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DiMauro PK. Clinical Recommendations for Improving Palliative Nursing Care for Patients With a Left Ventricular Assist Device. J Hosp Palliat Nurs 2024; 26:231-237. [PMID: 38885421 DOI: 10.1097/njh.0000000000001039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/20/2024]
Abstract
Nurses who care for patients with a left ventricular assist device (LVAD) are highly skilled clinicians who manage unique technological demands and complex complications within this specialized patient population. There is a demonstrated need and benefit for palliative care for patients with a LVAD, yet palliative consults are often underused, and the quality of consultation for these patients is poorly understood. Rarely, if at all, do nurses receive formal training on how to navigate the palliative care needs of patients with a LVAD, which includes preparedness planning, caregiver support, device/body image acceptance, and end-of-life care. In addition, there is a need for literature to address specifically how nurses in their role and scope of practice can improve palliative care for patients with a LVAD. The purpose of this article was to present recommendations to equip palliative care nurses to best serve the needs of patients with a LVAD, wherein they can partner with and advance their colleagues in cardiology to improve their delivery of primary palliative care.
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Affiliation(s)
- Pierce K DiMauro
- Pierce K. DiMauro, MSN, RN, is DNP candidate and palliative care DNP fellow, Columbia University School of Nursing, New York, NY
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Zhang Q, Yin J, Zou Y. MiR-568 mitigated cardiomyocytes apoptosis, oxidative stress response and cardiac dysfunction via targeting SMURF2 in heart failure rats. Heart Vessels 2023; 38:857-868. [PMID: 36717388 DOI: 10.1007/s00380-022-02231-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Accepted: 12/28/2022] [Indexed: 02/01/2023]
Abstract
Chronic heart failure (CHF), a conventional, complex, and severe syndrome, is generally defined by myocardial output inadequate to satisfy the metabolic requirements of body tissues. Recently, miR-568 was identified to be down-regulated in CHF patients' sera and negatively correlated with left ventricular mass index in symptomatic CHF patients with systolic dysfunction. Nevertheless, the role of miR-568 during CHF development remains obscure. The current study is aimed to investigate the role of miR-568 in CHF. The MTT assay, flow cytometry analysis, RT-qPCR analysis, western blot analysis and luciferase reporter assays were conducted to figure out the function and potential mechanism of miR-568 in vitro. Rats were operated with aortic coarctation to establish CHF animal model. The effects of miR-568 and SMURF2 on CHF rats were evaluated by hematoxylin-eosin staining, Masson's staining, serum index testing, cardiac ultrasound detection, and TUNEL staining assays. We discovered that miR-568 level was downregulated by H2O2 treatment in cardiomyocytes. In mechanism, miR-568 directly targeted and negatively regulated SMURF2. In function, SMURF2 overexpression reversed the effects of miR-568 on cardiac function and histological changes in vivo. Additionally, SMURF2 overexpression reversed the effects of miR-568 on the content of LDH, AST, CK and CK-MB in vivo. Moreover, SMURF2 overexpression reversed the effects of miR-568 on oxidative stress response in vivo. MiR-568 mitigated cardiomyocytes apoptosis, oxidative stress response and cardiac dysfunction via targeting SMURF2 in CHF rats. This discovery may serve as a potential biomarker for CHF treatment.
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Affiliation(s)
- Qian Zhang
- Department of Cardiology, The Sixth Hospital of Wuhan, Affiliated Hospital of Jianghan University, No. 168, Hong Kong Road, Jiang'an District, Wuhan, 430015, Hubei, China
| | - Jun Yin
- Department of Cardiology, The Sixth Hospital of Wuhan, Affiliated Hospital of Jianghan University, No. 168, Hong Kong Road, Jiang'an District, Wuhan, 430015, Hubei, China
| | - Yong Zou
- Department of Cardiology, The Sixth Hospital of Wuhan, Affiliated Hospital of Jianghan University, No. 168, Hong Kong Road, Jiang'an District, Wuhan, 430015, Hubei, China.
