scholarly journals Psychosocial adaptation to chronic heart failure in patients with coronary heart disease

2021 ◽  
Vol 102 (2) ◽  
pp. 156-166
Author(s):  
A G Zhidyaevskij ◽  
G S Galyautdinov ◽  
V D Mendelevich ◽  
A G Gataullina ◽  
A O Kuzmenko
Keyword(s):  
Quality Of Life ◽  
Heart Failure ◽  
Chronic Heart Failure ◽  
Psychosocial Adaptation ◽  
Functional Class ◽  
Adherence To Treatment ◽  
Nyha Functional Class ◽  
Type D ◽  
Sf 36

Aim. To assess the effects of acquired social status, neurotic conditions, type D personality, cognitive functions, quality of life and adherence to treatment on psychosocial adaptation of patients with coronary heart disease (IHD) to chronic heart failure (CHF), depending on the severity of decompensation. Methods. 87 patients with coronary artery disease and chronic heart failure aged between 55 and 72 years were examined. All patients were divided into two groups depending on the functional class of chronic heart failure [New York Heart Association (NYHA) class IIV]. The first group included 41 patients with NYHA functional class III, the second group 46 patients with NYHA functional class IIIIV. For a comprehensive study of the psychosocial adaptation of patients, a set of standardized questionnaires was used: the abridged variant of the Minnesota Multiphasic Personality Inventory (SMOL), a clinical questionnaire for identifying and assessing neurotic condition, the Minnesota Living with Heart Failure Questionnaire (MLHFQ), the 36-Item Short Form Health Survey Questionnaire (SF-36), the Mini Mental State Examination (MMSE), 14-question test Type D Scale-14 (DS14), MoriskyGreen test, the short version of the AUDIT questionnaire (AUDIT-C). We collected data on the patient's social status: gender, education, income level. The results obtained were analyzed. Results. Based on the SMOL personality profiles, patients of the second group were classified as neurotic an increase was noted in three neurotic scales: hypochondria (U=541; p=0.030), hysteria (U=579; p=0.048), and autism/schizoid (U=577.5; p=0.047) compared with patients of the first group. According to the results of the clinical questionnaire for the identification and assessment of neurotic condition, the greatest differences were found between patients of first and second groups on the scale of autonomic disorders (U=571; p=0.039) and neurotic depression (U=576; p=0.046). Comparing the groups according to the MLHFQ score, quality of life in patients of the second group was markedly reduced (U=447.5; p 0.001). According to the SF-36 questionnaire, a decrease in the quality of life was also found in patients of the second group on the scale Physical functioning (U=554; p=0.032) and Physical component of health (U=573.5; p=0.044). The cognitive status in patients of the second group was significantly decreased compared with the first group (U=427; p 0.001). No significant differences were found in adherence to treatment between the two groups (U=757; p=0.666). Also, there were no patients with type D personality on both subscales (U=717.5; p=0.483, U=784; p=0.933) and according to the AUDIT-C scores, there are no significant differences between men (U=681.5; p=0.257) and women (U=728.5; p=0.425) in both groups of patients. Conclusion. Signs of social maladjustment in patients with more severe NYHA functional class of the disease are expressed by significantly more pronounced social isolation (autism), a tendency to avoid communicating with others, isolation on their own problems and hypochondriacal attention to the somatic manifestations of chronic heart failure; probably, the main reason that reduces the level of social adaptation is a high score in neuroticism, which leads to a functional decrease in cognitive abilities and a significant deterioration in quality of life.

scholarly journals Vagal Neuromodulation in Chronic Heart Failure With Reduced Ejection Fraction: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 8 ◽  
Author(s):  
Lucas Bonacossa Sant'Anna ◽  
Sérgio Lívio Menezes Couceiro ◽  
Eduardo Amar Ferreira ◽  
Mariana Bonacossa Sant'Anna ◽  
Pedro Rey Cardoso ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Heart Failure ◽  
Systematic Review ◽  
Chronic Heart Failure ◽  
Meta Analysis ◽  
Functional Class ◽  
Walk Test ◽  
Reduced Ejection Fraction ◽  
Nyha Functional Class

Objectives: The aim of this study was to evaluate the effects of invasive vagal nerve stimulation (VNS) in patients with chronic heart failure (HF) and reduced ejection fraction (HFrEF).Background: Heart failure is characterized by autonomic nervous system imbalance and electrical events that can lead to sudden death. The effects of parasympathetic (vagal) stimulation in patients with HF are not well-established.Methods: From May 1994 to July 2020, a systematic review was performed using PubMed, Embase, and Cochrane Library for clinical trials, comparing VNS with medical therapy for the management of chronic HFrEF (EF ≤ 40%). A meta-analysis of several outcomes and adverse effects was completed, and GRADE was used to assess the level of evidence.Results: Four randomized controlled trials (RCT) and three prospective studies, totalizing 1,263 patients were identified; 756 treated with VNS and 507 with medical therapy. RCT data were included in the meta-analysis (fixed-effect distribution). Adverse effects related to VNS were observed in only 11% of patients. VNS was associated with significant improvement (GRADE = High) in the New York Heart Association (NYHA) functional class (OR, 2.72, 95% CI: 2.07–3.57, p < 0.0001), quality of life (MD −14.18, 95% CI: −18.09 to −10.28, p < 0.0001), a 6-min walk test (MD, 55.46, 95% CI: 39.11–71.81, p < 0.0001) and NT-proBNP levels (MD −144.25, 95% CI: −238.31 to −50.18, p = 0.003). There was no difference in mortality (OR, 1.24; 95% CI: 0.82–1.89, p = 0.43).Conclusions: A high grade of evidence demonstrated that vagal nerve stimulation improves NYHA functional class, a 6-min walk test, quality of life, and NT-proBNP levels in patients with chronic HFrEF, with no differences in mortality.

