scholarly journals Clinical manifestation features of chronic heart failure with comorbid obesity in consideration of cytochrome P450 system CYP2D6*4 gene polymorphism

2020 ◽  
Vol 86 (1) ◽  
pp. 9-16
Author(s):  
I.C. Gasanov ◽  
I.S. Ryduk ◽  
O.O. Medentseva ◽  
T.V. Lozyk
Keyword(s):  
Quality Of Life ◽  
Heart Failure ◽  
Cytochrome P450 ◽  
Chronic Heart Failure ◽  
Clinical Manifestation ◽  
Genetic Research ◽  
Main Group ◽  
Control Group ◽  
Cytochrome P450 System

In order to assess the characteristics of the clinical manifestation of CHF with obesity, taking into account the polymorphism of the CYP2D6*4 gene of the cytochrome P450 system in terms of patient’s quality of life a prospective randomized controlled trial was conducted, 127 people (93 men and 34 women) aged 32-87 (61) years with CHF of II—III stages, 1^1 functional class according to the classification of the New York Heart Association (NYHA) have been examined. The main group consisted of 73 patients with obesity of 1 degree and higher, the comparison group consisted of 54 patients without obesity, the control group consisted of 21 people without cardiovascular disorders. Research methods included estimation of clinical symptom score scale, 6-minute walk test, quality of life (with the Minnesota questionnaire for patients with heart failure), assessment of subjective symptoms and course of the disease, anthropometric data, determination of objective signs of the disease; instrumental methods (Doppler echocardiography, basic laboratory examination, etc.), as well as genetic research (G1846A variants of the CYP2D6 gene real-time polymerase chain reaction), statistical non-parametric methods (with 0.05 p-value thresold). It is shown, that in the clinical aspect, patients of the main group have been characterized by a tendency to more expressive pathological manifestations of CHF, especially in carriers of the heterozygous GA variant of the CYP2D6*4 gene of the cytochrome P450 system. According to the Minnesota questionnaire, the clinical condition of patients and the quality of life in case of GG polymorphism variant was better than in GA carriers of the CYP2D6*4 genotype variant of the cytochrome P450 system. Keywords: chronic heart failure, quality of life, obesity, genetic polymorphism, treatment, prognosis.

Effect of Acupoint Meridian Therapeutic Exercise on Cardiac Function in Patients with Chronic Heart Failure

2021 ◽  
Vol 46 (3) ◽  
pp. 177-189
Author(s):  
Tingying Hu ◽  
Haodengjie Xiong ◽  
Huilin Zhou ◽  
Yujie Song ◽  
Zhilin Zhang ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Heart Failure ◽  
Chronic Heart Failure ◽  
Cardiac Function ◽  
Left Ventricular Ejection ◽  
Control Group ◽  
Therapeutic Exercise ◽  
Cardiopulmonary Function ◽  
Experimental Group

Objective: To investigate the effect of acupoint meridian therapeutic exercise on cardiopulmonary function in patients with chronic heart failure (CHF).<br/> Methods: One hundred patients diagnosed with CHF at the Department of Cardiology from June 2019 to October 2019 were enrolled. One hundred patients were randomly divided into an experimental group (n = 50) and a control group (n = 50) according to the treatment they received. The experimental group received conventional treatment combined with acupoint meridian therapeutic exercise for three months. The patients in the two groups were compared in terms of their results on the six-minute walk test and their cardiac function grade, plasma brain natriuretic peptide (BNP) concentration, left ventricular ejection fraction (LVEF), and quality of life.<br/> Results: A statistically significant increase in six-minute walking distance was observed in the experimental group compared with the control group. Cardiac function and plasma BNP concentration decreased and LVEF and quality of life increased.<br/> Conclusion: Acupoint meridian therapeutic exercise improves exercise tolerance, cardiopulmonary function, and quality of life in patients with CHF.

scholarly journals The influence of myocardoprotection on the course of postinfarction chronic heart failure

