scholarly journals Simple Measures of Function and Symptoms in Hospitalized Heart Failure Patients Predict Short-Term Cardiac Event-Free Survival

2014 ◽  
Vol 2014 ◽  
pp. 1-11 ◽  
Author(s):  
Evanthia Zaharias ◽  
Janine Cataldo ◽  
Lynda Mackin ◽  
Jill Howie-Esquivel
Keyword(s):  
Heart Failure ◽  
Cardiac Event ◽  
Functional Limitation ◽  
Event Free Survival ◽  
Cardiac Events ◽  
Short Term ◽  
Free Survival ◽  
Nyha Classification ◽  
Katz Index ◽  
Patient Reported

Background. Heart failure (HF) is a prevalent chronic condition where patients experience numerous uncomfortable symptoms, low functional status, and high mortality rates.Objective. To determine whether function and/or symptoms predict cardiac event-free survival in hospitalized HF patients within 90 days of hospital discharge.Methods. Inpatients (N=32) had HF symptoms assessed with 4 yes/no questions. Function was determined with NYHA Classification, Katz Index of Activities of Daily Living (ADLs), and directly with the short physical performance battery (SPPB). Survival was analyzed with time to the first postdischarge cardiac event with events defined as cardiac rehospitalization, heart transplantation, or death.Results. Mean age was 58.2 ± 13.6 years. Patient reported ADL function was nearly independent (5.6 ± 1.1) while direct measure (SPPB) showed moderate functional limitation (6.4 ± 3.1). Within 90 days, 40.6% patients had a cardiac event. At discharge, each increase in NYHA Classification was associated with a 3.4-fold higher risk of cardiac events (95% CI 1.4–8.5). Patients reporting symptoms of dyspnea, fatigue, and orthopnea before discharge had a 4.0-fold, 9.7-fold, and 12.8-fold, respectively, greater risk of cardiac events (95% CI 1.2–13.2; 1.2–75.1; 1.7–99.7).Conclusions. Simple assessments of function and symptoms easily performed at discharge may predict short-term cardiac outcomes in hospitalized HF patients.

Racial differences in dietary antioxidant intake and cardiac event-free survival in patients with heart failure

2018 ◽  
Vol 17 (4) ◽  
pp. 305-313 ◽  
Author(s):  
Jia-Rong Wu ◽  
Eun Kyeung Song ◽  
Debra K Moser ◽  
Terry A Lennie
Keyword(s):  
Heart Failure ◽  
African American ◽  
African Americans ◽  
Cardiac Event ◽  
Event Free Survival ◽  
Free Survival ◽  
Dietary Antioxidant ◽  
Patients With Heart Failure ◽  
Antioxidant Intake ◽  
Carotene Beta

Background: Heart failure is a chronic, burdensome condition with higher re-hospitalization rates in African Americans than Whites. Higher dietary antioxidant intake is associated with lower oxidative stress and improved endothelial function. Lower dietary antioxidant intake in African Americans may play a role in the re-hospitalization disparity between African American and White patients with heart failure. Objective: The objective of this study was to examine the associations among race, dietary antioxidant intake, and cardiac event-free survival in patients with heart failure. Methods: In a secondary analysis of 247 patients with heart failure who completed a four-day food diary, intake of alpha-carotene, beta-carotene, beta-cryptoxanthin, lutein, zeaxanthin, lycopene, vitamins C and E, zinc, and selenium were assessed. Antioxidant deficiency was defined as intake below the estimated average requirement for antioxidants with an established estimated average requirement, or lower than the sample median for antioxidants without an established estimated average requirement. Patients were followed for a median of one year to determine time to first cardiac event (hospitalization or death). Survival analysis was used for data analysis. Results: African American patients had more dietary antioxidant deficiencies and a shorter cardiac event-free survival compared with Whites ( p = .007 and p = .028, respectively). In Cox regression, race and antioxidant deficiency were associated with cardiac event-free survival before and after adjusting for covariates. Conclusion: African Americans with heart failure had more dietary antioxidant deficiencies and shorter cardiac event-free survival than Whites. This suggests that encouraging African American patients with heart failure to consume an antioxidant-rich diet may be beneficial in lengthening cardiac event-free survival.

scholarly journals The Link of Unintentional Weight Loss to Cardiac Event–Free Survival in Patients With Heart Failure

2014 ◽  
Vol 29 (5) ◽  
pp. 439-447 ◽  
Author(s):  
Eun Kyeung Song ◽  
Yongjik Lee ◽  
Debra K. Moser ◽  
Rebecca L. Dekker ◽  
Seok-Min Kang ◽  
...  
Keyword(s):  
Heart Failure ◽  
Weight Loss ◽  
Cardiac Event ◽  
Event Free Survival ◽  
Unintentional Weight Loss ◽  
Free Survival ◽  
Patients With Heart Failure

Regular Monitoring of Lower Extremity Edema Predicts Cardiac Event-Free Survival in Patients with Heart Failure

2011 ◽  
Vol 17 (8) ◽  
pp. S5 ◽  
Author(s):  
Kyoung Suk Lee ◽  
Terry A. Lennie ◽  
Sandra B. Dunbar ◽  
Susan J. Pressler ◽  
Seongkum Heo ◽  
...  
Keyword(s):  
Heart Failure ◽  
Lower Extremity ◽  
Cardiac Event ◽  
Lower Extremity Edema ◽  
Event Free Survival ◽  
Free Survival ◽  
Regular Monitoring ◽  
Patients With Heart Failure

scholarly journals Higher dietary lycopene intake is associated with longer cardiac event-free survival in patients with heart failure

