Serum Magnesium, Calcium and Phosphorus status in Heart Failure patients attending tertiary care center of Nepal

Background: Lack of proper diet and use of different medications in heart failure contributes to electrolyte imbalance. Due to absence of routine measurement, their abnormalities are not recognized. This study is an attempt to portrait a picture of serum levels of electrolytes in heart failure patients Materials and Methods: 102 heart failure patients were enrolled in this study over 6 months period. Serum levels of magnesium, calcium, phosphorus, sodium and albumin were measured. SPSS ver. 20.0 was used to analyze the data. Analysis of Variance was used to find mean differences and Pearson’s correlation was used to establish the correlation. Results: Majority of patient fell under New York Heart Association (NYHA) class II and had isolated systolic heart failure. Mean serum values of sodium and magnesium were below the reference range. Mean values of serum sodium, magnesium and corrected calcium was less in patients receiving diuretics and digitalis. Likewise, serum phosphorus was more with diuretics and digitalis use. Also, serum sodium was less in Acetylcholine Eseterose (ACE) inhibitors use. Isolated diastolic heart failure patients had least serum calcium values. Although, serum sodium and magnesium value in heart failure patients was positively correlated, was not statistically significant. Conclusion: This study showed that low serum sodium and magnesium values are frequently associated in heart failure. Disturbances in other serum electrolytes could also be other cause of complications in heart failure which are not under routine investigation. Identification and correction of these disturbances could have significant impact. However, further studies are required to reinforce this idea.

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Abstract 18599: Clinical Assessment of Hemodynamic Profiles Predict Readmission and Mortality in Diastolic Heart Failure Patients

Circulation ◽

10.1161/circ.132.suppl_3.18599 ◽

2015 ◽

Vol 132 (suppl_3) ◽

Author(s):

Mohammed Siddiqui ◽

Salpy V Pamboukian ◽

Jose A Tallaj ◽

Michael Falola ◽

Sula Mazimba

Keyword(s):

Heart Failure ◽

Clinical Assessment ◽

Diastolic Heart Failure ◽

Clinical Care ◽

Systolic Heart Failure ◽

Health Care Expenditures ◽

Left Ventricular ◽

Readmission Rates ◽

Heart Failure Patients ◽

Increased Risk

Background: Reducing 30 day readmission rates for patients with heart failure (HF) has been a recent focus of lowering health care expenditures. Hemodynamic profiles (HP) have been associated with clinical outcomes in chronic systolic HF. The relationship of HP to outcomes in acute decompensated diastolic HF (DHF) has not been defined. Methods: This case-control study of 1892 DHF patients discharged alive from an academic hospital between 2002-2012 with left ventricular function greater or equal to 45% were categorized into 4 groups: Profile A, no evidence of congestion and hypoperfusion (dry-warm); Profile B, congestion with adequate perfusion (wet-warm); Profile C, congestion with hypoperfusion (wet-cold); and Profile L, hypoperfusion without congestion (dry-cold). All cause readmissions at 30 days and 1 year and mortality at 30 days and 1 year were examined. Statistical analysis using multivariable Cox Proportional hazard model was performed adjusting for demographic, clinical, care and hospital characteristics. Results: Of the 1892 patients, 1196 (63%) were females; mean age was 68 (±14) years. There were 724(38%), 1000 (53%), 88(5%) and 80 (4%) patients in the hemodynamic profiles A, B, C and L respectively. Profiles B and C were associated with an increased risk for 30-day all-cause HF readmission compared to profiles A and L: Hazard ratio (HR) [1.38 (95% C.I 1.17-1.61)], [1.39 (95% C.I 1.18-1.62)] for B and C profiles respectively. Profiles C and L were associated with increased mortality at 1 year: HR [1.46 (95% CI 1.06-1.89)] and [1.31 (95% CI 1.01-1.64)] for A and L profiles respectively (Table). Conclusions: Clinical assessment of HP can help identify DHF patients at increased risk of readmission and mortality, similar to systolic heart failure patients.

