Understanding Of Chronic Heart Failure Research Articles

Progress in Traditional Chinese Medicine Treatment of Chronic Heart Failure

Chronic heart failure (CHF) is the terminal stage of the development of various heart diseases, is a clinical syndrome. The study found that the incidence and mortality remain high, the rehospitalization rate is high, and the quality of life is low. Recent studies have found that traditional Chinese medicine (TCM) has the advantages of long history, exact curative effect and small side effects in improving heart failure. Therefore, this paper discusses the progress of traditional Chinese medicine in the treatment of chronic heart failure from the understanding of CHF in traditional Chinese medicine, syndrome type prescriptions and traditional Chinese medicine preparations.

The patient with left ventricular systolic dysfunction now and in the future.

This review provides a concise overview of the current understanding of chronic heart failure, focusing on the landmark clinical trials that form the basis of clinical management of patients with left ventricular systolic dysfunction.

Uric acid in chronic heart failure; correlation with prognostic markers

Background: Chronic heart failure (CHF) is a leading cause of both morbidity and mortality worldwide. The pathophysiologic understanding of chronic heart failure (CHF) has shifted from a mere hemodynamic disorder to a much more complex approach including changes and imbalances in neurohormonal, immune, and metabolic functions. Hyperuricemia is a constant finding in CHF. Aim: To estimate the level of uric acid (UA) in patients with CHF, and to explore the possible relationship with established prognostic markers in these patients. Patients and Methods: Ninety-five patients with CHF were studied. Detailed clinical assessment, ECG, laboratory investigations and echocardiography were performed for all patients. Serum UA level >7.0 mg/dl was considered high. Results: The age range of patients was 28-85 years (median age 67). Of this group, 54 were males. The duration of the disease ranged from 113 years. In addition, 56% of patients were diabetic, 64% were hypertensive, and 74% had ischemic heart disease. 41 patients were class III New York Heart Association (NYHA) functional calcification, whereas 34 patients and 12 patients were in class II & IV respectively. The following diagnostic information was obtained: 1) blood pressure readings were 60 -123mmHg (mean=87.9±14.4). 2) atrial fibrillation (AF) was noted in 36 patients (38%) 3) left ventricular ejection fraction (EF%) was 13-68% (mean=37.9±20.1) 4) blood urea ranged from 13-197 mg/dl (mean=64.7±42.6) 5) serum creatinine was 0.4-5.5mg/dl (mean=1.4±0.9) 6) serum sodium was 119-148 (mean=134.2±5.9) 7) Elevated serum uric acid levels were found in 73% of our patients. We found a significant inverse correlation between serum uric acid level and mean arterial blood pressure (r = -0.42, p = 0.019) and with left ventricular ejection fraction (EF%) (r = -0.31, p = 0.003). We also demonstrated a direct correlation between serum UA and blood urea (r= +0.21, p= .042), serum Cr (r= +0.21, p= 0.051) and age (r=+0.37, p= 0.034). No significant differences were noted in serum UA level in different (NYHA) functional subgroups. Conclusions: High serum UA was observed in 73% of patients with CHF. The observed significant correlation between UA level and some established prognostic markers in these patients may indicate that serum UA could provide additional prognostic information in this population. We propose that such a simple marker that can be measured anywhere at a low cost to help identify high-risk patients with CHF.

Современное предСтавление о хроничеСкой Сердечной недоСтаточноСти

Современное предСтавление о хроничеСкой Сердечной недоСтаточноСти

Adiponectin Resistance in Heart Failure and the Emerging Pattern of Metabolic Failure in Chronic Heart Failure

In recent years, an interesting shift in our understanding of chronic heart failure (CHF) pathophysiology may be observed. Beyond the traditional concepts of hemodynamic failure and neuroendocrine activation, it is increasingly appreciated that CHF is a much more complex and truly systemic disease including the peripheral organs and whole body regulatory processes as well. Novel concepts such as the systemic inflammatory immune activation and the skeletal muscle hypothesis have emerged.1 These concepts recognize the significant contribution of peripheral changes to symptomatic status, disease progression, and outcome in CHF. Article see p 185 A further novel facet in heart failure pathophysiology has emerged recently because impaired regulation of systemic metabolic balance is increasingly in the focus of clinical research. The emerging picture suggests a complex but characteristic pattern of metabolic pathways that are imbalanced, attenuated, or abnormally activated. Hormonal imbalances have been previously observed as common features in CHF, such as insulin resistance2 and growth hormone resistance3 that contribute to both morbidity and mortality of patients. The metabolic interaction of neuroendocrine activation and immune activation such as from cytokines and oxygen radical accumulation add to the complexity of these interrelated processes. In general, the findings repeat, again, the classical concept of short-term beneficial adaptive responses on acute injury or disease may eventually turn into harmful maladaptive signals on prolonged and chronic activation. The overall clinical effects that may be observed from impaired energy metabolic efficacy contribute to impaired exercise capacity, muscle fatigue, and early exhaustion—key symptoms in heart …

The Cholesterol Paradox Revisited: Heart Failure, Systemic Inflammation, and Beyond

The pathophysiologic understanding of chronic heart failure has made significant advances over the last decades. Counterintuitively, high levels of plasma cholesterol are associated with better survival, perhaps because plasma lipoproteins are able to scavenge lipopolysaccharide, a cell-wall component from gram-negative bacteria. A number of similar features are present in patients who have sepsis. This article explores the cholesterol paradox in patients who have chronic heart failure and extends this view to patients who have sepsis. Also discussed is the potential of statins, which might be able to exert beneficial effects in both clinical conditions, despite lowering plasma cholesterol values.

Evidence-based Treatment of Chronic Heart Failure

The past two decades have seen a knowledge explosion in the field of cardiovascular diseases, in general, and in the understanding of chronic heart failure (HF) as a complex neurohumoral syndrome in particular. A new staging system for chronic HF has been developed within the last decade to facilitate the evidence-based prescription of medications and medical devices for each of its four stages. The burden of care for patients with chronic HF is substantially provided in primary care settings. Primary care physicians need to understand the underlying pathophysiology of chronic HF, the elements of its evaluation and treatment by stage, and when referral is necessary.

Uric acid in chronic heart failure

The pathophysiologic understanding of chronic heart failure (CHF) has shifted from a mere hemodynamic disorder to a much more complex approach including changes and imbalances in neurohormonal, immune, and metabolic functions. Among metabolic abnormalities, hyperuricemia is a constant finding in CHF. The xanthine oxidase metabolic pathway increasingly is appreciated as an important contributor to both symptoms of CHF as well as progression of the disease. Recent data suggest hyperuricemia to be an independent marker of impaired prognosis in CHF. In this article, the significance of the xanthine oxidase metabolic pathway in CHF is discussed. Data on xanthine oxidase inhibition are reviewed, which suggest a beneficial effect of therapeutically targeting this enzymatic pathway.

Knowledge and communication difficulties for patients with chronic heart failure: qualitative study

A sample of 27 patients (mean age 69 years) took part in interviews to explore their understanding of chronic heart failure and to investigate their need for information. Their answers indicated that they tended to attribute their condition to advancing age and believed that little could be done about their symptoms. Many had questions about their illness that they felt unable to ask their doctors, and some wanted frank information about their prognosis. 16 references.

Knowledge and communication difficulties for patients with chronic heart failure: qualitative study

Objectives: To explore patients' understanding of chronic heart failure; to investigate their need for information and issues concerning communication.Design: Qualitative analysis of in-depth interviews by a constant comparative approach.Participants: 27...