promotion Intervention on Quality of Life in Patients with Congestive Heart Failure via Cognitive-Behavioral Procedure

    Directory of Open Access Journals (Sweden)

    M Zeraatkar

    2016-02-01

    Full Text Available Introduction: Reduced quality of life in cardiac patients and their frequent hospitalizations in the coronary care units is regarded as a main challenge for such patients. Therefore, this study aimed to explore the effectiveness of healthy lifestyle promotion intervention on quality of life in patients with congestive heart failure via cognitive-behavioral procedure. Methods: In this randomized controlled trial, assessment in pretest, posttest, and follow-up along with the control group were applied. Twenty-six patients with congestive heart failure were selected via convenience sampling among patients attended to Shahid Rajaee Heart hospital in Tehran. Then, they were randomly assigned to the experimental group (n=11; under administration of healthy lifestyle promotion intervention via cognitive-behavioral procedure during eight group sessions once a week and control group (n=15. Quality of life was measured for all the participants in three phases of pre-test, post-test and follow-up by Questionnaire of Quality of Life in Patients with Heart Failure (IHF-QoL and Depression Anxiety Stress Scales (DASS. Results: According to the results of variance analysis with repeated measures, this intervention was proved to have short-time effects on quality of life and its psychological components (P<0.001. Following the therapy termination, patients were returned to baseline, though the effect of intervention on depression was continued within 2 month follow-up (P<0.001. Conclusion: In regard with the effectiveness of healthy lifestyle promotion intervention via cognitive-behavioral procedure in improving quality of life and its psychological aspects, as well as high costs of hospital and prolonged treatment for these patients, applying this intervention in a permanent manner seem to be beneficial.

  4. Optimal medical therapy in chronic heart failure-an audit

    International Nuclear Information System (INIS)

    Objective: Systolic heart failure is a chronic condition with significant morbidity and mortality. Evidence based optimal medical therapy (OMT) has been shown to reduce mortality. Underuse of OMT due to multiple reasons has been a consistent problem. The study objective was to audit the use of OMT in patients with heart Failure. Study Design: Descriptive study. Place and Duration of study: This audit was carried out in AFIC-NIHD from April 2011- February 2012. Material and Methods: Seventy consecutive stage D heart failure patients were included in the study. The patients were assessed clinically by a cardiologist and all previous documentations, referral letters, prescriptions, and purchase receipts were reviewed. To identify any other medication patients might have been taking (which did not appear on the prescriptions) patients were asked to identify common medicine packs. The patients underwent a detailed clinical evaluation including history, physical examination. Relevant investigations were done. ACCF/AHA (American College of Cardiology Foundation / American Heart Association) and ESC (European Society of Cardiology) guidelines for the diagnosis and treatment of acute and chronic heart failure were taken as standard of care. Results: In our audit we found that a large proportion of patients who were at high risk as per the Seattle Heart Failure Model (SHFM) were not on OMT, only 4.3% of the patients were on beta blockers that have been shown to improve mortality in the large randomized clinical trials, 64.3% were not taking any beta blockers where as 55.7% were not on ACE inhibitors and adding the OMT greatly reduced their mortality risk. Conclusions: We concluded that a large proportion of patients were not on OMT despite not having any contraindication to such therapy. This deprives them of significant survival benefit. (author)

  5. Delivering Chronic Heart Failure Telemanagement via Multiple Interactive Platforms

    Directory of Open Access Journals (Sweden)

    Joseph Finkelstein

    2013-06-01

    Full Text Available Existing telemonitoring systems provide limited support in implementing personalized treatment plans. We developed a Home Automated Telemanagement (HAT system for patients with congestive heart failure (CHF to provide support in following individualized treatment plans as well as to monitor symptoms, weight changes, and quality of life, while educating the patient on their disease. The system was developed for both a laptop computer and a Nintendo Wii. The system is designed to be placed in the patient's home and to communicate all patient data to a central server implementing real-time clinical decision support. The system questions the patient daily on their condition, monitors their weight, and provides the patient with instant feedback on their condition in the form of a 3-zone CHF action plan. Their medication regimen and suggested actions are determined by their care management team and integrated into the system, keeping a personalized approach to disease management while taking advantage of the technology available. The systems are designed to be as simple as possible, making it usable by patients with no prior computer or videogame experience. A feasibility assessment in African American patients with CHF and without prior computer or videogame experience demonstrated high level of acceptance of the CHF HAT laptop and Wii systems. Keywords: telem

  6. Association between ambient carbon monoxide levels and hospitalizations for congestive heart failure in the elderly in 10 canadian cities; Association entre les niveaux atmospheriques de monoxyde de carbone et les hospitalisations pour insuffisance cardiaque congestive des personnes agees dans 10 villes canadiennes

    Energy Technology Data Exchange (ETDEWEB)

    Burnett, R.T.; Dales, R.E.; Brook, J.R.; Raizenne, M.E.; Krewski, D.

    2001-01-01

    In 1995, two studies, realized in the USA, showed the relation between the carbon monoxide content in the urban air and the hospitalization of elderly people for congestive heart failure. This study, realized this time in the Canada, take again the protocol of one of them increasing the period (4 to 11 years) and the number of concerned towns. (A.L.B.)

  7. The physiological basis of rehabilitation in chronic heart and lung disease.

    Science.gov (United States)

    Vogiatzis, Ioannis; Zakynthinos, Spyros

    2013-07-01

    Cardiopulmonary rehabilitation is recognized as a core component of management of individuals with congestive heart failure (CHF) or chronic obstructive pulmonary disease (COPD) that is designed to improve their physical and psychosocial condition without impacting on the primary organ impairment. This has lead the scientific community increasingly to believe that the main effects of cardiopulmonary rehabilitative exercise training are focused on skeletal muscles that are regarded as dysfunctional in both CHF and COPD. Accordingly, following completion of a cardiopulmonary rehabilitative exercise training program there are important peripheral muscular adaptations in both disease entities, namely increased capillary density, blood flow, mitochondrial volume density, fiber size, distribution of slow twitch fibers, and decreased lactic acidosis and vascular resistance. Decreased lactic acidosis at a given level of submaximal exercise not only offsets the occurrence of peripheral muscle fatigue, leading to muscle task failure and muscle discomfort, but also concurrently mitigates the additional burden on the respiratory muscles caused by the increased respiratory drive, thereby reducing dyspnea sensations. Furthermore in patients with COPD, exercise training reduces the degree of dynamic lung hyperinflation leading to improved arterial oxygen content and central hemodynamic responses, thus increasing systemic muscle oxygen availability. In patients with CHF, exercise training has beneficial direct and reflex sympathoinhibitory effects and favorable effects on normalization of neurohumoral excitation. These physiological benefits apply to all COPD and CHF patients independently of the degree of disease severity and are associated with improved exercise tolerance, functional capacity, and quality of life. PMID:23620491

  8. Heart rate and heart rate variability modification in chronic insomnia patients.

    Science.gov (United States)

    Farina, Benedetto; Dittoni, Serena; Colicchio, Salvatore; Testani, Elisa; Losurdo, Anna; Gnoni, Valentina; Di Blasi, Chiara; Brunetti, Riccardo; Contardi, Anna; Mazza, Salvatore; Della Marca, Giacomo

    2014-01-01

    Chronic insomnia is highly prevalent in the general population, provoking personal distress and increased risk for psychiatric and medical disorders. Autonomic hyper-arousal could be a pathogenic mechanism of chronic primary insomnia. The aim of this study was to investigate autonomic activity in patients with chronic primary insomnia by means of heart rate variability (HRV) analysis. Eighty-five consecutive patients affected by chronic primary insomnia were enrolled (38 men and 47 women; mean age: 53.2 ± 13.6). Patients were compared with a control group composed of 55 healthy participants matched for age and gender (23 men and 32 women; mean age: 54.2 ± 13.9). Patients underwent an insomnia study protocol that included subjective sleep evaluation, psychometric measures, and home-based polysomnography with evaluation of HRV in wake before sleep, in all sleep stages, and in wake after final awakening. Patients showed modifications of heart rate and HRV parameters, consistent with increased sympathetic activity, while awake before sleep and during Stage-2 non-REM sleep. No significant differences between insomniacs and controls could be detected during slow-wave sleep, REM sleep, and post-sleep wake. These results are consistent with the hypothesis that autonomic hyper-arousal is a major pathogenic mechanism in primary insomnia, and confirm that this condition is associated with an increased cardiovascular risk.

  9. Management of chronic heart failure in the older population

    OpenAIRE

    Azad, Nahid; Lemay, Genevieve

    2014-01-01

    Chronic heart failure (CHF) is the leading cause of hospitalization for those over the age of 65 and represents a significant clinical and economic burden. About half of hospital re-admissions are related to co-morbidities, polypharmacy and disabilities associated with CHF. Moreover, CHF also has an enormous cost in terms of poor prognosis with an average one year mortality of 33%–35%. While more than half of patients with CHF are over 75 years, most clinical trials have included younger pati...

  10. [Chronic heart failure and its consequences on the partner relationship].

    Science.gov (United States)

    Sztajzel, Juan

    2015-12-01

    There are presently few data on chronic heart failure (CHF) and its consequences on the partner relationship. The aim of our study was to assess how patients with severe CHF and their female partners were affected in their relationship. First, there was a need to address the issue of sexuality with the doctor because of fear of the occurrence of a cardiac event or an implantable cardioverter defibrillator shock. Second, there was often a significant decrease in libido and erectile dysfunction associated with general depressive symptoms. Finally, the female partners in several couples developed an overprotective behavior leading to resentment and frustration in patients towards them. PMID:26790235

  11. Increased Circulating Cathepsin K in Patients with Chronic Heart Failure

    OpenAIRE

    Guangxian Zhao; Yuzi Li; Lan Cui; Xiang Li; Zhenyi Jin; Xiongyi Han; Ennan Fang; Yihua Gao; Dongmei Zhou; Haiying Jiang; Xueying Jin; Guanghao Piao; Xiangshan Li; Guang Yang; Jiyong Jin

    2015-01-01

    Cysteinyl cathepsin K (CatK) is one of the most potent mammalian collagenases involved in cardiovascular disease. Here, we investigated the clinical predictive value of serum CatK levels in patients with chronic heart failure (CHF). We examined 134 patients with CHF, measuring their serum CatK, troponin I, high-sensitive C-reactive protein, and pre-operative N-terminal pro-brain natriuretic peptide levels. The patients were divided into two groups: the 44 patients who showed a left ventricula...

  12. Changes in derived measures from six-minute walk distance following home-based exercise training in congestive heart failure: A preliminary report.

    Science.gov (United States)

    Babu, Abraham Samuel; Desai, Charmie V; Maiya, Arun G; Guddattu, Vasudeva; Padmakumar, Ramachandran

    2016-01-01

    The response of derived parameters from six-minute walk distance (6MWD), like 6MW work (6MWW), to exercise training and its correlation with quality of life (QoL) in congestive heart failure (CHF) is not known. A secondary analysis from a randomized controlled trial on 30 patients (23 males; mean age 57.7±10.4 years; mean ejection fraction 31±10%) with CHF in NYHA class I-IV who completed an eight-week home-based exercise training program found a significant improvement in 6MWW (p<0.05), with similar correlations between 6MWD and 6MWW with QoL. 6MWW does not appear to provide additional benefit to 6MWD in cardiac rehabilitation for CHF.

  13. Effects of captopril and a combination of hydralazine and isosorbide dinitrate on myocardial sympathetic tone in patients with severe congestive heart failure.

    OpenAIRE

    Daly, P; Rouleau, J L; Cousineau, D.; Burgess, J H; Chatterjee, K.

    1986-01-01

    Changes in circulating catecholamines and transmyocardial catecholamine balance associated with improved left ventricular function were studied in patients with chronic heart failure after treatment with captopril (10 patients) and hydralazine in combination with isosorbide dinitrate (eight patients). Cardiac performance improved in response to both captopril and hydralazine-nitrate treatment. The systemic haemodynamic effects were also qualitatively similar, but the hydralazine-nitrate combi...

  14. Atrial fibrillation is associated with a lower exercise capacity in male chronic heart failure patients

    OpenAIRE

    Pardaens, K; Van Cleemput, J.; Vanhaecke, J.; Fagard, R.

    1997-01-01

    Objective—To study the influence of atrial fibrillation on peak oxygen uptake (peak V̇O2) in chronic heart failure. An unfavourable effect of atrial fibrillation has been shown in several patient populations, but the results have not been consistent in chronic heart failure.
Methods—Data were analysed from male heart transplant candidates who were able to perform graded bicycle ergometry until exhaustion with respiratory gas analysis and measurement of heart rate. Patients in atrial fibrillat...

  15. [11C]Acetate rest–stress protocol to assess myocardial perfusion and oxygen consumption reserve in a model of congestive heart failure in rats

    International Nuclear Information System (INIS)

    This study describes an [11C]acetate rest–stress method to obtain an indirect estimate of myocardial blood flow (MBF) and myocardial oxygen consumption (MVO2) in rats. Doxorubicin cardiotoxicity was used to test the usefulness of this approach for the assessment of congestive heart failure. Methods: [11C]Acetate rest–stress studies have been used in clinical research to assess the capacity of the coronary arteries to respond to stress. In this article, we used this approach to assess the cardiotoxicity of doxorubicin in a rat model. The method was first validated in a group of healthy rats and then used to follow the effect of doxorubicin chemotherapy on cardiac function. The effect of doxorubicin on myocardial perfusion and oxygen consumption reserve was measured at rest and under dobutamine stimulation. Results: Validation of the protocol showed a good correlation between the MBF and MVO2 (r2=.68). The doxorubicin-treated group showed a significant (P=.04) decrease in cardiovascular perfusion reserve at 1.3±0.2 compared with the control animals at 1.6±0.2. Similar results were obtained for the MVO2 reserve (treated 1.8±0.4 vs. controls 2.3±0.3; P=.02). Conclusions: We describe an [11C]acetate PET rest–stress protocol for the assessment of congestive heart failure in rats and its application to the follow-up of cardiotoxicity under doxorubicin chemotherapy. This is a rapid and reliable approach to the measurement of cardiac perfusion and oxygen consumption reserve that could be applied to the development of new strategies to reduce the cardiotoxicity of anthracycline.

  16. Significance of QRS duration and left bundle branch block in development and course of congestive heart failure

    Directory of Open Access Journals (Sweden)

    Bockeria L. A.

    2012-03-01

    Full Text Available Patients with severe chronic heart failure (CHF often have such intraventricular conduction disturbances as left bundle branch block which show morphological and QRS-duration changes on ECG and result in evident intra- and interventricular dyssinchrony. Delayed left ventricular activation via interventricular septum results in evident asynchrony at the beginning of left and right ventricular contration. Diagnostic significance of ECG data increases in presence of CHF clinical signs, especially echocardiographic signs of myocardial dysfunction. EVEREST study analyzed the influence of QRS duration on number of hospital admissions and mortality in patients with CHF. The study included 2962 patients, 1614 of them had normal QRS duration – less than 120 ms, 1321 patients had increased QRS duration – more than 120 ms. 678 deaths occurred during followup period, 307 (18.7% of them were from group with normal QRS duration and 371 (28.1% – from group with increased QRS interval. Mortality rate due to cardiovascular causes was more significant in patients with increased QRS. In 3 months of follow-up the mortality rate was 21.1% in patients with increased QRS and 14.6% in patients with normal QRS. In 9.9 months of follow-up the rates were 41.6% and 32.4%, respectively. Different international studies showed that isolated right ventricular pacing resulted in prolongation of QRS complex and contributed to CHF progression. 2010 patients were randomized in MOST-study which aimed to compare dual chamber pacing and right ventricular pacing. Reduction of CHF symptoms was noted in the course of study in patients who underwent dual chamber pacing, while M.O. Sweeney et al. analyzed the results of treatment of 1339 patients with initially normal QRS duration. However the authors revealed a higher rate in group of right ventricular pacing which proved the higher rates of hospital admission for CHF and more frequent rates for atrial fibrillation occurrence

  17. Pulmonary Hypertension and Right Heart Dysfunction in Chronic Lung Disease

    Directory of Open Access Journals (Sweden)

    Amirmasoud Zangiabadi

    2014-01-01

    Full Text Available Group 3 pulmonary hypertension (PH is a common complication of chronic lung disease (CLD, including chronic obstructive pulmonary disease (COPD, interstitial lung disease, and sleep-disordered breathing. Development of PH is associated with poor prognosis and may progress to right heart failure, however, in the majority of the patients with CLD, PH is mild to moderate and only a small number of patients develop severe PH. The pathophysiology of PH in CLD is multifactorial and includes hypoxic pulmonary vasoconstriction, pulmonary vascular remodeling, small vessel destruction, and fibrosis. The effects of PH on the right ventricle (RV range between early RV remodeling, hypertrophy, dilatation, and eventual failure with associated increased mortality. The golden standard for diagnosis of PH is right heart catheterization, however, evidence of PH can be appreciated on clinical examination, serology, radiological imaging, and Doppler echocardiography. Treatment of PH in CLD focuses on management of the underlying lung disorder and hypoxia. There is, however, limited evidence to suggest that PH-specific vasodilators such as phosphodiesterase-type 5 inhibitors, endothelin receptor antagonists, and prostanoids may have a role in the treatment of patients with CLD and moderate-to-severe PH.

  18. [Chronic heart failure and cachexia: role of endocrine system].

    Science.gov (United States)

    Dei Cas, A; Muoio, A; Zavaroni, I

    2011-12-01

    Chronic heart failure (CHF) is a major health problem that carries a devastating prognosis. The prognosis worsens considerably once cardiac cachexia has been diagnosed. Neurohormonal, metabolic, hemodynamic and immunological alterations are involved in the initiation and progression of cardiac cachexia. Cachexia is characterized by a hypothalamic inappropriate response to the mechanisms controlling energy homeostasis. Levels of the anorexigenic hormone leptin are decreased whereas the orexigenic gherlin hormone levels are normal or elevated. Nevertheless, energy intake is not increased as expected due to a persistent activation of the proopiomelanocortin (POMC) system (anorexigenic) paralleled by a decreased activity of the neuropeptide Y (NPY, orexigenic) neurons. Cachexia is also characterized by an imbalance in anabolic (impairment in the growth hormone/insulin-like growth factor-I axis, insulin resistance) and catabolic (increased levels of catecholamines, increased cortisol/dehydroepiandrosterone ratio and activation of proinflammatory cytokines such as tumor necrosis factor-alpha, interleuchin-6, interleuchin-1') at the basis of the wasting process. This review discusses the complex role of the endocrine system in modulating energy balance, appetite and metabolism in patients with chronic heart failure. A joint multidisciplinary effort of the cardiologists, immunologists and endocrinologists might be useful to identify the precise mechanisms involved in the neuroendocrine alteration and to develop therapeutic strategies able to improve the prognosis of CHF patients.

  19. Chronic oral pathology and ischemic heart disease and its complications

    Directory of Open Access Journals (Sweden)

    Ivaschenko Y.Y.

    2013-09-01

    Full Text Available Objective: to establish the relationship of chronic generalized periodontitis, multiple cavities and dentofacial anomalies with various forms of coronary heart disease and its complications. Material and methods. The study included 294 patients with coronary heart disease and its complications. The patients were divided into two groups. Group I included 89 patients with acute Q-myocardial infarction, which was placed in the presence of at least 2 of the following criteria identified on the basis of a comprehensive clinical and instrumental examination: clinical, laboratory confirmation (CK-MB, electrocardiographic signs of damage or myocardial necrosis. The following statistical methods were used: multi-variate and univariate analysis of variance, non-parametric tests, crosstabulation, chi-square test, Fisher»s exact test. As a measure of variability of the normal distribution standard deviation was used. Results. It is noted that in patients with myocardial infarction more likely than in patients without coronary heart attack in history severe generalized periodontitis, dentofacial anomalies and multiple dental caries have appeared. In patients with acute myocardial infarction, severe periodontal disease has been associated with increased fibrinogen levels in the blood and an increase in the dispersion of the interval QT, which are known to be indicators of poor prognosis in acute coronary disease.

  20. Management of chronic heart failure in the older population

    Institute of Scientific and Technical Information of China (English)

    Nahid Azad; Genevieve Lemay

    2014-01-01

    Chronic heart failure (CHF) is the leading cause of hospitalization for those over the age of 65 and represents a significant clinical and economic burden. About half of hospital re-admissions are related to co-morbidities, polypharmacy and disabilities associated with CHF. Moreover, CHF also has an enormous cost in terms of poor prognosis with an average one year mortality of 33%–35%. While more than half of patients with CHF are over 75 years, most clinical trials have included younger patients with a mean age of 61 years. Inadequate data makes treatment decisions challenging for the providers. Older CHF patients are more often female, have less cardiovascular diseases and associated risk factors, but higher rates of non-cardiovascular conditions and diastolic dysfunction. The prevalence of CHF with reduced ejection fraction, ischemic heart disease, and its risk factors declines with age, whereas the prevalence of non-cardiac co-morbidities, such as chronic renal failure, dementia, anemia and malignancy increases with age. Diabetes and hypertension are among the strongest risk factors as predictors of CHF particularly among women with coronary heart disease. This review paper will focus on the specific consideration for CHF assessment in the older population. Management strategies will be reviewed, including non-pharmacologic, pharmacologic, quality care indicators, quality improvement in care transition and lastly, end-of-life issues. Palliative care should be an integral part of an interdiscipli-nary team approach for a comprehensive care plan over the whole disease trajectory. In addition, frailty contributes valuable prognostic in-sight incremental to existing risk models and assists clinicians in defining optimal care pathways for their patients.

  1. Do telemonitoring projects of heart failure fit the Chronic Care Model?

    OpenAIRE

    Willemse, Evi; Adriaenssens, Jef; Dilles, Tinne; Remmen, Roy

    2014-01-01

    This study describes the characteristics of extramural and transmural telemonitoring projects on chronic heart failure in Belgium. It describes to what extent these telemonitoring projects coincide with the Chronic Care Model of Wagner.Background: The Chronic Care Model describes essential components for high-quality health care. Telemonitoring can be used to optimise home care for chronic heart failure. It provides a potential prospective to change the current care organisation.Methods: This...

  2. Sympathetic reflex control of skeletal muscle blood flow in patients with congestive heart failure: evidence for beta-adrenergic circulatory control

    Energy Technology Data Exchange (ETDEWEB)

    Kassis, E.; Jacobsen, T.N.; Mogensen, F.; Amtorp, O.