2020 ◽  
pp. 64-65
Author(s):  
A.A. Ruzieva
Keyword(s):  
Quality Of Life ◽  
Myocardial Infarction ◽  
Heart Failure ◽  
Chronic Heart Failure ◽  
Control Group ◽  
Positive Trend ◽  
Quality Of Life Indicators ◽  
Number Of Patients ◽  
Group 1

Objective. To study the effect of Thiotriazoline in patients with post-infarction chronic heart failure (CHF). Materials and methods. We examined 46 patients with ischemic heart disease (IHD) who had undergone myocardial infarction. The average age was 50.8±3.2 years; men – 32 (70 %), women – 14 (30 %). All patients were examined in the form of anamnesis and examination, general clinical and biochemical studies, electrocardiography. The assessment of CHF manifestations in patients of both groups was carried out according to the New York classification based on the results of the 6-minute walk test. The distribution into two groups was carried out according to the following parameters: the 1st group included 26 (56.5 %) patients (men – 19 [73.1 %], women – 7 [26.9 %]), who, along with basic therapy, received Thiotriazoline at a dose of 8.0 intravenously jet for 10 days; the 2nd (control) group included 22 (43.5 %) patients (men – 14 [63.6 %], women – 8 [36.4 %]) who received standard therapy (β-blockers, angiotensin-converting enzyme inhibitors, calcium antagonists, nitrates). Distribution by class of CHF at the time of inclusion in the study was observed in 1st group in 21 (80.7 %) patients: I functional class (FC) – 2 (9.5 %), II FC – 11 (52.4 %), III FC – 6 (28.6 %) and IV FC – 2 (9.5 %). In 2nd group – (77.3 %) patients: I FC – 3 (17.6 %), II FC – 6 (35.3 %), III FC – 7 (41.2 %) and IV FC – 1 (5.9 %) patients. According to the Minnesota questionnaire in group 1, the quality of life indicators (average value in points) were 71.1±1.8 points (p<0.05). The 2nd group had 67.9±1.9 points (p<0.05). Results and discussion. Positive hemodynamics and assessment of CHF manifestations by FC served as a clear statement of improvement in the quality of life. In the group receiving Thiotriazoline, the number of patients with II FC increased from 11 (42.3 %) to 14 (54 %), I FC – from 2 (9.5 %) to 6 (23 %) compared to the initial data due to patients from III FC and IV FC. The number of patients with III FC decreased to 2 (7.8 %) and IV FC – to 1 (3.8 %), and in the control group there was a slight negative dynamic (III FC – to 2 (9.5 %) and IV FC – without changes). The quality of life according to the Minnesota questionnaire indicated a positive trend. In group 1, the quality of life indicators improved from 71.1±1.8 to 53.3±0.6 points (p<0.01); in group 2 – from 67.9±1.9 to 63.3±1.9 points (p<0.05). Conclusions. Thiotriazoline is a cytoprotector of the highest class, in particular, a myocardoprotector, which, when used (from 10 days in a hospital and then up to 1 month), improves the metabolism of the heart muscle, stabilizing intracellular mechanisms. Thiotriazoline is indicated for all patients with IHD who have suffered a myocardial infarction in the early stages of CHF.

scholarly journals Effective Metods Of Treatment For Chronic Heart Failure In Elderli Women

2020 ◽  
Vol 02 (12) ◽  
pp. 125-133
Author(s):  
Adizova D.R. ◽  
Keyword(s):  
Quality Of Life ◽  
Heart Failure ◽  
Chronic Heart Failure ◽  
Training Program ◽  
Intervention Group ◽  
Self Control ◽  
Control Group ◽  
Study Group ◽  
Number Of Visits

