Abstract:
BACKGROUND:Studies on the effect of heart failure clinics have been encouraging and convincing with respect to reduced hospitalizations, improved quality of life, and reduced cost. However, previous results have been derived from patient populations either recently discharged and with specific exclusion criteria or from heart transplant lists. We here report the establishment of a heart failure clinic that offers an integrated approach to both diagnosing and managing heart failure patients, the baseline characteristics of the first 283 patients treated, and the impact on heart failure hospitalizations during establishment. METHODS:Since September l, 1999, a heart failure clinic has been in operation at Frederiksberg University Hospital. The clinic was designed with both a diagnostic and a therapeutic unit. The diagnostic unit offers open access to all patients with suspected heart failure, either through referral from general practitioners or from the medical departments of the hospital. In the case of confirmed systolic heart failure, the patient is referred to the therapeutic unit for (1) uptitration and optimization of medical therapy and thorough information and education. In addition, the unit offers a rapid access track and the possibility of intravenous diuretic treatment. RESULTS:During the 21 months of operation, a total of 460 patients were referred to the clinic. Of these, 320 (70%) were found to have clinical evidence of heart failure, and 283 (88% of the patients with heart failure) had left ventricular systolic dysfunction (defined by an ejection fraction of < or =45%). These patients were seen in the clinic for education, control of fluid retention, and uptitration of medications. These patients with left ventricular dysfunction were predominantly elderly (aged 72.7 +/- 10.7 y) and most often male (73%). Ischemic heart disease was the most common etiology (55%). Before referral, most patients with left ventricular dysfunction had been treated with none or only low-dose angiotensin-converting enzyme inhibitor (55%), and fewer than one third received beta-blockers (29%). During the first year of operation of the clinic, there was a 23% decline of heart failure-related hospital admissions to the department of cardiology (from 396 to 306). CONCLUSIONS:Patients with systolic heart failure are not always optimally treated. The establishment of a heart failure clinic, which offers the combination of diagnosing and managing congestive heart failure, appears to be efficient both in terms of therapy optimization and with respect to a concomitant decline in hospitalization for heart failure.
journal_name
Am Heart Jjournal_title
American heart journalauthors
Galatius S,Gustafsson F,Nielsen PH,Atar D,Hildebrandt PRdoi
10.1067/mhj.2002.123841subject
Has Abstractpub_date
2002-08-01 00:00:00pages
E2issue
2eissn
0002-8703issn
1097-6744pii
S0002870302000911journal_volume
144pub_type
杂志文章abstract:BACKGROUND:Previous studies reported an impairment of nervous autonomic activity in patients with Duchenne muscular dystrophy (DMD). However, the relationship of the autonomic dysfunction to the impairment of cardiac mechanical function and of respiratory failure is not completely understood. METHODS:We evaluated card...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1067/mhj.2001.114804
更新日期:2001-05-01 00:00:00
abstract:BACKGROUND:False positive rate (FPR) of the current basic life support (BLS) termination of resuscitation (TOR) rule in out-of-hospital cardiac arrest (OHCA) patients (not witnessed; no return of spontaneous circulation prior to transport; and no shocks were delivered) has been ethically challenging. We validated the c...
journal_title:American heart journal
pub_type: 杂志文章,多中心研究
doi:10.1016/j.ahj.2019.04.003
更新日期:2019-07-01 00:00:00
abstract::Repetitive 10-hour ECG recordings of 289 patients obtained within a year after myocardial infarction were analyzed for the presence of ventricular runs, and their association with various types of ventricular ectopic activity (VEA), average rate of premature ventricular complexes (PVCs), and coupling interval of PVCs ...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(83)90690-7
更新日期:1983-09-01 00:00:00
abstract:OBJECTIVES:We aim to review the studies comparing coronary calcification across different ethnic groups. BACKGROUND:There is still uncertainty regarding ethnic differences in the prevalence, progression, and risk of coronary artery disease. Clues to possible racial differences in rates of coronary heart disease (CHD) ...
journal_title:American heart journal
pub_type: 杂志文章,评审
doi:10.1016/j.ahj.2006.08.008
更新日期:2006-11-01 00:00:00
abstract:BACKGROUND:Although prior studies have demonstrated disparities in the management and outcomes of women with acute coronary syndrome (ACS), there are limited large-scale contemporary data on gender differences in post-intervention outcomes in this population. METHODS:We analyzed patients according to 2 ACS categories,...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2008.08.012
更新日期:2009-01-01 00:00:00
abstract:BACKGROUND:This study investigates whether pioglitazone reduces neointimal hyperplasia after coronary stenting in nondiabetic patients with metabolic syndrome (MS) using intravascular ultrasound (IVUS). Pioglitazone, a novel insulin-sensitizing thiazolidinedione, has been shown to reduce neointimal hyperplasia after co...