    1986-11-01

    Mechanisms controlling forearm muscle vascular resistance (FMVR) during postural changes were investigated in seven patients with severe congestive heart failure (CHF) and in seven control subjects with unimpaired left ventricular function. Relative brachioradial muscle blood flow was determined by the local /sup 133/Xe-washout technique. Unloading of baroreceptors with use of 45 degree upright tilt was comparably obtained in the patients with CHF and control subjects. Control subjects had substantially increased FMVR and heart rate to maintain arterial pressure whereas patients with CHF had decreased FMVR by 51 +/- 11% and had no increase in heart rate despite a fall in arterial pressure during upright tilt. The autoregulatory and local vasoconstrictor reflex responsiveness during postural changes in forearm vascular pressures were intact in both groups. In the patients with CHF, the left axillary nerve plexus was blocked by local anesthesia. No alterations in forearm vascular pressures were observed. This blockade preserved the local regulation of FMVR but reversed the vasodilator response to upright tilt as FMVR increased by 30 +/- 7% (p less than .02). Blockade of central neural impulses to this limb combined with brachial arterial infusions of phentolamine completely abolished the humoral vasoconstriction in the tilted position. Infusions of propranolol to the contralateral brachial artery that did not affect baseline values of heart rate, arterial pressure, or the local reflex regulation of FMVR reversed the abnormal vasodilator response to upright tilt as FMVR increased by 42 +/- 12% (p less than .02). Despite augmented baseline values, forearm venous but not arterial plasma levels of epinephrine increased in the tilted position, as did arteri rather than venous plasma concentrations of norepinephrine in these patients.

  3. The Prognostic Value of Non-Linear Analysis of Heart Rate Variability in Patients with Congestive Heart Failure—A Pilot Study of Multiscale Entropy

    OpenAIRE

    Yi-Lwun Ho; Chen Lin; Yen-Hung Lin; Men-Tzung Lo

    2011-01-01

    AIMS: The influences of nonstationarity and nonlinearity on heart rate time series can be mathematically qualified or quantified by multiscale entropy (MSE). The aim of this study is to investigate the prognostic value of parameters derived from MSE in the patients with systolic heart failure. METHODS AND RESULTS: Patients with systolic heart failure were enrolled in this study. One month after clinical condition being stable, 24-hour Holter electrocardiogram was recording. MSE as well as oth...

  4. 卡维地洛对扩张型心肌病心力衰竭患者心功能及运动耐量的改善作用%Improving effect of carvedilol on cardiac function and exercise tolerance in patients with congestive heart failure of dilated cardiomyopathy

    Institute of Scientific and Technical Information of China (English)

    吴大庆; 杨永健

    2002-01-01

    Objective To observe the improving effect of carvedilol on cardiac function in patients with congestive heart failure(CHF) of dilated cardiomyopathy(DCM).Methods Total 60 patients with chronic heart failure secondary to DCM were divided into two groups randomly, namely carvedilol group additionally treated with carvedilol (the test group), conventional group receiving placebo (the controls). The left ventricular fraction shortening (FS), ejection fraction (EF), stroke volume (SV), left ventricular diastolic dimension (LVDD) were measured with echocardiography, were measured before and after 4 month treatment. Results After treated for 4 months , the cardiac function improved greatly in both groups.In the test group, LVDD, EF and 6 minute walking distance improved more signicantly compared to the controls. Conclusion Carvedilol can improve cardiac function and exercise tolerance in the patients with CHF of DCM obviously.

  5. Overlap and distinctiveness of psychological risk factors in patients with ischemic heart disease and chronic heart failure

    DEFF Research Database (Denmark)

    Pelle, Aline J; Denollet, Johan; Zwisler, Ann-Dorthe;

    2009-01-01

    Growing evidence supports the importance of psychological factors in the etiology and progression of cardiovascular disease (CVD). However, this research has been criticized due to overlap between psychological constructs. We examined whether psychological questionnaires frequently used...... in cardiovascular research assess distinct constructs in a mixed group of ischemic heart disease (IHD) and chronic heart failure (CHF) patients....

  6. [Heart rate and outcome in patients with acute and chronic heart failure].

    Science.gov (United States)

    Oliva, Fabrizio; Ammirati, Enrico; Campana, Carlo; Carubelli, Valentina; Cirò, Antonio; Di Tano, Giuseppe; Mortara, Andrea; Senni, Michele; Morandi, Fabrizio; Metra, Marco

    2016-03-01

    Heart rate (HR) is not only a physical sign but also a biomarker. High HR in several cardiac disorders is associated with increased mortality. In heart failure (HF), HR represents an important therapeutic target, both in the acute and chronic phase. Beta-blockers are a milestone of recommended treatments in HF patients with reduced ejection fraction. However, hemodynamic profile or intolerance may limit the use or the optimization of beta-blocker treatment, both during hospitalization and outpatient follow-up. More recently, ivabradine has become available, a drug that lowers HR by blocking the I(f) current in the pacemaker cells at the sinoatrial node level. In the SHIFT trial, ivabradine was shown to improve the outcome of patients with chronic HF, in sinus rhythm, with HR >70 b/min while on beta-blockers. Preliminary data have shown that this drug has a good safety profile and lowers effectively HR even during hospitalization due to worsening HF. However, further studies are warranted to understand if an earlier administration of ivabradine can lead to a better prognosis beyond symptom control and improved hemodynamics. In patients with atrial fibrillation and HF, the target is the restoration of sinus rhythm, alternatively rate control should be pursued with beta-blockers, amiodarone or digitalis, even if there is no clear evidence of an association between ventricular rate response in patients with atrial fibrillation at discharge after an HF hospitalization and major cardiovascular events. In this review, the studies that point to a role of HR both as a biomarker and a therapeutic target in patients with acute and chronic HF are described. In addition, the proportions of patients who do not reach target HR values at discharge after an acute decompensated HF episode or in the chronic phase are evaluated based on the Italian registries. PMID:27030005

  7. Prognostic value of repeated {sup 123}I-metaiodobenzylguanidine imaging in patients with dilated cardiomyopathy with congestive heart failure before and after optimized treatments. Comparison with neurohumoral factors

    Energy Technology Data Exchange (ETDEWEB)

    Matsui, Toshiki; Tsutamoto, Takayoshi; Maeda, Keiko; Kusukawa, Junya; Kinoshita, Masahiko [Shiga Univ. of Medical Science, Otsu (Japan)

    2002-06-01

    The present study was undertaken to assess whether repeated measurement of cardiac {sup 123}I-metaiodobenzylguanidine (MIBG) imaging parameters before and after optimized treatments is useful for predicting the prognosis of patients with congestive heart failure (CHF) resulting from dilated cardiomyopathy (DCM). The subjects were 85 consecutive patients with DCM who had a left ventricular ejection fraction (LVEF) of less than 45%. The MIBG and the concentrations of neurohumoral factors were measured at baseline and after 6 months of optimized treatments. Cox proportional hazards analysis was performed to assess the various parameters before and after treatment. Twenty-three patients had a cardiac event (12 died; 11 hospitalized) during a mean follow-up period of 2 years. Although there was no difference between the baseline heart to mediastinum (H/M) ratio measured by MIBG between survivors and nonsurvivors, the H/M ratio was significantly decreased in nonsurvivors after 6 months. Multivariate analysis revealed that a high plasma concentration of brain natriuretic peptide level after 6 months (p=0.0049) and absolute changes in the H/M ratio (p=0.0046) were independent predictors of mortality. Comparison of the H/M ratio on MIBG imaging before and after optimized additional treatment provided useful information for predicting mortality and was independent of clinical and neurohumoral factors previously shown to be associated with poor prognosis in patients with DCM. (author)

  8. Differential number of CD34+, CD133+ and CD34+/CD133+ cells in peripheral blood of patients with congestive heart failure

    Directory of Open Access Journals (Sweden)

    Fritzenwanger M

    2009-03-01

    Full Text Available Abstract Background Endothelial progenitor cells (EPC which are characterised by the simulateous expression of CD34, CD133 and vascular endothelial growth receptor 2 (VEGF 2 are involved in the pathophysiology of congestive heart failure (CHF and their number and function is reduced in CHF. But so far our knowledge about the number of circulating hematopoietic stem/progenitor cells (CPC expressing the early hematopoietic marker CD133 and CD34 in CHF is spares and therefore we determined their number and correlated them with New York Heart Association (NYHA functional class. Methods CD34 and CD133 surface expression was quantified by flow cytometry in the peripheral venous blood of 41 healthy adults and 101 patients with various degrees of CHF. Results CD34+, CD133+ and CD34+/CD133+ cells correlated inversely with age. Both the number of CD34+ and of CD34+/CD133+ cells inversely correlated with NYHA functional class. The number of CD133+ cells was not affected by NYHA class. Furthermore the number of CD133+ cells did not differ between control and CHF patients. Conclusion In CHF the release of CD34+, CD133+ and CD34+/CD133+ cells from the bone marrow seems to be regulated differently. Modulating the releasing process in CHF may be a tool in CHF treatment.

  9. 城市道路拥堵状态下驾驶人心率特性研究%Characteristics Research for Driver's Heart Rate in Congestion State of Urban Road

    Institute of Scientific and Technical Information of China (English)

    漆巍巍; 裴玉龙

    2014-01-01

    Transportation infrastructure scale is constrained by many factors ,due to the limited space of the cities . Traffic congestion will affect people's daily life in a long time with the rapid increase of vehicle population .The mean heart rate is selected as an indicator to quantify the impact of traffic congestion on the driver's physiological and psychological status .Moreover ,the impact of traffic congestion level on the driver's heart rate characteristics is studied based on a large number of measured data .In addition ,the relational model between mean heart rate and pressure coefficient is estab-lished .Research shows that the effect of traffic congestion on heart rate characteristics is significant ,and that the deter-mination coefficient of the goodness-of-fit of the three regression models can be above 0 .6 with the best regression result of the quadratic polynomial .The results can provide a theoretical support for the efficiency and safety evaluation of traffic congestion .%为了量化交通拥堵对驾驶人生理和心理特性的影响,选取驾驶人的心率均值为指标,在大量实测数据基础上研究交通拥堵程度对驾驶人心率特性的影响,并构建心率均值和压力系数间的关系模型。研究表明,交通拥堵对驾驶人的心率特性影响显著,3种回归模型拟合优度的确定系数都达到了0.6以上,且二次多项式的回归效果最好。

  10. Clinical significance of pain in patients with chronic heart failure

    Institute of Scientific and Technical Information of China (English)

    GAN Qian; ZHANG Feng-ru; ZHOU Qing-fen; DAI Li-ying; LIU Ye-hong; CHAI Xi-chen; WU Fang; SHEN Wei-feng

    2012-01-01

    Background There is a paucity of studies investigating the clinical and biochemical characteristics of pain in chronic heart failure (CHF) patients.This study aimed to determine the clinical and biochemical characteristics and outcomes in Chinese patients with CHF and symptoms of pain.Methods Sociodemographics,serum levels of creatinine,NT-proBNP,high-sensitivity C-reactive protein (hs-CRP),tumor necrosis factor (TNF)-α,interleukin (IL)-6 and IL-10,and two-dimensional echocardiographic left ventricular ejection fraction (LVEF) were determined in 305 patients with CHF.A questionnaire packet including the Brief Pain Inventory (BPI) and the Minnesota Living with Heart Failure Questionnaire (MLHFQ) was used to assess the degree of pain rated on a 0-10 scale and the quality of life (QOL).A six-minute walking test was performed during routine clinic visits.Major adverse cardiac events (MACE) were recorded; including all-cause or cardiac mortality and rehospitalization because of myocardial infarction,worsening heart failure or stroke at follow-up.Results Pain occurred in 25.6% of CHF patients,and was more common when the New York Heart Association (NYHA) functional class was worse.More patients with pain were female in gender,and had more co-morbidities,lower LVEF,and shorter distance during the 6-minute walking test.Despite similar serum levels of creatinine,N-terminal prohormone of brain natriuretic peptide (NT-proBNP),IL-6 and IL-10,the TNF-α levels were higher and MLHFQ scores were greater in CHF patients with pain.At follow-up,CHF patients with moderate to severe pain (≥4 scale) had higher rates of all-cause and cardiac mortality and rehospitalization because of myocardial infarction,worsening heart failure or stroke.Multivariate regression analysis revealed that the presence of pain was an independent risk factor for MACE and reduced QOL in CHF patients.Conclusions Pain occurs in all stages of the CHF trajectory,and its incidence increases as clinical

  11. [Optimization of energy metabolism in patients with chronic heart failure].

    Science.gov (United States)

    Korzh, A N

    2010-01-01

    Nowadays particular interest of clinicians is attracted by metabolic therapy of patients with chronic heart failure (CHF). The objective of this study was to investigate the influence of complex therapy with addition of Vasonat on the dynamics of remodeling indexes of left ventricle and functional class of CHF on classification of NYHA. It has been shown that application of metabolic modulator Vasonat in addition to conventional therapy of CHF facilitated the clinical improvement and significant decline of functional class. Vasonat use resulted in the meaningful improvement of the contractive function of myocardium and increase of tolerance to the physical exercise. Moreover, high efficiency of Vasonat has been demonstrated in the control of the syndrome of oxidizing stress, by decrease in intensity of free-radical processes and activation of the antioxidant defense system. PMID:21265120

  12. The role of statins in chronic heart failure.

    Science.gov (United States)

    Szyguła-Jurkiewicz, Bożena; Szczurek, Wioletta; Król, Bogumiła; Zembala, Marian

    2014-09-01

    The efficacy of statins in reducing morbidity and mortality in patients with documented coronary artery disease is unquestionable. However, in chronic heart failure (CHF), evidence regarding the beneficial effects of statin therapy remains contradictory. Although numerous retrospective studies have demonstrated improved prognosis in CHF patients treated with statins, two randomized trials, GISSI-HF and CORONA, have not confirmed the benefit of rosuvastatin in this group of patients. The benefits of using statins in CHF probably result mostly from their pleiotropic action, including the improvement of endothelial function, the inhibition of neurohormonal activation, and the reduction of proinflammatory activation. On the other hand, it has been recognized that low cholesterol is associated with worse morbidity and mortality in patients with CHF. It appears that it is necessary to conduct further randomized clinical trials using different kinds of statins in different populations of patients with CHF. PMID:26336439

  13. Influence of diabetes and diabetes-gender interaction on the risk of death in patients hospitalized with congestive heart failure

    DEFF Research Database (Denmark)

    Gustafsson, Ida; Brendorp, Bente; Seibaek, Marie;

    2004-01-01

    OBJECTIVES: The purpose of this study was to investigate the influence of diabetes on long-term mortality in a large cohort of patients hospitalized with heart failure (HF). BACKGROUND: Diabetes is common in HF patients, but information on the prognostic effect of diabetes is sparse. METHODS: The...

  14. Prognostic importance of a restrictive transmitral filling pattern in patients with symptomatic congestive heart failure and atrial fibrillation

    DEFF Research Database (Denmark)

    Raunsø, Jakob; Møller, Jacob Eifer; Kjaergaard, Jesper;

    2009-01-01

    BACKGROUND: Restrictive diastolic filling pattern is associated with increased mortality in patients with myocardial infarction and heart failure. Most studies have excluded patients with atrial fibrillation. The aim of the present study was to assess the prognostic value of a restrictive filling...

  15. The clinical significance of detection to heart rate deceleration capacity and heart rate variability in patients with chronic heart failure

    Directory of Open Access Journals (Sweden)

    Jiang-rong Zhou

    2015-01-01

    Full Text Available Objective: To study the change of heart rate deceleration capacity ( DC and heart rate variability in patients with chronic heart failure (CHF and its relationship with left ventricular ejection fraction (LVEF. Methods: DC, LVEF, time and frequency domain parameters of HRV were measured in 66 patients with CHF and 34 healthy adults (control group by using 24h Holter recordings and Echocardiography. The standard deviation of normal R-R intervals( SDNN, squares of differences between adjacent NN intervals ( RMSSD,low frequency power( LFn and high frequency power( HFn and the changes of LVEF were compared between  the two groups,the relationship between DC,LVEF and HRV were studied in patients with CHF. Results: The median value of DC in the patients with CHF was significantly lower than that in control group( 3.1 ± 2.4 ms vs 7.2 ± 1.3 ms,P <0.01.Incidence of abnormal DC in the CHF group was 57.5%,which was significantly higher than that in the control group (P <0.01.The HRV index, including SDNN、RMSSD、LFn、HFn, in the CHF group was significantly lower than that in normal control group (P < 0.01. Significant positive correlation between HRV index and LVEF were confirmed (P < 0.01. Conclusions: DC and HRV index are lower in patients with CHF and have a good correlation with the left ventricular ejection fraction.

  16. Effects of Long-term Ramipril on Ventricular Remodeling, Cardiac Function and Survival in Rat Congestive Heart Failure after Myocardial Infarction

    Institute of Scientific and Technical Information of China (English)

    陶则伟; 黄元伟

    2004-01-01

    Objectives The purpose of this study was to investigate the effects of long-term ramipril on ventricular remodeling, cardiac function and survival in rat congestive heart failure after myocardial infarction. Methods Myocardial infarction (MI) was caused by ligation of the left anterior descending coronary artery in rats. 7 days after the surgery, the surviving rats were randomly assigned to the following treatment protocols: 1) MI rats with no therapy, 2) MI rats treated with ramipril 3 mg/kg per day, 3) Sham-operated control rats, and 4) Sham-operated rats treated with ramipril 3 mg/kg per day. At 22 weeks, cardiac hemodynamic parameters such as MAP, LVSP, ±dP/dtmax and LVEDP were measured,and cardiac morphometric parameters such as HW,LVW and LVCA were measured, mRNA of cardiacmolecule genes, such as βMHC, BNP, collagen Ⅰ and Ⅲ, and TGF-β1, were quantified, and survival rates were calculated. Results Compared with sham-operated rats, MI rats without therapy showed significant increases in cardiac morphological parameters as well as in mRAN expressions of cardiac molecule genes (P<0.01); while their hemodynamic parameters were significantly impaired (P<0.01), and survival rate shortened (P<0.05). Compared with MI rats with no therapy, MI rats treated with ramipril showed significant attenuation of mRAN expressions of cardiac molecule genes (P<0.01); while their hemodynamic parameters were significantly impaired (P<0.01), and survival rate shortened (P<0.05). Compared with MI rats with no therapy, MI rats treated with ramipril showed significant attenuation of mRAN expressions of cardiac molecule genes (P<0.01); while their hemodynamic parameters were significantly improved (P<0.05 or P<0.01), and survival rates prolonged (P<0.05). Conclusions Treatment with long-term ramipril may improve LV remodeling, cardiac function and survival in rat congestive heart failure after MI.

  17. Effect of the Diagnosis of Inflammatory Bowel Disease on Risk-Adjusted Mortality in Hospitalized Patients with Acute Myocardial Infarction, Congestive Heart Failure and Pneumonia

    Science.gov (United States)

    Ehrenpreis, Eli D.; Zhou, Ying; Alexoff, Aimee; Melitas, Constantine

    2016-01-01

    Introduction Measurement of mortality in patients with acute myocardial infarction (AMI), congestive heart failure (CHF) and pneumonia (PN) is a high priority since these are common reasons for hospitalization. However, mortality in patients with inflammatory bowel disease (IBD) that are hospitalized for these common medical conditions is unknown. Methods A retrospective review of the 2005–2011 National Inpatient Sample (NIS), (approximately a 20% sample of discharges from community hospitals) was performed. A dataset for all patients with ICD-9-CM codes for primary diagnosis of acute myocardial infarction, pneumonia or congestive heart failure with a co-diagnosis of IBD, Crohn’s disease (CD) or ulcerative colitis (UC). 1:3 propensity score matching between patients with co-diagnosed disease vs. controls was performed. Continuous variables were compared between IBD and controls. Categorical variables were reported as frequency (percentage) and analyzed by Chi-square tests or Fisher’s exact test for co-diagnosed disease vs. control comparisons. Propensity scores were computed through multivariable logistic regression accounting for demographic and hospital factors. In-hospital mortality between the groups was compared. Results Patients with IBD, CD and UC had improved survival after AMI compared to controls. 94/2280 (4.1%) of patients with IBD and AMI died, compared to 251/5460 (5.5%) of controls, p = 0.01. This represents a 25% improved survival in IBD patients that were hospitalized with AMI. There was a 34% improved survival in patients with CD and AMI. There was a trend toward worsening survival in patients with IBD and CHF. Patients with CD and PN had improved survival compared to controls. 87/3362 (2.59%) patients with CD and PN died, compared to 428/10076 (4.25%) of controls, p < .0001. This represents a 39% improved survival in patients with CD that are hospitalized for PN. Conclusion IBD confers a survival benefit for patients hospitalized with AMI. A

  18. [Chronic systolic heart failure - dosing recommendations at beginning and end of treatment].

    Science.gov (United States)

    Zugck, Christian; Remppis, Andrew; Katus, Hugo A; Frankenstein, Lutz

    2008-10-01

    As a multi-system disease, chronic heart failure requires a complex, multimodal therapy. Achieving maximum guideline adherence in (advanced) chronic heart failure can therefore become a challenge. The important decrease in morbidity and mortality seen lately largely depends on consequent and sometime tedious implementation of guideline targets. The present paper provides a comprehensive overview on medical therapeutic strategies with a particular focus of onset and discontinuation of drugs in patients with chronic systolic dysfunction.

  19. Salt Intake Is Associated with Inflammation in Chronic Heart Failure

    Directory of Open Access Journals (Sweden)

    Alper Azak

    2015-09-01

    Full Text Available Background: Chronic Heart Failure (CHF is highly prevalent and is associated with high morbidity and mortality rates. It has been well established that excessive intake of sodium chloride (salt induced hypertension in some populations. Although salt seems to induce cardiovascular diseases through elevation of blood pressure, it has also been indicated that salt can induce cardiovascular diseases independently from blood pressure elevation. Objectives: The present study aimed to evaluate the association between salt consumption and inflammation in CHF patients. Patients and Methods: This study was conducted on 86 patients between 18 and 65 years old who were diagnosed with New York Heart Association (NYHA functional class I and II heart failure. Salt intake was calculated by using 24 hour urine sodium excretion. Besides, the association between inflammation and daily salt intake was evaluated regarding C - reactive protein (CPR, High sensitive CRP (HsCPR, Erythrocyte Sedimentation Rate (ESR, and ferritin and fibrinogen levels using Pearson correlation analysis. Results: Our results showed a statistically significant difference between the low (n = 41 and high (n = 45 salt intake groups in terms of serum HsCRP levels (5.21 ± 2.62 vs. 6.36 ± 2.64 (P < 0.048. Additionally, a significant correlation was observed between the amount of salt consumption and HsCRP levels. In this study, daily salt consumption of the enrolled patients was 8.53 gram/day. The medications and even the blood pressures were similar in the two groups, but daily pill count, prevalence of hypertension, and coronary heart disease were higher in the high salt intake group; however, the differences were not statistically significant (P = 0.065. Also, no significant difference was observed between the groups concerning the inflammation markers, such as CRP, ESR, ferritin, and fibrinogen. Conclusions: Neurohumoral and inflammatory factors are thought to contribute to high mortality

  20. The Prognostic Value of Non-Linear Analysis of Heart Rate Variability in Patients with Congestive Heart Failure—A Pilot Study of Multiscale Entropy

    Science.gov (United States)

    Ho, Yi-Lwun; Lin, Chen; Lin, Yen-Hung; Lo, Men-Tzung

    2011-01-01

    Aims The influences of nonstationarity and nonlinearity on heart rate time series can be mathematically qualified or quantified by multiscale entropy (MSE). The aim of this study is to investigate the prognostic value of parameters derived from MSE in the patients with systolic heart failure. Methods and Results Patients with systolic heart failure were enrolled in this study. One month after clinical condition being stable, 24-hour Holter electrocardiogram was recording. MSE as well as other standard parameters of heart rate variability (HRV) and detrended fluctuation analysis (DFA) were assessed. A total of 40 heart failure patients with a mea age of 56±16 years were enrolled and followed-up for 684±441 days. There were 25 patients receiving β-blockers treatment. During follow-up period, 6 patients died or received urgent heart transplantation. The short-term exponent of DFA and the slope of MSE between scale 1 to 5 were significantly different between patients with or without β-blockers (p = 0.014 and p = 0.028). Only the area under the MSE curve for scale 6 to 20 (Area6–20) showed the strongest predictive power between survival (n = 34) and mortality (n = 6) groups among all the parameters. The value of Area6–2021.2 served as a significant predictor of mortality or heart transplant (p = 0.0014). Conclusion The area under the MSE curve for scale 6 to 20 is not relevant to β-blockers and could further warrant independent risk stratification for the prognosis of CHF patients. PMID:21533258

  1. The prognostic value of non-linear analysis of heart rate variability in patients with congestive heart failure--a pilot study of multiscale entropy.

