bluuebunny/crossref_metadata_2025 huggingface dataset:
Clinical characteristics and outcomes of patients with heart failure admitted to the intensive care unit with coronavirus disease 2019 (COVID19): a multicenter cohort study
Authors: Badreldin H , Hafidh DR , Bin Saleh DR , Al Sulaiman DR , Al Juhani DR , Alharbi DR , Alanazi DR , Almujarri MS , Alobathani MS , Al Harbi MR , Al Harbi DR
Published: July 2021

Funding Acknowledgements

Type of funding sources: None.

Background

Patients with heart failure in the setting of COVID-19 requiring admission to the intensive care unit may present a set of unique challenges. There is limited data to describe the clinical characteristics and outcomes in this subset of the patient population.

Purpose

The study"s purpose was to extensively describe the characteristics and outcomes of heart failure patients admitted to the intensive care unit with COVID-19 compared to non-heart failure patients .

Methods

We conducted a multicenter, prospective analysis for all adult critically ill patients with heart failure admitted to intensive care units (ICUs) between March 1 to August 31, 2020, with an objectively confirmed diagnosis of COVID-19.

Results

A total of 723 critically ill patients with COVID-19 had been admitted in ICUs, 59 patients with heart failure, and 664 patients with no heart failure before ICU admission. Heart failure patients had significantly more comorbid conditions such as diabetes mellitus, hypertension, dyslipidemia, atrial fibrillation, and acute coronary syndrome. Higher baseline severity scores (APACHE II & SOFA score) and nutritional risk (NUTRIC Score) were observed in heart failure patients. Also, heart failure patients had more acute kidney injury during ICU admission and required more mechanical ventilation within 24 hours of ICU admission. Patients with heart failure had a similar incidence of thrombosis compared to patients with no heart failure. Critically ill patients with COVID-19 and heart failure had similar ICU length of stay (LOS), mechanical ventilation duration, and hospital LOS compared to patients with no heart failure. During ICU stay, patients with heart failure had more in-hospital and ICU deaths in comparison to the non-heart failure group (64.3% vs. 44.6%, P-value <0.01) and (54.5% vs. 39%, P-value = 0.02) respectively.

Conclusion

In this observational study evaluating the clinical characteristics and outcomes of critically ill COVID-19 patients with heart failure, patients with COVID-19 and heart failure had similar ICU LOS, duration of MV and hospital LOS, thrombosis rate compared to patients with no heart failure. However, during ICU stay, patients with heart failure had more in-hospital and ICU deaths than the non-heart failure group.
Emergency Department chest pain patient experience time (PET): the impact of ANP cardiology autonomy from triage to diagnosis
Authors: Ingram S
Published: July 2021

Funding Acknowledgements

Type of funding sources: None.

Background

Chest pain accounts for 8% of local Emergency Department (ED) presentations. Patient experience time (PET) is the entire time each patient spends in ED and the national ED PET goal is 6 - 9 hours. The Cardiology Advanced Nurse Practitioner (ANP) consult service reduced PET for patients with chest pain from 17 hours, however the average PET for patients presenting with chest pain remains high at 10 hours in 2019.

Aim

To assess the impact on of ANP Cardiology autonomy on the PET of chest pain patients who present to a busy ED.

Method

Building on 6 years of ANP chest pain consultations in the ED, cardiology ANPs expanded their caseload to fully manage chest pain patients directly from the waiting room as named clinicians, instead of an ED doctor.  The ANP managed the patient completely from triage to diagnosis, resulting in discharge or admission. Enablers included ANP referral for ionising radiation and medicinal prescribing, with buy in from ED Consultants and Cardiology clinical lead. All patients managed directly by the ANP from 2017-2019 were included in the data analysis. The ED symphony system was used as a clinical and audit tool. ANP chest pain PET was compared to ED Doctor chest pain PET. This service evaluation was approved by the hospital audit committee. 

Results

197 patients who presented with chest pain were autonomously managed by one ANP as a named clinician over 3 years. Sixty-four percent were managed completely autonomously.  Eighty per cent were discharged from ED. ANP decision time from initial assessment to admit or discharge was 2.6 hours. The ANP average chest pain PET time was 7.5 hours compared to average ED doctor chest pain PET of 9.5 hours.

Conclusions

As social distancing now impacts more than ever on usual ED pressures, caseload expansion by the Cardiology ANPs evidences further PET reductions for patients who present with chest pain in line with targets. As only one ANP is on the floor and not every shift, many hours of the PET occurred in the ED prior to the ANP ‘clicking’ on as a named clinician. Professional courage to completely manage this potentially high risk cohort autonomously has been welcomed patients and ED staff. PET of the chest pain patient has the potential to reduce further with more ANPs proficient in chest pain assessment within the emergency department setting.
Post cardiac surgery Mediastinitis : Risk factors and therapeutic management
Authors: Mleyhi S , Miri R , Messai M , Ellouze H , Tesnim B , Ben Omrane S , Denguir R
Published: July 2021

Funding Acknowledgements

Type of funding sources: None.

