Abstract:
BACKGROUND:A greater understanding of how beliefs and perceptions inform LVAD placement refusals can help ensure that standards for informed decision making are met. We report on the factors that influence refusal and what accounts for changes in decliners' decision-making process when, and if, that occurs. METHOD AND RESULTS:We identified candidates (8 bridge to transplant; 6 destination therapy, 7 without designation) who declined LVAD placement (n = 21), 11 of whom were identified prospectively from February 2014 to March 2015, and 10 of whom were identified retrospectively with the use of our program database. Of these 21 decliners, 11 candidates persistently declined LVAD placement, with a median time of 175 days elapsing between time of LVAD offer and March 4, 2015. Ten candidates declined for an average of 224 days before agreeing to LVAD placement. From March 2014 to March 2015, we conducted structured interviews with LVAD decliners. Interviews were audio recorded, transcribed verbatim, and analyzed quantitatively with the use of Atlas.ti. The findings reflect that refusal can evolve over time. Decliners report that their initial refusals were made reflexively, but the 10 decliners who ultimately opted for LVAD placement changed their decisions as symptoms worsened. Decliners have concerns about the impacts of LVAD treatment on mobility, and they distrust LVAD technology. Some decliners believe LVAD placement would affect their ability to receive a transplant. Finally, decliners believe that they are not sick enough for LVAD placement when they are stabilized with medical management. CONCLUSIONS:Decliners' perspectives are integral for improving informed consent and refusal processes. Our analysis revealed decliners' decision-making processes and factors influencing their decisions. We provide several clinically based practical recommendations based on our findings.
journal_name
J Card Failjournal_title
Journal of cardiac failureauthors
Bruce CR,Kostick KM,Delgado ED,Wilhelms LA,Volk RJ,Smith ML,McCurdy SA,Loebe M,Estep JD,Blumenthal-Barby JSdoi
10.1016/j.cardfail.2015.06.008subject
Has Abstractpub_date
2015-10-01 00:00:00pages
835-9issue
10eissn
1071-9164issn
1532-8414pii
S1071-9164(15)00184-0journal_volume
21pub_type
杂志文章abstract::Diuretic resistance in heart failure is defined as a state in which diuretic response is diminished or lost before the therapeutic goal of relief from congestion has been reached. Diuretic resistance is very common and is associated with poor outcomes. Over the past decade, several new drugs and devices targeting deco...
journal_title:Journal of cardiac failure
pub_type: 杂志文章,评审
doi:10.1016/j.cardfail.2014.06.353
更新日期:2014-09-01 00:00:00
abstract:BACKGROUND:Previous studies have shown a paradox of lower mortality in black compared with white patients after hospitalization for heart failure, in contrast to the overall higher mortality reported for nonhospitalized black patients with heart failure. We examined racial differences in factors contributing to hospita...
journal_title:Journal of cardiac failure
pub_type: 杂志文章
doi:10.1016/j.cardfail.2004.04.002
更新日期:2005-02-01 00:00:00
abstract:BACKGROUND:We recently reported that serum levels of pentosidine, one of the well-defined advanced glycation end products (AGE), was an independent prognostic factor for heart failure. Receptor for AGEs (RAGE) is expressed in a variety of tissues, and RAGE has a C-truncated secretory isoform of the receptor protein, te...
journal_title:Journal of cardiac failure
pub_type: 杂志文章
doi:10.1016/j.cardfail.2007.10.019
更新日期:2008-03-01 00:00:00
abstract:OBJECTIVE:Disease management programs (DMPs) may reduce short-term readmission or death after heart failure (HF) hospitalization. We sought to determine if targeting of DMP to the highest-risk patients could improve efficiency. METHODS AND RESULTS:Patients (n = 412) admitted with HF were randomized to usual care or an...
journal_title:Journal of cardiac failure
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1016/j.cardfail.2019.01.015
更新日期:2019-05-01 00:00:00
abstract:BACKGROUND:Coronary angiography (CA) is usually performed in patients with reduced left ventricular ejection fraction (LVEF) to search ischemic cardiomyopathy. Our aim was to examine the agreement between CA and cardiovascular magnetic resonance (CMR) imaging among a cohort of patients with unexplained reduced LVEF, an...
