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1.
Rev. Pesqui. (Univ. Fed. Estado Rio J., Online) ; 11(5): 1340-1346, out.-dez. 2019. tab
Artigo em Inglês, Português | LILACS, BDENF - Enfermagem | ID: biblio-1022135

RESUMO

Objective: The study's purpose has been to assess the main limitations reported by heart failure bearing patients. Methods: It is a secondary analysis of an exploratory study with a qualitative approach. This study was performed with 15 patients with heart failure, out of the 167 undergoing ambulatory care, and over the period from March to July 2011. The collection of primary data was based on semi-structured interviews with subsequent analysis according to the Bardin's perspective. The secondary analysis was performed according to the retrospective interpretation strategy. Results: There were female predominance (73.3%); incomplete elementary school (80.2%); hypertensive patients (80.2%); dyslipidemic patients (53.4%); and diabetics patients (33.3%). Concerning the daily limitations, the following stand out: impaired walking, precarious sleep pattern, fatigue, dyspnea, loss of autonomy, dependence on others, poor sleep pattern, low sexual activity. Conclusion: By taking into consideration the heart failure, a chronic disease, it is fundamental for nurses to look for guidelines and strategies that are able to develop the capacity for self-care, prevention and health promotion


Objetivo: Analisar as principais limitações relatadas por pacientes com insuficiência cardíaca. Método: análise secundária de um estudo exploratório, de abordagem qualitativa, realizado com 15 pacientes portadores de insuficiência cardíaca no período de março a julho de 2011, dentre os 167 em atendimento ambulatorial. A coleta de dados primários deu-se a partir de uma entrevista semi-estruturada, com posterior análise de Bardin, e para presente análise secundária foi utilizada como estratégia a interpretação retrospectiva. Resultados: predominância do sexo feminino (73,3%); ensino fundamental incompleto (80,2%); hipertensos (80,2%); dislipidêmicos (53,4%); diabéticos (33,3%). Quanto às limitações no cotidiano, destacam-se: deambulação prejudicada, padrão de sono precário, fadiga, dispneia, perda de autonomia, dependência de terceiros, padrão de sono precário, baixa frequência da atividade sexual. Conclusão: na insuficiência cardíaca, uma doença crônica, é fundamental que o enfermeiro busque por orientações e estratégias, as quais possam desenvolver a capacidade de autocuidado, prevenção e promoção da saúde


Objetivo: Analizar las principales limitaciones relatadas por pacientes con insuficiencia cardiaca. Método: análisis secundario de un estudio exploratorio, de abordaje cualitativo, realizado con 15 pacientes portadores de insuficiencia cardíaca en el período de marzo a julio de 2011, entre los 167 en atención ambulatoria. La recolección de datos primarios se dio a partir de una entrevista semiestructurada, con posterior análisis de Bardin, y para el presente análisis secundario se utilizó como estrategia la interpretación retrospectiva. Resultados: predominio del sexo femenino (73,3%); educación básica incompleta (80,2%); hipertensos (80,2%); dislipidémicos (53,4%); diabéticos (33,3%). En cuanto a las limitaciones en el cotidiano, se destacan: deambulación perjudicada, patrón de sueño precario, fatiga, disnea, pérdida de autonomía, dependencia de terceros, patrón de sueño precario, baja frecuencia de la actividad sexual. Conclusión: en la insuficiencia cardíaca, una enfermedad crónica, es fundamental que el enfermero busque orientaciones y estrategias, que puedan desarrollar la capacidad de autocuidado, prevención y promoción de la salud


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Autocuidado/instrumentação , Insuficiência Cardíaca/enfermagem , Insuficiência Cardíaca/prevenção & controle , Promoção da Saúde
3.
Int J Mol Sci ; 20(9)2019 May 06.
Artigo em Inglês | MEDLINE | ID: mdl-31064116

