Is the clinical presentation of chronic heart failure different in elderly versus younger patients and those with preserved versus reduced ejection fraction?

Steinmann, E; Rocca, Hans‐Peter Brunner‐La; Maeder, Micha T.; Kaufmann, Beat A.; Pfisterer, Matthias; Rickenbacher, Peter

doi:10.1016/j.ejim.2018.06.005

Cited by 14 publications

(9 citation statements)

References 37 publications

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“…Similar results had been found, and higher level of NYHA functional class predicted stronger ability of identifying dyspnea-related symptoms [36,37]. Meanwhile, as reported in prior studies, the higher NYHA functional class level and LVEF level indicated that more symptoms were experienced [38,39]. Symptom clusters, even in different cultural groups, were found to be significantly related to symptom perception [35,40,41].…”

Section: Discussionsupporting

confidence: 78%

Symptom Perception and Influencing Factors in Chinese Patients with Heart Failure: A Preliminary Exploration

Hong

Lindell

Jurgens

et al. 2020

IJERPH

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A growing body of evidence supports the fact that optimal health-related quality of life is largely dependent on patient competence in symptom perception. However, many studies have reported poor symptom perception in patients with heart failure. In China, there has been no previous research on assessing the symptom perception ability of patients with heart failure. This study aimed to describe how Chinese patients with heart failure perceive their symptoms, as well as to explore their influencing factors. A theory-based, descriptive, correlational cross-sectional design was used in this study. Data on symptom perception and factors related to symptom perception were collected via structured interviews and medical records. A convenience sample of 208 hospitalized patients was enrolled. The degree of symptom perception in this study was at a high level. The results showed that the level of depression, the New York Heart Association functional class, the left ventricular ejection fraction, and educational background were identified as independent factors of symptom perception in Chinese patients with heart failure. The degree of symptom perception of patients with heart failure was affected by personal, psychological, and physiological factors. Health policy and healthcare providers should pay more attention and deepen the understanding to Chinese patients with heart failure to provide better healthcare.

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Section: Discussionsupporting

confidence: 78%

Symptom Perception and Influencing Factors in Chinese Patients with Heart Failure: A Preliminary Exploration

Hong

Lindell

Jurgens

et al. 2020

IJERPH

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“…In recent years, numerous studies have been conducted concerning the heterogeneous and complex syndrome known as heart failure (HF). In particular, heart failure with reduced ejection fraction (EF) and heart failure with preserved ejection fraction (HFpEF) were defined [100][101][102][103]. The majority of the population is affected by heart failure with preserved ejection fraction, prevalent in the ageing population.…”

Section: The Potential For N-3 Pufas Supplementation In Heart Failurementioning

confidence: 99%

The Anti-Inflammatory and Antioxidant Properties of n-3 PUFAs: Their Role in Cardiovascular Protection

et al. 2020

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Polyunsaturated fatty acids (n-3 PUFAs) are long-chain polyunsaturated fatty acids with 18, 20 or 22 carbon atoms, which have been found able to counteract cardiovascular diseases. Eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), in particular, have been found to produce both vaso- and cardio-protective response via modulation of membrane phospholipids thereby improving cardiac mitochondrial functions and energy production. However, antioxidant properties of n-3 PUFAs, along with their anti-inflammatory effect in both blood vessels and cardiac cells, seem to exert beneficial effects in cardiovascular impairment. In fact, dietary supplementation with n-3 PUFAs has been demonstrated to reduce oxidative stress-related mitochondrial dysfunction and endothelial cell apoptosis, an effect occurring via an increased activity of endogenous antioxidant enzymes. On the other hand, n-3 PUFAs have been shown to counteract the release of pro-inflammatory cytokines in both vascular tissues and in the myocardium, thereby restoring vascular reactivity and myocardial performance. Here we summarize the molecular mechanisms underlying the anti-oxidant and anti-inflammatory effect of n-3 PUFAs in vascular and cardiac tissues and their implication in the prevention and treatment of cardiovascular disease.

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“…A prospective randomized controlled multicenter trial, TIME-CHF, which included 499 HFrEF and 123 HFpEF patients, found that HFpEF patients were generally older more often females with higher prevalence of hypertension and higher body mass index. Additionally, on initial presentation, a higher percentage of HFpEF patients exhibited edema and had pulmonary crepitations present [25]. In one preclinical left ventricular diastolic dysfunction cohort study, the authors found that HFrEF patients were predominantly male with high percentage of cerebrovascular disease and low baseline of LVEF, while HFpEF patients more often had pulmonary diseases with renal impairment and anemia [26].…”

Section: The Challenges Of Hfref and Hfpefmentioning

confidence: 99%

Heart Failure with Reduced Ejection Fraction (HFrEF) and Preserved Ejection Fraction (HFpEF): The Diagnostic Value of Circulating MicroRNAs

Chen

Wong

Liew

et al. 2019

Cells

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Circulating microRNAs offer attractive potential as epigenetic disease biomarkers by virtue of their biological stability and ready accessibility in liquid biopsies. Numerous clinical cohort studies have revealed unique microRNA profiles in different disease settings, suggesting utility as markers with diagnostic and prognostic applications. Given the complex network of microRNA functions in modulating gene expression and post-transcriptional modifications, the circulating microRNA landscape in disease may reflect pathophysiological status, providing valuable information for delineating distinct subtypes and/or stages of complex diseases. Heart failure (HF) is an increasingly significant global health challenge, imposing major economic liability and health care burden due to high hospitalization, morbidity, and mortality rates. Although HF is defined as a syndrome characterized by symptoms and findings on physical examination, it may be further differentiated based on left ventricular ejection fraction (LVEF) and categorized as HF with reduced ejection fraction (HFrEF) and HF with preserved ejection fraction (HFpEF). The presenting clinical syndromes in HFpEF and HFrEF are similar but mortality differs, being somewhat lower in HFpEF than in HFrEF. However, while HFrEF is responsive to an array of therapies, none has been shown to improve survival in HFpEF. Herein, we review recent HF cohort studies focusing on the distinct microRNA profiles associated with HF subtypes to reveal new insights to underlying mechanisms and explore the possibility of exploiting these differences for diagnostic/prognostic applications.

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Is the clinical presentation of chronic heart failure different in elderly versus younger patients and those with preserved versus reduced ejection fraction?

Cited by 14 publications

References 37 publications

Symptom Perception and Influencing Factors in Chinese Patients with Heart Failure: A Preliminary Exploration

Symptom Perception and Influencing Factors in Chinese Patients with Heart Failure: A Preliminary Exploration

The Anti-Inflammatory and Antioxidant Properties of n-3 PUFAs: Their Role in Cardiovascular Protection

Heart Failure with Reduced Ejection Fraction (HFrEF) and Preserved Ejection Fraction (HFpEF): The Diagnostic Value of Circulating MicroRNAs

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