Understanding the Epidemic of Heart Failure: Past, Present, and Future

Dunlay, Shannon M.; Roger, Véronique L.

doi:10.1007/s11897-014-0220-x

Cited by 171 publications

(136 citation statements)

References 104 publications

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“…12 The estimated five-year mortality is between 48-65% in patients with HF after the initial diagnosis. 70 In Sweden, the estimated one-year mortality is 24% in patients with NYHA class III and 50% in patients with class IV. …”

Section: Epidemiology Aetiology Co-morbidities and Prognosismentioning

confidence: 99%

Thirst in Patients with Heart Failure : Description of thirst dimensions and associated factors with thirst

Waldréus

2016

Linköping University Medical Dissertations

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Introduction: Nurses and other health care professionals meet patients with heart failure (HF) who report they are thirsty. Thirst is described by the patients as a concern, and it is distressing. Currently there are no standardized procedures to identify patients with increased thirst or to help a patient to manage troublesome thirst and research in the area of thirst is scarce. In order to prevent and relieve troublesome thirst more knowledge is needed on how thirst is experienced and what factors cause increased thirst. Aim: The aim of this thesis was to describe the thirst experience of patients with HF and describe the relationship of thirst with physiologic, psychologic and situational factors. The goal was to contribute to the improvement of the care by identifying needs and possible approaches to prevent and relieve thirst in patients with HF. Methods: The studies in this thesis used a cross-sectional design (Study I) and prospective observational designs (II-IV). Studies include data from patients with HF who were admitted to the emergency department for deterioration in HF (I, IV) or visited an outpatient HF clinic for worsening of HF symptoms (III); others were patients who were following up after HF hospitalization (II), and patients with no HF diagnosis who sought care at the emergency department for other illness (I). Patients completed questionnaires on thirst intensity, thirst distress, HF self-care behaviour, feeling depressive and feeling anxious. Data on sociodemographic, clinical characteristics, pharmacological treatment and prescribed fluid restriction were retrieved from hospital medical records and by asking the patients. Data were also collected from blood, urine and saliva samples to measure biological markers of dehydration, HF severity and stress. Results: Thirst was prevalent in 1 out of 5 patients (II) and 63% of patients with worsening of HF symptoms experienced moderate to severe thirst distress at hospital admission (IV). Patients at an outpatient HF clinic who reported thirst at the first visit were more often thirsty at the follow-up visits compared to patients who did not report thirst at the first visit (II). Thirst intensity was significantly higher in patients hospitalized with decompensated HF compared to patients with no HF (median 75 vs. 25 mm, visual analogue scale [VAS] 0-100 mm; P < 0.001) (I). During optimization of pharmacological treatment of HF, thirst intensity increased in 67% of the patients. Thirst intensity increased significantly more in patients in the high thirst intensity group compared to patients in the low thirst intensity group (median +18 mm vs. -3 mm; P < 0.001) (III). Patients who were admitted to the hospital with high thirst distress continued to have high thirst distress over time (IV). A large number of patients were bothered by thirst and feeling dry in the mouth when they were thirsty (III, IV). Patients with a fluid restriction had high thirst distress over time and patients who were feeling depressed had high thirst intensity over time...

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Section: Epidemiology Aetiology Co-morbidities and Prognosismentioning

confidence: 99%

Thirst in Patients with Heart Failure : Description of thirst dimensions and associated factors with thirst

Waldréus

2016

Linköping University Medical Dissertations

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“…Patients with HF are at risk of frequent hospitalisations, and the risk for readmission is high. However, due to more effective treatment there have been improvements as hospitalisations have decreased in recent years (McMurray et al 2012, Dunlay & Roger 2014.…”

Section: Background Living With Heart Failurementioning

confidence: 99%

“…However, the prognosis is still poor and the estimated five-year mortality is high, between 48-65% after initial diagnosis of HF (Dunlay & Roger 2014). The HF prognosis is related to symptom severity, where deterioration in symptoms indicates an increased risk for hospitalisations and death (McMurray et al 2012).…”

