UMLS:C0018801 - FACTA Search

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Query: UMLS:C0018801 (heart failure)
72,216 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A total of 42 Japanese centenarians (9 males & 33 females) autopsied in Tokyo Metropolitan Geriatric Hospital during 22 years (1975-1996) were clinico-pathologically examined to determine details of the main cause of death. The main cause of death of the 42 cases were sepsis (16 cases), pneumonia (14 cases), suffocation (4 cases), heart failure (4 cases), cerebrovascular disorder (2 cases) and malnutrition (2 cases). Most pneumonias were caused aspiration of foreign bodies, and the origins of sepsis were pyelonephritis (7 cases), biliary tract infection (3 cases), necrotic lesions of the intestine due to ileus, ischemia and pseudomembranous colitis (3 cases) and indwelling vein catheter (3 cases). Malignant neoplasms were observed in 16 cases (38%), and 5 of them had 2 or 3 lesions. Thus, the total number of lesions of malignant neoplasms were 22, as follows; colonic cancer (36%), urinary bladder cancer (14%), lung adenocarcinoma (9%), gastric cancer (9%), malignant lymphoma (9%) and others. However, none of these malignant neoplasms were directly related with the cause of death. All 42 centenarians died not of simple "senile decay", but due to diseases.
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PMID:[Pathologic evaluation of the main cause of death in Japanese centenarians]. 1036 29

The aim of this study was to develop a reliable chronic heart failure model by coronary artery ligation in the rabbit on the basis of the new concept of the bifurcation/trifurcation classification system of the epicardial branching pattern of the left coronary artery (LCA). New Zealand White rabbits (n = 37) were divided into 3 experimental groups: a posterolateral division of the bifurcation pattern of the LCA was ligated at the 75% level from the apex along the course of the division (B75 group, n = 15); a lateral division of the trifurcation pattern at the 75% level (T75 group, n = 11); and a posterolateral division of the bifurcation pattern at the 50% level (B50 group, n = 11). The infarct size and the lung and liver water content were determined at 4 weeks following ligation. The Q or QS wave on electrocardiogram (ECG) and the left ventricular (LV) dimensions (LVIDs and LVIDd), fractional shortening (FS), and mitral E-point to septal separation on ultrasonography were assessed at 10 min and at preligation and at 1, 2, and 4 weeks following ligation. The B75 group showed higher mortality (46.7%) than the T75 and B50 groups. The mean infarct size in the B75 group was 22.55 +/- 5.34% which was significantly larger than in the B50 (13.84 +/- 5.46%) and T75 (12.90 +/- 2.67%) groups (p < 0.001). All 3 groups had significantly greater Q or QS wave amplitudes on ECG at 1, 2, and 4 weeks than at 10 min after ligation. At 1 and 2 weeks after ligation, LVIDd, LVIDs, and FS showed significant dfferences in the B75 group as compared with the other groups. The level of ligation of the LCA for the development of a reliable chronic heart failure model in the rabbit is recommended to be 50% from the apex along the course of the posterolateral division in the bifurcation pattern and 75% from the apex along the course of the lateral division in the trifurcation pattern.
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PMID:Chronic heart failure model in rabbits based on the concept of the bifurcation/trifurcation coronary artery branching pattern. 1195 7

The purpose of this study was to test the relationships between perceived self-efficacy, functional status and depression in a group of chronic heart failure patients. The conceptual model for this study was primarily derived from Bandura's social learning theory. The study is based on an exploratory, correlational design. A sample of 100 chronic heart failure patients who met the inclusion criteria were recruited from four cardiovascular clinics of major hospitals in northern Taiwan. The instruments used in this study included Jenkins' Self-Efficacy Expectation Scales, Seattle Angina Inventory, and Geriatric Depression Scale. Results demonstrate a significant inverse relationship between perceived self-efficacy and depressive symptoms (r = -.61, p < .001), a significant positive relationship between perceived self-efficacy and functional status (r = .55, p < .001), and a significant negative relationship between functional status and depressive symptoms (r = -.33, p < .001). The findings of the path analysis support the hypothesis that after controlling for disease severity, perceived self-efficacy has a direct and negative effect on depressive symptoms. An indirect effect of perceived self-efficacy on depression through functional status in heart failure patients was also revealed in the finding. All paths in the model were significant (p < .05). Results of the study can help to identify heart failure patients who are at risk for low perceived self-efficacy, low functional status, and a depressed mood. Nursing intervention to address these factors can then be developed and tested.
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PMID:Effects of perceived self-efficacy and functional status on depression in patients with chronic heart failure. 1252 40

