Health-related quality of life among congestive heart failure patients with preserved and reduced ejection fraction

Objective:To determine factors that affect the health-related quality of life(HRQOL)of congestive heart failure(CHF)patients with preserved and reduced ejection fraction.Methods:A cross-sectional study design was used for this study.The stratified random sampling was applied for each subgroup.HRQOL was measured with the Minnesota Living with Hear t Failure Questionnaire.The data were analyzed using chi-square,Spearman's correlation analysis,and independent t-test.Results:A number of 67 respondents participated in the recent study.The total mean scores of HRQOL were significantly different(P=0.001)between heart failure(HF)patients with reduced and preserved ejection fractions,41.07±7.54 and 54.97±4.36,respectively.It related with the physical(mean±standard deviation[SD]=10.4±2.14;t=-10.08,95%CI=-12.46 to-8.34;P-value=0.001)and psychological(mean±SD=3.5±0.5;t=-6.68,95%CI=-4.55 to-2.45;P-value=0.001)domain.Strong correlation was found between age(r=-0.898,P<0.05),NYHA functional classes(r=-0.858,P<0.01),duration of HF(r=-0.807,P<0.01),family support(r=0.927,P<0.01),and quality of life(Qo L).Conclusions:HRQOL in HF patients with reduced ejection fraction was higher than in those with preserved ejection fraction.Family suppor t is a fur ther determinant factor that has a positive correlation to the Qo L.

Effects of health concept model-based detailed behavioral care on mood and quality of life in elderly patients with chronic heart failure

BACKGROUND With the intensification of social aging,the susceptibility of the elderly population to diseases has attracted increasing attention,especially chronic heart failure(CHF)that accounts for a large proportion of the elderly.AIM To evaluate the application value of health concept model-based detailed behavioral care in elderly patients with CHF.METHODS This study recruited 116 elderly CHF patients admitted from October 2018 to October 2020 and grouped them according to the nursing care that they received.The elderly patients who underwent health concept model-based detailed behavioral care were included in a study group(SG;n=62),and those who underwent routine detailed behavioral nursing intervention were included as a control group(CG;n=54).Patients’negative emotions(NEs),quality of life(QoL),and nutritional status were assessed using the self-rating anxiety/depression scale(SAS/SDS),the Minnesota Living with Heart Failure Questionnaire(MLHFQ),and the Modified Quantitative Subjective Global Assessment(MQSGA)of nutrition,respectively.Differences in rehabilitation efficiency,NEs,cardiac function(CF)indexes,nutritional status,QoL,and nursing satisfaction were comparatively analyzed.RESULTS A higher response rate was recorded in the SG vs the CG after intervention(P<0.05).After care,the left ventricular ejection fraction was higher while the left ventricular end-diastolic dimension and left ventricular end systolic diameter were lower in the SG compared with the CG(P<0.05).The post-intervention SAS and SDS scores,as well as MQSGA and MLHFQ scores,were also lower in the SG(P<0.05).The SG was also superior to the CG in the overall nursing satisfaction rate(P<0.05).CONCLUSION Health concept model-based detailed behavioral care has high application value in the nursing care of elderly CHF patients,and it can not only effectively enhance rehabilitation efficiency,but also mitigate patients’NEs and improve their CF and QoL.

Effects of Kanlijian (坎离煎) on Exercise Tolerance, Quality of Life, and Frequency of Heart Failure Aggravation in Patients with Chronic Heart Failure