Abstract 2234: Self-care And Quality Of Life In Patients With Heart Failure

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Chantira Chiaranai ◽  
Jeanne Salyer
Keyword(s):  
Quality Of Life ◽  
Heart Failure ◽  
Decision Making ◽  
Self Care ◽  
Functional Class ◽  
Nyha Functional Class ◽  
Co Morbidity ◽  
Patients With Heart Failure ◽  
Disease Specific

Purpose: Although it is well-known that self-care (SC) reduces the frequency of hospital admissions and exacerbations, and enhances quality of life (QOL) in heart failure patients, little is known about SC in this population. The study purpose was to examine relationships among selected individual characteristics (demographics, severity of illness, co-morbidities, and social support), SC strategies, and QOL using Reigel’s Model of Self Care in Patients with Heart Failure as the guiding framework. Method: 114 subjects were recruited to participate in this descriptive correlational study. SC was measured using the Self-Care of Heart Failure Index , which measures self-care maintenance (SC-Mt), self-care management (SC-Mn), and self-care self-confidence (SC-Sc). QOL was measured using a disease-specific instrument, the Minnesota Living with Heart Failure Questionnaire , and a generic instrument, the Short-Form Health Survey characterizing physical and mental-emotional functioning. Multiple regression analysis was used to identify predictors of QOL. Findings: 98 subjects (age = 56.7 years; 53.8% male; 49.5% Caucasian) completed and returned mailed questionnaires. Multiple regression analyses demonstrated that better disease-specific QOL was predicted by being less likely to try SC-Mn strategies (β = .325; p = 0.003), better SC-Sc (β = −.251; p = 0.012), better NYHA functional class (β = .246; p = 0.008), and less co-morbidity (β = .236; p = 0.014) (R 2 = .334; F = 7.269, p = 0.000). Better generic QOL (physical functioning) was predicted by better NYHA functional class (β = −.309; p = 0.001), better SC-Mt (β = .205; p = 0.037), better SC-Sc (β = .296; p = 0.003), and being less likely to try SC-Mn strategies (β = −.165; p = 0.000) (R 2 = .361; F = 9.602, p = 0.000). Better generic QOL (mental-emotional functioning) was predicted by better NYHA functional class (β = −.229; p = 0.024), and being men (β = −.204; p = .047) (R 2 = .277; F = 4.548, p = 0.000). Discussion: Findings suggest that better QOL is influenced by gender (male), better NYHA functional class, less co-morbidity, and better use of SC strategies. Exploring patient decision-making can assist nurses in identifying how to improve decision-making performance and enhance QOL.

scholarly journals Outcome and Quality of Life of Patients following Valve Replacement Surgery: Predictors of Healthy Survival

2017 ◽  
Vol 10 (1) ◽  
pp. 21-30
Author(s):  
M Aftabuddin
Keyword(s):  
Quality Of Life ◽  
Valve Replacement ◽  
Heart Valve ◽  
Functional Class ◽  
Heart Valve Replacement ◽  
Nyha Functional Class ◽  
Sf 36 ◽  
History Of ◽  
Late Survival

