BackgroundA thorough analysis of the capability for self-care in patients with heart failure (HF) reduces the frequency of hospitalizations that are caused by decompensation. The aim of the study was to assess the effect of the method of therapy for HF, the degree of the acceptance of illness, and the occurrence of frailty syndrome on adherence to the therapeutic recommendations and self-care in patients with HF.MethodsThe study included 180 patients who were hospitalized after being diagnosed with HF. In all, we used the Polish versions of three validated instruments: the nine-item European Heart Failure Self-care Behavior Scale, Illness Acceptance Scale, and The Tilburg Frailty Indicator.ResultsThe capability for self-care of patients with HF was 27.8%. More than 65% of the patients followed the recommendations for taking medication and also followed a low-sodium diet, while only 5.5% of the patients followed the recommendations for physical exercise. Positive correlations were found between the capability for self-care and frailty syndrome and its components: general frailty components vs the capability for self-care: r=0.4449, P=0.0000; physical frailty components vs the capability for self-care: r=0.3974, P=0.0000; emotional frailty components vs the capability for self-care: r=0.2831, P=0.0001; social frailty components vs the capability for self-care: r=0.2180, P=0.0032, and a negative correlation between the capability for self-care and the degree of the acceptance of the illnesses (r=−0.4662, P=0.0000).ConclusionA relatively low capability for self-care was found in patients with HF. The presence of frailty syndrome and a low level of the acceptance of illness are connected with a low capability for self-care.
The proposed scheme in 64-slice computed tomography enables images to be generated similar to the intraoperative fluoroscopy, which can be useful in techniques where previsualization of the cardiac venous system is recommended.
Circulation Journal Official Journal of the Japanese Circulation Society http://www. j-circ.or.jp he variety of cardiac devices for transvenous implantation has increased in the years, mostly due to evidence of effectiveness of this therapy in chronic heart failure. Special attention is placed on cardiac resynchronization therapy (CRT) or combination of those devices with implanted cardioverter defibrillator. 1-5 During these procedures, the implantation of left ventricle lead is necessary. The only way for transvenous left ventricle lead implantation is coronary sinus (CS) cannulation from the right atrium, and finally implantation of the lead into one of the coronary veins. 6 Effectiveness and success of implantation have been shown to depend mainly on a proper placement of the left ventricle electrode into the coronary target vein. 7, 8 Lateral, posterolateral and anterolateral veins (PLV and ALV) provide optimal hemodynamic benefits. Meanwhile, most operators are faced with the problem of huge anatomical variability of coronary veins. Knowledge of the coronary venous system (CVS) anatomy is an important factor before many electrophysiological procedures, such as CRT or ablations. The CVS was the subject of a few research groups, but most of the research came from post mortem studies. 9,10 In a few studies, a huge anatomical variability of CVS was documented; however, its variants have only rarely been classified. 11 Recent data indicated a potential of the latest generation multislice computed tomography (MSCT) scanners for CVS anatomy visualization; 12,13 however, anatomical variants with emphasis on target veins for CRT have not been examined yet.The purpose of the present study was to evaluate anatomical variants of CVS in MSCT in the context of target veins for CRT. MethodsA total of 199 patients (114 males, 57.3%), aged 56.6±11.5 with suspected coronary artery disease (CAD) were included in the study. A suspicion of CAD was based on clinical symptoms such as chest pain, shortness of breath when exercising or during other vigorous activities and other typical/ atypical symptoms co-existing. Non-specific electrocardiogram (ECG) changes and positive results of exercise testing was also a basis for performing MSCT. Arterial hypertension and hyperlipidemia were the most prevalent CAD risk factors, present in 143 (71.8%) and 94 (47.2%) patients, respec- In a few studies, huge anatomical variability of coronary venous system (CVS) has been documented without analysis of its variants. The aim of the present study was to evaluate anatomical variants of CVS in multislice computed tomography (MSCT).
Rheumatoid arthritis (RA) has a large and varied impact on the quality of life as associated with patient health including both physical and mental well-being. The aim of the study was to assess the factors that affect the assessment of the quality of life of RA patients depending on the prevalence of frailty syndrome. Material and methods:The study involved 106 patients with RA (82 women; mean age 65.83 ± 5.01), who had been hospitalized in the Silesian Centre for Rheumatology, Rehabilitation and Disability Prevention in Ustron, Poland. The patients that were included in the study were divided into two groups depending on the incidence of frailty syndrome: Group 1robust patients and Group 2patients with frailty syndrome.Results: Frailty syndrome was identified in 34.9% of the patients with recognized/diagnosed RA; in women, it was 36.14% and in men, it was 25.92%. The average TFI value was 4.11 ± 2.05; in the physical domain, it was 3.39 ± 1.66; in the mental domain, it was 0.41 ± 0.55 and in the social domain, it was 0.31 ± 0.48. The robust patients assessed their quality of life associated with sleep as being worse compared to patients with recognized frailty syndrome. Conclusion:Frailty syndrome has no significant impact on the assessment of the quality of life of patients with diagnosed RA. The factors that determine quality of life are different in robust patients and in patients with frailty syndrome. The assessment of the quality of life is affected by the degree of an individual's fitness regardless of the occurrence of frailty syndrome.
There are no research studies that comprehensively analyze, with computed tomography, the coronary sinus (CS) ostium with respect to its importance for some electrophysiological procedures paying special attention to the Thebesian valve (ThebV). Our aim was to evaluate the characteristic features of the CS anatomy, which can be useful for electrophysiologists using multislice computed tomography (MSCT). An additional aim was to create a tomographic classification of ThebV types. Included into the study were 150 patients (aged 59.7 ± 11.4; 105M) (43 with heart failure). Due to the suspicion of coronary artery disease, 64-slice MSCT (Toshiba, Aquilion 64) was performed in all patients. All measurements and the search for the ThebV were performed on multiplanar reconstructions in axial projection at 0.5-mm slice thickness. The average diameter of CS ostium was 14.2 ± 3.5 mm and the angle of entrance of the CS to the right atrium was 112° ± 11°. Seven variants of the ThebV were introduced and six of them were confirmed in this group. The following frequency of variants of ThebV was confirmed: E, 11.3%; D, 10.6%; A1, 8.7%; A2, 7.4%; C, 6.0%; B2, 2.0%. A statistically significant correlation between age and the size of CS ostium was found (r = 0.25; p < 0.05). It is possible to visualize and evaluate the CS including measurements and ThebV evaluation in MSCT. Six anatomical variants of the valve were found. MSCT can potentially provide valuable knowledge before the CS cannulation.
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