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Heart Disease Patients (heart + disease_patient)
Kinds of Heart Disease Patients Selected AbstractsSerum and 24-hour Urine Analysis in Adult Cyanotic and Noncyanotic Congenital Heart Disease PatientsCONGENITAL HEART DISEASE, Issue 3 2009Efrén Martínez-Quintana MD ABSTRACT Introduction., Glomerulopathy is a complication of congenital heart disease patients. The risk of developing renal impairment is particularly high in cyanotic patients. Objective., The aim of this study was to determine the prevalence of renal dysfunction and microalbumiuria in adult cyanotic and non cyanotic congenital heart disease patients. Methods., Fourteen cyanotic and 22 noncyanotic congenital heart disease patients were studied in the Adult Congenital Heart Disease Unit at the Complejo Hospitalario Universitario Insular-Materno Infantil. Demographic characteristics, complete blood count, and 24-hour urianalysis were obtained, including abdominal ultrasound in those with cyanosis. Results., No differences were seen between age (years) (27.4 ± 8.2; 26.4 ± 8.3; P = .71), sex, size, weight, or glomerular filtration rate (mL/min/1.73 m2) (81.1 ± 22.9 vs. 84.9 ± 9.2, P = .482) between cyanotic and noncyanotic patients. However, Eisenmenger patients had significantly impaired renal function when compared with noncyanotic patients (73.0 ± 17.3 vs. 84.9 ± 9.2 mL/min/1.73 m2, P = .023). Significant differences were obtained in oxygen saturation (%) (83.8 ± 5.8 vs. 97.8 ± 0.8; P = .000), hematocrit (%) (59.3 ± 8.1 vs. 40.9 ± 8.5; P = .000), platelets (103/µL) (161.5 ± 70.5 vs. 277.9 ± 57.6; P = .000), serum uric acid (mg/dL) (7.5 ± 2.3 vs. 5.6 ± 1.5; P = .008) and microalbuminuria (mg/24 hours) (12.8 [0, 700.2] vs. 2.4 [0, 18.9]; P = .000) between cyanotic and noncyanotic patients. Five cyanotic patients (35.7%) had microalbuminuria (>30 mg/24 hours) and three of them (21.4%) proteinuria (>1 g/24 hours). No significant differences were seen between serum and urine parameters between cyanotic patients who had microalbuminuria (>30 mg/24 hours) and those cyanotic patients who did not have it (<30 mg/24 hours). Conclusions., Renal impairment is frequently seen in congenital heart disease patients, being associated occasionally with proteinuria and microalbuminuria in cyanotic ones. [source] Fungal rDNA signatures in coronary atherosclerotic plaquesENVIRONMENTAL MICROBIOLOGY, Issue 12 2007Stephan J. Ott Summary Bacterial DNA has been found in coronary plaques and it has therefore been concluded that bacteria may play a role as trigger factors in the chronic inflammatory process underlying coronary atherosclerosis. However, the microbial spectrum is complex and it is not known whether microorganisms other than bacteria are involved in coronary disease. Fungal 18S rDNA signatures were systematically investigated in atherosclerotic tissue obtained through catheter-based atherectomy of 38 patients and controls (unaffected coronary arteries) using clone libraries, denaturating gradient gel analysis (DGGE), in situ hybridization and fluorescence in situ hybridization (FISH). Fungal DNA was found in 35 of 38 (92.11%) coronary heart disease patients by either polymerase chain reaction (PCR) with universal primers or in situ hybridization analysis (n = 5), but not in any control sample. In a clone library with more than 350 sequenced clones from pooled patient DNA, an overall richness of 19 different fungal phylotypes could be observed. Fungal profiles of coronary heart disease patients obtained by DGGE analysis showed a median richness of fungal species of 5 (range from 2 to 9) with a high interindividual variability (mean similarity 18.83%). For the first time, the presence of fungal components in atherosclerotic plaques has been demonstrated. Coronary atheromatous plaques harbour diverse and variable fungal communities suggesting a polymicrobial contribution to the chronic inflammatory aetiology. [source] Depression and coronary heart mortality in older coronary heart disease patientsINTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 8 2004KivelÄ Sirkka-Liisa No abstract is available for this article. [source] Cardiac rehabilitation programme for coronary heart disease patients: An integrative literature reviewINTERNATIONAL JOURNAL OF NURSING PRACTICE, Issue 3 2009Nidal F Eshah RN, PhD(c) Previous Western cardiac rehabilitation (CR) purported to improve patients' quality of life and health-related parameters for cardiovascular diseases (CVD). Nursing's role in CR was minimally identified. The purpose of this integrative literature review was to determine the effectiveness of current CR programmes and to determine if nurses are included in multidisciplinary CR teams. An online search of databases for the National Institutes of Health Library, Medline, CINAHL, Blackwell Synergy and PsychINFO electronic databases, with keywords,cardiac rehabilitation, lifestyle modification, secondary prevention, quality of life, effects of