Objective： To observe the effects of conventional therapy combined with Kanlijian （ 坎离煎, KLJ） on exercise tolerance, quality of life and frequency of heart failure aggravation in patients with chronic heart failure（CHF）. Methods： Sixty CHF patients differentiated as sufferring from the syndrome of Xin-Shen Yang deficiency were included in the study and randomly assigned at the ratio of 2 ： 1 into the KLJ group （n =39） and the control group（n = 21）. All the patients were treated with conventional therapy of Western medicine, but to those in the KLJ group, KLJ was medicated additionally one dose daily with 24 wks as one therapeutic course. The efficacy on TCM syndrome and changes of scores on TCM syndrome were observed after treatment. The indexes, including 6-minute walking distance （6MWD）, quality of life （QOL, accessed by LHFQ scoring）, NYHA grade, hemodynamic indexes and reducing/withdrawal rate of diuretic and digoxin before and after treatment were recorded and compared. Also the frequency of re-admission due to aggravation of heart failure in one year＇ s time were observed. Results： （ 1 ） The efficacy on TCM syndrome, improvement on scores of TCM syndrome, therapeutic effects on 6MWD, QOL, and NYHA grade in the KLJ group were superior to those in the control group. （2） Hemodynamic indexes after treatment, left ventricular fractional shortening （LVFS） and E peak/A peak （E/A）, between the two groups had no significant difference, while left ventricular ejection fraction （LVEF） was increased significantly in the KLJ group, but with no obvious change in the control group. （3） The reducing/withdrawal rate of diuretic and digoxin in the KLJ group was significantly higher than that in the control group. （4） The 1-year frequency of re-admission significantly decreased in the KLJ group. Conclusion： The adjuvant treatment of KLJ on the basis of Western conventional therapy can significantly improve CHF patients＇ exercise tolerance, quality of life and cardiac function, reduce the dosage of diuretic and digoxin needed, and decrease the re-admission frequency due to aggravation of heart failure.

Symptom clusters and quality of life among patients with advanced heart failure

ObjectivesTo 与先进的心失败(HF ) 和与他们 .MethodsThis 是的生活(QoL ) 的质量的独立关系在病人之中识别症状簇会见了 119 个病人与的代表性的研究的第二等的数据分析在香港在一所地区性的医院的衰老老人单位推进了 HF。症状侧面和 QoL 被使用埃德蒙顿症状评价规模(ESAS ) 和 McGill QoL 问询表估计。探索因素分析被用来识别症状簇。层次回归分析被用来与他们的 QoL 检验独立关系，在调整病人们在先进年龄的年龄，性，和 comorbidities.ResultsThe 的效果以后(82.9 &#x000b1；6.5 年) 。三不同症状簇被识别：他们是悲痛簇(呼吸，焦虑，和消沉的包括的短小) ， decondition 簇(疲劳，睡意，恶心，和减少的胃口) ，和不快聚类(概括不快的疼痛，和感觉) 。这三症状簇说明了病人症状经验的 63.25% 变化。对在这些症状簇之间的中等关联小显示他们是独立人士互相。在调整年龄，性和 comorbidities 以后，悲痛(&#x003b2；=&#x02212； 0.635， P &#x0003c；0.001 ) ， decondition (&#x003b2；=&#x02212； 0.148， P = 0.01 ) ，并且不快(&#x003b2；=&#x02212； 0.258， P &#x0003c；0.001 ) 症状簇独立地预言他们的 QoL.ConclusionsThis 学习与先进 HF 在病人之中识别了特殊症状簇。结果使需要清楚些为为这限制生活的疾病优化症状控制开发辩解的照顾干预。

Neuroticism personality trait is associated with Quality of Life in patients with Chronic Heart Failure

AIM: To evaluate Quality of life(QoL) in chronic heart failure(CHF) in relation to Neuroticism personality trait and CHF severity.METHODS: Thirty six consecutive, outpatients with Chronic Heart Failure(6 females and 30 males, mean age: 54 ± 12 years), with a left ventricular ejection fraction ≤ 45% at optimal medical treatment at the time of inclusion, were asked to answer the Kansas City Cardiomyopathy Questionnaire(KCCQ) for Quality ofLife assessment and the NEO Five-Factor Personality Inventory for personality assessment. All patients un-derwent a symptom limited cardiopulmonary exercise testing on a cycle-ergometer, in order to access CHF severity. A multivariate linear regression analysis us-ing simultaneous entry of predictors was performed to examine which of the CHF variables and of the person-ality variables were correlated independently to QoL scores in the two summary scales of the KCCQ, namely the Overall Summary Scale and the Clinical Summary Scale.RESULTS: The Neuroticism personality trait score had a significant inverse correlation with the Clinical Sum-mary Score and Overall Summary Score of the KCCQ(r =-0.621, P < 0.05 and r =-0.543, P < 0.001, respec-tively). KCCQ summary scales did not show significant correlations with the personality traits of Extraversion, Openness, Conscientiousness and Agreeableness. Mul-tivariate linear regression analysis using simultaneous entry of predictors was also conducted to determine the best linear combination of statistically significant univari-ate predictors such as Neuroticism, VE/VCO2 slope and VO2 peak, for predicting KCCQ Clinical Summary Score. The results show Neuroticism(β =-0.37, P < 0.05), VE/VCO2 slope(β =-0.31, P < 0.05) and VO2 peak(β = 0.37, P < 0.05) to be independent predictors of QoL. In multivariate regression analysis Neuroticism(b =-0.37, P < 0.05), the slope of ventilatory equivalent for carbon dioxide output during exercise,(VE/VCO2 slope)(b =-0.31, P < 0.05) and peak oxygen uptake(VO2 peak),(b = 0.37, P < 0.05) were independent predictors of QoL(adjusted R2 = 0.64; F = 18.89, P < 0.001).CONCLUSION: Neuroticism is independently associat-ed with QoL in CHF. QoL in CHF is not only determined by disease severity but also by the Neuroticism person-ality trait.

