Patient, Nurse, and Doctor Assessment of New York Heart Association Class, Health, and Quality of Life in Heart Failure: Comparison and Outcome Prediction

2010 ◽  
Vol 16 (8) ◽  
pp. S117
Author(s):  
Jerneja Farkas ◽  
Darija Stevancec ◽  
Aleksandra Balazic-Gjura ◽  
Lea Majc-Hodoscek ◽  
Mitja Lainscak
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):  
Christian Sohns ◽  
Konstantin Zintl ◽  
Yan Zhao ◽  
Lilas Dagher ◽  
Dietrich Andresen ◽  
...  

Background: Recent data demonstrate promising effects on left ventricular dysfunction and left ventricular ejection fraction (LVEF) improvement following ablation for atrial fibrillation (AF) in patients with heart failure. We sought to study the relationship between LVEF, New York Heart Association class on presentation, and the end points of mortality and heart failure admissions in the CASTLE-AF study (Catheter Ablation for Atrial Fibrillation With Heart Failure) population. Furthermore, predictors for LVEF improvement were examined. Methods: The CASTLE-AF patients with coexisting heart failure and AF (n=363) were randomized in a multicenter prospective controlled fashion to ablation (n=179) versus pharmacological therapy (n=184). Left ventricular function and New York Heart Association class were assessed at baseline (after randomization) and at each follow-up visit. Results: In the ablation arm, a significantly higher number of patients experienced an improvement in their LVEF to >35% at the end of the study (odds ratio, 2.17; P <0.001). Compared with the pharmacological therapy arm, both ablation patient groups with severe (<20%) or moderate/severe (≥20% and <35%) baseline LVEF had a significantly lower number of composite end points (hazard ratio [HR], 0.60; P =0.006), all-cause mortality (HR, 0.54; P =0.019), and cardiovascular hospitalizations (HR, 0.66; P =0.017). In the ablation group, New York Heart Association I/II patients at the time of treatment had the strongest improvement in clinical outcomes (primary end point: HR, 0.43; P <0.001; mortality: HR, 0.30; P =0.001). Conclusions: Compared with pharmacological treatment, AF ablation was associated with a significant improvement in LVEF, independent from the severity of left ventricular dysfunction. AF ablation should be performed at early stages of the patient’s heart failure symptoms.


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