The Effects of Tailored Energy Preservation Training on Fatigue and Re-admission in Patients with Heart Failure: A Randomized Clinical Trial

Background: Fatigue and re-admissions are the important consequences of heart failure that cause limitations in patients’ daily activities, personal, and social affairs. Energy conservation techniques are among evidence-based and non-pharmacological approaches that can reduce fatigue in patients with chronic disease.      Aim: The present study was performed with aim to determine the effects of tailored energy conservation training on fatigue and readmissions of patients with heart failure (HF).Method: This randomized clinical trial study was performed from May 2019 to March 2020 on 96 patients with HF admitted to CCU and cardiovascular clinics affiliated to Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran. Patients who met the inclusion criteria were randomly assigned to the intervention and control groups. A three-part tool (demographic-clinical questionnaire and need assessment), the Fatigue Severity Scale (FSS) and a readmissions record checklist were used to collect data. After determining the training needs of each individual, the intervention group received five 45-minute face-to-face individual training sessions of energy conservation strategies reinforced by telephone support every two weeks and followed up for 12 weeks. The control group only received routine post-discharge training. Fatigue scores by FSS and the readmissions recorded were tested at baseline and three months after the end of the intervention.Results: At baseline, the two groups were comparable in the mean hospital admissions and fatigue scores. However, after the intervention, the mean frequency of hospital admissions and the mean fatigue score were significantly lower in the intervention group (1.36±1.26, P< 0.001; 2.86±1.01,P< 0.001) than in the control group (0.42±0.77, P< 0.001; 5.25±1.03, P< 0.001) respectively.Implications for Practice: Nurses and physicians are recommended to teach energy conservation methods to patients with HF and chronic conditions who are prone to fatigue and its side effects

Association between echocardiographic markers of pulmonary hypertension and short-term prognoses in patients with acute heart failure

Introduction: The prognostic value of pulmonary hypertension (PH) estimated by echocardiography in patients with acute decompensated heart failure (ADHF) is poorly studied. This study aimed to evaluate the association between echocardiographic markers of pulmonary hypertension and short-term prognoses in patients with AHF. Materials and Methods: This prospective cross-sectional study was conducted on patients with acute heart failure admitted to Golestan and Imam Khomeini hospitals in Ahvaz, Iran, in 2020.&nbsp; A total of 259 consecutive patients with ADHF underwent an echocardiographic evaluation to assess the probability of PH and right ventricular dysfunction (TAPSE&lt;16 mm). The patients were followed up for six months after hospital discharge, and their outcome was recorded. The probability of PH was estimated based on European Society of Cardiology (ESC) guidelines for echocardiographic evaluation. Kaplan-Meier method was used to determine the cumulative survival rate and the Cox regression model to define the hazard ratio. Results: During six months of follow-up, the all-cause mortality rate was 118 (45.55%), including 106 cardiovascular deaths (40.92%).&nbsp

QT Dispersion: Does It Change after Percutaneous Coronary Intervention?

Background: Myocardial ischemia is one of several causes of prolonged QT dispersion. The aim of this study was to evaluate the effect that percutaneous coronary intervention has on the depolarization and repolarization parameters of surface electrocardiography in patients with chronic stable angina.Methods: We assessed the effects of full revascularization in patients with chronic stable angina and single-vessel disease who underwent percutaneous coronary intervention. Twelve-lead electrocardiograms were recorded before intervention and 24 hours subsequently. We measured parameters including QRS duration, QT and corrected QT durations, and JT and corrected JT duration in both electrocardiograms and compared the values.Results: There were significant differences between the mean QRS interval (0.086 ± 0.01sec vs. 0.082 ± 0.01 second; p value = 0.01), mean corrected QT dispersion (0.080 ± 0.04 sec vs. 0.068 ± 0.04 sec; p value = 0.001), and mean corrected JT dispersion (0.074 ± 0.04 sec vs. 0.063 ± 0.04 sec; p value = 0.001) before and after percutaneous coronary intervention. No significant differences were found between the other ECG parameters.Conclusion: Our data indicate that the shortening of corrected QT dispersion and corrected JT dispersion in patients undergoing percutaneous coronary intervention is prominent