Quality of life in elderly heart failure patients

Quality of life (QOL), as a relevant area of research in the understanding of heart failure (HF) patient outcomes, has been increasingly studied during the last two decades. The purposes of this review article are to (1) describe QOL in older adults with HF, (2)identify and critique research designed to test interventions to improve QOL, (3) identify gaps in the literature, and (4) provide recommendations for future research. Seventeen studies describing QOL in older adults with HF were identified. Elderly HF patient QOL has been reported to be fair to poor and is worse as compared to a healthy control group. Furthermore, there is some evidence that suggests that QOL is better in older adults than younger adults and worse in women (both older and younger) than in men, although these findings are not consistent across studies. Predictors of QOL and its dimensions in older HF patients included demographic, clinical, and psychosocial variables. Sixteen interventional studies were identified that reported QOL as an outcome in older adults. Findings among randomized clinical trials (RCTs) to improve QOL outcomes in elderly HF patients do not allow strong conclusions about the benefits of the interventions. It must be noted, though, that while not all studies reported improvements in QOL (either significant or as a trend),no studies reported deterioration in QOL with randomization to an intervention versus control. These studies were limited by several methodological issues. While there has been some research of QOL in this elderly cohort, it is paramount that we address methodological issues and thereby improve the scientific rigor of our research, continue to explore QOL in elderly HF patients, and design intervention trials for elders at risk for poor QOL.

Comparative analysis of the quality of life of heart failure patients in South Western Nigeria

Background: Heart failure (HF) is a common, chronic clinical syndrome with appreciable impact on both prognosis and lifestyle of patients. Two main aims of management include preventing disease progression and improving quality of life (QoL). Not much work has been done in this area in Sub-Saharan Africa and most of the available disease specific instruments were developed using the Caucasian population. Aim: We therefore evaluated the QoL of stable HF patients attending the cardiology clinic of the Lagos University Teaching Hospital using a disease specific instrument, Kansas City Cardiomyopathy Questionnaire (KCCQ) and a generic one, the WHOQOL- BREF. Method: Consenting, stable HF patient were recruited from the cardiology clinic of the Lagos University Teaching Hospital. Relevant clinical data and echocardiographic parameters were retrieved from their clinical notes and the subjects filled out the questionnaires, the KCCQ and the WHOQOL-BREF. The QoL and four main domains in the WHOQOL- BREF were compared with scores on the KCCQ for relationships. Result: Data set of 190 patients was analysed. There were 91 (47.9%) males and 99 (52.1%) females with a mean age 51.90 ± 13.21 yrs. Only 52 (27.4%) had college education and 143 (75.2%) had very poor personal resources. About 104 (54.7%) were paying their medical bills themselves. The mean QoL score using the KCCQ score was 59.61 ± 23.80. With The KCCQ, 6.9% felt their QoL was poor and 20% felt it was fair while 11.6% and 20.5% felt their QoL was poor and fair respectively with the WHOQOL-BREF. There was positive correlation,

