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Kashiwakura D, Hiyama A, Muramatsu M, Hinotsu A, Takeda M, Suzuki N, Akiyama S, Kurihara S, Kida K. A Self-Administered Eating Behavior Scale for Patients With Heart Failure Living at Home: Protocol for a Mixed Methods Scale Development Study. JMIR Res Protoc 2024; 13:e60719. [PMID: 39423373 DOI: 10.2196/60719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2024] [Revised: 07/26/2024] [Accepted: 07/27/2024] [Indexed: 10/21/2024] Open
Abstract
BACKGROUND The prevalence of heart failure (HF) is increasing worldwide, with the associated mortality rates rising consistently. Preventing HF progression requires adherence to restricted sodium intake alongside sufficient and balanced nutritional consumption. For patients at home, preparing nutritionally balanced meals is essential, either self-assisted or with the aid of close individuals. Patients with HF frequently experience decreased exercise tolerance, depression, anxiety, and social isolation, which interfere with eating behaviors, leading to inadequate dietary habits. However, measures focusing on the determinants of eating behavior among patients with HF are currently lacking. OBJECTIVE This study aims to develop a self-administered scale to assess the eating behaviors of patients with HF living at home (Self-Administered Eating Behaviors Scale for Heart Failure [SEBS-HF]). METHODS This study encompasses 3 phases. Phase 1 involves identifying factors influencing eating behaviors in patients with HF. First, a literature review will be conducted using PubMed and CINAHL databases. The specified literature will be analyzed qualitatively and inductively. Additionally, verbatim transcripts obtained from semistructured interviews of patients with HF and medical experts will be qualitatively analyzed. Based on the Phase 1 results, a preliminary scale will be constructed. In Phase 2, cognitive interviews will be conducted with patients with HF and experts; the preliminary scale will be used to qualitatively evaluate its content validity. After validation, the scale will be used in Phase 3 to conduct a cross-sectional study involving patients with HF. In Phase 3, data will be collected from clinical records and self-administered questionnaires or scales. After conducting a preliminary survey, the main survey will be conducted. The reliability and validity of the scale will be assessed using statistical methods. RESULTS The first phase of this study commenced in September 2023, and by May 2, 2024, a total of 7 patients with HF and 6 expert professionals were enrolled as study participants. The draft creation of the scale will be completed in 2024, and the content validity evaluation of the draft scale is expected to be finished by early 2025. The third phase will begin its investigation in mid-2025 and is expected to be completed by late 2025, after which the SEBS-HF will be published. CONCLUSIONS The development and use of this scale will enable a more comprehensive evaluation of the factors influencing eating behaviors in patients with HF. Thus, medical and welfare professionals should provide appropriate support tailored to the specific needs of patients with HF. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/60719.
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Affiliation(s)
- Daisaku Kashiwakura
- Graduate School of Nursing, Sapporo City University, Sapporo, Japan
- Department of Nursing, Faculty of Health and Medical Care, Japan Healthcare University, Sapporo, Japan
| | - Akiko Hiyama
- Graduate School of Nursing, Sapporo City University, Sapporo, Japan
| | - Masumi Muramatsu
- Graduate School of Nursing, Sapporo City University, Sapporo, Japan
| | - Atsuko Hinotsu
- Graduate School of Nursing, Sapporo City University, Sapporo, Japan
| | - Michiko Takeda
- Department of Nursing, Aishin Memorial Hospital, Sapporo, Japan
| | - Norio Suzuki
- Division of Cardiology, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Sachie Akiyama
- Department of Nursing, Kawasaki Municipal Tama Hospital, Kawasaki, Japan
| | - Sayuri Kurihara
- Department of Nursing, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Keisuke Kida
- Department of Pharmacology, St. Marianna University School of Medicine, Kawasaki, Japan
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Kato M, Ono S, Seko H, Kito K, Omote T, Omote M, Seo Y, Omote S. Relationship between cachexia and short physical performance battery scores in patients with heart failure attending comprehensive outpatient cardiac rehabilitation. Heart Vessels 2024; 39:778-784. [PMID: 38649527 DOI: 10.1007/s00380-024-02400-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2024] [Accepted: 03/13/2024] [Indexed: 04/25/2024]
Abstract
Heart failure (HF) can cause metabolic imbalances, leading to anabolic resistance and increased energy expenditure, which often results in weight loss and cachexia. Comprehensive cardiac rehabilitation (CR), including exercise, nutritional support, and risk management, is crucial for enhancing the health and quality of life of patients with HF and is expected to play a central role in the prevention and treatment of HF-associated cachexia. However, the prevalence of cachexia in patients with HF undergoing comprehensive outpatient CR is currently unknown, and the detailed characteristics including of motor function of such patients remain undefined. Therefore, this cross-sectional study aimed to investigate the prevalence and characteristics of cachexia and the relationship between cachexia and lower limb motor function in patients with HF undergoing outpatient CR. This study included 115 consecutive patients with HF (43% male; mean age, 78 ± 8 years) who underwent comprehensive outpatient CR. The cachexia status was assessed according to the definition proposed by the Asian Working Group on Cachexia in 2023. The Short Physical Performance Battery (SPPB) and Mini Nutritional Assessment Short-Form (MNA-SF) were used to evaluate motor function of the lower limbs and nutritional status, respectively. Multivariate logistic regression analyses were used to examine the potential relationship between cachexia and low SPPB scores (≤ 9 points). The prevalence of cachexia was 30% in this study. Compared with those without cachexia, patients with cachexia were significantly older and showed notable reductions in body mass index, MNA-SF scores, handgrip strength, gait speed, and SPPB scores. A multivariate logistic regression analysis, adjusted for confounders, revealed that both age (odds ratio [OR], 1.129; 95% confidence interval [CI], 1.034-1.248; P = 0.016) and presence of cachexia (OR, 3.783; 95% CI, 1.213-11.796; P = 0.022) were independently associated with low SPPB scores. These findings highlight the importance of focusing on cachexia in patients with HF as part of a comprehensive outpatient CR and may be crucial in developing treatments to improve lower limb motor function in patients with HF who develops cachexia.
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Affiliation(s)
- Michitaka Kato
- Department of Shizuoka Physical Therapy, Faculty of Health Science, Tokoha University, 1-30 Mizuochi-cho, Aoi-ku, Shizuoka, 420-0831, Japan.
| | - Shintaro Ono
- Department of Cardiovascular Rehabilitation, Omote-jyunkankika Cardiovascular Clinic, Shizuoka, Japan
| | - Hiromasa Seko
- Department of Cardiovascular Rehabilitation, Omote-jyunkankika Cardiovascular Clinic, Shizuoka, Japan
| | - Kazuya Kito
- Department of Rehabilitation, Shizuoka Medical Center, Shizuoka, Japan
| | - Toshiya Omote
- Department of Cardiology, Omote-jyunkankika Cardiovascular Clinic, Shizuoka, Japan
| | - Mayuko Omote
- Department of Cardiology, Omote-jyunkankika Cardiovascular Clinic, Shizuoka, Japan
| | - Yoshihiro Seo
- Department of Cardiology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Shingo Omote
- Department of Cardiology, Omote-jyunkankika Cardiovascular Clinic, Shizuoka, Japan
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Kojima I, Koyama S, Terao Y, Tanaka S, Suzuki M, Otobe Y, Kita R, Abe R, Nishizawa K, Yamada M. Association between changes in nutritional status and ability to perform activities of daily living in older patients with heart failure: A stratified analysis by frailty status. Geriatr Nurs 2024; 59:208-214. [PMID: 39043048 DOI: 10.1016/j.gerinurse.2024.06.043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Revised: 06/07/2024] [Accepted: 06/27/2024] [Indexed: 07/25/2024]
Abstract
OBJECTIVES We aimed to determine the association between changes in nutritional status and the activities of daily living (ADL) at discharge, considering frailty status of older patients with heart failure (HF). METHODS This study included 491 older inpatients with HF categorized into the following groups based on their clinical frailty scale (CFS) scores: low, intermediate, and high. Changes in nutritional status were assessed using the Controlling Nutritional Status score at admission and discharge. The outcome variable was Barthel Index (BI) at discharge. RESULTS Multivariate logistic regression analysis indicated an association between improvement in nutritional status and high BI at discharge in both the low and intermediate CFS groups (odds ratio [OR], 2.18 [95% confidence interval, 1.04-4.58]), (OR, 2.45 [1.21-4.95]), respectively. CONCLUSIONS Improvement in the ADL at discharge in older patients with HF was associated with improved nutritional status during hospitalization in the low and intermediate CFS groups.