Background : Despite the progress in therapy and patient management in cardiac surgery, postoperative mediastinitis remains an serious complication. Our study aims to study the incidence of mediastinitis after cardiac surgery and to identify the risk factors.

Methods

We conducted a retrospective, descriptive study including patients who had undergone cardiac surgery by sternotomy during a period of 5 years ( 2015 – 2019)and who meet the definition of mediastinitis proposed by the "Centers of disease control and disease". We collected the demographic characteristics of the patients and operative operative data of the first intervention as well as those relating to mediastinitis.

Results

 25 patients ( 2.93%)  among 1042 patients operated for cardiac surgery during the cited period presented mediastinitis. The main clinical signs were : surgical wound infection (80%), fever (40%) and sternal instability (30%). Biological tests showed : hyperleukocytosis and high C-Reactive Protein  in 22.7 % and 58.1 % of cases respectively. Gram-positive cocci are largely predominant and one case of Candida mediastinitis was found. type 1 diabetes and coronary artery bypass grafting were significantly associated with the occurrence of mediastinitis with P <0.01. The mean duration of intra venous antibiotic therapy was 21 days.

92 % of patients operated on for mediastinitis are cured, 4 % had a recurrence of infection and 4 % died.

CONCLUSION

Mediastinitis after heart surgery is rare but serious. The main risk factors are  insulin-dependent diabetes and coronary bypass surgery. The curative treatment is heavy and it is based on a rigorous and long medico-surgical care.
Aortic Coarctation of the newborn and infant: predictors of morbidity and mortality
Authors: Mleyhi S , Miri R , Khadhar Y , Tesnim B , Ghedira F , Ben Omrane S , Ben Mrad M , Denguir R
Published: July 2021

Funding Acknowledgements

Type of funding sources: None.

Introduction

Aortic coarctation represents 8% of all congenital heart disease. Whether isolated or associated with an intra or extra cardiac anomaly, newborns or infants coarctation could lead to early heart failure. this specific form can be associated with peri-operative difficulties and subsequent complications especially recoarctation and late hypertension.

Objective : our objective is to determine the predictive factors of morbi-motality in this disease.

Methods

It’s a monocentric and restrospcetive study of 34 newborns and infants operated on for aortic coarctation between January 2010 and december 2019. Clinical, paraclinical and therapeutic data have been collected.

Results

Our study include 23 newborns and 11 infants, with sex ratio of 2,4. The diagnosis was retained at an average age of 2 months and  2/3 of which before the age of 1 month. The main clinical signs were an abnormality of the femoral pulses in 92% of cases (abolished in 15 babies), tachycardia with polypnea in 68% of cases and hypertension in 48% of patients. Other signs are less common, such as hepatomegaly (44%), left side-sternal murmur (38%) and hypotrophy (20.6%). The mean gradient in blood pressure between the upper and lower limbs was 22 mm Hg [17-38mmHg]. Eight patients required mechanical ventilation. Biological examinations showed metabolic acidosis in 8 patients hepatic failure and renal failure in five patients each one. On the chest x-ray, 60% had cardiomegaly and 42% had pulmonary edema. The trans-thoracic echocardiography detect coarctation in all cases which was preductal in 70.6% of cases. The averge of trans-isthmic gradient was 37mmHg. The main associated cardiac abnormalities were: IVC in 7 patients and aortic bicuspid in 6. However, persistent ductus arteriosus was in 27 cases (79.4%). Cardiac catheterization was used in 5 babies aged between 4 and 9 months with a mean trans-isthmic hemodynamic gradient of 65 mmHg [45-100] and MRI and Ct scann was done in 3 patients each one.

The average weight at the time of the operation was 4.780 kg [2.4-9.8]. 3 newborns were operated between the 9th and 20th days of life. The first approach was a posterolateral thoracotomy in the left 4th intercostal space in 33 patients and a vertical midline sternotomy in a single infant with a total abnormal pulmonary venous return. The modified Crafoord technique (extended-anastomosis) was performed in the majority of cases (97.05%) and 4 patients with unrestricted IVC required also pulmonary artery banding. The overall mortality rate was 29.4%. Prematurity, a birth weight <2.5 kg, an operative age <120 days and  complex heart disease were significantly associated with mortality (P< 0.05).

Conclusion

Coarctation of the aorta in newborns and infants is a surgical emergency in some cases, with still high mortality despite the surgical and anesthetic progress.
The impact of COVID-19 on recovery after heart surgery: preliminary findings from the CardiacCovid Study
Authors: Bueser T , Clayton T , Dodd M , Beaumont E , Owens G , Murray S , Sepehripour A , Oo A , Sanders J
Published: July 2021

Funding Acknowledgements

Type of funding sources: None.

Background/Introduction

The COVID-19 pandemic has had far-reaching effects on everyday life leading to stress and anxiety, which may be heightened in those undergoing cardiac surgery. Health impacts following a traumatic event may be apparent at one month but can also present after many months.

Purpose

The aim of the CardiacCovid study was to explore the effect of the pandemic on recovery from cardiac surgery. We report the preliminary results from a single centre study in the UK during the early phase of the COVID-19 pandemic.