RESUMO

Hypercholesterolemia may be causally related to heart failure with preserved ejection fraction (HFpEF). We aimed to establish a HFpEF model associated with hypercholesterolemia and type 2 diabetes mellitus by feeding a high-sucrose/high-fat (HSHF) diet to C57BL/6J low-density lipoprotein receptor (LDLr)-/- mice. Secondly, we evaluated whether cholesterol-lowering adeno-associated viral serotype 8 (AAV8)-mediated LDLr gene transfer prevents HFpEF. AAV8-LDLr gene transfer strongly (p < 0.001) decreased plasma cholesterol in standard chow (SC) mice (66.8 ± 2.5 mg/dl versus 213 ± 12 mg/dl) and in HSHF mice (84.6 ± 4.4 mg/dl versus 464 ± 25 mg/dl). The HSHF diet induced cardiac hypertrophy and pathological remodeling, which were potently counteracted by AAV8-LDLr gene transfer. Wet lung weight was 19.0% (p < 0.001) higher in AAV8-null HSHF mice than in AAV8-null SC mice, whereas lung weight was normal in AAV8-LDLr HSHF mice. Pressure-volume loop analysis was consistent with HFpEF in AAV8-null HSHF mice and showed a completely normal cardiac function in AAV8-LDLr HSHF mice. Treadmill exercise testing demonstrated reduced exercise capacity in AAV8-null HSHF mice but a normal capacity in AAV8-LDLr HSHF mice. Reduced oxidative stress and decreased levels of tumor necrosis factor-α may mediate the beneficial effects of cholesterol lowering. In conclusion, AAV8-LDLr gene therapy prevents HFpEF.


Assuntos
Diabetes Mellitus Tipo 2/complicações , Cardiomiopatias Diabéticas/prevenção & controle , Terapia Genética/métodos , Insuficiência Cardíaca/prevenção & controle , Hipercolesterolemia/terapia , Receptores de LDL/genética , Animais , Colesterol/sangue , Dependovirus/genética , Diabetes Mellitus Tipo 2/etiologia , Cardiomiopatias Diabéticas/fisiopatologia , Dieta Hiperlipídica/efeitos adversos , Sacarose na Dieta/efeitos adversos , Feminino , Insuficiência Cardíaca/fisiopatologia , Hipercolesterolemia/complicações , Hipercolesterolemia/etiologia , Camundongos , Camundongos Endogâmicos C57BL , Estresse Oxidativo , Receptores de LDL/metabolismo , Volume Sistólico , Fator de Necrose Tumoral alfa/sangue
4.
Heart Fail Clin ; 15(3): 341-347, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31079692

RESUMO

A strict bidirectional relationship exists between diabetes mellitus and heart failure. Diabetic cardiomyopathy is a specific cardiac manifestation of patients with diabetes characterized by left ventricular hypertrophy and diastolic dysfunction in the early phase up to overt heart failure with reduced systolic function in the advanced stages. The pathogenesis of this condition is multifactorial and recognizes as main promoting factors the presence of insulin resistance and hyperglycemia. Diabetic cardiomyopathy exerts a negative prognostic impact in affected patients and no target treatments are currently available. More efforts are needed to better define the diagnostic and therapeutic approach in this specific setting.


Assuntos
Cardiomiopatias Diabéticas , Diagnóstico por Imagem/métodos , Gerenciamento Clínico , Insuficiência Cardíaca , Cardiomiopatias Diabéticas/complicações , Cardiomiopatias Diabéticas/diagnóstico , Cardiomiopatias Diabéticas/terapia , Insuficiência Cardíaca/etiologia , Insuficiência Cardíaca/fisiopatologia , Insuficiência Cardíaca/prevenção & controle , Humanos
5.
Biomed Pharmacother ; 113: 108780, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30889487