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Affiliation(s)
- Iwao Kojima
- Department of Rehabilitation Medicine, Kawasaki Municipal Kawasaki Hospital, 12-1, Shinkawa-dori, Kawasaki-ku, Kawasaki-City, Kanagawa 210-0013, Japan; Graduate School of Comprehensive Human Sciences, University of Tsukuba, 3-29-1 Otsuka, Bunkyo-ku, Tokyo 112-0012, Japan.
| | - Shingo Koyama
- Faculty of Health Sciences, Tsukuba University of Technology, 4-12-7 Kasuga, Tsukuba-city, Ibaraki 305-8521, Japan
| | - Yusuke Terao
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, 3-29-1 Otsuka, Bunkyo-ku, Tokyo 112-0012, Japan
| | - Shu Tanaka
- Major of Physical Therapy, Department of Rehabilitation, School of Health Sciences, Tokyo University of Technology, 5-23-22 Nishikamata, Ota-ku, Tokyo 144-8535, Japan
| | - Mizue Suzuki
- Department of Rehabilitation, Faculty of Allied health sciences, Yamato University, 2-5-1, Katayama-cho, Suita-city, Osaka, 564-0082, Japan
| | - Yuhei Otobe
- Graduate School of Rehabilitation Science, Osaka Metropolitan University, 3-7-30 Habikino, Habikino-city, Osaka 583-8555, Japan
| | - Ryosuke Kita
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, 3-29-1 Otsuka, Bunkyo-ku, Tokyo 112-0012, Japan
| | - Reon Abe
- Department of Rehabilitation Medicine, Kawasaki Municipal Kawasaki Hospital, 12-1, Shinkawa-dori, Kawasaki-ku, Kawasaki-City, Kanagawa 210-0013, Japan
| | - Kenya Nishizawa
- Division of Cardiology, Department of Internal Medicine, Kawasaki Municipal Kawasaki Hospital, 12-1, Shinkawa-dori, Kawasaki-ku, Kawasaki-City, Kanagawa 210-0013, Japan
| | - Minoru Yamada
- Faculty of Human Sciences, University of Tsukuba, 3-29-1 Otsuka, Bunkyo-ku, Tokyo 112-0012, Japan
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Yamamoto S, Hashimoto T, Sano M, Kimura M, Sato O, Deguchi J. Absolute Lymphocyte Count Predicts Bypass Surgery Outcomes in Patients with Chronic Limb-Threatening Ischemia. Ann Vasc Dis 2024; 17:142-149. [PMID: 38919317 PMCID: PMC11196179 DOI: 10.3400/avd.oa.23-00088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 03/03/2024] [Indexed: 06/27/2024] Open
Abstract
Objectives: The aim of this study was to evaluate the relationship between absolute lymphocyte count (ALC) and outcomes of infrainguinal bypass surgery for chronic limb-threatening ischemia (CLTI). Methods: From 2004 to 2020, 209 limbs of 189 patients who underwent infrainguinal bypass surgery for CLTI and whose ALCs were available were included. Patients with survival >2 years and limb salvage >2 years were considered discriminant groups, and an ALC cut-off value was calculated. The relationship between preoperative ALC and outcomes was evaluated. Results: Survivorship of the higher ALC group was significantly higher than that of the lower ALC group (cut-off value 1030/μL, p = 0.0009). The limb salvage rate of the higher ALC group was significantly higher than that of the lower ALC group (cut-off value 1260/μL, p = 0.0081). In the dialysis patient group (103 limbs), the limb salvage rate of the higher ALC group was significantly higher than that of the lower ALC group (cut-off value 1170/μL, p = 0.026). ALC was independently associated with limb loss in multivariate analysis. Conclusion: ALC is promising as a predictor of outcomes after bypass surgery in CLTI. In particular, ALC is expected to be useful for limb prognosis in hemodialysis patients.
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Affiliation(s)
- Satoshi Yamamoto
- Department of Vascular Surgery, Saitama Medical Center, Saitama Medical University, Kawagoe, Saitama, Japan
- Department of Cardiovascular Surgery, Ome Medical Center, Ome, Tokyo, Japan
| | - Takuya Hashimoto
- Department of Vascular Surgery, Saitama Medical Center, Saitama Medical University, Kawagoe, Saitama, Japan
| | - Masaya Sano
- Department of Vascular Surgery, Saitama Medical Center, Saitama Medical University, Kawagoe, Saitama, Japan
| | - Masaru Kimura
- Department of Vascular Surgery, Saitama Medical Center, Saitama Medical University, Kawagoe, Saitama, Japan
| | - Osamu Sato
- Department of Vascular Surgery, Saitama Medical Center, Saitama Medical University, Kawagoe, Saitama, Japan
| | - Juno Deguchi
- Department of Vascular Surgery, Saitama Medical Center, Saitama Medical University, Kawagoe, Saitama, Japan
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Li Y, Zhu F, Ren D, Tong J, Xu Q, Zhong M, Zhao W, Duan X, Xu X. Establishment of in-hospital nutrition support program for middle-aged and elderly patients with acute decompendated heart failure. BMC Cardiovasc Disord 2024; 24:259. [PMID: 38762515 PMCID: PMC11102219 DOI: 10.1186/s12872-024-03887-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Accepted: 04/11/2024] [Indexed: 05/20/2024] Open
Abstract
OBJECTIVE To construct a nutrition support program for middle-aged and elderly patients with acute decompensated heart failure (ADHF) during hospitalization. METHODS Based on the JBI Evidence-Based Health Care Model as the theoretical framework, the best evidence was extracted through literature analysis and a preliminary nutrition support plan for middle-aged and elderly ADHF patients during hospitalization was formed. Two rounds of expert opinion consultation were conducted using the Delphi method. The indicators were modified, supplemented and reduced according to the expert's scoring and feedback, and the expert scoring was calculated. RESULTS The response rates of the experts in the two rounds of consultation were 86.7% and 100%, respectively, and the coefficient of variation (CV) for each round was between 0.00% and 29.67% (all < 0.25). In the first round of expert consultation, 4 items were modified, 3 items were deleted, and 3 items were added. In the second round of the expert consultation, one item was deleted and one item was modified. Through two rounds of expert consultation, expert consensus was reached and a nutrition support plan for ADHF patients was finally formed, including 4 first-level indicators, 7 s-level indicators, and 24 third-level indicators. CONCLUSION The nutrition support program constructed in this study for middle-aged and elderly ADHF patients during hospitalization is authoritative, scientific and practical, and provides a theoretical basis for clinical development of nutrition support program for middle-aged and elderly ADHF patients during hospitalization.
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Affiliation(s)
- Yongliang Li
- CCU, Jiading District Central Hospital Affiliated Shanghai University of Medicine & Health Sciences, Shanghai, 201800, China
| | - Fang Zhu
- CCU, Jiading District Central Hospital Affiliated Shanghai University of Medicine & Health Sciences, Shanghai, 201800, China
| | - Dongmei Ren
- Department of Nursing, Jiading District Central Hospital Affiliated Shanghai University of Medicine & Health Sciences, Shanghai, 201800, China
| | - Jianping Tong
- Department of Cardiovascular Medicine, Jiading District Central Hospital Affiliated Shanghai University of Medicine & Health Sciences, Shanghai, 201204, China
| | - Qin Xu
- Department of Emergency, Jiad-ing District Central Hospital Affiliated Shanghai University of Medicine &Health Sciences, Shanghai, 201800, China
| | - Minhui Zhong
- Department of Nursing, Shanghai Key Laboratory of Maternal Fetal Medicine, Shanghai Institute of Maternal-Fetal Medicine and Gynecologic Oncology, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, 200092, China
| | - Wei Zhao
- Suzhou Science & Technology Town Hospital, Tongji University School of Medicine, Shanghai, 200120, China
| | - Xia Duan
- Department of Nursing, Shanghai Key Laboratory of Maternal Fetal Medicine, Shanghai Institute of Maternal-Fetal Medicine and Gynecologic Oncology, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, 200092, China.
| | - Xiangdong Xu
- Department of Cardiovascular Medicine, Jiading District Central Hospital Affiliated Shanghai University of Medicine & Health Sciences, Shanghai, 201204, China.
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Sato Y, Kuragaichi T, Nakayama H, Hotta K, Nishimoto Y, Kato T, Taniguchi R, Washida K. Developing Multidisciplinary Management of Heart Failure in the Super-Aging Society of Japan. Circ J 2023; 88:2-9. [PMID: 36567108 DOI: 10.1253/circj.cj-22-0675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
The Japanese population is rapidly aging because of its long life expectancy and low birth rate; additionally, the number of patients with heart failure (HF) is increasing to the extent that HF is now considered a pandemic. According to a recent HF registry study, Japanese patients with HF have both medical and care-related problems. Although hospitalization is used to provide medical services, and institutionalization is used to provide care for frail older adults, it can be difficult to distinguish between them. In this context, multidisciplinary management of HF has become increasingly important in preventing hospital readmissions and maintaining a patient's quality of life. Academia has promoted an increase in the number of certified HF nurses and educators. Researchers have issued numerous guidelines or statements on topics such as cardiac rehabilitation, nutrition, and palliative care, in addition to the diagnosis and treatment of acute and chronic HF. Moreover, the Japanese government has created incentives through various medical and long-term care systems adjustments to increase collaboration between these two fields. This review summarizes current epidemiological registries that focus not only on medical but also care-related problems and the 10 years of multidisciplinary management experience in Japanese medical and long-term care systems.