rehabilitation,identified 13 articles published 2001,2006 for inclusion. Cardiac rehabilitation programmes provided significant improvement in participants' quality of life, exercise capacity, lipid profile, body mass index, body weight, blood pressure, resting heart rate, survival rate, mortality rate and decreased myocardial infarction (MI) risk factors, although there was limited participation. They also decreased depression and anxiety. Eight studies included Nurses as CR providers, but without clear descriptions of their role. Nurses in developing countries need to participate in CR programmes to improve patients' participation, and to focus on modalities with lower overhead costs, such as home-based CR, and to clearly articulate their unique contributions. [source] Cigarette Smoking and the Risk of Supraventricular and Ventricular Tachyarrhythmias in High-Risk Cardiac Patients with Implantable Cardioverter DefibrillatorsJOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY, Issue 9 2006ILAN GOLDENBERG M.D. Introduction: Nicotine elevates serum catecholamine concentration and is therefore potentially arrhythmogenic. However, the effect of cigarette smoking on arrhythmic risk in coronary heart disease patients is not well established. Methods and Results: The risk of appropriate and inappropriate defibrillator therapy by smoking status was analyzed in 717 patients who received an implantable cardioverter defibrillator (ICD) in the Multicenter Automatic Defibrillator Implantation Trial-II. Compared with patients who had quit smoking before study entry (past smokers) and patients who had never smoked (never smokers), patients who continued smoking (current smokers) were significantly younger and generally had more favorable baseline clinical characteristics. Despite this, the adjusted hazard ratio (HR) for appropriate ICD therapy for fast ventricular tachycardia (at heart rates ,180 b.p.m) or ventricular fibrillation was highest among current smokers (HR = 2.11 [95% CI 1.11,3.99]) and intermediate among past smokers (HR = 1.57 [95% CI 0.95,2.58]), as compared with never smokers (P for trend = 0.02). Current smokers also exhibited a higher risk of inappropriate ICD shocks (HR = 2.93 [95% CI 1.30,6.63]) than past (HR = 1.91 [95% CI 0.97,3.77]) and never smokers (P for trend = 0.008). Conclusions: In patients with ischemic left ventricular dysfunction, continued cigarette smoking is associated with a significant increase in the risk of life-threatening ventricular tachyarrhythmias and inappropriate ICD shocks induced by rapid supraventricular arrhythmias. Our findings stress the importance of complete smoking cessation in this high-risk population. [source] A psychometric evaluation of the Chinese version of the Cardiovascular Limitations and Symptoms Profile in patients with coronary heart diseaseJOURNAL OF CLINICAL NURSING, Issue 17 2008Violeta Lopez Aims and objectives., The aim of this study was to translate from English and evaluate the validity, reliability and cultural relevance of the Cardiovascular Limitations and Symptoms Profile (CLASP) as a health-related quality-of-life (HRQL) measure in Chinese patients with coronary heart disease. Background., Improvement in HRQL is increasingly used as a primary outcome in determining the treatment benefit using a generic instrument. However, disease-specific instruments are being cited as more responsive and sensitive in detecting even the smallest changes in health status. Therefore, valid and reliable disease-specific measures for patients with coronary heart disease are now being developed and evaluated. Design., Questionnaire design. Methods., The translation equivalence and content validity of the Chinese version of CLASP were evaluated by an expert panel. Measurement performance was tested on a convenience sample of 369 Chinese coronary heart disease patients. Results., The instrument demonstrated good content validity (content validity index 0·94), acceptable internal consistency (>0·70), except for two subscales of angina and tiredness and significant positive correlations among the subscales of CLASP, Hospital Anxiety Depression Scale and the Short Form 36 Health Survey. Principal components analysis revealed nine factors that together explained 69% of the variance. Conclusions., The results of this study support that CLASP is a valid and reliable disease-specific health status measure for Chinese patients with coronary heart disease. However, further item modifications and testings are needed when considering the cross-cultural context. Relevance to clinical practice., The use of disease-specific HRQL measures could effectively evaluate nursing interventions in clinical practice. Further validations of CLASP among different diagnostic groups, such as patients with heart failure and those who have survived an acute myocardial infarction, would provide further empirical support for its use with all patients with heart disorders. [source] A nurse-led cardiac rehabilitation programme improves health