    Directory of Open Access Journals (Sweden)

    Yi-Lwun Ho

    Full Text Available AIMS: The influences of nonstationarity and nonlinearity on heart rate time series can be mathematically qualified or quantified by multiscale entropy (MSE. The aim of this study is to investigate the prognostic value of parameters derived from MSE in the patients with systolic heart failure. METHODS AND RESULTS: Patients with systolic heart failure were enrolled in this study. One month after clinical condition being stable, 24-hour Holter electrocardiogram was recording. MSE as well as other standard parameters of heart rate variability (HRV and detrended fluctuation analysis (DFA were assessed. A total of 40 heart failure patients with a mea age of 56±16 years were enrolled and followed-up for 684±441 days. There were 25 patients receiving β-blockers treatment. During follow-up period, 6 patients died or received urgent heart transplantation. The short-term exponent of DFA and the slope of MSE between scale 1 to 5 were significantly different between patients with or without β-blockers (p = 0.014 and p = 0.028. Only the area under the MSE curve for scale 6 to 20 (Area(6-20 showed the strongest predictive power between survival (n = 34 and mortality (n = 6 groups among all the parameters. The value of Area(6-2021.2 served as a significant predictor of mortality or heart transplant (p = 0.0014. CONCLUSION: The area under the MSE curve for scale 6 to 20 is not relevant to β-blockers and could further warrant independent risk stratification for the prognosis of CHF patients.

  2. Differential clinical characteristics and prognosis of intraventricular conduction defects in patients with chronic heart failure

    Science.gov (United States)

    Cinca, Juan; Mendez, Ana; Puig, Teresa; Ferrero, Andreu; Roig, Eulalia; Vazquez, Rafael; Gonzalez-Juanatey, Jose R.; Alonso-Pulpon, Luis; Delgado, Juan; Brugada, Josep; Pascual-Figal, Domingo; Brugada, J.; Batlle, M.; Berruezo, A.; Hevia, S.; Mont, L.; Pérez-Villa, F.; Cinca, J.; Roig, E.; Bayés de Luna, A.; Borrás, X.; Carreras, F.; Ferrero, A.; Guerra, J.M.; Hove-Madsen, L.; Jorge, E.; Martínez, R.; Padró, J.; Puig, T.; Ribas, N.; Viñolas, X.; Alvarez-Garcia, J.; González-Juanatey, J.R.; Bandín, M.; Eiras, S.; Fernández-Hernández, L.; García-Acuña, J.; Gómez-Otero, I.; Grigorian-Shamagian, L.; Lago, F.; Manzón, P.; Moure, M.; Otero-Raviña, F.; Otero-Santiago, F.; Rodino Janeiro, B.K.; Rubio, J.; Salgado, A.; Seoane, A.; Varela, A.; Lear, P.V.; Fernández-Cruz, A.; Alvarez de Arcaya Vicente, A.; Avila, M.; Bordiu, E.; Calle, L.; Fernández-Pinilla, C.; Gómez-Garre, D.; González-Rubio, L.; Marco, J.; Martell, N.; Muñoz-Pacheco, P.; Ortega, A.; Patiño, R.; Pedrajas, J.; Reinares, L.; Pérez-Villacastín, J.; Bover, R.; Cobos, M.; García-Quintanilla, J.; Moreno, J.; Pérez-Castellano, N.; Pérez-Serrano, M.; Vila, I.; Delgado, J.F.; Arribas, F.; Escribano, P.; Flox, A.; Jiménez López-Guarch, C.; Paradina, M.; Ruiz-Cano, J.; Sáenz de la Calzada, C.; Salguero, R.; Sánchez-Sánchez, V.; Tello de Meneses, R.; Vicente-Hernández, M.; Alonso-Pulpón, L.; Fernández -Lozano, I.; García-Pavía, P.; García-Touchard, A.; Gómez-Bueno, M.; Márquez, J.; Segovia, J.; Silva, L.; Vázquez-Mosquera, M.; Valdés, M.; García-Alberola, A.; Garrido, I.; Pascual-Figal, D. A.; Pastor-Pérez, F.J.; Sánchez-Más, J.; Tornel, P.; Rivera, M.; Almenar, L.; Cortés, R.; Martínez-Dolz, L.; Montero, J.; Portolés, M.; Roselló-Lleti, E.; Salvador, A.; Vila, V.; Vázquez, R.; Cubero, J.; Fernández-Palacín, A.; García-Medina, D.; García-Rey, S.; Laguna, E.; Leal del Ojo, J.; Miñano, F.; Pastor-Torres, L.; Pavón, R.; Pérez-Navarro, A.; Villagómez, D.; Vázquez, R.; Arana, R.; Bartolomé, D.; Cabeza, P.; Calle-Pérez, G.; Camacho, F.; Cano, L.; Carrillo, A.; Díaz-Retamino, E.; Escolar, V.; Fernández-Rivero, R.; Gamaza, S.; Giráldes, A.; Hernández-Vicente, N.; Lagares, M.; López-Benítez, J.; Marante, M.; Otero, E.; Pedregal, J.; Sancho-Jaldón, M.; Sevillano, R.; Zayas, R.; Verdú, J.M.; Aguilar, S.; Aizpurúa, M.; Alguacil, F.; Casacuberta, J.; Cerain, J.; Domingo, M.; García-Lareo, M.; Herrero-Melechón, J.; López-Pareja, N.; Mena, A.; Pérez-Orcero, A.; Rodríguez- Cristóbal, J.; Rozas, M.; Sorribes, J.; Torán, P.; Worner, F.; Barta, L.; Bravo, C.; Cabau, J.; Casanova, J.; Daga, B.; De la Puerta, I.; Hernández-Martín, I.; Piñol, E.; Pueo, E.; Torres, G.; Troncoso, A.; Viles, D.; Bardají, A.; Mercè, J.; Sanz-Girgas, E.; Valdovinos, P.; Aramburu, O.; Arias, J.; García-González, C.; Alonso, M.; Bischofberger, C.; Domínguez-De Pablos, G.; Jiménez-Cervantes, D.; Ureña, I.; Grau-Sepúlveda, A.; Fiol, C.; Pericas, P.; Villalonga, M.; Orosa, P.; Agüero, J.; Planas-Aymá, F.; Grau-Amoros, J.; Planas-Comes, F.; San Vicente, L.

    2013-01-01

    Aims Intraventricular conduction defects (IVCDs) can impair prognosis of heart failure (HF), but their specific impact is not well established. This study aimed to analyse the clinical profile and outcomes of HF patients with LBBB, right bundle branch block (RBBB), left anterior fascicular block (LAFB), and no IVCDs. Methods and results Clinical variables and outcomes after a median follow-up of 21 months were analysed in 1762 patients with chronic HF and LBBB (n = 532), RBBB (n = 134), LAFB (n = 154), and no IVCDs (n = 942). LBBB was associated with more marked LV dilation, depressed LVEF, and mitral valve regurgitation. Patients with RBBB presented overt signs of congestive HF and depressed right ventricular motion. The LAFB group presented intermediate clinical characteristics, and patients with no IVCDs were more often women with less enlarged left ventricles and less depressed LVEF. Death occurred in 332 patients (interannual mortality = 10.8%): cardiovascular in 257, extravascular in 61, and of unknown origin in 14 patients. Cardiac death occurred in 230 (pump failure in 171 and sudden death in 59). An adjusted Cox model showed higher risk of cardiac death and pump failure death in the LBBB and RBBB than in the LAFB and the no IVCD groups. Conclusion LBBB and RBBB are associated with different clinical profiles and both are independent predictors of increased risk of cardiac death in patients with HF. A more favourable prognosis was observed in patients with LAFB and in those free of IVCDs. Further research in HF patients with RBBB is warranted. PMID:23512097

  3. Effect of repeated intracoronary injection of bone marrow cells in patients with ischaemic heart failure the Danish stem cell study--congestive heart failure trial (DanCell-CHF)

    DEFF Research Database (Denmark)

    Diederichsen, Axel Cosmus Pyndt; Møller, Jacob E; Thayssen, Per;

    2008-01-01

    BACKGROUND: It has been suggested that myocardial regeneration may be achieved by a single intracoronary bone marrow derived stem cell infusion in selected patients with ischaemic heart disease. The effect is uncertain in patients with chronic ischaemic heart failure and it is not known whether...... repeated infusions would have additional positive effects. AIMS: To assess whether two treatments of intracoronary infusion of bone marrow stem cells, administered 4 months apart, could improve left ventricular (LV) systolic function in patients with chronic ischaemic heart failure. METHODS: The study...... was prospective and non-randomised, comprising an observational baseline period of 4 months followed by an interventional period of 12 months. Intracoronary bone marrow cell infusion was performed at the end of the baseline period and repeated 4 months later. RESULTS: 32 patients were included. LV ejection...

  4. Traffic Congestion and Congestion Pricing

    OpenAIRE

    Verhoef, E.T.; Lindsey, C.R.

    2000-01-01

    For several decades growth of traffic volumes has outstrippedinvestments inroad infrastructure. The result has been a relentless increase intrafficcongestion. This paper reviews the economic principles behindcongestionpricing in static and dynamic settings, which derive from thebenefits ofcharging travellers for the externalities they create. Specialattention ispaid to various complications that make simple textbook congestionpricingmodels of limited relevance, and dictate that congestion pri...

  5. Cardiovascular and neurohumoral postural responses and baroreceptor abnormalities during a course of adjunctive vasodilator therapy with felodipine for congestive heart failure.

    Science.gov (United States)

    Kassis, E; Amtorp, O

    1987-06-01

    Studies in patients with congestive heart failure (CHF) have demonstrated an abnormal beta-adrenergic reflex vasodilation during orthostatic tilt. Baroreflex modulation of vascular resistance in patients with CHF was investigated during therapy with a vasoselective calcium antagonist, felodipine. Eight patients on conventional therapy for severe CHF were studied after a 3 week course of additional felodipine or placebo treatment under randomized, double-blind, and crossover conditions. Forearm subcutaneous vascular resistance (FSVR) was estimated with use of the local 133Xe washout. Aortic pulsatile stretch, expressed as the systolic distension in percent of diastolic diameter, was calculated from echocardiographic measurements of aortic root diameters. At 3 weeks, felodipine reduced the arterial pressure, systemic vascular resistance, and FSVR, preserved cardiac filling pressures and heart rate, and increased cardiac output, stroke volume, and aortic pulsatile stretch. Upright tilt (45 degrees) was used to study baroreflex-mediated cardiovascular responses. The unloading of cardiopulmonary baroreceptors during upright tilt was substantial and about equal during both treatment courses, but the pulse pressure was maintained during the placebo and decreased during the felodipine period. During tilt, the patients on placebo failed to increase heart rate and their FSVR, systemic vascular resistance, and arterial mean pressure were decreased, whereas during tilt after felodipine, heart rate and systemic vascular resistance increased to maintain arterial mean pressure and FSVR also tended to increase. Both the stroke volume and aortic pulsatile stretch increased during tilt in patients on placebo but they decreased in those on felodipine. The tilt caused increments in circulating norepinephrine and epinephrine levels during both treatment regimens. Regulation of FSVR during the sympathetic stimulation of orthostatic stress was further elucidated. Proximal neural blockade

  6. [RELATIONSHIP BETWEEN INFLAMMATIONAND HEART DYSSYNCHRONY IN PATIENTS WITH CHRONIC HEART FAILURE AND DIABETES MELLITUS TYPE 2].

    Science.gov (United States)

    Asoyan, I; Bilchenko, A; Pavlov, S

    2016-07-01

    The study involved 100 patients with chronic heart failure of ischemic origin II-III functional class (NYNA) and diabetes mellitus type 2. The concentration of serum markers of inflammation was determined by enzyme immunoassay. Сardiac dyssynchrony was detected echocardiographic and electrocardiographic methods. The study showed that the presence of cardiac dyssynchrony is accompanied by significant increase concentrations of inflammatory markers (CRP (p=2•10-9), TNF-α (p=4•10-6), IL-1β (p=0,01596), IL-6 (р=2•10-6) in patients. Аlso revealed statistically significant direct correlations between levels: Ts and CRP (r=0,604; pdiabetes. PMID:27661275

  7. Catheterization Caused Congestive Heart Failure Rabbit Model of Heart Qi deficiency%导管术致新西兰兔充血性心衰的心气虚模型研究

    Institute of Scientific and Technical Information of China (English)

    王萧; 董浩然; 林传权; 许庆文

    2012-01-01

    Objective To construct congestive heart failure rabbit model of heart Qi deficiency caused by catheterization. Methods Construct cardiac hyper-volume overload, rabbit heart failure model was caused by catheterization.Fifteen and 30 days after modeling, the general status, feed consumption index, body weight index, heart rate, respiration and ECG were observed and measured. Results Compared with the normal control group, SBP, DBP, LVSP and other hemodynamic index decreased significantly. After 15 and 30 days of modeling, the activity of model's rabbit was significantly reduced, the apathetic, efforts of resisting grab were reduced, feed consumption and body weight indices were decreased, breathing and heart rate were increased significantly, abnormal Q wave was appeared, and ST wave segment was elevated. Conclusion The heart rate, respiration, ECG, body weight and feed consumption index and other indicators can qualitatively and quantitatively reflect the heart failure model of heart qi deficiency.%目的 运用导管术构建新西兰兔充血性心衰的心气虚模型.方法 运用导管术造成兔的超容量负荷型心衰模型,造模后15d和30d从动物的一般状态、饲料消耗指数、体重增加指数、心率、呼吸频率和心电图等指标进行量化观察.结果 与正常对照组比较,SBP、DBP和LVSP 等血流动力学指标显著性下降,造模后15 d、30 d家兔活动明显减少、精神萎靡、抓起反抗力度减轻,饲料消耗指数与体重增加指数降低,呼吸频率和心率明显增加,且心电图出现异常Q波、ST段抬高.结论 以动物的一般状态、心率、呼吸频率、心电图表现、饲料消耗指数和体重增加指数等指标基本可以定性定量地反映出充血性心衰的心气虚模型特征.

  8. Comparison of the Frequency-dependent Effects of Amiodarone on Ventricular Electrophysiology in Congestive Heart Failure Canine Models and Normal Dogs

    Institute of Scientific and Technical Information of China (English)

    Zhou Shuxian; Zhang Yuling; Lei Juan; Wu Wei; Zhang Xuming

    2007-01-01

    Objectives To compare the frequency-dependent effects of amiodarone (Ami) on ventricular electrophysiology in right ventricular rapid pacing-induced congestive heart failure (CHF) canine models.Methods Thirty-two dogs were randomized into four groups: the control group, the Ami group in which the normal dogs were given Ami orally 300 mg a day for 4~5 weeks, the CHF group induced by right ventricular rapid pacing ( 240 pulses. min -1 for 4 ~ 5 weeks), and the group of CHF dogs fed with Ami orally 300 mg a day for 4 ~ 5 weeks. The techniques of electrical stimulation and monophasic action potential (MAP) recording were used in the electrophysiology studies. Results The effects of Ami on ventricular MAP duration(MAPD90) and effective refractory period (VERP)were not frequency-dependent in CHF dogs. There was also no frequency-dependent effect on the increase in the ratio of VERP to MAPD90 (VERP/MAPD90). The prolongation of ventricular conduction time was frequencydependent. Conclusions The frequency-dependent effects of Ami on ventricular electrophysiology in CHF dogs were similar to that in normal dogs.

  9. Association of chronic mucus hypersecretion with FEV1 decline and chronic obstructive pulmonary disease morbidity. Copenhagen City Heart Study Group

    DEFF Research Database (Denmark)

    Vestbo, J; Prescott, E; Lange, P

    1996-01-01

    The aim of this study was to examine the association between chronic mucus hypersecretion, and FEV1 decline, and subsequent hospitalization from chronic obstructive pulmonary disease (COPD). We used data from The Copenhagen City Heart Study on 5,354 women and 4,081 men 30 to 79 yr of age with...

  10. Multicenter, randomized, placebo-controlled, double-blind study of the safety and efficacy of oral delapril in patients with congestive heart failure.

    Science.gov (United States)

    Circo, A; Platania, F; Mangiameli, S; Putignano, E

    1995-06-16

    A total of 101 patients (67 delapril, 34 placebo) with congestive heart failure, New York Heart Association (NYHA) classes II and III, entered a multicenter, randomized (2:1), double-blind, placebo-controlled study to determine the minimum effective and maximum tolerated doses of delapril. Patients received placebo or increasing doses of delapril. After a 2-week run-in period on placebo, patients were randomly assigned to delapril or placebo. The dose of delapril was 7.5 mg twice daily for 2 weeks, 15 mg twice daily for another 2 weeks, followed by 30 mg twice daily for 4 weeks. The dose was increased only if the patient did not present any symptoms of orthostatic hypotension. If such symptoms developed, the code was broken and an open treatment was continued on the minimum effective dose (delapril group). Patients with symptoms of orthostatic hypotension in the placebo group were withdrawn. At the end of the 8-week treatment, 36 (54.5%) patients in the delapril group completed the study on 30 mg twice daily, 12 (18.2%) on 15 mg twice daily, and 18 (27.3%) on 7.5 mg twice daily. Seven patients on placebo were withdrawn because of insufficient therapeutic response; one patient on delapril was lost to follow-up. There was a significant improvement (p < 0.01) in bicycle ergometric performance involving an increase in the exercise duration and the maximum workload tolerated in those patients completing the study on delapril 30 mg twice daily and those finishing on 15 mg twice daily.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:7778529

  11. [CHARACTERISTIC OF ALTERATIONS OF ARTERIES IN PATIENTS WITH ISCHEMIC HEART DISEASE AND CHRONIC HEPATITIS C].

    Science.gov (United States)

    Guliaev, N I; Kuznetsov, V V; Poltareĭko, D S; Qleksiuk, I B; Gordienko, A V; Barsukov, A V

    2015-01-01

    The article presents an assessment of degree and type of atherosclerosis of coronary and non-coronary vessels in old patients with ischemic heart disease associated with chronic viral hepatitis C (VHC), the incidence of myocardial infarction and the possibility of participation chronic VHC in atherogenesis. Patients with ischemic heart disease have correlation of atherosclerosis of arteries with age, hypercholesterinemia. Patients without chronic VHC more often give a higher risk of myocardial infarction, especially in early period (1-1,5 years) of onset of ischemic heart disease clinical implications. Patients with ischemic heart disease associated with chronic viral hepatitis C more often have generalized alterations in vessels, multifocal type of alteration. So, participation of VHC in atherogenesis is most probably connected with maintenance of chronic immune inflammation in vascular endothelium.

  12. Sildenafil Improves Erectile Function in Men with Chronic Heart Failure

    Directory of Open Access Journals (Sweden)

    Niloufar Samiei

    2015-06-01

    Full Text Available Background: Patients with Chronic Heart Failure (CHF have been shown to have enhanced risk of Erectile Dysfunction (ED due to low cardiac output, endothelial dysfunction, medications, co-morbid conditions, and psychogenic factors. Objectives: The present study aimed to evaluate the effects of sildenafil on erectile function of patients with stable CHF using the abridged 5-item version of the International Index of Erectile Function (IIEF-5. Patients and Methods: Using convenience sampling, 222 sexually-active adult males with NYHA class I-III stable CHF were included in this cross-sectional study. All the patients filled out the IIEF-5 questionnaire, in which they were required to score the five domains of male sexual function, including erectile function, orgasm function, sexual desire, intercourse satisfaction, and overall satisfaction. All the analyses were performed using the SPSS statistical software (v. 19 and P < 0.05 was considered as statistically significant. Results: In our sample, the patients’ mean age was 47.14 ± 11.86 years, their mean left ventricular ejection fraction was 20% (15% - 25%, and the prevalence of ED was 70.3%. In addition, severe, moderate, mild to moderate, and mild ED were seen in 57%, 17%, 7%, and 19% of the patients with ED, respectively. ED was significantly more prevalent in the patients with ischemic heart failure compared to those with idiopathic dilated cardiomyopathy (84.68% vs. 55.85%, P < 0.001. Moreover, the prevalence of ED was significantly lower in the patients taking sildenafil compared to the other group (42.85% vs. 82.89%, P < 0.001. Conclusions: Sildenafil appears to provide satisfactory results toward improving sexual function in patients with CHF.

  13. End-of-life matters in chronic heart failure patients

    OpenAIRE

    Sobanski, Piotr; Jaarsma, Tiny; Krajnik, Malgorzata

    2014-01-01

    Purpose of review Until recently, concepts of care for people with heart failure had rarely included preparation for unavoidable imminent death or caring for the dying. The purpose of this review is to provide an update on current end-of-life issues specific to heart failure patients. Recent findings Mortality in the heart failure population remains high, especially shortly after the first acute heart failure hospitalization. Patients with systolic heart failure die more frequently from progr...