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Affiliation(s)
- Yukihito Sato
- Department of Cardiology, Hyogo Prefectural Amagasaki General Medical Center
| | - Takashi Kuragaichi
- Department of Cardiology, Hyogo Prefectural Amagasaki General Medical Center
| | - Hiroyuki Nakayama
- Department of Cardiology, Hyogo Prefectural Amagasaki General Medical Center
| | - Kozo Hotta
- Department of Cardiology, Hyogo Prefectural Amagasaki General Medical Center
| | - Yuji Nishimoto
- Department of Cardiology, Hyogo Prefectural Amagasaki General Medical Center
| | - Takao Kato
- Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine
| | - Ryoji Taniguchi
- Department of Cardiology, Hyogo Prefectural Amagasaki General Medical Center
| | - Koichi Washida
- Department of Nursing, Hyogo Prefectural Amagasaki General Medical Center
- Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine
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Nguyen HTT, Ha TTT, Tran HB, Nguyen DV, Pham HM, Tran PM, Pham TM, Allison TG, Reid CM, Kirkpatrick JN. Relationship between BMI and prognosis of chronic heart failure outpatients in Vietnam: a single-center study. Front Nutr 2023; 10:1251601. [PMID: 38099185 PMCID: PMC10720040 DOI: 10.3389/fnut.2023.1251601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Accepted: 11/08/2023] [Indexed: 12/17/2023] Open
Abstract
Background Insufficient data exists regarding the relationship between body mass index (BMI) and the prognosis of chronic heart failure (CHF) specifically within low- and middle-income Asian countries. The objective of this study was to evaluate the impact of BMI on adverse outcomes of ambulatory patients with CHF in Vietnam. Methods Between 2018 and 2020, we prospectively enrolled consecutive outpatients with clinically stable CHF in an observational cohort, single-center study. The participants were stratified according to Asian-specific BMI thresholds. The relationships between BMI and adverse outcomes (all-cause death and all-cause hospitalization) were analyzed by Kaplan-Meier survival curves and Cox proportional-hazards model. Results Among 320 participants (age 63.5 ± 13.3 years, 57.9% male), the median BMI was 21.4 kg/m2 (IQR 19.5-23.6), and 10.9% were underweight (BMI <18.50 kg/m2). Over a median follow-up time of 32 months, the cumulative incidence of all-cause mortality and hospitalization were 5.6% and 19.1%, respectively. After multivariable adjustment, underweight patients had a significantly higher risk of all-cause mortality than patients with normal BMI (adjusted hazard ratios = 3.03 [95% CI: 1.07-8.55]). Lower BMI remained significantly associated with a worse prognosis when analyzed as a continuous variable (adjusted hazard ratios = 1.27 [95% CI: 1.03-1.55] per 1 kg/m2 decrease for all-cause mortality). However, BMI was not found to be significantly associated with the risk of all-cause hospitalization (p > 0.05). Conclusion In ambulatory patients with CHF in Vietnam, lower BMI, especially underweight status (BMI < 18.5 kg/m2), was associated with a higher risk of all-cause mortality. These findings suggest that BMI should be considered for use in risk classification, and underweight patients should be managed by a team consisting of cardiologists, nutritionists, and geriatricians.
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Affiliation(s)
- Hoai Thi Thu Nguyen
- Vietnam National Heart Institute, Bach Mai Hospital, Hanoi, Vietnam
- Department of Internal Medicine, VNU-University of Medicine and Pharmacy, Hanoi, Vietnam
| | - Thuong Thi Thu Ha
- Department of Internal Medicine, VNU-University of Medicine and Pharmacy, Hanoi, Vietnam
| | - Hieu Ba Tran
- Vietnam National Heart Institute, Bach Mai Hospital, Hanoi, Vietnam
- Department of Internal Medicine, VNU-University of Medicine and Pharmacy, Hanoi, Vietnam
| | - Dung Viet Nguyen
- Vietnam National Heart Institute, Bach Mai Hospital, Hanoi, Vietnam
- Department of Internal Medicine, VNU-University of Medicine and Pharmacy, Hanoi, Vietnam
| | - Hung Manh Pham
- Vietnam National Heart Institute, Bach Mai Hospital, Hanoi, Vietnam
- Department of Cardiology, Hanoi Medical University, Hanoi, Vietnam
| | - Phuong Minh Tran
- Vietnam National Heart Institute, Bach Mai Hospital, Hanoi, Vietnam
| | - Tuan Minh Pham
- Vietnam National Heart Institute, Bach Mai Hospital, Hanoi, Vietnam
- Department of Cardiology, Hanoi Medical University, Hanoi, Vietnam
| | - Thomas G. Allison
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, United States
| | - Christopher M. Reid
- School of Population Health, Curtin University, Perth, WA, Australia
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - James N. Kirkpatrick
- Cardiovascular Division, Department of Medicine, University of Washington Medical Center, Seattle, WA, United States
- Department of Bioethics and Humanities, University of Washington Medical Center, Seattle, WA, United States
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Kojima I, Koyama S, Otobe Y, Suzuki M, Tanaka S, Terao Y, Aoki T, Kimura Y, Masuda H, Abe R, Nishizawa K, Yamada M. Combination of low muscle strength and malnutrition is associated with longer length of hospital stay among older patients with heart failure. Heart Lung 2023; 62:9-15. [PMID: 37290139 DOI: 10.1016/j.hrtlng.2023.05.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 05/24/2023] [Accepted: 05/24/2023] [Indexed: 06/10/2023]
Abstract
BACKGROUND Muscle strength and nutritional status are associated with length of hospital stay (LOHS) in older patients with heart failure (HF). OBJECTIVES The purpose of the study was to examine the association of the combination of muscle strength and nutritional status on LOHS in older patients with HF. METHODS This retrospective cohort study included 414 older inpatients with HF (men, 57.2%; median age, 81 years; interquartile range, 75-86 years). Patients were categorized into four groups according to their muscle strength and nutritional status: group 1, high muscle strength and normal nutritional status; group 2, low muscle strength and normal nutritional status; group 3, high muscle strength and malnutrition; and group 4, low muscle strength and malnutrition. The outcome variable was the LOHS, and an LOHS of >16 days was defined as long LOHS. RESULTS Multivariate logistic regression analysis adjusted for baseline characteristics (reference, group 1) showed that group 4 was associated with a more significant risk of long LOHS (odds ratio [OR], 3.54 [95% confidence interval, 1.85-6.78]). In the subgroup analysis, this relationship was maintained for the first admission HF group (OR, 4.65 [2.07-10.45]) but not for the HF readmission group (OR, 2.80 [0.72-10.90]). CONCLUSIONS Our results suggest that the long LOHS for older patients with HF at first admission was associated with a combination of low muscle strength and malnutrition but not by either factor individually.
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Affiliation(s)
- Iwao Kojima
- Department of Rehabilitation Medicine, Kawasaki Municipal Kawasaki Hospital, 12-1, Shinkawa-dori, Kawasaki-ku, Kawasaki-City, Kanagawa 210-0013, Japan; Graduate School of Comprehensive Human Sciences, University of Tsukuba, 3-29-1 Otsuka, Bunkyo-ku, Tokyo 112-0012, Japan.
