Objective: to analyze the effect of sports rehabilitation nursing combined with comfortable intervention on cardiac function for patients with chronic congestive heart failure. Methods: the study period was from Novem...Objective: to analyze the effect of sports rehabilitation nursing combined with comfortable intervention on cardiac function for patients with chronic congestive heart failure. Methods: the study period was from November 2019 to December 2020 (excluding January to February 2020). 80 patients with chronic congestive heart failure were selected by convenient sampling. They were divided into control group (routine care) and observation group (sports rehabilitation nursing) according to the order of admission. Cardiac function level, functional motor ability and quality of life were evaluated and compared between the two groups after intervention. Results: the indexes of heart function in the observation group were significantly better than those in the control group, and the difference was statistically significant (P < 0.05). The walking distance and walking speed of the observation group at 6min after intervention were longer and faster than those of the control group, and the differences were statistically significant (P < 0.05). The exercise ability of the two groups after intervention was better than that before intervention. The quality of life assessment in the observation group was better than that in the control group, and the difference was statistically significant (P < 0.05). Conclusion: exercise rehabilitation nursing combined with comfortable intervention (intermixed with muscle relaxation training) for patients with chronic congestive heart failure. It is helpful to improve cardiac function, enhance functional exercise ability, and improve life quality. It is suitable for routine implementation in cardiovascular medicine.展开更多
Objective: to explore the curative effect of sacubatrosalkubatroxartan sodium tablets combined with shenfu injection in the treatment of chronic congestive heart failure. Methods: 70 patients with chronic congestive h...Objective: to explore the curative effect of sacubatrosalkubatroxartan sodium tablets combined with shenfu injection in the treatment of chronic congestive heart failure. Methods: 70 patients with chronic congestive heart failure treated in our hospital from September 2020 to August 2021 were randomly divided into two groups. 35 patients in the control group were given sacubatrosalkubatroxartan sodium tablets and routine treatment, and 35 patients in the observation group were given shenfu injection on the basis of the treatment measures of the control group. The total effective rate and cardiac function indexes of the two groups were compared. Results: the effective rate of the control group was lower than that of the observation group (P < 0.05);LVEF, LVESD and LVEDD in the control group were lower than those in the observation group (P < 0.05);The levels of serum BNP, ET-1 and hs-CRP in the observation group were lower than those in the control group (P < 0.05);There was no significant difference in the incidence of adverse reactions between the two groups (P > 0.05). Conclusion: the curative effect of sacubatrosalkubatroxartan sodium tablets combined with shenfu injection in the treatment of chronic congestive heart failure is positive, which is conducive to the improvement of cardiac function, and is worthy of popularization.展开更多
Objective To explore the role of serum fibrotic indices including hyaluronic acid （HA）, procollagen type Ⅲ NH2-terminal peptide （PCIIIP）, and laminin （LN） in assessing the severity of myocardial fibrosis in chr...Objective To explore the role of serum fibrotic indices including hyaluronic acid （HA）, procollagen type Ⅲ NH2-terminal peptide （PCIIIP）, and laminin （LN） in assessing the severity of myocardial fibrosis in chronic congestive heart failure （CHF）. Methods Serum levels of HA, PCIIIP, and LN in 39 patients with CHF E [14 with New York Heart Association （NYHA） functional class II, 21 with class Ⅲ, 4 with class Ⅳ] and in 46 patients with NYHA functional class I were assessed by radioimmunoassay. Results The serum concentrations of HA, PCMP, and LN were 359.75 ± 84.59 μg/L, 77.88 ± 24. 67 μg/L, 86. 73 ± 23.90 μg/L in CHF group, and 211.60 ±54. 80 μg/L, 64.82 ±23.99 μg/L, 82. 26 ±23.98 μg/L in NYHA functional class Ⅰ group, respectively. The HA level was significantly higher in CHF patients as compared with NYHA functional class Ⅰ group （ P 〈 0.05 ）. However, no difference was found in the levels of PCIIIP and LN between CHF group and NYHA functional class Ⅰ group. The serum HA concentration was negatively correlated with left ventricular ejection fraction （ r = - 0.71, P 〈 0.05 ）. Conclusion Serum HA level may act as an indicator for myocardial fibrosis.展开更多
Objectives To investigate the relationship of serum leptin concentration with the lipids and body mass index （BMI） in patients with chronic congestive heart failure（CHF）. Methods The serum concentration of leptin ...Objectives To investigate the relationship of serum leptin concentration with the lipids and body mass index （BMI） in patients with chronic congestive heart failure（CHF）. Methods The serum concentration of leptin in 39 patients with CHF （14 in cardiac function class Ⅱ , 21 in class Ⅲ, 4 in classⅣ , NYHA） and in 46 patients with cardiac function class Ⅰ （NYHA） were assessed by radioimmunoassay. Results The serum concentration of leptin were 9.018±4.519 μg/l in CHF group （cardiac function class Ⅱ 11.492±5.649 μg/l, class Ⅲ 7.763±3.321 μg/l, class Ⅳ 6.100±2.657 μg/l）; 11.674± 6.911 μg/l in class Ⅰ group. The serum concentrations of leptin were significantly lower in CHF group, as compared with class Ⅰ group （P〈 0.05）. Moreover, the decrease of serum leptin concentration was significantly correlated with the decreased serum concentrations of total cholesterol, triglyceride, body mass index and left ventricular ejection fraction in CHF group, respectively （P 〈 0.05）. Conclusions The significance of the decrease in serum leptin in CHF patients needs further study.展开更多
To prove the effectiveness and safety of sodium nitroprusside (SNP) in the treatment of chronic congestive heart failure, 58 patients with heart failure and normal renal and hepatic function were selected and divided ...To prove the effectiveness and safety of sodium nitroprusside (SNP) in the treatment of chronic congestive heart failure, 58 patients with heart failure and normal renal and hepatic function were selected and divided into 3 groups and treated differently. Group A was treated with routine vasodilators; Group B was treaeted intermittently with SNP (12. 5 -75mg/24hrs); Group C was treated continuously with SNP (continuous infusion of 100 - 300mg/24hrs) Positively inotropie agents and diuretic agents were used in each group. The results showed that the highly effective rates of the three groups were 46. 9% (15/32), 90. 5% (19/21) and 100% (12/12) respectively. The effective rates were 81.3% (26/32), 100% (21/21), 100% (12/12) respectively. The highly effective rates of group B and C were much higher than that of group A ( P < 0. 005, P < 0. 005) . The reduction of blood pressure of group B and C was greater than that of group A ( P < 0. 025) . Among the patients we studied, no body had severe side effects. We concluded that the use of SNP in the treatment of chronic congestive heart failure is safe, with better effect than routine treatment, and continous infusion of SNP is the best choice.展开更多
Objectives To investi gate the association of soluble Fas ligand( sFasL) and soluble Fas receptor( sFas) with human chronic con gestive heart failure( CHF) . Methods The serum level of sFasL and sFas in 33 patients wi...Objectives To investi gate the association of soluble Fas ligand( sFasL) and soluble Fas receptor( sFas) with human chronic con gestive heart failure( CHF) . Methods The serum level of sFasL and sFas in 33 patients with CHF (13 in cardiac function class Ⅱ, 17 in class Ⅲ, 3 in class Ⅳ, NYHA) was assessed with enzyme - linked immunosorbent assay, and was compared with that of 18 age - , blood pressure - matched patients with car diac function class Ⅰ (NYHA). Results There was no difference in the level of sFasL between the two groups [CHF group: 231. 50 + / - 84. 50 (cardiac function class Ⅱ216. 50 + / - 96. 00 , class Ⅲ 226. 80 + / - 85. 70, class Ⅳ 244. 00 + / - 73. 00) vs. cardiac function class I group: 217. 50 + /-89. 00 pg/mL, P>0. 05]. However, the level of sFas was significantly higher in the patients with CHF than those of cardiac function class I group [CHF group: 1353. 30 +/-507. 71 (cardiac function class Ⅱ 1154. 85 + /-371. 20 , class Ⅲ1412.88 + /-493. 62, classⅣ1875. 67 + / - 806. 10) vs. cardiac function class I group: 983. 11+/ -461. 26 pg/mL, P<0. 05 ] . Conclusions sFasL was not associated with human CHF. However, the elevation of serum level of sFas was proportion to the severity of human CHF. sFas may play an important role in the patho- genesis of human CHF.展开更多
According to the Japanese Ministry of Health,Labour,and Welfare,14.2%of people were aged>75 years in Japan in 2018,and this number continues to rise.With population aging,the incidence of congestive heart failure(C...According to the Japanese Ministry of Health,Labour,and Welfare,14.2%of people were aged>75 years in Japan in 2018,and this number continues to rise.With population aging,the incidence of congestive heart failure(CHF)is also increasing.[1–3]Reports have shown that the presence of cognitive impairment(CI)in patients with CHF is associated with poor prognosis,[4–6]and the degree of CI is related to CHF severity.展开更多
