scholarly journals Peripheral Muscle Microcirculation Dynamics During Strength Exercise in Heart Failure Patients: A Cross-Sectional Study

Author(s):  
Amanda Vale-Lira ◽  
Natália Turri-Silva ◽  
Kenneth Verboven ◽  
João Luiz Quagliotti Durigan ◽  
Gaspar R. Chiappa ◽  
...  

Abstract This cross-sectional study aimed to compare the muscle microcirculation dynamics via near-infrared spectroscopy (NIRS) response during an isokinetic muscle strength test and ultrasound-derived parameters in heart failure patients with preserved or reduced ejection fraction phenotypes (HFpEF and HFrEF, respectively) and different functional severities (Weber Class A, B, and C). Twenty-eight aged-matched patients with HFpEF (n = 16) and HFrEF (n = 12) were assessed. Within HFpEF, Weber Class C patients presented a worse capability to reach a greater oxygen extraction during exercise than Classes A and B. Among those with Weber C severity, while HFrEF patients reached lower oxyhemoglobin (O2Hb, µM) (-10.9 ± 3.8 vs. -23.7 ± 5.7, p = 0.029) during exercise, HFpEF kept a lower O2Hb during the recovery period (-3.0 ± 3.4 vs. 5.9 ± 2.8, p = 0.007). Among the ultrasound-derived variables, HFpEF, Weber Class C, also presented a higher echo intensity than HFrEF patients (29.7 ± 8.4 vs. 15.1 ± 6.8, p = 0.017). Our study reveals more pronounced impairments in local microcirculatory dynamics in HFpEF vs. HFrEF patients during muscle strength exercise, combined with muscle-skeletal abnormalities detected via ultrasound imaging, which may help to explain the commonly observed exercise intolerance in HFpEF patients.

Author(s):  
Amanda Vale-Lira ◽  
Natália Turri-Silva ◽  
Kenneth Verboven ◽  
João Luiz Quagliotti Durigan ◽  
Alexandra Corrêa de Lima ◽  
...  

Exercise intolerance, a hallmark of patients with heart failure (HF), is associated with muscle weakness. However, its causative microcirculatory and muscle characteristics among those with preserved or reduced ejection fraction (HFpEF or HFrEF) phenotype is unclear. The musculoskeletal abnormalities that could result in impaired peripheral microcirculation are sarcopenia and muscle strength reduction in HF, implying lowered oxidative capacity and perfusion affect transport and oxygen utilization during exercise, an essential task from the microvascular muscle function. Besides that, skeletal muscle microcirculatory abnormalities have also been associated with exercise intolerance in HF patients who also present skeletal muscle myopathy. This cross-sectional study aimed to compare the muscle microcirculation dynamics via near-infrared spectroscopy (NIRS) response during an isokinetic muscle strength test and ultrasound-derived parameters (echo intensity was rectus femoris muscle, while the muscle thickness parameter was measured on rectus femoris and quadriceps femoris) in heart failure patients with HFpEF and HFrEF phenotypes and different functional severities (Weber Class A, B, and C). Twenty-eight aged-matched patients with HFpEF (n = 16) and HFrEF (n = 12) were assessed. We found phenotype differences among those with Weber C severity, with HFrEF patients reaching lower oxyhemoglobin (O2Hb, μM) (−10.9 ± 3.8 vs. −23.7 ± 5.7, p = 0.029) during exercise, while HFpEF reached lower O2Hb during the recovery period (−3.0 ± 3.4 vs. 5.9 ± 2.8, p = 0.007). HFpEF with Weber Class C also presented a higher echo intensity than HFrEF patients (29.7 ± 8.4 vs. 15.1 ± 6.8, p = 0.017) among the ultrasound-derived variables. Our preliminary study revealed more pronounced impairments in local microcirculatory dynamics in HFpEF vs. HFrEF patients during a muscle strength exercise, combined with muscle-skeletal abnormalities detected via ultrasound imaging, which may help explain the commonly observed exercise intolerance in HFpEF patients.


Author(s):  
Julious Julious ◽  
Jusak Nugraha ◽  
Mohammad Aminuddin

Introduction. Heart failure is a health problem in Indonesia. The 2013 Basic Health Research Data showed that the estimated heart failure in Indonesia was 530,068 people. Echocardiography examination which has been a routine examination of heart failure patients is not necessarily available in all hospitals, so that a more applicable and inexpensive alternative examination is needed. Previous studies have shown an increase in C3c levels associated with improved survival and better cardiac remodeling. On this basis, this research needs to be performed in order to determine the correlation between C3c complement levels, NT-proBNP and LVEF in heart failure patients. Method. A cross-sectional study was conducted at the Dr Soetomo Hospital between August 2018 to September 2018 with 30 samples. Samples were taken consecutively from patients with heart failure who were treated at the integrated heart service center. Examination of C3c complement, NT-proBNP and echocardiography (LVEF data) was carried out in all patients. Result. The result of this study showed no significant correlation between C3c complement and NT-proBNP (r = -0.253, p = 0.177). The correlation between C3c complement and LVEF was also not significant (r = -0.074, p = 0.696). A significant moderate correlation between NT-proBNP and LVEF was found (r = -0.444, p = 0.014). Conclusion. The C3c complement could not be used as an alternative examination for NT-proBNP and LVEF. The limitations of the study were heterogeneous sample characteristics. A further study with more stringent criteria is needed to minimize the bias of examination results.