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Huang J, Su Y, Mao X. Analysis of the Application Effect of Multidisciplinary Team Cooperation Model in Chronic Heart Failure under WeChat Platform. COMPUTATIONAL INTELLIGENCE AND NEUROSCIENCE 2022; 2022:4051955. [PMID: 36059410 PMCID: PMC9436525 DOI: 10.1155/2022/4051955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 07/15/2022] [Accepted: 07/27/2022] [Indexed: 11/17/2022]
Abstract
Methods From April 2020 to May 2021, 56 patients with CHF who were discharged from the cardiology department of our hospital after treatment were randomly divided into two groups: experimental group (n = 28) and control group (n = 28). The control group was given conventional nursing measures and health education and discharge instructions, while the experimental group received collaborative multidisciplinary team nursing care based on the WeChat platform on the basis of the control group, all for 3 months. All enrolled patients underwent the Self-Care of Heart Failure Index Version 6.2 (SCHFI v6.2), the Minnesota Living with Heart Failure Questionnaire (MLHFQ), and the 6-minute walking test (6MWT test). The SCHFI v6.2 and MLHFQ scores, 6 MWT test results, and readmission rates within 3 months were observed and compared between the two groups. Results There was no significant difference between the SCHFIv6.2 and MLHFQ scores of the two patients at admission and at discharge, and the scores of the experimental group were significantly higher than the scores of the control group at the end of 3 months after discharge. On the other hand, the SCHFIv6.2 and MLHFQ scores of the two groups were significantly higher at discharge compared to admission; the 6-minute walking distance of the experimental group was significantly higher than that of the control group at the end of 3 months. The readmission rate in the experimental group was significantly lower than that in the control group. Conclusion The multidisciplinary teamwork model based on the WeChat platform can significantly improve the self-care ability and quality of life of CHF patients and reduce the readmission rate.
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Affiliation(s)
- Jieyu Huang
- Department of Cardiovascular Medicine, Hezhou People's Hospital, Second Ward, Hezhou, China
| | - Yu Su
- Department of Nephrology, Hezhou People's Hospital, Hezhou, China
| | - Xiucai Mao
- Hezhou People's Hospital Nursing Department, Hezhou, China
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Chen Z, Li M, Yin C, Fang Y, Zhu Y, Feng J. Effects of cardiac rehabilitation on elderly patients with Chronic heart failure: A meta-analysis and systematic review. PLoS One 2022; 17:e0273251. [PMID: 36006944 PMCID: PMC9409506 DOI: 10.1371/journal.pone.0273251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Accepted: 08/04/2022] [Indexed: 11/22/2022] Open
Abstract
Aims The purpose of this study was to investigate the effects of cardiac rehabilitation (CR) on elderly patients with Chronic heart failure (CHF) by literature search and meta-analysis. Methods We conducted an electronic search on PubMed, Cochrane Library, Embase, CNKI, Wanfang, and VIP database platforms. The search period was from the establishment of the database to November 2021 for randomized controlled studies (RCTs) related to the effects of CR on elderly patients with CHF. The RevMan 5.4 was used for meta-analysis. Results This study included 16 articles involving a total of 1782 patients, including 892 in the CR group and 890 in the control group. Meta-analysis showed that compared with conventional interventions, CR increased left ventricular ejection fraction in elderly patients with CHF [mean difference (MD):5.73,95% confidence interval (CI):2.05 to 9.40,Z = 3.05,P = 0.002], and decreased left ventricular end-diastolic diameter in elderly patients with CHF (MD:-4.82,95%CI:-7.49 to 15,Z = 3.54,P = 0.0004), increased the 6-minute walk test distance (MD:62.66,95% CI:44.40 to 80.92,Z = 6.72,P<0.00001), decreased the rehospitalization rate (OR:0.32,95%) CI: 0.21 0.49, Z = 5.33, P < 0.000001). Conclusions CR can improve cardiac function, prognosis and reduce rehospitalization rate of elderly patients with CHF.
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Affiliation(s)
- Zhuang Chen
- Department of Cardiovascular Medicine, The Fifth People’s Hospital of Jinan, Jinan, Shandong, China
| | - Ming Li
- Department of Cardiovascular Medicine, The Fifth People’s Hospital of Jinan, Jinan, Shandong, China
| | - Chenghua Yin
- Department of Cardiovascular Medicine, The Fifth People’s Hospital of Jinan, Jinan, Shandong, China
| | - Youbo Fang
- Department of Emergency, Yidu Central Hospital, Weifang, Shandong, China
| | - Ye Zhu
- Department of Cardiovascular Medicine, The Fifth People’s Hospital of Jinan, Jinan, Shandong, China
| | - Jing Feng
- Department of Cardiovascular Medicine, The Fifth People’s Hospital of Jinan, Jinan, Shandong, China
- * E-mail:
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Yedavilli S, Singh AD, Singh D, Samal R. Nano-Messengers of the Heart: Promising Theranostic Candidates for Cardiovascular Maladies. Front Physiol 2022; 13:895322. [PMID: 35899033 PMCID: PMC9313536 DOI: 10.3389/fphys.2022.895322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Accepted: 06/06/2022] [Indexed: 11/13/2022] Open
Abstract
Till date, cardiovascular diseases remain a leading cause of morbidity and mortality across the globe. Several commonly used treatment methods are unable to offer safety from future complications and longevity to the patients. Therefore, better and more effective treatment measures are needed. A potential cutting-edge technology comprises stem cell-derived exosomes. These nanobodies secreted by cells are intended to transfer molecular cargo to other cells for the establishment of intercellular communication and homeostasis. They carry DNA, RNA, lipids, and proteins; many of these molecules are of diagnostic and therapeutic potential. Several stem cell exosomal derivatives have been found to mimic the cardioprotective attributes of their parent stem cells, thus holding the potential to act analogous to stem cell therapies. Their translational value remains high as they have minimal immunogenicity, toxicity, and teratogenicity. The current review highlights the potential of various stem cell exosomes in cardiac repair, emphasizing the recent advancements made in the development of cell-free therapeutics, particularly as biomarkers and as carriers of therapeutic molecules. With the use of genetic engineering and biomimetics, the field of exosome research for heart treatment is expected to solve various theranostic requirements in the field paving its way to the clinics.