Quality of Life of Chronic Heart Failure Patients

Background: Chronic Heart Failure is a complex clinical conditions affecting patients’ Quality of Life (QoL) globally. Objective: The aim of the study was to identify the factors influencing the quality of life of the chronic heart failure patients. Methods: A descriptive exploratory study was carried out by face-to-face interview with structured standard questionnaire. One hundred and forty two hospitalized chronic heart failure patients were conveniently recruited from National Institute of Cardiovascular Disease and Hospital, Sher-e-Bangla Nagar, Dhaka, Bangladesh. Data were collected from January to February, 2019. Quality of life related factors were identified using Patients’ General Characteristics Questionnaire. QOL of chronic heart failure patients was measured by the Minnesota Living with Heart Failure Questionnaire (MLHFQ) and the World Health Organization’s Quality of Life Instrument-Short Version (WHOQOL-BREF). Descriptive statistic was used to describe the samples’ characteristics. Association between Socio-demographic characteristics and QOL of chronic heart failure patients was measured using t-test and one way of ANOVA. Relationship between continuous variables was measured by Pearson correlation test. Results: Findings reveal that mean of the total chronic heart failure related quality of life was 94.16 (SD = 3.20) out of maximum of 105. This high score indicates worsen chronic heart failure patients’ quality of life. The mean score of general quality of life of chronic heart failure patients was calculated as 41.05 (SD = 5.109) out of maximum of 130 which indicates low level of general quality of life of chronic heart failure patients. There is a significant positive correlation found between disease related quality of life and general quality of life of chronic heart failure patients. Dimensions of physical (r = 0.248, p = 0.000), mental (r = −0.180, p < 0.001) and total (r = −0.141, p < 0.001) of MLHFQ were significantly correlated with psychological dimension of WHOQOL-BREF except total two dimensions of its. Gender, marital status, education, income, smoking, residence and BMI were identified as factors having an effect on QOL of Chronic Heart Failure patients. Conclusion: Further intervention study is necessary to improve the quality of life of chronic heart failure patients.

Prognostic Potential of B - type Natriuetic Peptide and Quality of Life in Patients with Chronic Heart Failure

Objectives To study wheth- er change of BNP levels reflect the change of cardiac function and to investigate the short - term prognostic potential of BNP and QOL in patients with CHF. Methods 96 consecutive patients admittedwith CHF between September 2002 and January 2003 were stud- ied , upon entry the study, BNP levels were measured, Patients administered the disease - specificquality of life questionnaire Minnesota living with heart failure questionnaire (LiHFe) within 1 day. BNP levels and administering LiHFe were repeated three months later. Results BNP levels were increased proportional to the severity of cardiac function. Physical domain and total score of LiHFe were significantly correlated to the severity of CHF ( p < 0. 05 ). BNP levels were de- creased in improving group(p =0. 032) . In deteriora- ting group BNP levels increased (P = 0. 043 ) . Kaplan - meier analysis according to BNP level cutoff point 150 ng/1, the life curve of higher BNP level group was significantly lower than the lower group ( p = 0. 001 ) . In univariate logistic regression, NYHA class, BNP, LVEF, LVEDD, heart size, total score of LiHFe, phys- ical domain of LiHFe and the emotional domain of LiH- Fe were all significant prognostic factors of CHF ( p < 0. 05 for all). While in multiple regression, only BNP level( p = 0. 036) and the emotional domain of LiHFe ( p = 0. 025 ) were independent prognostic factors. Conclusions Change of BNP reflects the treatment efficacy of CHF. BNP and QOL are the two major short - time prognostic factors of the chronic heart failure patients.

Comparative study of quality of life after hospital-at-home or in-patient admission for acute decompensation of chronic heart failure

AIMS: Hospitalisation at home (HaH) achieves comparable health outcomes to conventional in-patient care, in terms of cost-effectiveness and quality of life. Our objective was to assess the impact of episodes of acute decompensation of heart failure (ADCHF) on functional status and quality of life, in patients under HaH care compared with a matched group receiving conventional in-patient care at a Cardiology ward (CW). Methods: Randomised clinical trial in 71 patients with ADCHF attending the Emergency Department. Patients were either admitted to the hospital’s CW or to the HaH service. The functional status and health related quality of life (HRQOL) were assessed using the Barthel Index (BI) and the EQ-5D, Short Form-36 (SF-36) and Minnessota Living with Heart Failure (MLHFQ) questionnaires, administered at admission and, depending on the test, at discharge and 1, 3, 6 and 12 months after discharge. Results: MLHFQ and SF-36 experienced significant improvement in most domains with respect to the initial values at discharge and 6 months after only in the HaH group;though by 12-months there were no significant differences. Barthel Index and EQ-5D value scores showed improvement with respect to initial values in both arms. The improvement could be appreciated in more components and for longer among the HaH patients. Conclusions: Functional independence and quality of life improve at discharge compared to admission, after both home-based and in-patient hospitalisation, outcomes being better in various respects over the first year of follow-up after hospital-at-home care.

