Clinical significance of urinary cyclic guanosine monophosphate in diagnosis of heart failure

1994 ◽  
Vol 40 (1) ◽  
pp. 96-100 ◽  
Author(s):  
G Jakob ◽  
J Mair ◽  
K P Vorderwinkler ◽  
G Judmaier ◽  
P König ◽  
...  
Keyword(s):  
Heart Failure ◽  
New York ◽  
Renal Impairment ◽  
Heart Association ◽  
Cyclic Guanosine Monophosphate ◽  
Guanosine Monophosphate ◽  
Neoplastic Disease ◽  
Patients With Heart Failure ◽  
Functional Classes ◽  
New York Heart Association

Abstract We measured concentrations of guanosine 3',5'-monophosphate (cGMP) in plasma and urine of healthy subjects and patients with congestive heart failure, renal impairment, neoplastic disease, and hepatic cirrhosis. There was no correlation between cGMP concentrations in urine and in plasma. In all patients except those with renal impairment, urinary cGMP concentrations were significantly higher than in healthy persons. Only patients with heart failure or renal impairment showed significantly increased plasma cGMP concentrations. In contrast, cGMP in urine does not relate to the clinically assessed severity of heart failure (New York Heart Association functional classes). Determination of cGMP in plasma results in higher sensitivity and specificity for diagnosing heart failure than measurement of cGMP in urine.

scholarly journals Referral Criteria to Palliative Care for Patients With Heart Failure

2020 ◽  
Vol 13 (9) ◽  
Author(s):  
Yuchieh Kathryn Chang ◽  
Holland Kaplan ◽  
Yimin Geng ◽  
Li Mo ◽  
Jennifer Philip ◽  
...  
Keyword(s):  
Heart Failure ◽  
Systematic Review ◽  
New York ◽  
Palliative Care ◽  
Heart Association ◽  
Emotional Symptoms ◽  
Care Needs ◽  
Referral Criteria ◽  
Patients With Heart Failure ◽  
New York Heart Association

Background: Patients with heart failure have significant symptom burden, care needs, and often a progressive course to end-stage disease. Palliative care referrals may be helpful but it is currently unclear when patients should be referred and by whom. We conducted a systematic review of the literature to examine referral criteria for palliative care among patients with heart failure. Methods: We searched Ovid, MEDLINE, Ovid Embase, and PubMed databases for articles in the English language from the inception of databases to January 17, 2019 related to palliative care referral in patients with heart failure. Two investigators independently reviewed each citation for inclusion and then extracted the referral criteria. Referral criteria were then categorized thematically. Results: Of the 1199 citations in our initial search, 102 articles were included in the final sample. We identified 18 categories of referral criteria, including 7 needs-based criteria and 10 disease-based criteria. The most commonly discussed criterion was physical or emotional symptoms (n=51 [50%]), followed by cardiac stage (n=46 [45%]), hospital utilization (n=38 [37%]), prognosis (n=37 [36%]), and advanced cardiac therapies (n=36 [35%]). Under cardiac stage, 31 (30%) articles suggested New York Heart Association functional class ≥III and 12 (12%) recommended New York Heart Association class ≥IV as cutoffs for referral. Prognosis of ≤1 year was mentioned in 21 (21%) articles as a potential trigger; few other criteria had specific cutoffs. Conclusions: This systematic review highlighted the lack of consensus regarding referral criteria for the involvement of palliative care in patients with heart failure. Further research is needed to identify appropriate and timely triggers for palliative care referral.

Determinants of Self-Care in Patients With Heart Failure: Observations From a Developing Country in the Middle East

2019 ◽  
Vol 31 (3) ◽  
pp. 294-303 ◽  
Author(s):  
Angela Massouh ◽  
Huda Abu Saad Huijer ◽  
Paula Meek ◽  
Hadi Skouri
Keyword(s):  
Heart Failure ◽  
Social Support ◽  
New York ◽  
Care Management ◽  
Medical Center ◽  
Self Care ◽  
Heart Association ◽  
Caregiver Support ◽  
Patients With Heart Failure ◽  
New York Heart Association