Objective:Based on the breathing exercise derived from the self-efficacy theory,this study aims to construct a breathing exercise intervention program according to the conditions of patients with chronic heart failure...Objective:Based on the breathing exercise derived from the self-efficacy theory,this study aims to construct a breathing exercise intervention program according to the conditions of patients with chronic heart failure,to improve their cardiac function,relieve dyspnea,enhance their quality of life,and further enrich the research on the efficacy of respiratory rehabilitation exercises for patients with chronic heart failure.Method:A total of 98 inpatients with chronic heart failure admitted to the hospital from April 2024 to April 2025 were selected and randomly divided into an intervention group and a control group,with 49 patients in each group.The patients in the control group received conventional nursing,while the patients in the intervention group received the breathing exercise intervention program based on the self-efficacy theory in addition to the conventional nursing of the control group,with interventions conducted through guidance,psychological support,health education,and other methods.The conditions of patients in both groups before and after the intervention were observed.Results:After 1 month and 3 months of intervention,in terms of improving the degree of dyspnea in patients of both groups,the main effect of intervention and the time effect on the degree of dyspnea were statistically significant(F=13.948,P<0.001;F=38.423,P<0.001).Moreover,there was an interaction between the time factor and the intervention factor in both groups(F=113.763,P<0.001).In terms of increasing the 6-minute walking distance,the main effect and time effect in both groups were statistically significant(F=7.371,P=0.008;F=459.405,P<0.001),and there was an interaction effect between the time factor and intervention factor in both groups(F=177.180,P<0.001).After 1 month and 3 months of intervention,in terms of improving the level of exercise self-efficacy,the main effect of intervention and the time effect in both groups were statistically significant(F=6.860,P=0.01;F=25.133,P<0.001),and there was an interaction between the time factor and the intervention factor(F=159.576,P<0.05).Conclusion:Breathing exercise based on the self-efficacy theory is helpful to improve the sense of efficacy of patients with chronic heart failure,enable them to persist in breathing exercise for a long time,further alleviate their dyspnea,promote the recovery of cardiopulmonary function,and enhance their quality of life.Breathing exercise based on the self-efficacy theory can be used as a simple,home-based intervention method to provide corresponding help for patients with chronic heart failure during the rehabilitation period.展开更多
Lingguizhugan Decoction(LGZG)demonstrates significant efficacy in treating various cardiovascular diseases clinically,yet its precise mechanism of action remains elusive.This study aimed to elucidate the potential mec...Lingguizhugan Decoction(LGZG)demonstrates significant efficacy in treating various cardiovascular diseases clinically,yet its precise mechanism of action remains elusive.This study aimed to elucidate the potential mechanisms and effects of LGZG on isoproterenol(ISO)continuous stimulation-induced chronic heart failure(CHF)in mice,providing direct experimental evidence for further clinical applications.In vivo,continuous ISO infusion was administered to mice,and ventricular myocytes were utilized to explore LGZG's potential mechanism of action on theβ1-adrenergic receptor(β1-AR)/Gs/G protein-coupled receptor kinases(GRKs)/β-arrestin signaling deflection system in the heart.The findings reveal that LGZG significantly reduced the messenger ribonucleic acid(mRNA)expression of hypertrophy-related biomarkers[atrial natriuretic peptide(ANP)and B-type natriuretic peptide(BNP)]and improved cardiac remodeling and left ventricular diastolic function in mice with ISO-induced CHF.Furthermore,LGZG inhibited the overactivation of Gs/cyclic adenosine monophosphate(c AMP)/protein kinase A(PKA)signaling and downregulated the downstream transcriptional activity of c AMP-response element binding protein(CREB)and the expression of the coactivator CBP/P300.Notably,LGZG downregulated the expression ofβ-arrestin1 and GRK 2/3/5 while upregulating the expression ofβ1-AR andβ-arrestin2.These results suggest that LGZG inhibits Gs/c AMP/PKA signaling andβ-arrestin/GRK-mediated desensitization and internalization ofβ1-AR,potentially exerting cardioprotective effects through the synergistic regulation of theβ1-AR/Gs/GRKs/β-arrestin signaling deflection system via multiple pathways.展开更多
BACKGROUND Anxiety and depression are prevalent among patients with chronic heart failure(CHF)and can adversely contribute to treatment adherence and clinical outcomes.Poor fluid restriction adherence is a widespread ...BACKGROUND Anxiety and depression are prevalent among patients with chronic heart failure(CHF)and can adversely contribute to treatment adherence and clinical outcomes.Poor fluid restriction adherence is a widespread challenge in the management of CHF.To effectively manage disease progression and alleviate symptoms,it is crucial to identify key influencing factors to facilitate the implementation of targeted interventions.AIM To investigate the status of anxiety and depression among patients with CHF and determine the factors contributing to poor fluid restriction adherence.METHODS Three hundred CHF patients seeking medical treatment at The First Hospital of Hunan University of Traditional Chinese Medicine between June 2021 and June 2023 were included in the study.Questionnaires,including the Psychosomatic Symptom Scale,Self-Rating Anxiety Scale,Self-Rating Depression Scale,and Fluid Restriction Adherence Questionnaire were administered to patients.Based on their anxiety and depression scores,patients were categorized into anxiety/depression and non-anxiety/depression groups,as well as fluid restriction adherence and fluid restriction non-adherence groups.General patient data were collected,and univariate and logistic regression analyses were conducted to determine the occurrence of depression and anxiety.Logistic regression analysis was used to identify independent factors influencing fluid restriction adherence.RESULTS Statistically significant differences in age,New York Heart Association(NYHA)grading,marital status,educational attainment,and family support were observed between depressed and non-depressed CHF patients(P<0.05).Age,NYHA grading,marital status,educational attainment,and family support were identified as factors influencing the development of depression.The anxiety and non-anxiety groups differed statistically in terms of gender,age,NYHA grading,smoking history,alcohol consumption history,monthly income,educational attainment,and family support(P<0.05).Gender,smoking,alcohol consumption,monthly income,and educational attainment affected anxiety in these patients.The fluid restriction adherence rate was 28.0%,and thirst sensation,anxiety,and depression were identified as independent influencing factors.CONCLUSION CHF patients are susceptible to anxiety and depression,with multiple associated influencing factors.Moreover,anxiety and depression are independent factors that can influence fluid restriction adherence in these patients.展开更多
Objective:To analyze the burden of caregivers of CHF patients in the current environment,to explore the related burden and influencing factors of caring for patients with chronic heart failure,and to explore the impac...Objective:To analyze the burden of caregivers of CHF patients in the current environment,to explore the related burden and influencing factors of caring for patients with chronic heart failure,and to explore the impact of filial piety values on the burden of caring for patients.Methods:192 caregivers of CHF patients in the hospital were selected as the main objects of this study.The main method was convenient sampling.Through a questionnaire survey of 192 CHF patients'caregivers,a unified investigation was conducted from the aspects of patient"'s general condition,objective burden,anxiety and depression degree and relationship quality,etc.The structural equation model was constructed and adjusted by analyzing data entry and variable correlation.Finally,path analysis was used to conduct inferential research on the direct and indirect influencing factors of control burden.Results:More than half of the patients'caregivers had a caregiving burden,and the practical caregiving dimension had the highest score.The total effect values of patient-related factors,including anxiety degree,number of concomitant diseases and half-year readmission rate,were 0.36,0.31 and 0.20,respectively(P<0.05).The total effect values of filial piety,anxiety degree,average care time and understanding degree of disease directly derived from the caregivers themselves were-0.38,0.29,0.29 and-0.23,respectively(P<0.05).In addition,the influence of filial piety values on the caregiver burden was more obvious,and the direct effect value of the value was-0.41(P<0.001).Conclusion:Most caregivers of CHF patients have a certain objective burden of care,and there are many factors that affect it,among which the degree of filial piety value is the most important.This finding provides a clear goal for caregivers to develop measures to improve the caregiver burden.展开更多
Objective: To develop a best-evidence-based optimal nutrition management plan for patients with chronic heart failure, apply it in clinical practice, and evaluate its effectiveness. Methods: Use the KTA knowledge tran...Objective: To develop a best-evidence-based optimal nutrition management plan for patients with chronic heart failure, apply it in clinical practice, and evaluate its effectiveness. Methods: Use the KTA knowledge translation model to guide evidence-based practice in nutrition management, and compare the nutritional status, cardiac function status, quality of life, and quality review indicators of chronic heart failure patients before and after the application of evidence. Results: After the application of evidence, the nutritional status indicators (MNA-SF score, albumin, hemoglobin) of two groups of heart failure patients significantly increased compared to before the application of evidence, with statistically significant differences (p Conclusion: The KTA knowledge translation model provides methodological guidance for the implementation of evidence-based practice for heart failure patients. This evidence-based practice project is beneficial for improving the outcomes of malnutrition in chronic heart failure patients and is conducive to standardizing nursing pathways, thereby promoting the improvement of nursing quality.展开更多