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Characteristics, management modalities and outcome in chronic systolic heart failure patients treated in tertiary care centers: results from the EVIdence based TreAtment in Heart Failure (EVITA-HF) registry

Clinical Research in Cardiology ◽

10.1007/s00392-014-0743-x ◽

2014 ◽

Vol 103 (12) ◽

pp. 1006-1014 ◽

Cited By ~ 33

Author(s):

W. von Scheidt ◽

C. Zugck ◽

M. Pauschinger ◽

R. Hambrecht ◽

O. Bruder ◽

...

Keyword(s):

Heart Failure ◽

Tertiary Care ◽

Systolic Heart Failure ◽

Evidence Based ◽

Evidence Based Treatment ◽

Heart Failure Patients ◽

Chronic Systolic Heart Failure ◽

Tertiary Care Centers

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Renal function, serum sodium level, and outcomes in hospitalized systolic heart failure patients

Medicine ◽

10.1097/md.0000000000003898 ◽

2016 ◽

Vol 95 (25) ◽

pp. e3898 ◽

Cited By ~ 1

Author(s):

Jin Joo Park ◽

In-Ho Chae ◽

Dong-Ju Choi ◽

Seok-Min Kang ◽

Byung-Su Yoo ◽

...

Keyword(s):

Heart Failure ◽

Renal Function ◽

Serum Sodium ◽

Sodium Level ◽

Serum Sodium Level ◽

Systolic Heart Failure ◽

Heart Failure Patients

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Exploring the opinion of stakeholders about self-care, home care and hospital management of heart failure patients: A qualitative study

International Journal of Care Coordination ◽

10.1177/2053434520982224 ◽

2020 ◽

Vol 23 (4) ◽

pp. 137-146

Author(s):

Bandna Kumari ◽

Sukhpal Kaur ◽

Monika Dutta ◽

Parag Barwad ◽

Ajay Bahl

Keyword(s):

Heart Failure ◽

Qualitative Study ◽

Family Caregivers ◽

Healthcare Professionals ◽

Care Center ◽

Tertiary Care ◽

Self Care ◽

Hospital Management ◽

Heart Failure Patients ◽

Management Protocol

Introduction Heart failure is a widespread chronic cardiac illness with varying etiologies. If the HF patients manage themselves at home by following the appropriate advice by healthcare professionals, they tend to have better quality of life and less readmissions. This study was aimed to identify and explore practices of self-management by heart failure patients, home management of heart failure by their family caregivers and hospital management by healthcare providers. Methods A qualitative study was conducted in a tertiary care center in Northern India on participants (patients, their family caregivers, doctors and nurses) who were recruited purposively and interviewed individually by principle investigator using semi-structured questionnaires. Interviews were audio recorded and transcribed after taking informed consent. Iterative process including coding, reviewing and analyzing was done by four researchers and themes were finalized. Results Total 41 participants (15 patients, 12 family caregivers, 4 doctors and 10 nurses) completed the interviews. It was observed that patients and family caregivers were not able to manage heart failure efficiently. Nurses and doctors reported many barriers to provide specialized care to these patients. Discussion There were definite barriers and challenges in the management of heart failure symptoms by the stakeholders. For the patients and family members who suffer this debilitating illness, managing heroically is a challenge. It is important to develop self-care management protocol for the heart failure patients. Healthcare professionals must overcome the barriers to train patients and family caregivers. Multidisciplinary integration can fulfill the gap in providing care to such patients.

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Health Related Quality of Life in Systolic Heart Failure Patients at Tertiary Care Unit Cardiology OPD Hayatabad Medical Complex Peshawar Pakistan

Pakistan Journal of Public Health ◽

10.32413/pjph.v10i3.501 ◽

2021 ◽

Vol 10 (3) ◽

pp. 140-146

Author(s):

Ahsan Ullah ◽

Ayaz Ayub ◽

Bakhtawar Shah ◽

Rahmat Ghaffarr ◽

Awal Khan ◽

...