journal_title:American heart journal
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.ahj.2007.02.022
更新日期:2007-05-01 00:00:00
abstract::In a double-blind, randomized crossover study of 12 patients suffering from chronic bronchitis, the comparative influence of equipotent doses of pindolol (5 mg) and metoprolol (100 mg) on the bronchodilatory potential of inhaled fenoterol (0.4 mg), a beta 2-agonist, was investigated by means of body plethysmography. N...
journal_title:American heart journal
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/0002-8703(82)90138-7
更新日期:1982-08-01 00:00:00
abstract::Guidelines published in 2001 recommended 1 regional adult congenital heart disease (ACHD) center per 3 to 10 million population. Our objective was to determine if published guidelines on the numbers of regional ACHD centers are sufficient to meet the needs of adults with congenital heart disease in the general populat...
journal_title:American heart journal
pub_type: 杂志文章,评审
doi:10.1016/j.ahj.2008.08.029
更新日期:2009-01-01 00:00:00
abstract::In order to correlate the antiarrhythmic and electrophysiological effects of disopyramide phosphate during acute myocardial ischemia, we performed experiments in 17 mongrel dogs. Refractory periods obtained by the extrastimulus method and conduction times recorded from local electrograms were determined in potentially...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(79)90046-2
更新日期:1979-09-01 00:00:00
abstract:BACKGROUND:Chronic kidney disease (CKD) is associated with an adverse prognosis in patients with coronary heart disease. Cardiac rehabilitation (CR) improves morbidity and mortality among patients with coronary heart disease, but its impact on patients with concomitant CKD has not been described. METHODS:We compared b...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2005.01.048
更新日期:2005-12-01 00:00:00
abstract::The occurrence of thrombotic events is central to the course of polycythemia vera. Myocardial, cerebral, peripheral, and pulmonary infarctions are frequent and are consequences of throbmoses in small and medium caliber arteries. Thrombosis in large caliber arteries is a rare event. Thrombosis within the chambers of th...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(80)90667-5
更新日期:1980-10-01 00:00:00
abstract::Three hundred post infarction participants who had received type A behavioral counseling in the Recurrent Coronary Prevention Project, (RCPP) agreed to be followed for 1 additional year after stopping 4.5 years of continuous type A behavioral counseling. One hundred fourteen participants who had served for 4.5 years a...
journal_title:American heart journal
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/0002-8703(87)90742-3
更新日期:1987-09-01 00:00:00
abstract::Early postexercise polarcardiographic (PCG) changes in the ST segment vector, as reflected in the variable MS X theta, are reported to clearly distinguish normal subjects from those with myocardial ischemia. We prospectively assessed the value of this test in detecting coronary artery disease (CAD) during treadmill ex...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(85)90019-5
更新日期:1985-12-01 00:00:00
abstract:BACKGROUND:We sought to systematically evaluate whether percutaneous revascularization is associated with additional clinical benefit in patients with renal artery stenosis (RAS) as compared with medical management alone. METHODS:We included randomized controlled trials that compared percutaneous revascularization in ...
journal_title:American heart journal
pub_type: 杂志文章,meta分析
doi:10.1016/j.ahj.2010.12.006
更新日期:2011-03-01 00:00:00
abstract:BACKGROUND:Some pharmacist-managed anticoagulation services (PMAS) provide initial follow-up to patients on oral anticoagulant, who are transferred to their physician once they are stabilized. This may be as effective as and less expensive than long-term PMAS follow-up. METHODS:Once PMAS patients were stabilized and r...
journal_title:American heart journal
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.ahj.2008.02.009
更新日期:2008-07-01 00:00:00
abstract::The development of a group of calcium channel blockers that prolong the QT interval has raised interest in their possible proarrhythmic potential. In animal experiments lidoflazine has no observed arrhythmogenic potential and no antiarrhythmic potential in a model sensitive to the antiarrhythmic properties of both con...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(85)90628-3
更新日期:1985-02-01 00:00:00
abstract:BACKGROUND:In patients with coronary heart disease (CHD), atrial fibrillation (AF) is associated with increased morbidity and mortality. We investigated the associations between clinical risk factors and biomarkers with incident AF in patients with CHD. METHODS AND RESULTS:Around 13,153 patients with optimally treated...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2020.12.016
更新日期:2021-01-02 00:00:00
abstract:BACKGROUND:Reliable predictors have yet to be found for recurrent ischemia after thrombolysis for acute myocardial infarction (AMI), nor do we know whether early angiography can herald recurrent ischemia. This study sought to investigate the relationship between recurrent ischemia and cardiac procedures after thromboly...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1067/mhj.2001.113226
更新日期:2001-04-01 00:00:00
abstract:BACKGROUND:The APEX trial assessed the safety and efficacy of extended-duration thromboprophylaxis using betrixaban versus standard dosing of enoxaparin among hospitalized, acutely ill medical patients. The 80-mg betrixaban dose was halved to 40 mg among subjects with severe renal insufficiency and those receiving a co...
