Heart failure: why and how to define it?

Purcell, Ian; Poole‐Wilson, Philip A.

doi:10.1016/s1388-9842(98)00009-9

Cited by 23 publications

(14 citation statements)

References 15 publications

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“…One reason was the need to have a comparison group, since almost all the patients with HF are treated with diuretics. A second reason was that the prescription of diuretics has been used as an indicator of, or as a part of the definition of HF in order to calculate prevalence [4,5,29,30]. We have observed that a high number of patients received diuretic treatment without having HF (this number being similar to that of the patients with HF).…”

Section: Discussionmentioning

confidence: 99%

“…Technological advances have led to the use of investigations such as the echocardiogram prior to a formal diagnosis being made [1][2][3][4]. The diagnostic approach may differ depending on whether the diagnosis has been made by a cardiologist in a hospital environment or in General Practice [1,4,5]. Most community studies on patients with HF have been conducted by specialists who determined the diagnostic criteria and who report a population of HF patients meeting those criteria [1,[5][6][7][8][9][10][11].…”

Section: Introductionmentioning

confidence: 99%

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Incidence and outcome of persons with a clinical diagnosis of heart failure in a general practice population of 696,884 in the United Kingdom

Giuli

Khaw

Cowie

et al. 2005

European Journal of Heart Failure

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Background: There are few large population-based studies of the incidence and outcome of heart failure where the diagnosis of heart failure (HF) has been made by a General Practitioner (GP) in the community. Methods: From the General Practice Research Database in the UK, we selected a population of 686,884 people 45 years or older. Incident cases of HF in 1991 were classified definite HF, possible HF, or a first prescription of diuretics without a diagnosis of HF. The population was followed for 3-year mortality. Results: A total of 6478 patients had definite HF (mean age 77.2 years, 55.5% women), 14,050 had possible HF and 6076 persons were prescribed diuretics without a definite or possible diagnosis of HF. The overall incidence of definite HF was 9.3/1000 persons/year and of possible HF 20.2/1000 persons/year. Diuretics were prescribed for the first time for other reasons for 8.7 persons/1000/year. The incidence of HF was higher in men. The incidence of definite HF increased with age. Survival curves showed higher mortality rates in the first 3 months after the diagnosis of HF. One-year cumulative probability of death for patients with definite HF was 15.9 times higher in men and 14.7 times higher in women in comparison with the UK population. Conclusion: The diagnosis of HF by a GP successfully identifies patients at high risk of death, comparable to patients with HF identified by cardiologists on the basis of defined diagnostic criteria. HF is common in the general population, increases sharply with age, and has a poor prognosis.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Incidence and outcome of persons with a clinical diagnosis of heart failure in a general practice population of 696,884 in the United Kingdom

Giuli

Khaw

Cowie

et al. 2005

European Journal of Heart Failure

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“…The hemodynamic parameter, RPP, the product of HR and SBP, can be used to evaluate both dynamic and static exercise, and is not influenced by the use of βblockers. It is agreed that HR and SBP are increased by the increase of exercise intensity; however, the degree of increase can be reduced by proper exercise therapy10 ) .…”

Section: Discussionmentioning

confidence: 99%

Supervised Phase II Cardiac Exercise Therapy Shortens the Recovery of Exercise Capacity in Patients with Acute Myocardial Infarction

Lee

Wang²,

Hsieh³

et al. 2014

J Phys Ther Sci

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[Purpose] To investigate the effects of Phase II cardiac exercise therapy (CET) on exercise capacity and changes in coronary risk factors (CRFs) of patients with acute myocardial infarction (AMI). [Subjects] Thirty male subjects with AMI were divided into an experimental group (EG) and a control group (CG). Another 30 age-matched subjects with patent coronary arteries served as a normal-control group (NCG). [Methods] Subjects in EG (n=20) trained using a stationary bicycle for 30 min at their target heart rate twice a week for 8 weeks. Exercise capacity was defined as the maximal metabolic equivalents (METs) that subjects reached during the symptom-limited maximal exercise test. HR, BP and RPP were recorded. Subjects in EG and CG received exercise tests and screening for CRFs at the beginning of, end of, and 3 months after Phase II CET, while subjects in NCG participated only in the 1st test. [Results] METs of CG did not improve until the 3rd test, while RPP at the 2nd test showed a significant increase. However, EG showed increased METs at the 2nd test without increase of RPP, and increased their high density lipoprotein cholesterol (HDL-C) during the follow-up period between the 2nd and 3rd tests. [Conclusion] Phase II CET shortens the recovery time of exercise capacity, helps to maintain the gained exercise capacity and increases HDL-C in phase III.

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“…Heart failure has been defined as a “clinical syndrome caused by an abnormality of the heart but recognized by a characteristic pattern of hemodynamic, renal, neural, and hormonal responses”(7). In this review we prefer to define heart failure as a clinical syndrome that begins and ends with the heart.…”

Section: Congestive Heart Failure and Diabetesmentioning

confidence: 99%

Metformin in Diabetic Patients with Heart Failure: Safe and Effective

Ekeruo¹,

Solhpour²,

Taegtmeyer³

2013

Curr Cardiovasc Risk Rep

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Management of diabetic patients with heart failure is a complex endeavor. The initial reluctance to use metformin in these patients has given way to a broader acceptance after clinical trials and meta-analyses have revealed that some of the insulin-sensitizing agents lead to adverse cardiovascular events. We have proposed that an increase of substrate uptake by the insulinresistant heart is detrimental because the heart is already flooded with fuel. In light of this evidence, metformin offers a unique safety profile in the patient with diabetes and heart failure. Our article expands on the use of metformin in patients with heart failure. We propose that the drug targets both the source as well as the destination (in this case the heart) of excess fuel. We consider treatment of diabetic heart failure patients with metformin both safe and effective.

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Heart failure: why and how to define it?

Cited by 23 publications

References 15 publications

Incidence and outcome of persons with a clinical diagnosis of heart failure in a general practice population of 696,884 in the United Kingdom

Incidence and outcome of persons with a clinical diagnosis of heart failure in a general practice population of 696,884 in the United Kingdom

Supervised Phase II Cardiac Exercise Therapy Shortens the Recovery of Exercise Capacity in Patients with Acute Myocardial Infarction

Metformin in Diabetic Patients with Heart Failure: Safe and Effective

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