bluuebunny/crossref_metadata_2025_split huggingface dataset:
Factors affecting health-related quality of life after coronary artery bypass grafting
Authors: Giorgalla T 
Published: July 2024

Abstract

Background
Cardiovascular diseases are one of the major causes of mortality in the world. According to the World Health Organization (WHO), approximately 17.9 million people die annually due to cardiovascular diseases worldwide. The most common cardiovascular disease is coronary artery disease (CAD), which involves the narrowing or blockage of the heart arteries as a result of atherosclerosis. Coronary Artery Bypass Grafting (CABG) is a common surgical approach for patients with coronary heart disease (CHD), which improves symptoms and survival, and expected to enhance Health-Related quality of life (HR-QoL). Patients, even after recovery from GABG, may have physical and psychological limitations that reduce HR-QoL.

Aim
The investigation of factors that affecting the HR-QoL of people after coronary artery bypass grafting (CABG). The secondary aim of the study was the investigation of demographic or clinical factors, physical activity, stress or depression may affect the HR-QoL of people after CABG.

Methods
This is a descriptive correlational study with a cross-sectional design. Data were collected from the cardiac surgery department of two large general hospitals in Cyprus after consent from both, the management and their ethics committee. The study sample (N=56) included all patients who had undergone CABG surgery from January to June 2022. At, the patients completed a questionnaire at three to six months postoperatively. The data collection tool included: Demographic and Clinical Characteristics Record Form, the SF12 Health Survey Tool for assessing the Health-Related Quality of Life (HR-QoL) of patients, the HADS Tool for evaluating the anxiety and depression levels of patients, and the IPAQ tool for assessing Physical Activity. Descriptive statistic was used for the analysis and presentation of the data and ANOVA analysis to investigate the factors that affect the health-related quality of life.

Results
Gender (64.2±19.3 vs. 49.8±11.9, p&lt;0.05) and education level (78.5±6.7) (P&lt;0.05) were both found to influence HR-QoL. Other factors that affect the HR-QoL of subjects after CABG are intense physical activity, increased anxiety levels, severe depression and patient's symptoms such as dyspnea (53.3±18.6 vs. 64.6±18.4, p&lt;0.05) and orthopnea (45.4±17.4 vs. 65.6±17.3, p&lt;0.05).

Conclusion
The identification of the factors that were found to affect the HR-QoL of patients after coronary artery bypass grafting enlighten health professionals where they should pay attention when they develop rehabilitation programs.
Feasibility and effectiveness of cardiac telerehabilitation for older adults with coronary heart disease patients: a pilot randomized controlled trial
Authors: Su J , Lin R , Batalik L 
Published: July 2024

Abstract

Background
Cardiac rehabilitation is a standard and multidisciplinary treatment of exercise promotion, patient education, risk factor management, and psychosocial counseling for people with coronary heart disease (CHD) that is underutilized due to disparities in access, referral, and participation. Empirical studies suggest that cardiac telerehabilitation (CTR) have safety and efficacy comparable to traditional in-person CR, however, older adults are under-reported with effectiveness, feasibility, and usability of CTR for this population remains unclear .

Purpose
This study investigates the effects, usability, and feasibility of 12-week CTR on health outcomes of older people with CHD.

Design
A pilot randomized controlled trial with qualitative process evaluation.

Methods
The study randomized 43 older adults with CHD to the 12-week CTR intervention or usual care. Guided by Social Cognitive Theory, intervention group participants received individualized in-person assessment and orientation session, followed by CTR usage at home. Participants were encouraged to visit the CR website for self-learning and data uploading, use the pedometer for daily step tracking, and chat with peers and CR nurse via social media for problem-solving and mutual support. Data were collected at baseline (T0), six-week (T1), and 12-week (T2).

