scholarly journals Characteristics and health status of patients with and without confirmed HFpEF

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
C Deaton ◽  
F Forsyth ◽  
J Mant ◽  
D Edwards ◽  
R Hobbs ◽  
...  

Abstract Aims Patients with heart failure with preserved ejection fraction (HFpEF) are usually older and multi-morbid and diagnosis can be challenging. The aims of this cohort study were to confirm diagnosis of HFpEF in patients with possible HFpEF recruited from primary care, to compare characteristics and health status between those with and without HFpEF, and to determine factors associated with health status in patients with HFpEF. Methods Patients with presumed HFpEF were recruited from primary care practices and underwent clinical assessment and diagnostic evaluation as part of a longitudinal cohort study. Health status was measured by Montreal Cognitive Assessment (MOCA), 6-minute walk test, symptoms, and the Kansas City Cardiomyopathy Questionnaire (KCCQ), and quality of life (QoL) by EQ-5D-5L visual analogue scale (VAS). Results 151 patients (mean age 78.5±8.6 years, 40% women, mean EF 56% + 9.4) were recruited and 93 (61.6%) were confirmed HFpEF (those without HFpEF had other HF and cardiac diagnoses). Patients with and without HFpEF did not differ by age, MOCA, blood pressure, heart rate, NYHA class, proportion with atrial fibrillation, Charlson Comorbidity Index, or NT-ProBNP levels. Patients with HFpEF were more likely to be women, overweight or obese, frail, and to be more functionally impaired by 6 minute walk distance and gait speed than those without. Although not statistically significant, patients with HFpEF had clinically significant differences (>5 points) on the physical limitations, symptom burden and clinical summary subscales of the KCCQ, but did not differ by other subscales or by EQ-5D-5L VAS (70±17 vs 73±19, p=0.385). More patients with HFpEF reported daytime dyspnoea (63% vs 46%, p=0.035) and fatigue (81% vs 61%, p=0.008), but not other symptoms compared to those without HFpEF. For both groups BMI was moderately negatively correlated with KCCQ subscale scores, and 6 minute walk distance was positively correlated with KCCQ subscales. Conclusions Nearly 40% were not confirmed as HFpEF indicating the challenges of diagnosis. Patients with confirmed HFpEF differed by sex, overweight/obesity, frailty, functional impairment, and symptoms but not by age or comorbidities from those without HFpEF. These differences were reflected in some subscale scores of the KCCQ, but not how patients reported their quality of life on the KCCQ QoL subscale and EQ-5D-5L VAS. Older patients with HFpEF reported relatively high QoL despite poor health status by functional impairment, frailty and symptoms. Funding Acknowledgement Type of funding source: Public grant(s) – National budget only. Main funding source(s): National Institute of Health Research School of Primary Care Research

Author(s):  
Qurratu Iffoura ◽  
Agung Waluyo

The prevalence of Chronic Obstructive Pulmonary Disease (COPD) continues to increase in the world and predicted in 2030 to rank third in the world. COPD causes people to have difficulty breathing, limit mobility and lifestyle, and can cause more serious complications and lead to a decrease in quality of life. One of the nonpharmacological treatments that can be done is Tai chi a traditional Chinese mind-body exercise. Objective: This literature study aims to describe benefits of Tai chi in improving the quality of life of patients with COPD. Literature review was conducted from various sources such as CINAHL, MEDLINE, science Direct and proquest. Tai chi was a meditative martial art consisting of three basic concepts namely physical exercise, breathing techniques, and full awareness. Tai chi movements that were practiced vary, such as 24 movements which were or 6 movements that have been modified and simplified. Some of the benefits of doing Tai chi include increased muscle strength, reduced tightness, improved pulmonary function, increased 6-minute walk distance (6MWD) and increased St. George’s Respiratory Questionnaire (SGRQ) scores. Tai chi can be used as a complementary therapy in COPD patients according to their preferences and values. In addition this exercise can be recommended in patients with other chronic diseases. Keywords: Tai chi; COPD; complementary therapy ABSTRAK Prevalensi Penyakit Paru Obstruksi Kronis (PPOK) terus meningkat di dunia dan diprediksikan pada tahun 2030 akan menempati urutan ketiga di dunia. PPOK menyebabkan penderita sulit bernafas, membatasi mobilitas dan gaya hidup, serta dapat menyebabkan komplikasi yang lebih serius dan mengarah kepada penurunan kualitas hidup. Salah satu penatalaksanaan non farmakologis yang dapat dilakukan ialah Tai chi, latihan mind-body tradisional Tiongkok. Studi literatur ini bertujuan untuk menggambarkan manfaat Tai chi pada peningkatan kualitas hidup pada pasien PPOK. Penulusuran literature dilakukan dari berbagai sumber seperti CINAHL, MEDLINE, Science Direct dan proquest. Tai chi merupakan seni bela diri yang bersifat meditasi yang terdiri dari tiga konsep dasar yaitu latihan fisik, teknik pernapasan, dan kesadaran penuh. Gerakan Tai chi yang dipraktikkan bervariasi, seperti 24 gerakan Yang atau 6 gerakan yang telah dimodifikasi dan disederhanakan. Beberapa manfaat melakukan Tai chi seperti peningkatan kekuatan otot, mengurangi sesak, meningkatkan fungsi paru, meningkatkan 6-minute walk distance (6MWD) dan peningkatan skor St. George’s Respiratory Questionnaire (SGRQ). Tai chi dapat dijadikan terapi pelengkap pada pasien PPOK sesuai dengan preference dan nilai yang dimiliki individu. Latihan ini dapat direkomendasikan pada pasien penyakit kronis lainnya. Kata kunci: Tai chi; PPOK; terapi komplementer