BACKGROUND Chronic heart failure(CHF)has a prolonged clinical course,and patients commonly experience fatigue.It remains unclear whether anxiety and depression exacerbate fatigue in patients with CHF.AIM To examine th...BACKGROUND Chronic heart failure(CHF)has a prolonged clinical course,and patients commonly experience fatigue.It remains unclear whether anxiety and depression exacerbate fatigue in patients with CHF.AIM To examine the correlation of fatigue status with anxiety and depression in patients with CHF and identify factors influencing fatigue.METHODS This observational study included 162 patients with CHF who visited the Department of Cardiology,Suzhou Ninth Hospital Affiliated to Soochow University,between May 2023 and May 2025.Fatigue was assessed using the Chinese version of the Multidimensional Fatigue Scale(MFI-20).Anxiety and depression were evaluated with the Self-Rating Anxiety Scale(SAS)and the Self-Rating Depression Scale(SDS).Patient demographic and clinical data were collected using a general information questionnaire.Pearson correlation analysis was used to assess the relationship between fatigue,anxiety,and depression,while multiple linear regression analysis was conducted to identify factors influencing fatigue levels.RESULTS The mean MFI-20 fatigue score among the 162 patients with CHF was 70.76±8.42.The mean SAS score was 58.87±9.92,and the mean SDS score was 54.76±7.91.Both SAS and SDS scores were positively correlated with MFI-20 scores(r=0.479,r=0.468;both P<0.001).Multivariate regression analysis identified comorbidities[β=0.903,95%confidence interval(CI):0.258-1.695],New York Heart Association functional class(III-IV)(β=0.319,95%CI:0.269-0.743),poor sleep quality(β=0.465,95%CI:0.294-0.948),anxiety(β=1.728,95%CI:0.693-3.642),and depression(β=1.649,95%CI:0.712-3.517)as significant factors influencing fatigue(P<0.05).CONCLUSION Fatigue levels in patients with CHF were high and significantly influenced by comorbidities,advanced New York Heart Association functional class(III-IV),poor sleep quality,anxiety,and depression.Clinical interventions that address comorbid conditions,improve cardiac function,and provide sleep and psychological support may help alleviate fatigue in this population.展开更多
BACKGROUND Chronic heart failure(CHF)is a severe cardiovascular disease that significantly threatens human health.Depression,a common comorbidity,may substantially impact cardiac structure and function.However,the exa...BACKGROUND Chronic heart failure(CHF)is a severe cardiovascular disease that significantly threatens human health.Depression,a common comorbidity,may substantially impact cardiac structure and function.However,the exact relationship between depression and cardiac remodeling and left ventricular functional changes remains incompletely understood.This study sets out to explore,with a clinically grounded perspective,how depressive states may subtly or profoundly influence the trajectory of cardiac remodeling and the functional dynamics of the left ventricle in individuals grappling with CHF.Beyond mere observation,it also aims to untangle the underlying physiological or neurohormonal pathways that might bridge emotional distress and cardiac dysfunction.AIM To delve into how depressive symptoms might shape the progression of cardiac remodeling and impair left ventricular function among individuals living with CHF.Particular attention is given to the role of inflammatory signaling and disruptions in neuroendocrine balance as possible mediating factors.By examining these intertwined physiological and psychological processes,the study seeks to shed light on the reciprocal link between emotional distress and CHF,offering insights that may inform more precise,mechanism-based treatment strategies.METHODS In this retrospective clinical trial,248 patients diagnosed with CHF were analyzed in the tertiary treatment center between January 2018 and December 2022.According to Hamilton's Depression Scale score,participants were classified into two cohort of depression(score 17)and no significant depression characteristics(score 17).Cardiac morphology and functional parameters were assessed using a combination of hyperechocardiocardiocardiography,heart magnetic resonance,and associated blood biomarkers.RESULTS The results of this study underscore the significant effects that depression can have on both the structure and function of the heart in patients with CHF.In particular,the individuals in the cohort with depression were 42.3%±6.7%of the individuals without depression vs 51.6%±5.9%,P<0.01)In comparison,the left ventricular ejection fraction,an important measure of contractional performance,was significantly reduced,underlining the harmful physiological interaction between mood disorders and cardiac efficiency.The measurement of the left ventricular end-diastolic diameter showed a significant expansion of the ventricular envelope in the depression group(68.2±7.5 mm vs 59.6±6.3 mm,P<0.01).Inflammatory markers,including high-sensitivity C-reactive protein(hs-CRP)and tumor necrosis factor-α(TNF-α),were significantly elevated in the depressed group(hs-CRP:8.7±2.3 mg/L vs 4.5±1.6 mg/L;TNF-α:42.5±7.6 pg/mL vs 28.3±5.4 pg/mL).Both B-type natriuretic peptide(1256±345 pg/mL vs 756±234 pg/mL)and angiotensin II(86.4±15.7 ng/mL vs 62.5±12.3 ng/mL)levels were significantly higher in the depressed group.CONCLUSION Among people with CHF,the presence of depressive symptoms appears to be closely related to pronounced changes in heart structure and impaired functional abilities.It is likely that depressive states contribute to the progress of heart reform and deterioration of left stomach function,possibly due to increased inflammatory cascades and increased activation of neuroendocrine regulatory pathways.展开更多
BACKGROUND As the aging process has accelerated,psychological problems in older patients with chronic heart failure(CHF)have become increasingly prominent,significantly affecting their quality of life and prognosis.Th...BACKGROUND As the aging process has accelerated,psychological problems in older patients with chronic heart failure(CHF)have become increasingly prominent,significantly affecting their quality of life and prognosis.This study explored a sports rehabilitation program based on the concept of medical care-family integration to provide patients with comprehensive and effective rehabilitation interventions and improve their health status.AIM To explore the effects of medical care-family integration-based exercise rehabilitation in older patients with CHF and psychological problems.METHODS Data from 118 older patients with CHF and psychological problems were retrospectively analyzed.Patients were divided into conventional(n=56)and exercise rehabilitation groups(n=62).The results of the 6-min walking distance(6 MWD),N-terminal B-type natriuretic peptide(NT-proBNP),left ventricular end-diastolic diameter(LVEDD),left ventricular ejection fraction(LVEF),Minnesota living with heart failure questionnaire(MLHFQ),generalized anxiety disorder-7(GAD-7)scale,9-item patient health questionnaire(PHQ-9)and Athens insomnia scale(AIS)were compared before and after intervention.RESULTS After intervention,there were significant differences in the number of patients with depression and anxiety between the two groups.There was also a significant difference in the distribution of sleep disorders.The PHQ-9 score,GAD-7 score,AIS score,NT-proBNP value,LVEDD value,physical field,emotional field,other fields,and MLHFQ total scores were lower in the exercise rehabilitation group compared to the conventional rehabilitation group,while the 6 MWD and LVEF values were higher compared to the conventional rehabilitation group(P<0.05).During the intervention period,the readmission rate of the exercise rehabilitation group(1.61%)was significantly lower than that of the conventional rehabilitation group(12.50%)(χ^(2)=3.930,P=0.047).CONCLUSION This exercise rehabilitation program with medical care-family integration can improve cardiac function and quality of life,alleviate psychological problems,and reduce readmission rates in older patients with CHF.展开更多
