European journal of heart failure
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Eur. J. Heart Fail. · May 2013
Randomized Controlled TrialEffect of oral digoxin in high-risk heart failure patients: a pre-specified subgroup analysis of the DIG trial.
In the Digitalis Investigation Group (DIG) trial, digoxin reduced mortality or hospitalization due to heart failure (HF) in several pre-specified high-risk subgroups of HF patients, but data on protocol-specified 2-year outcomes were not presented. In the current study, we examined the effect of digoxin on HF death or HF hospitalization and all-cause death or all-cause hospitalization in high-risk subgroups during the protocol-specified 2 years of post-randomization follow-up. ⋯ Digoxin improves outcomes in chronic HF patients with NYHA class III-IV, LVEF <25%, or CTR >55%, and should be considered in these patients.
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Eur. J. Heart Fail. · May 2013
Comparative StudyHeart rate recovery after the 6 min walk test rather than distance ambulated is a powerful prognostic indicator in heart failure with reduced and preserved ejection fraction: a comparison with cardiopulmonary exercise testing.
Heart rate recovery (HRR) appears to be a robust prognostic marker in heart failure (HF). When using the 6 min walk test (6MWT) in HF, distance ambulated is generally the reference prognostic variable. We hypothesized that HRR after the 6MWT would be a better prognostic measure than distance ambulated. ⋯ HRR after the 6MWT is a powerful prognosticator that performs similarly to HRR after maximal exercise. If confirmed in subsequent studies, 6MWT HRR should replace 6MWT distance as the reference criterion 6MWT measure to consider when grading cardiovascular risk in HF patients.
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Eur. J. Heart Fail. · May 2013
Association between sleep-disordered breathing, sleep-wake pattern, and cognitive impairment among patients with chronic heart failure.
Chronic heart failure (CHF) and sleep-disordered breathing (SDB) are often co-existing problems among the elderly. Apnoeic events may cause cognitive impairment. The aim of the study was to compare sleep and wake patterns, insomnia, daytime sleepiness, and cognitive function in community-dwelling CHF patients, with and without SDB, and to investigate the association between sleep-related factors and cognitive dysfunction. ⋯ The prevalence of cognitive dysfunction was low in this population with predominantly mild to moderate CHF. This might have influenced the lack of associations between cognitive function and SDB. Insomnia was the only sleep-related factor significantly influencing cognition.
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Eur. J. Heart Fail. · May 2013
Randomized Controlled TrialImpact of adaptive servo-ventilation on cardiovascular function and prognosis in heart failure patients with preserved left ventricular ejection fraction and sleep-disordered breathing.
Effective pharmacotherapy for heart failure with preserved left ventricular ejection fraction (HFpEF) is still unclear. Sleep-disordered breathing (SDB) causes cardiovascular dysfunction, giving rise to factors involved in HFpEF. However, it remains unclear whether adaptive servo-ventilation (ASV) improves cardiovascular function and long-term prognosis of patients with HFpEF and SDB. ⋯ ASV may improve the prognosis of HFpEF patients with SDB, with favourable effects such as improvement of symptoms, cardiac diastolic function, and arterial stiffness. ASV may be a useful therapeutic tool for HFpEF patients with SDB.