| 1. |
- Albert, N.M., et al.
(författare)
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Exercise Factors Associated with 1-Year Mortality in Ambulatory Patients with Heart Failure
- 2013
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Ingår i: Journal of cardiac failure. - 1071-9164 .- 1532-8414. ; 19:8
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Konferensbidrag (refereegranskat)abstract
- Background: In prior research no differences have been found in 1-year mortality in pts with HF who participated in exercise interventions vs usual care. In HF-ACTION, over half of exercise pts were not fully adherent to the exercise intervention, even early into the trial. Understanding associations of exercise-related factors and 1-year mortality might lead to new interventions that promote exercise adherence. Methods. Using a prospective, correlational design, out-pts with chronic HF from 6 clinics completed questionnaires on demographics, comorbidites, and factors thought to be important in exercise capability and adherence (fatigue, depression, functional status, knowledge about exercise expectations, value of exercise, barriers/benefits of exercise, and exercise self-efficacy). Investigators provided 1-year survival data. Cox proportional hazards models were used to test for significance of the effects of variables of interest on survival. P-values for estimates of comparisons of hazard within levels of categorical variables were from tests based on z-statistics. If more than 2 categories, multiple comparisons were made to test for differences in the hazard ratios between each pair of categories. Continuous variables were categorized using cut scores. Results. Of the cohort of 492 pts (mean (SD) age 63 (± 13.6) yrs; LVEF 34.9% (± 14.8%); BMI 29.3 (± 6.73) kg/ml/m2; 40.3% ; male, 64.8%; Caucasian, 76.2%; married, 58.9%; NYHA-FC III/IV, 30.9%) 21 (4.2%) died within 1 year after enrollment. Only 46% reported exercising at a moderate-vigorous level. Pt characteristics associated with mortality were older age (p=0.037), no one to confide in (p=0.046) and NYHA-FC (p=0.001). Of exercise factors, mortality was reduced in pts with higher knowledge about exercise expectations (p=0.019), higher value for being active (p=0.002) and exercising (p=0.007), longer 6MWT distance (p=0.005), higher exercise self-efficacy (p=0.033) and reports of exercising at a moderate-vigorous level compared with no-infrequent exercise patterns (p=0.036). Conclusion. Among stable, out-pts with HF, many exercise-related factors were associated with 1-year mortality. Healthcare providers need to clearly communicate the value of exercise, explain details of moderate-vigorous exercise expectations and develop processes to increase self-efficacy for exercise to promote moderate-vigorous exercise behaviors and ongoing adherence to exercise.
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| 2. |
- Alehagen, Urban, et al.
(författare)
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Natriuretic Peptide Biomarkers as Information Indicators in Elderly Patients With Possible Heart Failure Followed Over Six Years : A Head-to-Head Comparison of Four Cardiac Natriuretic Peptides
- 2007
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Ingår i: Journal of Cardiac Failure. - : Elsevier BV. - 1071-9164 .- 1532-8414. ; 13:6, s. 452-461
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Tidskriftsartikel (refereegranskat)abstract
- Background: Little is known about the differences between natriuretic peptides used to evaluate elderly patients with heart failure. The aim of the study was to evaluate the information and the power to predict cardiovascular mortality derived from an analysis of cardiac natriuretic peptides from the same study population and at the same time. Methods and Results: In all, 415 elderly patients (age 65-82 years) in primary health care were evaluated and followed for 6 years. All patients had symptoms of heart failure and were examined by a cardiologist. An electrocardiogram and chest x-rays were taken, and the systolic and diastolic functions were assessed using Doppler echocardiography. Brain natriuretic peptide (BNP), N-terminal proBNP, atrial natriuretic peptide (ANP), and N-terminal proANP were analyzed. All 4 peptides were associated with age, and only 1 of them showed any gender difference. Three of the 4 peptides (not ANP) provided important information for identifying patients with impaired systolic function and diastolic dysfunction (pseudonormal or restrictive filling pattern), and for assessing the risk of cardiovascular death. Conclusions: Cardiac natriuretic peptides are useful tools for evaluating elderly patients with heart failure. Three of the 4 peptides were very similar. ANP exhibits inferior properties and cannot be recommended in clinical practice. © 2007 Elsevier Inc. All rights reserved.
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| 3. |
- Alehagen, Urban, et al.