journal_title:Journal of cardiac failure
pub_type: 杂志文章
doi:10.1016/j.cardfail.2020.09.005
更新日期:2020-12-01 00:00:00
abstract:BACKGROUND:Although beta-blockers were well-tolerated by heart failure (HF) patients in clinical trials, tolerability of these drugs in a general population of HF patients is not well-described. METHODS:We studied a total of 308 encounters with beta-blockers therapy in 268 ambulatory HF patients. Side effects and freq...
journal_title:Journal of cardiac failure
pub_type: 杂志文章,多中心研究
doi:10.1054/jcaf.2003.34
更新日期:2003-06-01 00:00:00
abstract:OBJECTIVE:The aim of this work was to determine whether adrenergic-induced left ventricular (LV) dilation and eccentric remodeling in pressure-overload hypertrophy is sex specific. METHODS AND RESULTS:Chronic β-adrenoreceptor activation was produced in male and female spontaneously hypertensive rats (SHRs) by means of...
journal_title:Journal of cardiac failure
pub_type: 杂志文章
doi:10.1016/j.cardfail.2016.09.017
更新日期:2017-02-01 00:00:00
abstract:BACKGROUND:Familial involvement is common in dilated cardiomyopathy (DCM) and >40 genes have been implicated in causing disease. However, the role of genetic testing in clinical practice is not well defined. We examined the experience of clinical genetic testing in a diverse DCM population to characterize the prevalenc...
journal_title:Journal of cardiac failure
pub_type: 杂志文章
doi:10.1016/j.cardfail.2012.01.013
更新日期:2012-04-01 00:00:00
abstract:OBJECTIVE:To elucidate the prevalence and role of β1 adrenergic receptor autoantibodies (β1AR-AAb) belonging to the immunoglobulin (Ig)G3 subclass in patients with heart failure (HF) treated with β-adrenergic blockers. BACKGROUND:Several cardiac AAbs have been reported to be present in sera from patients with dilated ...
journal_title:Journal of cardiac failure
pub_type: 杂志文章
doi:10.1016/j.cardfail.2016.03.005
更新日期:2016-06-01 00:00:00
abstract:BACKGROUND:Differentiating between constrictive pericarditis (CP) and restrictive cardiomyopathy (RCMP) is difficult because of similar clinical and hemodynamic presentation. Brain natriuretic peptide (BNP) has been reported a useful noninvasive biomarker to differentiate CP from RCMP; however, its utility in patients ...
journal_title:Journal of cardiac failure
pub_type: 杂志文章
doi:10.1016/j.cardfail.2007.05.001
更新日期:2007-10-01 00:00:00
abstract:BACKGROUND:This study was designed to examine the hemodynamic, renal, and hormonal effects of infusion of A-type natriuretic peptide (ANP) and B-type natriuretic peptide (BNP) in patients with congestive heart failure (CHF). METHODS AND RESULTS:We infused synthetic human ANP or BNP at a rate of 0.1 microgram/kg/ min i...
journal_title:Journal of cardiac failure
pub_type: 临床试验,杂志文章
doi:10.1016/s1071-9164(96)80088-1
更新日期:1996-12-01 00:00:00
abstract:BACKGROUND:Left ventricular remodeling after myocardial infarction is a key component of heart failure and it has long been postulated that it may result from increased wall stress. It has recently been suggested that an injectable, non-degradable polymer may limit pathological remodeling in a manner analogous to that ...
journal_title:Journal of cardiac failure
pub_type: 杂志文章
doi:10.1016/j.cardfail.2009.03.003
更新日期:2009-09-01 00:00:00
abstract::Although atrial fibrillation is common in patients with heart failure, patients with atrial fibrillation are often excluded from congestive heart failure trials or are not analyzed separately. Consequently, while the effect of angiotensin-converting enzyme inhibitors in patients with sinus rhythm is well established, ...