2018 ◽  
Vol 17 (8) ◽  
pp. 717-727 ◽  
Author(s):  
Hsiu-Chin Teng ◽  
Mei-Ling Yeh ◽  
Mei-Hua Wang

Background: Patients with heart failure experience not only impaired physical condition, but also their physical activity, moods, and quality of life may be diminished. Aims: The purpose of this study was to investigate the effects of 12-week walking with breathing program on physical activity tolerance considering time-dependent physiological factors and time-independent interoceptive awareness, as well as psychosocial factors. Methods: This randomized controlled trial recruited 90 heart failure patients and randomly assigned them. The walking with breathing group received the walking and breathing intervention for 12 weeks but the control group did not. Outcomes included activity tolerance measured by 6-minute walk distance, moods assessed by the Hospital Anxiety and Depression Scale, quality of life determined by the EuroQol 5-Dimensions, oxygen saturation by pulse oximetry, and interoceptive awareness by the Multidimensional Assessment of Interoceptive Awareness scale. Data were collected before the intervention at baseline and at Weeks 2, 4 and 12. Results: The results of the generalized estimating equation showed the 6-minute walk distance in the walking with breathing group was significantly different across time ( p<0.001) compared with the control group at baseline. Oxygen saturation by pulse oximetry ( p=0.04) and Trusting on the Multidimensional Assessment of Interoceptive Awareness scale ( p=0.001) significantly and positively correlated with results of the 6-minute walk distance. There were significant between-group differences at Week 12 in anxiety ( p=0.03) and quality of life ( p=0.02) but not depression ( p=0.06). Conclusions: Walking with breathing improved heart failure patients’ tolerance of physical activity, probably because of improved oxygen saturation and trusting interoceptive awareness. Walking with breathing also improved patients’ anxiety and quality of life.


Geriatrics ◽  
2020 ◽  
Vol 5 (4) ◽  
pp. 66 ◽  
Author(s):  
Lufei Young ◽  
Qi Zhang ◽  
Eric Lian ◽  
Kimberly Roberts ◽  
Neal Weintraub ◽  
...  

Although cardiac rehabilitation (CR) is clearly beneficial to improving patients’ physical functioning and reducing heart disease progression, significant proportions of patients do not complete CR programs. To evaluate the prevalence and predictors of completion of a center-based CR program in eligible cardiac patients, existing data collected from electronic medical records were used. To identify the predictors of CR completion, we used principal components analysis (PCA) and an artificial neural network (ANN) module. Among 685 patients, 61.4% (n = 421) completed the program, 31.7% (n = 217) dropped out, and 6.9% (n = 47) were referred but failed to initiate the program. PCA was conducted to consolidate baseline data into three factors—(1) psychosocial factors (depression, anxiety, and quality of life), (2) age, and (3) BMI, which explained 66.8% of the total variance. The ANN model produced similar results as the PCA. Patients who completed CR sessions had greater extremity strength and flexibility, longer six-minute walk distance, more CR knowledge, and a better quality of life. The present study demonstrated that patients who were older, obese, and who had depression, anxiety, or a low quality of life were less likely to complete the CR program.


2020 ◽  
Vol 64 (2) ◽  
pp. 89-100
Author(s):  
Oana Strinu

"The Five-Minute-Walk Distance Concept, Case Study: City of Cluj-Napoca, Romania. This term, also known as the “pedestrian shed”, refers to the distance that would make a person’s option of walking or driving to a destination differ. The distance is visualized as a 400-meter radius area most commonly found in some major cities or capitals’ downtown areas/main areas. To further highlight the characteristics of this concept I applied it on a case study of the city of Cluj-Napoca, checking the adherence of many areas against the concept’s principles. This will display the percentage of studied areas that meet the definition criteria and the results will indicate the proposed collection of measures to be adopted by the local authorities to increase the area definition validity score and to improve the citizens quality of life. This concept could be easily replicated in any city or capital and its metrics could be used to assess citizens. Keywords: neighborhood, 5-minute walking distance, urban development, city driving, pedestrian shed."


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