Illness Perception and Its Changes During Six Months After Cardiac Rehabilitation

2019 ◽  
Vol 26 (3) ◽  
pp. 90-100
Author(s):  
Justė Lukoševičiūtė ◽  
Kastytis Šmigelskas
Keyword(s):  
New York ◽  
Social Factors ◽  
Nyha Class ◽  
Illness Perception ◽  
Heart Association ◽  
Class Iii ◽  
Cognitive Representations ◽  
Coronary Syndrome ◽  
Type D ◽  
New York Heart Association

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.

scholarly journals The outcome of pulmonary hypertension and its association with pulmonary artery dilatation

2020 ◽  
Vol 28 (12) ◽  
pp. 645-655 ◽  
Author(s):  
A. L. Duijnhouwer ◽  
J. Lemmers ◽  
J. Smit ◽  
J. van Haren-Willems ◽  
H. Knaapen-Hans ◽  
...  
Keyword(s):  
New York ◽  
Pulmonary Hypertension ◽  
Pulmonary Artery ◽  
Nyha Class ◽  
Heart Association ◽  
Elevated Pressure ◽  
Walking Distance ◽  
Class Iii ◽  
Tertiary Centre ◽  
New York Heart Association

Abstract Background Pulmonary artery (PA) dilatation is often seen in pulmonary hypertension (PH) and is considered a long-term consequence of elevated pressure. The PA dilates over time and therefore may reflect disease severity and duration. Survival is related to the stage of the disease at the time of diagnosis and therefore PA diameter might be used to predict prognosis. This study evaluates the outcome of patients with pulmonary arterial hypertension (PAH) and chronic thrombo-embolic pulmonary hypertension (CTEPH) and investigates whether PA diameter at the time of diagnosis is associated with mortality. Methods Patients visiting an outpatient clinic of a tertiary centre between 2004 and 2018 with a cardiac catheterisation confirmed diagnosis of PAH or CTEPH and a CT scan available for PA diameter measurement were included. PA diameter and established predictors of survival were collected (New York Heart Association (NYHA) class, N‑terminal pro-brain natriuretic peptide (NT-proBNP) level and 6‑min walking distance (6MWD)). Results In total 217 patients were included (69% female, 71% NYHA class ≥III). During a median follow-up of 50 (22–92) months, 54% of the patients died. Overall survival was 87% at 1 year, 70% at 3 years and 58% at 5 years. The mean PA diameter was 34.2 ± 6.2 mm and was not significantly different among all the diagnosis groups. We found a weak correlation between PA diameter and mean PA pressure ( r = 0.23, p < 0.001). Male sex, higher age, shorter 6MWD and higher NT-proBNP level were independently associated with mortality, but PA diameter was not. Conclusion The prognosis of PAH and CTEPH is still poor. Known predictors of survival were confirmed, but PA diameter at diagnosis was not associated with survival in PAH or CTEPH patients.

scholarly journals The effect of foot massage on dyspnea ın heart faılure: Case report

2021 ◽  
Vol 2 (4) ◽  
pp. 01-03
Author(s):  
Arslan Gürcan
Keyword(s):  
Heart Failure ◽  
New York ◽  
Case Report ◽  
Nyha Class ◽  
Personal Data ◽  
Heart Association ◽  
Progressive Increase ◽  
Class Iii ◽  
Heart Failure Patients ◽  
New York Heart Association

Dyspnea is one of the reasons why many heart failure patients present to the emergency department. A 75 year-old female presented to a cardiologist with prominent dyspnea and orthopnea. Her heart failure was diagnosed by doctors as New York Heart Association (NYHA) Class III. Progressive increase in episodic shortness of breath forthe past 3 weeks. The patient had been in her normal state of health until 3 weeks ago that she had difficulty catching her breath while walking.The patient got 7 points from the first Borg Dyspnea Scale. The study is a case-report study. Personal Data Form (PDF), Borg Clinical Rating for Dyspnea (Borg CR-10) was evaluated by researcher. Classic foot massage was applied to each foot for a total of 30 minutes, up to 15 minutes, once a day for seven days. Dyspnea was measured after the massage following 10 min of resting. Foot massage was applied by the researcher. Distribution of dyspnea level first and seventh is given in Table 1. Dyspnea level of the patient intervention foot massage decreased to 5.00 from 7.00 at the end of seventh session. Foot massage which is an easy and safe method may be preferably used as a supportive treatment for elevated dyspnea. However, more studies are needed to examine the effect of foot massage on dyspnea level in heart failure patients.