Background1 Currently,there is a scarcity of risk prediction models for frailty in hospitalized patients with chronic heart failure(CHF).This study aimed to investigate the frailty status of hospitalized CHF patients,...Background1 Currently,there is a scarcity of risk prediction models for frailty in hospitalized patients with chronic heart failure(CHF).This study aimed to investigate the frailty status of hospitalized CHF patients,identify independent risk factors significantly associated with frailty,and construct an effective risk prediction model.The goal was to provide a reference for clinical strategies in preventing and managing frailty among CHF patients.Methodss Using convenience sampling,we enrolled 184 hospitalized CHF patients from a tertiary hospital between February 2022 and December 2024.General demographic data were collected via questionnaires,alongside frailty screening using the FRAIL scale and assessment of daily functioning with the Activities of Daily Living(ADL)scale.Clinical data were obtained by reviewing medical records.Participants were categorized into a frail group(n=65)and a non-frail group(n=119)based on frailty status.Clinical risk factors were compared between groups.Multivariate logistic regression was used to identify independent risk factors.A prediction model was constructed,and a receiver operating characteristic(ROC)curve was plotted to evaluate its predictive value.Results A total of 184 hospitalized CHF patients were included,with 65(35.33%)exhibiting frailty.Multivariate logistic regression analysis showed that independent risk factors for frailty included:age,ADL score,N-terminal pro-brain natriuretic peptide(NT-pro-BNP),left ventricular ejection fraction(LVEF),New York Heart Association(NYHA)class II/IV,≥3 comorbidities,comorbid diabetes mellitus(DM),comorbid valvular heart disease(VHD),smoking history,hemoglobin(Hb),albumin,high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C),creatinine(Cr),and blood urea nitrogen(BUN).The aforementioned factors were incorporated into logistic regression analysis and the prediction model was built.The prediction model showed quite strong predictive performance.Its area under the ROC curve was 0.904(95%CI:0.857-0.951),with a sensitivity of98.5%and a specificity of 85.7%.ConclusionssThe frailty risk prediction model for hospitalized CHF patients demonstrated robust discriminative ability and calibration.It provided substantial reference value for clinical management of CHF,offering a basis for early assessment,risk stratification,and targeted interventions to prevent frailty by identifying high-risk patients.展开更多
Background Chronic heart failure(CHF)and osteoporosis(OP)are major health issues affecting the middle-aged and elderly population.With the intensification of population aging,the incidences of both conditions are in-c...Background Chronic heart failure(CHF)and osteoporosis(OP)are major health issues affecting the middle-aged and elderly population.With the intensification of population aging,the incidences of both conditions are in-creasing,severely affecting the quality of life of patients and the development of social medical care.In recent years,many studies have found a close relationship between the two conditions,with mutual influences,especially the impact of CHF on the risk and prognosis of OP,which has attracted increasing attention.Comprehensively un-derstanding the risk of OP in heart failure patients and providing targeted interventions to prevent fractures is of great significance.However,the pathophysiological mechanisms of osteoporosis in patients with heart failure are not yet fully understood.A large number of recent studies have proven that,in addition to common risk factors(such as age,gender,blood lipids,smoking,etc.),there are still independent mutual connections between the two condi-tions.Domestic and international research has found that changes in cytokine or hormone levels in bone metabo-lism can affect the pathophysiological processes of CHF.Therefore,this article reviewed the correlation between bone metabolism and chronic heart failure and elderly osteoporosis,hoping to provide a reference for clinical treat-ment and prevention.展开更多
BACKGROUND The six-minute walk test(6MWT)allows to determine,in addition to the main parameters,the time of heart rate recovery(THRR),cardiac function,adaptation index(AI),which characterize the compensatory reserve o...BACKGROUND The six-minute walk test(6MWT)allows to determine,in addition to the main parameters,the time of heart rate recovery(THRR),cardiac function,adaptation index(AI),which characterize the compensatory reserve of patients with chronic heart failure(CHF).At the same time,the significance of these parameters in patients taking beta-blockers for CHF is insufficiently studied,taking into account the negative chronotropic effect of drugs.In this regard,it is relevant to identify factors that can characterize the compensatory capabilities of a patient with CHF during 6MWT,not related to the calculation of heart rate.AIM To identify hemodynamic indicators of the adaptive capabilities of patients with CHF during paired 6MWT depending on their intake of beta-blockers.METHODS Seventy-four patients with compensated CHF due to coronary heart disease and/or hypertension formed the main group,comprising 46 individuals who were taking beta-blockers,and a comparison group comprising 28 individuals who had not been taking beta-blockers for at least one month before 6MWT.All participants underwent Doppler echocardiography(DECG),paired 6MWT,with assessment of hemodynamic parameters before and after both the first and second test.AI,THRR,blood pressure variability(BPV)were calculated.Multivariate,correlation analyses,univariate analysis of variance were used.RESULTS There were no significant associations between adaptation characteristics and DECG parameters or functional class(FC)of CHF in patients of the main group.In the comparison group,the indicators of compensatory reserve were significantly and directly associated with left ventricular ejection fraction(LVEF),and inversely with FC CHF and cardiac cavity size.In both groups,a greater difference in systolic blood pressure between the end of the first and the beginning of the second 6MWT was significantly associated with a higher index of right ventricular systolic dysfunction(Tricuspid annular plane systolic excursion)and LVEF,as well as a smaller left ventricular size and mass,and a lower pulmonary artery systolic pressure in patients in the main group.CONCLUSION Systolic BPV,measured immediately after 6MWT and 20 minutes after its completion,can indirectly characterize the compensatory reserve in patients with CHF,regardless of their beta-blocker intake.展开更多
Objective:To evaluate the effectiveness of cardiac rehabilitation therapy in the treatment of patients with chronic heart failure(CHF).Methods:76 patients with CHF who were treated in the hospital from January 2023 to...Objective:To evaluate the effectiveness of cardiac rehabilitation therapy in the treatment of patients with chronic heart failure(CHF).Methods:76 patients with CHF who were treated in the hospital from January 2023 to December 2024 were selected and randomly divided into two groups using a random number table.The experimental group(38 patients)received cardiac rehabilitation therapy,while the reference group(38 patients)received conventional drug therapy.The total effective rate,cardiac function indicators,lung function indicators,and pulse wave velocity(PWV)were compared between the two groups.Results:The total effective rate was higher in the experimental group than in the reference group.After treatment,the cardiac and lung function indicators were better in the experimental group than in the reference group,and the PWV was lower in the experimental group(P<0.05).Conclusion:Cardiac rehabilitation therapy for patients with CHF can improve treatment efficacy,enhance cardiopulmonary function,and regulate PWV levels,with high professionalism and feasibility.展开更多
Traditional Chinese medicine(TCM)has played a significant role in the prevention and treatment of chronic heart failure(CHF).To study TCM diagnosis of CHF,a total of 278 Chinese clinical research articles on the study...Traditional Chinese medicine(TCM)has played a significant role in the prevention and treatment of chronic heart failure(CHF).To study TCM diagnosis of CHF,a total of 278 Chinese clinical research articles on the study of CHF syndromes in recent 40 years retrieved from Web of Science,Scopus,Pub Med,Embase,CNKI,Wanfang Data,Cq VIP,and Sino Med.According to cumulative frequency analysis,network analysis,and hierarchical cluster analysis,the study found the distribution of CHF syndromes was syndrome of qi deficiency with blood stasis,syndrome of qi and yin deficiency,syndrome of yang deficiency with water flooding,syndrome of heart blood stasis obstruction,syndrome of turbid phlegm,and syndrome of collapse due to primordial yang deficiency.The syndrome elements on location of illness were heart,kidney,lung,and spleen.The syndrome elements on nature of illness were qi deficiency,blood stasis,yang deficiency,yin deficiency,water retention,and turbid phlegm.These findings can provide reference to the research on diagnosis and treatment of CHF,and contribute to the study on syndrome standardization and objective research of TCM diagnosis.展开更多
文摘Objective: to analyze the effect of sports rehabilitation nursing combined with comfortable intervention on cardiac function for patients with chronic congestive heart failure. Methods: the study period was from November 2019 to December 2020 (excluding January to February 2020). 80 patients with chronic congestive heart failure were selected by convenient sampling. They were divided into control group (routine care) and observation group (sports rehabilitation nursing) according to the order of admission. Cardiac function level, functional motor ability and quality of life were evaluated and compared between the two groups after intervention. Results: the indexes of heart function in the observation group were significantly better than those in the control group, and the difference was statistically significant (P < 0.05). The walking distance and walking speed of the observation group at 6min after intervention were longer and faster than those of the control group, and the differences were statistically significant (P < 0.05). The exercise ability of the two groups after intervention was better than that before intervention. The quality of life assessment in the observation group was better than that in the control group, and the difference was statistically significant (P < 0.05). Conclusion: exercise rehabilitation nursing combined with comfortable intervention (intermixed with muscle relaxation training) for patients with chronic congestive heart failure. It is helpful to improve cardiac function, enhance functional exercise ability, and improve life quality. It is suitable for routine implementation in cardiovascular medicine.