RESUMO

Captopril (Cap) as angiotensin-converting enzyme inhibitor (ACEi) is commonly used to treat hypertension and some types of congestive heart failure. However, few studies reported on whether Cap exerts a protective effect on myocardial apoptosis induced by transverse aortic constriction (TAC). This study aimed at investigating the possible mechanism of Cap on myocardial apoptosis induced by pressure overload. Results showed that Cap significantly decreased heart-to-body weight ratios (HBWR). Cap markedly improved cardiac function, and reduced inner diameter of ascending aorta (Asc Ao) in TAC mice as shown by echocardiography. Enzyme-linked immunosorbent assay (ELISA) results demonstrated that Cap treatment also markedly decreased the level of N-terminal pro-B-type natriuretic peptide (NT-proBNP), atrial natriuretic peptide (ANP), tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6). Cardiac pathological changes and fibrosis have been improved after Cap treatment as shown by hematoxylin-eosin (H&E) staining and Masson's trichrome staining. Moreover, Terminal deoxynucleotidyl transferase-mediated dexoxyuridine triphosphate nick-end labeling (TUNEL) staining result indicated Cap treatment also significantly inhibited cardiac apoptosis. Western Blot results showed that Cap obviously decreased the expression of cleaved capase-3, Bax, phosphorylated Jak2 (p-Jak2), phosphorylated Stat3 (p-Stat3), Wnt3a and ß-catenin proteins, as well as increased Bcl-2 expression. In conclusion, Cap showed a protective effect on TAC-induced cardiac apoptosis, which could be attributed to the inhibition of Wnt3a/ß-catenin signaling pathway. Cap also attenuated myocardial hypertrophy induced by TAC via suppression of Jak2/Stat3 pathway.


Assuntos
Inibidores da Enzima Conversora de Angiotensina/farmacologia , Apoptose/efeitos dos fármacos , Captopril/farmacologia , Insuficiência Cardíaca/prevenção & controle , Animais , Aorta/efeitos dos fármacos , Aorta/patologia , Western Blotting , Ensaio de Imunoadsorção Enzimática , Marcação In Situ das Extremidades Cortadas , Janus Quinase 2/metabolismo , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Miocárdio/patologia , Fator de Transcrição STAT3/metabolismo , Transdução de Sinais/efeitos dos fármacos , Proteína Wnt3A/metabolismo , beta Catenina/metabolismo
6.
Pharm Biol ; 57(1): 176-183, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30860934

RESUMO

CONTEXT: Ophiopogonis Radix, the root of Ophiopogon japonicus (Thunb.) Ker-Gawl (Liliaceae), is a Traditional Chinese Medicine, which has been investigated to possess effective treatment of cardiovascular diseases. OBJECTIVE: This study evaluates the cardioprotective effects of steroidal saponins extract from Ophiopogon japonicus (SOJ) root against doxorubicin-induced chronic heart failure (CHF) through the amelioration of oxidative stress and inflammation. MATERIALS AND METHODS: A Sprague-Dawley rat model of CHF was established by intraperitoneally injected with DOX. All rats were randomly divided into four groups: Control group, CHF group, CHF + SOJ (100 mg/kg) treatment group, SOJ (100 mg/kg) treatment group (n = 8/group). After six weeks administration, biometric and echocardiography were measured. The levels of biochemical parameters were measured using commercial kits. RESULTS: The values of LVESP, +dP/dtmax, -dP/dtmax, EF and FS increased to 116.20 ± 1.68 mmHg, 2978.71 ± 168.26 mmHg/s, 3452.61 ± 286.09 mmHg/s, 68.26 ± 5.28% and 31.97 ± 3.79%, respectively; the values of LVEDP, LVESD and LVEDD decreased to 8.85 ± 0.84 mmHg, 8.39 ± 0.45 mm and 12.36 ± 0.87 mm in CHF + SOJ group. In addition, the levels of IL-6, TNF-α and IL-1ß decreased to 154.41 ± 7.72 pg/mg protein, 110.02 ± 6.96 pg/mg protein and 39.39 ± 5.27 pg/mg protein, respectively; the relative activity of p38 MAPK decreased to 2.60 ± 0.40 in CHF + SOJ group. Furthermore, the activities of SOD, CAT and GSH-Px increased to 268.77 ± 6.20 U/mg protein, 13.68 ± 0.68 U/mg protein and 316.90 ± 8.08 µmol/mg protein, and the content of MDA decreased to 4.03 ± 0.43 nmol/mg protein in CHF + SOJ group. CONCLUSIONS: SOJ exerts the cardioprotective effect against DOX-induced CHF through suppressing inflammatory and oxidative stress. These results provide evidence that SOJ might be an effective treatment for CHF.


