The Effect of Bisoprolol on Heart Failure Preserved Ejection Fraction / Hfpef Patient’s Quality Of Life

Background: Global Public Health Burden of Heart Failure reported the growing prevalence of heart failure which is 64.3 million affected in 2020 worldwide with half of the case classified as Heart Failure Preserved Ejection Fraction (HFpEF). It is well known that someone who has been diagnosed with heart failure will have a poorer 􏰼􏰞􏰏􏰦􏰝􏰊􏰗 􏰓􏰒 􏰦􏰝􏰒􏰋􏰷􏰽􏰓􏰬􏰣 􏰾􏰘􏰖􏰦􏰓􏰩􏰿􏰋􏰑 􏰝􏰌 􏰏 􏰜􏰋􏰏􏰑􏰊 􏰑􏰏􏰊􏰋 􏰦􏰓􏰎􏰋􏰑􏰝􏰚􏰟 􏰏􏰟􏰋􏰚􏰊 􏰎􏰝􏰊􏰜 􏰏 􏰐􏰓􏰊􏰋􏰚􏰩􏰗 􏰊􏰓 􏰝􏰔􏰐􏰑􏰓􏰻􏰋 􏰊􏰜􏰋 􏰐􏰏􏰊􏰝􏰋􏰚􏰊􏱀􏰌 􏰩􏰦􏰝􏰚􏰝􏰩􏰏􏰦 outcomes, one of them is QoL. Objective􏱁 􏰥􏰜􏰝􏰌 􏰌􏰊􏰞􏰕􏰗 􏰏􏰝􏰔􏰋􏰕 􏰊􏰓 􏰓􏰖􏰌􏰋􏰑􏰻􏰋 􏰏􏰚􏰕 􏰋􏰻􏰏􏰦􏰞􏰏􏰊􏰋 􏰊􏰜􏰋 􏰋􏰒􏰒􏰋􏰩􏰊 􏰓􏰒 􏰖􏰝􏰌􏰓􏰐􏰑􏰓􏰦􏰓􏰦􏰳 􏰏 􏰊􏰗􏰐􏰋 􏰓􏰒 􏰾􏰘􏰖􏰦􏰓􏰩􏰿􏰋􏰑􏰳 􏰝􏰚 􏰊􏰜􏰋 􏰝􏰔􏰐􏰑􏰓􏰻􏰋- 􏰔􏰋􏰚􏰊 􏰓􏰒 􏱂􏱃􏰐􏰺􏱃 􏰐􏰏􏰊􏰝􏰋􏰚􏰊􏱀􏰌 􏰽􏰓􏰬􏰣 Method: This study is a retrospective cohort following HFpEF patients who received bisoprolol and HFpEF patients who did not receive bisoprolol. The study participants were selected using purposive sampling method. Result: Our study found that from all HFpEF patients who received bisoprolol 102 patients had a good QoL and 2 patients had a poor QoL (p=0.000) according to Minnesota Living With Heart Failure Questionnaire (MLHFQ). The median physical score in the patient who did not receive bisoprolol was 10 while the median score of the 􏰐􏰏􏰊􏰝􏰋􏰚􏰊 􏰎􏰜􏰓 􏰑􏰋􏰩􏰋􏰝􏰻􏰋􏰕 􏰾􏰘􏰖􏰦􏰓􏰩􏰿􏰋􏰑 􏰎􏰏􏰌 􏰲 􏰪􏰐􏰡􏰢􏰣􏰢􏰢􏰢􏰮􏰣 􏰥􏰜􏰋 􏰔􏰋􏰏􏰚 􏰋􏰔􏰓􏰊􏰝􏰓􏰚􏰏􏰦 􏰌􏰩􏰓􏰑􏰋 􏰒􏰓􏰑 􏰊􏰜􏰋 􏰐􏰏􏰊􏰝􏰋􏰚􏰊􏰌 􏰎􏰜􏰓 􏰕􏰝􏰕 􏰚􏰓􏰊 􏰑􏰋􏰩􏰋􏰝􏰻􏰋 􏰾􏰘􏰖􏰦􏰓􏰩􏰿􏰋􏰑 􏰎􏰏􏰌 􏰸 􏰎􏰜􏰝􏰦􏰋 􏰊􏰜􏰋 􏰔􏰋􏰏􏰚 􏰌􏰩􏰓􏰑􏰋 􏰓􏰒 􏰊􏰜􏰋 􏰐􏰏􏰊􏰝􏰋􏰚􏰊􏰌 􏰎􏰜􏰓 􏰑􏰋􏰩􏰋􏰝􏰻􏰋􏰕 􏰾􏰘􏰖􏰦􏰓􏰩􏰿􏰋􏰑 􏰎􏰏􏰌 􏱄 􏰪􏰐􏰡􏰢􏰣􏰢􏰢􏰢􏰮􏰣 Conclusion􏱁 􏰛􏰋 􏰩􏰓􏰚􏰩􏰦􏰞􏰕􏰋 􏰊􏰜􏰏􏰊 􏰊􏰜􏰋 􏰞􏰌􏰋 􏰓􏰒 􏰖􏰝􏰌􏰓􏰐􏰑􏰓􏰦􏰓􏰦 􏰩􏰓􏰞􏰦􏰕 􏰝􏰔􏰐􏰑􏰓􏰻􏰋 􏰊􏰜􏰋 􏱂􏱃􏰐􏰺􏱃 􏰐􏰏􏰊􏰝􏰋􏰚􏰊􏱀􏰌 􏰽􏰓􏰬 􏰋􏰻􏰏􏰦􏰞􏰏􏰊􏰋􏰕 􏰖􏰗 􏰊􏰓􏰊􏰏􏰦 score, physical score, and emotional score.