  14. Discrimination power of long-term heart rate variability measures for chronic heart failure detection.

    Science.gov (United States)

    Melillo, Paolo; Fusco, Roberta; Sansone, Mario; Bracale, Marcello; Pecchia, Leandro

    2011-01-01

    The aim of this study was to investigate the discrimination power of standard long-term heart rate variability (HRV) measures for the diagnosis of chronic heart failure (CHF). The authors performed a retrospective analysis on four public Holter databases, analyzing the data of 72 normal subjects and 44 patients suffering from CHF. To assess the discrimination power of HRV measures, an exhaustive search of all possible combinations of HRV measures was adopted and classifiers based on Classification and Regression Tree (CART) method was developed, which is a non-parametric statistical technique. It was found that the best combination of features is: Total spectral power of all NN intervals up to 0.4 Hz (TOTPWR), square root of the mean of the sum of the squares of differences between adjacent NN intervals (RMSSD) and standard deviation of the averages of NN intervals in all 5-min segments of a 24-h recording (SDANN). The classifiers based on this combination achieved a specificity rate and a sensitivity rate of 100.00 and 89.74%, respectively. The results are comparable with other similar studies, but the method used is particularly valuable because it provides an easy to understand description of classification procedures, in terms of intelligible "if … then …" rules. Finally, the rules obtained by CART are consistent with previous clinical studies. PMID:21203855

  15. EFFECT OF MITRAL REGURGITATION ON CHRONIC HEART FAILURE COURSE AND STRUCTURE-FUNCTIONAL HEART STATE

    Directory of Open Access Journals (Sweden)

    V. N. Larina

    2009-01-01

    Full Text Available Aim. To evaluate chronic heart failure (CHF course, functional and structural heart changes in patients with functional mitral regurgitation (MR of various degrees.Material and methods. A total of 104 outpatients (60-85 y. o. with CHF of functional class II-IV by NYHA and functional MR of I-II degrees and MR of III-IV degrees were included into the study groups.Results: Patients in both groups were comparable in sex, age, CHF duration, body mass index, systolic and diastolic blood pressure, clinical state by the clinical state scale, quality of life, anxious and depressive status. The majority of patients with MR III had significant left ventricle (LV systolic dysfunction (p=0,029, severe CHF course (p=0,034, received furosemide (p=0.004 and digoxin (p=0,004. They had significant increase in end-diastolic dimension (p<0,001, end-systolic dimension (p<0,001, left atrium (p=0,004, end-diastolic volume (p<0,001, end-systolic volume (p<0,001, pulmonary artery pressure (p<0,001, decrease in LV relative wall thickness (p=0,021 and LV ejection fraction (p<0,001. Patients of this group were hospitalized because of CHF decompensation and ischemic heart disease exacerbation more often (p=0,045.Conclusion. MR can be considered as one of sensitive predictors of LV geometry and function alteration in CHF patients and play an important role in symptoms development.

  16. EFFECT OF MITRAL REGURGITATION ON CHRONIC HEART FAILURE COURSE AND STRUCTURE-FUNCTIONAL HEART STATE

    Directory of Open Access Journals (Sweden)

    V. N. Larina

    2016-01-01

    Full Text Available Aim. To evaluate chronic heart failure (CHF course, functional and structural heart changes in patients with functional mitral regurgitation (MR of various degrees.Material and methods. A total of 104 outpatients (60-85 y. o. with CHF of functional class II-IV by NYHA and functional MR of I-II degrees and MR of III-IV degrees were included into the study groups.Results: Patients in both groups were comparable in sex, age, CHF duration, body mass index, systolic and diastolic blood pressure, clinical state by the clinical state scale, quality of life, anxious and depressive status. The majority of patients with MR III had significant left ventricle (LV systolic dysfunction (p=0,029, severe CHF course (p=0,034, received furosemide (p=0.004 and digoxin (p=0,004. They had significant increase in end-diastolic dimension (p<0,001, end-systolic dimension (p<0,001, left atrium (p=0,004, end-diastolic volume (p<0,001, end-systolic volume (p<0,001, pulmonary artery pressure (p<0,001, decrease in LV relative wall thickness (p=0,021 and LV ejection fraction (p<0,001. Patients of this group were hospitalized because of CHF decompensation and ischemic heart disease exacerbation more often (p=0,045.Conclusion. MR can be considered as one of sensitive predictors of LV geometry and function alteration in CHF patients and play an important role in symptoms development.

  17. Percentage of peak-to-peak pulsatility of portal blood flow can predict right-sided congestive heart failure

    Institute of Scientific and Technical Information of China (English)

    Jui-Ting Hu; Sien-Sing Yang; Yun-Chih Lai; Cheng-Yen Shih; Cheng-Wen Chang

    2003-01-01

    AIM: To study the change of portal blood flow for the prediction of the status of right-sided heart failure by using non-invasive way.METHODS: We studied 20 patients with rheumatic and atherosclerotic heart diseases. All the patients had constant systemic blood pressure and body weight 1 week prior to the study. Cardiac index (CI), left ventricular end-diastolic pressure (LVEDP), mean aortic pressure (AOP), pulmonary wedge pressure (PWP), mean pulmonary arterial pressure (PAP), mean right atrial pressure (RAP), right ventricular end-diastolic pressure (RVEDP) were recorded during cardiac catheterization. Ten patients with RAP<10 mmHg were classified as Group 1. The remaining 10 patients with RAP ≥ 10 mmHg were classified as Group 2. Portal blood velocity profiles were studied using an ultrasonic Doppler within 12h after cardiac catheterization.RESULTS: CI, AOP, and LVEDP had no difference between two groups. Patients in Group 1 had normal PWP (14.6±7.3mmHg), PAP (25.0±8.2 mmHg), RAP (4.7±2.4 mmHg), and RVEDP (6.4±2.7 mmHg). Patients in Group 2 had increased PWP (29.9±9.3 mmHg), PAP (46.3±13.2 mmHg), RAP (17.5±5.7 mmHg), and RVEDP (18.3±5.6 mmHg) (P<0.001).Mean values of maximum portal blood velocity (Vmax), mean portal blood velocity (Vmean), cross-sectional area (Area)and portal blood flow volume (PBF) had no difference between 2 groups. All the patients in Group 1 had a continuous antegrade portal flow with a mean percentage of peak-topeak pulsatility (PP) 27.0±8.9 % (range: 17-40 %). All the patients in Group 2 had pulsatile portal flow with a mean PP 86.6±45.6 (range: 43-194 %). One patient had a transient stagnant and three patients had a transient hepatofugal portal flow, which occurred mainly during the ventricular systole. Vmax, Vmean and PBF had a positive correlation with CO (P<0.001) but not with AOP, LVEDP, PWP, PAP,RAP, and RVEDP.PP showed a good correlation (P<0.001)with PWP, PAP, RAP, and RVEDP but not with CI, AOP, and LVEDP. All

  18. The relationship of H-type hypertension and renal insufficiency in coronary heart disease patients with chronic heart failure

    Institute of Scientific and Technical Information of China (English)

    郑卫峰

    2014-01-01

    Objective To discuss the relationship between Htype hypertension and renal insufficiency in patients with coronary atherosclerotic heart disease(CHD)and chronic heart failure(CHF).Methods 100 CHD patients with both hypertension and CHF were chosen in our hospital from January 2011 to July 2013.Left ventricular ejection fraction(LVEF)was measured with echocardiography and estimated glomerular filtration rate(e GFR)was calculated with the simplified modification of diet in renal

  19. Features of The Heart Remodeling in Patients with Chronic Obstructive Pulmonary Diseases, Combined with Coronary Heart Diseases

    Directory of Open Access Journals (Sweden)

    A.Yu. Ryabova

    2009-09-01

    Full Text Available The characteristics of heart remodeling in patients with chronic obstructive pulmonary diseases ( COPD, associated with coronary heart diseases (CHD were examined. The changes of structural and functional state of myocardium, intracardiac relationships with associated pathology were under study. The role of blood inflammatory cytokines (IL-6, IL-8, TNF-a and the level of cell adhesion molecules (ICAM-1, VCAM-1 in exacerbating myocardial dysfunction was clarified.

  20. The Analysis of Anemia in Chronic Heart Failure

    Institute of Scientific and Technical Information of China (English)

    Yuan Guiyi; Wu Wei; Luo Yilong; Li Yiqing; Zhou Shuxian; Fang Chang

    2006-01-01

    objectives To demonstrate the phenomena and explore the causes of anemia in patients with chronic heart failure (CHF). Methods To observe the phenomena of anemia in patients with CHF, a total of 276 patients with CHF were included in this retrospective study. The clinical characteristics of the patients are: mean age 69.2±11.0 years; male 151,female 125; NYHA Ⅲ and Ⅳ 115 (41.7%). Results ①Among the 276 patients with CHF, 81 (29.4%)had anemia (Mean hemoglobulin concentration 101.5±13.0g/L). ② Patients with Anemia were more likely to be female and to have greater NYHA (Ⅲ or Ⅳ) (P<0.05), higher serum creatinine, as well as lower serum albumin and low-density lipoprotein levels (P<0.01).③ A weak negative correlation was also noted between the level of NYHA and hemoglobulin. ④ There was no significant difference in age, the primary cardiac etiology of the CHF, the history of diabetes, left ventricular end diastolic diameter, and left ventricular ejection fraction between CHF patient with and without anemia. Conclusions The prevalence of anemia is high among patients with CHF. The anemia patients with CHF tend to be female, have greater cardiac and renal functional impairment, but with lower serum albumin and LDL that suggests some degree of malnutrition.

  1. The progression to permanent atrial fibrillation with congestive heart failure is associated with sympathetic nerve abnormality. A study with I-123 metaiodobenzylguanidine scintigraphy

    International Nuclear Information System (INIS)

    The aim of this study was to evaluate the relationship between congestive heart failure (CHF) and atrial fibrillation (AF) using iodine-123 metaiodobenzylguanidine (MIBG) scintigraphic imaging. Ninety-two AF patients (47 male and 45 female patients; mean age, 67±13 years) who did not suffer from structural heart disease or myocardial ischemia underwent MIBG scintigraphy. Global MIBG uptake was assessed by measuring the heart-to-mediastinal ratio (H/M) and washout rate (WR) on planar images, and the abnormal score (AS) was calculated on delayed MIBG single photon emission computed tomography images. Echocardiography was performed within a week after MIBG scintigraphy, to measure left ventricular ejection fraction (EF) and deceleration time (DT). The AF patients were divided into four groups: patients with permanent AF with (n=23, group A) or without (n=19, group B) a history of CHF, and patients with paroxysmal AF with (n=19, group C) or without (n=39, group D) a history of CHF. The H/M ratio was significantly lower in group A than in other groups (2.0±0.6 vs. group B: 2.7±0.6, group C: 2.3±0.5, and group D: 2.6±0.8, P<0.05), and in group C than in group D (P<0.05). Similarly, the WR was significantly higher in group A than in groups B and C (45.9±2.0 vs. group B: 38.9±1.9 and group C: 38.4±2.3, P<0.05). The AS was the highest in group A (19.7±8.2 vs. group B: 7.1±6.6, P<0.01; group C: 11.6±10.6 and group D: 13.5±9.0, P<0.05). The DT was significantly longer in group A than in groups B and D (222.0±59.4 vs. group B: 179.5±49.1, P<0.05 and group D: 177.9±37.1, P<0.01), but did not differ between groups A and C (222.0±59.4 vs. 197.4±51.1). There was no difference in EF among the groups. Although CHF with AF is associated with diastolic dysfunction, the progression to permanent AF from paroxysmal AF with CHF might be caused mainly by sympathetic nerve abnormality. (author)

  2. 胺碘酮治疗心衰伴心律失常的临床分析%Therapeutic effects of amiodarone on chronic heart failure complicated by arrhythmia

    Institute of Scientific and Technical Information of China (English)

    周兰珠

    2010-01-01

    目的 评价胺碘酮治疗心力衰竭(HF)伴心律失常的疗效.方法 选择心力衰竭合并心律失常患者96例,在抗心衰治疗同时给予口服胺碘酮6周.结果 治疗6周后观察总有效率91.9%.结论 胺碘酮治疗HF伴心律失常安全、有效.%Objective To evaluate the the therapeutic effects of amiodarone on chronic heart failure complicated by arrhythmia. Methods From 2006 to 2008,96 chronic congestive heart failure patients with arrhythmia were enrolled. All patients were given standard medical treatment according to the current practice guidelines with a β-blocker, an angiotensin-converting enzyme(ACE) inhibitor, and diuretics. At the same time,they were also given oral amiodarone for six weeks. Results After 6 weeks' treatment with amiodarone,the total effective therapeutic effects was 91.9 percent. Conclusion For patients with chronic congestive heart failure complicated by with arrhythmia, amiodarone treatment for six weeks is safe and effective.

  3. Inhalation of diluted diesel engine emission impacts heart rate variability and arrhythmia occurrence in a rat model of chronic ischemic heart failure

    Energy Technology Data Exchange (ETDEWEB)

    Anselme, Frederic [Rouen University Hospital, Service de Cardiologie, Rouen (France); Loriot, Stephane; Henry, Jean-Paul; Thuillez, Christian; Morin, Jean-Paul [University of Rouen France, INSERM U644, School of Medicine-Pharmacy, Rouen, Cedex (France); Dionnet, Frederic [Centre d' Etudes et de Recherches Technologiques en Aerothermique et Moteurs, Saint Etienne du Rouvray (France); Napoleoni, Jean-Gerard [EMKA Technologies, Paris (France)

    2007-04-15

    Both increase in cardiac arrhythmia incidence and decrease in heart rate variability (HRV) have been described following human and experimental animal exposures to air pollutants. However, the potential causal relationship between these two factors remains unclear. Incidence of ventricular arrhythmia and HRV were evaluated during and after a 3 h period of Diesel engine exhaust exposure in ten healthy and ten chronic ischemic heart failure (CHF, 3 months after coronary ligation) Wistar rats using implantable ECG telemetry. Air pollutants were delivered to specifically designed whole body individual exposure chambers at particulate matter concentrations similar to those measured inside cabins of cars inserted in congested urban traffic. Recordings were obtained from unrestraint and unsedated vigil rats. Immediate decrease in RMSSD was observed in both healthy (6.64 {+-} 2.62 vs. 4.89 {+-} 1.67 ms, P < 0.05) and CHF rats (8.01 {+-} 0.89 vs. 6.6 {+-} 1.37 ms, P < 0.05) following exposure. An immediate 200-500% increase in ventricular premature beats was observed in CHF rats only. Whereas HRV progressively returned to baseline values within 2.5 h after exposure start, the proarrhythmic effect persisted as late as 5 h after exposure termination in CHF rats. Persistence of ventricular proarrhythmic effects after HRV normalization suggests that HRV reduction is not the mechanism of cardiac arrhythmias in this model. Our methodological approach, closely reflecting the real clinical situations, appeared to be a unique tool to provide further insight into the pathophysiological mechanisms of traffic related airborne pollution health impact. (orig.)

  4. Is Pancreatic Exocrine Insufficiency A Result of Decreased Splanchnic Circulation in Patients with Chronic Heart Failure?

    OpenAIRE

    Vujasinovic Miroslav; Martin Tretjak; Bojan Tepes; Apolon Marolt; Cirila Slemenik Pusnik; Mateja Kotnik Kerbev; Sasa Rudolf

    2016-01-01

    Introduction Pancreatic exocrine insufficiency is associated with various pancreatic illnesses and could be associated with extra pancreatic diseases. In chronic heart failure patients, the splanchnic circulation is decreased. If the reduced circulation is prolonged, tissue damage to the splanchnic organs is possible. The aim of our study was to determine the prevalence of pancreatic exocrine insufficiency in chronic heart failure patients as well as its clinical importance. Patients and Meth...

  5. Febuxostat, a nonpurine selective inhibitor of xanthine oxidase: a promising medical therapy for chronic heart failure?

    Institute of Scientific and Technical Information of China (English)

    GAO Ling-gen; YAO Xiu-ping; ZHANG Lin; WEN Dan; LUO Fang; ZHOU Xian-liang; HUI Ru-tai

    2010-01-01

    @@ Heart failure is currently one of the most common and most cost-intensive of the chronic diseases.1 The main cause of chronic heart failure (CHF) is the abnormalities of both cardiac contractile performance and myocardial energy metabolism. Elevated levels of reactive oxygen species (ROS) have been proposed to contribute to both of them. Xanthine oxidoreductase (XO)is a major source of ROS in the cardiovascular system.

  6. Serious adverse events experienced by patients with chronic heart failure taking spironolactone

    OpenAIRE

    C. Berry; McMurray, J.

    2001-01-01

    In patients with chronic heart failure, spironolactone added to conventional treatment may lead to serious and, occasionally, fatal hyperkalaemia. In some cases this seems to happen because spironolactone causes diarrhoea. Four cases involving men with New York Heart Association functional class III heart failure are presented. As these cases revealed, close monitoring of blood chemistry is mandatory after starting spironolactone, and patients should be advised to stop spironolactone immediat...

  7. Expression of platelet-bound stromal-cell derived factor-1 (SDF-1) and number of CD34(+) progenitor cells in patients with congestive heart failure.

    Science.gov (United States)

    Jorbenadze, Rezo; Schleicher, Erwin; Bigalke, Boris; Stellos, Konstantinos; Gawaz, Meinrad

    2014-01-01

    Platelet-bound stromal cell-derived factor-1 (SDF-1) plays a crucial role in attachment of circulating CD34(+) progenitor cells to the vascular wall, facilitating tissue healing after injury. However there is no evidence about expression of platelet-bound SDF-1 in patients with congestive heart failure (CHF). The aim of our study was to evaluate expression of platelet-bound SDF-1 and number of CD34(+) progenitor cells in patients with CHF. Forty-eight patients with idiopathic dilated cardiomyopathy (DCM) and 61 patients with ischaemic cardiomyopathy (ICM) were consecutively enrolled into the study. Blood taken from 109 consecutive patients was studied for surface expression of platelet-bound SDF-1 and number of CD34(+) progenitor cells by flow cytometry. The highest expression of platelet-bound SDF-1 was observed in patients with severe impairment of left ventricular systolic function compared with patients with mild or moderate impairment of left ventricular systolic function (mild vs. moderate vs. severe impairment of left ventricular systolic function: MFI ± SD: 35.6 ± 34 vs. 101.45 ± 73 vs. 124.86 ± 86.7, Kruskal-Wallis p number of CD34(+) progenitor cells was the highest in severe impairment of left ventricular systolic function (mild vs. moderate vs. severe impairment of left ventricular systolic function: mean ± SD: 260.4 ± 177.5 vs. 580.7 ± 340.5 vs. 640.82 ± 370.6, Kruskal-Wallis p number of circulating CD34(+) progenitor cells (r = 0.454, p number of CD34(+) cells were higher in patients with DCM compared with patients with ICM (p cells are especially increased in patients with severe impairment of left ventricular systolic function in CHF.

  8. The change of plasma leptin level and its correlation study with insulin resistance or TNF-αin patients with congestive heart failure

    Institute of Scientific and Technical Information of China (English)

    张金国; 杨娜; 高东升; 王学忠; 宋光耀; 王智华

    2004-01-01

    Objectives To determine the change of plasma leptin levels and the correlation between hyperleptinaemia and insulin resistance or TNF-o in patients with congestive heart failure (CHF). Methods The levels of plasma leptin, fasting plasma insulin (FINS) and TNF-α in 64 male patients with CHF and 30 healthy male people were measured by ELISA. Body mass index (BMI), waist/hip ratio (WHR) and insulin resistance index (Homa-IR) were calculated respectively. Results The plasma leptin levels in CHF group were higher compared with control group (P<0.001). There was a increased trend of plasma leptin levels in CHF group with the increase of NYHA class (rs=0.884, P<0.001); according to different etiology ,there was no significant difference of plasma leptin levels in CHF group (P>0.05); FINS,Homa-IR and TNF-o levels in CHF group were higher than in control group (all P<0.001); in CHF group plasma leptin levels correlated with FINS (r=0.652,P<0.001),Homa-IR (r=0.561,P<0.001) and TNF-α (r=0.629,P<0.001); in multiple stepwise regression analysis BMI, FINS and TNF-α were isolated factors affecting plasma leptin levels in CHF group, Y=-3.466+0.456 (BMI)+ 0.162 (FINS)+4.487(TNF-α), F=38.405,P<0.001. Conclusions plasma leptin levels were raised and correlated with disease severity in patients with CHF; FINS and TNF-α were isolated factor affecting plasma leptin level in CHF patients; hyperleptinaemia may play a role in the pathophysiology of CHF such as catabolic process and activation of neurohormonal.

  9. Increased Circulating Cathepsin K in Patients with Chronic Heart Failure.

    Directory of Open Access Journals (Sweden)

    Guangxian Zhao

    Full Text Available Cysteinyl cathepsin K (CatK is one of the most potent mammalian collagenases involved in cardiovascular disease. Here, we investigated the clinical predictive value of serum CatK levels in patients with chronic heart failure (CHF. We examined 134 patients with CHF, measuring their serum CatK, troponin I, high-sensitive C-reactive protein, and pre-operative N-terminal pro-brain natriuretic peptide levels. The patients were divided into two groups: the 44 patients who showed a left ventricular (LV ejection fraction (LVEF < 40% (the "lowLVEF" group and the 90 patients showing LVEF values ≥ 40% (the "highLVEF" group. The lowLVEF patients had significantly higher serum CatK levels compared to the highLVEF patients (58.4 ± 12.2 vs. 44.7 ± 16.4, P < 0.001. Overall, a linear regression analysis showed that CatK levels correlated negatively with LVEF (r = -0.4, P < 0.001 and positively with LV end-diastolic dimensions (r = 0.2, P < 0.01, LV end-systolic dimensions (r = 0.3, P < 0.001, and left atrial diameters (r = 0.3, P < 0.01. A multiple logistic regression analysis showed that CatK levels were independent predictors of CHF (odds ratio, 0.90; 95% confidence interval, 0.84-0.95; P < 0.01. These data indicate that elevated levels of CatK are closely associated with the presence of CHF and that the measurement of circulating CatK provides a noninvasive method of documenting and monitoring the extent of cardiac remodeling and dysfunction in patients with CHF.

  10. Type D personality and cardiac mortality in patients with chronic heart failure

    DEFF Research Database (Denmark)

    Schiffer, Angélique A; Smith, Otto R F; Pedersen, Susanne S.;

    2010-01-01

    Clinical predictors of cardiac mortality in chronic heart failure (CHF) are established, but less is known about chronic psychological predictors. Therefore, we examined the prognostic value of Type D personality (tendency to experience negative feelings and inhibit self-expression) in CHF patients....

  11. Chronic beta-blocker treatment in patients with advanced heart failure - Effects on neurohormones

    NARCIS (Netherlands)

    Teisman, ACH; van Veldhuisen, DJ; Boomsma, F; de Kam, PJ; Pinto, YM; de Zeeuw, D; van Gilst, WH

    2000-01-01

    Background: To date, the use of beta-blockers in treating patients with chronic heart failure gains support, this since several large clinical trials reported reduced mortality after chronic beta-blockade. Part of these beneficial effects may result from inhibition of deleterious neurohormone activa

  12. Shifts in the age distribution and from acute to chronic coronary heart disease hospitalizations

    NARCIS (Netherlands)

    Koopman, Carla; Bots, Michiel L.; Van Dis, Ineke; Vaartjes, Ilonca

    2016-01-01

    Background Shifts in the burden of coronary heart disease (CHD) from an acute to chronic illness have important public health consequences. Objective To assess age-sex-specific time trends in rates and characteristics of acute and chronic forms of CHD hospital admissions in the Netherlands. Methods

  13. Current Evidence on Treatment of Patients With Chronic Systolic Heart Failure and Renal Insufficiency

    NARCIS (Netherlands)

    Damman, Kevin; Tang, W. H. Wilson; Felker, G. Michael; Lassus, Johan; Zannad, Faiez; Krum, Henry; McMurray, John J. V.