Analysis of the Status and Factors Influencing Anxiety and Depression in Patients with Chronic Heart Failure and Their Primary Caregivers: Empirical Quantitative Research

Objective: This study examined the associations between anxiety, depression, and quality of life among hospitalized patients with chronic heart failure and their primary caregivers. Patients and Methods: Between May and September 2018, the data were collected from 61 patients and their caregivers. Demographic information of CHF patients was collected by questionnaires; the Hospital Anxiety and Depression Scale (HADS) and the Minnesota Living with Heart Failure Questionnaire (MLHFQ) were used to assess CHF patient’s anxiety, depression and quality of life (QOL); the HADS, the Family Caregiver Quality of Life (FAMQOL) were used to assess primary caregivers’ anxiety, depression and QOL. Descriptive statistics, correlation analysis, independent-sample t-test, one-way analysis of variance and multiple stepwise regression were used in the statistical analysis. SPSS 17.0 was used to manage and perform statistical analyses. Results: Quality of life, anxiety, and depression of the patients and caregivers had significant positive correlations. Gender, quality of life, number of hospitalizations, duration of patients’ heart failure, and the quality of life of caregivers influenced patients’ anxiety. Gender, quality of life, relationship with the patient, and depression of caregivers influenced their anxiety. The quality of life and anxiety of patients influenced their depression. Daily caregiving time, anxiety, relationship with patients, and the patients’ heart function influenced caregivers’ depression. Conclusion: The patients and caregivers experienced anxiety and depression, which interacts and decreases their quality of life. It is important to regularly assess anxiety, depression, and quality of life in patients with chronic heart failure and their primary caregivers.

Therapeutic Education of Heart Failure: Prospective Study in the Cardiology Department of the Dalal Jamm National Hospital Center in Dakar

Context: Heart failure (HF) is a common pathology requiring many types of treatments, including therapeutic education, which has demonstrated a major benefit in terms of reducing re-hospitalization and mortality from HF or all other causes. Objective: The aim of this study was to evaluate the contribution of therapeutic education (TPE) in patients with heart failure. Methodology: This was a single-centre, interventional, non-randomized, before-and-after type study. It focused on hospitalized heart failure patients aged 18 and over. We evaluated the effect of TPE on therapeutic compliance, knowledge, practical attitudes, patient perceptions and quality of life. Results: Our study included 41 patients prior to therapeutic education: 17 men (41%) and 24 women (59%). The mean age was 54.7 ± 16.2 years. After the TPE sessions we evaluated 32 patients: The patients with good compliance increased from 75% to 90.63%, and patients with a low level of compliance (90.6%) decreased to 34.4%. An increase in the number of patients who had an attitude adapted to not exceeding the recommended amount of salt (6 before TPE and 22 after TPE), as well as in the number of patients who had an attitude adapted to physical activity (12 before TPE and 16 after TPE). There was also an increase in the number of patients who were confident about the outcome of their disease (12 before TPE and 16 after TPE), and a decrease in those who were hopeless (8 before TPE and 5 after TPE), an improvement in the quality of life score (45.03 before TPE and 15.78 after TPE). Conclusion: This study shows the beneficial effect of therapeutic education in patients hospitalized for heart failure in improving their level of knowledge, compliance with treatment, lifestyle habits and quality of life.

Respiratory training interventions improve health status of heart failure patients: A systematic review and network meta-analysis of randomized controlled trials