Results
Participants in the CTR intervention group showed significant improvement in daily steps (T1: β=4126.58, p=0.001; T2: β=5285, p=0.01) and health-promoting lifestyle profile (T1: β= 23.26, p&lt;.001; T2: β=12.18, p=0.008) across study endpoints. No significant difference was observed regarding self-efficacy, quality of life, psychological symptoms, and body weight and blood pressure. Twenty participants completed the intervention, with 100% used social media for tele-consultation, 90% used the pedometer for tele-monitoring, 40% (n=8) used the website. Improving awareness on rehabilitation and a clear action focus were considered as key enablers while physical discomforts and difficulties in using the technology were described as main barriers.

Conclusions
The CTR is effective in improving physical activity and healthy behaviors for older adults. Considering the variation in individual cardiovascular risk factors, full-scale RCT with larger sample is needed to determine the effect of CTR on psychological symptoms, body weight and blood pressure, and quality of life. Strategies to improve user intervention usage is needed.
Psychometric analysis of the kansas city cardiomiopathy questionnaire-23 in a european population
Authors: Hamilton Dollaku H D , Paolo Iovino P I , Gianluca Pucciarelli P G , Laura Rasero L R , Izabella Uchmanowicz I U , Rosaria Alvaro R A , Ercole Vellone E V 
Published: July 2024

Abstract

Background
People affected by heart failure (HF) often exhibit poor quality of life, which places a great deal of burden on the healthcare systems. The Kansas City Cardiomyopathy Questionnaire (KCCQ)-23 is one of the most widespread instruments to measure quality of life in this population. So far, its psychometric properties have been investigated by a broad array of research, but the overall findings reveal inconsistency of the factorial structure and lack of rigorous psychometric testing.

Objective
The aim of this study was to evaluate the psychometric properties of the KCCQ-23 in a European cohort of HF patients.

Methods
The data used for this study were collected for the MOTIVATE-HF study, which was a three-arm, multicenter, randomized controlled trial to evaluate the effect of motivational interviewing for improving self-care in HF. A group of 510 patients (median age 74 years, IQR=18, 58% males) completed the KCCQ-23 along with clinical and psychosocial measures. Factorial validity was established with confirmatory factor analysis (CFA); omega and model-based internal consistency indexes were computed to examine the internal consistency of the scale. Convergent validity was established by correlating the KCCQ-23 scores with several clinical and psychosocial measures. Measurement invariance testing was conducted within a multigroup framework across patients with preserved vs those with reduced ejection fraction.

Results
Two CFA solutions were tested, which confirmed the theoretical and empirical models postulated by the original author. The internal consistency coefficients for the latent dimensions were adequate (Omega range =0.77-0.93; internal consistency coefficient =0.89-96)- KCCQ-23 scores were found to be correlated with ejection fraction, NYHA levels, quality of life, self-care confidence, anxiety and depression, and symptom burden, supporting its convergent validity. Finally, the KCCQ-23 was invariant across ejection fraction levels, both in the theoretical and empirical factor solution.

Conclusion
Overall, this study provides for the first time evidence that the KCCQ-23 has satisfactory psychometric properties, promoting its use in clinical settings and research to investigate the quality of life in patients with HF.
Fatigue in women after percutaneous coronary intervention - results from CONCARDPCI
Authors: Hamre M , Pettersen T R , Valaker I , Wentzel-Larsen T , Norekvaal T M 
Published: July 2024

Abstract

Background
Better and more efficient treatment have led to decreased mortality rates and shorter hospital stays in patients with coronary artery disease (CAD). Nevertheless, fatigue is a prominent and distressing symptom in patients with CAD more frequently reported in women. Therefore, further investigation through follow-up studies focusing on women and fatigue in the context of CAD is imperative to address this knowledge gap and enhance clinical outcomes.

Purpose
To investigate fatigue in women with CAD at baseline, 2, 6 and 12 months after percutaneous coronary intervention (PCI), and to determine whether self-reported health, and clinical and sociodemographic characteristics are associated with fatigue after PCI.