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Affiliation(s)
- Sneha Yedavilli
- Department of Life Science, Central University of Karnataka, Kalaburagi, India
| | | | - Damini Singh
- Environmental Pollution Analysis Lab, Bhiwadi, India
| | - Rasmita Samal
- Department of Life Science, Central University of Karnataka, Kalaburagi, India
- *Correspondence: Rasmita Samal,
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Luo Y, Chen J, Chen Y, Su Y, Wu X, Zheng W, Liu X, Chen L. Qishen Yiqi dropping pills improve isoproterenol-induced cardiomyocyte hypertrophy by regulating X-inactive specific transcript (XIST) expression in rats. J Thorac Dis 2022; 14:2213-2223. [PMID: 35813728 PMCID: PMC9264057 DOI: 10.21037/jtd-22-606] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Accepted: 06/17/2022] [Indexed: 12/15/2022]
Abstract
Background This study aimed to explore the potential mechanism of Qishen Yiqi dropping pills (QYDPs) in the treatment of chronic heart failure (CHF) by regulating the expression of lncRNAs during CHF. Methods Differences in the expression of the long non-coding RNA (lncRNA), X-inactive specific transcript (XIST), in an isoproterenol (ISO)-induced cardiomyocyte hypertrophy model treated with QYDPs was analyzed by reverse transcription quantitative polymerase chain reaction (RT-qPCR). A cell counting kit-8 (CCK8) assay, flow cytometry (FCM), and enzyme linked immunosorbent assay (ELISA) were used to analyze the protective effects of QYDPs on the proliferation rate, apoptosis, myocardial enzyme, oxidative stress, and inflammation of cardiomyocytes, as well as the molecular mechanism of XIST. Results Our results showed that in the ISO-induced cardiomyocyte hypertrophy model, XIST expression and apoptosis were increased, the cell proliferation rate was decreased, and myocardial enzyme levels increased [i.e., increased lactate dehydrogenase (LDH) and creatine kinase (CK) levels]. Furthermore, cellular oxidative stress [i.e., increased malondialdehyde (MDA) levels and decreased superoxide dismutase (SOD) levels] and inflammatory response [i.e., increased interleukin (IL)-1β, IL-6, and tumor necrosis factor (TNF)-α protein secretion] were also promoted. QYDP treatment effectively mitigated the effects of ISO induction. Subsequently, we found that suppressing XIST expression reversed the effect of ISO induction, whereas overexpression (ov) of XIST enhanced the effect of ISO induction. Finally, this study confirmed that QYDP treatment improved the ISO-induced decrease in proliferation, apoptosis, and promotion of oxidative stress and inflammatory response in cardiomyocytes, whereas ov of XIST partially negated the effect of QYDPs. Conclusions QYDPs protected H9c2 cells from ISO-induced damage by downregulating XIST expression.
