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- Cider, Åsa, 1960, et al.
(author)
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Hydrotherapy--a new approach to improve function in the older patient with chronic heart failure
- 2003
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In: Eur J Heart Fail. ; 5:4, s. 527-35
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Journal article (peer-reviewed)abstract
- AIMS: Hydrotherapy, i.e. exercise in warm water, as a rehabilitation program has been considered potentially dangerous in patients with chronic heart failure (CHF) due to the increased venous return caused by the hydrostatic pressure. However, hydrotherapy has advantages compared to conventional training. We studied the applicability of an exercise programme in a temperature-controlled swimming pool, with specific reference to exercise capacity, muscle function, quality of life and safety. METHODS AND RESULTS: Twenty-five patients with CHF (NYHA II-III, age 72.1+/-6.1) were randomised into either 8 weeks of hydrotherapy (n=15), or into a control group (n=10). The training program was well tolerated with no adverse events. Patients in the hydrotherapy group improved their maximal exercise capacity (+6.5 vs.-5.9 W, P=0.001), isometric endurance in knee extension (+4 vs.-9 s, P=0.01) together with an improvement in the performance of heel-lift (+4 vs. -3 n.o., P=<0.01), shoulder abduction (+12 vs. -8 s, P=0.01) and shoulder flexion (+6 vs. +4, P=0.01) in comparison to patients in the control group. CONCLUSION: Physical training in warm water was well tolerated and seems to improve exercise capacity as well as muscle function in small muscle groups in patients with CHF. This new approach broadens the variety of training regimes for older patients with CHF.
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| 3. |
- Schaufelberger, Maria, 1954, et al.
(author)
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Can brain natriuretic peptide (BNP) be used as a screening tool in general practice?
- 2004
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In: Scandinavian journal of primary health care. - : Informa UK Limited. - 0281-3432 .- 1502-7724. ; 22:3, s. 187-90
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Journal article (peer-reviewed)abstract
- OBJECTIVE:To investigate plasma brain natriuretic peptide (p-BNP) in consecutive primary care patients for heart failure screening. DESIGN: Open, descriptive. SETTING: Three primary care clinics, university hospital. SUBJECTS: 291 consecutive patients, > or =40 years. MAIN OUTCOME MEASURES: p-BNP and general practitioners estimated probability of CHF. RESULTS: Median p-BNP was 29 ng/L. In 42% p-BNP was >40 ng/L in the first sample. In 41 patients further investigated, median p-BNP was 98 ng/L, with a correlation between p-BNP and physicians' estimation of probability of heart failure (r=0.469, p<0.0001). New York Heart Association class was correlated to p-BNP (r=0.343, p=0.034). No correlation between ejection fraction and p-BNP was seen. CONCLUSION:P-BNP concentrations in unselected primary care patients of 40 years of age or above were elevated in a larger proportion of patients than previously reported. Owing to the low specificity, p-BNP concentration limits have to be defined before the test can be used for screening in primary care.
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| 4. |
- Schaufelberger, Maria, 1954, et al.
(author)
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Decreasing one-year mortality and hospitalization rates for heart failure in Sweden; Data from the Swedish Hospital Discharge Registry 1988 to 2000
- 2004
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In: European heart journal. - 0195-668X. ; 25:4, s. 300-7
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Journal article (peer-reviewed)abstract
- AIMS: To investigate if improved treatment of coronary heart disease and hypertension, the major causes of chronic heart failure (CHF), in the last 20 years has had an impact on the incidence of CHF and survival. METHODS: National Swedish registers on hospital discharges and cause-specific deaths were used to calculate age- and sex-specific trends and sex ratios for heart failure admissions and deaths. The study included all men and women 45 to 84 years old hospitalized for the first time for heart failure in 19 Swedish counties between 1988 and 2000, a mean annual population 2.9 million. A total of 156?919 hospital discharges were included. RESULT: In 1988, a total of 267 men and 205 women per 100?000 inhabitants (age adjusted) were discharged for the first time with a principal diagnosis of heart failure. After 1993 a yearly decrease was observed, with 237 men and 171 women per 100?000 inhabitants discharged during 2000. The 30-day mortality decreased significantly. The decrease in 1-year mortality was more pronounced in the younger age groups, with a total reduction in mortality of 69% among men and 80% among women aged 45-54 years. The annual decrease was 9% among men and 10% among women aged 45-54 years (95% CI -7% to -12% and -6% to -14% respectively) and 4% among men and 5% among women (95% CI -4% to -5% for both) aged 75-84 years. CONCLUSION: The decrease in incidence and improved prognosis after a first hospitalization for heart failure coincides with the establishment of ACE-inhibitor therapy, the introduction of beta-blockers for treatment of heart failure, home-care programmes for heart failure, and more effective treatment and prevention of underlying diseases. Notwithstanding, despite considerable improvement, 1-year mortality after a first hospitalization for heart failure is still high.
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