| | - Shingo Koyama
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, 3-29-1 Otsuka, Bunkyo-ku, Tokyo 112-0012, Japan
| | - Yuhei Otobe
- Graduate School of Rehabilitation Science, Osaka Metropolitan University, 3-7-30 Habikino, Habikino-city, Osaka 583-8555, Japan
| | - Mizue Suzuki
- Department of Rehabilitation, Faculty of Allied health sciences, Yamato University, 2-5-1, Katayama-cho, Suita-city, Osaka, 564-0082, Japan
| | - Shu Tanaka
- Major of Physical Therapy, Department of Rehabilitation, School of Health Sciences, Tokyo University of Technology, 5-23-22 Nishikamata, Ota-ku, Tokyo 144-8535, Japan
| | - Yusuke Terao
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, 3-29-1 Otsuka, Bunkyo-ku, Tokyo 112-0012, Japan
| | - Takuya Aoki
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, 3-29-1 Otsuka, Bunkyo-ku, Tokyo 112-0012, Japan
| | - Yosuke Kimura
- College of Science and Engineering, Health and Sports Technology Course, Kanto Gakuin University, 1-50-1 Mutsuura-higashi, Kanazawa-ku, Yokohama 236-8501, Japan
| | - Hiroaki Masuda
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, 3-29-1 Otsuka, Bunkyo-ku, Tokyo 112-0012, Japan
| | - Reon Abe
- Department of Rehabilitation Medicine, Kawasaki Municipal Kawasaki Hospital, 12-1, Shinkawa-dori, Kawasaki-ku, Kawasaki-City, Kanagawa 210-0013, Japan
| | - Kenya Nishizawa
- Division of Cardiology, Department of Internal Medicine, Kawasaki Municipal Kawasaki Hospital, 12-1, Shinkawa-dori, Kawasaki-ku, Kawasaki-City, Kanagawa 210-0013, Japan
| | - Minoru Yamada
- Faculty of Human Sciences, University of Tsukuba, 3-29-1 Otsuka, Bunkyo-ku, Tokyo 112-0012, Japan
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Kida K, Miyajima I, Suzuki N, Greenberg BH, Akashi YJ. Nutritional management of heart failure. J Cardiol 2023; 81:283-291. [PMID: 36370995 DOI: 10.1016/j.jjcc.2022.11.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 10/04/2022] [Indexed: 11/10/2022]
Abstract
Nutrition in the cardiovascular field to date has focused on improving lifestyle-related diseases such as hypertension and diabetes from the viewpoint of secondary prevention. For these conditions, "nutrition for weight loss" is recommended, and nutritional guidance that restricts calories is provided. On the other hand, in symptomatic Stage C and D heart failure, it is known that underweight patients who manifest poor nutrition, sarcopenia, and cardiac cachexia have a poor prognosis. This is referred to as the "Obesity paradox". In order to "avoid weight loss" in patients with heart failure, a paradigm shift to nutritional management to prevent weight loss is needed. Rather than prescribing uniform recommendation for salt reduction of 6 g/day or less, awareness of the behavior change stage model is attracting attention. In this setting, the value of salt restriction will need to be determined to determine the priority level of intervention for undernutrition versus the need to prevent congestive signs and symptoms. In the Intensive Care Unit (ICU)/Cardiac Care Unit (CCU) for acute heart failure, nutritional intervention should be considered within 48 h of admission. Key points are selection of access route, timing of intervention, and monitoring of side effects. In nutritional management at home and in end-of-life care, food is a reflection of an individual's values, as well as a source of joy and encouragement. The importance of digestive tract should also be recognized in heart failure from oral flail to intestinal edema, constipation, and the intestinal bacteria called the heart-gut axis. Finally, we would like to propose a new term "heart nutrition" for nutritional management in patients with heart failure in this review. Compared to the evidence for exercise therapy in heart failure, studies assessing nutritional management remain scarce and there is a need for research in this area in the future.
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Affiliation(s)
- Keisuke Kida
- Department of Pharmacology, St. Marianna University School of Medicine, Kawasaki, Japan.
| | - Isao Miyajima
- Department of Clinical Nutrition, Chikamori Hospital, Kochi, Japan
| | - Norio Suzuki
- Division of Cardiology, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Barry H Greenberg
- Division of Cardiology, Department of Medicine, University of California San Diego, San Diego, CA, USA
| | - Yoshihiro J Akashi
- Division of Cardiology, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Japan
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10
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Seki Y, Obokata M, Harada T, Kagami K, Sorimachi H, Saito Y, Kato T, Ishii H. Adiposity and clinical outcomes in East Asian patients with heart failure and preserved ejection fraction. IJC HEART & VASCULATURE 2022; 44:101162. [PMID: 36510581 PMCID: PMC9735262 DOI: 10.1016/j.ijcha.2022.101162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2022] [Revised: 11/13/2022] [Accepted: 12/02/2022] [Indexed: 12/12/2022]
Abstract
Background Despite the obesity paradox, visceral adiposity is associated with poor clinical outcomes in patients with heart failure with preserved ejection fraction (HFpEF). However, it remains unclear whether a relationship between visceral fat and clinical outcomes exists in Asian patients with HFpEF, in whom obesity is rare. Methods Visceral and subcutaneous adipose tissue (VAT and SAT) volume and area were measured using computed tomography (CT) in 196 HFpEF patients. The primary endpoint was a composite of all-cause mortality or HF hospitalization. Results Participants had a normal body mass index (BMI) (22.5 ± 4.4 kg/m2), and obesity (BMI > 30 kg/m2) was rare (4.6 %). The primary outcome was observed in 64 patients during a median follow-up of 11.6 months. Lower VAT and SAT volumes were associated with underweight and malnutrition. Composite outcomes increased as body weight, BMI, and height-indexed SAT volume and area decreased. Lower height-indexed VAT volume and area were also associated with the outcomes. The height-indexed SAT area provided independent and incremental prognostic value over age, BMI, blood pressure, and creatinine and albumin levels. Conclusions In lean East Asian patients with HFpEF, a lower VAT volume was associated with poorer clinical outcomes. CT-based assessments of adiposity may provide incremental prognostic value over simple anthropometric indices in lean HFpEF patients.
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Affiliation(s)
- Yuko Seki
- Department of Cardiovascular Medicine, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan,Department of Radiology, Gunma University Hospital, Maebashi, Gunma, Japan
| | - Masaru Obokata
- Department of Cardiovascular Medicine, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan,Corresponding author at: Department of Cardiovascular Medicine, Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, Maebashi, Gunma 371-8511, Japan.
| | - Tomonari Harada
- Department of Cardiovascular Medicine, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan
| | - Kazuki Kagami
- Division of Cardiovascular Medicine, National Defense Medical College, Tokorozawa, Saitama, Japan
| | - Hidemi Sorimachi
- Department of Cardiovascular Medicine, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan
| | - Yuki Saito
- Division of Cardiology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan
| | - Toshimitsu Kato
- Department of Cardiovascular Medicine, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan
| | - Hideki Ishii
- Department of Cardiovascular Medicine, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan
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11
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Barbosa JS, de Souza MFC, Costa JO, Alves LVS, de Oliveira LMSM, de Almeida RR, Oliveira VB, Pereira LMC, Rocha RMS, Costa IMNBDC, Vieira DADS, Baumworcel L, Almeida-Santos MA, Oliveira JLM, Neves EB, Díaz-de-Durana AL, Merino-Fernández M, Aidar FJ, Sousa ACS. Assessment of Malnutrition in Heart Failure and Its Relationship with Clinical Problems in Brazilian Health Services. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10090. [PMID: 36011722 PMCID: PMC9408367 DOI: 10.3390/ijerph191610090] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 08/08/2022] [Accepted: 08/09/2022] [Indexed: 06/15/2023]
Abstract
Malnutrition in heart failure (HF) is frequent and associated with a worse prognosis. Due to differences in investment and the profile of those assisted, the objective of this study was to evaluate the frequency of malnutrition in hospitalized patients with HF and its association with clinical outcomes in the public and private health systems. Methodology: A cross-sectional study, with 247 volunteers hospitalized with HF in three public hospitals and one private hospital in Aracaju, SE, Brazil. A subjective global nutritional assessment (SGA) and mini nutritional assessment (MNA) were performed. Results: Sample with 72.5% users of the public health system and 75.3% with malnutrition (public = 74.9%; private = 76.5%; p = 0.793). Regardless of the healthcare system, hospital stay (>14 days) was longer (p = 0.020) among those with malnutrition (48.4%) than well-nourished patients (29.5%). Malnutrition in the public system had higher mortality (7.5%; 5.8%; p < 0.001) and hospital transfer rate (21.1%; 0.0%; p < 0.001) than those in the private system. Death after discharge was observed only in the public system (p = 0.039). Conclusion: Malnutrition was frequent in both systems and was associated with longer hospital stays and, in the public hospital, in-hospital death and transfers.