Keyword(s):

Quality Of Life ◽

Heart Failure ◽

Nyha Class ◽

Tertiary Care ◽

Systolic Heart Failure ◽

Demographic Variables ◽

Class Iii ◽

Heart Failure Patients ◽

Related Quality

Background: Heart failure is a leading cardiac morbidity prevalent across the globe. Its incidence is rising in direct proportion to increasing longevity all over the world. Demographic variables are important predictors of quality of life, morbidity, rehospitalization, and mortality due to systolic heart failure. The objective of our study was to assess the association of demographic variables with quality of life of systolic heart failure in patients presenting at Cardiology Out Patient Department, Hayatabad Medical Complex, Peshawar. Our study aims to inform policy making as it highlights some important demographics factors associated with quality of life. Methods: A cross sectional method was employed in the study to examine systolic heart failure and its prevalence across various demographic variables such as age, gender, marital status, activity, number of children, education, employment status, and BMI at cardiology OPD of a medical teaching institution in Peshawar. Consecutive sampling was used and data were collected through a structured questionnaire from 368 Systolic Heart Failure patients. Data were analyzed using SPSS version 22. Results: We had 368 participants, a majority of whom (n=290; 78.8%), were in NYHA class III. The rest (n=78; 21.2%) were in class IV. Minnesota Living with Heart Failure Questionnaire (MLHFQ) was used to categorize quality of life into ‘Good’, ‘Moderate’ and ‘Poor’. Most participants were in the ‘poor’ category with MLHFQ scores >45 (n=193; 52.4%). Those who had scores between 25 -45 were categorized as ‘moderate’ (n=116; 31.5%), and participants who scored < 24 were categorized as having a ‘good’ quality of life (n=59; 16%). Reliability of tools was checked by Cronbach alpha which was 0.86 Conclusion: It was concluded that demographic variables have a significant effect on the overall morbidity of heart failure patients and heart failure related quality of life.

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Tissue doppler imaging for estimation of left ventricular filling pressure in patients with systolic and diastolic heart failure: a comparative simultaneous doppler catheterization study

International Journal of Advances in Medicine ◽

10.18203/2349-3933.ijam20200088 ◽

2020 ◽

Vol 7 (2) ◽

pp. 319

Author(s):

Manohar J. Suranagi ◽

K. Subramanyam ◽

K. S. Subramani ◽

K. H. Srinivasa

Keyword(s):

Heart Failure ◽

Tissue Doppler Imaging ◽

Diastolic Heart Failure ◽

Systolic Heart Failure ◽

Tissue Doppler ◽

Left Ventricular ◽

Filling Pressure ◽

Doppler Imaging ◽

Heart Failure Patients ◽

Mitral Annular Velocity

Background: Noninvasive assessment of diastolic filling by Doppler echocardiography provides important information about left ventricular (LV) status in selected subsets of patients. This study was designed to assess whether the lateral mitral annular velocity as assessed by tissue Doppler imaging is associated with invasive measures of diastolic LV performance in patients with diastolic and systolic heart failure. Aim of the study was to compare the diagnostic accuracy of lateral mitral annular E/E′ as an estimate of LV filling pressure with invasive LVEDP measurement in subjects with systolic or purely diastolic heart failure.Methods: Total 100 patients were studied, 50 patients with diastolic heart failure and 50 patients with systolic heart failure in patients undergoing diagnostic coronary angiogram. Detailed 2D Echocardiography, Trans mitral Doppler and Tissue Doppler velocities of lateral mitral annulus was obtained. The ratio of peak mitral velocity (E) to lateral mitral annular velocity (E′) by TDI (E/E′) was calculated.Results: The ratio of E/E′ in diastolic group was 13.4±4.9 and in systolic group it was 13.7±5.2. The mean LVEDP in diastolic heart failure patients was 14.3±4.5 and 14.2±4.9 in systolic heart failure patients. The ratio of E/E′ showed a better correlation with LVEDP. E/E′ <8 accurately predicted normal LVEDP, and E/E′ >15 identified increased LVEDP ≥15mmHg.Conclusions: E/E′ is a reliable estimate of LV filling pressures in subjects with systolic and diastolic heart failure. In subjects with diastolic heart failure, E/E′ seems helpful to identify those with truly elevated LV filling pressures. In patients with diastolic heart failure and normal E/E′, a search for other causes of symptoms (pulmonary disease, obesity and so forth) may be warranted.

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