Methods
CONCARDPCI is a multicentre, prospective cohort study including 3417 consecutive patients after PCI. Of these, 22% (n=746) were women and included in this analysis. Clinical data were collected from patients’ medical records and national registries. Sociodemographic characteristics were self-reported at baseline registration. Self-reported health was assessed with RAND-12 Item Short Form Health Survey (RAND-12) and the Myocardial Infarction Dimensional Assessment Scale (MIDAS). Fatigue was measured with a Visual Analogue Fatigue scale providing scores from 0-10 with higher scores indicating higher levels of fatigue. Patient-reported outcomes measures were completed at baseline and 2-, 6- and 12 months after hospital discharge.

Results
A substantial proportion was living alone (39%), retired (55%) or had three or more comorbidities (67%). Meanage was 68 years (SD 10). Age was significantly associated with fatigue at baseline (p&lt;0.001), 6 months (p=0.002) and 12 months (p&lt;0.001) in the RAND-12 model and at 2 months (p=0.018) and 12 months (p= 0.003) in the MIDAS model. Cohabitation status was significantly associated with fatigue at baseline (p=0.001), 2 months (p=0.033) and 12 months (p=0.016) in the RAND-12 model and at 2 months (p=0.032) in the MIDAS model. The degree of fatigue was at the highest level at baseline (5.2, SD 2.7) but was still present after one year (4.4, SD 2.6) (p≤0.004 for all comparisons). In RAND-12, self-reported physical health was associated with fatigue (p &lt;0.001 for all comparisons). Furthermore, mental health was associated with fatigue at all meassuring time points (p&lt;0.001- p=0.006). In MIDAS, physical health was associated with fatigue (p&lt;0.001 for all comparisons).

Conclusion
A substantial proportion of women reported challenges with fatigue long after hospital discharge. Therefore, healthcare providers must identify the most vulnerable patients and tailor interventions accordingly. Person-centered treatment strategies may be developed by identifying factors associated with fatigue, such as age, cohabitation status, and self-reported physical and mental health.
Assesment of adherence to therapeutic recommendations among patients with hypertension
Authors: Rachubinska K , Gierycz E , Cybulska A , Grochans E , Schneider-Matyka D 
Published: July 2024

Abstract

Hypertension is a multifactorial condition involving environmental and genetic factors along with risk behaviors. Data from the National Health Fund show that nearly 10 million adult Poles have hypertension. The main goal of drug therapy is to effectively lower blood pressure to normal or near-normal values, and the basic prerequisite for effective pharmacotherapy of chronic diseases is patient adherence to pharmacological recommendations.

Objectives
The aim of this study was to determine the level of adherence to treatment recommendations among patients with hypertension with regard to sociodemographic and medical variables.

Methods
This survey-based study included 200 patients with hypertension, hospitalized in the Department of Cardiology with the Intensive Cardiac Care Unit of an Independent Public Clinical Hospital. The author’s questionnaire and The Adherence to Refills and Medication Scale (ARMS) were used as research instruments.

Results
The study demonstrated the effect of age and place of residence on adherence to treatment recommendations (the older the age, the worse the adherence). The overall level of non-adherence to recommendations (ARMS total score), and the level of non-adherence to taking medications or refilling prescriptions were significantly higher in patients with than without diabetes, and in patients without heart failure than in those with this condition.

Conclusion
Adherence among patients diagnosed with hypertension was at a good level. Age, employment status, place of residence, and diagnosed diseases (diabetes, heart failure) significantly affected adherence to treatment among the subjects.Table1
Antimicrobial envelopes and endocarditis: innovative solutions for CIEDs infection
Authors: Pettillo V 
Published: July 2024