(författare)
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Pro-A-Type Natriuretic Peptide, Proadrenomedullin, and N-Terminal Pro-B-Type Natriuretic Peptide Used in a Multimarker Strategy in Primary Health Care in Risk Assessment of Patients With Symptoms of Heart Failure
- 2013
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Ingår i: Journal of Cardiac Failure. - : Elsevier. - 1071-9164 .- 1532-8414. ; 19:1, s. 31-39
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Use of new biomarkers in the handling of heart failure patients has been advocated in the literature, but most often in hospital-based populations. Therefore, we wanted to evaluate whether plasma measurement of N-terminal pro B-type natriuretic peptide (NT-proBNP), midregional pro A-type natriuretic peptide (MR-proANP), and midregional proadrenomedullin (MR-proADM), individually or combined, gives prognostic information regarding cardiovascular and all-cause mortality that could motivate use in elderly patients presenting with symptoms suggestive of heart failure in primary health care. less thanbrgreater than less thanbrgreater thanMethods and Results: The study included 470 elderly patients (mean age 73 years) with symptoms of heart failure in primary health care. All participants underwent clinical examination, 2-dimenstional echocardiography, and plasma measurement of the 3 propeptides and were followed for 13 years. All mortality was registered during the follow-up period. The 4th quartiles of the biomarkers were applied as cutoff values. NT-proBNP exhibited the strongest prognostic information with andgt;4-fold increased risk for cardiovascular mortality within 5 years. For all-cause mortality MR-proADM exhibited almost 2-fold and NT-proBNP 3-fold increased risk within 5 years. In the 5-13-year perspective, NT-proBNP and MR-proANP showed significant and independent cardiovascular prognostic information. NT-proBNP and MR-proADM showed significant prognostic information regarding all-cause mortality during the same time. In those with ejection fraction (EF) andlt;40%, MR-proADM exhibited almost 5-fold increased risk of cardiovascular mortality with 5 years, whereas in those with EF andgt;50% NT-proBNP exhibited andgt;3-fold increased risk if analyzed as the only biomarker in the model. If instead the biomarkers were all below the cutoff value, the patients had a highly reduced mortality risk, which also could influence the handling of patients. less thanbrgreater than less thanbrgreater thanConclusions: The 3 biomarkers could be integrated in a multimarker strategy for use in primary health care. (J Cardiac Fail 2013;19:31-39)
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| 4. |
- Alm, Torbjörn, et al.
(författare)
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The Value of Spatial Cues in 3D Air Traffic Displays
- 2007
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Ingår i: The International journal of aviation psychology. - : Informa UK Limited. - 1050-8414 .- 1532-7108. ; 17:2, s. 109-129
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Tidskriftsartikel (refereegranskat)abstract
- Interest in implementing 3D pictorial displays for traffic information in aircraft has been prevalent for decades without any obvious implementation in the cockpit. Our research is focused on design issues for these displays. The purpose of the experiments discussed here was to investigate where and when additional spatial cues, e.g., drop-lines, could contribute to better performance and whether such additions could replace shifts between 2D and 3D presentation for different tasks. Our results show that drop-lines are beneficial in focused attention tasks but are not necessarily beneficial in more integrated tasks. This speaks to the need for an adaptive approach to the presentation of flight situation displays.
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| 5. |
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| 6. |
- Andreae, Christina, 1969-, et al.
(författare)
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Psychometric Evaluation of Two Appetite Questionnaires in Patients With Heart Failure
- 2015
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Ingår i: Journal of Cardiac Failure. - : Elsevier BV. - 1071-9164 .- 1532-8414. ; 21:12, s. 954-958
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Tidskriftsartikel (refereegranskat)abstract
- Background: Decreased appetite in heart failure (HF) may lead to undemutrition which could negatively influence prognosis. Appetite is a complex clinical issue that is often best measured with the use of self-report instruments. However, there is a lack of self-rated appetite instruments. The Council on Nutrition Appetite Questionnaire (CNAQ) and the Simplified Nutritional Appetite Questionnaire (SNAQ) are validated instruments developed primarily for elderly people. Yet, the psychometric properties have not been evaluated in HF populations. The aim of the present study was to evaluate the psychometric properties of CNAQ and SNAQ in patients with HE Methods and Results: A total of 186 outpatients with reduced ejection fraction and New York Heart Association (NYHA) functional classifications II-IV were included (median age 72 y; 70% men). Data were collected with the use of a questionnaire that included the CNAQ and SNAQ. The psychometric evaluation included data quality, factor structure, construct validity, known-group validity, and internal consistency. Unidimensionality was supported by means of parallel analysis and confirmatory factor analyses (CFAs). The CFA results indicated sufficient model fit. Both construct validity and known-group validity were supported. Internal consistency reliability was acceptable, with ordinal coefficient alpha estimates of 0.82 for CNAQ and 0.77 for SNAQ. Conclusions: CNAQ and SNAQ demonstrated sound psychometric properties and can be used to measure appetite in patients with HF.