Methods

Patients >18 years old undergoing any form of cardiac surgery between 23rd March 2020 (UK lockdown) to 4th July 2020 (lifting of most restrictions) were recruited to this prospective observational study. Those too unwell or unable to give consent/complete study questionnaires were excluded. Participants completed a Quality of Life (QoL) (EQ-5D), impact of event (IES-R), depression (CES-D) and health service use questionnaire at baseline, 1 week after hospital discharge, and 6 weeks after surgery. Questionnaires were completed electronically on the Amplitude platform or via post. Ethics approval (20/YH/0132) was obtained and the study was registered (Clinicaltrials.gov:NCT04366167).

Results

A total of 395 patients had surgery of which 298 (91.7%) were screened and 203 (68.1%) were enrolled to the study.  Participants were mostly male (74.6%), with a mean age of 63 years, undergoing urgent/emergency (57.9%) CABG +/-valve (70.1%). Mean inpatient stay was 8.6 days and in-hospital mortality was 0.5%. No patients had Covid-19. The initial findings suggest a deterioration of QoL at 1 week post discharge with near restoration to baseline level at 6 weeks post-surgery. Mean scores for CES-D and IES-R remained within subclinical levels at all available time points. However, at 6 weeks, a proportion of patients reached levels for depression on the CES-D and had high IES-R scores indicating possible post-traumatic stress.

Conclusion

We believe that this is the largest/only study exploring the impact of the pandemic on cardiac surgery recovery, including QoL, spanning the immediate recovery phase but will continue until 1 year. The findings so far show that recovery from cardiac surgery during the Covid-19 pandemic is similar to that reported prior to the pandemic (Cromhout et al 2018) and reinforces the need for psychosocial assessments to identify patients who may require additional support during the immediate recovery phase.
Dietary intake of plant sterols in cardiovascular diseases: a population-based study of Polish adults
Authors: Witkowska AM , Waskiewicz A , Zujko ME , Szczesniewska D , Drygas W
Published: July 2021

Funding Acknowledgements

Type of funding sources: Public grant(s) – National budget only. Main funding source(s): National Institute of Cardiology, Warsaw, Poland

Introduction. Cardiovascular diseases (CVD) are a major cause of premature mortality and disability in developed countries. Among various risk factors, disorders of lipid metabolism are prevalent. Scientific evidence shows that plant sterols have a positive effect on dyslipidemia. The primary mechanism of hypolipemic effect of plant sterols is inhibition of cholesterol absorption in the small intestine, and this effect depends on the dose.

Purpose. The aim of the study was to determine the intake of plant sterols, which was never studied in the Polish population.

Methods. In total, 5690 participants of the population-based cross-sectional Polish National Multicenter Health Examination Survey WOBASZ II (2013-2014), aged 20+, were evaluated in the study (1). Nutritional data were collected using a single 24-hour dietary recall method. A dietary plant sterol database was compiled from available experimental data including total and individual plant sterols such as β-sitosterol, campesterol and stigmasterol. Plant sterol intakes were calculated taking into account plant sterol contents in individual food products and the volume of food consumption. Statistical calculations were performed using Statistical Analysis System (SAS), version 9.4 (SAS Institute Inc., Cary, NC, USA).

Results. The dietary plant sterol intake (DPSI) for the general population, 283 mg/day, was dependent on the age and gender. The intake of sterols among people over 65 years of age (264 mg/day in men and 208 mg/day in women) was lower than in younger age groups (20-44 years)  of participants (343 mg/day in men and 259 mg/day in women). The main dietary plant sterol for both genders was β-sitosterol (∼62% of intake), followed by campesterol (∼21%) and stigmasterol (∼9%). Overall, men and women with cardiovascular disease had significantly lower DPSI (p > 0.002) than men and women without cardiovascular disease, 298.6 and 237.8 vs. 326.1 and 255.9 mg/d, respectively, and men but not women with diabetes had significantly (p > 0.04) lower DPSI than men without diabetes, 301.7 vs. 323.3, respectively.

Conclusions. In the view of current recommendations to lower cholesterol, this research confirms findings for other populations, that the dietary intake of plant sterols in the Polish population is insufficient to beneficially modulate lipid metabolism, especially in CVD and diabetic patients.
Multidisciplinary program based in physiotherapy and nutrition in coronary artery disease patients: randomized controlled trial
Authors: Munoz Gomez E , Sempere-Rubio N , Blesa J , Iglesias P , Mico L , Sanchez-Torrijos J , Girbes V , Soriano JM , Espi-Lopez GV , Mesa-Rico R , Timonet-Andreu E , Canca-Sanchez JC , Senra S , Fernandez-Oliver AL , Marques-Sule E
Published: July 2021

Funding Acknowledgements

Type of funding sources: None.

Introduction. The interventions on eating habits and exercise in physiotherapy programs are usually recommended in coronary artery disease (CAD), since they are beneficial to improve physical and nutritional status of patient. Despite this, scarce studies are focused on combined protocols based on high intensity interval training (HIIT) and dietary education in CAD patients with percutaneous coronary intervention (PCI).

