scholarly journals Exercise-based cardiac rehabilitation in patients with reduced left ventricular ejection fraction: The Cardiac Rehabilitation Outcome Study in Heart Failure (CROS-HF): A systematic review and meta-analysis

2019 ◽  
Vol 27 (9) ◽  
pp. 929-952 ◽  
Author(s):  
Birna Bjarnason-Wehrens ◽  
R Nebel ◽  
K Jensen ◽  
M Hackbusch ◽  
M Grilli ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Heart Failure ◽  
Relative Risk ◽  
Left Ventricular Ejection Fraction ◽  
Confidence Interval ◽  
Cardiac Rehabilitation ◽  
Left Ventricular ◽  
Left Ventricular Ejection

Background In heart failure with reduced left ventricular ejection fraction (HFrEF) patients the effects of exercise-based cardiac rehabilitation on top of state-of-the-art pharmacological and device therapy on mortality, hospitalization, exercise capacity and quality-of-life are not well established. Design The design of this study involved a structured review and meta-analysis. Methods Evaluation of randomised controlled trials of exercise-based cardiac rehabilitation in HFrEF-patients with left ventricular ejection fraction ≤40% of any aetiology with a follow-up of ≥6 months published in 1999 or later. Results Out of 12,229 abstracts, 25 randomised controlled trials including 4481 HFrEF-patients were included in the final evaluation. Heterogeneity in study population, study design and exercise-based cardiac rehabilitation-intervention was evident. No significant difference in the effect of exercise-based cardiac rehabilitation on mortality compared to control-group was found (hazard ratio 0.75, 95% confidence interval 0.39–1.41, four studies; 12-months follow-up: relative risk 1.29, 95% confidence interval 0.66–2.49, eight studies; six-months follow-up: relative risk 0.91, 95% confidence interval 0.26–3.16, seven studies). In addition there was no significant difference between the groups with respect to ‘hospitalization-for-any-reason’ (12-months follow-up: relative risk 0.79, 95% confidence interval 0.41–1.53, four studies), or ‘hospitalization-due-to-heart-failure’ (12-months follow-up: relative risk 0.59, 95% confidence interval 0.12–2.91, four studies; six-months follow-up: relative risk 0.84, 95% confidence interval 0.07–9.71, three studies). All studies show improvement of exercise capacity. Participation in exercise-based cardiac rehabilitation significantly improved quality-of-life as evaluated with the Kansas City Cardiomyopathy Questionnaire: (six-months follow-up: mean difference 1.94, 95% confidence interval 0.35–3.56, two studies), but no significant results emerged for quality-of-life measured by the Minnesota Living with Heart Failure Questionnaire (nine-months or more follow-up: mean difference –4.19, 95% confidence interval –10.51–2.12, seven studies; six-months follow-up: mean difference –5.97, 95% confidence interval –16.17–4.23, four studies). Conclusion No association between exercise-based cardiac rehabilitation and mortality or hospitalisation could be observed in HFrEF patients but exercise-based cardiac rehabilitation is likely to improve exercise capacity and quality of life.

scholarly journals Correlation between Suppression of Tumorigenicity-2 with Left Ventricular Geometry, Left Ventricular Ejection Fraction and Quality of Life in Systolic Heart Failure Patients

2020 ◽  
Vol 12 (3) ◽  
pp. 233-8
Author(s):  
Johan Gunadi ◽  
Starry Homenta Rampengan ◽  
Janry Antonius Pangemanan ◽  
Agnes Lucia Panda ◽  
Nancy Lampus ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Heart Failure ◽  
Left Ventricular Ejection Fraction ◽  
Systolic Heart Failure ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Left Ventricular Geometry ◽  
Ventricular Ejection Fraction ◽  
Ventricular Geometry

BACKGROUND: Heart failure (HF) is a clinical syndrome caused by structural or functional cardiac disorders and is the final stage of every heart disease, marked by decreased functional capacity and patients’ quality of life (QoL). Suppression of tumorigenicity-2 (ST2) is a biomarker depicting heart fibrosis and remodeling that altered left ventricular geometry, which in turn decreases left ventricular contractility, decreases functional capacity, and ultimately affects the QoL of the HF patient.METHODS: An observational study was conducted with a cross-sectional approach involving 60 patients with systolic heart failure. Left ventricular geometry, left ventricular ejection fraction (LVEF), ST2 level, and other biomarkers were examined, continued by QoL assessment.RESULTS: The ST2 level (33.25±23.55 ng/mL) was negatively correlated with LVEF (r=-0.257; p=0.024) and was positively correlated with QoL (r=0.255; p=0.05). The LVEF was negatively correlated with QoL (r=-0.224; p=0.031). However, no significant correlation was found between left ventricular geometry with ST2 level or patients’ QoL.CONCLUSION: Elevated ST2 levels are correlated with decreased LVEF and worse QoL in systolic heart failure subjects. Therefore, ST2 together with LVEF can be used as prognostic tools for patients with HF.KEYWORDS: heart failure, ST2, left ventricular geometry, left ventricular ejection fraction, quality of life

scholarly journals Thiamin supplementation does not improve left ventricular ejection fraction in ambulatory heart failure patients: a randomized controlled trial

