Relation between VE/VCO2 slope and maximum phonation time in chronic heart failure patients

Impact of maximum phonation time on postoperative dysphagia and prognosis after cardiac surgery

Objective

The incidence of postoperative complications, including dysphagia, increases as the population undergoing cardiovascular surgery ages. This study aimed to explore the potential of maximum phonation time (MPT) as a simple tool for predicting postextubation dysphagia (PED) and major adverse cardiac and cerebrovascular events (MACCEs).

Methods

This retrospective study included 442 patients who underwent elective cardiac surgery at a university hospital. MPT was measured before surgery, and patients were stratified into 2 groups based on normal and abnormal MPTs. Postoperative complications, including PED and MACCEs, were also investigated. Swallowing status was assessed using the Food Intake Level Scale.

Results

MPT predicted PED with prevalence of 11.0% and 18.0% in the normal and abnormal MPT groups, respectively (P = .01). During the follow-up period, MACCEs developed in 17.0% of patients. Frailty, European System for Cardiac Operative Risk Evaluation II score, PED, and MPT were markedly associated with MACCEs (adjusted hazard ratios: 2.25, 1.08, 1.96, and 0.96, respectively). Mediation analysis revealed that MPT positively influenced PED and MACCEs, whereas PED positively influenced MACCEs. The trend in restricted cubic spline analysis indicated that the hazard ratio for MACCEs increased sharply when MPT was <10 seconds.

Conclusions

These findings underscore the potential of MPT as a valuable tool in the preoperative assessment and management of patients undergoing cardiac surgery. By incorporating MPT into routine preoperative evaluations, clinicians can identify patients at a higher risk of PED and MACCEs, allowing for targeted interventions and closer postoperative monitoring. This may improve patient outcomes and reduce the health care costs associated with these complications.

The relative and absolute reliability of maximum phonation time in community-dwelling Japanese people

BACKGROUND AND AIMS

The aim of the present study was to examine the approximate value of maximum phonation time in community-dwelling Japanese people and to set the range of error after ascertaining relative and absolute reliability.

METHODS

Participants in the present study were adults living in Kobe and Himeji City, Hyogo Prefecture, Japan. Participants were seated in the upright sitting position and were asked to produce an /a/ sound at their normal speaking volume for as long as they possibly could. The examiner measured the time until the sound became inaudible. Two trials were performed.

RESULTS

The subjects in the final analysis comprised 380 adults (246 women, 134 men; age, 72.7 ± 5.9 years). The values of trial 1 and trial 2 were analyzed with intraclass correlation coefficient (ICC_(1,1)), and Bland-Altman plot. Average values of the women, men, and both sexes combined were 16.1, 18.7, and 17.0 s, respectively. Average values of age groups 60-69, 70-79, and 80-89 years were 17.9, 16.8, and 15.9 s, respectively. The ICC_(1,1) was 0.87 (P < 0.001). Both fixed bias and proportional bias existed. Limits of agreement (LOA) were -5.0 to 7.7 and % change ranged from -27.1 to 41.8 %.

CONCLUSIONS

These normative data indicated that sufficiently reliable values could be measured in two trials. LOA showed that the second value tended to be higher. In determining the effect of treatment, one must consider that the value will be slightly higher at re-test.

Associations between heart failure and physical function in US adults

BACKGROUND

There is a paucity of nationally representative data in the area of heart failure (HF) and physical function (PF).

AIM

Examine the relationship(s) between HF and PF in a nationally representative sample of United States (US) adults.

DESIGN

Cross-section analysis of US adults.

METHODS

Sample (n = 6623) included adult (≥40 years of age) participants from the 1999-2006 National Health and Nutrition Examination Survey. Participants reporting HF answered questions related to their abilities to accomplish specific upper extremity and lower extremity tasks, and household chores.

RESULTS

Prevalence estimates of reporting much difficulty or the inability to stand from an armless chair was 9.9% and 4.3% (P = 0.002) in those with and without HF, respectively. Similar estimates were revealed for much difficulty or inability to lift or carry 10 pounds (16.8% and 8.6%, P = 0.0004) and much difficulty or inability to do household chores (13.3% and 6.1%, P = 0.0008). Following adjustments participants reporting HF had significantly greater odds of reporting much difficulty or the inability to stand from an armless chair [odds ratio (OR) 1.93; 95% confidence intervals (CI) 1.25, 2.96], much difficulty or the inability to lift or carry 10 lbs (OR 1.90; 95% CI 1.36, 2.65) and much difficulty or inability to do household chores (OR 2.06; 95% CI 1.41, 3.02) compared with participants not reporting HF.

CONCLUSIONS

Findings suggest US adults reporting HF are more likely to report poorer PF.

Relation Between V˙E/V˙CO2 Slope and Maximum Phonation Time in Chronic Heart Failure Patients

[In the article "Relation Between V˙E/V˙CO2 Slope and Maximum Phonation Time in Chronic Heart Failure Patients", which appeared in Volume 93, Issue 29 of Medicine, the acting editor's name, Salvatore Patanè, was incorrectly spelled as Salvatore Patane. Salvatore Patanè's name also incorrectly appeared online as an author of the paper. He was the editor of the paper, but not an author.].