文摘Objective: to explore the curative effect of sacubatrosalkubatroxartan sodium tablets combined with shenfu injection in the treatment of chronic congestive heart failure. Methods: 70 patients with chronic congestive heart failure treated in our hospital from September 2020 to August 2021 were randomly divided into two groups. 35 patients in the control group were given sacubatrosalkubatroxartan sodium tablets and routine treatment, and 35 patients in the observation group were given shenfu injection on the basis of the treatment measures of the control group. The total effective rate and cardiac function indexes of the two groups were compared. Results: the effective rate of the control group was lower than that of the observation group (P < 0.05);LVEF, LVESD and LVEDD in the control group were lower than those in the observation group (P < 0.05);The levels of serum BNP, ET-1 and hs-CRP in the observation group were lower than those in the control group (P < 0.05);There was no significant difference in the incidence of adverse reactions between the two groups (P > 0.05). Conclusion: the curative effect of sacubatrosalkubatroxartan sodium tablets combined with shenfu injection in the treatment of chronic congestive heart failure is positive, which is conducive to the improvement of cardiac function, and is worthy of popularization.
文摘Objective To explore the role of serum fibrotic indices including hyaluronic acid （HA）, procollagen type Ⅲ NH2-terminal peptide （PCIIIP）, and laminin （LN） in assessing the severity of myocardial fibrosis in chronic congestive heart failure （CHF）. Methods Serum levels of HA, PCIIIP, and LN in 39 patients with CHF E [14 with New York Heart Association （NYHA） functional class II, 21 with class Ⅲ, 4 with class Ⅳ] and in 46 patients with NYHA functional class I were assessed by radioimmunoassay. Results The serum concentrations of HA, PCMP, and LN were 359.75 ± 84.59 μg/L, 77.88 ± 24. 67 μg/L, 86. 73 ± 23.90 μg/L in CHF group, and 211.60 ±54. 80 μg/L, 64.82 ±23.99 μg/L, 82. 26 ±23.98 μg/L in NYHA functional class Ⅰ group, respectively. The HA level was significantly higher in CHF patients as compared with NYHA functional class Ⅰ group （ P 〈 0.05 ）. However, no difference was found in the levels of PCIIIP and LN between CHF group and NYHA functional class Ⅰ group. The serum HA concentration was negatively correlated with left ventricular ejection fraction （ r = - 0.71, P 〈 0.05 ）. Conclusion Serum HA level may act as an indicator for myocardial fibrosis.
文摘Objectives To investigate the relationship of serum leptin concentration with the lipids and body mass index （BMI） in patients with chronic congestive heart failure（CHF）. Methods The serum concentration of leptin in 39 patients with CHF （14 in cardiac function class Ⅱ , 21 in class Ⅲ, 4 in classⅣ , NYHA） and in 46 patients with cardiac function class Ⅰ （NYHA） were assessed by radioimmunoassay. Results The serum concentration of leptin were 9.018±4.519 μg/l in CHF group （cardiac function class Ⅱ 11.492±5.649 μg/l, class Ⅲ 7.763±3.321 μg/l, class Ⅳ 6.100±2.657 μg/l）; 11.674± 6.911 μg/l in class Ⅰ group. The serum concentrations of leptin were significantly lower in CHF group, as compared with class Ⅰ group （P〈 0.05）. Moreover, the decrease of serum leptin concentration was significantly correlated with the decreased serum concentrations of total cholesterol, triglyceride, body mass index and left ventricular ejection fraction in CHF group, respectively （P 〈 0.05）. Conclusions The significance of the decrease in serum leptin in CHF patients needs further study.
文摘To prove the effectiveness and safety of sodium nitroprusside (SNP) in the treatment of chronic congestive heart failure, 58 patients with heart failure and normal renal and hepatic function were selected and divided into 3 groups and treated differently. Group A was treated with routine vasodilators; Group B was treaeted intermittently with SNP (12. 5 -75mg/24hrs); Group C was treated continuously with SNP (continuous infusion of 100 - 300mg/24hrs) Positively inotropie agents and diuretic agents were used in each group. The results showed that the highly effective rates of the three groups were 46. 9% (15/32), 90. 5% (19/21) and 100% (12/12) respectively. The effective rates were 81.3% (26/32), 100% (21/21), 100% (12/12) respectively. The highly effective rates of group B and C were much higher than that of group A ( P < 0. 005, P < 0. 005) . The reduction of blood pressure of group B and C was greater than that of group A ( P < 0. 025) . Among the patients we studied, no body had severe side effects. We concluded that the use of SNP in the treatment of chronic congestive heart failure is safe, with better effect than routine treatment, and continous infusion of SNP is the best choice.
文摘Objectives To investi gate the association of soluble Fas ligand( sFasL) and soluble Fas receptor( sFas) with human chronic con gestive heart failure( CHF) . Methods The serum level of sFasL and sFas in 33 patients with CHF (13 in cardiac function class Ⅱ, 17 in class Ⅲ, 3 in class Ⅳ, NYHA) was assessed with enzyme - linked immunosorbent assay, and was compared with that of 18 age - , blood pressure - matched patients with car diac function class Ⅰ (NYHA). Results There was no difference in the level of sFasL between the two groups [CHF group: 231. 50 + / - 84. 50 (cardiac function class Ⅱ216. 50 + / - 96. 00 , class Ⅲ 226. 80 + / - 85. 70, class Ⅳ 244. 00 + / - 73. 00) vs. cardiac function class I group: 217. 50 + /-89. 00 pg/mL, P>0. 05]. However, the level of sFas was significantly higher in the patients with CHF than those of cardiac function class I group [CHF group: 1353. 30 +/-507. 71 (cardiac function class Ⅱ 1154. 85 + /-371. 20 , class Ⅲ1412.88 + /-493. 62, classⅣ1875. 67 + / - 806. 10) vs. cardiac function class I group: 983. 11+/ -461. 26 pg/mL, P<0. 05 ] . Conclusions sFasL was not associated with human CHF. However, the elevation of serum level of sFas was proportion to the severity of human CHF. sFas may play an important role in the patho- genesis of human CHF.