Assuntos
Cardiotônicos/farmacologia , Insuficiência Cardíaca/prevenção & controle , Ophiopogon/química , Saponinas/farmacologia , Animais , Cardiotônicos/isolamento & purificação , Doença Crônica , Doxorrubicina/toxicidade , Ecocardiografia , Insuficiência Cardíaca/induzido quimicamente , Inflamação/induzido quimicamente , Inflamação/prevenção & controle , Masculino , Medicina Tradicional Chinesa/métodos , Estresse Oxidativo/efeitos dos fármacos , Extratos Vegetais/farmacologia , Ratos , Ratos Sprague-Dawley , Saponinas/isolamento & purificação , Esteroides/isolamento & purificação , Esteroides/farmacologia
7.
Herz ; 44(3): 203-209, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30847507

RESUMO

Diabetes mellitus is an important comorbidity in patients with heart failure. The presence of heart failure in diabetes worsens the prognosis of patients. Recent studies suggest that appropriate diagnostic approaches followed by differential medical treatment are of crucial importance to improve patient outcomes. This article summarizes important aspects of the association between diabetes mellitus and heart failure.


Assuntos
Complicações do Diabetes , Diabetes Mellitus , Insuficiência Cardíaca , Comorbidade , Insuficiência Cardíaca/etiologia , Insuficiência Cardíaca/prevenção & controle , Humanos , Prognóstico
8.
Prog Cardiovasc Dis ; 62(2): 193-202, 2019 Mar - Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30867130

RESUMO

The benefits of physical activity in cardiovascular diseases have long been appreciated. However, the molecular mechanisms that trigger and sustain the cardiac benefits of exercise are poorly understood, and it is anticipated that unveiling these mechanisms will identify novel therapeutic targets. In search of these mechanisms we took advantage of unbiased RNA-sequencing (RNA-seq) technology to discover cardiac gene targets whose expression is disrupted in heart failure (HF) and rescued by exercise in a rat model. Upon exhaustive validation in a separate rat cohort (qPCR) and human datasets, we shortlisted 16 targets for a cell-based screening, aiming to evaluate whether targeted disruption of these genes with silencing RNA would affect the abundance of a CVD biomarker (BNP, B-type natriuretic peptide) in human cardiomyocytes. Overall, these experiments showed that Proline Dehydrogenase (PRODH) expression is reduced in human failing hearts, rescued by exercise in a rat model of HF, and its targeted knockdown increases BNP expression in human cardiomyocytes. On the other hand, overexpression of PRODH increases the abundance of metabolism-related gene transcripts, and PRODH appears to be crucial to sustain normal mitochondrial function and maintenance of ATP levels in human cardiomyocytes in a hypoxic environment, as well as for redox homeostasis in both normoxic and hypoxic conditions. Altogether our findings show that PRODH is a novel molecular target of exercise in failing hearts and highlight its role in cardiomyocyte physiology, thereby proposing PRODH as a potential experimental target for gene therapy in HF.


Assuntos
Exercício/fisiologia , Insuficiência Cardíaca , Prolina Oxidase/metabolismo , Animais , Biomarcadores/metabolismo , Modelos Animais de Doenças , Perfilação da Expressão Gênica , Insuficiência Cardíaca/metabolismo , Insuficiência Cardíaca/prevenção & controle , Humanos , Mitocôndrias Cardíacas/metabolismo , Ratos , Transdução de Sinais
9.
Diabetes Res Clin Pract ; 150: 8-16, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30794833

