| 1. |
|
|
| 2. |
- Ekman, Inger, 1952, et al.
(författare)
-
Exploring symptoms in chronic heart failure
- 2005
-
Ingår i: European Journal of Heart Failure. - : Wiley. - 1388-9842. ; 7:5, s. 699-703
-
Tidskriftsartikel (refereegranskat)abstract
- Symptoms in patients with chronic heart failure (CHF) are the cry for help, reflecting not only the physical aspects of the disease but the impact on lifestyle, anxiety, depression and expectations of the patient. Studies consistently show a difference in patients' self-assessed functional classification compared to investigator reported NYHA classification. Moreover, patient self-assessed symptoms have recently been shown to independently predict hospitalisation and mortality over 5 years. Recognition of symptoms and appreciation of their importance justifies the use of a structured assessment in order to provide optimal medical care for patients with CHF. A model of how to structure symptom assessment equally with signs is presented in this paper.
|
|
| 3. |
- Ekman, Inger, 1952, et al.
(författare)
-
Self-assessed symptoms in chronic heart failure--important information for clinical management
- 2007
-
Ingår i: Eur J Heart Fail. - : Wiley. - 1388-9842. ; 9:4, s. 424-8
-
Tidskriftsartikel (refereegranskat)abstract
- AIM: To compare the patients' self-assessment of the severity of their symptoms with a physicians assessment and to evaluate the ability of self-assessed symptoms and ejection fraction (EF) to predict long-term survival in heart failure patients. METHOD: Patients (n=332) evaluated symptoms using a self-administered functional classification scale (Specific Activity Scale, SAS), which is equivalent to the NYHA scale. EF and NYHA functional class was also recorded. All patients were followed over a 3-year period. RESULTS: Approximately 50% of patients classified themselves into SAS class I. In contrast, the cardiologists classified only 9% of the patients as NYHA class I. In patients with severe left ventricular dysfunction (EF
|
|
| 4. |
- Andersson, Bert, 1952
(författare)
-
Akut hjärtsvikt
- 2006
-
Bok (övrigt vetenskapligt/konstnärligt)
|
|
| 5. |
- Andersson, Bert, 1952, et al.
(författare)
-
Temporal improvement in heart failure survival related to the use of a nurse-directed clinic and recommended pharmacological treatment
- 2005
-
Ingår i: Int J Cardiol. - : Elsevier BV. - 0167-5273. ; 104:3, s. 257-63
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The use of recommended drugs for chronic heart failure (CHF) has been discouragingly low in clinical practice. The aim of this study was to prospectively evaluate to which extent a nurse-directed heart failure clinic could accomplish drug titration with modern heart failure treatments, with focus on beta-blockers. METHODS: Outcome of drug titration was evaluated for 418 patients referred to the nurse-run clinic from 1995 through 2001, using a prospective, open, non-randomised quality control protocol. RESULTS: Throughout the period, most of the patients were discharged on an ACE inhibitor (during 2001, 86%). The use of beta-blockers increased during the observation (from 43% to 88%). Patients started on an ACE-inhibitor treatment continued in 89% and in 95% when started on a beta-blocker. There was a significant decrease in mortality, relative risk per year 0.84 (95% CI, 0.75 to 0.94), P=0.002. Three-year mortality was reduced from 27% to 10%. In a multivariable analysis, survival was significantly associated with ejection fraction, renal function, the use of beta-blockers and ACE inhibitors, and negatively with digitalis treatment. CONCLUSIONS: The nurse-directed titration succeeded in introducing more patients on beta-blockers than on ACE-inhibitors. Mortality was reduced during the study period, associated with more use of documented therapy, beta-blockers in particular. These findings suggest that the observed signs of improvement in CHF prognosis are likely caused by more efficient medical treatment.
|
|
| 6. |
- Buvall, Lisa, 1976, et al.
(författare)
-
Antibodies against the beta1-adrenergic receptor induce progressive development of cardiomyopathy
- 2007
-
Ingår i: J Mol Cell Cardiol. - : Elsevier BV. - 0022-2828. ; 42:5, s. 1001-7
-
Tidskriftsartikel (refereegranskat)abstract
- Different immune disturbances have been found among patients with dilated cardiomyopathy (DCM), including antibodies directed against different cardiac antigens, such as the second extracellular loop of the beta(1)-adrenergic receptor. The aim of our study was to investigate antibodies directed against the second extracellular loop of the beta(1)-adrenergic receptor effect on cardiac functions at an early and late stage during DCM development. This was made in a mouse model, in which DCM was induced by immunization with the second extracellular loop of the beta(1)-adrenergic receptor. Mice were immunized for 14 or 25 weeks respectively with the second extracellular loop of the beta(1)-adrenergic receptor. At 14 weeks, there was no decreased heart function reviled by echocardiography at rest, but when dobutamine stress echocardiography was used, a lower cardiac reserve was shown in the mice with antibodies against the second extracellular loop of the beta(1)-adrenergic receptor. By 25 weeks, decreased heart function, dilatation of the left ventricle and thinner left ventricular posterior wall were observed. Further biochemical analyses at 25 weeks showed increased mRNA expressions for beta(1)-adrenergic receptor kinase, monocyte chemoattractant protein-1 and the brain natriuretic peptide as well as increased concentrations of complement factor 3 in sera in the immunized animals. Our data suggest a cardiotoxic effect of antibodies directed against the second extracellular loop of the beta(1)-adrenergic receptor and a capacity to induce DCM with progressive remodeling, decreased cardiac function, altered beta(1)AR signaling and upregulation of proinflammatory components.
|
|
| 7. |
- Cider, Åsa, 1960, et al.