2019 ◽  
Vol 110 (6) ◽  
pp. 1287-1295 ◽  
Author(s):  
Mary Keith ◽  
Shirley Quach ◽  
Mavra Ahmed ◽  
Parastoo Azizi-Namini ◽  
Abdul Al-Hesayen ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Heart Failure ◽  
Placebo Group ◽  
Left Ventricular Ejection Fraction ◽  
Ejection Fraction ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction ◽  
Ambulatory Patients

ABSTRACT Background Thiamin, a water-soluble B-complex vitamin, functions as a coenzyme in macronutrient oxidation and in the production of cellular ATP. Data suggest that thiamin depletion occurs in heart failure (HF). Therefore, thiamin supplementation in HF patients may improve cardiac function. Objective We sought to determine whether oral thiamin supplementation improves left ventricular ejection fraction (LVEF), exercise tolerance, and quality of life among patients with HF and reduced LVEF. Methods In this prospective, multicenter, double-blind, placebo-controlled randomized trial, eligible ambulatory patients with HF and reduced LVEF were recruited from 4 academic and community hospitals between 2010 and 2015. Participants were randomly assigned to receive either 200 mg oral thiamin mononitrate per day or placebo for 6 mo. Results Sixty-nine patients (mean ± SD age: 64 ± 12 y; 83% men; LVEF: 37% ± 11%) were randomly assigned: 34 received placebo and 35 received thiamin supplementation. Erythrocyte thiamin pyrophosphate and urine thiamin concentrations were significantly higher in the supplemented group than in the placebo group at 6 mo (P = 0.02 and <0.001, respectively). At 6 mo, LVEF was significantly higher in the placebo group than in the thiamin group (38%; 95% CI: 36%, 39% compared with 35%; 95% CI: 33%, 37%, P = 0.047) after adjusting for baseline measurements. There were no significant differences in Minnesota Living with Heart Failure score, distance walked in 6 min, and N-terminal prohormone of brain natriuretic peptide concentrations between the 2 groups. One patient (2.9%) in the thiamin-supplemented group and none in the control group died at 6 mo. Conclusions In ambulatory patients with HF and reduced LVEF, thiamin supplementation for 6 mo did not improve LVEF, quality of life, or exercise capacity, despite increases in thiamin concentrations. These findings do not support routine thiamin supplementation in the treatment of HF and reduced LVEF. This trial was registered at clinicaltrials.gov as NCT00959075.

scholarly journals Interim Results of the BYHEART Observational Study: Exogenous Phosphocreatine Effect on the Quality of life of Patients with Chronic Heart Failure

Kardiologiia ◽  
2021 ◽  
Vol 61 (7) ◽  
pp. 22-27
Author(s):  
S. N. Tereschenko ◽  
N. B. Perepech ◽  
I. A. Cheremisina ◽  
V. N. Belov ◽  
Y. A. Vollis ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Heart Failure ◽  
Chronic Heart Failure ◽  
Left Ventricular Ejection Fraction ◽  
Ejection Fraction ◽  
Left Ventricular ◽  
Ventricular Ejection ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction

Aim      Improvement of quality of life is one of the most important goals for the treatment of patients with chronic heart failure (CHF). This study searched for ways to increase the efficiency of CHF treatment based on parameters of quality of life in CHF patients during and after the treatment with exogenous phosphocreatine (EP).Material and methods  The effect of a single course of EP treatment on quality of life of patients with functional class (FC) II-IV CHF with reduced or mid-range left ventricular ejection fraction was studied as a part of the all-Russia prospective observational study BYHEART. The presence of FC II-IV CHF and a left ventricular ejection fraction <50 % were confirmed by results of 6-min walk test (6MWT) and findings of echocardiography after stabilization of the background therapy.Results An interim data analysis showed that the course of EP treatment was associated with a significant improvement of quality-of-life indexes as determined by the Minnesota Living with Heart Failure Questionnaire (LHFQ) total score. These indexes significantly increased and remained at a satisfactory level for 6 mos. following completion of the treatment course. Also, the treatment significantly beneficially influenced the clinical condition of patients (heart failure severity scale), results of 6MWT, and the increase in left ventricular ejection fraction.Conclusion      The conclusions based on results of the interim analysis should be confirmed by results of the completed study. Complete results are planned to be published in 2022.

