Statins in the treatment of heart failure

WOS: 00026297890001

Reliability and validity of the Turkish version of the Chronic Heart Failure Questionnaire

WOS: 000285431300010PubMed ID: 20952354Objective: Any disease specific Health Related Quality of Life Instrument for Chronic Heart Failure (CHF) is lacking in Turkey. The aim of this study is to adapt the Chronic Heart Failure Questionnaire (CHQ) into Turkish and probe the reliability and validity of this questionnaire. Methods: There are four dimensions of this 20 items scale. These dimensions are: dyspnea (5 items), fatigue (4 items), emotional status (7 items) and mastery (4 items). Response options were evaluated using a 7 -point Liken type scale. Quality of life (QOL) improves as the score increases. A total of 205 CHF patients hospitalized in the Department of Cardiology of Ege University hospital were enrolled in this study. The CHQ was applied to the patients twice with a wash-out period of 15 days. Confirmatory approach was used during the reliability and validity analysis. Cronbach alpha test was used for the reliability analysis. Confirmatory factor analysis (CFA) was used for the construct validity testing. NYHA classification for testing the criterion validity; SF-36 and WHOQOL-100 General Health and QOL facet for convergent validity testing of the Turkish version of the CHQ were used. Responsiveness to change was evaluated by Effect Size analysis by using test-retest data. Results: The range of Cronbach alpha values is 0.72-0.94. A considerable ceiling and floor effects were observed for the dyspnea dimension of the scale but no problematic items were observed for the entire scale. The CFA results supported the original four factors scale structure. Criterion and construct validity rebuts were satisfactory. Effect sizes obtained among dimensions of the CHQ were between 0.13 and 0.56. Conclusion: Overall results revealed that Turkish version of the CHQ is a reliable and valid instrument to be used for the evaluation of CHF patients. (Anadolu Kardiyol Derg 2010; 10: 526-38

The psychometric properties of the Turkish version of Myocardial Infarction Dimensional Assessment Scale (MIDAS)

WOS: 000293045000003PubMed ID: 21652294Objective: The purpose of this study was to describe the psychometric properties of the Myocardial Infarction Dimensional Assessment Scale (MIDAS). Methods: This is a methodological cultural adaptation study. The MIDAS consists of 35-items covering seven domains: physical activity, insecurity, emotional reaction, dependency, diet, concerns over medication, and side effects which are rated on a five-point Likert scale from 1: never to 5:always. The highest score of MIDAS is 100. Quality of life (QOL) decreases as the score of scale increases. Overall 185 myocardial infarction (MI) patients were enrolled in this study. Cronbach alpha was used for the reliability analysis. The criterion validity, structural validity, and sensitivity analysis approach was used for validity analysis. New York Heart Association (NYHA) and the Canadian Cardiovascular Society Functional Classifications (CCSFC) for testing the criterion validity; SF-36 for construct validity testing of the Turkish version of the MIDAS were used. Results: The range of Cronbach alpha values is 0.79-0.90 for seven domains of the scale. No problematic items were observed for the entire scale. Medication related domains of the MIDAS showed considerable floor effects (35.7%-22.7%). Confirmatory Factor analysis indicators [Comparative Fit Index (CFI)=0.95 and Root Mean Square Error of Approximation (RMSEA)=0.075] supported the construct validity of MIDAS. Convergent validity of the MIDAS was confirmed with correlation of SF-36 scale where appropriate. Criterion validity results was also satisfactory by comparing different stages of the NYHA and the CCSFC (p<0.05). Conclusion: Overall results revealed that Turkish version of the MIDAS is a reliable and valid instrument. (Anadolu Kardiyol Derg 2011; 11: 386-401

Miyokart enfarktüsü boyutsal değerlendirme ölçeği (MIDAS) Türkçe sürümünün psikometrik özellikleri

