Neue US-Hypertonie-Leitlinien lockern Therapieziele deutlich

Einecke, Dirk

doi:10.1007/s15027-014-0297-x

Cited by 4 publications

(5 citation statements)

References 22 publications

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“…Similar results were found in the study by Turner et al ( 35 ) in people with chronic diseases. According to the results of previous studies ( 22 , 33 – 35 ), changes in physical limitations are achieved with longer time educational programs and six months or more than six months follow up. However, further investigations were recommended.…”

Section: Discussionmentioning

confidence: 92%

“…This study showed that the mean score of the QOL in the dimension of physical limitation was improved; but this difference was not statistically significant compared with the control group. However, the study of McGillion et al ( 33 ) reported that the self-management education program improved the QOL and reduced physical limitations, angina periods and anxiety in people with angina pectoris. Otsu and Moriyama ( 22 ), and Smeulders et al ( 34 ) indicated that after the implementation of the 6-month self-management education program, the symptoms of CHF and physical capacities had improved and physical limitations had decreased compared with the control group.…”

Section: Discussionmentioning

confidence: 99%

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Effect of the self-management education program on the quality of life in people with chronic heart failure: a randomized controlled trial

Abbasi¹,

Ghezeljeh²,

Farahani³

2018

Electron Physician

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BackgroundChronic Heart Failure (CHF) is a syndrome that negatively affects a person’s Quality of Life (QOL). The efficient self-management education program increases the individual’s abilities and skills for following and participating in a long-term healthcare plan.ObjectiveThe aim of this study was to determine the effect of the self-management education program on QOL in people with CHF.MethodsThis randomized controlled trial study was conducted on 60 people with CHF and without sensory-cognitive problem from April-August 2015. They were selected using the convenience sampling method, and were randomly assigned into the intervention and control groups. The control group received the routine education presented to participants at discharge. However, besides the routine education, the intervention group received the self-management education program consisting of three sessions followed for a 3-month period. The Iranian heart failure QOL questionnaire was used for data collection before and after the intervention. The independent-samples and paired-samples t-tests, Chi-square and Fisher exact tests were used for data analysis via the SPSS v.16 software. P<0.05 was considered statistically significant.ResultsNo statistically significant differences were reported between the groups in terms of demographic and clinical characteristics, indicating that they were homogeneous. A statistically significant difference was reported between the two groups after the intervention in terms of the mean changes of total QOL (p<0.001) and its dimensions, including symptoms (p=0.002), social interference (p=0.01), psychological condition (p=0.013), and self-efficacy and knowledge (p<0.001). In addition, an improvement was observed in the total QOL in the intervention group after the education (p<0.001).ConclusionsAccording to the results of this study, the self-management education program can be considered an appropriate strategy for improving the QOL in people suffering from CHF by health care providers.Trial registrationThe trial was registered at the Iranian Registry of Clinical Trials (http://www.irct.ir) with the IRCT ID: IRCT2015032021521N1.FundingThe authors received financial support for the research, authorship, and/or publication of this article from Iran University of Medical Sciences (No: 107/105/94/D, date April 11, 2015).

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Section: Discussionmentioning

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Effect of the self-management education program on the quality of life in people with chronic heart failure: a randomized controlled trial

Abbasi¹,

Ghezeljeh²,

Farahani³

2018

Electron Physician

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“…Evaluating the mechanistic effects of this arrangement, particularly from the standpoint of sinus hemodynamics may give an insight into the significant risk of leaflet thrombosis and its subsequent role in elevating gradients. (11–13). …”

Section: Introductionmentioning

confidence: 99%

Aortic sinus flow stasis likely in valve-in-valve transcatheter aortic valve implantation