To study the effectiveness of teaching "self-care" and "self-control" in elderly and senile patients with chronic heart failure. The study included 107 patients with chronic heart failure. The training program was attended by 54 patients who made up the study group. 53 untrained patients made up the control group. These sessions were conducted with patients for 7 days, 1 hour per day. To assess the effectiveness of the training program, adherence to treatment was assessed using the Morisky-Green scale and the quality of life was assessed using the Minnesota questionnaire on the quality of life of patients. Results. During 1 year of follow-up, feedback was interrupted with 17 patients (15,8%) due to various reasons. Out of 90 subjects of observation, only 6 patients (6,7%) died due to the deterioration of their condition and the development of associated conditions. The assessment of the number of visits by patients to family polyclinics showed a generally satisfactory level of clinical examination in the study group - the average rate of planned visits was 3,2. In the control group, the average number of visits was 2,5 per year. There was a statistically significantly lower number of unplanned visits to the study group compared to patients from the control group. As a result, there was a significant decrease in the number of unplanned visits in the intervention group as a whole. Conclusion. The program of training elderly and senile patients on the aspects of self-medication and self-control in chronic heart failure is effective in improving the control of their adherence to therapy and the prognosis of the disease.

P771Metoprolol succinate efficacy in patients with chronic heart failure on the background of obesity: genetic aspects of individual sensitivity and tolerability

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
I Gasanov ◽  
O Medentseva ◽  
I Rudyk ◽  
V Galchinskaya
Keyword(s):  
Quality Of Life ◽  
Heart Failure ◽  
Heart Rate ◽  
Chronic Heart Failure ◽  
Left Ventricle ◽  
Control Group ◽  
Individual Sensitivity ◽  
Cyp2d6 Gene ◽  
Metoprolol Succinate

Abstract Background The cornerstone of modern cardiology is the problem of comorbidity, the combination of chronic heart failure (CHF) with obesity as well. Efficacy of treatment with beta-blockers in different patients varies significantly, partly depending on genotypically determined features of its metabolization with enzymes. Purpose To improve the CHF treatment with metoprolol succinate efficacy in patients with obesity by detection of genetic aspects of individual sensitivity and tolerability. Methods A prospective randomized dynamic (1 year) study was conducted involving 127 patients with CHF II–III stages at the age of 32–87 years; they were distributed into main group with combination of CHF and obesity (73 patients) and control group with only CHF (54 patients). The examination included an assessment of CYP2D6 gene 1846G/A polymorphism, clinical symptoms, quality of life (by Minnesota questionnaire), 6-minute walk test data, doppler echocardiography, heart rate variability, serum insulin, N-terminal prohormone of brain natriuretic peptide (NT-proBNP). Metoprolol succinate was administered according to a standard regimen with dose titration every 2 weeks from 12.5 to 100–200 mg. The critical p-level was 0.05. Results An association of “unfavorable” allele A with an increase in body weight was found (p=0.05). As a result of treatment, better indicators of the clinical status were found in control group (6 [5; 7] versus 7 [6; 8] points in obese patients, p=0.05) and quality of life in patients with genotype GG than the GA genotype (p<0,05). The use of metoprolol succinate in patients with GG genotype is associated with more pronounced positive dynamics of treatment efficacy. In contrast to the carriers of the GA genotype, in patients with the GG genotype there were an increase in left ventricle ejection fraction (by 21.5% versus 9.3%, p<0.01) and the reduction of the left ventricle end-diastolic size (p=0.02). The GG genotype carriers significantly increased the amount of exercise tolerance (p<0.05), and showed a more pronounced improvement in quality of life (p<0.03) and the clinical state (p=0.05), as well as the normalization of the vegetative balance (LF/HF index). The level of serum NT-proBNP in the GG genotype was lower than in patients with GA genotype (p=0.05). At the same time, patients with a GA genotype showed a more pronounced decrease in heart rate compared to those with a GG genotype (p<0.05). In carriers of the GA genotype, a tendency to a greater incidence of side effects compared with the GG genotype (bradycardia 42.0% vs. 28.0%, p<0,05; cold extremities 44.0% vs. 32.0%, p<0.05, fatigue 39.0% vs. 31.0%, p<0.05, headache 32.0% vs. 24.0%, p<0,10, drowsiness 38,0% vs. 27,0%, p<0,05). Conclusions It is useful to take into account the CYP2D6 gene 1846G/A polymorphism in order to improve the CHF treatment with metoprolol succinate in patients with obesity.