Abstract

Introduction
Endocarditis recurrence in patients with cardiac implantable electronic devices (CIEDs) remains a serious concern, demanding effective preventive measures. There is not always the possibility of extraction with a contralateral implant or the implantation of innovative devices. In recent years, two innovative technologies, TYRX and CanGaroo, have emerged as promising solutions to reduce the risk of endocarditis recurrence and improve patient outcomes. TYRX and CanGaroo are two cutting-edge medical technologies designed to address a critical concern in the management of patients with cardiac implantable electronic devices (CIEDs): the prevention and treatment of infected pockets. Both TYRX and CanGaroo offer unique approaches to mitigate this risk and improve patient outcomes.
The TYRX is composed of a mesh envelope containing two antimicrobial agents, minocycline, and rifampin, that providing local and sustained delivery of antimicrobial agents directly at the device pocket. Instead, the primary function of the CanGaroo is to create a physical barrier between the CIED and the surrounding tissues, reducing the risk of bacterial contamination. The CanGaroo is particularly valuable in cases where patients have a higher risk of endocarditis recurrence due to underlying health conditions, compromised immune systems, or previous episodes of infection. By minimizing the direct contact between the CIED and adjacent tissues, the CanGaroo helps reduce the risk of bacterial adherence and biofilm formation.

Objectives
Educate the patient and caregiver to recognize signs of infection and avoid contamination. Improve training and education of cardiology nurse specialists for the prevention and recurrence of endocarditis on intra-operative management using these new devices and the post-operative course.

Materials and Methods
Database research and field evaluations.

Outcome and Discussion
TYRX and CanGaroo are groundbreaking technologies that demonstrate the potential to reduce the recurrence of endocarditis in patients with CIEDs. Their innovative designs and positive clinical outcomes highlight their importance as valuable tools in infection prevention strategies for CIED recipients.

Conclusion
Both TYRX and CanGaroo offer innovative approaches to prevent endocarditis recurrence in patients with CIEDs. By utilizing their unique mechanisms, these devices contribute to a multi-pronged infection prevention strategy. The TYRX envelope's localized antimicrobial delivery and the CanGaroo envelope's physical protection complement standard infection control measures during implantation. It is important to note that while TYRX and CanGaroo offer significant advances in infection prevention, they are not standalone solutions. A comprehensive approach, including stringent infection control protocols, patient selection, and diligent post-implantation monitoring, is crucial in reducing the risk of endocarditis recurrence effectively.tryx
Socioeconomic factors and long-term mortality risk after transcatheter aortic valve implantation
Authors: Lachonius M , Petursson P , Giang K W , Skoglund K , Jeppsson A , Nielsen S J 
Published: July 2024

Abstract

Background
There is scarce knowledge about the association between socioeconomic factors and outcome in patients undergoing transaortic valve implantation (TAVI). Therefore, the aim was to explore the association between marital status, educational level and long-term mortality risk in patients who underwent TAVI.

Methods
The SWEDEHEART registry was used to identify all patients who underwent TAVI due to aortic stenosis in Sweden from 2014 to 2020. Socioeconomic factors and comorbidities were collected from mandatory national registries. Cox regression models adjusted for baseline comorbidities, age, sex, smoking, education and marital status were used to estimate the mortality risk. Median follow-up were 1.9 years (interquartile range 0.8-3.2 years).

Results
In total, 6280 patients were included (47.1% women) with a mean age of 81.5 years (SD 7.1). Common baseline characteristics were hypertension (84.4%), heart failure (45.9%) and history of smoking (51.0%). During follow-up, 1584 (25.6%) of the patients died, of these, 860 (54.3%) deaths were related to cardiovascular causes. Lowest educational level (&lt;10 years) was associated with a higher risk of mortality compared to patients with the highest education level (&gt;12 years) (adjusted hazard ratio (aHR) 1.17 (95% Confidence interval (CI 1.01–1.35). Never being married/cohabiting, compared to married/cohabiting was not associated with an increased risk of mortality, (aHR 1.21 (95% CI 0.98-1.50)). The risk was increased for men (aHR of 1.45 (95% CI 1.12–1.88)), but not for women (aHR 0.81 (95% CI 0.55–1.19)).