Purpose

The main goal of this study was to compare the effectiveness of a multidisciplinary program based in HIIT, with a program based in dietary education and HIIT (DEHIIT), on eating habits in CAD patients with PCI.

Methods. A prospective, randomized controlled trial with blinded outcome assessment was developed. The study was developed at a University research laboratory. 44 participants diagnosed with CAD, aged between 40 and 72 years, were randomly allocated to two treatment groups: HIIT group (HIITG, n = 22) and dietary intervention and HIIT group (DEHIITG, n = 22). The assessment consisted of applying a Food Frequency Questionnaires (FFQ) at baseline and post-intervention. DEHIITG performed a 3-month dietary intervention program combined with 24 HIIT sessions at 85-95% of peak heart rate, whilst HIITG performed a 3-month HIIT sessions at 85-95% of peak heart rate. This study did not receive any funding. No conflict of interest is declared.

Results. At the end of the program, when comparing between groups, statistically significant changes were noted. DEHIITG consumed more olive oil (p = 0.021), chicken or turkey (p = 0.039), stir-fried with vegetables (p = 0.033), vegetables (p = 0.003), fish and seafood (p = 0.039), and quantity of commercial juices (p = 0.042), sweets and snacks (p = 0.033). HIITG showed more improvements than DEHIITG in soups and creams consumption (p = 0.042). No adverse events were reported.

Conclusions. A dietary intervention with HIIT protocol yields better benefits than only HIIT on eating habits in CAD patients with PCI. Thus, our combined program could be considered a suitable treatment option among these patients.
Identify the patients perceived learning needs after myocardial infarction
Authors: Chi SY , Soh KL , Hasina AH , Noraini A , Mazrianna M
Published: July 2021

Funding Acknowledgements

Type of funding sources: None.

Background

Cardiovascular disease is the major trait to public health and the leading cause of death worldwide.  There are over 1 million new and recurrent myocardial infarctions (MI) occur each year and 12,000 of these individuals are still living. Patients surviving from MI have to adapt to live with the heart disease and restore their quality of life. Hence health education for patients to combat the disease as secondary prevention has become very important. Health care professionals must understand the information needs of patients so that effective health education could be taken place consistently with patients’ needs, to optimize outcome of risk factor modification and lifestyle changes.

Purpose

This study aims to identify post MI patients" perceived learning needs and the demographic factors that influence the needs.

Methods

Cross-sectional design and convenience sampling method were used for this study. A questionnaire adapted from Cardiac Patient Learning Needs Inventory (CPLNI) was completed by 56 patients who were recruited from a tertiary hospital during inpatient hospitalization in Malaysia. Data from the questionnaires were analyzed using SPSS version 24.

Results

It was shown that patients’ perceived learning needs were highly important in all eight domains. All domains range from mean 3.52-3.66. Information in the domains of other pertinent information (sign and symptom of MI), medication as well as anatomy and physiology were highly needed by post MI patients, with mean 3.66, 3.65 and 3.64 respectively. Age was significantly related to the patients’ learning need in the domain of anatomy and physiology.

Conclusion

MI patients need abundant cardiac related information prior discharge, to regain and improve their life. This need should be met by delivering appropriate health education before discharge or during follow-up by health care professionals. There is a necessity to integrate this study finding into the cardiac rehabilitation content to benefit post MI patients.
Coronary artery disease patients experience of patient education, follow up and self care support in rural areas of Iceland
Authors: Johannsdottir T , Svavarsdottir MH , Ingadottir B
Published: July 2021

Funding Acknowledgements

Type of funding sources: Public Institution(s). Main funding source(s): Icelandic regional development institute, The Icelandic Nurse´s Association, RHA-University of Akureyri, HSA, The Health Directorate of East-Iceland.

OnBehalf

KRANS

People living in rural Iceland have higher rate of cardiovascular risk factors, healthcare utilization and death and worse self-reported health than people in urban areas.

The aim of this qualitative study was to explore the experience of people with coronary heart disease, living in rural Iceland, of patient education, surveillance, and self-care support. The participants (N = 14, age 52-79 years, 8 male, 6 female) were interviewed 6-12 months after hospital discharge following a cardiac event (in 2018-2019). Systematic text-condensation was used for analysis. The findings were categorized into three main themes: 1) Education and support describes inadequate patient education and support from health professionals after discharge from hospital and how the internet was the main information source supplemented with spouse’s and family support. 2) Local health care services describe the lack of and importance of access to health professionals, stable services and underutilization of primary health care in the local area. 3) Self-care behavior describes the lack of professional support with lifestyle changes and how the participants manage self-care in their local area as well as their attitude towards the disease. In conclusion, the results indicate that access to continuous health services and person-centered support focusing on prevention strategies is widely impaired in rural areas in Iceland.
The types of comorbidities are associated with self-care of heart failure, but not the number of comorbidities
Authors: Lee KS , Moser DK , Dracup K
Published: July 2021

Funding Acknowledgements

Type of funding sources: Other. Main funding source(s): RO1HL083176 Improving Self-Care Behavior and Outcomes in Rural Patients with Heart Failure

Background/Introduction: Patients with heart failure (HF) experience cardiac and non-cardiac related comorbid conditions. Such comorbidities create challenges to successful engagement in self-care of HF because patients are asked to simultaneously perform a variety of recommended self-care activities for HF and their comorbid conditions. It is possible that patients with a greater number of comorbid conditions experience more difficulty performing activities of HF self-care compared to those with a smaller number of comorbid conditions. However, it is also possible that types of comorbid conditions are more important factors influencing self-care of HF.