Reduced beta-agonist sensitivity in single atrial cells from failing human hearts

1990 ◽  
Vol 259 (4) ◽  
pp. H1009-H1014 ◽  
Author(s):  
S. E. Harding ◽  
S. M. Jones ◽  
P. O'Gara ◽  
G. Vescovo ◽  
P. A. Poole-Wilson
Keyword(s):  
New York ◽  
Nyha Class ◽  
Heart Association ◽  
Beta Agonist ◽  
Right Atrial ◽  
Inotropic Agents ◽  
Class Iii ◽  
Atrial Cells ◽  
High Calcium ◽  
New York Heart Association

Human myocytes were isolated from right atrial appendage, and contractile responses to inotropic agents were studied. Responses to inotropic agents of cells isolated from patients with mild heart disease [New York Heart Association (NYHA) classes I and II] were compared with those of myocytes from rabbit atria. Maximally effective concentrations of calcium, forskolin, and isoproterenol increased contraction amplitude to a similar extent (11.9, 11.5, and 11.3% change in cell length, respectively), but histamine produced a smaller effect (7.1%). The maximum responses of rabbit atrial cells to calcium (18.5%) and isoproterenol (15.0%) were significantly greater than human. In human cells, the velocity of contraction or relaxation was accelerated more by isoproterenol (P less than 0.05) or forskolin (P less than 0.01) than by high calcium. Only relaxation velocity was increased by isoproterenol in rabbit cells (P less than 0.05). Rabbit myocytes contracted and relaxed 10-30% faster than human (P less than 0.05). Cells from the atria of patients with New York Heart Association (NYHA) heart failure class III or IV were less responsive to isoproterenol than those from class I or II (P less than 0.01). Omitting data from patients who had been taking calcium-channel blockers or beta-adrenoceptor agonist or antagonist drugs did not affect the conclusions. Analysis of variance revealed a significantly greater between-patient than within-patient variation (P less than 0.001), indicating that cells from the same patient have a tendency to respond in a similar way. Responses to high calcium did not differ among NYHA classes. The effect of forskolin was not reduced in NYHA class III, although there was a decreased response in cells from two patients in NYHA class IV.(ABSTRACT TRUNCATED AT 250 WORDS)

scholarly journals Heart Disease and its Consequence in Pregnancy

2012 ◽  
Vol 7 (1) ◽  
pp. 7-9
Author(s):  
Fatima Wahid ◽  
Firoza Begum ◽  
Umme Kulsum ◽  
Kaniz Fatema ◽  
Farzana Sharmin ◽  
...  
Keyword(s):  
New York ◽  
Heart Disease ◽  
Prospective Observational Study ◽  
Heart Diseases ◽  
Nyha Class ◽  
Heart Association ◽  
Normal Vaginal Delivery ◽  
Class Iii ◽  
New York Heart Association ◽  
Rheumatic Heart

The aim of the study is to evaluate the types of heart disease common in our pregnant woman and to assess its influence on the maternal outcome. This was a prospective observational study. The study was carried out in the department of obstetrics & Gynecology in BSMMU from Jan 2006 to Dec 2006. Thirty-five consecutive cases with heart diseases were included in the study. Out of 35 Cases, 26(74.3%) were suffering from rheumatic heart diseases and only 9 (25.7%) patients were suffering from congenital heart disease. Based on New York heart Association (NYHA) functional classification, 28(80%) belonged to NYHA class I, 5 (71.212%) belonged to NYHA class II and 2(28.57%) belonged to class III heart disease on presentation. The number of caeserian section was 33(94.28%) and normal vaginal delivery (5.71%). In this study only 1 woman of NYHA III disease expired. DOI: http://dx.doi.org/10.3329/uhj.v7i1.10201 UHJ 2011; 7(1): 7-9

scholarly journals Outcome after percutaneous edge-to-edge mitral repair for functional and degenerative mitral regurgitation: a systematic review and meta-analysis

Heart ◽  
2017 ◽  
Vol 104 (4) ◽  
pp. 306-312 ◽  
Author(s):  
Mauro Chiarito ◽  
Matteo Pagnesi ◽  
Enrico Antonio Martino ◽  
Michele Pighi ◽  
Andrea Scotti ◽  
...  
Keyword(s):  
Systematic Review ◽  
New York ◽  
Mitral Regurgitation ◽  
Meta Analysis ◽  
Heart Association ◽  
Class Iii ◽  
Term Outcome ◽  
Mitral Repair ◽  
New York Heart Association ◽  
One Year

