MODERN APPROACHES OF THE DIAGNOSIS AND PROGNOSIS OF OCCUPATIONAL CHRONIC HYPERSENSITIVE PNEUMONITIS

2021 ◽  
Author(s):  
L.V. Artemova ◽  
◽  
A.S. Kovaleva ◽  
Keyword(s):  
Heart Failure ◽  
Gas Exchange ◽  
Pulmonary Fibrosis ◽  
Clinical Symptoms ◽  
Contact Period ◽  
Radiological Criteria ◽  
Diagnosis And Prognosis ◽  
Significant Difference ◽  
Hypersensitive Pneumonitis

Abstract: Modern diagnostics of chronic hypersensitive pneumonitis of occupational origin (CHP) requires a dynamic clinical examination, even in the long-term post-contact period, can occurs with the progression of pulmonary fibrosis. Pulmonary fibrosis contributes to the formation of pulmonary heart failure and worsening of the prognosis. Purpose: to evaluate the clinical picture and dynamics of the course of CHP to determine the prognosis. Methods: 54 patients with CHP various etiologies were examined. There were studied clinical, functional and instrumental indicators in dynamics for 3 years. Results: the analysis revealed a significant difference in clinical symptoms, the degree of restrictive violations of ventilation function, changes in gas exchange, HRCT-criteria, evaluation of respiratory tests, the presence of specific sensitization, etc., which determine a different individual prognosis of the disease. Conclusions: confirmation of the study of clinical and radiological criteria in dynamics in order to assess the prognosis for improving the complex of treatment and rehabilitation measures was obtained.

scholarly journals CORRELATION BETWEEN VAS OPRESSIN CONCENTRATION AND CHRONIC HEART FAILURE SEVE RITY: CHARAC TERISTICS OF PA TIENTS WITH TERMINAL AND DECOMPE NSA TED HEART FAILURE

The Clinician ◽  
2018 ◽  
Vol 12 (1) ◽  
pp. 36-42
Author(s):  
E. S. Trofimov ◽  
A. S. Poskrebysheva ◽  
N. А. Shostak
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Clinical Symptoms ◽  
Left Ventricular ◽  
Stage Iii ◽  
Left Ventricular Ejection ◽  
Control Group ◽  
Ventricular Ejection Fraction ◽  
Significant Difference ◽  
Functional Classes

Objective: to evaluate vasopressin (VP) concentration in patients with varying severity of chronic heart failure (CHF), intensity of clinical symptoms, and decreased level of left ventricular ejection fraction (LVEF). Materials and methods. In total, 120 patients (44 males, 76 females) with CHF of varying genesis (mean age 72.12 ± 10.18 years) and 30 clinically healthy individuals (18 males, 12 females) as a control group (mean age 33.4 ± 6.23 years) were examined. All patients underwent comprehensive clinical and instrumental examination in accordance with the standards for patients with CHF. The VP level was determined using ELISA. Statistical analysis was performed using the IBM SPSS Statistics v. 23 software.Results. The patients with CHF had significantly higher blood VP levels compared to the control group (72.91 ± 53.9 pg/ml versus 6.6 ± 3.2 pg/ml respectively; p <0.01). At the same time, patients with stage III CHF had significantly lower VP levels than patients with stages IIВ and IIА (35.61 ± 21.53 pg/ml versus 71.67 ± 48.31 pg/ml and 86.73 ± 59.78 pg/ml respectively; p<0.01). A similar picture was observed for the functional classes (FC). For instance, for CHF FC II and III, the VP level was 91.93 ± 67.13 pg/ml and 77.95 ± 54.01 pg/ml respectively, while for FC IV it decreased to 50.49 ± 28.18 pg/ml (p <0.01). The VP concentration in patients who subsequently perished was significantly lower than in patients who survived (48.79 ± 26.30 pg/ml versus 79.72 ± 57.73 pg/ml; p = 0.012). Moreover, in patients with LVEF <50 %, the VP level was significantly lower than in patients with LVEF >50 % (59.43 ± 42.51 pg/ml versus 86.43 ± 62.46 pg/ml respectively; p <0.05).Conclusion. The observed significant differences in VP in patients with stage III and IV CFH can indicate depletion of neurohumoral mediators in this patient category. However, a correlation between the VP level and the level of LVEF decrease can indicate a significant difference in the role of VP in CHF pathogenesis in patients with preserved and decreased LVEF. This observation requires further research.

