scholarly journals Response shift after coronary revascularization

Author(s):  
Tom H. Oreel ◽  
Pythia T. Nieuwkerk ◽  
Iris D. Hartog ◽  
Justine E. Netjes ◽  
Alexander B. A. Vonk ◽  
...  

Abstract Purpose The aims of this study were to investigate (1) the extent to which response shift occurs among patients with coronary artery disease (CAD) after coronary revascularization, (2) whether the assessment of changes in health-related quality of life (HRQoL), controlled for response shift, yield more valid estimates of changes in HRQoL, as indicated by stronger associations with criterion measures of change, than without controlling for response shift, and (3) if occurrences of response shift are related to patient characteristics. Methods Patients with CAD completed the SF-36 and the Seattle Angina Questionnaire (SAQ7) at baseline and 3 months after coronary revascularization. Sociodemographic, clinical and psychosocial variables were measured with the patient version of the New York Heart Association-class, Subjective Significance Questionnaire, Reconstruction of Life Events Questionnaire (RE-LIFE), and HEXACO personality inventory. Oort’s Structural Equation Modeling (SEM) approach was used to investigate response shift. Results 191 patient completed questionnaires at baseline and at 3 months after treatment. The SF-36 showed recalibration and reprioritization response shift and the SAQ7 reconceptualization response shift. Controlling for these response shift effects did not result in more valid estimates of change. One significant association was found between reprioritization response shift and complete integration of having CAD into their life story, as indicated by the RE-LIFE. Conclusion Results indicate response shift in HRQoL following coronary revascularization. While we did not find an impact of response shift on the estimates of change, the SEM approach provides a more comprehensive insight into the different types of change in HRQoL following coronary revascularization.

2011 ◽  
Vol 18 (2) ◽  
pp. 157-163 ◽  
Author(s):  
Fábio Cangeri Di Naso ◽  
Juliana Saraiva Pereira ◽  
Simone Zani Beatricci ◽  
Renata Giovana Bianchi ◽  
Alexandre Simões Dias ◽  
...  

A insuficiência cardíaca (IC) é uma síndrome que se apresenta com crescente prevalência, podendo limitar o indivíduo quanto à capacidade físico-funcional, condição pulmonar e qualidade de vida. Este estudo tem como objetivo verificar as limitações pulmonares e físicas, bem como a qualidade de vida dos pacientes e compará-las com as classes funcionais da New York Heart Association (NYHA). Estudo transversal, com amostra de 66 pacientes (45 homens). Foram aplicados uma ficha de avaliação padronizada e o questionário de qualidade de vida Short Form-36 (SF-36). Foram realizados espirometria, manovacuometria e o teste da caminhada de seis minutos (TC6M). Os pacientes (classe I: 24 indivíduos, classe II: 27 e classe III: 15) possuíam uma média de idade de 57,95±10,96 anos e representaram uma amostra com características antropométricas homogêneas. Para a condição pulmonar, observou-se diferença estatística quanto a Capacidade Vital Forçada (CVF), Pico de Fluxo Expiratório e Pressão Expiratória Máxima (Pemáx). Na distância do TC6M houve diferença entre classe I e III e entre II e III (classe I: 439,27±58,85 m, classe II: 370,96±74,41 m e classe III: 268,96±83,88 m), com p<0,001. Para o SF-36, houve decréscimo da qualidade de vida conforme o agravo das classes funcionais. Pacientes com IC apresentam diminuição da condição pulmonar, capacidade físico-funcional e qualidade de vida relacionada ao aumento da classe funcional da NYHA.


Author(s):  
Líscia Divana Silva ◽  
Naine Dos Santos Linhares ◽  
Rosilda Silva Dias ◽  
Elza Lima da Silva

Estudo de revisão sistemática da literatura, de caráter exploratório e qualitativo sobre instrumentos de qualidade de vida em pacientes submetidos cirurgia cardíaca. A coleta de dados foi realizada nas bases de dados LILACS, MEDLINE e SciELO, considerando artigos originais na íntegra em português, inglês e espanhol, publicados a partir de 2000, abordando a temática qualidade de vida em cirurgia cardíaca. Foram encontrados 445 artigos, dos quais 15 contemplavam os critérios estabelecidos, destes 11 em português. O período das publicações compreendeu os anos de 2002 a 2010. Dentre as cirurgias cardíacas, a cirurgia de revascularização do miocárdio foi a mais frequente, seguida das cirurgias valvulares. O instrumento de avaliação de qualidade de vida mais utilizado foi o Medical Outcomes 36-Item Short-Form Health Survey–SF-36 (43%), seguido da classificação funcional da New York Heart Association – NYHA (22%) e do Escore de Duke (14%). O número de pacientes na amostra dos estudos analisado variou de 24 a 7.321 pacientes. Os estudos descreveram melhoria da qualidade de vida dos pacientes submetidos à cirurgia cardíaca. A qualidade de vida é um aspecto importante a ser avaliado, devendo ser mensurada com instrumentos validados e confiáveis


2019 ◽  
Vol 26 (3) ◽  
pp. 90-100
Author(s):  
Justė Lukoševičiūtė ◽  
Kastytis Šmigelskas

