American heart journal
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American heart journal · Apr 2017
Randomized Controlled Trial Multicenter StudyAerobic exercise training and general health status in ambulatory heart failure patients with a reduced ejection fraction-Findings from the Heart Failure and A Controlled Trial Investigating Outcomes of Exercise Training (HF-ACTION)trial.
Although aerobic exercise improves quality of life as assessed by a disease-specific instrument in ambulatory HF patients with a reduced ejection fraction (EF), the impact of an exercise intervention on general health status has not been previously reported. ⋯ Ambulatory HF patients with a reduced EF had impaired health status at baseline which was associated with increased morbidity and mortality, in part mitigated by a structured aerobic exercise regimen.
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American heart journal · Apr 2017
Randomized Controlled Trial Multicenter StudyDesign and rationale of the COMPARE-ACUTE trial: Fractional flow reserve-guided primary multivessel percutaneous coronary intervention to improve guideline indexed actual standard of care for treatment of ST-elevation myocardial infarction in patients with multivessel coronary disease.
What the best strategy is for nonculprit lesions in ST-elevation myocardial infarction (STEMI) patients presenting with multivessel disease remains a clinical dilemma. Based on recent clinical studies suggesting that complete revascularization in the acute phase is beneficial, the European Society of Cardiology and American College of Cardiology/American Heart Association guidelines have been recently changed from class 3 discouragement to a class 2B recommendation concerning the treatment of the nonculprit lesions in the acute index procedure. ⋯ Fractional flow reserve (FFR) guidance for treatment of nonculprit vessels seems to be a reasonable approach, and in the acute setting of STEMI, it is not yet investigated. The COMPARE-ACUTE trial aims to investigate FFR-guided complete revascularization in comparison to a culprit lesion treatment-only strategy in STEMI patients with multivessel disease presenting for primary percutaneous coronary intervention.
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American heart journal · Apr 2017
Randomized Controlled TrialRandomized trial of inhaled nitric oxide to treat acute pulmonary embolism: The iNOPE trial.
The study hypothesis is that administration of inhaled nitric oxide (NO) plus oxygen to subjects with submassive pulmonary embolism (PE) will improve right ventricular (RV) systolic function and reduce RV strain and necrosis, while improving patient dyspnea, more than treatment with oxygen alone. ⋯ We present methods and a protocol for the first double-blinded, randomized trial of inhaled NO to treat PE.
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American heart journal · Apr 2017
The impact of body mass index on the wearable cardioverter defibrillator shock efficacy and patient wear time.
The impact of body mass index (BMI) on the shock efficacy and patient adherence among patients using a wearable cardioverter defibrillator (WCD) is unknown. ⋯ The WCD first-shock success rate and post-event 24-hour survival were high and independent from BMI. TTI was positively correlated with BMI but did not impact early clinical outcome. WCD was safe to all BMI groups and the patient wear time was excellent across all groups.
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American heart journal · Apr 2017
Trends in health care expenditure among US adults with heart failure: The Medical Expenditure Panel Survey 2002-2011.
Population-based national data on the trends in expenditures related to heart failure (HF) are scarce. Assessing the time trends in health care expenditures for HF in the United States can help to better define the burden of this condition.