scholarly journals Current approaches to rehabilitation of patients with chronic heart failure

2010 ◽  
Vol 1 (1) ◽  
pp. 20-24 ◽  
Author(s):  
G. P Arutyunov ◽  
E. A Kolesnikova ◽  
A. K Rylova
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Treatment Adherence ◽  
Treatment Process ◽  
Functional Class ◽  
Respiratory Muscle Training ◽  
Class Iii ◽  
Muscle Training ◽  
Russian Study ◽  
Positive Results

The paper provides a critical review of the specific features of treatment in patients with Functional Class III-IV chronic heart failure (CHF). In addition, the authors give the positive results of their own studies dealing with respiratory muscle training in CHF. Greater treatment adherence by a patient is promoted by the attraction of his/her relatives to the treatment process. For wider involvement of physicians in the problem, the authors arranged a Russian study to increase the adherence of patients with CHF to treatment and rehabilitation, by attracting patients’ relatives to this process.

scholarly journals Remote monitoring of chronic heart failure patients: invasive versus non-invasive tools for optimising patient management

2019 ◽  
Vol 28 (1) ◽  
pp. 3-13 ◽  
Author(s):  
J. F. Veenis ◽  
J. J. Brugts
Keyword(s):  
Heart Failure ◽  
New York ◽  
Chronic Heart Failure ◽  
Remote Monitoring ◽  
Heart Association ◽  
The United States ◽  
Pharmacological Therapy ◽  
Functional Class ◽  
Class Iii ◽  
Additional Tool

AbstractExacerbations of chronic heart failure (HF) with the necessity for hospitalisation impact hospital resources significantly. Despite all of the achievements in medical management and non-pharmacological therapy that improve the outcome in HF, new strategies are needed to prevent HF-related hospitalisations by keeping stable HF patients out of the hospital and focusing resources on unstable HF patients. Remote monitoring of these patients could provide the physicians with an additional tool to intervene adequately and promptly. Results of telemonitoring to date are inconsistent, especially those of telemonitoring with traditional non-haemodynamic parameters. Recently, the CardioMEMS device (Abbott Inc., Atlanta, GA, USA), an implantable haemodynamic remote monitoring sensor, has shown promising results in preventing HF-related hospitalisations in chronic HF patients hospitalised in the previous year and in New York Heart Association functional class III in the United States. This review provides an overview of the available evidence on remote monitoring in chronic HF patients and future perspectives for the efficacy and cost-effectiveness of these strategies.

scholarly journals Selection of the optimal respiratory muscle training mode in patients with class II-III chronic heart failure

Kardiologiia ◽  
2021 ◽  
Vol 61 (2) ◽  
pp. 69-75
Author(s):  
A. G. Arutyunov ◽  
E. A. Kolesnikova ◽  
K. V. Ilyina ◽  
A. K. Rylova ◽  
G. P. Arutyunov ◽  
...  
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Muscle Mass ◽  
Respiratory Muscle ◽  
Training Group ◽  
Dynamic Loads ◽  
Diaphragm Muscle ◽  
Respiratory Muscle Training ◽  
Muscle Training ◽  
Combined Training

Aim To study the effect of various types of respiratory muscle training (RMT) in patients with functional class (FC) II-III chronic heart failure (CHF) and more than 70% preserved diaphragm muscle mass.Material and methods 53 patients (28 men and 25 women) aged 50-75 years with NYHA FC II-III ischemic heart disease (IHD) and arterial hypertension with more than 70% preserved diaphragm muscle mass of >70% were randomized to one of four RMT types: static loads, dynamic loads, their combination, and breathing without applied resistance as a control. Peak oxygen consumption (VO2 peak) and maximum inspiratory pressure (MIP) were evaluated at baseline and in 6 months.Results All study groups showed significant improvement of physical endurance indexes compared to baseline values (р<0.05). In pairwise comparison, the groups significantly differed (р<0.01). The greatest improvement was observed for patients of dynamic and combined training groups. Furthermore, in the combined training group, results were significantly higher than in the group of isolated dynamic loads. The most significant (р <0.01), positive changes in the force of inspiratory muscles were observed in groups of dynamic and combined trainings with the best results displayed by patients of the combined training group.Conclusion With preserving more than 70 % of diaphragm muscle tissue (as determined by MIP >60 cm H2O), a combination of static and dynamic RMT is most effective for patients with FC II-III CHF.