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Affiliation(s)
- Juliana Santos Barbosa
- Graduate Program in Health Sciences, Federal University of Sergipe (UFS), Aracaju 49060-676, Brazil
| | - Márcia Ferreira Cândido de Souza
- Graduate Program Professional in Management and Technological Innovation in Health, Federal University of Sergipe, Aracaju 49100-000, Brazil
| | - Jamille Oliveira Costa
- Graduate Program in Health Sciences, Federal University of Sergipe (UFS), Aracaju 49060-676, Brazil
| | | | | | - Rebeca Rocha de Almeida
- Graduate Program in Health Sciences, Federal University of Sergipe (UFS), Aracaju 49060-676, Brazil
| | - Victor Batista Oliveira
- Graduate Program in Health Sciences, Federal University of Sergipe (UFS), Aracaju 49060-676, Brazil
| | | | | | | | - Diva Aliete dos Santos Vieira
- Department of Nutrition, Campus Prof. Antônio Garcia Filho, Federal University of Sergipe (UFS), Lagarto 49400-000, Brazil
| | - Leonardo Baumworcel
- Clinic and Hospital São Lucas/Division, Rede D’Or São Luiz, Aracaju 49060-676, Brazil
| | - Marcos Antonio Almeida-Santos
- Clinic and Hospital São Lucas/Division, Rede D’Or São Luiz, Aracaju 49060-676, Brazil
- Graduate Program in Health and Environment, Tiradentes University (UNIT), Aracaju 49032-490, Brazil
| | - Joselina Luzia Menezes Oliveira
- Graduate Program in Health Sciences, Federal University of Sergipe (UFS), Aracaju 49060-676, Brazil
- Clinic and Hospital São Lucas/Division, Rede D’Or São Luiz, Aracaju 49060-676, Brazil
- Department of Medicine, Federal University of Sergipe (UFS), São Cristovão 49100-000, Brazil
- Division of Cardiology, University Hospital of Federal University of Sergipe (UFS), São Cristovão 49100-000, Brazil
| | - Eduardo Borba Neves
- Graduate Program in Biomedical Engineering, Federal Technological University of Paraná (UTFPR), Curitiba 80230-901, Brazil
| | - Alfonso López Díaz-de-Durana
- Sports Department, Physical Activity and Sports Faculty—INEF, Universidad Politécnica de Madrid, 28040 Madrid, Spain
| | | | - Felipe J. Aidar
- Group of Studies and Research in Performance, Sport, Health and Paralympic Sports—GEPEPS, Federal University of Sergipe (UFS), São Cristovão 49100-000, Brazil
- Graduate Program in Physical Education, Federal University of Sergipe (UFS), São Cristovão 49100-000, Brazil
- Graduate Program in Physiological Science, Federal University of Sergipe (UFS), São Cristovão 49100-000, Brazil
| | - Antônio Carlos Sobral Sousa
- Graduate Program in Health Sciences, Federal University of Sergipe (UFS), Aracaju 49060-676, Brazil
- Clinic and Hospital São Lucas/Division, Rede D’Or São Luiz, Aracaju 49060-676, Brazil
- Department of Medicine, Federal University of Sergipe (UFS), São Cristovão 49100-000, Brazil
- Division of Cardiology, University Hospital of Federal University of Sergipe (UFS), São Cristovão 49100-000, Brazil
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12
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Shibata K, Yamamoto M, Kameshima M, Fujiyama H, Sano T, Kagase A, Tokuda T, Adachi Y, Yamaguchi R, Shimura T, Iritani N, Murase K, Koyama Y. Impact of arm circumference on clinical outcomes in patients undergoing transcatheter aortic valve replacement. IJC HEART & VASCULATURE 2022; 40:101049. [PMID: 35601527 PMCID: PMC9118512 DOI: 10.1016/j.ijcha.2022.101049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Revised: 04/25/2022] [Accepted: 05/04/2022] [Indexed: 11/28/2022]
Affiliation(s)
- Kenichi Shibata
- Department of Cardiac Rehabilitation, Nagoya Heart Center, Nagoya, Japan
| | - Masanori Yamamoto
- Department of Cardiology, Nagoya Heart Canter, Nagoya, Japan
- Department of Cardiology, Toyohashi Heart Canter, Toyohashi, Japan
- Department of Cardiology, Gifu Heart Center, Gifu, Japan
- Corresponding author at: Department of cardiology, Toyohashi Heart Canter, 21-1 Gobudori, Oyamachyo, Toyohashi, Aichi 441-8530, Japan.
| | - Masataka Kameshima
- Department of Cardiac Rehabilitation, Nagoya Heart Center, Nagoya, Japan
| | - Hiroaki Fujiyama
- Department of Cardiac Rehabilitation, Nagoya Heart Center, Nagoya, Japan
| | - Taisei Sano
- Department of Cardiac Rehabilitation, Nagoya Heart Center, Nagoya, Japan
| | - Ai Kagase
- Department of Cardiology, Nagoya Heart Canter, Nagoya, Japan
| | - Takahiro Tokuda
- Department of Cardiology, Nagoya Heart Canter, Nagoya, Japan
| | - Yuya Adachi
- Department of Cardiology, Toyohashi Heart Canter, Toyohashi, Japan
| | - Ryo Yamaguchi
- Department of Cardiology, Toyohashi Heart Canter, Toyohashi, Japan
| | | | - Naoki Iritani
- Department of Cardiac Rehabilitation, Toyohashi Heart Canter, Toyohashi, Japan
| | - Kazuma Murase
- Department of Cardiac Rehabilitation, Toyohashi Heart Canter, Toyohashi, Japan
| | - Yutaka Koyama
- Department of Cardiovascular Surgery, Gifu Heart Center, Gifu, Japan
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13
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Kinugasa Y, Sota T, Kamitani H, Nakayama N, Nakamura K, Hirai M, Yanagihara K, Kato M, Ono T, Takahashi M, Matsuo H, Matsukawa R, Yoshida I, Kakinoki S, Yonezawa K, Himura Y, Yokota T, Yamamoto K, Tsuchihashi‐Makaya M, Kinugawa S. Diagnostic performance of nutritional indicators in patients with heart failure. ESC Heart Fail 2022; 9:2096-2106. [PMID: 35411707 PMCID: PMC9288786 DOI: 10.1002/ehf2.13886] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 02/07/2022] [Accepted: 03/02/2022] [Indexed: 01/04/2023] Open
Abstract
Aims The aim of this study was to compare the diagnostic performance of the nutritional indicators, the mini nutritional assessment‐short form (MNA‐SF), the geriatric nutritional risk index (GNRI), and the controlling nutritional status (CONUT), in heart failure (HF) patients. Methods and results Nutritional status was prospectively assessed by the aforementioned three nutritional indicators in 150 outpatients with HF who were then followed for 1 year. The prevalence of patients with the nutritional risk as assessed by the MNA‐SF, GNRI, and CONUT scores was 50.0%, 13.3%, and 54.0%, respectively. There was slight agreement of nutritional risk assessment between the MNA‐SF and GNRI scores (κ coefficient = 0.16), as well as the GNRI and CONUT scores (κ = 0.11), but poor agreement between the MNA‐SF and CONUT scores (κ = −0.09). The CONUT score had the lowest area under the curve (AUC) for the identification of low body weight, low muscle mass, and low physical function among the three indicators (all P < 0.05). Compared with the MNA‐SF score, both the GNRI and CONUT scores had lower AUCs for the identification of reduced dietary intake and weight loss (all P < 0.05). There was no significant difference in predicting all‐cause mortality or HF rehospitalization among the three indicators. The prescription of statins reduced the diagnostic performance of the CONUT score, as the CONUT score includes cholesterol level assessment. Conclusions Of the three indicators, the diagnostic ability of the MNA‐SF score was the highest, and that of the CONUT score was the lowest, for the assessment of HF patient nutritional status. The CONUT score may misrepresent nutritional status, particularly in patients receiving statins.
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Affiliation(s)
- Yoshiharu Kinugasa
- Department of Cardiovascular Medicine and Endocrinology and Metabolism, Faculty of MedicineTottori University36‐1 NishichoYonago683‐8504Japan
| | - Takeshi Sota
- Division of RehabilitationTottori University HospitalYonagoJapan
| | - Hiroko Kamitani
- Department of Cardiovascular Medicine and Endocrinology and Metabolism, Faculty of MedicineTottori University36‐1 NishichoYonago683‐8504Japan
| | | | - Kensuke Nakamura
- Department of Cardiovascular Medicine and Endocrinology and Metabolism, Faculty of MedicineTottori University36‐1 NishichoYonago683‐8504Japan
| | - Masayuki Hirai
- Department of Cardiovascular Medicine and Endocrinology and Metabolism, Faculty of MedicineTottori University36‐1 NishichoYonago683‐8504Japan
| | - Kiyotaka Yanagihara
- Department of Cardiovascular Medicine and Endocrinology and Metabolism, Faculty of MedicineTottori University36‐1 NishichoYonago683‐8504Japan
| | - Masahiko Kato
- Department of Pathobiological Science and Technology, School of Health Science; Major in Clinical Laboratory Science, Faculty of MedicineTottori UniversityYonagoJapan
| | - Taisuke Ono
- Department of CardiologyKitami Red Cross HospitalKitamiJapan
| | | | - Hisashi Matsuo
- Department of CardiologyKeiwakai Ebetsu HospitalEbetsuJapan
| | | | - Ichiro Yoshida
- Department of CardiologyObihiro Kyokai HospitalObihiroJapan
| | | | - Kazuya Yonezawa
- Department of Clinical ResearchNational Hospital Organization Hakodate National HospitalHakodateJapan
| | | | - Takashi Yokota
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of MedicineHokkaido UniversitySapporoJapan
- Institute of Health Science Innovation for Medical CareHokkaido University HospitalSapporoJapan
| | - Kazuhiro Yamamoto
- Department of Cardiovascular Medicine and Endocrinology and Metabolism, Faculty of MedicineTottori University36‐1 NishichoYonago683‐8504Japan
| | | | - Shintaro Kinugawa
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of MedicineHokkaido UniversitySapporoJapan
- Department of Cardiovascular Medicine, Faculty of Medical SciencesKyushu UniversityFukuokaJapan
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14
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Kojima I, Tanaka S, Otobe Y, Suzuki M, Koyama S, Kimura Y, Ishiyama D, Maetani Y, Kusumi H, Terao Y, Abe R, Nishizawa K, Yamada M. What is the optimal nutritional assessment tool for predicting decline in the activity of daily living among older patients with heart failure? Heart Vessels 2022; 37:1356-1362. [PMID: 35122493 DOI: 10.1007/s00380-022-02033-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Accepted: 01/21/2022] [Indexed: 11/04/2022]
Abstract
The clinical importance of nutritional management in activities of daily living (ADL) among older inpatients with heart failure (HF) is greatly increasing. We determined the optimal nutritional assessment tool that can predict ADL decline among older inpatients with HF. We prospectively investigated 91 inpatients aged ≥ 65 years with HF in an acute hospital. We measured their nutritional status at admission using nutrition indices: the controlling nutritional status (CONUT), the geriatric nutritional risk index, the prognostic nutritional index, and the mini nutritional assessment. Logistic regression analysis was used to estimate the odds ratios (ORs) and 95% confidence intervals (CIs) of the relationships between the malnutrition status assessed by each nutritional index category and the ADL decline measured by the Barthel index (BI) in the univariate and multivariate analyses. Among the participants, 28.6% (n = 26; median age 81.5 years; 69.2% men) of the participants were included in the Reduced BI group and 71.4% (n = 65; median age 79.0 years; 67.7% men) in the Maintained BI group. The Reduced BI group showed a significantly higher CONUT value than the Maintained BI group, but there were no significant differences in other nutritional indices. In the multivariate logistic regression analysis, a higher CONUT score was associated with a significantly elevated risk of Reduced BI (adjusted OR 0.24; 95%CI 0.08-0.75; p = 0.014). We found that CONUT is an appropriate nutritional assessment tool for predicting ADL decline among older inpatients with HF in the early phase of hospitalization.