In this study the authors sought to determine the prevalence and long-term prognostic value of low triiodothyronine levels in elderly patients with heart failure and no thyroid disease. Lower levels of triiodothyronine are more prevalent in patients with advanced heart failure without thyroid disease, and this may have prognostic implications. However, this hormonal milieu has not been investigated in elderly patients. The authors prospectively followed a consecutive sample of 69 elderly patients aged 76.5+/-5.9 years with heart failure and 44 age-matched controls without heart failure between March 1997 and September 2000 at the Geriatric Cardiology Outpatient Clinic of the Heart Institute of Sao Paulo, Brazil. Events analyzed included death, hospitalization, and the combined end point of death or hospitalization. The study revealed that levels of triiodothyronine were lower in heart failure patients than in controls (89+/-23 vs. 101+/-16 ng/dL, p=0.001). During the follow-up period of 14.3+/-8.1 months there were 19 deaths and 33 hospitalizations in the heart failure group. The combined end point of death or hospitalization occurred in 38 patients. Triiodothyronine levels were lower in heart failure patients who had a cardiovascular event than in event-free patients (82.7+/-24.8 vs. 96.7+/-19.2 ng/dL, p=0.012). The odds ratio for events was 9.8 (95% confidence interval, 2.2-43, p=0.004) for patients in the lowest tertile of triiodothyronine, that is, lower than 80 ng/dL, compared with patients with levels above 80 ng/dL. The authors conclude that among elderly patients with heart failure, lower triiodothyronine concentrations are more prevalent and are associated with a worse prognosis.
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PMID:Long-term prognostic value of triiodothyronine concentration in elderly patients with heart failure. 1296 54

Morbidity and mortality rates from heart diseases are highly represented in geriatric-aged patients, but these patients also have supporting diseases. Acute coronary syndrome includes unstable angina and acute myocardial infarction with and without ST elevation. The aim of this study was to make a retrospective morbidity analysis of patients admitted to the emergency department. The study is made for a period of three years (from 1998 to 2000). It includes 588 patients divided by age (395 were 65-75 years old; 193 were older than 75 years) and sex (there were 326 men and 262 women). Comorbidity and mortality were investigated. Patients with one, two, three, and more than three supporting diseases were 6.29%, 23.13%, 68.53%, and 2.04%, respectively, of the total number. The most frequent geriatric patients had heart failure, followed by endocrinological diseases (type 2 diabetes, obesity, struma), neurological diseases (insultus, paresis), and chronic kidney diseases (pielonephritis, nephrolithiasis). The combination of hypertension, heart failure, and type 2 diabetes had the highest comorbidity frequency. The mortality rate for 1998 was 8.81%, for 1999 7.74%, and for 2000 13.41%. The mortality rate at the first 12 hours at the beginning of the acute coronary syndrome was 66.6%. Geriatric patients suffer from many diseases, and at the beginning of the onset of acute coronary syndrome they have multiorganal failure. Elderly patients are a high-risk contingent in intensive coronary care units.
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PMID:Acute coronary syndrome, comorbidity, and mortality in geriatric patients. 1524 1

