Life In Chronic Heart Failure Research Articles

A double-blind placebo-controlled pilot study of controlled-release paroxetine on depression and quality of life in chronic heart failure

Depression is frequently observed in patients with heart failure and is associated with poor quality of life and adverse prognosis. However, the prevalence of depression in heart failure could be overestimated because symptoms of depression overlap with those of heart failure. Similarly, the importance of depression may be overestimated if depression merely reflects worse heart failure. Because the response to depression treatment has not been evaluated in this patient population, we evaluated the efficacy of controlled-release paroxetine (paroxetine CR), a selective serotonin reuptake inhibitor, on depression and quality of life in chronic heart failure. A double-blind, randomized, placebo-controlled design was used to evaluate reductions in depression following 12 weeks of treatment with paroxetine CR (n = 14, age 62.1 +/- 12.3 years) or placebo (n = 14, age = 61.9 +/- 9.0 years). Patients with symptomatic congestive heart failure and a score of at least 10 on the Beck Depression Inventory (BDI) were eligible. Beck Depression Inventory was obtained at baseline and 4, 8, and 12 weeks of follow-up. Quality of life was assessed using the Medical Outcomes Study Short Form and the Minnesota Living with Heart Failure Questionnaire. Controlled-release paroxetine resulted in significantly more recovery from depression (BDI <10) than placebo (69% vs 23%, P = .018) and resulted in lower continuous BDI scores throughout the intervention (P = .024). Controlled-release paroxetine was associated with higher general health levels compared with placebo on the Medical Outcomes Study 36-Item Short Form survey (38 +/- 10 vs 30 +/- 6, P = .016) at 12 weeks of follow-up. Reductions in depression were correlated with improvements in psychological aspects of quality of life (P < .05) but not with physical quality of life measures (P > .10). Antidepressant therapy with paroxetine CR results in significant reductions in depression among patients with heart failure. The reductions in depression with paroxetine CR are accompanied by improvements in psychological aspects of quality of life. Larger controlled trials are needed to further document the effectiveness of paroxetine CR and other selective serotonin reuptake inhibitors in patients with heart failure and to determine patient subgroups that are most likely to benefit from antidepressive interventions.

Symptom Control in Palliative Care—Part II: Cachexia/Anorexia and Fatigue

Cachexia may occur in up to 80% of patients with advanced cancer.1 This complex metabolic syndrome, characterized by profound loss of lean body mass, is the main cause of death in 20% of patients. Cachexia (involuntary loss of more than 10% of premorbid weight) is a marker for poor prognosis2 and is associated with anorexia (loss of appetite), asthenia and changes in body image. Cancer cachexia tends to occur in patients with solid tumors, in children, and in elderly patients. Cachexia is also common in acquired immune deficiency syndrome (AIDS), chronic obstructive pulmonary disease (COPD), congestive heart failure (CHF)3–6 and other chronic illnesses, such as dementia, tuberculosis, malaria,7 chronic kidney disease, liver disease,8 and rheumatoid arthritis.

Poor quality of life in chronic heart failure is independently predictive of worse short-term outcome

Poor quality of life in chronic heart failure is independently predictive of worse short-term outcome

195 Counselling may improve quality of life in chronic heart failure in spite of lack of improvement in left ventricular dysfunction after medical therapy

195 Counselling may improve quality of life in chronic heart failure in spite of lack of improvement in left ventricular dysfunction after medical therapy

Measurement of health-related quality of life in chronic heart failure, from a nursing perspective-a review of the literature.

Living with chronic heart failure (CHF) is distressful and affects daily life. Because of the lack of a cure for CHF, there has been a progressive interest in using health-related quality of life (Hr-QoL) as an outcome measurement of the treatment in patients with CHF. The aim of this review was to describe the instruments/questionnaires used in different studies in the measurement of Hr-QoL in patients with CHF, and how they were put into operation as seen from a nursing perspective. MEDLINE and CINAHL databases were searched from January 1995 to June 2002, by using the keywords CHF, heart failure, QoL and Hr-QoL. A total of 33 articles were analysed. Thirty-two different Hr-QoL questionnaires were found. Generic, disease-specific and battery approaches were different ways used to measure Hr-QoL. To assess/describe Hr-QoL, evaluate the impact of interventions and examine relations/predictors were three main objectives. However, different aspects of the concept Hr-QoL, influencing factors, how to implement the questionnaires and a lack of unified CHF criteria existed. To create a guideline for the measurement of Hr-QoL in CHF patients is of great importance for nurses and might generate homogeneity in the measurement methods and promote the scientific approach in the nursing care process.

Measurement of health-related quality of life in chronic heart failure, from a nursing perspective—a review of the literature

Measurement of health-related quality of life in chronic heart failure, from a nursing perspective—a review of the literature

1227: Measurement of Health-Related Quality of Life in Chronic Heart Failure from a Nursing Perspective

1227: Measurement of Health-Related Quality of Life in Chronic Heart Failure from a Nursing Perspective

Exercise training reduced mortality and cardiac events and improved quality of life in chronic heart failure

Source Citation Belardinelli R, Georgiou D, Cianci G, Purcaro A. Randomized, controlled trial of long-term moderate exercise training in chronic heart failure. Effects on functional capacity, quali...

Quality of life in chronic heart failure: cilazapril and captopril versus placebo

ObjectiveTo measure quality of life (QOL) in patients with mild to moderate heart failure treated with angiotensin converting enzyme (ACE) inhibitors cilazapril or captopril.DesignRandomised, double blind, placebo controlled, parallel groups...

Does digitalis work in chronic heart failure? The end of a 200-year-old controversy

Controlled trials using modern methods of assessment in well-defined groups of patients have now convincingly demonstrated that digitalis is an effective and well-tolerated drug in patients with chronic heart failure who have left ventricular systolic dysfunction. These encouraging findings concerning digitalis, however, should not be construed to suggest that the drug should be used alone in the treatment of heart failure. Digitalis cannot adequately control the fluid retention seen in most patients with chronic heart failure; diuretics should be added to maintain sodium balance. Digitalis has not been shown to prolong life in chronic heart failure; converting-enzyme inhibitors should be added to reduce morbidity and mortality. All three drugs should be used together in the management of patients with this disorder.