Introduction: Self-care is recognized as a means for improving outcomes of heart failure (HF), yet studies have not addressed what predicts successful self-care in collectivist cultures like Lebanon. Methodology: Self-care was measured, using the Arabic Self-Care of HF index, in 100 participants with HF (76% males; mean age 67.59) recruited from a tertiary medical center. Results: Self-care was suboptimal, with mean scores of 67.26, 66.96, and 69.5 for self-care maintenance, management, and confidence. Better HF knowledge, social support, and self-care confidence and lower New York Heart Association score predicted better self-care maintenance. Better knowledge, social support, and self-care maintenance, no recent hospitalization, and being unemployed predicted better self-care confidence. Better self-care confidence, maintenance, and HF knowledge predicted better self-care management. Discussion: HF self-care in Lebanon is suboptimal. Nurses need to identify facilitators of and barriers to self-care particular to this population. Interventions targeting HF knowledge, confidence, and caregiver support are expected to improve self-care in Lebanese patients.

scholarly journals Salivary Biomarkers, Oral Inflammation, and Functional Status in Patients With Heart Failure

2016 ◽  
Vol 19 (2) ◽  
pp. 153-161 ◽  
Author(s):  
Rebecca L. Dekker ◽  
Terry A. Lennie ◽  
Debra K. Moser ◽  
Craig S. Miller ◽  
Jeffrey L. Ebersole ◽  
...  
Keyword(s):  
Heart Failure ◽  
New York ◽  
Nyha Class ◽  
Heart Association ◽  
Serum Levels ◽  
Functional Class ◽  
Reactive Protein ◽  
Patients With Heart Failure ◽  
New York Heart Association ◽  
Oral Inflammation

Aims: To describe correlations and agreement between salivary and serum B-type natriuretic peptide (BNP), C-reactive protein (CRP), interleukin (IL)-6, and IL-10 and determine which biomarkers predict worse functional class in patients with heart failure (HF). Methods: Serum and saliva were collected from 75 hospitalized patients with HF (57 ± 12 years, 43% female, New York Heart Association [NYHA] Classes I [4%], II [43%], and III [53%]). Oral inflammation was rated as good, fair, or poor. Spearman’s ρ and Bland–Altman were used to determine correlations and agreement of the salivary and serum forms of each biomarker. Logistic regressions were used to determine which biomarkers predicted worse NYHA functional class, controlling for depression, body mass index, smoking, and oral inflammation. Results: Median biomarker concentrations were as follows: BNP (serum 361 pg/ml, saliva 9 pg/ml), CRP (serum 13 ng/ml, saliva 25.6 ng/ml), IL-6 (serum 19.3 pg/ml, saliva 10.5 pg/ml), and IL-10 (serum 64.1 pg/ml, saliva 4.7 pg/ml). There was a moderate-to-strong correlation for serum–salivary CRP, weak correlation for serum–salivary IL-6, and no correlations for serum–salivary BNP and IL-10. The Bland–Altman test showed good salivary–serum agreement for all biomarkers, but as serum concentrations rose, salivary measures underestimated serum levels. Visible oral inflammation was the only predictor of worse NYHA class.

scholarly journals The impact of heart failure on patients and caregivers: A qualitative study

PLoS ONE ◽  
2021 ◽  
Vol 16 (3) ◽  
pp. e0248240
Author(s):  
Colleen A. McHorney ◽  
Sonal G. Mansukhani ◽  
Milena Anatchkova ◽  
Natalie Taylor ◽  
Heidi S. Wirtz ◽  
...  
Keyword(s):  
Heart Failure ◽  
New York ◽  
Heart Association ◽  
Family Interactions ◽  
Patients With Heart Failure ◽  
Association Class ◽  
New York Heart Association ◽  
The Impact ◽  
Climbing Stairs ◽  
Difficulty Walking

Background Heart failure is rising in prevalence but relatively little is known about the experiences and journey of patients and their caregivers. The goal of this paper is to present the symptom and symptom impact experiences of patients with heart failure and their caregivers. Methods This was a United States-based study wherein in-person focus groups were conducted. Groups were audio recorded, transcribed and a content-analysis approach was used to analyze the data. Results Ninety participants (64 patients and 26 caregivers) were included in the study. Most patients were female (52.0%) with mean age 59.3 ± 8 years; 55.6% were New York Heart Association Class II. The most commonly reported symptoms were shortness of breath (81.3%), fatigue/tiredness (76.6%), swelling of legs and ankles (57.8%), and trouble sleeping (50.0%). Patients reported reductions in social/family interactions (67.2%), dietary changes (64.1%), and difficulty walking and climbing stairs (56.3%) as the most common adverse disease impacts. Mental-health sequelae were noted as depression and sadness (43.8%), fear of dying (32.8%), and anxiety (32.8%). Caregivers (mean age 55.5 ± 11.2 years and 52.0% female) discussed 33 daily heart failure impacts, with the top three being reductions in social/family interactions (50.0%); being stressed, worried, and fearful (46.2%); and having to monitor their “patience” level (42.3%). Conclusions There are serious unmet needs in HF for both patients and caregivers. More research is needed to better characterize these needs and the impacts of HF along with the development and evaluation of disease management toolkits that can support patients and their caregivers.