BACKGROUND Prior studies indicate that doing breathing exercises improves physical performance and quality of life (QoL) in heart failure patients. However, these effects remain unclear and contradictory. AIM To determine the effects of machine-assisted and non-machine-assisted respiratory training on physical performance and QoL in heart failure patients. METHODS This was a systematic review and network meta-analysis study. A literature search of electronic databases was conducted for randomized controlled trials (RCTs) on heart failure. Respiratory training interventions were grouped as seven categories: IMT_Pn (inspiratory muscle training without pressure or < 10% maximal inspiratory pressure, MIP), IMT_Pl (inspiratory muscle training with low pressure, 10%-15% MIP), IMT_Pm (inspiratory muscle training with medium pressure, 30%-40% MIP), IMT_Ph (inspiratory muscle training with high pressure, 60% MIP or MIP plus aerobics), Aerobics (aerobic exercise or weight training), Qi_Ex (tai chi, yoga, and breathing exercise), and none. The four outcomes were heart rate, peak oxygen uptake (VO2 peak), 6-min walking distance test (6MWT), and Minnesota Living with Heart Failure QoL. The random-effects model, side-splitting model, and the surface under the cumulative ranking curve (SUCRA) were used to test and analyze the data. RESULTS A total of 1499 subjects from 31 RCT studies were included. IMT_Ph had the highest effect sizes for VO2 peak and 6MWT, IMT_Pm highest for QoL, and Qi_Ex highest for heart rate. Aerobics had the second highest for VO2 peak, Qi_Ex second highest for 6MWT, and IMT_Ph second highest for heart rate and QoL.CONCLUSION This study supports that high- and medium-intensity machine-assisted training improves exercise capacity and QoL in hospital-based heart failure patients. After hospital discharge, non-machine-assisted training continuously improves cardiac function.

Exercise Training Post Cardiac Resynchronization Therapy Improves Exercise Tolerance and Quality of Life

Background: Cardiac resynchronization therapy (CRT) results in improved morbidity, mortality, symptoms, quality of life (QOL) and exercise capacity, in appropriate chronic heart failure (CHF) patients. Moreover, combined exercise training (ET) and CRT maximize these improvements in these patients. The study evaluated the effect of ET on these patients in terms of QOL, functional class, exercise capacity and left ventricular ejection fraction (LVEF). Results: There were significant improvements in the QOL, functional class, exercise capacity, and LVEF compared with the Control Group. Comparison of both groups confirmed the cumulative effects of ET with CRT. The QOL improved by the end of training in the exercise group (p = 0.001), compared to the Control Group (p = 0.850). NYHA functional class improved significantly in the Exercise Group (p = 0.013). Percent-predicted peak oxygen consumption (VO2 peak) had significantly improved in the trained (p < 0.001) versus the untrained CRT Group (p= 0.596). There was a mean percent rise of the ejection fraction from 39.2 ± 12.86 to 44.40% ± 14.42% in the Exercise Group compared to a non-significant change in the Control Group. Conclusion: ET in resynchronized CHF patients is feasible and further enhances QOL and exercise tolerance in addition to the improvements seen after CRT. The study therefore recommends for the prescription of ET after implantation in order to maximize the expected benefit.

Clinical Research of Zhenwu Decoction Combined with Tingli Dazao Xiefei Decoction in the Treatment of Chronic Heart Failure with Edema Syndrome due to Yang Deficiency

[Objectives]The paper was to investigate the clinical effects of Zhenwu Decoction combined with Tingli Dazao Xiefei Decoction in the treatment of chronic heart failure with edema syndrome due to yang deficiency.[Methods]Eighty patients with chronic heart failure were randomly divided into 2 groups(control group and treatment group),with 40 cases in each group.The patients in the control group were treated with conventional western medicine for 14 d,and the patients in the treatment group were treated with Zhenwu Decoction and Tingli Dazhao Xiefeng Decoction on the basis of the control group for 14 d.The curative effect of traditional Chinese medicine(TCM)syndrome score,left ventricular ejection fraction(LVEF),plasma N-terminal brain natruretic peptide precursor(NT-proBNP)and New York Heart Association(NYHA)functional class were compared between the two groups before and after treatment.Minnesota living with heart failure questionnaire in the principle of Chinese civilization and traditional medicine characteristics(C-MLHF)at admission and 1 month after discharge were compared between the two groups.[Results]After treatment,the total effective rate of TCM syndrome score in the treatment group was 82.50%,and that in the control group was 67.50%.The curative effect of TCM syndrome score in the treatment group was better than that in the control group(P<0.05).After treatment the LVEF in both groups was increased compared with that before treatment,and the NT-proBNP level was decreased compared with that before treatment(P<0.05),and those in the treatment group were better than those in the control group.The total effective rate of cardiac function in the treatment group was 87.50%,and that in the control group was 65.00%.The improvement of cardiac function in the treatment group was better than that in the control group(P<0.05).One month after discharge,C-MLHF scores in both groups were decreased compared with those before treatment,and that in the treatment group was lower than in the control group(P<0.05).[Conclusions]Zhenwu Decoction combined with Tingli Dazao Xiefei Decoction based on traditional western medicine treatment could improve the clinical efficacy,symptoms and quality of life of patients in the treatment of chronic heart failure with edema syndrome due to yang deficiency.