scholarly journals Pentoxyphylline: possibilities to reduce manifestations of chronic heart failure with preserved left ventricular ejection fraction in elderly

2021 ◽  
Vol 23 (1) ◽  
pp. 24-31
Author(s):  
V. B. Shatylo ◽  
L. A. Bodretska ◽  
I. S. Shapovalenko ◽  
H. P. Voinarovska ◽  
Zh. S. Butynets
Keyword(s):  
Quality Of Life ◽  
Heart Failure ◽  
Chronic Heart Failure ◽  
Left Ventricular Ejection Fraction ◽  
Ejection Fraction ◽  
Left Ventricular ◽  
Ventricular Ejection ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction

The aim: to study the effect of add-on pentoxifylline therapy on the structural and functional indicators of the heart state, endothelial function, quality of life and physical abilities in patients with chronic heart failure with preserved left ventricular ejection fraction. Materials and methods. The indicators of the structural and functional state of the heart, endothelial function, quality of life and physical abilities of patients older than 60 years, who were followed-up in the Department of Cardiology of the State Institution “D. F. Chebotarev Institute of Gerontology of the NAMS of Ukraine”, based on 67 case histories, 37 of them were prescribed pentoxifylline as add-on therapy to the standard therapeutic regimen. Statistical data were calculated using modern application packages, in particular SPSS v.22, Statistica 7.0, MedCalc statical software v.11.5.0.0. The significance level was assessed using paired and unpaired Student's t-test with Bonferroni corrections, and the correlation and two-way analysis of variance were performed. Results. A significant additional effect of pentoxifylline treatment on the indicators of maximum blood flow in the forearm microvessels in response to the reactive hyperemia test, which characterizes the ability of the microvessel endothelium to synthesize relaxation factors, was detected. Patients who additionally received pentoxifylline showed significantly better indicators of left ventricular myocardial relaxation and reduction of hypertrophy than those on the standard therapy. There was a significant increase in walking distance in the third year of treatment in the patients who additionally received pentoxifylline. There was no difference in the impact on the quality of life of the patients. Conclusions. The addition of pentoxifylline to the standard therapy in patients with chronic heart failure with preserved left ventricular ejection fraction significantly reduces myocardial hypertrophy, improves diastolic relaxation, increases volumetric blood flow velocity in microvessels mediating reactive hyperemia, which may contribute to further stabilizing the clinical course of the disease and increasing 6-minute walking distance. The presented data are an additional evidence of pathogenetically reasonable therapy with pentoxifylline in patients with chronic heart failure with preserved left ventricular ejection fraction, which allows us to consider this drug as potentially promising for the routine treatment of such patients.

Efficacy of Vitamin D on Chronic Heart Failure Among Adults

2020 ◽  
Vol 90 (1-2) ◽  
pp. 49-58 ◽  
Author(s):  
Wang Chunbin ◽  
Wang Han ◽  
Cai Lin
Keyword(s):  
Heart Failure ◽  
Vitamin D ◽  
Chronic Heart Failure ◽  
Left Ventricular Ejection Fraction ◽  
Confidence Interval ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Controlled Trials ◽  
Ventricular Ejection Fraction ◽  
Randomized Controlled

Abstract. Vitamin D deficiency commonly occurs in chronic heart failure. Whether additional vitamin D supplementation can be beneficial to adults with chronic heart failure remains unclear. We conducted a meta-analysis to derive a more precise estimation. PubMed, Embase, and Cochrane databases were searched on September 8, 2016. Seven randomized controlled trials that investigated the effects of vitamin D on cardiovascular outcomes in adults with chronic heart failure, and comprised 592 patients, were included in the analysis. Compared to placebo, vitamin D, at doses ranging from 2,000 IU/day to 50,000 IU/week, could not improve left ventricular ejection fraction (Weighted mean difference, WMD = 3.31, 95% confidence interval, CL = −0.93 to 7.55, P < 0.001, I2 = 92.1%); it also exerts no beneficial effects on the 6 minute walk distance (WMD = 18.84, 95% CL = −24.85 to 62.52, P = 0.276, I2 = 22.4%) and natriuretic peptide (Standardized mean difference, SMD = −0.39, 95% confidence interval CL = −0.48 to 0.69, P < 0.001, I2 = 92.4%). However, a dose-response analysis from two studies demonstrated an improved left ventricular ejection fraction with vitamin D at a dose of 4,000 IU/day (WMD = 6.58, 95% confidence interval CL = −4.04 to 9.13, P = 0.134, I2 = 55.4%). The results showed that high dose vitamin D treatment could potentially benefit adults with chronic heart failure, but more randomized controlled trials are required to confirm this result.

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