scholarly journals Patients' Self-Assessed Functional Status in Heart Failure by New York Heart Association Class: A Prognostic Predictor of Hospitalizations, Quality of Life and Death

2010 ◽  
Vol 16 (2) ◽  
pp. 150-156 ◽  
Author(s):  
Richard Holland ◽  
Boika Rechel ◽  
Karolina Stepien ◽  
Ian Harvey ◽  
Iain Brooksby
2021 ◽  
pp. 1-10
Author(s):  
Noeleen Fallon ◽  
Mary Quirke ◽  
Caroline Edgeworth ◽  
Rose O'Mahony ◽  
Nora Flynn ◽  
...  

Background/Aims Cardiac rehabilitation has long been seen as effective for many cardiovascular diseases and, more recently, as having a positive impact on patients with heart failure. To evaluative the effectiveness of a phase three specialised heart failure cardiac rehabilitation programme on patients' cardiovascular risk factor profile. Methods This retrospective, longitudinal study examined profile factors of patients, pre- and post-cardiac rehabilitation programme. Patients with New York Heart Association class I–III, of any origin, were recruited through a specialised heart failure service to a 10-week exercise and education programme. Outcome variables included anxiety, depression, quality of life (Minnesota), 6-minute walking test result, blood pressure, weight, waist circumference, body mass index, Duke Activity Status Index and self-care, and were analysed with the Statistical Package for the Social Sciences using repeated measures t-test. Results 100 patients were eligible and 85 patients completed the programmes. Mean age was 66 years, 80% male, 59% were New York Heart Association class I and 73% had ejection fraction of ≤40%. There was a significant improvement in 6-minute walking test, systolic blood pressure, quality of life and anxiety post programme. Conclusions In-hospital and out of hospital cardiac care has developed significantly, especially in acute symptom control. More recently, emphasis has been put on the long-term control of other risk factors. This study contributes to the literature indicating that attendance at a hospital-based phase three cardiac rehabilitation programme providing supervised, tailored exercise, with intensive education and psychological support, is effective in reducing risk factors and improving quality of life in patients with lower grades of heart failure.


Author(s):  
James Redfern ◽  
Rachel Goode ◽  
Wing Yin Leung ◽  
Clare Quarterman ◽  
Archana Rao

Aims/Background Heart failure affects approximately 1 million people in the UK, adversely affecting quality of life, functional capacity and cognitive health. Iron deficiency complicates heart failure in approximately 50% of patients. Giving intravenous ferric carboxymaltose has been shown to improve quality of life in patients with heart failure (New York Heart Association class and Kansas City Cardiomyopathy Questionnaire). Methods A quality improvement project was designed to assess the feasibility, safety and cost implications of establishing an intravenous iron service in the authors' centre. Results Between July and December 2019 61 patients who were screened met the inclusion criteria and were administered intravenous ferric carboxymaltose. There were statistically significant improvements in ferritin levels (83.3 ug/litre to 433 ug/litre; P<0.0001), transferrin saturation (18% to 30% P<0.0001) and haemoglobin levels (126 g/litre to 135 g/litre; P<0.01). No demonstrable changes in New York Heart Association class or quality of life scores were noted. The overall financial impact for the trust was income generation of £14 665, a net income of £240 per patient. Conclusions Intravenous iron replacement with ferric carboxymaltose is safe and cost effective, and should be considered in eligible iron-deficient patients with symptomatic heart failure. Integration with another day case intravenous service represented the most logistically simple and economically viable method of service delivery.


Author(s):  
Luca Testa ◽  
Mauro Agnifili ◽  
Nicolas M. Van Mieghem ◽  
Didier Tchétché ◽  
Anita W. Asgar ◽  
...  

Background: Transcatheter aortic valve replacement (TAVR) has determined a paradigm shift in the treatment of patients with severe aortic stenosis. However, the durability of bioprostheses is still a matter of concern, and little is known about the management of degenerated TAV. We sought to evaluate the outcomes of patients with a degenerated TAV treated by means of a second TAVR. Methods: The TRANSIT is an international registry that included cases of degenerated TAVR from 28 centers. Among around 40 000 patients treated with TAVR in the participating centers, 172 underwent a second TAVR: 57 (33%) for a mainly stenotic degenerated TAV, 97 (56%) for a mainly regurgitant TAV, and 18 (11%) for a combined degeneration. Overall, the rate of New York Heart Association class III/IV at presentation was 73.5%. Results: Valve Academic Research Consortium 2 device success rate was 79%, as a consequence of residual gradient (14%) or regurgitation (7%). At 1 month, the overall mortality rate was 2.9%, while rates of new hospitalization and New York Heart Association class III/IV were 3.6% and 7%, respectively, without significant difference across the groups. At 1 year, the overall mortality rate was 10%, while rates of new hospitalization and New York Heart Association class III/IV were 7.6% and 5.8%, respectively, without significant difference across the groups. No cases of valve thrombosis were recorded. Conclusions: Selected patients with a degenerated TAV may be safely and successfully treated by means of a second TAVR. This finding is of crucial importance for the adoption of the TAVR technology in a lower risk and younger population. REGISTRATION: URL: https://www.clinicaltrials.gov ; Unique identifier: NCT04500964.


Sign in / Sign up

Export Citation Format

Share Document