Quality of life of CHD patients with normal and moderately lowered left ventricular ejection fraction before and after endomyocardial cellular cardiomyoplasty

Aim. To determine effectiveness of combination therapy with lisinopril and fosinopril in patients with chronic heart failure (CHF) with preserved left ventricular ejection fraction (LV EF), considering its impact on the regulatory and adaptive capabilities organism. Materials and methods. 80 patients were examined with CHF II functional class with preserved systolic function of the left ventricle (left ventricular ejection fraction ≥50%) (classification of the New York Heart Association) in the presence of hypertension disease (HD) III stage and/or ischemic heart disease (IHD). Randomly divided into two equal groups. In the first group was appointed for treatment with lisinopril (the average dose was 14.0±3.8 mg/day), in the second group - fosinopril (the average dose - 14.7±4.2 mg/day). All patients were prescribed nebivolol (7.1±2.2 mg/day and 6.8±2.1 mg/day). Depending on the concomitant pathology were appointed acetylsalicylic acid in the intestinal shell (100 mg/day, n=9 and 100 mg/day, n=10) and atorvastatin (15.3±4.9 mg/day, n=15 and 16.5±4.8 mg/day, n=17). Initially and after six months later of combined pharmacotherapy studied: a quantitative assessment of regulatory and adaptive capabilities of the organism, echocardiography, treadmill test, six-minute walk test, determination in blood plasma of the N-terminal precursor of the natriuretic brain peptide level, all-day monitoring of blood electrocardiograms and pressure. The quality of life was also assessed using a questionnaire. Results. Both treatment regimens of patients equally improved the structural and functional parameters of the heart, reduced neurohumoral activity, optimized heart rate and pulse. In this case, treatment with fosinopril is more pronounced positively regulatory-adaptive capacity and tolerance to physical load, and also there was an improvement in the quality of life. Conclusion. In patients with CHF with preserved LV EF, in the presence of HD and/or IHD combined pharmacotherapy with fosinopril in comparison with lisinopril probably is preferable due to the more pronounced increase in regulatory and adaptive capabilities.

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The North American experience with the Ablate and Pace Trial (APT) for medically refractory atrial fibrillation

EP Europace ◽

10.1053/eupc.1998.0001 ◽

1999 ◽

Vol 1 (1) ◽

pp. 22-25 ◽

Cited By ~ 14

Author(s):

M. A. Wood ◽

G. N. Kay ◽

K. A. Ellenbogen

Keyword(s):

Quality Of Life ◽

Atrial Fibrillation ◽

Left Ventricular Ejection Fraction ◽

Ejection Fraction ◽

Left Ventricular ◽

Ventricular Ejection ◽

Left Ventricular Ejection ◽

Ventricular Ejection Fraction ◽

One Year

Abstract The Ablate and Pace Trial (APT) was a prospective registry study of clinical outcomes and survival following ablation and pacing therapy for medically refractory atrial fibril-lation. One hundred and fifty-six patients were enrolled at 16 centres in North America. The mean patient age was 66±11 years, with mean left ventricular ejection fraction of 48%±18%. Seventy-eight percent of the patients had structural heart disease. During one year of follow up, multiple measures of quality-of-life showed significant and sustained improvement following ablation and pacing therapy. Also, left ventricular ejection increased significantly for patients with baseline left ventricular ejection fraction <45%. Metabolic exercise testing showed trends toward improved exercise tolerance; however, these did not achieve statistical significance. The one year overall survival was 85%, with 3% of patients experiencing sudden death. In summary, this large, non-randomized, trial showed significant improvement in quality of life and left ventricular function following ablation and pacing therapy. Ablation and pacing therapy is a viable strategy for palliative management of patients with medically refractory, highly symptomatic atrial fibrillation.

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Interim Results of the BYHEART Observational Study: Exogenous Phosphocreatine Effect on the Quality of life of Patients with Chronic Heart Failure

Kardiologiia ◽

10.18087/cardio.2021.7.n1649 ◽

2021 ◽

Vol 61 (7) ◽

pp. 22-27

Author(s):

S. N. Tereschenko ◽

N. B. Perepech ◽

I. A. Cheremisina ◽

V. N. Belov ◽

Y. A. Vollis ◽

...

Keyword(s):

Quality Of Life ◽

Heart Failure ◽

Chronic Heart Failure ◽

Left Ventricular Ejection Fraction ◽

Ejection Fraction ◽

Left Ventricular ◽

Ventricular Ejection ◽

Left Ventricular Ejection ◽

Ventricular Ejection Fraction

Aim Improvement of quality of life is one of the most important goals for the treatment of patients with chronic heart failure (CHF). This study searched for ways to increase the efficiency of CHF treatment based on parameters of quality of life in CHF patients during and after the treatment with exogenous phosphocreatine (EP).Material and methods The effect of a single course of EP treatment on quality of life of patients with functional class (FC) II-IV CHF with reduced or mid-range left ventricular ejection fraction was studied as a part of the all-Russia prospective observational study BYHEART. The presence of FC II-IV CHF and a left ventricular ejection fraction <50 % were confirmed by results of 6-min walk test (6MWT) and findings of echocardiography after stabilization of the background therapy.Results An interim data analysis showed that the course of EP treatment was associated with a significant improvement of quality-of-life indexes as determined by the Minnesota Living with Heart Failure Questionnaire (LHFQ) total score. These indexes significantly increased and remained at a satisfactory level for 6 mos. following completion of the treatment course. Also, the treatment significantly beneficially influenced the clinical condition of patients (heart failure severity scale), results of 6MWT, and the increase in left ventricular ejection fraction.Conclusion The conclusions based on results of the interim analysis should be confirmed by results of the completed study. Complete results are planned to be published in 2022.