Cardiac exercise rehabilitation for heart failure:a review of the literature

The most common symptom of patients with heart failure is reduced exercise tolerance,as indicated by decreased peak oxygen uptake(VO2peak),which is associated with both reduced quality of life and survival.Cardiac rehabilitation is a safe and effective treatment for clinically stable patients with heart failure,and is associated with improvements in cardiopulmonary function,muscle strength,physical functional performance,and quality of life.Further,cardiac rehabilitation is associated with a reduction in heart failure hospitalization and mortality.Despite evidence of these benefits,cardiac rehabilitation referral and compliance among patients with heart failure remains low.In this review,we discuss exercise and training program selection for patients with heart failure,including optimal exercise training intensity,and a summary of recent literature on the use of cardiac rehabilitation for patients with heart failure.

Ivabradine tolerability in heart failure

The Systolic Heart failure treatment with the I( inhibitor ivabradine Trial (SHIFT, n = 6505) evaluated patients with symptomatic chronic heart failure (CHF), in sinus rhythm with resting heart rate ≥70 beats/min and left ventricular ejection fraction (LVEF)≤ 35%, average age 60 ± 11 years[1].

Drug therapy for heart failure in older patients —what do they want？

长期的心失败(CHF ) 主要在更老的病人被看见，因此真实的生活药经常从在年轻得多的人口进行的试用要求调查结果的推测。规定模式和潜力受益在老被 polypharmacy 和 co 疾病的病理重重地影响。增加的长寿可以变得不太相关在脆弱老，而改善，生活(QoL ) 的质量经常成为优先级；在改进幸福上的义务，维持独立为更长，并且推迟 institutionalisation。与 CHF 评估老病人的特定的研究正在缺乏，很少关于 tolerability 和证据的副作用侧面被知道在这张人口的基于的药治疗。在有征兆的 CHF 的病人的心率的影响上有最近的兴趣。与降低能力的选择心率， Ivabradine 在湾穴节奏具有在有 CHF 和左室的收缩机能障碍的病人的利益，导致心失败 hospitalisation 和心血管的死亡的减小。这张手稿将集中于 CHF 和更老的病人并且将讨论心率，药治疗和 tolerability 的影响。它将也为集中于描述很治疗学的审判的集中病人的学习结束点而非死亡目标的特定的研究加亮未满足的需要。在介绍一个唯一的机会评估 tolerability 并且确定的治疗影响大量真实生活的 QoL 上评估 ivabradine 的影响的进行中的研究，有 CHF 的更老的病人将被讨论。

循序渐进的运动康复护理对慢性心衰患者运动耐力、生活质量及不良心脏事件的影响

目的探究循序渐进的运动康复护理对慢性心衰患者运动耐力、生活质量及不良心脏事件的影响。方法选取2022年6月-2023年6月我院收治的106例慢性心衰患者进行研究。以随机数字表法均分为2组。对照组(53例):基础护理。观察组(53例):循序渐进的运动康复护理。比较6 MWD、生活质量、不良心脏事件、满意度。结果干预前,两组6 MWD相比差异不显著(t=0.267,P=0.790),干预3个月后,两组6 MWD均显著提升(t=11.710,P=0.000,t=8.469,P=0.000),且观察组(403.18±62.11)m高于对照组(375.51±68.43)分,差异显著(t=2.180,P=0.032)。干预前,两组生活质量评分相比差异不显著(t=1.690,P=0.094),干预3个月后,两组生活质量评分均显著提升(t=14.053,P=0.000,t=8.409,P=0.000),且观察组(47.11±3.16)分高于对照组(42.34±3.28)分,差异显著(t=7.625,P=0.000)。与对照组16.98%的心衰加重、心源性再入院、急性心肌梗死、心律失常等不良心脏事件总发生率相比,观察组(3.77%)显著降低,差异显著(χ^(2)=4.970,P=0.026)。观察组满意度(90.57%)优于对照组(75.47%),差异显著(χ^(2)=4.283,P=0.039)。结论循序渐进的运动康复护理在提升慢性心衰患者运动耐力方面有积极意义。该护理能够提高患者生活质量及满意度,降低不良心脏事件的发生率。