Regulatory Adaptive Status in Assessment of Efficacy of Pharmacotherapy and Prognostication of Complications in Functional Class III Chronic Heart Failure

Kardiologiia ◽  
2016 ◽  
Vol 1_2016 ◽  
pp. 12-17 ◽  
Author(s):  
V.G. Tregubov Tregubov ◽  
S.G. Kanorskiy Kanorskiy ◽  
V.M. Pokrovskiy Pokrovskiy ◽  
◽  
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Functional Class ◽  
Class Iii

scholarly journals Anemia in chronic heart failure patients: comparison between invasive and non-invasive prognostic markers

2005 ◽  
Vol 64 (2) ◽  
Author(s):  
Monica Ceresa ◽  
Soccorso Capomolla ◽  
GianDomenico Pinna ◽  
Eleonora Aiolfi ◽  
Maria Teresa La Rovere ◽  
...  
Keyword(s):  
Heart Failure ◽  
Regression Analysis ◽  
Chronic Heart Failure ◽  
Nyha Class ◽  
Functional Class ◽  
Prognostic Models ◽  
Class Iii ◽  
Cardiac Events ◽  
Non Invasive ◽  
Peak Vo2

Background: The prognosis of chronic heart failure (CHF) remains poor despite advances in medical management. Several different variables determine prognosis. Recently anemia has emerged as an independent prognostic variable in the evaluation of CHF. It is therefore important to analyze the role of anemia in patients with mild to severe CHF already well characterized by hemodynamic, echo- Doppler, and cardiopulmonary exercise testing. Objective: We performed this study to evaluate, in a large general cohort of CHF patients, the frequency of anemia and its correlation with their clinical profile. We assessed the prognostic value of anemia in relation to other known prognostic variables. Methods: Two-dimensional echocardiography, right heart catheterization, cardiopulmonary tests and laboratory examinations were performed in a population of 980 consecutive patients with CHF (53±9.4 years, 85% male, LVEF 25±8%; 45% with NYHA class III-IV). A hemoglobin (Hb) concentration less than 12 g/dl was used to define anemic patients. The primary end point was cardiac death or urgent heart transplantation. Results: Nineteen percent of patients were anemic. These patients had a lower body mass index (24±3 vs. 25±4 Kg/m2 p &lt;0.0004), a worse functional class (64% were in NYHA class III-IV vs 41% in the non-anemic group, p &lt;0.0001), poorer exercise capacity (12.4 vs. 14.8 ml/kg/min peak VO2, p &lt;0.0001) and increased right (7±5 vs. 5±4 mmHg, p &lt;.0004) and left (21±9 vs. 19±10 p &lt;0.007) ventricular filling pressures. During a 3-year follow-up cardiac deaths occurred in 236 (24%) and 52 (5%) of patients received an urgent heart transplant. On univariate regression analysis anemia was significantly correlated with these “hard” cardiac events (39% of anemic patients vs 27% of non-anemic patients). By multivariate logistic regression analysis different prognostic models were identified using non-invasive, with or without peak VO2, or invasive parameters. The prognostic model including anemia (AUCROC: 0.720) showed similar accuracy in predicting cardiac events to other prognostic models with peak VO2 (AUCROC: 0.719) or invasive variables (AUCROC: 0.719). Conclusions: The present study demonstrates that anemia in CHF patients is associated with prognosis, worse NYHA functional class, exercise capacity and hemodynamic profiles. The relationship between anemia and mortality is independent of other simple non-invasive prognostic factors. Prognostic models with more complex or invasive independent predictors did not increase the accuracy to predict cardiac mortality or the need for urgent transplantation.