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Pentoxyphylline: possibilities to reduce manifestations of chronic heart failure with preserved left ventricular ejection fraction in elderly

Zaporozhye Medical Journal ◽

10.14739/2310-1210.2021.1.224839 ◽

2021 ◽

Vol 23 (1) ◽

pp. 24-31

Author(s):

V. B. Shatylo ◽

L. A. Bodretska ◽

I. S. Shapovalenko ◽

H. P. Voinarovska ◽

Zh. S. Butynets

Keyword(s):

Quality Of Life ◽

Heart Failure ◽

Chronic Heart Failure ◽

Left Ventricular Ejection Fraction ◽

Ejection Fraction ◽

Left Ventricular ◽

Ventricular Ejection ◽

Left Ventricular Ejection ◽

Ventricular Ejection Fraction

The aim: to study the effect of add-on pentoxifylline therapy on the structural and functional indicators of the heart state, endothelial function, quality of life and physical abilities in patients with chronic heart failure with preserved left ventricular ejection fraction. Materials and methods. The indicators of the structural and functional state of the heart, endothelial function, quality of life and physical abilities of patients older than 60 years, who were followed-up in the Department of Cardiology of the State Institution “D. F. Chebotarev Institute of Gerontology of the NAMS of Ukraine”, based on 67 case histories, 37 of them were prescribed pentoxifylline as add-on therapy to the standard therapeutic regimen. Statistical data were calculated using modern application packages, in particular SPSS v.22, Statistica 7.0, MedCalc statical software v.11.5.0.0. The significance level was assessed using paired and unpaired Student's t-test with Bonferroni corrections, and the correlation and two-way analysis of variance were performed. Results. A significant additional effect of pentoxifylline treatment on the indicators of maximum blood flow in the forearm microvessels in response to the reactive hyperemia test, which characterizes the ability of the microvessel endothelium to synthesize relaxation factors, was detected. Patients who additionally received pentoxifylline showed significantly better indicators of left ventricular myocardial relaxation and reduction of hypertrophy than those on the standard therapy. There was a significant increase in walking distance in the third year of treatment in the patients who additionally received pentoxifylline. There was no difference in the impact on the quality of life of the patients. Conclusions. The addition of pentoxifylline to the standard therapy in patients with chronic heart failure with preserved left ventricular ejection fraction significantly reduces myocardial hypertrophy, improves diastolic relaxation, increases volumetric blood flow velocity in microvessels mediating reactive hyperemia, which may contribute to further stabilizing the clinical course of the disease and increasing 6-minute walking distance. The presented data are an additional evidence of pathogenetically reasonable therapy with pentoxifylline in patients with chronic heart failure with preserved left ventricular ejection fraction, which allows us to consider this drug as potentially promising for the routine treatment of such patients.

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Rest and exercise left ventricular ejection fraction before and after therapy in young adults with hyperthyroidism and hypothyroidism

The American Journal of Cardiology ◽

10.1016/0002-9149(87)91056-3 ◽

1987 ◽

Vol 60 (10) ◽

pp. 929-931 ◽

Cited By ~ 19

Author(s):

Robert C. Smallridge ◽

Michael H. Goldman ◽

Kristen Raines ◽

Stephen Jones ◽

Douglas Van Nostrand

Keyword(s):

Young Adults ◽

Left Ventricular Ejection Fraction ◽

Ejection Fraction ◽

Left Ventricular ◽

Ventricular Ejection ◽

Left Ventricular Ejection ◽

Ventricular Ejection Fraction ◽

Before And After ◽

Rest And Exercise

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The functional state of the heart in women prior to extracorporeal fertilization and its dynamics after stimulation of superovulation

Pediatrician (St Petersburg) ◽

10.17816/ped10659-65 ◽

2020 ◽

Vol 10 (6) ◽

pp. 59-65

Author(s):

Victoria V. Vakareva ◽

Marina V. Avdeeva ◽

Larisa V. Scheglova ◽

Varvara V. Popova ◽

Pavel B. Voronkov

Keyword(s):