Background: In search of factors influencing the postoperative health-related quality of life after heart valve replacement, the present study was designed to see the effects of valve replacement on the long-term healthy survival. The aim of the study was to explore whether the Preoperative variables, such as clinical characteristics and test data could he used to predict the effects of valve replacement on functional status and quality of life in patients with heart valve malfunctions after alter surgical intervention.Method: We retrospectively identified 200 patients who underwent heart valve replacement for stenosis between 2005 and 20l2 in the department of Cardiac Surgery. BSMMU. Dhaka. Bangladesh and survived the surgery and initial 30 day postoperative period. Late follow-up between January 2013 and July 2015 was done and completed in 50% cases.Results: Among 100 study population, 47 were male and the rest 53 were female, aged 22 to 65 years (mean 37.0±7.4 years). The quality of life was assessed with the Medical Outcomes Study Short Form -36 (MOS SF-36) and the functional outcome was evaluated using New York Heart Association (NYHA) functional class scores, in addition to analysis of laboratory tests, like ECG, X-ray chest, echocardiography, prothrombin time. Evaluation of preoperative medical history revealed that there were hypertension in 7l%, diabetes mellitus in l3%, and history of stroke in 09% patients. Prolonged length of stay in intensive care unit and in hospital (mean: 14.7 and 37.l days respectively) was observed in 17% patients. Late postoperative survival rate was 86% at l year and 63% at the end of 5 years. Predictors of late morbidity and mortality were Preoperative or Perioperative complications, preoperative history of stroke, chronic obstructive pulmonary disease. postoperative renal dysfunction. The mean NYHA functional class for all late survivors improved from 3.6 ± 0.9 to 1.9 ± 0.7. Late survival was worse for those who were in an advanced NYHA functional class before surgery. Patient in NYHA Functional class Ill and IV had a worse late survival late than those in Class I or ll. There was Significant improvement in all 8 health domains of the SF-36 Questionnaire in the overall sample.Conclusion: The present study indicated that the late survival rate and functional outcome after heart valve replacement in Bangladeshi population with major valvular dysfunction was satisfactory. It was also observed that the preoperative physical as well as mental health status were identified as the only risk factors for potential non-improving quality of healthy survival following heart valve replacement after correction for age, gender and type after surgery.Cardiovasc. j. 2017; 10(1): 21-30

scholarly journals Possibilities of coenzyme q10 as a part of complex therapy of patients with chronic heart failure and its influence on indicators of quality of life

2019 ◽  
pp. 90-95
Author(s):  
Zh. M. Sizova ◽  
V. L. Zakharova ◽  
K. A. Alibeyli
Keyword(s):  
Quality Of Life ◽  
Heart Failure ◽  
Chronic Heart Failure ◽  
Coenzyme Q10 ◽  
Traditional Therapy ◽  
Comparative Aspect ◽  
Sf 36 ◽  
Complex Therapy ◽  
A Current

The research objective consisted in studying of influence of coenzyme Q10 as a part of complex therapy of patients with the chronic heart failure (CHF) on indicators of quality of life in comparison with traditional therapy without coenzyme Q10 addition. The research included 75 patients with CHF 1-3 of FC, the coronary heart disease (CHD) which complicated a current with a myocardial infarction in the anamnesis In comparative aspect were analyzed dynamics of physical and psychological components of quality of life of patients with CHF 1-3 of FC under the influence of traditional therapy and traditional therapy with coenzyme Q10 addition. The indicators of quality of life defined on the basis of questionnaires of EQ-5D-DL and SF-36, supplementing a disease picture, are multiple-factor criterion for evaluation of a condition of patients with CHF 1-3 of FC. Improvement of indicators of quality of life is more expressed under the influence of traditional therapy with coenzyme Q10 addition.

P769Quality of life in outpatients with heart failure in relation to mortality and admissions for heart failure

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
M Grundtvig ◽  
T Vollnes-Eriksen ◽  
T Hole
Keyword(s):  
Quality Of Life ◽  
Heart Failure ◽  
Nyha Class ◽  
Functional Class ◽  
Physical Domain ◽  
Significant Independent Predictor ◽  
Nyha Functional Class ◽  
Daily Dose

Abstract Studies report relation between quality of life and outcome. However, less is known about how various aspects of quality of life relates to mortality and admissions for heart failure. Method Mortality was examined in 7001 patients with completed Minnesota Living with Heart Failure Questionnaire (MLWHFQ) at the first visit to specialised hospital outpatient clinics included in our registry. A subset of 4264 patients with a second MLWHFQ at a late follow-up visit was assessed for the number of admissions and days in hospital for reason of heart failure during a six months period prior to the late visit. Results In multivariate Cox proportional hazard regression model for time to death after the first visit with a median 19 months follow-up and 1001 deaths, the MLWHFQ score for the subset of the “physical domain” (question 2 to 9) was a significant independent predictor for mortality (P=0.002) adjusted for gender, NYHA-class, blood pressure, s-sodium, stroke, obstructive lung disease, eGFR, anemia, age, daily dose diuretic, and ischemic cause for heart failure. The total MLWHFQ score and the Minnesota “emotional domain” (question 17–21) were not significant variables when the MLWHFQ “physical domain” was entered in the analysis. The number of admissions for heart failure and the number of days in hospital for these admissions in a six months period prior to the late visit were analysed by linear regression for related variables. The total MLWHFQ score at the late visit was highly significant for the number of admissions in the six months period (p<0.001) adjusted for the daily dose diuretic, NYHA functional class and proBNP. The MLWHFQ “physical domain” and the MLWHFQ “emotional domain” were not significant variables when the total score was entered. The number of days in hospital was related to the daily dose diuretic, NYHA functional class, proBNP, and in addition anaemia at the late visit again with the MLWHFQ total score being a significant predictor (=0.001) Conclusions Disease specific quality of life measured with MLWHFQ “physical domain” was a highly significant predictor for mortality after the first visit. The late total MLWHFQ score was a better predictor for heart failure related admissions and days in hospital than the subset domains in multivariate analysis. Acknowledgement/Funding None

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