Zinc is an essential trace element, and constituent of many metallo-enzymes required for normal metabolism. Age may be associated with altered metallothionein metabolism related to changes in zinc metabolism. The objectives of this study were: (i) to assess the prevalence of zinc deficiency among hospitalised elderly patients; (ii) to define the social, functional, pathological and nutritional characteristics of zinc deficient elderly hospitalised patients; and (iii) to assess the relationship between the zinc status and humoral immune function among hospitalised elderly patients. Fifty consecutive patients underwent comprehensive geriatric assessments included evaluations of the medical (index of the severity of the disease(s)), psychiatric (Geriatric depression scale (GDS)), therapeutic, social, functional (Katz's scale), and nutritional problems (Mini Nutritional Assessment (MNA) and biochemical markers (zinc, albumin, prealbumin (PAB), cholesterol) before their discharge. Fourteen patients (28%) presented a zinc concentrations lower than 10.7 micromol/l, this value is usually considered as the cut-off level below which a zinc deficient status is possible. Higher proportions of respiratory infections, cardiac failure, and depression were observed among zinc deficient patients as compared with the group of patients with normal zinc status. The other parameters of comprehensive geriatric assessment did not allow to discriminate the zinc deficient patients. The only slight differences (which remained unsignificant) concerned the prealbumin levels which tended to be higher in the group of patients presenting normal zinc status than in the group with poor zinc status (0.208+/-0.062 versus 0.171+/-0.068 g/l respectively, P=0.06), and the IgG2 levels which tended to be lower in the group of patients with normal zinc status than in the group presenting poor zinc status (2.77+/-1.91 versus 4.06+/-2.56, respectively, P=0.057). A negative correlation was observed between the Zn concentrations and the IgG2 levels (Spearman R=-0.311, P=0.028). To the best of our knowledge, this is the first study presenting zinc status according to a comprehensive geriatric assessment among European hospitalised geriatric patients. We decided to perform this study to known whom of our patients needed to be supplemented with zinc administration. Considering the low energy intake of hospitalised patients (confirmed here in regards of the nutritional assessment), and the insufficient trace element density in European foods, the relevance of providing medical supplements or enriched foods to this population has to be evaluated. Although most of the current diseases may be relevant to long-term interactions between nutrition and ageing, certain states observed in the elderly, like impaired immune and cognitive functions, could still benefit from an appropriate nutritional supplementation.
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PMID:Prevalence of zinc deficiency and its clinical relevance among hospitalised elderly. 1537 21

The QDF (Quality of life, Depression Cognitive Function) is a project by nursing personnel, as companion study of the GISSI-HF (Gruppo Italiano per lo Studio della Sopravvivenza nell'Infarto miocardico- Heart Failure). The study aims at describing the evolution of the QDF variables in the patients randomised for the GISSI-HF; at evaluating the reliability of the assessments with standardised instruments (Kansas City Quality of life Questionnaire (KCQQ); Geriatric Depression Scale (GDS) and Mini Mental State Examination (MMSE) compared to the clinical judgement of the nurses; and at describing whether and how the assessment of QDF variables influences decision making and care for these patients (i.e. drug therapies, psychosocial interventions etc). The QDF data are collected at baseline and at 6 months and at 1, 2 and 3 years. The greatest majority of patients are expected to comply with the self administered questionnaires (KCQQ and QDF) while the MMSE will be proposed, via a didactical presentation, only to patients older than 70 years. A specific goal of the project focuses on the degree of independence between the results of the questionnaire and the judgement of nurses. Expected outcomes: epidemiology and distribution of QDF variables among patients of different age-groups and disease severity; description of the prevalence and incidence of severe problems. Up to 2000 patients are expected to be included in this prospective protocol which has already been activated in a network of more then 70 centres.
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PMID:[The QDF-HF (Quality of life, Depression and Cognitive Functioning in Heart Failure). The project and study protocol]. 1555 28

