European journal of heart failure
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Eur. J. Heart Fail. · Aug 2004
Living with advanced heart failure: a prospective, community based study of patients and their carers.
Services for people with heart failure are under-developed. The perspectives of patients, their informal and professional carers should inform development of service models. ⋯ Patients with advanced heart failure may benefit from specific models of care with strategic planning across primary and secondary care, and involvement of health and social care services and specialist palliative care providers. Models of care, which focus on quality of life, symptom control, and psychosocial support for patients and their families while continuing active treatment, should be developed.
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Eur. J. Heart Fail. · Jun 2004
Randomized Controlled Trial Comparative Study Clinical TrialTolerability of carvedilol and ACE-Inhibition in mild heart failure. Results of CARMEN (Carvedilol ACE-Inhibitor Remodelling Mild CHF EvaluatioN).
Management guidelines for heart failure recommend ACE-I and beta-blockers. The perception of difficult up-titration might have added to the slow uptake of beta-blockers despite their mortality and morbidity benefits. ⋯ The safety profile was similar in all treatment arms. In contrast to common perception, there was no difference in tolerability between the ACE-I and carvedilol. This result is even more remarkable as the high prestudy use of ACE-I (65%) might have introduced a bias by selecting ACE-I tolerant patients, who were only switched from their former ACE-I to enalapril.
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Eur. J. Heart Fail. · Jun 2004
Case ReportsCardiogenic shock shortly after initial success of cardiac resynchronization therapy.
Cardiac resynchronisation therapy (CRT) has been shown to improve symptoms, exercise capacity and left ventricular function, as well as a reduction in morbidity/mortality in heart failure patients. Failures following initial success of this treatment are mostly related to lead dislodgement. Another entirely different reason is presented in this case study.
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Eur. J. Heart Fail. · Mar 2004
Suppression of cytokines and nitric oxide production, and protection against lethal endotoxemia and viral myocarditis by a new NF-kappaB inhibitor.
Nuclear factor kappa B (NF-kappaB) is activated by several factors, which increase the inflammatory response, and this activation, in turn, leads to the expression of several genes such as cytokines, and may play an important role in cardiovascular diseases. ⋯ These findings suggest that the activation of NF-kappaB plays an important role in the pathogenesis of endotoxemia and viral myocarditis, and that the NF-kappaB inhibitor, SUN C8079, may be therapeutic in these disorders.