scholarly journals Cerebral Microhemorrhage: A Frequent Magnetic Resonance Imaging Finding in Pediatric Patients after Cardiopulmonary Bypass

2017 ◽  
Vol 7 ◽  
pp. 27 ◽  
Author(s):  
Paggie P C Kim ◽  
Benjamin W Nasman ◽  
Erica L Kinne ◽  
Udochukwu E Oyoyo ◽  
Daniel K Kido ◽  
...  
Keyword(s):  
Heart Failure ◽  
Cardiopulmonary Bypass ◽  
Magnetic Resonance ◽  
Pediatric Patients ◽  
Univariate Analysis ◽  
Control Group ◽  
Time Interval ◽  
Female Age ◽  
Patients With Heart Failure ◽  
Cerebral Microhemorrhage

Objectives: This study was undertaken to estimate the incidence and burden of cerebral microhemorrhage (CM) in patients with heart disease who underwent cardiopulmonary bypass (CPB), as detected on susceptibility-weighted imaging (SWI), a magnetic resonance (MR) sequence that is highly sensitive to hemorrhagic products. Materials and Methods: With Institutional Review Board waiver of consent, MR imaging (MRI) of a cohort of 86 consecutive pediatric patients with heart failure who underwent heart transplantation evaluation were retrospectively reviewed for CM. A nested case–control study was performed. The CPB group consisted of 23 pediatric patients with heart failure from various cardiac conditions who underwent CPB. The control group was comprised of 13 pediatric patients with similar cardiac conditions, but without CPB history. Ten patients in the CPB group were female (age: 5 days to 16 years at the time of the CPB and 6 days to 17 years at the time of the MRI). The time interval between the CPB and MRI ranged from 11 days to 4 years and 5 months. Six patients in the control group were female, age range of 2 days to 6 years old. The number of CM on SWI was counted by three radiologists (PK, EK and DK). The differences in number of CM between groups were tested for significance using Mann–Whitney U-test, α = 0.05. Using the univariate analysis of variance model, the differences in number of CM between groups were also tested with adjustment for age at MRI. Results: There are statistically significant differences in CM on SWI between the CPB group and control group with more CM were observed in the CPB group without and with adjustment for age at MRI (P < 0.001). Conclusions: Exposure of CPB is associated with increased prevalence and burden of CM among pediatric patients with heart failure.

Abstract 15154: Objectively Measured Physical Activity in Patients With Heart Failure

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Leonie Klompstra ◽  
Maria Back ◽  
Anna Stromberg ◽  
Massimo Piepoli ◽  
Tiny JAARSMA
Keyword(s):  
Physical Activity ◽  
Heart Failure ◽  
Vigorous Physical Activity ◽  
Nyha Class ◽  
Univariate Analysis ◽  
Social Motivation ◽  
Lower Amount ◽  
Control Group ◽  
Motivational Support ◽  
Patients With Heart Failure

Introduction: Novel interventions, such as exergaming, might be promising to increase physical activity (PA). We aim to explore the difference in PA in patients with heart failure (HF) who have access to exergaming compared to patients who received motivational support and to explore predictors of PA increase. Methods: This study is part of the HF-Wii study (patients randomized to exergaming or to motivational support) in which a group of HF patients (n=64, mean age 69±9, 27% female, 80% NYHA I/II) wore an accelerometer (Actigraph GT9X). Ten minutes change in daily non-sedentary PA was defined as clinically relevant change. Potential predictors of PA change were, i.e. demographic and clinical variables, self-efficacy (ESS), exercise motivation (EMI), depression (HADs) and Health-related Quality of Life (MLHFQ) analyzed by independent sample t-tests and chi-square. Factors with a significance of 0.15 in the univariate analysis were tested in a logistic regression analysis, corrected for randomization, age, gender and NYHA-class and baseline values for light PA and moderate- to vigorous physical activity (MVPA). Results: No differences were found between the exergame group and the control group at 3 months in activity counts (p=0.27), sedentary time (p=0.16), light PA (p=0.69) or MVPA (p=0.17). At baseline, patients had a mean of 173718 (±100545) PA counts/day; 9 hours and 43 minutes a day (±1h 23min) were spent sedentary, 3 hours and 29 minutes a day (±1h 6min) on light PA and 43 minutes a day (±1h 5min) on MVPA ) and 28 patients increased their PA. History of stroke (p=0.05), having grandchildren (p=0.04), recently diagnosed HF (p=0.04), total motivation (p=0.12) and social motivation (p=0.05) were included for the multivariate analysis. Only recently diagnosed HF (p=0.01), a higher social motivation (p=0.02) and a lower amount of light PA at baseline were independent predictors of increasing PA. Conclusions: Exergaming did not significantly change PA. A recently diagnosed HF, higher social motivation and lower baseline light PA are factors that need to be considered when developing PA interventions and when motivating patients to become more physically active.

Impact of a pharmacy team–led intervention program on the readmission rate of elderly patients with heart failure

2018 ◽  
Vol 75 (4) ◽  
pp. 183-190 ◽  
Author(s):  
Pamela M. Moye ◽  
Pui Shan Chu ◽  
Teresa Pounds ◽  
Maria Miller Thurston
Keyword(s):  
Heart Failure ◽  
Older Patients ◽  
Readmission Rate ◽  
Academic Medical Center ◽  
Hospital Readmissions ◽  
Intervention Group ◽  
Historical Control Group ◽  
Historical Control ◽  
Control Group ◽  
Patients With Heart Failure

Purpose The results of a study to determine whether pharmacy team–led postdischarge intervention can reduce the rate of 30-day hospital readmissions in older patients with heart failure (HF) are reported. Methods A retrospective chart review was performed to identify patients 60 years of age or older who were admitted to an academic medical center with a primary diagnosis of HF during the period March 2013–June 2014 and received standard postdischarge follow-up care provided by physicians, nurses, and case managers. The rate of 30-day readmissions in that historical control group was compared with the readmission rate in a group of older patients with HF who were admitted to the hospital during a 15-month intervention period (July 2014–October 2015); in addition to usual postdischarge care, these patients received medication reconciliation and counseling from a team of pharmacists, pharmacy residents, and pharmacy students. Results Twelve of 97 patients in the intervention group (12%) and 20 of 80 patients in the control group (25%) were readmitted to the hospital within 30 days of discharge (p = 0.03); 11 patients in the control group (55%) and 7 patients in the intervention group (58%) had HF-related readmissions (p = 0.85). Conclusion In a population of older patients with HF, the rate of 30-day all-cause readmissions in a group of patients targeted for a pharmacy team–led postdischarge intervention was significantly lower than the all-cause readmission rate in a historical control group.

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