Abstract. Illness perception is a concept that reflects patients' emotional and cognitive representations of disease. This study assessed the illness perception change during 6 months in 195 patients (33% women and 67% men) with acute coronary syndrome, taking into account the biological, psychological, and social factors. At baseline, more threatening illness perception was observed in women, persons aged 65 years or more, with poorer functional capacity (New York Heart Association [NYHA] class III or IV) and comorbidities ( p < .05). Type D personality was the only independent factor related to more threatening illness perception (βs = 0.207, p = .006). At follow-up it was found that only self-reported cardiovascular impairment plays the role in illness perception change (βs = 0.544, p < .001): patients without impairment reported decreasing threats of illness, while the ones with it had a similar perception of threat like at baseline. Other biological, psychological, and social factors were partly associated with illness perception after an acute cardiac event but not with perception change after 6 months.


Open Heart ◽  
2021 ◽  
Vol 8 (1) ◽  
pp. e001600
Author(s):  
Joanne Kathryn Taylor ◽  
Haarith Ndiaye ◽  
Matthew Daniels ◽  
Fozia Ahmed

AimsIn response to the COVID-19 pandemic, the UK was placed under strict lockdown measures on 23 March 2020. The aim of this study was to quantify the effects on physical activity (PA) levels using data from the prospective Triage-HF Plus Evaluation study.MethodsThis study represents a cohort of adult patients with implanted cardiac devices capable of measuring activity by embedded accelerometery via a remote monitoring platform. Activity data were available for the 4 weeks pre-implementation and post implementation of ‘stay at home’ lockdown measures in the form of ‘minutes active per day’ (min/day).ResultsData were analysed for 311 patients (77.2% men, mean age 68.8, frailty 55.9%. 92.2% established heart failure (HF) diagnosis, of these 51.2% New York Heart Association II), with comorbidities representative of a real-world cohort.Post-lockdown, a significant reduction in median PA equating to 20.8 active min/day was seen. The reduction was uniform with a slightly more pronounced drop in PA for women, but no statistically significant difference with respect to age, body mass index, frailty or device type. Activity dropped in the immediate 2-week period post-lockdown, but steadily returned thereafter. Median activity week 4 weeks post-lockdown remained significantly lower than 4 weeks pre-lockdown (p≤0.001).ConclusionsIn a population of predominantly HF patients with cardiac devices, activity reduced by approximately 20 min active per day in the immediate aftermath of strict COVID-19 lockdown measures.Trial registration numberNCT04177199.


Herz ◽  
2021 ◽  
Author(s):  
Harilaos Bogossian ◽  
Dimitrios Panteloglou ◽  
Zana Karosiene ◽  
Susanne Macher-Heidrich ◽  
Heinz Jürgen Adomeit ◽  
...  

Zusammenfassung Hintergrund Implantierbare Kardioverter-Defibrillatoren (ICD) sind zum Schutz vor plötzlichem Herztod bei Patienten mit primär- oder sekundärprophylaktischer Indikation etabliert. Wie bei allen komplexen operativen Verfahren verbleibt auch bei der ICD-Implantation ein Risiko für Komplikationen bis hin zum Tod. Gegenstand der vorliegenden Arbeit ist es, anhand der Datensätze zur obligaten Qualitätssicherung in Nordrhein-Westfalen die prozedurbezogene Mortalität nach ICD-Implantation zu analysieren. Methoden Aus den Datensätzen erfolgte eine Analyse der stationären Todesfälle bei allen 18.625 ICD-Implantationen der Jahre 2010 bis 2012. Ergebnisse Während des stationären Aufenthalts verstarben 118 Patienten (0,6 %) nach ICD-Implantation. Patienten im Alter über 80 Jahre (7 %) zeigten eine höhere Mortalität (1,9 % vs. 0,5 % bei < 80-jährigen Patienten, p > 0,001), ebenso Frauen (0,95 % vs. 0,54 % bei Männern; p = 0,004) und Patienten mit hoher NYHA(New York Heart Association)-Klasse (0,3 % bei NYHA II, 0,7 % bei NYHA III, 3,4 % bei NYHA IV; p < 0,001 für alle Vergleiche). Das Vorliegen von Diabetes mellitus (23 % des Kollektivs) beeinflusste die perioperative Letalität nicht, während eine dialysepflichtige Niereninsuffizienz eine signifikant erhöhte Mortalität aufwies (p < 0,001 gegenüber Patienten mit Kreatinin ≤ 1,5 mg/dl; p = 0,002 gegenüber nicht dialysepflichtigen Patienten mit Kreatinin > 1,5 mg/dl). Patienten mit sekundärprophylaktischer ICD-Indikation wiesen eine signifikant höhere Mortalität auf (1,2 % vs. 0,4 %; p < 0,001), die sich beim Auftreten von Komplikationen von 0,6 % auf 3,7 % erhöhte (p < 0,001). Schlussfolgerung Die operationsbezogene Mortalität bei ICD-Implantation ist bei Patienten über 80 Jahre, hoher NYHA-Klasse, Dialysepflicht, sekundärprophylaktischer Indikation und nach Auftreten von Komplikationen erhöht.


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