P3453Gender difference in impact of ischemic heart disease on long-term outcome in patients with heart failure reduced ejection fraction

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
H J Kim ◽  
M A Kim ◽  
D I Lee ◽  
H L Kim ◽  
D J Choi ◽  
...  
Keyword(s):  
Heart Failure ◽  
Clinical Outcomes ◽  
Survival Rates ◽  
Free Survival ◽  
Reduced Ejection Fraction ◽  
Clinical Events ◽  
Significant Difference ◽  
Patients With Heart Failure

Abstract Background Ischemic heart disease (IHD) is a major underlying etiology in patients with heart failure (HF). Although the impact of IHD on HF is evolving, there is a lack of understanding of how IHD affects long-term clinical outcomes and uncertainty about the role of IHD in determining the risk of clinical outcomes by gender. Purpose This study aims to evaluate the gender difference in impact of IHD on long-term clinical outcomes in patients with heart failure reduced ejection fraction (HFrEF). Methods Study data were obtained from the nationwide registry which is a prospective multicenter cohort and included patients who were hospitalized for HF composed of 3,200 patients. A total of 1,638 patients with HFrEF were classified into gender (women 704 and men 934). The primary outcome was all-cause death during follow-up and the composite clinical events of all-cause death and HF readmission during follow-up were also obtained. HF readmission was defined as re-hospitalization because of HF exacerbation. Results 133 women (18.9%) were died and 168 men (18.0%) were died during follow-up (median 489 days; inter-quartile range, 162–947 days). As underlying cause of HF, IHD did not show significant difference between genders. Women with HFrEF combined with IHD had significantly lower cumulative survival rate than women without IHD at long-term follow-up (74.8% vs. 84.9%, Log Rank p=0.001, Figure 1). However, men with HFrEF combined with IHD had no significant difference in survival rate compared with men without IHD (79.3% vs. 83.8%, Log Rank p=0.067). After adjustment for confounding factors, Cox regression analysis showed that IHD had a 1.43-fold increased risk for all-cause mortality independently only in women. (odds ratio 1.43, 95% confidence interval 1.058–1.929, p=0.020). On the contrary to the death-free survival rates, there were significant differences in composite clinical events-free survival rates between patients with HFrEF combined with IHD and HFrEF without IHD in both genders. Figure 1 Conclusions IHD as predisposing cause of HF was an important risk factor for long-term mortality in women with HFrEF. Clinician need to aware of gender-based characteristics in patients with HF and should manage and monitor them appropriately and gender-specifically. Women with HF caused by IHD also should be treated more meticulously to avoid a poor prognosis. Acknowledgement/Funding None

The Effect of Echocardiography Based on Lipid Nano Contrast Agent on Cardiology Patients with Heart Failure and Atrial Fibrillation

2021 ◽  
Vol 21 (2) ◽  
pp. 852-858
Author(s):  
Lizhong Wang ◽  
Jianing Xi ◽  
Qian Cao ◽  
Yaowen Jia ◽  
Zhenying Zhang ◽  
...  
Keyword(s):  
Heart Failure ◽  
Atrial Fibrillation ◽  
Contrast Agent ◽  
Stress Echocardiography ◽  
Clinical Symptoms ◽  
Diastolic Heart Failure ◽  
Significant Difference ◽  
Patients With Heart Failure ◽  
Before And After ◽  
Conventional Echocardiography

This paper discusses the effect and evaluation of echocardiography based on lipid nano contrast agent on patients with heart failure and atrial fibrillation in cardiology department, providing reference for clinical diagnosis and treatment. Fifty two patients with diastolic heart failure diagnosed by echocardiography were selected for routine echocardiographic examination after optimizing the drug treatment scheme, and then the patients underwent treadmill exercise test and stress echocardiography evaluation. The results of conventional echocardiography and stress echocardiography after treatment were compared with those before treatment, and the clinical parameters and biochemical indexes before and after treatment were compared. Results after treatment, the clinical symptoms of the patients improved, the level of NT proBNP in the N-terminal forebrain decreased significantly, and the exercise tolerance increased significantly. Compared with the conventional echocardiography before and after treatment, the left ratio and e′ value of stress echocardiography after treatment increased significantly, while E/e′ decreased significantly. There was no significant difference in the indexes of general echocardiography before and after treatment. After treatment, positively correlated with the ratio of peak a to peak E. The results show that the sensitivity of stress echocardiography to evaluate ischemic diastolic heart failure has been improved, and some indexes have clinical significance. Compared with conventional echocardiography, it can effectively evaluate the therapeutic effect of drugs.