Effect of Iron deficiency on health-related quality of life in chronic heart failure patients regardless of anaemia status

Background Chronic Heart Failure (CHF) patients have marked functional limitations causing a significant impact on Health Related Quality of Life (HRQoL) in these patients. Iron Defeciency is very common in Heart Failure patients & it is suggested that it affects HRQoL in CHF patients regardless of the Anemia status . Objective To evaluate the impact of iron deficiency (ID) on health-related quality of life (HRQoL) in chronic heart failure (CHF) patients using Minnesota Living with Heart Failure questionnaire (MLHFQ) in patients with normal hemoglobin levels . Methods From October 2018 to August 2019 ,100 patients with CHF from out- patient clinics in ASU university hospitals were subjected to history taking , examination , Echocardiography , measurement of Iron status using serum ferritin, Assessment of Health Related Quality of Life (HRQoL) using Minnesota Living with Heart Failure Questionnaire (MLHFQ) . Patients then were divided into 2 equal groups depending on their serum ferritin level & comparison of MLHFQ score between the 2 groups was done . Results The study population was divided into 2 groups: Iron Defecient (ID) (n = 50) & non Iron Defecient (non ID) (n = 50) , 61 patients were males & 39 were females. The MLHFQ scores were 66.9 ± 9.1 among ID patients vs 46.9 ± 7.3 in non ID patients (p value < 0.001) indicating worse HRQoL in ID group . The physical domain (p value < 0.001) was markedly affected than the emotional domain (p value 0.006) of the MLHFQ score . Conclusion In CHF patients , HRQoL was markedly affected among ID patients than non ID patients with physical factors more affected than the emotional factors .

Prevalência de disfunção sexual e incontinência urinária em indivíduos cardiopatas candidatos à reabilitação cardíaca e indivíduos sem evento cardíaco prévio

Objetivo: Analisar a prevalência de disfunção sexual e incontinência urinária em sujeitos cardiopatas candidatos a um programa de reabilitação cardíaca (PRC), assim como comparar os achados a sujeitos sem evento cardíaco prévio (n=25) e correlacionar com as variáveis capacidade funcional (CF) e qualidade de vida (QV). Métodos: Trata-se de um estudo transversal com avaliação dos seguintes desfechos: disfunção sexual (Female Sexual Function Index e Índice Internacional de Função Erétil Simplificado), incontinência urinária (International Consultation Incontinence Questionnaire – Short Form, Incontinence Severity Index), qualidade de vida (Minnesota Living with Heart Failure Questionnaire e MacNew Heart Disease Health-Related Quality of Life Questionnaire para sujeitos cardiopatas e Medical Outcomes Study 36-Item Short-Form Health Survey e Notthingam Health Profile para sujeitos sem evento cardíaco prévio) e CF (teste de caminhada de 6 minutos). Resultados: A amostra foi composta por 25 indivíduos cardiopatas candidatos a um PRC (59,88 ± 8,53 anos, 19 homens) e 25 indivíduos sem evento cardíaco prévio (57,88 ± 9,54 anos, 19 homens). Não houve diferença significativa na prevalência de disfunção sexual e incontinência urinária entre os grupos. Houve correlação inversa e forte (r=-0,803; p=0,005) entre disfunção sexual e CF nos homens cardiopatas. Os pacientes cardiopatas demonstraram uma menor capacidade funcional quando comparados aos sujeitos sem evento cardíaco prévio. Considerações Finais: Ressalta-se a importância da abordagem de temas como disfunção sexual e incontinência urinária dentro de um PRC, sobretudo em função do manejo precoce dos seus fatores de risco.