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| 7. |
- Barbareschi, Giorgio, et al.
(författare)
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Educational Level and the Quality of Life of Heart Failure Patients: A Longitudinal Study
- 2011
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Ingår i: Journal of Cardiac Failure. - : Elsevier Science B.V., Amsterdam. - 1071-9164 .- 1532-8414. ; 17:1, s. 47-53
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Tidskriftsartikel (refereegranskat)abstract
- Background: Lower education in heart failure (HF) patients is associated with high levels of anxiety, limited physical functioning, and an increased risk of hospitalization. We examined whether educational level is related to longitudinal differences in quality of life (QoL) in HF patients. Methods and Results: This research is a substudy of the Coordinating study evaluating Outcomes of Advising and Counselling in Heart failure (COACH). QoL of 553 HF patients (mean age 69, 38% female, mean left ventricular ejection fraction 33%) was assessed during their hospitalization and at 4 follow-up measurements after discharge. In total 32% of the patients had very low, 24% low, 32% medium, and 12% high education. Patients with low educational levels reported the worst QoL. Significant differences between educational groups (P less than .05) were only reported in physical functioning, social functioning, energy/fatigue, pain, and limitations in role functioning related to emotional problems. Longitudinal results show that a significantly higher proportion of high-educated patients improved in functional limitations related to emotional problems over time compared with lower-educated patients (P less than .05). Conclusions: Patients with low educational levels reported the worst physical and functional condition. High-educated patients improved more than the other patients in functional limitations related to emotional problems over time. Low-educated patients may require different levels of intervention to improve their physical and functional condition.
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| 8. |
- Björklund, Caroline M., et al.
(författare)
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Mode monitoring and call-outs : An eye-tracking study of 2-crew automated flight deck operations
- 2006
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Ingår i: The International journal of aviation psychology. - : Taylor & Francis. - 1050-8414 .- 1532-7108. ; 16:3, s. 263-275
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Tidskriftsartikel (refereegranskat)abstract
- Mode awareness has been suggested as a critical factor in safe operations of automated aircraft. This study investigated mode awareness by measuring eye point of gaze of both pilots during simulated commercial flights, while recording call-outs and tracking aircraft performance. The results of this study show that the compliance to manufacturer or air carrier procedures regarding mode monitoring and call-outs was very low. However, this did not seem to have a negative effect on the flight path or safety during our observations. Crews exhibited a proliferation of strategies to keep track of status and behavior of the automation, often with little reliance on the flight mode annunciations of the primary flight display. The data confirm the limitations of current flight mode annunciator designs, and suggest that mode awareness is a more complex phenomenon than what can be captured by measuring eye point of gaze and communication alone.
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| 9. |
- Cabrera, Carin C., et al.
(författare)
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Increased iron absorption in patients with chronic heart failure and iron deficiency
- 2020
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Ingår i: Journal of Cardiac Failure. - : Elsevier BV. - 1071-9164 .- 1532-8414. ; 26:5, s. 440-443
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Tidskriftsartikel (refereegranskat)abstract
- Background: Iron deficiency (ID) is common in patients with chronic heart failure (CHF), but the underlying causes are not fully understood. We investigated whether ID is associated with decreased iron absorption in patients with CHF.Methods and Results: We performed an oral iron-absorption test in 30 patients and 12 controls. The patients had CHF with reduced (n = 15) or preserved (n = 15) ejection fraction and ID, defined as s- ferritin < 100 mu g/L, or s-ferritin 100-299 mu g/L and transferrin saturation < 20%. The controls had no HF or ID and were of similar age and gender. Blood samples were taken before and 2 hours after ingestion of 100 mg ferroglycin sulphate. The primary endpoint was the delta plasma iron at 2 hours. The delta plasma iron was higher in the group with HF than in the control group (median increase 83.8 [61.5;128.5] mu g/dL in HF vs 47.5 [ 30.7;61.5] mu g/dL in controls, P = 0.001), indicating increased iron absorption. There was no significant difference between the groups with preserved or reduced ejection fraction (P = 0.46).Conclusion: We found increased iron absorption in patients with CHF and ID compared to controls without ID and HF, indicating that reduced iron absorption is not a primary cause of the high prevalence of ID in patients with CHF.
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| 10. |
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