scholarly journals Exercise Rehabilitation Improves Heart Function and Quality of Life in Elderly Patients with Chronic Heart Failure

2022 ◽  
Vol 2022 ◽  
pp. 1-12
Author(s):  
Xingyun Peng ◽  
Liuquan Tang
Keyword(s):  
Quality Of Life ◽  
Heart Failure ◽  
Chronic Heart Failure ◽  
Elderly Patients ◽  
Heart Function ◽  
Failure Process ◽  
Life Assessment ◽  
Control Group ◽  
Exercise Rehabilitation

With the acceleration of the aging process, there are more and more elderly patients with chronic heart failure. Chronic heart failure has severely affected the heart function and quality of life of the elderly. This article aims to study the further improvement of the heart function and the quality of life of elderly patients with chronic heart failure through exercise rehabilitation. In this paper, experimental analysis and comparative analysis are adopted, the experimental group and the control group are designed, the adaptive heart rate and breathing rate algorithm is adopted, the heart failure symptom assessment scale and the quality of life assessment tool are selected, and the two groups of different rehabilitation forms are compared. Data collection, sorting, and analysis of the patient’s conditions are utilized. Through the use of exercise rehabilitation, the heart failure process will be slower and the recovery of heart strength will be faster than the control group. Before the experiment, the probability of shortness of breath in the two groups of patients with chronic heart failure symptoms was as high as 84.08%, and the symptom clusters were more serious; after the experiment, the SV and EF values after exercise rehabilitation were higher than those of the control group ( p < 0.05 ). The quality of life in the realm, emotional realm, and other realms has been significantly improved. For elderly patients with chronic heart failure, reasonable exercise rehabilitation training can provide them with effective preventive measures and protective measures, improve the patients’ heart function and quality of life, and play an important and key role.

Coronary Stress Test as a Predictor of Quality of Life in Chronic Heart Failure Patients

2015 ◽  
Vol 69 (1) ◽  
pp. 26-29
Author(s):  
Borjanka Taneva ◽  
Dejan Ristevski
Keyword(s):  
Quality Of Life ◽  
Heart Failure ◽  
Chronic Heart Failure ◽  
Conventional Therapy ◽  
Exercise Tolerance ◽  
Therapy Group ◽  
Beta Blockers ◽  
Control Group ◽  
Heart Failure Patients

Abstract Introduction. Exercise tolerance is one of the life quality parmeters in chronic heart failure patients. The aim of our study was to assess the quality of life of patients with chronic heart failure by estimating their exercise tolerance. Methods. We examined 113 patients with stable chronic heart failure in the period of 18 months. They were divided in two groups, a control group (on conventional therapy of angiotensin-converting enzyme inhibitors and diuretics) and a therapy group (conventional therapy plus beta-blockers). The therapy group was divided into 3 subgroups according to the beta-blocker taken (a Metoprolol Bisoprolol and Carvedilol subgroup). Exercise tolerance was detected by coronary trade-mill stress testing every 6 months (only in patients of NYHA FC II and III), symptoms limited or modified after 6-minutes Bruce test. Results. Our results showed that there was a statistically significant difference between the control group and all the therapy subgroups in NYHA FC, NYHA score and exercise tolerance at the end of the study, but there was no difference among the subgroups. Conclusion. Beta-blockers improve the exercise tolerance as a variable defining quality of life.

scholarly journals Pengaruh Latihan Sirkuit Terhadap Biomarker Inflamasi,Kapasitas Fungsional, Fungsi Paru, dan Kualitas Hidup Pasien Gagal Jantung Kronik