RESUMO

AIM: To assess the effects DPP-4i; SGLT2-i & GLP1-RA on CV death, MI, stroke and hHF. This is probably the first meta-analysis to assess the effects of these drugs on MI and stroke in totality, including non-fatal & fatal MI and stroke. METHODS: Scientific databases were searched for RCTs with pre-specified inclusion criteria and each end-point from the selected 13 studies was reported as an effect size (M H odds ratio) with a 95% confidence interval P value. RESULTS: The pooled analysis of all the 5 available CVOT with DPP-4i resulted in a neutral effect on MI, stroke, the combined end points of MI & Stroke, CV death and hHF. The pooled analysis of all the 5 available CVOTs with GLP1-RA resulted in a neutral effect on MI. However, there was a statistically significant 12% reduction in CV death (P = 0.01), 13% reduction in stroke (P = 0.02) and 11% reduction the combined end points of MI & Stroke (P = 0.001). The impact of GLP1-RA inhibitors on hHF was neutral. The pooled analysis of all the 3 available CVOTs with SGLT2-i resulted in a neutral effect on MI, stroke, the combined end points of MI & Stroke and CV death. There was however a statistically significant 28% reduction in hHF (P < 0.001). CONCLUSION: DPP-4i & SGLT-2i are neutral as far as all aspects of CV outcomes are concerned except for hHF which is significantly reduced by the latter. GLP1-RA as a class reduce risk of ASCVD showing a significant reduction in MI and stroke.


Assuntos
Doenças Cardiovasculares/epidemiologia , Inibidores da Dipeptidil Peptidase IV/farmacologia , Peptídeo 1 Semelhante ao Glucagon/agonistas , Insuficiência Cardíaca/epidemiologia , Hospitalização/estatística & dados numéricos , Hipoglicemiantes/farmacologia , Inibidores do Transportador 2 de Sódio-Glicose/farmacologia , Acidente Vascular Cerebral/epidemiologia , Doenças Cardiovasculares/induzido quimicamente , Doenças Cardiovasculares/prevenção & controle , Diabetes Mellitus Tipo 2/tratamento farmacológico , Insuficiência Cardíaca/induzido quimicamente , Insuficiência Cardíaca/prevenção & controle , Humanos , Incidência , Infarto do Miocárdio , Acidente Vascular Cerebral/induzido quimicamente , Acidente Vascular Cerebral/prevenção & controle
10.
Future Cardiol ; 15(2): 53-61, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30767672

RESUMO

Transthyretin (TTR) related cardiomyopathy is an underdiagnosed cause of heart failure but is increasingly recognized in various settings - from patients admitted with heart failure to symptomatic aortic stenosis - and is rapidly becoming the most frequent form of systemic amyloidosis. Following the recent publication of the landmark ATTR-ACT trial that showed tafamidis to be the first treatment to improve survival in patients with TTR-related cardiac amyloidosis and heart failure, we reviewed the drug's rationale, characteristics and evidence supporting its use in TTR amyloidosis.


Assuntos
Neuropatias Amiloides Familiares/tratamento farmacológico , Benzoxazóis/uso terapêutico , Neuropatias Amiloides Familiares/complicações , Neuropatias Amiloides Familiares/mortalidade , Saúde Global , Insuficiência Cardíaca/etiologia , Insuficiência Cardíaca/prevenção & controle , Humanos , Taxa de Sobrevida/tendências
11.
Proc Natl Acad Sci U S A ; 116(9): 3614-3623, 2019 02 26.
Artigo em Inglês | MEDLINE | ID: mdl-30755533

RESUMO

Despite therapeutic advances, heart failure is the major cause of morbidity and mortality worldwide, but why cardiac regenerative capacity is lost in adult humans remains an enigma. Cardiac regenerative capacity widely varies across vertebrates. Zebrafish and newt hearts regenerate throughout life. In mice, this ability is lost in the first postnatal week, a period physiologically similar to thyroid hormone (TH)-regulated metamorphosis in anuran amphibians. We thus assessed heart regeneration in Xenopus laevis before, during, and after TH-dependent metamorphosis. We found that tadpoles display efficient cardiac regeneration, but this capacity is abrogated during the metamorphic larval-to-adult switch. Therefore, we examined the consequence of TH excess and deprivation on the efficiently regenerating tadpole heart. We found that either acute TH treatment or blocking TH production before resection significantly but differentially altered gene expression and kinetics of extracellular matrix components deposition, and negatively impacted myocardial wall closure, both resulting in an impeded regenerative process. However, neither treatment significantly influenced DNA synthesis or mitosis in cardiac tissue after amputation. Overall, our data highlight an unexplored role of TH availability in modulating the cardiac regenerative outcome, and present X. laevis as an alternative model to decipher the developmental switches underlying stage-dependent constraint on cardiac regeneration.