LITERATURE REVIEW: PENGARUH RESISTANCE EXERCISE DENGAN ELASTIC BAND UNTUK EKSTREMITAS BAWAH TERHADAP WALKING SPEED PADA LANJUT USIA

Tujuan dari penelitian ini adalah untuk mengetahui adakah pengaruh Resistance Exercise dengan Elastic Band untuk ekstremitas bawah terhadap walking speed pada lanjut usia, sehingga dapat me minimalisir resiko jatuh pada lanjut usia. Pasien lanjut usia dengan fisik yang sehat secara umum dan dapat berjalan tanpa bantuan. Penelitian ini menggunakan metore Studi Literatur. Dari penemuan 6 jurnal yang bersumber dari Google Schoolar, Pubmed, Scient Direct, dan Jospt bahwa Resistance Exercise menggunakan Elastic Band untuk ekstremitas bawah terhadap Walking Speed pada lanjut usia terdapat perubahan yang signifikan pada durasi berjalan, disisi lain dalam studi Saeterbakken et al., 2018 tidak ada perubahan yang signifikan pada durasi berjalan. Dari 6 studi, Test Kecepatan Berjalan menggunakan Resistance Exercise menggunakan intervensi (Elastic Band) dengan parameter berbeda, disimpulkan bahwa kecepatan berjalan menggunakan parameter 4,44 Meter Walk dan Fried Frailty Phenotype lebih baik digunakan dibandingkan dengan Minnesota Living with Heart Failure Questionnaire (MLHFQ) dan Time Up and Go Test (TUG). Kata Kunci : mobilitas fisik, bergerak, resiko jatuh, kelemahan otot

Remote Hemodynamic‐Guided Therapy of Patients With Recurrent Heart Failure Following Cardiac Resynchronization Therapy

Background Patients with recurring heart failure (HF) following cardiac resynchronization therapy fare poorly. Their management is undecided. We tested remote hemodynamic‐guided pharmacotherapy. Methods and Results We evaluated cardiac resynchronization therapy subjects included in the CHAMPION (CardioMEMS Heart Sensor Allows Monitoring of Pressure to Improve Outcomes in New York Heart Association Class III Heart Failure Patients) trial, which randomized patients with persistent New York Heart Association Class III symptoms and ≥1 HF hospitalization in the previous 12 months to remotely managed pulmonary artery (PA) pressure‐guided management (treatment) or usual HF care (control). Diuretics and/or vasodilators were adjusted conventionally in control and included remote PA pressure information in treatment. Annualized HF hospitalization rates, changes in PA pressures over time (analyzed by area under the curve), changes in medications, and quality of life (Minnesota Living with Heart Failure Questionnaire scores) were assessed. Patients who had cardiac resynchronization therapy (n=190, median implant duration 755 days) at enrollment had poor hemodynamic function (cardiac index 2.00±0.59 L/min per m 2 ), high comorbidity burden (67% had secondary pulmonary hypertension, 61% had estimated glomerular filtration rate <60 mL/min per 1.73 m 2 ), and poor Minnesota Living with Heart Failure Questionnaire scores (57±24). During 18 months randomized follow‐up, HF hospitalizations were 30% lower in treatment (n=91, 62 events, 0.46 events/patient‐year) versus control patients (n=99, 93 events, 0.68 events/patient‐year) (hazard ratio, 0.70; 95% CI, 0.51–0.96; P =0.028). Treatment patients had more medication up‐/down‐titrations (847 versus 346 in control, P <0.001), mean PA pressure reduction (area under the curve −413.2±123.5 versus 60.1±88.0 in control, P =0.002), and quality of life improvement (Minnesota Living with Heart Failure Questionnaire decreased −13.5±23 versus −4.9±24.8 in control, P =0.006). Conclusions Remote hemodynamic‐guided adjustment of medical therapies decreased PA pressures and the burden of HF symptoms and hospitalizations in patients with recurring Class III HF and hospitalizations, beyond the effect of cardiac resynchronization therapy. Registration URL: https://www.clinicaltrials.gov ; Unique identifier: NCT00531661.