Hatoum

Moore

Maureira

et al. 2017

The Journal of Thoracic and Cardiovascular Surgery

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Objective Valve in valve (ViV) procedures using transcatheter aortic valves (TAV) are increasingly performed to treat degenerated bioprosthetic surgical aortic valves (SAV) due to being less invasive than redo aortic valve replacement. The objective of this study is to quantify the changes in aortic sinus blood flow dynamics before and after ViV to gain insight into mechanisms for clinical and sub-clinical thrombosis of leaflets. Methods A detailed description of the sinus hemodynamics for ViV implantation was performed in-vitro. A Medtronic Hancock II porcine bioprosthesis was modeled as SAV and a Medtronic CoreValve and Edwards Sapien were used as the TAVs. High-resolution particle image velocimetry (PIV) was employed to compare the flow patterns from these two valves within both the left coronary and non-coronary sinuses in vitro. Results Velocity and vorticity within the surgical valve sinuses reached peak values of 0.7 m/s and 1000 s−1, with a 70% decrease in peak fluid shear stress near the aortic side of the leaflet in the non-coronary sinus. With the introduction of TAV, peak velocity and vorticity were reduced to around 0.4 m/s and 550 s−1 and 0.58 m/s and 653 s−1 without coronary flow and 0.60 m/s and 631 s−1 and 0.81 m/s and 669 s−1 with coronary flow for CoreValve and Sapien ViV respectively. Also, peak shear stress was around 38% higher along the aortic side of the coronary vs non-coronary TAV leaflet. Conclusions Decreased flow and shear stress in ViV indicates higher risk of leaflet thrombosis secondary to flow stasis in the non-coronary sinus.

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“…Coronary artery disease (CAD) continues to be a major source of public health burden particularly in industrialized countries [ 1 ]. For the European Union, the estimated costs for CAD management were 60 billion Euros in 2009, of which approximately 20 billion Euros were attributed to direct health care costs [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

Cost-minimization analysis of three decision strategies for cardiac revascularization: results of the “suspected CAD” cohort of the european cardiovascular magnetic resonance registry

Moschetti¹,

Petersen²,

Pilz³

et al. 2016

Journal of Cardiovascular Magnetic Resonance

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BackgroundCoronary artery disease (CAD) continues to be one of the top public health burden. Perfusion cardiovascular magnetic resonance (CMR) is generally accepted to detect CAD, while data on its cost effectiveness are scarce. Therefore, the goal of the study was to compare the costs of a CMR-guided strategy vs two invasive strategies in a large CMR registry.MethodsIn 3’647 patients with suspected CAD of the EuroCMR-registry (59 centers/18 countries) costs were calculated for diagnostic examinations (CMR, X-ray coronary angiography (CXA) with/without FFR), revascularizations, and complications during a 1-year follow-up. Patients with ischemia-positive CMR underwent an invasive CXA and revascularization at the discretion of the treating physician (=CMR + CXA-strategy). In the hypothetical invasive arm, costs were calculated for an initial CXA and a FFR in vessels with ≥50 % stenoses (=CXA + FFR-strategy) and the same proportion of revascularizations and complications were applied as in the CMR + CXA-strategy. In the CXA-only strategy, costs included those for CXA and for revascularizations of all ≥50 % stenoses. To calculate the proportion of patients with ≥50 % stenoses, the stenosis-FFR relationship from the literature was used. Costs of the three strategies were determined based on a third payer perspective in 4 healthcare systems.ResultsRevascularizations were performed in 6.2 %, 4.5 %, and 12.9 % of all patients, patients with atypical chest pain (n = 1’786), and typical angina (n = 582), respectively; whereas complications (=all-cause death and non-fatal infarction) occurred in 1.3 %, 1.1 %, and 1.5 %, respectively. The CMR + CXA-strategy reduced costs by 14 %, 34 %, 27 %, and 24 % in the German, UK, Swiss, and US context, respectively, when compared to the CXA + FFR-strategy; and by 59 %, 52 %, 61 % and 71 %, respectively, versus the CXA-only strategy. In patients with typical angina, cost savings by CMR + CXA vs CXA + FFR were minimal in the German (2.3 %), intermediate in the US and Swiss (11.6 % and 12.8 %, respectively), and remained substantial in the UK (18.9 %) systems. Sensitivity analyses proved the robustness of results.ConclusionsA CMR + CXA-strategy for patients with suspected CAD provides substantial cost reduction compared to a hypothetical CXA + FFR-strategy in patients with low to intermediate disease prevalence. However, in the subgroup of patients with typical angina, cost savings were only minimal to moderate.Electronic supplementary materialThe online version of this article (doi:10.1186/s12968-015-0222-1) contains supplementary material, which is available to authorized users.

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Neue US-Hypertonie-Leitlinien lockern Therapieziele deutlich

Cited by 4 publications

References 22 publications

Effect of the self-management education program on the quality of life in people with chronic heart failure: a randomized controlled trial

Effect of the self-management education program on the quality of life in people with chronic heart failure: a randomized controlled trial

Aortic sinus flow stasis likely in valve-in-valve transcatheter aortic valve implantation

Cost-minimization analysis of three decision strategies for cardiac revascularization: results of the “suspected CAD” cohort of the european cardiovascular magnetic resonance registry

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