    2014-01-01

    Chronic kidney disease (CKD) is increasingly prevalent in patients with chronic systolic heart failure. Therefore, evidence-based therapies are more and more being used in patients with some degree of renal dysfunction. However, most pivotal randomized clinical trials specifically excluded patients

  14. Influence of sex on treatment and outcome in chronic heart failure.

    Science.gov (United States)

    Frankenstein, Lutz; Clark, Andrew L; Ribeiro, Jorge P

    2012-06-01

    The population is aging, the prevalence of heart failure increases with age, and on average women live longer than men. There is evidence for sex-specific effects of individual, guideline-recommended drugs used for treatment of chronic heart failure. Women are underrepresented in most clinical trials and only a minority of drug applications to regulatory authorities have included sex analyses. The present review focuses on the potential female survival benefit in heart failure, the influence of sex on medical treatment in a broader sense, and the potential benefit to be derived from guideline recommended treatment and common adjunctive heart failure medication.

  15. Color Doppler imaging of the ophthalmic artery in patients with chronic heart failure

    Directory of Open Access Journals (Sweden)

    Daniela B. Almeida-Freitas

    2011-10-01

    Full Text Available Purpose: To evaluate the ophthalmic artery hemodynamics in patients with chronic heart failure. Methods: Doppler parameters of ophthalmic artery of 18 patients with chronic heart failure in different stages of the disease were compared with 21 healthy volunteers (control group. These parameters were also correlated with echocardiographic assessments and clinical cardiologic status. Results: Mean diastolic velocity was 5.14 ± 2.4 cm/s in the chronic heart failure group and 7.44 ± 3.5 cm/s in the control group (p=0.007. Mean resistance index of the ophthalmic artery was 0.76 ± 0.08 in the chronic heart failure group and 0.70 ± 0.08 in the control group (p=0.04. Mean systolic velocity of the ophthalmic artery was 22.03 ± 7.7 cm/s in the chronic heart failure group and 25.32 ± 9.2 cm/s in the control group (p=0.24. There was a negative correlation between the resistance index of the ophthalmic artery and systemic blood pressure of patients with chronic heart failure (r= -0.47, p=0.007. Diastolic velocity of the ophthalmic artery correlated positively with systemic blood pressure (r=0.44, p=0.02. Conclusion: Lower diastolic velocity and higher resistance index were observed in the ophthalmic artery of chronic heart failure patients when compared to the control group, which probably reflects the presence of orbital vasoconstriction in response to low cardiac output. Therefore, the influence of these findings on the structure and function of the optic nerve head deserves investigation.

  16. Bridging the gap in heart failure prevention: rationale and design of the Nurse-led Intervention for Less Chronic Heart Failure (NIL-CHF) Study

    DEFF Research Database (Denmark)

    Carrington, Melinda J; Stewart, Simon; de Courten, Barbora

    2010-01-01

    AIMS: The primary objective of the Nurse-led Intervention for Less Chronic Heart Failure (NIL-CHF) Study is to develop a programme of care that cost-effectively prevents the development of chronic heart failure (CHF). Methods NIL-CHF is a randomized controlled trial of a hybrid, home- and clinic-...

  17. Advanced chronic heart failure : A position statement from the Study Group on Advanced Heart Failure of the Heart Failure Association of the European Society of Cardiology

    NARCIS (Netherlands)

    Metra, Marco; Ponikowski, Piotr; Dickstein, Kenneth; McMurray, John J. V.; Gavazzi, Antonello; Bergh, Claes-Hakan; Fraser, Alan G.; Jaarsma, Tiny; Pitsis, Antonis; Mohacsi, Paul; Boehm, Michael; Anker, Stefan; Dargie, Henry; Brutsaert, Dirk; Komajda, Michel

    2007-01-01

    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 c

  18. 参麦注射液对充血性心力衰竭患者微循环的影响研究%Study on the influence of Shenmai injection for the microcirculation of patients with congestive heart failure

    Institute of Scientific and Technical Information of China (English)

    尤莉

    2014-01-01

    目的:研究观察参麦注射液对充血性心力衰竭患者微循环的影响。方法将本院于2011年12月~2013年12月收治的70例充血性心力衰竭患者随机分为对照组(常规充血性心力衰竭治疗组)35例和观察组(常规充血性心力衰竭治疗加参麦注射液组)35例,然后将两组患者治疗前和治疗后1周与2周时的甲襞微循环积分值及其他指标进行统计与比较。结果观察组治疗后1周与2周时的甲襞微循环积分值均低于对照组,而其他指标也均好于对照组(P<0.05),两组患者治疗后1周与2周时统计结果之间差异均有统计学意义。结论参麦注射液对充血性心力衰竭患者微循环的影响较大,在充血性心力衰竭患者中的应用价值较高。%Objective To study and observe the influence of Shenmai injection for the microcirculation of patients with congestive heart failure. Methods 70 patients with congestive heart failure in our hospital from December 2011 to December 2013 were randomly divided into control group(conventional congestive heart failure treatment group) 35 cases and observation group(conventional congestive heart failure treatment and Shenmai injection group) 35 cases,then the nail fold microcirculation integral value and other indexes of two groups before the treatment and at first and second week after the treatment were analyzed and compared. Results The nail fold microcirculation integral value of observation group at first and second week after the treatment were all lower than those of control group,other indexes were all better than those of control group too(P<0.05),the analysis results of two groups at first and second week after the treatment all had significant differences. Conclusion The influence of Shenmai injection for the microcirculation of patients with congestive heart failure is great,and its application value in the patients with congestive heart failure is high.

  19. Rheumatic heart disease with triple valve involvement

    OpenAIRE

    BRAMBATI, MATTEO; LAURENZI, PIER FRANCESCO; MARLETTA, FIORANGELA; MANINA, GIORGIA; COMINA, DENISE PROVVIDENZA; PRESTON, NGAMBE MANDI; CASSETTI, GIUSEPPINA; MERLO, CHIARA; Volpi, Michele; MUSSO, ROBERTA; LA ROCCA, ROBERTO

    2013-01-01

    Acute rheumatic fever (ARF) is a postinfectious, nonsuppurative sequela of pharyngeal infection caused by Streptococcus pyogenes, or Group A β hemolytic Streptococcus (GABHS). Of the associated symptoms, only damage to the heart’s valvular tissue, or rheumatic heart disease (RHD), can become a chronic condition leading to congestive heart failure, stroke, endocarditis, and death. ARF is the most common cause of cardiac disease in children in developing countries. A joint meeting o...

  20. Indicators psychological status in patients with chronic heart failure

    OpenAIRE

    KADIROVA SHAHLO; KAMILOVA UMIDA KABIROVNA

    2016-01-01

    In patients with heart failure to study the psychological status of the relationship between indicators of psychological status and progression of the disease: patients with FC III identified more often more severe disorders with revalence of depressive disorders.

  1. Influence of Androgen Deprivation Therapy on All-Cause Mortality in Men With High-Risk Prostate Cancer and a History of Congestive Heart Failure or Myocardial Infarction

    International Nuclear Information System (INIS)

    Purpose: It is unknown whether the excess risk of all-cause mortality (ACM) observed when androgen deprivation therapy (ADT) is added to radiation for men with prostate cancer and a history of congestive heart failure (CHF) or myocardial infarction (MI) also applies to those with high-risk disease. Methods and Materials: Of 14,594 men with cT1c–T3aN0M0 prostate cancer treated with brachytherapy-based radiation from 1991 through 2006, 1,378 (9.4%) with a history of CHF or MI comprised the study cohort. Of these, 22.6% received supplemental external beam radiation, and 42.9% received a median of 4 months of neoadjuvant ADT. Median age was 71.8 years. Median follow-up was 4.3 years. Cox multivariable analysis tested for an association between ADT use and ACM within risk groups, after adjusting for treatment factors, prognostic factors, and propensity score for ADT. Results: ADT was associated with significantly increased ACM (adjusted hazard ratio [AHR] = 1.76; 95% confidence interval [CI], 1.32–2.34; p = 0.0001), with 5-year estimates of 22.71% with ADT and 11.62% without ADT. The impact of ADT on ACM by risk group was as follows: high-risk AHR = 2.57; 95% CI, 1.17–5.67; p = 0.019; intermediate-risk AHR = 1.75; 95% CI, 1.13–2.73; p = 0.012; low-risk AHR = 1.52; 95% CI, 0.96–2.43; p = 0.075). Conclusions: Among patients with a history of CHF or MI treated with brachytherapy-based radiation, ADT was associated with increased all-cause mortality, even for patients with high-risk disease. Although ADT has been shown in Phase III studies to improve overall survival in high-risk disease, the small subgroup of high-risk patients with a history of CHF or MI, who represented about 9% of the patients, may be harmed by ADT.

  2. Influence of Androgen Deprivation Therapy on All-Cause Mortality in Men With High-Risk Prostate Cancer and a History of Congestive Heart Failure or Myocardial Infarction

    Energy Technology Data Exchange (ETDEWEB)

    Nguyen, Paul L., E-mail: pnguyen@LROC.harvard.edu [Department of Radiation Oncology, Dana Farber Cancer Institute and Brigham and Women' s Hospital, Harvard Medical School, Boston, MA (United States); Chen, Ming-Hui [Department of Statistics, University of Connecticut, Storrs, CT (United States); Beckman, Joshua A. [Department of Cardiology, Brigham and Women' s Hospital, Harvard Medical School, Boston, MA (United States); Beard, Clair J.; Martin, Neil E. [Department of Radiation Oncology, Dana Farber Cancer Institute and Brigham and Women' s Hospital, Harvard Medical School, Boston, MA (United States); Choueiri, Toni K. [Lank Center for Genitourinary Oncology, Dana-Farber Cancer Institute, Boston, MA (United States); Hu, Jim C. [Division of Urologic Surgery, Brigham and Women' s/Faulkner Hospital, Harvard Medical School, Boston, MA (United States); Hoffman, Karen E. [Department of Radiation Oncology, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States); Dosoretz, Daniel E. [21st Century Oncology, Fort Myers, FL (United States); Moran, Brian J. [Chicago Prostate Center, Westmont, IL (United States); Salenius, Sharon A. [21st Century Oncology, Fort Myers, FL (United States); Braccioforte, Michelle H. [Chicago Prostate Center, Westmont, IL (United States); Kantoff, Philip W. [Lank Center for Genitourinary Oncology, Dana-Farber Cancer Institute, Boston, MA (United States); D' Amico, Anthony V. [Department of Radiation Oncology, Dana Farber Cancer Institute and Brigham and Women' s Hospital, Harvard Medical School, Boston, MA (United States); Ennis, Ronald D. [Department of Radiation Oncology, St. Luke' s-Roosevelt and Beth Israel Hospitals, Continuum Cancer Centers of New York, Albert Einstein College of Medicine, New York, NY (Israel)

    2012-03-15

    Purpose: It is unknown whether the excess risk of all-cause mortality (ACM) observed when androgen deprivation therapy (ADT) is added to radiation for men with prostate cancer and a history of congestive heart failure (CHF) or myocardial infarction (MI) also applies to those with high-risk disease. Methods and Materials: Of 14,594 men with cT1c-T3aN0M0 prostate cancer treated with brachytherapy-based radiation from 1991 through 2006, 1,378 (9.4%) with a history of CHF or MI comprised the study cohort. Of these, 22.6% received supplemental external beam radiation, and 42.9% received a median of 4 months of neoadjuvant ADT. Median age was 71.8 years. Median follow-up was 4.3 years. Cox multivariable analysis tested for an association between ADT use and ACM within risk groups, after adjusting for treatment factors, prognostic factors, and propensity score for ADT. Results: ADT was associated with significantly increased ACM (adjusted hazard ratio [AHR] = 1.76; 95% confidence interval [CI], 1.32-2.34; p = 0.0001), with 5-year estimates of 22.71% with ADT and 11.62% without ADT. The impact of ADT on ACM by risk group was as follows: high-risk AHR = 2.57; 95% CI, 1.17-5.67; p = 0.019; intermediate-risk AHR = 1.75; 95% CI, 1.13-2.73; p = 0.012; low-risk AHR = 1.52; 95% CI, 0.96-2.43; p = 0.075). Conclusions: Among patients with a history of CHF or MI treated with brachytherapy-based radiation, ADT was associated with increased all-cause mortality, even for patients with high-risk disease. Although ADT has been shown in Phase III studies to improve overall survival in high-risk disease, the small subgroup of high-risk patients with a history of CHF or MI, who represented about 9% of the patients, may be harmed by ADT.

  3. Sudden cardiac death in patients with diabetes mellitus and chronic heart failure.

    Science.gov (United States)

    Walker, Andrew Mn; Cubbon, Richard M

    2015-07-01

    In patients with diabetes mellitus, around 50% of deaths due to cardiovascular causes are sudden cardiac deaths. The prevalence of diabetes in cohorts with chronic heart failure is increasing, and while sudden cardiac death is an increasingly rare mode of death in chronic heart failure patients as a whole, the risk of this outcome remains high in those with diabetes. This review summarises the current knowledge on the incidence of sudden cardiac death in patients with diabetes and chronic heart failure, before discussing the causes of the excess risk seen in those with these coexistent conditions. We then describe current strategies for risk stratification and prevention of sudden cardiac death in these patients before discussing the priorities for further study in this area.

  4. Do telemonitoring projects of heart failure fit the Chronic Care Model?

    Directory of Open Access Journals (Sweden)

    Evi Willemse

    2014-07-01

    Full Text Available This study describes the characteristics of extramural and transmural telemonitoring projects on chronic heart failure in Belgium. It describes to what extent these telemonitoring projects coincide with the Chronic Care Model of Wagner.Background: The Chronic Care Model describes essential components for high-quality health care. Telemonitoring can be used to optimise home care for chronic heart failure. It provides a potential prospective to change the current care organisation.Methods: This qualitative study describes seven non-invasive home-care telemonitoring projects in patients with heart failure in Belgium. A qualitative design, including interviews and literature review, was used to describe the correspondence of these home-care telemonitoring projects with the dimensions of the Chronic Care Model.Results: The projects were situated in primary and secondary health care. Their primary goal was to reduce the number of readmissions for chronic heart failure. None of these projects succeeded in a final implementation of telemonitoring in home care after the pilot phase. Not all the projects were initiated to accomplish all of the dimensions of the Chronic Care Model. A central role for the patient was sparse.Conclusion: Limited financial resources hampered continuation after the pilot phase. Cooperation and coordination in telemonitoring appears to be major barriers but are, within primary care as well as between the lines of care, important links in follow-up. This discrepancy can be prohibitive for deployment of good chronic care. Chronic Care Model is recommended as basis for future.

  5. Do telemonitoring projects of heart failure fit the Chronic Care Model?

    Directory of Open Access Journals (Sweden)

    Evi Willemse

    2014-07-01

    Full Text Available This study describes the characteristics of extramural and transmural telemonitoring projects on chronic heart failure in Belgium. It describes to what extent these telemonitoring projects coincide with the Chronic Care Model of Wagner. Background: The Chronic Care Model describes essential components for high-quality health care. Telemonitoring can be used to optimise home care for chronic heart failure. It provides a potential prospective to change the current care organisation. Methods: This qualitative study describes seven non-invasive home-care telemonitoring projects in patients with heart failure in Belgium. A qualitative design, including interviews and literature review, was used to describe the correspondence of these home-care telemonitoring projects with the dimensions of the Chronic Care Model. Results: The projects were situated in primary and secondary health care. Their primary goal was to reduce the number of readmissions for chronic heart failure. None of these projects succeeded in a final implementation of telemonitoring in home care after the pilot phase. Not all the projects were initiated to accomplish all of the dimensions of the Chronic Care Model. A central role for the patient was sparse. Conclusion: Limited financial resources hampered continuation after the pilot phase. Cooperation and coordination in telemonitoring appears to be major barriers but are, within primary care as well as between the lines of care, important links in follow-up. This discrepancy can be prohibitive for deployment of good chronic care. Chronic Care Model is recommended as basis for future.

  6. Early predictors of renal dysfunction in patients with chronic heart failure

    Directory of Open Access Journals (Sweden)

    Umida Kamilova

    2013-04-01

    Full Text Available Study was aimed at an early detection of subclinical disorders in renal function in patients with chronic heart failure (CHF. Fifty-two patients with ischemic heart disease (IHD with post-infarction cardiosclerosis were examined. All the patients were underwent complex clinical examination, a level of serum creatinine, residual nitrogen and urine enzymes. Determination of urine enzymes level in CHF patients may be considered as diagnostic approach for an early diagnosis of renal dysfunction.

  7. Exertional dyspnoea in chronic heart failure: the role of the lung and respiratory mechanical factors

    OpenAIRE

    Bruno-Pierre Dubé; Piergiuseppe Agostoni; Pierantonio Laveneziana

    2016-01-01

    Exertional dyspnoea is among the dominant symptoms in patients with chronic heart failure and progresses relentlessly as the disease advances, leading to reduced ability to function and engage in activities of daily living. Effective management of this disabling symptom awaits a better understanding of its underlying physiology. Cardiovascular factors are believed to play a major role in dyspnoea in heart failure patients. However, despite pharmacological interventions, such as vasodilators o...

  8. Health-related quality of life in elderly patients hospitalized with chronic heart failure

    Directory of Open Access Journals (Sweden)

    Erceg P

    2013-11-01

    Full Text Available Predrag Erceg,1,2 Nebojsa Despotovic,1,2 Dragoslav P Milosevic,1,2 Ivan Soldatovic,3 Sanja Zdravkovic,2 Snezana Tomic,2 Ivana Markovic,2 Gordana Mihajlovic,2 Milan D Brajovic,4,5 Ognjen Bojovic,6 Bojana Potic,2 Mladen Davidovic1 1Department of Gerontology, Faculty of Medicine, University of Belgrade, 2Clinical Department of Geriatrics, Zvezdara University Hospital, 3Institute of Medical Statistics and Informatics, Faculty of Medicine, 4Department of Internal Medicine, Faculty of Dentistry, University of Belgrade, 5Clinical Department of Cardiology, Zvezdara University Hospital, Belgrade, Serbia; 6Department of Biomedicine, University of Bergen, Bergen, Norway Background: Chronic heart failure is a very common condition in the elderly, characterized not only by high mortality rates, but also by a strong impact on health-related quality of life (HRQOL. Previous studies of HRQOL in elderly heart failure subjects have included mostly outpatients, and little is known about determinants of HRQOL in hospitalized elderly population, especially in Serbia. In this study, we tried to identify factors that influence HRQOL in elderly patients hospitalized with chronic heart failure in Serbia. Methods: The study population consisted of 136 patients aged 65 years or older hospitalized for chronic heart failure. HRQOL was assessed using the Minnesota Living with Heart Failure questionnaire. Predictors of HRQOL were identified by multiple linear regression analysis. Results: Univariate analysis showed that patients with lower income, a longer history of chronic heart failure, and longer length of hospital stay, as well as those receiving aldosterone antagonists and digoxin, taking multiple medications, in a higher NYHA class, and showing signs of depression and cognitive impairment had significantly worse HRQOL. Presence of depressive symptoms (P<0.001, higher NYHA class (P=0.021, lower income (P=0.029, and longer duration of heart failure (P=0.049 were

  9. Plasma calprotectin levels reflect disease severity in patients with chronic heart failure

    DEFF Research Database (Denmark)

    Jensen, Louise Jn; Kistorp, Caroline Michaela Nervil; Bjerre, Mette;

    2011-01-01

    Background: Low-grade inflammation has been associated with cardiovascular disease (CVD) and chronic heart failure (CHF). The aim of the present study was to investigate the potential usefulness of the inflammatory protein calprotectin as a biomarker in CHF. Methods: Plasma calprotectin was measu......Background: Low-grade inflammation has been associated with cardiovascular disease (CVD) and chronic heart failure (CHF). The aim of the present study was to investigate the potential usefulness of the inflammatory protein calprotectin as a biomarker in CHF. Methods: Plasma calprotectin...

  10. Blood stasis in congestive heart failure bears relation with digoxin clinical pharmacokinetics%充血性心力衰竭血瘀证对地高辛临床药代动力学的影响

    Institute of Scientific and Technical Information of China (English)

    文爱东; 黄熙; 等

    2001-01-01

    AIM To study the influential factors in patients with congestive heart failure blood stasis on clinical pharmacokinetics of digoxin. METHODS Patients with congestive heart failure blood stasis were divided into two groups according to blood stasis degree and heart function. The first group (heart function Ⅰ~Ⅱ) included 34 cases with light blood stasis, while the second group (heart function Ⅲ~Ⅳ) included 38 cases with serious blood stasis. Patients of both groups were administered digoxin tables 0.125~0.385 mg*d-1 orally. Fluorescence Polarization Immunoassay (FPIA) was used to measure serum steady state digoxin concentrations, the method of one point of Bayesian to calculate digoxin clinical pharmacokinetics parameters, and the pharmacokinetics parameters of two groups were compared statistically. RESULTS With the aggravation of blood stasis and heart function damage, the Vd and CL of digoxin decreased markedly, but AUC of digoxin increased significantly. CONCLUSION The pharmacokinetics parameters are different in patients with different degrees of blood stasis in congestive heart failure, and the kidney function decrease is one of the major causes of this difference.%目的 研究充血性心力衰竭(congestive heart failure, CHF)血瘀证对地高辛药代动力学的影响. 方法 将充血性心力衰竭血瘀证患者按血瘀程度及心功能状况分为两组,第1组34例,血瘀较轻,心功能为Ⅰ~Ⅱ级,第2组38例,血瘀较重,心功能为Ⅲ~Ⅳ级,两组患者均口服地高辛片0.125~0.385 mg*d-1,用荧光偏振酶标免疫法检测地高辛的稳态血药浓度,同时以苦味酸法测定血清肌酐,用Bayesian一点法拟合地高辛的个体药动学参数,统计学比较两组患者地高辛药动学参数间差异. 结果 随着血瘀及心功能损伤的加重,地高辛的分布容积显著减少,清除率显著下降,AUC显著提高,血清中肌酐显著增高. 结论

  11. Transplanted Bone Marrow Cells Repair Heart Tissue and Reduce Myocarditis in Chronic Chagasic Mice

    OpenAIRE

    MILENA B. P. SOARES; Lima, Ricardo S.; Rocha, Leonardo L.; Takyia, Christina M; Pontes-de-Carvalho, Lain; Campos de Carvalho, Antonio C.; Ribeiro-dos-Santos, Ricardo

    2004-01-01

    A progressive destruction of the myocardium occurs in ∼30% of Trypanosoma cruzi-infected individuals, causing chronic chagasic cardiomyopathy, a disease so far without effective treatment. Syngeneic bone marrow cell transplantation has been shown to cause repair and improvement of heart function in a number of studies in patients and animal models of ischemic cardiopathy. The effects of bone marrow transplant in a mouse model of chronic chagasic cardiomyopathy, in the presence of the disease ...

