A Patient’s Guide to Living Confidently With Chronic Heart Failure

Sears, Samuel F.; Woodrow, Lawrence K.; Cutitta, Katherine; Ford, Jessica; Shea, Julie B.; Cahill, John

doi:10.1161/circulationaha.112.000734

Cited by 11 publications

(8 citation statements)

References 17 publications

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“…The variable with the strongest association with fatigue in our analysis was depression, suggesting a strong psychological component to fatigue in HF. Depression is common in HF (26% in our study), and depressive symptoms have significant overlap with several HF-related symptoms, including fatigue [3, 5, 18]. Several previous studies have noted an association between depression and fatigue in HF, but the nature of the causal relationship is not clear and may be bidirectional [6, 18, 19].…”

Section: Discussionmentioning

confidence: 70%

“…These symptoms impair quality of life, drive the need for HF-related hospitalizations, inhibit individuals’ ability to function physically and perform activities of daily living, and in many cases signal a poor prognosis in the HF condition [1, 8]. Fatigue in particular has often been cited as the most common and distressing symptom associated with HF [3, 5–7, 9]. However, as instruments for measuring the quantitative and qualitative aspects of fatigue have not been studied extensively in HF nor reached widespread incorporation in clinical practice, the true burden imposed by fatigue in HF has been challenging to assess [5].…”

Section: Introductionmentioning

confidence: 99%

“…However, as instruments for measuring the quantitative and qualitative aspects of fatigue have not been studied extensively in HF nor reached widespread incorporation in clinical practice, the true burden imposed by fatigue in HF has been challenging to assess [5]. Furthermore, the origins of fatigue in HF are not well understood and several contributing etiologies are possible which confounds proper application of therapy [3–7, 9–12]. Previous studies have had limited ability to evaluate these several potential etiologic factors collectively.…”

Section: Introductionmentioning

confidence: 99%

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The clinical epidemiology of fatigue in newly diagnosed heart failure

Williams

2017

BMC Cardiovasc Disord

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BackgroundFatigue is a common and distressing but poorly understood symptom among patients with heart failure (HF). This study sought to evaluate the prevalence, predictors, and prognostic value of clinically documented fatigue in newly diagnosed HF patients from the community.MethodsThis retrospective cohort study consisted of 12,285 newly diagnosed HF patients receiving health care services through the Geisinger Health System, with passive data collection through electronic medical records (EMR). Incident HF, fatigue, and other study variables were derived from coded data within EMRs. A collection of 87 candidate predictors were evaluated to ascertain the strongest independent predictors of fatigue using logistic regression. Patients were followed for all-cause mortality for an average of 4.8 years. The associations between fatigue and 6-month, 12-month, and overall mortality were evaluated via Cox proportional hazards regression models.ResultsClinically documented fatigue was found in 4827 (39%) newly diagnosed HF patients. Depression demonstrated the strongest association with fatigue. Fatigue was often part of a symptom cluster, as other HF symptoms including dyspnea, chest pain, edema, syncope, and palpitations were significant predictors of fatigue. Volume depletion, lower body mass index, and abnormal weight loss were also strong predictors of fatigue. Fatigue was not significantly associated with either 6-month (HR = 1.12, p = 0.16) or overall mortality (HR = 1.00, p = 0.89) in adjusted models.ConclusionsFatigue is a commonly documented symptom among newly diagnosed HF patients, and its origins may lie in both psychologic and physiologic factors. Though fatigue did provide a prognostic signal in the short-term, this was largely explained by physiologic confounders. Proper therapeutic remediation of fatigue in HF relies on identifying underlying factors.

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Section: Discussionmentioning

confidence: 70%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The clinical epidemiology of fatigue in newly diagnosed heart failure

Williams

2017

BMC Cardiovasc Disord

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“…In addition, CR personnel can assist in managing complex medical problems, coordinating care with other providers, identifying medication side effects, and facilitating early recognition and management of worsening symptoms, thereby reducing readmissions. Self-care tools such as the Self-Care of Heart Failure Index (SCHFI) (64,65), the European Heart Failure Self-Care Behavior Scale (66) and the Heart Failure Activity Checklist (67) can be utilized to evaluate the impact of self-care interventions. In summary, CR programs can facilitate management of CHF patients through a combination of exercise training, education, and promotion and monitoring of self-management skills.…”

