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- Holst, M., et al.
(författare)
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Fluid restriction in heart failure patients : Is it useful? The design of a prospective, randomised study
- 2003
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Ingår i: European Journal of Cardiovascular Nursing. - : Elsevier Science. - 1474-5151 .- 1873-1953. ; 2:3, s. 237-242
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Tidskriftsartikel (refereegranskat)abstract
- Thirst is a common and troublesome symptom for patients with moderate to severe heart failure. The pharmacological and non-pharmacological treatment as well as the nature of the disease itself causes increased thirst. There is no evidence in the literature about the usefulness of fluid restriction for heart failure patients. Formerly, when very little pharmacological treatment was available, fluid restriction was one of the few interventional options but nowadays when the pharmacological treatment has improved, its importance may be questioned. This article describes the design of an ongoing study with the aim to determine if an individualised and less restrictive fluid prescription can improve the quality of life, cardiac function and exercise capacity, and decrease in hospital admissions and thirst. This study will be performed as a two-group, 1:1 randomised cross-over study. In group 1, the patients are instructed to comply with a maximum fluid intake of 1.5 l. This is a standard treatment today. In group 2, the patients are recommended to intake a fluid, based on the physiological need of 30 ml/kg body weight/24 h, and are allowed to increase the fluid intake to a maximum of 35 ml/kg body weight/24 h. After 16 weeks, the patients will cross over to the other intervention strategy and continue for another 16 weeks. © 2003 European Society of Cardiology. Published by Elsevier B.V. All rights reserved.
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| 2. |
- Rydberg, Erik, et al.
(författare)
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Left atrioventricular plane displacement determined by echocardiography: a clinically useful, independent predictor of mortality in patients with stable coronary artery disease
- 2003
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Ingår i: Journal of Internal Medicine. - : Wiley. - 1365-2796 .- 0954-6820. ; 254:5, s. 479-485
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Tidskriftsartikel (refereegranskat)abstract
- Background. Echocardiographically determined left atrioventricular plane displacement (AVPD) is strongly related to prognosis in patients with chronic heart failure and in postmyocardial infarction patients. We aimed at exploring whether AVPD, unlike ejection fraction, is related to mortality in patients with stable coronary artery disease (CAD). Methods and results. Atrioventricular plane displacement was assessed by two dimensionally guided M-mode echocardiography in the four and two chamber views, in 333 consecutive patients with stable CAD and an abnormal coronary angiogram. Patients were followed up for an average of 41 months. AVPD was lower in patients who died (n = 30, 9.0 %) compared with survivors (9.0 +/- 2.2 vs. 11.5 +/- 2.1 mm, P < 0.0001). Amongst patients with prior myocardial infarction (n = 184) AVPD was 8.7 +/- 2.3 mm in those who died (n = 17) and 11.2 +/- 2.3 mm in the survivors (P < 0.0001). In patients without prior myocardial infarction (n = 149), AVPD was 9.4 +/- 2.1 (n = 13) and 11.8 +/- 1.8 mm, respectively (P < 0.0001). Age, AVPD and four other echocardiographical variables correlated significantly with prognosis in univariate logistic regression analysis. In multiple logistic regression analysis only AVPD (P < 0.0001) correlated independently with mortality. Conclusion. Echocardiographically determined AVPDis a clinically useful, independent prognostic tool in patients with stable CAD. The presence of a documented previous myocardial infarction does not influence this observation.
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| 3. |
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| 4. |
- Winter, Reidar, et al.
(författare)
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Feasibility of noninvasive transthoracic echocardiography/Doppler measurement of coronary flow reserve in left anterior descending coronary artery in patients with acute coronary syndrome: A new technique tested in clinical practice
- 2003
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Ingår i: Journal of the American Society of Echocardiography. - 1097-6795. ; 16:5, s. 464-468
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Tidskriftsartikel (refereegranskat)abstract
- Objective: The aim of this study was to test the feasibility and accuracy of transthoracic Doppler echocardiography measurement of coronary flow reserve (CFR) in the left anterior descending coronary artery (LAD) territory in the clinical setting of the acute coronary syndrome. Methods: Transthoracic Doppler echocardiography measurements of CFR were made in 42 consecutive patients in the distal LAD before and during adenosine infusion. The results were validated by coronary angiography. A normal CFR was predefined as a more than 2-fold increase of flow velocity during adenosine infusion. Results. We were able to detect significant stenosis in the LAD territory with 92% sensitivity and 82% specificity if we considered a stenosis greater than or equal to 50% to be significant. Defining a stenosis of greater than or equal to 70% as significant increased the sensitivity and the negative-predictive value to 100%, with a specificity of 70%. Conclusion: Measuring CFR using transthoracic Doppler echocardiography is noninvasive, feasible, accurate, and relatively inexpensive. The excellent negative-predictive value of this technique makes it a useful tool for identifying patients who can avoid repeated angiography as a result of suspected subacute LAD restenosis after percutaneous coronary intervention.
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