38 research outputs found
Involvement of private investors on the financial market of the Russian Federation: analysis of problems and actions of regulating authorit
In this article, the problems of attracting private investment in the financial markets of the Russian Federation are examined. The analysis of measures carried out by the regulator of the financial market on achievement of positive dynamics in attraction of savings of the population in the financial markets is carried out. Conclusions have been made about the need for additional instruments of impact on the population and on the pfessional market participants who would help stimulate the population in choosing the Russian stock market
Management of End Stage Heart Failure (Advanced Heart Failure)
Video/audio presentation of Aurora St. Luke\u27s Transplant Grand Rounds on June 27, 2012, presented by Nasir Sulemanjee, MD, Advanced Heart Failure & Transplant Cardiologist. 59 minutes
Reduction in 90 day readmission rates with ambulatory pulmonary artery pressure monitoring
Right Ventricular Sarcoidosis, Mimic for Arrhythmogenic Right Ventricular Cardiomyopathy
Can gene-expression profiling score help explain the adverse clinical outcomes seen in gender-mismatched heart transplants?
Background: Gene-expression profiling (GEP) testing, in conjunction with clinical assessment, is an established laboratory test intended to aid in the identification of acute cellular rejection in heart transplant recipients. In this patient population, donor- and recipient-gender mismatch is a well-known risk factor for adverse outcomes (including survival and rejection). The mechanism for this variant outcome is unclear. The objective of this study was to determine if gender-mismatched heart transplant recipients have different GEP scores.
Methods: Outcomes AlloMap® Registry (OAR) comprises 11 heart transplant centers contributing clinical data on short- and long-term outcomes in heart transplant recipients who receive GEP testing as part of allograft rejection surveillance. All 237 consecutive patients (651 visits) from the OAR were selected for analysis.
Results: Of 237 patients, 216 had both donor- and recipient genders reported. Of those, 76% were Caucasians, and recipient mean age was 56y. 46% had ischemic etiology and 58% were on mechanical circulatory support prior to transplant. There were 46 gender mismatches identified (25 female donor\u3emale recipient & 21 male donor\u3efemale recipient). Mean (median) GEP scores for the gender-mismatched group were compared to the non-mismatched group: female\u3emale 27.71 (28), male\u3efemale 27.77 (28) vs. male\u3emale 28.76 (30), female\u3efemale 27.78 (29). No statistically significant difference was observed in clinical outcomes (heart failure symptoms, hospitalizations, rejection, CMV infection and cancer) in the gender-mismatched cohort; however, there were few of these events.
Conclusion: No significant difference in GEP scores was noted in gender-mismatched heart transplant recipients as compared to gender-matched transplant recipients. A larger sample size is needed to determine significance of these results
Validation of the Heart QoL Health Related Quality of Life Questionnaire in patients with chronic ischemic cardiomyopathy
Objective: The English HeartQoL health-related quality of life questionnaire has been validated in patients with angina and myocardial infarction living in the USA but not in patients with symptomatic heart failure. The factor structure, reliability, validity, and responsiveness of the English HeartQoL was assessed in patients with heart failure due to chronic ischemic cardiomyopathy.
Methods: A battery of five questionnaires, including the HeartQoL with a Global scale and Physical and Emotional subscales, was self-administered by 90 patients with chronic ischemic cardiomyopathy in Wisconsin, USA, and the HeartQoL factor structure, reliability and validity were assessed. Responsiveness was examined in a separate cohort of 20 patients undergoing cardiac resynchronization therapy.
Results: The 2-factor HeartQoL structure was confirmed. Internal consistency reliability was strong with Cronbach’s α ≥0.88. Convergent validity correlations between similar HeartQoL and Minnesota Living with Heart Failure questionnaire (r=-0.81 to -0.82) and Short Form 36 Health Survey constructs (r=0.74 to 0.78) were strong with significantly weaker correlations between dissimilar constructs. Discriminative validity was confirmed on eight of the 10 a priori hypotheses. Over a 3-month period, responsiveness (minimal important difference and effect size) was confirmed on the HeartQoL Global scale and Physical subscale.
Conclusion: The English HeartQoL is a reliable, valid, and responsive health-related quality of life questionnaire in patients with symptomatic heart failure due to chronic ischemic cardiomyopathy. The English HeartQoL can be recommended as a core heart disease health-related quality of life questionnaire within and across patients with angina, myocardial infarction or heart failure