Association between depressive symptoms and quality of life in outpatients and inpatients with heart failure

ABSTRACT Objective: To analyze sociodemographic and clinical characteristics, depressive symptoms and quality of life of patients with heart failure and associate quality of life with depressive symptoms. Method: A cross-sectional study conducted with outpatients and inpatients. Sociodemographic data were collected and questionnaires were applied to assess quality of life (Minnesota Living with Heart Failure Questionnaire) and depressive symptoms (Beck Depression Inventory). Results: The sample consisted of 113 patients. Outpatients were retired (p=0.004), with better education (p=0.034) and higher ventricular ejection fraction (p=0.001). The inpatient group had greater depressive symptoms (18.1±10 vs 14.6±1.3; p=0.036) and lower quality of life (74.1±18.7 vs 40.5±3.4; p<0.001) than the outpatient group. Outpatients with depressive symptom scores from 18 points had worse quality of life scores in 17 of the 21 questions. Conclusion: Inpatients had worse depressive symptoms and quality of life, which was more affected in the physical dimension in those with moderate/severe depressive symptoms. Outpatients with more severe depressive symptoms had worse quality of life in all dimensions.

A patient-centered mobile intervention to promote self-management and improve patient outcomes in chronic heart failure: The ManageHF4Life trial (Preprint)

BACKGROUND Successful management of heart failure (HF) involves guideline based medical therapy as well as self-care behavior. As a result, the management of HF is moving toward a proactive real-time technological model of assisting patients with monitoring and self-management. OBJECTIVE Evaluate the effectiveness of a mobile application intervention that enhances self-monitoring on health-related quality of life, self-management, and reduces HF readmissions. METHODS A single-center randomized controlled trial was performed. Patients greater than 45 years of age and admitted for acute decompensated HF or recently discharged in the past 4 weeks were included. The intervention group used a mobile application (App). The intervention prompted daily self-monitoring and promoted self-management. The control group (No App) received usual care. The primary outcome was the change in Minnesota Living with Heart Failure Questionnaire (MLHFQ) from baseline to 6 and 12 weeks. Secondary outcomes were the Self-Care Heart Failure Index (SCHFI) questionnaire and recurrent HF admissions. RESULTS Eighty-three patients were enrolled and completed all baseline assessments. Baseline characteristics were similar between groups with the exception of HF etiology. The App group had a reduced MLHFQ at 6 weeks (37.5 ± 3.5 vs. 48.2 ± 3.7, P=0.039) but not at 12 weeks (44.2 ± 4 vs. 45.9 ± 4, P=0.778) compared to No App. There was no effect of the App on the SCHFI at 6 or 12 weeks. The time to first HF admission was not statistically different between the App versus No App groups (HR 0.89, 95% CI 0.39-2.02, P=0.781) over 12 weeks. CONCLUSIONS The mobile application intervention improved MLHFQ at 6 weeks, but did not sustain its effects at 12 weeks. No effect was seen on HF self-care. Further research is needed to enhance engagement in the application for a longer period of time and to determine if the application can reduce HF admissions in a larger study. CLINICALTRIAL NCT03149510

Positive impact of cardiac contractile modulation on myocardial contractility and left ventricular synchronization in a patient with a left ventricular noncompaction

The article provides a clinical case of a 58-year-old man with the fi rst clinical manifestation of chronic heart failure in the presence of a signifi cant decrease in the left ventricular ejection fraction. Left ventricular non-compaction cardiomyopathy was diagnosed by echocardiography. After 12 months, a cardiac contractility modulation device was implanted to the patient in the presence of disease progression despite optimal medical therapy. We assessed the course of disease, quality of life, exercise tolerance, and myocardial contractility of the patient before and six months after surgery. The methods of assessment were collection of patient complaints, physical examination, electrocardiography (ECG), fi lling out the Minnesota Living with Heart Failure Questionnaire (MLHFQ), sixminute walk test, spiroergometry, and echocardiography.