Purpose

To explore whether self-care of HF is associated with the number of comorbid conditions or types of comorbid conditions.

Methods

A total of 589 patients with HF (66 years, 41% female, 65% NYHA III/IV) were included in this study. The number of comorbid conditions was measured using the list of the conditions in the Charlson Comorbidity Index. Types of comorbidities were defined as follows: concordant conditions, sharing overall pathophysiologic risk profiles with HF, and discordant conditions, not being directly related to HF. Patients were categorized into 4 groups: HF patients without comorbidities; those with concordant conditions; those with discordant conditions; and those with both concordant and discordant conditions. Self-care was measured with the European HF self-care behavior scale. A multivariate linear regression was performed to explore the relationship of HF self-care with the number and types of comorbid conditions after adjusting for relevant covariates.

Results

The number of comorbid conditions was not associated with self-care of HF. However, the types of comorbid conditions were related to self-care of HF after controlling for covariates. Compared to HF patients without comorbidities, patients with both concordant and discordant conditions were more likely to have poorer self-care (β=0.155, 95% CI 0.29-4.09). However, levels of self-care in patients having either concordant or discordant conditions were not different from levels in patients having no comorbid conditions. Conclusion: Patients’ adherence to HF self-care was associated with the types of comorbidities, but not the simple count of comorbidities. Patients who had both concordant and discordant conditions were more likely to perform poor self-care of HF compared to those who had either concordant or discordant conditions or no comorbid conditions. It appears that HF patients with both concordant and discordant conditions experience difficulty integrating HF self-care in relation to a variety of conditions.
Cultural adaptation of the Polish version of the PAH-SYMPACT questionnaire (PL)
Authors: Sarzynska K , Polanski J , Kopec G , Mroczek E , Jankowska-Polanska B
Published: July 2021

Funding Acknowledgements

Type of funding sources: None.

Background

Pulmonary arterial hypertension (PAH) is a rare chronic disease that significantly affects patients" ability to perform daily activities, decreasing physical and mental well-being and social functioning. Symptoms of the disease increase as it progresses, leading to disability and death. In addition, the quality of life of patients deteriorates as the disease progresses and may reflect the effectiveness of the therapy used. Most questionnaires used in PAH clinical trials are generic quality-of-life (QoL) measures that may do not adequately reflect the clinical status and symptoms, changes in health status, or prognosis of patients with PAH.

Purpose

The purpose of this study was to translate and culturally adapt the Polish version of the PAH-SYMPACT questionnaire to reflect the severity of symptoms and their effects on daily functioning.

Material and methods

The study included 55 patients with PAH treated, as part of a pulmonary hypertension treatment program in Poland. Patients were asked to complete the PAH-SYMPACT questionnaire. After about 2 weeks, a follow-up was carried out. Validation of this questionnaire met the guidelines for translation and validation of questionnaires, which are set out in the document on the process of translation and adaptation of World Health Organization tools.  Reliability was tested using a measure of internal consistency (Cronbach"s α) and test-retest reliability. Correctness was confirmed using known group validity.

Results

Moderate internal consistency (Cronbach"s) was found for all questionnaire domains (cardiopulmonary symptoms α=0.706; cardiovascular symptoms α=0.806, physical effects α=0.904, psychological effects α=0.817) and test-retest reliability was satisfactory. The PAH-SYMPACT questionnaire (PL) met all validation criteria and can be used to assess quality of life in patients with PAH.

Conclusion

Psychometric evaluation of the Polish version of the PAH-SYMPACT (PL) indicates that it is a reliable and valid measure tool to detect quality of life patients with PAH.
Participation of the nurse in the prevention of patients with CVD through health education and monitoring of health related quality of life
Authors: Todorova MT
Published: July 2021

Funding Acknowledgements

Type of funding sources: None.

Introduction. Cardiovascular Disease is the most common cause of mortality worldwide and causes major social and economic problems to society. Despite significant progress in prevention, satisfactory results are still being reported. The education of nurses in Bulgaria includes preparation for promotional, preventive, and health-educational activities, which can be performed in a medical team and independently. Nurses resources could be used effectively to prevent Ischemic Heart Disease.

Purpose. The aim of the study is to establish the quality of life in patients with IHD and to promote nursing interventions, including health counseling to address certain behavioral risk factors and monitoring.

Methods. The study was conducted in two stages. A case-control study was performed in 146 patients with chronic ischemic heart disease and the same number of controls. The two groups are equal in gender. For the purposes of the research, a standardized questionnaire for the study of health-related quality of life was used (EQ-5D-3L, an adapted Bulgarian version). The experimental part included 52 patients with IHD, who are monitored in Primary medical care. Health education was provided by a nurse to reduce behavioral risk factors and monitor indicators. The study covers adults who have given informed consent to participate, in compliance with the ethical principles outlined in the Helsinki Declaration.