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Affiliation(s)
- Iwao Kojima
- Department of Rehabilitation Medicine, Kawasaki Municipal Kawasaki Hospital, Kanagawa, Japan. .,Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tokyo, Japan.
| | - Shu Tanaka
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tokyo, Japan
| | - Yuhei Otobe
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tokyo, Japan
| | - Mizue Suzuki
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tokyo, Japan
| | - Shingo Koyama
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tokyo, Japan
| | - Yosuke Kimura
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tokyo, Japan.,Department of Electrical Engineering, Health and Sports Technology Course, Kanto Gakuin University, Kanagawa, Japan
| | - Daisuke Ishiyama
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tokyo, Japan
| | - Yusuke Maetani
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tokyo, Japan
| | - Haruhiko Kusumi
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tokyo, Japan
| | - Yusuke Terao
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tokyo, Japan
| | - Reon Abe
- Department of Rehabilitation Medicine, Kawasaki Municipal Kawasaki Hospital, Kanagawa, Japan
| | - Kenya Nishizawa
- Division of Cardiology, Department of Internal Medicine, Kawasaki Municipal Kawasaki Hospital, Kanagawa, Japan
| | - Minoru Yamada
- Faculty of Human Sciences, University of Tsukuba, Tokyo, Japan
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15
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Saijo T, Yasumoto K, Ryomoto K, Momoki C, Habu D. Initiating enteral nutrition in patients with severe acute heart failure during mechanical circulatory support. CLINICAL NUTRITION OPEN SCIENCE 2022. [DOI: 10.1016/j.nutos.2022.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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16
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Yamamoto S, Deguchi J, Hashimoto T, Suhara M, Sato O. Relationship between the Controlling Nutritional Status Score and Infrainguinal Bypass Surgery Outcomes in Patients with Chronic Limb-threatening Ischemia. Ann Vasc Dis 2021; 14:334-340. [PMID: 35082938 PMCID: PMC8752930 DOI: 10.3400/avd.oa.21-00132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 11/18/2021] [Indexed: 11/13/2022] Open
Abstract
Objective: We investigated the association between Controlling Nutritional Status (CONUT) scores and the outcomes of bypass surgery in patients with chronic limb-threatening ischemia (CLTI). Methods: We retrospectively calculated preoperative CONUT scores in 118 patients (127 limbs) with CLTI who underwent infrainguinal bypass surgery. Survival, graft patency, and limb salvage were compared between the high and low CONUT score groups based on the respective cutoff points. Results: The median and mean CONUT scores were 5 and 4.8, respectively. The postoperative survival rate was lower in the high CONUT score (3–12) group than in the low CONUT score (0–2) group (P=0.0043). The limb salvage rate after arterial reconstruction was also significantly lower in the high CONUT score (8–12) group than in the low CONUT score (0–7) group (P=0.0009). Conclusions: The CONUT score can predict infrainguinal bypass surgery outcomes in patients with CLTI. (This is a translation of J Jpn Coll Angiol 2020; 60: 35–41.)
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Affiliation(s)
- Satoshi Yamamoto
- Department of Vascular Surgery, Saitama Medical Center, Saitama Medical University, Kawagoe, Saitama, Japan
| | - Juno Deguchi
- Department of Vascular Surgery, Saitama Medical Center, Saitama Medical University, Kawagoe, Saitama, Japan
| | - Takuya Hashimoto
- Department of Vascular Surgery, Saitama Medical Center, Saitama Medical University, Kawagoe, Saitama, Japan
| | - Masamitsu Suhara
- Department of Vascular Surgery, Saitama Medical Center, Saitama Medical University, Kawagoe, Saitama, Japan
| | - Osamu Sato
- Department of Vascular Surgery, Saitama Medical Center, Saitama Medical University, Kawagoe, Saitama, Japan
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17
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Tsutsui H, Ide T, Ito H, Kihara Y, Kinugawa K, Kinugawa S, Makaya M, Murohara T, Node K, Saito Y, Sakata Y, Shimizu W, Yamamoto K, Bando Y, Iwasaki YK, Kinugasa Y, Mizote I, Nakagawa H, Oishi S, Okada A, Tanaka A, Akasaka T, Ono M, Kimura T, Kosaka S, Kosuge M, Momomura SI. JCS/JHFS 2021 Guideline Focused Update on Diagnosis and Treatment of Acute and Chronic Heart Failure. Circ J 2021; 85:2252-2291. [PMID: 34588392 DOI: 10.1253/circj.cj-21-0431] [Citation(s) in RCA: 94] [Impact Index Per Article: 31.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Hiroyuki Tsutsui
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kyushu University
| | - Tomomi Ide
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kyushu University
| | - Hiroshi Ito
- Department of Cardiovascular Medicine, Division of Biophysiological Sciences, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
| | | | - Koichiro Kinugawa
- Second Department of Internal Medicine, Faculty of Medicine, University of Toyama
| | - Shintaro Kinugawa
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kyushu University
| | | | - Toyoaki Murohara
- Department of Cardiology, Nagoya University Graduate School of Medicine
| | - Koichi Node
- Department of Cardiovascular Medicine, Saga University
| | - Yoshihiko Saito
- Department of Cardiovascular Medicine, Nara Medical University
| | - Yasushi Sakata
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine
| | - Wataru Shimizu
- Department of Cardiovascular Medicine, Nippon Medical School
| | - Kazuhiro Yamamoto
- Department of Cardiovascular Medicine and Endocrinology and Metabolism, Faculty of Medicine, Tottori University
| | - Yasuko Bando
- Department of Cardiology, Nagoya University Hospital
| | - Yu-Ki Iwasaki
- Department of Cardiovascular Medicine, Nippon Medical School
| | - Yoshiharu Kinugasa
- Department of Cardiovascular Medicine and Endocrinology and Metabolism, Faculty of Medicine, Tottori University
| | - Isamu Mizote
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine
| | | | - Shogo Oishi
- Department of Cardiology, Himeji Brain and Heart Center
| | - Akiko Okada
- Kitasato University Graduate School of Nursing
| | | | - Takashi Akasaka
- Department of Cardiovascular Medicine, Wakayama Medical University
| | - Minoru Ono
- Department of Cardiac Surgery, Graduate School of Medicine and Faculty of Medicine, The University of Tokyo
| | - Takeshi Kimura
- Department of Cardiovascular Medicine, Graduate School of Medicine and Faculty of Medicine, Kyoto University
| | - Shun Kosaka
- Department of Cardiology, Keio University School of Medicine
| | - Masami Kosuge
- Cardiovascular Center, Yokohama City University Medical Center
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18
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Tsutsui H, Ide T, Ito H, Kihara Y, Kinugawa K, Kinugawa S, Makaya M, Murohara T, Node K, Saito Y, Sakata Y, Shimizu W, Yamamoto K, Bando Y, Iwasaki YK, Kinugasa Y, Mizote I, Nakagawa H, Oishi S, Okada A, Tanaka A, Akasaka T, Ono M, Kimura T, Kosaka S, Kosuge M, Momomura SI. JCS/JHFS 2021 Guideline Focused Update on Diagnosis and Treatment of Acute and Chronic Heart Failure. J Card Fail 2021; 27:1404-1444. [PMID: 34600838 DOI: 10.1016/j.cardfail.2021.04.023] [Citation(s) in RCA: 73] [Impact Index Per Article: 24.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 04/16/2021] [Accepted: 04/27/2021] [Indexed: 02/06/2023]
Affiliation(s)
- Hiroyuki Tsutsui
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Tomomi Ide
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Hiroshi Ito
- Department of Cardiovascular Medicine, Division of Biophysiological Sciences, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Yasuki Kihara
- Kobe City Medical Center General Hospital, Kobe, Japan
| | - Koichiro Kinugawa
- Second Department of Internal Medicine, Faculty of Medicine, University of Toyama, Toyama, Japan
| | - Shintaro Kinugawa
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Miyuki Makaya
- Kitasato University Graduate School of Nursing, Tokyo, Japan
| | - Toyoaki Murohara
- Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Koichi Node
- Department of Cardiovascular Medicine, Saga University, Saga, Japan
| | - Yoshihiko Saito
- Department of Cardiovascular Medicine, Nara Medical University, Kashihara, Japan
| | - Yasushi Sakata
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Wataru Shimizu
- Department of Cardiovascular Medicine, Nippon Medical School, Tokyo, Japan
| | - Kazuhiro Yamamoto
- Department of Cardiovascular Medicine and Endocrinology and Metabolism, Faculty of Medicine, Tottori University, Tottori, Japan