  12. Transcapillary escape rate of albumin and right atrial pressure in chronic congestive heart failure before and after treatment

    DEFF Research Database (Denmark)

    Hesse, B; Parving, H H; Lund-Jacobsen, H;

    1976-01-01

    The transcapillary escape rate of albumin (TERalb), i.e., the fraction of intravascular mass of albumin that passes to the extravascular space per unit of time, was determined from the disappearance of intravenously injected 125I-labeled human serum albumin during the first 60 minutes after injec...

  13. The fascial system and exercise intolerance in patients with chronic heart failure: hypothesis of osteopathic treatment

    Directory of Open Access Journals (Sweden)

    Bordoni B

    2015-10-01

    Full Text Available Bruno Bordoni,1–3 F Marelli2,3 1Don Carlo Gnocchi Foundation, Department of Cardiology, IRCCS Santa Maria Nascente, Milan, Italy; 2School CRESO, Osteopathic Centre for Research and Studies, Falconara Marittima, AN, Italy; 3School CRESO, Osteopathic Centre for Research and Studies, Castellanza, VA, Italy Abstract: Chronic heart failure is a progressive, debilitating disease, resulting in a decline in the quality of life of the patient and incurring very high social economic costs. Chronic heart failure is defined as the inability of the heart to meet the demands of oxygen from the peripheral area. It is a multi-aspect complex disease which impacts negatively on all of the body systems. Presently, there are no texts in the modern literature that associate the symptoms of exercise intolerance of the patient with a dysfunction of the fascial system. In the first part of this article, we will discuss the significance of the disease, its causes, and epidemiology. The second part will explain the pathological adaptations of the myofascial system. The last section will outline a possible osteopathic treatment for patients with heart failure in order to encourage research and improve the general curative approach for the patient. Keywords: manual therapy, fatigue, chronic heart failure, osteopathic

  14. Haemostatic and inflammatory biomarkers in advanced chronic heart failure: role of oral anticoagulants and successful heart transplantation.

    Science.gov (United States)

    Cugno, Massimo; Mari, Daniela; Meroni, Pier Luigi; Gronda, Edoardo; Vicari, Francesco; Frigerio, Maria; Coppola, Raffaella; Bottasso, Bianca; Borghi, Maria Orietta; Gregorini, Luisa

    2004-07-01

    Advanced chronic heart failure (CHF) is associated with abnormal haemostasis and inflammation, but it is not known how these abnormalities are related, whether they are modified by oral anticoagulants (OAT), or if they persist after successful heart transplantation. We studied 25 patients with CHF (New York Heart Association class IV, 10 of whom underwent heart transplantation) and 25 age- and sex-matched healthy controls by measuring their plasma levels of prothrombin fragment 1 + 2 (F1 + 2), thrombin-antithrombin (TAT) complexes, tissue plasminogen activator (t-PA), plasminogen activator inhibitor-1 (PAI-1), D-dimer, factor VII (FVII), fibrinogen, von Willebrand factor (VWF), tumour necrosis factor (TNF), soluble TNF receptor II (sTNFRII), interleukin 6 (IL-6), soluble intercellular adhesion molecule-1 (sICAM-1), soluble vascular cell adhesion molecule-1 (sVCAM-1), endothelial-selectin (E-selectin) and thrombomodulin. CHF patients had higher plasma levels of TAT, D-dimer, t-PA, fibrinogen, VWF, TNF, IL-6, sTNFRII, sVCAM-1 (P = 0.0001), sICAM-1 (P = 0.003) and thrombomodulin (P = 0.007) than controls. There were significant correlations (r = 0.414-0.595) between coagulation, fibrinolysis, endothelial dysfunction and inflammation parameters, which were lower in those patients treated with OATs. Heart transplantation led to reductions in fibrinogen (P = 0.001), VWF (P = 0.05), D-dimer (P = 0.05) and IL-6 levels (P = 0.05), but all the parameters remained significantly higher (P = 0.01-0.0001) than in the controls. Advanced CHF is associated with coagulation activation, endothelial dysfunction and increased proinflammatory cytokine levels. Most of these abnormalities parallel each other, tend to normalize in patients treated with OATs and, although reduced, persist in patients undergoing successful heart transplantation, despite the absence of clinical signs of CHF. PMID:15198737

  15. Association of the Functional MICA-129 Polymorphism With the Severity of Chronic Chagas Heart Disease.

    Science.gov (United States)

    Ayo, Christiane Maria; Oliveira, Amanda Priscila de; Camargo, Ana Vitória da Silveira; Mattos, Cinara Cássia Brandão de; Bestetti, Reinaldo Bulgarelli; Mattos, Luiz Carlos de

    2015-10-15

    MICA-129 polymorphism affects the binding affinity of MICA molecules with the NKG2D receptor and influences effector cell function. The genotype met/met was associated with the severity of left ventricular systolic dysfunction (LVSD) in patients with chronic Chagas heart disease, while the val/val genotype was associated with the absence of LVSD.

  16. Distinct trajectories of fatigue in chronic heart failure and their association with prognosis

    NARCIS (Netherlands)

    Smith, Otto R. F.; Kupper, Nina; de Jonge, Peter; Denollet, Johan

    2010-01-01

    Aims To identify distinct trajectories of fatigue over a 12-month period and to examine their impact on mortality in chronic heart failure (CHF). Methods and results Consecutive CHF patients (n = 310) were assessed at baseline and at 2- and 12-month follow-up for symptoms of exertion and general fat

  17. Nebivolol: Its role in the treatment of hypertension and chronic heart failure

    NARCIS (Netherlands)

    Voors, Adriaan; Van Veldhuisen, D.J.

    2006-01-01

    (beta)-blockers are standard therapy in patients with cardiovascular disease, and have become a cornerstone in the treatment of both hypertension and chronic heart failure. However, two meta-analyses have recently raised doubts about the use of (beta)-blockers in patients with essential hypertension

  18. Erythropoiesis-stimulating agents for anaemia in chronic heart failure patients

    NARCIS (Netherlands)

    Ngo, Katherine; Kotecha, Dipak; Walters, Julia A. E.; Manzano, Luis; Palazzuoli, Alberto; van Veldhuisen, Dirk J.; Flather, Marcus

    2010-01-01

    Background Chronic heart failure (CHF) is a leading cause of morbidity and mortality worldwide. Anaemia is a common (12-55%) co-morbid condition and is associated with worsening symptoms and increased mortality. Anaemia is treatable and can be targeted in the treatment of patients with CHF. Erythrop

  19. Survival in Mediterranean Ambulatory Patients With Chronic Heart Failure. A Population-based Study

    NARCIS (Netherlands)

    Frigola Capell, E.; Comin-Colet, J.; Davins-Miralles, J.; Gich-Saladich, I.J.; Wensing, M.; Verdu-Rotellar, J.M.

    2013-01-01

    INTRODUCTION AND OBJECTIVES: Scarce research has been performed in ambulatory patients with chronic heart failure in the Mediterranean area. Our aim was to describe survival trends in our target population and the impact of prognostic factors. METHODS: We carried out a population-based retrospective

  20. Prescribing for chronic heart failure in Europe : does the country make the difference? A European survey

    NARCIS (Netherlands)

    Sturm, H. B.; van Gilst, W. H.; Veeger, N.; Haaijer-Ruskamp, F. M.

    2007-01-01

    Purpose International differences in prescribing patterns for chronic heart failure (CHF) have been demonstrated repeatedly. It is not clear whether these differences arise entirely from patient characteristics or factors related to the country itself, such as health care systems or culture. We aim

  1. Adherence to guidelines is a predictor of outcome in chronic heart failure: the MAHLER survey

    NARCIS (Netherlands)

    Komajda, M.; Lapuerta, P.; Hermans, N; Gonzalez-Juanatey, J.R.; Van Veldhuisen, D.J.; Erdmann, E.; Tavazzi, L.; Poole-Wilson, P.; Le Pen, C.

    2005-01-01

    Aims The impact on outcome of the implementation of European guidelines for the treatment of chronic heart failure (CHF) has not been evaluated. We investigated the consequences of adherence to care by cardiologists on the rate of CHF and cardiovascular (CV) hospitalizations and time to CV hospitali

  2. Anaemia is associated with shorter leucocyte telomere length in patients with chronic heart failure

    NARCIS (Netherlands)

    Wong, Liza S. M.; Huzen, Jardi; van der Harst, Pim; de Boer, Rudolf A.; Codd, Veryan; Westenbrink, B. Daan; Benus, Germaine F. J. D.; Voors, Adriaan A.; van Gilst, Wiek H.; Samani, Nilesh J.; Jaarsma, Tiny; van Veldhuisen, Dirk J.

    2010-01-01

    Aims Anaemia is highly prevalent and associated with poor prognosis in patients with chronic heart failure (CHF). Reduced erythroid proliferation capacity of haematopoietic progenitor cells is associated with reduced telomere length, a marker of cellular ageing. We hypothesize that short telomere le

  3. Reduction of mismatch of global ventilation and perfusion on exercise is related to exercise capacity in chronic heart failure.

    OpenAIRE

    Uren, N G; Davies, S W; Agnew, J E; Irwin, A G; Jordan, S L; Hilson, A J; Lipkin, D.P.

    1993-01-01

    BACKGROUND--The inability to match lung perfusion to ventilation because of a reduced cardiac output on exercise contributes to reduced exercise capacity in chronic heart failure. OBJECTIVE--To quantify ventilation to perfusion matching at rest and at peak exercise in patients with chronic heart failure and relate this to haemodynamic and ventilatory variables of exercise capacity. DESIGN--Eight men in New York Heart Association class II underwent maximal bicycle ergometry with expired gas an...

  4. On improvement of exercise tolerance in patients with chronic heart failure, with special reference to local muscle training

    OpenAIRE

    Gordon, Allan

    1996-01-01

    ON IMPROVEMENT OF EXERCISE TOLERANCE IN PATIENTS WrrH CHRONIC HEART FAILURE With special reference to local muscle traimng Thesis by Allan Gordon, MD, Division of Cardiology at the Department of Medicine, Karolinska Institutet, Huddinge University Hospital, S-14186 Huddinge, Sweden Reduced heart pump function and skeletal muscle abnormalities are considered important determinants for the low physical exercise capacity in chronic heart failure. Because of reduce...

  5. The use of metoprolol CR/XL in the treatment of patients with diabetes and chronic heart failure

    Directory of Open Access Journals (Sweden)

    Ovidio De Freitas

    2006-06-01

    Full Text Available Ovidio De Freitas, Oliver Lenz, Alessia Fornoni, Barry J MatersonDivision of Nephrology and Hypertension, Department of Medicine, Miller School of Medicine, University of Miami, Miami, Florida, USAAbstract: About 5 million Americans suffer from heart failure. Given the correlation of heart failure with age and the rising life expectancy, the prevalence of heart failure continues to increase in the general population. Sympathetic stimulation intensifies with progressive heart failure. The rationale to use β-blockers in individuals with impaired myocardial function is based on experimental evidence supporting the notion that prolonged α- and β-adrenergic stimulation leads to worsening heart failure. Until recently, safety concerns have precluded the use of β-blockers in patients with diabetes and heart failure. However, several large, randomized, placebo-controlled clinical trials such as Metoprolol Randomized Intervention Trial in Congestive Heart Failure (MERIT-HF have shown that β-blockers can be safely used in patients with diabetes and heart failure. Moreover, β-blockers significantly improved morbidity and mortality in this population. Based on this evidence, it is now recommended to add β-blockers such as metoprolol CR/XL with an escalating dosage regimen to the treatment of patients with symptomatic heart failure who already are receiving a stable medical regimen including angiotensin-converting enzyme inhibitors or angiotensin receptor blockers, diuretics, vasodilators, or digitalis.Keywords: metoprolol, heart failure, diabetes mellitus, β-adrenergic blocking agents, MERITHF

  6. Adjustment and Characterization of an Original Model of Chronic Ischemic Heart Failure in Pig

    Directory of Open Access Journals (Sweden)

    Laurent Barandon

    2010-01-01

    Full Text Available We present and characterize an original experimental model to create a chronic ischemic heart failure in pig. Two ameroid constrictors were placed around the LAD and the circumflex artery. Two months after surgery, pigs presented a poor LV function associated with a severe mitral valve insufficiency. Echocardiography analysis showed substantial anomalies in radial and circumferential deformations, both on the anterior and lateral surface of the heart. These anomalies in function were coupled with anomalies of perfusion observed in echocardiography after injection of contrast medium. No demonstration of myocardial infarction was observed with histological analysis. Our findings suggest that we were able to create and to stabilize a chronic ischemic heart failure model in the pig. This model represents a useful tool for the development of new medical or surgical treatment in this field.

  7. Exertional dyspnoea in chronic heart failure: the role of the lung and respiratory mechanical factors.

    Science.gov (United States)

    Dubé, Bruno-Pierre; Agostoni, Piergiuseppe; Laveneziana, Pierantonio

    2016-09-01

    Exertional dyspnoea is among the dominant symptoms in patients with chronic heart failure and progresses relentlessly as the disease advances, leading to reduced ability to function and engage in activities of daily living. Effective management of this disabling symptom awaits a better understanding of its underlying physiology.Cardiovascular factors are believed to play a major role in dyspnoea in heart failure patients. However, despite pharmacological interventions, such as vasodilators or inotropes that improve central haemodynamics, patients with heart failure still complain of exertional dyspnoea. Clearly, dyspnoea is not determined by cardiac factors alone, but likely depends on complex, integrated cardio-pulmonary interactions.A growing body of evidence suggests that excessively increased ventilatory demand and abnormal "restrictive" constraints on tidal volume expansion with development of critical mechanical limitation of ventilation, contribute to exertional dyspnoea in heart failure. This article will offer new insights into the pathophysiological mechanisms of exertional dyspnoea in patients with chronic heart failure by exploring the potential role of the various constituents of the physiological response to exercise and particularly the role of abnormal ventilatory and respiratory mechanics responses to exercise in the perception of dyspnoea in patients with heart failure. PMID:27581831

  8. 探讨超声在评价充血性心力衰竭患者心脏非同步化运动中的应用效果%Application Effect of Ultrasound in the Asynchronous Movement of the Heart in Congestive Heart Failure Patients

    Institute of Scientific and Technical Information of China (English)

    沈梦茜; 陈耀琴

    2015-01-01

    ObjectiveTo analyze the effect of ultrasound applied in patients with congestive heart failure heart asynchronous movement in the evaluation work. Methods35 patients with congestive heart failure in our hospital, according to the different of QRS duration can be divided into three groups A, B, C, and analysis the clinical data of the three groups retrospectively, there were some differences analysising the ultrasound examination index level.ResultsThe patients with left ventricular diastolic filling time, left/right ventricular ejection time difference value before cardiac synchronization movement related indexes such as compared with statistical signiifcance (P<0.05).Conclusion For patients with congestive heart failure, the use of ultrasound evaluate heart asynchronous movement has the good effect.%目的分析超声技术应用于充血性心力衰竭患者心脏非同步化运动评价工作中的效果。方法选择本院35例充血性心力衰竭患者,根据QRS时限的不同将其划分为A、B、C三组,对三组患者的临床资料开展回顾性分析,分析其超声检查指标水平存在的差异。结果患者左室舒张充盈时间、左/右室射血前时间差值等心脏同步化运动相关指标比较具有统计学意义(P<0.05)。结论针对充血性心力衰竭患者,采用超声技术进行心脏非同步化运动评价具有良好效果。

  9. Interactions of the heart and the liver

    DEFF Research Database (Denmark)

    Møller, Søren; Bernardi, Mauro

    2013-01-01

    There is a mutual interaction between the function of the heart and the liver and a broad spectrum of acute and chronic entities that affect both the heart and the liver. These can be classified into heart diseases affecting the liver, liver diseases affecting the heart, and conditions affecting...... the heart and the liver at the same time. In chronic and acute cardiac hepatopathy, owing to cardiac failure, a combination of reduced arterial perfusion and passive congestion leads to cardiac cirrhosis and cardiogenic hypoxic hepatitis. These conditions may impair the liver function and treatment should...... be directed towards the primary heart disease and seek to secure perfusion of vital organs. In patients with advanced cirrhosis, physical and/or pharmacological stress may reveal a reduced cardiac performance with systolic and diastolic dysfunction and electrophysical abnormalities termed cirrhotic...

  10. Barriers and facilitators to palliative care of patients with chronic heart failure in Germany: a study protocol

    Directory of Open Access Journals (Sweden)

    Stefan Köberich

    2015-07-01

    Full Text Available Background. Despite its high prevalence, similar symptoms and symptom burden, people suffering from chronic heart failure receive less palliative care than patients with malignant diseases. Internationally, numerous barriers to palliative care of patients with chronic heart failure are known, however, there are no credible data regarding barriers and facilitators to palliative care of people suffering from chronic heart failure available for Germany. Design and Methods. Tripartite study. First part of this study evaluates health care providers’ (physicians and nurses perceived barriers and facilitators to palliative care of patients with chronic heart failure using a qualitative approach. At least 18 persons will be interviewed. In the second part, based on the results of part one, a questionnaire about barriers and facilitators to palliative care of patients with chronic heart failure will be designed and applied to at least 150 physicians and nurses. In the last part a classic Delphi method will be used to develop specific measures to improve the palliative care for chronic heart failure patients. Expected Impact for Public Health. The results of this study will help to understand why patients with heart failure are seldom referred to palliative care and will provide solutions to overcome these barriers. Developed solutions will be the first step to improve palliative care in patients with heart failure in Germany. In addition, the results will help health care providers in other countries to take action to improve palliative care situations for heart failure patients.

  11. Experimental investigations on chronic irradiation damage of the heart

    International Nuclear Information System (INIS)

    Irradiation of rat hearts induced the following clinical phenomena: increasingly severe dyspnea, associated flank respiration and deterioration of the general condition bordering on a prefinal syndrome. Dissection of the sick animals and thoracal x-rays taken regularly revealed extensive pesicardial and pleural effusions. The tissue of the pericardium was thickened and edematous. The most striking histological finding consisted in a focal degeneration and destruction of the myocardium without an increase in collagenous fibres. This damage to the heart muscle was quite severe and seen in all dose groups from 15 to 40 Gy. At the same time there was a reduction of the capillary density as a function of the radiation dose. Clinical symptoms were also observed in animals irradiated with 10 Gy only. All animals irradiated with at least 20 Gy, attained a state where death was imminent. Consequently, the LD-50 must be lower than 20 Gy. The latency period was over a year at 15 Gy but decreased considerably as the dose increased. (orig.)

  12. [Changes of heart function after different cell type stem cell transplantation in chronic heart failure].

    Science.gov (United States)

    Fan, Zhongcai; Chen, Mao; Deng, Juelin; Liu, Xiaojing; Zhang, Li; Rao, Li; Yang, Qing; Huang, Dejia

    2006-12-01

    To investigate the feasibility of introcoronary cell infusion into nonischemic heart failure (HF) heart and whether different types of stem cell transplantation would affect heart function to a similar degree. Japanese white ears rabbits were used as HF models by intravenous injection adriamycin. Autologous bone marrow mononuclear cells(BMCs), bone marrow stromal cells (MSCs), skeletal myoblasts (SMs) or culture medium were infused into coronary arteries respectively by occluding the root of ascending aorta. The mortality during and 4 weeks after the procedure the mortality was 7.1% and 16.7% respectively. After 4 weeks, the ejection fraction (EF) in BMCs group had significant improvement (P 0.05). In sham group,the left ventricular endostolic diameter (LVED) had significant enlargement (P 0.05). Immunofluorescence revealed de novo expression of cardiac troponin I in BMCs and MSCs groups, cardiac troponin I was not detected in SMs group. In conclusions, intracoronary cell transplantation could provide effective cell delivery into dilated cardiomyopathy hearts and could be a useful strategy for treating CHF, BMCs cell transplantation may be the first choice in all the above cell types. PMID:17228727

  13. Manipulable Congestion Tolls

    NARCIS (Netherlands)

    Brueckner, Jan K.; Verhoef, Erik T.

    2009-01-01

    The recent literature on congestion pricing with large agents contains a remarkable inconsistency: though agents are large enough to recognize self-imposed congestion and exert market power over prices, they do not take into account the impact of their own actions on the magnitude of congestion toll

  14. Therapeutic options in chronic heart failure. Findings on chest X-ray; Nicht medikamentoese Therapieoptionen der chronischen Herzinsuffizienz. Befunde in der Projektionsradiografie des Thorax

    Energy Technology Data Exchange (ETDEWEB)

    Granitz, M.R.; Meissnitzer, T.; Meissnitzer, M.W.; Hergan, K.; Altenberger, J.; Granitz, C. [Uniklinikum Salzburg - Landeskrankenhaus (Austria)

    2016-05-15

    The contribution covers drugless therapeutic options for chronic heart failure: the implantable cardioverter/defibrillator (ICD), the cardiac resynchronization therapy (CRT), the interventional catheter treatment of functional mitral insufficiency, and mechanical heart supporting systems and heart transplantation.

  15. Heart failure

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    2008037 Factors associated with efficacy of cardiac resynchronization therapy for patients with congestive heart failure. SHI Haoying(史浩颖), et al. Dept Cardiol, Zhongshan Hosp Fudan Univ, Shanghai 200032. Chin J Cardiol 2007;35(12):1099-1163. Objective The efficacy of cardiac resynchronization therapy (CRT) in patients with congestive heart failure and the potential factors associated with responder or nonresponder were investigated. Methods Fifty

  16. [A failed improvement in pulmonary function and exercise capacity with carvedilol in congestive heart failure despite an excellent effect on left ventricular function].

    Science.gov (United States)

    Guazzi, M; Pontone, G; Trevisi, N; Lomanto, M; Matturri, M; Agostoni, P

    1998-02-01

    This study was aimed at investigating in chronic heart failure (CHF) the effects that beta-blockade with carvedilol may have on lung function, and their relationship with left ventricular (LV) performance and peak exercise oxygen uptake (VO2p). CHF causes disturbances in ventilation and pulmonary gas transfer (stress failure of alveolar-capillary membrane) that participate in limiting VO2p. Carvedilol improves LV function and not VO2p. Twenty-one NYHA functional class II-III patients were randomized (2 to 1) to carvedilol (25 mg bid., 14 patients) or placebo (7 patients) for 6 months. Rest forced expiratory volume (FEV1), vital capacity (VC), total lung capacity (TLC), carbon monoxide diffusing capacity (DLCO), its alveolar-capillary membrane component (DM), pulmonary venous and transmitral flows (for monitoring changes in LV end-diastolic pressure, EDP), LV diastolic (EDD) and systolic (ESD) dimensions, stroke volume (SV), ejection fraction (EF), fiber shortening velocity (VCF) were measured at baseline and at 3 and 6 months. VO2p, peak ratio of dead space to tidal volume (VD/VTp), ventilatory equivalent for CO2 production (VE/VCO2), VO2 at anaerobic threshold (VO2at) were also determined. FEV1, VC, TLC, DLCO, DM were impaired in CHF compared to 14 volunteers, and did not vary with treatment. Carvedilol reduced EDP, EDD, ESD, and increased EF, SV, VCF, without affecting VO2p, VO2at, VD/VTp, VE/VCO2, at 3 and 6 months. Placebo was ineffective. In CHF, carvedilol exerts neutral effects on ventilation and pulmonary gas transfer and ameliorates LV function at rest. This proves that antifailure treatment may not be similarly effective on cardiac and pulmonary function; and does not contradict the possibility that persistence of lung impairment may contribute to lack of improvement in exercise performance with carvedilol.