Section: Cr Self-care Counseling In Heart Failurementioning

confidence: 99%

Cardiac Rehabilitation Exercise and Self-Care for Chronic Heart Failure

Ades

Keteyian

Balady

et al. 2013

JACC: Heart Failure

175

120

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Chronic heart failure (CHF) is highly prevalent in older individuals and a major cause of morbidity, mortality, hospitalizations and disability. Cardiac rehabilitation (CR) exercise training and CHF self-care counseling have each been shown to improve clinical status and clinical outcomes in CHF. Systematic reviews and meta-analyses of CR exercise training alone (without counseling) have demonstrated consistent improvements in CHF symptoms in addition to reductions of cardiac mortality and hospitalizations, although individual trials have been less conclusive of the latter two findings. The largest single trial, HF-ACTION, showed a reduction in the adjusted risk for the combined end point of all-cause mortality or hospitalization (HR: 0.89, 95% CI: 0.81-0.99; P=0.03). Quality of life and mental depression also improved. CHF-related counseling whether provided in isolation or in combination with CR exercise training improves clinical outcomes and reduces CHF-related hospitalizations We review current evidence on the benefits and risks of CR and self-care counseling in patients with CHF, provide recommendations for patient selection for third party payers, and discuss the role of CR in promoting self-care and behavioral changes.

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“…Inflammatory responses and apoptosis have a considerable role in the pathogenesis of multiple cardiovascular diseases, including cardiomyopathy, cardiac hypertrophy, HF, atherosclerosis, ischemia/reperfusion injury and others (6,(22)(23)(24). Anti-inflammatory and anti-apoptotic agents are highly beneficial in the treatment of these pathological processes.…”

Section: Discussionmentioning

confidence: 99%

Hesperetin attenuates mitochondria-dependent apoptosis in lipopolysaccharide-induced H9C2 cardiomyocytes

Zheng

Liu

Deng

et al. 2014

Molecular Medicine Reports

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Apoptosis is closely associated with the occurrence and development of cardiovascular diseases and is considered as one of the crucial pathological processes of cardiomyopathy, sepsis, ischemia/reperfusion injury, myocardial infarction and heart failure. Hesperetin (HES), a flavanone glycoside found in citrus fruit peels, has been known to exhibit several key biological and pharmacological properties. Previous studies have demonstrated the anti-inflammatory, anti-oxidant and anti-tumor functions of HES. However, with regards to the pro- or anti-apoptotic functions of HES, there are several disagreements within the literature. To examine whether HES has protective effects in cardiac apoptosis, the present study examined the role of HES in lipopolysaccharide (LPS)-stimulated H9C2 cardiomyocytes, aiming to clarify the possible mechanisms underlying its effects. In the present study, HES reduced the percentage of viable apoptotic (VA) cells in a flow cytometry analysis. It had an anti-apoptosis function in LPS-stimulated H9C2 cells. To clarify whether HES alleviated LPS-stimulated apoptosis through the mitochondria-dependent intrinsic apoptotic pathway, certain indicators of this pathway were detected, including members of the caspase family. The data revealed that HES attenuated the activation of capase-3 and caspase-9. These results indicated HES has a mitochondria-dependent anti-apoptosis effect in LPS-stimulated H9C2 cells. To explore the possible mechanisms, the protein expression levels of certain markers in the possible signaling pathway were detected, including JNK and Bcl-2 family. As a result, HES downregulated the protein expression of Bax, upregulated the expression of Bcl-2 and attenuated the phosphorylation level of JNK. Therefore, the anti-apoptosis effects of HES were possibly mediated by the JNK/Bax signaling pathway. In conclusion, HES has a mitochondria-dependent anti-apoptosis effect in LPS-induced H9C2 cells via the JNK/Bax signaling pathway.

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A Patient’s Guide to Living Confidently With Chronic Heart Failure

Cited by 11 publications

References 17 publications

The clinical epidemiology of fatigue in newly diagnosed heart failure

The clinical epidemiology of fatigue in newly diagnosed heart failure

Cardiac Rehabilitation Exercise and Self-Care for Chronic Heart Failure

Hesperetin attenuates mitochondria-dependent apoptosis in lipopolysaccharide-induced H9C2 cardiomyocytes

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