Author(s):  
Nazuk Eraj Qureshi ◽  
Simran Batra ◽  
Muhammad Tanzeel Ul Haque ◽  
Javeria Saquib ◽  
Noorulain Qureshi ◽  
...  

Aims: Congestive heart failure affects about five million Americans and has become an increasingly frequent reason for hospital admission during the last two decades. It represents a significant health problem. The aim of this study was to enumerate the frequency of self-care and to study the factors affecting adherence to self-care in patients with heart failure. Study Design: Cross-sectional study. Place and Duration of Study: Department of Cardiology and Department of Medicine in three public sector hospitals of Karachi, between March 2020 and September 2020. Methodology: In this study, 187 heart failure patients from three hospitals were surveyed with consent. Demographic details of the participants were also collected, which included gender, mean age, BMI, education, living and marital status, smoking history, an ejection fraction <40, cancer, chronic kidney disease, diabetes mellitus, hypertension, dyslipidemia, atrial fibrillation, and coronary artery bypass graft procedure in patients. The data were analyzed through SPSS v. 25.0 using an adherence scale. A cumulative score of ≥32/40 (80%) was termed as good adherence. In an individual question, a score of four or five and zero to three inclusive was taken as good and poor adherence, respectively. Results: It was found that patients who were not educated (65.8%, n=123), with age > 65years (67.4%, n=126) and with no history of coronary artery bypass grafting surgery (94.1%, n=176) had a significantly bad impact on heart-failure self-care (P-value<0.05). Good adherence was seen in 16.6% of the patients (n=31). Hence, most of the patients were non-adherent. Conclusion: There is an urgent need to counsel patients regarding heart failure self-care for a better prognosis of the disease. Government and doctors together should take part in enlightening the issue.


2021 ◽  
Vol 18 (3) ◽  
pp. 155
Author(s):  
AbdulwasiuAdeniyi Busari ◽  
OlagokeKorede Ale ◽  
EmmanuelS Irokosu ◽  
AkinwumiAkinyinka Akinyede ◽  
SikiruO Usman ◽  
...  

2020 ◽  
pp. 105477382096124
Author(s):  
Tsegu Hailu Gebru ◽  
Kalayou Kidanu Berhe ◽  
Weyzer Tilahun Tsehaye ◽  
Haftea Hagos Mekonen ◽  
Kbrom Gemechu Kiros ◽  
...  

The purpose of this study was to assess the prevalence of self-care behavior and associated factors among heart failure patients. This institutional-based cross-sectional study design was done in Tigray region, Ethiopia. The data collection process was made between February and April 2018. An interviewer assisted structured questionnaire and medical chart review was used to collect the data. Data was entered and analyzed using Statistical Package for the Social Science (SPSS) version 22. Bivariate and multivariable logistic regression were conducted to identify the predictors ( p < .05). In this study, a total of 408 study subjects was included. The mean age of the participants was 45.4 (±19). The overall prevalence of good self-care behavior was 45.8% (95% CI: 40.9–50.5). Regression analysis revealed that age, educational level, co-morbidity, knowledge about heart failure, and social support were significantly associated with self-care behavior. Healthcare providers should strengthen patient education to improve self-care behavior.


2015 ◽  
Vol 23 (5) ◽  
pp. 888-894 ◽  
Author(s):  
Andressa Freitas da Silva ◽  
Ana Carla Dantas Cavalcanti ◽  
Mauricio Malta ◽  
Cristina Silva Arruda ◽  
Thamires Gandin ◽  
...  

Objectives: to analyze treatment adherence in heart failure (HF) patients followed up by the nursing staff at specialized clinics and its association with patients' characteristics such as number of previous appointments, family structure, and comorbidities.Methods: a cross-sectional study was conducted at two reference clinics for the treatment of HF patients (center 1 and center 2). Data were obtained using a 10-item questionnaire with scores ranging from 0 to 26 points; adherence was considered adequate if the score was ≥ 18 points, or 70% of adherence.Results: a total of 340 patients were included. Mean adherence score was 16 (±4) points. Additionally, 124 (36.5%) patients showed an adherence rate ≥ 70%. It was demonstrated that patients who lived with their family had higher adherence scores, that three or more previous nursing appointments was significantly associated with higher adherence (p<0.001), and that hypertension was associated with low adherence (p=0.023).Conclusions: treatment adherence was considered satisfactory in less than a half of the patients followed up at the two clinics specialized in HF. Living with the family and attending to a great number of nursing appointments improved adherence, while the presence of hypertension led to worse adherence.


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