Conclusions
Disadvantage in socioeconomic status was associated with an increased risk of mortality after TAVI. These findings emphasize the importance to develop strategies to increase health literacy and social support after TAVI, to patients with unfavorable socioeconomic factors.
Quality assurance in cardio-pulmonary exercise testing
Authors: Bruce D , Ashdown A , Focacci F , Stain N 
Published: July 2024

Abstract

Introduction
Quality assurance (QA) ensures agreed standards are being met and facilitates service improvement. Recent government initiatives aiming to increase diagnostic activity to reduce wait times emphasises the importance of a robust framework to assess standards and drive improvement. Quality frameworks exist for other areas of cardiac diagnostics but there is limited information on assessing quality in cardio-pulmonary exercise testing (CPET).

Purpose
We aim to develop and pilot a quality assurance framework for CPET. This will facilitate further QA development in this area and drive continuous service improvement.

Methods
Data were collected from June to November 2023. A random sample of 10% of tests were selected each month. A total of 39 tests were included. Our framework consisted of 30 checks across four domains: Requesting, data quality, reporting, and documentation. Checks were assessed for compliance using a Red, Amber, Green (RAG) rating system. Green - compliant. Amber - minor deviation (e.g., minor deviation from spirometry repeatability criteria). Red - significant deviation (e.g., incorrectly plotted VO2 peak). An overall test rating was then given: Green (≤ 3 amber), Amber (4 – 5 amber) and Red (&gt; 5 amber or any red).

Results
The analysis comprised of individual domain checks and an overall test rating (OTR). Domain results (figure 1.) were: Requesting 95%; Data Quality; 89%, Reporting 96%; and Documentation 98%. OTRs (figure 2.) were as follows: Green (85%), Amber (13%) and Red (2%). Tests with a red OTR led to supportive discussions with operators, additional training and follow up QA. Protocol selection and spirometry repeatability were the most common individual check deviations (41% amber and 31% amber respectively).

Conclusions
Our QA framework showed that overall CPETs were being conducted to a high standard. There were however some variances identified which led to targeted staff training and additional audits to guide service improvement. Qualitative and subjective aspects of CPET make QA complex and a patient focused model should be employed. It is also salient to note that QA in CPET should be developed to be pragmatic and scalable to the service to ensure sustainability.Figure 1:Domain resultsFigure 2:Overall test rating
Pre-existing cardiovascular disease in the intensive care population: a national data study in scotland
Authors: Rea N , Mchale S , Neubeck L 
Published: July 2024

Abstract

Introduction/Background
Each year, nearly 17,000 patients are admitted to Intensive Care Units (ICU) in Scotland. Forty percent of these patients suffer from one or more pre-existing co-morbidity. Pre-existing co-morbid disease is a known risk factor for readmission to ICU, increased healthcare use, protracted recovery and reduced health-related quality of life. Nonetheless, it is unknown which group of patients is most affected. Given the heterogeneity of the ICU population and in consideration of more "targeted" care, understanding the influence of co-morbidities and identification of specific patient groups is necessary. In tandem, the association between cardiovascular disease and critical illness is under researched. Yet it is known that 20% of ICU patients suffer from cardiovascular disease (CVD), with some evidence to suggest CVD is linked to increased 5-year mortality in this group of patients.

Purpose
To understand the prevalence of pre-existing CVD and other pre-existing co-morbidities in the critically ill population and to determine the influence of pre-existing CVD on hospital readmission rates (within one year of index hospital discharge).

Methods
This study is a retrospective cohort analysis using routinely collected data on ICU admissions between 2010 and 2019 in Scotland. Following public benefit and privacy panel (PBPP) approval and university integrity committee review, data was accessed via a secure National Safe Haven platform. Demographic data are presented alongside correlation analysis.

Results
More than 100,000 patients were admitted to ICU between 2010 and 2019. Of these patients, around 10% suffered from pre-existing CVD, with 30% suffering from any co-morbid disease, as defined by Charlson Co-morbidity index. It was identified that around 10% of ICU patients were readmitted to ICU within one year and a further 20% readmitted to hospital within one year. Of those patients readmitted to ICU, 10% suffer from pre-existing CVD.

Conclusion
This study identified that CVD is prevalent amongst the critically ill population with many experiencing a further admission to ICU. Despite this, little is known about the follow-up care provided to these patients with regards to managing CVD.