Results. The results of the quality of life test EQ-5D-3L show more problems in the group of patients in the field of mobility (41.1%) (U = 5.58; p <0.05). There was a significant difference in the relative proportions of patients and controls with problems in the field of self-care, usual routine and pain/discomfort (U = 3.13; p <0.05), which is reflected in a lower self-assessment of quality of life. There is a statistically significant difference in the mean values between patients and controls (t = 13.5, p = 0.001). Short health sessions were conducted with 52 patients to correct behavioral risk factors: guidelines for physical activity, diet, creating an appropriate daily routine, patient diary for blood pressure control, weight reduction, smoking cessation and others.

Conclusions. The nurse can contribute to improving the prevention of CVD by educating patients in a healthy lifestyle, self-management and reducing behavioral risk factors. The delegation of preventive activities within the competence of the nurse can improve the health services and quality of life of patients with coronary heart disease.
Health related quality of life of Icelandic patients six months after coronary heart disease incidence
Authors: Svavarsdottir M , Ingadottir B
Published: July 2021

Funding Acknowledgements

Regional Development Institute, Landspitali, Akureyri Hospital; University of Akureyri, Icelandic Nursing Association, KEA, Akureyri Heart Association

OnBehalf

KRANS-Study research group

Background

Patients with coronary heart disease (CHD) are likely to have impaired health-related quality of life (HRQoL) due to functional and emotional effects of the disease. Research suggests that HRQoL is an indicator of CHD patient’s health and it has been associated with self-care and risk factor management.

Purpose

The aim of this study was to assess HRQoL of Icelandic patients with CHD, six months after coronary heart disease incidence and to identify associated factors.

Methods

Cross-sectional study design was used. Participants were admitted to two main hospitals in Iceland. Data was collected with questionnaires and from patient records in the years 2018 to 2019. HRQoL was assessed with The HeartQoL questionnaire, which comprises 14-items with 10-item physical and 4-item emotional subscales which are scored from 0 (poor) to 3 (better) HRQoL and a global score. Data was analyzed with descriptive and inferential statistics.

Results

Data from 366 patients with CHD will be presented. Preliminary data analysis shows that patients, (mean age 64 years (SD 8.8), 81% male), had mean global HRQoL score of 2.3 (SD = 0.6). The physical score measured 2.2 (SD = 0.7) and the emotional score 2.4 (SD = 0.7). The mean global HRQoL score were lower in women (t(364) =3.7, p < 0.001) and so were the physical score (t(364) =3.8, p < 0.001). However, the emotional score did not differ between the genders (t(363) =1.9, p = 0.061). Low income patients had lower HRQoL (p < 0.001). While physical HRQoL decreased with age (β= -0.12, p = 0.006), emotional HRQoL increased (β=0.14, p = 0.001). Better HRQoL was associated with more physical activity on global (β=0.28, p < 0.001), emotional (β=0.16, p = 0.001) and physical (β=0.36, p < 0.001) scales. Association between HRQoL and other risk factor profiles will be presented.

Conclusion Our findings suggest that among patients with CHD physical activity is associated with better HRQoL. This emphasizes the importance of cardiac rehabilitation and physical activity after discharge from hospital. Special attention should be given to follow up of women and low-income groups.
Sexual satisfaction and subjective well-being after heart transplantation
Authors: Matic I , Grubisic M , Matic N , Ljubas A , Miljas A
Published: July 2021

Introduction

Heart transplantation is still the most dominant method used to achieve successful results in treating end-stage heart failure patients. Besides using new medicines, technologies and monitoring of patients" physical condition, overall care should also include monitoring patients’ well–being, which is not often done. The purpose of this study was to undertake a sexual satisfaction and subjective well-being after heart transplantation.

Methods

The study was conducted on a random sample of 30 patients who had heart transplantation. The data were collected prospectively during a visit to the clinic. Sexual satisfaction was measured by short form of the New Scale of Sexual Satisfaction. The questionnaire consists of twelve items in which patients evaluate their satisfaction with sexual domains. Subjective well-being was measured by the Personal Wellbeing Index. The questionnaire consists of seven items in which patients evaluate their satisfaction with some domains of life. All reported values have been converted onto a standard 0-100 range. The values were given as mean (M) and standard deviation (SD). The differences were tested by the t-test. The result of the questionnaire was determined by correlation analysis and multiple regression.