Amaç: Bu çalışmada; Miyokart Enfarktüsü Boyutsal Değerlendirme Ölçeği’nin (MIDAS) Türkçe’ye uyarlanması ve psikometrik özelliklerinin çözümlenmesi amaçlanmıştır. Yöntemler: Bu araştırma, metodolojik tipte bir kültürel uyarlama çalışmasıdır. Miyokart Enfarktüsü Boyutsal Değerlendirme Ölçeği, 35 madde ve yedi alt boyuttan (fiziksel aktivite, güvensizlik, duygusal tepki, bağımlılık, beslenme şekli, ilaç hakkında endişeler ve ilaç yan etkileri) oluşmaktadır. Maddeler 5’li Likert tipindedir. Ölçekten alınabilecek en yüksek puan 100’dür. Ölçek puanları arttıkça algılanan yaşam kalitesi kötüleşmektedir. Araştırmaya miyokart enfarktüs geçirmiş 185 izlem hastası alınmıştır. Güvenilirlik analizlerinde iç tutarlılık analizi (Cronbach alfa); geçerlilik analizlerinde ise, ölçüt geçerliliği, yapısal geçerlilik yaklaşımları kullanılmış ve duyarlılık analizleri yapılmıştır. Ölçüt geçerliliğinde, New York Kalp Cemiyeti (NYHA) kalp yetersizliği sınıflaması, Kanada Kalp Cemiyeti Anjina Pektoris Sınıflaması (KKCAPS); yapısal geçerlilikte birleşim-ayrışım geçerliliği, bilinen gruplar geçerliliği yaklaşımları ve faktör analizi kullanılmıştır. Bilinen gruplar geçerliliğinde sosyodemografik değişkenler ve birleşim-ayrışım geçerliliğinde boyutlar arası korelasyonlar ve SF-36 ölçeği ile karşılaştırma yöntemi kullanılmıştır. Bulgular: Ölçeğin Cronbach alfa değerleri yedi boyutta, 0.79-0.90 aralığında bulunmuştur. Madde çıkarıldığında hiçbir madde ve boyutta alfa değeri yükselmemiştir. Yani sorunlu maddeye rastlanmamıştır. Ölçeğin ilaç ile ilgili alt boyutlarında önemli taban etkileri görülmüştür (%35.7- %22.7). Doğrulayıcı faktör analizi göstergeleri [Karşılaştırmalı Uyum İndeksi; KUİ (Comparative Fit Index; CFI)=0.95 ve tahminin ortalama karekök hatası (TOKH) (Root Mean Square Error of Approximation; RMSEA)=0.075] MIDAS'ın yapı geçerliğini desteklemektedir. Yapı geçerliliği açısından MIDAS’ın benzer boyutları ile SF-36 alt boyutları arasında anlamlı korelasyonlar bulunmuştur. Ölçüt geçerliliği analizlerinde ise MIDAS alt boyutları ile KKCAPS ve NYHA sınıflamaları arasında anlamlı ilişkiler saptanmıştır (p<0.05). Sonuç: Bulgular, MIDAS Türkçe sürümünün geçerli ve güvenilir bir ölçek olduğunu göstermektedir

Reliability and validity of the Turkish version of the Chronic Heart Failure Questionnaire

WOS: 000285431300010PubMed ID: 20952354Objective: Any disease specific Health Related Quality of Life Instrument for Chronic Heart Failure (CHF) is lacking in Turkey. The aim of this study is to adapt the Chronic Heart Failure Questionnaire (CHQ) into Turkish and probe the reliability and validity of this questionnaire. Methods: There are four dimensions of this 20 items scale. These dimensions are: dyspnea (5 items), fatigue (4 items), emotional status (7 items) and mastery (4 items). Response options were evaluated using a 7 -point Liken type scale. Quality of life (QOL) improves as the score increases. A total of 205 CHF patients hospitalized in the Department of Cardiology of Ege University hospital were enrolled in this study. The CHQ was applied to the patients twice with a wash-out period of 15 days. Confirmatory approach was used during the reliability and validity analysis. Cronbach alpha test was used for the reliability analysis. Confirmatory factor analysis (CFA) was used for the construct validity testing. NYHA classification for testing the criterion validity; SF-36 and WHOQOL-100 General Health and QOL facet for convergent validity testing of the Turkish version of the CHQ were used. Responsiveness to change was evaluated by Effect Size analysis by using test-retest data. Results: The range of Cronbach alpha values is 0.72-0.94. A considerable ceiling and floor effects were observed for the dyspnea dimension of the scale but no problematic items were observed for the entire scale. The CFA results supported the original four factors scale structure. Criterion and construct validity rebuts were satisfactory. Effect sizes obtained among dimensions of the CHQ were between 0.13 and 0.56. Conclusion: Overall results revealed that Turkish version of the CHQ is a reliable and valid instrument to be used for the evaluation of CHF patients. (Anadolu Kardiyol Derg 2010; 10: 526-38

Intercostal Artery - Pulmonary Artery Arterio-Arteriolar Fistula: A Case Report

CHEST Annual Meeting -- OCT 22-26, 2016 -- Los Angeles, CAWOS: 000400118602316CHES

Pulmonary arterial hypertension and pregnancy

WOS: 000317860700016PubMed ID: 23900530This is the case report of a pregnant woman who refused pregnancy termination when diagnosed with pulmonary arterial hypertension (PAH) functional class 2-3 at the 24th week of gestation and of her newborn. A pregnant woman with PAH functional class 2-3 was treated with inhaled prostacyclin analog ( iloprost), oral sildenafil, oxygen, and low molecular weight heparin. She delivered at 32nd week by Cesarean section. The infant required oxygen up to 36th week postconceptional age and had a short steroid treatment. The mother needed close cardiovascular monitorization, intensive oxygen and pulmonary vasodilator therapy for 2 months and was discharged with oxygen and oral iloprost treatment. A multidisciplinary approach together with pulmonary vasodilator therapy may be succesful in such a high-risk pregnant woman