  17. 妊娠合并肺动脉高压伴心力衰竭患者的围生结局%Perinatal outcomes in pregnant women with pulmonary hypertension and concurrent congestive heart failure

    Institute of Scientific and Technical Information of China (English)

    谢爱兰; 杨安素; 颜林志; 王剑平; 王玉环; 徐肖文

    2011-01-01

    目的 探讨妊娠合并肺动脉高压伴心衰患者的围生结局.方法 收集2000年1月至2010年12月温州医学院附属第二医院产科、心内科收治的妊娠合并肺动脉高压患者54例,其中伴心衰患者34例,分析其终止妊娠的时机、方式及围生结局,并比较肺动脉高压伴心衰患者和无心衰患者的妊娠结局.结果 (1)54例妊娠合并肺动脉高压患者中,心衰发生率为62.96%(34/54),轻度、中度和重度肺动脉高压心衰发生率分别为27.78%(5/18),73.33%(11/15),85.71%(18/21),三组比较差异具有统计学意义(P<0.05);(2)妊娠合并肺动脉高压伴心衰患者中并发症发生率为47.06%(16/34),孕产妇病死率为17.64%(6/34),医源性胎儿丢失率为29.41%(10/34),早产发生率52.94%(18/34),新生儿窒息35.29%(12/34),围生儿死亡23.53%(8/34).(3)妊娠合并肺动脉高压伴心衰患者以剖宫产分娩为主91.18%(31/34).(4)妊娠合并肺动脉高压伴心衰患者医源性引产、早产,孕产妇并发症,孕产妇死亡,新生儿窒息和胎儿、新生儿死亡发生率明显高于无心衰组,差异有统计学意义(P<0.05).结论 随着肺动脉压力的升高,孕妇心衰发生率随之增加;心衰是影响妊娠合并肺动脉高压患者围生预后的最主要因素;剖宫产终止妊娠是比较安全的分娩方式.%Objective To discuss the effect of the occurrence of congestive heart failure on the outcome of pregnant women with pulmonary hypertension. Methods Fifty-four pregnant patients complicated with pulmonary hypertension were admitted from January 2000 through December 2010. Among them, 34 had comorbidity of congestive heart failure. The timing and mode of pregnancy termination, and perinatal outcomes were studied, and comparison was made between those with and without heart failure. Results ① Of all 54 pregnant women with pulmonary hypertension, 34 had congestive heart failure. The incidences of congestive heart failure in patients with mild

  18. Clinical Curative Effect Observation of Milrinone in the Treatment of Senile Congestive Heart Failure%米力农治疗老年性充血性心力衰竭的临床疗效观察

    Institute of Scientific and Technical Information of China (English)

    刘跃忠

    2015-01-01

    目的:探究米力农在治疗老年性充血性心力衰竭中的临床治疗效果。方法选取我院就诊的49例老年性充血性心力衰竭患者为研究对象,将其随机分为对照组和治疗组,对照组24例患者,治疗组25例患者。对照组采用常规性治疗方法,治疗组采用米力农进行治疗。对两组治疗效果进行比较分析。结果对照组总有效率为62.5%,治疗组总有效率为84%。治疗组的治疗效果优于对照组,两组比较结果的差异具有统计学意义(P<0.05)。结论对老年充血性心力衰竭患者采用米力农进行治疗,能有效的减少临床不良症状,起到稳定病情。%Objective To explore the clinical therapeutic effect of milrinone in the treatment of senile congestive heart failure. Methods 49 elderly patients with congestive heart failure in our hospital were randomly selected into control group(24 patients)and treatment group(25 patients). The control group patients were treated with conventional therapy,the treatment group patients were treated with milrinone. The treatment effects of two groups were compared. Results The total effective rate of treatment group(84%)was better than control group(62.5%)significantly(P< 0.05). Conclusion Milrinone in the treatment of senile congestive heart failure,can effectively reduce the clinical symptoms,stabilize patient’s condition,it is worthy to be promoted in clinical.

  19. Percutaneous Cell Delivery Into the Heart Using Hydrogels Polymerizing In Situ

    OpenAIRE

    Martens, Timothy P.; Godier, Amandine F. G.; Parks, Jonathan J.; Wan, Leo Q.; Koeckert, Michael S; Eng, George M.; Hudson, Barry I.; Sherman, Warren; Vunjak-Novakovic, Gordana

    2009-01-01

    Heart disease is the leading cause of death in the US. Following an acute myocardial infarction, a fibrous, noncontractile scar develops, and results in congestive heart failure in more than 500,000 patients in the US each year. Muscle regeneration and the induction of new vascular growth to treat ischemic disorders of the heart can have significant therapeutic implications. Early studies in patients with chronic ischemic SLVD using skeletal myoblasts or bone marrow-derived cells report impro...

  20. Effectiveness of education programs in the treatment of patients with heart failure

    OpenAIRE

    Natalya Zagorulya; Gulnar Zhussupova

    2010-01-01

    The paper describes efficiency of education program targeted to patientsin “School for patients with congestive heart failure”. During 6 months20 patients proceeding standard therapy were being simultaneouslyeducated on topics related to heart failure. These topics covered causesof chronic heart failure (CHF) formation, basic clinical CHF displays,the role of medicamentous and non-medicamentous CHF treatment,significance of self-control with CHF. The screening group was similarto baseline (wh...

  1. Prognostic value of Doppler transmitral filling patterns in patients with chronic heart failure

    Institute of Scientific and Technical Information of China (English)

    ZHENG Zhe-lan郑哲岚; A.Meissner; B.Hausmann; H.Alexander; R.Simon

    2004-01-01

    Background Chronic heart failure is a significant cause of cardiovascular morbidity and mortality.This study tested the hypothesis that restrictive filling pattern may provide useful prognostic data for identifying patients with chronic heart failure at high risk of all-cause cardiac death.Methods Ninety patients with chronic heart failure [70 men and 20 women, mean age (58.1±11.6) years] were investigated and followed for (18. 8±7. 9) months. During this period, 14 patients died of progressive pump failure, 12 patients underwent heart transplantation, 5 patients died suddenly, and 2 patients died of acute myocardial infarction. A new criterion, the restrictive filling index (RFI), was designed to subgroup patients into a restrictive and a nonrestrictive group.Results Patients with restrictive filling pattern had a more severe left ventricular dysfunction and a higher cardiac mortality. Analysis by the Kaplan-Meier method revealed that patients in the RFI≥1 and RFI<1 groups had a cardiac events-free survival rate of 52% versus 94% at 1 year, and 27. 5% versus 92% at 2 years, respectively. The multivariate Cox proportional hazard model selected RFI as the most powerful prognostic factor (χ2 =8. 8017, P =0. 0030) for all-cause cardiac death.

  2. [Chronic heart failure as a crisis event of the family].

    Science.gov (United States)

    Rocchi, Silvana; Boraso, Antonella; Bettinardi, Ornella; Ghidelli, Claudio

    2006-03-01

    The family greatly influences any of its members and significantly contributes to the patient rehabilitation. A limited and superficial interest from the family as well as an overprotective and anxiogenic behavior may lead to chronicization, relapse or even to progression of the disease. The close relationship between the patient and the physician is an illusion, since family members deeply affect this interaction. They may first influence the cardiologist's choice and later, through comments or actions, treatment expectations, diagnosis and therapy by sustaining or, on the contrary, minimizing the patient-physician interaction. A therapeutic triangle, which includes the family, the patient and the physician, develops from the beginning; thus the physician needs to be aware of it to use these interactions in the best interest of the patient himself. In this context clinical psychologists play a pivotal role first in identifying dysfunctional relations within the family and then in supporting the family to overcome crisis events. PMID:16572984

  3. Evaluation of proinflammatory cytokines and brain natriuretic peptide in patients with rheumatic heart diseases and coronary heart disease complicated by chronic heart insufficiency

    Directory of Open Access Journals (Sweden)

    N A Shoslak

    2005-01-01

    Full Text Available Objective. To study proinflammatory cytokines and brain natriuretic peptide (BNP in patients with rheumatic heart diseases (RHD and coronary heart disease (CHD complicated by chronic heart insufficiency (CHI. Material and methods. 54 pts with CHI (among them 16 with RHD and 38 with CHD with signs of CHI ofll-IV functional class according to NYHA that correspond to 11A-III stage according to N.D. Strazesko-V.H. \\frsilenko classification and 30 healthy persons of control group were examined. Besides clinical evaluation common laboratory and instrumental methods were used. Thorough echocardiography analysis, quantitative evaluation of serum TNF a, IL6 and BNP by immuno-enzyme assay was performed. Results. Direct correlation between cytokines and BNP levels and pts with CHI clinical state severity was revealed. These indiccs significantly differed in coronary and non-coronary (RHD CHI. TNF a concentration was minimal in mitral stenosis. Maximal concentrations of IL6 and TNF a were revealed in tricuspid regurgitation. TNF a concentration elevated with increase of heart linear dimensions. BNP showed similar but less prominent tendencies. Conclusion. Significant difference of studied indices in coronary and non-coronary (RHD CHI was shown. Despite of similarity of CHI clinical features levels of inflammation biological indices in RHD was significantly lower than in CHD that requires further discussion.

  4. Changes in absolute and relative importance in the prognostic value of left ventricular systolic function and congestive heart failure after acute myocardial infarction. TRACE Study Group. Trandolapril Cardiac Evaluation

    DEFF Research Database (Denmark)

    Køber, L; Torp-Pedersen, C; Jørgensen, S;

    1998-01-01

    3.2 (CI 2.0 to 5.1) to 1.7 (CI 1.2 to 2.4) in patients with CHF. The risk of dying decreases steeply with time after an AMI with or without LV dysfunction or CHF and stabilizes at low values after 1 year. This is in contrast to the relative importance of these risk factors, which is maintained......Changes in the importance of left ventricular (LV) systolic dysfunction and congestive heart failure (CHF) with time after an acute myocardial infarction (AMI) after the introduction of thrombolytic therapy have not been studied. LV systolic function, measured as wall motion index (WMI......) by echocardiography, was assessed in 6,676 consecutive patients with an enzyme-confirmed AMI. So that changes in the prognostic value of WMI or CHF could be studied, separate analyses were performed at selected time periods. Average monthly mortality (deaths per 100 patients per month) was determined from life...

  5. Angiotensin Ⅱ receptor antagonists for treatment of congestive heart failure%血管紧张素Ⅱ受体拮抗剂治疗充血性心力衰竭的进展

    Institute of Scientific and Technical Information of China (English)

    谢瑞奎

    2002-01-01

    @@ 充血性心力衰竭(Congestive heart failure,CHF)的主要矛盾是心脏收缩无力,心脏泵血功能不足,造成动脉系统供血不足,组织缺血缺氧,静脉系统回流障碍,出现肺循环和体循环瘀血征象;同时由于心输出量减少,通过窦弓压力感受器的反射性调节,使交感神经活性增强;肾素-血管紧张素-醛固酮系统(RAAS)被激活等,从而使心率加快,血管收缩,外周阻力升高,心衰征象加重.

  6. 细胞凋亡与充血性心力衰竭关系及中医药研究%Discussing the relationship between cell apoptosis and congestive heart-failure and study progress of TCM

    Institute of Scientific and Technical Information of China (English)

    李爱民; 张明辉

    2006-01-01

    细胞凋亡是充血性心力衰竭(congestive heart failure,CHF)发生发展的重要机制.心肌细胞丧失可能是心力衰竭进行性恶化的重要基础.神经内分泌改变、TNF-a、氧化应激是此过程中的重要因素.大量研究表明,单味中药及复方可明显抑制心肌细胞凋亡,从而改善心肌供血及心功能.中医药对CHF中细胞凋亡影响的研究是中医现代化的方向之一.

  7. Progress in the Predictive Value of Brain Natriuretic Peptide for Congestive Heart Failure%脑钠肽对充血性心力衰竭近期预后影响研究进展

    Institute of Scientific and Technical Information of China (English)

    洪斌; 葛均波

    2007-01-01

    脑钠肽(brain natriuretic peptide,BNP)是由心室分泌的一种调节心血管系统功能的多肽类激素,半衰期为23min,随充血性心力衰竭(congestive heart failure,CHF)的加重而分泌增加。BNP来源于心室,心肌缺血、损伤、坏死,心室壁张力和压力过重、苯福林、肾上腺素、异丙肾上腺素等均刺激BNP的合成与分泌。BNP通过受体起作用。

  8. 胰岛素抵抗与充血性心力衰竭关系的研究%The research of relationship between insulin resistance and congestive heart failure

    Institute of Scientific and Technical Information of China (English)

    罗宗; 秦永文

    2009-01-01

    充血性心力衰竭(congestive heart failure,CHF)患者存在胰岛素抵抗(IR)已引起人们的高度重视,研究表明随着心功能的恶化IR也进一步加重。IR特点表现为具有与正常对照者相似的空腹血糖水平和明显高于对照者的胰岛素水平,但胰岛素在促进靶器官的葡萄糖摄取和利用方面的作用低于正常的预计水平而导致代谢异常。这种异常的高胰岛素血症不可避免地引起一系列非生理性代谢效应,

  9. 血浆catestatin、VEGF、MMP及TIMP水平与充血性心力衰竭的关系%Study on the Correction between the Plasma Catestatin,VEGF,MMP,TIMP and Congestive Heart Failure

    Institute of Scientific and Technical Information of China (English)

    许涛; 赵楚敏; 宋月霞; 李莉; 徐爱茹

    2014-01-01

    Objective To investigate and analyze the correction between the plasma catestatin,VEGF, MMP,TIMP and congestive heart failure. Methods 48 patients with congestive heart failure in our hospital from September 2011 to August 2013 were selected as observation group,48 healthy persons with the same age were the control group,then the plasma catestatin,VEGF,MMP and TIMP of two groups were detected and compared,then the detection levels of observation group with different cardiac functional grading were compared too,and the correction between the detection indexes and disease was analyzed by Logistic analy-sis. Results The plasma catestatin,VEGF,MMP-2,MMP-9 and TIMP-1 of observation group were all higher than those of control group,and the detection levels of patients with higher cardiac functional grading were all higher than those of patients with lower cardiac functional grading(P<0. 05). Logistic analysis showed that the 5 indicators were predictive factors for congestive heart failure(P<0. 05). Conclusion The plasma cat-estatin,VEGF,MMP and TIMP of patients with congestive heart failure all show increasing trend,and the car-diac functional grading higher,the detection levels higher.%目的:探讨分析血浆儿茶酚抑素( catestatin)、血管内皮生长因子( VEGF)、基质金属蛋白酶(MMP)及基质金属蛋白酶组织抑制剂(TIMP)水平与充血性心力衰竭的关系。方法选取2011年9月至2013年8月唐山市人民医院收治的48例充血性心力衰竭患者为观察组,并选取同龄的48例健康人员作为对照组,检测并比较两组及观察组中不同心功能分级的血浆catestatin、VEGF、MMP、TIMP水平,采用Logistic分析检测指标与疾病的关系。结果观察组血浆catestatin、VEGF、MMP-2、MMP-9及TIMP-1均高于对照组,且观察组心功能分级较高者的检测水平高于心功能较低者( P<0.05);Logistic回归分析显示:血浆catestatin、VEGF、MMP-2、MMP-9及TIMP-1均是充血性心

  10. A meta-analysis of the effects of β-adrenergic blockers in chronic heart failure

    Science.gov (United States)

    Zhang, Xiaojian; Shen, Chengwu; Zhai, Shujun; Liu, Yukun; Yue, Wen-Wei; Han, Li

    2016-01-01

    Adrenergic β-blockers are drugs that bind to, but do not activate β-adrenergic receptors. Instead they block the actions of β-adrenergic agonists and are used for the treatment of various diseases such as cardiac arrhythmias, angina pectoris, myocardial infarction, hypertension, headache, migraines, stress, anxiety, prostate cancer, and heart failure. Several meta-analysis studies have shown that β-blockers improve the heart function and reduce the risks of cardiovascular events, rate of mortality, and sudden death through chronic heart failure (CHF) of patients. The present study identified results from recent meta-analyses of β-adrenergic blockers and their usefulness in CHF. Databases including Medline/Embase/Cochrane Central Register of Controlled Trials (CENTRAL), and PubMed were searched for the periods May, 1985 to March, 2011 and June, 2013 to August, 2015, and a number of studies identified. Results of those studies showed that use of β-blockers was associated with decreased sudden cardiac death in patients with heart failure. However, contradictory results have also been reported. The present meta-analysis aimed to determine the efficacy of β-blockers on mortality and morbidity in patients with heart failure. The results showed that mortality was significantly reduced by β-blocker treatment prior to the surgery of heart failure patients. The results from the meta-analysis studies showed that β-blocker treatment in heart failure patients correlated with a significant decrease in long-term mortality, even in patients that meet one or more exclusion criteria of the MERIT-HF study. In summary, the findings of the current meta-analysis revealed beneficial effects different β-blockers have on patients with heart failure or related heart disease. PMID:27703506

  11. Decongestion in acute heart failure

    NARCIS (Netherlands)

    Mentz, Robert J.; Kjeldsen, Keld; Rossi, Gian Paolo; Voors, Adriaan A.; Cleland, John G. F.; Anker, Stefan D.; Gheorghiade, Mihai; Fiuzat, Mona; Rossignol, Patrick; Zannad, Faiez; Pitt, Bertram; O'Connor, Christopher; Felker, G. Michael

    2014-01-01

    Congestion is a major reason for hospitalization in acute heart failure (HF). Therapeutic strategies to manage congestion include diuretics, vasodilators, ultrafiltration, vasopressin antagonists, mineralocorticoid receptor antagonists, and potentially also novel therapies such as gut sequesterants

  12. Prolactin mediates effects of chronic psychological stress on induction of fibrofatty cells in the heart.

    Science.gov (United States)

    Song, Jiangping; Wang, Mangyuan; Chen, Xiao; Liu, Li; Chen, Liang; Song, Zhizhao; Teng, Xiao; Xing, Yong; Chen, Kai; Zhao, Kun; Hou, Jianfeng; Yang, Pingchang

    2016-01-01

    Cardiocyte apoptosis plays an important role in the pathogenesis of heart diseases. The mechanism is unclear. It is reported that prolactin (PRL) is involved in cardiac disorders. This study aims to investigate the role of PRL in mediating the psychological stress-induced fibrofatty cell differentiation in the heart. In this study, BALB/c mice were treated with a 30-day restraint stress. The heart tissue was processed by paraffin embedding and hematoxylin and eosin. The expression of Sca1 in NIH3T3 cells was assessed by cell culture, flow cytometry and Western blotting. The results showed that chronic stress induced fibrofatty cells in the mouse heart and high serum PRL levels. The induction of fibrofatty cell was mimicked by administration with recombinant PRL. The stress also induced the expression of Sca1 in the mouse heart. Exposure of NIH3T3 cells (a fibroblast cell line) to PRL in the culture enhanced the expression of stem cell antigen-1 (Sca1), phosphorylation of signal transducer and activator of transcription 3 (STAT3) and expression of adipocyte-related protein molecules, including adiponectin, fatty acid binding protein (aP2), peroxisome proliferator activated receptor-g (PPARg) and CCAAT/enhancer binding protein (C/EBP)α, in the cells. We conclude that psychological stress-derived PRL induces fibroblasts to differentiate into fibrofatty cells in the heart.

  13. Measuring congestion costs

    Energy Technology Data Exchange (ETDEWEB)

    Waters, W.G. II; Von Wartburg, M. [British Columbia Univ., Vancouver, BC (Canada). Centre for Transportation Studies, Sauder School of Business

    2005-07-01

    One of the important problems facing the transportation sector is the cost of delay and frustration due to traffic congestion. Several studies have estimated the total costs of congestion borne by local and national economies. Many empirical estimates compare the cost of congestion against hypothetical free-flow conditions. However, the authors argued that free-flow conditions may not be a basis for comparison. Rather, the economic approach would be to compare actual versus optimal levels of congestion. This paper described this economic approach, along with the challenges of implementing it. Empirical estimates of congestion costs relative to GDP were also presented for several countries. In an effort to address the external costs of transportation, Transport Canada has recognized that national policies are needed to improve efficiency in transportation. This paper reviewed the underlying concept for measuring congestion costs, including the environmental cost of transportation. It was noted that the collective delay costs are borne by all motorists as a group. The 2 broad categories of users of congested facilities include those engaged in commercial activity, and those travelling for personal reasons, including commuting. This paper also demonstrated how to measure congestion costs, with reference to measuring the total social costs of transportation, and the economic approach to measuring congestion. The significance of incorporating the value of travel time savings (VTTS) of reduced delays to all travelers was also discussed. Various studies have confirmed that congestion costs can be substantial. 12 refs., 2 tabs., 2 figs.

  14. Haptoglobin Phenotype Predicts a Low Heart Rate Variability in Patients with Chronic Kidney Disease

    DEFF Research Database (Denmark)

    Svensson, My; Strandhave, Charlotte; Krarup, H.B.;

    F-PO1096 Haptoglobin Phenotype Predicts a Low Heart Rate Variability in Patients with Chronic Kidney Disease My Svensson,1 Charlotte Strandhave,1 Henrik My Svensson,1 Charlotte Strandhave,1 HenrikKrarup,2 Jeppe H. Christensen.1 1Department of Nephrology, Aalborg Hospital, Aalborg, Denmark; 2...... to a phenotype-dependent antioxidant capacity where Hp 2-2 exhibits a low antioxidant ability, increasing the risk of cardiovascular disease. An attenuated heart rate variability (HRV) may be an important predictor of mortality in patients with chronic kidney disease (CKD). In the present study, we examined......Department of Clinical Biochemistry, Aalborg Hospital, Aalborg, Denmark. Introduction Three major phenotypes for the haptoglobin (Hp) gene has been identified: Hp 1-1, Hp 2-2, and the heterozygous Hp 2-1. Hp 2-2 is associated with a poor outcome in patients with cardiovascular disease. This may be due...