ObjectivesDifferences in terms of safety and efficacy of percutaneous edge-to-edge mitral repair between patients with functional and degenerative mitral regurgitation (MR) are not well established. We performed a systematic review and meta-analysis to clarify these differences.MethodsPubMed, EMBASE, Google scholar database and international meeting abstracts were searched for all studies about MitraClip. Studies with <25 patients or where 1-year results were not delineated between MR aetiology were excluded. This study is registered with PROSPERO.ResultsA total of nine studies investigating the mid-term outcome of percutaneous edge-to-edge repair in patients with functional versus degenerative MR were included in the meta-analysis (n=2615). At 1 year, there were not significant differences among groups in terms of patients with MR grade≤2 (719/1304 vs 295/504; 58% vs 54%; risk ratio (RR) 1.12; 95% CI: 0.86 to 1.47; p=0.40), while there was a significantly lower rate of mitral valve re-intervention in patients with functional MR compared with those with degenerative MR (77/1770 vs 80/818; 4% vs 10%; RR 0.60; 95% CI: 0.38 to 0.97; p=0.04). One-year mortality rate was 16% (408/2498) and similar among groups (RR 1.26; 95% CI: 0.90 to 1.77; p=0.18). Functional MR group showed significantly higher percentage of patients in New York Heart Association class III/IV (234/1480 vs 49/583; 16% vs 8%; p<0.01) and re-hospitalisation for heart failure (137/605 vs 31/220; 23% vs 14%; p=0.03). No differences were found in terms of single leaflet device attachment (25/969 vs 20/464; 3% vs 4%; p=0.81) and device embolisation (no events reported in both groups) at 1 year.ConclusionsThis meta-analysis suggests that percutaneous edge-to-edge repair is likely to be an efficacious and safe option in patients with both functional and degenerative MR. Large, randomised studies are ongoing and awaited to fully assess the clinical impact of the procedure in these two different MR aetiologies.

scholarly journals Clinical course and prognosis of dilated cardiomyopathy in children

2019 ◽  
Vol 7 (11) ◽  
pp. 4218
Author(s):  
Iranna S. Hirapur ◽  
Ravindran Rajendran ◽  
Jayaranganath . ◽  
Manjunath Nanjappa
Keyword(s):  
New York ◽  
Dilated Cardiomyopathy ◽  
Clinical Course ◽  
Care Center ◽  
Nyha Class ◽  
Tertiary Care ◽  
Heart Association ◽  
Paediatric Population ◽  
Class Iii ◽  
Serious Disease

Background: Epidemiology and clinical course of dilated cardiomyopathy (DCM) in children and infants are not well established. Thus, this study aims to investigate the clinical course and prognosis of DCM in childrenMethods: This was a single-center, prospective, observational study conducted at a tertiary-care center in India between February 2011 and September 2012. A total of 31 patients admitted to the paediatric department diagnosed with DCM were included in the study. Patients were divided into three groups based on the age at the time of diagnosis: 0-3 years, >3-12 years and >12-16 years. Among the study population, 28 patients were followed up for a mean period of 1.44 years and three patients were lost to follow-up.Results: Of the 31 patients, 11 patients were male with a mean age of 8.9±6 years and 20 patients were female with a mean age of 8.3±6 years. All patients were presented with same characteristics of New York heart association (NYHA) class III-IV dyspnoea and fatigue. Among 28 patients who were followed-up for a mean period of 1.44 years, 20(71.4%) patients died and eight patients were on follow up. Of the eight patients, five patients were with NYHA class III symptoms and three patients were with NYHA class I-II symptoms.Conclusions: Dilated cardiomyopathy in children is a very serious disease with a grave prognosis. Patients with NYHA III-IV symptoms have a very high mortality rate and potential use of other therapies remains to be fully evaluated in paediatric population.

Transcatheter Aortic Valve Replacement for Degenerated Transcatheter Aortic Valves: The TRANSIT International Project

2021 ◽  
Author(s):  
Luca Testa ◽  
Mauro Agnifili ◽  
Nicolas M. Van Mieghem ◽  
Didier Tchétché ◽  
Anita W. Asgar ◽  
...  
Keyword(s):  
New York ◽  
Transcatheter Aortic Valve Replacement ◽  
Heart Association ◽  
York Heart Association Class ◽  
Class Iii ◽  
Transcatheter Aortic Valve ◽  
Significant Difference ◽  
Association Class ◽  
New York Heart Association ◽  
Overall Mortality

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.

scholarly journals Peripartum Cardiomyopathy in South Indian Women—Challenges and Outcomes

2019 ◽  
Vol 04 (03) ◽  
pp. 129-132
Author(s):  
Jayaraj Cecily Mary Majella ◽  
Ganesan Gnanavelu
Keyword(s):  
New York ◽  
Pregnant Women ◽  
Nyha Class ◽  
Tertiary Care ◽  
Heart Association ◽  
Peripartum Cardiomyopathy ◽  
Care Hospital ◽  
Class Iii ◽  
Indian Women ◽  
South Indian