文摘According to the Japanese Ministry of Health,Labour,and Welfare,14.2%of people were aged>75 years in Japan in 2018,and this number continues to rise.With population aging,the incidence of congestive heart failure(CHF)is also increasing.[1–3]Reports have shown that the presence of cognitive impairment(CI)in patients with CHF is associated with poor prognosis,[4–6]and the degree of CI is related to CHF severity.
文摘Objective:Based on the breathing exercise derived from the self-efficacy theory,this study aims to construct a breathing exercise intervention program according to the conditions of patients with chronic heart failure,to improve their cardiac function,relieve dyspnea,enhance their quality of life,and further enrich the research on the efficacy of respiratory rehabilitation exercises for patients with chronic heart failure.Method:A total of 98 inpatients with chronic heart failure admitted to the hospital from April 2024 to April 2025 were selected and randomly divided into an intervention group and a control group,with 49 patients in each group.The patients in the control group received conventional nursing,while the patients in the intervention group received the breathing exercise intervention program based on the self-efficacy theory in addition to the conventional nursing of the control group,with interventions conducted through guidance,psychological support,health education,and other methods.The conditions of patients in both groups before and after the intervention were observed.Results:After 1 month and 3 months of intervention,in terms of improving the degree of dyspnea in patients of both groups,the main effect of intervention and the time effect on the degree of dyspnea were statistically significant(F=13.948,P<0.001;F=38.423,P<0.001).Moreover,there was an interaction between the time factor and the intervention factor in both groups(F=113.763,P<0.001).In terms of increasing the 6-minute walking distance,the main effect and time effect in both groups were statistically significant(F=7.371,P=0.008;F=459.405,P<0.001),and there was an interaction effect between the time factor and intervention factor in both groups(F=177.180,P<0.001).After 1 month and 3 months of intervention,in terms of improving the level of exercise self-efficacy,the main effect of intervention and the time effect in both groups were statistically significant(F=6.860,P=0.01;F=25.133,P<0.001),and there was an interaction between the time factor and the intervention factor(F=159.576,P<0.05).Conclusion:Breathing exercise based on the self-efficacy theory is helpful to improve the sense of efficacy of patients with chronic heart failure,enable them to persist in breathing exercise for a long time,further alleviate their dyspnea,promote the recovery of cardiopulmonary function,and enhance their quality of life.Breathing exercise based on the self-efficacy theory can be used as a simple,home-based intervention method to provide corresponding help for patients with chronic heart failure during the rehabilitation period.
基金supported by the National Natural Science Foundation of China(No.82074054)Shanghai Municipal Commission of Health and Family Planning(No.ZY(2021-2023)-0208)+2 种基金Youth Program of the National Natural Science Foundation of China(No.81903831)Shanghai Municipality:Shanghai Chenguang Program(No.19CG48)Natural Science Foundation of Shanghai(No.24ZR1465900)。
文摘Lingguizhugan Decoction(LGZG)demonstrates significant efficacy in treating various cardiovascular diseases clinically,yet its precise mechanism of action remains elusive.This study aimed to elucidate the potential mechanisms and effects of LGZG on isoproterenol(ISO)continuous stimulation-induced chronic heart failure(CHF)in mice,providing direct experimental evidence for further clinical applications.In vivo,continuous ISO infusion was administered to mice,and ventricular myocytes were utilized to explore LGZG's potential mechanism of action on theβ1-adrenergic receptor(β1-AR)/Gs/G protein-coupled receptor kinases(GRKs)/β-arrestin signaling deflection system in the heart.The findings reveal that LGZG significantly reduced the messenger ribonucleic acid(mRNA)expression of hypertrophy-related biomarkers[atrial natriuretic peptide(ANP)and B-type natriuretic peptide(BNP)]and improved cardiac remodeling and left ventricular diastolic function in mice with ISO-induced CHF.Furthermore,LGZG inhibited the overactivation of Gs/cyclic adenosine monophosphate(c AMP)/protein kinase A(PKA)signaling and downregulated the downstream transcriptional activity of c AMP-response element binding protein(CREB)and the expression of the coactivator CBP/P300.Notably,LGZG downregulated the expression ofβ-arrestin1 and GRK 2/3/5 while upregulating the expression ofβ1-AR andβ-arrestin2.These results suggest that LGZG inhibits Gs/c AMP/PKA signaling andβ-arrestin/GRK-mediated desensitization and internalization ofβ1-AR,potentially exerting cardioprotective effects through the synergistic regulation of theβ1-AR/Gs/GRKs/β-arrestin signaling deflection system via multiple pathways.
基金Huxiang TCM Physique Intervention Clinical Research Center,No.2023SK4061Traditional Chinese Medicine Research Project of Hunan Province,No.B2023065+4 种基金Hunan Province"14th Five-Year Plan"key specialty of TCM,No.[2023]4Hunan University of Chinese Medicine and Hospital Joint Foundation,No.2023XYLH019 and 2024XYLH365R&D Plan for Key Areas of Hunan Provincial Department of Science and Technology,No.2019SK2321Excellent Youth Program of Hunan Education Department,No.24B0346Hunan Provincial Natural Science Foundation for Young Scientists,No.2025JJ60626.
文摘BACKGROUND Anxiety and depression are prevalent among patients with chronic heart failure(CHF)and can adversely contribute to treatment adherence and clinical outcomes.Poor fluid restriction adherence is a widespread challenge in the management of CHF.To effectively manage disease progression and alleviate symptoms,it is crucial to identify key influencing factors to facilitate the implementation of targeted interventions.AIM To investigate the status of anxiety and depression among patients with CHF and determine the factors contributing to poor fluid restriction adherence.METHODS Three hundred CHF patients seeking medical treatment at The First Hospital of Hunan University of Traditional Chinese Medicine between June 2021 and June 2023 were included in the study.Questionnaires,including the Psychosomatic Symptom Scale,Self-Rating Anxiety Scale,Self-Rating Depression Scale,and Fluid Restriction Adherence Questionnaire were administered to patients.Based on their anxiety and depression scores,patients were categorized into anxiety/depression and non-anxiety/depression groups,as well as fluid restriction adherence and fluid restriction non-adherence groups.General patient data were collected,and univariate and logistic regression analyses were conducted to determine the occurrence of depression and anxiety.Logistic regression analysis was used to identify independent factors influencing fluid restriction adherence.RESULTS Statistically significant differences in age,New York Heart Association(NYHA)grading,marital status,educational attainment,and family support were observed between depressed and non-depressed CHF patients(P<0.05).Age,NYHA grading,marital status,educational attainment,and family support were identified as factors influencing the development of depression.The anxiety and non-anxiety groups differed statistically in terms of gender,age,NYHA grading,smoking history,alcohol consumption history,monthly income,educational attainment,and family support(P<0.05).Gender,smoking,alcohol consumption,monthly income,and educational attainment affected anxiety in these patients.The fluid restriction adherence rate was 28.0%,and thirst sensation,anxiety,and depression were identified as independent influencing factors.CONCLUSION CHF patients are susceptible to anxiety and depression,with multiple associated influencing factors.Moreover,anxiety and depression are independent factors that can influence fluid restriction adherence in these patients.
文摘Objective:To analyze the burden of caregivers of CHF patients in the current environment,to explore the related burden and influencing factors of caring for patients with chronic heart failure,and to explore the impact of filial piety values on the burden of caring for patients.Methods:192 caregivers of CHF patients in the hospital were selected as the main objects of this study.The main method was convenient sampling.Through a questionnaire survey of 192 CHF patients'caregivers,a unified investigation was conducted from the aspects of patient"'s general condition,objective burden,anxiety and depression degree and relationship quality,etc.The structural equation model was constructed and adjusted by analyzing data entry and variable correlation.Finally,path analysis was used to conduct inferential research on the direct and indirect influencing factors of control burden.Results:More than half of the patients'caregivers had a caregiving burden,and the practical caregiving dimension had the highest score.The total effect values of patient-related factors,including anxiety degree,number of concomitant diseases and half-year readmission rate,were 0.36,0.31 and 0.20,respectively(P<0.05).The total effect values of filial piety,anxiety degree,average care time and understanding degree of disease directly derived from the caregivers themselves were-0.38,0.29,0.29 and-0.23,respectively(P<0.05).In addition,the influence of filial piety values on the caregiver burden was more obvious,and the direct effect value of the value was-0.41(P<0.001).Conclusion:Most caregivers of CHF patients have a certain objective burden of care,and there are many factors that affect it,among which the degree of filial piety value is the most important.This finding provides a clear goal for caregivers to develop measures to improve the caregiver burden.