journal_title:American heart journal
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1016/j.ahj.2016.12.004
更新日期:2017-03-01 00:00:00
abstract::The purpose of this study was to compare the three most commonly used maximal graded exercise test (GXT) protocols in healthy women. Submaximal and maximal metabolic and hemodynamic responses were determined from two treadmill protocols, Bruce and Balke, and a bicycle protocol, in 49 women. Maximum oxygen uptake (VO2 ...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(82)90275-7
更新日期:1982-03-01 00:00:00
abstract:BACKGROUND:Cardiac resynchronization therapy (CRT) improves outcomes, functional capacity and quality of life in patients with heart failure. Despite two decades of experience with CRT, the rate of non-response remains approximately 30%. CRT efficacy is impacted by pacing location, which is anatomically limited in conv...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2019.04.002
更新日期:2019-11-01 00:00:00
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journal_title:American heart journal
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/0002-8703(94)90632-7
更新日期:1994-09-01 00:00:00
abstract::The purpose of this study was to determine the effect of age on the in-hospital mortality of all 30,972 patients undergoing coronary artery bypass graft (CABG) surgery in New York in 1991 and 1992. Mortality rates were relatively low for patients 40-49, 50-59, and 60-64, 65-69, and 70-74 years old (1.10%, 1.65%, 2.17%...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(94)90750-1
更新日期:1994-12-01 00:00:00
abstract::An experimental canine model of pericardial effusion was designed to validate previous clinical nuclear magnetic resonance imaging (NMR) studies. Saline (n = 7), serum (n = 4), blood (10% hematocrit [n = 5]; 20% hematocrit [n = 5]), and lipid (n = 4) effusions were chosen to resemble: (1) transudative/exudative, (2) n...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(91)90678-b
更新日期:1991-04-01 00:00:00
abstract::Recently developed unstable angina clinical practice guidelines have recommended risk stratification with dipyridamole thallium-201 myocardial imaging in patients at "intermediate" pretest clinical risk who cannot exercise maximally. The prognostic value of predischarge dipyridamole technetium 99m sestamibi (MIBI) tom...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(95)90071-3
更新日期:1995-10-01 00:00:00
abstract::This study correlates the anatomic pathologic coronary anatomy found by arteriography in each of three groups of symptomatic patients, all with coronary artery disease, divided according to the magnitude of ST-segment depression after an adequate submaximal treadmill exercise test. Group I consists of 45 patients with...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(75)90080-0
更新日期:1975-03-01 00:00:00
abstract::Myocarditis Disease Unit (MDU) is a functional multidisciplinary network designed to offer multidisciplinary assistance to patients with myocarditis. More than 300 patients coming from the whole Country are currently followed up at a specialized multidisciplinary outpatient clinic. Following the pandemic outbreak of t...
journal_title:American heart journal
pub_type: 信件
doi:10.1016/j.ahj.2020.07.015
更新日期:2020-11-01 00:00:00
abstract::Atherosclerosis and its vascular sequela are responsible for considerable morbidity and mortality rates. Several risk factors have been implicated in the pathogenesis of atherosclerosis, and the search for other risk factors continues on the medical horizon. Renin-angiotensin system (RAS), a multienzyme, multilocale a...
journal_title:American heart journal
pub_type: 杂志文章,评审
doi:10.1016/s0002-8703(97)70089-9
更新日期:1997-09-01 00:00:00
abstract::We compared the pauses that followed the spontaneous termination of supraventricular tachyarrhythmias with the pauses that followed the cessation of atrial overdrive pacing in 21 patients. In 10 patients with abnormal sinus node function and in 11 patients with normal sinus node function we recorded the spontaneous te...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(83)90515-x
更新日期:1983-02-01 00:00:00
abstract::It has been suggested that the myocardium is able to recruit endogenous protective mechanisms in response to repeated ischemia and reperfusion. We set out to study whether this is manifested in patients with coronary artery disease in the form of fewer signs of myocardial ischemia during the second of two successive e...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(96)90272-0
更新日期:1996-04-01 00:00:00