Results

The mean age of participants was 59.5 ± 7.3, most of them were male (80%) and married (76%). The mean score on the sexual satisfaction scale was 30.7 ± 9.9. Compared to the results of the general population 46,9 ± 8,5 result are significantly unfavorable (p<.001). The overall subjective well-being was 75.0 ± 13.2 within the normative range. Compared to women, men were significantly more satisfied with sex life, 33.40 ±8.33 vs 20.20 ±9.41 (p=.005), significantly higher well-being 77.3 ± 13.8; vs 65.7 ± 2.4 (p=.002). Patients who were married had significantly greater satisfaction with sex lives 33,1 ± 9,1 than singles 23,1 ± 9,2 (p=.029), whereas this difference was not observed with respect to well-being 75,4 ± 12,4 vs 73,5 ± 16,67 (p=.764). Positive and significant correlations were found between sexual satisfaction and subjective well-being (.60; p=.002) as well as negative, between sexual satisfaction and female gender (-.54; p=.005). Results of multiple regression of the model that included the predictors: subjective well-being, gender and marital status has shown predictive success of the model explains about 56% of sexual satisfaction variance. Sexual satisfaction was a significant predictor in explaining 33% of variance in subjective well-being.

Conclusion(s)

Subjective well-being is satisfactory after successful heart transplantation, but sexual satisfaction is poorly. It takes a certain time for some patients to adapt to new life situations but gender and marital status play an important role. Further studies which will include more patients, especially women and young, should be made to evaluate variables associated with sexual satisfaction of patients after heart transplantation.
Use of a force measuring walker to optimize recovery after median sternotomy
Authors: Lapier A , Cleary K
Published: July 2021

Funding Acknowledgements

Type of funding sources: None.

BACKGROUND

Patients often need to use their arms to assist with functional activities, but after open-heart surgery, pushing with the arms is often limited to <10 lb (4.5 kg), to minimize force across the healing sternum. Restricting arm use often limits patient functional independence which can contribute to longer hospital stays and greater need for care after hospitalization. Therefore, appropriate arm use is important for return to function. Currently, no method exists to measure patient upper extremity weight bearing (UEWB) forces objectively in clinical settings. The ultimate goal was to develop a walker that provides UEWB force feedback to patients recovering from median sternotomy. This research project included three interrelated parts that sequentially built on each other.

PART 1

First, I conducted a secondary data analysis comparing UEWB force and Pectoralis Major Muscle EMG during functional mobility in younger vs. older subjects (n = 65). Results showed that the mean arm force was >10 lb before feedback training during all functional mobility tasks for both groups. There were significant differences in UEWB force and EMG between groups (young vs. old) and trials (pre- vs. post-feedback training). There was significantly greater improvement (change) in the UEWB force in the older than younger subjects. We also found a significantly greater reduction in EMG activity in the older subjects than younger subjects for all tasks except during stand-to-sit. Results suggested that patients, particularly older ones, may not accurately estimate UEWB force <10 lb, and feedback training is effective for improving accuracy. This established proof-of-concept, the need for a Clinical Force Measuring (CFM) walker, and the efficacy of its use with feedback training.

PART 2

Next, I completed a qualitative study to obtain critiques of a CFM walker prototype from rehabilitation professionals through structured interviews that were recorded and transcribed. I coded key statements and phrases that allowed "themes" to emerge (Table 1), which guided device revisions.

PART 3

Lastly, I fabricated and tested a second CFM Walker prototype (Figure 1) based on key design elements including: 1) integrated vertical force measuring capability, 2) ergonomic handles, 3) simple visual and auditory feedback with upper limit alarms, 4) streamline, stable, and manoeuvrable frame, 5) lightweight construction, 6) minimal drag, 7) adjustable height, 8) ability to disinfect, and 9) affordable cost.

CONCLUSIONS

The CFM Walker could help patients recover safer and faster from open heart surgery, especially elderly adults.
Operationalization of heart failure patients engagement with mHealth
Authors: Madujibeya I , Aroh A
Published: July 2021

Funding Acknowledgements

Type of funding sources: None.

Introduction

The computing and communication features of mobile devices have been leveraged in mobile Health (mHealth) interventions to provide comprehensive and tailored support that may have positive outcomes in patients with heart failure (HF.  However, the effects of the interventions have shown mixed evidence. Considering that patients’ engagement is a prerequisite for the effectiveness of the interventions, understanding how patients engage with the interventions, and the effects of patients’ engagement on HF outcomes may explain the mixed findings.

Objective

This study aimed to synthesize current evidence on measures of HF patients’ engagement with mHealth interventions, and the effects of the interventions on HF outcomes.

Method

In accordance with the Arksey and O’Malley framework for scoping review, a comprehensive search of the literature was conducted in 7 databases for relevant studies published in the English language from 2009 to Feb. 2021. The descriptive characteristics of the studies were reported. Thematic analysis was conducted to identify themes that described patients’ engagement in the qualitative studies included in the review.

Results

The review synthesized 29 studies that operationalized engagement with mHealth interventions in 3665 patients with HF, ranging from a sample of 7 to 1571, with a median of 80 patients. Patients’ engagement with mHealth interventions was measured quantitively based on system usage data (82.7%, 24/29), qualitatively by semi-structured interviews and focus groups (10.3%, 3/29), and by mixed methods or combination of qualitative and system usage data (17.2%, 5/29). System usage data were evaluated using 7 metrics: (1) number of physiological parameters measured (88.5%, 3/26); (2) duration of use or time spent (3.8%, 6/26);  (3) features accessed/screen viewed (11.5%, 3/26); (4) number of HF educational videos viewed (7.7%, 2/26); (5) number of SMS response (3.8%, 1/26); (6) number of HF questionnaire completed (3.8%,  1/26; (7)numbers of logins (5%, 1/19).  There is a lack of consistency in how system usage metrics were reported across the studies; 73.7 % of the studies reported only the descriptive statistics of the System usage data. Intervention usage was the most identified subtheme in the qualitative measure. The effect of patients’ engagement with mHealth interventions on HF-related outcomes was inconclusive.