Abstract Introduction Peripartum cardiomyopathy (PPCM) continues to be a therapeutic challenge. Actual incidence is not exactly known as routine screening by echocardiogram is not recommended for all pregnant women across various parts of the world. Aim We, in our study, report the incidence, clinical profile, and prognosis of peripartum cardiomyopathy among South Indian women in a tertiary care hospital. Materials and Methods All pregnant ladies, referred for cardiac evaluation in the last month of pregnancy and 5 months postpartum, were included in this study. Transthoracic ehocardiography was used for the diagnosis of PPCM. The patients who were diagnosed with PPCM were followed-up clinically and echocardiographically for 1, 3, 6 months and 1 year. Results Among 5,475 of pregnant women who were screened with transthoracic echocardiogram, 14 patients were diagnosed with PPCM (0.26%). All 14 PPCM patients presented with New York Heart Association (NYHA) class III or IV. The incidence of PPCM was high in primigravida in our subgroup. The thrombus burden was high, constituting 42.86% in our subgroup and mortality occurred in three patients. Conclusion The incidence of PPCM was 0.25% in our subgroup, with high–thrombus burden. Hence, early diagnosis and proper anticoagulation is the need of the hour among appropriate patients along the heart failure management.

scholarly journals Reduced Albuminuria and Potassemia Indicate Early Renal Repair Processes after Resynchronization Therapy in Cardiorenal Syndrome Type 2

2020 ◽  
Vol 2020 ◽  
pp. 1-10 ◽  
Author(s):  
Agnieszka Gala-Błądzińska ◽  
Janusz Romanek ◽  
Danuta Mazur ◽  
Tomasz Stepek ◽  
Marcin Braun ◽  
...  
Keyword(s):  
New York ◽  
Renal Function ◽  
Nyha Class ◽  
Kidney Injury ◽  
Heart Association ◽  
Cardiorenal Syndrome ◽  
Syndrome Type ◽  
Class Iii ◽  
Resynchronization Therapy

Background. Patients with chronic cardiorenal syndrome type 2 (T2-CRS) who qualify for resynchronization therapy (CRT) are exposed perioperatively to potentially nephrotoxic factors including contrast agents and blood loss. Methods. The objective of this prospective interventional study was to assess the effects of CRT on renal function in patients with T2-CRS within the first 48 hours following implantation. Initially, 76 patients (15% female; aged 69 ± 9.56 years) with heart failure (New York Heart Association classes II–IV), ejection fraction ≤ 35%, and QRS > 130 ms were included in the study. During CRT implantation, a nonionic contrast agent (72.2 ± 44.9 mL) was administered. Prior to and 48 hours following implantation, renal function was evaluated using the following serum biomarkers: creatinine (sCr), estimated glomerular filtration rate (using the Chronic Kidney Disease Epidemiology Collaboration equation [eGFRCKD-EPI]), and the electrolyte and urine biomarkers albumin (uAlb), albumin/creatinine ratio (UACR), and neutrophil gelatinase-associated lipocalin (uNGAL). Results. Before CRT, patients classified as NYHA class III or IV had higher uNGAL levels in comparison to uNGAL levels after CRT (43.63 ± 60.02 versus 16.63 ± 18.19; p=0.041). After CRT implantation, uAlb, UACR, and potassium levels were reduced (p<0.05), and uNGAL, sCr, and eGFRCKD-EPI were unchanged. The contrast medium volume did not correlate with the test biomarkers (p>0.05). Conclusions. In patients with T2-CRS, uNGAL is a biomarker of kidney injury that correlates with the NYHA classes. A stable uNGAL value before and after CRT implantation confirms the lack of risk of contrast-induced nephropathy. Reduced albuminuria and blood potassium are biomarkers of improving T2-CRS in the early post-CRT period.

Left atrial high-grade rhabdomyosarcoma; an unusual location

2020 ◽  
pp. 021849232098348
Author(s):  
Hemant Chaturvedi ◽  
Ravindra Singh Rao ◽  
Navneet Mehta ◽  
Ajeet Bana
Keyword(s):  
New York ◽  
Heart Association ◽  
Surgical Excision ◽  
Interatrial Septum ◽  
Large Mass ◽  
Surgical Removal ◽  
High Grade ◽  
Class Iii ◽  
Term Survival ◽  
New York Heart Association

A 63-year-old diabetic and hypertensive lady presented in New York Heart Association class III–IV dyspnea on exertion. Echocardiography showed a large mass attached to the anterior mitral leaflet and the base of the interatrial septum. After removal of the mass and excision of the anterior and posterior mitral leaflets, a bioprosthetic valve was deployed. The postoperative course was uneventful. Histopathology showed that the tumor was a high-grade rhabdomyosarcoma. Although it is a highly lethal tumor, surgical removal was indicated to relieve dyspnea, clarify the diagnosis, and improve short-term survival. Our patient survived for 8 months after surgical excision.

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