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Affiliation(s)
- Ying Luo
- Department of Cardiology, the Second Affiliated Hospital of Hainan Medical College, Haikou, China
| | - Jiaxian Chen
- Department of Cardiology, the Second Affiliated Hospital of Hainan Medical College, Haikou, China
| | - Yuewu Chen
- Department of Cardiology, the Second Affiliated Hospital of Hainan Medical College, Haikou, China
| | - Yangshen Su
- Department of Cardiology, the Second Affiliated Hospital of Hainan Medical College, Haikou, China
| | - Xiaoyan Wu
- Department of Cardiology, the Second Affiliated Hospital of Hainan Medical College, Haikou, China
| | - Wanling Zheng
- Department of Cardiology, the Second Affiliated Hospital of Hainan Medical College, Haikou, China
| | - Xianxia Liu
- Department of Cardiology, the Second Affiliated Hospital of Hainan Medical College, Haikou, China
| | - Lei Chen
- Department of Cardiology, the Second Affiliated Hospital of Hainan Medical College, Haikou, China
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Chen Y, Li X, Lai W, Zhu F, Tan X, Xian W, Kang P, Wang H. [RIP1/RIP3-MLKL signaling pathway correlates with occurrence, progression and prognosis of chronic heart failure]. NAN FANG YI KE DA XUE XUE BAO = JOURNAL OF SOUTHERN MEDICAL UNIVERSITY 2021; 41:1534-1539. [PMID: 34755669 DOI: 10.12122/j.issn.1673-4254.2021.10.12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To detect plasma levels of receptor-interacting protein kinase 1 (RIP1), RIP3 and mixed lineage kinase domain-like protein (MLKL) in patients with chronic heart failure and explore the expression pattern of programmed necrosis signaling pathway RIP1/RIP3-MLKL in the progression of heart failure. METHODS The patients with chronic heart failure (NYHA class Ⅱ-Ⅳ) admitted in our hospital between February, 2020 and March, 2021 were prospectively enrolled in this study, with 21 healthy volunteers as the control group. The enrolled patients included 20 with grade Ⅱ, 33 with grade Ⅲ, and 43 with grade Ⅳ cardiac function. Fasting venous blood was collected from all the participants for detecting plasma levels of RIP1, RIP3, and MLKL and protein expressions of RIP1/RIP3-MLKL pathway using enzyme-linked immunosorbent assay (ELISA) and Western blotting. The patients with grade Ⅳ cardiac function were followed up for 5 months to evaluate the clinical prognostic indicators. RESULTS Compared with the healthy volunteers, the patients with grade Ⅱ, Ⅲ and Ⅳ cardiac function had significantly increased plasma levels of RIP1, RIP3, and MLKL (P < 0.01), and their levels were significantly higher in grade Ⅲ/Ⅳ patients than in those with grade Ⅱ cardiac function (P < 0.01); the plasma levels of RIP1 and MLKL were significantly higher in grade Ⅳ patients than in grade Ⅲ patients (P < 0.05). The results of Western blotting also showed increased expressions of the proteins in the RIP1/RIP3-MLKL pathway in patients with heart failure. Pearson correlation analysis suggested that in patients with heart failure, the expression levels of RIP1, RIP3, and MLKL were positively correlated with SCR, AST, LVEDD and NT-proBNP (P < 0.05). Follow-up study of the patients with grade Ⅳ cardiac function showed that higher expression levels of RIP1/RIP3-MLKL were associated with a poorer prognosis of the patients. CONCLUSION The expressions of RIP1, RIP3 and MLKL are significantly upregulated in patients with heart failure in positive correlation with the severity of the disease condition, and the activation of the RIP1/RIP3-MLKL signaling pathway may contribute to the occurrence, development and prognosis of chronic heart failure.
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Affiliation(s)
- Y Chen
- Department of Cardiology, First Affiliated Hospital, Bengbu Medical College, Bengbu 233000, China.,Cardiovascular and Cerebrovascular Disease Research Center, Bengbu Medical College, Bengbu 233000, China
| | - X Li
- Department of Cardiology, First Affiliated Hospital, Bengbu Medical College, Bengbu 233000, China.,Cardiovascular and Cerebrovascular Disease Research Center, Bengbu Medical College, Bengbu 233000, China
| | - W Lai
- Class 1, Grade 2017, School of Medical Imaging, Bengbu Medical College, Bengbu 233000, China
| | - F Zhu
- Department of Cardiology, First Affiliated Hospital, Bengbu Medical College, Bengbu 233000, China
| | - X Tan
- Department of Cardiology, First Affiliated Hospital, Bengbu Medical College, Bengbu 233000, China.,Cardiovascular and Cerebrovascular Disease Research Center, Bengbu Medical College, Bengbu 233000, China
| | - W Xian
- Department of Cardiology, First Affiliated Hospital, Bengbu Medical College, Bengbu 233000, China.,Cardiovascular and Cerebrovascular Disease Research Center, Bengbu Medical College, Bengbu 233000, China
| | - P Kang
- Department of Cardiology, First Affiliated Hospital, Bengbu Medical College, Bengbu 233000, China
| | - H Wang
- Department of Cardiology, First Affiliated Hospital, Bengbu Medical College, Bengbu 233000, China
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