scholarly journals Clinical traits of chronic heart failure in patients with arterial hypertension and senile asthenia syndrome: an observational cross-sectional study

2021 ◽  
Vol 28 (4) ◽  
pp. 25-40
Author(s):  
V. A. Safronenko ◽  
A. I. Chesnikova ◽  
A. V. Safronenko ◽  
N. S. Skarzhinskaya ◽  
I. I. Kuznetsov ◽  
...  
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Arterial Hypertension ◽  
Exercise Tolerance ◽  
Clinical Symptoms ◽  
Functional Class ◽  
Clinical Severity ◽  
Class Iii ◽  
Cross Sectional ◽  
Severity Scores

Background. A steady population aging and high incidence of arterial hypertension (AH) lead to a stable increase in chronic heart failure (CHF). The rate of senile asthenia syndrome (SAS) rises in people aged over 80 years and becomes an independent factor of cardiovascular complications.Objectives. The identification of risk factors (RF), comorbidity and clinical symptoms in elderly patients with CHF, AH and SAS.Methods. The study covered 161 AH and CHF patients aged over 80 years. Cohort 1 contained “frailty” patients with AH, CHF and SAS, cohort 2 — “strong” patients with AH, CHF but no SAS. RF, concomitant pathology, clinical symptoms and six-minute walk test were evaluated in all patients. Statistical analyses were performed with Statistica 12.0.Results. Cohort 1 had a higher incidence of atrial fibrillation (AF) (p = 0.001) and chronic kidney disease (CKD) (p = 0.036) compared to cohort 2. Frailty women revealed a higher AF incidence vs. frailty men (p = 0.0002). No-SAS patients had statistically significantly higher body mass index (BMI) (p = 0.047) and obese proportion (by 13.8%). Cohort 1 contained a significantly higher CHF FC III (functional class III), and cohort 2 — CHF FC II rate (p = 0.041). CHF FC III was significantly more frequent in frailty women, and CHF FC II — in frailty men (p = 0.018). Cohort 1 had higher clinical severity scores and a lower exercise tolerance compared to cohort 2 (p < 0.001).Conclusion. Patients with CHF and SAS had a more frequent comorbidity with AF and CKD, greater number of comorbidities and a significantly higher CHF FC III rate, especially in women. Frailty patients showed a greater CHF severity and lower exercise tolerance compared to noSAS individuals.

scholarly journals Ivabradine therapy effectiveness in patients with chronic heart failure, Functional Class III

2011 ◽  
Vol 10 (2) ◽  
pp. 69-74
Author(s):  
S. G. Kanorskiy ◽  
V. G. Tregubov ◽  
V. M. Pokrovskiy
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Blood Pressure Monitoring ◽  
Functional Class ◽  
Stage Iii ◽  
Class Iii ◽  
Treadmill Test ◽  
Positive Effects ◽  
Group I ◽  
Ras Status

Aim. To assess the effectiveness of ivabradine-including therapy, as well as the effects of ivabradine on regulatoryadaptive status (RAS), in patients with chronic heart failure (CHF), Functional Class (FC) III. Material and methods. The study included 100 patients with FC III CHF and coronary heart disease (CHD) and/ or Stage III arterial hypertension (AH). The participants were previously prescribed a complex treatment regime. After randomisation, Group I included 56 patients (mean age 62,9±1,8 years), who were additionally administered metoprolol succinate extended-release (mean dose 59,1±4,5 mg/day). Group II (n=44; mean age 59,4±1,3 years) was additionally administered an If channel inhibitor ivabradine, when beta-adrenoblocker (BAB) therapy was not possible. At baseline and 6 months later, participants underwent treadmill test (with VO2max assessment), echocardiography, 24-hour blood pressure monitoring, and the measurement of plasma levels of N-terminal probrain natriuretic peptide (NT-proBNP). RAS status was qualitatively assessed in a cardio-respiratory synchronism test. Results. Ivabradine-including therapy improved myocardial structure and function, increased exercise capacity, and demonstrated positive effects on plasma NT-proBNP levels, VO2мах during treadmill test, and RAS status.Conclusion. Ivabradine could be an alternative medication when BAB therapy is not possible in patients with FC III CHF and CHD and/or Stage III AH.

