Heart failure and chronic obstructive pulmonary disease: the ...

What is the impact of structured nursing care on heart failure management costs?

The limitations to the effectiveness of heart failure management in clinical practice include physicians’ suboptimal utilization of effective medications, patients’ poor adherence to an optimal treatment regimen, including lifestyle advice, and the failure to monitor patients routinely after hospitalization. A Veterans’ study in Palo Alto, California, used a physician-supervised, nurse-mediated, home-based system for heart failure […] Read more

How useful are diastolic indicators as hemodynamic variables?_0.jpg

How useful are diastolic indicators as hemodynamic variables?

In the last two decades, Doppler echocardiography has emerged as the main tool for assessing left ventricular (LV) diastolic function. Echocardiography not only provides anatomical and functional information, but is a widely available, safe, and inexpensive imaging modality. LV filling and, more recently, pulmonary venous Doppler flow indices, have been used to evaluate diastolic functional […] Read more

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Diabetes and hypertension

There seems to be synergy between diabetes and hypertension in the development of structural myocardial changes. This may explain why aggressive antihypertensive therapy, in particular when combined with cholesterol control, has particular value in diabetics in terms of heart failure, stroke, and coronary events. Therapy A comprehensive approach is required to prevent or at least […] Read more

How useful are neurohumoral markers in the management of heart failure?_0.jpg

How useful are neurohumoral markers in the management of heart failure?

Current treatment strategies ignore plasma neurohumoral levels, despite their status as independent markers of function and prognosis in cardiac disease, including heart failure, and their utility in guiding therapy. Many large trials have shown that angiotensin-converting enzyme (ACE) inhibitors, P-blockers, and spironolactone all decrease mortality. Further promising treatments are now on the horizon: endothelin antagonists, […] Read more

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Diabetes and ischemic heart disease

Diabetes Insulin resistance is believed to be the initial defect leading to glucose intolerance. Together with hyperin-sulinemia, it is an independent predictor of cardiovascular disease. The Framingham study was the first epidemiological study to demonstrate an increased risk of congestive heart failure in diabetes mellitus. Subsequent studies have confirmed that glucose abnormalities and congestive heart […] Read more

Use of digoxin down among patients with heart failure

Is digoxin still useful in the treatment of heart failure?

As most patients with heart failure remain symptomatic despite optimal medical treatment, there is a continuing need for drugs that improve symptoms, functional capacity, exercise tolerance, and quality of life. Digitalis glycosides owe their effects in heart failure to their ability to inhibit the Na+/K+ adenosine triphosphatase pump, thereby increasing Ca2+ availability to contractile proteins […] Read more