2019 ◽  
Vol 6 (1) ◽  
pp. 48-53
Author(s):  
Fauzan Muttaqien ◽  
Yulvina Yulvina ◽  
Riana Novita Sari ◽  
Fahmi Syarif ◽  
Sri Wahyudati ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Heart Failure ◽  
Oxygen Consumption ◽  
Chronic Heart Failure ◽  
Pulmonary Function ◽  
Maximal Oxygen Consumption ◽  
Control Group ◽  
Circuit Training ◽  
Before And After

Background: Physical exercise in patients with heart failure maydecrease the level of proinflammatory biomarkers,increase maximal oxygen consumption, improve pulmonary function and quality of life. Circuit training is one of the most advantageous exercise models because it improves cardiorespiratory fitness and muscle strength. Objective: This study was aimed to investigate the effect of circuit training on proinflammatory biomarkers, functional capacity, pulmonary function, and quality of life in patients with chronic heart failure in RSUP Dr. Kariadi Methods: Twenty-six stable chronic heart failure with reduced ejection fraction patients were randomized into exercise group that received circuit training in the rehabilitation center of Kariadi Hospital for a month and control group. TNF- ? levels, maximum oxygen consumption, pulmonary function, and quality of life were taken before and after the exercise period. Data between two groups was analyzed with the Mann-Whitney test. Pre and post data was analyzed with the Wilcoxon test.  Results: Nine-teensubjects completed the study without any significant side effects.There was no significant difference in TNF-? levels before and after treatment between treatment groups and control groups (p=0,513). The treatment group with circuit training showed a greater increase in maximum oxygen consumption (p=0,034), greater increase in Forced Vital Capacity value(p=0,010) and a greater increase in quality of life score(p=0,047)than the control group. Conclusion: Circuit training in patients with chronic heart failure can increase maximal oxygen consumption, lung function, and quality of life, but no changes in inflammatory biomarkers. Keywords: Circuit training, TNF-a, maximal oxygen consumption, FVC, quality of life   Latar belakang: Latihan fisik pada pasien gagal jantung dapat menurunkan kadar biomarker proinflamasi, meningkatkan konsumsi oksigen maksimal, memperbaiki fungsi paru dan meningkatkan kualitas hidup. Latihan sirkuit merupakan salah satu model latihan fisik yang lebih menguntungkan karena mampu memperbaiki kebugaran kardiorespirasi dan kekuatan otot sekaligus. Tujuan:Menganalisispengaruh latihan sirkuit terhadap biomarker inflamasi, kapasitas fungsional, fungsi parudan kualitas hiduppasien gagal jantung kronik di RSUP Dr.Kariadi. Metode:Dua puluh enam pasien gagal jantung kronik stabil dengan penurunan fraksi ejeksi ventrikel kiri dirandomisasi menjadi kelompok yang  mendapatkan latihan sirkuit di bagian rehabilitasi RSUP Kariadi selama 1 bulan dan kelompok kontrol. Kadar TNF-a, nilai konsumsi oksigen maksimal, fungsi paru, dan kualitas hidupdiambil sebelum dan sesudah periode latihan. Analisis data antara dua kelompok menggunakan uji Mann-Whitney.Analisis data pre dan post, menggunakan uji Wilcoxon Hasil: Sembilan belas subjek menyelesaikan studi tanpa ada efek samping.Tidak didapati perubahan kadar TNF-a sesudah latihan sirkuit (p=0,513);Kelompok perlakuan dengan latihan sirkuit menunjukkan peningkatan konsumsi oksigen maksimal yang lebih besar (p=0,034), rerata peningkatan nilai FVC (Forced Vital Capacity) setelah latihan yang lebih besar (p=0,010), sertarerata peningkatan kualitas hidup yang lebih besar (p=0,047) dibandingkan kelompok kontrol. Simpulan: Latihan sirkuit pada pasien gagal jantung kronik dapat meningkatkan konsumsi oksigen maksimal, fungsi paru, dan kualitas hidup, namun tidak menyebabkan perubahan padabiomarker inflamasi. Kata Kunci: Latihan sirkuit, TNF-a, konsumsi oksigen maksimal, FVC, kualitas hidup

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