文摘Objective: To develop a best-evidence-based optimal nutrition management plan for patients with chronic heart failure, apply it in clinical practice, and evaluate its effectiveness. Methods: Use the KTA knowledge translation model to guide evidence-based practice in nutrition management, and compare the nutritional status, cardiac function status, quality of life, and quality review indicators of chronic heart failure patients before and after the application of evidence. Results: After the application of evidence, the nutritional status indicators (MNA-SF score, albumin, hemoglobin) of two groups of heart failure patients significantly increased compared to before the application of evidence, with statistically significant differences (p Conclusion: The KTA knowledge translation model provides methodological guidance for the implementation of evidence-based practice for heart failure patients. This evidence-based practice project is beneficial for improving the outcomes of malnutrition in chronic heart failure patients and is conducive to standardizing nursing pathways, thereby promoting the improvement of nursing quality.
基金Supported by the 2024 Academy-Level Research Start-up Fund,No.YK202437.
文摘BACKGROUND Chronic heart failure(CHF)has a prolonged clinical course,and patients commonly experience fatigue.It remains unclear whether anxiety and depression exacerbate fatigue in patients with CHF.AIM To examine the correlation of fatigue status with anxiety and depression in patients with CHF and identify factors influencing fatigue.METHODS This observational study included 162 patients with CHF who visited the Department of Cardiology,Suzhou Ninth Hospital Affiliated to Soochow University,between May 2023 and May 2025.Fatigue was assessed using the Chinese version of the Multidimensional Fatigue Scale(MFI-20).Anxiety and depression were evaluated with the Self-Rating Anxiety Scale(SAS)and the Self-Rating Depression Scale(SDS).Patient demographic and clinical data were collected using a general information questionnaire.Pearson correlation analysis was used to assess the relationship between fatigue,anxiety,and depression,while multiple linear regression analysis was conducted to identify factors influencing fatigue levels.RESULTS The mean MFI-20 fatigue score among the 162 patients with CHF was 70.76±8.42.The mean SAS score was 58.87±9.92,and the mean SDS score was 54.76±7.91.Both SAS and SDS scores were positively correlated with MFI-20 scores(r=0.479,r=0.468;both P<0.001).Multivariate regression analysis identified comorbidities[β=0.903,95%confidence interval(CI):0.258-1.695],New York Heart Association functional class(III-IV)(β=0.319,95%CI:0.269-0.743),poor sleep quality(β=0.465,95%CI:0.294-0.948),anxiety(β=1.728,95%CI:0.693-3.642),and depression(β=1.649,95%CI:0.712-3.517)as significant factors influencing fatigue(P<0.05).CONCLUSION Fatigue levels in patients with CHF were high and significantly influenced by comorbidities,advanced New York Heart Association functional class(III-IV),poor sleep quality,anxiety,and depression.Clinical interventions that address comorbid conditions,improve cardiac function,and provide sleep and psychological support may help alleviate fatigue in this population.
文摘BACKGROUND Chronic heart failure(CHF)is a severe cardiovascular disease that significantly threatens human health.Depression,a common comorbidity,may substantially impact cardiac structure and function.However,the exact relationship between depression and cardiac remodeling and left ventricular functional changes remains incompletely understood.This study sets out to explore,with a clinically grounded perspective,how depressive states may subtly or profoundly influence the trajectory of cardiac remodeling and the functional dynamics of the left ventricle in individuals grappling with CHF.Beyond mere observation,it also aims to untangle the underlying physiological or neurohormonal pathways that might bridge emotional distress and cardiac dysfunction.AIM To delve into how depressive symptoms might shape the progression of cardiac remodeling and impair left ventricular function among individuals living with CHF.Particular attention is given to the role of inflammatory signaling and disruptions in neuroendocrine balance as possible mediating factors.By examining these intertwined physiological and psychological processes,the study seeks to shed light on the reciprocal link between emotional distress and CHF,offering insights that may inform more precise,mechanism-based treatment strategies.METHODS In this retrospective clinical trial,248 patients diagnosed with CHF were analyzed in the tertiary treatment center between January 2018 and December 2022.According to Hamilton's Depression Scale score,participants were classified into two cohort of depression(score 17)and no significant depression characteristics(score 17).Cardiac morphology and functional parameters were assessed using a combination of hyperechocardiocardiocardiography,heart magnetic resonance,and associated blood biomarkers.RESULTS The results of this study underscore the significant effects that depression can have on both the structure and function of the heart in patients with CHF.In particular,the individuals in the cohort with depression were 42.3%±6.7%of the individuals without depression vs 51.6%±5.9%,P<0.01)In comparison,the left ventricular ejection fraction,an important measure of contractional performance,was significantly reduced,underlining the harmful physiological interaction between mood disorders and cardiac efficiency.The measurement of the left ventricular end-diastolic diameter showed a significant expansion of the ventricular envelope in the depression group(68.2±7.5 mm vs 59.6±6.3 mm,P<0.01).Inflammatory markers,including high-sensitivity C-reactive protein(hs-CRP)and tumor necrosis factor-α(TNF-α),were significantly elevated in the depressed group(hs-CRP:8.7±2.3 mg/L vs 4.5±1.6 mg/L;TNF-α:42.5±7.6 pg/mL vs 28.3±5.4 pg/mL).Both B-type natriuretic peptide(1256±345 pg/mL vs 756±234 pg/mL)and angiotensin II(86.4±15.7 ng/mL vs 62.5±12.3 ng/mL)levels were significantly higher in the depressed group.CONCLUSION Among people with CHF,the presence of depressive symptoms appears to be closely related to pronounced changes in heart structure and impaired functional abilities.It is likely that depressive states contribute to the progress of heart reform and deterioration of left stomach function,possibly due to increased inflammatory cascades and increased activation of neuroendocrine regulatory pathways.
文摘BACKGROUND As the aging process has accelerated,psychological problems in older patients with chronic heart failure(CHF)have become increasingly prominent,significantly affecting their quality of life and prognosis.This study explored a sports rehabilitation program based on the concept of medical care-family integration to provide patients with comprehensive and effective rehabilitation interventions and improve their health status.AIM To explore the effects of medical care-family integration-based exercise rehabilitation in older patients with CHF and psychological problems.METHODS Data from 118 older patients with CHF and psychological problems were retrospectively analyzed.Patients were divided into conventional(n=56)and exercise rehabilitation groups(n=62).The results of the 6-min walking distance(6 MWD),N-terminal B-type natriuretic peptide(NT-proBNP),left ventricular end-diastolic diameter(LVEDD),left ventricular ejection fraction(LVEF),Minnesota living with heart failure questionnaire(MLHFQ),generalized anxiety disorder-7(GAD-7)scale,9-item patient health questionnaire(PHQ-9)and Athens insomnia scale(AIS)were compared before and after intervention.RESULTS After intervention,there were significant differences in the number of patients with depression and anxiety between the two groups.There was also a significant difference in the distribution of sleep disorders.The PHQ-9 score,GAD-7 score,AIS score,NT-proBNP value,LVEDD value,physical field,emotional field,other fields,and MLHFQ total scores were lower in the exercise rehabilitation group compared to the conventional rehabilitation group,while the 6 MWD and LVEF values were higher compared to the conventional rehabilitation group(P<0.05).During the intervention period,the readmission rate of the exercise rehabilitation group(1.61%)was significantly lower than that of the conventional rehabilitation group(12.50%)(χ^(2)=3.930,P=0.047).CONCLUSION This exercise rehabilitation program with medical care-family integration can improve cardiac function and quality of life,alleviate psychological problems,and reduce readmission rates in older patients with CHF.