scholarly journals Effectiveness of Cognitive Behavioral Therapy to Reduce Depression, Anxiety and Stress among Hospitalized Patients with Congestive Heart Failure in Central Java

Jurnal NERS ◽  
2020 ◽  
Vol 14 (3) ◽  
pp. 367
Author(s):  
Dian Hudiyawati ◽  
Ajie Maulana Prakoso
Keyword(s):  
Heart Failure ◽  
Clinical Symptoms ◽  
Psychological Symptoms ◽  
Behavioral Therapy ◽  
Demographic Data ◽  
Hospitalized Patients ◽  
Case Group ◽  
Chi Square ◽  
Study Results ◽  
Significant Difference

Introduction: Psychological problems in patients with heart failure are the result of a combination of the influence of behavior and interactions with physiological responses, which if not handled properly will contribute to worsening clinical symptoms and have a higher risk of rehospitalization. The objective of the study was to evaluate the effects of cognitive behavior therapy (CBT) on psychological symptoms among CHF patients.Methods: This was a quasi-experimental, pretest-posttest control study that applying a CBT to overcome depression, anxiety, and stress. Thirty eligible respondents were recruited and were randomly divided into a case group and waiting list group. Psychological symptoms of respondents were measured using Depression, Anxiety and Stress Scale – 21 questionnaires (DASS-21). Chi-square was used to compare demographic data between groups and T-test analysis was used to describe changes in mean scores between and within groups. Both groups had similar characteristics and psychological symptoms level at baseline.Results: The mean score of depression, anxiety and stress showed a significant difference within the group after the intervention (p<0.05).Conclusion: A recent study found that CBT was effective to reduce psychological symptoms among CHF patients. Based on the study results it can be highlighted that it is important for nurses to provide brief CBT to hospitalized patients in an effort to reduce short term psychological symptoms.

scholarly journals Angina Severity at the Time of Revascularization in Patients With Diabetes Mellitus and Its Association With Long-term Outcomes: A Multicenter Cohort Study.

2021 ◽  
Author(s):  
Nozomi Niimi ◽  
Satoshi Shoji ◽  
Mitsuaki Sawano ◽  
Nobuhiro Ikemura ◽  
Yasuyuki Shiraishi ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Heart Failure ◽  
Hazard Ratio ◽  
Adjusted Hazard Ratio ◽  
Contributing Factors ◽  
Long Term Outcomes ◽  
Coronary Syndrome ◽  
Significant Difference ◽  
Patients With Diabetes

Abstract Background: While angina severity is pertinent in determining the management strategy for patients with stable ischemic heart disease (SIHD), its contributing factors and prognostic effect remain unclear, particularly in patients with diabetes mellitus (DM). Methods: From a multicenter percutaneous coronary intervention (PCI) registry, 1,911 consecutive SIHD patients without previous revascularization or heart failure between 2008 and 2015 were analyzed. Angina severity was assessed by the Canadian Cardiovascular Society (CCS) functional classification at the time of PCI. We assessed the contributing factors of CCS III/IV angina. Further, the association between CCS III/IV angina and subsequent occurrence of major adverse cardiac and cerebrovascular events (MACCE: all-cause death, acute coronary syndrome, heart failure, and stroke) within 2 years were analyzed in patients with DM and without DM.Results: A total of 771 SIHD patients (40.3% of all SIHD patients) had DM at the time of revascularization. In the total cohort, 52.4% had CCS I/II, and 13.0% had CCS III/IV angina, with less prevalence of CCS III/IV angina in patients with DM than in those without DM (11.3% vs. 14.2%, P<0.001). In patients with DM, the prevalence of unprotected left main coronary trunk lesions and proximal left anterior descending lesion increased with angina severity. The presence of severe angina at the time of PCI was associated with MACCE in patients with DM (adjusted hazard ratio 1.93; [95% CI 1.01, 3.71]; P=0.047), while no significant difference in those without DM (adjusted hazard ratio 0.82; [95% CI 0.42, 1.59]; P=0.55).Conclusions: In SIHD patients with DM that underwent PCI, severe angina at the time of revascularization was associated with complex coronary anatomies and long-term outcomes. These findings underscore the importance of evaluating angina-related health status while considering revascularization in SIHD patients with DM.

