60 research outputs found
Global Strain in Severe Aortic Valve Stenosis:Relation to Clinical Outcome after Aortic Valve Replacement
Effect of implantable cardioverter-defibrillators in patients with non-ischaemic systolic heart failure and concurrent coronary atherosclerosis
AIMS: Prophylactic implantable cardioverterâdefibrillators (ICD) reduce mortality in patients with ischaemic heart failure (HF), whereas the effect of ICD in patients with nonâischaemic HF is less clear. We aimed to investigate the association between concomitant coronary atherosclerosis and mortality in patients with nonâischaemic HF and the effect of ICD implantation in these patients. METHODS AND RESULTS: Patients were included from DANISH (Danish Study to Assess the Efficacy of Implantable Cardioverter Defibrillators in Patients with NonâIschaemic Systolic Heart Failure on Mortality), randomizing patients to ICD or control. Study inclusion criteria for HF were left ventricular ejection fraction â¤Â 35% and increased levels (>200 pg/mL) of Nâterminal proâbrain natriuretic peptide. Of the 1116 patients from DANISH, 838 (75%) patients had available data from coronary angiogram and were included in this subgroup analysis. We used Cox regression to assess the relationship between coronary atherosclerosis and mortality and the effect of ICD implantation. Of the included patients, 266 (32%) had coronary atherosclerosis. Of these, 216 (81%) had atherosclerosis without significant stenoses, and 50 (19%) had significant stenosis. Patients with atherosclerosis were significantly older {67 [interquartile range (IQR) 61â73] vs. 61 [IQR 54â68] years; P < 0.0001}, and more were men (77% vs. 70%; P = 0.03). During a median followâup of 64.3 months (IQR 47â82), 174 (21%) of the patients died. The effect of ICD on allâcause mortality was not modified by coronary atherosclerosis [hazard ratio (HR) 0.94; 0.58â1.52; P = 0.79 vs. HR 0.82; 0.56â1.20; P = 0.30], P for interaction = 0.67. In univariable analysis, coronary atherosclerosis was a significant predictor of allâcause mortality [HR, 1.41; 95% confidence interval (CI), 1.04â1.91; P = 0.03]. However, this association disappeared when adjusting for cardiovascular risk factors (age, gender, diabetes, hypertension, smoking, and estimated glomerular filtration rate) (HR 1.05, 0.76â1.45, P = 0.76). CONCLUSIONS: In patients with nonâischaemic systolic heart failure, ICD implantation did not reduce allâcause mortality in patients either with or without concomitant coronary atherosclerosis. The concomitant presence of coronary atherosclerosis was associated with increased mortality. However, this association was explained by other risk factors
Twelve weeks of treatment with empagliflozin in patients with heart failure and reduced ejection fraction:A double-blinded, randomized, and placebo-controlled trial
Prevalence and prognostic significance of hyponatraemia in outpatients with chronic heart failure
Effect of family nursing therapeutic conversations on health-related quality of life, self-care and depression among outpatients with heart failure : a randomized multi-centre trial
Objective: To evaluate the short-term (3 months) effects of family nursing therapeutic conversations (FNTC) on health-related quality of life, self-care and depression in outpatients with Heart failure (HF).
Methods: A randomised multi-centre trial was conducted in three Danish HF clinics. The control group (n = 167) received usual care, and the intervention group (n = 180) received FNTCs as supplement to usual care. Primary outcome was clinically significant changes (6 points) in Kansas City Cardiomyopathy Questionnaire (KCCQ) summary score between groups. Secondary outcomes were changes in self-care behaviour and depression scores. Data were assessed before first consultation and repeated after three months.
Results: No statistically significant difference was found in the change of KCCQ, self-care and depression scores between the groups. KCCQ scores of patients in the FNTC group changed clinically significant in seven domains, compared to one domain in the control group, with the highest improvement in selfefficacy, social limitation and symptom burden.
Conclusion: FNTC was not superior to standard care of patients with HF regarding health-related quality of life, self-care and depression. Implication for practice: Addressing the impact of the disease on the family, might improve self-efficacy, social limitation and symptom burden in patients with heart failur
Hemodilution, central blood volume, and renal responses after an isotonic saline infusion in humans
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