scholarly journals Insomnia and Cardiac Events in Patients With Heart Failure　– Reply –

2017 ◽  
Vol 81 (1) ◽  
pp. 126
Author(s):  
Akiomi Yoshihisa ◽  
Yuki Kanno ◽  
Yasuchika Takeishi
Keyword(s):  
Heart Failure ◽  
Cardiac Events ◽  
Patients With Heart Failure

Abstract 3103: A Cardiopulmonary Exercise Testing Score for Predicting Risk in Patients with Heart Failure

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Jonathan Myers ◽  
Ross Arena ◽  
Daniel Bensimhon ◽  
Joshua Abella ◽  
Leon Hsu ◽  
...  
Keyword(s):  
Heart Failure ◽  
Proportional Hazards ◽  
Heart Rate Recovery ◽  
Full Range ◽  
Cardiopulmonary Exercise Testing ◽  
Relative Weight ◽  
Cox Proportional Hazards ◽  
Cardiac Events ◽  
Cardiopulmonary Exercise ◽  
Patients With Heart Failure

Background. Cardiopulmonary exercise test (CPX) responses, including markers of ventilatory inefficiency (eg. the VE/VCO 2 slope and oxygen uptake efficiency slope [OUES]), and hemodynamic responses, such as heart rate recovery (HRR) and chronotropic incompetence (CRI) predict outcomes in patients with heart failure (HF). However, multivariate risk models integrating the full range of CPX variables have not been fully explored. Methods: 710 HF patients (568 male/142 female, mean age 56±13 years, EF 33±14%) underwent CPX and were followed for major cardiac events (death, transplant, LVAD implantation) for a mean of 29± 25 months. The age-adjusted prognostic power of peak VO 2 , VE/VCO 2 slope, OUES (VO 2 = a log 10 VE + b), resting end-tidal CO 2 pressure (PetCO 2 ), HRR, and CRI were determined using Cox proportional hazards, optimal cutpoints were determined, the variables were weighted, and a multivariate score was derived. Results. There were 111 composite outcomes. Multivariately, only CRI was not a significant predictor of risk. The VE/VCO 2 slope (≥ 34) was the strongest predictor, and was attributed a relative weight of 7, with weighted scores for abnormal HRR (≤6 beats at 1 min), OUES (>1.4), PetCO2 (<33mmHg), and peak VO 2 (≤14 ml/kg/min) having scores of 5, 3, 3, and 2, respectively. A Kaplan-Meier curve illustrating the incremental scores is presented in the figure ; a score >15 was associated with an annual mortality rate of 26% and a relative risk of 15. Conclusion . A score using CPX responses provides a simple and integrated method that powerfully predicts outcomes in patients with HF.

scholarly journals Cerebral Perfusion and the Occurrence of Nonfocal Transient Neurological Attacks

2019 ◽  
Vol 47 (5-6) ◽  
pp. 303-308
Author(s):  
Eline A. Oudeman ◽  
Esther E. Bron ◽  
Renske M. Van den Berg-Vos ◽  
Jacoba P. Greving ◽  
Geert Jan Biessels ◽  
...  
Keyword(s):  
Heart Failure ◽  
Magnetic Resonance ◽  
Brain Magnetic Resonance Imaging ◽  
Brain Perfusion ◽  
Cerebral Hypoperfusion ◽  
Cardiac Events ◽  
Adjusted Risk ◽  
Total Brain ◽  
Increased Risk ◽  
Patients With Heart Failure

Introduction: Nonfocal transient neurological attacks (TNAs) are associated with an increased risk of cardiac events, stroke and dementia. Their etiology is still unknown. Global cerebral hypoperfusion has been suggested to play a role in their etiology, but this has not been investigated. We assessed whether lower total brain perfusion is associated with a higher occurrence of TNAs. Methods: Between 2015 and 2018, patients with heart failure were included in the Heart Brain Connection study. Patients underwent brain magnetic resonance imaging, including quantitative magnetic resonance angiography (QMRA) to measure cerebral blood flow (CBF). We calculated total brain perfusion of each participant by dividing total CBF by brain volume. Patients were interviewed with a standardized questionnaire on the occurrence of TNAs by physicians who were blinded to QMRA flow status. We assessed the relation between total brain perfusion and the occurrence of TNAs with Poisson regression analysis. Results: Of 136 patients (mean age 70 years, 68% men), 29 (21%) experienced ≥1 TNAs. Nonrotatory dizziness was the most common subtype of TNA. Patients with TNAs were more often female and more often had angina pectoris than patients without TNAs, but total CBF and total brain perfusion were not different between both groups. Total brain perfusion was not associated with the occurrence of TNAs (adjusted risk ratio 1.12, 95% CI 0.88–1.42). Conclusion: We found no association between total brain perfusion and the occurrence of TNAs in patients with heart failure.

