جستجوی مقالات مرتبط با کلیدواژه « Chronic Heart Failure » در نشریات گروه « پزشکی »

The present systematic review and meta-analysis aimed to systematically evaluate a risk prediction model for the readmission of patients with CHF.

The search was carried out in databases including PubMed, Embase, EBSCO, Web of Science, Cochrane Library and also domestic databases including Chinese Biomedical Literature Database, Chinese Academic Journal Full Text Database, Wanfang Database, and Vipu Chinese Journal Service Platform. All the original studies published by July 2021. Two researchers identified previous studies involving readmission risk prediction models that met our selection criteria. The quality of the included studies was evaluated based on the CHARMS checklist, and the prediction models were systematically evaluated.

Of the overall 4787 studies retrieved, nine studies—two prospective, seven retrospective—met our selection criteria. The area under the receiver operating characteristic curve exceeded 0.63 (0.63-0.80) for all the studies. The most common predictors in the model were B-type natriuretic peptide (BNP) or N-terminal pro-brain BNP (Odds Ratio 4.35; 95% confidence interval (CI) 2.53–7.49; P<0.001), renal insufficiency (Odds Ratio 1.60; 95%CI 1.24–2.08; P<0.001), comorbidities, and a history of hospitalization.

The use of non-parametric statistical methods and assessment of large samples of electronic data improve the predictive abilities of the risk assessment models. It is necessary to calibrate and verify such models and promote the combined use of parametric and non-parametric methods to establish precise predictive models for clinical use.

The results of this study can be used as a guide to provide valid evidence for the decision of senior managers of the Ministry of Health and large hospitals to use common technologies used in distance care for patients with CHF and other chronic diseases. This study will also provide a new understanding of the various studies that have been conducted to help patients with chronic failure by different types of remote care technologies in terms of effectiveness, safety, technology, and economic costs.

To assess the influence of the COVID-19 (Coronavirus Disease 2019) pandemic on treatment adherence by patients with CHF (Chronic heart failure) and to determine the factors associated with changing adherence during home-isolation.

The survey was conducted in patients participating in the COMPLIANCE study (ClinicalTrials.gov. NCT04262583). Thirty-one patients, included into in the COMPLIANCE study before March 1, 2020, were interviewed through phone calls. A modified adherence scale of the National Society for Evidence-Based Pharmacotherapy was used, which permits to assess of overall adherence, adherence to particular drugs and the main causes for non-adherence.

In the whole group of patients, only a tendency to reduced overall adherence was registered during the COVID-19 pandemic (р=0,256). Significant differences in the rate of adherence deterioration were revealed for angiotensin-converting enzyme (ACE) inhibitors (p=0.031) and for statins (p=0.002). The reasons for non-adherence were lack of opportunity to contact with a physician, inability to perform investigations necessary for correcting prescribed pharmacotherapy, and side effects.

A tendency to deterioration of adherence to prescribed pharmacotherapy was revealed during the COVID-19 pandemic. A significant decline in adherence was registered to ACE inhibitors and statins.

TGF-β1 is known to promote cardiac remodeling and fibrosis during Congestive Heart Failure (CHF). In this study, an attempt was made to investigate expression of Transforming Growth Factor beta1 (TGF-β1) and relative expansion or contraction of regulatory T-cell (Tregs) population in peripheral blood of patients with Chronic Heart Failure (CHF).

Real-time PCR assay was used to investigate expression and post-stimulation levels of TGF-β1 in cell culture supernatant of Peripheral Blood Mononuclear Cells (PBMC) of 42 patients with CHF and 42 controls. Flow cytometry was used to identify relative counts of CD4+CD25+FoxP3+ Tregs.

PBMCs in patients with CHF expressed higher levels of TGF-β1 compared to controls. Post-stimulation levels of TGF-β1 expression were significantly higher in New York Heart Association (NYHA) functional class IV patients compared to stage I patients. Tregs were significantly expanded in PBMC in CHF, while the CD4+ helper T-cells were unchanged. Treg expansion was more significant in NYHA functional class I patients compared to class IV patients.

Expansion of Treg population in CHF provides an extrinsic source for TGF-β1 production to induce reactive fibrosis and cardiac remodeling. Relative decrease in Treg population at advanced stages of CHF is indicative of a loss of regulatory characteristics in these cells and unopposed proinflammatory milieu.

A decrease in cardiorespiratory function is associated with increased body mass index (BMI) in normal individuals according to scientific evidence. However, the relationship has not been studied in patients with chronic heart failure (CHF). Hence, we planned to evaluate the relationship between modifiable anthropometric measurements and cardiorespiratory parameters in CHF patients.

This research was a retrospective study conducted utilizing the data of CHF patients who had visited the Madhavbaug clinics in Maharashtra for consultation, between July 2018 and December 2018. The correlation between the modifiable anthropometric measurements (BMI and abdominal girth) and the exercise indices ( VO2 max and metabolic equivalents [METs]) was calculated.

Of the 147 patients included in the study, 74.15% were males with mean age of 59.15 ± 10.28 years. Mean BMI and abdominal girth were 26.69 ± 4.97 kg/m2 and 98.82 ± 12.74 cm, respectively. Mean VO2 max and METs were calculated to be 17.1 ± 6.78 ml/kg/min and 5.99 ± 2.01 units. The correlation coefficients (R) between VO2 max and the anthropometric variables were indicative of negligible correlation (R = 0.01 with BMI and R = −0.05 with abdominal girth, P > 0.05). However, the correlation between METs and the anthropometric variables was found to indicate moderate negative correlation, which was also statistically significant (R = −0.23 with BMI and R = −0.33 with abdominal girth, P < 0.05).

Higher BMI and abdominal girth in CHF patients were found to have a negative correlation with METs, indicating higher energy expenditure on physical activities. Lifestyle modifications will help improve the cardiorespiratory fitness in CHF patients and have a positive impact on METs.