scholarly journals Clinical and laboratory features of 48 feline hyperthyroidism cases in Japan

2014 ◽  
Vol 4 (1) ◽  
Author(s):  
Shinichi Namba ◽  
Nami Matsubara ◽  
Mayuko Ishikawa ◽  
Yurie Arase ◽  
Akiko Doi ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Heart Failure ◽  
Neurological Disorders ◽  
Hind Limb ◽  
Clinical Symptoms ◽  
Endocrine Disorder ◽  
Significant Difference ◽  
Laboratory Features ◽  
Complete Blood Counts ◽  
Hind Limb Paralysis

Feline hyperthyroidism (HT) is a common endocrine disorder worldwide, but clinical and laboratory features might vary geographically. The aim of this retrospective study was to evaluate feline HT in Japan, and compare results to those of previous study for feline HT. We evaluated 48 feline HT cases clinical and laboratory features. Surprisingly, the youngest patient was 32 months of age (2 year 9 months). There was no significant difference among the study subjects in sex, but frequency of spayed/castrated cats was high (85.4%). Median age was 186 months (32-272 months). 91.3% (n=42) of subjects were over 10 years of age, and 8.7% (n=4) were under 10 years of age. Clinical symptoms included vomiting, 56.3% (n=27); diarrhea, 2.1% (n=1); hyperactivity, 12.5% (n=6); emaciation, 41.7% (n=20); polyuria and polydipsia, 22.9% (n=11); chronic weight loss, 60.4% (n=29); and palpated enlarged thyroid, 2.1% (n=1). Concurrent findings included chronic kidney disease, 20.8% (n=10); congestive heart failure, 20.8% (n=10); tachycardia (over 240 beats/min), 18.8% (n=9); gallop rhythm, 31.3% (n=15); neurological disorders such as hind-limb paralysis, 14.6% (n=7); cystitis, 8.7% (n=4); gingivitis, 4.2% (n=2); diabetes mellitus, 4.2% (n=2); and arterial thromboembolism, 6.3% (n=3). In addition, laboratory features (complete blood counts and biochemistry) differed from those of previous reports in certain respects. Our results show that it might be important for practitioners to comprehend epidemiologic differences regarding feline HT worldwide.

Abstract 15403: Is the Sum Greater Than the Whole? Association of Heart Risk Factors and Echocardiographic Parameters With Reduction in 6-Minute Walk Test in Stage A Heart Failure

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Mark T Nolan ◽  
Ying Wang ◽  
Hilda Yang ◽  
Thomas H Marwick
Keyword(s):  
Risk Factors ◽  
Heart Failure ◽  
Walk Test ◽  
Prior Chemotherapy ◽  
6Mwt Distance ◽  
Significant Difference ◽  
Echocardiographic Parameters ◽  
6 Minute Walk Test ◽  
Minute Walk

Introduction: Chemotherapy increases long-term risk of heart failure (HF), but its impact relative to other HF risk factors is unknown. 6 minute walk test (6MWT) provides prognostic information regarding hospitalization and mortality in HF patients. We sought the relative role of these factors on echocardiographic changes and 6MWT. Hypothesis: Prior chemotherapy is associated with greater functional impairment than other stage A HF risk factors. Methods: We recruited 521 asymptomatic pts from the community aged ¬>65 years with stage A heart failure (SAHF, based on at least one of: diabetes, obesity, hypertension, coronary artery disease or chemotherapy). All went echocardiographic studies and 6MWT. 45 patients had previous chemotherapy (mean interval 7±7.5 years) and underwent 6MWT. These patients were matched 2:1 using demographic and clinical characteristics with patients who did not receive chemotherapy. Fisher’s test and independent t-test were used for statistical analysis. Results: There were no significant difference in demographic variables. The chemotherapy group had a significantly lower 6MWT distance (mean difference -155m) and significantly higher proportion of patients with 6MWT distance < 400m (26.7% vs. 11%, p=0.043). There were no significant difference in other echocardiographic parameters assessing systolic, diastolic and geometrical parameters. Conclusion: Prior chemotherapy has a significant long-term effect on functional capacity in comparison with other SAHF factors. As no one echo parameter was associated with this difference, this could potentially be secondary to noncardiac (including vascular) parameters.