Assuntos
Insuficiência Cardíaca/prevenção & controle , Regeneração/genética , Hormônios Tireóideos/metabolismo , Xenopus laevis/genética , Animais , Regulação da Expressão Gênica no Desenvolvimento/efeitos dos fármacos , Insuficiência Cardíaca/fisiopatologia , Humanos , Larva/genética , Larva/crescimento & desenvolvimento , Metamorfose Biológica/genética , Camundongos , Salamandridae/genética , Salamandridae/crescimento & desenvolvimento , Hormônios Tireóideos/administração & dosagem , Hormônios Tireóideos/genética , Xenopus laevis/crescimento & desenvolvimento , Peixe-Zebra/genética , Peixe-Zebra/crescimento & desenvolvimento
12.
Biol Pharm Bull ; 42(3): 453-461, 2019 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-30626801

RESUMO

Protein quality control (PQC) in the heart plays an important role to maintain cellular protein homeostasis. Impairment of PQC may cause the development of heart failure. It is well known that histone deacetylase 6 (HDAC6) is an essential enzyme for regulating the cellular PQC response. In this study, we aimed at examining the association between HDAC6 and the chaperone system and the effects of HDAC6 inhibition in the development of heart failure following myocardial infarction (MI). MI was induced by coronary artery ligation. Coronary artery-ligated and sham-operated rats were divided into groups that were orally administered suberoylanilide hydroxamic acid (SAHA) or vehicle from the 2nd to 8th week after the operation. The cardiac function and protein expression levels in the viable left ventricle were analyzed by echocardiography, Western blotting, and immunohistochemistry at the 2nd and 8th weeks after the operation. The deacetylase activity of HDAC6 was markedly elevated during the development of heart failure after MI. In the failing heart, a decrease in heat-shock protein (HSP) contents and an accumulation of ubiquitinated proteins were observed, indicating PQC dysfunction. Inhibition of HDAC6 activity by SAHA treatment enhanced the translocation of heat-shock transcription factor 1 to the nucleus and induced the expression of HSP, resulting in maintenance of cellular protein homeostasis. The cardiac pump function after MI was also improved by SAHA administration. Our findings suggest that inhibition of HDAC6 activity is a novel approach for the treatment of heart failure following MI.


Assuntos
Insuficiência Cardíaca/prevenção & controle , Proteínas de Choque Térmico/metabolismo , Vorinostat/uso terapêutico , Animais , Regulação da Expressão Gênica/efeitos dos fármacos , Inibidores de Histona Desacetilases/uso terapêutico , Masculino , Infarto do Miocárdio , Ratos , Ratos Wistar
14.
Presse Med ; 48(2): 127-133, 2019 Feb.
Artigo em Francês | MEDLINE | ID: mdl-30665788

RESUMO

After 80 years old, antihypertensive treatment significantly reduces cardiovascular events. In the elderly, blood pressure target depends on patients' frailty. After 80 years, French guidelines propose to aim a SBP<150 mmHg without orthostatic hypotension and without exceeding the prescription of more than three antihypertensive drugs. The target may be more ambitious for robust elderly patients. The new 2018 European guidelines set: a stricter target for robust elderly patient aged 80 years or older (SBP between 130 and 139 mmHg and DBP between 70 and 79 mmHg); this objective is less strict for frail elderly (with several comorbidities, with loss of autonomy, elderly living in nursing home or with orthostatic hypotension). A recent randomized controlled trial shows a significant reduction in mortality and cardiovascular events by achieving a low blood pressure goal in patients over the age of 75 years old. Five major drug classes can be used: thiazide diuretics, calcium channel blockers, angiotensin-converting enzyme inhibitors, angiotensin II receptor blockers and beta-blockers. Beta-blockers are less efficient to prevent stroke and are indicated in second line. However, beta-blockers represent first choice of treatment in cases of heart failure, coronary artery disease or atrial fibrillation. Appropriate follow-up and monitoring enable assessment of safety (recording BP while standing, ionogram, creatinine).


