No abstract
Introduction: The integrated out-patient management of the Heart Failure (HF) seems to constitute a winning approach to this condition, even if its effects in the clinical practice are nevertheless object of discussion. Objectives: Purpose of this study has been that to appraise the variations of the NYHA class and of ejection fraction (EF%) after 12 months of integrated out-patient management in a population of hypertensive patient (pts) affected from HF. Methods: 220 pts with HF (defined according to the criteria suggested by the ACC/AHA guidelines) have been inserted in a comprehensive program of integrated management of educational intervention on the patient himself and on the family. A clinical evaluation, with determination of the class NYHA and echocardiography evaluation with determination of the EF%, have been performed both at the entry of the study and after 12 months. The variation of the risk to develop a fatal event has been evaluated with the COX model. Results: 160 pts (72,7%, average age 72,9% years) presented EF> 45% (group 1) and 60 pts (27,3%, average age 74,6) presented FE < = 45% (group 2). In group 1 EF% was 61,5 ±8 at the basal measurement and 62±8 after 12 months (ns) while in group 2 EF was 35±6 at the basal one and 46,6 ±13after 12 months (p < 0.002). There is a 10% of risk reduction for every 1% of EF increment (RR=0,90; 0,84-0,96: p < 0,001). The variations of NYHA class is reassumed in the chart (for the trend in improvement: p < 0,001, FE < = 45%; p < 0,0001, FE > 45%) [see table]. NYHA I NYHA II NYHA III NYHA IV basal 12 months basal 12 months basal 12 months basal 12 months FE ≤45% 6,7% 30% 65% 55% 28,3% 10% 0% 5% FE >45% 46,9% 65,5% 40% 33,3% 13,1% 1,4% 0% 0% Conclusions:The ambulatory integrated management has independently allowed an improvement of the clinical conditions of the pts with HF independently from the presence or absence of systolic dysfunction and an improvement of the EF% in the pts with systolic dysfunction, with benefit effect also on the correlated events to the same HF.
BackgroundLeft ventricular hypertrophy (LVH) is an independent and powerful risk factor for cardiovascular events and death. Serum uric acid (SUA) may induce LVH, on one hand, through an inflammatory effect which promotes cardiac hypertrophy and, on the other, through an activation of the renin-angiotensin-aldosterone system which generates hypertrophy and hyperplasia of myocytes and fibrosis of the heartObjectivesAim of the study was to investigate the correlation between SUA levels and left ventricular mass in a group of hypertensive patientsMethodsWe evaluated 51 patients (mean age 74±10 years; range 49-87, F 37.7%; M 62.3%) with essential hypertension. Each patient underwent a standardized medical history and clinical examination, laboratory tests and echocardiographic assessment with the determination of left ventricular mass index (LVMI)ResultsMean value of SUA was 6.68±2 mg/dl. Mean blood pressure (MAP) was 95±12 mmHg. A positive significant correlation between SUA and LVMI (P=0.029) was observed. After adjusting for MAP and age in standard multiple linear regression analysis, SUA level remains independently associated with LVMI suggesting that increased urate levels are associated with a higher myocardial mass.ConclusionsOur results demonstrate that SUA is independently associated with LVMI and suggest that the combination of hyperuricemia with LVH could be a powerful predictor of cardiovascular eventsReferencesYoshio Iwashima, Takeshi Horio, Kei Kamide, Hiromi Rakugi, Toshio Ogihara and Yuhei Uric Acid, Left Ventricular Mass Index, and Risk of Cardiovascular Disease in Essential Hypertension. Hypertension 2006;47:195-202;Ayako Yoshimura, Hisashi Adachi, Yuji Hirai, Mika Enomoto, Ako Fukami, Eita Kumagai, Kyoko Ohbu, Sachiko Nakamura, Aya Obuchi, Yume Nohara, Tsutomu Imaizumi. Serum Uric Acid Is Associated With the Left Ventricular Mass Index in Males of a General Population. Int Heart J, January 2014Cristiana Catena, GianLuca Colussi, Frine Capobianco, Gabriele Brosolo and Leonardo A. Sechi. Uricaemia and left ventricular mass in hypertensive patients. Eur J Clin Invest 2014;44(10):972-981Disclosure of InterestNone declared
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.