Journal of cardiac failure
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Review
Autonomic abnormalities in congestive heart failure patients with sleep-disordered breathing.
The increasing prevalence of chronic heart failure is affecting patients' longevity, quality of life, and health resources, despite advances in management. Recognizing and treating comorbid illnesses is critical. Risk factors such as hypertension and diabetes are treated, but less importance is placed on the role of sleep apnea in heart failure. ⋯ This review explores the impact of sleep disordered breathing in patients with chronic heart failure, focusing on the autonomic nervous system.
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Comparative Study
Validation of remote cardiopulmonary examination in patients with heart failure with a videophone-based system.
The aim of this study was to evaluate feasibility and accuracy of a videophone-based system for remote cardiopulmonary examination of patients with heart failure. ⋯ Remote cardiopulmonary examination appears as a feasible method for assessing patients with heart failure. Telestethoscopy can therefore be reliably used in the context of comprehensive telecare programs.
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Clinical Trial
Predictors of delivery of hospital-based heart failure patient education: a report from OPTIMIZE-HF.
Although recent heart failure (HF) management guidelines recommend delivery of patient education and discharge instructions, little is known about predictors of delivery of these materials or how such materials relate to outpatient disposition postdischarge. This report assesses the degree to which the full set of HF discharge instructions and education comprising the Joint Commission on Accreditation of Healthcare Organizations process-of-care measure (HF-1) was provided, identifies factors predictive of use of HF-1, and determines if HF-1 predicts postdischarge outcome disposition in a registry and performance improvement (PI) program for patients hospitalized for HF. ⋯ Despite recommendations that complete instructions be given to patients with HF before hospital discharge, both PI tools to facilitate HF-1 and HF-1 itself are underused. Efforts should focus on strengthening processes and structures that will improve consistent delivery of HF-1 to all patients.
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Randomized Controlled Trial Multicenter Study
Effects of combined candesartan and ACE inhibitors on BNP, markers of inflammation and oxidative stress, and glucose regulation in patients with symptomatic heart failure.
We assessed the effects of candesartan in addition to angiotensin-converting enzyme (ACE) inhibitors on N-terminal pro-type natriuretic peptide (Nt-proBNP), systemic markers of inflammation and oxidative stress as well as on glucose regulation in patients with heart failure (HF). ⋯ The addition of candesartan to ACE inhibitor and beta-blocker decreases Nt-proBNP and hsCRP, but does not change the other markers of inflammation or oxidative stress in patients with heart failure. Dual angiotensin-II suppression also decreased blood glucose with a greater impact in patients with higher blood glucose level.