“Dose-dependent” Impact of Recurrent Cardiac Events on Mortality in Patients with Heart Failure

2009 ◽  
Vol 122 (2) ◽  
pp. 162.e1-162.e9 ◽  
Author(s):  
Douglas S. Lee ◽  
Peter C. Austin ◽  
Thérèse A. Stukel ◽  
David A. Alter ◽  
Alice Chong ◽  
...  
Keyword(s):  
Heart Failure ◽  
Cardiac Events ◽  
Patients With Heart Failure ◽  
Dose Dependent

Cystatin C, a Novel Measure of Renal Function, Is an Independent Predictor of Cardiac Events in Patients With Heart Failure

2005 ◽  
Vol 11 (8) ◽  
pp. 595-601 ◽  
Author(s):  
Takanori Arimoto ◽  
Yasuchika Takeishi ◽  
Takeshi Niizeki ◽  
Noriaki Takabatake ◽  
Hidenobu Okuyama ◽  
...  
Keyword(s):  
Heart Failure ◽  
Renal Function ◽  
Cystatin C ◽  
Independent Predictor ◽  
Cardiac Events ◽  
Patients With Heart Failure

scholarly journals Mechanisms by Which Metformin Improves Mortality and Hospital Readmission in Diabetic Patients with Heart Failure

2017 ◽  
Vol 1 (3) ◽  
pp. 01-02
Author(s):  
David Bell
Keyword(s):  
Heart Failure ◽  
Hospital Readmission ◽  
Meta Analysis ◽  
Total Mortality ◽  
Diabetic Patients ◽  
Cardiac Events ◽  
Develop Heart Failure ◽  
Metformin Monotherapy ◽  
Patients With Heart Failure ◽  
Obese Subjects

From the UKPDS it was concluded that metformin decreased cardiac events. However, this only occurred in a small group of obese subjects while in a larger group failing sulfonylurea therapy the addition of metformin resulted in an increase in cardiac events . Indeed, a meta-analysis of metformin studies has shown that overall metformin does not decrease cardiac events. However, if in this meta-analysis the group utilizing metformin and sulfonylurea combinations were removed from the analysis then there was a significant decrease in cardiac events with metformin monotherapy. The major decrease in cardiac events, cardiac mortality and total mortality with metformin is likely due to a decreased susceptibility to develop heart failure. From Medicare billing records of 16,417 diabetic patients with heart failure discharged from hospital on metformin were compared to those with heart failure discharged on a sulfonylurea or insulin, mortality was reduced by 13% and readmission by 8%.

scholarly journals Mediated effects of insomnia, psychological distress and medication adherence in the association of eHealth literacy and cardiac events among Iranian older patients with heart failure: a longitudinal study

2019 ◽  
Vol 19 (2) ◽  
pp. 155-164 ◽  
Author(s):  
Chung-Ying Lin ◽  
Maryam Ganji ◽  
Mark D Griffiths ◽  
Marie Ernsth Bravell ◽  
Anders Broström ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Heart Failure ◽  
Psychological Distress ◽  
Medication Adherence ◽  
Older Patients ◽  
Longitudinal Design ◽  
Cardiac Events ◽  
Ehealth Literacy ◽  
Patients With Heart Failure

Background: Given the importance of improving health for patients with heart failure, the present study examined the temporal associations between eHealth literacy, insomnia, psychological distress, medication adherence, quality of life and cardiac events among older patients with heart failure. Methods: With a longitudinal design older patients with echocardiography verified heart failure ( N=468; 50.4% New York Heart Association class II, mean age 69.3±7.3 years; 238 men) in need of cardiac care at seven Iranian university outpatient clinics went through clinical examinations and completed the following questionnaires at baseline: eHealth literacy scale (eHEALS, assessing eHealth literacy); 5-item medication adherence report scale (MARS-5, assessing medication adherence); Minnesota living with heart failure questionnaire (MLHFQ, assessing quality of life); insomnia severity index (ISI, assessing insomnia); and hospital anxiety and depression scale (HADS, assessing psychological distress). All the patients completed the ISI and HADS again 3 months later; and the MARS-5 6 months later. Also, their cardiac events were collected 18 months later. Three mediation models were then conducted. Results: eHealth literacy had direct and indirect effects (through insomnia and psychological distress) on medication adherence and quality of life. Moreover, eHealth literacy had protecting effects on cardiac events (hazard ratio (HR) 0.53; 95% confidence interval (CI) 0.37, 0.65) through the mediators of insomnia (HR 0.19; 95% CI 0.15, 0.26), psychological distress (HR 0.08; 95% CI 0.05, 0.12) and medication adherence (HR 0.05; 95% CI 0.04, 0.08). Conclusion: As eHealth literacy was a protector for patients with heart failure, healthcare providers may plan effective programmes to improve eHealth literacy for the population. Additional benefits of improving eHealth literacy in heart failure may be decreased insomnia and psychological distress, improved quality of life, as well as decreased cardiovascular events.

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