Socio-clinical variables affecting the level of self-care in elderly patients with heart failure

2019 ◽  
Vol 18 (7) ◽  
pp. 628-636 ◽  
Author(s):  
Barbara Prochota ◽  
Katarzyna Szwamel ◽  
Izabella Uchmanowicz
Keyword(s):  
Heart Failure ◽  
New York ◽  
Elderly Patients ◽  
Self Care ◽  
Heart Association ◽  
York Heart Association Class ◽  
Patients With Heart Failure ◽  
New York Heart Association ◽  
Behavior Scale ◽  
Care Behavior

Background: Promoting self-care is the cornerstone of heart failure management. The number of hospitalizations and unscheduled visits could be reduced in elderly patients with heart failure by the patients’ active involvement in self-care. Aims: The aim of this study was to measure the level of self-care in elderly patients with heart failure, to examine the influence of socio-clinical variables on the level of self-care, and identify the socio-clinical variables that are predictors of self-care. Methods: The study included 100 heart failure patients (48 female, 52 male) aged between 60 and 88 years, treated at the Oleśno Health Care Center (Poland). The European Heart Failure Self-care Behavior Scale-9 and Mini-Mental State Examination were used. Results: The total classic European Heart Failure Self-care Behavior Scale-9 score was 22.76 points (standard deviation=8.49), and the standardised European Heart Failure Self-care Behavior Scale-9 score was 61.78 (standard deviation=23.59). Patients who were in a relationship, did not take digoxin or diuretics, were in New York Heart Association classes I and II, and had normal scores or cognitive impairment in the Mini-Mental State Examination, had significantly higher levels of self-care. Self-care was also correlated with patient age ( rs=−0.36, p<0.001) and left ventricle ejection fraction ( rs=0.23, p=0.019). Linear regression analysis demonstrated that only the New York Heart Association class has a significant impact on European Heart Failure Self-care Behavior Scale-9 scores. Compared to classes I and II, New York Heart Association class IV decreases the standardised European Heart Failure Self-care Behavior Scale-9 score by a mean of 23.60 points. Conclusions: Intensified self-care education should be provided to patients living alone, taking digoxin and diuretics, suffering from moderate dementia, and classified in New York Heart Association class IV. These patients may require specific educational strategies to gain the knowledge required for effective self-care.

A feeling in the waters: diagnosis of heart failure using urinary natriuretic peptides

2004 ◽  
Vol 106 (2) ◽  
pp. 111-112 ◽  
Author(s):  
Henry KRUM ◽  
Danny LIEW
Keyword(s):  
Heart Failure ◽  
New York ◽  
Plasma Levels ◽  
Large Scale ◽  
Ventricular Dysfunction ◽  
Heart Association ◽  
Functional Class ◽  
Co Morbidity ◽  
Patients With Heart Failure ◽  
New York Heart Association

Plasma levels of brain natriuretic peptide (BNP) and N-terminal pro-BNP (N-BNP) are highly sensitive markers of ventricular dysfunction and/or hypertrophy and, in established disease, offer prognostic value and may be useful for guidance of therapy. Ng and co-workers report in this issue of Clinical Science that urinary levels of N-BNP may be as useful as plasma levels for the discrimination of patients with and without heart failure. This raises the potential for a relatively simple urine test that could be used for the diagnosis of heart failure. Roles in prognostication and the guidance of therapy may also be possible but, perhaps of most significance, measurement of urinary N-BNP may be applied to screening of patients at high risk of heart failure. The main limitations of the study were that the sample of heart failure patients comprised only 34 individuals with New York Heart Association functional Class IV and that the observed correlation between levels of urinary N-BNP and plasma creatinine seemed counter-intuitive. The latter issue needs clarification, as renal impairment is a frequent co-morbidity among patients with heart failure and will potentially confound any observed association between ventricular dysfunction and urinary N-BNP levels. Another caveat is that it is unclear if testing for urinary N-BNP can be cheaply and conveniently administered on a large scale. Nevertheless, this first demonstration of elevated N-BNP in the urine of patients with heart failure raises a number of exciting possibilities with regard to the management of patients with established or possible heart failure. Further investigation is required and eagerly awaited.

Sign in / Sign up

Export Citation Format

Share Document