Left Ventricular Ejection Fraction ◽

Ejection Fraction ◽

Functional State ◽

Left Ventricular ◽

Ventricular Ejection ◽

Left Ventricular Ejection ◽

Ventricular Ejection Fraction ◽

Healthy Women ◽

Myocardial Stress ◽

Before And After

The purpose of the work to study echocardiographic parameters before and after the induction of superovulation to determine the nature of the effect of extracorporeal fertilization on the functional state of the cardiovascular system in healthy women of reproductive age. Materials and methods. The article presents the results of clinical and instrumental examination of 80 practically healthy women (mean age 32.3 3.5 years). All women were examined twice before and after induction of superovulation during extracorporeal fertilization. Results. It was established that a decrease in the stroke volume of blood (p 0.001) was accompanied by a compensatory increase in heart rate (p 0.001). These changes ensured the stability of the minute blood volume after induction of superovulation (before 51.1 1.1 ml; after 52.1 1.2 ml; p 0.05). After induction of superovulation in women, an increase in the integral systolic index of cardiac remodeling was noted (before 108.7 2.5 units; after 118.5 4.7 units; p 0.001), an indicator of myocardial stress in systole (before 111.5 6.7 dyne/cm2; after 127.3 7.4 dyne/cm2; p 0.001) and the indicator of myocardial stress in diastole (before 139.4 6.8 dyne/cm2; after 165.7 7.9 dyne/cm2; p 0.001). In practically healthy women, after induction of superovulation, the left ventricular ejection fraction increased (before 71.3 4.2%; after 74.8 4.1%; p 0.001). The revealed dynamics is regarded as a response of the myocardium to a change in the hormonal background during superovulation induction. This is evidenced by the correlation between the estradiol level and the left ventricular ejection fraction (r = 0.36; p 0.05). Conclusion. Induction of superovulation does not adversely affect systolic and diastolic function of the left ventricle. However, after these manipulations there is an increase in systolic and diastolic myocardial stress, which reflects myocardial stress in response to hemodynamic changes. Remodeling indices are more informative for evaluating maladaptive and adaptive variants of myocardial changes in healthy women than traditional echocardiographic indicators. In this regard, remodeling indices should be used as additional indicators of the functional state of the heart in women before and after the induction of superovulation in vitro fertilization.

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Quality of life in patients with heart failure with preserved ejection fraction and the bendopnea symptom

Kardiologiia ◽

10.18087/cardio.2507 ◽

2019 ◽

Vol 59 (6S) ◽

pp. 24-32

Author(s):

D. O. Dragunov ◽

A. V. Sokolova ◽

G. P. Arutyunov ◽

A. D. Gasanova ◽

T. V. Latyshev

Keyword(s):

Quality Of Life ◽

Left Ventricular Ejection Fraction ◽

Ejection Fraction ◽

Physical Functioning ◽

Salt Intake ◽

Left Ventricular ◽

Left Ventricular Ejection ◽

Ventricular Ejection Fraction ◽

Sf 36

Purpose. The study of quality of life (QOL) in patients with CHF with preserved LVEF (left ventricular ejection fraction) and a symptom of bendopnea with diﬀerent levels of salt intake. Materials and methods. The study included 66 patients. The main symptoms of CHF were edema in 54.5% of cases, dyspnea in 77% of cases, ascites was detected in only 2 patients, an enlarged liver in 7 patients. Abdominal obesity was detected in 53 patients. Quality of life was assessed by the SF‑36 questionnaire, the level of salt intake was assessed by the Charlton: SaltScreener questionnaire. Results. On average, the time of occurrence of the bendopnea was 22.5±9.3 seconds, the minimum was 5 seconds. The absence of the eﬀect of abdominal obesity on the risk of bendopnea (relative risk 1.18 [0.76; 1.83]) was revealed. According to the SF‑36 questionnaire, a decrease in physical health indicators (median 31.3 points [20.7; 42.3]) and psychological health (average score 43.2±21.7) was found. In patients with bendopnea, QOL was reduced due to both physical and mental health, unlike patients without bendopnea: physical functioning (Physical Functioning – PF) 24.8±16.1 against 47±28.9 points, p=0.001 ; role‑based functioning due to physical condition (Role‑Physical Functioning – RP), 0 [0; 25] vs. 37.5 [0; 100] points, p=0.008; general health (General Health – GH) 29.9±15.8 against 50±14.2 points, p=0.0005, social functioning (Social Functioning – SF) 56 ± 38 against 78.9 ± 17.8 points ; p = 0.004. Multidimensional regression analysis revealed the relationship between the time of occurrence of the symptom bendopnea and the level of salt intake, physical and psychological activity (r2=0.25; p<0.009). The time of onset of the symptom of bendopnea in patients with CHF decompensation was significantly longer (18.9±8.7 vs. 26.2±8.5 seconds, p=0.003). The presence of diseases such as hypertension, COPD, IHD, atrial fibrillation, cerebrovascular disease did not significantly aﬀect QOL (p> 0.05), while the presence of bronchial asthma or chronic kidney disease significantly reduced QOL of patients (p<0.05). Conclusion. The presence of the symptom bendopnea significantly reduces the quality of life of patients with CHF with preserved LVEF (left ventricular ejection fraction).

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