  15. The fascial system and exercise intolerance in patients with chronic heart failure: hypothesis of osteopathic treatment

    OpenAIRE

    Bordoni B; Marelli F

    2015-01-01

    Bruno Bordoni,1–3 F Marelli2,3 1Don Carlo Gnocchi Foundation, Department of Cardiology, IRCCS Santa Maria Nascente, Milan, Italy; 2School CRESO, Osteopathic Centre for Research and Studies, Falconara Marittima, AN, Italy; 3School CRESO, Osteopathic Centre for Research and Studies, Castellanza, VA, Italy Abstract: Chronic heart failure is a progressive, debilitating disease, resulting in a decline in the quality of life of the patient and incurring very high social economic costs. C...

  16. Heart rate response during 6-minute walking testing predicts outcome in operable chronic thromboembolic pulmonary hypertension

    OpenAIRE

    Richter, Manuel Jonas; Milger, Katrin; Tello, Khodr; Stille, Philipp; Seeger, Werner; Mayer, Eckhard; Ghofrani, Hossein A.; Gall, Henning

    2016-01-01

    Background Six-minute walk test (6MWT) is routinely performed in chronic thromboembolic pulmonary hypertension (CTEPH) before pulmonary endarterectomy (PEA). However, the clinical relevance of heart rate response (ΔHR) and exercise-induced oxygen desaturation (EID) during 6MWT is remaining unknown. Methods Patients undergoing PEA in our center between 03/2013-04/2014 were assessed prospectively with hemodynamic and exercise parameters prior to and 1 year post-PEA. Patients with symptomatic ch...

  17. The obesity paradox is not observed in chronic heart failure patients with metabolic syndrome

    OpenAIRE

    Narumi, Taro; Watanabe, Tetsu; Kadowaki, Shinpei; Otaki, Yoichiro; Honda, Yuki; Nishiyama, Satoshi; Takahashi, Hiroki; Arimoto, Takanori; Shishido, Tetsuro; Miyamoto, Takuya; Kubota, Isao

    2014-01-01

    Introduction: Although being overweight or obese is a risk factor for cardiovascular disease, obese subjects often live longer than their lean peers, and this is known as the obesity paradox. We investigated the impact of obesity on cardiac prognosis in chronic heart failure (CHF) patients, with or without metabolic syndrome. Design and Methods: We divided 374 consecutive CHF patients into two groups according to their mean body mass index (BMI) and prospectively followed them for 2 years. Re...

  18. Gene expression changes associated with myocarditis and fibrosis in hearts of mice with chronic chagasic cardiomyopathy

    DEFF Research Database (Denmark)

    Soares, Milena Botelho Pereira; de Lima, Ricardo Santana; Rocha, Leonardo Lima;

    2010-01-01

    an extensive microarray analysis of hearts from a mouse model of this disease and identified significant alterations in expression of approximately 12% of the sampled genes. Extensive up-regulations were associated with immune-inflammatory responses (chemokines, adhesion molecules, cathepsins, and major...... histocompatibility complex molecules) and fibrosis (extracellular matrix components, lysyl oxidase, and tissue inhibitor of metalloproteinase 1). Our results indicate potentially relevant factors involved in the pathogenesis of the disease that may provide new therapeutic targets in chronic Chagas disease....

  19. Differential clinical characteristics and prognosis of intraventricular conduction defects in patients with chronic heart failure

    OpenAIRE

    Cinca, Juan; Mendez, Ana; Puig, Teresa; Ferrero, Andreu; Roig, Eulalia; Vazquez, Rafael; Gonzalez-Juanatey, Jose R.; Alonso-Pulpon, Luis; Delgado, Juan; Brugada, Josep; Pascual-Figal, Domingo; ,; Brugada, J.; Batlle, M.; Berruezo, A.

    2013-01-01

    Aims Intraventricular conduction defects (IVCDs) can impair prognosis of heart failure (HF), but their specific impact is not well established. This study aimed to analyse the clinical profile and outcomes of HF patients with LBBB, right bundle branch block (RBBB), left anterior fascicular block (LAFB), and no IVCDs. Methods and results Clinical variables and outcomes after a median follow-up of 21 months were analysed in 1762 patients with chronic HF and LBBB (n = 532), RBBB (n = 134), LAFB ...

  20. Chronic hypoxia downregulates ZO-2 expression in children with cyanotic congenital heart defect

    OpenAIRE

    Jenkins, Emma L.; Caputo, Massimo; Angelini, Gianni D; Ghorbel, Mohamed

    2016-01-01

    AimsTight junction protein zonula occludens protein 2 (ZO-2) is a member of the membrane-associated guanylate kinases protein family known to be expressed at tight junctions of epithelial and endothelial cells and at adherens junctions (AJs) in cardiomyocytes. Little is known about ZO-2 expression and function in the human heart. Here, we examined the hypothesis that chronic hypoxia down-regulates ZO-2 expression in human myocardium and cultured rat cardiomyocytes.Methods and resultsPatients ...

  1. Molecular pathogenesis of myocardial remodeling and new potential therapeutic targets in chronic heart failure

    OpenAIRE

    Distefano Giuseppe; Sciacca Pietro

    2012-01-01

    Abstract It is well known that the natural history of chronic heart failure (CHF),regardless of age and aetiology,is characterized by progressive cardiac dysfunction refractory to conventional cardiokinetic, diuretic and peripheral vasodilator therapy. Several previous studies, both in animals and humans, showed that the key pathogenetic element of CHF negative clinical evolution is constituted by myocardial remodeling. This is a complex pathologic process of ultrastructural rearrangement of ...

  2. “Nihilism” of chronic heart failure therapy in children and why effective therapy is withheld

    OpenAIRE

    Schranz, Dietmar; Voelkel, Norbert F.

    2016-01-01

    Major advances in chronic heart failure (cHF) therapy have been achieved and documented in adult patients, while research regarding the mechanisms and therapy of cHF in children has lagged behind. Based on receptor physiological studies and pharmacological knowledge, treatment with specific ß1-adrenergic receptor blocker (ARB), tissue angiotensin-converting enzyme inhibitor (ACE-I), and mineralocorticoid antagonists have to be recommended in children despite lack of sufficient data derived fr...

  3. Chronic heart failure modifies respiratory mechanics in rats: a randomized controlled trial

    OpenAIRE

    Deise M. Pacheco; Viviane D. Silveira; Alex Thomaz; Ramiro B Nunes; Viviane R. Elsner; Pedro Dal Lago

    2016-01-01

    ABSTRACT Objective To analyze respiratory mechanics and hemodynamic alterations in an experimental model of chronic heart failure (CHF) following myocardial infarction. Method Twenty-seven male adult Wistar rats were randomized to CHF group (n=12) or Sham group (n=15). Ten weeks after coronary ligation or sham surgery, the animals were anesthetized and submitted to respiratory mechanics and hemodynamic measurements. Pulmonary edema as well as cardiac remodeling were measured. Results The C...

  4. Testosterone level and mortality in elderly men with systolic chronic heart failure

    OpenAIRE

    Wu, Hai-Yun; Wang, Xiao-Fei; Wang, Jun-Hua; Li, Jiang-Yuan

    2011-01-01

    Previous studies on the prognostic significance of serum levels of androgens in patients with chronic heart failure (CHF) have yielded conflicting results. The aim of this study was to examine the relationship between serum concentration of testosterone and mortality in men with systolic CHF. A total of 175 elderly men (age≥60 years) with CHF were recruited. Total testosterone (TT) and sex hormone-binding globulin (SHBG) were measured, and estimated free testosterone (eFT) was calculated. The...

  5. Huangqi Injection (a Traditional Chinese Patent Medicine) for Chronic Heart Failure: A Systematic Review

    OpenAIRE

    Shufei Fu; Junhua Zhang; Francesca Menniti-Ippolito; Xiumei Gao; Francesca Galeotti; Marco Massari; Limin Hu; Boli Zhang; Rita Ferrelli; Alice Fauci; Fabio Firenzuoli; Hongcai Shang; Ranieri Guerra; Roberto Raschetti

    2011-01-01

    BACKGROUND: Chronic heart failure (CHF) is a global public health problem. Therefore, novel and effective drugs that show few side-effects are needed. Early literature studies indicated that Huangqi injection is one of the most commonly used traditional Chinese patent medicines for CHF in China. As a large number of clinical studies has been carried out and published, it is essential to evaluate the effectiveness and safety of Huangqi injection. Therefore, we carried out this systematic revie...

  6. Complexity in caring for an ageing heart failure population: concomitant chronic conditions and age related impairments.

    Science.gov (United States)

    De Geest, Sabina; Steeman, Els; Leventhal, Marcia E; Mahrer-Imhof, Romy; Hengartner-Kopp, Beatrice; Conca, Antoinette; Bernasconi, Arlette T; Petry, Heidi; Brunner-La Rocca, Hanspeter

    2004-12-01

    The complexity of caring for the ageing heart failure (HF) population is further complicated by concomitant chronic conditions (i.e., polypharmacy, depression), age related impairments (i.e., hearing, visual and cognitive impairments, impairments in activities of daily living (ADL/IADL), and other issues (e.g., health illiteracy, lack of social support). This paper provides an overview of these risk factors, outlines how they individually and in interplay endanger favourable outcome by putting patients at risk for poor self-management. Moreover, suggestions are made on how these issues could be addressed and integrated in heart failure management by applying gerontological care principles in caring for the ageing heart failure population.

  7. Alterations of cardiac and lymphocyte β-adrenoceptors in rat with chronic heart failure

    Institute of Scientific and Technical Information of China (English)

    张萍; 韩启德; 张幼怡; 许开明; 田斌; 吕志珍; 郭静萱; 陈明哲

    1997-01-01

    The alterations of cardiac and lymphocyte β-adrenoceptors were observed in the rats with chronic heart failure produced by constriction of both abdominal aorta and renal artery. The results showed that β1-adrenocep-tor density and mRNA levels were increased, whereas these levels remained unchanged for β2 The concentration-contractile response curve for isoproterenol was shifted to the right in cardiac atrium, whereas the concentration-cAMP accumulation response curve for isoproterenol in myocardium was not changed. The number of β-adrenoceptors in blood lymphocyte was markedly reduced. Thus in the heart-failure rats the density of cardiac β-adrenoceptor was increased accompanying reduced β-adrenoceptor-mediated positive inotropic response, suggesting a post adenylate cyclase dys-function or impaired contractile components. In contrast, the alteration of β-adrenoceptor in lymphocyte is consistent with the reduced β-adrenoceptor-mediated inotropic response in heart.

  8. Improving medication adherence of patients with chronic heart failure: challenges and solutions

    Directory of Open Access Journals (Sweden)

    Shah D

    2015-07-01

    Full Text Available Deval Shah,1 Kim Simms,2 Debra J Barksdale,3 Jia-Rong Wu3 1Internal Medicine, Wake Forest Baptist Hospital, Winston-Salem, 2Duke University Hospital, Durham, 3School of Nursing, University of North Carolina, Chapel Hill, NC, USA Abstract: Heart failure is a chronic debilitating illness that affects 5.7 million Americans. The financial burden of heart failure in the US toppled $31 billion in 2012, which is one of the highest among all chronic medical conditions. Medication adherence is a major component of heart failure self-care behaviors. Therefore, medication non-adherence is associated with more emergency department visits, frequent rehospitalizations, and higher medical cost. Medication adherence rates have varied from 10% to 98% depending on the definition and measurement used to assess and analyze adherence. Many factors contribute to medication non-adherence such as lack of support, finances, absent of symptoms, cognitive decline, adverse reactions, depression, poor attention span, poor knowledge about medication, multiple medications, difficulty swallowing large pills, and inconveniences of urinary frequency with diuretics. Researchers have explored various strategies such as the use of pharmacists, nurses, telemedicine, and interdisciplinary teams to provide interventions to improve medication adherence in heart failure. Health care providers should continue to provide education, constantly reinforce the importance of taking medication as prescribed, and when feasible, utilize one of the successful evidence-based strategies to increase adherence. Keywords: pharmacy, tele-health, interdisciplinary, registered nurse, interventions

  9. EVALUATION CARDIAC RESYNCHRONIZATION THERAPY IN PATIENTS WITH CHRONIC ISCHEMIC HEART FAILURE

    Directory of Open Access Journals (Sweden)

    A. J. Fishman

    2011-01-01

    Full Text Available Objective — studying dyssynchrony characteristics and evaluation correction effectiveness in patients with chronic heart failure (CHF of ischemic origin.Materials and methods. The study included 125 patients with chronic heart failure of ischemic etiology, 28 of them — with coronary heart disease (CHD who had undergone aorto-and / or mammarokoronary bypass and / or percutaneous coronary intervention, 42 — with coronary artery disease and postinfarction cardiosclerosis, 32 — with arrhythmic variant of coronary artery disease, 23 — with stable angina without evidence of arrhythmia. Among included patients, biventricular pacemakers were implanted for 17 patients. All patients underwent echocardiography with determination of the parameters of dyssynchrony.Results and conclusion. Among patients with CHF ischemic symptoms dyssynchrony was diagnosed in 36 (28.8 % cases. Statistically significant association between patients with cardiac arrhythmias and dyssynchrony was determined. At the same time the incidence of dyssynchrony was not associated with various forms of ischemic heart disease, and did not depend on the anamnesis of cardiac surgery. Dependence of the frequency of occurrence of dyssynchrony on the severity of CHF was revealed. Patients selected for implantation of biventricular pacemakers, especially in view of echocardiographic signs of dyssynchrony had significant improvement after providing cardiac resynchronization therapy. Effect of the treatment does not depend on the atrial fibrillation rhythm presence.

  10. Strength improvement of knee extensor muscles in patients with chronic heart failure by neuromuscular electrical stimulation.

    Science.gov (United States)

    Quittan, M; Sochor, A; Wiesinger, G F; Kollmitzer, J; Sturm, B; Pacher, R; Mayr, W

    1999-05-01

    Patients with severe chronic heart failure (CHF) suffer from marked weakness of skeletal muscles. Neuromuscular electrical stimulation (NMES) proved to be an alternative to active strength training. The objective of this study was to test the feasibility and effectiveness of NMES in patients with chronic heart failure. Seven patients (56.0 +/- 5.0 years, CHF for 20 +/- 4 months, left ventricular ejection fraction 20.1 +/- 10.0%) finished an 8 week course of NMES of the knee extensor muscles. The stimulator delivered biphasic, symmetric, constant voltage impulses of 0.7 ms pulse width with a frequency of 50 Hz, 2 s on and 6 s off. No adverse effects occurred. After the stimulation period, the isokinetic peak torque of the knee extensor muscles increased by 13% from 101.0 +/- 8.7 Nm to 113.5 +/- 7.2 Nm (p = 0.004). The maximal isometric strength increased by 20% from 294.3 +/- 19.6 N to 354.14 +/- 15.7 N (p = 0.04). This increased muscle strength could be maintained in a 20 min fatigue test indicating decreased muscle fatigue. These results demonstrate that NMES of skeletal muscles in patients with severe chronic heart failure is a promising method for strength training in this group of patients.

  11. [New markers of progression of chronic heart failure in patients with myocardial infarction, type 2 diabetes and obesity].

    Science.gov (United States)

    Kravchun, P P; Kadykova, O I; Gabisonia, T N

    2015-01-01

    Currently identified a large number of biomarkers that are closely linked with the development of chronic heart failure, some of which are clusterin and fractalkine. Accordingly, the purpose of our study was - to evaluate the role of clusterin and fractalkine in progression of chronic heart failure in patients with postinfarction cardiosclerosis, type 2 diabetes and obesity. We investigated 71 patients with postinfarction cardiosclerosis, type 2 diabetes and obesity. All patients with postinfarction cardiosclerosis, diabetes and obesity were divided into groups according to the functional class of chronic heart failure (CHF). It was found that an increase the level of fractalkine and reduced clusterin leads due to the development of systolic dysfunction and heart failure progression in patients with postinfarction cardiosclerosis, type 2 diabetes and obesity. Fractalkine and clusterin play an important role in progression of the heart failure in patients with postinfarction cardiosclerosis, type 2 diabetes and obesity, and this gives them the right to be considered indicators of the severity of CHF.

  12. Characterization of exercise limitations by evaluating individual cardiac output patterns : A prospective cohort study in patients with chronic heart failure

    NARCIS (Netherlands)

    Spee, Ruud F.; Niemeijer, Victor M.; Wessels, Bart; Jansen, Jasper P.; Wijn, Pieter F F; Doevendans, Pieter A F M; Kemps, Hareld M C

    2015-01-01

    Background: Patients with chronic heart failure (CHF) suffer from exercise intolerance due to impaired central hemodynamics and subsequent alterations in peripheral skeletal muscle function and structure. The relative contribution of central versus peripheral factors in the reduced exercise capacity

  13. Comparison of permanent left ventricular and biventricular pacing in patients with heart failure and chronic atrial fibrillation: prospective haemodynamic study

    OpenAIRE

    Garrigue, S; Bordachar, P.; Reuter, S.; Jaïs, P.; Kobeissi, A; Gaggini, G; Haïssaguerre, M; Clementy, J

    2002-01-01

    Objective: To compare clinical and haemodynamic variables between left ventricular and biventricular pacing in patients with severe heart failure; and to analyse haemodynamic changes during daily life and maximum exercise during chronic left ventricular and biventricular pacing.

  14. Effects of perindopril on expression of kidney aquaporin-2 and urine aquaporin-2 excretion in chronic heart failure rats

    Institute of Scientific and Technical Information of China (English)

    欧阳邵

    2013-01-01

    Objective To determine the expression of kidneyaquaporin-2(AQP2) and urine AQP2 excretion in chronic heart failure(CHF) rats and investigate effects of perindopril on the expression and excretion of AQP2.Methods

  15. Results of a non-specific immunomodulation therapy on chronic heart failure (ACCLAIM trial): a placebo-controlled randomised trial

    DEFF Research Database (Denmark)

    Torre-Amione, G.; Anker, S.D.; Bourge, R.C.;

    2008-01-01

    Background Evidence suggests that inflammatory mediators contribute to development and progression of chronic heart failure. We therefore tested the hypothesis that immunomodulation might counteract this pathophysiological mechanism in patients. Methods We did a double-blind, placebo-controlled s...

  16. Randomised trial of low-dose amiodarone in severe congestive heart failure. Grupo de Estudio de la Sobrevida en la Insuficiencia Cardiaca en Argentina (GESICA)

    Science.gov (United States)

    Doval, H C; Nul, D R; Grancelli, H O; Perrone, S V; Bortman, G R; Curiel, R

    1994-08-20

    In severe heart failure many deaths are sudden and are presumed to be due to ventricular arrhythmias. The GESICA trial evaluated the effect of low-dose amiodarone on two-year mortality in patients with severe heart failure. Our prospective multicentre trial included 516 patients on optimal standard treatment for heart failure. Patients were randomised to 300 mg/day amiodarone (260) or to standard treatment (256). Intention-to-treat analysis showed 87 deaths in the amiodarone group (33.5%) compared with 106 in the control group (41.4%) (risk reduction 28%; 95% CI 4%-45%; log rank test p = 0.024). There were reductions in both sudden death (risk reduction 27%; p = 0.16) and death due to progressive heart failure (risk reduction 23%; p = 0.16). Fewer patients in the amiodarone group died or were admitted to hospital due to worsening heart failure (119 versus 149 in the control group; risk reduction 31%; 95% CI 13-46%; p = 0.0024). The decrease in mortality and hospital admission was present in all subgroups examined and independent of the presence of non-sustained ventricular tachycardia. Side-effects were reported in 17 patients (6.1%); amiodarone was withdrawn in 12. Low-dose amiodarone proved to be an effective and reliable treatment, reducing mortality and hospital admission in patients with severe heart failure independently of the presence of complex ventricular arrhythmias.

  17. Effects of a 14-month low-cost maintenance training program in patients with chronic systolic heart failure

    DEFF Research Database (Denmark)

    Prescott, Eva; Hjardem-Hansen, Rasmus; Ørkild, Bodil;

    2009-01-01

    Exercise training is known to be beneficial in chronic heart failure (CHF) patients but there is a lack of studies following patient groups for longer duration with maintenance training programs to defer deconditioning.......Exercise training is known to be beneficial in chronic heart failure (CHF) patients but there is a lack of studies following patient groups for longer duration with maintenance training programs to defer deconditioning....

  18. Ethnic differences in mortality from acute rheumatic fever and chronic rheumatic heart disease in New Mexico, 1958-1982.

    OpenAIRE

    Becker, T M; Wiggins, C L; Key, C. R.; Samet, J M

    1989-01-01

    To examine time trends and differences in mortality rates from acute rheumatic fever and chronic rheumatic heart disease in New Mexico's Hispanic, American Indian, and non-Hispanic white populations, we analyzed vital records data for 1958 through 1982. Age-adjusted mortality rates for acute rheumatic fever were low and showed no consistent temporal trends among the three ethnic groups over the study period. Age-adjusted and age-specific mortality rates for chronic rheumatic heart disease in ...

  19. The effect of chronic heart failure and type 2 diabetes on insulin-stimulated endothelial function is similar and additive

    DEFF Research Database (Denmark)

    Falskov, Britt; Hermann, Thomas Steffen; Rask-Madsen, Christian;

    2011-01-01

    AIM: Chronic heart failure is associated with endothelial dysfunction and insulin resistance. The aim of this investigation was to study insulin-stimulated endothelial function and glucose uptake in skeletal muscles in patients with heart failure in comparison to patients with type 2 diabetes. ME...

  20. Aerobic exercise improves the inflammatory profile correlated with cardiac remodeling and function in chronic heart failure rats

    Directory of Open Access Journals (Sweden)

    Ramiro B. Nunes

    2013-06-01

    Full Text Available OBJECTIVE: The aim of the present study was to evaluate the effect of 8 weeks of aerobic exercise training on cardiac functioning and remodeling and on the plasma levels of inflammatory cytokines in chronic heart failure rats. METHODS: Wistar rats were subjected to myocardial infarction or sham surgery and assigned to 4 groups: chronic heart failure trained (n = 7, chronic heart failure sedentary (n = 6, sham trained (n = 8 and sham sedentary (n = 8. Four weeks after the surgical procedures, the rats were subjected to aerobic training in the form of treadmill running (50 min/day, 5 times per week, 16 m/min. At the end of 8 weeks, the rats were placed under anesthesia, the hemodynamic variables were recorded and blood samples were collected. Cardiac hypertrophy was evaluated using the left ventricular weight/body weight ratio, and the collagen volume fraction was assessed using histology. RESULTS: The chronic heart failure trained group showed a reduction in left ventricular end-diastolic pressure, a lower left ventricular weight/body weight ratio and a lower collagen volume fraction compared with the chronic heart failure sedentary group. In addition, exercise training reduced the plasma levels of TNF-α and IL-6 and increased the plasma level of IL-10. CONCLUSION: An 8-week aerobic exercise training program improved the inflammatory profile and cardiac function and attenuated cardiac remodeling in chronic heart failure rats.