Assuntos
Anti-Hipertensivos/uso terapêutico , Hipertensão/complicações , Hipertensão/tratamento farmacológico , Idoso de 80 Anos ou mais , Disfunção Cognitiva/diagnóstico , Disfunção Cognitiva/etiologia , Comorbidade , Fragilidade/diagnóstico , Avaliação Geriátrica , Insuficiência Cardíaca/etiologia , Insuficiência Cardíaca/prevenção & controle , Humanos , Hipertensão/diagnóstico , Hipotensão Ortostática/diagnóstico , Hipotensão Ortostática/etiologia , Guias de Prática Clínica como Assunto , Acidente Vascular Cerebral/etiologia , Acidente Vascular Cerebral/prevenção & controle
15.
J Ethnopharmacol ; 229: 15-21, 2019 Jan 30.
Artigo em Inglês | MEDLINE | ID: mdl-30261193

RESUMO

ETHNOPHARMACOLOGICAL RELEVANCE: Cardiovascular disease is the main concern of breast cancer survivors who received doxorubicin treatment. Traditional Chinese medicine (TCM) provides as a complementary therapy to patients with breast cancer and is an important component of health care in Taiwan. However, the TCM utilization patterns and it's efficacy in breast cancer patients is unknown. MATERIALS AND METHODS: From a sample of claims data collected over the period of 1997-2010 in Taiwan, we identified 24,457 breast cancer patients who received TCM treatments and 24,457 breast cancer patients who did not receive TCM treatments. All enrollment patients had received doxorubicin chemotherapy. These patients were paired by age; index day; and propensity score for selected comorbidities, Herceptin and tamoxifen. The incidence of cumulative congestive heart failure (CHF) was compared between cohorts. Fine and Gray regression hazard model was used to evaluate the risk of CHF. RESULTS: After adjusting for age, Herceptin, tamoxifen, diabetic drug, cardiovascular drug, statin and comorbidities, the stratified Fine and Gray model revealed that the TCM cohort had an adjusted subdistribution hazard ratio (sHR) of 0.68 (95% confidence interval (CI) = 0.62-0.76, p < 0.0001) for the development of CHF. In addition, the sub-cohort analysis revealed that the Baihuasheshecao cohort compared to the non-TCM cohort had an adjusted sHR of 0.29 (95% CI = 0.15-0.56, p = 0.0002) for the development of CHF. CONCLUSION: Using TCM significantly decreased the incidence of CHF in patients with breast cancer who received conventional chemotherapy with or without radiotherapy.


Assuntos
Antibióticos Antineoplásicos/uso terapêutico , Neoplasias da Mama/tratamento farmacológico , Cardiotônicos/uso terapêutico , Doxorrubicina/uso terapêutico , Insuficiência Cardíaca/prevenção & controle , Medicina Tradicional Chinesa , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Insuficiência Cardíaca/induzido quimicamente , Humanos , Pessoa de Meia-Idade , Adulto Jovem
16.
Heart Fail Clin ; 15(1): 1-8, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30449373

RESUMO

Sex specific differences exist in the impact of risk factors for the development of heart failure (HF). Addressing these differences can have an impact on prevention of HF. This article reviews sex-specific risk factors associated with development of HF. These risk factors include current smoking, diabetes, hypertension, and myocardial infarction. Other risks for HF are toxins, inflammation, and other chronic conditions, such as sleep breathing disorders, anemia, obesity, and renal insufficiency. Some of these risks factors present risk reduction opportunities that may improve outcomes.