2012 ◽  
Vol 12 (4) ◽  
pp. 377-384 ◽  
Author(s):  
Martha Biddle ◽  
Debra Moser ◽  
Eun Kyeung Song ◽  
Seongkum Heo ◽  
Heather Payne-Emerson ◽  
...  
Keyword(s):  
Heart Failure ◽  
Cardiac Event ◽  
Event Free Survival ◽  
Free Survival ◽  
Patients With Heart Failure

scholarly journals Medication Adherence, Depressive Symptoms, and Cardiac Event–Free Survival in Patients With Heart Failure

2013 ◽  
Vol 19 (5) ◽  
pp. 317-324 ◽  
Author(s):  
Jia-Rong Wu ◽  
Terry A. Lennie ◽  
Rebecca L. Dekker ◽  
Martha J. Biddle ◽  
Debra K. Moser
Keyword(s):  
Heart Failure ◽  
Depressive Symptoms ◽  
Medication Adherence ◽  
Cardiac Event ◽  
Event Free Survival ◽  
Free Survival ◽  
Patients With Heart Failure

Symptom Clusters in Men and Women With Heart Failure and Their Impact on Cardiac Event-Free Survival

2010 ◽  
Vol 25 (4) ◽  
pp. 263-272 ◽  
Author(s):  
Kyoung Suk Lee ◽  
Eun Kyeung Song ◽  
Terry A. Lennie ◽  
Susan K. Frazier ◽  
Misook L. Chung ◽  
...  
Keyword(s):  
Heart Failure ◽  
Cardiac Event ◽  
Symptom Clusters ◽  
Event Free Survival ◽  
Free Survival ◽  
Men And Women

scholarly journals Cardiac resynchronization therapy improves left atrial reservoir function through resynchronization of the left atrium in patients with heart failure

2021 ◽  
Vol 22 (Supplement_1) ◽  
Author(s):  
K Dokuni ◽  
K Matsumoto ◽  
K Tatsumi ◽  
A Shono ◽  
M Suzuki ◽  
...  
Keyword(s):  
Heart Failure ◽  
Cardiac Resynchronization Therapy ◽  
Cardiac Resynchronization ◽  
Qrs Complex ◽  
Resynchronization Therapy ◽  
Event Free Survival ◽  
Cardiac Events ◽  
Free Survival ◽  
Reservoir Function ◽  
Patients With Heart Failure

Abstract Funding Acknowledgements Type of funding sources: None. Background The structural remodeling of the left atrium (LA) has been proposed as an important determinant of adverse outcomes in patients with heart failure (HF). However, little is known about the potential impact of LA mechanical dyssynchrony on its reservoir function and the prognosis of patients with HF. In addition, it has not been fully investigated whether cardiac resynchronization therapy (CRT) is also beneficial to LA function. Purposes The purposes of this study were to test whether left ventricular (LV) dyssynchrony may negatively affect LA synchronicity and reservoir function, and to assess whether residual LA dyssynchrony after CRT affects the prognosis in patients with HF with reduced ejection fraction (HFrEF). Methods This study included total of 90 subjects: 40 HFrEF with a wide-QRS complex (≧130 ms), 28 HFrEF with a narrow-QRS, and 22 age- and sex-matched normal controls. LA global longitudinal strain (LA-GLS) and LA dyssynchrony were quantified using speckle-tracking strain analysis. LA dyssynchrony was defined as the maximal difference of time-to-peak strain (LA time-diff). All wide-QRS HFrEF received CRT, and event-free survival was tracked for 24 months. Results At baseline, HFrEF patients showed significant LA remodeling coupled with the reduced LA reservoir function, as evidenced by larger LA volume index (LAVi: 46 ± 16 vs. 30 ± 14 mL/m², P < 0.01) and smaller LA-GLS (13.0 ± 4.8 vs. 30.6 ± 10.7%, P < 0.01). Of note was that, not only LV dyssynchrony (381 ± 178 vs. 177 ± 62 ms, P < 0.01) but also LA dyssynchrony (298 ± 136 vs. 186 ± 78 ms, P < 0.01) were significantly larger in patients with HFrEF compared to normal subjects and this applied even more to patients with a wide-QRS complex. All patients with a wide-QRS complex underwent CRT, and only responders exhibited the significant decrease in LA time-diff (from 338 ± 123 to 245 ± 141 ms, P < 0.05) and increase in LA-GLS (from 11.9 ± 4.7 to 19.6 ± 10.1%, P < 0.05) in parallel with the reduction in LAVi (from 48 ± 17 to 37 ± 18 mL/m², P < 0.05) at 6 months after CRT. Receiver operating characteristic curve analysis identified the optimal cut-off value of LA time-diff at 6 months after CRT as 202 ms (P < 0.05) and that of LA-GLS as 14.6% (P < 0.05) for predicting adverse cardiac events. The patients whose LA time-diff reduced <202 ms after CRT showed significantly favorable event-free survival than the others. Similarly, the patients whose LA-GLS improved >14.6% after CRT exhibited significantly favorable event-free survival than the others (P < 0.05, respectively). Of note was that, when the patients were restricted to CRT responders only, those who showed LA time-diff less than 202 ms at 6 months after CRT almost never experienced cardiac events (P < 0.05). Conclusions The improved LV coordination by CRT also resulted in resynchronization of discoordinated LA wall motion and a consecutive improvement of LA reservoir function, which ultimately lead to the favorable outcome for HFrEF patients with wide-QRS complex. Abstract Figure.

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