| | - Yasuko Bando
- Department of Cardiology, Nagoya University Hospital, Nagoya, Japan
| | - Yu-Ki Iwasaki
- Department of Cardiovascular Medicine, Nippon Medical School, Tokyo, Japan
| | - Yoshiharu Kinugasa
- Department of Cardiovascular Medicine and Endocrinology and Metabolism, Faculty of Medicine, Tottori University, Tottori, Japan
| | - Isamu Mizote
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Hitoshi Nakagawa
- Department of Cardiovascular Medicine, Nara Medical University, Kashihara, Japan
| | - Shogo Oishi
- Department of Cardiology, Himeji Brain and Heart Center, Hyogo, Japan
| | - Akiko Okada
- Kitasato University Graduate School of Nursing, Tokyo, Japan
| | - Atsushi Tanaka
- Department of Cardiovascular Medicine, Saga University, Saga, Japan
| | - Takashi Akasaka
- Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan
| | - Minoru Ono
- Department of Cardiac Surgery, Graduate School of Medicine and Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Takeshi Kimura
- Department of Cardiovascular Medicine, Graduate School of Medicine and Faculty of Medicine, Kyoto University, Kyoto, Japan
| | - Shun Kosaka
- Department of Cardiology, Keio University School of Medicine, Tokyo, Japan
| | - Masami Kosuge
- Cardiovascular Center, Yokohama City University Medical Center, Yokohama, Japan
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19
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Kinugasa Y, Saitoh M, Ikegame T, Ikarashi A, Kadota K, Kamiya K, Kohsaka S, Mizuno A, Miyajima I, Nakane E, Nei A, Shibata T, Yokoyama H, Yumikura S, Yumino D, Watanabe N, Isobe M. Differences in Priorities for Heart Failure Management Between Cardiologists and General Practitioners in Japan. Circ J 2021; 85:1565-1574. [PMID: 34234052 DOI: 10.1253/circj.cj-21-0335] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND The purpose of this study was to clarify the current status and issues of community collaboration in heart failure (HF) using a nationwide questionnaire survey. METHODS AND RESULTS We conducted a survey among hospital cardiologists and general practitioners (GPs) using a web-based questionnaire developed with the Delphi method, to assess the quality of community collaboration in HF. We received responses from 46 of the 47 prefectures in Japan, including from 281 hospital cardiologists and 145 GPs. The survey included the following characteristics and issues regarding community collaboration. (1) Hospital cardiologists prioritized medical intervention for preventing HF hospitalization and death whereas GPs prioritized supporting the daily living of patients and their families. (2) Hospital cardiologists have not provided information that meets the needs of GPs, and few regions have a community-based system that allows for the sharing of information about patients with HF. (3) In the transition to home care, there are few opportunities for direct communication between hospitals and community staff, and consultation systems are not well developed. CONCLUSIONS The current study clarified the real-world status and issues of community collaboration for HF in Japan, especially the differences in priorities for HF management between hospital cardiologists and GPs. Our data will contribute to the future direction and promotion of community collaboration in HF management.
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Affiliation(s)
- Yoshiharu Kinugasa
- Department of Cardiovascular Medicine and Endocrinology and Metabolism, Faculty of Medicine, Tottori University
| | | | | | - Aoi Ikarashi
- Department of Cardiovascular Medicine, St Luke's International Hospital
| | | | - Kentaro Kamiya
- Department of Rehabilitation Sciences, Kitasato University Graduate School of Medical Sciences
| | - Shun Kohsaka
- Department of Cardiology, Keio University School of Medicine
| | - Atsushi Mizuno
- Department of Cardiovascular Medicine, St Luke's International Hospital
| | - Isao Miyajima
- Department of Clinical Nutrition, Chikamori Hospital
| | - Eisaku Nakane
- Cardiovascular Center, the Tazuke Kofukai Medical Research Institute, Kitano Hospital
| | - Azusa Nei
- Toho University Medical Center Ohashi Hospital
| | - Tatsuhiro Shibata
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine
| | | | | | | | | | - Mitsuaki Isobe
- Sakakibara Heart Institute
- Tokyo Medical and Dental University
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20
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Durante A, De Maria M, Boyne J, Jaarsma T, Juarez-Vela R, Strömberg A, Vellone E. Development and psychometric testing of the European Heart Failure Self-Care behaviour scale caregiver version (EHFScB-C). PATIENT EDUCATION AND COUNSELING 2021; 104:2106-2111. [PMID: 33516593 DOI: 10.1016/j.pec.2021.01.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/29/2020] [Revised: 01/10/2021] [Accepted: 01/12/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND The European Heart Failure Self-Care Behaviour Scale (EHFScBS) is used worldwide to measure heart failure (HF) patient self-care, but a caregiver version does not exist. OBJECTIVE To develop and test the European HF Self-Care Behaviour Scale for Caregivers (EHFScBS-C) in a population of informal caregivers of HF patients. METHODS The EHFScBS-C was derived from the EHFScBS to measure the extent to which caregivers contribute to HF patient self-care. The EHFScBS-C was developed in English and then translated into Italian, Spanish and Dutch, after which it was back-translated. EHFScBS-C data were collected from 193 HF caregivers enrolled in Italy, Spain and the Netherlands. RESULTS Exploratory factor analysis revealed two factors with supportive fit indices (CFI = 0.990; RMSEA = 0.048): caregivers' contributions to HF self-care related to medical issues, and caregivers' contributions related to lifestyle. Internal consistency reliability was supported as well (Cronbach's alpha 0.90 for the overall scale). Construct validity was demonstrated with significant correlations with the Caregiver Preparedness Scale. CONCLUSION AND PRACTICE IMPLICATIONS The EHFScBS-C has adequate validity and reliability for its use in clinical practice and research to measure the extent to which caregivers contribute to HF patient self-care. The EHFScBS-C can be used in combination with the EHFScBS to conduct dyadic studies.
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Affiliation(s)
- Angela Durante
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy.
| | - Maddalena De Maria
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy
| | - Josiane Boyne
- Department of Cardiology, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Tiny Jaarsma
- Department of Health, Medicine and Caring Sciences, Division of Nursing, Linköping University, Linköping, Sweden
| | | | - Anna Strömberg
- Department of Health, Medicine and Caring Sciences, Division of Nursing, Linköping University, Linköping, Sweden; Department of Cardiology, Linköping University, Linköping, Sweden
| | - Ercole Vellone
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy
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21
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Multidisciplinary Team-Based Palliative Care for Heart Failure and Food Intake at the End of Life. Nutrients 2021; 13:nu13072387. [PMID: 34371897 PMCID: PMC8308898 DOI: 10.3390/nu13072387] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 07/07/2021] [Accepted: 07/10/2021] [Indexed: 11/17/2022] Open
Abstract
Traditionally, patients with end-stage heart failure (HF) have rarely been involved in end-of-life care (EOLC) discussions in Japan. The purpose of this study was to examine the impact of HF-specific palliative care team (HF-PCT) activities on EOLC discussions with patients, HF therapy and care, and food intake at the end of life. We retrospectively analyzed 52 consecutive patients with HF (mean age, 70 ± 15 years; 42% female) who died at our hospital between May 2013 and July 2020 and divided them into two groups: before (Era 1, n = 19) and after (Era 2, n = 33) the initiation of HF-PCT activities in June 2015. Compared to Era 1, Era 2 showed a decrease in invasive procedures, an increase in opioid and non-intubating sedative use for symptom relief, improved quality of meals at the end of life, and an increase in participation in EOLC discussions. The administration of artificial nutrition in the final three days was associated with non-ischemic cardiomyopathy etiology, the number of previous hospitalizations for HF, and multidisciplinary EOLC discussion support. HF-PCT activities may provide an opportunity to discuss EOLC with patients, reduce the burden of physical and psychological symptoms, and shift the goals of end-of-life nutritional intake to ensure comfort and quality of life.
