Quality of Life and Prognosis in Heart Failure: Results of the Beta-Blocker Evaluation of Survival Trial (BEST)

Tate, Charles; Robertson, Alastair D.; Zolty, Ronald; Shakar, Simon F.; Lindenfeld, JoAnn; Wolfel, Eugene E.; Bristow, Michael R.; Lowes, Brian D.

doi:10.1016/j.cardfail.2007.07.001

Cited by 42 publications

(32 citation statements)

References 23 publications

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“…Exclusion of patient with missing data would have inevitably lead to a survivorship bias 26 . We also performed the Little’s Missing Completely At Random (MCAR) test to determine whether the appropriateness of imputing missing values (Supplemental Data), and performed a Multivariate Imputation by Chained Equation (MICE) 27 to validate the finding of peak VO2 using a different method for data inference (Supplemental Data).…”

Section: Methodsmentioning

confidence: 99%

Interleukin-1 Blockade in Recently Decompensated Systolic Heart Failure

Tassell

Canada

Carbone

et al. 2017

Circ: Heart Failure

186

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Background An enhanced inflammatory response predicts worse outcomes in heart failure (HF). We hypothesized that administration of Interleukin-1 (IL-1) receptor antagonist (anakinra) could inhibit the inflammatory response and improve peak aerobic exercise capacity in patients with recently decompensated systolic HF. Methods and Results We randomly assigned 60 patients with reduced left ventricular ejection fraction (<50%) and elevated C-reactive protein (CRP) levels (>2 mg/L), within 14 days of hospital discharge, to daily subcutaneous injections with anakinra 100 mg for 2 weeks, 12 weeks, or placebo. Patients underwent measurement of peak oxygen consumption (VO2 [mL•kg−1•min−1]) and ventilatory efficiency (the VE/VCO2 slope). Treatment with anakinra did not affect peak VO2 or VE/VCO2 slope at 2 weeks. At 12 weeks, patients continued on anakinra showed an improvement in peak VO2 from 14.5 [10.5–16.6] to 16.1 [13.2–18.6] mL•kg−1•min−1 (P=0.009 for within-group changes), whereas no significant changes occurred within the anakinra 2-week or placebo groups. The between groups differences, however, were not statistically significant. The incidence of death or re-hospitalization for HF at 24 weeks was 6%, 31%, and 30%, in the anakinra 12-week, anakinra 2-week and placebo groups, respectively (Log-rank test P=0.10). Conclusions No change in peak VO2 occurred at 2 weeks in patients with recently decompensated systolic HF treated with anakinra, whereas an improvement was seen in those patients in whom anakinra was continued for 12 weeks. Additional larger studies are needed to validate the effects of prolonged anakinra on peak VO2 and re-hospitalization for HF.

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Section: Methodsmentioning

confidence: 99%

Interleukin-1 Blockade in Recently Decompensated Systolic Heart Failure

Tassell

Canada

Carbone

et al. 2017

Circ: Heart Failure

186

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“…Although we attempted to control for confounding factors, other, unidentified factors could have influenced the relationship between self-care management and event risk that were not included in the analysis. In previous studies, age,22 gender,35 BMI,36 depressive symptoms,25 comorbid conditions,37 LVEF,38 NYHA functional class,39 ischemic etiology,40 treatment with ACE inhibitors41 and β-blockers,26 quality of life,42 and activity limitations29 were identified as significant determinants of mortality or hospitalization in persons with HF. Thus, a strength of our study was that we controlled the influence of these factors.…”

Section: Strengths and Limitationsmentioning

confidence: 97%

Event-free survival in adults with heart failure who engage in self-care management

et al. 2011

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Background-Self-care management in heart failure (HF) involves decision-making to evaluate, and actions to ameliorate symptoms when they occur. The purpose of this study was to compare the risk of all-cause mortality, hospitalization or emergency room admission among HF patients who practice above average self-care management, those who practice below average self-care management, and those who are symptom-free.

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“…Numerous quality of life instruments are available for assessing patients with chronic heart failure, many of which cover aspects of emotional burden. [37][38][39] Whether these measures provide a comprehensive assessment of emotional work requires further research, and this important aspect of living with chronic illness must not be overlooked.…”

Section: T R E At Men T Bur Den O F Chronic He a R T Fa Ilur Ementioning

confidence: 99%

Understanding Patients' Experiences of Treatment Burden in Chronic Heart Failure Using Normalization Process Theory

Gallacher¹,

May²,

Montori³

et al. 2011

The Annals of Family Medicine

298

399

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PURPOSE Our goal was to assess the burden associated with treatment among patients living with chronic heart failure and to determine whether Normalization Process Theory (NPT) is a useful framework to help describe the components of treatment burden in these patients. METHODSWe performed a secondary analysis of qualitative interview data, using framework analysis, informed by NPT, to determine the components of patient "work." Participants were 47 patients with chronic heart failure managed in primary care in the United Kingdom who had participated in an earlier qualitative study about living with this condition. We identifi ed and examined data that fell outside of the coding frame to determine if important concepts or ideas were being missed by using the chosen theoretical framework. RESULTSWe were able to identify and describe components of treatment burden as distinct from illness burden using the framework. Treatment burden in chronic heart failure includes the work of developing an understanding of treatments, interacting with others to organize care, attending appointments, taking medications, enacting lifestyle measures, and appraising treatments. Factors that patients reported as increasing treatment burden included too many medications and appointments, barriers to accessing services, fragmented and poorly organized care, lack of continuity, and inadequate communication between health professionals. Patient "work" that fell outside of the coding frame was exclusively emotional or spiritual in nature.CONCLUSIONS We identifi ed core components of treatment burden as reported by patients with chronic heart failure. The fi ndings suggest that NPT is a theoretical framework that facilitates understanding of experiences of health care work at the individual, as well as the organizational, level. Although further exploration and patient endorsement are necessary, our fi ndings lay the foundation for a new target for treatment and quality improvement efforts toward patientcentered care.

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Quality of Life and Prognosis in Heart Failure: Results of the Beta-Blocker Evaluation of Survival Trial (BEST)

Cited by 42 publications

References 23 publications

Interleukin-1 Blockade in Recently Decompensated Systolic Heart Failure

Interleukin-1 Blockade in Recently Decompensated Systolic Heart Failure

Event-free survival in adults with heart failure who engage in self-care management

Understanding Patients' Experiences of Treatment Burden in Chronic Heart Failure Using Normalization Process Theory

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