The continued aging of the population is an acknowledged fact. The proportion of individuals in the European Union aged over 65 years will reach 29.9% by 2050, almost double the present figure of 16.4%. Approximately one third of people in this age-group has clinically significant cardiovascular disease. Physicians dealing with cardiology in older patients have to be aware of the specific clinical and prognostic features of cardiovascular disease in the elderly, and with its treatment. Consequently, it is clear that continuing medical education in geriatric cardiology is essential, and that is one of the tasks of the Working Group on Geriatric Cardiology. This special issue provides a magnificent opportunity for presenting an update on important topics in geriatric cardiology, such as the aging of the cardiovascular system, heart failure, and atrial fibrillation.
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PMID:[Advances in geriatric cardiology]. 1654 26

The elderly are increasingly been hospitalised into medical wards in Nigeria and little information is currently available on this group of patients. The objective of this study was to describe the demographic, clinical characteristics and outcome of management of elderly patients admitted into medical wards at the University of Ilorin Teaching Hospital Ilorin, Nigeria. A retrospective study in which hospital records of patients admitted between years 2001 to 2004 were reviewed. Information obtained included gender, occupation, diagnosis, investigations, duration of stay and outcome management. A total of 4113 adults were admitted into the medical wards within the period under review. Of these, 456 were aged 60 years and above. The elderly patients accounted for 11.1% of total hospitalisation into the medical wards. The mean age of the patients was 69 +/- 9 years with male:female ratio of 243:105. The 3 most common diagnoses were: hypertensive heart failure (HHF), 19%; cerebrovascular accident (CVA), 12%; and tuberculosis (TB), 11%. The mean duration of hospitalisation was 15.6 +/- 13.8 days. Cases of mortality had significantly higher value of mean serum potassium, urea and creatinine, compared to those with favourable outcome and were eventually discharged home. A total of 192 patients (55.2%) were discharged home, while 109 (31%) died giving in-hospital mortality of 31.7%. Majority of the deaths (75%) occurred within 14 days of hospitalisation. Significantly higher number of patients died within the first seven days compared to those discharged (P<0.01). The mean duration of hospital stay was 15.6 +/- 13.8 days. Patients with favourable outcome spent a mean of 18.5 +/- 14.1 days while cases of mortality had a mean of 10.4 +/- 8.8 days in hospital before death. Geriatric patients constituted more than a tenth of total hospitalisation into UITH medical wards. They accounted for a significant proportion of in-hospital mortality. Since a third of the death occurred within the first few days of admission, improvement in the management of acute medical cases especially in the elderly is urgent needed. This will ensure survival of greater number of patients and thus reduces mortality.
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PMID:Pattern and outcome of medical admission of elderly patients seen at University of Ilorin Teaching Hospital, Ilorin. 1930 16

This document was produced by the Spanish Society of Cardiology Section on Geriatric Cardiology "End-stage heart disease in the elderly" working group. Its aim was to provide an expert overview that would increase understanding of the last days of life of elderly patients with heart disease and improve treatment and clinical decision-making. As elderly heart disease patients form a heterogeneous group, thorough clinical evaluation is essential, in particular to identify factors that could influence prognosis (e.g., heart disease, comorbid conditions, functional status and frailty). The evaluation should be carried out before any clinical decisions are made, especially those that could restrict therapy, such as do-not-resuscitate orders or instructions to deactivate an implantable cardioverter-defibrillator. Elderly patients with terminal heart disease have the right to expect a certain level of care and consideration: they should not suffer unnecessarily, their freely expressed wishes should be respected, they should be fully informed about their medical condition, they should be able to express an opinion about possible interventions, and they should be entitled to receive psychospiritual care. After an incurable disease has been diagnosed, the aim of palliative care should be to control symptoms. It should not be used only when the patient is close to death. Although palliative care is relatively undeveloped in heart disease, its use must be borne in mind in elderly patients with advanced heart failure. The main aims are to make the patient as comfortable as possible in all senses and to optimize quality of life in the patient's final days, while avoiding the use of aggressive treatments that consume health-care resources without providing any benefits.
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PMID:End-stage heart disease in the elderly. 1940 Nov 26

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