Conclusion

The operational definitions of patients’ engagement with mHealth interventions are underreported and lack consistency. The application of inferential analytical methods to the engagement data is extremely limited, which indicates a gap in mHealth research in patients with HF. More research focusing on developing optimal and standardized measures of patients’ engagement that may be applied across different study designs is warranted
The CADI-study: Compression after device implantation - To examine the effect of a compressive dressing after device implantation or replacement focusing on the patient"s bleeding, hematomas and pain
Authors: Fuglsbjerg C , Philbert BT , Risum N , Vinther M , Christensen SW , Risom SS
Published: July 2021

Funding Acknowledgements

University Hospital Rigshospitalet, Centre for Cardiac, Vascular, Pulmonary and Infectious Diseases, Denmark

Background

Bleeding and pocket hematomas are a known complication in pacemaker or implantable cardioverter defibrillator (ICD) implantations.  Hematomas are associated with increased risk of infection and pain.

Purpose

To investigate whether a compressive dressing applied for three hours can prevent bleeding, pocket hematomas and pain.

Method

The study was a pseudo-randomized intervention study including patients scheduled for implantation or box change of a pacemaker or an ICD. In alternating months patients either received a compressive dressing (intervention group) or not (control group). Patients were excluded by the implanting physician if there was a clinical indication for a compressive dressing due to seeping bleeding. Patients were followed at the catheterization lab, for three hours at the ward and until the first outpatient control visit (1-3 months). The outcomes were: Bleeding, pocket hematomas and pain. The bleedings were graded as active bleeding or seeping bleeding or hematomas. Hematomas were measured by degree 1 to 3 (3 largest) and size (in cm). Pain was rated by the patient by numerical rank scale (NRS) from 0 to 10 (10 worst). Descriptive statistics were used.

Results

A total of 191 patients were included, 95 patients in the intervention group. After inclusion 24 patients of the 96 patients in the control group were excluded by the implanting physician on clinical indication for a compressive dressing.

Before the intervention there were significantly more patients with bleeding (graded as: Seeping bleeding) in the intervention group (n = 25, (26.9%)) compared to the control group (n = 4, (5.6%), p <0.001). No patients had developed pocket hematomas at the end of the procedure. Furthermore, the pain score was low in both groups (Total n = 19, NRS score ≤ 2.5).

Over the next three hours in the ward, there was no significant difference in the bleeding (graded as: Seeping bleeding) in the groups (intervention: n = 8 vs. control: n = 3, p = 0.55). Two patients in each group had developed a pocket hematoma after three hours (p = 0.36) and the intervention group experienced more pain (intervention: 1.7 (±2.4) vs. control: 1.1(±1.7), p= 0.02).

At the outpatient control 1-3 months after implantation, there was no significant difference between the groups related to bleeding, pocket hematomas and pain.

Conclusion

Compressive dressing did not significantly reduce bleeding or the number of pocket hematomas after pacemaker or ICD implantation. In addition patients reported a slight increase in pain scores related to the compressive dressing.

The results question routine compression after procedure, but should be validated in larger studies.
Haplotype reconstruction in connected tetraploid F1 populations
Authors: Zheng Chaozhi , Amadeu Rodrigo R , Munoz Patricio R , Endelman Jeffrey B
Published: July 2021

In diploid species, many multiparental populations have been developed to increase genetic diversity and quantitative trait loci (QTL) mapping resolution. In these populations, haplotype reconstruction has been used as a standard practice to increase the power of QTL detection in comparison with the marker-based association analysis. However, such software tools for polyploid species are few and limited to a single biparental F1 population. In this study, a statistical framework for haplotype reconstruction has been developed and implemented in the software PolyOrigin for connected tetraploid F1 populations with shared parents, regardless of the number of parents or mating design. Given a genetic or physical map of markers, PolyOrigin first phases parental genotypes, then refines the input marker map, and finally reconstructs offspring haplotypes. PolyOrigin can utilize single nucleotide polymorphism (SNP) data coming from arrays or from sequence-based genotyping; in the latter case, bi-allelic read counts can be used (and are preferred) as input data to minimize the influence of genotype calling errors at low depth. With extensive simulation we show that PolyOrigin is robust to the errors in the input genotypic data and marker map. It works well for various population designs with ≥30 offspring per parent and for sequences with read depth as low as 10x. PolyOrigin was further evaluated using an autotetraploid potato dataset with a 3 × 3 half-diallel mating design. In conclusion, PolyOrigin opens up exciting new possibilities for haplotype analysis in tetraploid breeding populations.