behaviours and cardiac physiological risk parameters: evidence from Chengdu, ChinaJOURNAL OF CLINICAL NURSING, Issue 10 2007Xiaolian Jiang MSc Aim., The aim of this study was to examine the effect of a cardiac rehabilitation programme on health behaviours and physiological risk parameters in patients with coronary heart disease in Chengdu, China. Background., Epidemiological studies indicate a dose-, level- and duration-dependent relationship exists between cardiac behavioural and physiological risks and coronary heart disease incidence as well as subsequent cardiac morbidity and mortality. Cardiac risk factor modification has become the very primary goal of modern cardiac rehabilitation programmes. Design methods., A randomized controlled trial was conducted. Coronary heart disease patients (n = 167) who met the sampling criteria in two tertiary medical centres in Chengdu, south-west China, were randomly assigned to either an intervention group (the cardiac rehabilitation programme) or control group (the routine care). The change of health behaviours (walking performance, step II diet adherence, medication adherence, smoking cessation) and physiological risk parameters (serum lipids, blood pressure, body weight) were assessed to evaluate the programme effect. Results., Patients in the intervention group demonstrated a significantly better performance in walking, step II diet adherence, medication adherence; a significantly greater reduction in serum lipids including triglyceride, total cholesterol, low-density lipoprotein; and significantly better control of systolic and diastolic blood pressure at three months. The majority of these positive impacts were maintained at six months. The effect of the programme on smoking cessation, body weight, serum high-density lipoprotein, was not confirmed. Conclusions., A cardiac rehabilitation programme led by a nurse can significantly improve the health behaviours and cardiac physiological risk parameters in coronary heart disease patients. Nurses can fill significant treatment gaps in the risk factor management of patients with coronary heart disease. Relevance to clinical practice., This study raises attention regarding the important roles nurses can play in cardiac rehabilitation and the unique way for nurses to meet the rehabilitative care needs of coronary heart disease patients. Furthermore, the hospital,home bridging nature of the programme also created a model for interfacing the acute care and community rehabilitative care. [source] Risk factors of Hong Kong Chinese patients with coronary heart diseaseJOURNAL OF CLINICAL NURSING, Issue 7 2007Sek Ying Chair RN Aims and objectives., The aims of the study were to describe the level of modifiable coronary risk factors and to explore the relationships among these risk factors in patients with coronary heart disease. Background., Appropriate patient education and therapies for coronary risk reduction will prevent recurrent cardiac events and progression of coronary heart disease. Therefore, having knowledge of the risk profile of these patients is essential so that appropriate contents and focus of patient educations can be developed. Methods., Coronary heart disease patients admitted for cardiac catheterization at the two studied hospitals in Hong Kong were recruited for this study. Demographic date and risk factors of blood pressure, smoking status, body mass index, total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol and exercise level were collected from subjects as well as from medical records for analysis. Results., The body mass index was significantly different among non-smoker, ex-smoker and smoker (p = 0·027). Non-smokers had the highest body mass index but smokers had the lowest body mass index among the three groups in this study. Physical inactivity, overweight and hypercholesterolaemia were the risk factors seen in about 50% of the studied subjects. Body mass index correlated positively with systolic blood pressure but negatively correlated with high-density lipoprotein cholesterol and hour of exercise. Conclusions., Heavier subjects had a higher systolic blood pressure but a lower level of high-density lipoprotein cholesterol. Heavier subjects also exercised less. The study results provided additional information on the database of the risk profile among Hong Kong cardiac patients. Relevance to clinical practice., Hypertension, obesity, physical inactivity, abnormal serum lipid levels and smoking are the modifiable risk factors for coronary heart diseases. As physical inactivity, overweight and hypercholesterolaemia were found in half of the studied subjects, the importance of risk factors control should be addressed to this group of patients. Nurses should be aware of their educator role to provide appropriate education to coronary heart disease patients with the focus on reducing and controlling of cardiac risk factors, which has been shown to be effective in reducing the progress of disease. [source] | ||||||||||||||||||||||