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22
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Kinugasa Y, Nakamura K, Kamitani H, Hirai M, Yanagihara K, Kato M, Yamamoto K. Trimethylamine N-oxide and outcomes in patients hospitalized with acute heart failure and preserved ejection fraction. ESC Heart Fail 2021; 8:2103-2110. [PMID: 33734604 PMCID: PMC8120352 DOI: 10.1002/ehf2.13290] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Revised: 02/05/2021] [Accepted: 02/19/2021] [Indexed: 12/25/2022] Open
Abstract
Aims Trimethylamine N‐oxide (TMAO) is a metabolite derived from the gut microbiota. Elevated TMAO levels are associated with a poor prognosis in patients with heart failure with reduced ejection fraction. However, the prognostic effect of elevated TMAO levels on heart failure with preserved ejection fraction (HFpEF) remains unclear. Methods and results We consecutively enrolled 146 patients who were hospitalized and discharged from Tottori University Hospital with the primary diagnosis of HFpEF (ejection fraction ≥ 50%). High TMAO levels were defined as those greater than the median value in the patients (20.37 μmol/L). Patients with high TMAO levels had a significantly higher prevalence of prior hospitalization for heart failure and severe renal dysfunction than those with low TMAO levels. They also had a significantly higher acylcarnitine to free carnitine ratio than those with low TMAO levels, which indicated abnormal fatty acid metabolism and relative carnitine deficiency. After adjustment for differences in the patients' background in multivariate analysis, high TMAO levels remained independently associated with a high incidence of the composite endpoints of death due to cardiac causes and hospitalization for heart failure (adjusted hazard ratio, 1.91; 95% confidence interval, 1.01 to 3.62; P < 0.05). There was a significant interaction between TMAO and nutritional status on the primary outcome, and the prognostic effect of TMAO was enhanced in patients with malnutrition. Conclusions Elevated TMAO levels at discharge are associated with an increased risk of post‐discharge cardiac events in patients with HFpEF, especially those with the complication of malnutrition.
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Affiliation(s)
- Yoshiharu Kinugasa
- Department of Cardiovascular Medicine and Endocrinology and Metabolism, Faculty of MedicineTottori University36‐1 NishichoYonago683‐8504Japan
| | - Kensuke Nakamura
- Department of Cardiovascular Medicine and Endocrinology and Metabolism, Faculty of MedicineTottori University36‐1 NishichoYonago683‐8504Japan
| | - Hiroko Kamitani
- Department of Cardiovascular Medicine and Endocrinology and Metabolism, Faculty of MedicineTottori University36‐1 NishichoYonago683‐8504Japan
| | - Masayuki Hirai
- Department of Cardiovascular Medicine and Endocrinology and Metabolism, Faculty of MedicineTottori University36‐1 NishichoYonago683‐8504Japan
| | - Kiyotaka Yanagihara
- Department of Cardiovascular Medicine and Endocrinology and Metabolism, Faculty of MedicineTottori University36‐1 NishichoYonago683‐8504Japan
| | - Masahiko Kato
- Department of Pathobiological Science and Technology, School of Health Science, Major in Clinical Laboratory Science, Faculty of MedicineTottori UniversityYonagoJapan
| | - Kazuhiro Yamamoto
- Department of Cardiovascular Medicine and Endocrinology and Metabolism, Faculty of MedicineTottori University36‐1 NishichoYonago683‐8504Japan
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23
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Tanaka S, Kamiya K, Saito H, Saito K, Ogasahara Y, Maekawa E, Konishi M, Kitai T, Iwata K, Jujo K, Wada H, Kasai T, Hamazaki N, Nozaki K, Nagamatsu H, Ozawa T, Izawa K, Yamamoto S, Aizawa N, Wakaume K, Oka K, Momomura SI, Kagiyama N, Matsue Y. Prevalence and prognostic value of the coexistence of anaemia and frailty in older patients with heart failure. ESC Heart Fail 2020; 8:625-633. [PMID: 33295134 PMCID: PMC7835564 DOI: 10.1002/ehf2.13140] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 11/01/2020] [Accepted: 11/11/2020] [Indexed: 12/17/2022] Open
Abstract
Aims There have been no investigations of the prevalence and clinical implications of coexistence of anaemia and frailty in older patients hospitalized with heart failure (HF) despite their association with adverse health outcomes. The present study was performed to determine the prevalence and prognostic value of the coexistence of anaemia and frailty in hospitalized older patients with HF. Methods and results We performed post hoc analysis of consecutive hospitalized HF patients ≥65 years old enrolled in the FRAGILE‐HF, which was the prospective, multicentre, observational study. Anaemia was defined as haemoglobin < 13 g/dL in men and <12 g/dL in women, and frailty was evaluated according to the Fried phenotype model. The study endpoint was all‐cause mortality. Of the total of 1332 patients, 1217 (median age, 81 years; 57.4% male) were included in the present study. The rates of anaemia and frailty in the study population were 65.7% and 57.0%, respectively. The patients were classified into the non‐anaemia/non‐frail group (16.6%), anaemia/non‐frail group (26.4%), non‐anaemia/frail group (17.7%), and anaemia/frail group (39.3%). A total of 144 patients died during 1 year of follow‐up. In multivariate analyses, only the anaemia/frail group showed a significant association with elevated mortality rate (adjusted hazard ratio, 1.94; 95% confidence interval, 1.02–3.70; P = 0.043), compared with the non‐anaemia/non‐frail group after adjusting for other covariates. Conclusions Coexistence of anaemia and frailty are prevalent in hospitalized older patients with HF, and it has a negative impact on mortality.
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Affiliation(s)
- Shinya Tanaka
- Department of Rehabilitation, Nagoya University Hospital, Aichi, Japan
| | - Kentaro Kamiya
- Department of Rehabilitation, School of Allied Health Science, Kitasato University, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa, 252-0373, Japan
| | - Hiroshi Saito
- Department of Rehabilitation, Kameda Medical Center, Chiba, Japan.,Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Kazuya Saito
- Department of Rehabilitation, The Sakakibara Heart Institute of Okayama, Okayama, Japan
| | - Yuki Ogasahara
- Department of Nursing, The Sakakibara Heart Institute of Okayama, Okayama, Japan
| | - Emi Maekawa
- Department of Cardiovascular Medicine, Kitasato University School of Medicine, Kanagawa, Japan
| | - Masaaki Konishi
- Division of Cardiology, Yokohama City University Medical Center, Kanagawa, Japan
| | - Takeshi Kitai
- Department of Cardiovascular Medicine, Kobe City Medical Center General Hospital, Hyogo, Japan
| | - Kentaro Iwata
- Department of Rehabilitation, Kobe City Medical Center General Hospital, Hyogo, Japan
| | - Kentaro Jujo
- Department of Cardiology, Nishiarai Heart Center Hospital, Tokyo, Japan
| | - Hiroshi Wada
- Department of Cardiovascular Medicine, Saitama Medical Center, Jichi Medical University, Saitama, Japan
| | - Takatoshi Kasai
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan.,Cardiovascular Respiratory Sleep Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Nobuaki Hamazaki
- Department of Rehabilitation, Kitasato University Hospital, Kanagawa, Japan
| | - Kohei Nozaki
- Department of Rehabilitation, Kitasato University Hospital, Kanagawa, Japan
| | - Hirofumi Nagamatsu
- Department of Cardiology, Tokai University School of Medicine, Tokyo, Japan
| | - Tetsuya Ozawa
- Department of Rehabilitation, Odawara Municipal Hospital, Kanagawa, Japan
| | - Katsuya Izawa
- Department of Rehabilitation, Kasukabe Chuo General Hospital, Saitama, Japan
| | - Shuhei Yamamoto
- Department of Rehabilitation, Shinshu University Hospital, Nagano, Japan
| | - Naoki Aizawa
- Department of Cardiovascular Medicine, Nephrology and Neurology, University of Ryukyus, Okinawa, Japan
| | - Kazuki Wakaume
- Department of Rehabilitation, Kitasato University Medical Center, Saitama, Japan
| | - Kazuhiro Oka
- Department of Rehabilitation, Saitama Citizens Medical Center, Saitama, Japan
| | | | - Nobuyuki Kagiyama
- Department of Cardiology, The Sakakibara Heart Institute of Okayama, Okayama, Japan.,West Virginia University Heart and Vascular Institute, Morgantown, WV, USA
| | - Yuya Matsue
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan.,Cardiovascular Respiratory Sleep Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
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