scholarly journals Evaluation of a chronic fatigue in patients with moderate-to-severe chronic heart failure

Medicina ◽  
2008 ◽  
Vol 44 (5) ◽  
pp. 366 ◽  
Author(s):  
Lina Jasiukevičienė ◽  
Donatas Vasiliauskas ◽  
Aušra Kavoliūnienė ◽  
Jolanta Marcinkevičienė ◽  
Regina Grybauskienė ◽  
...  
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Chronic Fatigue ◽  
Functional Class ◽  
Cortisol Concentration ◽  
Class Iii ◽  
Nyha Functional Class ◽  
Adrenal Axis ◽  
Hypothalamus Pituitary Adrenal Axis ◽  
Pituitary Adrenal Axis

The aim of the study. To evaluate the chronic fatigue and its relation to the function of hypothalamus-pituitary-adrenal axis in patients with New York Heart Association (NYHA) functional class III–IV chronic heart failure. Material and methods. A total of 170 patients with NYHA functional class III–IV chronic heart failure completed MFI-20L, DUFS, and DEFS questionnaires assessing chronic fatigue and underwent echocardiography. Blood cortisol concentration was assessed at 8:00 AM and 3:00 PM, and plasma N-terminal brain natriuretic pro-peptide (NT-proBNP) concentration was measured at 8:00 AM. Neurohumoral investigations were repeated before cardiopulmonary exercise test and after it. Results. The results of all questionnaires showed that 100% of patients with NYHA functional class III–IV heart failure complained of chronic fatigue. The level of overall fatigue was 54.5±31.5 points; physical fatigue – 56.8±24.6 points. Blood cortisol concentration at 8:00 AM was normal (410.1±175.1 mmol/L) in majority of patients. Decreased concentration was only in four patients (122.4±15.5 mmol/L); one of these patients underwent heart transplantation. In the afternoon, blood cortisol concentration was insufficiently decreased (355.6±160.3 mmol/L); reaction to a physical stress was attenuated (∆ 92.9 mmol/L). Plasma NTproBNP concentration was 2188.9±1852.2 pg/L; reaction to a physical stress was diminished (∆ 490.3 pg/L). Conclusion. All patients with NYHA class III–IV heart failure complained of daily chronic fatigue. Insufficiently decreased blood cortisol concentration in the afternoon showed that in the presence of chronic fatigue in long-term cardiovascular organic disease, disorder of a hypothalamus-pituitary-adrenal axis is involved.

118 NT-proBNP values and Weber functional class classification in patients with chronic heart failure

2007 ◽  
Vol 6 (1) ◽  
pp. 29-29
Author(s):  
R FERNANDES ◽  
R SOARES ◽  
J FELICIANO ◽  
J SERRA ◽  
A MAMEDE ◽  
...  
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Functional Class

Benefit of Selective Respiratory Muscle Training on Exercise Capacity in Patients With Chronic Congestive Heart Failure

Circulation ◽  
1995 ◽  
Vol 91 (2) ◽  
pp. 320-329 ◽  
Author(s):  
Donna M. Mancini ◽  
David Henson ◽  
John La Manca ◽  
Lisa Donchez ◽  
Sanford Levine
Keyword(s):  
Heart Failure ◽  
Congestive Heart Failure ◽  
Exercise Capacity ◽  
Respiratory Muscle ◽  
Respiratory Muscle Training ◽  
Chronic Congestive Heart Failure ◽  
Muscle Training
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