Assuntos
Insuficiência Cardíaca , Feminino , Insuficiência Cardíaca/etiologia , Insuficiência Cardíaca/fisiopatologia , Insuficiência Cardíaca/prevenção & controle , Humanos , Serviços Preventivos de Saúde , Fatores de Risco , Fatores Sexuais , Saúde da Mulher
17.
Heart Fail Clin ; 15(1): 65-75, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30449381

RESUMO

Heart failure and breast cancer have shared risks and morbidities. Multimodality therapies for breast cancer, including conventional chemotherapy, targeted therapeutics, radiation therapy, and hormonal agents, may make patients more susceptible to asymptomatic left ventricular dysfunction and clinical heart failure during and after treatment. New or preexisting left ventricular dysfunction may lead to interruptions in cancer treatment and limit options of breast cancer systemic therapy, leading to adverse outcomes. Early recognition and management of cardiovascular risk factors before, during, and after cancer treatment are of utmost importance. This review presents advances, challenges, and opportunities for cardiovascular care in contemporary breast cancer treatment.


Assuntos
Antineoplásicos , Neoplasias da Mama/terapia , Insuficiência Cardíaca , Administração dos Cuidados ao Paciente/métodos , Antineoplásicos/efeitos adversos , Antineoplásicos/uso terapêutico , Cardiotoxicidade/etiologia , Cardiotoxicidade/prevenção & controle , Feminino , Insuficiência Cardíaca/induzido quimicamente , Insuficiência Cardíaca/prevenção & controle , Humanos , Trastuzumab/efeitos adversos , Trastuzumab/uso terapêutico , Disfunção Ventricular Esquerda/fisiopatologia
18.
Heart Fail Clin ; 15(1): 87-96, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30449383

RESUMO

Heart failure remains the most common cause of morbidity and mortality in adults with congenital heart disease (CHD). Although gender-specific outcomes are not robust, it seems that women with CHD may be more affected by late heart failure (HF) than men. A specialized and experienced adult CHD team is required to care for these women as they age, including assessment for reversible causes of HF and in the management of pregnancy, labor, and delivery.


Assuntos
Cardiopatias Congênitas , Insuficiência Cardíaca , Administração dos Cuidados ao Paciente/métodos , Complicações Cardiovasculares na Gravidez , Adulto , Feminino , Cardiopatias Congênitas/complicações , Cardiopatias Congênitas/mortalidade , Cardiopatias Congênitas/terapia , Insuficiência Cardíaca/etiologia , Insuficiência Cardíaca/prevenção & controle , Humanos , Masculino , Gravidez , Complicações Cardiovasculares na Gravidez/mortalidade , Complicações Cardiovasculares na Gravidez/terapia , Medição de Risco , Fatores Sexuais
20.
Lakartidningen ; 1152018 12 18.
Artigo em Sueco | MEDLINE | ID: mdl-30561752

RESUMO

The literature describing medical aspects on sauna bathing is briefly reviewed. The circulatory effects of heating and subsequent cooling related to sauna bath differ with age, underlying medical condition and use of drugs. The circulatory changes may often be beneficial but can sometimes prove dangerous. More than 2000 sauna bathers were followed for around 20 years in a Finnish population study. The investigators have recently reported health benefits of abundant sauna use for individuals concerning hypertension, ischemic heart disease, dementia and certain pulmonary diseases. Others have recommended the use of sauna for patients with heart failure. Fatal events in sauna are very uncommon and often linked to the use of alcohol, to ischemic heart disease and to bathing alone. Medical conditions in which sauna bathing should be avoided are shortly reviewed. Further studies are urgently needed for illustration of the possible benefit of sauna bath at different medical conditions.


Assuntos
Banho a Vapor , Consumo de Bebidas Alcoólicas/efeitos adversos , Arritmias Cardíacas/fisiopatologia , Arritmias Cardíacas/prevenção & controle , Regulação da Temperatura Corporal , Temperatura Baixa , Contraindicações , Demência/fisiopatologia , Demência/prevenção & controle , Insuficiência Cardíaca/fisiopatologia , Insuficiência Cardíaca/prevenção & controle , Hemodinâmica/fisiologia , Temperatura Alta , Humanos , Hipertensão/fisiopatologia , Hipertensão/prevenção & controle , Isquemia Miocárdica/fisiopatologia , Isquemia Miocárdica/prevenção & controle , Banho a Vapor/efeitos adversos , Banho a Vapor/métodos , Banho a Vapor/mortalidade
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