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- Persson, H, et al.
(författare)
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Neurohormonal activation in heart failure after acute myocardial infarction treated with beta-receptor antagonists
- 2002
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Ingår i: European Journal of Heart Failure. - 1879-0844 .- 1388-9842. ; 4:1, s. 73-82
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Tidskriftsartikel (refereegranskat)abstract
- Background: Few studies have described how neurohormonal activation is influenced by treatment with beta-receptor antagonists in patients with heart failure after acute myocardial infarction. The aims were to describe neurohormonal activity in relation to other variables and to investigate treatment effects of a beta, receptor-antagonist compared to a partial beta, receptor-agonist. Methods: Double-blind, randomized comparison of metoprolol 50-100 mg b.i.d. (n = 74), and xamoterol 100-200 mg b.i.d (n = 67). Catecholamines, neuropeptide Y-like immunoreactivity (NPY-LI), renin activity, and N-terminal pro-atrial natriuretic factor (N-ANF) were measured in venous plasma before discharge and after 3 months. Clinical and echocardiographic variables were assessed. Results: N-ANF showed the closest correlations to clinical and echo cardiographic measures of heart failure severity, e.g. NYHA functional class, furosemide dose, exercise tolerance, systolic and diastolic function. Plasma norepinephrine, dopamine and renin activity decreased after 3 months on both treatments, in contrast to a small increase in NPY-LI which was greater (by 3.9 pmol/l, 95% CI 1.2-6.6) in the metoprolol group. N-ANF increased on metoprolol, and decreased on xamoterol (difference: 408 pmol/l, 95% CI 209-607). Increase above median of NPY-LI (> 25.2 pmol/l, odds ratio 2.8, P = 0.0050) and N-ANF (> 1043 pmol/l, odds ratio 2.8, P = 0.0055) were related to long term (mean follow-up 6.8 years) cardiovascular mortality. Conclusions: Decreased neurohormonal activity, reflecting both the sympathetic nervous system and the renin-angiotensin system, was found 3 months after an acute myocardial infarction with heart failure treated with beta-receptor antagonists. The small increase in NPY-LI may suggest increased sympathetic activity or reduced clearance from plasma. The observed changes of N-ANF may be explained by changes in cardiac preload, renal function, and differences in beta-receptor mediated inhibition of atrial release of N-ANF. NPY-LI, and N-ANF at discharge were related to long term cardiovascular mortality. (C) 2002 European Society of Cardiology. All rights reserved.
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| 9. |
- Jaarsma, Tiny
(författare)
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Heart failure management programs : how far should we go?
- 2003
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Ingår i: European Journal of Heart Failure. - 1388-9842 .- 1879-0844. ; 5:3, s. 215-216
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Tidskriftsartikel (refereegranskat)abstract
- An increasing number of management programs for heart failure patients, aimed at optimising individual care, have been described and evaluated during the last decade. The existence and content of heart failure management programs differs between and within countries, depending on the patient population, national health care systems and level of education of nurses. Recently heart failure management programs in Sweden and the Netherlands were described and a variation in the content of these programs was found [1–3].In general, heart failure management programs differ in 3 ways: content (which components are involved); intensity (how often is the patient contacted) and the organisational model.
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| 10. |
- Jacobsson, Anna, et al.
(författare)
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Malnutrition in patients suffering from chronic heart failure; the nurse's care
- 2001
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Ingår i: European Journal of Heart Failure. - Amsterdam : Elsevier. - 1388-9842 .- 1879-0844. ; 3:4, s. 449-456
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Tidskriftsartikel (refereegranskat)abstract
- Chronic heart failure is associated with a bad prognosis with considerably shortened survival and repeated hospitalisations. Patients suffering from heart failure also have symptoms that can affect their food intake, for example, tiredness when strained, breathing difficulties and gastrointestinal symptoms like nausea, loss of appetite and ascites. Pharmacological therapy can lead to a loss of appetite, which will make the intake of food inadequate to fill the required energy and nutritional needs. The nurse's interest in and knowledge of diet issues can improve these patients' nutritional status, The aim of this literature review was to describe the nurse's interventions regarding malnutrition in patients suffering from chronic heart failure. The literature search gave 13 articles, which were analysed, and sentences whose content was related to the aim were identified. Three areas of content appeared; drug treatment and consequences, gastrointestinal effects, and information and education. The results show that the nutritional status of these patients can be significantly improved by means of simple nursing interventions. Future research should focus on controlled experimental studies to evaluate differences in body weight, body mass index and quality of life between patients suffering from chronic heart failure, who are taking part in a fully enriched nutrition intervention, and patients suffering from chronic heart failure, who are eating their normal diet.
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