journal_title:Journal of cardiac failure
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/s1071-9164(05)80004-1
更新日期:1995-12-01 00:00:00
abstract::Heart failure is a major public health problem and is increasing in incidence throughout the industrialized world. Despite recent advances in pharmacotherapy, the overall mortality remains high and largely unchanged. Ultrafiltration has received increased attention in the treatment of acute decompensated congestive he...
journal_title:Journal of cardiac failure
pub_type: 杂志文章,评审
doi:10.1016/j.cardfail.2008.07.230
更新日期:2008-11-01 00:00:00
abstract:BACKGROUND:The present study was designed to study the progression of heart failure in rabbits with catecholamine-induced cardiomyopathy. METHODS AND RESULTS:We investigated the effects of three repetitive applications (at 16-day intervals) of high-dose epinephrine (first infusion, 5 micrograms/kg/min for 60 minutes; ...
journal_title:Journal of cardiac failure
pub_type: 杂志文章
doi:10.1016/s1071-9164(99)90033-7
更新日期:1999-06-01 00:00:00
abstract:BACKGROUND:The role of matrix metalloproteinases (MMPs) polymorphisms on heart failure (HF) susceptibility, phenotypic characteristics, and prognosis has been poorly explored. METHODS AND RESULTS:We studied 313 HF patients with left ventricular systolic dysfunction and 367 healthy control subjects. Genotyping of MMP-1...
journal_title:Journal of cardiac failure
pub_type: 杂志文章
doi:10.1016/j.cardfail.2010.09.017
更新日期:2011-02-01 00:00:00
abstract:BACKGROUND:The value of the plain chest roentgenogram in predicting cardiac status remains controversial. METHODS AND RESULTS:A total of 111 randomly selected survivors of acute myocardial infarction (age 38 to 83 years) were studied prospectively. X-ray and radionuclide examinations were performed on a morning in the...
journal_title:Journal of cardiac failure
pub_type: 杂志文章
doi:10.1016/j.cardfail.2004.10.004
更新日期:2005-05-01 00:00:00
abstract:BACKGROUND:Renal impairment is associated with increased mortality in heart failure (HF). Recently, reports suggest that worsening renal function (WRF) is another predictor of clinical outcome in HF. The present study was designed to establish the proportion of patients with HF that exhibits (WRF) and the associated ri...
journal_title:Journal of cardiac failure
pub_type: 杂志文章,meta分析,评审
doi:10.1016/j.cardfail.2007.04.008
更新日期:2007-10-01 00:00:00
abstract:BACKGROUND:There are few data on the prevalence and pattern of complementary and alternative medicine (CAM) supplement use among people with chronic heart failure (CHF). The aim of this survey was to characterize the prevalence, pattern, and reasons for use of CAM supplements among those with CHF. METHODS AND RESULTS:...
journal_title:Journal of cardiac failure
pub_type: 杂志文章
doi:10.1016/j.cardfail.2005.06.427
更新日期:2005-10-01 00:00:00
abstract:BACKGROUND:Left ventricular assist devices (LVADs) are increasingly used to treat patients with refractory heart failure. Current-generation LVADs have major limitations, including the need for open chest surgery, limiting their widespread use. We hypothesized that the aortoatrial continuity could be used as a unique a...
journal_title:Journal of cardiac failure
pub_type: 杂志文章
doi:10.1016/j.cardfail.2011.01.014
更新日期:2011-06-01 00:00:00
abstract:BACKGROUND:Treatment-seeking delays for heart failure (HF) symptoms are significantly high. However, earlier studies did not closely examine race as a characteristic that could potentially influence delay times. The purpose of this study was (1) to describe racial differences in treatment-seeking delays for HF symptoms...
journal_title:Journal of cardiac failure
pub_type: 杂志文章
doi:10.1054/jcaf.2002.129234
更新日期:2002-12-01 00:00:00
abstract:BACKGROUND:The definition of response to cardiac resynchronization therapy (CRT) remains controversial, with variable rates of response depending on the criteria used. Our aim was to analyze the impact of CRT on diastolic function in different degrees of response, particularly in patients with positive clinical but no ...