(författare)
-
Cardiorespiratory effects of warm water immersion in elderly patients with chronic heart failure
- 2005
-
Ingår i: Clin Physiol Funct Imaging. ; 25:6, s. 313-7
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Hydrotherapy might be included in the rehabilitation of patients with chronic heart failure (CHF), but little is known about the acute cardiorespiratory reaction in warm water. The aim of this study was to assess the acute cardiorespiratory effect of immersion in warm water, in a clinical setting, in elderly patients with CHF compared with healthy age and sex matched persons. METHODS: Twelve patients (three females) with CHF, NYHA II-III, age 64 +/- 6 years, and 12 healthy subjects were studied. Cardiorespiratory changes, on land and in a temperature-controlled swimming pool (33-34 degrees C) were assessed during rest and exercise, in a sitting position, using continuous gas analyses. RESULTS: There were no significant differences, land versus water, in carbon dioxide production, total ventilation, respiratory frequency, respiratory exchange ratio, heart rate or blood pressure in either of the groups. A significant difference was found in oxygen uptake, at rest, land versus water in patients with CHF in comparison with healthy subjects (-0.2 +/- 0.4 versus +0.3 +/- 0.6 ml kg(-1) min(-1), P < 0.01). Oxygen kinetics (tau) increased significantly (P = 0.01) in both groups during exercise in water. CONCLUSION: Hydrotherapy was well tolerated and the vast majority of the cardiorespiratory responses, during warm water immersion in a clinical setting, are similar in patients with CHF compared with healthy subjects. However, further larger studies, are needed to better understand the physiological reactions during hydrotherapy.
|
|
| 8. |
- Cider, Åsa, 1960, et al.
(författare)
-
Immersion in warm water induces improvement in cardiac function in patients with chronic heart failure
- 2006
-
Ingår i: Eur J Heart Fail. - : Wiley. - 1388-9842. ; 8:3, s. 308-13
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The effects of immersion and training of patients with chronic heart failure (CHF) in warm water has not been thoroughly investigated. The aim of this study was to assess the acute hemodynamic response of immersion and peripheral muscle training in elderly patients with CHF. METHODS: Thirteen CHF patients and 13 healthy subjects underwent echocardiography on land and in a temperature-controlled swimming pool (33-34 degrees C). RESULTS: Rest. Heart rate decreased (CHF, p=0.01; control, p=0.001) and stroke volume increased (CHF, p=0.01; control, p=0.001) during water immersion in both groups, with no change in systolic or diastolic blood pressure. Ejection fraction (p<0.05) and transmitral Doppler E/A ratio (p=0.01) increased in the CHF group, with no changes in left ventricular volumes. The healthy subjects had similar responses, but also displayed an increase in cardiac output (p<0.01) and left ventricular volumes (p<0.001). Exercise. Cardiac output and systolic blood pressure increased significantly in water, in both groups. CONCLUSION: A general increase in early diastolic filling was accompanied by a decrease in heart rate, leading to an increase in stroke volume and ejection fraction in most patients with CHF during warm water immersion. These beneficial hemodynamic effects might be the reason for the previously observed good tolerability of this exercise regime.
|
|
| 9. |
- Cider, Åsa, 1960, et al.
(författare)
-
Reliability of clinical muscular endurance tests in patients with chronic heart failure
- 2006
-
Ingår i: Eur J Cardiovasc Nurs. ; 5:2, s. 122-6
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: In clinical praxis it is important to be able to assess the effect of rehabilitation in patients with chronic heart failure (CHF). There is therefore a need for simple clinical tests that are objective, reliable and valid measures. AIM: The aim of this study was to examine the reliability of three muscle endurance tests for patients with CHF and to compare the results to a healthy control group. METHOD: The study included 20 patients (7 women) with CHF and 20 healthy persons. Dynamic endurance of the shoulder and calf muscle was measured as well as static shoulder endurance. All three tests were performed twice, within 5-10 days. RESULTS: The reliability (rs) of the tests for the patients with CHF was between 0.90-0.99 and for the healthy persons between 0.79-0.98. There was also a significant difference in dynamic endurance in shoulder flexion and in heel-rise left leg test between patients with CHF and healthy persons. CONCLUSION: Tests of dynamic and static endurance of the shoulder muscle and dynamic calf muscle endurance are reliable assessment tools for use in clinical practice. Patients with CHF have reduced isotonic muscular endurance compared with healthy persons.
|
|
| 10. |
- Elliott, Perry, et al.
(författare)
-
Classification of the cardiomyopathies: a position statement from the European Society Of Cardiology Working Group on Myocardial and Pericardial Diseases.
- 2008
-
Ingår i: European heart journal. - : Oxford University Press (OUP). - 0195-668X .- 1522-9645. ; 29:2, s. 270-6
-
Tidskriftsartikel (refereegranskat)abstract
- In biology, classification systems are used to promote understanding and systematic discussion through the use of logical groups and hierarchies. In clinical medicine, similar principles are used to standardise the nomenclature of disease. For more than three decades, heart muscle diseases have been classified into primary or idiopathic myocardial diseases (cardiomyopathies) and secondary disorders that have similar morphological appearances, but which are caused by an identifiable pathology such as coronary artery disease or myocardial infiltration (specific heart muscle diseases). In this document, The European Society of Cardiology Working Group on Myocardial and Pericardial Diseases presents an update of the existing classification scheme. The aim is to help clinicians look beyond generic diagnostic labels in order to reach more specific diagnoses.
|
|