Abstract 18183: Short-term Impact of Defibrillation Testing on Heart Failure Admission

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Baris Akdemir ◽  
Balaji Krishnan ◽  
Venkatakrishna Tholakanahalli ◽  
David Benditt ◽  
Jian-Ming Li
Keyword(s):  
Heart Failure ◽  
Retrospective Study ◽  
Short Term ◽  
Primary Endpoints ◽  
Significant Difference ◽  
Heart Failure Admission ◽  
The Mean ◽  
Demographic Features ◽  
Long Term Mortality

Introduction: SIMPLE trial showed that defibrillation testing (DT) is safe but does not improve shock efficacy or mortality. However, impact of DT on heart failure (HF) admission at 30 days is unclear. Objectives: The aim of this study was to compare mortality and HF admission of ICD recipients who underwent DT (DT+) compared with those who did not (DT-). Methods: In this retrospective study, we analyzed consecutive patients who received an ICD ( new implant or generator change ) with DT+ and DT- between January 2008 and May 2014 from our ICD registry. Primary endpoints were death ( 30 days and 1 year ) and HF admission ( 30 days) . Results: Of the 501 patients, 311 patients (62,1%) were in DT+ group vs 190 (37,9%) were in DT- group. The mean ages in DT+ and DT- were 66 ± 10 and 70 ± 10 respectively (p<0.0001). DT- group had more generator change than DT+ group ( 61,1% versus 30,9%, p < 0.0001). Other demographic features were not significantly different between two groups (Table 1). No significant difference in mortality was found between two groups at 30 days and 1 year. HF admission at 30 days was significantly higher in DT+ group than in DT- group ( 17,4 % versus 4,7%, p < 0.0001) (Table 2). Conclusion: No short-term and long-term mortality were associated with DT, but DT was associated with increased HF admission at 30 days. Future prospective studies are needed to prove this association.

scholarly journals Telemonitoring in patients with heart failure: Is there a long-term effect?

2017 ◽  
Vol 25 (3) ◽  
pp. 158-166 ◽  
Author(s):  
Arno J Gingele ◽  
Hanspeter Brunner-la Rocca ◽  
Bram Ramaekers ◽  
Anton Gorgels ◽  
Gerjan De Weerd ◽  
...  
Keyword(s):  
Heart Failure ◽  
Hospital Admission ◽  
Rank Test ◽  
Long Term Effects ◽  
Long Term Outcome ◽  
Log Rank Test ◽  
Significant Difference ◽  
All Cause Mortality

Introduction Evidence suggests that telemonitoring decreases mortality and heart failure (HF)-related hospital admission in patients with HF. However, most studies follow their patients for only several months. Little is known about the long-term effects of telemonitoring after a period of application. Methods In 2007, the TEHAF study was initiated to compare tailored telemonitoring with usual care with respect to time until first HF-related hospital admission. In total, 301 patients completed the study after a follow-up period of one year. No differences could be found in time to first HF-related admission between intervention and control groups. Here, we performed a retrospective analysis in order to investigate potential long-term effects of telemonitoring. The primary endpoint was time to first HF-related hospital admission. Secondary endpoints were, amongst others, all-cause mortality, hospital admission due to HF and days alive and out of hospital (DAOOH). Electronic files of all included patients were reviewed between October 2007 and September 2015. Result Mean follow-up duration was 1652 days (standard deviation: 1055 days). No significant difference in time to first HF-related hospital admission (log-rank test, p = 0.15), all-cause mortality (log-rank test, p = 0.43), or DAOOH (two-sample t-test, p = 0.87) could be found. However, patients that underwent telemonitoring had significantly fewer HF-related hospital admissions (incident rate ratio 0.54, 95% confidence interval 0.31–0.88). Discussion Telemonitoring did not significantly influence the long-term outcome in our study. Therefore, extending the follow-up period of telemonitoring studies in HF patients is probably not beneficial.

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