基金supported by Guangdong Medical Science and Technology Research Fund Project(No.A2022458)Guangdong Provincial People's Medical Climbing Plan(Nursing Research Project)(No.DFJH2020011)。
文摘Background1 Currently,there is a scarcity of risk prediction models for frailty in hospitalized patients with chronic heart failure(CHF).This study aimed to investigate the frailty status of hospitalized CHF patients,identify independent risk factors significantly associated with frailty,and construct an effective risk prediction model.The goal was to provide a reference for clinical strategies in preventing and managing frailty among CHF patients.Methodss Using convenience sampling,we enrolled 184 hospitalized CHF patients from a tertiary hospital between February 2022 and December 2024.General demographic data were collected via questionnaires,alongside frailty screening using the FRAIL scale and assessment of daily functioning with the Activities of Daily Living(ADL)scale.Clinical data were obtained by reviewing medical records.Participants were categorized into a frail group(n=65)and a non-frail group(n=119)based on frailty status.Clinical risk factors were compared between groups.Multivariate logistic regression was used to identify independent risk factors.A prediction model was constructed,and a receiver operating characteristic(ROC)curve was plotted to evaluate its predictive value.Results A total of 184 hospitalized CHF patients were included,with 65(35.33%)exhibiting frailty.Multivariate logistic regression analysis showed that independent risk factors for frailty included:age,ADL score,N-terminal pro-brain natriuretic peptide(NT-pro-BNP),left ventricular ejection fraction(LVEF),New York Heart Association(NYHA)class II/IV,≥3 comorbidities,comorbid diabetes mellitus(DM),comorbid valvular heart disease(VHD),smoking history,hemoglobin(Hb),albumin,high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C),creatinine(Cr),and blood urea nitrogen(BUN).The aforementioned factors were incorporated into logistic regression analysis and the prediction model was built.The prediction model showed quite strong predictive performance.Its area under the ROC curve was 0.904(95%CI:0.857-0.951),with a sensitivity of98.5%and a specificity of 85.7%.ConclusionssThe frailty risk prediction model for hospitalized CHF patients demonstrated robust discriminative ability and calibration.It provided substantial reference value for clinical management of CHF,offering a basis for early assessment,risk stratification,and targeted interventions to prevent frailty by identifying high-risk patients.
基金supported by the Shanghai Putuo District Health System Science and Technology Innovation Project (No. ptkwws202221)。
文摘Background Chronic heart failure(CHF)and osteoporosis(OP)are major health issues affecting the middle-aged and elderly population.With the intensification of population aging,the incidences of both conditions are in-creasing,severely affecting the quality of life of patients and the development of social medical care.In recent years,many studies have found a close relationship between the two conditions,with mutual influences,especially the impact of CHF on the risk and prognosis of OP,which has attracted increasing attention.Comprehensively un-derstanding the risk of OP in heart failure patients and providing targeted interventions to prevent fractures is of great significance.However,the pathophysiological mechanisms of osteoporosis in patients with heart failure are not yet fully understood.A large number of recent studies have proven that,in addition to common risk factors(such as age,gender,blood lipids,smoking,etc.),there are still independent mutual connections between the two condi-tions.Domestic and international research has found that changes in cytokine or hormone levels in bone metabo-lism can affect the pathophysiological processes of CHF.Therefore,this article reviewed the correlation between bone metabolism and chronic heart failure and elderly osteoporosis,hoping to provide a reference for clinical treat-ment and prevention.
基金Supported by Ministry of Health of the Russian Federation titled Development of a Hardware-Software Complex for the Non-Invasive Monitoring and Prediction of Circulatory Decompensation in Patients with Chronic Heart Failure,No.125030703255-7.
文摘BACKGROUND The six-minute walk test(6MWT)allows to determine,in addition to the main parameters,the time of heart rate recovery(THRR),cardiac function,adaptation index(AI),which characterize the compensatory reserve of patients with chronic heart failure(CHF).At the same time,the significance of these parameters in patients taking beta-blockers for CHF is insufficiently studied,taking into account the negative chronotropic effect of drugs.In this regard,it is relevant to identify factors that can characterize the compensatory capabilities of a patient with CHF during 6MWT,not related to the calculation of heart rate.AIM To identify hemodynamic indicators of the adaptive capabilities of patients with CHF during paired 6MWT depending on their intake of beta-blockers.METHODS Seventy-four patients with compensated CHF due to coronary heart disease and/or hypertension formed the main group,comprising 46 individuals who were taking beta-blockers,and a comparison group comprising 28 individuals who had not been taking beta-blockers for at least one month before 6MWT.All participants underwent Doppler echocardiography(DECG),paired 6MWT,with assessment of hemodynamic parameters before and after both the first and second test.AI,THRR,blood pressure variability(BPV)were calculated.Multivariate,correlation analyses,univariate analysis of variance were used.RESULTS There were no significant associations between adaptation characteristics and DECG parameters or functional class(FC)of CHF in patients of the main group.In the comparison group,the indicators of compensatory reserve were significantly and directly associated with left ventricular ejection fraction(LVEF),and inversely with FC CHF and cardiac cavity size.In both groups,a greater difference in systolic blood pressure between the end of the first and the beginning of the second 6MWT was significantly associated with a higher index of right ventricular systolic dysfunction(Tricuspid annular plane systolic excursion)and LVEF,as well as a smaller left ventricular size and mass,and a lower pulmonary artery systolic pressure in patients in the main group.CONCLUSION Systolic BPV,measured immediately after 6MWT and 20 minutes after its completion,can indirectly characterize the compensatory reserve in patients with CHF,regardless of their beta-blocker intake.
基金Study on the Efficacy and Safety of Hyperbaric Oxygen Therapy Combined with Exercise in Improving Heart Rate Variability in Patients with Stable Chronic Cardiac Insufficiency(Project No.:2023-E-49)。
文摘Objective:To evaluate the effectiveness of cardiac rehabilitation therapy in the treatment of patients with chronic heart failure(CHF).Methods:76 patients with CHF who were treated in the hospital from January 2023 to December 2024 were selected and randomly divided into two groups using a random number table.The experimental group(38 patients)received cardiac rehabilitation therapy,while the reference group(38 patients)received conventional drug therapy.The total effective rate,cardiac function indicators,lung function indicators,and pulse wave velocity(PWV)were compared between the two groups.Results:The total effective rate was higher in the experimental group than in the reference group.After treatment,the cardiac and lung function indicators were better in the experimental group than in the reference group,and the PWV was lower in the experimental group(P<0.05).Conclusion:Cardiac rehabilitation therapy for patients with CHF can improve treatment efficacy,enhance cardiopulmonary function,and regulate PWV levels,with high professionalism and feasibility.
基金financed by the grants from the National Natural Science Foundation of China(No.81803996)Shanghai Key Laboratory of Health Identification and Assessment(No.21DZ2271000)。
文摘Traditional Chinese medicine(TCM)has played a significant role in the prevention and treatment of chronic heart failure(CHF).To study TCM diagnosis of CHF,a total of 278 Chinese clinical research articles on the study of CHF syndromes in recent 40 years retrieved from Web of Science,Scopus,Pub Med,Embase,CNKI,Wanfang Data,Cq VIP,and Sino Med.According to cumulative frequency analysis,network analysis,and hierarchical cluster analysis,the study found the distribution of CHF syndromes was syndrome of qi deficiency with blood stasis,syndrome of qi and yin deficiency,syndrome of yang deficiency with water flooding,syndrome of heart blood stasis obstruction,syndrome of turbid phlegm,and syndrome of collapse due to primordial yang deficiency.The syndrome elements on location of illness were heart,kidney,lung,and spleen.The syndrome elements on nature of illness were qi deficiency,blood stasis,yang deficiency,yin deficiency,water retention,and turbid phlegm.These findings can provide reference to the research on diagnosis and treatment of CHF,and contribute to the study on syndrome standardization and objective research of TCM diagnosis.