journal_title:Journal of cardiac failure
pub_type: 更正并重新发布的文章,杂志文章
doi:10.1016/j.cardfail.2013.11.001
更新日期:2013-12-01 00:00:00
abstract:BACKGROUND:Recent advances in cardiac multi-detector computed tomography (MDCT) technology now permits entire coronary tree evaluation in a single breath hold with submillimeter slice collimation and improved temporal resolution. METHODS AND RESULTS:Besides excellent correlation with invasive angiogram for the detecti...
journal_title:Journal of cardiac failure
pub_type: 杂志文章,评审
doi:10.1016/j.cardfail.2006.11.014
更新日期:2007-04-01 00:00:00
abstract::Since the introduction of biomarkers in the late 1980s, considerable research has been dedicated to their validation and application. As a result, many biomarkers are now commonly used in clinical practice. However, the role of biomarkers in the prediction of right ventricular failure (RVF) and in the prognostication ...
journal_title:Journal of cardiac failure
pub_type: 杂志文章
doi:10.1016/j.cardfail.2019.09.007
更新日期:2020-09-01 00:00:00
abstract:BACKGROUND:It was not until 1919 that the diuretic properties of mercury were observed in patients with syphilis; in the same year the beneficial effects of mercurial diuretics were shown in a patient with severe rheumatic heart disease and anasarca. However, mercury had been used much earlier for the treatment of drop...
journal_title:Journal of cardiac failure
pub_type: 传,历史文章,杂志文章
doi:10.1054/jcaf.2001.26564
更新日期:2001-09-01 00:00:00
abstract:BACKGROUND:In vivo administration of norepinephrine fails to cause beta-adrenergic receptor desensitization. However, short-term exposure of cultured cells to norepinephrine induces the phenomenon in vitro. We sought to identify the local regulatory mechanisms responsible for in vivo beta-adrenergic receptor desensitiz...
journal_title:Journal of cardiac failure
pub_type: 杂志文章
doi:10.1054/jcaf.2000.19223
更新日期:2000-12-01 00:00:00
abstract:BACKGROUND:Tissue kallikrein is a serine proteinase that generates the vasoactive kinin peptide, which produces vasodilatory, angiogenic, and antiapoptotic effects. In this study, we investigated the effect of a stable supply of kallikrein and kinin on ventricular remodeling and blood vessel growth in rats after myocar...
journal_title:Journal of cardiac failure
pub_type: 杂志文章
doi:10.1016/j.cardfail.2007.04.009
更新日期:2007-09-01 00:00:00
abstract:BACKGROUND:Cachexia in chronic heart failure carries a poor prognosis, but little is known about the influence of body mass on the prognosis of noncachectic heart failure patients. METHODS:We studied 589 consecutive chronic heart failure patients followed for at least a year, in whom there were accurate baseline data ...
journal_title:Journal of cardiac failure
pub_type: 杂志文章
doi:10.1054/jcaf.2003.4
更新日期:2003-02-01 00:00:00
abstract:BACKGROUND:Limited data exist on outcomes in patients ≥70 years of age supported with the use of continuous-flow left ventricular assist devices (LVADs). METHODS:Data on 1149 continuous-flow LVAD recipients was queried from the Mechanical Circulatory Support Research Network. Groups were assigned based on age: ≥70 yea...
journal_title:Journal of cardiac failure
pub_type: 杂志文章
doi:10.1016/j.cardfail.2016.10.004
更新日期:2016-12-01 00:00:00
abstract:BACKGROUND:Numerous models predicting the risk of incident heart failure (HF) have been developed; however, evidence of their methodological rigor and reporting remains unclear. This study critically appraises the methods underpinning incident HF risk prediction models. METHODS AND RESULTS:EMBASE and PubMed were searc...
journal_title:Journal of cardiac failure
pub_type: 杂志文章,评审
doi:10.1016/j.cardfail.2017.03.005
更新日期:2017-09-01 00:00:00