Section: IIImentioning

confidence: 99%

Participation in heart failure home-care : Patients’ and partners’ perspectives

Näsström¹

2015

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Introduction: Patient participation is important for improving outcomes and respecting selfdetermination and legal aspects in care. Heart failure is a chronic condition that puts high demands on self-care and patient participation. Patients often need advanced care due to deterioration of their heart failure symptoms, and one option is to provide care as home-care. There is limited knowledge of how patients with heart failure and their partners view participation in home-care. Aim: The overall aim of this thesis was to describe different perspectives of participation in structured heart failure home-care among patients with heart failure and their partners. Methods: All patients in this thesis received structured heart failure home-care, according to a model aiming to facilitate care, where safety, participation, and gaining knowledge about the illness and treatment, are in focus. Study I had a prospective pre-post longitudinal design including 100 patients with heart failure receiving home-care. Data was collected by selfadministered questionnaires. Study II had a descriptive design. Nineteen patients receiving home-care were interviewed, and data was analysed using qualitative content analysis. Study III had a descriptive and explorative design. Data was collected by video-recorded observations of 19 home visits and analysed by qualitative content analysis. Study IV had a parallel convergent mixed-method design including 15 partners of patients receiving structured home-care. Data was collected by interviews and self-administered questionnaires. Datasets were first analysed separately and then together. Results: Better self-care behaviour was significantly associated with all measured aspects of participation. Participation by received information increased significantly during the 12-month follow-up (I). Patients’ descriptions of participation included communication between patients and health care professionals, access to care, active involvement in care, a trustful relation with health care professionals, and options for decision-making(II). Observed care encounters revealed that participation was made possible by; (i) interaction, including exchange of care-related information, care-related reasoning, and collaboration, (ii) an enabling approach, including the patient expresses own wishes and shows an active interest, and the nurse is committed and invites to a dialogue (III). Partners scored fairly positive for their participation in care and they performed different levels of caregiving tasks. Descriptions of participation included; adapting to the caring needs and illness trajectory, mastering caregiving demands, interacting with care providers, and gaining knowledge to comprehend the health situation. The mixed-method results showed both convergent results and expanded knowledge (IV). Conclusions: Structured heart failure home-care facilitated participation both for patients and their partners. Patient participation with regard to received information improved significantly after receiving home-care. As...

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“…eart failure (HF) is a major growing public health problem in most industrialized countries (1,2), among which Japan is now included. It is estimated that there are approximately 1-2 million patients with HF and nearly 130 per 100,000 individuals die of heart disease each year, which is closely related to the rapid aging of the Japanese population (3,4).…”

mentioning

confidence: 99%

Utility of Phase Standard Deviation and Histogram Bandwidth, Derived from Phase Analysis, as Clinical Indicators of Heart Failure

Tomita

Nakae

Hayashi

et al. 2017

Annals of Nuclear Cardiology

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Purpose: "Heart Function View (HFV)" is a software that performs phase analysis as well as functional assessment of the left ventricle (LV) using myocardial perfusion single photon emission computed tomography (SPECT) (MPS). Phase analysis-derived phase standard deviation (PhSD) and histogram bandwidth (PhHB) are good indices for detecting LV dyssyncrony. We aimed to examine whether PhHB and/or PhSD (PhHB/PhSD) are useful clinical indicators that reflect the severity of heart failure (HF) in comparison with the LV ejection fraction (EF). Methods: Patients underwent 99mTc-tetrofosmin quantitative gated MPS including treadmill exercise. In HFV analyses, patients with induced ischemia were excluded. Phase and time-volume curve analyses were performed using HFV (n=66).Results: PhHB/PhSD correlated with LV end-diastolic volume (EDV), end-systolic volume (ESV), the first-third filling fraction (1/3FF), and peak filling rate (PFR) as well as echocardiography tissue Doppler-derived E/e' as hemodynamic parameters of HF severity. LVEF also correlated with these hemodynamic parameters, except for 1/3FF. PhHB/PhSD positively correlated with log BNP as a neurohumoral marker of HF severity. LVEF negatively correlated with log BNP. PhHB/PhSD negatively correlated with exercise capacity as physiological indicators of HF severity, whereas LVEF did not. PhHB/PhSD were significantly greater in patients receiving cardiac resynchronization therapy (CRT, n=6) than in non-CRT patients (n=66), whereas LVEF were lower. Conclusion: PhHB/PhSD, similar to LVEF, are useful clinical indicators for evaluating HF severity. However, the clinical significance of LVEF and PhHB/PhSD differ. Thus, a phase analysis may additively offer useful information for the management of HF.

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Understanding the Epidemic of Heart Failure: Past, Present, and Future

Cited by 171 publications

References 104 publications

Thirst in Patients with Heart Failure : Description of thirst dimensions and associated factors with thirst

Thirst in Patients with Heart Failure : Description of thirst dimensions and associated factors with thirst

Participation in heart failure home-care : Patients’ and partners’ perspectives

Utility of Phase Standard Deviation and Histogram Bandwidth, Derived from Phase Analysis, as Clinical Indicators of Heart Failure

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